A high-resolution whole-genome map of the distinctive epigenomic landscape induced by butyrate in bovine cells

This report presents a study utilizing next-generation sequencing technology, combined with chromatin immunoprecipitation (ChIP-seq) technology to analyze histone modification induced by butyrate and to construct a high-definition map of the epigenomic landscape with normal histone H3 and H4 and their variants in bovine cells at the whole-genome scale. A total of 10 variants of histone H3 and H4 modifications were mapped at the whole-genome scale (acetyl-H3K18-ChIP-seq, trimethy-H3K9, histone H4 ChIP-seq, acetyl-H4K5 ChIP-seq, acetyl-H4K12 ChIP-seq, acetyl-H4K16 ChIP-seq, histone H3 ChIP-seq, acetyl H3H9 ChIP-seq, acetyl H3K27 ChIP-seq and tetra-acetyl H4 ChIP-seq). Integrated experiential data and an analysis of histone and histone modification at a single base resolution across the entire genome are presented. We analyzed the enriched binding regions in the proximal promoter (within 5 kb upstream or at the 5'-untranslated region from the transcriptional start site (TSS)), and the exon, intron and intergenic regions (defined by regions 25 kb upstream and 10 kb downstream from the TSS). A de novo search for the binding motif of the 10 ChIP-seq datasets discovered numerous motifs from each of the ChIP-seq datasets. These consensus sequences indicated that histone modification at different locations changes the histone H3 and H4 binding preferences. Nevertheless, a high degree of conservation in histone binding also was presented in these motifs. This first extensive epigenomic landscape mapping in bovine cells offers a new framework and a great resource for testing the role of epigenomes in cell function and transcriptomic regulation.

Angiographic evaluation of hepatic arterial injury after cisplatin and Gelfoam-based transcatheter arterial chemoembolization for hepatocellular carcinoma in a 205 patient cohort during a 6-year follow-up

OBJECTIVE

To evaluate the overall and cumulative incidence, degree, interval change and predictors of hepatic arterial injury (HAI) after cisplatin and Gelfoam® (Upjohn, Kalamazoo, MI)-based transcatheter arterial chemoembolization (TACE) for hepatocellular carcinoma (HCC).

METHODS

A total of 205 patients with HCC who underwent three or more sessions of TACE without additional surgical or local treatment were included. HAI was evaluated at each segment of the hepatic artery using a three-grade scale: 1 (slight wall irregularity), 2 (overt stenosis) and 3 (occlusion). HAI interval change was categorized into three groups: progression, stable state and improvement. Cumulative incidence of HAI was analysed using Kaplan- Meier method, and predictors of HAI (patient age, sex, portal vein thrombosis and Child-Pugh classification) were analysed by univariate logistic regression.

RESULTS

HAI occurred in 50 of the 205 study patients (24.4%). The cumulative incidence of HAI was 16.0% [95% confidence interval (CI), 10.21-21.77] during 5 sessions of TACE, 52.1% (95% CI, 37.83-66.29) during 10 sessions and 68.0% (95% CI, 67.62-88.46) during 15 sessions. Initial HAI was interpreted as grades 1, 2 and 3 in 11 (22.0%), 17 (34.0%) and 22 (44.0%) patients, respectively. When the interval change was assessed in 48 patients with available follow-up TACE, 40 (83.3%) were included in the progression, 2 (4.2%) in the stable state and 6 (12.5%) in the improvement groups. The univariate analysis used to determine the predictors of HAI revealed no significant predictors.

CONCLUSION

In three or more sessions of TACE, the incidence of HAI was 24%. Increasing TACE causes increased incidence of HAI. The initial presentation was most commonly grade 3, and 12.5% of the patients with HAI showed improvement of the HAI grade during follow-up TACE.

ADVANCES IN KNOWLEDGE

In patients who underwent three or more sessions of cisplatin and Gelfoam-based TACE, the overall incidence of HAI was 24.4%, and increasing TACE causes increased incidence of HAI.

