15-Lipoxygenase promotes resolution of inflammation in lymphedema by controlling Treg cell function through IFN-β

Lymphedema (LD) is characterized by the accumulation of interstitial fluid, lipids and inflammatory cell infiltrate in the limb. Here, we find that LD tissues from women who developed LD after breast cancer exhibit an inflamed gene expression profile. Lipidomic analysis reveals decrease in specialized pro-resolving mediators (SPM) generated by the 15-lipoxygenase (15-LO) in LD. In mice, the loss of SPM is associated with an increase in apoptotic regulatory T (Treg) cell number. In addition, the selective depletion of 15-LO in the lymphatic endothelium induces an aggravation of LD that can be rescued by Treg cell adoptive transfer or ALOX15-expressing lentivector injections. Mechanistically, exogenous injections of the pro-resolving cytokine IFN-β restores both 15-LO expression and Treg cell number in a mouse model of LD. These results provide evidence that lymphatic 15-LO may represent a therapeutic target for LD by serving as a mediator of Treg cell populations to resolve inflammation.

Anti-CCL2 antibody combined with etoposide prolongs survival in a minimal residual disease mouse model of neuroblastoma

C-C motif chemokine ligand 2 (CCL2) is a monocyte chemoattractant that promotes metastatic disease and portends a poor prognosis in many cancers. To determine the potential of anti-CCL2 inhibition as a therapy for recurrent metastatic disease in neuroblastoma, a mouse model of minimal residual disease was utilized in which residual disease was treated with anti-CCL2 monoclonal antibody with etoposide. The effect of anti-CCL2 antibody on neuroblastoma cells was determined in vitro with cell proliferation, transwell migration, and 2-dimensional chemotaxis migration assays. The in vivo efficacy of anti-CCL2 antibody and etoposide against neuroblastoma was assessed following resection of primary tumors formed by two cell lines or a patient-derived xenograft (PDX) in immunodeficient NOD-scid gamma mice. In vitro, anti-CCL2 antibody did not affect cell proliferation but significantly inhibited neuroblastoma cell and monocyte migration towards an increasing CCL2 concentration gradient. Treatment of mice with anti-CCL2 antibody combined with etoposide significantly increased survival of mice after resection of primary tumors, compared to untreated mice.

Histologic type predicts disparate outcomes in pediatric hepatocellular neoplasms: A Pediatric Surgical Oncology Research Collaborative study

BACKGROUND

Hepatocellular carcinoma (HCC) is a rare cancer in children, with various histologic subtypes and a paucity of data to guide clinical management and predict prognosis.

METHODS

A multi-institutional review of children with hepatocellular neoplasms was performed, including demographic, staging, treatment, and outcomes data. Patients were categorized as having conventional HCC (cHCC) with or without underlying liver disease, fibrolamellar carcinoma (FLC), and hepatoblastoma with HCC features (HB-HCC). Univariate and multivariate analyses identified predictors of mortality and relapse.

RESULTS

In total, 262 children were identified; and an institutional histologic review revealed 110 cHCCs (42%; 69 normal background liver, 34 inflammatory/cirrhotic, 7 unknown), 119 FLCs (45%), and 33 HB-HCCs (12%). The authors observed notable differences in presentation and behavior among tumor subtypes, including increased lymph node involvement in FLC and higher stage in cHCC. Factors associated with mortality included cHCC (hazard ratio [HR], 1.63; P = .038), elevated α-fetoprotein (HR, 3.1; P = .014), multifocality (HR, 2.4; P < .001), and PRETEXT (pretreatment extent of disease) stage IV (HR, 5.76; P < .001). Multivariate analysis identified increased mortality in cHCC versus FLC (HR, 2.2; P = .004) and in unresectable tumors (HR, 3.4; P < .001). Disease-free status at any point predicted survival.

CONCLUSIONS

This multi-institutional, detailed data set allowed a comprehensive analysis of outcomes for children with these rare hepatocellular neoplasms. The current data demonstrated that pediatric HCC subtypes are not equivalent entities because FLC and cHCC have distinct anatomic patterns and outcomes in concert with their known molecular differences. This data set will be further used to elucidate the impact of histology on specific treatment responses, with the goal of designing risk-stratified algorithms for children with HCC.

