Metastasis of the choroid plexuses: A systematic review of the literature and case illustration

BACKGROUND

Choroid plexus (CP) metastases are an extremely rare condition accounting for less than 1% of brain metastases. Due to its scarcity, little is known about this pathology and its management. Herein, we propose a review of the current literature to help its diagnosis and management.

METHODS

Through a literature review based on PubMed/MEDLINE database, we reviewed 94 cases of intraventricular metastasis of solid cancer in 28 full-text articles in English from 1980 to 2010. We have reported epidemiological, clinical, radiological, histological data, as well as management strategies and outcomes. A case report of fourth ventricular pulmonary metastasis illustrates this review.

RESULTS

Intraventricular metastases are most often reported in patients in their 6th decade. The clinical presentation is marked by acute hydrocephalus, more rarely lesional bleeding. Three-quarters of intraventricular metastases develop in lateral ventricle, then respectively in the fourth and third ventricles. Kidney cancer accounts for 45% of the cases. The treatment modalities are surgical removal in case of a single lesion and adjuvant radiotherapy and chemotherapy depending on the primary cancer. The prognosis remains poor due to dissemination via the cerebrospinal fluid.

CONCLUSION

Multiple choroid plexus metastasis is a rare diagnosis, affecting patients with a specific clinical presentation and a misleading radiological appearance. There is no standard of care for the management of these lesions and surgical approach can be challenging.

On-therapy HBsAg kinetics can predict HBsAg loss after nucleos(t)ide analogues interruption in HBeAg-negative patients. The cup is half full and half empty

BACKGROUND

Nucleos(t)ide analogues withdrawal may improve HBsAg loss rates. However, conditions to select patients are not well established.

AIMS

to evaluate the impact of HBsAg kinetics before treatment interruption on post-treatment response.

METHODS

Longitudinal, ambispective study in non-cirrhotic chronic hepatitis B HBeAg-negative patients, analysing on-treatment and post-treatment HBsAg kinetics. On-treatment HBsAg kinetics diagnostic accuracy (AUROC) to identify HBsAg loss was evaluated.

RESULTS

52 HBeAg-negative patients stopped treatment after 8.2 years, and 6 (11.5%) achieved HBsAg loss one year after withdrawal. Multivariate analysis showed that on-treatment HBsAg kinetics was related to HBsAg loss (OR=0.10; 95%CI=0.016-0.632; p = 0.014) with a high diagnostic accuracy (AUROC=0.935). A significant HBsAg decline ≥1 log10 IU/mL showed a positive and negative predictive value of 50% and of 97.6%, respectively. After treatment interruption, HBsAg decline speed (log10 IU/mL/year) accelerated in patients treated >6 years (from -0.06 to -0.20, p<0.05) and remained stable in treated <6 years (from -0.12 to -0.12 p=ns).

CONCLUSIONS

On-treatment HBsAg kinetics can predict post-treatment HBsAg loss rate. Half of patients with a significant HBsAg decline can eliminate HBsAg the first year after withdrawal. Post-treatment HBsAg decline is faster not only in patients who lost the HBsAg but also in those who remain HBsAg-positive.

Follow-up evaluation of patients with liver test abnormalities detected during SARS-CoV2 infection

Abnormal liver function tests (A-LFTs) during admission for coronavirus disease-19 (COVID-19) are frequent, but its evolution after COVID-19 resolution remains unexplored. We evaluated factors related to A-LFTs during COVID-19 and assessed the liver outcome after patients' discharge. This is a observational study including: (1) retrospective analysis of variables related to A-LFTs during COVID-19; and (2) follow-up evaluation with blood test, transient elastography and liver biopsy in those with persistent A-LFTs. A-LFTs were defined according to CTCAEv4.0. Among 595 patients, 366 (61.5%) showed A-LFTs. The ratio of partial pressure of oxygen and inspired oxygen fraction (P/F) below 200, ferritin ≥1000 ng/mL, male gender and antibiotic and immunomodulatory treatments were related to A-LFTs. Follow-up evaluation was performed in 153 individuals. Persistent A-LFTs at follow-up was similar in patients with/without A-LFTs during admission (14.1% vs. 4.9%, p = 0.104). Fifteen (93%) and 58 (39%) patients with/without A-LFTs at follow-up showed metabolic fatty liver disease criteria (p < 0.001), which were histologically confirmed. In conclusion, A-LFTs during COVID-19 were related to infection severity. Abnormalities remitted at follow-up in >80% of patients, and no correlation between A-LFTs at admission and at follow-up was found. Most patients with A-LFTs at follow-up had non-invasive and histologically proven fatty liver disease.

