Agro-morphological characterization of Pakistani maize accessions using qualitative and quantitative traits

Abstract Agro-morphological characterizations offer robust and vigorous means for the precise characterization of germplasm to be used in breeding programs. Here, agro-morphological features-based analyses were considered to figure out the genetic variability within 99 maize accessions and five (5) check varieties including Azam, W. Islamabad, Haq Nawaz, Ev-5 and Evr197. A total of 28 important agro-morphological traits were accounted in the field trails at Hazara University Mansehra Pakistan, during spring 2015. The maximum variation was detected in grain weight per cob (53.43), followed by number of kernels per row (38.64) and flag leaf area (cm2), (38.09%). Cluster analysis divided the 99 maize accession with five check varieties of maize accessions into 7 clusters following the hierarchical clustering. Cluster II recorded 29 genotypes with maximum grain yield per cob, and highest flag leaf length, followed by cluster IV. Lowest grain yield per cob was noted for accessions of cluster I. Similarly, cluster VII consisted of accession with the longest cob length. Moreover, the investigations also revealed that the primary constituent among first five principal components with an eigen value about more than 0.98 in relation to 68.75% of the total variants. PCI accounted for 25.53%, PCII contributed 18.31%, and PCIII is 9.88% of the overall morphological variability were significant contributors were grain weight per cob, number of kernel per row, 1000 grain weight. The identification of a significant level of genetic diversity during the present investigation having implications for maize germplasm characterisation, conservation, and breeding programs aiming at developing improvement maize cultivars.

Mesenchymal Stem Cell-Derived Exosomes and Their MicroRNAs in Heart Repair and Regeneration

Mesenchymal stem cells (MSCs) can be differentiated into cardiac, endothelial, and smooth muscle cells. Therefore, MSC-based therapeutic approaches have the potential to deal with the aftermaths of cardiac diseases. However, transplanted stem cells rarely survive in damaged myocardium, proposing that paracrine factors other than trans-differentiation may involve in heart regeneration. Apart from cytokines/growth factors, MSCs secret small, single-membrane organelles named exosomes. The MSC-secreted exosomes are enriched in lipids, proteins, nucleic acids, and microRNA (miRNA). There has been an increasing amount of data that confirmed that MSC-derived exosomes and their active molecule microRNA (miRNAs) regulate signaling pathways involved in heart repair/regeneration. In this review, we systematically present an overview of MSCs, their cardiac differentiation, and the role of MSC-derived exosomes and exosomal miRNAs in heart regeneration. In addition, biological functions regulated by MSC-derived exosomes and exosomal-derived miRNAs in the process of heart regeneration are reviewed.

Ascorbic acid and salvianolic acid B enhance the valproic acid and 5-azacytidinemediated cardiac differentiation of mesenchymal stem cells

BACKGROUND

Cardiovascular diseases remain a major cause of death globally. Cardiac cells once damaged, cannot resume the normal functioning of the heart. Bone marrow derived mesenchymal stem cells (BM-MSCs) have shown the potential to differentiate into cardiac cells. Epigenetic modifications determine cell identity during embryo development via regulation of tissue specific gene expression. The major epigenetic mechanisms that control cell fate and biological functions are DNA methylation and histone modifications. However, epigenetic modifiers alone are not sufficient to generate mature cardiac cells. Various small molecules such as ascorbic acid (AA) and salvianolic acid B (SA) are known for their cardiomyogenic potential. Therefore, this study is aimed to examine the synergistic effects of epigenetic modifiers, valproic acid (VPA) and 5-azacytidine (5-aza) with cardiomyogenic molecules, AA and SA in the cardiac differentiation of MSCs.

METHODS AND RESULTS

BM-MSCs were isolated, propagated, characterized, and then treated with an optimized dose of VPA or 5-aza for 24 h. MSCs were maintained in a medium containing AA and SA for 21 days. All groups were assessed for the expression of cardiac genes and proteins through q-PCR and immunocytochemistry, respectively. Results show that epigenetic modifiers VPA or 5-aza in combination with AA and SA significantly upregulate the expression of cardiac genes MEF2C, Nkx2.5, cMHC, Tbx20, and GATA-4. In addition, VPA or 5-aza pretreatment along with AA and SA enhanced the expression of the cardiac proteins connexin-43, GATA-4, cTnI, and Nkx2.5.

CONCLUSION

These findings suggest that epigenetic modifiers valproic acid and 5-azacytidine in combination with ascorbic acid and salvianolic acid B promote cardiac differentiation of MSCs. This pretreatment strategy can be exploited for designing future stem cell based therapeutic strategies for cardiovascular diseases.

Evaluation of economic loss caused by Indian crested porcupine (Hystrix indica) in agricultural land of district Muzaffarabad, Azad Jammu and Kashmir, Pakistan

The Indian crested porcupine (Hystrix indica) is a vertebrate pest of agricultural lands and forest. The study was aimed to report the damage to local crops by the Indian crested porcupine (Hystrix indica) in the Muzaffarabad District. A survey was conducted to identify the porcupine-affected areas and assess the crop damage to the local farmers in district Muzaffarabad Azad Jammu and Kashmir (AJK) from May 2017 to October 2017. Around 19 villages were surveyed, and a sum of 191 semi-structured questionnaires was distributed among farmers. Crop damage was found highest in village Dhanni where a porcupine destroyed 175 Kg/Kanal of the crops. Regarding the total magnitude of crop loss, village Danna and Koomi kot were the most affected areas. More than half (51.8%) of the respondents in the study area suffered the economic loss within the range of 101-200$, and (29.8%) of the people suffered losses in the range of 201-300$ annually. Among all crops, maize (Zea mays) was found to be the most damaged crop ranging between 1-300 Kg annually. In the study area, porcupine also inflicted a lot of damages to some important vegetables, including spinach (Spinacia oleracea), potato (Solanum tuberosum) and onion (Allium cepa). It was estimated that, on average, 511Kg of vegetables are destroyed by porcupine every year in the agricultural land of Muzaffarabad. It was concluded that the Indian crested porcupine has a devastating effect on agriculture which is an important source of income and food for the local community. Developing an effective pest control strategy with the help of the local government and the Wildlife department could help the farmers to overcome this problem.

