Treatment implications of the emerging molecular classification system for melanoma.

Melanoma is an aggressive disease with few standard treatment options. The conventional classification system for this disease is based on histological growth patterns, with division into four subtypes: superficial spreading, lentigo maligna, nodular, and acral lentiginous. Major limitations of this classification system are absence of prognostic importance and little correlation with treatment outcomes. Recent preclinical and clinical findings support the notion that melanoma is not one malignant disorder but rather a family of distinct molecular diseases. Incorporation of genetic signatures into the conventional histopathological classification of melanoma has great implications for development of new and effective treatments. Genes of the mitogen-associated protein kinase (MAPK) pathway harbour alterations sometimes identified in people with melanoma. The mutation Val600Glu in the BRAF oncogene (designated BRAF(V600E)) has been associated with sensitivity in vitro and in vivo to agents that inhibit BRAF(V600E) or MEK (a kinase in the MAPK pathway). Melanomas arising from mucosal, acral, chronically sun-damaged surfaces sometimes have oncogenic mutations in KIT, against which several inhibitors have shown clinical efficacy. Some uveal melanomas have activating mutations in GNAQ and GNA11, rendering them potentially susceptible to MEK inhibition. These findings suggest that prospective genotyping of patients with melanoma should be used increasingly as we work to develop new and effective treatments for this disease.

Nodulação em cultivares de feijão dos conjuntos gênicos andino e meso-americano

O objetivo deste trabalho foi determinar a capacidade de nodulação e a especificidade de feijão (Phaseolus vulgaris L.) dos conjuntos gênicos andino e meso-americano submetidos a inóculo de Rhizobium. O experimento foi estabelecido em parcelas subdivididas em blocos ao acaso, com quatorze cultivares de feijão e três estirpes de Rhizobium (R. etli KIM 5, R. etli CIAT 632 e R. tropici CIAT 899). Somente as cultivares andinas WAF 15, WAF 7, Mineiro Precoce, WAF 6 e Antioquia 8 apresentaram especificidade na nodulação. Em relação à massa seca dos nódulos, houve diferenças significativas dos tratamentos de inoculação nas cultivares andinas WAF 15, WAF 7, WAF 6 e Diacol Andino, e na cultivar meso-americana Ouro Negro. Nenhuma das cultivares restringiu a nodulação, embora tenham sido verificadas diferenças de até 53 e 103 vezes no número e massa de nódulos por planta, respectivamente. Considerando todas as cultivares e estirpes de rizóbio, WAF 15 foi a cultivar com melhor desempenho em número e massa nodular. WAF 6 foi a cultivar de pior desempenho, chegando quase ao nível de restrição da nodulação com a estirpe R. etli CIAT 632.

Avaliação de cultivares de soja, sob manejo orgânico, para fins de adubação verde e produção de grãos

O objetivo deste trabalho foi avaliar o desempenho de seis cultivares de soja, sob manejo orgânico, para fins de adubação verde e produção de grãos. Utilizou-se delineamento experimental de blocos casualizados, com quatro repetições por tratamento (cultivar). Na época da colheita, 81 dias após a emergência das plântulas, todas as cultivares testadas (Celeste, Surubi, Campo Grande, Mandi, Lambari e Taquari) mostraram excelente nodulação, variando de 545 a 760 mg/planta de massa nodular seca. As cultivares Celeste e Taquari, que produziram, respectivamente, 8,33 e 7,12 t ha-1 de biomassa seca da parte aérea, apresentaram outras características agronômicas vantajosas, tais como: ciclo curto, alta acumulação de nutrientes (N, P, K, Ca e Mg) nos tecidos verdes e bom rendimento de sementes. Esses caracteres indicam potencial de 'Celeste' e 'Taquari' para adubação verde de verão em sistemas de agricultura orgânica. Cinco das cultivares avaliadas revelaram tendência ao acamamento, porém dentro de níveis aceitáveis. As cultivares Celeste, Surubi, Campo Grande, Mandi e Taquari suplantaram em 23%, 32%, 33%, 44% e 70%, respectivamente, a média nacional de produtividade de soja, estimada em 2.398 kg ha-1 nas últimas três safras.

International Society of Urological Pathology (ISUP) Consensus Conference on Handling and Staging of Radical Prostatectomy Specimens. Working group 4: seminal vesicles and lymph nodes.

