CD133-Dependent Activation of Phosphoinositide 3-Kinase /AKT/Mammalian Target of Rapamycin Signaling in Melanoma Progression and Drug Resistance

Melanoma frequently harbors genetic alterations in key molecules leading to the aberrant activation of PI3K and its downstream pathways. Although the role of PI3K/AKT/mTOR in melanoma progression and drug resistance is well documented, targeting the PI3K/AKT/mTOR pathway showed less efficiency in clinical trials than might have been expected, since the suppression of the PI3K/mTOR signaling pathway-induced feedback loops is mostly associated with the activation of compensatory pathways such as MAPK/MEK/ERK. Consequently, the development of intrinsic and acquired resistance can occur. As a solid tumor, melanoma is notorious for its heterogeneity. This can be expressed in the form of genetically divergent subpopulations including a small fraction of cancer stem-like cells (CSCs) and non-cancer stem cells (non-CSCs) that make the most of the tumor mass. Like other CSCs, melanoma stem-like cells (MSCs) are characterized by their unique cell surface proteins/stemness markers and aberrant signaling pathways. In addition to its function as a robust marker for stemness properties, CD133 is crucial for the maintenance of stemness properties and drug resistance. Herein, the role of CD133-dependent activation of PI3K/mTOR in the regulation of melanoma progression, drug resistance, and recurrence is reviewed.

Characterization of steel lined with multilayers of micro/nano-polymeric composites.. [DOI: 10.21203/rs.3.rs-1630739/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0]

A more cost-effective method to prevent steel structures from degradation is coating. This study investigated a comparison between different configurations of three multilayers polymeric coating on both sides of steel. Epoxy filled with 1 wt%, 2wt%, and 3wt% micron or nano-sized alumina (Al2O3) particles represents the coating layers to steel on both sides. Mechanical and barrier resistance properties were conducted on the micro/nanocomposite coated specimens and compared with pure epoxy coated specimens. Barrier resistance was performed by immersing the lined steel specimens in salt solution and in citric acid medium. Adding alumina (Al2O3) particles in micron and nano size to epoxy coatings improves the barrier resistance, the tensile and hardness under dry and wet conditions as compared to pure epoxy coating. The maximum improvement of the tensile strength and barrier resistance was attained with the addition of 1wt% Al2O3 nanoparticles. Further increases in Al2O3 micro/nanoparticles cause deterioration in tensile strength and barrier resistance. Good properties were observed with stepwise graded micro/nanocomposite coatings. However, the maximum improvement of hardness under dry and wet conditions improved with the further addition of 3wt% Al2O3 nanoparticles to epoxy coatings.

Using ANN and OA techniques to determine the specific wear rate effectors of A356 Al-Si/Al2O3 MMC

In the present work, it’s required to obtained the wear rate effectors’ values of A356 Al-Si/Al2O3 composite (Al2O3 wt%, applied load, hardness, and sliding distance) required to obtain a certain specific wear rate. So, the specific wear behavior of cast and heat-treated A356 Al-Si/Al2O3 metal matrix composites (MMC) were investigated as a function of its effectors. Five weight fractions of Al2O3 particles were used to produce specimens using stir casting. Two different hardness are obtained for each fraction (casted and heat-treated specimens). Sliding wear tests were done under three loads (20, 30, and 40 N), four sliding distances (310, 620, 930 and 1240 m) at constant speed (1 m/min). Experimental results indicated that the specific wear rate is generally reversed proportional to Al2O3 percentage. The impact of Al2O3 percentage was eliminated with the grown of applied load. Increasing the applied load decreases the specific wear rate, up to 20% Al2O3. However, at 25% Al2O3 the applied load increases the specific wear rate with a small graduation. Moreover, the heat treatment process improves the hardness and specific wear behavior of the casted MMC. Both Artificial neural network (ANN) and multiple regression techniques were used to predict the wear rate. The orthogonal array technique (OA) used in selecting the data set to train ANN and obtained a 2nd degree regression equation. ANN gives more realistic prediction then the regression equation. So, at the end, an algorithm is designed and tested to determine the weight fraction and other wear rate effectors for A356 Al-Si/Al2O3 MMC to obtain a certain wear rate, according to the uncertainty of the ANN. The used algorithm for obtaining the wear rate effectors provides a very good choices to produce a certain wear rate’s value, with error less than 1%.