A comparative study to evaluate the effects of antibiotics, plant extracts and fluoride-based toothpaste on the oral pathogens isolated from patients with gum diseases in Pakistan

Oral diseases caused by various microorganisms are common around the world. Scientific research has now been focusing on novel medicines to overcome bacterial resistance and antibiotics side effects; therefore, the current study was designed to assess the efficacy of certain antibiotics, toothpaste, and medicinal plant extracts (Ajuga bracteosa and Curcuma longa) versus the bacterial pathogens isolated from the human oral cavity. A total of 130 samples were collected from Khyber Teaching Hospital Peshawar, Pakistan, among those 27 species isolated, and eight bacterial species were identified from the samples. Among all the bacterial species, Staphylococcus aureus (29.62%) and Proteus mirabilis (22.2%) were found to be more prevalent oral pathogens. In comparison, the least pervasive microbes were Proteus vulgaris, Shigella sonnei, Escherichia coli and Aeromonas hydrophila. The study also suggested that dental problems were more prevalent in males (41-50 years of age) than females. Among the eight antibiotics used in the study, the most promising results were shown by Foxicillin against A. hydrophila. The survey of TP1 revealed that it showed more potent antagonist activity against Proteus vulgaris as compared TP2 and TP3 that might be due to the high content of fluoride. The Curcuma longa showed more significant activity than Ajuga bracteosa (Stem, leaves and root) extracts. The data obtained through this study revealed that antibiotics were more effective for oral bacterial pathogens than toothpaste and plant extracts which showed moderate and low activity, respectively. Therefore, it is suggested that the active compounds in individual medicinal plants like Curcuma longa and Ajuga bracteosa could replace the antibiotics when used in daily routine as tooth cleansers or mouth rinses.

Ecological impacts of climate change on the snow leopard (Panthera unica) in South Asia

Snow leopard (Panthera unica) is a felid which lives in the highly rugged areas of alpine regions in different mountain ranges of South and Central Asia. This solitary animal needs large spaces for its ranges but due to climate change and relatively faster rate of global warming in South Asian mountain ranges, its habitat is going to shrink and fragment by tree-line shifts and change in hydrology of the area. Vegetative modification of montane flora and competition with domestic goats will create its prey's population to decline along with a chance of a direct conflict and competition with the common leopard. Common leopard being more adaptable, grouped, and larger in size can be a significant stressor for a smaller and solitary snow leopard. Habitat would shrink, and snow leopard can possibly move upslope or northward to central Asian ranges and their predicted migratory patterns are unknown.

Plasma extracellular vesicles modulate immune cell gene expression following myocardial infarction

Background

Myocardial infarction (MI) induces activation of immune cells and alters their gene expression en route to the injured myocardium but the underlying mechanisms coordinating immune cell programming following MI remain unknown. Plasma extracellular vesicle (EV) numbers are elevated in MI, correlate with the extent of myocardial injury and mobilises immune cells from the splenic reserve to peripheral blood. Here, we describe the role of plasma EV-microRNAs (miRs) in the modulation of peripheral blood mononuclear cell (PBMC) transcriptomes post-MI.

Methods

PBMCs were exposed to plasma EVs followed by whole transcriptome RNA-sequencing. Plasma EVs were isolated by size-exclusion chromatography and ultra-centrifugation (2 hours at 120,000 x g) from patients presenting with ST-segment elevation MI (STEMI) (N=9) and non-STEMI (NSTEMI) (N=11) control patients. Plasma EVs were characterised by western blot and Nanoview for EV markers CD9 and CD63, transmission electron microscopy (TEM) for morphology and Nanoparticle Tracking Analysis for size and concentration. High sensitive C-reactive protein (hs-CRP) and PCSK9 were determined in plasma by ELISA and compared to plasma EV number using Pearson's correlation. Plasma EV-miRs were measured by Agilent microarray and miR-mRNA putative targets assessed by TargetScanHuman.

Results

Plasma EVs were positive for EV markers CD9 and CD63, displayed typical EV morphology by TEM and had a heterogeneous size and concentration distribution profile as determined by Nanoparticle Tracking Analysis. Plasma EV number correlated significantly with hs-CRP at presentation (R2= 0.20 and P<0.05). miRNA array analysis revealed STEMI plasma-EVs contained significantly more miR-4487 (P<0.001), miR-6511b-5p (P<0.001), miR-4508 (P<0.001) vs NSTEMI control plasma-EVs at the time of injury. STEMI-plasma-EVs induced differential gene expression in PBMCs vs. NSTEMI-control-plasma-EVs. Gene set enrichment analysis (GSEA) showed STEMI-plasma-EVs upregulated pro-inflammatory pathways including: interferon-α (IFN-α) (P<0.01), IFN-γ (P<0.01), tumour necrosis factor-α (TNF-α) (P<0.01) and interleukin-6 (IL-6)-STAT3 signalling of the acute phase response (P<0.05). miR-4487 (P<0.001) and miR-6511-5p (P<0.05) predicted mRNA targets were significantly enriched in PBMC transcriptomes following treatment with STEMI plasma-EVs.

Conclusions

Plasma EVs mediating immune cell transcriptional programming following MI by promoting inflammatory pathways in PBMCs is a novel finding. Targeting PBMCs with EVs may allow modulation of the immune response following myocardial injury, to perturb inflammatory immune mediated damage following ischaemic injury.

