Despite differential gene expression profiles pediatric MDS derived mesenchymal stromal cells display functionality in vitro

Pediatric myelodysplastic syndrome (MDS) is a heterogeneous disease covering a spectrum ranging from aplasia (RCC) to myeloproliferation (RAEB(t)). In adult-type MDS there is increasing evidence for abnormal function of the bone-marrow microenvironment. Here, we extensively studied the mesenchymal stromal cells (MSCs) derived from children with MDS. MSCs were expanded from the bone-marrow of 17 MDS patients (RCC: n=10 and advanced MDS: n=7) and pediatric controls (n=10). No differences were observed with respect to phenotype, differentiation capacity, immunomodulatory capacity or hematopoietic support. mRNA expression analysis by Deep-SAGE revealed increased IL-6 expression in RCC- and RAEB(t)-MDS. RCC-MDS MSC expressed increased levels of DKK3, a protein associated with decreased apoptosis. RAEB(t)-MDS revealed increased CRLF1 and decreased DAPK1 expressions. This pattern has been associated with transformation in hematopoietic malignancies. Genes reported to be differentially expressed in adult MDS-MSC did not differ between MSC of pediatric MDS and controls. An altered mRNA expression profile, associated with cell survival and malignant transformation, of MSC derived from children with MDS strengthens the hypothesis that the micro-environment is of importance in this disease. Our data support the understanding that pediatric and adult MDS are two different diseases. Further evaluation of the pathways involved might reveal additional therapy targets.

The use of recombinant human TSH in a patient with metastatic follicular carcinoma and insufficient endogenous TSH production

We present a case of a patient suffering from metastatic differentiated thyroid carcinoma (DTC) and insufficient endogenous TSH production suspicious of secondary hypothyroidism. The use of recombinant human TSH (rhTSH) enabled us to administer a therapeutic activity of radioactive iodine (RAI) under maximal TSH-stimulation, achieving a marked decrease in thyroglobulin accompanied by a clinical improvement.

Delayed motor response correlates with striatal degeneration in Parkinson's disease

OBJECTIVE

Studies on reaction time have suggested a selective deficit of slowness in motor readiness and motor programming in Parkinson's disease (PD). Objective of this study was the putative relation between delayed initiation and execution of movement and the striatal dopamine deficiency in PD.

MATERIAL AND METHODS

We investigated 32 idiopathic, previously untreated parkinsonian patients to evaluate dopaminergic nigrostriatal degeneration by single photon emission tomography in combination with the radiotracer [123I]-beta-CIT and performed a simple reaction time paradigm on the same day.

RESULTS

Significant relations between the [123I]-beta-CIT-SPECT-ratio striatum/cerebellum and reaction--and movement time appeared. Reaction time and movement time of parkinsonian patients were significantly longer compared to age-matched controls.

CONCLUSIONS

We conclude that reaction- and movement-time is related to the dopaminergic nigrostriatal degeneration in untreated parkinsonian subjects.

Colour vision abnormalities do not correlate with dopaminergic nigrostriatal degeneration in Parkinson's disease

Sensory disturbances such as olfactory or visual dysfunctions are common in Parkinson's disease (PD). A possible relationship between distorted colour discrimination and the nigrostriatal dopamine deficit is still a matter of debate. We examined 31 de novo Parkinsonian patients with [123I]beta-CIT single photon emission tomography (SPECT). We used a single-head gamma-camera and calculated the binding ratio striatum/cerebellum (specific/nonspecific binding) of [123I]beta-CIT uptake. On the same day, we performed the Farnsworth-Munsell 100 Hue Test (FMT) in these patients and estimated the total error score, in order to investigate abnormalities of colour vision. Parkinsonian patients' total error score was higher compared with an age- and sex-matched control group (P = < 0.0001), whereas disability scores of the Hoehn and Yahr scale (P = 0.019, Spearman r = 0.419) and the Unified Parkinson's Disease Rating Scale (P = 0.039, Spearman r = 0.373) correlated with total error score. No significant association appeared between total error score (Spearman r = -0.119, P = 0.525) and [123I]P-CIT-SPECT ratio. Thus both total error scores of the FMT and [1231]beta-CIT-SPECT binding ratios have been found to reflect the severity of PD. However, only [123I]beta-CIT SPECT reflects degeneration of dopaminergic neurons of the basal ganglia, but does not reflect alterations of the visual system and/or extranigral lesions in PD. From our results, we speculate that FMT may be a valuable clinical method to measure extranigral lesions of the visual system in PD.

Neutron therapy (dT, 14 MeV) for recurrence of rectal cancer: interim analysis from Münster

For rectal recurrent cancer and macroscopic residual disease after surgery neutron radiotherapy has been suggested to be superior to photon radiotherapy. At the d,T generator in Münster (14 MeV) 20 patients have been treated with a combined photon-/neutron-radiotherapy: two patients with residual disease after surgery: among the 18 patients with rectal recurrence 15 for pain relief; all for tumor control. Tumor resection had been carried out in five recurrent tumors. Six patients presented with distant metastases. 30 to 40 Gy photons for tumor region and potential microscopic spread with 2 Gy per fraction and 5 to 10 Gy neutrons for macroscopic tumor volume with 0.7 to 1.6 Gy per fraction were applied using multiple fields (three to five). The mean follow-up period is nine months. Pain relief was achieved in eleven of 15 patients (73%), the onset of pain was fast, the probability for a pain-free period is 46% for nine months and for survival 56% for twelve months. Side-effects were slight to moderate beside a severe subcutaneous fibrosis in two patients. The superiority of neutrons to photons in rectal recurrent cancer remains questionable and is to be proven in a prospective trial comparing different schedules for frequency, onset and duration of pain relief, tumor control, survival and side-effects.