A100 CAVERNOUS TRANSFORMATION OF THE PORTAL VEIN IN A PEDIATRIC PATIENT WITH GOLDENHAR SYNDROME: A CASE REPORT

Background

Goldenhar syndrome is a rare congenital condition thought to arise from the first and second branchial arches and typically asymmetrically affects the eyes, ears, and spine. Portal vein thrombosis/cavernous transformation is one of the main causes of portal hypertension in children. It is often associated with risk factors such as catheterization of the umbilical vein in the neonatal period, omphalitis, intra-abdominal infections in the neonatal period and prothrombotic conditions. This is a challenging clinical scenario as it leads to portal hypertension and variceal bleed with no chronic liver disease stigmata and liver function is essentially normal. While previous European literature from the early-2000s reported associated portal vein anomalies in Goldenhar syndrome, we are not aware of any recent and/or Canadian pediatric cases.

Purpose

We report a Canadian case of cavernous transformation of the portal vein with resulting gastrointestinal bleeding in a child with Goldenhar syndrome.

Method

Case report

Result(s)

A pediatric patient with a postnatal suspicion of Goldenhar syndrome, with confirmation by 6 months of age, presented with an acute 3-day history of melena, on the context of a recent viral illness and ibuprofen use. Laboratory testing showed a normocytic anemia (Hb 68) with a normal INR (1.1). The rest of the workup was unremarkable. There was no history of catheterization of the umbilical vein on the neonatal period nor other hematological complications. To assess for potential duplication cyst as differential diagnosis, a computerized tomography of the chest, abdomen and pelvis was ordered and revealed suspected cavernous transformation of the portal vein with suspected varices near the gastroesophageal junction and within the abdomen, and hepatomegaly with spleen size at the upper limit of normal. Octreotide was started after the CT results. A gastroscopy was done 24h after presentation and found portal hypertensive gastropathy and esophageal varices (2 Grade II and 1 Grade I). Sclerotherapy was performed. Post-gastroscopy ultrasound supported earlier radiographic findings of cavernous portal vein transformation and hepatosplenomegaly. Moreover, the ultrasound noted normal flow direction in the portal and hepatic veins. The patient has not re-presented for further episodes of gastrointestinal bleeding.

Conclusion(s)

This case report supports the previously reported association between Goldenhar syndrome and portal venous anomalies. Early consideration may lead to prompt diagnosis and management of the potentially life-threatening complications of portal hypertension in this population.

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Disclosure of Interest

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Scintillation light detection in the 6-m drift-length ProtoDUNE Dual Phase liquid argon TPC

DUNE is a dual-site experiment for long-baseline neutrino oscillation studies, neutrino astrophysics and nucleon decay searches. ProtoDUNE Dual Phase (DP) is a 6  ×  6  ×  6 m 3 liquid argon time-projection-chamber (LArTPC) that recorded cosmic-muon data at the CERN Neutrino Platform in 2019-2020 as a prototype of the DUNE Far Detector. Charged particles propagating through the LArTPC produce ionization and scintillation light. The scintillation light signal in these detectors can provide the trigger for non-beam events. In addition, it adds precise timing capabilities and improves the calorimetry measurements. In ProtoDUNE-DP, scintillation and electroluminescence light produced by cosmic muons in the LArTPC is collected by photomultiplier tubes placed up to 7 m away from the ionizing track. In this paper, the ProtoDUNE-DP photon detection system performance is evaluated with a particular focus on the different wavelength shifters, such as PEN and TPB, and the use of Xe-doped LAr, considering its future use in giant LArTPCs. The scintillation light production and propagation processes are analyzed and a comparison of simulation to data is performed, improving understanding of the liquid argon properties.

In vitro antiplasmodial activity of selected plants from the Colombian North Coast with low cytotoxicity

Background

Plants are an important option in the treatment of malaria, especially in endemic regions, and are a less expensive and more accessible alternative with a lower risk of toxicity. Colombia has a great diversity of plants, and evaluation of natural extracts could result in the discovery of new compounds for the development of antimalarial drugs. The purpose of this work was to evaluate the in vitro antiplasmodial activity and the cytotoxicity of plant extracts from the Colombian North Coast against Plasmodium falciparum.

