Young apheresis platelet donors show significant and sustained growth over the last decade in the US, 2010-2019: A favorable sign of the resiliency of the platelet supply.

BACKGROUND: Platelet demand continues to rise and US hospitals frequently face shortages. The peak median age of apheresis platelet donors (APD) is believed to have increased over the last decade, raising concerns that the APD base is not being adequately replenished with young donors. STUDY DESIGN/METHODS: American Red Cross (ARC) apheresis platelet collections were evaluated from calendar years 2010 through 2019. APD, products per procedure/split rate (PPP) and donation frequencies were stratified into age groups. RESULTS/FINDINGS: The number of unique APD from calendar year 2010 through 2019 in the ARC donor pool increased from 87,573 to 115,372 donors, representing a 31.7% overall growth. Donors in the 16-40 year-old (y) age group increased by 78.8% overall, with the largest absolute increases seen in the 26-30 y (4852 donors, 99.9% growth), followed by the 31-35 y (3991, 94.1%) group. Donors aged 56+ increased by 50.4% overall, with the largest increase seen in the 66-70 y (5988 donors, 108.1% growth) group. Middle-aged donors, aged 41-55 y, demonstrated a decrease of 16.5%. Over the last decade, the youngest age groups (16-40 y) comprised 61.3% of first-time donors (FTD). Annual donation frequency increased with increasing age and PPP. The highest donation frequencies were seen in the oldest age groups. CONCLUSION: Although the peak median age of APD increased over the study period, relative contribution of the 16-40 y APD base also increased. Older donors exhibited the highest donation frequencies and thus contributed the largest volume of apheresis platelet units. Platelet donor activity declined in the middle age (41-55 y) group.

Can clinical characteristics differentiate patients with unexplained chronic cough from patients with asthma and COPD?

Background: Chronic cough is reported in up to 20% of the adult population and often persists despite medical treatment with currently available therapies. Many clinical conditions, including asthma and chronic obstructive pulmonary disease (COPD), must be excluded before making a Unexplained chronic cough diagnosis. Methods: The primary objective was to use a large hospital dataset to compare clinical features of patients with a primary diagnosis of UCC with those with asthma or COPD without a primary diagnosis of UCC to help clinicians differentiate between these conditions more readily. Data were collected for all hospitalization and outpatient medical encounters for each patient between November 2013 and December 2018. Information included demographics, encounter dates, medications prescribed at every encounter for chronic cough, lung function testing, and hematologic parameters. Asthma and COPD were combined into one group to ensure there was no overlap with UCC and due to limitations of International Classification of Diseases coding to confirm an asthma(A)/COPD diagnosis. Results: Female gender represented 70% of encounters for UCC versus 61.8% for asthma/COPD (p < 0.0001); the mean age was 56.9 years for UCC versus 50.1 years for A/COPD (p < 0.0001). The number of patients on cough medications and the cough medication frequency were significantly higher in the UCC versus A/COPD group (p < 0.0001). UCC versus A/COPD patients had a total of eight versus three cough-related encounters over the study duration (i.e., 5 years) (<0.0001). The average interval between successive encounters was less for UCC (114 days) versus the A/COPD (288 days) group. Gender-adjusted Forced expiratory volume in the first second of exhalation/Forced vital capacity (FEV1/FVC) ratios, residual volume%, and Diffusion capacity for carbon monoxide (DLCO%) were significantly higher in UCC versus A/COPD, whereas the response to bronchodilators of FEV1, FVC and residual volumes were significantly greater in A/COPD patients. Conclusions: Clinical characteristics differentiating UCC from A/COPD could accelerate recognition of UCC diagnosis especially in the subspecialty setting where patients with these disorders are referred.

Genome wide mining of SNPs and INDELs through ddRAD sequencing in Sahiwal cattle.

