Spontaneous recovery of bone mass after cure of endogenous hypercortisolism

Patients with Cushing's syndrome (CS) develop osteopenia-osteoporosis. The present study evaluates the recovery of bone mass within 2 years after remission of hypercortisolism and in long term follow up, an issue rarely addressed. Twenty patients (6M, 14F, 3 post-menopausal, 15-64 years old), 15 with Cushing's disease, 2 with ectopic ACTH syndrome, 3 with ACTH-independent CS were studied. BMD, T and Z scores at lumbar spine and proximal femur were assessed by dual-energy X-ray absorptiometry before and 7-33 months after treatment of hypercortisolism. Five patients were treated with bisphosphonates. Four patients had hypogonadism and 4 GH-deficiency. At baseline all patients showed osteopenia/osteoporosis and the spine appeared more damaged than the femur; femur BMD was positively related with body mass index (BMI). No correlations were observed between spine and femur bone parameters and duration of disease or severity of hypercortisolism. Bone parameters did not differ in patients with or without GH or other pituitary deficiencies. After cure of hypercortisolism a significant improvement in spine BMD, Z and T scores and in femur Z and T scores was observed with normalization in 3 patients; there was no significant difference in percent improvement between femur and spine. The increase in bone parameters at spine and femur was independent from values at baseline. The percent increase in spine T and Z scores was positively related with time elapsed since cure. Bisphosphonates did not influence the recovery of bone mineralization. In long term follow up, after a median period of 7 years a further improvement in bone density was observed in 100% of patients at spine and in 9/11 at femur, although 8/11 patients still had femoral and/or vertebral T score in the range of osteopenia/osteoporosis. Spontaneous improvement of osteoporosis after cure of hypercortisolism occurs both at spine and femur, is independent from basal conditions and not affected by bisphosphonates. The improvement at spine depends on time since cure

A Computerized, Operator-Independent Morphometric Model for the Histological Assessment of Adrenal Neoplasia: Preliminary Data

Specific biomarkers for diagnosis and prognosis of adrenocortical carcinomas (ACCs) are still lacking.(1) The proliferation marker Ki-67 is under evaluation for validation as a reliable IHC marker of malignancy for ACCs.(2) Although a well defined diagnostic cutoff has not been demonstrated yet, Ki-67 staining between 5-7% is thought to be a feature of AT malignant behavior.(3) As for the morphological markers currently used in the determination of AT malignancy, also for Ki-67 an interobserver variability is frequently reported. The aim of this pilot study was to determine, with an operator independent and repeatable technique, the proliferative activity and cell morphology of AT histological samples; a preliminary comparison with visual perception was also attempted. METHODS IHC study of 14 ACCs and 7 adrenal adenomas (AAs) samples was done (Rabbit anti-human Ki-67 monoclonal Ab, Clone SP6, 1:400); two pathologists performed a blinded examination with a consensus determination and according to Weiss score. We generated a computerized morphometric model on AT slices to evaluate the volume fractions occupied by nuclei (nVF) and cytoplasm (cVF) of both Ki-67(+)/Ki-67(-) neoplastic cells, and by inflammatory infiltrate. All morphometric variables were obtained by a computerized image analyzer (Kontron-Zeiss KS400) with a color camera attached to a light microscope (40x objective) for microscopic fields examination. More than 200 fields were systematically selected and examined by an automatically controlled procedure to assure unbiased sampling. The method of point counting by using a counting frame was used to determine the relative volume proportion of the investigated structures. Statistics: t-test. RESULTS nVF (p<0.0001), cVF (p<0.0001), nuclear/cytoplasmic ratio (p<0.0001) were the most discriminatory features between ACCs/AAs. Moreover nVF of Ki-67(+) cells was more prominent in ACCs than in AAs (p<0.0001) but in some cases an overlapping was still evident. When compared with computerized analysis, Ki-67 pathologist's evaluation in ACCs showed a marked overestimation and a wide range (average of 9,9% vs 1,4%, range 1-25 % and 0,2-4,2% respectively; p=0,00036). CONCLUSIONS Based on these preliminary data our computerized morphometric method could be considered in the future as an helpful tool for pathologists in the histological assessment of ACCs/AAs, particularly minimizing subjectivity and possibly integrating the actual morphologic Weiss criteria

Ilusões de modernidade: o fetiche da marca McDonald's no Brasil Illusions of modernity: the fetish of McDonald's' brand in Brazil

