Further evidence for a non-random chromosomal abnormality in acute promyelocytic leukemia

We have previously reported on two patients with acute promyelocytic leukemia (APL) who had what appeared to be a deletion of chromosome No. 17. We now describe a third patient with APL. All three patients had a structural rearrangement involving No. 15 and No. 17. Our current interpretation of the chromosomal abnormality is that it is a reciprocal translocation, t (15;17) (q22; q21). Evidence that this is a consistent rearrangement associated with APL comes not only from our three patients, but also from two other published cases of APL, studied with banding, who also had an identical abnormality.

Functional connectivity predicts gender: Evidence for gender differences in resting brain connectivity

Prevalence of certain forms of psychopathology, such as autism and depression, differs between genders and understanding gender differences of the neurotypical brain may provide insights into risk and protective factors. In recent research, resting state functional magnetic resonance imaging (rfMRI) is widely used to map the inherent functional networks of the brain. Although previous studies have reported gender differences in rfMRI, the robustness of gender differences is not well characterized. In this study, we use a large data set to test whether rfMRI functional connectivity (FC) can be used to predict gender and identify FC features that are most predictive of gender. We utilized rfMRI data from 820 healthy controls from the Human Connectome Project. By applying a predefined functional template and partial least squares regression modeling, we achieved a gender prediction accuracy of 87% when multi-run rfMRI was used. Permutation tests confirmed that gender prediction was reliable ( p<.001). Effects of motion, age, handedness, blood pressure, weight, and brain volume on gender prediction are discussed. Further, we found that FC features within the default mode (DMN), fronto-parietal and sensorimotor networks contributed most to gender prediction. In the DMN, right fusiform gyrus and right ventromedial prefrontal cortex were important contributors. The above regions have been previously implicated in aspects of social functioning and this suggests potential gender differences in social cognition mediated by the DMN. Our findings demonstrate that gender can be reliably predicted using rfMRI data and highlight the importance of controlling for gender in brain imaging studies.

Cytoprotection by Jun kinase during nitric oxide-induced cardiac myocyte apoptosis

Nitric oxide (NO) induces apoptosis in cardiac myocytes through an oxidant-sensitive mechanism. However, additional factors appear to modulate the exact timing and rate of NO-dependent apoptosis. In this study, we investigated the role of mitogen-activated protein kinases (MAPKs) (extracellular signal-regulated kinase [ERK] 1/2, c-Jun N-terminal kinase [JNK] 1/2, and p38MAPK) in NO-mediated apoptotic signaling. The NO donor S:-nitrosoglutathione (GSNO) induced caspase-dependent apoptosis in neonatal rat cardiac myocytes, preceded by a rapid (<10-minute) and significant (approximately 50-fold) activation of JNK1/2. Activation of JNK was cGMP dependent and was inversely related to NO concentration; it was maximal at the lowest dose of GSNO (10 micromol/L) and negligible at 1 mmol/L. NO slightly increased ERK1/2 beginning at 2 hours but did not affect p38MAPK activity. Inhibitors of ERK and p38MAPK activation did not affect cell death rates. In contrast, expression of dominant-negative JNK1 or MKK4 mutants significantly increased NO-induced apoptosis at 5 hours (56.77% and 57.37%, respectively, versus control, 40.5%), whereas MEKK1, an upstream activator of JNK, sharply reduced apoptosis in a JNK-dependent manner. Adenovirus-mediated expression of dominant-negative JNK1 both eliminated the rapid activation of JNK by NO and accelerated NO-mediated apoptosis by approximately 2 hours. These data indicate that NO activates JNK as part of a cytoprotective response, concurrent with initiation of apoptotic signaling. Early, transient activation of JNK serves both to delay and to reduce the total extent of apoptosis in cardiac myocytes.

Do infant formula samples shorten the duration of breast-feeding?

To determine whether advertising by infant formula companies shortens the duration of breast-feeding, we randomly assigned 448 breast-feeding new mothers to either receive or not receive a formula sample packet upon discharge from a maternity ward. These mother, unaware of the study, were then telephoned 3 months post partum by a research assistant blind to the randomisation status. "Sample" mothers were less likely to still be breast-feeding at 1 month (78% vs 84%, p = 0.07) and more likely to have introduced solid foods by 2 months (18% vs 10%, p = 0.01). These trends became more significant in three vulnerable subgroups: less educated mothers, primiparas, and mothers who had been ill post partum. Our results suggest that infant formula samples may shorten the duration of breast-feeding and hasten the age at which solids are introduced.

