Signs Of Regrowth Research Articles

A large helmet-shaped proliferating trichilemmal tumor of the scalp: Is definitive radiotherapy the treatment? A case report

BackgroundBenign proliferating trichilemmal tumors (PTTs) are a rare entity that arises from the outer root sheath of a hair follicle. They range from a benign PTT that recurs locally to the more aggressive malignant PTT that, in addition to recurring locally, has the potential for metastatic spread. However, as a group, PTTs are slow growing and amenable to surgery. To the best of our knowledge, radical radiotherapy without surgery has been used in only one case in an elderly male patient with good oncological and cosmetic results.Case presentationWe present a case of a young unmarried female with a disfiguring PTT of the scalp not amenable to surgery treated successfully with radiotherapy providing good cosmesis. Volumetric modulated arc therapy was used to treat this patient with a dose of 50 Gy in 25 fractions over 5 weeks. A theoretical risk of malignant transformation was explained to the patient. The patient has maintained good cosmesis over the last 12 months with no signs of re-growth.ConclusionIn patients with PTT not amenable to surgery, radiotherapy may be an effective alternative providing local control and good cosmesis.

Coral reefs in the Southern Barents Sea: habitat description and the effects of bottom fishing

ABSTRACTFifteen Lophelia reefs from offshore to coastal areas off northern Norway were studied using video. Health status of the coral habitat (degree of physical impact, % cover of living tissue, colony size), occurrence of trawl marks and lost fishing gear, height of coral colonies and associated fauna were analysed from 44 video-lines. Fishing impact was more frequent on the offshore reefs (36.5% of the observed areas) than those in the coastal reefs (0.6%). The most visible effects of fishing were broken and displaced coral colonies. At some sites only small scattered fragments of live corals were observed, indicating recent impact. The mean colony height of Lophelia and gorgonian corals at impacted sites was around half the size of those at non-impacted sites. Both species richness and abundance was higher at non-impacted coral habitats compared to impacted. The actinarian Protanthea simplex and unidentified brittlestars were the only taxa with higher abundance on impacted compared with non-impacted habitats. The reefs at the offshore location were protected against bottom trawling in 2009 through the establishment of a marine protected area (MPA), but a general ban against trawling on known coral reefs had already been implemented in 1999. In the MPA, signs of regrowth were observed. Most of the observed damage probably occurred over 10 years earlier. Results show that live and non-impacted cold water coral reefs have an important ecological function by enhancing the local biodiversity and fish abundance. Preventing further damage to impacted reefs may lead to full recovery within a few decades.

Impacto do Fogo em Campo Sujo no Parque Estadual do Biribiri, Minas Gerais, Brasil

RESUMO Objetivou-se avaliar a regeneração natural pós-fogo em uma área de campo sujo. Foram selecionados três ambientes; I e II, com ocorrência de fogo, e III, sem ocorrência. Em cada local foi instalado um transecto com 20 parcelas de 5 × 5 m (25 m2). Foram mensurados o diâmetro ao nível do solo (DNS), altura total e rebrota de todos os indivíduos com altura ≥ 0,10 m e DNS ≤ 5,0 cm. Nos ambientes I e II foram amostrados 436 e 387 indivíduos e 29 e 24 espécies, respectivamente. Já no ambiente III foram amostrados 741 indivíduos e 29 espécies. Houve diferença significativa no número de perfilhos, número de indivíduos e na área basal. Nos ambientes I e II, 72% e 88%, respectivamente, apresentaram indícios de rebrotamento. O incêndio modificou a estrutura da vegetação e a rebrota foi a principal estratégia utilizada pelas espécies nos locais com ocorrência de incêndio.

OPTIMIZATION OF DEMETHYLATING THERAPY FOR IDH1 MUTANT GLIOMAS

BACKGROUND: Mutations in Isocitrate Dehydrogenase 1 (IDH1) are found in the majority of grade II and III gliomas and the subsequent progressive GBMs. The mutant IDH1 enzyme produces 2-hydroxyglutarate (2-HG), an “oncometabolite” that inhibits α-ketogluterate dependent histone and DNA demethylases resulting in characteristic hypermethylation of genomic DNA and suppression of cellular differentiation as a key mechanism of tumor progression and maintenance. METHODS: To accurately test therapeutics for IDH1 mutant gliomas, we developed a patient derived IDH1 mutant anaplastic astrocytoma model which produces 2-HG and exhibits characteristic DNA hypermethylation. This IDH1 mutant glioma grows only as a xenograft and not in cell culture. We measured tumor growth using a flank model in 5-azacytidine treated vs. untreated animals, passaging both sets of tumors from animal to animal in order to increase the exposure time to the drug. Tumor size was measured for treated vs. untreated mice and tumors were analyzed for gene expression, differentiation markers and promoter DNA methylation. Methylation status was by pyrosequencing analysis of bisulfate-converted genomic DNA at five genetic loci, with subsequent studies assessing global gene promoter methylation status. RESULTS: Long term administration of 5-azacytidine resulted in reduction of DNA methylation of promoter loci, induction of glial differentiation, reduction of cell proliferation and significantly reduced tumor growth. Nearly complete tumor regression was observed by 14 weeks, resulting in a sustainable response and significant survival benefit. When therapy was discontinued, tumors did not show any signs of re-growth for at least an additional 8 weeks. Statistical analyses were performed using a student t-test for comparisons between the treatment groups. Following one cycle of 5-azacytidine treatment, GFAP expression was strongly increased and protein levels were maintained throughout subsequent cycles. 5-azacytidine treatment significantly reduced the fraction of Ki-67 positive cells in a time dependent manner and loss of DNMT1 expression in vivo following one treatment cycle. CONCLUSIONS: Using this genetically and molecularly accurate model we have demonstrated the preclinical efficacy and mechanism of action of the FDA approved demethylating drug 5-azacytidine in vivo. The goal of this work is to optimize treatment efficacy and to precisely define the molecular alterations responsible for successful therapy. Long term administration of 5-azacytidine resulted in tumor regression acting through the expected mechanism of reversal of DNA methylation, and promoting a more normal cellular differentiation process. Optimization of demethylating therapy shows promise for IDH1 mutant gliomas. SECONDARY CATEGORY: Tumor Biology.

