Diagnosis and Treatment of Pythium Insidiosum Corneal Ulcer in a Chinese Child: A Case Report and Literature Review

Patient: Male, 7

Final Diagnosis: Pythium insidiosum

Symptoms: Painful vision loss • red eye

Medication:—

Clinical Procedure: Application of multiple antifungal medicines followed by the penetrating keratoplasty

Specialty: Ophthalmology

Newly developed and validated eosinophilic esophagitis histology scoring system and evidence that it outperforms peak eosinophil count for disease diagnosis and monitoring

Eosinophilic esophagitis (EoE) is diagnosed by symptoms, and at least 15 intraepithelial eosinophils per high power field in an esophageal biopsy. Other pathologic features have not been emphasized. We developed a histology scoring system for esophageal biopsies that evaluates eight features: eosinophil density, basal zone hyperplasia, eosinophil abscesses, eosinophil surface layering, dilated intercellular spaces (DIS), surface epithelial alteration, dyskeratotic epithelial cells, and lamina propria fibrosis. Severity (grade) and extent (stage) of abnormalities were scored using a 4-point scale (0 normal; 3 maximum change). Reliability was demonstrated by strong to moderate agreement among three pathologists who scored biopsies independently (P ≤ 0.008). Several features were often abnormal in 201 biopsies (101 distal, 100 proximal) from 104 subjects (34 untreated, 167 treated). Median grade and stage scores were significantly higher in untreated compared with treated subjects (P ≤ 0.0062). Grade scores for features independent of eosinophil counts were significantly higher in biopsies from untreated compared with treated subjects (basal zone hyperplasia P ≤ 0.024 and DIS P ≤ 0.005), and were strongly correlated (R-square >0.67). Principal components analysis identified three principal components that explained 78.2% of the variation in the features. In logistic regression models, two principal components more closely associated with treatment status than log distal peak eosinophil count (PEC) (R-square 17, area under the curve (AUC) 77.8 vs. R-square 9, AUC 69.8). In summary, the EoE histology scoring system provides a method to objectively assess histologic changes in the esophagus beyond eosinophil number. Importantly, it discriminates treated from untreated patients, uses features commonly found in such biopsies, and is utilizable by pathologists after minimal training. These data provide rationales and a method to evaluate esophageal biopsies for features in addition to PEC.

Effects of piezosurgery in accelerating the movement of orthodontic alveolar bone tooth of rats and the expression mechanism of BMP-2

The aim of the study was to investigate the effects of piezosurgery in accelerating the movement of orthodontic alveolar bone tooth of rats and the expression mechanism of bone morphogenetic protein-2 (BMP-2). Adult male Wistar rats (n=30), with an age range of 14–15 weeks, and an average weight of 250±16 g were used. The animals were randomly divided into the control and observation groups. The rats in the control group were injected with 25-dihydroxyvitamin (1,25-dihydroxycholecalciferol) into their dental ligament. The rats in the observation group were placed with an orthodontic device between the first molar and central incisor in the maxillary. On the first day after animal treatment, piezosurgery stimulation was performed on the first molar in maxillary. The changes of the movement distance of the first molar and gum surface temperature on days 1, 3, 5, 7 and 14 were then compared. Immunohistochemical staining was performed to detect the expression of BMP-2 of periodontal tissue in the tension side of the first molar. Tooth movement distance in the observation group on days 5, 7 and 14 was significantly longer than that in the control group (p<0.05). The gum surface temperature of the observation group was elevated to some extent, peaking after 20 min. BMP-2 mRNA and protein levels in the observation group were significantly higher than those of the control group at days 3, 5, 7 and 14 (p<0.05). In conclusion, piezosurgery may significantly accelerate the movement of orthodontic alveolar bone tooth of rats and be associated with an increasing BMP-2 expression.

Esthetic Restoration of Multiple Congenitally Missing Anterior Teeth with Oral Implants: A Clinical Case Report

Having multiple congenitally missing anterior teeth heavily influences the patient's countenance and pronunciation. There are few reports on the esthetic restoration of such situations with oral implants. This clinical case history report presents a multidisciplinary approach to treat a young woman with multiple congenitally missing anterior teeth using implant-supported prostheses. The treatment steps and clinical implications are discussed.