Flow cytometric characterization of the response of Fanconi's anemia cells to mitomycin C treatment

DNA flow histogram analysis, using 33342 Hoechst as a stain, has been used to detect the effect of the potentially bifunctional alkylating agent, mitomycin C (MMC) on dermal fibroblasts from patients with Fanconi's anemia (FA), a hereditary human disease characterized by pancytopenia, hypersensitivity to DNA-crosslinking agents, congenital abnormalities and a predisposition for neoplasia. At 24 or 48 hr after a 2-hr exposure to 0.05 or 0.10 micrograms/ml MMC, (3)HdT incorporation was reduced to a greater extent in FA cells than in normal cells. Cells sorted from the last half of S phase showed a slightly greater inhibition of (3)HdT incorporation than did those sorted from the first half of S. Fanconi's anemia cells exhibited a marked accumulation in the G(2) + M peak of flow histograms following exposure to MMC. Twenty-four hr after treatment with .0.5 micrograms/ml MMC, the G(2) + M fraction of FA cells (eight lines) increased to more than 0.5 from a control value of approximately 0.02. Both normals (six lines) and heterozygotes (eight lines) showed, on the average, much less of a G(2) + M increment than did FA cells, even after exposure to 0.1 micrograms/ml MMC. Examination of cells sorted from the G(2) + M peak revealed that MMC-treated FA cells were blocked prior to mitosis. To determine whether the response of FA cells was specific for bifunctional alkylating agent, cells were also treated with ethylmethanesulfonate, a monofunctional agent. Twenty-four hours after exposure to 0.25 or 0.5 mg/ml ethylmethanesulfonate, FA and normal cells showed similar, small increases in the G(2) + M peak. The results suggest the utility of flow cytometry in the diagnostic evaluation of fibroblasts from patients suspected of having Fanconi's anemia.

A Review of the Default Mode Network in Autism Spectrum Disorders and Attention Deficit Hyperactivity Disorder

Functional magnetic resonance imaging (fMRI) has been widely used to examine the relationships between brain function and phenotypic features in neurodevelopmental disorders. Techniques such as resting-state functional connectivity (FC) have enabled the identification of the primary networks of the brain. One fMRI network, in particular, the default mode network (DMN), has been implicated in social-cognitive deficits in autism spectrum disorders (ASD) and attentional deficits in attention deficit hyperactivity disorder (ADHD). Given the significant clinical and genetic overlap between ASD and ADHD, surprisingly, no reviews have compared the clinical, developmental, and genetic correlates of DMN in ASD and ADHD and here we address this knowledge gap. We find that, compared with matched controls, ASD studies show a mixed pattern of both stronger and weaker FC in the DMN and ADHD studies mostly show stronger FC. Factors such as age, intelligence quotient, medication status, and heredity affect DMN FC in both ASD and ADHD. We also note that most DMN studies make ASD versus ADHD group comparisons and fail to consider ASD+ADHD comorbidity. We conclude, by identifying areas for improvement and by discussing the importance of using transdiagnostic approaches such as the Research Domain Criteria (RDoC) to fully account for the phenotypic and genotypic heterogeneity and overlap of ASD and ADHD.

Asymmetry of fusiform structure in autism spectrum disorder: trajectory and association with symptom severity

Background

While asymmetry in the fusiform gyrus (FFG) has been reported in functional and structural studies in typically developing controls (TDC), few studies have examined FFG asymmetry in autism spectrum disorder (ASD) subjects and those studies are limited by small sample sizes, and confounded by cognitive ability or handedness. No previous work has examined FFG surface area or cortical thickness asymmetry in ASD; nor do we understand the trajectory of FFG asymmetry over time. Finally, it is not known how FFG structural asymmetry relates to ASD symptom severity.

