Measurement sensitivity analysis and on-orbit calibration of systematic errors for a narrow field-of-view camera

Narrow field-of-view (FOV) cameras enable long-range observations and have been often used in deep space exploration missions. To solve the problem of systematic error calibration for a narrow FOV camera, the sensitivity of the camera systematic errors to the angle between the stars is analyzed theoretically, based on a measurement system for observing the angle between stars. In addition, the systematic errors for a narrow FOV camera are classified into "Non-attitude Errors" and "Attitude Errors". Furthermore, the on-orbit calibration methods for the two types of errors are researched. Simulations show that the proposed method is more effective in the on-orbit calibration of systematic errors for a narrow FOV camera than the traditional calibration methods.

Primary Malignant Peripheral Nerve Sheath Tumor of the Breast: A Rare Case Report

Introduction/Objective

Primary breast sarcomas are uncommon and primary mammary malignant peripheral nerve sheet tumors (MPNST) are exceptionally rare. MPNST’s are malignant variants of peripheral nerve sheath tumors. These neoplasms are often associated neurofibromatosis type I (NF-I) but can also occur sporadically. They tend to occur in the deeper soft tissues, trunk, and extremities.

Methods/Case Report

A 60-year-old female was referred to our University Hospital for evaluation of an abnormal mammogram. Patient noticed a mass in the left breast 3 months ago and mammogram showed a large solid mass located at the left superior breast. Subsequent biopsy of the left breast lesion showed high grade malignant neoplasm with differential diagnosis of malignant phyllodes tumor, primary sarcoma, and metaplastic carcinoma. The tumor was non-responsive to the initial neoadjuvant therapy. The patient underwent modified radical mastectomy. The excised tumor was well-circumscribed, tan-white, firm, measuring 9.6 x 6.1 x 4.3 cm. The neoplastic cells were positive for CD99, S-100, SOX-10, neuron specific enolase, p53, Vimentin, focally positive for neurofilament, D2-40, p63, and negative for epithelial, melanoma and other sarcoma markers. The tumor was triple negative ER, PR, HER-2, with Ki- 67 at 61%. A diagnosis of primary high grade malignant peripheral nerve sheath tumor of the breast was rendered. The patient does not have a history of NF-1. There was no lympho-vascular or perineural invasion. After the surgery, the patient followed up without complications.

Results (if a Case Study enter NA)

N/A

Conclusion

An accurate diagnosis of this rare entity is necessary because it plays a crucial role in the therapeutic options and prognosis. In our case the patient was treated with neo-adjuvant chemotherapy followed by modified radical mastectomy. The purpose of presenting this unique case is to provide awareness of the existence of this entity among pathologists and clinicians for better patient care.

Primary Chronic Myelogenous Leukemia Blast Crisis with Precursor B Lymphoblastic Leukemia, a Case Report

Introduction/Objective

Primary chronic myelogenous leukemia (CML) blast crisis at the initial disease presentation is rare. Most CML blast crisis cases present with increased myeloblasts with a minority of patients showing lymphoblastic leukemia. Differentiating primary CML lymphoblast crisis from de novo acute lymphoblastic leukemia may represent a diagnostic challenge to both pathologists and treating clinicians. This distinction is important as it has significant implications on patient management.

Methods/Case Report

A 15-year-old male patient was admitted to our University Hospital for hyperleukocytosis. Patient reportedly had weight loss with occasional sweats and cervical lymphadenopathy. She was found to have massive splenomegaly. Peripheral blood showed hyperleukocytosis with predominance of granulocytes at all maturation stages ranging from blast to segmented neutrophils with increased blasts. Subsequent bone marrow findings were consistent with extensive involvement by B-lymphoblastic leukemia. Ten-color Flow cytometry showed approximately 30% blasts with rare lymphocytes and monocytes. The blasts revealed precursor B-lymphoblastic immunophenotypic expression of CD45, CD10, CD19, CD20, CD22, CD34, CD38, CD200, HLA-DR and TdT expression. The results were similar to that of peripheral blood. Granulocytes showed abnormal maturation pattern with increased immature precursors and partial expression of CD4 and CD56 with no abnormalities detected in lymphocytes. In this case, while the bone marrow findings are consistent with B-lymphoblastic leukemia, the peripheral blood findings are consistent with blast phase of chronic myeloid leukemia. Further evaluation by cytogenetic and molecular studies confirmed the presence of Philadelphia chromosome, p210 transcripts, and rearrangement of BCR-ABL1, which supported the impression of precursor B-lymphoblastic leukemia in primary blast phase of CML. The patient was treated with tyrosine kinase inhibitor combined chemotherapy and went into remission. She has been followed up without significant complications for a year.

Results (if a Case Study enter NA)

NA.

Conclusion

The diagnosis of CML in primary lymphoblastic crisis is rare and needs to be systemically excluded before giving the diagnosis of de novo BCR-ABL1-positive acute lymphoblastic leukemia. If the patient does not have splenomegaly or previous leukocytosis, it needs cytological examination and extensive molecular analyses.

Endometrial Serous Adenocarcinoma with Septate Uterus: A Rare Case Report

Introduction/Objective

Congenital structural malformations of the uterus rarely coincide with uterine malignancies and can cause significant challenges to the detection of tumors originating from the uterine cavity. We report a case of delayed diagnosis of endometrial high-grade serous adenocarcinoma following an initial false-negative endometrial biopsy result. A septate uterus was discovered incidentally upon gross dissection, and it was recognized as the cause of the initial false-negative biopsy result. Exceptionally rare cases of uterine malformation combined with carcinoma have been reported in the literature and we are sharing this case to provide further awareness of such clinical scenario.

Methods/Case Report

A 67- year-old multigravida (G3P2103) female presented with postmenopausal bleeding. Initially, the patient underwent an endometrial biopsy revealing strips of benign glandular epithelium. Three months later endometrial biopsy showed high-grade serous carcinoma. A computed tomography scan (CT) of the abdomen and pelvis showed expanded and heterogeneously hypodense endometrium. The patient underwent a total abdominal hysterectomy and bilateral salpingo-oophorectomy. Gross examination of the specimen revealed a septate uterus with two cavities. Within the right cavity, there was an infiltrating polypoid mass and a superficial benign-appearing endometrial polyp was identified in the left cavity. After histologic examination of the right cavity mass, a diagnosis of endometrial high-grade serous adenocarcinoma was rendered.