LAY SUMMARY

This is the largest reported granular data set on children with hepatocellular carcinoma. The study evaluates different subtypes of hepatocellular carcinoma and identifies key differences between subtypes. This information is pivotal in improving understanding of these rare cancers and may be used to improve clinical management and subsequent outcome in children with these rare malignancies.

[Statement of the Spanish Interdisciplinary Vascular Prevention Committee on the updated European Guidelines on Cardiovascular Disease Prevention]

Statement of the Spanish Interdisciplinary Vascular Prevention Committee on the updated European Guidelines on Cardiovascular Disease Prevention. We present the Spanish adaptation of the 2021 European Guidelines on Cardiovascular Disease (CVD) prevention in clinical practice. The current guidelines besides the individual approach greatly emphasize on the importance of population level approaches to the prevention of cardiovascular diseases. Systematic global CVD risk assessment is recommended in individuals with any major vascular risk factor. Regarding LDL-Cholesterol, blood pressure, and glycemic control in patients with diabetes mellitus, goals and targets remain as recommended in previous guidelines. However, it is proposed a new, stepwise approach (Step 1 and 2) to treatment intensification as a tool to help physicians and patients pursue these targets in a way that fits patient profile. After Step 1, considering proceeding to the intensified goals of Step 2 is mandatory, and this intensification will be based on 10-year CVD risk, lifetime CVD risk and treatment benefit, comorbidities and patient preferences. The updated SCORE algorithm-SCORE2, SCORE-OP- is recommended in these guidelines, which estimates an individual's 10-year risk of fatal and non-fatal CVD events (myocardial infarction, stroke) in healthy men and women aged 40-89 years. Another new and important recommendation is the use of different categories of risk according different age groups (< 50, 50-69 ≥ 70 years). Different flow charts of CVD risk and risk factor treatment in apparently healthy persons, in patients with established atherosclerotic CVD, and in diabetic patients are recommended. Patients with chronic kidney disease are considered high risk or very high-risk patients according to the levels of glomerular filtration rate and albumin-to-creatinine ratio. New lifestyle recommendations adapted to the ones published by the Spanish Ministry of Health as well as recommendations focused on the management of lipids, blood pressure, diabetes and chronic renal failure are included.

Appendectomy Versus Observation for Appendicitis in Neutropenic Children With Cancer

BACKGROUND

Optimal management of neutropenic appendicitis (NA) in children undergoing cancer therapy remains undefined. Management strategies include upfront appendectomy or initial nonoperative management. We aimed to characterize the effect of management strategy on complications and length of stay (LOS) and describe implications for chemotherapy delay or alteration.

METHODS

Sites from the Pediatric Surgery Oncology Research Collaborative performed a retrospective review of children with NA over a 6-year period.

RESULTS

Sixty-six children, with a median age of 11 years (range 1-17), were identified with NA while undergoing cancer treatment. The most common cancer diagnoses were leukemia (62%) and brain tumor (12%). Upfront appendectomy was performed in 41% of patients; the remainder had initial nonoperative management. Rates of abscess or perforation at diagnosis were equivalent in the groups (30% vs 24%; P = .23). Of patients who had initial nonoperative management, 46% (17 of 37) underwent delayed appendectomy during the same hospitalization. Delayed appendectomy was due to failure of initial nonoperative management in 65% (n = 11) and count recovery in 35% (n = 6). Cancer therapy was delayed in 35% (n = 23). Initial nonoperative management was associated with a delay in cancer treatment (46% vs. 22%, P = .05) and longer LOS (29 vs 12 days; P = .01). Patients who had initial nonoperative management and delayed appendectomy had a higher rate of postoperative complications (P < .01).

CONCLUSIONS

In pediatric patients with NA from oncologic treatment, upfront appendectomy resulted in lower complication rates, reduced LOS, and fewer alterations in chemotherapy regimens compared to initial nonoperative management.

Vortex Dynamics in a Compact Kardar-Parisi-Zhang System

We study the dynamics of vortices in a two-dimensional, nonequilibrium system, described by the compact Kardar-Parisi-Zhang equation, after a sudden quench across the critical region. Our exact numerical solution of the phase-ordering kinetics shows that the unique interplay between nonequilibrium and the variable degree of spatial anisotropy leads to different critical regimes. We provide an analytical expression for the vortex evolution, based on scaling arguments, which is in agreement with the numerical results, and confirms the form of the interaction potential between vortices in this system.