320 The Initial Impact Of COVID-19 On Paediatric Spinal Services Across Scotland

Background

The COVID-19 pandemic has meant a significant decline in the activities of the paediatric spinal services in Scotland.

Method

All referrals to the Scottish paediatrics spinal service from 1st January 2020 to 30th June 2020 were analysed. Comparison was made to the same period in 2019. All orthotist initial consultations and all paediatrics spinal theatre activity in Scotland from 1st March 2020 to 30th June 2020 was analysed and compared to the previous year.

Results

There was a 64.3% decline in referrals during the first wave of the pandemic in Scotland to the paediatric spinal service. The mean wait time to be seen in 1st clinic for a new referral was 6.56 weeks in 2020 compared to 10.94 in 2019. There were however 60 patients still waiting to be seen. The number of paediatric spinal operations declined by 34% during March to June 2020 when compared to the same months in 2019 There was a reduction of 50% of new paediatric patients seen by orthotists from March – June 2020 when compared to 2019

Conclusions

COVID-19 has had a significant effect on paediatric spinal services in Scotland. This is likely due to a combination of service delivery factors and patient factors. This is likely to result in delays to children getting the care they require for their spinal condition. There will also be a back-log of patients requiring to be seen when services start to re-establish themselves. There are several options available to department to optimise efficiency, such as video consultants and streamlining referral systems.

Acute, subacute and chronic mountain sickness

More than 100 million people ascend to high mountainous areas worldwide every year. At nonextreme altitudes (<5500m), 10-85% of these individuals are affected by acute mountain sickness, the most common disease induced by mild-moderate hypobaric hypoxia. Approximately 140 million individuals live permanently at heights of 2500-5500m, and up to 10% of them are affected by the subacute form of mountain sickness (high-altitude pulmonary hypertension) or the chronic form (Monge's disease), the latter of which is especially common in Andean ethnicities. This review presents the most relevant general concepts of these 3 clinical variants, which can be incapacitating and can result in complications and become life-threatening. Proper prevention, diagnosis, treatment and management of these conditions in a hostile environment such as high mountains are therefore essential.

The expression of the transcription factor TAF1 is modified by the HPV16 E2 protein

High-risk human papillomaviruses (e.g., HPV16 and 18) are associated with cervical cancer occurrence and development. The early viral gene E2 encodes a protein involved in several key processes in HPV biology, such as replication, genome segregation, and viral gene transcription. E2's presence also affects the expression of a variety of cellular genes involved in a wide range of biological processes, including cell cycle regulation and apoptosis, which are mediated by E2's interaction with cellular proteins. In this report, a lentiviral system was used to express the HPV16 E2 gene in the HPV-negative C-33A cell line for several weeks. E2 expression was measured by RT-qPCR and its biological activity was evaluated using a reporter gene. In HPV16 E2-positive cells, we observed a statistically significant increase in mRNA and protein levels of TAF1 and p27, a basal transcription factor and one of its target genes, respectively. To our knowledge, this is the first study showing that the viral protein HPV16 E2 upregulates TAF1 expression. This suggests that E2's expression promotes a transcriptionally-favorable cellular environment that allows HPV to successfully complete its replication cycle. Keywords: HPV16; E2 protein; transcription; TAF1 regulation.

Acute, subacute and chronic mountain sickness

More than 100 million people ascend to high mountainous areas worldwide every year. At nonextreme altitudes (<5500 m), 10-85% of these individuals are affected by acute mountain sickness, the most common disease induced by mild-moderate hypobaric hypoxia. Approximately 140 million individuals live permanently at heights of 2500-5500 m, and up to 10% of them are affected by the subacute form of mountain sickness (high-altitude pulmonary hypertension) or the chronic form (Monge's disease), the latter of which is especially common in Andean ethnicities. This review presents the most relevant general concepts of these 3 clinical variants, which can be incapacitating and can result in complications and become life-threatening. Proper prevention, diagnosis, treatment and management of these conditions in a hostile environment such as high mountains are therefore essential.