Zwanzig-Nagel-Dystrophie der Kindheit

Zwanzig-Nagel-Dystrophie (ZND) der Kindheit ist eine seltene gutartige Nagelkrankheit, bei der alle 20 Nägel betroffen sind. Sie tritt normalerweise idiopathisch auf, kann sich aber mit einer Vielzahl von dermatologischen und nicht dermatologischen Erkrankungen entwickeln. Histopathologisch handelt es sich u. a. um eine Entzündung der Matrix der Nägel, deren Ausmaß zu dem Schweregrad des klinischen Bilds beiträgt. ZND der Kindheit ist i. d. R. eine selbstlimitierende Erkrankung, sodass die Beratung und Beruhigung des Kindes und der Eltern als vernünftige Behandlungsmöglichkeiten gelten. Wir berichten über einen Fall eines 7-jährigen Jungen mit einer 1-jährigen Vorgeschichte von 20-Nagel-Dystrophie ohne eigene Krankheiten oder Haut- oder Nagelerkrankungen in der Familienanamnese.

Chitosan-based nanocomposites: preparation and characterization for food packing industry

In the present work, Cerium (IV)-Zirconium (IV) oxide nanoparticles (CeO4ZrNPs) was successfully dispersed into Chitosan/15Gelatin nanocomposites with different quantities. The obtained chitosan-based nanocomposites represented remarkable improvements in structural, morphological, mechanical, and thermal properties. Roughness increased from 74 nm to 6.4 nm, Young’s Modulus enhanced from 1.36 GPa to 2.99 GPa. The influence of dispersed CeO4ZrNPs contents on the phase transition temperature (T g) and the non-isothermal degradation processes of chitosan-based nanocomposites were examined using Differential Scanning Galorimetry (DSC) with different heating rates. Kinetic parameters of the thermal degradation for chitosan-based nanocomposites were evaluated using Kissinger-Akahira-Sunose (KAS) and Kissenger (KIS) procedures. Chitosan-based nanocomposites showed an increase in the thermal degradation temperature with higher activation energies, indicating improved thermal stability. Thermal analysis demonstrated that chitosan-based nanocomposites became more ordered by increasing CeO4ZrNPs as inferred from the negative entropy increase. Moreover, the degradation of chitosan-based nanocomposites has been described as a non-spontaneous process. The resulting information is particularly important in applications in which there is a need to obtain chitosan nanocomposites with improved mechanical and thermal properties such as food packing industry.

Synthesis of developed rice straw sheets and glass fiber-reinforced polyester composites

In this study, a sheet of random rice straw fiber was developed. These rice straw sheets were used to reinforce polyester matrix. Synthesis of rice straw sheets and glass fibers as synthetic fibers-reinforced polyester composites were investigated. Several new stacking sequences were fabricated with random glass fiber mats with different areal densities (225 g/m2, 300 g/m2, and 450 g/m2) and rice straw sheets. The specific mechanical properties of these natural/synthetic fiber composites were investigated. Scanning electron microscopy was used to study the morphology of the fracture surfaces of the fabricated hybrid composites. Experimental results showed that specific tensile and flexural stiffness of rice straw fiber composite is better those obtained with glass fiber composites. The hybrid natural/synthesis composites with alternating glass fiber mat with areal densities 300 g/m2, and rice straw shows higher specific tensile strength than rice straw and other hybrid composites. Hybrid composites with high areal density on the outer surfaces yield a significant increase in flexural-specific strength and hardness as compared to other fabricated composites.

[Double sensitization to PR10 and PR-14 proteins]

A patient with mild oral allergy syndrome presented with a history of anaphylaxis induced by both hazelnuts and peaches. The ensuing work-up showed a double sensitization to proteins in both pathogenesis-related group 10 (e.g. Bet v1, Cor a1, Pru p1) and 14 (e.g. Pru p3, Cor a8). Such double sensitization profiles are increasingly being recognized in Europe.