Funding Acknowledgement

Type of funding source: Foundation. Main funding source(s): British Heart Foundation Centre of Research Excellence Awards, British Heart Foundation Project Grant, Novo Nordisk Fonden the Tripartite Immunometabolism Consortium and Wellcome Institutional Strategic Support Fund (ISSF)

Distinct transcriptional and functional features of regenerative mouse neonatal cardiac macrophages

Background

The myocardium of neonatal mice is able to regenerate after myocardial infarction (MI), whereas in adults the formation of scar predominantly occurs following heart injury. Macrophages are involved in the fibrotic response in adult mouse hearts, but also required for successful regeneration in neonates. Recent work has demonstrated that macrophages directly contribute collagen to scar formation following MI. Furthermore, neonatal and adult cardiac macrophages have divergent transcriptional responses to injury. Here, we describe differential transcriptomes and signalling pathways of these functionally distinct neonatal resident cardiac macrophages.

Methods

Hearts from neonatal P1, P7 and adult CD1 mice (n=3 per group) were digested with collagenase to produce a single cell suspension. Macrophages were isolated by FACS and identified as Ly6G, F4/80+, LyChi/lo cells. Macrophage whole transcriptomes were measured by Illumina RNA-sequencing. Transcript abundance was quantified from raw reads by Salmon and analysis of differentially expressed (DE) genes was carried out with DESeq2. Gene Ontology (GO) enrichment analysis of DE genes was performed with PANTHER. Genes were ranked according to p-value for differential expression, then these ranked genes were used for Gene Set Enrichment Analysis (GSEA) to detect enriched gene sets from the Molecular Signatures Database.

Results

RNA-sequencing of transcriptomes from neonatal P1, P7 and adult mouse macrophages from hearts highlighted distinct gene expression profiles. The greatest differences were between P1 vs. adult (4,494 differentially expressed (DE) genes at p<0.05) and P7 vs. adult (3,347 DE genes), whereas P1 and P7 macrophages were relatively similar (478 DE genes). A set of 171 genes was found to be DE in P1 vs. P7 and adult macrophages. This P1-specific gene set was highly enriched for GO terms including matrix disassembly (29-fold enrichment, p<0.05) and regulation of chemokine production (12-fold enrichment, p<0.05). GSEA analysis highlighted key functional pathways that were differentially regulated in P1 macrophages, including oxidative phosphorylation and glycolysis, the E2F transcription factors and cell cycle regulators Myc and p53.

Conclusions

We highlight key genes and pathways distinct to resident neonatal cardiac macrophages to determine the basis for the regenerative capacity of these cells. Interestingly, while genes associated with extracellular matrix were previously shown to be altered after MI in neonatal macrophages, similar differences were also observed here in the basal state of resident neonatal macrophages. We also identified transcriptional and cell cycle regulators linked to the programming and regenerative capacity of these macrophages. The functional differences found in neonatal macrophages might represent potential targets for novel therapeutics.

Funding Acknowledgement

Type of funding source: Foundation. Main funding source(s): Novo Nordisk Fonden the Tripartite Immunometabolism Consortium (NNF15CC0018486), British Heart Foundation Centre of Research Excellence Awards (RE/13/1/30181)

Gut microbiome and human health under the space environment

The gut microbiome is well recognized to have a pivotal role in regulation of the health and behaviour of the host, affecting digestion, metabolism, immunity, and has been linked to changes in bones, muscles and the brain, to name a few. However, the impact of microgravity environment on gut bacteria is not well understood. In space environments, astronauts face several health issues including stress, high iron diet, radiation and being in a closed system during extended space missions. Herein, we discuss the role of gut bacteria in the space environment, in relation to factors such as microgravity, radiation and diet. Gut bacteria may exact their effects by synthesis of molecules, their absorption, and through physiological effects on the host. Moreover we deliberate the role of these challenges in the dysbiosis of the human microbiota and possible dysregulation of the immune system.

P6267Novel direct effects of SGLT2 inhibitor, Canagliflozin, on myocardial redox state in humans

Background

Sodium glucose cotransporter 2 (SGLT2) inhibitors are antidiabetic drugs that control plasma glucose levels by inhibiting reabsorption of glucose in kidney. Recent clinical trials have suggested a class effect of SGLT2 inhibitors in preventing hospitalization due to heart failure. However, the underlying mechanism has not been fully elucidated.

Purpose

We investigated the direct effect of the SGLT2 inhibitor, Canagliflozin (Cana), on myocardial redox state in humans.

Methods

The study included 48 patients undergoing cardiac surgery. Fresh myocardial tissues were incubated ex vivo with or without Cana and then used for superoxide quantification and Western immunoblotting. NADPH-oxidases activity was evaluated with NADPH 100μM stimulation, while nitric oxide synthase (NOS) coupling was assessed by using N(ω)-nitro-L-arginine methyl ester (L-NAME, a NOS inhibitor). A human cardiomyocyte (HCM) cell line was also used for in vitro validation of the effects of Cana on myocardium.

Results

Ex vivo incubation of myocardium with Cana significantly reduced baseline (A) and NADPH-oxidase-derived O2·− (B) and improved NOS coupling reflected by positive L-NAME delta O2·− values (C). Regulation of NADPH-oxidases activity by Cana was found to result from reduced GTP-activation (D) and consequent membrane translocation (E) of Rac1, a key subunit of NADPH-oxidases. Cana also reduced tetrahydrobiopterin (BH4) oxidation, increasing its bioavailability (F), which is a key mechanism to improve NOS coupling. Incubation with Cana enhanced phosphorylation of AMPK, and the downstream signalling, ACC (not shown). Additional Compound C, which is inhibitor of AMPK, significantly reversed these effects of Cana (A, B, C, D, E, F). These findings were replicated in HCM (not shown). In line with these, Cana increased the ADP/ATP ratio of cytoplasm in HCM, which could provide an upstream mechanism for AMPK activation.

Conclusions

We demonstrate for the first time in humans, that Cana suppresses myocardial NADPH-oxidases activity and improves NOS coupling through an AMPK-mediated pathway. This could be an underlying mechanism for the cardioprotective effects of SGLT2 inhibitors.