Ahnak functions as a tumor suppressor via modulation of TGFβ/Smad signaling pathway

We provide detailed mechanisms of Ahnak-mediated potentiation of transforming growth factor β (TGFβ) signaling, which leads to a negative regulation of cell growth. We show that Smad3 interacts with Ahnak through MH2 domain and that Ahnak stimulates Smad3 localization into nucleus leading to potentiating TGFβ-induced transcriptional activity of R-Smad. Moreover, overexpression of Ahnak resulted in growth retardation and cell cycle arrest through downregulation of c-Myc and cyclin D1/D2. We describe results from analyses of Ahnak^−/− mouse model expressing middle T antigen in a mammary gland-specific manner (MMTV^Tg/+Ahnak^−/−), which showed significantly progressed hyperplasia of mammary glands compared with MMTV^Tg/+Ahnak^+/+. Finally, we screened multiple human breast cancer tissues and showed that the expression of Ahnak in cancer tissues is lower than that in control tissues by 50%. Taken together, these data indicate that Ahnak mediates a negative regulation of cell growth and acts as novel tumor suppressor through potentiation of TGFβ signaling.

Stereotactic radiosurgery for metastatic spine tumors

Spinal metastases invariably affect the majority of patients with cancer. Many will develop symptoms related to pain and disability from epidural spinal cord compression as well as pathologic fracture of the vertebrae. With the emergence of targeted systemic therapies and a better understanding of cancer biology, patients are living longer with bony metastases. This poses particular challenges, as palliation of pain and maintenance of local tumor control are paramount to quality of life and overall functional independence for these patients. Stereotactic radiosurgery (SRS) has emerged as a potent primary standalone and adjuvant treatment option for spinal metastases. To date, the primary indications for SRS include 1) upfront standalone treatment for painful bony metastases in the oligometastatic patient, 2) standalone or post-operative treatment following progression or recurrence of local disease despite previous conventional external beam radiation therapy (cEBRT), and 3) following surgery during which epidural disease is decompressed and the spine stabilized when indicated. SRS has demonstrated a significant advantage over cEBRT for tumors traditionally regarded as relatively radioresistant such as sarcoma, melanoma, renal cell carcinoma, non-small cell lung cancer and colon carcinoma.9 The radiobiological advantage of increased tumoricidal dose delivery and spinal cord dose sparing in SRS have made this a powerful treatment alternative to cEBRT particularly within the context of re-irradiation. Given the limitations of spinal cord dose constraints, surgery is still the first-line therapy in patients with high-grade epidural spinal cord compression (ESCC). Epidural compression can be treated with SRS, however this risks radiation-induced myelopathy and challenges the safety of effective dose delivery at the dural margin.11 With increasing dose, radiation-induced vertebral fracture is the most serious and prevalent side effect of SRS.53 An overview of SRS, including the most common indications, complications, and outcomes for spinal metastases are presented here.

Identification of a novel HLA-B allele, B*46:39, by sequence-based typing

The new allele B*46:39 showed a single-nucleotide substitution compared with B*46:01 at codon 185 (CCA/ACA).

Mid-long term effect of non-ablative high radiofrequency therapy on the rabbit dermal extracellular matrix

This study quantitatively investigated the postoperative effects of radiofrequency (RF) application on the normal dermal extracellular matrix (ECM) of in vivo rabbits. Postoperative effects were evaluated by histology and atomic force microscopy analysis of dermal tissues treated using three RF energy levels (10 ~ 30 W) and either a single- or multiple-pass procedure. Progressive changes in the morphology of rabbit dermal ECMs were investigated over a 30-day postoperartive period. All RF-treated groups, except for the low energy group (10 W), displayed more prominent inflammatory responses compared to the control. This inflammatory reaction was more prominent a day after application. Dermal tissues 30 days after RF application exhibited prominent myofibroblast activity associated with ECM contractile activity during wound healing in addition to chronic inflammation. A decrease in the morphology of dermal ECMs after RF application continued until seven days postoperatively. The ECM diameter increased to near baseline at 30 days postoperatively. Low energy and multi-pass applications resulted in greater collagen fibril contraction and recovery at the ultra-structural level at 30 days postoperatively than did a single high energy application.

