[Effects of malathion on testicular enzyme activities and sperm quality of male rats]

OBJECTIVE

The aim of this study is to investigate the effects of sub chronic exposure to malathion on testicular enzyme activities and sperm quality of male rats.

METHODS

Forty male rats were divided into four groups: three exposure groups and a control group. Malathion was administered orally to male rats at 0, 33.75, 54.00, and 108.00 mg/kg for 60 days to evaluate the toxic alterations in sperm dynamics and testicular enzyme activities including ACP,LDH,SDH and γ-GT. The control rats were administered with an equivalent volume of distilled water in the same manner.After sacrificed, the testes were collected and weighed.

RESULTS

The body weight and the testis weight of animals showed a decreasing tendency, and there was a statistical difference between the 54.00, 108.00 mg/kg groups, and the control group (P<0.05). Malathion brought about marked reduction in testicular sperm counts, sperm motility, and significant growth of sperm malformation rate in 108.00 mg/kg group. A significant decrease in the activities of testicular enzyme ACP and γ-GT was observed in malathion exposed rats, while the activities of LDH was significant increased and there were no obvious effects on the activities of SDH. The activities of ACP, γ-GT and LDH showed a statistical difference between the 108.00 mg/kg groups, and the control group.

CONCLUSION

Malathion reduced the sperm counts and sperm motility, increased the malformation rate and reduced the activities of testicular enzymies of male rats.

[Analysis of correlation between pulmonary function and expression levels of matrix metalloproteinases-9 and tissue inhibitor of metalloproteinase-1 among toluene diisocyanate exposed workers]

OBJECTIVE

To investigate the effect of occupational toluene diisocyanate(TDI) exposure on matrix metalloproteinases-9 (MMP-9) and tissue inhibitor of metalloproteinase-1(TIMP-1), and analysis of the correlation of MMP-9,TIMP-1,MMP-9/TIMP-1 and lung function.

METHODS

In October 2014, based on cluster sampling, we conducted a cross-sectional study in a TDI production factory located in China's western region. 61 exposed workers were recruited from workers engaged in packing, operating and checking. Based on different levels of the external exposure, the packers were classified as high exposed group, while operators and checkers as low exposed group. 58 factory managers, matching age and agent, were selected as controls, having same work intense and not contacting the TDI or other allergens. The questionnaire surveys were used to obtain the agent, age, work age, smoking and drinking, personal and family allergic history, occupational history, and the recent health conditions. The levels of MMP-9 and TIMP-1 in serum of subjects were determind by ELISA. The time weighted average concentrations (8h-TWA) were used to describe the levels of TDI air exposure in working environment. Spearman correlation assay was used to investigate the correlation of MMP-9, TIMP-1, MMP-9/TIMP-1 and lung function, exposure time.

RESULTS

8-hour TWA means of TDI air levels in exposed group, packers, operators and checkers were 0.39, 0.76, 0.25 mg/m(3), respectively . According to the external exposure concentration, the packers were classified as high exposed group, and the operators and checkers were classified as low exposed group. In controls, low exposed group and high exposed group, the levels of MMP-9, respectively, were (807.21±347.70),(586.91±317.50),(388.94±312.01) ng/ml (χ(2)=16.69, P<0.001), respectively, and the P50(P25-P75) of MMP-9/TIMP-1 were 4.67(2.87-6.68), 2.3(1.44-3.48), 1.11(0.59-1.48) (χ(2)=39.42, P<0.001), respectively, and the concentrations of TIMP-1, were (173.44±72.67), (236.12±51.98), (302.81±44.39) ng/ml (F=20.09, P< 0.001), respectively. The levels P50(P25-P75) of FVC, FEV1.0 and FEV1.0/FVC in exposed group were, 92.8% (86.0%-101.8%), 85.5%(76.7%-92.8%), 112.5(108.2-118.5), respectively, which were lower than that in control group (124.3%(107.9%-144.2%), 142.7%(119.1%-155.7%), 129.2(123.5-134))(Z values were 7.70, 8.97, 8.62, and all P<0.001). Spearman rank correlation analysis showed that levels of MMP-9 were positively associated with FEV1.0, and FEV1.0/FVC (r values were 0.27, 0.25, respectively, all P<0.05), and The levels of TIMP-1 were negatively associated with FVC, FEV1.0, and FEV1.0/FVC (r valuse were -0.33, -0.39, -0.39, all P<0.05).The levels of MMP-9 were negatively correlated with exposure time(r=-0.26, P=0.040). The positive correlations of MMP-9/TIMP-1 with FVC, FEV1.0, and FEV1.0/FVC were also found (r valuse were 0.34, 0.44, 0.40, all P<0.05).

CONCLUSION

TDI exposure could induce the downs of MMP-9 and MMP-9/TIMP-1 associated with lung functions. The MMP-9 and MMP-9/TIMP-1,in a way, could reflect the respiratory inflammatory injury caused by TDI exposure.