Materials and Methods

The antiplasmodial activity of 12 plant species from the Colombian North Coast that are used in traditional medicine was evaluated through in vitro cultures of P. falciparum, and the cytotoxicity of extracts of these species to human cells was determined. Plant extracts with high antiplasmodial activity were subjected to preliminary phytochemical screening.

Results

Extracts from five plants had promising antiplasmodial activity. Specifically, Bursera simaruba (Burseraceae) (bark), Guazuma ulmifolia Lam. (Malvaceae) (whole plant), Murraya exotica L. (Rutaceae) (leaves), Hippomane mancinella L. (Euphorbiaceae) (seeds), and Capparis odoratissima Jacq. (Capparaceae) (leaves). Extracts presented 50% inhibitory concentration values between 1 and 9 μg/ml. Compared to no extract, these active plant extracts did not show cytotoxic effects on mononuclear cells or hemolytic activity in healthy human erythrocytes.

Conclusions

The results obtained from this in vitro study of antiplasmodial activity suggest that active plant extracts from the Colombian North Coast are promising for future bioassay-guided fractionation to allow the isolation of active compounds and to elucidate their mechanism of action against Plasmodium spp.

The World Organisation for Animal Health - current and potential roles in safe international trade of bees and other insects

The World Organisation for Animal Health (WOAH, founded as OIE) is the recognised intergovernmental standard-setting organisation for animal health and welfare. The WOAH mandate is to support its members in the prevention of the spread of animal diseases of concern, as listed in the Terrestrial Animal Health Code (Terrestrial Code). Once a disease, infection or infestation is listed, national Veterinary Authorities have the obligation regularly to notify WOAH of the presence or absence of the listed disease. In regard to insects, the scope of the Terrestrial Code limits its recommendations to preserving the health of bees (species of the genus Apis, extended to the genus Bombus and to the stingless bees for one disease). However, it does not include standards to mitigate the potential animal health risks associated with the international trade of other insects. A description of the standard-setting process and a review of the history of the standards for bee health highlight the resources and requirements to expand the scope of the Terrestrial Code to include recommendations for animal health risk mitigation measures for the safety of international trade in insects. Any initiative to develop guidance on insect trade should include WOAH in its role as the sole global standard-setting organisation on animal health and welfare matters. This aligns with the WOAH commitment to a One Health approach.

Can there be a common, risk-based framework for decisions around live insect trade?

A network of scientists involved in shipment of live insects has met and generated a series of articles on issues related to live insect transport. The network is diverse, covering large-scale commercial interests, government operated areawide control programmes, biomedical research and many smaller applications, in research, education and private uses. Many insect species have a record of safe transport, pose minimal risks and are shipped frequently between countries. The routine shipments of the most frequently used insect model organism for biomedical research, Drosophila melanogaster, is an example. Successful large scale shipments from commercial biocontrol and pollinator suppliers also demonstrate precedents for low-risk shipment categories, delivered in large volumes to high quality standards. Decision makers need access to more information (publications or official papers) that details actual risks from the insects themselves or their possible contaminants, and should propose proportionate levels of management. There may be harm to source environments when insects are collected directly from the wild, and there may be harm to receiving environments. Several risk frameworks include insects and various international coordinating bodies, with experience of guidance on relevant risks, exist. All stakeholders would benefit from an integrated overview of guidance for insect shipping, with reference to types of risk and categories of magnitude, without trying for a single approach requiring universal agreement. Proposals for managing uncertainty and lack of data for smaller or infrequent shipments, for example, must not disrupt trade in large volumes of live insects, which are already supporting strategic objectives in several sectors.

