Gynandroblastoma with the symptoms of infertility and secondary amenorrhea: a case report

The case of a female patient who failed to get pregnant due to delayed menstruation is reported. Gynecological examination showed that the patient had a male pubic distribution, hypertrophic clitoris, unobstructed vagina and hypertrophic cervices with smooth and medium texture. B ultrasonic examination detected a 42 x 30 mm in size medium echo mass. This mass had irregular shape, smooth surface, relatively clear boundary and hard texture. Examination with paraffin-embedded section indicated that the tumor was composed of supporting cells and to a lesser amount of interstitial components. Some regions had particle-like cell differentiation. These results suggested that the tumor was gynandroblastoma. We found that the increased level of serum testosterone in the patient was the reason for amenorrhea and infertility. The diagnosis and treatment for patients with gynandroblastoma is also discussed.

L-selectin is dispensable for T regulatory cell function postallogeneic bone marrow transplantation

In murine models, the adoptive transfer of CD4(+) /CD25(+) regulatory T cells (T(regs) ) inhibited graft-versus-host disease (GvHD). Previous work has indicated a critical role for the adhesion molecule L-selectin (CD62L) in the function of T(regs) in preventing GvHD. Here we examined the capacity of naive wild-type (WT), CD62L(-/-) and ex vivo expanded CD62L(Lo) T(regs) to inhibit acute GvHD. Surprisingly, we found that CD62L(-/-) T(regs) were potent suppressors of GvHD, whereas CD62L(Lo) T(regs) were unable to inhibit disease despite being functionally competent to suppress allo T cell responses in vitro. Concomitant with improved outcomes, WT and CD62L(-/-) T(regs) significantly reduced liver pathology and systemic pro-inflammatory cytokine production, although CD62L(-/-) T(regs) were less effective in reducing lung pathology. While accumulation of CD62L(-/-) T(regs) in GvHD target organs was equivalent to WT T(regs) , CD62L(-/-) T(regs) did not migrate as well as WT T(regs) to peripheral lymph nodes (PLNs) over the first 2 weeks posttransplantation. This work demonstrated that CD62L was dispensable for T(reg) -mediated protection from GvHD.

Linking river, floodplain, and vadose zone hydrology to improve restoration of a coastal river affected by saltwater intrusion

Floodplain forests provide unique ecological structure and function, which are often degraded or lost when watershed hydrology is modified. Restoration of damaged ecosystems requires an understanding of surface water, groundwater, and vadose (unsaturated) zone hydrology in the floodplain. Soil moisture and porewater salinity are of particular importance for seed germination and seedling survival in systems affected by saltwater intrusion but are difficult to monitor and often overlooked. This study contributes to the understanding of floodplain hydrology in one of the last bald cypress [Taxodium distichum (L.) Rich.] floodplain swamps in southeast Florida. We investigated soil moisture and porewater salinity dynamics in the floodplain of the Loxahatchee River, where reduced freshwater flow has led to saltwater intrusion and a transition to salt-tolerant, mangrove-dominated communities. Twenty-four dielectric probes measuring soil moisture and porewater salinity every 30 min were installed along two transects-one in an upstream, freshwater location and one in a downstream tidal area. Complemented by surface water, groundwater, and meteorological data, these unique 4-yr datasets quantified the spatial variability and temporal dynamics of vadose zone hydrology. Results showed that soil moisture can be closely predicted based on river stage and topographic elevation (overall Nash-Sutcliffe coefficient of efficiency = 0.83). Porewater salinity rarely exceeded tolerance thresholds (0.3125 S m(-1)) for bald cypress upstream but did so in some downstream areas. This provided an explanation for observed vegetation changes that both surface water and groundwater salinity failed to explain. The results offer a methodological and analytical framework for floodplain monitoring in locations where restoration success depends on vadose zone hydrology and provide relationships for evaluating proposed restoration and management scenarios for the Loxahatchee River.

Sensitivity study of an ultrasound coupled transrectal electrical impedance tomography system for prostate imaging

In 2009, prostate cancer ranked as the most common cancer and the second most fatal cancer in men in the United States. Unfortunately, the current clinical diagnostic methods (e.g. prostate-specific antigen (PSA), digital rectal examination, endorectal MRI, transrectal ultrasound, biopsy) used for detecting and staging prostate cancer are limited. It has been shown that cancerous prostate tissue has significantly different electrical properties when compared to benign tissues. Based on these electrical property findings, a transrectal electrical impedance tomography (TREIT) system is proposed as a novel prostate imaging modality. The TREIT system comprises an array of electrodes interfaced with a clinical transrectal ultrasound (TRUS) probe. We evaluate this imaging system through a series of phantom imaging experiments to assess the system's ability to image high and low contrast objects at various positions. We found that the TREIT system can easily discern high contrast inclusions of 1 cm in diameter at distances centered at two times the radius of the TREIT probe away from the probe surface. Furthermore, this technology's ability to detect low contrast inclusions suggests that it has the potential to successfully detect prostate cancer.