SNP Array in Hematopoietic Neoplasms: A Review

Cytogenetic analysis is essential for the diagnosis and prognosis of hematopoietic neoplasms in current clinical practice. Many hematopoietic malignancies are characterized by structural chromosomal abnormalities such as specific translocations, inversions, deletions and/or numerical abnormalities that can be identified by karyotype analysis or fluorescence in situ hybridization (FISH) studies. Single nucleotide polymorphism (SNP) arrays offer high-resolution identification of copy number variants (CNVs) and acquired copy-neutral loss of heterozygosity (LOH)/uniparental disomy (UPD) that are usually not identifiable by conventional cytogenetic analysis and FISH studies. As a result, SNP arrays have been increasingly applied to hematopoietic neoplasms to search for clinically-significant genetic abnormalities. A large numbers of CNVs and UPDs have been identified in a variety of hematopoietic neoplasms. CNVs detected by SNP array in some hematopoietic neoplasms are of prognostic significance. A few specific genes in the affected regions have been implicated in the pathogenesis and may be the targets for specific therapeutic agents in the future. In this review, we summarize the current findings of application of SNP arrays in a variety of hematopoietic malignancies with an emphasis on the clinically significant genetic variants.

Dendritic cell and histiocytic neoplasms: biology, diagnosis, and treatment

BACKGROUND

Dendritic and histiocytic cell neoplasms are rare malignancies that make up less than 1% of all neoplasms arising in lymph nodes or soft tissues. These disorders have distinctive disease biology, clinical presentations, pathology, and unique treatment options. Morphology and immunohistochemistry evaluation by a hematopathologist remains key for differentiating between these neoplasms. In this review, we describe tumor biology, clinical features, pathology, and treatment of follicular dendritic cell sarcoma, interdigitating dendritic cell sarcoma, indeterminate dendritic cell sarcoma, histiocytic sarcoma, fibroblastic reticular cell tumors, and disseminated juvenile xanthogranuloma.

METHODS

A literature search for articles published between 1990 and 2013 was undertaken. Articles are reviewed and salient findings are systematically described.

RESULTS

Patients with dendritic cell and histiocytic neoplasms have distinct but variable clinical presentations; however, because many tumors have recently been recognized, their true incidence is uncertain. Although the clinical features can present in many organs, most occur in the lymph nodes or skin. Most cases are unifocal and solitary presentations have good prognoses with surgical resection. The role of adjuvant therapy in these disorders remains unclear. In cases with disseminated disease, prognosis is poor and data on treatment options are limited, although chemotherapy and referral to a tertiary care center should be considered. Excisional biopsy is the preferred method of specimen collection for tissue diagnosis, and immunohistochemistry is the most important diagnostic method for differentiating these disorders from other entities.

CONCLUSIONS

Dendritic cell and histiocytic cell neoplasms are rare hematological disorders with variable clinical presentations and prognoses. Immunohistochemistry remains important for diagnosis. Larger pooled analyses or clinical trials are needed to better understand optimal treatment options in these rare disorders. Whenever possible, patients should be referred to a tertiary care center for disease management.

Therapy-related acute myeloid leukemia with eosinophilia, basophilia, t(4;14)(q12;q24) and PDGFRA rearrangement: a case report and review of the literature

The myeloid and lymphoid neoplasms with eosinophilia and PDGFRA gene rearrangements usually show a good response to Imatinib and are typically associated with a normal karyotype, occasionally exhibiting a secondary chromosomal abnormality associated with clonal evolution. Five variant translocations involving PDGFRA have been reported. Here, we report a rare case of therapy-related acute myeloid leukemia with PDGFRA rearrangement after chemotherapy for prior B lymphoblastic leukemia (B-ALL). The patient had a history of BCR-ABL negative, hypodiploid B-ALL in complete remission after chemotherapy. However, 15 months later the patient developed acute myeloid leukemia with rapidly increasing eosinophilia, basophilia and a complex karyotype that included a novel t(4;14)(q12;q24). FIP1L1 was not associated with the PDGFRA rearrangement. The patient had a very aggressive clinical course, and died from the disease shortly after diagnosis. This is the first case of a primary therapy-related myeloid neoplasm with secondary PDGFRA rearrangement. The t(4:14)(q12;q24) is joining the growing list of the variant translocations involving PDGFRA.

Longitudinal assessment of oxytocin efficacy on bone and bone marrow fat masses in a rabbit osteoporosis model through 3.0-T magnetic resonance spectroscopy and micro-CT

This study aims to longitudinally assess the effect of oxytocin on bone and bone fat masses using micro-CT, in vivo magnetic resonance spectroscopy (MRS), and histopathological adipocyte quantification. Early in vivo oxytocin (OT) treatment to the osteoporosis (OP) rabbit model may reliably inhibit bone degeneration and reduce bone marrow fat accumulation by decreasing marrow adipocyte size and density.

INTRODUCTION

This study aims to longitudinally assess the effect of early OT treatment on bone and bone fat masses in a rabbit OP model by comparing the results of MRS and micro-CT with histopathological findings.

METHODS

Sixty 20-week-old female rabbits were randomly assigned into three groups. The control and OP groups were subjected to either sham surgery or bilateral ovariectomy (OVX). The OT group was subcutaneously injected with OT daily from the second week after OVX for 8 weeks. The left proximal femurs of the rabbits were evaluated through MRS, micro-CT, and histopathological examination at 0, 4, 8, 10, and 12 weeks after operation. Differences in fat fraction (FF) values, micro-CT parameters, and calculated pathological marrow adipocytes among three groups were analyzed.