Fibrolytic enzyme and ammonia application effects on the nutritive value, intake, and digestion kinetics of bermudagrass hay in beef cattle

The objectives were to compare the effect of exogenous fibrolytic enzyme (Biocellulase A20) or anhydrous ammonia (4% DM) treatment on the nutritive value, voluntary intake, and digestion kinetics of bermudagrass (Cynodon dactylon cultivar Coastal) hay harvested after 2 maturities (5- and 13-wk regrowths). Six individually housed, ruminally cannulated Brangus steers (BW 325 ± 10 kg) were used in an experiment with a 6 × 6 Latin square design with a 3 (additives) × 2 (maturities) factorial arrangement of treatments. Each period consisted of 14 d of adaptation and 7, 4, 1, 1, and 4 d for measuring in vivo digestibility, in situ degradability, no measurements, rumen liquid fermentation and passage indices, and rate of solid passage, respectively. Steers were fed hay for ad libitum intake and supplemented with sugarcane molasses and distillers grain (supplement total of 2.88 kg DM/d). Enzyme did not affect the nutritional composition of hay but ammonia treatment decreased hay NDF, hemicellulose, and ADL concentrations and increased the CP concentration particularly for the mature lignified 13-wk hay. The enzyme increased NDF and hemicellulose digestibility of the 5-wk hay but decreased those of the 13-wk hay. Ammoniation decreased intake of hay but increased digestibility of DM, OM, NDF, hemicellulose, ADF, and cellulose and increased the ruminal in situ soluble and potentially digestible fractions and the rate of DM degradation of the 13-wk hay. Also, ammoniation increased the concentrations of ruminal NH3, total VFA, acetate, and butyrate but enzyme treatment did not. Neither enzyme addition nor ammoniation affected rate of liquid and solid passage. In conclusion, ammoniation decreased the concentration of most fiber fractions, decreased the intake of hays, and increased their CP concentration, in vivo digestibility, and in situ degradability at both maturities whereas enzyme application increased fiber digestibility of the 5-wk hay but decreased it in the case of the 13-wk hay.

Optimized cutoff value and indication for washout thyroglobulin level according to ultrasound findings in patients with well-differentiated thyroid cancer

BACKGROUND AND PURPOSE

Washout thyroglobulin provides evidence for metastatic or recurrent lesions, However, the cutoff value is still controversial. We investigated an optimized cutoff value and indication for the use of washout thyroglobulin from fine-needle aspiration in neck lymph nodes from preoperative or postoperative patients with well-differentiated thyroid cancers.

MATERIALS AND METHODS

A total of 177 lymph nodes from 161 patients underwent sonographically guided fine-needle aspiration cytology and washout thyroglobulin measurement and then underwent surgery and clinical follow-up. We assessed an optimized cutoff value of washout thyroglobulin for diagnosing metastasis and compared its diagnostic performance with that of washout thyroglobulin > 10 ng/mL, the currently accepted cutoff value. We also analyzed diagnostic performances of fine-needle aspiration cytology alone and of the combination of fine-needle aspiration cytology and washout thyroglobulin on the basis of the presence or absence of suspicious ultrasonographic findings.

RESULTS

Of the 177 lymph nodes, 77 were metastases and 100 were benign. An optimized cutoff value for washout thyroglobulin was 1.8 ng/mL. The sensitivity and negative predictive value in diagnosing metastasis improved significantly with a cutoff value of 1.8 ng/mL compared with a cutoff value of 10 ng/mL (P = .0412 for sensitivity, P = .0188 for negative predictive value). In patients with suspicious ultrasonographic findings, applying washout thyroglobulin along with fine-needle aspiration cytology significantly enhanced the sensitivity and negative predictive value of fine-needle aspiration cytology performances to 100% and 100%, respectively (P = .0051, and P = .0088). There was no difference in diagnostic performance between fine-needle aspiration cytology and the combination of the 2 methods in patients without suspicious ultrasonographic findings.

CONCLUSIONS

Applying the optimized cutoff value of washout thyroglobulin of 1.8 ng/mL in patients with suspicious ultrasonographic features facilitates the diagnostic evaluation of neck lymph nodes in both preoperative and postoperative patients with well-differentiated thyroid cancer.

Multidisciplinary approach in the management of a complicated crown root fracture

BACKGROUND

This article describes the management of a complicated crown root fracture.

CASE REPORT

A young patient presented with a crown root fracture of the maxillary left central incisor with an oblique subgingival fracture line. A multidisciplinary treatment approach including endodontic treatment, orthodontic extrusion, surgical extraction and intra-alveolar repositioning was used to gain sufficient crown length of the fractured maxillary incisor. The coronally repositioned maxillary left central incisor was stabilised by sutures and a resin wire splint. A resin core was built up followed by fabrication of an all-ceramic crown. Clinical and radiographic follow-up of the maxillary left central incisor after 24 months showed no signs of bone resorption or pathology and good aesthetics and functions were maintained.

