Longitudinal plasma metanephrines preceding pheochromocytoma diagnosis: a retrospective case-control serum repository study

OBJECTIVE

Plasma metanephrines (PMN) are highly sensitive for diagnosis of pheochromocytoma, but the natural history of PMN before pheochromocytoma diagnosis has not been previously described. The aim of the study was to compare the progression of PMN before pheochromocytoma diagnosis to matched healthy and essential hypertension disease controls.

DESIGN

A retrospective case-control Department of Defense Serum Repository (DoDSR) study.

METHODS

We performed a DoDSR study that compared three longitudinal pre-diagnostic PMN for 30 biopsy-proven pheochromocytoma cases to three longitudinal PMN for age, sex, race, and age of serum sample matched healthy and essential hypertension disease controls. Predominant metanephrine (MN) or normetanephrine (NMN) production was identified for each case and converted to a percentage of the upper limit of normal to allow analysis of all cases together. PMN were measured by Quest Diagnostics.

RESULTS

The predominant plasma metanephrine (PPM) was >100 and 300% of the upper limit of normal a median of 6.6 and 4.1 years before diagnosis respectively. A greater percentage of pheochromocytoma patients had a PPM >100 and >300% of the upper limit of normal compared with combined healthy and essential hypertension disease controls <2, 2-8, and >8 years prior to diagnosis. For patients with a baseline PPM 90-300% of the upper limit of normal, a 25% rate of rise per year was 100% specific for pheochromocytoma.

CONCLUSIONS

PPMs elevate years before diagnosis which suggests that delayed diagnoses are common. For mild PMN elevations, follow-up longitudinal PMN trends may provide a highly specific and economical diagnostic tool.

Prognostic value of tumor-infiltrating lymphocytes in Epstein-Barr virus-associated gastric cancer

BACKGROUND

This study explored the prognostic impact of tumor-infiltrating lymphocytes (TILs) and investigated whether three histologic subtypes (lymphoepithelioma-like carcinoma, carcinoma with Crohn's disease-like lymphoid reaction, and conventional-type adenocarcinoma) could stratify a prognostic subset for patients with Epstein-Barr virus (EBV)-associated gastric cancer (EBVaGC).

MATERIALS AND METHODS

After reviewing 1318 consecutive cases of surgically resected or endoscopic submucosal dissected gastric cancers, 120 patients were identified as EBV-positive using EBV-encoded RNA in situ hybridization. The evaluation of the percentage of intratumoral (iTu-) and stromal (str-) TILs was carried out, and the cases were also subclassified into three histologic subtypes as noted above.

RESULTS

Among the 120 patients, 73 patients (60.8%) and 60 patients (50.0%) were determined as str-TIL-positive and iTu-TIL-positive, respectively. In a univariate analysis, str-TIL-positivity was significantly associated with longer recurrence-free survival (RFS; P = 0.002) and disease-free survival (DFS; P = 0.008), yet not overall survival (OS; P = 0.145). While iTu-TIL-positivity has a tendency of favorable outcome indicator for DFS and OS, but statistically significant differences were not shown, respectively (RFS, P = 0.058; DFS, P = 0.151; OS, P = 0.191). In a multivariate analysis using a Cox proportional hazard model adjusted for age, pTNM stage, lymphatic invasion, perineural invasion, and venous invasion; histologic subtype, WHO classification, and str-TIL-positivity were independently or tentatively associated with favorable RFS (hazard ratio [HR] = 12.193, 95% confidence interval [95% CI] 1.039-143.055, P = 0.047) or DFS (HR = 4.836, 95% CI 0.917-25.525, P = 0.063).

CONCLUSION

The histologic subclassification and TILs can be used to predict RFS and DFS for patients with EBVaGC.

Predisposition to and effects of methamphetamine use on the adolescent brain

Adolescence is a period of heightened vulnerability both to addictive behaviors and drug-induced brain damage. Yet, only limited information exists on the brain mechanisms underlying these adolescent-specific characteristics. Moreover, distinctions in brain correlates between predisposition to drug use and effects of drugs in adolescents are unclear. Using cortical thickness and diffusion tensor image analyses, we found greater and more widespread gray and white matter alterations, particularly affecting the frontostriatal system, in adolescent methamphetamine (MA) users compared with adult users. Among adolescent-specific gray matter alterations related to MA use, smaller cortical thickness in the orbitofrontal cortex was associated with family history of drug use. Our findings highlight that the adolescent brain, which undergoes active myelination and maturation, is more vulnerable to MA-related alterations than the adult brain. Furthermore, MA-use-related executive dysfunction was greater in adolescent MA users than in adult users. These findings may provide explanation for the severe behavioral complications and relapses that are common in adolescent-onset drug addiction. Additionally, these results may provide insights into distinguishing the neural mechanisms that underlie the predisposition to drug addiction from effects of drugs in adolescents.