Prospects for beyond the Standard Model physics searches at the Deep Underground Neutrino Experiment: DUNE Collaboration

The Deep Underground Neutrino Experiment (DUNE) will be a powerful tool for a variety of physics topics. The high-intensity proton beams provide a large neutrino flux, sampled by a near detector system consisting of a combination of capable precision detectors, and by the massive far detector system located deep underground. This configuration sets up DUNE as a machine for discovery, as it enables opportunities not only to perform precision neutrino measurements that may uncover deviations from the present three-flavor mixing paradigm, but also to discover new particles and unveil new interactions and symmetries beyond those predicted in the Standard Model (SM). Of the many potential beyond the Standard Model (BSM) topics DUNE will probe, this paper presents a selection of studies quantifying DUNE's sensitivities to sterile neutrino mixing, heavy neutral leptons, non-standard interactions, CPT symmetry violation, Lorentz invariance violation, neutrino trident production, dark matter from both beam induced and cosmogenic sources, baryon number violation, and other new physics topics that complement those at high-energy colliders and significantly extend the present reach.

Effect of a gradually increasing temperature on the behavioural and physiological response of juvenile Hippocampus erectus: Thermal preference, tolerance, energy balance and growth

The physiological and behavioural responses of ectotherms to temperature is strongly dependent on the individuals' previous thermal history. Laboratory based studies investigating the mechanisms of thermoregulation in marine ectotherms, however, rarely consider key temporal elements of thermal exposure, such as the rate at which temperature changes. We tested the hypothesis that juvenile seahorses, Hippocampus erectus, from a tropical coastal lagoon in Yucatan, Mexico, would exhibit variations in physiological and behavioural descriptors of thermoregulation when submitted to contrasting regimes during 30 days: temperature constant at 25 °C (C 25); gradually increasing 1 °C every 5 days from 25 to 30 °C (GI 25-30); and constant at 30 °C (C 30). Immediately after exposure, critical maximum temperature, thermal preference, oxygen consumption, partial energy balance, growth rate and survival of seahorses were measured. Seahorses exposed to GI 25-30 showed a significantly higher critical thermal maxima (37.8 ± 0.9 °C), preference (28.7 ± 0.4 °C), growth (1.10 ± 0.49%) and survival (97.6%) than those exposed to C 30 (36.5 ± 1, 29.4 ± 0.3 °C, 0.48 ± 0.32%, 73.8%, respectively). Both high temperature regimes induced metabolic depression, but ramping resulted in a greater amount of energy assimilated (278.9 ± 175.4 J g^-1 day^-1) and higher energy efficiency for growth (89.8%) than constant exposure to 30 °C (115.4 ± 63.4 J g^-1 day^-1, 65.3%, respectively). Gradually increasing temperature allowed physiological mechanisms of thermal adjustment to take place, reflecting the capacity of juvenile H. erectus to respond to environmental change. Despite its advantage, this capacity is limited in time, since the cumulative effect of thermal exposure affected metabolic performance, eventually compromising survival. The study of seahorse response to thermal variations in the context of ocean warming needs to consider the temporal elements of thermal exposure to foresee its vulnerability under future scenarios.

A screening of plants used in Colombian traditional medicine revealed the anti-inflammatory potential of Physalis angulata calyces

The use of natural products by communities from the Colombian Caribbean region to treat health issues, together with biodiversity and geographical features, constitute a great scenery to develop new therapies based on ethnopharmacological heritage. Here, we investigated the anti-inflammatory potential of 10 commonly used plants in Colombian folk medicine, evaluating their effect on nitric oxide (NO) production by LPS-stimulated RAW 264.7 macrophages. The most active plant was evaluated in vivo using 12-O-tetradecanoyl-phorbol-13-acetate (TPA)-induced mouse ear edema, along with its effect on the production of pro-inflammatory mediators in vitro. The extract of Physalis angulata L. calyces showed the highest activity. This extract was fractionated and its dichloromethane fraction (DF) was the most active in vitro, inhibiting the production of NO, prostaglandin E₂ (PGE₂), interleukin (IL)-1β, IL-6, tumor necrosis factor (TNF)-α and monocyte chemotactic protein (MCP)-1 (CCL2). In vivo, DF showed a significant inhibition of ear edema and myeloperoxidase (MPO) activity, with evident reduction of the leukocyte infiltration into tissue. Our results support the ethnopharmacological use of the selected plants in folk medicine. P. angulata dichloromethane fraction represents a promising source of pharmacological compounds with great potential therapeutic use to treat inflammatory illness.

