Thoracic SMARCA4-deficient undifferentiated tumor with associated granulomatous reaction and response to pembrolizumab.

Thoracic SMARCA4-deficient undifferentiated tumor (SMARCA4-UT) is a rare entity that was recently described in the current World Health Organization Classification of Tumors. These lesions are highly aggressive with dismal prognosis, and most patients present with metastasis at the time of diagnosis. While there are about 100 cases of SMARCA4-UT described in the literature, there are only few existing reports that describe the cytomorphology of these lesions.

Calyceal diverticula: Clinical, radiological and histopathological findings of an uncommon entity with presumed congenital origin.

Calyceal diverticula (CD) are relatively uncommon urologic conditions that generally follow an asymptomatic course and rarely require medical intervention. CD are thought to have a congenital origin due to abnormalities during the process of ureteral bud formation. Clinically and radiologically, they can mimic multiple neoplastic and non-neoplastic renal processes, with potentially relevant differences in the management of these patients.

Pembrolizumab plus azacitidine in patients with chemotherapy refractory metastatic colorectal cancer: a single-arm phase 2 trial and correlative biomarker analysis.

Background: DNA mismatch repair proficient (pMMR) metastatic colorectal cancer (mCRC) is not responsive to pembrolizumab monotherapy. DNA methyltransferase inhibitors can promote antitumor immune responses. This clinical trial investigated whether concurrent treatment with azacitidine enhances the antitumor activity of pembrolizumab in mCRC.

Lessons learned from clinical trial queries on small biopsy collections: importance of rapid on-site evaluation.

Introduction: Small biopsies and cytology specimens have become increasingly important for clinical trials and biomarker testing. Thus, institutions must ensure that adequate lesional material meeting the specifications for a multitude of different protocols is available. This can be achieved using rapid on-site evaluation (ROSE).

Clinical trial cytology: Use of on-site evaluation of small biopsy and FNA samples for clinical trials and biomarker research studies.

Background: After increased requests for biopsies for clinical trials and biomarker research, the University of Pittsburgh Medical Center created a clinical trial research service that partnered pathology, radiology, and medicine to facilitate rapid on-site evaluation (ROSE) of fine-needle aspiration (FNA) and/or core needle biopsy (CNB) samples to confirm the presence of tumor in these studies.

Methods: Clinical trial coordinators organized biopsies for patients needing tumor samples for trials, and informed the cytopathology and radiology team. ROSE was performed to confirm the presence of sufficient tumor in FNA specimens and/or touch preparations of CNB.

Gemcitabine/nab-paclitaxel as second-line therapy following FOLFIRINOX in metastatic/advanced pancreatic cancer-retrospective analysis of response.

Background: Given the tolerability of nPG in first-line therapy, we desired to evaluate the response and toxicity profiles of second-line gemcitabine with nab-paclitaxel (nPG) following FOLFIRINOX. We retrospectively identified 30 patients who received first-line FOLFIRINOX for unresectable or metastatic pancreatic adenocarcinoma followed by second-line nPG. Response was evaluated by RECIST criteria and carbohydrate antigen 19-9 (CA19-9) change.

Cytomorphology of Erdheim-Chester disease presenting as a retroperitoneal soft tissue lesion.

Erdheim-Chester disease (ECD) is a rare, multisystem disorder of macrophages. Patients manifest with histiocytic infiltrates that lead to xanthogranulomatous lesions in multiple organ systems. The cytologic features of this disorder are not well characterized.

Ecdysteroids and a sucrose phenylpropanoid ester from Froelichia floridana.

Phytoecdysteroid glycosides (1-5) and a phenylpropanoid ester of sucrose (6) were isolated from the whole plant of Froelichia floridana, along with eight known compounds including three ecdysteroids (7-9), four flavonoids (10-13), and one phenolic compound (14). Structures were determined using a combination of spectroscopic techniques. Compounds 1, 2 and 6-14 were tested in vitro for their activity against human DNA topoisomerase I.

Phenolic compounds and rare polyhydroxylated triterpenoid saponins from Eryngium yuccifolium.

Phytochemical investigation on the whole plant of Eryngium yuccifolium resulted in the isolation and identification of three phenolic compounds (1-3) and 12 polyhydroxylated triterpenoid saponins, named eryngiosides A-L (4-15), together with four known compounds kaempferol-3-O-(2,6-di-O-trans-p-coumaroyl)-beta-D-glucopyranoside (16), caffeic acid (17), 21beta-angeloyloxy-3beta-[beta-D-glucopyranosyl-(1-->2)]-[beta-d-xylopyranosyl-(1-->3)]-beta-D-glucuronopyranosyloxyolean-12-ene-15alpha,16alpha,22alpha,28-tetrol (18), and saniculasaponin III (19). This study reports the isolation of these compounds and their structural elucidation by extensive spectroscopic analyses and chemical degradation.

