Homozygous and compound heterozygous MMP20 mutations in amelogenesis imperfecta

In this article, we focus on hypomaturation autosomal-recessive-type amelogenesis imperfecta (type IIA2) and describe 2 new causal Matrix metalloproteinase 20 (MMP20) mutations validated in two unrelated families: a missense mutation p.T130I at the expected homozygous state, and a compound heterozygous mutation having the same mutation combined with a nucleotide deletion, leading to a premature stop codon (p.N120fz*2). We characterized the enamel structure of the latter case using scanning electron microscopy analysis and microanalysis (Energy-dispersive X-ray Spectroscopy, EDX) and confirmed the hypomaturation-type amelogenesis imperfecta as identified in the clinical diagnosis. The mineralized content was slightly decreased, with magnesium substituting for calcium in the crystal structure. The anomalies affected enamel with minimal inter-rod enamel present and apatite crystals perpendicular to the enamel prisms, suggesting a possible new role for MMP20 in enamel formation.

[Does the body mass index influence the results of revision total knee arthroplasty?]

BACKGROUND

Revision total knee arthroplasty (TKA) is one of the most demanding as well as increasing orthopaedic operations. The influence of a higher body weight or body mass index (BMI) on the results of revision TKA is not evident so far. We therefore hypothesised that obesity as well as a high body weight could influence the results of revision TKA.

PATIENTS

75 consecutive revision TKA in 75 patients were included and stratified according to a BMI greater or smaller than 30 kg/m2 and a body weight greater or smaller than 90 kg. The Knee Society score (KSS), the function and the knee subscales were analysed pre- and postoperatively as well as the pre- to postoperative improvement. The duration of the procedure, the occurrence of complications, the blood loss and the length of hospital stay were collected.

RESULTS

All patients showed a significant improvement of the KSS and function score (p < 0.05). There was a tendency to superior results in patients with a smaller BMI and a lower body weight. This tendency was most pronounced in the function subscale which depicted significant differences in favour of a BMI smaller 30 kg/m2. No significant differences were observed in the other analysed factors.

CONCLUSION

BMI greater than 30 kg/m2 as well as a higher body weight seem to negatively influence the function of revision TKA. However, all patients significantly improved after revision TKA and no differences were found according to the occurrence of complications. Therefore, revision TKA should not be refused to obese or heavy patients.

miRNA-30a-5p-mediated silencing of Beta2/NeuroD expression is an important initial event of glucotoxicity-induced beta cell dysfunction in rodent models

AIMS/HYPOTHESIS

The loss of beta cell function is a critical factor in the development of type 2 diabetes. Glucotoxicity plays a major role in the progressive deterioration of beta cell function and development of type 2 diabetes mellitus. Here we demonstrate that microRNA (miR)-30a-5p is a key player in early-stage glucotoxicity-induced beta cell dysfunction.

METHODS

We performed northern blots, RT-PCR and western blots in glucotoxicity-exposed primary rat islets and INS-1 cells. We also measured glucose-stimulated insulin secretion and insulin content. In vivo approaches were used to evaluate the role of miR-30a-5p in beta cell dysfunction.

RESULTS

miR-30a-5p expression was increased in beta cells after exposure to glucotoxic conditions, and exogenous miR-30a-5p overexpression also induced beta cell dysfunction in vitro. miR-30a-5p directly suppressed expression of Beta2/NeuroD (also known as Neurod1) by binding to a specific binding site in its 3'-untranslated region. After restoration of Beta2/NeuroD expression by knockdown miR-30a-5p or transfection of the Beta2/NeuroD gene, beta cell dysfunction, including decreased insulin content, gene expression and glucose-stimulated insulin secretion, recovered. Glucose tolerance and beta cell dysfunction improved on direct injection of Ad-si30a-5p into the pancreas of diabetic mice.

CONCLUSIONS/INTERPRETATION

Our data demonstrate that miR-30a-5p-mediated direct suppression of Beta2/NeuroD gene expression is an important initiation step of glucotoxicity-induced beta cell dysfunction.

A multicenter, randomized, controlled trial testing the effects of acupuncture on allergic rhinitis

BACKGROUND

The aim of this study was to evaluate the efficacy and safety of acupuncture in the treatment for allergic rhinitis.