Results (if a Case Study enter NA)

N/A

Conclusion

Congenital structural malformations of the uterus carry a higher risk of delayed or missed uterine cancer diagnosis. Septate uterus is associated with a higher chance of failed endometrial biopsy and can result in a false- negative outcome. The use of hysteroscopy, hysterosonography, and three-dimensional ultrasound could improve the diagnostic modality of malignant uterine tumors associated with structural malformations.

Sporadic Uterine Cervical Angiomyolipoma with Concurrent Endometrial Adenocarcinoma

Introduction/Objective

Angiomyolipoma is a benign mesenchymal neoplasm composed of variable admixture of thick dysmorphic blood vessels, smooth muscle cells, and fat cells that commonly arises in the kidney. It is strongly associated with tuberous sclerosis but it can also occur as sporadic. Extra renal angiomyolipomas have been reported with the liver being the most common location. Few cases of angiomyolipoma in the female genital have been reported where the uterus being the most common site. Uterine cervical angiomyolipoma has rarely been reported.

Methods/Case Report

We reported a case of 64-year-old white female with postmenopausal bleeding. Endometrial biopsy revealed endometrioid type endometrial adenocarcinoma. MRI showed endometrium was thickened, and the cervix was enlarged with disruption of the cervical fibrous stroma on the anterior surface concerning for cervical stromal invasion. Grossly, besides the polypoid mass that involved the endometrial cavity, there was a firm nodule with whorled cut surface noted on the anterior surface of the cervix.

Microscopic examination of the cervical nodule revealed a classic variant of angiomyolipoma with mature adipocytes, spindle shaped smooth myocytes and anomalous thick-walled blood vessels with hyalinization. The spindle cells were positive for smooth muscle actin and caldesmon. CD34 highlighted the thick walled blood vessels. The stain for HMB- 45 was negative in contrast to renal counterpart. These findings are consistent with cervical angiomyolipoma. In addition, there was endometrioid endometrial adenocarcinoma, FIGO grade 1, with microsatellite stable phenotype, with only superficial invasion of myometrium, without involvement of cervical stroma.

Results (if a Case Study enter NA)

NA

Conclusion

This is a rare and probably the only presentation of cervical angiomyolipoma concurrently occurring with endometrial adenocarcinoma. It is uncertain if these two disease entities have genetic or pathogenesis association. The imaging studies were very concerning for cervical stromal invasion or questionable cervical cancer with local invasion. Cervical angiomyolipomas, though, extremely rare, may also be included in dysfunctional uterine bleeding differential diagnosis.

Blinatumomab resistant clone presenting as mixed phenotype myeloid sarcoma causing cord compression

Introduction/Objective

Blinatumomab is a monoclonal antibody directed against CD19/CD3 utilized for the treatment of relapsed or refractory B-cell precursor acute lymphoblastic leukemia (ALL) and for the treatment of B-cell precursor ALL in first or second complete remission with minimal residual disease (MRD) ≥0.1%. Although Blinatumomab treatment has shown better overall survival, progression-free survival, and complete remission when compared to chemotherapy, most patients have a relapse and ultimately succumb to the disease. Interestingly, there are a number of cases reporting relapse in extramedullary places. The mechanisms for relapse in these unusual extramedullary sites are not well-understood. We herein report a case of a 20-year-old African American male with primary refractory Philadelphia-negative (Ph-) precursor B cell ALL with MLL rearrangement, who received treatment with Blinatumomab after achieving morphological remission with a pediatric-inspired regimen but found to be MRD +.

Methods/Case Report

A 20 year old African American male was found to have B cell precursor ALL. It was found to be Ph-. While initally receiving vincristine, prednisone, and aspariginase, the ALL proved to be refractory to treatment. Blinatumomab was used as second line therapy after the first failed remission. The patient remained with morphological response; however, remained MRD+ after three cycles of Blinatumomab. During the fourth cycle, the patient presented with back pain and lower extremity weakness. A spine MRI revealed an extradural mass in the thoracic spine causing cord compression. A thoracic laminectomy with partial removal of the mass, followed by radiation, was performed with improvement of symptoms. Pathology results of the extradural mass revealed a myeloid sarcoma with MLL rearrangement.

Results (if a Case Study enter NA)

NA

Conclusion

This case report demonstrates how patients treated with blinatumomab can have relapse in unusual extramedullary places. The possibility of leukemia manifesting in extramedullary sites should always be kept in mind by clinicians treating patients with Blinatumomab. The mechanisms of resistance against Blinatumomab are not well- understood and need further elucidation.

Four PAX5 Negative Nodular Sclerosing Hodgkins Lymphoma Case Series

Introduction/Objective

Hodgkins lymphoma is a B cell lymphoproliferative disease, with most cases showing PAX5 positivity. Very few PAX5 negative hodgkins lymphoma cases have been described. We describe four PAX5 negative nodular sclerosing hodgkins lymphoma cases. All received standard chemotherapy, three received additional chemotherapeutic agents. Exploring these rare cases can be invaluable in characterizing and later treating his atypical presentation.

Methods/Case Report

Four cases of Hodgkins Lymphoma were diagnosed between 2017 and 2020. Two males and two females between 31 and 80 year old. Case 1 was a 31 year old male with a left neck lymphadenopathy that revealed nodular sclerosing Hodgkins lymphoma without bone marrow involvement. IHC staining revealed CD15, CD30, fascin and MUM-1 positivity, and PAX5 negativity. He received Doxorubicin, Vinblastine, Dacarbazine (AVD) and Brentuximab with radiation, and later brentuximab with bendamutine. Follow up PET-CT and left axillary node excisional biopsy found nodular sclerosing classic hodgkins. He received Ifosfamide, Carboplatin, and Etoposide.

Case 2 was a 37 year old male with bilateral mediastinal lymphadenopathy that demonstrated nodular sclerosing Hodgkins lymphoma on biopsy. The cells were CD15, CD30 positive, and PAX5 negative. He received AVD with bleomycin (ABVD), and field radiation with excellent response and is currently under surveillance. Case 3 was a 31 year old female with a left chest mass that demonstrated nodular sclerosing Hodgkins lymphoma. The cells were positive for MUM1, CD30 and fascin and negatively for CD15 and PAX5. She received ABVD. Case 4 was an 80 year old female with prior stage IV gastric diffuse large B cell lymphoma treated with Rituximab, Cyclophophamide, Vincristine, and Prednisone and achieved remission. She later developed neck masses that were biopsied revealing classic Hodgkins lymphoma. The cells stained for CD30, for CD15, and were negative for PAX5. She was started on AVD and is on palliative care.