Methods

In this study, we examined FFG volume, surface area, and cortical thickness asymmetry, as well as their cross-sectional trajectories in a large sample of right-handed males aged 7 to 25 years with 128 ASD and 127 TDC subjects using general linear models. In addition, we examined the relationship between FFG asymmetry and ASD severity using the Autism Diagnostic Observation Schedule (ADOS) and Gotham autism severity scores.

Results

Findings revealed that while group differences were evident with mean leftward asymmetry in ASD and mean near symmetry in TDC volume and surface area, asymmetry for both groups existed on a spectrum encompassing leftward and rightward asymmetry. In ASD subjects, volume asymmetry was negatively associated with ADOS and autism severity score symptom measures, with a subset of rightward asymmetric patients being most severely affected. We also observed differential trajectory of surface area asymmetry: ASD subjects exhibited a change from leftward asymmetry toward symmetry from age 7 to 25, whereas TDCs exhibited the reverse trend with a change from near symmetry toward leftward symmetry over the observed age range.

Conclusions

Abnormalities in FFG structural asymmetry are related to symptom severity in ASD and show differential developmental trajectory compared to TDC. This study is the first to note these findings. These results may have important implications for understanding the role of FFG asymmetry in ASD.

Electronic supplementary material

The online version of this article (doi:10.1186/s13229-016-0089-5) contains supplementary material, which is available to authorized users.

Inter-Method Discrepancies in Brain Volume Estimation May Drive Inconsistent Findings in Autism

Previous studies applying automatic preprocessing methods on Structural Magnetic Resonance Imaging (sMRI) report inconsistent neuroanatomical abnormalities in Autism Spectrum Disorder (ASD). In this study we investigate inter-method differences as a possible cause behind these inconsistent findings. In particular, we focus on the estimation of the following brain volumes: gray matter (GM), white matter (WM), cerebrospinal fluid (CSF), and total intra cranial volume (TIV). T1-weighted sMRIs of 417 ASD subjects and 459 typically developing controls (TDC) from the ABIDE dataset were estimated using three popular preprocessing methods: SPM, FSL, and FreeSurfer (FS). Brain volumes estimated by the three methods were correlated but had significant inter-method differences; except TIVSPM vs. TIVFS, all inter-method differences were significant. ASD vs. TDC group differences in all brain volume estimates were dependent on the method used. SPM showed that TIV, GM, and CSF volumes of ASD were larger than TDC with statistical significance, whereas FS and FSL did not show significant differences in any of the volumes; in some cases, the direction of the differences were opposite to SPM. When methods were compared with each other, they showed differential biases for autism, and several biases were larger than ASD vs. TDC differences of the respective methods. After manual inspection, we found inter-method segmentation mismatches in the cerebellum, sub-cortical structures, and inter-sulcal CSF. In addition, to validate automated TIV estimates we performed manual segmentation on a subset of subjects. Results indicate that SPM estimates are closest to manual segmentation, followed by FS while FSL estimates were significantly lower. In summary, we show that ASD vs. TDC brain volume differences are method dependent and that these inter-method discrepancies can contribute to inconsistent neuroimaging findings in general. We suggest cross-validation across methods and emphasize the need to develop better methods to increase the robustness of neuroimaging findings.

Twin pregnancy: the impact of the Higgins Nutrition Intervention Program on maternal and neonatal outcomes

Perinatal outcomes were compared between 354 twins treated with the Higgins Nutrition Intervention Program and 686 untreated twins. After differing distributions of key confounding variables were adjusted for, the twins in the intervention group weighed an average of 80 g more (P less than 0.06) than the nonintervention twins; their low-birth-weight rate was 25% lower (P less than 0.05) and their very-low-birth-weight rate was almost 50% lower (P less than 0.05). Although the rate of preterm delivery was 30% lower in the intervention group (P less than 0.05), the rates of intrauterine growth retardation were similar in the two groups. Fetal mortality was slightly higher (14 vs 12 per 1000, NS), but early neonatal mortality was fivefold lower (3 vs 19 per 1000, P less than 0.06) in the intervention group. Maternal morbidity was significantly lower (P less than 0.05) in the intervention group. There was a trend towards lower infant morbidity in the intervention group. These results suggest that nutritional intervention can significantly improve twin-pregnancy outcome.