METHODS

This study was a multicenter, randomized, parallel-controlled study. Participants were randomized to either the active acupuncture, sham acupuncture, or waitlist groups. The active and sham acupuncture groups received acupuncture treatment three times per week for 4 weeks. In the sham group, minimal acupuncture at nonacupuncture points was used. The waitlist group did not receive any acupuncture treatment.

RESULTS

Of the 238 participants, 97, 94, and 47 individuals were assigned to the active acupuncture, sham acupuncture, and waitlist group, respectively. After the treatment, the difference in the total nasal symptom score (TNSS) was significantly reduced in the active acupuncture group compared with the sham acupuncture (difference: -1.03, 95% confidence interval [CI]: -1.96, -0.09, P = 0.03) and waitlist (difference: -2.49, 95% CI: -3.68, -1.29, P < 0.0001). The active acupuncture group exhibited a significant change in the total non-nasal symptom score (TNNSS) compared with the waitlist (difference: -0.78, 95% CI: -1.22, -0.34, P = 0.0002), but not the sham acupuncture group (difference; 0.15, 95% CI: -0.21, 0.5, P = 0.56). Both active and sham acupuncture treatments resulted in significant improvements in TNSS and TNNSS compared to baseline.

CONCLUSION

Active acupuncture showed a significantly greater effect on symptoms of allergic rhinitis than either sham acupuncture or no active treatment. The symptoms of allergic rhinitis decreased significantly after treatment in the both acupuncture and sham acupuncture groups. Acupuncture appears to be an effective and safe treatment for allergic rhinitis.

Electrical characteristics of 2D and 3D microelectrodes for high-resolution retinal prostheses

In order to provide high quality visual information to patients who have implanted retinal prosthetic devices, the number of microelectrode should be large. As the number of microelectrode is increased, the dimension of the microelectrode is decreased, which in turn results in the increased interface impedance of microelectrode and decreased dynamic range of injection current. In addition, the reduced maximum limit of injection current may not be sufficiently large to stimulate the ganglion cells in a retina. In order to improve the trade-off envelope between number of microelectrode and current injection limit, a 3D microelectrode structure can be used as an alternative. From the advancement of microfabrication technology, the fabrication of highly-accurate 3D structures with small dimensions is possible. This paper presents a first comprehensive electrical characterization of 2D and 3D microelectrodes for high-resolution retinal prostheses. Microelectrodes which differ in shapes and diameters are analyzed. Their interface impedances and charge injection limits are quantitatively analyzed. This research can be used to define requirements for further retinal prosthetic device research.

Abstract P2-11-05: Work status and financial stability during treatment for early breast cancer: a pilot study of an ethnically diverse sample

Background: Black and Latina women have lower rates of return to work than non-Latina whites (NLW) after breast cancer treatment. We recently showed that stopping work during chemotherapy is associated with not returning to work for 5 years after treatment. Little is known about the impact of breast cancer on employment outcomes in other low-English proficiency (LEP) immigrant or minority groups. The ongoing longitudinal Breast Cancer and the Workforce study measures work status in LEP immigrants and ethnic minorities undergoing breast cancer treatment with curative intent. For this pilot, we assessed work status and financial stability during treatment.

Methods: Women aged 18–64, undergoing treatment for stage I-III breast cancer, employed at diagnosis, and able to consent in English, Korean, Mandarin, or Spanish were recruited at 3 community oncology clinics and an NCI-designated cancer center. Participants enrolled any time prior to completing their last treatment (chemo, XRT, or surgery) and self-administered web surveys with in-person assistance, as needed, in their preferred language. Demographic, financial, and pre- and post-diagnosis employment characteristics were analyzed using descriptive statistics.