Water quality effects of clearcut harvesting and forest fertilization with best management practices.

Nine small (2.5 ha) and four large (70-135 ha) watersheds were instrumented in 1999 to evaluate the effects of silvicultural practices with application of best management practices (BMPs) on stream water quality in East Texas, USA. Two management regimes were implemented in 2002: (i) conventional, with clearcutting, herbicide site preparation, and BMPs and (ii) intensive, which added subsoiling, aerial broadcast fertilization, and an additional herbicide application.

Flavonoids, coumarins and triterpenes from the aerial parts of Cnidoscolus texanus.

Phytochemical investigation on Cnidoscolus texanus led to the isolation of 26 compounds, which included 15 flavonoids (1-15), three coumarins (16-18), three coumaric acid derivatives (19-21), four triterpenoids (22-25), and one phytosterol (26). Among them, aromadendrin 7-O-(4''-O-P-E-coumaroyl-beta-glucopyranoside) (1), aromadendrin 7-O-(3'',6''-di-O-P-E-coumaroyl-beta-glucopyranoside) (2), and naringenin 7-O-(4''-O-P-Z-coumaroyl-beta-glucopyranoside) (3) are new compounds. Their structures were determined by spectroscopic and chemical methods.

A rare case of anomalous left anterior descending artery with a large interarterial communication: an invasive and CT angiographic study.

Recent advances in computed tomography (CT) technology have made this technique useful in evaluating coronary anatomy. Although CT has been the method of choice to evaluate vascular anatomy of the thorax for many years, the coronary arteries, until recently, could not be imaged with diagnostic quality due to cardiac and respiratory motion. The improved temporal and spatial resolution of new-generation multirow detector scanners makes noninvasive evaluation of the coronary arteries possible.

Percutaneous computed tomography-guided gastric remnant access after laparoscopic Roux-en-Y gastric bypass.

Background: The bypassed portion of the stomach is difficult to access and evaluate after Roux-en-Y gastric bypass. Access to the excluded stomach may be needed for nutritional support or decompression owing to acute distension and obstruction. We report our experience with percutaneous, computed tomography (CT)-guided gastrostomy tube placement into the gastric remnant after laparoscopic Roux-en-Y gastric bypass (LRYGB).

POEMS syndrome: radiographic appearance with MRI correlation.

POEMS syndrome is a rare disorder in which patients present with the hallmark signs of polyneuropathy, organomegaly, endocrinopathy, M protein and skin changes. Many other clinical findings are also often present, most notably osseous lesions. The MRI appearance of the bony lesions in POEMS syndrome has been described in five cases, four of which are in the non-English literature.

Thalidomide inhibits the growth and progression of hepatic epithelioid hemangioendothelioma.

Hepatic epithelioid hemangioendothelioma (HEH) is a rare vascular tumor of the liver with an unpredictable malignant potential. Its growth can lead to hepatic failure, extrahepatic metastasis and death. Surgical resection or liver transplantation is the treatment of choice if metastasis is not identified.

New camptothecin and ellagic acid analogues from the root bark of Camptotheca acuminata.

As part of a study on chemical constituents of Camptotheca species, one new natural camptothecin analogue (2), two new alkaloids (3, 4), one new ellagic acid analogue (5), and 19 known compounds (1, 6-23) have been isolated from the root bark, stem bark, fruits, and leaves of Camptotheca acuminata Decaisne. The structures of 2-5 were determined from spectral data to be 10-methoxy-20-O-acetylcamptothecin (2), 20-O-beta-glucopyranosyl 18-hydroxycamptothecin (3), 20-formylbenz indolizino [1,2-b]quino-line-11(13H)-one (4), and 3,4-methylenedioxy-3'-O-methyl-5'-hydroxyellagic acid (5).

Roofing as a source of nonpoint water pollution.

Sixteen wooden structures with two roofs each were installed to study runoff quality for four commonly used roofing materials (wood shingle, composition shingle, painted aluminum, and galvanized iron) at Nacogdoches, Texas. Each roof, either facing NW or SE, was 1.22 m wide x 3.

Camptothecin accumulation and variations in camptotheca.

Camptotheca (Nyssaceae) is a major source of anticancer camptothecin (CPT). It is imperative to understand CPT accumulation and variations in Camptotheca in order to develop CPT production strategies for endangered germplasm. Our study results showed that CPT is primarily accumulated in glandular trichomes of leaves and stems, and CPT content varies among species and varieties but even more significantly within the plant (with different tissues, tissue ages, and seasons).