Molecular markers of carcinogenesis for risk stratification of individuals with colorectal polyps: a case-control study.

Risk stratification using number, size, and histology of colorectal adenomas is currently suboptimal for identifying patients at increased risk for future colorectal cancer. We hypothesized that molecular markers of carcinogenesis in adenomas, measured via immunohistochemistry, may help identify high-risk patients. To test this hypothesis, we conducted a retrospective, 1:1 matched case-control study (n = 216; 46% female) in which cases were patients with colorectal cancer and synchronous adenoma and controls were patients with adenoma but no colorectal cancer at baseline or within 5 years of follow-up.

Pathology Image of the Month: Black Thyroid.

A 54-year-old Caucasian male had a witnessed collapse on the street. He was transported to the emergency department and subsequently pronounced dead. An unlimited autopsy examination was conducted under authorization of the coroner.

Radiology case of the month: recurrent knee pain in a young athlete.

A 22-year-old male collegiate basketball player with a history of right knee pain presents with pain and swelling of his right knee. Physical exam reveals local swelling and tenderness over the right proximal tibial-fibular joint.

Pathology case of the month: sudden unexplained death in a young adult with known alcohol abuse.

A 35-year-old, recently deceased woman with a medical history known only to include Hepatitis C and alcohol abuse was transferred to the autopsy service for an unrestricted autopsy under coroner authorization following a sudden unexplained death. External examination revealed marked scleral icterus and cutaneous jaundice. Internal examination was remarkable for 3 liters of ascitic fluid and established cirrhosis with a micronodular pattern (nodules all <0.

Radiology case of the month. 49-year-old female with an anterior mediastinal mass.

Castleman's disease is an uncommon benign lymphoproliferative disorder characterized by hypervascular lymphoid hyperplasia. Two distinct histologic variants of Castleman's disease exist - hyaline vascular type and plasma cell type. The etiology is uncertain; however, it is thought to be inflammatory or hamartomatous in nature.

Pathology case of the month. Altered mental status, alcohol abuse, and hyperammonemia. DIAGNOSIS: Mallory-Denk bodies (a.k.a. Mallory’s hyaline)–seen most commonly in alcoholic liver disease.

A 74-year-old woman with a past medical history of diabetes, hypertension, and alcohol abuse was brought to the emergency department and subsequently admitted to the intensive care unit with an altered mental status and weakness. Laboratories revealed acute renal failure (BUN 15 mg/dL, creatinine 2.5 mg/dL), elevated serum transaminase (AST of 83 IU/L), hyperammonemia (187 ug/dL), and marked normocytic anemia requiring transfusion of three units of packed red cells (hemoglobin 4.

Radiology case of the month. Progressive slurring of speech and difficulty reading in a 62-year-old male. Final diagnosis: Metastatic small cell cancer of the prostate gland.

A 62-year-old male with controlled hypertension, coronary artery disease, and borderline diabetes presented to the emergency room after experiencing a gradual one-month progression of slurring of speech and difficulty reading. The patient maintained his vital signs throughout his ambulance ride to the hospital and was clinically stable at time of arrival to the emergency department.

The supply of hematology/oncology specialists.

National hematology and oncology organizations and experts in the field, predict a shortage of hematology/oncology specialists in the United States. Four types of hematology/oncology graduate medical education programs picked to represent direct patient care specialists are presented as physician supply in quantitative data proportional to the averages of the United States in this paper. The hematology/oncology physician production in Louisiana is similar to the average of all programs in the United States.

Blastic plasmacytoid dendritic cell neoplasm: report of a case presenting with lung and central nervous system involvement and review of the literature.

Blastic plasmacytoid dendritic cell neoplasm (BPDCN) is a rare hematopoietic malignancy with almost invariably cutaneous involvement and poor prognosis. We report a case of BPDCN in a 58-year-old man who presented with skin, lymph node, bone marrow, peripheral blood, lung, and central nervous system involvement. To the best of our knowledge, central nervous system (CNS) involvement as initial presentation has not been reported since the latest World Health Organization (WHO) classification of tumors of the hematopoietic and lymphoid tissues in 2008.

Incretin physiology and its role in type 2 diabetes mellitus.

Incretins are hormones that are released after ingestion of a meal and augment the secretion of insulin. Current research suggests that GLP-1 (glucagon-like peptide 1) is the most important. Their action is terminated by enzymes known as dipeptidyl peptidase-4 (DPP-4).

Initial implementation of mixed reality simulation targeting teamwork and patient safety.

Patient safety is one of the most pressing challenges of modern healthcare. Being a multifactorial problem, patient safety requires improvement interventions on multiple levels including individual, team and organization as a whole. Using high-fidelity human patient simulator in real clinical setting allows creating a mixed reality environment for teaching healthcare teams to improve patient safety.

Survival signaling in retinal pigment epithelial cells in response to oxidative stress: significance in retinal degenerations.

