Myasthenia gravis in our study was more common in males (M:F of 2.70:1). There was a single peak of age at onset (males sixth to seventh decade; females third decade). The higher prevalence of thymomas in this series is in all probability related to selection bias as patients with thymic enlargement or more severe disease underwent thymectomy. Thymoma was more common in males; hyperplasia in females.

BACKGROUND AND PURPOSE:White matter hyperintensities (WMHs) are frequently characterized as markers of cerebrovascular disease, whereas medial temporal atrophy (MTA) is a recognized marker of Alzheimer disease (AD). Our purpose was to test the reliability of a visual rating system (VRS) in evaluating WMHs and MTA and in distinguishing healthy from cognitively impaired subjects.

Targeting altered pathways during initial stage of hepatocellular carcinoma (HCC) development is viewed as an effective and promising strategy to control this disease. Present study investigated the potential effect of lycopene-enriched tomato extract (LycT) on hypoxia-induced factor (HIF)-1α, HOX, VEGF, CD31, matrix metalloproteinase (MMP)-2, MMP-9, and alpha fetoprotein (AFP)expression during initial stages of N-nitrosodiethylamine (NDEA) induced HCC. Female Balb/c mice (8-10 wk) were assigned to 4 groups: control, NDEA (200 mg NDEA i.p./kg body weight, cumulative), LycT (5 mg lycopene orally/kg body weight; 3 times a week), and LycT + NDEA. LycT treatment began 2 wk before NDEA administration and continued until the end of the 10 wk study. The onset of HCC by NDEA was associated with significant alteration in serum biochemical markers [alanine transaminases (ALT), aspartate transaminases (AST), and alkaline phosphatases (ALP), lactate dehydrogenase (LDH), urea, A/G ratio, and bilirubin] and in liver histopathology. LycT treatment significantly reduced the levels of these markers. LycT treatment to NDEA mice also led to significant reduction in protein levels of AFP, HIF-1α, VEGF, CD31, MMP-2, and MMP-9 in comparison with NDEA group alone. These parameters are important biomarkers of hypoxia, angiogenesis, and metastasis, which reflect the advanced disease stage. The study provides evidence that prophylactic dietary supplementation with LycT may counteract HCC progression and/or protect against disease onset.

AIMTo investigate the effect of lycopene extracted from tomatoes (LycT) on ultrastructure, glycolytic enzymes, cell proliferation markers and hypoxia during N-Nitrosodiethylamine (NDEA)-induced hepatocarcinogenesis.METHODSFemale BALB/c mice were randomly divided into four groups: The Control, NDEA (200 mg NDEA/kg b.w. given i.p.), LycT (5 mg/kg b.w. given orally on alternate days) and LycT + NDEA group. The mRNA and protein expression of various cell proliferation markers (PCNA, Cyclin D1, and p21) were assessed by reverse transcription-polymerase chain reaction and enzyme linked immunosorbent assay, respectively. The ultrastructure of hepatic tissue was analyzed using scanning and transmission electron microscopy. The enzymatic activity of glycolytic enzymes was estimated using standardized protocols, while glucose-6-phosphate dehydrogenase activity level was estimated using a kit obtained from Reckon Diagnostic P. Ltd. (India).RESULTSUncontrolled proliferation in the liver of NDEA (P ≤ 0.001) mice was evident from the high expression of cell-proliferation associated genes (PCNA, Cyclin D1, and p21) when compared to control and LycT mice. In addition, enhanced activities of hexokinase, phosphoglucoisomerase, aldolase, glucose-6-phosphate dehydrogenase and hypoxia-inducible factor-1α were observed in NDEA mice as compared to control (P ≤ 0.001) and LycT (P ≤ 0.001) mice. The alterations in hepatic ultrastructure observed in the NDEA group correlated with the changes in the above parameters. LycT pre-treatment in NDEA-challenged mice ameliorated the investigated pathways disrupted by NDEA treatment. Moreover, hepatic electron micrographs from the LycT + NDEA group showed increased macrophages, apoptotic bodies and well-differentiated hepatocellular carcinoma (HCC) in comparison to undifferentiated HCC as observed in the NDEA treated group.CONCLUSIONThis study demonstrates that dietary supplementation with LycT has a multidimensional role in preventing HCC development.

fWe describe the application of PCR and electrospray-ionization with mass spectrometry (PCR/ESI-MS) to culture-negative bronchoalveolar lavage (BAL) fluid in order to identify septate hyphae noted by Gomori methenamine silver (GMS) staining of the fluid that was obtained from an immunocompromised woman with neutropenia following induction chemotherapy for treatment of acute myelogenous leukemia (AML). The patient was treated with empirical antifungal therapy, including intrathecal amphotericin B, while results of fungal cultures were pending. Ultimately, Aspergillus terreus, an amphotericin-resistant mold, was cultured from bilateral brain abscesses. PCR/ESI-MS correctly identified the mold. CASE REPORTA 55-year-old woman with acute myelogenous leukemia (AML) was hospitalized for induction chemotherapy. Before the initiation of treatment, magnetic resonance imaging (MRI) of the brain was performed and did not reveal any intraparenchymal brain abnormalities. A cytology exam was performed on cerebrospinal fluid (CSF) obtained by lumbar puncture (LP) and was negative for malignant cells. Routine testing of the CSF was normal: total protein, 30 mg/dl; glucose, 48 mg/dl; white blood cell (WBC) count, 1 cell/mm 3 ; red blood cell (RBC) count, 1 cell/ mm 3 . Primary prophylactic antimicrobial treatment with acyclovir, fluconazole, and levofloxacin was initiated on day 1 of the chemotherapy regimen (i.e., idarubicin and cytarabine).One week following completion of induction chemotherapy, the patient complained of a mild headache, prompting sinus computerized tomography (CT) that demonstrated only well-aerated maxillary and paranasal sinuses. The headache resolved, and the patient did well until a nonproductive cough developed on day 13 following induction chemotherapy. At that time, her temperature was 38.2°C, and a physical exam was notable for rales in the left lung. The WBC count was 0.3 ϫ 10 3 cells/l. A chest X-ray revealed a left lingular infiltrate consistent with either atelectasis or pneumonia; meropenem was added to the antimicrobial therapy. During the next 3 days, the patient became more lethargic and confused. Her fever worsened to 38.9°C, and her pulse and respiratory rate also increased to 110 and 32 beats and breaths per minute, respectively. A physical exam was notable for decreased breath sounds on the left and new left-upper-extremity weakness. WBC count was unchanged at 0.2 ϫ 10 3 cells/l. A portable chest X-ray confirmed progression of a left lingular infiltrate with extension to the left upper lobe. Antifungal treatment was changed from fluconazole to voriconazole, and the patient was transferred to the medical intensive care unit (MICU).An MRI was obtained 1 day following transfer to the MICU; the MRI demonstrated at least eight lesions in the brain associated with faint incomplete contrast enhancement suggestive of infectious or inflammatory foci. Two days later, repeat cytology of CSF obtained by LP was negative for malignant cells: total protein was 71 mg/dl; glucose, 43 mg/dl; WBC count, 4 cel...