Localized Congenital Cutis Verticis Gyrate with Skull Erosion

Localized congenital cutis verticis gyrate (CVG) is rare and potentially risks skull involvement. A 23-year-old woman presented with a congenital scalp mass in the occipital region. Local thickening of her left occipital scalp with ridges and furrows was observed on examination. Head computed tomography scan showed a lytic area underneath the same area of the occipital calvarium. The mass was surgically removed due to the skull erosion and cosmetic reasons. Pathologic evaluation established CVG. Surgical excision is best for localized congenital CVG with skull erosion due to cosmetic reasons. Surgical excision was rewarding to the patient it allowed her to style her hair.

Long-term intra- and inter-individual biological variation of serum lipid of HIV-infected and uninfected men participating in the Los Angeles Multi-Center AIDS Cohort Study (MACS)

BACKGROUND

To assess the long-term biological coefficient of variation within individuals (CV_I) and between individuals (CV_G), effect of aging and cholesterol lowering drugs on blood levels of lipids in HIV-1-infected and -uninfected men.

METHODS

Bloods were analyzed every six months over 17 years for total cholesterol (TC), triglycerides (TGs), high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C) in 140 HIV-uninfected (38-66 years old) and 90 HIV-treated infected (48-64 years old) white Caucasian men to examine CV_I, CV_G, and the effect of cholesterol lowering drugs (CLDs) on lipid levels, and estimated changes per year of biomarkers.

RESULTS

With exception of HDL-C, the long term CV_I compared with CV_G were higher for serum levels of TC, TGs, and LDL-C in both HIV-1 infected and uninfected men not taking CLDs. Excluding results of TGs in HIV positive men, the CV_I compared with CV_G were lower for serum levels of TC, HDL-C, and LDL-C in both groups not taking CLDs. There were significant (p < 0.05) differences in the median serum values of lipid biomarkers among 77 HIV negative men taking and 63 not taking CLDs. Also, with exception of HDL, there were significant (p < 0.05) differences in the median values of TC, TGs and LDL-C among 28 HIV positive men taking or not taking CLDs.

CONCLUSION

Long term CV_I and CV_G of biomarkers will be useful for monitoring antiviral therapy side effects on lipid profiles in HIV-infected men. CV_I of HIV-infected men for TC, TGs, HDL, LDL were higher significantly than CV_I of HIV-uninfected men. Interestingly the long term CV_I were higher than CV_G for the men, who were on CLDs compared to men not on CLDs. The long-term pattern of CV_I and CV_G of lipid markers in both HIV-infected and uninfected men on CLDs differed from their short-term pattern.

Evaluating Genome Assemblies and Gene Models Using gVolante

In daily practice of de novo genome assembly and gene prediction, it would be a natural urge to evaluate their products. Different programs and parameter settings give rise to variable outputs, which leaves a decision of which output to adopt for downstream analysis for addressing biological questions. Instead of superficial assessment of length-based statistics of output sequences (e.g., N50 scaffold length), completeness assessment by means of scoring the coverage of reference orthologs has been increasingly utilized.We previously launched a web service, gVolante ( https://gvolante.riken.jp /), to provide a user-friendly interface and a uniform environment for completeness assessment with the pipelines CEGMA and BUSCO. Completeness assessments performed on gVolante report scores based on not just the coverage of reference genes but also on sequence lengths, allowing quality control in multiple aspects. This chapter focuses on the procedure for such assessment and provides technical tips for higher accuracy.

Comparative expression analysis of POU4F1, POU4F2 and ISL1 in developing mouse cochleovestibular ganglion neurons