2379Endothelial cell derived extracellular vesicles mediate immune cell deployment from the spleen and transcriptional programming following acute myocardial infarction

Background

Acute myocardial infarction (AMI) induces transcriptional activation of monocyte en route to the injured myocardium, possibly through interactions involving plasma liberated extracellular vesicles (EVs), which are enriched for proteins and microRNAs (miRNAs) post-AMI. Neutrophils are the first immune cells to arrive at sites of injury and mediate further damage to the ischaemic myocardium. Here, we describe neutrophil-deployment from the spleen in AMI and by endothelial cell (EC) derived-EVs.

Methods

Patients presenting AMI provided informed consent as part of the Oxford Acute Myocardial Infarction Study (OxAMI). Plasma EV were isolated by differential ultra-centrifugation (120,000g, 2 hours) followed by washing and characterised for: morphology using transmission electron microscopy (TEM), size and concentration profiling by Nanoparticle Tracking Analysis, EV markers (TSG101, ALIX, CD9, HSP70) by western blot, and miRNAs by RT-qPCR. Mouse and human EC were used in vitro to derive EC-EV under control conditions or after inflammatory stimulation with tumour necrosis factor-alpha (TNF-α) (10ng/mL) and from CRISPR-edited miRNA-126 knock-out ECs. EC-EVs were tail vein injected into wild-type mice or exposed to primary human peripheral blood neutrophils in vitro.

Results

Patients presenting with AMI (N=15) have significantly more plasma EV at time of injury vs a 6-month follow-up measurement (2.2-fold more, P=0.008). Plasma EVs at the time of AMI presentation correlate significantly with the extent of ischaemic injury (R=0.046, P=0.006) and plasma neutrophils (R=0.37, P=0.017). Experimental AMI in wild-type mice induced a significant increase in peripheral blood neutrophils and a simultaneous reduction in splenic-neutrophils, suggesting splenic-neutrophil deployment (P=0.004). Human plasma EV are enriched for vascular cell adhesion molecule-1 (VCAM-1) and EC-associated miR-126 post-AMI (Akbar et al 2017). miRNA-126-mRNA targets are significantly over represented when compared to neutrophil Gene Ontology terms for: degranulation (P<0.001), activation (P<0.001), chemotaxis (P=0.008) and migration (P=0.008). Human and mouse EC release more EV after inflammatory stimulation and show enrichment for miRNA-126. CRISPR-edited miRNA-126 deficient human EC express more VCAM-1 (P<0.001) and release more EC-EVs (P<0.001). EC-EV exposure to primary human neutrophils alters inflammatory gene expression (IL-6 (P<0.05), CCL7 (P<0.001) and CCL18 (P<0.001)). EC-EV tail vein injected into wild-type mice mobilise splenic-neutrophils to peripheral blood (P<0.001).

Conclusions

Neutrophil deployment from the spleen is a novel finding in acute injury and interactions with EC-EV may mediate their splenic liberation and transcriptional programming following AMI, en route to the injured myocardium. The splenic neutrophil reserve may be a novel therapeutic target in AMI to modulate the inflammatory response before recruitment of cells to sites of injury.

Acknowledgement/Funding

British Heart Foundation Project Grant and Centre for Research Excellence Awards (RE/13/1/30181), Nuffield Benefaction for Medicine and ISSF

Gut bacteria of cockroaches are a potential source of antibacterial compound(s)

Here, we hypothesized that the microbial gut flora of animals/pests living in polluted environments, produce substances to thwart bacterial infections. The overall aim of this study was to source microbes inhabiting unusual environmental niches for potential antimicrobial activity. Two cockroach species, Gromphadorhina portentosa (Madagascar) and Blaptica dubia (Dubia) were selected. The gut bacteria from these species were isolated and grown in RPMI 1640 and conditioned media were prepared. Conditioned media were tested against a panel of Gram-positive (Methicillin-resistant Staphylococcus aureus, Streptococcus pyogenes, Bacillus cereus) and Gram-negative (Escherichia coli K1, Salmonella enterica, Serratia marcescens, Pseudomonas aeruginosa, Klebsiella pneumoniae) bacteria, as well as the protist pathogen, Acanthamoeba castellanii. The results revealed that the gut bacteria of cockroaches produce active molecule(s) with potent antibacterial properties, as well as exhibit antiamoebic effects. However, heat-inactivation at 95°C for 10 min had no effect on conditioned media-mediated antibacterial and antiamoebic properties. These results suggest that bacteria from novel sources i.e. from the cockroach's gut produce molecules with bactericidal as well as amoebicidal properties that can ultimately lead to the development of therapeutic drugs.

SIGNIFICANCE AND IMPACT OF THE STUDY

The bacteria isolated from unusual dwellings such as the cockroaches' gut are a useful source of antibacterial and antiamoebal molecules. These are remarkable findings that will open several avenues in our search for novel antimicrobials from unique sources. Furthermore studies will lead to the identification of molecules to develop future antibacterials from insects.