The study was conducted in Sahiwal cattle for genome wide identification and annotation of single nucleotide polymorphisms (SNPs) and insertions and deletions (INDELs) in Sahiwal cattle. The double digest restriction-site associated DNA (ddRAD) sequencing, a reduced representation method was used for the identification of variants at nucleotide level. A total of 1,615,211 variants were identified at RD10 and Q30 consisting of 1,480,930 SNPs and 134,281 INDELs with respect to the Bos taurus reference genome. The SNPs were annotated for their location, impact and functional class. The SNPs identified in Sahiwal cattle were found to be associated with a total of 26,229 genes. A total of 1819 SNPs were annotated for 209 candidate genes associated with different production and reproduction traits. The variants identified in the present study may be useful to strengthen the existing bovine SNP chips for reducing the biasness over the taurine cattle breeds. The diversity analysis provides the insight of the genetic architecture of the Sahiwal population Studied. The large genetic variations identified at the nucleotide level provide ample scope for implementing an effective and efficient breed improvement programme for increasing the productivity of Sahiwal cattle.

Differentially expressed microRNAs in biochemically characterized FrieswalTM crossbred bull semen.

In addition to the transmission of paternal genome, spermatozoa also carry coding as well as noncoding microRNAs (miRNAs) into the female oocyte during the process of biological fertilization. Based on RNA deep sequencing, a total 28 number of differentially expressed miRNAs were cataloged in categorized FrieswalTM crossbred (Holstein Friesian X Sahiwal) bull semen on the basis of conception rate (CR) in field progeny testing program. Validation of selected miRNAs viz. bta-mir-182, bta-let-7b, bta-mir-34c and bta-mir-20a revealed that, superior bull semen having comparatively (p < .05) lower level of all the miRNAs in contrast to inferior bull semen. Additionally, it was illustrated that, bta-mir-20a and bta-mir-34c miRNAs are negatively (p < .01) correlated with seminal plasma catalase (CAT) activity and glutathione peroxidase (GPx) level. Interactome studies identified that bta-mir-140, bta-mir-342, bta-mir-1306 and bta-mir-217 can target few of the important solute carrier (SLC) proteins viz. SLC30A3, SLC39A9, SLC31A1 and SLC38A2, respectively. Interestingly, it was noticed that all the SLCs were significantly (p < .05) expressed at higher level in superior quality bull semen and they are negatively correlated (p < .01) with their corresponding miRNAs as mentioned. This study may reflect the role of miRNAs in regulating few of the candidate genes and thus may influence the bull semen quality traits.

Genetic variants in 5'UTR and exonic region of NPY gene alter the reproduction performance in Indian cattle breeds.

Neuropeptide Y (NPY) is one of the most potent orexigenic factors which can produce diverse effects on behaviour and other physiological functions and is highly conserved in evolution. The present study was aimed to identify and associate SNPs in the 5' UTR and exon2 region of the NPY gene with reproduction and production traits in Kankrej cattle of Indian origin. Three mutations in the 5'-UTR region and one mutation in the exon2 region of the NPY gene were identified by PCR-SSCP and PCR-RFLP, respectively, followed by sequencing. Further, association studies were conducted with reproduction and production traits in Kankrej cattle. The GACCGA genotyped animals based on the 5'UTR variants indicated better dry period and calving interval, whereas with GGCCGG genotypes showed higher total lactation milk yield and 305-day milk yield in comparison to other genotypes. Also, service period and inter calving period varied significantly among the genotypes of exon2, as the GG genotyped animals had significantly longer calving interval. Other traits like age at first heat, age at first service and age at first calving were not affected by the mutations. So, the present study outlined that the bovine NPY gene may be considered to be one of the candidate gene for improvement of reproductive performance of cattle, after validation on large sample size.

Design and synthesis of novel spirocyclic carboxylic acids as potent and orally bioavailable DGAT1 inhibitors and their biological evaluation.