Emergence of Clusters: Halos, Efimov States, and Experimental Signals

We investigate the emergence of halos and Efimov states in nuclei by use of a newly designed model that combines self-consistent mean-field and three-body descriptions. Recent interest in neutron heavy calcium isotopes makes ^{72}Ca (^{70}Ca+n+n) an ideal realistic candidate on the neutron dripline, and we use it as a representative example that illustrates our broadly applicable conclusions. By smooth variation of the interactions we simulate the crossover from well-bound systems to structures beyond the threshold of binding, and find that halo configurations emerge from the mean-field structure for three-body binding energy less than ∼100  keV. Strong evidence is provided that Efimov states cannot exist in nuclei. The structure that bears the most resemblance to an Efimov state is a giant halo extending beyond the neutron-core scattering length. We show that the observable large-distance decay properties of the wave function can differ substantially from the bulk part at short distances, and that this evolution can be traced with our combination of few- and many-body formalisms. This connection is vital for interpretation of measurements such as those where an initial state is populated in a reaction or by a beta decay.

The effect of frequency-dependent selection on resistance and tolerance to herbivory

Negative frequency-dependent selection (FDS), where rare genotypes are favoured by selection, is commonly invoked as a mechanism explaining the maintenance of genetic variation in plant defences. However, empirical tests of FDS in plant-herbivore interactions are lacking. We evaluated whether the oviposition preference of the specialist herbivore Lema daturaphila is a mechanism through which this herbivore can exert FDS on its host plant Datura stramonium. The frequency of contrasting resistance-tolerance strategies was manipulated within experimental plots, and the plants were exposed to a similar initial density of their natural herbivore. Herbivore oviposition preference and final density, as well as plant damage and seed production, were estimated. Overall, we found that the high-resistant-low-tolerant genotypes produced four times more seeds when common than when rare, whereas the high-tolerant-low-resistant genotypes achieved twice its fitness when rare than when common. This pattern was the result of differential oviposition preferences. In addition, when the high-resistant-low-tolerant genotypes were common, there was a three-fold decreased in herbivore final density which led to a decrease in damage level by 10%. Thus, in our experiment positive FDS seems to favour resistance over tolerance. We discuss how this result would change if the extent of herbivore local adaptation and damage modify the pattern of positive FDS acting on resistance and the optimal allocation to tolerance.

Infantile developmental thoracolumbar kyphosis with segmental subluxation of the spine

Acute angulation at the thoracolumbar junction with segmental subluxation of the spine occurring at the level above an anteriorly hypoplastic vertebra in otherwise normal children is a rare condition described as infantile developmental thoracolumbar kyphosis. Three patient series with total of 18 children have been reported in the literature. We report five children who presented with thoracolumbar kyphosis and discuss the treatment algorithm. We reviewed the medical records and spinal imaging at initial clinical presentation and at minimum two-year follow-up. The mean age at presentation was eight months (two to 12). All five children had L2 anterior vertebral body hypoplasia. The kyphosis improved spontaneously in three children kept under monitoring. In contrast, the deformity was progressive in two patients who were treated with bracing. The kyphosis and segmental subluxation corrected at latest follow-up (mean age 52 months; 48 to 60) in all patients with near complete reconstitution of the anomalous vertebra. The deformity and radiological imaging on a young child can cause anxiety to both parents and treating physicians. Diagnostic workup and treatment algorithm in the management of infantile developmental thoracolumbar kyphosis is proposed. Observation is indicated for non-progressive kyphosis and bracing if there is evidence of kyphosis and segmental subluxation deterioration beyond walking age. Surgical stabilisation of the spine can be reserved for severe progressive deformities unresponsive to conservative treatment.

Cite this article: Bone Joint J 2015;97-B:982–7.

Hydrallantois in a female dog: a case report

The aim of this study was to describe the clinical, ultrasound and histological findings of hydrallantois in a Pug bitch. On the 56th day of pregnancy the patient presented pronounced abdominal distention, lethargy, anorexia and dyspnea. The ultrasound revealed the presence of abnormal fluid accumulation within the fetal membranes, especial in the allantois, which was incompatible with the 8th week of pregnancy in bitches. The macroscopic exam during the C-section, distention of the fetal membranes and accumulation of fluid within the allantois was observed. The precise amount of liquid could not be assessed due to the surgical procedure. All neonates of our case report were normal at the initial physical exam. The histologic exam revealed normal placenta. In conclusion, clinical and ultrasound assessment were able to diagnose hydrallantois in a canine patient.

Safety of thiopurines and anti-TNF-α drugs during pregnancy in patients with inflammatory bowel disease

OBJECTIVES

The safety of thiopurines and anti-tumor necrosis factor-α (TNF-α) drugs during pregnancy remains controversial, as the experience with these drugs in this situation is limited. Our aim is to assess the safety of thiopurines and anti-TNF-α drugs for the treatment of inflammatory bowel disease (IBD) during pregnancy.