HVSI polymorphism indicates multiple origins of mtDNA in the Hazarewal population of Northern Pakistan

Mitochondrial DNA (mtDNA) is an important tool used to explore ethnogenetics and the evolutionary history of human populations. In this study, hypervariable segment I (HVSI) from mtDNA was analyzed to establish the genetic lineage of the Hazarewal populations residing in the Mansehra and Abbottabad districts of Northern Pakistan. HVSI was extracted from genetic specimens obtained from 225 unrelated male and female individuals belonging to seven distinct Pakistani ethnic groups (31 Abbassis, 44 Awans, 38 Gujars, 16 Jadoons, 23 Karlals, 33 Syeds, and 40 Tanolis). Eighty-three haplogroups, 39 of which were unique, were identified; haplogroup H was predominantly represented (in 40% of the people), followed by haplogroups M (21.78%), R (16.89%), N (15.56%), L (3.11%), and HV (2.67%). The results revealed a sex-biased genetic contribution from putative West Eurasian, South Asian, and Sub-Saharan populations to the genetic lineage of Hazarewal ancestry, with the effect of Eurasians being predominant. The HVSI nucleotide sequences exhibited some characteristic deletion mutations between 16,022 and 16,193 bp, which is characteristic of specific ethnic groups. HVSI sequence homology showed that Hazarewal populations fall into three major clusters: Syeds and Awans sorted out into cluster I; Tanolis, Gujars, and Karlals segregated in cluster II; and Abbassis and Jadoons in cluster III. Here, we have reported the firsthand genetic information and evolutionary sketch of the selected populations residing alongside the historical Silk Route, which provides a baseline for collating the origin, route of migration, and phylogenetics of the population.

ID: 67: HENOCH-SCHONLEIN PRPURA WITH A NEGATIVE SKIN BIOPSY

Henoch-Schonlein purpura (HSP) is an autoimmune condition also referred to as anaphylactoid purpura. It is a self-limited systemic, IgA-mediated small vasculitis. It is non-granulomatous, autoimmune complex, with multi-organ involvement, and most commonly in children. Its etiology is unclear but is associated with upper respiratory tract infections, drugs, foods, insect bites, vaccinations, tumors (non-small cell lung cancer, prostate cancer, and hematological malignancies), alpha-1-antitrypsin deficiency, and Familial Mediterranean Fever.

Case Stem

We present a 17 years old caucasian male with 3 weeks history of itchy erythematous, palpable pruritic rash which progressed proximally from both feet to thighs and upper extremities. He went to an outlying facility and was given steroids for a few days. Symptoms subsided temporary. Later the patient developed peri-umbilical abdominal pain which was colicky in nature, 8/10 in intensity, associated with vomiting, bloody diarrhea, joint pain and fever. Review of systems was unremarkable otherwise. Abdominal examination showed mild tenderness in the peri-umbilical area, non-blanching palpable purpuric rash involving both upper and lower extremities.

Laboratory tests showed leukocytosis, high CRP and ESR.

Normal Hb, Hct, BUN, Serum Creatinine, Urinalysis, C3 and C4.

Anti-HAV IgM: Negative; HbsAg: Negative; Anti-HBc IgG Negative.

Colonoscopy showed pancolitis. Abdominal ultrasonography detected increased bowel wall thickness, skin biopsy was not specific because it was taken after 24 hrs of once of rash.

The patient was diagnosed with HSP as per the American College of Rheumatology and European League Against Rheumatism (EuLAR) as well as Pediatric Rheumatology Society (PReS) criteria.

He was treated with intravenous fluids and was abstained from food and liquids. He was started on oral prednisone. He recovered well and was discharged with a follow up appointment.

Conclusion

Although HSP patients mostly range from 4–7 years old it can still presents in adolescent age group. Non-thrombocytopenic palpable purpura with multi-organ involvement (gastrointestinal, skin and joints) should make one consider the diagnosis. skin biopsy should be taken less than 24 hrs from the presentation because in more chronic lesions, vessel damage leads to nonspecific leakage of all isotypes of immunoglobulin.

Abstract ID: 67 Figure 1

A clinicopathological study of serotonin of sigmoid colon mucosa in association with chronic symptoms in uncomplicated diverticulosis

INTRODUCTION

Neurotransmitter imbalance is hypothesised as a pathogenetic mechanism in several bowel conditions. We previously reported increased 5-HT in the sigmoid mucosa of colon resected for complicated diverticular disease (DD). We aimed to identify if abnormal 5-HT expression is associated with symptoms of uncomplicated DD.

METHODS

This was a prospective, comparative study and follow-up survey of symptoms. We examined the differences in 5-HT between DD patients and controls, as well as the presence of bowel symptoms at time of endoscopy and also 2 years later. Sigmoid biopsies were collected at colonoscopy. Immunohistochemical staining for 5-HT cells was performed.

RESULTS

Eighty-seven patients were recruited, 37 (42.5 %) DD and 50 (57.5 %) controls. No patients underwent surgery. There was no significant difference in total mean number of 5-HT-positive cells in DD compared to controls or between patients and controls with abdominal symptoms. Forty-one patients (47.1 %) responded to questionnaires at median 57.8 months from biopsy. Eighteen (43.9 %) were DD and 23(56.1 %) controls. 5-HT counts showed no significant association to symptom persistence.

DISCUSSION

Although 5-HT expression has previously been found to be increased in complicated DD in whole bowel-resected specimens, the same is not confirmed on colonic mucosal biopsies. This raises the suggestion that 5-HT may be involved in the development of acute complications but may not be involved in the pathogenesis of chronic symptoms.

Relationship of Age at First Live Birth, Parity and Duration of Breast Feeding with Non Familial Breast Cancer in Pakistani Women. A Study of the Cancer Research Group Pakistan