Ultrasonography-guided core needle biopsy for the thyroid nodule: does the procedure hold any benefit for the diagnosis when fine-needle aspiration cytology analysis shows inconclusive results?

OBJECTIVE

We evaluated the diagnostic role of ultrasonography-guided core needle biopsy (CNB) according to ultrasonography features of thyroid nodules that had inconclusive ultrasonography-guided fine-needle aspiration (FNA) results.

METHODS

A total of 88 thyroid nodules in 88 patients who underwent ultrasonography-guided CNB because of previous inconclusive FNA results were evaluated. The patients were classified into three groups based on ultrasonography findings: Group A, which was suspicious for papillary thyroid carcinoma (PTC); Group B, which was suspicious for follicular (Hurthle cell) neoplasm; and Group C, which was suspicious for lymphoma. The final diagnoses of the thyroid nodules were determined by surgical confirmation or follow-up after ultrasonography-guided CNB.

RESULTS

Of the 88 nodules, the malignant rate was 49.1% in Group A, 12.0% in Group B and 90.0% in Group C. The rates of conclusive ultrasonography-guided CNB results after previous incomplete ultrasonography-guided FNA results were 96.2% in Group A, 64.0% in Group B and 90.0% in Group C (p=0.001). 12 cases with inconclusive ultrasonography-guided CNB results were finally diagnosed as 8 benign lesions, 3 PTCs and 1 lymphoma. The number of previous ultrasonography-guided FNA biopsies was not significantly different between the conclusive and the inconclusive result groups of ultrasonography-guided CNB (p=0.205).

CONCLUSION

Ultrasonography-guided CNB has benefit for the diagnosis of thyroid nodules with inconclusive ultrasonography-guided FNA results. However, it is still not helpful for the differential diagnosis in 36% of nodules that are suspicious for follicular neoplasm seen on ultrasonography.

ADVANCES IN KNOWLEDGE

This study shows the diagnostic contribution of ultrasonography-guided CNB as an alternative to repeat ultrasonography-guided FNA or surgery.

Effects of feeding crude glycerin on performance and ruminal kinetics of lactating Holstein cows fed corn silage- or cottonseed hull-based, low-fiber diets

The objective was to determine whether crude glycerin could partially replace concentrate ingredients in corn silage- or cottonseed hull-based diets formulated to support minimal milk fat production without reducing milk production. Multiparous, lactating Holstein cows (n=24; 116 ± 13d in milk) were assigned to dietary treatments arranged in a 2 × 3 factorial design; namely, 2 dietary roughage sources (cottonseed hulls or corn silage) and 3 dietary concentrations of glycerin [0, 5, or 10% on a dry matter (DM) basis]. Four different cows received each dietary treatment in each of 3 periods such that each diet was evaluated using 12 cows. Crude glycerin, produced using soybean oil, contained 12% water, 5% oil, 6.8% sodium chloride, and 0.4% methanol. Glycerin partially replaced ground corn, corn gluten feed, and citrus pulp. Diets of minimum fiber concentrations were fed to lactating dairy cows and resulted in low concentrations of milk fat (averaging 3.12% for cows fed diets without glycerin). The effects of glycerin on cow performance and ruminal measurements were the same for both dietary roughage sources with the exception of feed efficiency. Replacing concentrate with crude glycerin at 5% of dietary DM increased DM intake without increasing milk yield. Concentration and yield of milk fat were reduced when glycerin was fed at 10% of dietary DM. This was accompanied by a 30% reduction in apparent total-tract digestion of dietary neutral detergent fiber. Crude glycerin affected the microbial population in the rumen as evidenced by increased molar proportions of propionic, butyric, and valeric acids and decreased molar proportions of acetic acid. Efficiency of N utilization was improved as evidenced by lower concentrations of blood urea nitrogen and ruminal ammonia-N. Cows fed cottonseed hull-based diets consumed 5.3 kg/d more DM but produced only 1.7 kg/d more milk, resulting in reduced efficiency. Increased production of ruminal microbial protein, molar proportion of propionic acid, and passage of ruminal fluid resulted from feeding the cottonseed hull- versus corn silage-based diets, although apparent digestibilities of DM and neutral detergent fiber were reduced. Replacing 5 and 10% of concentrate ingredients with crude glycerin improved efficiency of 4% fat-corrected milk production when corn silage-based diets were fed but decreased it when cottonseed hull-based diets were fed.