METHODS

Retrospective, multicenter study in IBD patients. Pregnancies were classified according to the therapeutic regimens during pregnancy or during the 3 months before the conception: non-exposed group, pregnancies exposed to thiopurines alone (group A), and pregnancies exposed to anti-TNF-α drugs (group B). An unfavorable Global Pregnancy Outcome (GPO) was considered if pregnancy developed with obstetric complications in the mother and in the newborn.

RESULTS

A total of 187 pregnancies in the group A, 66 pregnancies in the group B, and 318 pregnancies in the non-exposed group were included. The rate of unfavorable GPO was different among the three groups (31.8% in non-exposed group, 21.9% in group A, and 34.8% in group B), being lower in pregnancies under thiopurines than among non-exposed (P = 0.01). The rate of pregnancy complications was similar among the three groups (27.7% in non-exposed, 20.9% in group A, and 30.3% in group B). The rate of neonatal complications was different among the three groups (23.3% in non-exposed group, 13.9% in group A, and 21.2% in group B), being lower in pregnancies under thiopurines than among non-exposed (P = 0.01). In the multivariate analysis, the treatment with thiopurines (odds ratio = 0.6; 95% confidence interval = 0.4-0.9, P = 0.02) was the only predictor of favorable GPO, whereas maternal age >35 years at conception was the only predictor of unfavorable GPO. The treatment with anti-TNF-α drugs was not associated with an unfavorable GPO.

CONCLUSION

The treatment with thiopurines and anti-TNF-α drugs does not seem to increase the risk of complications during pregnancy and does seem to be safe for the newborn.

Repair of spondylolysis using compression with a modular link and screws

We describe the results of a prospective case series of patients with spondylolysis, evaluating a technique of direct stabilisation of the pars interarticularis with a construct that consists of a pair of pedicle screws connected by a U-shaped modular link passing beneath the spinous process. Tightening the link to the screws compresses bone graft in the defect in the pars, providing rigid intrasegmental fixation. We have carried out this procedure on 20 patients aged between nine and 21 years with a defect of the pars at L5, confirmed on CT. The mean age of the patients was 13.9 years (9 to 21). They had a grade I or less spondylolisthesis and no evidence of intervertebral degeneration on MRI. The mean follow-up was four years (2.3 to 7.3). The patients were assessed by the Oswestry Disability Index (ODI) and a visual analogue scale (VAS). At the latest follow-up, 18 patients had an excellent clinical outcome, with a significant (p < 0.001) improvement in their ODI and VAS scores. The mean ODI score at final follow-up was 8%. Assessment of the defect by CT showed a rate of union of 80%. There were no complications involving the internal fixation. The strength of the construct removes the need for post-operative immobilisation.

The ANKK1 protein associated with addictions has nuclear and cytoplasmic localization and shows a differential response of Ala239Thr to apomorphine

The TaqIA single-nucleotide polymorphism (SNP), which is the most widely studied genetic polymorphism in addictions, is located at the gene that encodes the RIP kinase ANKK1 near the gene for dopamine receptor D2. The TaqIA SNP is in strong linkage disequilibrium with the SNP rs7118900, which changes the alanine at position 239 to threonine in the ANKK1 protein (Ala239/A2; Thr239/A1). In silico analysis has predicted that this polymorphic substitution creates an additional phosphorylation site in the kinase domain of ANKK1. To investigate the contribution of ANKK1 to the pathophysiology of TaqIA-associated phenotypes, we analyzed transfected HEK293T cells with the human ANKK1-kinase(Ala239) and ANKK1-kinase(Thr239) variants tagged with GFP. We observed that the ANKK1-kinase is located in both the nucleus and the cytoplasm, suggesting that there is nucleocytoplasmic shuttling of this putative signal transducer. In addition, we found that the Ala239Thr ANKK1-kinase polymorphism exhibited strong expression differences in both the nucleus and the cytoplasm at basal level and when stimulated with the dopamine agonist apomorphine. Specifically, the ANKK1-kinase(Thr239) variant showed the highest level of basal protein expression, while ANKK1-kinase(Ala239) was 0.64-fold lower. After treatment with apomorphine, ANKK1-kinase(Ala239) showed a 2.4-fold increment in protein levels, whereas a 0.67-fold reduction was observed in ANKK1-kinase(Thr239). Thus, here we provide the first evidence of functional ANKK1 differences that are marked by TaqIA and could be associated with vulnerability to addiction.

