Identification of the putative ancestral allele of bovine single-nucleotide polymorphisms

Identifying the action of natural selection from patterns of standing genetic variation has long been of interest to the population genetic community. Thanks to the availability of large single-nucleotide polymorphism (SNP) data sets for many species and of high-throughput SNP genotyping methods, whole-genomic surveys to detect selective sweeps are now possible. Knowing the ancestral allele increases the power to detect selection. We present here a comparative genomic approach to determine the putative ancestral allele of bovine SNPs deposited in public databases. We analysed 19,551,488 SNPs and identified the putative ancestral allele for 14,339,107 SNPs. Our predicted ancestral alleles were in agreement with ancestral alleles detected by genotyping outgroup species for 97% SNPs from the BovineSNP50 BeadChip. This comparison indicates that our comparative genomic-based approach to identify putative ancestral alleles is reliable.

Variants of renal angiomyolipoma closely simulating renal cell carcinoma: difficulties in the histological diagnosis

Renal angiomyolipoma is considered to be a benign renal tumor composed of atypical blood vessels, smooth muscles and fat cells. We report 2 cases of unilateral renal angiomyolipoma. In both cases, our preoperative diagnosis was renal cell carcinoma, because no low density area compatible with fat tissue was noted in the tumors on radiographic evaluation. Through histological examination, both tumors proved to be angiomyolipomas mainly composed of epithelioid cells in 1 case, and spindle-shaped smooth muscle cells mimicking a leiomyoma in the other case. Both patients are well showing no evidence of metastases 16 and 14 months after nephrectomy, respectively.

[Erdheim-Chester disease. Apropos of a case with autopsy findings]

Erdheim-Chester's Disease is a very uncommon variety of non-Langerhans histiocytosis of unknown etiology, which characteristically affects long bones bilaterally and symmetrically in adults. It may be accompanied by visceral foci of variable localization and extension determining prognosis. Bone scintigraphy is characteristic enough to evoke the disease but histologic examination of a peripheral specimen is required to confirm the diagnosis: spumous histiocytes CD68+, PS100+/-, CD1a-. We describe a case revealed by a severe lung disease with detailed autopsy.

Influence of cigarette smoking on P53 gene mutations in bladder carcinomas

BACKGROUND

The aim of this study was to analyse the influence of cigarette smoking on bladder carcinomas.

PATIENTS AND METHODS

98 cases of bladder cancers were examined by single strand conformation polymorphism analysis of exons 5 to 9, followed by DNA direct sequencing.

RESULTS

The incidence of p53 gene mutations was not significantly influenced by habitual smoking. However, the p53 mutation spectrum of current smokers differed significantly from the pattern for non-smokers and ex-smokers. Differences between the two populations included multiple mutations in the current-smokers and an absence in non- and ex-smokers (p<0.01), with the predominance of G:C to A:T transitions at CpG sites in non-smokers (60.0%) in comparison with current smokers (7.6%) (p<0.02). Moreover, G:C to T:A and G:C to C:G transversions were found solely in current smokers.

CONCLUSION

It would appear that, in current-smokers, the spectrum of p53 gene mutations is related to tobacco-smoke carcinogens and that the habit of smoking increases the extent of DNA damage.

[Uretero-vesical implantation after failure of endoscopic treatment of reflux: anatomical and histological study of 61 resection specimens from 40 children]

OBJECTIVE

To evaluate the anatomy and histology of the ureterovesical junction resected during secondary surgical reimplantation for persistent reflux after failure of initial endoscopic treatment by polytetrafluoroethylene (Teflon) in 27 cases and polydimethylsiloxane (Macroplastique) in 13 cases.

MATERIAL AND METHOD

61 ureterovesical junctions from 40 children were studied histologically. The mean age of the patients at the time of the operation was 4.1 years (range: 1 to 15 years). The mean interval between endoscopic injection and surgical reimplantation was 15.3 months (range: 2 to 54 months).

RESULTS

Persistent reflux was not correlated with the anatomical situation of the implant, which was found to be in a satisfactory position in 52.4% of cases. Both of the substances used induced a giant-cell macrophage reaction which colonized the implant and triggered new vessel formation. Macroplastique appeared to be associated with a more intense inflammatory reaction than Teflon. Despite the difference in particle size, the two substances induced a macrophage phenomenon characterized by microfragmentation into 6 micron particles. No conclusions can be drawn concerning distant migration, but this study showed rarefaction of particles which were replaced by fibrosis, the density of which was correlated with the age of the implant.