The 2009 International Society of Urological Pathology Consensus Conference in Boston made recommendations regarding the standardization of pathology reporting of radical prostatectomy specimens. Issues relating to the infiltration of tumor into the seminal vesicles and regional lymph nodes were coordinated by working group 4. There was a consensus that complete blocking of the seminal vesicles was not necessary, although sampling of the junction of the seminal vesicles and prostate was mandatory. There was consensus that sampling of the vas deferens margins was not obligatory. There was also consensus that muscular wall invasion of the extraprostatic seminal vesicle only should be regarded as seminal vesicle invasion. Categorization into types of seminal vesicle spread was agreed by consensus to be not necessary. For examination of lymph nodes, there was consensus that special techniques such as frozen sectioning were of use only in high-risk cases. There was no consensus on the optimal sampling method for pelvic lymph node dissection specimens, although there was consensus that all lymph nodes should be completely blocked as a minimum. There was also a consensus that a count of the number of lymph nodes harvested should be attempted. In view of recent evidence, there was consensus that the diameter of the largest lymph node metastasis should be measured. These consensus decisions will hopefully clarify the difficult areas of pathological assessment in radical prostatectomy evaluation and improve the concordance of research series to allow more accurate assessment of patient prognosis.

Thymic stromal lymphopoietin plays divergent roles in murine models of atopic and nonatopic airway inflammation.

BACKGROUND: Thymic stromal lymphopoietin (TSLP) is a cytokine primarily produced by epithelial cells, which has been shown to be a potent inducer of T-helper 2 (Th2)-type responses. However, TSLP has pleiotropic effects upon immune cells, and although extensively studied in the context of atopic asthma, its relevance as a therapeutic target and its role in the pathogenesis of nonatopic asthma remains unknown. We sought to investigate the role of TSLP in atopic, nonatopic and viral-induced exacerbations of pulmonary inflammation. METHODS: Using stringently defined murine models of atopic, nonatopic and virally exacerbated forms of pulmonary inflammation, we compared inflammatory responses of C57BL/6 wild-type (WT) and TSLP receptor-deficient (TSLPR KO) mice. RESULTS: Thymic stromal lymphopoietin receptor (TSLPR) signaling was crucial for the development of atopic asthma. Specifically, TSLPR signaling to lung recruited CD4+ T cells enhanced eosinophilia, goblet cell hyperplasia, and overall inflammation within the airways. In contrast, the absence of TSLPR signaling was associated with strikingly exaggerated pulmonary neutrophilic inflammation in a nonatopic model of airway inflammation. The inflammation was associated with excessive levels of interleukin (IL)-17A in the lungs, indicating that TSLP negatively regulates IL-17A. In addition, in a model of influenza-induced exacerbation of atopic airway inflammation, the absence of TSLPR signaling also led to exaggerated neutrophilic inflammation. CONCLUSION: Thymic stromal lymphopoietin plays divergent roles in the pathogenesis of atopic and nonatopic asthma phenotypes by either enhancing Th2 responses or curtailing T-helper 17 responses. These findings raise important caveats for the design of therapeutic interventions targeting TSLP in asthma.

Eficiência simbiótica de estirpes de Bradyrhizobium isoladas de solo do Cerrado em caupi

O objetivo deste trabalho foi avaliar as relações filogenéticas de estirpes de Bradyrhizobium e a contribuição destas estirpes para a fixação biológica de nitrogênio em caupi, em solos do Cerrado. Na avaliação da relação filogenética, o gene 16S rDNA de cada uma das estirpes foi amplificado e seqüenciado, e para a análise da eficiência simbiótica, determinou-se: N total, matéria seca das plantas, massa de nódulos e redução de acetileno, em casa de vegetação, e ocupação nodular, em experimento de campo. A maioria das estirpes estudadas pertence a B. elkanii e, pelo menos dez das estirpes, independentemente da espécie, apresentaram bom desempenho quanto à fixação biológica de N2. As estirpes BR3262, BR3280 (caracterizadas como B. elkanii) e BR3267, BR3287 e BR3288 (Bradyrhizobium sp.) mostram-se como inoculantes potenciais para o caupi, em razão do bom desempenho tanto na eficiência simbiótica quanto na ocupação nodular.

Nephrocalcinosis (enamel renal syndrome) caused by autosomal recessive FAM20A mutations.

BACKGROUND/AIMS: Calcium homeostasis requires regulated cellular and interstitial systems interacting to modulate the activity and movement of this ion. Disruption of these systems in the kidney results in nephrocalcinosis and nephrolithiasis, important medical problems whose pathogenesis is incompletely understood. METHODS: We investigated 25 patients from 16 families with unexplained nephrocalcinosis and characteristic dental defects (amelogenesis imperfecta, gingival hyperplasia, impaired tooth eruption). To identify the causative gene, we performed genome-wide linkage analysis, exome capture, next-generation sequencing, and Sanger sequencing. RESULTS: All patients had bi-allelic FAM20A mutations segregating with the disease; 20 different mutations were identified. CONCLUSIONS: This autosomal recessive disorder, also known as enamel renal syndrome, of FAM20A causes nephrocalcinosis and amelogenesis imperfecta. We speculate that all individuals with biallelic FAM20A mutations will eventually show nephrocalcinosis.

