Ductopenia and fetal liver-like architecture as unique and evocative sign of Turner syndrome

BACKGROUND

Turner syndrome is the most common genetic disorder in females. In most subjects, with a normal physical appearance at birth, the diagnosis is suspected long after birth because of short stature, delayed puberty, primary or secondary amenorrhea or infertility. Abnormalities of liver function tests are reported in literature, with a prevalence ranging from 20% to 80%. In most subjects liver diseases are self-limiting, associated with obesity, hormonal therapy and autoimmune diseases. An association between Turner syndrome and cryptogenic liver disease has been reported. Abnormalities of liver function tests could be the unique sign of Turner syndrome in subjects with normal phenotypes. The histological picture of "fetal liver-like architecture" and "ductopenia" is of fundamental importance for the diagnosis of chromosomopathy.

AIM

Review the causes of hypertransaminasemia by focusing on more rare as metabolic and genetic diseases.

MATERIALS AND METHODS

We evaluated a 10 year old girl with a normal phenotype affected by chronic hypertransaminasemia and cholestasis, in whom a needle liver biopsy was performed after the most common causes of hypertransaminasemia were excluded.

RESULTS

Liver histological evaluation revealed a smoldering colangiopathy with mild ductopenia and a fetal liver-like architecture. Turner syndrome, suspected on the basis of this histological picture, was confirmed by a pelvic ultrasound and a chromosome analysis.

CONCLUSIONS

The histological features of "fetal liver-like architecture" and "ductopenia" represent an evocative sign that could indicate the diagnostic suspicion of Turner syndrome in a subject lacking in signs or symptoms of this disease. It is important to perform a pelvic ultrasound and an endocrinological evaluation in all females with chronic asymptomatic hypertransaminasemia even though they have normal phenotypes.

[Application medical history indicators and goals for the diagnosis of OSAS in a cohort of workers of the private car transportation: results of a year of health surveillance]

Even though Obstructive Sleep Apnea Syndrome (OSAS) is one of the main causes of daytime sleepiness with high subsequent risk for causing vehicle accidents, its evaluation is not usually included among the criteria used for the certification of job fitness among professional drivers. In order to assess the feasibility of a screening method that allows the occupational physician to identify the subjects at risk for OSAS which should undergo second level tests (cardiorespiratory monitoring), we recorded and subsequently processed appropriate subjective and objective indicators among 455 professional drivers employed in private transportation companies. Only 17 subjects (47%) out of 36 tested positive underwent cardiorespiratory monitoring (due to technical and organizational difficulties and to the poor compliance of workers). OSAS was confirmed in 15 subjects out of 17 showing an excellent positive predictive value of the screening. Risk management for OSAS is currently unavoidable yet not formally provided by law. Our results show the possibility of completing the health surveillance program with feasible and valuable screening tests. Difficulties (hardly compliant with a timely certification of the job fitness) arise instead as far as second level confirmatory procedures are involved.

Congenital cytomegalovirus infection: current strategies and future perspectives

INTRODUCTION

Cytomegalovirus is the most common cause of congenital infections in humans and it produces considerable morbidity in newborns.

AIMS

The present study reviews current concepts on epidemiology, clinical manifestations, diagnosis, treatment, future strategies and prognosis of children with congenital cytomegalovirus infection.

RESULTS

Congenital cytomegalovirus infection can be symptomatic or not at birth, but about 10-20% of them all will exhibit neurological damage when followed up. Sensorineural hearing loss is the most frequent long-term consequence and is not manifest invariably at birth or in the neonatal period but in many cases becomes clinically apparent in later childhood. There are growing evidences that newborns with symptomatic congenital cytomegalovirus infection would benefit from treatment with either ganciclovir or valganciclovir, the most widely studied drugs in this setting. It is not yet clear if children with asymptomatic or pauci-symptomatic infection at birth would benefit from treatment.

DISCUSSION

Studies evaluating treatment and long-term follow-up of infants with both symptomatic and asymptomatic infection are necessary, in order to definitely evaluate the short and long-term effectiveness and safety of both ganciclovir and valganciclovir and to identify risk factors associated to the development of long-term sequelae. In this way it will be possible to select those children that might benefit for treatment.