Results: The sample (n = 61) median age was 48 years. 20 (33%) were black, 14 (23%) NLW, 11 (18%) Latina, 8 (13%) Korean, 7 (12%) Chinese, and 1 (2%) other. 37 (61%) were foreign born, 35 (58%) had &lt;college education, 30 (49%) had annual household income &lt;$50,000. 41 (69%) had private insurance, 14 (24%) Medicaid or Emergency Medicaid, and 2 (3%) Medicare/VA. Before diagnosis, 47 (78%) worked full time and 13 (22%) part time. 36 (60%) had white collar jobs (37% manager/professional, 2% arts/media, 22% sales/admin. support); 24 (40%) had blue collar jobs (5% fabricators/laborers; 35% service). 32 (52%) had paid sick leave available at work; 33 (57%) had disability pay. Most were undergoing active therapy: 44 (75%) receiving chemotherapy (7% neo-adjuvant), 3 (5%) post-surgery awaiting adjuvant therapy, 7 (11%) receiving XRT and 5 (8%) awaiting surgery.

When surveyed, 25 (41%) were working full time, 11 (18%) part time and 25 (41%) not working (13% on disability, 16% on paid sick leave, 12% other). 31 (51%) changed work status – stopped working or reduced hours. Of pre-diagnosis full-time workers (n = 47), 23 (49%) changed work status – 4 (9%) to part-time, 8 (17%) sick leave, 7 (15%) disability and 4 (9%) stopped working. Of pre-diagnosis part-time workers (n = 13), 6 (46%) changed status – 2 (16%) sick leave, 1 (8%) disability and 3 (23%) stopped working. Overall, 26 (43%) had less money to spend on food since starting treatment; 31 (53%) did not have enough money to cover their needs.

Discussion: In this pilot, 51% of women changed work status during breast cancer treatment. 41% stopped working, of whom almost a third did not have sick leave or disability. 43% experienced food insecurity during treatment, and 53% said they did not have enough money to cover their needs. Additional research is needed to understand the factors that disrupt work during or soon after treatment, how these factors vary for low-income and minority groups, and to better define the impact of change in work status on financial stability.

Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr P2-11-05.

Resumption or persistence of menstruation after cytotoxic chemotherapy is a prognostic factor for poor disease-free survival in premenopausal patients with early breast cancer

BACKGROUND

We investigated the relationship between resumption or persistence of menstruation after cytotoxic chemotherapy (RM) and disease-free survival (DFS) in premenopausal patients with early breast cancer.

METHODS

Medical records from 872 patients who received cytotoxic chemotherapy for stage I to III breast cancer were retrospectively reviewed.

RESULTS

The median patient age was 41 years (range, 21-54) and the median follow-up duration was 6.2 years (range, 0.7-10.4). Six hundred ninety-two patients (79.4%) were hormone receptor (HR) positive and the majority of these received tamoxifen therapy after completing chemotherapy. The chemotherapy-induced amenorrhea (CIA) rate was 76.7% (n = 669), and 51.8% (n = 452) experienced RM during the follow-up period. One hundred twenty-one (13.9%) patients had persistent menstruation without CIA. DFS was significantly affected by younger age at diagnosis (≤35 years) (P = 0.013), tumor size > 2 cm (P < 0.001), node positivity (P < 0.001), HR negativity (P < 0.001), HER2 positivity (P = 0.010), and RM (P < 0.001). HR negativity [hazard ratio 1.7, 95% confidence interval (CI) 1.2-2.4, P = 0.006], tumor size > 2 cm (hazard ratio 2.1, 95% CI 1.4-3.0, P < 0.001), node positivity (hazard ratio 3.0, 95% CI 2.0-4.7, P < 0.001), and RM (hazard ratio 1.8, 95% CI 1.2-2.7, P = 0.004) remained significant factors for DFS on multivariate analysis.

CONCLUSIONS

A considerable proportion of premenopausal patients treated with chemotherapy experienced RM after CIA. RM was a poor prognostic factor for DFS in premenopausal patients with early breast cancer.

Phase II trial of galiximab (anti-CD80 monoclonal antibody) plus rituximab (CALGB 50402): Follicular Lymphoma International Prognostic Index (FLIPI) score is predictive of upfront immunotherapy responsiveness

BACKGROUND

This phase II CALGB trial evaluated the activity and safety of an extended induction schedule of galiximab (G) plus rituximab (R) in untreated follicular lymphoma (FL).

PATIENTS AND METHODS

Patients with previously untreated FL (grades 1, 2, 3a) received 4 weekly infusions of G + R, followed by an additional dose every 2 months four times. International Workshop Response Criteria were used to evaluate response.