[Folliculotropic mycosis fungoides]

BACKGROUND

Folliculotropic mycosis fungoides represents a rare variant of the CD4-positive cutaneous T-cell lymphoma mycosis fungoides. It is characterized by tropism of the lymphocytic infiltrate for hair follicle and other adnexal structures.

CASE PRESENTATION

Our patient presented with a 20-year history of pruritic skin lesions, which had been diagnosed as atopic dermatitis. The diagnosis of folliculotropic mycosis fungoides was confirmed by skin biopsy. Since topical therapy was ineffective, systemic therapy was initiated promptly. Treatment with pegylated interferon alpha-2b 25 µg/week led to significant improvement of the skin condition.

CONCLUSION

Due to its polymorphic clinical presentation, folliculotropic mycosis fungoides is diagnosed with delay and in a later stage than classical mycosis fungoides. Thus we recommend an early skin biopsy in patients with therapy-resistant pruritic skin lesions.

[Anaphylaxis to PR-10 proteins (Bet v1 homologues)]

Secondary food allergies to PR-10 proteins (Bet v1 homologues) are the most common food allergies in Germany. Clinically they present with an oral allergy syndrome (intraoral pruritus and perhaps swelling). When drinks containing PR-10 proteins are rapidly consumed, for example after sporting activities, large concentrations of allergen can be reached without any intraoral symptoms and then lead to anaphylaxis. This phenomenon has often been described for soja milk and occurred in our case with an apple drink with 60% fruit concentration. It seems likely that such cases of anaphylaxis are not adequately represented in the anaphylaxis registry.

[Squamous cell carcinoma as the most common oral carcinoma. Diagnosis and therapy]

BACKGROUND

About 5 % of all malignant tumors affect oral cavity. With a share of 95% squamous cell carcinoma is the most common type of the malignant tumors of oral mucosa.

CASE REPORT

In our case the patient developed a squamous cell carcinoma of buccal mucosa about 2 years after excision of verrucous leukoplakia with epithelial dysplasia at the same location. Although chronic alcohol abuse, tobacco use and infection with HPV 16 are the most important risk factors for development of squamous cell carcinoma of the oral cavity, our patient had none of these risk factors. We treated the patient in accordance with current guidelines by complete excision of the tumor as well as an elective neck dissection of the ipsilateral side. Untill the present time the patient is free of recurrence.

CONCLUSIONS

Although rare, squamous cell carcinoma of oral mucosa may also occur in patients that have no risk factors for it. Therefore, every dental and medical examination in each patient should include an inspection of the entire oral mucosa.

[Pyogenic granuloma of the oral mucosa]

Pyogenic granuloma is regarded as a vascular proliferation that may result from trauma or local irritation. The most common intraoral site is the gingiva, affected in 75 % of cases. Therapy of pyogenic granuloma consists of surgical excision. Recurrence after excision may occur. In our patient, there were no post-operative complications.

[Lupoid perioral dermatitis as a special form of perioral dermatitis: review of pathogenesis and new therapeutic options]

Lupoid perioral dermatitis is classified as a special form of perioral dermatitis with dense aggregations of red-brown papules which display a lupoid infiltrate on diascopy. There are various treatment options ranging from total avoidance of all topical substances to different topical treatment. Cases resistant to therapy require systemic treatment, which, however, is off-label use. In our case we were able to achieve a significant improvement with systemic therapy with isotretinoin over a period of 6 months.

[Pemphigus vulgaris. Therapy with cyclophosphamide]

Pemphigus vulgaris is an autoimmune blistering disorder. The diagnosis is based on clinical presentation, histology, and direct and indirect immunofluorescence. Optimal treatment remains the greatest challenge. Treatment options include combinations of systemic steroids with azathioprine, mycophenolate, and cyclophosphamide. However, there is little solid data regarding the drug of choice. In our patient, the best tolerated and effective treatment was found after several therapeutic attempts.