Results (if a Case Study enter NA)

NA

Conclusion

Most hodgkins lymphomas are PAX5 positive. We found four cases of PAX5 negative Hodgkins lymphoma. Incidentally, all were of the nodular sclerosing subtype. All cases were treated with recommended chemotherapy and/or radiation. All four cases had good response with reduction in disease burden. This finding suggests that PAX5 negativity still allows the nodular sclerosing hodgkins lymphoma to be responsive to standard treatment modalties.

Toxic Adenoma Mimicking Papillary Thyroid Carcinoma

Introduction/Objective

A thyroid nodule requires multiple steps in the identification of its nature, which determines its management. In most cases, low TSH levels support a benign origin. However, examples of hyperfunctioning thyroid carcinoma have been reported. Recent observations show that the number of thyroid cancer increases with the prevalence in young patients. The ambiguity of some cases necessitates the use of a full range of diagnostic methods up to molecular cytological diagnostics.

Methods

We present a report on the case of an 11-year-old boy complaining of weight loss despite having a good appetite.

Results

The blood test showed free T4 1.51 (0.81 - 1.35 ng/dL), free T3 6.04 (3.31 - 4.88 pg/mL), and TSH 0.01 (0.662 - 3.90 mU/L). During sonography, the left thyroid lobe was almost completely replaced by an isoechogenic circumscribed mass with multiple colloid cystic spaces. No suspicious microcalcifications or abnormal cervical lymph nodes were identified. A thyroid scan revealed the presence of a toxic autonomously functioning thyroid nodule in the left lobe. Methimazole and propranolol were prescribed, with subsequent left hemithyroidectomy on 10/21/2019.

Grossly, the left thyroid lobe was 3.4 x 2.5 x 2 cm. The sectioning revealed light brown homogeneous stroma with a well-defined yellow-tan nodule (1.1 x 1.1 x 1 cm) in the middle of the lobe. The specimen was entirely submitted for permanent fixation in formalin. Microscopically, an encapsulated nodule was seen with the follicular and focal papillary pattern; nuclear features strongly and multifocally suggested a diagnosis of papillary carcinoma. HBME1 and calcitonin immunostains were negative; CK19 immunostain was multifocally positive. Next-generation sequencing supported the diagnosis of toxic adenoma with atypical features.

Conclusion

Every case of thyroid neoplasm should be fully investigated using modern and high-tech technologies, regardless of the functioning state of the gland. Molecular testing is supportive, especially in ambiguous situations, which benefits the patient.

Nodular Lymphocyte Predominant Hodgkin Lymphoma: A Rare Case with Fan Pattern E

Introduction/Objective

Growth patterns of nodular lymphocyte predominant Hogdkin lymphoma (NLPHL) has been further described by Fan et all. Pattern E is T cell/histiocyte rich large B-cell lymphoma-like and is quite rare. The treatment usually may follow large B cell lymphoma protocol instead of Hodgkin lymphoma regimen.

Methods

Here we report a patient with NLPHL pattern E. Patient was a 25 years-old African American man who initially presented with generalized lymphadenopathy.

Results

Biopsy of the axillary lymph node revealed effaced lymph node architecture by a malignant neoplasm in a diffuse and vaguely nodular pattern. In the background of a diffuse infiltrate, there were small to medium sized lymphocytes, numerous atypical large cells with irregular, basophilic nucleoli, and variable cytoplasm. The large cells focally sheeted out. Many histiocytes were also seen in the background. The large atypical cells were positive for CD20, BOB-1, OCT2, BCL-2 (focally), BCL-6, PAX5, and MUM-1, and IgD, whereas negative for BCL-1, CD10, CD15, CD30. CD2, CD3, CD4, CD5, CD7, CD8 highlighted numerous T cells with mild cytological atypia, forming rosettes around the large atypical cells. T cells were negative for ALK-1, CD1a, TdT with increased Ki-67 proliferation index around 35%. Although the surrounding T cells appear atypical in morphology, flow cytometric analysis showed predominantly reactive T-cells with no loss of T-cell associated antigens. PCR analysis showed a producible peak in a single IgH reaction. However, the fragment size of the peak observed did not meet the criteria. T-cell gene rearrangement by TCR gamma and TCR beta PCR was negative for monoclonal T-cells. BCL-1, BCL-2, and BCL-6 FISH panel were negative for gene rearrangements. Based on these findings the diagnosis was made at stage IV. Patient started treatment with R-CHOP therapy with subsequent relapse. Patient has been placed on RICE chemotherapy with partial response.

Conclusion

NLPHL Pattern E type should be differentiated from classical Hodgkin lymphoma, diffuse large B-cell lymphoma and peripheral T cell lymphoma because the treatment greatly differs from those with higher stage and tendency for recurrence. It is the pathologist role to lead the clinician and render a correct histopathologic diagnosis.

Genomic Analysis Identifies Rare ALK Positive Cases In The TCGA Database

Introduction/Objective

The anaplastic lymphoma kinase (ALK) gene is a receptor tyrosine kinase gene located in the 2p23.2 region. Normally, dimerization of ALK receptor by binding to its ligand activates the ALK receptor by autophosphorylation of c-termius and activates downstream PI3K, MAPK and JAK3 pathways. The ALK gene is abnormally hyperactivated by fusion of the 3’ half containing the kinase domain with 5’ portion of other genes, resulting in the ligand independent dimerization and activation of the ALK receptor. The tumors harboring these translocations are termed as ALK-positive tumors and can be treated with ALK inhibitors.

Methods

We analyzed the status of clinically relevant ALK fusion driver mutations in 230 different cancer studies, containing tumors from 79222 different individuals, in The Cancer Genome Atlas database (TCGA) using the cbioportal web browser.

Results

We observed that, as expected ALK-positive mutations are predominantly present in NSCLC, with EML4- ALK being the most common. In addition, we were able to identify ALK positive mutations in colorectal carcinomas, papillary thyroid carcinomas, papillary renal cell carcinomas, sarcomas and invasive ductal carcinomas of the breast. Most important, our analysis identified extremely rare ALK positive cases in salivary duct carcinomas, urothelial carcinomas, cutaneous melanomas and prostatic adenocarcinomas.