Usefulness of PSA Density and PSA Excess in the Differential Diagnosis between Prostate Cancer and Benign Prostatic Hypertrophy

The usefulness of PSA density (PSAD) was evaluated in relation to the volume of the transitional zone (PSAT) and PSA excess. With this purpose we conducted a study including 27 patients diagnosed as having prostatic cancer (PC) and 46 patients with benign prostatic hypertrophy (BPH). In all of them, the PSA concentration in the serum was determined as well as the total prostatic volume and the transitional zone volume; digital rectal examination (DRE) was also performed. The major diagnostic efficacy was obtained with the excess of PSA (73%, cutoff = -13 ng/ml), followed by DRE (68%), PSAT (64%, cutoff = 0.5), PSAD (64%, cutoff = 0.2), and lastly PSA and ultrasonography (60%). Multivariate analysis (logistic regression) demonstrated PSA excess and DRE to be the best predictors. The model obtained by regression shows the best positive predictive value, and PSA excess the best negative predictive value. Consequently, PSA excess could be relevant in prostate cancer diagnosis.

Upconversion thermometry: a new tool to measure the thermal resistance of nanoparticles

The rapid evolution in luminescence thermometry in the last few years gradually shifted the research from the fabrication of more sensitive nanoarchitectures towards the use of the technique as a tool for thermal bioimaging and for the unveiling of properties of the thermometers themselves and of their local surroundings, for example to evaluate heat transport at unprecedented small scales. In this work, we demonstrated that KLu(WO4)2:Ho3+,Tm3+ nanoparticles are able to combine controllable heat release and upconversion thermometry permitting to estimate its thermal resistance (in air), a key parameter to model the heat transfer at the nanoscale.

High frequency oscillatory ventilation in children. What do we know so far?

Respiratory failure in children continues to be a common and important indication for admission to intensive care units around the world. Acute respiratory distress syndrome represents the most severe form of respiratory failure in children and results from a variety of pulmonary and extra-pulmonary conditions. Despite important strides in our understanding and improved ventilator strategies of this very heterogeneous disease process, the mortality continues to be fairly high at 33%. High frequency oscillatory ventilation is an alternative form of mechanical ventilation with some attractive features in respect to attempting to improve gas exchange limiting ventilator induced lung injury. The objective of this review is to discuss the principles and the physiology of high frequency oscillatory ventilation, and its role in the management of children with respiratory failure. The adult literature will briefly be reviewed. The main emphasis on this review will be on the use of the "open lung" strategy in conditions that cause a reduction in functional residual capacity. In addition the "low volume" strategy that is useful in the setting of airleaks, such as pneumothorax and pneumomediastinum, will be briefly discussed.

Fertility of a high-altitude sheep model is compromised by deficiencies in both preovulatory follicle development and plasma LH availability

At high altitude, hypoxia and/or oxidative stress may compromise fertility. This study tested the relative effect of short- or long-term exposure to high-altitude hypobaric hypoxia and oxidative stress in sheep on preovulatory follicle dynamics and gonadotrophin secretion. Thus, growth dynamics, stereidogenic function and competence to ovulate of preovulatory follicles, as well as FSH and LH availability throughout the entire oestrous cycle, were compared among sheep native from low and high altitude, and sheep newcomers to high altitude. The results indicates that short-term exposure in sheep newcomers to high altitude has a deleterious effect on both the ovarian function (affecting preovulatory follicular development) and the pituitary function (diminishing plasma LH availability). On the other hand, there were no detected differences in the preovulatory follicular development in sheep adapted to high altitude for generations and, conversely, LH secretion was increased, which suggests an adaptive mechanism. The treatment with antioxidant agents during a relative short period for the time of folliculogenesis (approximately 1 month and a half) changed substantially the development of preovulatory follicles in short-term exposed sheep to similar patterns than in sheep native and living to both high and low altitude. These results highlight the role of oxidative stress in the detriment of the reproductive function in individuals recently exposed to high-altitude hypoxic environment.

