Mixed Epithelial and Stromal Tumor of the Kidney: a Case Report

Introduction: Mixed epithelial and stromal tumor (MEST) of the renal pelvis, also known in the past as cystic hamartoma is a rare benign tumor, recently recognized as a distinct clinical and pathological entity. This complex neoplasm is composed of a mixture of stromal and epithelial elements. Women are more often involved (ratio of women to men 6:1), especially perimenopausal women. It was originally described in 1973 by Block as a congenital mesoblastic nephroma. The term MEST was credited to Michal and Syrucek in 1998.Methods and Materials: A 54-year-old woman underwent laparotomy because of pheochromocytoma. In addition, another tumor was found in the left kidney - a partly cystic and partly solid mass in the renal pelvis, so left-sided  nephrectomy was carried out.Results: Macroscopically, the lesion in the renal pelvis had an oval form, measuring 15/8 cm, well circumscribed from the surrounding parenchyma, and with fatty tissue at the periphery; the cut surface revealed multiple cysts of varying size, showing papillary projections on the inner side. On histological examination, a well-delineated tumor was seen, composed of cysts of varying size lined by columnar and cuboidal epithelium. Surrounding stroma showed a mixture of an ovarian type of stroma and eosinophilic loci resembling white bodies and a lot of calcifications.Conclusion: Only about 200 cases of MEST have been described in the literature. Mixed epithelial and stromal tumor of the kidney usually presents in perimenopausal women as a partially cystic mass, and its growth may be influenced by hormones. In the literature, there is no other description of coexisting  MEST and pheochromocytoma

Development of Chronic Traumatic Encephalopathy in Athletes after Repetitive Head Injury

Introduction: Chronic traumatic encephalopathy is a state presenting with cognitive, behavioral, or motor abnormalities in athletes, especially within the boxing community and used to be referred to by various terms, such as `punch drunk,` `goofy,` and `slug-nutty`. Later, a more formal term was introduced bearing more medical validity - dementia pugilistica. By the end of the XX century it was concluded that this form of neurodegenerative disease was in fact similar to and yet different from other cases of neurodegeneration. As more evidence came forward about this condition a term coined by Miller became most widely used - chronic traumatic encephalopathy (CTE). The issue received more attention thanks to Omalu`s research.Materials and Methods: This review summarizes data from recent studies, findings and records in the literature on sport-related concussion in a significant number of cases of neuropathologically verified CTE and the detailed findings of CTE in 3 professional athletes, 1 football player and 2 boxers.Results: The clinical picture of CTE is associated with behavioral and personality changes, loss of attention and concentration, short-term memory loss, parkinsonism, and speech and gait abnormalities. Microscopically, CTE can be described as a tauopathy with preferential involvement of the superficial cortical layers, irregular patchy distribution in the frontal and temporal cortices, propensity for sulcal depths, prominent perivascular, periventricular, and subpial distribution, and marked accumulation of tau-immunoreactive astrocytes. Deposition of A-amyloid, most commonly as diffuse plaques, occurs in fewer than half of the cases.Conclusion: Chronic traumatic encephalopathy is a neuropathologically distinct slowly progressive tauopathy with a clear environmental etiology which suggests a significant public health risk for persons who suffer repetitive mild traumatic brain injuries (TBIs). Early identification and prevention of this disease has become a critical focus of current studies

Anticancer potential of artemisia annua

Introduction: Cancer is one of the major challenges of medicine. Chemotherapy, surgery, radiother­apy are available treatment methods, but in many cases have limited efficacy. In recent years, the po­tential anticancerogenic effects of some plants have been investigated. One of these plants is Artemis­ia annua (AA) - sweet Wormwood. Its main chemical component is artemisinin.Materials and methods: The aim of this article is a discussion of molecular mechanisms of antican­cer effects of artemisinin. A documentary approach is used. A literature analysis of articles, available in Pubmed and ClinicalKey is presented. The keywords used for collecting of data were: `artemis­inin cancer` (5 articles); `artemisinin mechanism of action`(3 articles) and `artemisinin breast can­cer` (4 articles).Results: Pharmacochemical investigations claim that the potential anticancer mechanisms of arte­misinin are: endoperoxide moiety (the peroxide bridge of artemisinin can react with the ferrous atom and produce free oxygen radicals that leads to Deoxyribonucleic acid (DNA) damage in tumor cells); cell cycle arrest (inhibition of cyclins and cyclin-dependent kinases (CDKs)), resulting in arrest of cancer cell in Growth2 phase/Metaphase); stimulating apoptosis and autophagy (promoting the re­lease of cytochrome 3 and the overexpression of proapoptotic gene B-cell-lymphoma-associated-X-protein(BAX)) , but also by activating caspase-3 and caspase-9) and anti-metastatic activity (reduc­ing angiogenesis growth factors like vascular endothelial growth factor). In vivo studies by rats with breast cancer (BC) show that following an application of artemisinin there is impressive decrease in tumor cell volume. In vitro studies with adenocarcinoma cell line implanted rat mammary glands present that artemisinin significantly retards the growth of tumor cells.Conclusion: In the future, after further investigation of its mechanisms of actions, safety and effi­ciency artemisinin and its derivatives could be a new class of anticancer agents as up-to-date there are randomized trials for colon cancer (Artesunate), acute myeloid leukemia (Artesunate+Dihydroar temisinin+Cytarabine) and BC

OUTBREAK OF ZIKA VIRUS DISEASE AND ITS COMPLICATIONS

Zika virus (ZIKV) is an arbovirus from Flaviviridae family, genus Flavivirus. Like most of the viruses which belong to the Flavivirus genus, it replicates in and is transmitted by mosquitoes. Unlike other arbovirus infections including dengue and chikungunya, Zika virus causes a relatively mild disease. The most common symptoms of ZIKV are mild fever, arthralgia, myalgia, headache, asthenia, abdominal pain, oedema, lymphadenopathy, retro-orbital pain, conjunctivitis, and cutaneous maculopapular rash, which last for several days to a week. Although 80% of the cases with ZIKV are asymptomatic, severe complications such as microcephalia and GBS may be observed. This explains why ZIKV is more dangerous that it was thought to be and why it rapidly evolves in unexpected challenge for the international and national public health authorities