Electrical impedance tomography reconstruction for three-dimensional imaging of the prostate

Transrectal electrical impedance tomography (TREIT) has been proposed as an adjunct modality for enhancing standard clinical ultrasound (US) imaging of the prostate. The proposed TREIT probe has an array of electrodes adhered to the surface of a cylindrical US probe that is introduced inside of the imaging volume. Reconstructing TREIT images in the open-domain geometry established with this technique poses additional challenges to those encountered with closed-domain geometries, present in more conventional EIT systems, because of the rapidly decaying current densities at increasing distances from the probe surface. We developed a finite element method (FEM)-based dual-mesh reconstruction algorithm which employs an interpolation scheme for linking a fine forward mesh with a coarse grid of pixels, used for conductivity estimation. Simulation studies using the developed algorithm demonstrate the feasibility of imaging moderately contrasting inclusions at distances of three times the probe radius from the probe surface and at multiple angles about the probe's axis. The large, dense FEM meshes used here require significant computational effort. We have optimized our reconstruction algorithm with multi-core processing hardware and efficient parallelized computational software packages to achieve a speedup of 9.3 times when compared to a more traditional Matlab-based, single CPU solution. The simulation findings and computational optimization provide a state-of-the-art reconstruction platform for use in further evaluating transrectal electrical impedance tomography.

Determining which automatic digital blood pressure device performs adequately: a systematic review

The aim of this study is to systematically examine the proportion of accurate readings attained by automatic digital blood pressure (BP) devices in published validation studies. We included studies of automatic digital BP devices using recognized protocols. We summarized the data as mean and s.d. of differences between measured and observed BP, and proportion of measurements within 5 mm Hg. We included 79 articles (10 783 participants) reporting 113 studies from 22 different countries. Overall, 25/31 (81%), 37/41 (90%) and 34/35 (97%) devices passed the relevant protocols [BHS, AAMI and ESH international protocol (ESH-IP), respectively]. For devices that passed the BHS protocol, the proportion of measured values within 5 mm Hg of the observed value ranged from 60 to 86% (AAMI protocol 47–94% and ESH-IP 54–89%). The results for the same device varied significantly when a different protocol was used (Omron HEM-907 80% of readings were within 5 mm Hg using the AAMI protocol compared with 62% with the ESH-IP). Even devices with a mean difference of zero show high variation: a device with 74% of BP measurements within 5 mm Hg would require six further BP measurements to reduce variation to 95% of readings within 5 mm Hg. Current protocols for validating BP monitors give no guarantee of accuracy in clinical practice. Devices may pass even the most rigorous protocol with as few as 60% of readings within 5 mm Hg of the observed value. Multiple readings are essential to provide clinicians and patients with accurate information on which to base diagnostic and treatment decisions.

Sensitivity study and optimization of a 3D electric impedance tomography prostate probe

In current clinical practice, the primary diagnostic method for testing for prostate cancer is ultrasound-guided biopsy. In this paper, we consider using a sonolucent array of electrodes, printed on a thin Kapton layer and positioned on the imaging window of a transrectal ultrasound probe, as a method for providing coregistered electrical and ultrasound imaging of the prostate. As the electrical properties of malignant tissues have been shown to differ significantly from benign tissues, the estimation of the electrical properties is expected to be helpful in distinguishing certain beginning pathologies from cancer and in improving the detection rate that current biopsy methods provide. One of the main difficulties in estimating electrical properties of tissues with this electrode configuration is the rapid decay of the sensitivity with distance from the sensing array. In order to partially overcome this difficulty, we propose to use prior information from the ultrasound (US). Specifically we intend to delineate the boundaries of the prostate from the US, to subdivide the organ into a small number of voxels and to estimate the conductivity as constant on each of these subvolumes. We use a 3D forward model based on the finite element method for studying the sensitivity of a simulated segmented prostate for three different electrode array designs. The three designs present different electrode areas and inter-electrode gaps. Larger electrodes are desirable as they present a better contact, but we show that as they result in smaller inter-electrode gaps, shunting currents can be significant and the sensitivity is reduced. Because our clinical measurement system employs a single current source, we consider tetrapolar measurement patterns for evaluating these electrode configurations. Optimal measurement patterns are well defined for adaptive systems, where multiple currents are injected at the same time. For the electrode array designs we consider, which are three dimensional, there are no established systematic methods for forming sets of linearly independent tetrapolar measurement patterns. We develop a novel method for automatically computing a full set of independent tetrapolar measurement patterns that maximizes the sensitivity in a region of interest (ROI). We use these patterns in the forward modeling and sensitivity studies. In addition to the electrode arrays on the probe, we study the use of a further configuration, where a distal electrode is positioned on the exterior of the body and used for current injection.