Conclusion

Our analysis identified ALK positive cases were predominant in adenocarcinoma of lung with EML4-ALK being the most common ALK positive mutation, which is also consistent with the literature. However, the ALK positive mutations were at a lower prevalence rate than that described in the literature. We attribute the lower prevalence rate to underrepresentation of the Asian population in the TCGA database. In addition, we identified extremely rare ALK positive cases in salivary duct carcinomas, melanomas and prostate cancers, thus highlighting the need for testing for these mutations in these cancers.

Establishing Adrenocortical Carcinoma Specific Prognostic Genes Signature

Introduction/Objective

Adrenal Cortical Carcinoma (ACC) is a rare malignant neoplasms originating from adrenal cortical tissue with an annual incidence rate of 1 to 2 cases per million individuals. These tumors have poor prognosis with 5-year disease free survival being 30% after complete resection in Stage I to Stage III patients. Hence, there is a need for identifying prognostic markers for effective management of disease in these patients.

Methods

We analyzed the data in The Cancer Genome Atlas of 1141 ACC individuals, using cbioportal.org, a web- based platform for analysis of large-scale cancer genomics data sets, and derived correlation between prognosis and genetic alterations in approximately 51,309 genes.

Results

We identified 15 signature genes (NOTCH1, TP53, ZNRF3, LRP1, KIF5A, MDM2, LETMD1, MTOR, NOTCH3, RERE, SMARCC2, LDLR, HRNR, AVPR1A and PCDH15), alterations in which indicated a poor prognosis for ACC individuals. Analysis of 15 signature genes demonstrated that disease specific median survival for the patients with ACC, was reduced to 39.5 months (p value < 8 x 10 -9 and sensitivity of 93%) when any one or more of these genes was altered. Whereas, disease specific median survival was greater than 180 months (90% survival being 180 months) with no alteration in our signature genes. In addition, our analysis of our signature genes demonstrates reduced overall survival, disease free survival and progression free survival in individuals having alterations in our signature genes. Moreover, our set of 15 genes belonged mainly to MDM2-TP53, NOTCH and mTOR pathways, and small molecule modulators of these pathways are in process of development.

Conclusion

Our 15 gene signature was not only able to predict poor prognosis in ACC, but also has the potential to serve as a molecular marker set for initiation of NOTCH and mTOR specific targeted therapies in these patients.

Frequent Mutations in p53, CDKN2A, PTEN Genes in Lung Squamous Cell Carcinoma: A Next Generation Sequencing Study

Introduction/Objective

Targeted therapies have been successfully used for the treatment of lung adenocarcinoma but have not been implemented in the treatment of lung squamous cell carcinoma (SqCC). In order to better understand the underlying biology of SqCC, we present comprehensive Next Generation Sequencing (NGS) data via Cancerplex from SqCC. We have observed frequent mutations in p53, CDKN2A, PTEN, CDKN2B, and TGFBR2 genes together with few new rare gene mutations.

Methods

Twenty-one patients with diagnosis of Lung SqCC have been selected for Cancerplex assay (Kew, Inc., Waltham, MA). Formalin-fixed tissues from these patients were used for the assay. Neoplastic tissues with tumor content higher than 20% were micro-dissected from the blocks and NGS was performed with at least 50 ng DNA content and with a limit of detection of 10% mutant alleles. The depth of coverage was 500, and the size of the targeted region was 2.8 Mb. Results were compared with published databases.

Results

We have observed p53 mutations in 100% cases. p53 gene mutations included single point mutations with various coding protein mutations as well as splice variants. Mutations in CDKN2A is found in 47.6% of cases; PTEN mutations in 33.3% of cases; CDKN2B mutations in 28.6% of cases, and TGFBR2 in 28.6% of cases, which has been reported as actionable variants and actionable copy number variants.

Conclusion

Previous literatures have provided evidence that SqCC arising in different anatomical sites share common genomic mutation patterns. Our data partially supports this finding. We demonstrated p53, CDKN2A and PTEN are among the most commonly mutated genes in lung SqCC, while a few other genes mutations does not fit in this pattern. Apparently more studies need to be done to provide a more clear genetic landscape of SqCC, which would facilitate the development of targeted therapies.

Accuracy of the Criteria for Hemophagocytic Lymphohistiocytosis

Introduction/Objective

Regular assessment and analysis of diagnostic criteria for any type of human pathology is a prerequisite for ensuring the highest level of patient care. Hemophagocytic lymphohistiocytosis, also known as hemophagocytic syndrome, is a life-threatening condition. The syndrome can develop in critically ill patients with malignancies, severe infections, during chemotherapy, and may be associated with currently known genetic abnormalities, but this list is incomplete.

We draw attention to the accuracy of diagnostic criteria, association with a variety of clinical conditions, pathophysiological mechanisms, and outcomes of the disease.

Methods

From the medical records in our hospital, we were able to extract several cases over a 10-year period. Based on hemophagocytosis features, our list included 13 patients representing 11 bone marrow aspirates, 4 lymph node biopsies, 1 liver biopsy, and 1 spleen sample; repeated examination of the slides confirmed the accuracy.

Analyzing medical documentation, we evaluated the sequence and competence of the criteria used, the time required for diagnosis, management, and outcomes.

Results

We found that not all criteria were used for diagnosis, and the most sensitive and specific tests were bypassed. The preliminary diagnosis was made by a consultant (a rheumatologist or an oncologist-hematologist) on the 5th day of the hospital stay that delayed treatment. Of all the available treatment options, only a few were used.

Conclusion

The hemophagocytic syndrome is a very rare and fatal entity, it requires highly sensitive and specific diagnostic criteria for prompt diagnosis, targeted management, and thorough follow up. Every patient admitted to the hospital with a life-threatening condition should be suspected and tested for hemophagocytic syndrome on the first day. The criteria for hemophagocytic lymphohistiocytosis should be revised, with the most sensitive and specific ones are done in 100% of cases. Subsequently, each patient should be tested for the presence of genetic abnormalities that correlate with the syndrome.