RESULTS

Sixty-one patients were treated and antibody infusions were well tolerated. The overall response rate (ORR) is 72.1% (95% confidence interval 59.2% to 82.9%): 47.6% complete response (CR)/unconfirmed complete response (CRu) and 24.6% partial response. At a median follow-up time of 4.3 years (range, 0.3-5.3 years) median progression-free survival (PFS) is 2.9 years. Notably, Follicular Lymphoma International Prognostic Index (FLIPI) correlated with ORR, CR rate, and PFS, and the low-risk FLIPI group (n = 12) achieved a 92% ORR, 75% CR/CRu rate, and 75% 3-year PFS.

CONCLUSIONS

An extended induction schedule of G + R in previously untreated FL is well tolerated and appears particularly efficacious in those patients with low-risk FLIPI scores. In addition, this trial served as the initial platform for additional CALGB 'doublet' combination regimes of rituximab plus other novel targeted agents.

Experimental evaluation of immediate recanalization effect and recanalization efficacy of a new thrombus retriever for acute stroke treatment in vivo

BACKGROUND AND PURPOSE

Currently, several new stent retriever devices for acute stroke treatment are under development and early clinical evaluation. Preclinical testing under standardized conditions is an important first step to evaluate the technical performance and potential of these devices. The aim of this study was to evaluate the immediate recanalization effect, recanalization efficacy, thrombus-device interaction, and safety of a new stent retriever intended for thrombectomy in patients with acute stroke.

MATERIAL AND METHODS

The pREset thrombectomy device (4 × 20 mm) was evaluated in 16 vessel occlusions in an established swine model. Radiopaque thrombi (10-mm length) were used for visualization of thrombus-device interaction during application and retrieval. Flow-restoration effect immediately after deployment and after 5-minute embedding time before retrieval, recanalization rate after retrieval, thromboembolic events, and complications were assessed. High-resolution FPCT was performed to illustrate thrombus-device interaction during the embedding time.

RESULTS

Immediate flow restoration was achieved in 75% of occlusions. An increase or stable percentage of recanalizations during embedding time before retrieval was seen in 56.3%; a decrease, in 12.5%; reocclusion of a previously recanalized vessel, in 18.8%; and no recanalization effect at all, in 12.5%. Complete recanalization (TICI 3) after retrieval was achieved in 93.8%; partial recanalization (TICI 2b), in 6.2%. No distal thromboembolic events were observed. High-resolution FPCT illustrated entrapment of the thrombus between the stent struts and compression against the contralateral vessel wall, leading to partial flow restoration. During retrieval, the thrombus was retained in a straight position within the stent struts.

CONCLUSIONS

In this experimental study, the pREset thrombus retriever showed a high recanalization rate in vivo. High-resolution FPCT allows detailed illustration of the thrombus-device interaction during embedding time and is advocated as an add-on tool to the animal model used in this study.

[Validity of digital templating in total hip arthroplasty: impact of stem design and planner's experience]

INTRODUCTION

Preoperative planning in total hip arthroplasty decreases the risk of implant oversizing and facilitates intraoperative orientation. The size of the acetabular and femural components can be estimated. The aim of the present study was to determine the validitiy of digital templating. Furthermore, we compared the accuracy of three planners with different clinical experience and the effect of two different femoral component designs on planning accuracy.

METHODS

On 60 a. p. pelvis radiographs, 60 unilateral, non-cemented total hip arthroplasties using the planning tool "AGFA-Orthopaedic-Tools Version V2.10®" (Fa. Agfa Health Care, Mertsel, Belgium) were repeatedly planned by three orthopaedic surgeons (planner A fifth year, planner B third year, planner C second year of training). All 60 patients received pressfit acetabular components, a straight stem was implanted in 28 (CLS-Spotorno™, Fa. Zimmer) and a short stem (Fitmore™, Fa. Zimmer) in 32 patients. The planned sizes of the components and the offset-variations were compared to the implanted sizes.