A series of novel spirocyclic DGAT1 inhibitors containing the oxadiazole motif were designed and synthesized for biological evaluation. Several compounds exhibited potent diacylglycerol acyltransferase 1 (DGAT1) inhibitory activity. Optimization of the series led to the identification of five lead compounds 8, 9, 10, 11 and 12 that showed excellent in-vitro activity with IC50 values ranging from 7 to 20 nM against human DGAT1. All compounds demonstrated good druggability as well as microsomal stability and safety profiles such as hERG and CYP. Compound 12 significantly reduced plasma triglyceride levels in-vivo in the mouse model of acute lipid challenge. Significant reduction in plasma TG excursion was observed, thus indicating DGAT1 inhibition in-vivo.

Exploring a variance decomposition approach integrated with the Monte Carlo method to evaluate groundwater fluoride exposure on the residents of a typical fluorosis endemic semi-arid tract of India.

This study appraised the groundwater fluoride (F-) endemicity and the exposure levels under the Central Tendency Exposure (CTE) condition and the Reasonable Maximum Exposure (RME) condition on the residents of the semi-arid parts of the Birbhum district of Peninsular India using a Variance Decomposition (Sobol Sensitivity Indices) approach combined with Monte Carlo Simulations. The study finds the national scale drinking water standard limit for F- (1.5 mg L-1) is inappropriate for the present survey area where F- concentration in groundwater varied between 0.26 and 11.82 mg L-1 and ~54.5% of the samples (N = 400) exceeded this limit. Therefore, estimated the optimum F- concentration of 0.733 mg L-1 for the region using the method recommended by the World Health Organization (WHO) to calculate the optimum F- limit at a regional scale. The average value of F- concentrations for this region (1.71 mg L-1) is considerably higher than the estimated optimum concentration or even the maximum permissible limits recommended for the subtropical regions (0.5-0.7 mg L-1). The exposure analysis revealed the infants and children as potentially vulnerable populations compared to adolescents and adults of the study area for CTE and RME scenarios. The multi-exposure pathways indicated oral intake as the main exposure pathway whereas exposure through dermal contact was insignificant for the residents of all age groups of this region. Based on the first, second and total order Sobol Sensitivity Indices, F- concentration (C) in groundwater, the groundwater ingestion rate and their combined interaction are the greatest significant parameters for the oral exposure model whereas C and its interaction effects with the proportion of the skin surface area in contact with groundwater as the utmost sensitive variables for the dermal health risks assessment model. The present study insists the inhabitants to intake defluoridated groundwater.

Longitudinal experience with treatment of acquired angioedema using tranexamic acid.

Background: Acquired angioedema (AAE) is a rare form of angioedema (AE) and is often associated with lymphoproliferative conditions and/or anti-C1 esterase inhibitor (C1-INH) antibodies without clear treatment consensus. Current treatments have been reported to have variable effectiveness with different safety concerns. A large Italian cohort of patients with AAE was previously found to respond well to tranexamic acid (TXA). Herein, we report our experience treating AAE with TXA used as prophylaxis. Objective: The objective was to describe clinical characteristics of patients with AAE and to report our experience with treating AAE with TXA. Methods: A retrospective chart review of patients with AAE (N = 13) from a large practice was conducted to assess characteristics and treatment responses. Patient demographics in addition to C1-INH quantitative, C1-INH functional, C4, and C1q levels; the presence of C1-INH antibodies; and a history of lymphoproliferative disease were extracted. The patients were also characterized by their treatment response to TXA. Results: All the patients were white, with a mean age at diagnosis of 67 years, an average body mass index of 31.3 kg/m², and a male-to-female ratio of 7:6. Nine patients had positive C1-INH antibodies. The patients were on various prophylaxis treatments before TXA, including chemotherapy that targeted malignancy, cyclophosphamide, rituximab, and plasmapheresis. Ultimately, 11 of the 13 patients were on TXA for prophylaxis. At 1, 12, and 24 months after TXA treatment, attacks decreased by 97, 86, and 99%, respectively. One patient developed a deep vein thrombosis and TXA was stopped. Conclusion: These findings demonstrated that treatment of AAE with TXA was effective as prophylaxis for AE attacks. However, potential adverse effects remain a concern, which emphasizes the need for additional options.