Crossover versus mutation: a comparative analysis of the evolutionary strategy of genetic algorithms applied to combinatorial optimization problems

Since their first formulation, genetic algorithms (GAs) have been one of the most widely used techniques to solve combinatorial optimization problems. The basic structure of the GAs is known by the scientific community, and thanks to their easy application and good performance, GAs are the focus of a lot of research works annually. Although throughout history there have been many studies analyzing various concepts of GAs, in the literature there are few studies that analyze objectively the influence of using blind crossover operators for combinatorial optimization problems. For this reason, in this paper a deep study on the influence of using them is conducted. The study is based on a comparison of nine techniques applied to four well-known combinatorial optimization problems. Six of the techniques are GAs with different configurations, and the remaining three are evolutionary algorithms that focus exclusively on the mutation process. Finally, to perform a reliable comparison of these results, a statistical study of them is made, performing the normal distribution z-test.

The metabolic response to postnatal leptin in rats varies with age and may be litter dependent

Hyperleptinemia during postnatal life induces long-term effects on metabolism. However, these effects are controversial as both increased and decreased propensity towards obesity has been reported. To further analyze the effects of chronic neonatal hyperleptinemia on the subsequent metabolic profile, male Wistar rats proceeding from 18 different litters (8 pups/litter) received a daily subcutaneous injection of either saline (10 ml/kg, n=36) or leptin (3 μg/g, n=36) from postnatal day (PND) 2 to PND9. Rats were sacrificed at 10, 40, or 150 days of age. At 10 days of age, leptin treated rats had decreased body weight (p<0.001) and body fat (p<0.05). Leptin levels and glycemia were increased (p<0.01), whereas insulin, total lipids, triglycerides and glycerol levels were decreased (p<0.05). At PND40 rats receiving leptin had increased glycemia (p<0.01) and plasma HDL and LDL levels, but decreased total lipids (p<0.05). At PND150 neonatal leptin treatment induced different effects in rats raised in different litters. Rats from litter 1 had increased body weight (p<0.05), body fat (p<0.01), and plasma leptin (p<0.001), cholesterol (p<0.001), triglyceride (p<0.001), total lipid (p<0.001), LDL (p<0.05), and glycerol (p<0.001) levels. In rats from litter 2 these parameters did not differ from controls. Rats from litter 3 had decreased body weight (p<0.05), visceral fat (p<0.01) and plasma leptin (p<0.001), cholesterol (p<0.001), triglyceride (p<0.001), glycerol (p<0.001), and HDL (p<0.001) levels. In conclusion, the metabolic response to postnatal leptin varies with age, with the response in adulthood being variable and most likely influenced by other factors, including the genetic make-up.

Interactive image guidance in skull base surgery using an opto-electronic device

The applicability of an image guidance frameless system based on an opto-electronic sensor device in skull base surgery was explored in this study. Five embalmed heads with external fiducial markers placed in noncoplanar points were scanned (CT scan) and different skull base approaches were reproduced in these specimens. The opto-electronic system is comprised of an infrared camera, a local rigid body, and a 24-light-emitting diode probe attached to different surgical instruments. DOS-based calibration and transformation software and Unix-based surgical planning software were also used. The anatomic landmarks identified during the dissection were matched with the corresponding points derived from computed tomographic (CT) scans. This information allowed the surgeon to develop a three-dimensional representation of the surgical field and to anticipate the next anatomic structure encountered during the dissection. This infrared device operated in real time, is not affected by external factors with regard to its accuracy, and does not interfere with standard neurosurgical techniques. This frameless system is helpful in minimizing the risk of morbidity and provides an accurate guide during the approach, as well as unobstructed access to the surgical field.