[Polypoid basal cell carcinoma]

The basal cell carcinoma is a malignant tumor which originates from the epidermal stem cells. The polypoid basal cell carcinoma is an uncommon variant. We report on a 70-year-old man with a red nodule on his left breast. Clinical and histopathologic criteria led to the diagnosis of polypoid basal cell carcinoma. This variant is characterized by exophytic, polypoid growth. Histologically, the aggregates of tumor cells are usually limited to the polypoid zone.

[Eccrine poroma]

A 42-year-old man presented with a rapidly growing nodule on his right cheek. Except for some itching, it was asymptomatic. The tumor was excised with 3-4 mm safety margin. The clinical differential diagnostic considerations included pyogenic granuloma, amelanotic melanoma, basal cell carcinoma and eccrine poroma. An eccrine poroma is a rare tumor derived from the eccrine sweat gland. Hormonal disturbances, trauma, immunosuppression, actinic damages and radiotherapy have been suggested as possible etiologic factors; however, the exact pathophysiology remains unclear.

Coiling of ruptured tiny cerebral aneurysms, feasibility, safety, and durability at midterm follow-up, and individual experience

BACKGROUND AND PURPOSE

The tiny size of cerebral aneurysms represents one of the challenging facets for endovascular treatment, with a high risk for intraoperative rupture (IOR). We report on the treatment of tiny ruptured saccular cerebral aneurysms by coil embolization. All cases were that of £ 2-3 mm aneurysms with at least one of the dimensions < 2 mm.

MATERIALS AND METHODS

Between April 2008 and December 2010, we performed a retrospective analysis of nine consecutive cases of tiny aneurysms treated by coil embolization in our institution.

RESULTS

Coil embolization was successfully performed in nine cases, whereas in one case, intraoperative rupture (IOR) of the fundus was encountered before complete obliteration of the aneurysm expected to be achieved with two coils. Complete occlusion (in n = 7 aneurysms) or near-complete immediate occlusion (in n = 2 aneurysms) was achieved. A total of 18 coils was used for coiling of the nine aneurysms, wherein five aneurysms were coiled with two coils each, two aneurysms with three coils each, and two aneurysms with only one coil each to achieve accepted results. Balloon assistance was used in three cases. Although a minimal coil projection in the parent vessel was seen in three cases, no untoward clinical complications were seen. At mean follow-up (6.7 months, interquartile range (IQR) 3-12 months), digital subtraction angiography (DSA) and magnetic resonance angiography (MRA) in nine patients demonstrated persistent complete occlusion in six of the aneurysms; one aneurysm showed marked filling of the fundus, and two showed neck remnant but did not need retreatment. All patients with available follow-up were independent in day-to-day activities with a modified Rankin score (mRS) of 0 or 1.

CONCLUSIONS

Coil embolization of tiny ruptured cerebral aneurysms is feasible. Careful consideration of the technical issues in treatment of such aneurysms is essential to achieve technical success while avoiding complications.

[Mycosis fungoides palmaris et plantaris]

Mycosis fungoides (MF) is a low-grade cutaneous T-cell lymphoma characterized by skin-homing CD4- positive helper T cells. Mycosis fungoides palmaris et plantaris is an uncommon variant primarily involving the palms and soles. An 80-year old man presented with hyperkeratotic erythematous palmoplantar changes. Clinical and histopathologic criteria led to the diagnosis mycosis fungoides palmaris et plantaris. Tumor staging using sonography of the abdomen and lymph nodes, chest x-ray and blood examination is recommended, because extracutaneous manifestations may be present.

[Keratosis palmoplantaris papulosa]

Keratosis palmoplantaris punctata (KPPP) is a rare genodermatosis inherited in autosomal dominant fashion. Clinical findings are multiple, hyperkeratotic, mostly asymptomatic, pinhead-sized papules localized on the palms and soles with progression to hyperkeratotic plaques at pressure sites. A 79-year-old woman presented with a history of hyperkeratotic papules on the palms and soles. Clinical and histopathologic criteria led to the diagnosis KPPP. Identification of causative genes is necessary to permit a better classification and estimation of associated disorders.