Ozonolysis of Trimethylamine Exchanged with Typical Ammonium Salts in the Particle Phase

Alkylamines contribute to both new particle formation and brown carbon. The toxicity of particle-phase amines is of great concern in the atmospheric chemistry community. Degradation of particulate amines may lead to secondary products in the particle phase, which are associated with changes in the adverse health impacts of aerosols. In this study, O₃ oxidation of particulate trimethylamine (TMA) formed via heterogeneous uptake of TMA by (NH₄)₂SO₄, NH₄HSO₄, NH₄NO₃ and NH₄Cl, was investigated with in situ attenuated total reflection Fourier transform infrared spectroscopy (ATR-FTIR) and proton transfer reaction mass spectrometry (PTR-MS). HCOOH, HCHO, CH₃N═CH₂, (CH₃)₂NCHO, CH₃NO₂, CH₃N(OH)CHO, CH₃NHOH and H₂O were identified as products on all the substrates based upon IR (one-dimensional IR and two-dimensional correlation infrared spectroscopy), quantum chemical calculation and PTR-MS results. A reaction mechanism was proposed to explain the observed products. This work demonstrates that oxidation might be a degradation pathway of particulate amines in the atmosphere. This will aid in understanding the fate of particulate amines formed by nucleation and heterogeneous uptake and their potential health impacts during atmospheric aging.

Lentiviral vector-mediated down-regulation of Notch1 in endometrial stem cells results in proliferation and migration in endometriosis

The recent characterization of stem/progenitor cells in the endometrium has shed new light for pathogenesis of endometriosis. The present study was undertaken to investigate the role of Notch1, known as a cell fate regulator, in the mechanism of endometriosis. Influence of Notch1 on endometrial stem cells proliferation and migration was evaluated by knocking down Notch1 expression using shRNA. Furthermore, human endometrial stromal and epithelial stem cells with or without LV-Notch1-shRNA were injected into the peritoneal cavity of nude mice, to assess the in vivo effects of a specific antagonist of Notch1 on the progression of endometriosis. The results showed that LV-Notch1-shRNA led to a significant decline of clonogenicity and migration in human endometrial stem cells in vitro, as well as the size of endometriotic lesions in murine models. These data provide evidence that specific inhibition of Notch1 alters endometriotic tissue growth and progression, and may represent a promising potential therapeutic avenue.

Dentofacial traits in association with lower incisor alveolar cancellous bone thickness: A multiple regression analysis

OBJECTIVE

To identify dentofacial anatomic traits associated with lower incisor cancellous bone thickness (LICBT) and then to assess their separate contributions and their combined contributions to the variation in LICBT.

MATERIALS AND METHODS

A consecutive sample of cone beam computed tomography (CBCT) data taken in a university hospital within the same setting was retrospectively reviewed. Within the sample, CBCT data of 252 eligible subjects were reconstructed and measured for LICBT, facial traits, and mandibular symphyseal traits. A backward multiple linear regression was employed to explore the association between LICBT and seven representative dentofacial traits.

RESULTS

Four dentofacial traits (vertical facial pattern, transverse jaw relationship, lower incisor cervical diameter, and mandibular symphyseal width) were identified as significantly associated with LICBT. The combination of these four factors could predict 64.3% of variations in LICBT (adjusted R² = 0.643). Further comparison of LICBT among different transverse jaw relationships suggested that the LICBT of the normal (5.94 ± 1.58 mm) group and the inferior convergent group (5.38 ± 1.32 mm) were significantly larger than that of the crossbite group (4.34 ± 1.27 mm) and the superior convergent group (4.53 ± 1.67 mm).

CONCLUSIONS

The bony support of lower incisors is significantly associated with several dentofacial traits. Reduced lower incisor bony support was statistically associated with increased vertical facial pattern, transverse jaw discrepancy, thinner mandibular symphyseal width, and smaller lower incisor cervical diameter.

Efficacy, Safety, and Acceptability of Low-Dose Mifepristone and Self-Administered Misoprostol for Ultra-Early Medical Abortion: A Randomized Controlled Trial

