Itay A. Sternberg MD, Benjamin F. Katz MD, Lauren Baldinger DO, Roy Mano MD, Gal E. Keren Paz MD, Melanie Bernstein BA, Oguz Akin MD, Paul Russo MD and Christoph Karlo MD
Abstract
Background: Renal hemangiomas are rare benign tumors seldom distinguished from malignant tumors preoperatively.
Objectives: To describe the Memorial Sloan-Kettering Cancer Center (MSKCC) experience with diagnosing and treating renal hemangiomas, and to explore possible clinical and radiologic features that can aid in diagnosing renal hemangiomas preoperatively.
Methods: Patients with renal hemangiomas treated at MSKCC were identified in our prospectively collected renal tumor database. Descriptive statistics were used to describe the patient characteristics and the tumor characteristics. All available preoperative imaging studies were reviewed to assess common findings and explore possible characteristics distinguishing benign hemangiomas from malignant renal tumors preoperatively.
Results: Of 6341 patients in our database 15 were identified. Eleven (73%) were males, median age at diagnosis was 53.3 years, and the affected side was evenly distributed. All but two patients were treated surgically. The mean decrease in estimated glomerular filtration rate (eGFR) after surgery was 36.3%; one patient had an abnormal presurgical eGFR and only two patients had a normal eGFR after surgery. We could not identify radiographic features that would make preoperative diagnosis certain, but we did identify features characteristic of hepatic hemangiomas that were also present in some of the renal hemangiomas.
Conclusions: Most renal hemangiomas cannot be distinguished from other common renal cortical tumors preoperatively. In select cases a renal biopsy can identify this benign lesion and the deleterious effects of extirpative surgery can be avoided.
Dan Oieru MD, Nir Shlomo, Israel Moalem, Eli Rozen MD, Alexey Naimushin MD, Robert Klempfner MD, Ilan Goldenberg MD and Ronen Goldkorn MD
Abstract
Background: Heart rate variability (HRV) analysis has been shown to be a predictor of sudden cardiac death and all-cause mortality in patients with cardiac disease.
Objectives: To examine whether newer HRV analysis algorithms, as used by the HeartTrends device, are superior to exercise stress testing (EST) for the detection of myocardial ischemia in patients without known coronary artery disease (CAD).
Methods: We present pilot data of the first 100 subjects enrolled in a clinical trial designed to evaluate the yield of short-term (1 hour) HRV testing for the detection of myocardial ischemia. The study population comprised subjects without known CAD referred to a tertiary medical center for EST with single-photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI). All patients underwent a 1 hour electrocardiographic acquisition for HRV analysis with a HeartTrends device prior to EST with MPI. Sensitivity, specificity, and positive and negative predictive values (PPV and NPV, respectively) were calculated for EST and HRV analysis, using MPI as the gold standard for the non-invasive detection of myocardial ischemia.
Results: In this cohort 15% had a pathologic MPI result. HRV analysis showed superior sensitivity (85%), PPV (50%) and NPV (97%) as compared to standard EST (53%, 42%, 90%, respectively), while the specificity of the two tests was similar (86% and 85%, respectively). The close agreement between HRV and MPI was even more pronounced among patients > 65 years of age.
Conclusions: Our pilot data suggest that the diagnostic yield of the novel HeartTrends HRV algorithm is superior to conventional EST for the non-invasive detection of myocardial ischemia.
Slavomíra Mattošová MSc, Ján Chandoga MD PhD, Anna Hlavatá MD PhD MPH, Jana Šaligová MD and Danka Maceková PhD
Abstract
Background: Gaucher disease is the most common lysosomal storage disorder and is caused by a deficiency of the enzyme glucocerebrosidase. Enzyme deficiency leads to the accumulation of undegraded substrates, mainly in cells of the monocyte/macrophage lineage, which is responsible for the clinical manifestations of the disease. To date, no study has attempted to identify the mutation spectrum of the glucocerebrosidase gene (GBA) in Slovak patients
Objectives: To identify mutations in 14 Slovak patients with confirmed glucocerebrosidase deficiency.
Methods: Using molecular genetics methods PCR-RFLP (polymerase chain reaction-restriction fragment length polymorphism) and direct sequencing of coding region GBA we identified the spectrum of mutations in our patients.
Results: Five mutations (N370S, L444P, G377S, D409H and RecNciI) accounted for 75% of the mutant alleles. The remaining 25% were rare and probably individual mutations.
Conclusions: The mutational spectrum in our patients is similar to that observed in other European countries and corresponds to a Caucasian population, with N370S, L444P, RecNciI being the most common mutation. Interestingly, mutation G377S was more frequent in our patients as compared to other published data. The C4W, L96P, H311N, 745delG and 1127_1128delTT mutations are described here for the first time in Gaucher disease, contributing to the panel of published GBA mutations.
Olga Reitblat MD, Tsahi T. Lerman MD, Olga Grisko MD, Anna Gelfand MD, Azaria Simonovich MD, Galina Novokhatko MD, Doron Zamir MD and Tatiana Reitblat MD
Michael Shpoliansky BSc, Dan Spiegelstein MD, Amihai Shinfeld MD and Ehud Raanani MD
Firas Rinawi MD, Theodore C. Iancu MD, Corina Hartman MD, Hofit Cohen MD, Havatzelet Yarden-Bilavsky MD, Michal Rozenfeld Bar Lev MD and Raanan Shamir MD
Eilon Krashin MD, Michael Lishner MD, Michal Chowers and Sharon Reisfeld MD
Aaron Ngamolane MBBS, Ludo Taboka Molobe MuDr, Kabo Mojela MBChB, Canuto Silava MD DPBR, FUSP, FCT-MRISP, Francesca Cainelli MD and Sandro Vento MD