Mercaptopurine rescue after azathioprine-induced liver injury in inflammatory bowel disease

BACKGROUND

Azathioprine (AZA) liver toxicity arises in approximately 3% of inflammatory bowel disease patients and may result in treatment discontinuation.

AIM

To describe the tolerance to mercaptopurine (MP) in patients with previous AZA-related liver injury.

METHODS

Retrospective description of 31 patients (14 Crohn's, 17 ulcerative colitis), in which AZA therapy was interrupted because of liver injury, with MP started as alternative therapy.

RESULTS

Mean AZA dose was 2.2 +/- 0.4 mg x kg/day. Median (interquartile range) of AZA exposure when liver injury was detected was 2 months (1-5.2). The type of AZA-related injury was cytolitic in 32%, cholestatic in 39% and mixed in 29%. After a median of 2.5 months (0.7-5.2), the therapy was switched to MP at a mean dose of 1.3 +/- 0.2 mg x kg/day. Median of follow-up of MP therapy was 32 months (8-54). In 87.1% of patients (95%CI: 70-96%), MP was tolerated without further liver injury; of these, 77.4% tolerated full MP doses and 9.7% tolerated lower doses. In a further cohort of 12.9% of patients, (95%CI: 3-29%), liver injury reappeared (two cholestasis, two mixed), 1-3 months after the onset of MP exposure.

CONCLUSION

The administration of MP is a good alternative in patients with AZA-related liver injury, before thiopurines are definitely discarded.

Training model for teaching endoscopic submucosal dissection of gastric tumors

INTRODUCTION

The elevated risk of complications and technical complexity of endoscopic submucosal dissection (ESD) has limited its implementation in our medical system.

OBJECTIVE

To design and evaluate a training program for learning the ESD technique.

METHODS

Four endoscopists with no experience with ESD underwent a 4-step training program: 1) review of the existing literature, didactic material, and theoretical aspects of ESD; 2) ESD training in an ex-vivo animal model; 3) ESD training in an in-vivo animal model (supervised by ESD expert); and 4) ESD performance in a patient. A standard gastroscope and an ESD knife (IT, Flex or Hook-knife Olympus) were employed. The classical ESD technique was performed: rising of the lesion, circumferential incision, and submucosal dissection.

RESULTS

Ex-vivo animal model: 6 x swine stomach/esophagus -cost < 100 euro; 6 x ESD: antrum (n = 2), body (n = 3) and fundus/cardia (n = 1)-; size of resected specimen: 4-10 cm; ESD duration: 105-240 minutes; therapeutic success: 100%; complications: perforation (1/6: 16%) sealed with clips. In-vivo animal model: 6 ESD (antrum/body of stomach: 4; esophagus: 2); size: 2-5 cm; duration: 40-165 minutes; success: 100%; complications: 0%.

PATIENT

ESD of a gastric lesion located in the antrum/body; size: 3 cm; duration 210 minutes; a complete resection was achieved; no complications.

CONCLUSIONS

The results of the present study support the usefulness of this model for learning ESD in our system.

Abstract B57: Regulation of Eag expression by p53 and Rb in tumoral cells

Introduction: Ether à go-go (Eag) potassium channels display oncogenic properties. Their expression in healthy tissues is limited almost exclusively to the brain; however, it is highly expressed in several types of cancer. In addition, the inhibition of its activity or expression remarkably diminishes cellular proliferation and tumor progression. Our group found the expression of Eag in cells having alterations in p53 and Rb including C-33 and HeLa from cervical cancer. On the other hand, we have observed that Eag gene expression is regulated by factors that inhibit Rb or p53, such as, E6 and E7 oncogenes of the human papilloma virus and estradiol. Therefore, we have considered p53 and Rb like possible pathways for Eag regulation. To our knowledge, there are no reports on Eag regulation by tumor suppressor proteins. Thus in this work we evaluated the effect of p53 and Rb overexpression on the expression of Eag in C-33, HeLa (cervix) and A549 (lung cancer) cells. We also analyzed the expression of Eag in tumor samples from patients with retinoblastoma (a malignant tumor characterized by the loss of the gene Rb and alterations in the p53 pathway).