RESULTS

The percental accuracy and ICC planning for the straight stem were 42.9 %/0.906 for planner A, 39.3 %/0.833 for planner B, and 28.6 %/0.836 for planner C. Planning the short stem, the percental accuracy and ICC were 34.4 %/0,886 for planner A, 21.9 %/0.708 for planner B, and 12.5 %/0.681 for planner C. The accuracy and ICC of templating the acetabular components were 35 %/0.796 for planner A, 30 %/0.725 for planner B, and 26.8 %/0.511 for planner C. Planning the sizes of both femoral components showed significant differences between planner A and C and planner B and C in Wilcoxon's signed-rank test.

CONCLUSION

A lower level of experience showed no effect on the planning results of the acetabular components, but there were considerable and significant differences on planning the femoral components. Furthermore, the design of the femoral component had an impact on planning accuracy.

Comparison between a guaiac and three immunochemical faecal occult blood tests in screening for colorectal cancer

BACKGROUND

The aim of this study was to compare the performance of the guaiac-based faecal occult blood test (G-FOBT), with that of three immunochemical faecal occult blood tests (I-FOBT) which allow automatic interpretation.

PATIENTS AND METHODS

Under the French organised screening programme, 85,149 average-risk individuals aged 50-74 participating in the third screening round, performed both the G-FOBT (Hemoccult-II test) and one of the I-FOBTs: FOB-Gold, Magstream and OC-Sensor.

RESULTS

Given the chosen threshold, the positivity ratio between the different I-FOBTs and the G-FOBT was 2.4 for FOB-Gold, 2.0 for Magstream and 2.2 for OC-Sensor (P=0.17). The three I-FOBTs were superior to the G-FOBT for colorectal cancer (CRC) detection. The ratios for detection rates were 1.6 (FOB-Gold), 1.7 (Magstream) and 2.1 (OC-Sensor) (P=0.74). For non-invasive CRC they were, respectively, 2.5, 3.0 and 4.0 (P=0.83) and for advanced adenomas 3.6, 3.1 and 4.0 (P=0.39).

CONCLUSIONS

This study provides further evidence that I-FOBT is superior to G-FOBT. None of the three I-FOBTs studied appeared to be significantly better than the others.

Susceptibility-weighted MR imaging for diagnosis of capillary telangiectasia of the brain

BACKGROUND AND PURPOSE

BCT is a benign entity, whose appearance on conventional MR imaging makes its differentiation from neoplastic, inflammatory, or subacute ischemic disease challenging. SWI is sensitive to susceptibility effects from deoxyhemoglobin with excellent spatial resolution. Only scarce case reports have described the utility of SWI in cases of BCT. Our aim was to show the diagnostic value of SWI applied to a larger series of cases.

MATERIALS AND METHODS

This was an observational retrospective study of 33 BCTs in 27 consecutive patients examined from August 2009 to January 2011 with MR imaging, including SWI. Morphology, signal intensity characteristics, and additional vascular malformations were analyzed. Preceding or follow-up examinations were available in 18 patients with a median time interval of 14.5 months (range, 2-115 months).

RESULTS

Twenty-five pontine and 8 supratentorial BCTs demonstrated distinct signal-intensity loss on SWI in combination with postcontrast enhancement. Mean lesion diameter was 4.9 mm (range, 1.5-17 mm). Thirty-nine percent showed slight signal-intensity changes on T1 and/or T2; the remainder were isointense to normal brain. In 30%, a prominent draining vessel was observed. Additional cerebral vascular malformations were found in 5 patients.

CONCLUSIONS

SWI represents a valuable tool for confirmation of presumed BCT. Demonstration of signal-intensity loss on SWI in an enhancing focal brain lesion, otherwise unremarkable on conventional MR images, is highly specific for BCT, thus excluding serious pathology and reassuring the patient and referring physician. This is particularly helpful for BCT in less typical locations.

P4-01-13: Biology of Aggressiveness and Tamoxifen Resistance in Hormone Receptor-Positive Very Young Age Breast Cancer

It has been known that young breast cancer patients have worse outcomes compared with older premenopausal or postmenopausal patients. Survival difference between young and older breast cancer patients is evident only in hormone receptor positive breast cancer regardless of tamoxifen treatment according to our previous report. However, the biology of aggressiveness and endocrine resistance of breast cancer in very young women is largely unknown. The purpose of this study is to find molecular characteristics of hormone receptor positive breast cancers of very young age women (&lt;35) compared with those of older premenopausal women.