Photoreceptor survival depends on the integrity of retinal pigment epithelial (RPE) cells. The pathophysiology of several retinal degenerations involves oxidative stress-mediated injury and RPE cell death; in some instances it has been shown that this event is mediated by A2E and its epoxides. Photoreceptor outer segments display the highest DHA content of any cell type.

The onset of brain injury and neurodegeneration triggers the synthesis of docosanoid neuroprotective signaling.

Bioactive lipid messengers are formed through phospholipase-mediated cleavage of specific phospholipids from membrane reservoirs. Effectors that activate the synthesis of lipid messengers, include ion channels, neurotransmitters, membrane depolarization, cytokines, and neurotrophic factors. In turn, lipid messengers regulate and interact with multiple pathways, participating in the development, differentiation, function (e.

Cell survival matters: docosahexaenoic acid signaling, neuroprotection and photoreceptors.

Recent data have provided important clues about the molecular mechanisms underlying certain retinal degenerative diseases, including retinitis pigmentosa and age-related macular degeneration. Photoreceptor cell degeneration is a feature common to these diseases, and the death of these cells in many instances seems to involve the closely associated retinal pigment epithelial (RPE) cells. Under normal circumstances, both cell types are subject to potentially damaging stimuli (e.

A2E selectively induces cox-2 in ARPE-19 and human neural cells.

Purpose: To investigate the expression of cyclooxygenase (COX)-1, -2, and -3 RNA and protein in retinal pigment epithelial (ARPE-19) cells and in human neural (HN) cells exposed to the stress-inducing cytokines IL-1beta and TNF-a, the oxidizing peroxide H(2)O(2), the combination of TNF-alpha + H(2)O(2), and the lipofuscin fluorophore A2E.

Methods: Three-week-old ARPE-19 and HN cells were incubated with IL-1beta (10 ng/ml), TNF-alpha (10 ng/ml), H(2)O(2) (0.6 microM), TNF-alpha + H(2)O(2) (10 ng/ml and 0.

Fever and headache in an intravenous drug user.

Zygomycosis refers to diseases caused by filamentous fungi from the class Zygomycetes. These organisms are ubiquitous in nature and can be found in soil as well as in decaying organic matter such as fruit and bread. Risk factors for zygomycosis include uncontrolled diabetes mellitus, hematologic malignancies, corticosteroid therapy, deferoxamine therapy, intravenous drug use, and malnutrition.

Epileptogenesis in diacylglycerol kinase epsilon deficiency up-regulates COX-2 and tyrosine hydroxylase in hippocampus.

Diacylglycerol kinase (DGK) phosphorylates the second messenger diacylglycerol (DAG) to yield phosphatidic acid, two neural signaling elements that function to modulate synaptic activity. Of the nine mammalian DGK isotypes known, DGK epsilon (DGKepsilon) shows specificity for arachidonoyldiacylglycerol (20:4-DAG) and selectively contributes to modulate brain signaling pathways linked to synaptic activity and epileptic seizure activity. In this study, we examined changes in gene transcription in a mouse kindling model of epileptogenesis using control DGKepsilon (+/+) and DGKepsilon-knockout (-/-) mice.

Lipid signaling: sleep, synaptic plasticity, and neuroprotection.

Increasing evidence indicates that bioactive lipids participate in the regulation of synaptic function and dysfunction. We have demonstrated that signaling mediated by platelet-activating factor (PAF) and cyclooxygenase (COX)-2-synthesized PGE2 is involved in synaptic plasticity, memory, and neuronal protection [Clark GD, Happel LT, Zorumski CF, Bazan NG. Enhancement of hippocampal excitatory synaptic transmission by platelet-activating factor.

CT-angiography for the detection of a lower gastrointestinal bleeding source.

The evaluation of lower gastrointestinal bleeding (LGIB) often involves the collaborative efforts of the gastroenterologist, radiologist, and surgeon. Efforts to localize the acute LGIB have traditionally involved colonoscopy, technetium-labeled red blood cell (RBC) scintigraphy, angiography, or a combination of these modalities. The sensitivity of each method of diagnosis is limited, with the most common cause of a negative study the spontaneous cessation of hemorrhage.

Oxidative stress-induced retinal damage up-regulates DNA polymerase gamma and 8-oxoguanine-DNA-glycosylase in photoreceptor synaptic mitochondria.

Bright light triggers biphasic photoreceptor nuclear DNA fragmentation, suggesting a DNA-repair response (Invest Ophthalmol Vis Sci 43:3511; 2002; Adv Med Biol 533:229-240; Mol Neurobiol 28:111-122). Here, we demonstrate a remarkable increase in expression of the mitochondrial DNA-repair enzymes, DNA polymerase gamma and 8-oxoguanine-DNA-glycosylase, following bright light treatment in rats. DNA polymerase gamma and 8-oxoguanine, the product of guanine oxidation, were selectively localized in photoreceptor synaptic terminals only within the superior central retinal region, where most light damage occurred.