[Pemphigus erythematosus]

Pemphigus erythematosus, also known as Senear-Usher syndrome, was originally described as a variant of pemphigus with features of lupus erythematosus but regarded today as a localized form of pemphigus foliaceus and considered an autoimmune bullous disease. The autoantigen is desmoglein 1, a desmosomal adhesion protein in keratinocytes. A 69-year-old man presented with a 3-month history of erosions and blisters on the cheeks, which then also appeared on the trunk. Clinical and histopathologic criteria as well as immunofluorescence studies lead to the diagnosis of pemphigus erythematosus with transition to pemphigus foliaceus.

[Disseminated cutaneous leiomyomas]

Cutaneous leiomyomas are benign smooth muscle tumors. Depending on the site of origin, one distinguishes three different types--piloleiomyoma, angioleiomyoma and genital leiomyoma. They appear between the first and third decades of life. A 56-year-old woman presented with painful red - brown papules and nodules on her trunk. Based on clinical and histological criteria the diagnosis of disseminated cutaneous leiomyomas was made. Because of the widespread cutaneous involvement, surgical treatment was not possible. Therefore we decided to employ a pharmacologic anti-depressive treatment. With this approach, the patient experienced considerable pain reduction.

[Congenital self-healing Langerhans cell histiocytosis]

A male infant, born at term after an uncomplicated pregnancy, presented with multiple red-brown papules and nodules spread over his body. The infant's general condition was not affected and there was no systemic involvement. After only 6 weeks the lesions had healed completely without recurrence. Based on histological and immunohistochemical findings, the clinical appearance and the self-healing course, the diagnosis of congenital self-healing Langerhans cell histiocytosis was established.

Extrapontine myelinolysis and cortical laminar necrosis caused by severe hypernatremia following peritoneal lavage for ruptured hydatid cyst of the liver. A case report and review of the literature

Extrapontine myelinolysis (EPM) and cortical laminar necrosis (CLN) have rarely been reported in association with severe hypernatremia. We describe a patient with EPM associated with CLN following severe hypernatremia due to hypertonic peritoneal lavage after a ruptured hydatid cyst of the liver. Clinical and neuroimaging findings in acute stage and serial brain MRI at two and five month follow-up are discussed in detail.

[Malignant fibrous histiocytoma]

A 62-year-old patient presented with slow-growing blue-red tumor on his left forearm for around two years. A biopsy revealed the tumor was a rare malignant fibrous histiocytoma (MFH). The finger-like extensions of MFH in the fatty tissue are responsible not only for the high local recurrence rate, but also increase the metastatic potential and affect the prognosis. For this reason radical surgery with surgical margins of 2-3 cm is absolutely required. After wide excision, the patient has been alive for years without evidence of local recurrence or distant metastasis.

[Cutis verticis gyrata with a combined blue and congenital dermal nevus]

Cutis verticis gyrata (CVG) describes a rare thickening and folding of the scalp resembling the outer surface of the brain. Secondary CVG is caused by a variety of diseases such as nevi. A 38-year-old woman presented with a long history of a deformed right parietofrontal scalp. Clinical and histopathologic criteria lead to the diagnosis of CVG secondary to a combined blue and congenital nevus. Reports of malignant melanoma developing in this clinical setting mean that each patient must be followed closely or considered for prophylactic excision.

Thyroglossal duct cyst papillary carcinoma

Thyroglossal duct cysts are usually located in the midline of the neck. The coexistence of carcinomas in thyroglossal duct cysts is extremely rare, with most being papillary carcinomas. Usually, the diagnosis is only made postoperatively after excision of the cyst. Although the Sistrunk procedure is often regarded as adequate, controversies exist concerning the need for thyroidectomy depending on histopathological findings. We report the case of a 31-year-old man diagnosed with papillary carcinoma within a thyroglossal duct cyst, who underwent total thyroidectomy as has been recommended for differentiated papillary cancer.

[Linear IgA disease of the oral mucosa with pharyngeal and esophageal involvement]

A 69-year-old man presented with multiple recurrent oral ulcerations for about 20 years. After he began having difficulty in breathing and swallowing, esophagogastroscopy was performed and showed ulcerations, erosions and scars on the mucous membrane of the pharynx as well of the esophagus. Linear IgA disease (LAD) was diagnosed based on histopathological and immunofluorescence examinations. In this patient with LAD, the buccal, pharyngeal and esophageal mucosa was affected without involvement of the skin.