RESULTS

The FF values of the OP group significantly increased (p = 0.019), but the tissue mineral density (TMD) decreased (p = 0.037) from eighth week compared with those of the control group. The FF values of the OT group significantly decreased (p = 0.044), but the TMD values increased (p = 0.042) from eighth week compared with those of the OP group. The adypocyte diameter of the OT group significantly decreased (p = 0.041) from eighth week and then adypocyte density did so too from tenth week, compared with those of the OP group at the same time point. No difference in adypocyte calculation was found between the OT and control groups until the 12th week after operation.

CONCLUSION

Early in vivo OT treatment slowed down bone deterioration and reduced bone marrow adiposity accumulation in a rabbit OP model, which is consistent with pathologic findings. OT treatment is a promising preventive OP therapy.

Management of a patient with small-area burns, severe sepsis and superficial vein thrombosis

Sepsis is frequently seen in severely burned patients, however it is not common in those with small-area burns. We present a case of a 22-year-old man suffering from a hot crush injury to his left hand dorsum covering 1% of his total body surface area. The patient developed severe sepsis and superficial vein thrombosis, probably due to wound infection. Culture of the wound secretion indicated Corynebacterium striatum. Following intensive topical and systemic treatment the severe sepsis was controlled. The local wound was repaired by the abdominal skin pedicle flap which had taken well by day 27 post admission. A topical superficial vein thrombosis, unintentionally found 42 days after admission, was partially excised. This case demonstrates that when treating severe sepsis in patients with small-area burns, the timely recognition and diagnosis along with active systemic support, play a vital role in successful management.

DECLARATION OF INTEREST

None of the authors have any financial interest to declare.

An analysis of the main reasons that perimenopausal and postmenopausal women in China have for seeking outpatient treatment and factors influencing their symptoms: a single-center survey

OBJECTIVE

To explore the main reasons that perimenopausal and postmenopausal women have for seeking treatment and factors influencing their symptoms in order to provide (peri-) menopausal women with better healthcare treatments.

MATERIALS AND METHODS

Interviews were conducted with 357 (peri-) menopausal women who sought outpatient treatment at The Sixth People's Hospital, Shanghai Jiaotong University from July 1, 2010 to March 31, 2012. The survey includes general questions and an evaluation of (peri-) menopausal symptoms using the modified Kupperman index score.

RESULTS

The average age of the women who took part in the study was 51.47 years old (standard deviation = 5.18). Of the women, 47.6% were perimenopausal, 34.7% were early postmenopausal, and 17.7% were late postmenopausal. The age of natural menopause was between 39 and 56 years, and the average natural menopause age was 49.3 years (standard deviation = 4.0). The incidence of (peri-) menopausal symptoms was 91%. Age, education level, and chronic diseases were associated with menopausal symptoms. The main reasons for seeking treatment were hot flushes, insomnia, bone and joint pains, mood swings, and palpitations.

CONCLUSIONS

The main reasons for Chinese (peri-) menopausal women seeking treatment were hot flushes, insomnia, bone and joint pains, mood swings, and palpitations; age, education level, and chronic diseases are the main factors that influencing the (peri-) menopausal symptoms.

[Eisenmenger's syndrome in pregnancy: a case report and literature review]

OBJECTIVE

To investigate the clinical presentation, diagnosis and treatment of the Eisenmenger's syndrome in pregnancy.

METHODS

One case of Eisenmenger's syndrome in pregnancy in our hospital was retrospectively analyzed and the literature reviewed.

RESULTS

This patient who received antenatal care irregularly in other hospital was diagnosed with Eisenmenger's syndrome with the symptoms of chest distress. The other hospital suggested her to terminate pregnancy, but the patient refused. She was admitted to our hospital in her late pregnancy, received the treatment of rest, oxygen, blood gas and pulmonary artery pressure monitoring. Considering perioperative pulmonary hypertension crisis likely to occur, pulmonary artery catheter was placed preoperatively. In general anesthesia, the cesarean was performed. After operation, the patient was transferred to the intensive care unit, with the treatment of expanding blood vessels, reducing pulmonary artery pressure, administering anticoagulation and preventing infection. One week later, the patient was discharged from hospital with smooth condition.

CONCLUSION

Eisenmenger's syndrome in pregnancy is associated with extremely poor maternal and fetal outcome. Termination of pregnancy should be offered to such patients. When interruption of pregnancy is refused, the early hospital admission is needed. The patients should be managed in a high-risk pregnancy unit by a multidisciplinary team from obstetrics, cardiology, anesthesia and pediatrics for improving pregnancy outcomes.

Reconsideration of the relevance of mild wedge or short vertebral height deformities across a broad age distribution

Based on an evaluation of vertebral fracture prevalence on lateral radiographs across all age groups in a large cohort, mild or wedge-shaped vertebral body changes identified among adults should be managed as osteoporosis or at least considered as a risk factor for osteoporotic fracture, since they are rare among young subjects.

