Benign liver tumors in pediatric patients-Review with emphasis on imaging features

Benign hepatic tumors are commonly observed in adults,but rarely reported in children.The reasons for this remain speculative and the exact data concerning the incidence of these lesions are lacking.Benign hepatic tumors represent a diverse group of epithelial and mesenchymal tumors.In pediatric patients,most benign focal liver lesions are inborn and may grow like the rest of the body.Knowledge of pediatric liver diseases and their imaging appearances is essential in order to make an appropriate differential diagnosis.Selection of the appropriate imaging test is challenging,since it depends on a number of age-related factors.This paper will discuss the most frequently encountered benign liver tumors in children(infantile hepatic hemangioendothelioma,mesenchymal hamartoma,focal nodular hyperplasia,nodular regenerative hyperplasia,and hepatocellular adenoma),as well as a comparison to the current knowledge regarding such tumors in adult patients.The current emphasis is on imaging features,which are helpful not only for the initial diagnosis,but also for pre- and posttreatment evaluation and follow-up.In addition,future perspectives of contrast-enhanced ultrasound(CEUS) in pediatric patients are highlighted,with descriptions of enhancement patterns for each lesion being discussed.The role of advanced imaging tests such as CEUS and magnetic resonance imaging,which allow for non-invasive assessment of liver tumors,is of utmost importance in pediatric patients,especially when repeated imaging tests are needed and radiation exposure should be avoided.

DNA methylation in hepatocellular carcinoma

As for many other tumors,development of hepatocellular carcinoma(HCC)must be understood as a multistep process with accumulation of genetic and epigenetic alterations in regulatory genes,leading to activation of oncogenes and inactivation or loss of tumor suppressor genes(TSG).In the last decades,in addition to genetic alterations,epigenetic inactivation of(tumor suppressor) genes by promoter hypermet hylation has been recognized as an important and alternative mechanism in tumorigenesis.In HCC,aberrant methylation of promoter sequences occurs not only in advanced tumors, it has been also observed in premalignant conditions just as chronic viral hepatitis B or C and cirrhotic liver. This review discusses the epigenetic alterations in hepatocellular carcinoma focusing DNA methylation.

Expression of c-kit receptor in human cholangiocarcinoma and in vivo treatment with imatinib mesilate in chimeric mice

瞄准：与额外的肝的 cholangiocarcinoma (CC ) 从病人在胆道癌症房间线和组织学的节调查 c 工具包表示并且与 imatinib mesilate 评估在试管内和在试管内治疗的功效。方法：在从有额外的肝的 CC 的 19 个病人的人的胆道癌症房间线 Mz-ChA-2 和 EGI-1 和组织学的节的 c 工具包的蛋白质表示被免疫弄污，免疫细胞化学，和免疫组织化学估计。胆道癌症房间线 Mz-ChA-2 和 EGI-1 上的 imatinib mesilate 的 anti-proliferative 效果是由自动化房间数的学习在试管内。另外，免疫缺乏的 NMRI 老鼠(Taconic ) 皮下地与 5x10 (6 ) 被注射房间线 MzChA-2 和 EGI-1 的房间。在到达了 200 mm3 的瘤体积以后，每日的治疗在 50 mg/kg 或生理盐水(NS ) 的剂量以 imatinib mesilate intraperitoneally 被开始。肿瘤体积与游标 caliper 被计算。在 14 d 以后，老鼠被牺牲，肿瘤和决定的肿瘤质量切除了。结果：Immunoblotting 在 EGI-1 房间在 Mz-ChA-2 和缺席揭示了 c 工具包的存在。有 c 工具包抗体的 Immunocytochemistry 在 EGI-1 房间在 Mz-ChA-2 房间和 c 工具包的缺席显示了 cytoplasmatic 和受体蛋白质的膜的本地化。c 工具包在 19 中的 7 个被表示(37%) 额外的肝的人的 CC 织物取样， 2 出现了一中等并且染色的 5 一相当弱的免疫。在 5 micromol/L 的低集中的 Imatinib mesilate 在 c 工具包引起了重要生长抑制积极房间线 Mz-ChA-2 (31%) ，然而并非在 c 工具包 negative，房间衬里 EGI-1 (0%)(P【0.05 ) 。在 10 micromol/L 的中间的集中的 Imatinib mesilate 禁止了两根细胞线(51% 对 57%) 的细胞的生长。在 20 micromol/L 的更高的集中的 Imatinib mesilate 似乎在两根房间线上有一般有毒的效果。IC50 价值分别地是 9.7 micromol/L 和 11 micromol/L。在有 imatinib mesilate 的在试管内处理的 14 d 以后，使用妄想的老鼠模型，积极 Mz-ChA-2 肿瘤有的 c 工具包显著地减少的体积和团作为与 NS 处理(P【0.05 ) 相比。与那相对照，忍受 c 工具包 negative EGI-1 肿瘤的鼠标的处理没作为与 NS 处理相比导致肿瘤体积和质量的任何变化。结论：c 工具包表示是可检测的在一对在胆道癌症的低蛋白质水平中等。Imatinib mesilate 在肿瘤生长在试管内和 c 工具包表示诚实的在试管内依赖者上施加显著效果。