UHRF1 coordinates peroxisome proliferator activated receptor gamma (PPARG) epigenetic silencing and mediates colorectal cancer progression

Peroxisome proliferator-activated receptor gamma (PPARG) inactivation has been identified as an important step in colorectal cancer (CRC) progression, although the events involved have been partially clarified. UHRF1 is emerging as a cofactor that coordinates the epigenetic silencing of tumor suppressor genes, but its role in CRC remains elusive. Here, we report that UHRF1 negatively regulates PPARG and is associated with a higher proliferative, clonogenic and migration potential. Consistently, UHRF1 ectopic expression induces PPARG repression through its recruitment on the PPARG promoter fostering DNA methylation and histone repressive modifications. In agreement, UHRF1 knockdown elicits PPARG re-activation, accompanied by positive histone marks and DNA demethylation, corroborating its role in PPARG silencing. UHRF1 overexpression, as well as PPARG-silencing, imparts higher growth rate and phenotypic features resembling those occurring in the epithelial-mesenchymal transition. In our series of 110 sporadic CRCs, high UHRF1-expressing tumors are characterized by an undifferentiated phenotype, higher proliferation rate and poor clinical outcome only in advanced stages III-IV. In addition, the inverse relationship with PPARG found in vitro is detected in vivo and UHRF1 prognostic significance appears closely related to PPARG low expression, as remarkably validated in an independent dataset. The results demonstrate that UHRF1 regulates PPARG silencing and both genes appear to be part of a complex regulatory network. These findings suggest that the relationship between UHRF1 and PPARG may have a relevant role in CRC progression.

Design and Validation of Force Control Loops for a Parallel Manipulator

This paper addresses problems for design and validation of force control loops for a 3-DOF parallel manipulator in drilling applications. In particular, the control design has been investigated for a built prototype of CaPaMan2bis at LARM (Laboratory of Robotics and Mechatronics of Cassino). Two control loops have been developed, each one with two types of controllers. The first one is a Constrained Control Loop, which limits the force that is applied to an object to stay below a given value. The second one is a Standard Control Loop with external force feedback, which keeps the force at a given value. The control loops have been implemented on CaPaMan2bis by a Virtual Instrument in LABVIEW Software. CaPaMan2bis has been attached to a serial robot to make dynamic tests. The results of the experimental tests show the effectiveness and quick response of both algorithms after a careful calibration process.

Analysis and design of a modular underactuated mechanism for robotic fingers

This paper presents an analysis of the design problems and requirements for underactuated mechanisms for robotic fingers. The case of performing a grasping task is considered and a solution is proposed that consists of a series of linked underactuated mechanisms. Optimality criteria are analysed with the aim of formulating a general design algorithm based on a suitable optimization problem. An example of a four-phalanx modular finger is used to highlight the practical feasibility of the proposed modular design concepts and procedures.

Pediatric hepatitis C infection: to treat or not to treat...what's the best for the child?

OBJECTIVES

Pediatric hepatitis C mainly occurs through mother to child transmission, to date. Children usually present a mild disease, but they are not spared from its long-term complications. Thus this infection cannot be underestimated in children and intervention is necessary. Current treatment is based on the administration of pegylated-interferon associated with ribavirin, but few studies evaluated the efficacy and safety of this therapeutic protocol. Moreover, there is still no clarity on who, when and how to treat pediatric patients. This article, based on the information in literature, provides an overview of the main aspects of the disease, with particular attention to treatment.

METHODOLOGY AND RESULTS

We describe the different treatment options available. About the association peginterferon plus ribavirin, we analyze thirteen non-randomized studies and one trial, found in recent literature. These studies are not directly compared because of differences in age, type of infection (vertical or not), viral genotypes and duration of treatment, between groups enrolled. The overall sustained viral response rate ranges from 28.6% to 81.8%. The rate of treatment success is higher in children infected with genotypes 2 and 3 than with other genotypes. The therapy does not induce severe adverse effects and children present better tolerance to antiviral than adults.

CONCLUSIONS

The pharmacological efficacy of peginterferon and ribavirin seems to be proven by data collected in studies cited, but there are different opinions about who, when and how to treat children infected. Thus, further research is needed to define the best management of vertical acquired hepatitis C.

Intraspecific genotypic diversity in plants

Variations in the nuclear DNA, mainly as a result of quantitative modulations of DNA repeats belonging to different sequence families of satellite DNA and to the activity of transposable elements, have been assessed within several angiosperm species. These variations alter the amount and organization of the DNA and therefore the genotype, rather than the genome proper. They take place on an evolutionary time scale as the result of selection processes after the occurrence of uncontrolled events in the genome or may be due to direct responses of plant genomes to environmental stimuli that occur under plant-level control within a short developmental period of a single generation. These DNA changes are correlated to changes in the developmental dynamics and phenotypic characteristics of the plants, and the capability to carry out genotypic variation is an evolutionary trait that allows plant species to adapt to different environmental conditions, as well as to the variability of conditions in a given environment. The link between developmental and environmental stimuli and repetitive DNA that elicits the intraspecific diversity of plant genotypes may provide models of evolutionary change that extend beyond the conventional view of evolution by allelic substitution and take into account epigenetic effects of the genome structure.