Kibble-Zurek Mechanism in Driven Dissipative Systems Crossing a Nonequilibrium Phase Transition

The Kibble-Zurek mechanism constitutes one of the most fascinating and universal phenomena in the physics of critical systems. It describes the formation of domains and the spontaneous nucleation of topological defects when a system is driven across a phase transition exhibiting spontaneous symmetry breaking. While a characteristic dependence of the defect density on the speed at which the transition is crossed was observed in a vast range of equilibrium condensed matter systems, its extension to intrinsically driven dissipative systems is a matter of ongoing research. In this Letter, we numerically confirm the Kibble-Zurek mechanism in a paradigmatic family of driven dissipative quantum systems, namely exciton-polaritons in microcavities. Our findings show how the concepts of universality and critical dynamics extend to driven dissipative systems that do not conserve energy or particle number nor satisfy a detailed balance condition.

Dynamical Critical Exponents in Driven-Dissipative Quantum Systems

We study the phase ordering of parametrically and incoherently driven microcavity polaritons after an infinitely rapid quench across the critical region. We confirm that the system, despite its driven-dissipative nature, satisfies the dynamical scaling hypothesis for both driving schemes by exhibiting self-similar patterns for the two-point correlator at late times of the phase ordering. We show that polaritons are characterized by the dynamical critical exponent z≈2 with topological defects playing a fundamental role in the dynamics, giving logarithmic corrections both to the power-law decay of the number of vortices and to the associated growth of the characteristic length scale.

Compositional and biochemical changes during cold storage of starter-free fresh cheeses made from ultra-high-pressure homogenised milk

The aim of the present study was to evaluate the effects of using ultra-high pressure homogenisation (UHPH) on the composition and biochemistry of starter-free fresh cheeses and to monitor their evolution during cold storage as an alternative to conventional treatments applied in the production of fresh cheese such as conventional pasteurisation and homogenisation-pasteurisation. Although both homogenisation treatments increased cheese moisture content, cheeses from UHPH-treated milk showed lower moisture loss during storage than those from conventionally homogenised-pasteurised milk. Lipolysis and proteolysis levels in cheeses from UHPH-treated milk were lower than those from conventionally treated milk samples. Although, oxidation was found to be the major drawback, in general terms, high quality starter-free fresh cheeses were obtained from UHPH-treated milk.

Acanthamoeba encephalitis: A Case Report and Review of Therapy

Background:

Acanthamoeba is a rare cause of encephalitis yet is associated with high mortality. Treatment protocols vary greatly and generally include combination therapy across a wide spectrum of antiinfective classes.

Case Description:

A 63-year-old male who underwent renal transplantation presented 6 months after transplantation with depressed level of consciousness. Imaging of the head with computerized tomography showed an enhancing lesion suspicious for brain abscess. Biopsy of the lesion showed Acanthamoeba cysts. The patient was treated with sulfadiazine, fluconazole, flucytosine, azithromycin, and miltefosine but without success. We review recently published cases of Acanthamoeba encephalitis with an emphasis on treatment protocols and outcomes.

Conclusion:

Free-living protozoans such as Acanthamoeba are ubiquitous in the environment and should be suspected in immunosuppressed persons who present with central nervous system findings and brain abscess. Biopsy is critical to establish the etiology so that appropriate combination therapy can be deployed.

Abstract P2-05-01: Induction of PELP1 expression in mammary gland promotes tumorigenesis by enhancing CDK-CyclinD1 signaling

Introduction: Estrogen receptor coregulator over-expression promotes carcinogenesis and/or progression of endocrine related-cancers where steroid hormones are powerful mitogenic agents. Recent studies in our laboratory as well as others demonstrated that PELP1 is a proto-oncogene and a prognostic indicator of decreased survival in breast cancer patients. Recent studies indicated that PELP1 is needed for optimal epigenetic modifications at ER target genes and PELP1 interactions with KDM1 play a key role in PELP1 mediated oncogenic functions. However, the in vivo significance of PELP1 deregulation during initiation and progression of breast cancer remains unknown. The objective of this study is determine the molecular mechanisms by which PELP1 regulate breast cancer progression in vivo.