Expression of toxin-related human mono-ADP-ribosyltransferase 3 in human testes

Aim： To investigate wether the corresponding protein of mono-ADP-ribosyltransferase 3 （ART3） mRNA is expressed in human testes and, if so, whether the expression is cell type-specific. Methods： ART3 mRNA was determined in human testes and sperm by reverse transcription-polymerase chain reaction （RT-PCR）. The glycosylphosphatidylinositol linkage of ART3 was shown by treating ART3-transfected HEK-293-T cells with phospholipase C. Fluorescent activated cell sorter （FACS）-analyses were used to detect ART3 on mature spermatozoa and immunohistological studies to detect the protein in testes. Results： ART3 protein was shown to be present in testes. It was found on spermatocytes only. It was absent from spermatogonia, spermatids and spermatozoa. The absence of ART3 from spermatozoa was confirmed by FACS-analysis. ART3 protein was detected neither within a seminoma nor on Leydig cells. Conclusion： Here we show for the first time that ART3 protein is expressed in testes in particular on spermatocytes, indicating that ART3 exerts a specific function only required at a particular stage of spermatogenesis.

Triggers of histologically suspected drug-induced colitis

BACKGROUND Drug toxicity is a common and even serious problem in the gastrointestinal tract that is thought to be caused by a broad spectrum of agents.Although withdrawal of the causative agent would cure the disease knowledge is scarce and mostly derives from case reports and series.AIM To investigate potential triggers of drug-induced colitis(DiC).METHODS We conducted a retrospective,observational case control study.Patients were assigned to DiC or one of two age-and gender-matched control groups(noninflammatory controls and inflammatory colitis of another cause)based on histopathological findings.Histopathology was reassessed in a subset of patients(28 DiC with atherosclerosis,DiC without atherosclerosis and ischaemic colitis each)for validation purposes.Medical history was collected from the electronic database and patient records.Statistical analysis included chi-squared test,t-test,logistic and multivariate regression models.RESULTS Drug-induced colitis was detected in 211 endoscopically sampled biopsy specimens of the colon mucosa(7%of all screened colonoscopic biopsy samples);a total of 633 patients were included equally matched throughout the three groups(291 males,mean age:62.1±16.1 years).In the univariate analysis,DiC was associated with diuretics,dihydropyridines,glycosides,ASS,platelet aggregation inhibitors,nonsteroidal anti-inflammatory drugs(NSAIDs),statins and fibrates,and with atherosclerosis,particularly coronary heart disease,and hyperlipoproteinaemia.Echocardiographic parameters did not show substantial differences.In the multivariate analysis only fibrates[odds ratio(OR)=9.1],NSAIDs(OR=6.7)and atherosclerosis(OR=2.1)proved to be associated with DiC.Both DiC reassessment groups presented milder inflammation than ischaemic colitis.The DiC patients with atherosclerosis exhibited histological features from both DiC without atherosclerosis and ischaemic colitis.CONCLUSION Several drugs indicated for the treatment of cardiovascular and related diseases are associated with DiC.Atherosclerosis and microcirculatory disturbances seem to play an important pathogenetic role.