Characterization of Face-Selective Patches in Orbitofrontal Cortex

Face processing involves a complex, multimodal brain network. While visual-perceptual face patches in posterior parts of the brain have been studied for over a decade, the existence and properties of face-selective regions in orbitofrontal cortex (OFC) is a relatively new area of research. While regions of OFC are implicated in the emotional processing of faces, this is typically interpreted as a domain-general response to affective value rather than a face- or socially-specific response. However, electrophysiology studies in monkeys have identified neurons in OFC that respond more to faces than any other stimuli. Here, we characterize the prevalence and location of OFC face-selective regions in 20 healthy college students. We did this by including another biologically motivating category (appetizing foods) in a variant of the standard face localizer. Results show that face-selective patches can be identified at the individual level. Furthermore, in both a region of interest (ROI) and a whole brain analysis, medial regions of the OFC were face-selective, while lateral regions were responsive to faces and foods, indicating a domain-general response in lateral OFC. Medial OFC (mOFC) response to faces scales in relationship to a measure of social motivation that is distinct from face processing abilities associated with fusiform cortex.

Cytogenetic and flow cytometric studies of cells from patients with Fanconi's anemia

Cells from patients wtih Fanconi's anemia are unusually sensitive to agents which are capable of crosslinking DNA. This increased sensitivity can be detected both by cytogenetic and flow cytometric methods. An elevated frequency of chromosome aberrations, which is further exaggerated by exposure of cells to DNA crosslinking agents, is a general feature of Fanconi's anemia. Information about the formation of sister chromatid exchanges in this disease is less consistent. Cytogenetic analysis of cells from patients with Fanconi's anemia can be compromised by a low mitotic index. This is reflected in an accumulation of cells In the G2 phase of the cycle, after exposure to the bifunctional alkylating agent, mitomycin C. New methods for differentiating individuals with Fanconi's anemia from unaffected individuals should be of empirical use and might also facilitate mechanistic studies of this disease.

Simultaneous reticulocyte and platelet counting on a clinical flow cytometer

Laser flow cytometric analysis is well suited to many clinical immunofluorescent and hematologic applications. One of these is automated reticulocyte and platelet enumerations. We have performed a clinical evaluation of a fluorescence laser flow cytometer reticulocyte and platelet enumeration method using the fluorochrome acridine orange. One hundred and thirty-two clinical specimens from inpatients in our comprehensive cancer center were analyzed for platelet counts and 101 samples from the same population were analyzed for reticulocyte counts by the flow cytometer and simultaneously by conventional techniques. Both the reticulocyte and platelet enumerations achieved a high degree of correlation with standard methods for the nonbone marrow-transplant patients studied (R = .989 for reticulocytes and R = .995 for platelets). Marrow transplant patients had a slightly poorer correlation coefficient for the reticulocyte enumeration (R = .923), but analysis of serial determinations of these patients' samples for reticulocyte counts revealed that results were more consistent over time with the automated method than with the traditional manual method. The laser flow cytometer fluorescence reticulocyte and platelet enumeration methods described are efficient, rapid, and reliable for platelet and reticulocyte counting.

Hemodynamic effects of molsidomine, isosorbide dinitrate, and nifedipine at rest and during exercise

In the first study the hemodynamic effects of standard doses of molsidomine (2 mg intravenously), isosorbide dinitrate (ISDN) (5 mg sublingually), and nifedipine (20 mg sublingually) were assessed at rest and under exercise conditions in a group of 30 patients with coronary heart disease. With the patients at rest both molsidomine and ISDN were associated with prompt reductions in left ventricular end-diastolic pressure and mean pulmonary artery pressure, whereas nifedipine was associated with slight reductions in left ventricular end-diastolic pressure and mean pulmonary artery pressure that did not attain statistical significance. Nifedipine and ISDN caused a decrease in mean aortic blood pressure, which resulted in a reactive increase in heart rate that was only significant with nifedipine. After administration of molsidomine, there was no significant change in mean aortic pressure at rest. There were reductions in stroke volume index and cardiac index after administration of molsidomine and ISDN. Nifedipine, however, was associated with significant increases in stroke volume index and cardiac index. None of the three test substances caused changes of contractility parameters. Under exercise conditions reductions in left ventricular end-diastolic pressure, mean pulmonary pressure, and mean aortic pressure were documented following administration of molsidomine, ISDN, and nifedipine. There were no major changes in maximum heart rate or stroke volume index during exercise with any of the three drugs. However, nifedipine was associated with a significant increase in cardiac index, whereas molsidomine and ISDN produced no major changes.(ABSTRACT TRUNCATED AT 250 WORDS)