INTRODUCTION

Radiographic assessment of vertebral fractures is limited by the inability to distinguish mild fractures from congenital mild wedge deformities or vertebrae of short vertebral height. We attempted to quantify the expected background prevalence of these deformities by measuring vertebral fracture prevalence across all age groups in a large hospital-based retrospective Chinese cohort.

METHODS

We reviewed eligible lateral chest radiographs from patients admitted to Peking Union Medical College Hospital during 2011 using the Genant semiquantitative method for vertebral fracture assessment (T4-L2). We evaluated fracture prevalence among subjects by sex, 10-year age group, and fracture severity grades subjectively. We further analyzed characteristics of subjects with mild (grade I) fractures to estimate the relative contribution of congenital mild wedge deformities.

RESULTS

A total of 10,720 subjects (5,396 men and 5,324 women) with lateral chest radiographs were evaluated. Subjects ranged in age from 0.5 to 97 years with a mean of 51.8 ± 17.4 years (men 52.8 ± 17.6 years; women 50.8 ± 17.2 years). When stratified by 10-year age groups, the prevalence of vertebral fractures was relatively low until about 40 years of age, after which prevalence increased for both genders. Fractures (13 fractures for 9 males and 6 fractures for 5 females) seen in subjects younger than 40 years of age were almost exclusively mild grade fractures. No fractures were identified in subjects younger than 20 years of age.

CONCLUSIONS

Mild or wedge-shaped vertebral body changes on lateral radiographs are rare among young subjects, indicating that when mild vertebral deformities are found among adults, they are likely to be the product of aging and not congenital variation. Clinically, therefore, mild vertebral body changes should be managed as osteoporosis or at least considered as a risk factor for osteoporotic fracture.

Isolation of a goose parvovirus from swan and its molecular characteristics

Goose parvovirus (GPV) causes high mortality and morbidity in goslings and Muscovy ducklings. In this study, a GPV was isolated from a 20-day old swan in Shanghai, China. Complete genome of the swan isolate contained 5,050 nt and showed the highest homology with Taiwanese GPV isolates from 1982. In comparison with the Chinese mainland GPV isolates reported previously, the swan isolate shows two deletions, particularly at positions 67-80 and 334-347 in inverted terminal repeats (ITRs). These findings suggest that the swan could serve as a potential host for GPV and provide insights into molecular characteristics and etiology of GPV.

Magnetic sensing technology for molecular analyses

Magnetic biosensors, based on nanomaterials and miniature electronics, have emerged as a powerful diagnostic platform. Benefiting from the inherently negligible magnetic background of biological objects, magnetic detection is highly selective even in complex biological media. The sensing thus requires minimal sample purification and yet achieves a high signal-to-background contrast. Moreover, magnetic sensors are also well-suited for miniaturization to match the size of biological targets, which enables sensitive detection of rare cells and small amounts of molecular markers. We herein summarize recent advances in magnetic sensing technologies, with an emphasis on clinical applications in point-of-care settings. Key components of sensors, including magnetic nanomaterials, labeling strategies and magnetometry, are reviewed.

Study of individualization therapy for 61 patients with cesarean scar pregnancy

OBJECTIVE

To investigate the clinical value of the individualization therapy for cesarean scar pregnancy (CSP).

MATERIALS AND METHODS

According to the individual characteristics of the CSP in 61 patients admitted and treated by the People's Hospital of Yuyao City, China between March 2010 and February 2013, methotrexate (MTX) with leucovorin (CF) or uterine artery chemotherapy embolization (UACE) were used to kill the embryos, stanch, and prevent bleeding. Guided by hysteroscopy or B ultrasound, uterine curettage was carried out under the surveillance of laparoscopy if necessary.

RESULTS

Fifty-four cases of patients were treated by UACE. MTX with CF was used,in seven cases. Uterine curettage was performed in 44 cases under the guidance of hysteroscopy. Six cases were under the surveillance of the B ul- trasound and both hysteroscopic guidance and B ultrasound surveillance were used in seven cases. The lesions disappeared in two cases after transabdominal excision and two cases after UACE. All of the 61 patients were cured without hysterectomy.

CONCLUSION

Selection of individualization treatment programs according to the characteristics of the disease could improve the efficacy and prognosis of patients with CSP. The appropriate timing to perform curettage was five to seven days after embryo killing in order to reduce bleeding and shorten the course of the disease.

Epstein-Barr virus positive inflammatory pseudotumor of the liver: report of a challenging case and review of the literature

Inflammatory pseudotumor (IPT) is an uncommon, benign lesion of unclear etiology, which is sometimes associated with Epstein-Barr virus (EBV). In this study, we discuss a case of hepatic EBV positive IPT and discuss mimickers, prognosis, and treatment. The case we describe was located in the liver and composed of a mixture of spindle cells and polymorphic inflammatory cells with areas of necrosis. The spindle cells were negative for CAM5.2, ALK1, CD21, CD23, CD35, actin, S-100, and CD34. EBV-encoded small RNA in situ hybridization showed a large number of EBV positive cells. The diagnosis of hepatic EBV positive IPT with uncertain biological behavior was issued, presenting numerous difficulties with diagnostic and therapeutic challenges.

