Lumbosacral non-terminal myelocystocele associated with teratoma: case report and review of literature

Non-terminal myelocystoceles are commonly found in the cervical or thoracic spinal region. Their sac can rarely be associated with tumor. A rare case of an infant with a lumbosacral non-terminal myelocystocele and accompanying mature teratoma is reported in whom the tumor was attached to the placode not as a part of the sac.

P–102 GM-CSF (granulocyte-macrophage colony-stimulating factor) as a sperm medium supplement improves sperm quality in Oligoastenoteratospermia (OAT) men by activating the PI3K/Akt pathway

Study question

Can GM-CSF as a sperm medium supplement improve sperm quality in OAT men?

Summary answer

GM-CSF can be used to improve sperm quality in OAT men by activating the PI3K/Akt pathway.

What is known already

OAT patients have very low sperm parameters, including morphology, count, and motility, which can adversely affect the results of assisted reproduction technologies. It seems the development of sperm media is necessary to improve the sperm parameters of these patients. GM-CSF is a natural growth factor produced by the reproductive organs, culture media supplemented with GM-CSF is widely commercially available and enhances the embryo development and implantation rate. Studies show that this growth factor in the semen of infertile men is lower than that of fertile men. However, there is no study to assess the effect of GM-CSF on sperm quality.

Study design, size, duration

In the present study, Semen specimens were collected from 20 OAT patients who have male infertility factors, according to WHO criteria. After the swim-up washing procedure, each of the samples is divided into two groups; experiment, and control. In the experimental group, samples are incubated with a medium containing 2 ng/ml GM-CSF for one hour, yet, in the control group, the sperms are incubated without GM-CSF for the same time.

Participants/materials, setting, methods

The sperm motility was examined with phase-contrast microscopy, Eosin-nigrosin staining method was used to assess sperm viability. The expression of sperm glucose transporters (GLUT 1, 3) was determined using immunofluorescent staining, the ratio of pAkt to total Akt was assessed by the Western blotting method. Image J software was used to quantify results; the data was analyzed by SPSS software. P-value<0.05 was considered statistically significant.

Main results and the role of chance

As compared to the control group, supplementation with GM-CSF improved sperm progressive motility, enhanced GLUT 1 and 3, and p-AKT/AKT expression (P < 0.05). There was no significant difference between the viability of the control and experimental groups.

Limitations, reasons for caution

This study needs further investigations, including Real-time PCR for the genes of this signaling pathway which is ongoing.

Wider implications of the findings: We showed for the first time that GM-CSF can improve sperm quality by influencing motility and energy metabolism in spermatozoa which can be affected by increasing the phosphorylation of AKT. This growth factor could be an appropriate supplement in sperm media for OAT patients.

Trial registration number

IRCT20200519047508N1

948 Visceral Artery Aneurysms- A Single Centre Experience Over 6 Years

Introduction

The incidence of visceral artery aneurysms (VAA) varies from 0.01-0.1%. They are significant with a mortality risk of up to 75% if ruptured. Given there are no national guidelines we decided to conduct this study to assess the management of VAA in our trust and recommend local guidelines.

Method

We retrospectively identified patients who had a detected VAA between April 2014 and April 2020. Medical records and relevant imaging were reviewed in detail. MDT outcomes and subsequent mortalities noted.

Results

We identified 62 VAA in 59 patients (23 male), median age 65 years, and mean diameter 18.1 mm. 95 % were detected on CT, the indication was mostly malignancy. MDT outcomes were to continue surveillance for 43 patients with yearly scans, 5 patients had primary surgical repair, 7 patients had endovascular interventions, 1 patient had primary endovascular intervention that failed and required surgical intervention. 7 patients were discharged from follow up due to age and size (12 mm) or VAA completely thrombosed.

Conclusions

In our unit decisions to intervene were based on size > 20mm, rapid increase in size on surveillance, the presence of portal hypertension or possibly the patients’ young age. There were no mortalities linked to VAA.

The role of blood neutrophil count and the neutrophil-to-lymphocyte ratio as a predictive factor for prostate biopsy results

BACKGROUND:

It is apparent that prostate cancer has harmful effects on the erythrocytes, leucocytes, and platelets. In addition, it has been suggested that the toxic granules in neutrophils lead to inflammation in the cancerous tissues besides the activation of monocytes, so in this study we aimed to evaluate the blood neutrophil count besides the neutrophil-to-lymphocyte ratio as a predictive factor for prostate biopsy results and their relationship with prostate cancer grade in patients undergoing biopsy of the prostate.

METHODS:

For all men with irritative lower urinary tract symptoms visiting Hasheminezhad Hospital from January to July 2015, in case of having a suspicious digital rectal examination or aged above 40 years, prostate-specific antigen was requested and in case of abnormal results, they underwent prostate biopsy. In order to examine the study hypothesis, the blood neutrophil count and the neutrophil-to-lymphocyte ratio were measured and compared with the abnormal prostate-specific antigen results and suspicious digital rectal examination.

RESULTS:

Among the 500 referred samples for biopsy, 352 (70.4%) had a negative biopsy result, while it was positive in the other 148 (29.6). The mean neutrophil count showed no statistical difference regarding the biopsy results (p = 0.381). When measuring the neutrophil-to-lymphocyte ratio again with biopsy results, no statistically significant difference was obtained based on the biopsy results (p = 0.112).