Method: To determine the significance of PELP1 over-expression in mammary tumorigenesis, we used an inducible, tissue-specific PELP1 expressing transgenic mouse. Mammary epithelial-specific expression of PELP1 was validated by immunohistochemistry and Western blot analysis. PELP1-mediated morphological and histological changes were analyzed by examining carmine-stained whole mounts and H&E-stained paraffin embedded mammary glands sections. Differential expression of breast cancer-focused genes between wild type and PELP1 transgenic mammary glands was determined using real-time RT2 Profiler PCR array. Proliferation was analyzed using Ki-67 immuno staining. RTqPCR, Western and IHC analysis were used to confirm the changes in the expression of PELP1 regulated genes.

Results: We observed an increase in proliferation, extensive side branching and precocious differentiation in PELP1 expressing mammary gland compared to controls. Aged MMTVrtTA-TetOPELP1 bitransgenic mice revealed hyperplasia and preneoplastic changes as early as 12 weeks and mammary tumors occurred at a latency of 10.5 months. Mechanistic studies using tissues from control and PELP1 transgenic mice revealed that PELP1 deregulation modulates expression of a number of known ER target genes involved in cellular proliferation (such as cyclin D1, CDKs) and morphogenesis (EGFR, MMPs) and such changes facilitated altered mammary gland morphogenesis and tumor progression. Western and IHC analysis of mammary glands confirmed upregulation of CDK and Cyclin D1 protein levels in PELP1 Tg mice. Further, PELP1 is hyperphosphorylated at CDK phosphorylation site in PELP1 (Ser 991), suggesting an autocrine loop involving CDk-CyclinD1-PELP1 axis in promoting mammary tumorigenesis. Treatment of PELP1 Tg mice with pargyline, an inhibitor of KDM1 for four months significantly reduced PELP1 driven hyperplasia. Mechanistic studies revealed that pargyline treatment reduced cyclin D1 expression levels and substantially reduced CDK driven PELP1 phosphorylation.

Conclusions: PELP1 deregulation modulates expression of a number of known ER target genes and cancer promoting genes. PELP1 mediated epigenetic changes via KDM1 play role in PELP1 oncogenic functions in vivo. Collectively, these results support that PELP1 deregulation has potential to promote breast tumorigenesis in vivo.

Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P2-05-01.

Falls' and fallers' profiles

OBJECTIVE

To describe the different falls typology and to investigate whether different falls profiles and faller profiles could be identified among a cohort of community-dwelling women aged 75 years and older.

DESIGN

Prospective cohort study.

PARTICIPANTS

Women aged 75 years and older were enrolled in five French centers after a random selection from electoral lists and included in the EPIDOS study.

MEASUREMENTS

During a 4 year follow-up, women were contacted by telephone every 4 months to investigate the occurrence of falls. To minimize the memory bias, the specific questionnaire on falls was completed only if the fall took place in the week preceding the contact. A multiple correspondence analysis followed by clustering was carried out to identify the typology of falls.

RESULTS

727 women described at least one fall. A full description of 662 falls was obtained during the follow-up period. In the multiple correspondence analysis the main discriminant item was outside versus inside falls. Moreover, four clusters were showed: outside falls linked to lack of attention (28% of women), outside falls related to exogenous/environmental factors (16%), inside falls associated with frailty (44%) and in height falls (11%). We also found that each type of falls was correlated with particular health or functional status (i.e.;dependence, motion difficulty, weakness, use of walking aid, ...).

CONCLUSION

From frailty to hyperactivity there are different falls and fallers profiles. Assessing such fall profiles could be helpful to develop new dedicated fall prevention programs in the elderly.