Evaluation of groundwater quality for irrigation water supply using multi-criteria decision-making techniques and GIS in an agroeconomic tract of Lower Ganga basin, India.

Groundwater irrigation has evolved the monocropping cultivation pattern to multi-cropping, especially in many arid/semi-arid tracts globally. Irrigation practices with the groundwater of poor quality can limit the selection of the crop, reduce crop yields and degrade the soil quality. The present study has been undertaken to identify the hydrogeochemical phenomena of groundwater systems in the south-western Birbhum district, India and to analyze groundwater suitability for irrigation during the pre-and post-monsoon cycles by adopting the Irrigation Water Quality Index (IWQI) using Multivariate Factor Analysis along with some traditional methods viz. sodium adsorption ratio, sodium percentage, magnesium hazards, residual sodium bicarbonate (RSBC) and carbonate (RSC), Wilcox's and USSL diagrams, permeability index and Kelly's index. The hydrogeochemical analysis revealed that chemical weathering and evaporation are predominant in the aquifer systems. Groundwater quality reflected soil salinity, sodicity and magnesium hazards risks and water toxicity to the sensitive plants at 0-46.4% of the post-monsoon samples and 0-38.4% of the pre-monsoon samples based on the individual traditional methods whereas about 97.73-98.88% of the total area was classified as moderate to severely unsuitable for irrigation during both seasons when integrated multiple parameters using the IWQI method. Prolonged use of such groundwater for irrigation is susceptible to causing moderate to severe infiltration problems at a greater extent of the study area. The study recommends adaptation of salinity, sodicity and RSC/RSBC reduction procedures (e.g., the use of acid and gypsum amendments in the irrigation lands and through water blending) and advanced irrigation practices (viz. drips, sprinklers and micro irrigations) to prevent soil degradation and increase crops productivity. Adopting Managed Aquifer Recharge procedures as well as rainwater harvesting in the areas bearing unsuitable water quality can dilute the ionic concentrations of the groundwater facies which in turn will improve the groundwater quality for irrigation.

Profiling of key heat shock proteins and their relationship with male sexual behavior and seminal characteristics in Kankrej (Bos indicus) breeding bulls during different seasons.

The goal of this study is to use indirect ELISA to determine the concentration of major heat shock proteins (Hsps) in Kankrej (Bos indicus) breeding bulls and their relationship with certain male phenotypic traits including sexual behavior, sperm quality, and bull fertility in different seasons. The seasonal fluctuation in the concentration of three major Hsps (60, 70, and 90) was determined using an indirect enzyme-linked immunosorbent assay (ELISA). According to the findings, Hsps levels are significantly higher during the summer season and are associated with both fresh and post-thawed semen quality traits in Kankrej breeding bulls. The better sexual behavior of bulls and seminal parameters of fresh or thawed semen was observed in the winter season together with the lower concentrations of HSPs. These could suggest negative association between HSPs with bull sexual behavior and seminal parameters. As a result, the concentration of Hsps in breeding bulls may be a useful indicator for determining fertility traits.

Role of seminal MDA, ROS, and antioxidants in cryopreservation and their kinetics under the influence of ejaculatory abstinence in bovine semen.