Quantitative evolution of transposable and satellite DNA sequences in Picea species

Clones containing tandemly arranged repeats belonging to two distinct sequence families, (i) PAG004P22F (2F) and PAG004E03C (3C) or (ii) Ty3/gypsy- (8R; PAG004B08R) and Ty1/copia-like sequences (9R; PAG007F19R), were selected from a randomly sheared total genomic DNA library of Picea abies . The inserts were used as probes in dot-blot hybridizations to genomic DNA of P. abies, Picea orientalis , Picea pungens , and Picea pungens var. glauca. All these entities are diploid and share the same chromosome number (2n = 24), but the genome sizes differ largely. The redundancy (copy number per 1C DNA) of sequences related to each probe varied greatly between the genomes. No significant correlation was found between the genome size and the copy number of sequences in any family. The quantitative ratios varied greatly (in each genome) between the two families of satellite DNA, between the sequences that represented copia or gypsy retrotransposons, and between tandemly arranged sequences and retroelements as a whole, suggesting that there is no common factor that controls the quantitative evolution of repeats belonging to different sequence families during speciation in Picea.

Water Dancer II-A: A Non-Tethered Telecontrollable Water Strider Robot

Water Strider Robot (WSR) is a kind of bio-inspired micro robot that can stand and move on water surface via surface tension. In this paper, a design method is presented with algorithms for designing driving leg. Structure, control system and software of the robot are also discussed in details. A prototype Water Dancer II-a that is driven with two electric motors is presented as successfully tested in lab. The proposed WSR is tele-controlled with infrared signals and has the capability of turning and speed regulation with features of light tiny volume and low power consumption. Experimental results are reported and discussed to show practical feasibility of the presented WSR prototype. The new results in the paper are related also to the WSR prototype design with a robot body of less than 30 × 30 mm size and with ten leg rods of 90 mm length and 0.2 diameter that are able to provide lifting force for a water walk of the 6.0 grams robot at a forward speed of 20 cm/s or angular velocity of 9 degree/s with two micro DC motors(RoomFlight 4 × 8 mm, 28 Ohm).

Upregulation of miR-21 by Ras in vivo and its role in tumor growth

miR-21 is a microRNA (miRNA) frequently overexpressed in human cancers. Here we show that miR-21 is upregulated both in vitro and in vivo by oncogenic Ras, thus linking this miRNA to one of the most frequently activated oncogenes in human cancers. Ras regulation of miR-21 occurs with a delayed kinetic and requires at least two Ras downstream pathways. A screen of human thyroid cancers and non-small-cell lung cancers for the expression of miR-21 reveals that it is overexpressed mainly in anaplastic thyroid carcinomas, the most aggressive form of thyroid cancer, whereas in lung its overexpression appears to be inversely correlated with tumor progression. We also show that a LNA directed against miR-21 slows down tumor growth in mice. Consistently, a search for mRNAs downregulated by miR-21 shows an enrichment for mRNAs encoding cell cycle checkpoints regulators, suggesting an important role for miR-21 in oncogenic Ras-induced cell proliferation.

Workspace Analysis and Design Improvement of a Carotid Flow Measurement System

Heart and cerebrovascular diseases such as arteriosclerosis and myocardial ischemia dysfunction are currently among the main causes of death in developed countries. Recently, wave intensity (WI), which is an index used to obtain the force of cardiac contraction, has been investigated as a method for early-stage diagnosis of the above-mentioned diseases. Nevertheless, experimental tests have proven that the manual measurements of WI by means of commercial ultrasonic diagnostic systems require too much time and can be affected by the operator's skills. For this purpose, the introduction of robotic-assisted technology has advantages in terms of repetitiveness and accuracy of the measurement procedure. Therefore, at Waseda University, the development of a carotid blood flow measurement system has been proposed to support doctors while using ultrasound diagnostic equipment to measure the WI. This robotic system is composed of a serial robot with a wrist having a six-degree-of-freedom (6-DOF) parallel mechanism. The main focus is to obtain a suitable workspace performance of the 6-DOF parallel mechanism wrist. In this paper, a workspace analysis is carried out on a wrist prototype built for the Waseda-Tokyo Women's Medical Aloka Blood Flow Measurement System No.1 Refined (WTA-1R). Then, mechanical design enhancements are proposed and validated to provide a suitable workspace performance both as reachable workspace and dexterity, and a refined prototype WTA-1RII has been built.

Experimental and Numerical Characterization of CaPaMan 2bis Operation

In this paper, the operation performance of CaPaMan 2bis (Cassino Parallel Manipulator 2 bis) was investigated through lab experimental tests and computer simulations. Milli‐CaTraSys (Milli‐Cassino Tracking System) was implemented to determine displacements and orientation variations of CaPaMan 2bis end‐effector during experimental tests. A 3D (three dimension) virtual model was built in ADAMS environment to simulate the operation behavior for different prescribed motions. Several prescribed motions have been simulated and tested under different conditions in order to characterize the system behavior. In particular, the kinematic characteristics were obtained from both, experimental tests and numerical simulations. Finally, experiment results and simulation computations were compared for purpose of performance evaluation and design characterization of the parallel manipulator structure and its prototype.