CONCLUSION:

Neutrophil count and neutrophil-to-lymphocyte ratio cannot be predictive factors for positive prostate cancer biopsy.

A real time PCR assay on blood for diagnosis of invasive candidiasis in immunocompromised patient

Background and Purpose:

Invasive candidiasis (IC) is a significant cause of morbidity and mortality in patients with hematologic disorders and bone marrow transplant recipients. Rapid, specific and sensitive test for the timely accuracy in immunocompromised patients to reduce mortality rates and prevent IC progress is necessary. We established a real-time PCR assay on blood for the diagnosis and differentiation of the causative Candida species.

Materials and Methods:

Whole blood samples were collected twice, from 72 patients for Real Time PCR and blood culture assays. The primers and hybridization probes were designed to potentiate the specific sequence of 18S rRNA genes using Light Cycler system and Fluorescence Resonance Energy Transfer (FERT). The patients with hematologic malignancies and bone marrow transplant recipients were evaluated for IC based on the revised European Organization for Research and Treatment of Cancer/ Mycoses Study Group (EORTC/MSG) criteria.

Results:

From 2009 to 2011, 72 patients with hematologic malignancies and bone marrow transplant recipients were evaluated for IC. The female to male ratio was 27:45; the mean age was 32.1 years. The most common malignancy in this patient was acute myeloid leukemia (AML) (27.8%) and acute lymphoblastic leukemia (ALL) (26.4%). Out of 72 patients, 11 patients (15.3%) had positive real time PCR /probe results. Based on the melting temperature (Tm) analysis, 5 (45.4%) C. krusei, 3 (27.2%) C. tropicalis, 2 (18.1%) C. parapsilosis and 1 C. albicans (9%) were identified. According to the revised EORTC / MSG, 1 patient (9%) and 10 patients (91%) were defined as proven and possible groups of IC, respectively. The mortality rate in proven and possible IC patient was found 54.5%.

Conclusion:

The established Real-time PCR/FRET probe assay is an appropriate diagnostic tool for the detection of Candida species DNA and the management of patients suffering from hematologic malignancies and bone marrow recipient are at risk for IC

Intussusception of the appendix secondary to mucinous cystadenoma: A rare cause of abdominal pain

A 35-year-old woman was seen as an outpatient with a 3-month history of pain in the right iliac fossa. A CT scan of her abdomen revealed the presence of a mucocele of the appendix. Intra-operatively, an appendico-appendicular intussusception was found. Histology confirmed the presence of a mucinous cystadenoma with the presence of acellular mucin on the serosal surface of the appendix. This association has rarely been described in the literature. Prompt surgical intervention is advocated to prevent the subsequent development of pseudomyxoma peritonei. We present a case of intussusception of the appendix with a mucinous cystadenoma as its lead point.

The effect of carotenoids obtained from saffron on histone H1 structure and H1-DNA interaction

It is already known that transcriptional activation of genes occurs due to the H1 dissociation from linker DNA; hence, histone H1-DNA complex is considered as a model of chromatin. Anticancer property of saffron and its carotenoids has already been reported. The present study aimed at investigating the effect of saffron carotenoids on H1 structure and H1-DNA interaction as a possible mechanism of their anticarcinogenic action. After purification of the saffron carotenoids (crocin, crocetin and dimethylcrocetin), their interaction with histone H1 was studied using spectrophotometry and spectrofluorometry. Some changes on the absorption spectra of H1 indicated the complex formation between this protein and saffron carotenoids. Also, the fluorescence emission of H1 was quenched by the mentioned ligands. The binding parameters of all the three ligands were obtained through Schatchard analysis of the quenching data. Then, the effect of each ligand on the H1-DNA interaction was studied. The results showed a shift in the precipitation curve to the left in the presence of the mentioned carotenoids, which is due to the reduction in the interaction of H1 with DNA. These observations led to the suggesting a mechanism in which the H1 depletion may promote transcription.

Follicle stimulating hormone as a predictor of ovarian response in women undergoing controlled ovarian hyperstimulation for IVF

OBJECTIVE

To evaluate the effect of basal follicle stimulating hormone (FHS) level on ovarian response in women undergoing controlled ovarian hyperstimulation for in vitro fertilization.

METHODS

A descriptive and analytic study of 212 cycles of IVF chosen from about 2200 files of women treated at Royan Institute, Tehran, Iran, from 1991 to 1999. Treatment was started with intranasal or subcutaneous buserlin (0.5 cm3), on day 21 (long protocol). On day 2 of the next cycle, stimulation with human menopausal gonadotropin (hMG) was initiated. When the number and size of follicles were suitable, human chorionic gonadotropin (hCG) was given intramuscularly for ovulation induction, followed by oocyte retrieval 36 to 40 h later. Embryos were transferred about 48 to 72 h after oocyte retrieval. The women were assigned to 2 groups on the basis of day 3 serum FSH levels (>or=15 IU/mL, group 1 and <15 IU/mL, group 2).

RESULTS

There were statistically significant differences between the 2 groups in number of follicles, number of oocytes retrieved and embryos transferred (lower in group 1), and level of serum luteinizing hormone and number of canceled cycles (higher in group 1). There were no statistical differences in number of ampoules of hMG used or age of patients.

CONCLUSION

Day-3 serum FSH level was a predictor of ovarian response and IVF outcome in this study.