CONCLUSION

Extinction of the local reaction induced by the products used in this study appears to be long and the end of this process is unknown, which justifies prolonged surveillance of children treated for reflux by endoscopic submeatal injection.

The predictive value of muscularis mucosae invasion and p53 over expression on progression of stage T1 bladder carcinoma

PURPOSE

We determine the significance of muscularis mucosae invasion and nuclear p53 over expression on the progression of stage T1 transitional cell bladder cancer.

MATERIALS AND METHODS

The pathological findings in 149 cases of T1 tumors diagnosed between 1973 and 1996 were reviewed. Diagnosis was stage T1 in 94 tumors in which the muscular layer was clearly identifiable and disease-free. Mean followup was 64.9 months (range 5 to 288). T1 bladder cancers were subclassified into 2 groups, with (T1b) or without (T1a) muscularis mucosae invasion. The p53 nuclear antibody immunoreactivity was determined with antibody D07 and a cutoff point at 15%.

RESULTS

T1 subclassification was possible in all 94 patients. Of all tumors 37.2% expressed p53 nuclear over expression. Univariate statistical analysis showed that p53 expression (p <0.05) and tumor invasion depth (p <0.001) significantly correlated with progression. However, on multivariate analysis only invasion depth (p <0.0001) and associated carcinoma in situ (p <0.03) remained independently significant as predictors of progression.

CONCLUSIONS

In our study the depth of tumor invasion was a significant independent predictor of progression in patients with T1 bladder cancer. This result suggests that the depth of invasion in stage T1 should be included in the histopathological report.

[Unusual variety of bladder urothelial carcinoma: "nest type" microlobular carcinoma: report of an anatomoclinical case and review of the literature]

We report a case of nested cell carcinoma, an uncommon transitional tumor. These tumors are composed of regular cuboidal transitional cells forming small nests with minimal cytologic atypia. Despite the benign course, this tumor resembling proliferation of Brunn's nests or inverted papilloma, must be considered as an aggressive transitional tumor. Thus, morphologic criteria are needed to make the diagnosis. Because of its aggressive behaviour, the surgical therapy depends on the tumor's infiltration.

[Protocol for the pathologic examination of cystectomy and cystoprostatectomy specimens. Proposal for a standardized form]

We present practice guidelines for the examination of bladder specimens removed for bladder cancer and propose an example of standardized form for their reporting. This approach takes place in looking for better quality and facilitates use of the morphologic data.

Immunohistochemical detection of p53 protein overexpression versus gene sequencing in urinary bladder carcinomas

PURPOSE

Mutations of p53 tumor suppressor gene and nuclear accumulation of p53 protein are common in bladder tumors. The prognostic significance of p53 alterations in bladder tumors has not been established. The aim of the present study was to evaluate an immunohistochemical (IHC) method for the routine determination of p53 protein overexpression in human bladder tumors and to determine the relation between nuclear accumulation of p53 with the traditional prognostic indicators and patient survival.

MATERIALS AND METHODS

104 transitional cell carcinomas of the bladder were analyzed simultaneously by immunohistochemistry for p53 protein overexpression and direct DNA sequencing for p53 gene mutations.

RESULTS

The overexpression of p53 protein was reported in 30.8% of the cases and mutations of p53 gene in 23.0%. A significant association was observed between p53 alterations established either by IHC or direct DNA sequencing and stage (p<0.0001), grade (p<0.001), vascular invasion (p = 0.0005), DNA ploidy (p = 0.0002) and carcinoma in situ (p<0.0001). The correlation between the p53 gene mutations and p53 nuclear reactivity as detected by IHC was highly significant (p<0.0001). Univariate statistical analysis showed that the expression of p53 was significantly correlated to poor prognosis (p<0.0001). However, in multivariate analysis, only stage was significantly correlated to prognosis (p<0.0001).

CONCLUSIONS

The IHC method was highly sensitive and specific and simple to apply for the routine examination of p53 overexpression in bladder tumors. However, overexpression of p53 as determined immunohistochemically, does not appear to have a better predictive prognostic value than stage in bladder tumors.