Background and objectives; This multicenter case control study is being conducted at seven different centers in Pakistan in order to find out the association and relationship of different hormonal and reproductive factors with breast cancer. These factors have been identified either as risk factors or protective factors for breast cancer in other communities but not in Pakistani women. Preliminary results from four centers are being reported here.Method; Patients attending these cancer treatment centers were interviewed by the trained medical personals and the findings were recorded in a proforma. Age and area matched unrelated controls were randomly selected and interviewed with same questions and findings were recorded in a corresponding proforma. SPSS version 11.5 was used for statistical analysis.Results; From June, 2008 to May, 2009 six hundred eighty eight cases were compared with an equal number of controls. Median age of cases was 47 years (26-70 years) and controls 47.5 years (25-71 years). One hundred ninety eight of cases (28.78%) and 208 of controls (30.23 %) gave first full term live birth before the age of 20. Sixty two cases (09.01%) and 38 controls (5.52%) gave first full term live birth after the age of 30. Seventy one cases and 65 controls were nulliparous.Fifty cases (07.27%) and 51 controls (07.41%) had only one child whereas 104 (15.12%) cases and 118 controls (17.15%) had more then 7 children.Breast feeding duration was more then 24 months in 410 (72.31%) of all women who had more then 1 child. Duration of breast feeding in cases Vs. control in women with 2-4 children, 5-7 children and more then 7 children was similar. Statistical analysis reveals that first live birth below the age of 20 and duration of breast feeding of greater then 24 months duration are not associated as protective factors in this patient population. Odds ratio of 1.35, 95% CI; 1.01-1.70 and 1.014, 95% CI; 0.80-1.22 respectively. Age at first live birth after 30 years of age seems to be positively associated with breast cancer. Odds ratio of 1.75, 95% CI; 1.15-2.65. These results do not support the young age at first full term pregnancy and prolonged duration of breast feeding as protective factors against the breast cancer.Key Words: Breast Cancer, Breast feeding, Parity, Risk Factor

Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 2071.

Diffusion tensor imaging abnormalities in depressed multiple sclerosis patients

Depression is common in patients with multiple sclerosis, but to date no studies have explored diffusion tensor imaging indices associated with mood change. This study aimed to determine cerebral correlates of depression in multiple sclerosis patients using diffusion tensor imaging. Sixty-two subjects with multiple sclerosis were assessed for depression with the Beck Depression Inventory (BDI-II). All subjects underwent magnetic resonance imaging. Whole brain and regional volumes were calculated for lesions (hyper/hypointense) and normal-appearing white and grey matter. Fractional anisotropy and mean diffusivity were calculated for each brain region. Magnetic resonance imaging comparisons were undertaken between depressed (Beck Depression Inventory > or = 19) and non-depressed subjects. Depressed subjects (n = 30) had a higher hypointense lesion volume in the right medial inferior frontal region, a smaller normal-appearing white matter volume in the left superior frontal region, and lower fractional anisotropy and higher mean diffusivity in the left anterior temporal normal-appearing white matter and normal-appearing grey matter regions, respectively. Depressed subjects also had higher mean diffusivity in right inferior frontal hyperintense lesions. Magnetic resonance imaging variables contributed to 43% of the depression variance. We conclude that the presence of more marked diffusion tensor imaging abnormalities in the normal-appearing white matter and normal-appearing grey matter of depressed subjects highlights the importance of more subtle measures of structural brain change in the pathogenesis of depression.

Aicardi-Goutières syndrome presenting with haematemesis in infancy

Aicardi-Goutières syndrome is a genetic childhood encephalopathy characterized by basal ganglia calcification, chronic cerebrospinal lymphocytosis and elevated cerebrospinal fluid interferon-alpha, mimicking acquired congenital viral infections. As more is discovered about the pathogenesis of Aicardi-Goutières, it is becoming evident that a dysfunction of the immune system is likely to be responsible for the disease phenotype. We describe a previously healthy 2-month-old female infant who presented with haematemesis and seizures and was subsequently diagnosed with Aicardi-Goutières syndrome. To our knowledge, this is the first documented case of Aicardi-Goutières syndrome presenting with haematemesis. The gastrointestinal tract is an area of high cell loss, revealing early signs of systemic inflammation and we postulate that a systemic proinflammatory milieu occurs in Aicardi-Goutières syndrome.

CONCLUSION

Aicardi-Goutières syndrome can present with haematemesis, adding to the growing evidence that the Aicardi-Goutières syndrome spectrum encompasses an immune-mediated multisystem involvement. Gastrointestinal inflammation should also be considered in these patients and treated appropriately.

Outcome analysis of 4 years' follow-up of patients referred for colposcopy with one smear showing mild dyskaryosis

OBJECTIVE

To assess the 4-year outcome of patients after one smear showing mild dyskaryosis with respect to smear regression rate, prevalence of cervical intraepithelial neoplasia (CIN) and the effect of age.

METHODS

Retrospective analysis of patients diagnosed with initial mildly dyskaryotic smear during the year 2000 with a follow-up period of 48 months. These women had not had any previous abnormal smears.

SETTINGS

Cytopathology Department and Colposcopy Unit, King's College Hospital, London, UK.

RESULTS

We identified 524 patients of whom 375 patients with complete follow-up data are included. The age range was 19-67 years with a median of 29 years. There were 207 patients aged 35 years or less (55%). At 6 months, 258 smears were performed and 47.8% of them were negative (95% CI: 41.6-54.0%). The total number of negative follow-up smears in the first year was 198 out of a total of 397 smears performed (50%). This proportion has significantly increased between 1 and 4 years' follow-up to 67.5% (RR: 1.24; 95% CI: 1.14-1.35). Over the 4-year period, 791 smears were performed and 477 were negative (60.3%; 95% CI: 56.9-63.7%). Of the 477 negative smears there were only 61 smears (12.8%; 95% CI: 10-16%), in 54 patients (14%; 95% CI: 11-18%) that reverted back to low-grade cytological abnormality. In only one case the repeat smear showed high-grade abnormality after initial negative follow-up; however, on biopsy, histology showed CIN I. Out of the 375 patients, 70 required treatment with excisional biopsy (19%; 95% CI: 15.0-22.9%). Histology confirmed high-grade CIN in only 41 cases giving a prevalence of 11% (95% CI: 8.1-14.5%). There were no cases of microinvasive or invasive cancer detected. Age (< or =35 years versus >35 years) did not significantly affect either cytological or histological outcome.

CONCLUSION

Sixty per cent of follow-up smears after initial mild dyskaryosis subsequently became negative; of them 87.2% remained negative over the 4 year follow-up. Treatment was only required in 19% of patients, with 11% prevalence of high-grade CIN. Age did not affect the outcome. These results are reassuring and indicate that colposcopic referral may not be necessary after only one mildly dyskaryotic smear.