Midazolam suppresses osteogenic differentiation of human bone marrow-derived mesenchymal stem cells

OBJECTIVE

Previous study showed that peripheral-type benzodiazepine receptors (PBRs) are expressed in human mesenchymal stem cells (hMSCs) and diazepam was found to inhibit hMCSs viability in high concentration. Midazolam, a benzodiazepine derivative, is widely used as an intravenous sedative in hospital. Peripheral-type benzodiazepine receptors (PBRs) affect a broad spectrum of cellular functions. We tested the cell viability and osteogenic differentiation of hMSCs.

PATIENTS AND METHODS

Bone marrow was collected from 12 patients during the operation of spine internal fixation. Cultivated with basal medium, the hBMSCs were incubated with or without midazolam (0.1, 1, 5, 10, 15, 20 µM, respectively). Cell viability were tested with MTS assay after 2, 4, 6 hours respectively. Cell morphology was observed and recorded at 6 hour. After cultivated with osteogentic medium, the hBMSCs were incubated with or without midazolam (5, 10, 15, 20 µM, respectively). Alkaline phosphatase (ALP) activity and alizarin red S staining were measured. Cultivated with osteogentic medium with or without treatment of 15 µM midazolam, the mRNA expression of ALP, type 1 collagen (COL1), Runx2 and PPARγ was analyzed by real-time RT-PCR.

RESULTS

The treatments of midazolam inhibited cell viability to 85%-16% respectively (p < 0.05). Rounded up phenomenon with floating cells, Membrane-blebbed cells and cytoplasmic contraction were observed after 10, 15 or 20 µM midazolam treatment. The ALP activity and Calcium deposition of hBMSCs exposed to 15 and 20 µM midazolam was significantly inhibited at 7, 14 and 21 days (p < 0.05). And the mRNA expression of ALP, COL1 and PPARγ was significantly suppressed in the hBMSCs cultured with 15 µM midazolam (p < 0.05).

CONCLUSIONS

Midazolam exert negative effect on cell viability and osteogenic differentiation of cultured hBMSCs. During sedation in critical care, the use of midazolam may suppress activity of hBMSCs.

Differentiation of tuberculosis from lymphomas in neck lymph nodes with multidetector-row computed tomography

BACKGROUND

Tuberculosis (TB) of the cervical lymph nodes may mimic lymphoma.

OBJECTIVE

To evaluate multidetector-row computed tomographic (MDCT) imaging criteria for differentiating between the two diseases.

MATERIALS AND METHODS

We retrospectively reviewed the anatomical distribution and CT enhancement patterns of the nodes in 81 patients, 27 (33%) with untreated TB and 54 (67%) with untreated lymphomas involving cervical lymph nodes. Of the patients with lymphomas, 19 (35%) had Hodgkin's disease and 35 (65%) had non-Hodgkin's lymphoma.

RESULTS

TB predominantly involved the upper cervical nodes. The supraclavicula fossa nodes on MDCT were involved more often in Hodgkin's disease (n = 15, 79%) and non-Hodgkin's lymphoma (n = 25, 71%) than in TB (n = 3, 11%). Tuberculous lymphadenopathy commonly showed peripheral enhancement, frequently with a multilocular appearance. Peripheral enhancement was significantly more frequent in TB (n = 19, 70%) than in Hodgkin's disease (n = 1, 5%) and non-Hodgkin's lymphoma (n = 1, 3%), but homogeneous enhancement was less common in the TB group.

CONCLUSION

Our findings indicate that a specific enhancement pattern of lymphadenopathy seen on MDCT was useful in differentiating between untreated TB and lymphomas of the cervical lymph nodes.

Primary hepatosplenic CD5-positive diffuse large B-cell lymphoma: a case report with literature review

De novo CD5-positive diffuse large B-cell lymphoma (CD5(+) DLBCL) accounts for approximately 10% of DLBCL, and is usually associated with aggressive clinical course. We report a case of CD5(+) DLBCL with primary involvement of the spleen and liver, and no distinct mass lesions or lymphadenopathy. The patient had stage IV disease with bone marrow involvement by lymphoma. The lymphoma cells showed characteristic portal and intrasinusoidal pattern of infiltrate in the liver. The literature was reviewed and the clinicopathologic features of 7 similar reported cases were summarized. All cases share the common features of hepatosplenomegaly without mass lesions, exclusive red pulp infiltrate with a diffuse and cordal pattern in the spleen, portal and intrasinusoidal pattern of infiltrate in the liver, and stage IV disease with poor response to conventional chemotherapy. This may represent a distinct subgroup of CD5(+) DLBCL and the diagnosis is important for prompt clinical treatment.

