A massive pleural-based tumour: The challenge of diagnosis

AbstractLiposarcomas of the mediastinum and chest wall have been previously described; however, primary pleural liposarcoma is extremely rare.We report an exceedingly rare case of a well-differentiated sclerosing pleural liposarcoma in a 47-year-old male that was resected. We emphasise the importance of careful inspection of the origin of these tumours to allow accurate diagnosis

The effect of macro and micro-nutrient fortification of biscuits on their sensory properties and on hedonic liking of older people

BACKGROUND: Under-nutrition in older adults is widespread. Oral nutritional supplement beverages (ONS) are prescribed, yet consumption by older people is often insufficient. A variety of supplement formats may improve nutrient intake. This study developed protein and micro-nutrient fortified biscuits and evaluated their sensory attributes and liking by older people. Two micro-nutrient strategies were taken, to match typical ONS and to customise to the needs of older people. RESULTS: Oat biscuits and gluten-free biscuits developed contained over 12% protein and over 460 kcal 100 g-1 . Two small (40 g) biscuits developed to match ONS provided approximately 40% of an ONS portion of micro-nutrients and 60% of macro-nutrients; however, the portion size was considered realistic whereas the average ONS portion (200 mL) is excessive. Biscuits developed to the needs of older adults provided, on average, 18% of the reference nutrient intake of targeted micro-nutrients. Sensory characteristics were similar between biscuits with and without micro-nutrient fortification, leading to no differences in liking. Fortified oat biscuits were less liked than commercial oat biscuits, partly attributed to flavour imparted by whey protein fortification. CONCLUSION: Macro- and micro-nutrient fortification of biscuits could provide an alternative fortified snack to help alleviate malnutrition in older adults

PD-L1 testing for lung cancer in the UK: recognizing the challenges for implementation.

A new approach to the management of non-small-cell lung cancer (NSCLC) has recently emerged that works by manipulating the immune checkpoint controlled by programmed death receptor 1 (PD-1) and its ligand programmed death ligand 1 (PD-L1). Several drugs targeting PD-1 (pembrolizumab and nivolumab) or PD-L1 (atezolizumab, durvalumab, and avelumab) have been approved or are in the late stages of development. Inevitably, the introduction of these drugs will put pressure on healthcare systems, and there is a need to stratify patients to identify those who are most likely to benefit from such treatment. There is evidence that responsiveness to PD-1 inhibitors may be predicted by expression of PD-L1 on neoplastic cells. Hence, there is considerable interest in using PD-L1 immunohistochemical staining to guide the use of PD-1-targeted treatments in patients with NSCLC. This article reviews the current knowledge about PD-L1 testing, and identifies current research requirements. Key factors to consider include the source and timing of sample collection, pre-analytical steps (sample tracking, fixation, tissue processing, sectioning, and tissue prioritization), analytical decisions (choice of biomarker assay/kit and automated staining platform, with verification of standardized assays or validation of laboratory-devised techniques, internal and external quality assurance, and audit), and reporting and interpretation of the results. This review addresses the need for integration of PD-L1 immunohistochemistry with other tests as part of locally agreed pathways and protocols. There remain areas of uncertainty, and guidance should be updated regularly as new information becomes available

Elevated P53 expression correlates with a history of heavy smoking in squamous cell carcinoma of the head and neck.

Expression of the tumour suppressor gene p53 was examined in squamous cell carcinoma of the head and neck using two p53 antibodies, PAb 421 and PAb 1801. Elevated p53 expression was found in 67% of the 73 patients investigated. P53 expression was not found to correlate with whether the patient had been previously treated or not, nor any of the clinico-pathological parameters. However a correlation was found between the patients smoking history and positive p53 staining. Six out of seven non-smokers did not express p53 whereas 29 of 37 heavy smokers were found to have elevated p53 expression (P less than 0.005). Also, of a group of ten patients who had given up smoking more than 5 years ago, nine had elevated expression. Epidemiological studies have shown a correlation between heavy smoking and head and neck cancer. The present study indicate a genetic link for this correlation

p53 gene aberrations in non-small-cell lung carcinomas from a smoking population.

We examined 46 non-small-cell lung carcinomas (NSCLCs) for the presence of p53 mutations in exons 4-9, positive p53 immunostaining and loss of heterozygosity (LOH) in the TP53 locus. p53 mutations were detected in 13 tumour samples (28.3%), whereas overexpression of the p53 protein was found in 30 of 45 (67%) samples. Allelic loss was found in 9 of 38 (23.6%) informative cases. The statistical analysis revealed no significant correlation between p53 mutations and clinicopathological data, although mutations appear to occur more frequently in squamous cell carcinomas (7 of 18) than in adenocarcinomas (2 of 15). All but three individuals in this study group smoked. In contrast to previous reports, we found a higher prevalence of GC-->AT transitions than of GC-->TA transversions, as expected in a smoking population. A trend was found between p53-positive immunostaining and a history of heavy smoking (76-126 pack-years) and was inversely correlated with allelic deletion (LOH) at the TP53 locus. Eight of the 12 NSCLCs containing p53 mutations also had concomitant p53 overexpression, and it is of specific note that three of the four tumours containing p53 'mutations' with no overexpression of the p53 protein had either insertions or deletions in the p53 gene. No correlation was found between p53 mutations and fractional allele loss or ras mutations. p53 mutations in this Merseyside population in the UK do not appear to be as common as in other reports for NSCLC and exhibit predominance of GC-->AT transitions preferentially at non-CpG sites, suggesting that other carcinogens in addition to those in tobacco smoke may be involved in NSCLC in the Merseyside area of the UK