Increased presence of serotonin-producing cells in colons with diverticular disease may indicate involvement in the pathophysiology of the condition

INTRODUCTION

Serotonin is an important neuroendocrine transmitter participating in the control of colonic motor activity through neural and biochemical mechanisms in the Enteric Nervous System (ENS). A possible pathophysiological factor for diverticular disease (DD) is altered colonic motility. The study compared the distribution of serotonin cells (SC) in the colonic mucosa of patients with diverticular disease to controls.

METHODS

Sixteen paraffin specimens with sigmoid diverticular disease were selected and sections of bowel without diverticula from the same specimen were used as its own control. The resection margins from sixteen colonic specimens excised for sigmoid cancer were additional controls. Immunocytochemical staining for serotonin cells was performed on 4-mum tissue sections with polyclonal antibody (NCL-SEROTp). The number of serotonin-positive cells per ten microscopic fields (x200) was assessed in all groups and the staining distribution was defined as low (0-33%), moderate (>33-66%) and high (>66%) according to the percentage of the entire cell containing contrast material. The control specimens were blinded before analysis. Student's t test was used for statistical analysis and significance level was set as P < 0.05.

RESULTS

The mean number of serotonin-positive cells per ten fields in the colonic mucosa of specimens with diverticular disease was significantly higher [252.44 (SD 90.64)] than the specimen's own control [147.31 (SD 50.16)] and at normal resection margins of cancer specimens [228.38 (SD 120.10)]. The paired analysis between diverticular disease specimens and its own control (paired t test) showed significant differences for moderate (P = 0.008), high (P = 0.001) and total (P = 0.002) number of serotonin cells. There was no evidence of significance between mean DD and cancer values.

DISCUSSION

Increased presence of SCs and the higher proportion of high and moderate staining cells (indicating increased hormone content) indicate the possible role of serotonin in DD. This may be contributing to the pathogenesis of the condition by altered colonic motility in the affected segments in a similar way as in irritable bowel syndrome.

The impact of image guided needle biopsy on the outcome of mammographically detected indeterminate microcalcification

A study was carried out to examine the impact of development in image guided needle biopsy on the outcome of mammographically detected indeterminate microcalcification. Between 01.04.1991 and 31.03.2001, the South East London Breast Screening Programme detected 392 cases of indeterminate microcalcificaton. Histological diagnosis was obtained using open biopsy, fine needle aspiration cytology (FNAC), 18/14 G wide bore needle core biopsy (WBNCB) and 11 G vacuum assisted core biopsy (VACB). The study period group was divided into two. Group A (between 01.04.1991 and 31.03.1996) and group B (between 01.04.1996 and 31.03.2001). There was a significant reduction in the benign open biopsy rate in group B compared to group A (25% vs. 51%) (P=0.0001). Of the malignant cases, there is a higher percentage of ductal carcinoma in situ (DCIS) in group B compared to group A (77% vs. 62%). In conclusion, the implementation of more effective methods of image guided biopsy has led to a 50% reduction in benign open biopsies for indeterminate microcalcification and to an increase in the detection of DCIS.

An unusual case of an enlarging mass on a screening mammogram: a case report and review of the radiology and current literature

We report the case of a woman who was recalled after screening because an opacity seen on her previous screening mammogram had changed in appearance. The new features were of a circumscribed soft-tissue opacity with some lobulation. Ultrasound showed an oval mass which was slightly hypoechoic compared to the surrounding fatty parenchyma and contained small focal anechoic areas. The lesion was biopsied and found to be a cavernous haemangioma. Haemangioma of the breast is a rare cause of a well-circumscribed soft-tissue mass on a mammogram.

The association between telomerase activity and hormone receptor status and p53 expression in breast cancer

BACKGROUND

Telomerase is a ribonucleoprotein enzyme that seems to play an important role in cellular immortality and carcinogenesis. p53 mutations account for approximately 50% of human cancers and represent the most frequent genetic lesion in breast cancer.

AIMS

This study aims to examine the association between telomerase reactivation and hormonal receptor status and p53 expression in invasive breast cancer.

METHODS

Using a polymerase chain reaction-based assay, telomerase activity was determined in 47 invasive breast carcinomas and 21 adjacent non-cancerous breast tissue specimens (stored at -80 degrees C) prospectively collected from 47 women undergoing elective surgical treatment in our centre. The histopathological features of the tumour were determined by experienced breast pathologists using light microscopy and haematoxylin and eosin staining. Oestrogen receptor (ER), progesterone receptor (PR) and p53 expressions were determined using immunohistochemistry techniques.

RESULTS

Telomerase activity was detected in 34 (72%) of 47 breast carcinomas and in none of the adjacent non-cancerous breast specimens. There was a significant association between telomerase reactivation, tumour size and nodal status. Telomerase positive tumours were more likely to be poorly differentiated (65% versus 46%), but this association failed to reach statistical significance. There was no significant difference in ER expression (68% versus 85%). PR expression (62% versus 62%) and p53 expression (19% versus 27%) between telomerase positive and telomerase negative cancers.

CONCLUSION

Telomerase reactivation is associated with important prognostic factors such as tumour size and nodal status in invasive breast cancer and seems to be independent of hormonal receptor status and p53 expression.

Echomorphologic and histopathologic characteristics of unstable carotid plaques

BACKGROUND AND PURPOSE

Our hypothesis was that the carotid plaques associated with retinal and cerebrovascular symptomatology and asymptomatic presentation may be differ from each other. The aim of this study was to identify the sonographic and histopathologic characteristics of plaques that corresponded to these three clinical manifestations.

