K-ras gene point mutation: a stable tumor marker in non-small cell lung carcinoma.

K-ras gene point mutation is a highly frequent event in human malignancy. About one third of non-small cell lung cancer (NSCLC) patients harbor K-ras gene point mutational activations. This study investigates the prevalence of K-ras mutation in autopsy tumors with NSCLC, and the correlation of K-ras gene point mutations between primary tumors and metastases in NSCLC. Formalin-fixed, paraffin-embedded tissue sections of 15 primary lung tumors and their metastases, (obtained from autopsy), were examined for the presence of point mutations in K-ras gene codon 12, 13 and 61 by oligodeoxynucleotide hybridization analysis of DNA fragments, amplified by polymerase chain reaction (PCR). K-ras gene point mutations were detected in five cases of lung carcinoma, of which four were adenocarcinomas and one was squamous cell carcinoma. In each of these cases, identical K-ras gene mutations were found in the DNA of both the primary tumor and its corresponding distant metastases. Activating K-ras base-substitutions correlate well between the primary tumor and its corresponding metastases in NSCLC. In the negative cases where no K-ras mutation was found in the primary tumors, no newly acquired K-ras mutation appeared in the metastases. Our study indicates that K-ras point mutation serves as a stable tumor marker in NSCLC.

Multilobated non-Hodgkin lymphoma of B-cell type: leukemization and multiorganic involvement.

A case of multilobated non-Hodgkin lymphoma (Pinkus' lymphoma) is presented. Its clinical manifestations (extreme leukemization) and immunological characteristics are stressed.

Amiodarone toxicity: recurrence of interstitial pneumonitis after withdrawal of the drug.

Amiodarone hydrochloride, an iodinated benzofuran derivative, is effective for treatment of supraventricular and ventricular arrhythmias. Pulmonary fibrosis has been reported after treatment with this drug. We present a patient with amiodarone pulmonary toxicity, who initially responded to corticosteroid therapy, but who developed a clinical relapse two months after withdrawal of the drug.

Normal level of thyroglobulin messenger ribonucleic acid in a human congenital goiter with thyroglobulin deficiency.

Two siblings with congenital goiter were investigated from clinical, biochemical, and molecular biology standpoints. The association of clinical and biological hypothyroidism with undetectable levels of serum thyroglobulin (Tg) and the presence of iodohistidines in the urine suggested the diagnosis of defective Tg gene expression. This conclusion was confirmed by analysis of proteins present in goiter extracts. Only minute amounts of Tg-related material was detected by RIA (0.28 and 0.17 mg/g tissue compared to 80-100 mg/g in normal thyroid tissue), by Sepharose 6B chromatography, and by sucrose density gradient centrifugation. Surprisingly, the goiters contained normal amounts of Tg mRNA. The size of the mRNA and the sequence organization of its first five exons also were normal. We conclude that no gross alteration of structure or transcription of the Tg gene was present in these patients. The results are compatible with a lesion affecting the mRNA sequence (point mutation, splicing error etc.), leading to defective translation or abnormal routing of the translation product through the membrane system of the cell. This latter hypothesis is supported by the extreme distension of the goiter endoplasmic reticulum found on electron microscopy.

Acute worsening of renal function during episodes of macroscopic hematuria in IgA nephropathy.

The appearance of renal failure during episodes of macroscopic hematuria (EMH) in IgA nephropathy (IgAN) has been described as very unusual. The results of a prospective investigation on the effect of EMH on renal function in IgAN are presented. During a 3-year period, 29 episodes of EMH occurring in 21 patients with IgAN have been studied. A derangement of renal function (increase of serum creatinine by more than 0.5 mg/dl) was observed in 11 episodes (37.9%) with peak creatinine values ranging from 1.2 to 6.7 mg/dl. The worsening of renal function was accompanied by a longer duration of EMH (4.8 +/- 1.3 vs. 3.5 +/- 1.5 days; P less than 0.05) but not by arterial hypertension or edema. A complete recovery of renal function was observed in every patient 1 to 2 months after the start of EMH. The histological survey disclosed that the decrease of renal function correlated closely with the presence of red blood cell casts in as much as 50% of the tubular lumen and with findings of tubular necrosis. We conclude that a worsening of renal function can be observed frequently during the EMH. Tubular damage and obstruction by red blood cell casts may play a significant role in the pathogenesis of this complication.

La evaluacion diagnostica desde el punto de vista de la terapia racional-emotiva. / Diagnostic evaluation from the rational-emotive therapy point-of-view

Se presentan algunas ideas importantes acerca del proceso de evaluacion-intervencion en la terapia racional-emotiva (TRE), que parte de los tabajos de Ellis. Se clarifican los aspectos mas relevantes del psicodiagnostico racional-emotivo, tales como la relacion terapeutica-cliente, las actitudes del terapeuta, las etapas en la categorizacion de la problematica de los clientes, etc. Se mencionan algunas de las barreras que existen para la formulacion del diagnostico y las metas de la terapia.El objetivo del trabajo es indicar la forma como la TRE enfrenta el problema del diagnostico, la manera como trata la problematica de los clientes, y los aspectos cruciales que se tienen en cuenta en cada etapa

Choroid plexus papilloma: light and electron microscopic study of three cases.

Three cases of choroid plexus papilloma were studied by light and electron microscopy. All had the typical papillary pattern, and, in addition, two exhibited solid areas of tumor growth which predominated in one case. PAS positive (diastase resistant) and argyrophilic cytoplasmic inclusions were present in all three tumors but were particularly abundant in the predominantly solid one. Ultrastructurally, the inclusions appeared as irregularly shaped structures containing lipid droplets, filamentous material and microtubules, and resembled the "silver bodies" of Biondi found in normal choroid plexus. Along with other ultrastructural features of normal choroid plexus, these cytoplasmic inclusions may be helpful in the differential diagnosis of papillary tumors involving the ventricular system.

Primary lymphoma of the breast: ultrastructural study of two cases.

Two cases of primary non-Hodgkin's lymphomas of the breast were studied with light and electron microscopy. By light microscopy, according to Rappaport's classification, one was a poorly differentiated lymphocytic lymphoma, the other a diffuse histiocytic lymphoma. However, the ultrastructural features of the latter were more consistent with transformed lymphocytes. The differential diagnosis with medullary and poorly differentiated carcinomas of the breast is discussed. The first case had rapid dissemination as did most of the cases reported in the literature.