We extracted mRNA from fresh frozen hormone receptor positive primary breast cancer tissues of 24 young age breast cancer patients (&lt;35 years) and 31 older premenopausal women (40 to 49 years) by standard method. All tumor specimens analyzed contained more than 50% tumor cells. Hormone receptor status was determined by immunohistochemistry (IHC). Gene expression microarray experiment was done in the 55 samples using Illumina HumanRef-8 v3 Expression BeadChip (Illumina, Inc., San Diego, CA). Functional and pathway analysis of differentially expressed genes were done using DAVID (http://david.abcc.ncifcrf.gov/home.jsp) and Ingenuity pathway analysis (IPA, http://www.ingenuity.com). Ki-67 assay was done using IHC in 4,957 ER+ breast cancer patients of Seoul National University cohort and 1,863 ER+ patients from National Cancer Center, Korea.

355 genes were upregulated (&gt;1.5 fold) and 209 genes were down-regulated in breast cancer tissues of young age patients (&lt;35) compared with those of older patients. In pathway analysis of the highly expressed genes in young patients, cell cycle function and pathway was significantly activated. The genes of central role in this pathway were MYC and CCND1. In IHC assay for 4,957 ER+ Seoul National University dataset, the proportion of high Ki-67 expression (&gt;=10%) was positively correlated with decreasing age: 26.4%, 24.0%, 21.3%, 14.8%, 12.0% of women aged &lt;30, 30–34, 35–39, 40–49, 50–59, respectively (p&lt;0.001). The same correlation pattern between younger age and high Ki-67 expression was also seen in another 1,863 patient cohort.

In conclusion, we showed that genes involved in cell cycle pathway were upregulated in very young age (&lt;35) ER+ breast cancer using microarray study. It was validated in large data set using Ki-67 IHC assay. High proliferation and fast cell cycle could be a mechanism of worse outcome and tamoxifen resistance of ER+ very young age breast cancer patients.

Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr P4-01-13.

Taboo: a novel paradigm to elicit aphasia-like trouble-indicating behaviour in normally speaking individuals

Two important research lines in neuro- and psycholinguistics are studying natural or experimentally induced slips of the tongue and investigating the symptom patterns of aphasic individuals. Only few studies have focused on explaining aphasic symptoms by provoking aphasic symptoms in healthy speakers. While all experimental techniques have so far dealt with the single word or the sentence level, the current study intended to provoke aphasia-like trouble-indicating behaviour (i.e. prepairs and repairs) in the spontaneous language production of unimpaired speakers. In their descriptions of complex pictures, the participants were requested to avoid particular words terming central elements of the pictures. The results show that the error pattern provoked by the novel "taboo" paradigm resembled substantially the pattern of aphasic individuals. Consequently, the paradigm is applicable for further studies, e.g. for bringing forward the understanding of spontaneous language production or for comparing the neurofunctional basis of errors in healthy and aphasic speakers.

Infectious agents and B cell tolerance breakdown

The role of infectious agents in autoimmune diseases genesis is still a matter of debate. Several observations have suggested that autoimmune diseases may be initiated or worsened by infections (review by Kivity et al., 2009). However, there is no clear understanding of the underlying mechanisms. In particular, autoantibody production during infections could be the result of the non specific activation of “natural” autoreactive B cells that produce only low-affinity antibodies (Lacroix-Desmazes et al., 1998). A relevant hypothesis making the link between infections and autoimmune diseases could be the progressive genesis of more affine autoreactive B cells that could be involved in different pathogenic conditions. The major purpose of our work is therefore to study the breakdown of B cell tolerance and the ability for autoreactive B cells,especially low reactive B cells, to engage in an affinity maturation process during infections.We have created a new autoreactive B cell model allowing a relevant study of affinity maturation process. In this intermediate affinity SWHEL X HEL2x autoreactive model, knock-in B cells (Taki etal., 1993) express a B cell receptor highly specific for Hen-Egg Lysozyme (HEL) that recognizes HEL2x mutated auto-antigen with intermediate affinity (Phan et al., 2003; SWHEL model).Phenotypic analysis revealed that these autoreactive B cells are in a state of partial tolerance compared to the high affinity model (Phan et al., 2003; SWHEL X ML5 model) characterized by a strong anergy of HEL positive B cells.Experimental infections were performed with Borrelia burgdorferi, a Gram-negative spirochete,leading to sustained lymph nodes polyclonal B cell activation and hypergammaglobulinemia (Soulas et al., 2005). In SWHEL X HEL2x infected mice, in the presence of their auto-antigen,intermediate affinity autoreactive B cells are able to proliferate, to be activated, to enter into lymph nodes germinal centers and to produce IgM and IgG autoantibodies, although in low amounts.Moreover, IgG auto-antibodies in infected mice appear somatically mutated in the auto-antigen recognizing area. These data are consistent with a partial tolerance breakdown and the next experimental step will consist in checking the long-term survival of such activated autoreactive B cells and the impact of the observed mutations