A Twenty-Four-Year-Old Woman with Left Flank Lipoma-Like Hibernoma

A 24-year-old woman presented with a 5-month history of a left flank mass that was painful on palpation. Magnetic resonance imaging revealed a 10.0 × 6.0 × 2.5 cm mass consistent with lipoma. A fatty lobulated mass was excised and subjected to H&E staining and immunohistochemical analyses. The specimen consisted of mature univacuolated adipocytic cells, with intermixed multivacuolated eosinophilic granular cells. No atypia or hyperchromasia was identified. Most of the cells were S100 positive and Ki-67 immunonegative. A diagnosis of a lipoma-like hibernoma was rendered. Hibernomas are rare benign lipomatous tumors that show differentiation toward brown fat. The lipoma-like hibernoma subtype is rare and can be misdiagnosed as atypical lipoma or well-differentiated liposarcoma. Here we describe an example of this rare tumor.

Involvement of cysteinyl leukotriene receptors in angiogenesis in rat thoracic aortic rings

Cysteinyl leukotrienes (CysLTs) are potent inflammatory mediators that induce inflammation through the activation of CysLT1 and CysLT2 receptors. It has been reported that inflammatory mediators, such as prostaglandins, play an important role in angiogenesis. However, whether CysLTs and the receptor subtypes are involved in angiogenesis is not clarified. Here, we determined the effects of CysLT receptor agonist leukotriene D4 (LTD4) and antagonists on angiogenesis by rat thoracic aortic ring assay. We found that the microvessel growth in 25% serum-containing cultures was significantly inhibited by the CysLT1 receptor antagonist montelukast (0.1-1 microM), but not by the CysLT2 receptor antagonist BAY cyslt2 (0.1-1 microM). The microvessel growth in serum-free culture was affected neither by montelukast (0.01-1 microM) nor by BAY cyslt2 (0.1-1 microM). Furthermore, LTD4 at 100 nM significantly enhanced the microvessel growth in serum-free culture and LTD4 at 10-100 nM significantly enhanced the microvessel growth in 25% serum-containing cultures. The enhancement was abrogated by both montelukast and BAY cyslt2. Thus, CysLT1 receptors may mediate endogenously regulated microvessel growth in normal culture; whereas the exogenous agonist LTD4 induces angiogenesis through the activation of both CysLT1 and CysLT2 receptors. The CysLT receptor antagonists can be developed as angiogenesis inhibitors.

Corticotropin-releasing hormone triggers differentiation in HaCaT keratinocytes

BACKGROUND

Corticotropin-releasing hormone (CRH) is proposed to be involved in the regulation of the proliferative capacity of keratinocytes, based on its significant actions in the skin. These are mediated by CRH-R1alpha and represented by adenylate cyclase activation, Ca2+ influx, inhibition of cell proliferation and modifications in intracellular signal transduction by NF-kappaB.

OBJECTIVES

To define CRH action in the cell cycle we investigated its effects on the differentiation programme using the HaCaT keratinocytes model.

METHODS

HaCaT keratinocytes were incubated with CRH in Dulbecco's modified Eagles's medium (containing 1.8 mmol L(-1) calcium) or EpiLife (containing 0.06 mmol L(-1) calcium) medium. Cell proliferation was assessed with the MTT assay. Flow cytometry was used for the measurement of DNA content, cell size and granularity and the expression of cytokeratin 14, cytokeratin 1 and involucrin. The electrophoretic mobility shift assay was used to determine DNA binding activity by AP-1 transcription factor. Expression of cytokeratin 1 was also assessed with immunofluorescence microscopy.

RESULTS

CRH did produce inhibition of proliferation, which was dose-dependent; the shape of the inhibition curve was determined by the media calcium concentration. CRH action was pinpointed at inhibition of the G0/1 to the S phase transition of the cell cycle. CRH also increased AP-1 binding activity, cell granularity, cytokeratin 1 and involucrin expression, and inhibited cytokeratin 14 expression.

CONCLUSIONS

These results are consistent with CRH induction of the keratinocyte differentiation programme. Thus, the overall CRH cutaneous actions connote protective functions for the epidermis, that appear to include the triggering or acceleration of the differentiation programme.

Maltreatment of boys and the development of disruptive and delinquent behavior

Data from a longitudinal, inner-city community sample were used to examine the prevalence of child maltreatment in males and to relate this to disruptive and delinquent child behavior. By age 18 years, almost one fourth of the families had been referred to Children and Youth Services (CYS). Investigation by the CYS resulted in substantiated maltreatment of 10% of the participants, mostly for physical abuse and neglect. Almost all maltreatment was perpetrated by people living in the same house as the victim. Maltreatment was related to the boys progressing on three pathways in disruptive and delinquent behavior: authority conflict pathway, overt pathway, and covert pathway. Two thirds of the victims showed authority conflict problems, and almost all of the maltreated boys displayed behaviors characteristic of the overt and covert pathways. Victims, compared to matched controls, were more likely to have engaged in behaviors characteristic of the authority conflict and the overt pathways but less strongly engaged in behaviors associated with the covert pathway. Victims were also more likely than controls to have a referral to juvenile court. Most of the CYS contact tended to precede or co-occur with onset of overt and covert problem behavior, but about half of the onset of authority conflict behaviors tended to precede contact with CYS.

Family-based association test method: age of onset traits and covariates

We apply different family-based association test (FBAT) statistics for age of onset traits to the Genetics Analysis Workshop 12, problem 2 data. To evaluate different FBAT statistics we used the software package FBAT, which allows one to evaluate any test statistic that can be expressed as the sum of products between an arbitrary function of an offspring's genotype with an arbitrary function of the offspring's phenotype even if there are missing parental information. For single nucleotide polymorphisms (SNPs) in gene 1, our age-of-onset FBAT test based on the exponential model is significantly more powerful than the test by Mokliatchouk et al. [Hum Hered 51:46-53, 2000], which is based on the Cox model. We suggest incorporating covariates into FBAT statistics by replacing the trait values by their regression residuals. For the age of onset trait statistics we find that deviance residuals have much more power than "plain" martingale residuals. We discuss why for SNPs in gene 1, the usual affectation status trait, which underlies the transmission disequilibrium test (TDT), has higher power than the age-of-onset trait. We find only weak evidence (p = 0.0002) that marker D06G032 is associated with the affectation status.