Neurological, imaging and pathological features of a meningeal inflammatory pseudotumour in a Maltese terrier

A five-year eight-month-old Maltese terrier was presented with a 3-week history of progressive paraparesis and pelvic limb ataxia. Neurological examination was consistent with a lesion involving the T3-L3 spinal cord segments. Myelogram and magnetic resonance imaging revealed a spherical, intradural-extramedullary mass lesion at T13/L1. A dorsal laminectomy, durotomy and debulking of the mass were performed. Histopathologic examination revealed a highly cellular tissue, most likely of mesenchymal origin, infiltrated by many lymphocytes, macrophages and neutrophils. The pathological diagnosis of an inflammatory pseudotumour was made. Postsurgical analgesia was achieved with opioids and 2 mg/kg carprofen twice daily for 5 days. When the histopathological diagnosis was made, a tapering course of 1 mg/kg prednisolone twice daily was prescribed, with dose reduction by approximately 50% every 4 to 6 weeks over a 4-month period. Magnetic resonance imaging was repeated at 22, 32 and 85 weeks postsurgery; no signs of regrowth could be detected and the patient recovered with residual mild paraparesis. Inflammatory pseudotumour has not been documented previously at this site in dogs and, although rare, should be considered in the differential diagnosis of a focal mass lesion affecting the spinal cord. Surgical debulking and immunomodulatory therapy can be curative.

Adult rhabdomyosarcoma in the nasal and paranasal sinuses showing complete local response to a combination of chemotherapy and radiotherapy using 3D-CRT and IMRT.

We report on a 69-year-old woman with rhabdomyosarcoma arising from the nasal and paranasal sinuses. She was referred to our hospital with a reduced ability to smell and impaired bilateral vision, narrowing of the visual field, and left facial pain. Computed tomography (CT) revealed a large tumor in the nasal and left paranasal sinuses invading the left orbital cavity and anterior skull base, and lymph node swellings in the submental and left accessory nerve areas. A biopsy specimen from the nasal tumor was diagnosed histologically as a rhabdomyosarcoma, alveolar type. Because the intracranial direct invasion and distant metastases to the thoracic spine were suspected by pretreatment examination, our case was determined to be inoperable by a head and neck surgeon. Radiotherapy with a total dose of 60 Gy was carried out to control the primary disease. The three-dimensional conformal radiotherapy (3D-CRT) and intensity-modulated radiotherapy (IMRT) techniques were used in order to reduce the doses to risk organs. Combined with radiotherapy, chemotherapy was also performed for the treatment of lymph-node metastases and distant diseases. After the treatment was completed, the primary tumor and lymph-node metastases disappeared completely; there was no sign of re-growth during the follow-up period. Chemoradiotherapy may be an effective treatment also for inoperable adult rhabdomyosarcoma in the head and neck region. Furthermore, the 3D-CRT and IMRT techniques are both useful methods of radiotherapy for this disease.

Less radical drilling in surgery for exostoses of the external auditory canal

Objective: To estimate the anatomical and functional long-term result of surgery for ear canal exostosis. Methods: Case rapport review with extraction of data concerning pre- and postoperative anatomical conditions, symptoms and audiology and a clinical and audiological re-evaluation. In the 20-year-period from 1 January 1976 to 1 January 1996, 26 patients were operated on primarily for ear canal exostosis. 19 patients with in total 24 ears were re-evaluated. Control-period 7.2 years. Pre-operatively were found occluding ear-canal exostosis in all patients as well as hearing loss, otitis externa and pain. Results: At the re-evaluation all patient were completely free of their symptoms. 19 out of 24 ears still had some remnants of exostosis, but the ear canal was covered with completely normal skin and had normal migration properties. No signs of re-growth were found in this material. Postoperatively one patient had a sensorineural hearing loss of 85 dB at 6 kHz, one had a dehiscence of the temporomandibular joint and one patient had an anterior ear drum perforation. Conclusion: To avoid the complications a less radical drilling of exostoses is proposed, in particular along the superior wall and near the short process of the malleus handle and along the anterior tympanomeatal angle. Removal of the bone from the posterior, inferior and anterior walls with preservation of the canal skin, creates enough lumen providing permanent cure.