Light stimuli control neuronal migration by altering of insulin-like growth factor 1 (IGF-1) signaling.

The role of genetic inheritance in brain development has been well characterized, but little is known about the contributions of natural environmental stimuli, such as the effect of light-dark cycles, to brain development. In this study, we determined the role of light stimuli in neuronal cell migration to elucidate how environmental factors regulate brain development. We show that in early postnatal mouse cerebella, granule cell migration accelerates during light cycles and decelerates during dark cycles. Furthermore, cerebellar levels of insulin-like growth factor 1 (IGF-1) are high during light cycles and low during dark cycles. There are causal relationships between light-dark cycles, speed of granule cell migration, and cerebellar IGF-1 levels. First, changes in light-dark cycles result in corresponding changes in the fluctuations of both speed of granule cell migration and cerebellar IGF-1 levels. Second, in vitro studies indicate that exogenous IGF-1 accelerates the migration of isolated granule cells through the activation of IGF-1 receptors. Third, in vivo studies reveal that inhibiting the IGF-1 receptors decelerates granule cell migration during light cycles (high IGF-1 levels) but does not alter migration during dark cycles (low IGF-1 levels). In contrast, stimulating the IGF-1 receptors accelerates granule cell migration during dark cycles (low IGF-1 levels) but does not alter migration during light cycles (high IGF-1 levels). These results suggest that during early postnatal development light stimuli control granule cell migration by altering the activity of IGF-1 receptors through modification of cerebellar IGF-1 levels.

Estimated radiation exposure and cancer risk from CT and PET/CT scans in patients with lymphoma.

INTRODUCTION: The purpose of this study was to estimate total effective dose and cancer risk related to treatment monitoring and surveillance computed tomography (CT) scans in a cohort of patients diagnosed with lymphoma. METHODS: 76 patients with head, neck, chest, abdomen or pelvis CT and whole-body positron emission tomography (PET)/CT were identified from an institutional lymphoma database; this included 54 (71%) patients with non-Hodgkin and 22 (29%) patients with classical Hodgkin lymphoma. Average treatment and surveillance periods were 8 months (range, 3-14 mo) and 23 months (range, 1-40 mo), respectively. Radiation exposure was estimated from the dose-length product (DLP) for CT scans and milli-Curies and DLP for PET/CT scans. Cancer risk was estimated using the Biological Effects of Ionizing Radiation model. RESULTS: During their treatment period, 45 patients had 161 CT exams and 39 patients had 73 PET/CT exams. Mean effective dose was 39.3 mSv (range, 7.1-100 mSv). During the surveillance period, 60 patients had 378 CT exams and 25 patients had 39 PET/CT exams. Mean effective dose was 53.2 mSv (range, 2.6-154 mSv). Seventeen of 76 (22.4%) patients had total cumulative doses greater than 100 mSv. The mean increase in estimated cancer risk was 0.40%; the greatest estimated risk to any one patient was 1.19%. CONCLUSION: Mean total effective dose and mean estimated cancer risk were low in patients with lymphoma undergoing serial imaging, suggesting that theoretical risks of radiation-induced cancer need not be a major consideration in radiologic follow-up.

Flow cytometric analysis of cerebrospinal fluid has low diagnostic yield in samples without atypical morphology or prior history of hematologic malignancy.

OBJECTIVES: To identify pretest characteristics of cerebrospinal fluid (CSF) specimens that will allow the rational use of flow cytometric analysis (FCA) in the diagnosis of hematologic malignancy. METHODS: Retrospective data were collected on 501 consecutive CSF samples submitted for FCA. RESULTS: A positive diagnosis of hematologic malignancy was made in 41 specimens (8.2%). Blasts or atypical lymphocytes were noted on Wright-stained slides in 98% of FCA-positive specimens (40/41), and a history of a hematologic malignancy was present in 89% of specimens (34/38). All FCA-positive specimens had atypical morphology or history of hematologic malignancy. Four hundred six specimens (81%) were FCA negative. Of FCA-negative specimens, 7% (30/406) had atypical morphology, and 3% (12/404) had future central nervous system involvement seen within 30 days. CONCLUSIONS: These data support a policy in which FCA of CSF is actively discouraged unless atypical lymphocytes or blasts are seen or a history of hematologic malignancy is present.