Food-dependent Cushing's syndrome: possible involvement of leptin in cortisol hypersecretion.

Stimulation ofcortisol secretion by food intake has been implicated in the pathogenesis of some cases of ACTH-independent Cushing's syndrome, via an aberrant response of the adrenal glands to gastric inhibitory polypeptide (GIP). We report here a novel case of food-dependent Cushing's syndrome in a patient with bilateral macronodular adrenal hyperplasia. In this patient we were able to confirm a paradoxical stimulation of cortisol secretion by GIP in vivo as well as in vitro on dispersed tumor adrenal cells obtained at surgery. In addition to GIP, in vitro stimulation of these cultured tumor adrenal cells with leptin, the secreted product of the adipocyte, induced cortisol secretion. By comparison, no such stimulation was observed in vitro in adrenal cells obtained from another patient with bilateral macronodular adrenal hyperplasia and Cushing's syndrome that did not depend on food intake, in tumor cells obtained from a solitary cortisol-secreting adrenal adenoma, and in normal human adrenocortical cells. These results demonstrate that as in previously described cases of food-dependent Cushing's syndrome, GIP stimulated cortisol secretion from the adrenals of the patient reported here. Therefore, they indicate that such a paradoxical response probably represents the hallmark of this rare condition. In addition, they suggest that leptin, which normally inhibits stimulated cortisol secretion in humans, participated in cortisol hypersecretion in this case. Further studies in other cases of food-dependent Cushing's syndrome, however, will be necessary to better ascertain the pathophysiological significance of this finding.

Dépistage du cancer de la prostate: utilité, buts et perspectives en 2010 [Prostate cancer screening: utility, goals and perspectives in 2010].

According to recent results of a sub-group of 20,000 patients from the ERSPC study, prostate cancer screening significantly increases disease specific survival for men with a life expectancy of 15 years. However presently, only 20% of prostate biopsies lead to the diagnosis of cancer. This low yield may be increased by using new tools on their way to validation, such as the blood and urinary markers p2-PSA and PCA3, so as MRI and tridimensional computerized echography. Finally, the tumours detected must be managed with subtlety, since a third of them are not overtly aggressive clinically. Hence, a significant proportion of such tumours may not need immediate curative intent treatment, and can be followed up in an active surveillance protocol.

Pulmonary involvement in Fabry disease: Overview and perspectives.

Fabry disease (FD) is an X-linked lysosomal storage disorder caused by deficiency of alpha-galactosidase A, which leads to storage of sphingolipids in virtually all human cells and consequently to organ dysfunction. Pulmonary involvement is still debated. But, obstructive lung disease is up to ten times more prevalent in patients with FD compared to general public. Also, an accelerated decline in forced expiratory volume in one second (FEV1) over time was observed in these patients. Lysosomal storage of glycosphingolipids is considered leading to small airway disease via hyperplasia of the bronchiolar smooth muscle cells. Larger airways may become involved with ongoing disease process. There is no evidence for involvement of the lung interstitium in FD. The effect of enzyme replacement therapy on respiratory involvement remains to be determined in large, prospective controlled trials.

Fixação biológica de nitrogênio em cultivares de feijão-caupi recomendadas para o Estado de Roraima

O objetivo deste trabalho foi avaliar a fixação biológica de nitrogênio (FBN) em cinco cultivares de feijão-caupi: BR 17 Gurguéia, BRS Guariba, BRS Mazagão, UFRR Grão Verde e Pretinho Precoce 1. Em 2007, foram conduzidos um experimento em casa de vegetação e outro em campo, em esquema fatorial com cinco cultivares de feijão-caupi e quatro fontes de nitrogênio: adubação com ureia (50 kg ha-1 de N), inoculação com a estirpe de Bradyrhizobium BR 3262 ou BR 3267 e um controle absoluto. Aos 35 dias após a emergência das plantas, foram avaliados número e massa de nódulos secos, massa de matéria seca e N total da parte aérea, eficiência nodular em casa de vegetação e rendimento de grãos na colheita em campo. Em casa de vegetação, foi observada alta nodulação e eficiência nodular para ambas as estirpes em todas as cultivares. Em campo, a nodulação e o N total foram menores para todas as cultivares, comparativamente à casa de vegetação, o que indica interferência de fatores edafoclimáticos na FBN. Ocorreu aumento no rendimento de grãos em todas as cultivares em decorrência da inoculação, especialmente com a estirpe BR 3262.