[Epididymal cysts in adolescents]

Epididymal tumours are uncommon in children and adolescents and are usually benign. Epididymal cyst is exceptionally reported in the literature, although it is certainly underdiagnosed. The authors report 3 cases of epididymal cyst in 3 children, 12, 14 and 16 years of age. These children presented with an uncomfortable scrotal mass and were treated by excision of the cyst in every case. The aetiology of epididymal cysts is unclear. It is probably a congenital abnormality related to hormonal disorders during embryonic life. Physical examination is very important, but not sufficient for the diagnosis and must be completed by scrotal ultrasonography, which shows an echo-free cystic epididymal structure. Despite ultrasonography, the differential diagnosis of other scrotal cystic masses and even some solid epididymal tumours, which may present all of the sonographic characteristics of a cyst, must be considered. The treatment of symptomatic epididymal cyst in children must be surgical. For asymptomatic cysts diagnosed by sonography, clinical follow-up to document stability of the mass is justified.

Fibrinogen A alpha chain mutation (Arg554 Leu) associated with hereditary renal amyloidosis in a French family

A French family with hereditary renal amyloidosis (HRA) was studied. The disease presented in 7 of the 8 affected individuals with proteinuria or the nephrotic syndrome. The age of onset was in the fifth decade of life. There is currently no sign of extrarenal involvement in any affected individual. However, the nephropathy in this family is progressive and led to terminal renal failure in 4 patients. Immunohistochemistry studies of glomerular amyloid deposits suggested that the amyloid protein was the fibrinogen A alpha chain. Direct DNA sequencing revealed a G 4993 T transversion and subsequently Arg 554 Leu mutation in the fibrinogen A alpha chain. This is the first description of this fibrinogen A alpha chain mutation in Europe. This family is of French descent and cannot be related to the previously reported Peruvian/Mexican and African-American kindreds.

Mycophenolate mofetil in renal transplant recipients with cyclosporine-associated nephrotoxicity: a preliminary report

BACKGROUND

There is a great concern over cyclosporine (CsA) nephrotoxicity in renal transplant recipients, and the effects of conversion from CsA to azathioprine (AZA) remain controversial. Large studies have demonstrated that mycophenolate mofetil (MMF), the morpholinoethyl ester of mycophenolic acid, is superior to AZA as a posttransplant immunosuppressant.

METHODS

Six patients with isolated biopsy-proven CsA nephrotoxicity were converted from CsA-AZA to MMF.

RESULTS

Mean follow-up was 12+/-2 months. No patient experienced acute rejection. The mean serum creatinine concentration decreased from 225+/-58 to 159+/-66 micromol/L (P<0.0005). Hyperlipidemia and blood pressure improved after CsA withdrawal.

CONCLUSION

In a selected transplant population with biopsy-proven CsA nephrotoxicity, CsA withdrawal with a concomitant switch from AZA to MMF seems to be safe and allows a significant improvement of renal function.

Metanephric adenoma of the kidney. A clinicopathologic, immunohistochemical and electron microscopic study of two cases

We report two cases of metanephric adenoma in 40 and 48 year-old women. These rare kidney tumors were composed of cuboidal epithelial cells forming tubules, glomeruloid structures and sheets. Ultrastructural and immunohistochemical studies revealed that the tumor cells are similar to epithelial cells of developing nephrons. These features differentiate the metanephric adenoma from tubulo-papillary renal carcinoma, nephroblastoma, and cortical adenoma. According to its invariably benign course, the metanephric adenoma treatment could be restricted to a simple tumorectomy.

A genotype study of the c-Ha-ras-1 locus in human bladder tumors

PURPOSE

To clarify the role of the c-Ha-ras-1 gene in bladder cancer predisposition and prognosis.

MATERIALS AND METHODS

The c-Ha-ras-1 locus was studied by Southern blotting in white blood cells and tumor samples obtained from 126 patients with bladder cancer (74 Ta-T1 and 52 T2-T4). A comparison with 84 unaffected patients and a survival analysis were performed.