Distinguishing hairy cell leukemia variant from hairy cell leukemia: development and validation of diagnostic criteria

Hairy cell leukemia (HCL) and hairy cell leukemia-variant (HCL-v) are rare diseases with overlapping clinico-pathological features. We performed flow cytometry analysis (FCM) of 213 cases (169 HCL, 35 HCL-v, 9 splenic marginal zone lymphoma (SMZL)), correlating results with available corresponding clinical and morphological data. FCM distinguished HCL-v from HCL and SMZL based solely upon expression of four antigens (CD11c, CD25, CD103, CD123) combined with B-cell markers (CD19, CD20, CD22). HCL-v expressed bright CD20, bright CD22, CD11c(100%), CD103(100%), dim(40%) or negative(60%) CD123, and uniformly lacked CD25(100%). HCL expressed bright CD20, bright CD22, bright CD11c, bright CD25, CD103, and bright homogeneous CD123(100%). Aberrant expression of CD5(2%/3%), CD10(12%/3%), CD23(21%/11%), CD38(14%/0%), CD2(2%/9%), CD4(0.5%/0%) and CD13(0.5%/3%), was observed in HCL/HCL-v, respectively. SMZL cases were CD103(-) and CD123(-) except for one case with dim CD123. HCL showed significantly greater marrow infiltration over HCL-v. Prominent nucleoli were observed in most HCL-v but rarely in HCL. A third of HCL and HCL-v marrows were hypocellular or aplastic-appearing. Detection of BRAFV600E mutation and annexin A1 were examined in a subset of cases to further validate FCM diagnostic criteria. HCL-v was negative for both annexin A1 (100%) and BRAFV600E mutation (100%), in contrast to HCL (74% positive for annexin A1; 76% positive for BRAFV600E mutation). HCL-v is resistant to traditional HCL therapy, making accurate diagnosis imperative. We have defined FCM criteria for differentiation of HCL-v from HCL and SMZL.

Double-hit mantle cell lymphoma with MYC gene rearrangement or amplification: a report of four cases and review of the literature

Mature B-cell lymphomas with both BCL2 and MYC translocations are known as "double hit" lymphomas. These lymphomas are aggressive and show high proliferation rate due to the growth advantages provided by MYC and BCL2 translocation and overexpression. Mantle cell lymphoma (MCL) is a neoplasm of mature B-lymphocytes with characteristic t(11;14) and subsequent Cyclin D1 overexpression. Secondary cytogenetic changes are frequent in MCL, but MYC translocation has only been rarely reported. In this study, we report four cases of MCL with MYC translocation or MYC gene amplification detected by conventional cytogenetics, fluorescence in situ hybridization and whole genome single nucleotide polymorphism (SNP) array, and determined the clinicopathologic features. Our study provides further evidence supporting the concept of "double hit" MCL with co-involvement of MYC gene rearrangement and/or amplification and CCND1 gene rearrangement.

A rat model of diabetic artery calcification

OBJECTIVES

The aim of this study was to develop a rat model that shares the similarities of calcification in diabetes.

METHODS

Male Wistar rats received a high-fat diet during 8 weeks followed by a low dose of streptozotocin. Half of them were treated with vitamin D3 and nicotine (VDN) 1 week after streptozotocin injection (DM) (DM+VDN). The others were treated with vehicle (DM). Arterial calcification was facilitated by vitamin D3 and nicotine in age-matched rats (VDN). Measurements of metabolic parameters, aortic calcium content, von Kossa staining, alkaline phosphatase activity and immunohistochemistry for osteopontin were performed. The expression of genes and proteins associated with calcification were also examined.

RESULTS

Treatment with VDN alone resulted in a small but not significant elevation of calcium content in aorta. However, in DM+VDN, aortic calcium content increased significantly as compared to the VDN. This calcification had also dramatically increased, as shown by von Kossa staining. Mechanistic studies revealed that addition of VDN treatment in diabetic rats enhanced both activity and mRNA expression of alkaline phosphatase. This treatment in diabetic- rats also enhanced the expression of core binding factor α 1 and its downstream protein osteopontin. In aorta, strong immunostaining for osteopontin was observed in DM+VDN. The result was also confirmed by Western blot analysis.

CONCLUSION

These results suggest that a model of accelerated arterial calcification in diabetes have been established and this model could be useful to investigate mechanisms related to vascular complication in diabetes.

Differentiation between tuberculosis and lymphoma in mediastinal lymph nodes: Evaluation with contrast-enhanced MDCT

AIM

To determine the specific imaging criteria on contrast-enhanced multidetector computed tomography (MDCT) for differentiating between tuberculosis and lymphoma in mediastinal lymph nodes.

MATERIALS AND METHODS

The anatomical distribution and enhancement patterns of mediastinal lymph nodes on contrast-enhanced MDCT were reviewed in 37 patients with tuberculosis and 54 patients with lymphoma. Of the patients with lymphoma, 18 had Hodgkin's disease and 36 had non-Hodgkin's lymphoma.

RESULTS

Region 10R was involved more often in tuberculosis than in Hodgkin's disease and non-Hodgkin's lymphoma. Region 6 had a higher tendency to be affected in Hodgkin's disease and non-Hodgkin's lymphoma compared with tuberculosis. Tuberculosis showed peripheral enhancement in 78% of cases, frequently with a multilocular appearance, compared to Hodgkin's disease and non-Hodgkin's lymphoma, which showed peripheral enhancement in only 6 and 3% of cases, respectively. Homogeneous enhancement was more commonly seen in lymphoma (83% for Hodgkin's disease, and 83% for non-Hodgkin's lymphoma) than in tuberculosis (8%). In the determination of tuberculosis, results showed that when a peripheral enhancement pattern was seen, sensitivity was 78%, specificity was 96%, and accuracy was 89%. In the determination of lymphoma, results showed that when a homogeneous enhancement pattern was seen, sensitivity was 83%, specificity was 92%, and accuracy was 87%.