与毒素有关的人类单腺苷二磷酸-核糖基转移酶3(ART3)在人类睾丸中的表达

目的:研究单腺苷二磷酸-核糖基转移酶3(ART3)的 mRNA 在人类睾丸中是否表达其相应的蛋白,如果有表达是否细胞特异性表达。方法:用逆转录聚合酶链反应(RT-PCR)确定人类睾丸和精子中 ART3的mRNA 水平。用磷脂酶 C 处理转染了 ART3的 HEK-293-T 细胞,并通过它检测 ART3的糖基化磷酸肌醇链。用荧光激活细胞分类(FACS)分析和免疫组织学方法分别检测 ART3蛋白在成熟精子和睾丸中的表达。结果:ART3蛋白在睾丸和精母细胞中有表达,而在精原细胞、精子细胞和精子中未检测到,FACS 分析进一步确认精子中无 ART3蛋白。在精原细胞瘤和睾丸间细胞中也未检测到 ART3蛋白。结论:本研究首次发现ART3蛋白在睾丸中表达,尤其是在精母细胞中,这表明 ART3执行一个特定的功能,此功能只在精子发生的某个特殊阶段发挥作用。

Preservation of aberrant right hepatic arteries does not affect safety and oncological radicality of pancreaticoduodenectomy-own results and a systematic review of the literature

Background:Aberrant right hepatic arteries(aRHA)are frequently encountered during pancreaticoduodenectomy(PD).Their effects on surgical morbidity and resection margin are still debated.This study aimed to compare the short term and long term outcomes in patients with and without aRHA.Methods:A single-center retrospective analysis of 353 consecutive PD during a 5-year period was done.The type of arterial supply was determined preoperatively by CT and confirmed at surgery.Hiatt types III-VI included some type of aRHA and comprised the study group.Hiatt types I and II were considered irrelevant for PD and used as controls.Primary endpoints were the rates of major postoperative complications and the rate of R0-resection in cases of malignant disease.Secondary endpoints included duration of surgery,postoperative stay,number of harvested lymph nodes and survival in patients with pancreatic cancer.Own results were compared to existent data using a systematic review of the literature.Results:No aRHA had to be sacrificed or reconstructed.Surgical morbidity and specific complications such as post-pancreatectomy hemorrhage(PPH),pancreatic fistula and bile leak were the same in patients with and without aRHA.There was no significant difference in operative time,blood loss,length of ICU-and hospital stay.Patients with malignancy had similar high rates of R0-resection and identical number of harvested lymph nodes.Survival of patients with pancreatic cancer was not affected by aRHA.Conclusions:aRHA may be preserved in virtually all cases of PD for resectable pancreatic head lesions without increasing surgical morbidity and without compromising oncological radicality in patients with cancer,provided the variant anatomy is being recognised on preoperative CT and a meticulous surgical technique is used.

Histopathology of hepatocellular carcinoma-when and what

When do you need to take biopsies of the liver,and what information will you get is the topic of this review on hepatocellular carcinoma(HCC).If,clinically,the differential diagnosis of HCC after imaging is suggested,a biopsy has become obligatory as a diagnostic confirmation of HCC in the non-cirrhotic liver prior to definitive therapeutic interventions,as well as in a palliative therapy concept.In the case of hepatic lesions with an uncharacteristic contrast uptake,a biopsy should be performed immediately to confirm the diagnosis of HCC.After diagnosing HCC,a treatment strategy is evaluated.Further,the biopsy,or in case of surgical treatment,the resected tissue,shows us the different subtypes of HCC,with the steatohepatitic subtype being the most common and the lymphocyte-rich subtype being the least common.Further,the histological grade of HCC is determined according to the grading system of the WHO or the Edmonson and Steiner System.Through biopsies,HCC can be differentiated from intrahepatic cholangiocarcinoma or combined hepatocellular-cholangiocarcinoma or metastases of other malignant tumors,especially metastases of the gastrointestinal tract.In summary,biopsies are fundamental in the diagnosis of HCC.