Objetiva-se apresentar e discutir as relações atuais entre imagem e entretenimento a partir de pesquisas realizadas sobre a construção da imagem de marca McDonald's e sobre as modernas técnicas de marketing. Visando compreender porque nos tornamos consumidores de imagens, procurou-se recuperar, a partir da própria historia do McDonald's, os acontecimentos econômicos, sociais, culturais, políticos, que teriam nos transformado em uma sociedade na qual "estar na imagem é existir". Embora trágica em seu sentido de fundo, essa perda da forma nos é compensada por imagens de diversão e felicidade que as marcas nos transmitem. Ao final, questiona-se o alcance global dessa promessa a partir de uma digressão sobre o Brasil: como a marca McDonald's nos fornece as imagens para uma certa constituição identitária; e o seu nome para um sentimento de permanência? Como falar de "identificação" com uma marca que, aparentemente, não teria uma relação histórica e cultural com o Brasil?<br>This article presents and discusses the current relationship between image and entertainment, based on the results of research studies on the constitution of McDonald's' brand image all over the world and contemporary marketing. Aiming to understand why we have become image consumers, those studies tried to recover, based on McDonald's history, economical, social, cultural, and political events that have lead us towards an obsessed image society, in which, "being in the image is the same as existing". Although tragic in its bottom line, that inexistence of form is compensated to us by amusement and happiness images conveyed by the brands. Finally, the research questions the global reach of that promise, starting from a digression on Brazil: how does McDonald's' brand supply us images for a certain identity constitution; and its brand name for a permanence feeling? How is it possible to speak of "identification" with a brand that, seemingly, would not have a historical and cultural relationship with Brazil

PAST VARIATIONS OF WATER LEVEL OF JEZERO PALEOLAKE

International audienceThe western fan of Jezero crater displays features interpreted as fluvial and deltaic sedimentary rocks from orbital data [1,2]. Images obtained using the SuperCam Remote Micro-Imager (RMI) and the Mastcam-Z camera provide in-situ observations of Jezero crater’s western fan in various locations along the Perseverance traverse. In the last two years, the rover analyzed the fan front from a distance using these imaging tools and at close range using its entire payload. Then, in 2023, the Perseverance rover explored the top of the western Jezero sedimentary fan. Here we show that fluvial topsets and deltaic foresets dominate sedimentary rocks. Determining the boundary between fluvial and prodelta deposits enables us to draw the evolution of the lake level through time

Landscape evolution on early Mars: insights from the Jezero western fan

International audienceThe modern surface of Mars does not sustain liquid water, however relict landforms observed onorbital images provide strong evidence of past aqueous activity. Nevertheless on-the-groundanalysis of sedimentary strata are required to robustly characterise the specific nature of early Marspalaeoenvironments. The Mars 2020 Perseverance rover is exploring a prominent sedimentary fandeposit at the western margin of Jezero crater – the Western fan – which has been interpreted to bean river delta that prograded into an ancient lake basin during the Late Noachian-Early Hesperianepochs on Mars (~3.6-3.8 Ga). Perseverance’s traverse across the fan in 2022-2023 provides aremarkable window into a fossilised sediment routing system on Mars with potential to understandhow water and sediment were distributed across a Martian landscape under a markedly differentclimate to present day. Here we use the rover’s cameras to characterise sedimentary geometries ina distal to proximal transect across the western fan and reconstruct sediment dynamics on theWestern fan and infer past environmental change. The distal reaches of the preserved fan show asedimentary succession that records a transition from distal alluvial fan into lacustrine andsubsequently foreset delta deposits. This succession records the initiation of a martian lake systemand lake level rise, though overlying delta stratal geometries suggest deposition during episodes oflake level fall. In the medial sector of the upper exhumed portion of the fan, complex stratalgeometries are observed with a variety of scenarios for palaeoenvironmental interactions possible.In particular, the presence of large-scale foreset units preserved in this ‘mid-fan’ sector possiblysuggests complex deltaic interfingering with fluvial strata during lake level fluctuations. In moreproximal and stratigraphically higher (and hence younger) sectors of the fan, we observe stratadeposited by progradation of fluvial systems culminating in a sequence of rounded bouldercontainingdeposits that signal transition to a routing system characterised by high discharges.Misquoting Shakira “the sediments don’t lie”; they record a history of sustained water transport andhabitability on early Mars

PAST VARIATIONS OF WATER LEVEL OF JEZERO PALEOLAKE

International audienceThe western fan of Jezero crater displays features interpreted as fluvial and deltaic sedimentary rocks from orbital data [1,2]. Images obtained using the SuperCam Remote Micro-Imager (RMI) and the Mastcam-Z camera provide in-situ observations of Jezero crater’s western fan in various locations along the Perseverance traverse. In the last two years, the rover analyzed the fan front from a distance using these imaging tools and at close range using its entire payload. Then, in 2023, the Perseverance rover explored the top of the western Jezero sedimentary fan. Here we show that fluvial topsets and deltaic foresets dominate sedimentary rocks. Determining the boundary between fluvial and prodelta deposits enables us to draw the evolution of the lake level through time