The transcription factor nuclear factor-kappa B and cancer

Since the discovery of nuclear factor-kappa B (NF-kappaB) in 1986, many studies have been conducted showing the link between the NF-kappaB signalling pathway and control of the inflammatory response. Today it is well known that control of the inflammatory response and apoptosis is closely related to the activation of NF-kappaB. Three NF-kappaB activation pathways exist. The first (the classical pathway) is normally triggered in response to microbial and viral infections or exposure to pro-inflammatory cytokines that activate the tripartite IKK complex, leading to phosphorylation-induced IkappaB degradation and depends mainly on IKKbeta activity. The second (the alternative pathway), leads to selective activation of p52:RelB dimers by inducing the processing of the NF-kappaB2/p100 precursor protein, which mostly occurs as a heterodimer with RelB in the cytoplasm. This pathway is triggered by certain members of the tumour necrosis factor cytokine family, through selective activation of IKKalpha homodimers by the upstream kinase NIK. The third pathway is named CK2 and is IKK independent. NF-kappaB acts through the transcription of anti-apoptotic proteins, leading to increased proliferation of cells and tumour growth. It is also known that some drugs act directly in the inhibition of NF-kappaB, thus producing regulation of apoptosis; some examples are aspirin and corticosteroids. Here we review the role of NF-kappaB in the control of apoptosis, its link to oncogenesis, the evidence of several studies that show that NF-kappaB activation is closely related to different cancers, and finally the potential target of NF-kappaB as cancer therapy.

Effects of Ultra-High Pressure Homogenization on the Cheese-Making Properties of Milk

The effects of single- or 2-stage ultra-high pressure homogenization (UHPH; 100 to 330 MPa) at an inlet temperature of 30 degrees C on the cheese-making properties of bovine milk were investigated. Effects were compared with those from raw, heat-pasteurized (72 degrees C for 15 s), and conventional homogenized-pasteurized (15 + 3 MPa, 72 degrees C for 15 s) treatments. Rennet coagulation time, rate of curd firming, curd firmness, wet yield, and moisture content of curds were assessed. Results of particle size and distribution of milk, whey composition, and gel microstructure observed by confocal laser scanning microscopy were analyzed to understand the effect of UHPH. Single-stage UHPH at 200 and 300 MPa enhanced rennet coagulation properties. However, these properties were negatively affected by the use of the UHPH secondary stage. Increasing the pressure led to higher yields and moisture content of curds. The improvement in the cheese-making properties of milk by UHPH could be explained by changes to the protein-fat structures due to the combined effect of heat and homogenization.

Immunochemistry of the Group-Specific Polysaccharide of Nocardia brasiliensis

Estrada-Parra, Sergio (Escuela Nacional de Ciencias Biológicas, México, D.F., México), Abel Zamora, and L. F. Bojalil. Immunochemistry of the group-specific polysaccharide of Nocardia brasiliensis. J. Bacteriol. 90:571-574. 1965.-The group-specific polysaccharide of Nocardia brasiliensis was further purified, yielding an amorphous white material with the following characteristics: [alpha](D) (20) = + 48; nitrogen, 0.5%; phosphorus, 0.1%; and ash as sodium, 0.8%. The polymer is made of d-arabinose and d-galactose in a molar ratio of 3:1, and no other sugars were detected. Mild hydrolysis liberates mainly arabinose. The polysaccharide consumes 3.46 mumoles of periodate per mg of polymer in 15 days at 4 C (this value remains constant after 4 more days). Oxidation results in destruction of two of the arabinose, with the formation of two glycerols after borohydride reduction and hydrolysis. The polysaccharide oxidized by periodate and reduced under mild acid hydrolysis at 20 C yields glycerol and a polymer formed by galactose and arabinose (in a ratio of 1:1) which is resistant to a second oxidation. Therefore, the polysaccharide is probably formed by a main chain of glactose linked 1,3 and arabinose linked 1,2 or 1,3 or both, and nonreducing side chains of arabofuranose residues. The intact polysaccharide cross-reacts with sera from patients with active tuberculosis, and this, as well as the homologous reaction, is abolished by oxidation with periodate.

Lowering of blood pressure leads to decreased circulating interleukin-6 in hypertensive subjects