METHODS

The echo process involved duplex preoperative imaging of 71 plaques (67 patients, 21 plaques were associated with retinal, 25 with cerebrovascular symptoms, and 25 were asymptomatic), which was performed in a longitudinal fashion. Appropriate frames were captured and digitized via S-video signal in a computer and digitized sonograms were normalized by two echo-anatomic reference points: the gray scale median (GSM) of the blood and that of the adventitia. The GSM of the plaques was evaluated to distinguish dark (low-GSM) from bright (high-GSM) plaques. Subsequent to endarterectomy, the plaques were sectioned transversely, and a slice at the level of the largest plaque area was examined for the relative size of necrotic core and presence of calcification and hemorrhage.

RESULTS

Retinal symptomatology was associated with a hypoechoic plaque appearance (median GSM: 0), asymptomatic status with a hyperechoic plaque appearance (median GSM: 34), and cerebrovascular symptomatology with an intermediate plaque appearance (median GSM: 16) (P = .001). The histopathologic characteristics did not disclose differences between the three clinical groups. The hypoechoic plaque appearance was associated only with the presence of hemorrhage (median GSM for the hemorrhagic plaques, 6, and for the non-hemorrhagic ones, 20 [P = .04]). The relative necrotic core size and the presence of calcification did not show any echomorphologic predilection.

CONCLUSION

Our results showed that distinct echomorphologic characteristics of plaques were associated with retinal and cerebrovascular symptomatology and asymptomatic status. Histopathologically, only the presence of hemorrhage proved to have an echomorphologic predilection.

Immunohistochemical study of P53, PCNA and AFP in hepatocellular carcinoma, a comparison between Indonesian and Japanese cases

Mutations of p53 as a tumor suppressor gene in hepatocellular carcinoma (HCC) have been reported to occur with varying frequency in different geographic regions, which might be different etiology for HCC. Overexpressions of p53 (well known for its implications in mutations of the p53 gene), PCNA and alpha-fetoprotein (AFP) have been reported to be associated with carcinogenesis and/or tumor progression and poor prognosis in various types of cancer. To estimate the geographical difference of the p53 gene, PCNA and AFP in HCC, we examined 14 Japanese HCC cases, 8 Indonesian HCC cases, and 27 Indonesian chronic active hepatitis (CAH) or liver cirrhosis cases, using immunohistochemical approaches. Overexpression of p53 was identified in 37.5% of Japanese HCC, in 62.5% of Indonesian HCC and none in CAH. The mean PCNA Labeling Index of Japanese HCC, Indonesian HCC and CAH was detected in 48.6%, 30.4%, and 43.5%, respectively. AFP was detected in 35.7% of Japanese and 25% of Indonesian HCC. The rate of p53 overexpression in Indonesian HCC was as high as in HCC of southern part of China, which might share the similar etiology in both regions.

Effectiveness of the analogue of natural Schisandrin C (HpPro) in treatment of liver diseases: an experience in Indonesian patients

OBJECTIVE

To determine the effect of dimethyl-4,4'-dimethoxy-5,6, 5',6-dimethylene dioxybiphenyl-2,2'-dicarboxylate (HpPro) on patients with acute and chronic liver diseases.

METHODS

An open trial and a prospective randomized and controlled study were performed. The open trial consisted of 56 cases (16 cases of acute hepatitis, 20 cases of chronic hepatitis, 14 cases of liver cirrhosis and 6 cases of fatty liver). Controlled study consisted of 20 cases of Child A chronic hepatitis which were randomly treated with either HpPro or a mixture of known drugs which used as a liver protective agent in Indonesia as control for one week. The patients were then crossed over those two drugs in the next week.

RESULTS

In the open trial, after 4 weeks' treatment with HpPro 7.5 mg orally three times daily, acute hepatitis, chronic hepatitis and fatty liver cases showed rapid decrease of SGOT and SGPT. In the liver cirrhosis cases, SGOT and SGPT were decreased slowly. In the controlled trial, nine patients received HpPro 7.5 mg three times daily orally and eleven were treated with a mixture of known drugs as the controls. After one week treatment, HpPro group clinically showed significant decrease of SGPT and SGOT levels compared to control group (P = 0.035). At the second week, HpPro group showed significant decrease of SGOT compared to control group (P = 0.038) but the decrease of SGPT was not significant (P = 0.096).

CONCLUSION

Treatment with HpPro is effective to reduce liver impairment in acute and chronic liver diseases on Indonesian patients. No side effect of HpPro was observed.

Ethnicity, socioeconomic status, transfusions and risk of hepatitis B and hepatitis C infection

This study identifies the risk factors for hepatitis B virus (HBV) and hepatitis C virus (HCV) and measures the prevalence of hepatitis B surface antigen (HBsAg) and antibody to hepatitis C (anti-HCV) in the general population of Jakarta. A population-based sample of 985 people aged 15 and above was surveyed. Risk factors were identified through questionnaires and home visits. Serum was analysed for HBsAg, antibody to hepatitis B surface antigen (anti-HBs), anti-HCV, aspartate aminotransferase (AST) and alanine aminotransferase (ALT). The seroprevalence was: 4.0% (39/985) for HBsAg, 17.2% (170/985) for anti-HBs, and 3.9% (38/985) for anti-HCV. The risk factors for hepatitis B and hepatitis C infection had little in common. Low socioeconomic status was a strong risk factor for HBsAg (adjusted odds ratio (OR) 18.09; 95% confidence interval (CI) 2.35-139.50). In addition, the Chinese group has 2.97 higher risk of having HBV infection compared with the Malayan ethnic group (adjusted OR 2.97; 95% CI 1.22-7.83). There was moderate positive trend between family size and risk of HBsAg positivity (P = 0.130). Age over 50 (adjusted OR 14.72; 95% CI 4.35-49.89) and history of transfusion were significant risk factors for hepatitis C (adjusted OR 3.03; 95% CI 1.25-7.33). Hepatitis B and hepatitis C infections have different risk factors in Jakarta, a high risk in population for both diseases. Hepatitis B transmission is associated with low socioeconomic status, Chinese ethnic group and large family size, while hepatitis C is associated with an older age and a history of transfusions.