POU-homeodomain and LIM-homeodomain transcription factors are expressed in developing projection neurons within retina, inner ear, dorsal root ganglion, and trigeminal ganglion, and play synergistic roles in their differentiation and survival. Here, using immunohistochemistry, we present a comparative analysis of the spatiotemporal expression pattern of POU4F1, POU4F2, and ISL1 during the development of cochleovestibular ganglion (CVG) neurons in mouse inner ear. At early stages, when otic neurons are first detected in the otic epithelium (OE) and migrate into periotic mesenchyme to form the CVG, POU4F1 and ISL1 are co-expressed in a majority of the delaminated CVG neurons, which are marked by NEUROD1 expression, but POU4F1 is absent in the otic epithelium. The onset of POU4F2 expression starts after that of POU4F1 and ISL1, and is observed in the NEUROD1-negative, post-mitotic CVG neurons. When the CVG neurons innervate the vestibular and cochlear sensory organs, the expression of POU4F1, POU4F2, and ISL1 continues in both vestibular and spiral ganglion cells. Later in development, POU4F1 expression becomes down-regulated in a majority of spiral ganglion (SG) neurons and more neurons express POU4F2 expression while ISL1 expression is maintained. The differential as well as overlapping expression of POU4F1, POU4F2, and ISL1 combined with previous studies suggests possible functional interaction and regulatory relationship of these transcription factors in the development of inner ear neurons.

Incidence and progression of mild aortic regurgitation after Tirone David reimplantation valve-sparing aortic root replacement

OBJECTIVE

The study objective was to determine whether recurrent or residual mild aortic regurgitation, which occurs after valve-sparing aortic root replacement, progresses over time.

METHODS

Between 2003 and 2008, 154 patients underwent Tirone David-V valve-sparing aortic root replacement; 96 patients (62%) had both 1-year (median, 12 ± 4 months) and mid-term (62 ± 22 months) transthoracic echocardiograms available for analysis. Age of patients averaged 38 ± 13 years, 71% were male, 31% had a bicuspid aortic valve, 41% had Marfan syndrome, and 51% underwent aortic valve repair, predominantly cusp free margin shortening.

RESULTS

Forty-one patients (43%) had mild aortic regurgitation on 1-year echocardiogram. In 85% of patients (n = 35), mild aortic regurgitation remained stable on the most recent echocardiogram (median, 57 ± 20 months); progression to moderate aortic regurgitation occurred in 5 patients (12%) at a median of 28 ± 18 months and remained stable thereafter; severe aortic regurgitation developed in 1 patient, eventually requiring reoperation. Five patients (5%) had moderate aortic regurgitation at 1 year, which did not progress subsequently. Two patients (2%) had more than moderate aortic regurgitation at 1 year, and both ultimately required reoperation.

CONCLUSIONS

Although mild aortic regurgitation occurs frequently after valve-sparing aortic root replacement, it is unlikely to progress over the next 5 years and should not be interpreted as failure of the valve-preservation concept. Further, we suggest that mild aortic regurgitation should not be considered nonstructural valve dysfunction, as the 2008 valve reporting guidelines would indicate. We need 10- to 15-year follow-up to learn the long-term clinical consequences of mild aortic regurgitation early after valve-sparing aortic root replacement.

Cost-effectiveness of human papillomavirus vaccination in low and middle income countries: a systematic review

The World Health Organization recommends establishing that human papillomavirus vaccination is cost-effective before vaccine introduction. We searched Pubmed, Embase and the Cochrane Library to 1 April 2012 for economic evaluations of human papillomavirus vaccination in low and middle income countries. We found 25 articles, but almost all low income countries and many middle income countries lacked country-specific studies. Methods, assumptions and consequently results varied widely, even for studies conducted for the same country. Despite the heterogeneity, most studies conclude that vaccination is likely to be cost-effective and possibly even cost saving, particularly in settings without organized cervical screening programmes. However, study uncertainty could be reduced by clarity about vaccine prices and vaccine delivery costs. The review supports extending vaccination to low income settings where vaccine prices are competitive, donor funding is available, cervical cancer burden is high and screening options are limited.

Isolated cutis verticis gyrata of the glabella and nasal bridge: a case report and review of the literature

Cutis verticis gyrata (CVG) is an uncommon morphological condition of the scalp characterised by ridges and furrows resembling the surface of the brain. We present a case of secondary CVG affecting both the glabella and nasal aesthetic unit. To our knowledge, isolated CVG of the glabella has never been reported nor has extension of CVG onto the nasal aesthetic unit of the face. We also describe an association between hyper-IgE syndrome and CVG, and review this rare disorder including options for its surgical management.