Neurofibromatosis Type 1: Review of Cutaneous and Subcutaneous Tumor Treatment on Quality of Life.

BACKGROUND: Neurofibromatosis Type 1 (NF1) is the most common type of neurogenetic disorder with a worldwide incidence of between 1 in 2,600 and 1 in 3,000. NF1 has a wide range of manifestations; as a result, NF1 has no "public persona." Beginning at puberty and continuing thereafter patients may grow cutaneous and subcutaneous tumors (neurofibromas) in large numbers, which cause severe problems with appearance, which are similar in severity to those of psoriasis. Appearance concerns due to tumors affect NF1 patients' Quality of Life (QoL). NF1 patients are at increased risk for depression and treatment for depression and significantly enhance QoL. Improving appearance and QoL by decreasing the number of tumors is the NF1 patient's greatest concern. Improving QoL is an end in itself. METHODS: There are no currently available medical or pharmacological treatments for cutaneous and subcutaneous tumors of NF1. Surgery is the only treatment option for cutaneous and subcutaneous tumors. High Quantity (HQ) surgical removal by several methods has been used. RESULTS: HQ electrosurgical (ES) allows removal of large numbers of tumors, hundreds per surgical session, appears to be highly effective, and most patients are happy with their results. Other surgical techniques, such as scalpellic surgery, are not effective. Inadequate insurance payments, few plastic surgeons performing HQ tumor removal, lack of support from nonsurgeon physicians, few if any NF clinics providing HQ tumor removal, pediatric orientation, focus on basic research, and a dismissive attitude toward NF1 patients are all components in the unavailability of HQ NF tumor removal. Such surgery is not cosmetic but restoration of normal appearance from disfigurement due to a congenital, neoplastic disease. CONCLUSIONS: National legislation is required to mandate insurance companies to provide coverage for HQ tumor removal. Payments by health insurance companies to plastic surgeons must be reasonable and comparable with other procedures. Effort by neurologists and other nonsurgeons is needed to gain support of plastic surgeons. Strong pressure is needed by support groups of NF for providing NF1 HQ surgery at institutions with NF clinics and for proper payments for surgeons and others.

Mineral inclusions in diamonds may be synchronous but not syngenetic.

It is widely assumed that mineral inclusions and their host diamonds are 'syngenetic' in origin, which means that they formed simultaneously and from the same chemical processes. Mineral inclusions that, instead, were formed earlier with respect to diamonds are termed protogenetic. However, minerals can have the same age as the diamonds in that they become enclosed in and isolated from any further isotopic exchange. But this is termed 'synchronous' not 'syngenetic'. Here we demonstrate conclusively the protogenesis of inclusions in diamonds, based upon data from an exceptional fragment of a diamond-bearing peridotite, its clinopyroxene and a gem-quality diamond. Clinopyroxenes in the xenolith had the same chemistry and crystallographic orientation as those for inclusions in the diamond. With our results with garnets, olivines and sulfides, we can state that a major portion of the mineral inclusions in non-coated, monocrystalline-lithospheric diamonds are protogenetic. Our discovery here presented has implications for all genetic aspects of diamond growth, including their ages.

The Tissint Martian meteorite as evidence for the largest impact excavation.

High-pressure minerals in meteorites provide clues for the impact processes that excavated, launched and delivered these samples to Earth. Most Martian meteorites are suggested to have been excavated from 3 to 7 km diameter impact craters. Here we show that the Tissint meteorite, a 2011 meteorite fall, contains virtually all the high-pressure phases (seven minerals and two mineral glasses) that have been reported in isolated occurrences in other Martian meteorites. Particularly, one ringwoodite (75 × 140 µm(2)) represents the largest grain observed in all Martian samples. Collectively, the ubiquitous high-pressure minerals of unusually large sizes in Tissint indicate that shock metamorphism was widely dispersed in this sample (~25 GPa and ~2,000 °C). Using the size and growth kinetics of the ringwoodite grains, we infer an initial impact crater with ~90 km diameter, with a factor of 2 uncertainty. These energetic conditions imply alteration of any possible low-T minerals in Tissint.

Lunar apatite with terrestrial volatile abundances.