High-dose chemotherapy augments the efficacy of recombinant adenovirus vaccines and improves the therapeutic outcome

We have investigated the therapeutic potential of a prototypic melanoma vaccine based on recombinant adenovirus expressing human dopachrome tautomerase in the B16F10 murine melanoma model. We found that in the presence of a tumor, the magnitude of T-cell immunity evoked by the vaccine was significantly reduced. This impairment was compounded by defects in cytokine production and degranulation within the tumor-infiltrating lymphocytes (TILs). We showed that the combination of vaccination with high-dose cyclophosphamide was able to skew the response toward the target antigen and enhanced both the quantity and quality of antigen-specific CD8+ and CD4+ T-cell responses in tumor-bearing mice, which resulted in the inhibition of tumor growth. Furthermore, when tumor-specific antigens were targeted by the vaccine, the combination therapy could actually produce tumor regression, which appeared to result from the high frequency of antigen-specific T cells. These data show that recombinant adenovirus vaccines are compatible with conventional high-dose chemotherapy and that the combined treatment results in improved therapeutic outcomes relative to either agent individually.

Designing spatially heterogeneous strategies for control of virus spread

The spread of a virus--whether in a human population, computer network or cell-to-cell--is closely tied to the spatial (graph) topology of the interactions among the possible infectives. The authors study the problem of allocating limited control resources (e.g. quarantine or recovery resources) in these networks in a way that exploits the topological structure, so as to maximise the speed at which the virus is eliminated. For both multi-group and contact-network models for spread, these problems can be abstracted to a particular decentralised control problem for which the goal is to minimise the dominant eigenvalue of a system matrix. Explicit solutions to these problems are provided, using eigenvalue sensitivity ideas together with constrained optimisation methods employing Lagrange multipliers. The proposed design method shows that the optimal strategy is to allocate resources so as to equalise the propagation impact of each network component, as best as possible within the constraints on the resource. Finally, we show that this decentralised control approach can provide significant advantage over a homogeneous control strategy, in the context of a model for SARS transmission in Hong Kong.

Enterochromaffin cell and 5-hydroxytryptamine responses to the same infectious agent differ in Th1 and Th2 dominant environments

BACKGROUND/AIM

5-Hydroxytryptamine (5-HT) released from enterochromaffin cells influences intestinal homeostasis by altering gut physiology and is implicated in the pathophysiology of various gut disorders. The mechanisms regulating 5-HT production in the gut remain unclear. This study investigated the T helper (Th) 1/Th2-based immunoregulation of enterochromaffin cell function and 5-HT production in a model of enteric infection.

METHODS AND RESULTS

Trichuris muris-infected AKR (susceptible to infection and generates Th1 response), BALB/c (resistant to infection and generates Th2 response), Stat4-deficient (impaired in Th1 response) and Stat6-deficient (impaired in Th2 response) mice were investigated to assess enterochromaffin cells, 5-HT and cytokines. In association with the generation of a Th2 response we observed higher enterochromaffin cell numbers and 5-HT content in the colon of BALB/c mice compared with AKR mice. Numbers of enterochromaffin cells and amount of 5-HT were significantly lower in Stat6-deficient mice after infection compared with Stat4-deficient mice. In addition, enterochromaffin cell numbers and 5-HT content were significantly higher after reconstitution of severe combined immunodeficient mice with in-vitro polarised Th2 cells.

CONCLUSION

The study demonstrated that enterochromaffin cell and 5-HT responses to the same infectious agent are influenced by Th1 or Th2 cytokine predominance and suggests that the immunological profile of the inflammatory response is important in the regulation of enterochromaffin cell biology in the gut. In addition to new data on enterochromaffin cell function in enteric infection and inflammation, this study provides important information on the immuno-endocrine axis in the gut, which may ultimately lead to improved strategies against gut disorders.

Urinary levels of RANTES and M-CSF are predictors of lupus nephritis flare

OBJECTIVE

To explore a new predictor of renal flares after successful inductive treatment for diffuse proliferative glomerulonephritis(DPGN) in patients with lupus nephritis.

METHODS

A cohort of patents with SLE DPGN who were treated initially with prednisone and cyclophosphamide were studied. Those who responded to inductive treatment were followed up for the occurrence of renal flares. Urinary levels of RANTES, MCP-1 and M-CSF were measured by ELISA. Other clinical and laboratory data were collected. The predictors and outcome of renal flare were analyzed.