Murine phosphatidylserine-specific phospholipase A1 (Ps-pla1) maps to chromosome 16 but is distinct from the lpd (lipid defect) locus

We have previously generated a mouse transgenic line with an insertional mutation designated lpd that demonstrates a phenotype of hypertriglyceridemia and fatty liver. Since the recently identified phosphatidylserine-specific phospholipase A1 (PS-PLA1) demonstrates significant homology to triglyceride lipases, we reasoned that the mouse Ps-plaI gene may be the disrupted gene within the lpd locus. Using a rat PS-PLA1 cDNA sequence to search the EST database, we identified a mouse EST homolog AA839424. Sequencing analysis of AA839424 revealed a putative Ps-pla1 protein of 456 amino acids with extensive overall structural conservation with human and rat PS-PLA1 and with triglyceride lipases. Conserved sequences in Ps-pla1 include a lipase consensus sequences GxSxG, a catalytic triad, and eight of the ten conserved cysteine residues that are required for tertiary structure. Mouse Ps-plal carries a phosphatidylserine-binding motif that is absent in all triglyceride lipases. Using a mouse whole-genome radiation hybrid (WG-RH) mapping panel (T31), we mapped mouse Ps-pla1 to Chromosome (Chr) 16 between genetic markers D16Mit194 and D16Mit38, which is 17.1 cM centromeric to the lpd locus. On the basis of chromosome location, we conclude that Ps-pla1 and lpd are distinct genes in lipid metabolism.

Pleiotropic effects of corticotropin releasing hormone on normal human skin keratinocytes

The hypothalamic-pituitary-adrenal (HPA) axis is the major stress response system. Several components of the HPA axis, such as corticotropin-releasing hormone (CRH) and POMC peptides and their receptors are also present in the skin. In earlier studies, we showed that CRH inhibits cellular proliferation of immortalized human keratinocytes. We now examine further the functional activity of the HPA axis in the skin, by characterizing the actions of CRH on normal foreskin keratinocytes. The CRH receptor was detected as CRH-R1 antigen at 47 kDa in the cultured keratinocytes by Western blotting, and immunohistochemistry demonstrated its presence in the epidermal and follicular keratinocytes. CRH is also biologically active in cultured keratinocytes, where it inhibits proliferation and enhances the interferon-gamma-stimulated expression of the hCAM and ICAM-1 adhesion molecules and of the HLA-DR antigen. These effects were concentration-dependent, with maximal activity at CRH 10(-7) M. Thus, in the keratinocyte, the most important cellular component of the epidermis, CRH appears to induce a shift in energy metabolism away from proliferation activity, and toward the enhancement of immunoactivity. Therefore, similar to its central actions, cutaneous CRH may also he involved in the stress response, but at a highly localized level.

Effects of resveratrol on oxidative modification of human low density lipoprotein

OBJECTIVE

To determine the antioxidative effects of resveratrol (RES), a polyphenolic compound in red wine, on the oxidation of human low density lipoprotein (LDL) using two different oxidation systems.

METHODS

Oxidation of LDL was induced by adding either Cu2+ or an azo compound. The extent of LDL modification was assessed by measuring the formation of thiobarbituric acid reactive substances (TBARS), the relative electrophoretic mobilities (REM), and the amount of oxidized LDL degradation by macrophages.

RESULTS

During Cu(2+)-induced oxidation, RES reduced TBARS formation in LDL by 70.5%, REM of LDL by 42.3% and the amount of macrophage degradation by 65.7%, respectively. The lag phase of LDL oxidation was also delayed by adding RES both in the copper ion and azo compound-induced oxidation systems.

CONCLUSION

RES can protect LDL against both Cu(2+)-induced and azo compound-initiated oxidative modification in vitro, which might be due to its free radical scavenging capacity.

Cutaneous expression of CRH and CRH-R. Is there a "skin stress response system?"

The classical neuroendocrine pathway for response to systemic stress is by hypothalamic release of corticotropin releasing hormone (CRH), subsequent activation of pituitary CRH receptors (CRH-R), and production and release of proopiomelanocortin (POMC) derived peptides. It has been proposed that an equivalent to the hypothalamic-pituitary-adrenal axis functions in mammalian skin, in response to local stress (see Reference 1). To further define such system we used immunocytochemistry, RP-HPLC separation, and RIA techniques, in rodent and human skin, and in cultured normal and malignant melanocytes and keratinocytes. Production of mRNA for CRH-R1 was documented in mouse and human skin using RT-PCR and Northern blot techniques; CRH binding sites and CRH-R1 protein were also identified. Addition of CRH to immortalized human keratinocytes, and to rodent and human melanoma cells induced rapid, specific, and dose-dependent increases in intracellular Ca2+. The latter were inhibited by the CRH antagonist alpha-helical-CRH(9-41) and by the depletion of extracellular calcium with EGTA. CRH production was enhanced by ultraviolet light radiation and forskolin (a stimulator for intracellular cAMP production), and inhibited by dexamethasone. Thus, evidence that skin cells, both produce CRH and express functional CRH-R1, supports the existence of a local CRH/CRH-R neuroendocrine pathway that may be activated within the context of a skin stress response system.

Angiotensinogen gene polymorphisms M235T/T174M: no excess transmission to hypertensive Chinese

The gene encoding angiotensinogen (AGT) has been widely studied as a candidate gene for hypertension. Most studies to date have relied on case-control analysis to test for an excess of AGT variants among hypertensive cases compared with normotensive controls. However, with this design, nothing guarantees that a positive finding is due to actual allelic association as opposed to an inappropriate control population. To avoid this difficulty in our study of essential hypertension in Anqing, China, we tested AGT variants using the transmission/disequilibrium test, a procedure that bypasses the need for a control sample by testing for excessive transmission of a genetic variant from parents heterozygous for that variant. We analyzed two AGT polymorphisms, M235T and T174M, which have been associated with essential hypertension in whites and Japanese, using data on 335 hypertensive subjects from 315 nuclear families and their parents. Except in the group of subjects younger than 25 years, M235 and T174 were the more frequently transmitted alleles. We found that 194 parents heterozygous for M235T transmitted M235 106 times (P=0.22) and that 102 parents heterozygous for T174M transmitted T174 60 times (P=0.09). Stratifying offspring by gender, M235 and T174 were transmitted 60 of 106 times (P=0.21) and 44 of 75 times (P=0.17), respectively, in men, and 46 of 88 times (P=0.75) and 16 of 27 times (P=0.44), respectively, in women. Our results were also negative in all age groups and for the affected offspring with blood pressure values >/=160/95 mm Hg. Thus, this study provides no evidence that either allele of M235T or T174M contributes to hypertension in this Chinese population.