Reaktive Thymushyperplasie infolge der Therapie ACTH-produzierender Tumoren [Reactive thymus dysplasia following therapy for ACTH-producing tumors]

Surgical or conservative treatment of ACTH-producing tumors results in acute drop of the previously excessively high cortisol levels. The following associated pathophysiological changes also occur in the organism's recovery from stress, such as trauma, operation or chemotherapy of tumors. Both cases result in a regeneration of the immune system, which might even be exalted. The corresponding radiographic feature is the "rebound" enlargement of the thymus occurring about six months after remission of hypercortisolism. Histological examination reveals benign thymus hyperplasia. Especially in cases of still unknown primary tumor the appearance of this anterior mediastinal mass can lead to misdiagnosis. We present the cases of two patients with diffuse thymic hyperplasia following surgical and medical correction of hypercortisolism. One patient suffered from classic Cushing's disease responding to transsphenoidal resection of an ACTH-secreting pituitary microadenoma. Six months later CT of the chest incidentally demonstrated an anterior mediastinal mass known as thymic hyperplasia. The second patient presented with an ectopic, still unkown source of ACTH-production. Six months after medical correction of hypercortisolism CT of the thorax showed an enlargement of the anterior mediastinum. Thymectomy was performed in order to exclude thymus carcinoid. Histological examination revealed benign thymus hyperplasia with negative immunostaining. CONCLUSION: Radiologists and clinicians should be familiar with the pathophysiological changes resulting from precipitously dropping cortisol levels in order to prevent diagnostic errors and unnecessary operations.

Multiple pulmonary artery aneurysms in tuberous sclerosis complex.

Tuberous sclerosis complex (TSC) is a rare genetic disorder characterised by multiple hamartomas, caused by inactivating mutations of the TSC1/TSC2 tumour suppressor genes. Classical pulmonary involvement in tuberous sclerosis complex (TSC) consists of lymphangioleiomyomatosis and/or multiple micronodular pneumocyte hyperplasia (MMPH). Association of TSC with pulmonary artery aneurysm (PAA) has been only exceptionally described. We report here the first case of TSC with multiple PAA in combination with MMPH, cardiac rhabdomyomas and bone, skin and brain involvement.

Large gypsum nodules in the Paleogene and Neogene evaporites of Spain: distribution and palaeogeographic significance

Sabkha and deep burial set tings are the most com mon sites where diagenetic anhydrite forms. In a sabkha setting, displacive facies (iso lated nodules, bed ded nodules, enterolithic levels) of early diagenetic or primary anhydrite are generated (Shearman, 1966; Hardie, 1967). These anhydrite facies are commonly foundat the top of shoal ing cycles representing the evolution from subaqueous depositional conditions at the base (carbonates, lutites) to exposure conditions at the top where in ter stitially-grown gypsum/anhydrite de velops ( sabkha cy cles). In a deep burial setting, gypsum transforms to tally to anhydrite with in creas ing temperature and lithostatic pressure (Murray, 1964). Al though this mineral transformation usually preserves the depositional gypsum facies, a significant textural change is in volved in other cases, resulting in replacive anhydrite with a nodular-mosaic or"chicken-wire" fabric (Warren, 2006). In the two settings, how ever, the size of the individual anhydrite nodules is relatively small, rarely reaching some tens of centimetres across. More over, bedding is preserved or little disturbed, al though minor de formation is caused by the displacive sabkha nodules.

Lipoproteins and mitogen-activated protein kinase signaling: a role in atherogenesis?

PURPOSE OF REVIEW: Lipoproteins play a critical role in the development of atherosclerosis, which might result partly from their capacity to induce specific intracellular signaling pathways. The goal of this review is to summarize the signaling properties of lipoproteins, in particular, their capacity to induce activation of mitogen-activated protein kinase pathways and the resulting modulation of cellular responses in blood vessel cells. RECENT FINDINGS: Lipoproteins activate the extracellular signal-regulated kinase and p38 mitogen-activated protein kinase pathways in all blood vessel cell types. This may require lipoprotein docking to scavenger receptor B1, allowing transfer of cholesterol and sphingosine-1-phosphate to plasma membranes. Subsequent propagation of the signals probably requires the stimulation of G protein-coupled receptors, followed by the transactivation of receptor tyrosine kinases. Lipoprotein-induced extracellular signal-regulated kinase activity favors cell proliferation, whereas lipoprotein-induced p38 mitogen-activated protein kinase activity leads to cell hyperplasia and promotes cell migration. Some signaling pathways and cellular effects induced by lipoproteins have been observed in atherosclerotic plaques and therefore represent potential targets for the development of anti-atherosclerotic drugs. SUMMARY: The main blood vessel cell types have the capacity to activate protein kinase pathways in the presence of lipoproteins. This induces cell proliferation, hyperplasia and migration, known to be dysregulated in atherosclerotic lesions.