Severe paraneoplastic hypoglycemia in a patient with a gastrointestinal stromal tumor with an exon 9 mutation: a case report

BACKGROUND: Non-islet cell tumor induced hypoglycemia (NICTH) is a very rare phenomenon, but even more so in gastrointestinal stromal tumors. It tends to present in large or metastatic tumors, and can appear at any time in the progression of the disease. We present herein a case of NICTH in a GIST tumor and report an exon 9 mutation associated to it. CASE PRESENTATION: A thirty nine year-old man with a recurrent, metastatic gastrointestinal stromal tumor presented to the hospital with nausea, dizziness, loss of consciousness, and profound hypoglycemia (20 mg/dL). There was no evidence of factitious hypoglycemia. He was stabilized with a continuous glucose infusion and following selective vascular embolization, the patient underwent debulking of a multicentric 40 cm × 25 cm × 10 cm gastrointestinal stromal tumor. After resection, the patient became euglycemic and returned to his normal activities. Tumor analysis confirmed excessive production of insulin-like growth factor II m-RNA and the precursor protein, "big" insulin-like growth factor II. Mutational analysis also identified a rare, 6 bp tandem repeat insert (gcctat) at position 1530 in exon 9 of KIT. CONCLUSION: Optimal management of gastrointestinal stromal tumor-induced hypoglycemia requires a multidisciplinary approach, and surgical debulking is the treatment of choice to obtain immediate symptom relief. Imatinib or combinations of glucocorticoids and growth hormone are alternative palliative strategies for symptomatic hypoglycemia. In addition, mutations in exon 9 of the tyrosine kinase receptor KIT occur in 11–20% of GIST and are often associated with poor patient outcomes. The association of this KIT mutation with non-islet cell tumor induced hypoglycemia has yet to be established

Diagnostic value of copper parameters to predict growth of suckling calves grazing native range in Argentina

A study was conducted to evaluate the predictive diagnostic value of different copper (Cu) parameters as indicators of average daily gain (ADG) in growing calves. The effects in calves of cow Cu supplementation in the last one-third gestation period were also evaluated. Five supplementation trials, with a total of 300 calves, were carried out. Two groups of 30 calves were randomly assigned to each trial, one group was parenterally supplemented (SG) and the other was not supplemented (NSG). Trials began when calves were three-month-old and ended at weaning time. At each sampling calves were weighed and blood was taken to determine Cu concentrations in plasma, Whole Blood (WB), Red Cells (RC) and Packed Cell Volume (PCV). Liver samples from six animals of each group were taken both at the beginning and at the end of the trial. In two trials the mothers of the SG received Cu supplementation at the last one- third gestation period. Four of the five trials exhibited low ADG in the NSGs. In these groups, plasma Cu concentration decreased rapidly before low ADG was detected, which occurred with values remaining below 25µg/dl. The decrease of RC Cu concentration was considerably slow. WB showed an intermediate position. PCV in the SGs was higher than in the NSGs in all trials. Cow supplementation was insufficient to generate a liver storage able to last after calves reached the 3 months of age. These data could be useful to predict the risk of low ADG in grazing calves

Renal cortex copper concentration in acute copper poisoning in calves

The aim of this study was to estimate the diagnostic value of renal cortex copper (Cu) concentration in clinical cases of acute copper poisoning (ACP). A total of 97 calves that died due to subcutaneous copper administration were compiled in eleven farms. At least, one necropsy was conducted on each farm and samples for complementary analysis were taken. The degree of autolysis in each necropsy was evaluated. The cases appeared on extensive grazing calf breeding and intensive feedlot farms, in calves of 60 to 200 kg body weight. Mortality varied from 0.86 to 6.96 %, on the farms studied. The first succumbed calf was found on the farms between 6 and 72 hours after the susbcutaneous Cu administration. As discrepancies regarding the reference value arose, the local value (19.9 parts per million) was used, confirming the diagnosis of acute copper poisoning in 93% of the analyzed kidney samples. These results confirm the value of analysis of the cortical kidney Cu concentration for the diagnosis of acute copper poisoning

Amplitude analysis of the B(s)0→K∗0K‾∗0B^0_{(s)} \to K^{*0} \overline{K}^{*0} decays and measurement of the branching fraction of the B0→K∗0K‾∗0B^0 \to K^{*0} \overline{K}^{*0} decay

International audienceThe ${B}^0\to {K}^{\ast 0}{\overline{K}}^{\ast 0}$ and ${B}_s^0\to {K}^{\ast 0}{\overline{K}}^{\ast 0}$ decays are studied using proton-proton collision data corresponding to an integrated luminosity of 3 fb$^{−1}$. An untagged and timeintegrated amplitude analysis of B_{( s}_{)}^{0}  → (K$^{+}$π$^{−}$)(K$^{−}$π$^{+}$) decays in two-body invariant mass regions of 150 MeV/c$^{2}$ around the K$^{∗0}$ mass is performed. A stronger longitudinal polarisation fraction in the ${B}^0\to {K}^{\ast 0}{\overline{K}}^{\ast 0}$ decay, f$_{L}$ = 0.724 ± 0.051 (stat) ± 0.016 (syst), is observed as compared to f$_{L}$ = 0.240 ± 0.031 (stat) ± 0.025 (syst) in the ${B}_s^0\to {K}^{\ast 0}{\overline{K}}^{\ast 0}$ decay. The ratio of branching fractions of the two decays is measured and used to determine $\mathrm{\mathcal{B}}\left({B}^0\to {K}^{\ast 0}{\overline{K}}^{\ast 0}\right)=\left(8.0\pm 0.9\left(\mathrm{stat}\right)\pm 0.4\left(\mathrm{syst}\right)\right)\times {10}^{-7}$

Measurement of CPCP-violating and mixing-induced observables in Bs0→ϕγB_s^0 \to \phi\gamma decays

International audienceA time-dependent analysis of the Bs0→ϕγ decay rate is performed to determine the CP -violating observables Sϕγ and Cϕγ and the mixing-induced observable AϕγΔ. The measurement is based on a sample of pp collision data recorded with the LHCb detector, corresponding to an integrated luminosity of 3  fb-1 at center-of-mass energies of 7 and 8 TeV. The measured values are Sϕγ=0.43±0.30±0.11, Cϕγ=0.11±0.29±0.11, and AϕγΔ=-0.67-0.41+0.37±0.17, where the first uncertainty is statistical and the second systematic. This is the first measurement of the observables S and C in radiative Bs0 decays. The results are consistent with the standard model predictions