Gastrointestinal stromal tumor presenting as a pelvic mass

Gastrointestinal stromal tumors (GISTs) are c-kit-positive tumors that may arise anywhere in the tubular gastrointestinal tract. Around 5% of the cases arise elsewhere in the abdominal cavity. Tumors originating in the omentum and mesentery have been reported.A 31-year-old woman presented with pelvic pain, a palpable pelvic mass, and elevated CA-125. Imaging showed innumerable pelvic and abdominal masses. Histopathology showed a GIST that was positive for c-kit and vimentin and negative for desmin and smooth muscle actin. The patient was started on imatinib mesylate. Six months after diagnosis the tumor has remained stable.GI stromal tumors (GIST) may initially present as pelvic mass with elevated CA-125. Imatinib mesylate is the current mainstay therapy for GISTs after surgery.     

Cerebral cortex lesions decrease the number of bromodeoxyuridine-positive subventricular zone cells in mice

We previously showed that cortical lesions in rats increase the number of subventricular zone (SVZ) cells. Here, we examined the response of the SVZ to cortical lesions in mice from 6 h to 35 days later. Whereas the total number of cells did not change, the number of cells in S-phase (bromodeoxyuridine-positive) decreased in a biphasic manner (from 6 h to day 3, and again at days 25-35). In addition, there was a delayed (days 25-35) increase in immunoreactivity for polysialylated neural cell adhesion molecule, a marker of neuroblasts. The results suggest that in mice there are rapid as well as delayed responses in the SVZ to injury of the overlying cerebral cortex. They also show that the SVZ of different mammalian species can exhibit widely divergent responses to the same brain injury.     

Eye findings of diffuse unilateral subacute neuroretinitis and multiple choroidal infiltrates associated with neural larva migrans due to Bbaylisascaris procyonis

PURPOSE: To report childhood infection with Baylisascaris procyonis (raccoon round worm) manifesting as diffuse unilateral subacute neuroretinitis (DUSN) and choroidal infiltrates in association with neurologic disease (neural larva migrans).METHOD: Observational case series, one with eye manifestations of DUSN, the other with choroidal infiltrates, both with severe neurologic degeneration. RESULTS: Indirect immunofluorescence assays on serum and cerebrospinal fluid were positive for B. procyonis in one and serially positive and increasing in the other. Both children had a history of pica and raccoon exposure. CONCLUSIONS: Baylisascaris procyonis infection is associated with two cases of severe neurologic degeneration with ocular lesions: DUSN and choroidal infiltrates. Although B. procyonis is known to cause DUSN, these cases indicate that concomitant ocular migration may accompany neural larva migrans. These are the third and forth cases in the US literature of neural larva migrans due to B. procyonis with eye findings.     

Bordetella pertussis Clones Identified by Multilocus Variable-Number Tandem-Repeat Analysis

Multilocus variable-number tandem-repeat analysis (MLVA) of 316 Bordetella pertussis isolates collected over 40 years from Australia and 3 other continents identified 66 MLVA types (MTs), including 6 predominant MTs. Typing of genes encoding acellular vaccine antigens showed changes that may be vaccine driven in 2 MTs prevalent in Australia.     

Chilaiditi Syndrome Precipitated by Colonoscopy: A Case Report and Review of the Literature

Chilaiditi syndrome is a rare condition defined by the presence of gastrointestinal symptoms associated with the radiological finding of segmental interposition of the bowel between the liver and the diaphragm. While it is infrequently indentified as a source of abdominal pain, Chilaiditi syndrome carries clinical significance as it can lead to a number of serious complications including intestinal obstruction, perforation, and ischemia. A 58-year-old woman presented with Chilaiditi syndrome immediately following colonoscopic evaluation. Conservative measures failed to alleviate the patient''s symptoms, and the patient ultimately elected to have operative management. Pexy of the cecum and ascending colon led to full resolution of her symptoms. To our knowledge, this is the first documented case of Chilaiditi syndrome iatrogenically induced by colonoscopy. Identification of this syndrome as a complication of colonoscopy and a source of post-procedural pain bears significance for providers involved in the peri-operative care of patients with factors predisposing them to the development of this condition.     

Surface contamination of chemotherapy drug vials and evaluation of new vial-cleaning techniques: results of three studies.

PURPOSE: The results of three studies that describe the external contamination of chemotherapy drug vials are presented. New techniques for the improved decontamination of vials containing cisplatin are also described. SUMMARY: Study 1 evaluated the external contamination of drug vials with cyclophosphamide and ifosfamide in a pharmacy setting. Widespread contamination of the outside of drug vials was found with each drug. Study 2 evaluated the surface contamination of drug vials with cyclophosphamide and fluorouracil in three pharmacies. Sporadic contamination with fluorouracil was detected, while cyclophosphamide was found on most vials. In study 3, investigators compared the decontamination abilities of a standard decontamination procedure at the manufacturer level with an improved decontamination procedure and the use of sleeves to further decrease contamination. Though the methods of each study reported herein differed, the outcomes were similar. All chemotherapy drug vials studied demonstrated levels of contamination with the drug well above the limit of detection. Improved decontamination procedures, combined with the use of protective sleeves, reduced the level of platinum contamination by 90%, suggesting that standard decontamination procedures should be reconsidered. CONCLUSION: The results of these studies are consistent with several others that have reported contamination of the outside surface of drug vials for a number of chemotherapy drugs. Contamination can be reduced by using decontamination equipment and protective sleeves during the manufacturing process.