Management of chronic pelvic pain

Chronic pelvic pain is a complex condition that requires evaluation of the reproductive, gastrointestinal, urologic, musculoskeletal, psychological, and neurological systems. Usually, diagnosis and management entail identifying a network of disorders rather than a single cause of pain with a definitive cure. Only disorders that we commonly encounter in our practice will be discussed in this review.

Primary anaplastic lymphoma kinase-negative anaplastic large-cell lymphoma of the breast in a male patient

Anaplastic large-cell lymphoma is an extremely rare lymphoma subtype. We describe the mammographic and ultrasonographic findings in a 51-year-old male patient who suffered from a palpable lump caused by this rare disease.

Rupture of benign thyroid tumors after radio-frequency ablation

Rupture of benign thyroid tumors after RFA is very rare. We experienced 6 cases in 4 institutions. All patients presented with abrupt neck swelling and pain between 9 and 60 days after RFA. Imaging and clinical findings of the ruptured tumors were anterior subcapsular location, mixed composition, large size, and repeated ablations. Conservative treatment was sufficient in 3 cases, whereas surgical management was required in 3.

Stereotactic radiosurgery for spinal metastases: update on treatment strategies

Metastatic tumors are the most common tumors that affect the spinal column and are the source of significant pain and disability in cancer patients. The management of symptomatic spinal metastases presents unique challenges to surgeons as a number of considerations specific to the underlying tumor histology, extent of disease, the functional status of the patient and response to systemic therapy often affect the role, timing and effectiveness of any surgical intervention. As surgical techniques have evolved, the focus of therapy has shifted towards minimizing the morbidity associated with treatments for patients in whom limited nutrition and functional reserve impact their overall survival. As such, stereotactic spinal radiosurgery (SRS) has emerged as a powerful adjunct to surgery as well as a stand-alone treatment option for patients with metastatic disease. Recent technological innovations such as intensity-modulated radiation therapy, image-guidance, and non-invasive spine immobilization have made significant improvements to the delivery of highly conformal radiation to spinal tumors. In this article, current treatment strategies utilizing SRS in the multidisciplinary management of spinal metastases are discussed.

Diagnostic dilemmas of hyalinizing trabecular tumours on fine needle aspiration cytology: a study of seven cases with BRAF mutation analysis

OBJECTIVE

Hyalinizing trabecular tumours (HTTs) are rare follicular-derived neoplasms that behave in an almost benign manner. HTT is frequently misdiagnosed as papillary carcinoma by fine needle aspiration (FNA) cytology or as papillary or medullary carcinoma on surgical resection.

METHODS

The authors examined FNA material from seven cases of histologically verified HTT. Cytological findings were reviewed and correlated with ultrasonographic and histological features. In addition, MIB-1 and calcitonin immunostaining was performed on surgical specimens, and BRAF mutation analysis on three pre-operative FNA specimens and seven histology specimens.

RESULTS

The original cytological diagnosis was either suspicious or positive for papillary carcinoma in all patients. The FNA-based differential diagnoses included HTT, papillary carcinoma or, less likely, medullary carcinoma in two patients. Aspirates showed oval to spindle-shaped cells with frequent intranuclear inclusions, isolated in loosely cohesive groups with a trabecular or syncytial pattern in a bloody background. Radiating arrangements of tumour cells surrounding hyaline stroma with serrated calcifications and a lack of papillary or sheet-like fragments may suggest HTT on FNA. Spherical calcified bodies and possible psammoma bodies were frequently found in three cases. Retrospectively, six of the seven cases showed membranous immunoreactivity for MIB-1, but none of the seven possessed the BRAF (V600E) mutation or showed calcitonin reactivity.

CONCLUSIONS

Although the recognition of HTT on FNA cytology is difficult, because of its morphological similarities to papillary and medullary carcinoma, its characteristic cytological features along with ultrasonographic findings may suggest the diagnosis preoperatively and avoid surgical over-treatment.