Interleukin-6 (IL-6), the major proinflammatory cytokine, has been described to be associated with the hypertensive and atherosclerotic states. We aimed to explore whether the concentration of circulating IL-6 and adhesion molecules could be modified by decreasing blood pressure in hypertensive subjects. A total of 30 subjects (18 men), aged 34-48 years, were enrolled in this study, 17 hypertensive never-treated patients (HTA) and 13 normotensive subjects (C). HTA subjects were treated with irbesartan, 150-300 mg/day for 3 months, and serum IL-6, vascular cell adhesion molecule-1, intercellular adhesion molecule-1, sP-selectin, sE-selectin and monocyte chemoattractant protein-1 were measured at 0 and 12 weeks. The two study groups were similar in age, body mass index (BMI) and gender. At baseline, circulating IL-6 levels, but not adhesion molecules, were significantly associated with systolic blood pressure (r=0.41; P=0.03) and BMI (r=0.53; P=0.005). Systolic and diastolic blood pressure decreased significantly (P<0.01) in parallel to serum IL-6 levels (from 3.72+/-0.82 to 3.23+/-0.19 pg/ml, P=0.02) reaching a similar concentration to normotensive patients (3.33+/-0.3 pg/ml) after treatment with irbesartan. No significant changes were observed in any other of the tested parameters. In conclusion, the treatment of high blood pressure lowers circulating IL-6 in young hypertensive patients.

17 beta-estradiol inhibits cytokine, chemokine, and chemokine receptor mRNA expression in the central nervous system of female mice with experimental autoimmune encephalomyelitis

Cytokines and chemokines govern leukocyte trafficking, thus regulating inflammatory responses. In this study, the anti-inflammatory effects of low dose 17 beta-estradiol were evaluated on chemokine, chemokine receptor, and cytokine expression in the spinal cords (SC) of BV8S2 transgenic female mice during acute and recovery phases of experimental autoimmune encephalomyelitis (EAE). In EAE protected mice, 17 beta-estradiol strongly inhibited mRNA expression of the chemokines RANTES, MIP-1 alpha, MIP-2, IP-10, and MCP-1, and of the chemokine receptors CCR1, CCR2 and CCR5 at both time points. Conversely, ovariectomy, which abrogated basal 17 beta-estradiol levels and increased the severity of EAE, enhanced the expression of MIP-1 alpha and MIP-2 that were over-expressed by inflammatory mononuclear cells in SC. 17 beta-estradiol inhibited expression of LT-beta, TNF-alpha, and IFN-gamma in SC, but had no effect on IL-4 or IL-10, indicating reduced inflammation but no deviation toward a Th2 response. Interestingly, elevated expression of CCR1 and CCR5 by lymph node cells was also inhibited in 17 beta-estradiol treated mice with EAE. Low doses of 17 beta-estradiol added in vitro to lymphocyte cultures had no direct effect on the activation of MBP-Ac1-11 specific T cells, and only at high doses diminished production of IFN-gamma, but not IL-12 or IL-10. These results suggest that the beneficial effects of 17 beta-estradiol are mediated in part by strong inhibition of recruited inflammatory cells, resulting in reduced production of inflammatory chemokines and cytokines in CNS, with modest effects on encephalitogenic T cells that seem to be relatively 17 beta-estradiol insensitive.

Estrogen treatment down-regulates TNF-alpha production and reduces the severity of experimental autoimmune encephalomyelitis in cytokine knockout mice

A shift toward Th2 cytokine production has been demonstrated during pregnancy and high dose estrogen therapy and is thought to be the primary mechanism by which estrogen suppresses the development of experimental autoimmune encephalomyelitis. However, low dose estrogen treatment is equally protective in the absence of a significant shift in cytokine production. In this study cytokine-deficient mice were treated with estrogen to determine whether a shift in Th2 cytokine production was required for the protective effects of hormone therapy. Estrogen effectively suppressed the development of experimental autoimmune encephalomyelitis in IL-4 and IL-10 knockout mice and in wild type littermate mice with a similar potency of protection. Significant disease suppression was also seen in IFN-gamma-deficient mice. The decrease in disease severity was accompanied by a concomitant reduction in the number of proinflammatory cytokine- and chemokine-producing cells in the CNS. Although there was no apparent increase in compensatory Th2 cytokine production in cytokine-deficient mice, there was a profound decrease in the frequency of TNF-alpha-producing cells in the CNS and the periphery. Therefore, we propose that one mechanism by which estrogen protects females from the development of cell-mediated autoimmunity is through a hormone-dependent regulation of TNF-alpha production.

MRI findings in Möbius syndrome: correlation with clinical features

The authors studied the MRI findings of three patients with Möbius syndrome. Möbius syndrome is a rare congenital disorder characterized by complete or partial facial diplegia accompanied by other cranial nerve palsies. MRI demonstrated brainstem hypoplasia with straightening of the fourth ventricle floor, indicating an absence of the facial colliculus. These MRI features suggest the diagnosis of Möbius syndrome and correlate with the clinical and neurophysiologic findings.