RESULTS

The patients with bladder cancer presented 7 different c-Ha-ras-1 alleles, 12 different genotypes, heterozygosity in 49% of cases and a loss of heterozygosity (in the tumor) in 13 cases. The most frequent allele (a1, 6.6 kb) was present in 83% of patients. Heterozygosity correlated with vascular invasion in the tumor (p < 0.0001). In the small subgroup of 11 patients with rare alleles and genotypes, these alleles and genotypes occurred more often in patients with T2-T4 tumors (p < 0.01 for alleles and genotypes), aneuploid tumors (p < 0.001, p < 0.005) and tumors with vascular invasion (p < 0.01, p < 0.005). However, in this study, the majority of patients with high risk tumors possessed common alleles and genotypes. Survival analysis showed that neither the c-Ha-ras-1 genotype nor allelomorphism was an independent prognostic factor. Elsewhere, no rare allele occurred more frequently in bladder cancer affected patients than in unaffected patients.

CONCLUSION

This study confirms c-Ha-ras-1 gene polymorphism in a bladder cancer affected population and, in some cases, a loss of genetic material in the vicinity of this locus. No specific genotype can be implicated in the predisposition to bladder carcinoma, and c-Ha-ras-1 genotyping appears of limited value in the clinical management of these patients.

Glomerular lesions in juvenile cystinosis: report of 2 cases

We report glomerular lesions in 2 siblings presenting a juvenile cystinosis. Kidney biopsy in one of them showed focal, segmental, mesangial proliferative and hyalinosis lesions, and the second showed segmental juxtahilar hyalinosis in one third of glomeruli. Neither of the 2 patients displayed a Toni-Debre-Fanconi syndrome. In one of the patients, cystine crystals were found by means of electronic microscopy. The first patient developed chronic renal failure and a kidney transplantation was performed. No recurrence of the cystine deposits was observed in the graft. Pedigree of the described family seems to be in accordance with an autosomal dominant pattern of inheritance.

Flow cytometry versus urinary cytology in the diagnosis and follow-up of bladder tumors: critical review of a 5-year experience

The authors report the results of a 5-year experience with flow cytometry (FCM) in the diagnosis and evaluation of bladder tumors. FCM was applied to 400 patients (225 without a urinary tumor and 175 with a past or recent bladder tumor). For the patients without a tumor, bladder-irrigation-fluid FCM was positive in 22% of samples vs 1% of those tested with conventional cytology. The high rate of false-positive results may have been due to an imperfect quality of the samples, to the staining procedure and to the high amount of squamous cells. For 72 selected tumors in which the bladder washing was performed under specific requirements, the detection rate of FCM was lower than that of conventional cytology, including G1-grade tumors. A comparison between bladder-irrigation-fluid FCM and disaggregated-biopsy FCM revealed a 22% rate of discordant results. From these data it does not seem desirable tu use bladder-irrigation FCM instead of conventional cytology in routine urologic examinations. The use of this technique must be more selective in bladder tumor evaluation.

Alterations in polymeric immunoglobulin receptor expression and secretory component levels in bladder carcinoma

To assess the capacity of transitional cells to synthesize the release polymeric immunoglobulin receptor (pIg-R) in bladder carcinoma, we studied the localization of pIg-R in normal and tumor tissues and measured the levels of secretory component (SC) either in the free form or bound to Ig (S-IgA, S-IgM) in the serum and urine of 56 patients with transitional-cell carcinoma (TCC) of the bladder. In the normal bladder mucosa, pIg-R was localized in the cytoplasm and plasma membranes of the superficial cells and on all epithelial cell membranes. In TCC cases, 65% of those studied expressed pIg-R. A marked heterogeneity in pIg-R staining was observed in some tumors. Although a better expression of pIg-R in tumors with a well-preserved epithelial architecture was observed, no correlation was found between pIg-R expression and the grade or stage of the tumors in the patients under study. Three groups were established: (1) in TCC with no complications, serum levels of free SC and S-IgA were significantly increased; (2) in TCC with urinary infections (UI), serum levels of free SC and S-IgA were significantly higher than control values but lay within the same range observed in TCC with no complications and rates of urinary excretion of SC were significantly higher than those in normal subjects; (3) in TCC without UI but with hepatic disorders [high gamma-glutamyl transferase (GGT) activity], there was a correlation between serum S-IgA levels and GGT activity (r = 0.5, P less than 0.005) and serum SC levels were significantly higher than those observed in the other groups.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult onset Still's disease and related renal amyloidosis

A 57 year old woman presented with clinical and biological features of adult onset Still's disease. A kidney biopsy was performed at the onset of the condition and was found to be normal. Four years later, in view of a nephrotic syndrome, histopathological examination of a new kidney biopsy specimen was made and showed typical amyloid deposition. Renal amyloidosis was suspected in five previously reported cases but demonstrated by kidney biopsy in only two of them. In the present case renal amyloidosis was recorded after disease of four years' duration. The normality of the first renal biopsy specimen suggests the possibility of a direct relation between amyloidosis and adult onset Still's disease.