CONCLUSION

The findings of the present study indicate that specific anatomical distribution and enhancement patterns of lymphadenopathy shown on contrast-enhanced MDCT can be useful in differentiating tuberculosis from lymphoma of mediastinal lymph nodes.

Nanostructured Ti-catalyzed MgH2 for hydrogen storage

Nanocrystalline Ti-catalyzed MgH(2) can be prepared by a homogeneously catalyzed synthesis method. Comprehensive characterization of this sample and measurements of hydrogen storage properties are discussed and compared to a commercial MgH(2) sample. The catalyzed MgH(2) nanocrystalline sample consists of two MgH(2) phases-a tetrahedral β-MgH(2) phase and an orthorhombic high-pressure modification γ-MgH(2). Transmission electron microscopy was used for the observation of the morphology of the samples and to confirm the nanostructure. N(2) adsorption measurement shows a BET surface area of 108 m(2) g(-1) of the nanostructured material. This sample exhibits a hydrogen desorption temperature more than 130 °C lower compared to commercial MgH(2). After desorption, the catalyzed nanocrystalline sample absorbs hydrogen 40 times faster than commercial MgH(2) at 300 °C. Both the Ti catalyst and the nanocrystalline structure with correspondingly high surface area are thought to play important roles in the improvement of hydrogen storage properties. The desorption enthalpy and entropy values of the catalyzed MgH(2) nanocrystalline sample are 77.7 kJ mol(-1) H(2) and 138.3 J K(-1) mol(-1) H(2), respectively. Thermodynamic properties do not change with the nanostructure.

Activation of Notch1 signaling in stromal fibroblasts inhibits melanoma growth by upregulating WISP-1

The tumor microenvironment is emerging as an important target for cancer therapy. Fibroblasts (Fbs) within the tumor stroma are critically involved in promoting tumor growth and angiogenesis through secretion of soluble factors, synthesis of extracellular matrix and direct cell-cell interaction. In this work, we aim to alter the biological activity of stromal Fbs by modulating the Notch1 signaling pathway. We show that Fbs engineered to constitutively activate the Notch1 pathway significantly inhibit melanoma growth and tumor angiogenesis. We determine that the inhibitory effect of 'Notch-engineered' Fbs is mediated by increased secretion of Wnt-induced secreted protein-1 (WISP-1) as the effects of Notch1 activation in Fbs are reversed by shRNA-mediated blockade of WISP-1. When 'Notch-engineered' Fbs are co-grafted with melanoma cells in SCID mice, shRNA-mediated blockade of WISP-1 reverses the tumor-suppressive phenotype of the 'Notch-engineered' Fbs, significantly increases melanoma growth and tumor angiogenesis. Consistent with these findings, supplement of recombinant WISP-1 protein inhibits melanoma cell growth in vitro. In addition, WISP-1 is modestly expressed in melanoma-activated Fbs but highly expressed in inactivated Fbs. Evaluation of human melanoma skin biopsies indicates that expression of WISP-1 is significantly lower in melanoma nests and surrounding areas filled with infiltrated immune cells than in the adjacent dermis unaffected by the melanoma. Overall, our study shows that constitutive activation of the Notch1 pathway confers Fbs with a suppressive phenotype to melanoma growth, partially through WISP-1. Thus, targeting tumor stromal Fbs by activating Notch signaling and/or increasing WISP-1 may represent a novel therapeutic approach to combat melanoma.

ERCC6 founder mutation identified in Finnish patients with COFS syndrome

Cerebro-oculo-facio-skeletal (COFS) syndrome is an autosomal recessive disorder characterized by microcephaly, congenital cataracts, facial dysmorphism, neurogenic arthrogryposis, growth failure and severe psychomotor retardation. We report a large consanguineous pedigree from northern Finland with six individuals belonging into four different sibships and affected with typical COFS syndrome phenotype. Two deceased patients have been published previously in 1982 as the first cases exhibiting cerebral calcifications typical for this disorder. Two living and one of the deceased patients were all shown to possess a novel homozygous mutation in the ERCC6 [Cockayne syndrome B (CSB)] gene, thereby confirming the diagnosis on molecular genetic level even for the earlier published cases. Genealogical investigation showed a common ancestor living in a northeastern village in Finland in the 18th century for all six patients implying a founder effect.

Influence of CYP2C9 and CYP2C19 genetic polymorphisms on pharmacokinetics and pharmacodynamics of gliclazide in healthy Chinese Han volunteers

BACKGROUND AND OBJECTIVE

CYP2C9 is the major contributor to gliclazide metabolic clearance in vitro, while the pharmacokinetics of gliclazide modified release are affected mainly by CYP2C19 genetic polymorphisms in vivo. This study aims to investigate the influence of CYP2C9 and CYP2C19 genetic polymorphisms on the pharmacokinetics and pharmacodynamics of gliclazide in healthy Chinese Han volunteers.