Necroptosis is preceded by nuclear translocation of the signaling proteins that induce it

A signaling pathway that induces programmed necrotic cell death (necroptosis) was reported to be activated in cells by several cytokines and various pathogen components. The major proteins participating in that pathway are the protein kinases RIPK1 and RIPK3 and the pseudokinase mixed lineage kinase domain-like protein (MLKL). Recent studies have suggested that MLKL, once activated, mediates necroptosis by binding to cellular membranes, thereby triggering ion fluxes. However, our knowledge of both the sequence of molecular events leading to MLKL activation and the subcellular sites of these events is fragmentary. Here we report that the association of MLKL with the cell membrane in necroptotic death is preceded by the translocation of phosphorylated MLKL, along with RIPK1 and RIPK3, to the nucleus.

Hydroacoustic and spatial analysis of sediment fluxes and accumulation rates in two Virginia reservoirs, USA

Watershed sediment fluxes and reservoir sediment accumulation rates were analyzed in two contrasting reservoir systems in central and western Virginia. Lake Pelham, located in the Piedmont geologic province, is a human-impacted reservoir with a watershed dominated by agricultural, residential and industrial land uses. Conversely, Lake Moomaw has a largely undeveloped watershed characterized by very steep slopes and forested land use located in the Valley and Ridge province. The Revised Universal Soil Loss Equation (RUSLE) and sediment delivery ratios (SDRs) were used to estimate soil losses in the two watersheds. Bathymetric and sediment accumulation surveys of the two reservoirs were also conducted using a multi-frequency hydroacoustic surveying system. The RUSLE/SDR erosion model estimates 2150 kg ha(-1) year(-1) for Lake Pelham and 2720 kg ha(-1) year(-1) for Lake Moomaw, a 410 and 13 % increase from assumed pristine (100 % forested) land use for the respective basins. Mean sediment accumulation rates of 1.51 and 0.60 cm year(-1) were estimated from the hydroacoustic survey of Lake Pelham and Lake Moomaw, respectively. Overall, Lake Moomaw has relatively low sediment accumulation rates; however, the reservoir is vulnerable to increases in sediment fluxes with further human development due to the steep slopes and highly erodible colluvial soils that characterize the basin. Higher erosion and sediment accumulation rates in Lake Pelham are most likely reflecting the impact of human development on sedimentation processes, where the loss of vegetal buffers and increase in impervious surfaces exacerbates both the surficial soil losses as well as intrinsic stream sediment production leading to the current annual reservoir capacity loss of 0.4 %.

Critical behavior of the relaxation rate, the susceptibility, and a pair correlation function in the Kuramoto model on scale-free networks

We study the impact of network heterogeneity on relaxation dynamics of the Kuramoto model on uncorrelated complex networks with scale-free degree distributions. Using the Ott-Antonsen method and the annealed-network approach, we find that the critical behavior of the relaxation rate near the synchronization phase transition does not depend on network heterogeneity and critical slowing down takes place at the critical point when the second moment of the degree distribution is finite. In the case of a complete graph we obtain an explicit result for the relaxation rate when the distribution of natural frequencies is Lorentzian. We also find a response of the Kuramoto model to an external field and show that the susceptibility of the model is inversely proportional to the relaxation rate. We reveal that network heterogeneity strongly impacts a field dependence of the relaxation rate and the susceptibility when the network has a divergent fourth moment of degree distribution. We introduce a pair correlation function of phase oscillators and show that it has a sharp peak at the critical point, signaling emergence of long-range correlations. Our numerical simulations of the Kuramoto model support our analytical results.

Mesoporous hollow carbons on graphene and their electrochemical properties

We synthesized mesoporous hollow carbon on a graphene surface (MHCG). When applied into supercapacitor electrode, MHCG electrode exhibited outstanding maintenance of energy density above 30 W h kg⁻¹ even under 1 kW kg⁻¹ power density.

Google unveils a glimpse of allergic rhinitis in the real world

Google Trends (GT) is a Web-based surveillance tool used to explore the searching trends of specific queries on Google. Recent studies have suggested the utility of GT in predicting outbreaks of influenza and other diseases. However, this utility has not been thoroughly evaluated for allergic diseases. Therefore, we investigated the utility of GT for predicting the epidemiology of allergic rhinitis. In the USA, GT for allergic rhinitis showed repetitive seasonality that peaked in late April and early May and then rapidly decreased, and a second small peak occurred in September. These trends are highly correlated with the searching trends for other queries such as 'pollen count', antihistamines such as loratadine and cetirizine (all r > 0.88 and all P < 0.001), and even the total pollen count collected from 21 pollen counters across the USA (r = 0.928, P < 0.001). Google Trends for allergic rhinitis was similar to the monthly changes in rhinitis symptoms according to the US National Health and Nutrition Examination Survey III, sales for Claritin(®) and all over-the-counter antihistamines, and the number of monthly page views of 'claritin.com'. In conclusion, GT closely reflects the real-world epidemiology of allergic rhinitis in the USA and could potentially be used as a monitoring tool for allergic rhinitis.