RESULTS

Seventy-three qualified patients with SLE DPGN were investigated. After a mean follow-up of 24.5 +/- 6.4 months, 22 patients experienced renal flares. The median time to relapse was 14.1 +/- 4.1 months. The patients experiencing renal flare showed higher urinary RANTES, MCP-1 and M-CSF. However, independent predictors of renal flares were increased urinary RANTES and M-CSF. Eight patents developed doubling of the serum creatinine (CRX2) level. The occurrence of renal flares was the only predictor of CRX2.

CONCLUSIONS

Persistently increased urinary levels of RANTES and M-CSF after initial remission are predictors of renal flare in patients with SLE DPGN. Our results indicate monitoring urinary pro-inflammatory factors may direct us in managing those patients.

Zeolite (clinoptilolite) as feed additive to reduce manure mineral content

Clinoptilolite (a species of zeolite) as grower hog feed additive can potentially improve nutrient ingestion and lower manure nutrient levels. A first objective was to establish the optimal particle size of the zeolite powder, as a fine size increases the adsorption surface while a coarse size can facilitate handling. The second objective tested the effect of feeding zeolite on manure nutrient levels. For the first objective, three zeolite powders (250-500 microm; 50-250 microm, and 50-500 microm) were exposed to an NH(4)(+) solution under a pH of either 7.0 or 2.0. The resulting solutions were tested for cation exchange. A commercial zeolite was also tested for the pH of 2.0 to evaluate zeolite stability. At 0%, 5% and 10% humidity, the same three particle size powders were subjected to shear tests to determine the zeolite's angle of friction. For the second objective using metabolic cages, female hogs were subjected to one of four rations (a control and three with zeolite) while collecting and analyzing their manures. For the first objective, the coarse particle zeolite performed best, adsorbing 158 and 123 Cmol(+)/kg of NH(4)(+) under neutral and acid pH, respectively, and releasing an equivalent amount of minerals only under neutral pH. The commercial zeolite with less clinoptilolite released more Al, Fe, Cu and Pb, showing less stability. The high internal angle of friction of zeolite did not vary with particle size and moisture, indicating funnel flow under gravity. For the second objective, hogs fed a zeolite diet produced manure with 15% and 22% less N and P, respectively, and demonstrated a better feed conversion, although not statistically significant (P>0.05). These results show that there is some potential in using high quality clinoptilolite in the ration of grower hogs.

Clinical significance of Cdh1-Skp2 cascade in breast cancer

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Background: Skp2 (S-phase kinase-associated protein 2) is substrate-recognizing subunit of an ubiquitin E3 ligase SCF (Skp1, Cullin and F-box) complex and has a major role in p27 regulation. Overexpression of Skp2 is frequently seen in human tumors, often correlating with poor prognosis. Anaphase-promoting complex/cyclosome (APC/C) is another most prominent ubiquitin E3 ligase in cell cycle control, and its function is tightly controlled by activating subunit Cdh1 (Fizzy-related). APC-Cdh1 complex is supposed to be involved in Skp2 proteolysis and have essential role for S phase entry, however clinical significance of Cdh1 have not evaluated yet. Herein we examined the significance of Cdh1 in breast cancer. Methods: Firstly, MCF7 human breast cancer cells and MCF10A normal breast epithelial cells were analyzed in vitro and in vivo. Thereafter, using tissue microarray, we evaluate the expression profile of Cdh1, Skp2 and p27 in both breast cancer and normal breast epithelial tissue. Moreover, clinicopathological significance (age, tumor size, lymph node metastasis, distant metastasis, histological grade, and stage) of Cdh1 was analyzed from 126 breast cancer patients. Chi square-test, Fisher's exact test were used for statistical analysis of immunostaining results and clinicopathological data. p<0.05 was considered statistically significant. Results: Overexpression of Cdh1 induced attenuation of Skp2 and increased p27 protein expression, resulted in growth suppression. Moreover, knockdown of Cdh1 promoted higher Skp2 expression and S-phase population, reduced p27 and consequently induced cell transformation and proliferation in vitro and in vivo. Tissue microarray results appeared that positive Cdh1 and p27 was more frequently seen in normal breast tissue and statistically significant. On the other hand, Skp2 was less in normal tissue. Furthermore, Cdh1 positive breast cancer was more frequently seen in low histological grade tumors and statistically significant (p=0.04). Conclusions: Skp2 protein expression is regulated by Cdh1 in breast cancer. Cdh1 expression could be possible novel biomarker in patient with breast cancer.

No significant financial relationships to disclose.