The Moon is thought to be depleted relative to the Earth in volatile elements such as H, Cl and the alkalis. Nevertheless, evidence for lunar explosive volcanism has been used to infer that some lunar magmas exsolved a CO-rich and CO(2)-rich vapour phase before or during eruption. Although there is also evidence for other volatile species on glass spherules, until recently there had been no unambiguous reports of indigenous H in lunar rocks. Here we report quantitative ion microprobe measurements of late-stage apatite from lunar basalt 14053 that document concentrations of H, Cl and S that are indistinguishable from apatites in common terrestrial igneous rocks. These volatile contents could reflect post-magmatic metamorphic volatile addition or growth from a late-stage, interstitial, sulphide-saturated melt that contained approximately 1,600 parts per million H(2)O and approximately 3,500 parts per million Cl. Both metamorphic and igneous models of apatite formation suggest a volatile inventory for at least some lunar materials that is similar to comparable terrestrial materials. One possible implication is that portions of the lunar mantle or crust are more volatile-rich than previously thought.

Early formation of evolved asteroidal crust.

Mechanisms for the formation of crust on planetary bodies remain poorly understood. It is generally accepted that Earth's andesitic continental crust is the product of plate tectonics, whereas the Moon acquired its feldspar-rich crust by way of plagioclase flotation in a magma ocean. Basaltic meteorites provide evidence that, like the terrestrial planets, some asteroids generated crust and underwent large-scale differentiation processes. Until now, however, no evolved felsic asteroidal crust has been sampled or observed. Here we report age and compositional data for the newly discovered, paired and differentiated meteorites Graves Nunatak (GRA) 06128 and GRA 06129. These meteorites are feldspar-rich, with andesite bulk compositions. Their age of 4.52 +/- 0.06 Gyr demonstrates formation early in Solar System history. The isotopic and elemental compositions, degree of metamorphic re-equilibration and sulphide-rich nature of the meteorites are most consistent with an origin as partial melts from a volatile-rich, oxidized asteroid. GRA 06128 and 06129 are the result of a newly recognized style of evolved crust formation, bearing witness to incomplete differentiation of their parent asteroid and to previously unrecognized diversity of early-formed materials in the Solar System.

Highly siderophile element constraints on accretion and differentiation of the Earth-Moon system.

A new combined rhenium-osmium- and platinum-group element data set for basalts from the Moon establishes that the basalts have uniformly low abundances of highly siderophile elements. The data set indicates a lunar mantle with long-term, chondritic, highly siderophile element ratios, but with absolute abundances that are over 20 times lower than those in Earth's mantle. The results are consistent with silicate-metal equilibrium during a giant impact and core formation in both bodies, followed by post-core-formation late accretion that replenished their mantles with highly siderophile elements. The lunar mantle experienced late accretion that was similar in composition to that of Earth but volumetrically less than (approximately 0.02% lunar mass) and terminated earlier than for Earth.

Space weathering on airless planetary bodies: clues from the lunar mineral hapkeite.

Physical and chemical reactions occurring as a result of the high-velocity impacts of meteorites and micrometeorites and of cosmic rays and solar-wind particles are major causes of space weathering on airless planetary bodies, such as the Moon, Mercury, and asteroids. These weathering processes are responsible for the formation of their regolith and soil. We report here the natural occurrence of the mineral hapkeite, a Fe2Si phase, and other associated Fe-Si phases (iron-silicides) in a regolith breccia clast of a lunar highland meteorite. These Fe-Si phases are considered to be a direct product of impact-induced, vapor-phase deposition in the lunar soil, all part of space weathering. We have used an in situ synchrotron energy-dispersive, single-crystal x-ray diffraction technique to confirm the crystal structure of hapkeite as similar to the structure of synthetic Fe2Si. This mineral, hapkeite, is named after Bruce Hapke of the University of Pittsburgh, who predicted the presence and importance of vapor-deposited coatings on lunar soil grains some 30 years ago. We propose that this mineral and other Fe-Si phases are probably more common in the lunar regolith than previously thought and are directly related to the formation of vapor-deposited, nanophase elemental iron in the lunar soils.