DRGs and the "negative" trauma workup

We conducted a study to assess the financial impact of the diagnostic workup and care of 136 trauma patients admitted to our institution during a six-month period who were subsequently found to have only minor injuries (Injury Severity Score less than or equal to 9, Abbreviated Injury Score less than 3). The New Jersey DRG reimbursement system, an all-payer system, failed to provide adequate financial compensation overall, as the average loss per patient (operating cost minus reimbursement) was $508. Lost potential revenue (hospital charges minus reimbursement) was even greater, averaging $1,834 per patient. We conclude that the New Jersey DRG reimbursement system, in its current form, provides inadequate reimbursement for the system, in its current form, provides inadequate reimbursement for the proper workup and treatment of trauma patients with minor injuries. Because these patients are those most likely to help "subsidize" the care of sicker patients, changes in the system are necessary to allow hospitals to continue to provide state-of-the-art trauma care and to continue to minimize the number of preventable deaths due to trauma.

Estrogen and progesterone receptors can be maintained in normal human breast epithelial cells in primary culture and after transplantation into nude mice

The estrogen and progesterone receptor expression was determined in breast epithelial cells from reduction mammoplasty specimens. Only a subset of the luminal epithelial cell population was found to be positive for these receptors. When these cells were subsequently cultured in 3-dimensional collagen gel system (in vitro model) or transplanted into nude mice (in vivo model), the cells retained their ability to express both receptors in these experimental systems. The maintenance of primary normal human breast epithelial cells expressing the estrogen and progesterone receptors in experimental systems has not been reported previously.

Utilizing student-led contact tracing initiative to alleviate COVID-19 disease burden in central Pennsylvania

PURPOSE

Contact tracing elicits probable contacts from COVID-19 cases. Our student-led contact tracing initiative promoted isolation of both confirmed and probable cases and quarantine of contacts to reduce disease in Central Pennsylvania.

METHODS

Close contacts of COVID-19 cases were contacted by tracers, advised to quarantine, and monitored for 14 days for symptoms. Symptomatic contacts were classified as probable cases and advised to isolate. Data was collected from March 24, 2020 to May 26, 2020. Poisson regression and linear regression were utilized to examine the relationships between case and number of contacts and proportion of symptomatic contacts.

RESULTS

Study sample comprised of 346 confirmed and 157 probable cases. Our results indicate a significant difference in percent of household contacts who became symptomatic between confirmed and probable cases (22% vs. 3%; adjusted P<.01). Similarly, probable cases had significantly fewer non-household contacts compared to confirmed cases (0.87 vs. 0.55; adjusted P<.01).

CONCLUSIONS

Timely notification of exposure to a COVID-19 positive individual by student contact tracers allowed for probable cases to quarantine early in the disease process. Our data suggests that early quarantine and/or isolation may have directly contributed to probable cases having fewer non-household contacts and a smaller proportion of symptomatic household-contacts compared to confirmed cases.

Adeno-associated virus vector mediated transduction of primary normal human breast epithelial cells

Cultured human breast epithelial cells from reduction mammoplasty specimens were transduced using an adeno-associated virus vector encoding the marker gene E. coli -galactosidase. Subconfluent, growing, breast epithelial cells were more easily transduced than confluent, quiescent, cells. Transduction of non-dividing confluent cells could be greatly increased by ultraviolet light-induced DNA damage or by prior exposure to the DNA synthesis inhibitor hydroxyurea. The effects of ultraviolet light and hydroxyurea on transduction were additive when these agents were applied together.