[Diagnosis and treatment of postrenal acute renal failure]

52 cases of postrenal acute renal failure (ARF) from 1985 to 1995 were studied. 50 cases underwent emergency operation, and 2 were drained with ureter intubation by cystoscope. 37 cases (71.2%) were cured, 14 (26.9%) were improved, and 1 (1.9%) died. Oliguria, anuria and progressive increase of blood urea nitrogen and serum creatinine are the main points of diagnosis. Renal percussive pain is the important sign. B-ultrasonography examination is the first choice and often indicate the increase of the volume of kidney and mild hydronephrosis. Obstruction should be removed as quickly as possible, infection should be prevented and treated to protect renal function. The way of treatment should be adopted according to the variant causes and conditions of disease. The etiology, clinical findings, diagnosis, operating methods and cautions were discussed.

[Determination of airway reactivity in the conscious and unrestrained guinea pigs]

A simple, stable determining system in the conscious and unrestrained guinea pigs was established that can quantitatively analyse the airway reactivity (AR). In this model, the response to histamine (His) or acetylcholine (ACh) aerosol was concentration-dependent with EC50 effective concentration causing 50% animals wheezing) of 53.3 mumol/m3 and 269 mumol/m3 respectively.

Interactions between macrophages and oxidized low density lipoprotein in the presence of type I collagen

In order to investigate the influence of collagen on the interactions between macrophages and oxidatively modified low density lipoprotein (ox-LDL), type I collagen was isolated from rat tail tendon and prepared as a gel. The binding of 125I-ox-LDL, 125I-malondialdehyde (MDA)-LDL and 125I-acetyl-LDL to collagen was higher but the binding of 125I-4-hydroxynonenal (HNE)-LDL was lower than that of native 125I-LDL. When mouse peritoneal macrophages were cultivated on this collagen gel, most of the modified LDL was bound to the collagen gel rather than taken up by macrophages. The amount of modified 125I-LDL degraded by the macrophages decreased in the presence of the collagen gel. In the absence of gel a similar degree of reduction in degradation of modified 125I-LDL by macrophages was obtained when the cells were treated with cytochalasin D, an inhibitor of non-specific phagocytosis. However, the treatment of the macrophages cultivated on the collagen gel with cytochalasin D did not influence the degradation of 125I-ox-LDL and 125I-HNE-LDL. These results suggest that the uptake of ox-LDL by macrophages grown on collagen gel is primarily mediated via the scavenger receptors pathway, whereas in the absence of collagen also other mechanisms of uptake are operating.

Analysis of cardiovascular effects of morphine in the cat

In cats anaesthetized with chloralose, the effect of morphine on arterial blood pressure and heart rate was examined by injecting the drug through different routes. When injected into the cerebral ventricles, it acted on structures in the walls of the third ventricle and produced a naloxone resistant tachycardia through a sympathetic discharge to the heart. When injected into the cisterna magna or subcutaneously, it produced a naloxone sensitive long-lasting fall in blood pressure and bradycardia resulting from inhibition of sympathetic tone to blood vessels and heart; increased vagal tone played a minor role in the development of bradycardia. When injected intracisternally or subcutaneously, morphine acted near the obex at the dorsal surface of the medulla, because it produced the same circulatory effects but in much smaller doses when applied to this region on a piece of filter paper. Conversely, small doses of naloxone similarly applied abolished or prevented the circulatory effects of subcutaneous morphine. The action of morphine may be on the commissural nucleus of the tractus solitarius. Intravenous naloxone restored the circulatory effects of intracisternal and subcutaneous morphine and sometimes produced a pronounced overshoot, but without a preceding injection of morphine, naloxone had no effect on circulation. It is suggested that inhibition of sympathetic tone to the cardiovascular system by an action on structures near the obex is the mechanism by which morphine produces in man orthostatic hypotension and its beneficial effect in left ventricular failure.

In vivo evidence for the selectivity of ICI 154129 for the delta-opioid receptor

The in vivo selectivity of the novel delta opioid-receptor antagonist N,N-bisallyl-Tyr-Gly-Gly-psi-(CH2S)-Phe-Leu-OH (ICI 154129) was examined in several opioid-selective models. Antagonism at the delta receptor was demonstrated in the striatal head-turn model in the rat. Intrapallidal injection of the relatively selective delta-receptor agonist D-Ala2,D-Leu5-enkephalin (0.5 micrograms) slowed the head-turn time and this effect was completely prevented by prior subcutaneous administration of ICI 154129 (30 mg/kg). The role of delta receptors in two classical test situations was studied using the mixed opioid agonist etorphine and the antagonists naloxone and ICI 154129. The drug ICI 154129 (30 mg/kg, s.c.) failed to prevent the antinociceptive effects and stimulation of locomotor activity produced by etorphine, whereas the relatively selective mu-opioid receptor antagonist, naloxone was effective in both test situations. The possible involvement of delta receptors in morphine-induced dependence was studied by monitoring the abstinence behaviour precipitated in rats given pellets of morphine by either ICI 154129 or naloxone. Naloxone (0.5 mg/kg, i.p.) precipitated a characteristic withdrawal syndrome in conscious rats and, at a much smaller dose (0.02 mg/kg, i.p.), induced shaking behaviour in pentobarbitone-anaesthetised rats. No withdrawal signs were observed in either model after injection of ICI 154129 (30 mg/kg, s.c.), suggesting that the delta receptors are not involved in dependence on morphine.

Cardiovascular effects of hypertonic sodium chloride solutions when injected into the liquor space of anaesthetized cats

1 In cats anaesthetized with chloralose, hyper- and hypotonic solutions were injected into the cisterna magna (in 0.5 ml) or into a lateral cerebral ventricle (in 0.2 to 0.3 ml), with aqueduct cannulated to prevent the injected solution from entering the subarachnoid space, and the effects on blood pressure and heart rate were examined. 2 Cisternal injections of hyper- and hypotonic solutions of NaCl (0.51 M and 0.05 M), glucose (1.03 M and 0.10 M), or sucrose (1.02 M and 0.10 M), as well as distilled water produced a rise in arterial blood pressure with tachycardias. Isotonic solutions of NaCl, glucose or sucrose were ineffective. 3 Ventricular injections of the hypertonic NaCl solution, also produced a pressor response with tachycardia effects when injected in this way. 4 The pressor responses and the tachycardias occurred after bilateral vagotomy and resulted from a sympathetic discharge which, on cisternal injection, originated from structures reached from the subarachnoid space, and on ventricular injection, from structures in the ventricular walls, probably in the hypothalamus. 5 The stimuli responsible for the discharge, were, on cisternal injection, the changes in osmolarity and on ventricular injection, the sodium ions.