Recovery of minimal change nephrotic syndrome and acute renal failure in a patient withRenal cell carcinoma

We describe a 78-year-old patient with nephrotic syndrome due to minimal-change glomerulopathy, associated with a renal adenocarcinoma. Oliguric acute renal failure requiring hemodialysis was also observed. Surgical removal of the tumor and corticosteroid therapy resulted in resolution of the nephrotic state and improvement of the renal function. Nephrotic syndrome is an unusual complication of renal cell carcinomas, and the association of minimal-change glomerulopathy (MCG) and solid tumors is particularly uncommon. In spite of this, MCG should be considered in the nephropathies causing nephrotic syndrome and acute renal failure in patients with renal malignancies.

[Isolation of Escherichia coli O157:H7 in storm drains in the city of Mar del Plata with bacterial contamination of fecal origin]

The present study was focused on the isolation and characterization of Escherichia coli, particularly the serotype O157:H7, from five combined-sewer outflows waters, which drain into the beaches of Mar del Plata. Seventeen hemolytic uremic syndrome cases were reported in Mar del Plata during the sampling period (May 1995-April 1996) in children between 9 month- and 5 year-old, and 3 deaths were recorded. E. coli identification was carried out by biochemical tests. E. coli was detected in 75% of the samples and a total of 98 strains were selected, with 11 sorbol non-fermenting strains. The strains belonged to the O1, O6, O44, O86a, O119 and O168 serogroups. As none of the known virulence factors was detected, strains could not be grouped within any of the diarrheagenic E. coli categories. None of the E. coli strains belonged to the O157:H7 serotype, but E. coli isolation showed fecal contamination in the combined-sewer outflows. Since their waters drain into beaches for recreational use, it is necessary to emphasize the detection of E. coli that would cause severe human illness. Bacterial pollution in combined-sewer outflows draining into Mar del Plata coasts might represent a high risk for human health.

Estrogen potentiates treatment with T-cell receptor protein of female mice with experimental encephalomyelitis

Transgenic mice expressing the BV8S2 chain, which is specific for the myelin basic protein determinant Ac1-11, possess a naturally induced set of regulatory T cells directed against BV8S2. Further activation of anti-BV8S2 T cells in male mice with recombinant BV8S2 protein can inhibit IFN-gamma release by Ac1-11-specific T cells through a cytokine-driven mechanism and prevent induction of experimental autoimmune encephalomyelitis (EAE). In contrast, naive female mice possess fewer anti-BV8S2-reactive T cells, and treatment with BV8S2 delayed but did not prevent EAE. We here demonstrate that combining T-cell receptor (TCR) vaccination with supplemental estrus doses of estrogen potentiated IL-10 production by anti-BV8S2-reactive T cells and induced Ac1-11-specific T cells to produce IL-10 and TGF-beta. This combined treatment resulted in full protection against EAE, which was not observed with either therapy alone. These findings imply that supplemental estrogen can enhance the efficacy of TCR-based immunotherapy for autoimmune diseases that predominate in females.

Differences between lactate concentration of samples from ear lobe and the finger tip

Blood lactate concentrations in capillary samples obtained from the ear lobe or from the finger tip are used indistinctly, since they are considered equivalents. The aim of the study reported in this paper was to verify whether that assumption is valid due to the practical implications which any possible differences between these two sampling sites would have in the planning and assessing of an athletic training program. Twenty six healthy male athletes competing in different sports at the national level (9 rowers, 7 cyclists and 10 runners) were studied during the performance of a graded exercise test up to the point of exhaustion, on specific ergometers. In each group, capillary blood samples were obtained simultaneously from both the ear lobe and the finger tip at three different times during the test: 1) in resting conditions; 2) when exercising at a submaximal work load and 3) seven minutes after the point of exhaustion. Significant differences were found between the blood lactate concentrations of samples obtained from the ear lobe and from the finger tip (p < 0.001). The method error of repeated measurements for lactate concentrations from paired samples obtained in resting conditions was 27%, when exercising at a submaximal work load, 16% and at maximal work load, 3%. Capillary blood samples collected from the finger tip consistently showed higher values in lactate concentration than those obtained, at the same time, from the ear lobe.