Methods: C-33, HeLa and A549 cells were obtained from American Type Culture Collection (ATCC) and the RNA's of patients with retinoblastoma from the Hospital of Pediatrics of the Medical Centre XXI century. In order to evaluate the expression of Eag, retrotranscription was performed and the analysis of gene expression was carried out by real time PCR, the results were analyzed by the method of ΔΔ-CT. In order to evaluate the effect of p53 and Rb overexpression on Eag, HeLa and C-33 cells were grown in DMEM and A549 cells on F12-K medium, supplemented with 10% of bovine fetal serum; later they were transfected with 1 µg of plasmid containing p53 and/or Rb. The RNA was obtained 72 hours later and then subjected to retrotranscription. Eag gene expression was then analyzed by real time PCR.

Results: We found that p53 and Rb transfection in C-33 cells does not affect the expression of Eag. However, Eag expression in HeLa cells was clearly down-regulated when transfected with p53 and/or Rb. Transfection of p53 in A549 cells diminished the expression of Eag, in contrast to Rb transfection which increased expression. Interestingly, we observed a very high expression of Eag in samples of retinoblastoma in comparison with the Eag expression in HeLa cells and in normal retina.

Conclusions: Our results suggest that tumor suppressor proteins p53 and Rb regulate the expression of Eag. In addition, our results also suggest Eag as a retinoblastoma potential therapeutic target for this type of tumors.

This project was partially supported by ICyT DF.

Citation Information: Cancer Res 2009;69(23 Suppl):B57.

Integral relations for three-body continuum states with the adiabatic expansion

The application of the hyperspherical adiabatic expansion to describe three-body scattering states suffers from the problem of very slow convergence. Contrary to what happens for bound states, a huge number of hyper-radial equations has to be solved, and even if done, the extraction of the scattering amplitude is problematic. In this Letter we show how to obtain accurate scattering phase shifts using the hyperspherical adiabatic expansion. To this aim two integral relations, derived from the Kohn variational principle, are used. The convergence of this procedure is as fast as for bound states.

Distinction between sequential and direct three-body decays

We discuss the three-body decay mechanisms of many-body resonances. Sequential decays proceed via two-body configurations after emission of the third particle. In direct decay all three particles leave their interaction regions simultaneously. The intermediate paths within the interaction regions are not observables and are only accessible through models. The momentum distributions carry, apart from polarization, all possible information about decay modes and resonance structure. In this context we discuss detailed results for the decay of the (9)Be(5/2(-)) resonance.

Energy distributions from three-body decaying many-body resonances

We compute energy distributions of three particles emerging from decaying many-body resonances. We reproduce the measured energy distributions from decays of two archetypal states chosen as the lowest 0+ and 1+ resonances in 12C populated in beta decays. These states are dominated by sequential, through the 8Be ground state, and direct decays, respectively. These decay mechanisms are reflected in the "dynamic" evolution from small, cluster or shell-model states, to large distances, where the coordinate or momentum space continuum wave functions are accurately computed.

Expression of the costimulatory molecule CD86, but not CD80, in keratinocytes of normal cervical epithelium and human papillomavirus-16 positive low squamous intraepithelial lesions

Keratinocytes have been traditionally considered as nonprofessional antigen presenting cells, since multipassaged cells from skin biopsies of healthy individuals do not constitutively express major histocompatibility complex (MHC) class II or costimulatory molecules, but can be induced to do so after exposure to interferon-gamma. In normal and human papillomavirus (HPV)-infected cervical epithelium, keratinocytes are affected by a variety of soluble mediators that could modulate the expression of molecules including costimulatory proteins; however, the presence of these molecules within the cervix has been poorly studied. Therefore, our aim was to further explore the presence of costimulatory molecules on normal cervical epithelium and HPV-16 positive low squamous intraepithelial lesions (LSIL). We found in situ CD86 (but not CD80) displayed on the surface of normal keratinocytes from the spinous layer of human cervical epithelium. The presence of the protein and its messenger RNA level (evaluated by in situ hybridization) was diminished in HPV-16 positive LSILs. Although downregulation of costimulatory molecules is frequently related to cytokines expression, we did not observe differences in the presence of interleukin-10, the main cytokine that inhibits CD86 expression. Expression of CD86 on keratinocytes from normal cervical epithelium could indicate the potentiality of these cells to activate cytotoxic T cells, while the shut-off of this molecule in HPV-16 positive lesions could be a mechanism for evading host immune surveillance, resulting in the persistent HPV infection and probable progression of cervical lesions.