Nanometrology of delignified Populus using mode synthesizing atomic force microscopy

The study of the spatially resolved physical and compositional properties of materials at the nanoscale is increasingly challenging due to the level of complexity of biological specimens such as those of interest in bioenergy production. Mode synthesizing atomic force microscopy (MSAFM) has emerged as a promising metrology tool for such studies. It is shown that, by tuning the mechanical excitation of the probe-sample system, MSAFM can be used to dynamically investigate the multifaceted complexity of plant cells. The results are argued to be of importance both for the characteristics of the invoked synthesized modes and for accessing new features of the samples. As a specific system to investigate, we present images of Populus, before and after a holopulping treatment, a crucial step in the biomass delignification process.

Orthognathic surgery in Melnick-Needles-Syndrome. Case report and review of the literature

Melnick-Needles Syndrome (MNS) is a congenital syndrome associated with severe architectural disorder of the skeletal system that can cause significant effects on the craniofacial skeleton including poor aesthetics, impaired speech and masticatory problems. The authors report a case of a female patient who experienced masticatory constraint, hindered speech and functional problems related to a severe bite dysfunction due to the mandibular hypoplasia and the underlying bony architectural disorder associated with MNS. The patient underwent bilateral sagittal split osteotomy (BSSO) to correct her skeletal malocclusion and improve the characteristic aesthetics and speech. The inherent bony abnormalities with their altered collagen structure presented unique challenges to orthognathic surgery in this patient with an unpredictable bone healing process. In MNS patients a fragile trabecular bone structure and an increased bleeding tendency is thought to delay or forestall wound healing. The patient was treated successfully with BSSO and monocortical plate fixation following a well-established algorithm from orthodontic preparation to surgical protocol. A very satisfying outcome has been achieved, concerning functional rehabilitation and aesthetic improvement. A review of the literature revealed that little is known about bone regeneration and fracture healing in cases with MNS.

Precuneus hypoperfusion plays an important role in memory impairment of patients with systemic lupus erythematosus

The present study was designed to identify regional cerebral blood flow (rCBF) abnormalities in systemic lupus erythematosus (SLE) patients with memory impairments. Nineteen SLE patients (mean age 36.1 ± 8.6 years, range 17-47) with subjective memory complaints underwent brain single-photon emission computed tomography (SPECT). The Korean Wechsler Adult Intelligence Scale (K-WAIS) and the Rey-Kim Memory Test (RKMT) were used objectively to evaluate cognitive functions in these patients. On the basis of the Intelligence Quotient-Memory Quotient (IQ-MQ) difference score, patients were classified into two groups: those with below one standard deviation (SD) from the mean for normal subjects of comparable age and education (memory impairment, n = 6) and those with without memory impairment (non-memory impairment, n = 13). Their brain SPECT images were analyzed by statistical parametric mapping (SPM) for group comparisons. The group of SLE patients with memory impairment showed significant hypoperfusion in the right precuneus compared with those with non-memory impairment (p < 0.001). Hypoperfusion of the precuneus may play a significant role in the memory function of SLE patients. SPM analysis of brain SPECT images could be a useful and objective tool for identifying abnormal rCBF in SLE patients with memory impairment.