Primary follicular lymphoma of the conjunctiva in a 12 year-old male.

BACKGROUND: Follicular lymphoma (FL) is the second most common adnexal lymphoma of the eye that almost all of them are reported in elderly patients. Primary FL of the eye has been reported in only two children. Pediatric FL appears to be biologically distinct from typical adult FL. In cases without other organ involvement excision alone with close monitoring is a treatment of choiceand the prognosis is excellent. CASE PRESENTATION: A 12 year -old male with a nodular lesion involving the inner can thus of the right eye was admitted to ophthalmology clinic. The lesion was painless and the nodule size gradually increased over a period of 6 months.Excisional biopsy demonstrated follicular lymphoma composed of neoplastic lymphoid cells which arranged in follicular pattern without germinal centers. Neoplastic cells were positive for Bcl2 and CD20. CONCLUSION: Although follicular lymphoma of the conjunctiva is rare in childhood but it could be considered as one of the differential diagnosis in this age group.

Laparoscopic pyeloplasty in secondary ureteropelvic junction obstruction after failed open surgery.

BACKGROUND AND PURPOSE: Laparoscopic pyeloplasty has been accepted as a helpful option for the treatment of primary ureteropelvic junction (UPJ) obstruction. We report the results of laparoscopic pyeloplasty in cases with secondary UPJ obstruction after failed open pyeloplasty. PATIENTS AND METHODS: Between September 2003 and March 2006, 18 patients with secondary UPJ obstruction secondary to failed open surgery who had undergone laparoscopic pyeloplasty using different techniques were enrolled in this study. The mean age and male-to-female ratio were 29.8 years (range 5-65 years) and 14: 4, respectively. Pain, fever, duration of the operation, changes in renal function, and rate of complications were reviewed. RESULTS: The mean operation time and average hospital stay were 254 +/- 82 minutes and 7.2 days (range 3-12 days), respectively. The mean follow-up was 14.1 months (range 4-25.5 months). No intraoperative complication occurred. Flank pain, urinary-tract infection, and severe hydronephrosis decreased from 88.9% to 22.2%, 33.3% to 0, and 83.3% to 16.6%, respectively. After laparoscopic pyeloplasty, 100% of patients had improvement in renal function. The number of patients with >50% washout on the DTPA scan 10 and 20 minutes after furosemide injection were 0 and 2 before the operation and 5 and 12 after the operation (27.8% and 62.5% increment, respectively). CONCLUSION: Laparoscopic pyeloplasty can be used with acceptable success rate in secondary UPJ obstruction in patients with previous open pyeloplasty.

Engineering of implantable cartilaginous structures from bone marrow-derived mesenchymal stem cells.

Fabrication of implantable cartilaginous structures that could be secured in the joint defect could provide an alternative therapeutic approach to prosthetic joint replacement. Herein we explored the possibility of using biodegradable hydrogels in combination with a polyglycolic acid (PGA) scaffold to provide an environment propitious to mesenchymal stem cells (MSCs) chondrogenic differentiation. We examined the influence of type I collagen gel and alginate combined with PGA meshes on the extracellular matrix composition of tissue-engineered transplants. MSCs were isolated from young rabbits, expanded in monolayers, suspended in each hydrogel, and loaded on PGA scaffolds. All constructs (n=48) were cultured in serum-free medium containing transforming growth factor beta-1, under dynamic conditions in specially designed bioreactors for 3-6 weeks. All cell-polymer constructs had a white, shiny aspect, and retained their initial size and shape over the culture period. Their thickness increased substantially over time, and no shrinkage was observed. All specimens developed a hyalin-like extracellular matrix containing glycosaminoglycans (GAGs) and type II collagen, but significant differences were observed among the three different groups. In PGA/MSCs and collagen-PGA/MSCs constructs, the cell growth phase and the chondrogenic differentiation phase of MSCs occurred during the first 3 weeks. In alginate-PGA/MSCs constructs, cells remained round in the hydrogel and cartilage extracellular matrix deposition was delayed. However, at 6 weeks, alginate-PGA/MSCs constructs exhibited higher contents of GAGs and lower contents of type I collagen. These results suggest that the implied time for the transplantation of in vitro engineered constructs depends, among other factors, on the nature of the scaffold envisioned. In this study, we demonstrated that the use of a composite hydrogel-PGA scaffold supported the in vitro growth of implantable cartilaginous structures cultured in a bioreactor system.

Effect of smoking on prognostic factors of transitional cell carcinoma of the bladder.

PURPOSE: This study was conducted to evaluate the effects of smoking on the clinical characteristics and growth trend of transitional cell carcinoma (TCC) of the bladder. MATERIALS AND METHODS: In a retrospective case-control study from February 2000 to March 2003, patients with TCC of bladder, referred to our clinic, were selected and divided into high-grade and low-grade groups. Groups were matched for other known risk factors and the effect of smoking on size, number, and presenting grade of TCC in each group was evaluated. RESULTS: A total of 185 patients, with a mean age of 65.1 +/- 14.0 year, were included in this study, of whom 36 were females and 149 were males (male to female ratio of 4.1 to 1). Eighty-three patients were smokers (44.9%) with a mean 20.01 +/- 11.09 pack-year (range 0.75 to 60) smoking history. History of smoking was positive in 36.1% of the patients with low-grade tumors; whereas, 90% of the patients with high-grade tumors were smokers (P = 0.000, OR = 15.9, 95% CI: 6.7-36.9). There was a statistically significant correlation between the history of smoking and size and number of tumoral lesions (P = 0.000, P = 0.000, respectively). Positive history of smoking was also associated with higher grades of tumor in both men and women (OR = 12.8 and 8.8, respectively). CONCLUSION: This study showed that smoking not only induces bladder cancer, but also, once it develops, it can increase the grade of tumor, resulting in worse prognosis. Thus, smoking cessation might favorably alter the course of bladder cancer.

Conceptually new sulfone analogues of the hormone 1alpha, 25-dihydroxyvitamin D(3): synthesis and preliminary biological evaluation.

A conceptually new series of vitamin D(3)-like nonfluorinated and fluorinated 16-ene side chain tert-butyl sulfones 3-7 has been synthesized. Even though these novel C,D-ring side chain analogues of the hormone 1alpha,25-dihydroxyvitamin D(3) (1,1,25D(3)) lack a terminal OH group, thought previously to be essential for high biological activity, they are highly antiproliferative and, in several cases, transcriptionally active in vitro but desirably noncalcemic in vivo. The side chain sulfone group may be binding to the nVDR as a hydrogen-bond acceptor, in contrast to the hydrogen-bond donor function of the 25-OH group of natural 1,25D(3).