A subgroup of HOX Abd-B gene is differentially expressed in cervical cancer

The HOX genes are a family of transcription factors that bind to specific sequences of DNA in target genes regulating their expression. The role of HOX genes in adult cell differentiation is still obscure, but growing evidence suggests that they may play an important role in the development of cancer. In order to study the role of the HOX Abd-B genes in cervical cancer, we analyzed their expression in cervical tissues. Reverse transcription-polymerase chain reaction and RNA in situ hybridization were used to detect HOX Abd-B messenger RNA expression in nine normal cervical tissues and ten cervical carcinomas. The normal tissues were human papillomavirus (HPV) negative, whereas all invasive carcinomas included were HPV16 positive. In this study, we show that HOXA9, A10, A11, A13, B9, D11, and D13 genes are expressed in both the epithelium of normal tissues and neoplastic cells from squamous cervical carcinomas. Interestingly, the HOXC10 and D12 genes were not expressed in any cervical tissues; however, HOXB13, C9, C11, C12, C13, D9, and D10 genes were expressed only in the tumoral tissues but not in the normal cervix. Our findings suggest that the expression of HOXB13, D9, D10, and HOXC cluster (HOXC9, C11-C13) genes might be an important step involved in cervical cancer.

Induction of DNA synthesis in Anopheles albimanus tissue cultures in response to a Saccharomyces cerevisiae challenge

DNA synthesis was detected by the incorporation of 5-bromo-2' deoxy-uridine (BrdU) in adult Anopheles albimanus organs in culture in response to a challenge with Saccharomyces cerevisiae. Abdomens of mosquitoes inoculated with Roswell Park Memorial Institute medium (RPMI, control) or yeast were cultivated in RPMI plus ConA and BrdU for 5 days. DNA was obtained by phenolic extraction and the incorporated BrdU was quantified by ELISA using anti-BrdU peroxidase-labeled antibodies. Abdomen tissues of mosquitoes inoculated with yeast showed higher DNA synthesis than controls. Organs from untreated mosquitoes cultured in the presence of zymosan also synthesized DNA but at a lower level than tissues from yeast-inoculated mosquitoes. In similar experiments, DNA synthesis was inhibited by the addition of colchicine. DNA synthesis, evidenced by epifluorescence using an anti-BrdU fluorescein-labeled antibody, occurred in fat body, epithelial cells in pleural membranes, and the dorsal vessel. Pleural membranes showed the highest number of labeled cells. These tissues were also labeled with anti-PCNA (proliferating cell nuclear antigen) antibodies, two of which were able to produce polytene chromosomes under yeast stimulation. These results demonstrate that different An. albimanus tissues undergo DNA synthesis in response to foreign particles.

HOXB homeobox gene expression in cervical carcinoma

The homeobox (HOX) genes are a family of transcription factors that bind to specific DNA sequences in target genes regulating gene expression. Thirty-nine HOX genes have been mapped in four conserved clusters: A, B, C, and D; they act as master genes regulating the identity of body segments along the anteroposterior axis of the embryo. The role played by HOX genes in adult cell differentiation is unclear to date, but growing evidence suggests that they may play an important role in the development of cancer. To study the role played by HOX genes in cervical cancer, in the present work, we analyzed the expression of HOXB genes and the localization of their transcripts in human cervical tissues. Reverse transcription-polymerase chain reaction analysis and nonradioactive RNA in situ hybridization were used to detect HOXB expression in 11 normal cervical tissues and 17 cervical carcinomas. It was determined that HOXB1, B3, B5, B6, B7, B8, and B9 genes are expressed in normal adult cervical epithelium and squamous cervical carcinomas. Interestingly, HOXB2, HOXB4, and HOXB13 gene expression was found only in tumor tissues. Our findings suggest that the new expression of HOXB2, HOXB4, and B13 genes is involved in cervical cancer.

Efimov effect in nuclear three-body resonance decays

We investigate the effects of the nearly fulfilled Efimov conditions on the properties of three-body resonances. Using the hyper-spheric adiabatic expansion method we compute energy distributions of fragments in a three-body decay of a nuclear resonance. As a realistic example we investigate the 1- state in the halo nucleus 11Li within a three-body model 9Li + n +n model. Characteristic features appear as sharp peaks in the energy distributions. Their origin, as in the Efimov effect, is in the large two-body s-wave scattering lengths between the pairs of fragments.

