Unusual Presentation of Metanephric Stromal Tumor in a Neonate.

Metanephric stromal tumor (MST) of kidney is an under-reported benign stromal specific renal neoplasm with good prognosis. This tumor is to be differentiated from congenital mesoblastic nephroma and clear-cell sarcoma of the kidney. In this case report, we describe the imaging, gross, and microscopic features of MST with ischemic left kidney in a 1-month-old child and discuss treatment with relevant literature.

Immediate and long-term outcome analysis of lipomeningomyelocele repair in asymptomatic infants in a tertiary care center.

OBJECTIVE: To analyze immediate and long-term results of lipomeningomyelocele (LMM) repair in asymptomatic patients. MATERIALS AND METHODS: Seventeen patients of LMM presented to Department of Paediatric Surgery over a period from 2011 to 2015 were evaluated preoperatively by magnetic resonance imaging of whole spine, and pre- and post-operative Ultrasound of kidney, ureter, bladder, and neurosonogram. Surgical procedure involved total excision of lipoma in 15 patients and near total excision in 2 patients. Division of filum terminale could be done in 15 out of 17 patients. Follow-up varied from 1 to 3.5 years (mean 1.9 years). RESULTS: This study included 10 (58.8%) patients of lumbosacral LMM, 5 (29.4%) patients of sacral, and 2 (11.7%) patients of thoracolumbar LMM. About 13 (76.4%) patients were operated before 3 months of age, 2 (23.5%) patients were operated between 3 and 6 months, and two patients were operated between 6 and 11 months. None of the patients had bladder/bowel dysfunction preoperatively. Preoperative lower limb power was normal in all patients. Objective improvement in lower limb motor function was observed in 3 (17.6%) patients and three patients had decreased lower limb power. Two patients developed altered sensations and weakness of lower limb about 2.5-3 years after initial LMM repair. They needed repeat detethering of cord. Two patients had fecal pseudoincontinence, whereas one patient developed constipation. Bowel dysfunction was managed by rectal washouts, and oral laxatives were added if required. One (5.8%) patient of lumbosacral LMM and 1 (5.8%) patient of sacral LMM had urinary incontinence postoperatively. This was managed by clean intermittent catheterization with continuous overnight drainage. Conservative management of bladder and bowel dysfunction was effective in all patients till the last follow-up. Two patients developed hydrocephalus after LMM repair for which low-pressure ventriculoperitoneal shunt was inserted. Wound infection occurred in 1 (5.8%) patient, whereas 7 (41.1%) patients developed seroma in wound which responded to repeated aspirations under aseptic precautions. CONCLUSION: With total excision of lipoma and division of filum terminale satisfactory outcome for asymptomatic patients of LMM can be achieved. Authors recommend early surgery for LMM even in asymptomatic patients. Patients with residual lipoma and undivided filum terminale should be observed closely for the development of progressive neurological changes.

Cryopreservation technique: comparison of Test yolk buffer versus SpermCryo and vapour versus computerised freezing.

Semen cryopreservation offers the possibility to maintain fertility over a long time period e.g. for male cancer patients. Although its use expands worldwide, there is no established method that can be referred to as an entrenched standard for routine laboratory use. Cryodamage is still a general phenomenon and the success of cryopreservation is affected on one side by the cryoprotective agent and on the other side by the technique of freezing. In this methodological study, we compared the newly offered SpermCryo (SC) with the standard used cryoprotectant Test yolk buffer (TYB). We could show that TYB is superior to SC. In addition, we compared the two mainly used techniques for cryopreservation: computerised slow-stage freezing versus nitrogen vapour fast freezing. Regarding the sperm post-thaw motility and viability, no significant difference was found between these two methods. In conclusion, TYB can be recommended as a cryomedium of first choice and the appropriate freezing technique can be selected according to the local facilities of the institution.

Lessons learned from the Hunter Region Health Promoting Schools Project in New South Wales, Australia.

This paper describes development, over a five-year period, of the Hunter Region Health Promoting Schools Project in New South Wales (NSW), Australia. The project implemented the principles and philosophy of the Health Promoting Schools concept and evaluated its effectiveness using a randomized controlled trial involving 22 public secondary schools. An overview of the preliminary intervention model based on the health promoting schools philosophy and trialed in a pilot study is provided. The authors also outline barriers to, and difficulties in, implementing the philosophically based intervention model in the secondary school setting. The current intervention approach, which evolved over five years, is described in relation to the roles played by project team members and school communities. In addition, the authors outline guiding principles arising from the new approach which facilitated adoption of health promotion strategies in secondary school settings.