Despite many cryopreservation techniques in bovine semen, various stressors' detrimental effects remain a significant issue. The present study targeted to assess the role of semen quality parameters, sperm function tests, lipid peroxidation, reactive oxygen species (ROS), and different antioxidants in the cryopreservation of bovine semen. Further, the kinetics of lipid peroxidation, ROS, and antioxidants on repeated semen collection under short ejaculatory abstinence were studied. We designed a comparative study where bulls were grouped into good and low freezable semen groups (Freeze-groups) based on their post-thaw motility. All the bulls included had similar initial motility and qualified minimum standards for initial semen parameters viz. semen volume and sperm concentration. The present study detected a higher lipid peroxidation and ROS viz. superoxide anions (•O2-) and a lower total antioxidant capacity (TAC) in the low freeze-group compared to the good freeze-group. The ROS and antioxidants showed unique kinetics on repeated semen collection at short intervals, and no significant change was detected in semen volume, sperm motility, and sperm concentration. This study detected higher head abnormalities and poor acrosome integrity in the low freeze-groups. The present study results indicated that the sperm head might be the most vulnerable part of the sperm to cryopreservation stress. The present study finds significantly higher lipid peroxidation and ROS levels and reduced antioxidant capacity as the primary reasons for low cryopreservability. Further, repeated semen collection with a shorter or lack of abstinence does not impose any significant change in the semen volume and sperm concentration; moreover, it could be beneficial for higher antioxidant levels and lower lipid peroxidation levels. As seminal plasma has both inhibitory and stimulatory roles in sperm function and cryopreservation, identifying the critical role players of seminal plasma and identifying sperm related changes in cryopreservation could predict the cryopreservability potential of semen.

Comparative CpG methylation kinetic patterns of cis-regulatory regions of heat stress-related genes in Sahiwal and Frieswal cattle upon persistent heat stress.

The kinetic patterns of CpG methylation of the cis-regulatory region of heat stress-related genes on exposed to heat stress (at 42 °C) between the Sahiwal and Frieswal cattle was compared in the present study. Using an in vitro whole blood culture model, cells were continuously exposed to heat stress (at 42 °C) for 6 h. Methylation levels of five genes, viz., GPX1, HSP70, HSP90, c-FOS, and JUN were estimated by SyberGreen-based quantitative methylation-specific PCR (qMSP) assay. CpG methylation kinetics at different time points of heat stress (0.5, 1, 2, 4, 6 h) were analyzed using mixed ANOVA. The initial methylation level, estimated at 37 °C, of HSP70 was significantly high in the Sahiwal breed. A significant (p<0.001) time-dependent hypomethylation of an antioxidant gene (GPX1) CpG islands was detected at the acute phase of the stress. Heat shock protein gene (HSP70) showed a similar CpG methylation kinetics where the hypomethylation was prominent from 1 h and persisted up to 4 h. The heat stress responses of both Sahiwal and Frieswal cattle were identical as there was no distinctiveness in the methylation kinetics of CpG islands of studied genes. The acclimatization of Frieswal cattle-a breed developed in India over the years to the tropical climatic conditions, maybe one of the reasons for this similarity. Thus, the present study results could pave a path to understand the molecular mechanism of heat stress and adaptation of indigenous and crossbred cattle populations to the changing scenario in tropical climate conditions.

Development of a RAPD marker-based classification criterion for quality semen production in Holstein crossbred bulls.

In cattle production systems, an intense selection pressure for production traits has resulted in the decline of fertility traits. To optimize an efficient reproduction system, the inclusion of both male and female fertility traits in the selection process is very much essential. RAPD (Random Amplified Polymorphic DNA) was developed as a molecular biology tool and has been extensively used, to study intra- and interspecific genetic diversity. The present study was undertaken to utilize RAPD primers to investigate the association between DNA markers and semen quality traits viz. Sperm concentration, total sperm count ejaculate and initial sperm motility and thereby to identify good/poor semen producers. DNA isolated from the blood samples of healthy bulls was subjected to RAPD-PCR. The multiple regression analysis followed by independent t test was carried out to identify suitable markers. Based on the results, only 12 bands were identified as marker suitable for any of the quality trait. This includes, OPA2 ~ 760, OPA2 ~ 700, OPA6 ~ 1,200, OPA9 ~ 400, OPA9 ~ 380, OPA12 ~ 970, OPA14 ~ 715, OPA14 ~ 605, OPA16 ~ 485, OPA17 ~ 860 and OPA18 ~ 480. Multiple regression analysis selected, OPA2 ~ 760 and OPA2 ~ 1,750 for sperm concentration and OPA2 ~ 760, OPA2 ~ 700, OPA9 ~ 620, OPA4 ~ 670 and OPA18 ~ 1,015 for total sperm count/ejaculate. But the t test revealed a significant association between OPA2 ~ 760 and total sperm count. Further, discriminant function analysis also identified this marker in the first step itself. The results of the present study can be exploited as a low-cost alternative strategy for identification of good /poor semen producers in crossbred bulls at an early age.