[Cerebrospinal fluid drainage in endovascular repair of thoracic aortic lesions: preliminary report of experience with 5 patients]

Endovascular repair of thoracic or thoracoabdominal aortic lesions as an alternative to open surgery, to avoid the high complication and mortality rates associated with the conventional approach, does not eliminate the risk of postoperative paraplegia. We report on a series of 5 patients with different thoracic aortic lesions who underwent endovascular stent-graft repair procedures. We describe measures to drain cerebrospinal fluid to prevent ischemic spinal cord injury. We also review the anesthetic management of patients undergoing this type of surgery.

Methodology of environmental diagnosis for construction and demolition waste landfills: a tool for planning and making decisions

Current legislation in the European Union regarding landfills provides measures, procedures and guidance to prevent or reduce, insofar as possible, negative effects on the environment. This means that Member States must take measures so that landfills cannot operate unless the operator first presents a plan for the site, which includes the implementation of improvements considered necessary by the engineer for compliance with regulations. Researchers at the University of Granada have developed a method to ascertain the degree of environmental impact that a construction and demolition waste landfill may produce on its immediate surroundings. This methodology is based on environmental indexes; its objective is to give crucial information concerning possible environmental problems produced by a landfill. The data thus obtained will permit the elaboration of guidelines for improvements in the location, design, and operation of landfills, or in extreme cases, their dosing, sealing, and rehabilitation.

Helicobacter pylori vacA s1a and s1b alleles from clinical isolates from different regions of Chile show a distinct geographic distribution

AIM

To establish the most common vacA alleles in Helicobacter pylori (H pylori) strains isolated from Chilean patients and its relationship with gastritis and gastroduodenal ulcers.

METHODS

Two hundred and forty five H pylori clinical isolates were obtained from 79 biopsies from Chilean infected patients suffering from gastrointestinal diseases. An average of 2-3 strains per patient was isolated and the vacA genotype was analyzed by PCR and 3% agarose electrophoresis. Some genotypes were checked by DNA sequencing.

RESULTS

The most prevalent vacA genotype in Chilean patients was s1b m1 (76%), followed by s1a m1 (21%). In contrast, the s2 m2 genotype was scarcely represented (3%). The s1b m1 genotype was found most frequently linked to gastropathies (P<0.05) rather than ulcers. Ulcers were found more commonly in male and older patients. Curiously, patients living in cities located North and far South of Santiago, the capital and largest Chilean city, carried almost exclusively strains with the s1b m1 genotype. In contrast, patients from Santiago and cities located South of Santiago carried strains with either one or both s1a m1 and s1b m1 genotypes. Regarding the s2 m2 genotype, comparison with GenBank sequences revealed that Chilean s2 sequence was identical to those of Australian, American, and Colombian strains but quite different from those of Alaska and India.

CONCLUSION

Differences in geographic distribution of the s and m vacA alleles in Chile and a relationship of s1b m1 genotype with gastritis were found. Sequence data in part support a hispanic origin for the vacA genotype. Asymmetric distribution of genotypes s1b m1 and s2 m2 recedes H Pylori strain distribution in Spain and Portugal.

Continual supplementation with n-3 fatty acids does not modify plasma lipid profile in spinal cord injury patients

STUDY DESIGN

A prospective study during a diet modification.

OBJECTIVE

To observe the evolution of the plasma lipid profile in a group of spinal cord injury (SCI) patients given a supplement of a mixture of docosahexanoic acid (DHA) and eicosapentaenoic acid (EPA).

SETTING

Department of Physiological Sciences II, Medical School of the University of Barcelona and Guttmann Institut of Badalona, Barcelona, Spain.

METHODS

A total of 19 adult males with SCI, 17 with paraplegia and two with tetraplegia, were given a daily supplement of 1.5 g of DHA and 0.75 g of EPA for 6 months. Determination of plasma values of DHA, EPA, total cholesterol, HDL-c, LDL-c, VLDL-c, triglycerides, and glucose was performed before supplementation and at 3 and 6 months of supplementation.

RESULTS

A statistically significant increase in the plasma concentration of EPA (F=30.556, P<0.05) and DHA (F=106.6, P<0.05) was observed after 3 and 6 months of supplementation. However, there were no observable differences in the plasma concentration of total-cholesterol, HDL-c, LDL-c, VLDL-c, and triglycerides during the study.

CONCLUSION

DHA-EPA supplementation for 6 months does not modify the glycemic and lipid plasmatic levels in SCI patients. Despite its absence of effect on the serum lipid profile, n-3 fatty acids may induce beneficial cardiovascular effects in this population.