Glucose-induced increase in memory performance in patients with schizophrenia.

Previous investigations have found that increasing circulating glucose availability can increase memory performance in rodents, healthy humans, and individuals with dementia of the Alzheimer's type. In this study, patients with schizophrenia, healthy control subjects, and controls with bipolar affective disorder were tested using double-blind treatment with either 50 g anhydrous dextrose plus 4 mg sodium saccharin (for "taste") or 23.7 mg saccharin alone, followed by cognitive testing on a complex battery. At this glucose dose, verbal memory performance on a paragraph recall task was increased during the glucose condition relative to the saccharin condition in the patients with schizophrenia; this effect was not detected in either the psychiatric or normal controls. The results provide preliminary support for the hypothesis that memory performance can be improved in patients with schizophrenia by increasing circulating glucose availability and suggest the importance of further evaluation of therapeutic manipulations of glucose availability.

BCL6 can repress transcription from the human immunodeficiency virus type I promoter/enhancer region.

The gene BCL6 encodes a zinc finger protein with similarities to transcription factors. We previously reported that a number of viral genomes, including human immunodeficiency virus type I (HIV-1), contain sequences which are similar to the BCL6 DNA-binding consensus in their promoter regions. Electrophoretic mobility shift assays showed that the full-length BCL6 protein extracted from transfected COS cells and a bacterially expressed truncated protein containing the BCL6 zinc fingers can bind specifically to DNA from the U3 promoter/enhancer region of HIV-1. Transient transfections were performed to analyze the effects of the BCL6 protein on luciferase expression driven by the HIV-1 long terminal repeat (LTR) sequences. Full-length BCL6 significantly repressed luciferase activity compared with multiple controls. We conclude that the BCL6 protein can bind to the HIV-1 promoter-enhancer region and contains a domain upstream of its zinc fingers that can repress transcription from the HIV-1 LTR.

An investigation of accessory foramina in furcation areas of human primary molars: Part 1. SEM observations of frequency, size and location of accessory foramina in the internal and external furcation areas.

Although the existence of accessory foramina in the furcation area and roots of permanent teeth has been demonstrated, the presence of accessory foramina in furcation areas of primary molars is less certain. This investigation was conducted to determine the presence or absence of accessory foramina in the furcation areas of human primary molars using the scanning electron microscope (SEM). Twenty extracted, carious and noncarious human primary molars were placed in fixative and then mounted in a hard tissue cutting machine: ten teeth were cut transversely 2.0mm coronal to the floor of the pulpal chamber and ten teeth were cut transversely 2.0mm apical to the external furcation. Both the internal and external furcation surfaces of these sectioned molars were debrided with sodium hypochlorite/hydrogen peroxide solutions to remove organic materials, which might obscure visibility of possible foramina and then rinsed in water and dried. The tissues were then prepared for and examined by SEM. Twenty percent of the molars examined by SEM on the internal furcation surface and 50% of the molars examined by SEM on the external furcation surface demonstrated accessory foramina.

An investigation of accessory canals in furcation areas of human primary molars: Part 2. Latex perfusion studies of the internal and external furcation areas to demonstrate accessory canals.

Four classes of accessory canals: "true," "blind," "looping" and "enclosed" canals have been suggested to exist in furcation areas of primary teeth. Although the existence of accessory canals in the furcation areas and roots of permanent teeth has been demonstrated, their presence in furcation areas of primary teeth is uncertain. This investigation was conducted to determine the presence or absence of accessory canals in the furcation areas of human primary molars using a variety of latex perfusion techniques. Twenty extracted, noncarious human primary molars were placed in fixative and then sectioned on a hard tissue cutting machine: ten teeth were cut transversely 2.0 mm coronal to the floor of the pulpal chamber and ten teeth were cut transversely 2.0 mm apical to the external furcation area. The internal and external furcation surfaces of these sectioned molars were debrided with sodium hypochlorite/hydrogen peroxide solutions, rinsed in water and dried to remove organic materials, which might obscure the existence of possible canals. Twenty of these extracted teeth were examined by SEM to detect the possible presence of accessory foramina in the internal and external furcation areas (Part 1). Twenty percent of the molars examined by SEM on the IFA and 50 percent of the molars examined by SEM on the EFA exhibited accessory foramina. Twenty molars were perfused with low viscosity latex using vacuum [negative] pressure (10 molars) and positive pressure (10 molars) to detect the possible existence of the patency and the extent of such accessory canals in the internal and external furcation areas (Part 2).(ABSTRACT TRUNCATED AT 250 WORDS)