Comparison of diamond-like carbon-coated nitinol stents with or without polyethylene glycol grafting and uncoated nitinol stents in a canine iliac artery model

OBJECTIVE

Neointimal hyperplasia is a major complication of endovascular stent placement with consequent in-stent restenosis or occlusion. Improvements in the biocompatibility of stent designs could reduce stent-associated thrombosis and in-stent restenosis. We hypothesised that the use of a diamond-like carbon (DLC)-coated nitinol stent or a polyethylene glycol (PEG)-DLC-coated nitinol stent could reduce the formation of neointimal hyperplasia, thereby improving stent patency with improved biocompatibility.

METHODS

A total of 24 stents were implanted, under general anaesthesia, into the iliac arteries of six dogs (four stents in each dog) using the carotid artery approach. The experimental study dogs were divided into three groups: the uncoated nitinol stent group (n = 8), the DLC-nitinol stent group (n = 8) and the PEG-DLC-nitinol stent group (n = 8).

RESULTS

The mean percentage of neointimal hyperplasia was significantly less in the DLC-nitinol stent group (26.7±7.6%) than in the nitinol stent group (40.0±20.3%) (p = 0.021). However, the mean percentage of neointimal hyperplasia was significantly greater in the PEG-DLC-nitinol stent group (58.7±24.7%) than in the nitinol stent group (40.0±20.3%) (p = 0.01).

CONCLUSION

Our findings indicate that DLC-coated nitinol stents might induce less neointimal hyperplasia than conventional nitinol stents following implantation in a canine iliac artery model; however, the DLC-coated nitinol stent surface when reformed with PEG induces more neointimal hyperplasia than either a conventional or DLC-coated nitinol stent.

Connectional parameters determine multisensory processing in a spiking network model of multisensory convergence

For the brain to synthesize information from different sensory modalities, connections from different sensory systems must converge onto individual neurons. However, despite being the definitive, first step in the multisensory process, little is known about multisensory convergence at the neuronal level. This lack of knowledge may be due to the difficulty for biological experiments to manipulate and test the connectional parameters that define convergence. Therefore, the present study used a computational network of spiking neurons to measure the influence of convergence from two separate projection areas on the responses of neurons in a convergent area. Systematic changes in the proportion of extrinsic projections, the proportion of intrinsic connections, or the amount of local inhibitory contacts affected the multisensory properties of neurons in the convergent area by influencing (1) the proportion of multisensory neurons generated, (2) the proportion of neurons that generate integrated multisensory responses, and (3) the magnitude of multisensory integration. These simulations provide insight into the connectional parameters of convergence that contribute to the generation of populations of multisensory neurons in different neural regions as well as indicate that the simple effect of multisensory convergence is sufficient to generate multisensory properties like those of biological multisensory neurons.

Experimental lung collapse following deployment of a self-expandable bronchial occluder in a rabbit model

OBJECTIVES

Closure of a bronchopleural fistula is required to prevent fatal empyema or aspiration pneumonia. The purpose of this study was to determine the feasibility and efficacy of bronchial occlusion with a self-expandable occluder to induce experimental lung collapse in a rabbit model.

METHODS

10 bronchial occluders (wine glass appearance; 8 mm in diameter and 15 mm in length) were implanted in the native left main bronchi of 10 rabbits via an endotracheal route. We analysed the following: (1) diameters and morphological changes of the bronchial occluders during follow-up; (2) percentage volume of the collapsed lung during follow-up; and (3) complications and gross pathology. 1-day and 2-week follow-up CT scans were routinely obtained. Rabbits were sacrificed 4 weeks after the experiment.

RESULTS

In all 10 rabbits, the bronchial occluders were successfully implanted and were completely expanded within 2 weeks. Complete collapse of the left lung occurred in three rabbits on day 1 and in an additional two rabbits 2 weeks following implantation. Two other rabbits maintained the percentage volume of the collapsed lung between 51% and 99% during follow-up; the other three rabbits had <50% during follow-up. Pneumothoraces occurred in nine rabbits, but completely resolved at the 2-week follow-up. Right lung herniation across the midline progressed 2 weeks after occluder implantation.

CONCLUSION

Placement of self-expandable occluders in a rabbit bronchus model was feasible and showed a potential to induce artificial lung collapse. While pneumothoraces were common, they resolved during follow-up.