Endorphins may function in heat adaptation

Administration of the opiate antagonist naloxone to rats after acute or chronic heat exposure precipitates an increase in colonic temperature, an increase in escape attempts, and a decrease in body weight. These changes are accompanied by signs associated with hyperthermia such as salivation, diarrhea, and an abnormal extended posture. Although brain endorphin involvement is possible, hypophysectomy diminishes the intensity and magnitude of these naloxone effects, indicating that the naloxone effect in intact animals may be due to a functional antagonism of pituitary endorphins. These observations suggest that endorphins attenuate physiological responses to thermal and noxious stimuli triggered in common neuroanatomical pathways by heat.

Quinoline: conversion to a mutagen by human and rodent liver

Quinoline, a hepatocarcinogen in rats, and 23 quinoline derivatives were tested for mutagenic activity with the Ames Salmonella typhimurium assay. Quinoline, 5-hydroxyquinoline, and 8-hydroxyquinoline were mutagenic in strain TA 100 when Aroclor 1254-induced rat (male outbred Sprague-Dawley) liver homogenate was present in the incubation mixture. Enzyme preparations from rats pretreated with P-448-dependent aryl hydrocarbon hydroxylase inducers [3-methylcholanthrene (MCA) and beta-naphthoflavone] and MCA-treated "responsive" C57BL mice also metabolized quinoline to a mutagen, but phenobarbital and pregnenolone-16alpha-carbonitrile pretreatment did not yield active preparations. The mutagenicity of quinoline was blocked by the in vitro addition of menadione, butylated hydroxytoluene, alpha-naphthoflavone, vitamin A acetate, and glutathione to the test system. Depletion of glutathione by diethyl maleate pretreatment in vivo enhanced the mutagenic potential of the liver enzyme preparation. Mutagenic activity was correlated to the formation of water-soluble quinoline metabolites, and we suggested that the reactive quinoline intermediate is quinoline-2,3-epoxide. Microsomal enzymes isolated from human liver tissue, but not lung tissue, also converted quinoline to a mutagen.

Airborne mutagens bioassayed in Salmonella typhimurium

Particulate airborne pollutants, collected in Buffalo, New York, and Berkeley, California, were asayed for mutagenic activity in the Ames Salmonella typhimurium test system. Mutagens requiring liver enzymes for activation, as well as direct acting mutagens, were readily detected in the Buffalo sample. By contrast, only direct acting mutagens were detected in the Berkeley sample.

Physical dependence of opiate-like peptides

Methionine-enkephalin and beta-endorphin, endogenous peptides with activities similar to those of opiates, were infused for 70 hours into the periaqueductal gray-fourth ventricular space of the rat brain. When challenged with a naloxone, a specific opiate antagonist, these animals manifested a typical morphine-like withdrawal syndrome. These results show that such peptides can cause physical dependence.

beta-endorphin is a potent analgesic agent

beta-Endorphin, an opiate-like peptide, has potent antinociceptive properties when it is administered directly into the brain and assayed in the the tail-flick, hot-plate, and writhing tests in mice and in the wet shake test in rats. On a molar basis, beta-endorphin is 18 to 33 times more potent than morphine and its actions are blocked by the specific opiate antagonist, naloxone hydrochloride. The activity of beta-endorphin in vivo is also compared to other peptides that show opiate-like activity in assays in vitro.

Potency of the N3im-methyl analog of TRH in the induction of shaking movements in the rat

The relative potencies of TRH analogs in provoking a shaking response in rats were determined. Bilateral administration of 0.011-2.0 mug TRH analog into the periaqueductal-fourth ventricular spaces of the barbiturate-anesthetized rat showed that N3im-methyl TRH was approximately 10X more potent than TRH, whereas N1im-methyl TRH was approximately 10X less potent than TRH. These results indicate that the potencies of the TRH analogs in inducing shaking parallel their thyrotropin-releasing activities.

Central sites of naloxone-precipitated shaking in the anesthetized, morphine-dependent rat

Naloxone hydrochloride, an opiate antagonist, administered via the intracranial or parenteral route precipitates shaking behavior in the morphine-dependent rat. We made localized bilateral injections of naloxone HCl, 1.5 mug/rat, into 60 subcortical sites of the pentobarbital-anesthetized, morphine-dependent rat and found that two circumscribed areas of the brain, the medial hypothalamus and the periaqueductal-4th ventricular spaces, were selectively sensitive to naloxone-precipitated shaking. In the nondependent rat, morphine injections into the anterior diencephalon inhibited the shaking response to ice water; injections of morphine into the medial diencephalon were less effective. However, naloxone antagonized the morphine-inhibited shaking more effectively when injections of naloxone were made in the medial diencephalon than when injections were made in the anterior diencephalon. These results suggest that the reciprocal relationship of morphine and morphine-naloxone effects on shaking behavior may be regulated by topographically different structures in the diencephalon.

Regional sensitivity of the rat brain to the inhibitory effects of morphine on wet shake behavior

The aim of this investigation was to determine the brain regions which were most sensitive to the inhibitory effects of morphine on the shaking response of pentobarbital-anesthetized rats to ice water. The median inhibitory dose (ID50) of morphine sulfate administered intraventricularly was found to be 0.35 mug/rat. When morphine was bilaterally injected into different regions of the brain, the ID50 values ranged from 0.04 to 17.9 mug/rat. The lowest ID50 values (0.04-0.20 mug) were found in the periaqueductal gray, the medial preoptic area and the locus ceruleus. The ID50 values ranged from 0.65 to 1.6 mug for areas around the nucleus accumbens, the fasciculus retroflexus, the medical thalamus and the septal area; from 5.6 to 7.3 mug for various hypothalamic nuclei; and from 11.0 to 17.9 mug for the basal ganglia, reticular formation substantia nigra and the reticular nucleus of the thalamus. The brain areas with the lowest ID50 values are known to have thermoregulatory functions. The similarity of the shaking response to shivering is discussed. It is concluded that the central inhibitory effects of morphine on shaking are subserved by discrete neuroanatomical substrates located in medial subcortical structures.