Rapid intraoperative insulin assay: a novel method to differentiate insulinoma from nesidioblastosis in the pediatric patient

Introduction: Hyperinsulinism is the most common cause of recurrent and persistent hypoglycemia in infancy and childhood. Causes can include nesidioblastosis, pancreatic islet cell tumors such as insulinoma, and associations with multiple endocrine neoplasia syndromes. Although new, improved imaging techniques have allowed for more precise preoperative localization of insulinomas, the differentiation of nesidioblastosis and insulinoma, particularly in children, can be challenging. To improve intraoperative localization and confirmation of successful resection of insulinoma, a novel hormonal assay, the rapid intraoperative insulin assay, is reported for the first time in a pediatric patient. This intraoperative radioimmunoassay for insulin yields results within several minutes and confirms complete resection of insulinoma. Case description: We present a case of pancreatic insulinoma in a child with symptoms of severe hypoglycemia, causing seizures. The insulinoma was enucleated laparoscopically, and rapid intra-operative insulin assay used to determine the success of the procedure. Discussion and evaluation: This rapid intra-operative test provides a valuable adjunct for determining complete excision in complicated cases of recurrent or questionable insulinoma. Although not a common problem, for pediatric patients in whom the diagnosis is not clear, this test may provide a novel approach to confirming disease. Conclusion: We propose the use of this assay in facilitating intra-operative resection and confirmation of complete excision in pediatric patients. This population may especially benefit from this novel assay to confirm complete resection and to differentiate multiple etiologies of hyperinsulinism

SOSORT consensus paper: school screening for scoliosis. Where are we today?

This report is the SOSORT Consensus Paper on School Screening for Scoliosis discussed at the 4th International Conference on Conservative Management of Spinal Deformities, presented by SOSORT, on May 2007. The objectives were numerous, 1) the inclusion of the existing information on the issue, 2) the analysis and discussion of the responses by the meeting attendees to the twenty six questions of the questionnaire, 3) the impact of screening on frequency of surgical treatment and of its discontinuation, 4) the reasons why these programs must be continued, 5) the evolving aim of School Screening for Scoliosis and 6) recommendations for improvement of the procedure

Effect of lipid composition on the toxicity of trichlorobenzene isomers to diatoms. I. Short-term effects of 1,3,5-trichlorobenzene

Cultures of Cyclotella meneghiniana and Melosira varians were split into four flasks. Two flasks of each taxon were used for exposure experiments and two were used as controls. Exposure to 1,3,5-trichlorobenzene was initiated in one flask of each taxon in the 1 lth hour of the light period on a 16:8 h L/D regime. Another exposure was initiated four hours later in the same day (the 15th hour of the light period) in the second experimental flask of each taxon. These experiments were conducted at 15°C and 20°C for 2–4 days and were analyzed for lipid class composition. Cyclotella demonstrated some short-term changes in lipid class composition when exposures were initiated in the 11th hour of the light cycle at 20°C and in both exposures at 15°C. In contrast, short-term effects were only observed in Melosira when the exposure was initiated in the 11th hour of the light period at 20°C. Control cells demonstrated periodicities in lipid composition that appeared to be entrained with the light/dark cycle. The cultures that demonstrated toxicity effects were characterized by low triacylglycerol content, low neutral/polar lipid ratios, and a pattern of chlorophyll synthesis at the time of exposure. It is suggested that rapidly growing cells are more susceptible to short term effects of this trichlorobenzene isomer. Furthermore, timing of the initial exposure may alter toxicity results and this may be a consequence of lipid class composition at the time of exposure.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/48079/1/244_2005_Article_BF01141353.pd

miRNA contents of cerebrospinal fluid extracellular vesicles in glioblastoma patients

INTRODUCTION: Analysis of extracellular vesicles (EVs) derived from plasma or cerebrospinal fluid (CSF) has emerged as a promising biomarker platform for therapeutic monitoring in glioblastoma patients. However, the contents of the various subpopulations of EVs in these clinical specimens remain poorly defined. Here we characterize the relative abundance of miRNA species in EVs derived from the serum and cerebrospinal fluid of glioblastoma patients. METHODS: EVs were isolated from glioblastoma cell lines as well as the plasma and CSF of glioblastoma patients. The microvesicle subpopulation was isolated by pelleting at 10,000×g for 30 min after cellular debris was cleared by a 2,000×g (20 min) spin. The exosome subpopulation was isolated by pelleting the microvesicle supernatant at 120,000×g (120 min). qRT-PCR was performed to examine the distribution of miR-21, miR-103, miR-24, and miR-125. Global miRNA profiling was performed in select glioblastoma CSF samples. RESULTS: In plasma and cell line derived EVs, the relative abundance of miRNAs in exosome and microvesicles were highly variable. In some specimens, the majority of the miRNA species were found in exosomes while in other, they were found in microvesicles. In contrast, CSF exosomes were enriched for miRNAs relative to CSF microvesicles. In CSF, there is an average of one molecule of miRNA per 150-25,000 EVs. CONCLUSION: Most EVs derived from clinical biofluids are devoid of miRNA content. The relative distribution of miRNA species in plasma exosomes or microvesicles is unpredictable. In contrast, CSF exosomes are the major EV compartment that harbor miRNAs