[Multinucleate cell angiohistiocytoma]

Multinucleate cell angiohistiocytoma is a rare, benign, usually asymptomatic fibrohistiocytic and vascular proliferation which occurs predominantly on the extremities of middle-aged women. Histology shows characteristic multinucleate cells and is indispensable for diagnosis. We present a 42-year-old man from Egypt who was diagnosed with multinucleate cell angiohistiocytoma on the left cheek. As no malignant transformation has been reported, with the patient's agreement, no treatment was performed.

Pre-expanded Extended Island Parascapular Flap for Reconstruction of Post-burn Neck Contracture

Background. Since it was described by Nassif et al. in 1982, the parascapular flap has been used as a pedicled or island flap for axillary contractures and as a free flap for neck reconstruction. To the best of our knowledge, there are no reports in English describing its use as an island flap for neck reconstruction. Methods. Nine patients with severe post-burn neck contracture scars were reconstructed with pre-expanded extended island parascapular flaps. Results. All flaps survived completely, providing thin skin coverage of the neck defect with satisfactory natural appearance. The size of the flaps ranged from 32 to 44 cm in length and 11 to 16 cm in width (mean: length 38.2; width, 14.2 cm). No debulking was done but secondary revisions such as Z-plasty and scar revision were performed for all flaps. The donor site was closed primarily in all patients but delayed wound healing was recorded in two. Widening and hypertrophic scar changes developed at the donor site of seven patients. Conclusions. The utilization of pre-expanded extended island parascapular flap is an effective way for reconstruction of post-burn neck contracture. It provides a large good-quality skin flap that can cover all the aesthetic units of the neck without any microvascular anastomosis. However, the protracted time required for the procedure and the requirement of two operations, plus the repeated follow-up visits, may constitute major disadvantages.

[Primary cutaneous CD30+ ALK(-) anaplastic large cell T-cell lymphoma]

Anaplastic large cell lymphomas (ALCL) are characterized by large, pleomorphic cells with a strong expression of cytokine receptor CD 30. We present a 71-year-old patient with several nodules on the right temple extending to his right ear. Based on clinical, histological and immunophenotypic criteria, the diagnosis of a primary cutaneous CD30(+) ALK(-) anaplastic large cell lymphoma was made. After local excision and adjuvant radiotherapy no relapse occurred during a follow-up period of three months.

[HPV type 33-associated penile intraepithelial neoplasia (PIN)]

For appoximately 6 month a 69-year old man had been suffering from an itching scaly skin change of the penis. Virological and histological examinations confirmed the diagnosis of an intraepithelial neoplasia induced by an infection with human papillomavirus (HPV) type 33. HPV type 33 is comparatively rarely detected in intraepithelial neoplasia. In anogenital lesions intraepithelial neoplasia should be considered and confirmed via histological and virological examinations.

[Therapy of subcorneal pustulosis (Sneddon-Wilkinson disease) with tacalcitol]

Subcorneal pustular dermatosis is a rare, chronic recurrent disease with disseminated pustules involving trunk and proximal extremities. We report on a patient in whom topical treatment with tacalcitol induced a complete remission.

[Eccrine adenocarcinoma in a patient with familial breast carcinoma]

A 67-year-old patient developed a subcutaneous, non-tender nodule in her left groin over a period of about seven years. The patient underwent surgery and 4 procedures were required to obtain complete excision. The histopathologic findings showed eccrine adenocarcinoma, a member of the heterogeneous group of sweat gland tumors which occur primarily in adults with a peak of 50-60 years of age. Sweat gland carcinomas are extremely rare neoplasms of the skin and exhibit a slow growth rate with a rather high local recurrence rate. The tumor has a disposition to metastasize and shows a poor response rate to adjuvant therapy regimens. Therefore wide, deep surgical excision with an excision margin of 2-3 cm is the treatment of choice. Nevertheless there are some case reports on successful therapy of a metastasized sweat gland carcinoma with 5-fluorouracil and tamoxifen. Here further studies are needed to achieve a better survival rate for patients with metastatic disease.