A case of primary renal angiosarcoma

A 78-year old man was diagnosed with a left bleeding renal cyst from CT scan results. Serial CT scans revealed the left kidney mass to be increasing in size and a new lesion in the liver. Renal cell carcinoma with liver metastasis was diagnosed and a radical nephrectomy performed. The initial pathological diagnosis was a benign chronic hematoma. However, the liver mass increased in size and multiplied, while another mass emerged in the twelfth thoracic vertebra with spinal paralysis and was immediately removed. Pathological findings for that specimen showed malignancy of stromal cell origin but low atypia. The renal specimen was re-evaluated using whole cross-section analysis and immunohistochemistry, and diagnosed as a primary renal angiosarcoma. Recombinant interleukin-2 therapy was started immediately; however, the patient died of metastatic disease 13 months after the initial operation. Although contrast imaging depicted the primary lesion as a non-specific hematoma with little focal pooling, and low-grade cytological atypia was shown pathologically, the angiosarcoma was extremely aggressive

Medium and long-term adherence to postabortion contraception among women having experienced unsafe abortion in Dar es Salaam, Tanzania

<p>Abstract</p> <p>Background</p> <p>Postabortion contraceptive service is considered an effective means in addressing the problem of unsafe abortion; in spite this fact this component remains one of the weakest parts of postabortion care. In this context, the paper aims to describe the impact of a postabortion contraceptive service intervention among women admitted with complications from unsafe abortions and to explore the women's long-term contraceptive adherence.</p> <p>Methods</p> <p>392 women having experienced unsafe abortion were identified by an empathetic approach and offered postabortion contraceptive service, which included counselling on HIV and condom use. Questionnaire interviews about contraceptive use were conducted at the time of inclusion and 12 months after the abortion. Additionally, in-depth interviews were performed 6–12 months after the abortion.</p> <p>Results</p> <p>Eighty-nine percent of the women accepted postabortion contraception. Follow-up information was obtained 12 months after the abortion among 59 percent of the women. Among these, 79 percent of the married women and 84 percent of the single women stated they were using contraception at 12 months. Condom use among the single women increased significantly during the 12 months follow up.</p> <p>Conclusion</p> <p>Postabortion contraceptive services appear to be well accepted by women who are admitted with complications after an unsafe abortion and should thus be recognized as an important means in addressing the problem of unsafe abortion. In addition, counselling about HIV and condom use should be considered an essential aspect of postabortion care.</p

Synchronization in G0/G1 enhances the mitogenic response of cells overexpressing the human insulin receptor A isoform to insulin

Evaluating mitogenic signaling specifically through the human insulin receptor (IR) is relevant for the preclinical safety assessment of developmental insulin analogs. It is known that overexpression of IR sensitizes cells to the mitogenic effects of insulin, but it is essentially unknown how mitogenic responses can be optimized to allow practical use of such recombinant cell lines for preclinical safety testing. We constitutively overexpressed the short isoform of the human insulin receptor (hIR-A, exon 11-negative) in L6 rat skeletal myoblasts. Because the mitogenic effect of growth factors such as insulin is expected to act in G0/G1, promoting S-phase entry, we developed a combined topoinhibition + serum deprivation strategy to explore the effect of G0/G1 synchronization as an independent parameter in the context of serum deprivation, the latter being routinely used to reduce background in mitogenicity assays. G0/G1 synchronization significantly improved the mitogenic responses of L6-hIR cells to insulin, measured by 3H-thymidine incorporation. Comparison with the parental L6 cells using phospho-mitogen-activated protein kinase, phospho-AKT, as well as 3H-thymidine incorporation end points supported that the majority of the mitogenic effect of insulin in L6-hIR cells was mediated by the overexpressed hIR-A. Using the optimized L6-hIR assay, we found that the X-10 insulin analog was more mitogenic than native human insulin, supporting that X-10 exhibits increased mitogenic signaling through the hIR-A. In summary, this study provides the first demonstration that serum deprivation may not be sufficient, and G0/G1 synchronization may be required to obtain optimal responsiveness of hIR-overexpressing cell lines for preclinical safety testing

Abstract P6-01-01: Risk of Invasive Breast Cancer and Ductal Carcinoma In-Situ in Women with Atypical Papillary Lesions of the Breast

Abstract Background: Benign papillary lesions of the breast including papilloma and papillomatosis are believed to be associated with a low risk of developing breast cancer. The risk of breast cancer development in patients who have an atypical papilloma or who have a papilloma in conjunction with atypical hyperplasia is not well defined. Methods: All patients who underwent a biopsy at Duke University Medical Center between October 1992 and December 2009 for a papillary lesion of the breast were identified. Patients were excluded if they had a previous or concurrent diagnosis of invasive or in-situ malignancy or less than 6 months of follow up. The remaining patients were analyzed to determine the risk of developing breast cancer. Results: Median follow up for the 167 patients with a papillary lesion of the breast included in the analysis was 4.6 years. 51 patients had an atypical papillary lesion. 111 patients had atypical hyperplasia in conjunction with a papilloma. 35 patients had a papilloma without atypia or atypical hyperplasia. Patients with an atypical papilloma were more likely to develop an invasive or in-situ breast cancer with a 5 year actuarial risk of 13.0% (24 patients at risk) versus 4.6% (49 patients at risk) (p=0.03). Patients who had atypical hyperplasia in conjunction with a papilloma were also more likely to develop invasive or in-situ breast cancer with a 5 year actuarial risk of 9.8% (48 patients at risk) versus 0% (15 patients at risk) (p=0.05). In the group with an atypical papillary lesion, the actuarial risk of ipsilateral breast cancer or DCIS development was 8.2% at 5 years (24 patients at risk) and 21.1% at 10 years (12 patients at risk). In the group with atypical hyperplasia in conjunction with a papilloma, the actuarial risk of ipsilateral breast cancer development was 3.9% at 5 years (48 patients at risk) and 8.5% at 10 years (18 patients at risk). The majority of patients underwent an excisional biopsy for their papilloma (150 patients). Patients who had a core needle biopsy alone had a 5 year actuarial risk of ipsilateral breast cancer or DCIS of 15.3% versus 2.0% for patients who had an excisional biopsy (p=0.03). All of the patients who had only a core biopsy and later developed an ipsilateral cancer or in-situ disease had an atypical papilloma. Discussion: Papillary lesions of the breast with atypical features may be associated with an increased risk of breast cancer and DCIS. Atypical papillary lesions should be fully excised or followed closely. Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P6-01-01.</jats:p