Clinical use of biologics for asthma treatment by allergy specialists: A questionnaire survey.

BACKGROUND: Asthma is a heterogeneous disease with emerging phenotypes and endotypes. At present, 5 distinct biologics are Food and Drug Administration-approved as an add-on therapy for difficult-to-control type 2-high asthma. Because allergy specialists manage a spectrum of diseases for which biologics may be appropriate, it is important to understand their prescribing patterns. OBJECTIVE: To elucidate the allergist's use of biologics in the treatment of asthma, including barriers, preferences, indications for prescribing, measures to determine effectiveness, and cost-effectiveness. METHODS: A survey was performed among allergists using a semistructured 10-item self-administered web-based questionnaire and the responses were analyzed using one-way frequencies and multiple logistic regression. RESULTS: The response rate was approximately 9%. Omalizumab was the most prescribed biologic for asthma (98%), and "uncontrolled asthma despite adherence to controller medication" was the most common reason. The common selection criteria among the biologics included elevated peripheral eosinophil count, asthma with nasal polyps, and asthma type (type 1; type 2; nonallergic). A decreased exacerbation frequency was the best standard to determine the efficacy among biologics. Benralizumab was considered the most cost-effective. CONCLUSION: This study represents one of the largest surveys among allergy specialists regarding the real-world use of asthma biologics. It seems that there has been reasonably good dissemination and application of current guidelines among allergists based on prescribing patterns. However, their responses reflect the need for the continued modification of asthma guidelines that incorporate novel biologics and other pathway-specific agents into step therapy. As clinical phenotypes and predictive biomarkers develop, allergy specialists will be better prepared to practice precision medicine that optimizes the use of asthma biologics.

Characterization of a putative ribosome binding site at the 5' untranslated region of bovine heat shock protein 90.

Untranslated regions (UTRs) of the transcripts play significant roles in translation regulation and continue to raise many intriguing questions in our understanding of cellular stress physiology. Internal ribosome entry site (IRES) mediated alternative translation initiations are emerging as unique mechanisms. Present study is aimed to indentify a functional short 92 base pair length putative sequence located at the 5' untranslated region of bovine heat shock protein 90 AA1 (Hsp90AA1) may interact with ribosomal as well as eukaryotic initiation factor binding site. Here we have predicted both the two and three dimensional structures of bovine Hsp90AA1 IRES (MF400854) element with their respective free energy. Molecular interactions between bovine RPS5 and IRES have been determined after the preparation of docking complex of IRES bound RPS5. Structure of bovine ribosomal translational initiation factor (TIF) has also been determined and docked with IRES. Molecular interaction between bovine TIF and IRES was analyzed from the complex structure. We further detected the relative expression efficiency of the viral (original) in relation with Hsp90AA1 IRES-driven GFP expression, which revealed that efficiency under the control of identified bovine Hsp90AA1 IRES was slightly lower than viral origin. It was also noted that identified bovine HSP90 IRES may increase the expression level of GFP under in vitro heat stressed condition.

Association of bovine KISS1 single nucleotide polymorphisms with reproductive traits in Indian Cattle.