The aim of this study was to investigate the efficacy, safety, and acceptability of low-dose mifepristone combined with self-administered misoprostol for ultra-early medical abortion. A total of 744 women with ultra-early pregnancy (amenorrhea ≤35 days) who fulfilled the inclusion criteria were enrolled in the study. Equal numbers of participants were allocated randomly to the hospital administration and self-administration groups. All participants took 75 mg mifepristone at the initial visit and 400 µg oral misoprostol 24 hours later in the hospital or by self-administration. The primary end point was complete abortion. Secondary end points were rates of unscheduled reattendance, time required for and cost of hospital observation and follow-up, vaginal bleeding, adverse effects, menstrual disturbance in the posttreatment period, and satisfaction rating. No differences in the rates of complete abortion, unscheduled reattendance, vaginal bleeding, adverse effects, or return of posttreatment menstruation were observed. The time required for (and costs of) hospital observation and follow-up per participant was 557.82 minutes (and US$40.12) in the hospital administration group and 18.46 minutes (and US$1.96) in the self-administration group (both P < .001). Satisfaction rates were similar in both groups, but the rates of "very satisfied" responses (87.60% vs 25.41%) and follow-up compliance (loss to follow-up, 0.45% vs 7.70%) were higher in the self-administration group (both P < .001). Low-dose mifepristone combined with self-administered misoprostol for ultra-early pregnancy termination was as effective and safe as hospital administration, with greater acceptability and lower cost to the women.

Experimental investigation on dynamic characteristics and strengthening mechanism of laser-induced cavitation bubbles

The dynamic features of nanosecond laser-induced cavitation bubbles near the light alloy boundary were investigated with the high-speed photography. The shock-waves and the dynamic characteristics of the cavitation bubbles generated by the laser were detected using the hydrophone. The dynamic features and strengthening mechanism of cavitation bubbles were studied. The strengthening mechanisms of cavitation bubble were discussed when the relative distance parameter γ was within the range of 0.5-2.5. It showed that the strengthening mechanisms caused by liquid jet or shock-waves depended on γ much. The research results provided a new strengthening method based on laser-induced cavitation shotless peening (CSP).

Testosterone replacement therapy improves health-related quality of life for patients with late-onset hypogonadism: a meta-analysis of randomized controlled trials

Although testosterone replacement therapy can restore serum testosterone concentrations to normal level in late-onset hypogonadism patients, whether it can improve patients' quality of life remains uncertain. Therefore, we perform a meta-analysis of randomized controlled trials on this issue. Five randomized controlled trials total 1,212 patients were included. Fixed-effect model was used to calculate the weighted mean difference of score of Aging Males' Symptom rating scale. Our result reveals that testosterone replacement therapy improves patients' health-related quality of life in terms of the decrease in the AMS total score [WMD = -2.96 (-4.21, -1.71), p < .00001] and the psychological [WMD = -0.89 (-1.41, -0.37), p = .0008], somatic [WMD = -0.89 (-1.41, -0.37), p = .0008] and sexual [WMD = -1.29 (-1.75, -0.83), p < .00001] subscale score.

[Mechanism of Electropuncture for Reducing Diet-induced Obesity Rat Weight through Hypothala- mus TSC1 -mTOR Signal Pathway]

OBJECTIVE

To explore the mechanism of electropuncture (EA) for reducing diet-induced obesity (DIO) rat weight through tuberous sclerosis complex 1 (TSC1 )-mammalian target of rapa- mycin (mTOR) signal pathway in hypothalamus.

METHODS

Forty male SD rats were randomly divided into the model group (n =30) and the normal control group (n =10). DIO rat model was prepared by high fat forage for 12 successive weeks. Successfully modeled 19 rats were further randomly divided into the model group (n =9) and the EA group (n =10). EA at Tianshu (ST25) , Sanyinjiao (SP6) , Zhongwan ( RN12) , Zusanli (ST36) was performed in the EA group, 5 successive days per week with a 2-day rest, 4 weeks in total. No intervention was given to rats in the model group and the normal control group. Body weight was observed in all rats. Methylation of TSC1 promotor was detected by bisulfite sequencing method. mRNA expression of mTOR in hypothalamus was detected by RT-PCR.

RESULTS

After EA treatment body weight in the EA group were obviously reduced (P <0. 05). Compared with the normal control group, body weight was not statistically different between the model group and the EA group after treatment (P> 0. 05). Methylation rate of TSC1 promotor was higher in model group (94. 0% ±4. 5%) than in the normal control group (87. 0% ±3. 6%) and the EA group (87. 4% ±3. 9%) (P <0. 05). Expression of mTOR in the model group (1. 84 ±0. 51) was higher than that in the normal control group (1. 02 ±0. 22) and the EA group (1. 46 ±0. 29) (P <0. 05).

CONCLUSION

EA could lower DIO rats' body weight by down-regulating methylation rate of TSC1 promotor and regulating expression of mTOR in hypothalamus.

