Time of day, but not sleep restriction, affects markers of hemostasis following heavy exercise

We sought to determine the effects of sleep restriction on markers of hemostasis the morning after an exercise session. Seven subjects performed evening exercise followed by an exercise session the next morning, both with and without sleep restriction. Evening exercise included a 20-min submaximal cycling trial (10 min at 50% maximal power (Wmax), 10 min at 60% Wmax), a 3-km cycling time trial, 60 min of cycling intervals, and 3 sets of leg press. Subsequent morning exercise was the same, excluding intervals and leg press. Blood samples were collected at rest and following the 20-min submaximal trial for factor VIII antigen, tissue plasminogen activator (tPA) activity, and plasminogen activator inhibitor-1 (PAI-1) activity. Sleep restriction had no effect on the variables. Factor VIII antigen was higher and tPA activity lower in the morning versus evening, respectively (P < 0.05). There were larger (P < 0.05) exercise responses for tPA activity in the evening (pre-exercise = 0.32 ± 0.14, postexercise = 1.89 ± 0.60 AU/mL) versus morning (pre-exercise = 0.27 ± 0.13 AU/mL, postexercise = 0.69 ± 0.18 AU/mL). PAI-1 exhibited lower (P < 0.05) responses in the evening (pre-exercise = 0.78 ± 0.26 AU/mL, postexercise = 0.69 ± 0.29 AU/mL) versus morning (pre-exercise = 7.06 ± 2.66, postexercise = 5.40 ± 2.31 AU/mL). Although a prothrombotic environment was observed the morning following an evening exercise session, it was not exacerbated by sleep restriction.

Giant Thoracocervical Lymphangioma with Multivisceral Involvement: A Different Concept

ABSTRACT Background Lymphangiomas are benign lymphatic malformations frequently seen in head and neck region. Most reported cases are cervical lesions with mediastinal extension.1,2 Most are conceived as due to failure of fetal lymph sacs. Synchronous or metachronus lymphangiomatosis with cystic hygroma of the neck is also reported.3 Case details Massive multicompartmental mediastinal lymphangioma with cervical extension and concomitant visceral involvement is presented. It is proposed as a hamartomatous tumor rather than malunion of fetal jugular lymphatic sacs.2 Solid intrathoracic component with cystic neck extension supports mediastinal origin. Cell culture lines at 4 months were positive for endothelial cell lines positive for factor VIII antigen. Conclusion Giant thoracocervical lymphangioma is more likely to be a tumor rather than simple fetal failure of lymphatic sac fusion. Surgical excision is curative. How to cite this article Prasad GR, Nori M, Naseeruddin MD Rao JVS, Quadri SS. Giant Thoracocervical Lymphangioma with Multivisceral Involvement: A Different Concept. Int J Phonosurg Laryngol 2014;4(2):63-66.

Hepatic Malignant Epithelioid Hemangioendothelioma: A Case Report and Review of the Literature

Malignant epithelioid hemangioendothelioma is a rare hepatic tumor of vascular origin. It is most commonly found in young to middle aged women, and the tumors vary in reported malignant potential. Compounds such as oral contraceptive pills, poly vinyl chloride, and Thorotrast have been identified as risk factors for subsequent disease development. Radiologic (“lollipop” sign, capsular flattening) and pathologic (Factor-VIII antigen staining positive) evaluation aids in the diagnosis. As with most mesenchymal tumors, surgical resection is the most effective means of controlling local disease and preventing distant metastasis, though adjuvant therapies have been offered for those that are unresectable or not transplant candidates. We present our case of a hepatic malignant epithelioid hemangioendothelioma and a review of the English-language literature.

Feline Cystic Thymoma: A Clinicopathologic, Immunohistologic, and Electron Microscopic Study of 14 Cases

Cystic thymoma was diagnosed in 14 cats in a period of 6 years. The most common clinical sign was laboured breathing. The tumours were characterized by various-sized cystic spaces with central vessels. The epithelial cells varied from oval to spindle to polygonal cells enclosing cystic spaces or in pure epithelial cell components. The nuclei of the neoplastic cells had scattered chromatin and small nucleoli. The cytoplasm was pale eosinophilic. The concentration of mature lymphocytes varied from area to area with rare germinal centres. Immunohistochemically, the epithelial cells stained only with AE1/AE3. The central vessels were positive for vimentin, smooth muscle actin, and factor VIII antigen. Electron microscopy revealed that the cyst walls were lined by epithelial cells that were joined by desmosomes, and the walls were well separated from the cystic spaces by a well-defined basement membrane. The neoplastic epithelial cells contained scattered tonofilaments. Three of the cats had metastasis to the lymph nodes and lungs. Two novel cases of ectopic cystic thymoma have also been described. Results of this study reveal that cystic thymoma is uncommon in cats, and that the histomorphologic, immunohistochemical, and electron microscopic features are similar to those of cystic thymoma in humans.