Kisspeptins, a family of neuropeptide encoded by the Kiss1 gene, have emerged as crucial regulator of fertility and reproduction by regulating the hypothalamic-pituitary-gonadal axis. The present study was aimed to identify and associate SNPs in the KISS1 gene with reproductive traits in cattle of Indian origin. DNA samples collected from 300 individual cows of three Indian dairy breeds (Gir, Kankrej and Frieswal) of cattle were used in the study. The SNPs of KISS1 gene were identified with PCR-RFLP and sequence analysis using two sets of primer pairs. A total of 5 SNPs were identified in the targeted region of which, two were selected for screening the population and association studies. The analysis revealed that genotypes of rs442633552G>A and rs42022871C>T had a significant association with dry period. The SNP rs42022871C>T also established significant role in milk production traits, and selection of TT-genotyped animals will improve the reproduction and production potential of the animals.

Effect of heat stress on superoxide anion production in native and crossbred cattle under in vitro whole blood culture model.

Impact of global warming on the dairy industry has gained attention due to huge economic losses through low production and fertility caused by heat stress. Exposure to hyperthermia provokes a series of complex responses in mammals which are been related to morphological and physiological alterations including the production of reactive oxygen species (ROS). A quantitative spectrophotometric based nitroblue tetrazolium (NBT) reduction assay was used to estimate the superoxide anion (•O2-) level in heat stressed (at 42 °C) whole blood cultures of native and crossbred bulls (Sahiwal and Frieswal), in vitro. The breed effect in the kinetics of •O2- production at different time periods of continual heat stress was analyzed by repeated measures ANOVA. Comparison between different time periods in reference to 37 °C was analyzed by paired t-test. The •O2- level was significantly different (p < 0.05) between cells at 37 °C and 42 °C at different periods of incubation. Kinetics study showed increment of •O2- production on the acute phase of stress followed by a reduction in both Sahiwal and Frieswal breeds. In Sahiwal breed, the inflated superoxide level continued abated till 4 h and raised again at 6 h, while in Frieswal •O2- level reverted to raise sooner with in 2 h of incubation itself. Contrarily, kinetic of •O2- level in plasma showed a significant reduction (p < 0.001) at 30 min of 42 °C incubation followed by increment of •O2- level. Further, the breed variation was significant (p < 0.05) and a significant high reduction of •O2- level was observed in Sahiwal breed. Our finding indicates that, a better and longer •O2- production homeostasis and higher plasma scavenging ability of native breed may be one of the reasons for the higher thermal tolerance of these breeds in tropical climate.

Giant Phyllodes Tumor in Ectopic Breast Tissue.

Breast masses are uncommon in children and adolescents. Ectopic breast tissue is further uncommon and may be present in locations such as the face, back, and thigh. A 12-year-old female child presented with a hard, nonmobile lump in the right breast. On exploration by submammary incision, the lump was found to be below the pectoralis major muscle and had no communication with the overlying orthotopic breast tissue. Histopathological examination revealed a well-encapsulated biphasic lesion, with features characteristic of a phyllodes tumor. We report a hitherto unreported case of aberrant breast tissue lying under the pectoralis muscle and containing phyllodes tumor.

Hepatoblastoma with Precocious Puberty.

Hepatoblastoma (HB), a primary liver tumor of childhood, is often accompanied by raised levels of alpha-fetoprotein (α-FP). Rarely, the beta-human chorionic gonadotropin (ß-hCG) levels may also be elevated, which can cause peripheral precocious puberty (PPP). We report a case of HB with precocious puberty wherein hormonal assays showed an increase in α-FP, ß-hCG, and testosterone levels, and suppression of follicle-stimulating and luteinizing hormone levels. After chemotherapy and surgery, α-FP, ß-hCG, and testosterone levels normalized, and the signs of virilization did not progress further. New therapeutic approaches have made a previously reported grim prognosis of virilizing HB, more favorable now. In the assessment of PPP, the possibility of a tumoral source for the hormones should also be considered.