METHODS

Eighteen healthy Han subjects with various combinations of CYP2C9 and CYP2C19 genotypes received 80 mg gliclazide. Plasma gliclazide concentrations were measured by a liquid chromatography-tandem mass spectrometry method for 84 h and plasma glucose and insulin levels were measured up to 15 h post-dose.

RESULTS AND DISCUSSION

There was no difference in either pharmacokinetic and or pharmacodynamic parameters of gliclazide when group A (CYP2C9*1/*1, CYP2C19 extensive metabolizers) was compared with group B (CYP2C9*1/*3, CYP2C19 *1/*1). When group C (CYP2C9*1/*1 and CYP2C19 poor metabolizers) was compared with group A, the AUC(0-∞) and C(max) in group C were significantly higher [83.94 ± 40.41 vs. 16.39 ± 5.10 μg·h/mL (P = 0.000) and 1.50 ± 0.85 vs. 0.45 ± 0.18 μg/mL (P = 0.000)], and the oral clearance was significantly lower [1.17 ± 0.63 vs. 5.38 ± 1.86 L/h (P = 0.000)]. The half-life of gliclazide was also significantly prolonged in group C subjects when compared with that of group A (33.47 ± 12.39 vs. 19.34 ± 10.45 h), but the difference was not significant (P = 0.052). The increase in serum glucose level at 11 h after dosing (ΔC(glu11)) in group C was significantly higher than that of group A (-1.08 ± 0.42 vs. 0.22 ± 1.01 mmol/L, P = 0.022). The corresponding insulin levels showed no difference between the two groups.

CONCLUSION

CYP2C9*3 was not associated with any change in the disposition of gliclazide. CYP2C19 polymorphisms appear to exert the dominant influence on the pharmacokinetics of gliclazide in healthy Chinese Han subjects, and may also affect the observed pharmacodynamics of the drug as a result.

The 32-year relationship between cholesterol and dementia from midlife to late life

BACKGROUND

Cellular and animal studies suggest that hypercholesterolemia contributes to Alzheimer disease (AD). However, the relationship between cholesterol and dementia at the population level is less clear and may vary over the lifespan.

METHODS

The Prospective Population Study of Women, consisting of 1,462 women without dementia aged 38-60 years, was initiated in 1968-1969 in Gothenburg, Sweden. Follow-ups were conducted in 1974-1975, 1980-1981, 1992-1993, and 2000-2001. All-cause dementia was diagnosed according to DSM-III-R criteria and AD according to National Institute of Neurological and Communicative Disorders and Stroke-Alzheimer's Disease and Related Disorders Association criteria. Cox proportional hazards regression examined baseline, time-dependent, and change in cholesterol levels in relation to incident dementia and AD among all participants. Analyses were repeated among participants who survived to the age of 70 years or older and participated in the 2000-2001 examination.

RESULTS

Higher cholesterol level in 1968 was not associated with an increased risk of AD (highest vs lowest quartile: hazard ratio [HR] 2.82, 95% confidence interval [CI] 0.94-8.43) among those who survived to and participated in the 2000-2001 examination. While there was no association between cholesterol level and dementia when considering all participants over 32 years, a time-dependent decrease in cholesterol over the follow-up was associated with an increased risk of dementia (HR 2.35, 95% CI 1.22-4.58).

CONCLUSION

These data suggest that midlife cholesterol level is not associated with an increased risk of AD. However, there may be a slight risk among those surviving to an age at risk for dementia. Declining cholesterol levels from midlife to late life may better predict AD risk than levels obtained at one timepoint prior to dementia onset. Analytic strategies examining this and other risk factors across the lifespan may affect interpretation of results.

Minimal residual disease detection by flow cytometry in adult T-cell leukemia/lymphoma

Little information exists regarding the detection of minimal residual disease (MRD) in adult T-cell leukemia/lymphoma (ATLL). We evaluated 75 peripheral blood samples from 17 ATLL cases using flow cytometry (FC); 50 of the samples were concurrently evaluated by polymerase chain reaction (PCR) for clonal T-cell receptor gamma chain (TRG) gene rearrangement and the presence of human T-cell lymphotropic virus-1 proviral sequences. Residual ATLL cells were identified using a multiparametric approach to identify aberrant T-cell immunophenotypes. Malignant T cells were CD4+, CD3 dim+, CD26-, CD25 bright, CD7+, and CD27+, with occasional dim expression of CD2 or CD5. FC exhibited a high sensitivity, detecting as few as 0.29% ATLL cells/WBC (4.9 cells/microL) in the peripheral blood. PCR for TRG gene rearrangement was slightly more sensitive, and FC and PCR complemented each other in detecting MRD. In 2 patients, there was complete remission; 4 patients had disease refractory to therapy, and 3 died; 11 others had persistent disease with variable numbers of ATLL cells in the peripheral blood. Higher levels of ATLL cells appeared to correlate with disease severity. FC detection of aberrant T cells permits sensitive and quantitative monitoring of MRD in ATLL.