Polyneuropathy: an unusual extraintestinal manifestation of Crohn's disease

Among the extraintestinal complications of Crohn's disease, neuropathy seems to be rare, and is only exceptionally reported in the literature. The authors present the report of a patient followed over a 12-year period who developed polyneuropathy with a parallel course to Crohn's disease. There was no evidence of any other underlying condition. On one occasion, the patient developed a cutaneous vasculitis with fibrinoid deposits in the vessels. The search for circulating immune complexes was positive. The authors demonstrated increased intestinal permeability using the 51chromium-labeled ethylenediaminetetra-acetate (51Cr-EDTA) test. Ultrastructural study of a biopsy of the superficial peroneal nerve disclosed a marked denervation process. Therapeutic plasmapheresis were performed, improving the neurologic symptoms. Vasculitis with circulating immune complexes is suggested as a possible mechanism in view of the occurrence of cutaneous vasculitis, increased intestinal permeability, and plasma exchange efficiency.

[Hand-Schüller-Christian disease with tumor localization in the posterior fossa]

A 19-year-old girl had been suffering since the age of 4 from Hand-Schüller-Christian disease. The condition was diagnosed by biopsy of a cranial bone lacuna. Later on, she developed diabetes insipidus and bilateral exophthalmos, both being typical signs of Hand-Schüller-Christian disease. At the age of 14, an intracranial tumour in the posterior cerebral fossa was discovered by computerized tomography, but in view of her parent's refusal of surgery, she was operated upon only 4 years later for obstructive hydrocephalus with intracranial hypertension. Two years after this operation, she presented with neurological signs of compression of the medulla oblongata, including tetraparesis and respiratory disorders, and the tumour was resected. Following a brief improvement she died of major hydroelectrolytic disorders due to her irreducible unstable diabetes insipidus. A review of the literature on Hand-Schüller-Christian disease and its rare association with intracranial tumours is analysed. The occurrence of such tumours raise important therapeutic problems and make the prognosis considerably worse.

In utero aminoglycosides-induced nephrotoxicity in rat neonates

Pregnant Wistar females were treated with gentamicin (G), netilmicin (N) or amikacin (A) during two periods of pregnancy covering organogenesis and the beginning of nephrogenesis. Deliveries occurred normally. We studied functional effects--influence of sex, litter size, diuresis, creatinine clearance, G-kidney concentration, and kidney morphological alterations--in rat neonates on day 1 of life. After G and N, the creatinine clearance of the neonates was decreased according to the dosage given to the mother. Whatever the aminoglycoside, kidneys presented proximal tubular alterations (close to those observed in adults) at protonic microscopy and, with electron microscopy, some modifications of distal tubules and of mature and immature glomeruli. It is concluded that the developing kidney can be altered after treating pregnant mothers with aminoglycosides. This model of in utero-induced nephrotoxicity is dose-dependent. Mature and/or immature structures could be affected. The toxicity of the investigated antibiotics could be asserted as G greater than or equal to N greater than A.

[Nephrogenic metaplasia of the urothelial mucosa. Apropos of 11 cases]

The authors report eleven new cases of nephrogenic metaplasia - a substantial addition to the sixty-three cases already reported in the literature. In their series, two cases involved the ureter, and nine, the bladder. They discuss the clinical and pathological aspects of the disease, and put forward suggestions concerning different aspects of the histogenesis. They consider the possibility of introducing new terminology.

[Laryngeal leishmaniasis in a patient from the Jura. Unusual cause of epitheloid and giant cell granulomatosis]

A case of laryngeal leishmaniasis in a patient living in eastern France is reported. Mucosal leishmaniasis appears to be frequent in the New World but rare in the Old World, where only 9 cases have been published, including 3 from France. In this particular patient, there probably was some relationship between the laryngeal lesion and an unexplained malaria-like fever contracted in Algeria 19 years before. This case provides evidence that leishmaniasis is one single nosological entity throughout the world, its different clinical forms (cutaneous, mucosal, visceral) merely reflecting the adaptation of the parasite to its environment.