Up-regulation of stem cell markers by P21-activated kinase 1 contributes to 5-fluorouracil resistance of colorectal cancer

Cancer stem cells (CSC) are tumorigenic and resistant to chemotherapy. In colorectal cancer (CRC), CSCs have been identified by the expression of specific markers, including CD44, Bmi1 and Nanog. Although p21-activated kinase 1 (PAK1), acting downstream of Ras, stimulates Wnt/β-catenin signaling and is known to play an important role in CRC development and progression, the role of PAK1 in the expression of CSC markers has not previously been investigated. The effect of PAK1 over-expression, knockdown or inhibition on the expression or alteration (in the case of CD44) of CSC markers in human CRC cell lines was measured by immunofluorescence and Western blotting. The effect of PAK1 modulation on tumorigenesis, and on resistance to treatment with 5-fluorouracil (5-FU), was measured by sphere formation in vitro and by growth of xenografted tumors in vivo. The results show that PAK1 activity correlated with the expression of CSC markers and the CD44 isoform profile, and with tumor growth both in vitro and in vivo. Furthermore PAK overexpression partially overcame the inhibition of CRC growth by 5-FU, and PAK inhibition was synergistic with 5-FU treatment. Our findings lay the foundation for a combination therapy in which PAK1 inhibitors targeting CSCs may be combined with conventional 5-FU-based chemotherapy for the treatment of CRC.

A novel TCR-like CAR with specificity for PR1/HLA-A2 effectively targets myeloid leukemia in vitro when expressed in human adult peripheral blood and cord blood T cells

BACKGROUND AIMS

The PR1 peptide, derived from the leukemia-associated antigens proteinase 3 and neutrophil elastase, is overexpressed on HLA-A2 in acute myeloid leukemia (AML). We developed a T-cell receptor (TCR)-like monoclonal antibody (8F4) that binds the PR1/HLA-A2 complex on the surface of AML cells, efficiently killing them in vitro and eliminating them in preclinical models. Humanized 8F4 (h8F4) with high affinity for the PR1/HLA-A2 epitope was used to construct an h8F4- chimeric antigen receptor (CAR) that was transduced into T cells to mediate anti-leukemia activity.

METHODS

Human T cells were transduced to express the PR1/HLA-A2-specific CAR (h8F4-CAR-T cells) containing the scFv of h8F4 fused to the intracellular signaling endo-domain of CD3 zeta chain through the transmembrane and intracellular costimulatory domain of CD28.

RESULTS

Adult human normal peripheral blood (PB) T cells were efficiently transduced with the h8F4-CAR construct and predominantly displayed an effector memory phenotype with a minor population (12%) of central memory cells in vitro. Umbilical cord blood (UCB) T cells could also be efficiently transduced with the h8F4-CAR. The PB and UCB-derived h8F4-CAR-T cells specifically recognized the PR1/HLA-A2 complex and were capable of killing leukemia cell lines and primary AML blasts in an HLA-A2-dependent manner.

CONCLUSIONS

Human adult PB and UCB-derived T cells expressing a CAR derived from the TCR-like 8F4 antibody rapidly and efficiently kill AML in vitro. Our data could lead to a new treatment paradigm for AML in which targeting leukemia stem cells could transfer long-term immunity to protect against relapse.

Glaucarubinone Combined with Gemcitabine Improves Pancreatic Cancer Survival in an Immunocompetent Orthotopic Murine Model

BACKGROUND

Pancreatic cancer continues to have a poor survival rate with an urgent need for improved treatments. Glaucarubinone, a natural product first isolated from the seeds of the tree Simarouba glauca, has recently been recognized as having anti-cancer properties that may be particularly applicable to pancreatic cancer.

METHODS

The effect of glaucarubinone on the growth and migration of murine pancreatic cancer cells was assessed by ³H-thymidine incorporation assay. The survival impact of glaucarubinone alone and in combination with gemcitabine chemotherapy was assessed using an immunocompetent orthotopic murine model of pancreatic cancer.

RESULTS

Glaucarubinone inhibited the growth of the murine pancreatic cancer cell lines LM-P and PAN02. Treatment with either glaucarubinone or gemcitabine reduced proliferation in vitro and the combination was synergistic. The combination treatment improved survival two-fold compared to gemcitabine treatment alone (p = 0.046) in PAN02 cells.

CONCLUSIONS

The synergistic inhibition by glaucarubinone and gemcitabine observed in vitro and the improved survival in vivo suggest that glaucarubinone may be a useful adjunct to current chemotherapy regimens.