Rapid accurate absolute granulocyte count determination during severe leukopenia using the flow cytometer

The absolute granulocyte count (AGC) in 125 blood samples from patients with total white blood cell counts of less than 1,000/microliter was estimated using three different methods, which were then compared for efficiency and accuracy. The three methods were 25 cell differential counts using Wright's-stained blood smears, granulocyte percentage estimates from WBC counting chambers, and combined narrow- and wide-angle light-scatter characteristics determined on a flow cytometer. A survey of clinical laboratories at University Hospital Cancer Centers revealed that the smear differential was the most-often-used method in those laboratories even when less than 25 cells could be counted. Consequently the data obtained from the counting chamber and flow cytometer methods were compared to the smear differential "standard" using linear regression, and outliers were identified. There was good correlation between AGC determined by smear differential and WBC counting chamber (correlation coefficient .911) and excellent correlation between the AGC determined by smear differential and the flow cytometer method (correlation coefficient .970). The flow cytometer method used in this investigation required minimal specimen preparation, and test results were available at a rate of 60 seconds/sample. The ease of sample preparation, speed, and statistical reliability of test results makes the flow cytometer an attractive alternate method of determining granulocyte counts on leukopenic patients as compared to the stained blood smear differential.

Effect of a methylxanthine preparation in the form of a retention enema on pulmonary function and theophylline levels in patients with acute bronchospasm

The goal of the current study was to determine whether administration of a methylxanthine preparation in the form of a retention enema (theophylline-diprophylline-proxyphylline combination, Neobiphyllin-Clys) has an effect similar to that of intravenous theophylline in the treatment of acute bronchospasm. In a randomized cross-over study 16 patients with a history of asthma were given 0.48 g of theophylline-ethylenediamine (TE) in the form of rapid intravenous infusion or a retention enema containing 400 mg theophylline, 600 mg diprophylline and 600 mg proxyphylline (TDP). Forced expiratory volume in the first second (FEV1) airways resistance (Rt) and serum theophylline levels were determined before administration of the drug and at 15 min, 30 min and hourly for a period of 6 h after administration of the medication. The results were significant at the 5% level. There were significant increases in serum theophylline levels with both TE and TDP. After administration of TE there were significant changes in FEV1 at 15 min and Rt at 30 min which persisted for 5 h after administration of the drug. Statistically significant differences in FEV1 were observed 60 min and in Rt 30 min after administration of TDP. These effects persisted for 6 h. The data document that a retention enema offers the advantage of prolonged action in comparison to intravenous infusion of theophylline in the treatment of acute bronchospasm.

Persistent craniopharyngeal canal with an associated sphenoid sinus fistula

Persistent craniopharyngeal canal (PCC) is a rare congenital anomaly that appears as a linear well-corticated canal running from the sella through the clivus and into the nasopharynx. Case reports of this anomaly have shown it is associated with a range of craniofacial defects, pituitary abnormalities, and meningoencephaloceles. It predisposes patients to bacterial meningitis. In this case a 46-year-old gentleman presenting for preoperative planning for surgical drainage of Potts Puffy tumor was found to have a PCC on CT and MRI. Imaging also demonstrated the presence of chronic inflammation and a fistula extending from the tract into the sphenoid sinus. This unusual presentation of a PCC with a sphenoid sinus fistula broadens the potential clinical presentations of PCC and further emphasizes the ability of this anomaly to serve as a conduit for CNS infection.

Beware of contaminating mouse cells in human xenografts from nude mice

Human tumor xenografts in nude mice are widely utilized model system for the transplantation of human surgical specimens and human established cell lines. Gene expression studies are often carried out in these model systems. With an increasing use of PCR based analyses, the extreme sensitivity of this technique poses a serious challenge with regards to the extent of contaminating host mouse cells in the human tumor xenografts. These xenografts are never free of host cell contamination. We detected mouse estrogen receptor expression in several human tumor xenografts using RT-PCR demonstrating that precaution is necessary when utilizing PCR based analyses in human tumor xenografts. A cytologically based methodology which distinguishes human versus mouse cells will be more suitable for ER expression studies using human xenograft models. Both (1) in situ hybridization using human probe and (2) immunocytochemistry using a monoclonal antibody directed against human cytokeratin have been used successfully to distinguish human cells versus host mouse cells in human xenografts in nude mice. Immunostaining of ER can then be utilized to determine the expression pattern of ER in the transplanted human cells.