Odkrycie i zastosowanie pegwisomantu: antagonisty hormonu wzrostu

Growth hormone (GH) is a well established participant in several complex physiological processes including growth, differentiation, and metabolism. Recombinant human GH is a drug that has been approved for use for several clinical conditions where the action of GH is diminished or completely lacking. Thus there is considerable interest in developing novel drugs that modify the function of GH. Only in the last several decades have the detailed structural features of GH along with its interaction with its receptor been elucidated. In this review we summarise the basic structural and functional properties of GH, its receptor and their interaction. In addition, we discuss the discovery and development of an effective GH receptor antagonist, pegvisomant, and summarise potential therapeutic uses of this drug. (Pol J Endocrinol 2007; 58 (4): 322-329)Hormon wzrostu (GH, growth hormone) uczestniczy w wielu fizjologicznych procesach dotyczących wzrastania, różnicowania i metabolizmu. Leczenie rekombinowanym ludzkim GH jest akceptowane w wielu schorzeniach wiążących się z całkowitym brakiem lub zmniejszeniem działania GH. Wynika stąd znaczne zainteresowanie rozwojem nowych leków mogących modyfikować czynność GH. Dopiero niedawno wyjaśniono dokładną strukturę GH i jego interakcje z receptorem. W niniejszej pracy autorzy podsumowują wiedzę dotyczącą podstawowej budowy GH, jego receptora i interakcji między nimi. Ponadto, omówiono odkrycie i rozwój skutecznego antagonisty receptora GH, pegvisomantu i przedstawiono potencjalne możliwości zastosowania terapeutycznego tego leku

Ageing and taste

Taste perception has been studied frequently in young and older adult groups. This paper systematically reviews these studies to determine the effect of ageing on taste perception and establish the reported extent of sensory decline. Five databases were searched from 1900 to April 2012. Articles relating to healthy ageing in human subjects were included, reviewed and rated (Downs and Black scoring system). Sixty-nine studies investigated the effect of ageing on taste perception; forty examined detection thresholds of which twenty-three provided sufficient data for meta-analysis, eighteen reported identification thresholds and twenty-five considered supra-threshold intensity perception. Researchers investigating detection thresholds considered between one and thirteen taste compounds per paper. Overall, the consensus was that taste detection thresholds increased with age (Hedges' g = 0·91, P < 0·001), across all taste modalities. Identification thresholds were reported to be higher for older adults in seventeen out of eighteen studies. Sixteen out of twenty-five studies reported perception of taste intensity at supra-threshold levels to be significantly lower for older adults. However, six out of nine studies concerning sucrose found perceived intensity of sweet taste not to diminish with age. The findings of this systematic review suggest taste perception declines during the healthy ageing process, although the extent of decline varies between studies. Overall, the studies reviewed had low Downs and Black scores (mean 16 (SD 2)) highlighting the need for more robust large scale and longitudinal studies monitoring the impact of ageing on the sensory system, and how this influences the perception of foods and beverages

Fractional allele loss data indicate distinct genetic populations in the development of non-small-cell lung cancer.

Allelic imbalance or loss of heterozygosity (LOH) has been widely used to assess genetic instability in tumours, and high LOH on chromosome arms 3p, 9p and 17p has been considered to be a common event in non-small-cell lung cancer (NSCLC). We have investigated allelic imbalance in 45 NSCLCs using 92 microsatellite markers on 38 chromosome arms. LOH of 38% was observed on 3p using nine markers, 58% on 9p using 15 markers and 38% on 17p using five markers. Fractional allele loss (FAL) has been calculated for each tumour (FAL is the number of chromosome arms showing LOH/number of informative chromosome arms) and a median FAL value of 0.09 was obtained in the 45 NSCLCs studied. The LOH data were examined on the basis of FAL scores: low FAL (LFAL) (0.00-0.04), medium FAL (MFAL) (0.05-0.13) and high FAL (HFAL) (0.14-0.45) based symmetrically around the median FAL value of 0.09. Tumours with HFAL values showed a very clear polarisation of the LOH data on chromosome arms 3p, 9p and 17p, such that 80% showed loss on 3p, 80% on 9p and 73% on 17p. These incidences of LOH were significantly higher than would be expected, since overall genetic instability in these HFAL tumours ranged from 14% to 45% LOH. Nine of the 14 patients in the LFAL group were found to have no LOH on 3p, 9p or 17p, but five of these had LOH at other sites: i.e. LOH on 5p, 5q, 8p, 13q, 16q and 19q. These results indicate that LFAL patients form a new subset of NSCLC tumours with distinct molecular-initating events, and may represent a discrete genetic population