Autologous mesenchymal stem cell treatment increased T regulatory cells with no effect on disease activity in two systemic lupus erythematosus patients

Mesenchymal stem cells (MSCs) exert suppressive effects in several disease models including lupus prone mice. However, autologous MSC therapy has not been tested in human systemic lupus erythematosus (SLE). We evaluate the safety and efficacy of bone marrow (BM)-derived MSCs in two SLE patients; the suppressor effect of these cells in-vitro and the change in CD4+CD25+FoxP3+ T regulatory (Treg) cells in response to treatment. Two females (JQ and SA) of 19 and 25 years of age, fulfilling the 1997 American College of Rheumatology (ACR) criteria for SLE were infused with autologous BM-derived MSCs. Disease activity indexes and immunological parameters were assessed at baseline, 1, 2, 7 and 14 weeks. Peripheral blood lymphocyte (PBL) subsets and Treg cells were quantitated by flow cytometry, and MSCs tested for in-vitro suppression of activation and proliferation of normal PBLs. No adverse effects or change in disease activity indexes were noted during 14 weeks of follow-up, although circulating Treg cells increased markedly. Patient MSCs effectively suppressed in-vitro PBL function. However, JQ developed overt renal disease 4 months after infusion. MSC infusion was without adverse effects, but did not modify initial disease activity in spite of increasing CD4+CD25+FoxP3+ cell counts. One patient subsequently had a renal flare. We speculate that the suppressive effects of MSC-induced Treg cells might be dependent on a more inflammatory milieu, becoming clinically evident in patients with higher degrees of disease activity.

Feasibility of irrigating pickleweed (Salicornia bigelovii. Torr) with hyper-saline drainage water

Reuse of drainage water (DW) for irrigation reduces the volume of DW requiring treatment or disposal. We conducted a greenhouse study to evaluate the performance of the halophyte Salicornia bigelovii Torr. when irrigated with hyper-saline DW and seawater (SW) treatments, ranging from 1/3 strength to full strength (18-49 dS m(-1)), in a sand-culture system. Results indicate that Salicornia grows well over the entire range of iso-osmotic SW and DW salinity treatments. Moreover, when boron (B) was added to SW treatments to concentrations equivalent to that of corresponding 1/3- and 2/3-strength DW treatments (i.e., 9 and 17 mg L(-1)), growth was not affected, and tissue B concentrations were <150 mg kg(-1) dry wt. However, when plants were irrigated with synthetic DW where B was reduced to solution culture levels (0.5-1.0 mg L(-1)), plants generally performed worse than when irrigated with actual DW high in B at the same salinity level. Evapotranspiration (ET) rates exceeded that lost from an evaporation pan from 1.5 to 2.5 times. Using a method accounting for changes in the isotopic signature of water in the reservoir due to evaporation, we estimated that high ET rates were due primarily to high transpiration rates (>78% of ET). The salt content in the tissue was very high (ash content 43-52%), but ionic composition in the shoot tissue reflected that of the treatment water used to irrigate the plants. These data indicate that hyper-saline DW, characteristic of California's San Joaquin Valley, can be used to irrigate Salicornia and substantially reduce drainage volumes.

Mortality in psittacine birds resembling Pacheco's disease in Spain

The sudden death of five sulphur-crested cockatoos (Cacatua galerita) with no apparent clinical signs was investigated. The birds had hepatitis with intranuclear inclusion bodies (IIBs), as well as IIBs in mononuclear spleen cells, epithelial cells of the kidney tubules and endothelial cells of the glomerular capillaries. Ultrastructurally, icosahedral herpesvirus-like particles, 110 to 115 nm in diameter were found consistent with Pacheco's disease. This is the first time the disease has been reported in cockatoos in Spain.

A pilot experience launching a national dose protocol for vascular and interventional radiology

The design of a national dose protocol for interventional radiology has been one of the tasks during the European SENTINEL Coordination Action. The present paper describes the pilot experience carried out in cooperation with the Spanish Society on Vascular and Interventional Radiology (SERVEI). A prospective sample of procedures was initially agreed. A common quality control of the X-ray systems was carried out, including calibration of the air kerma area product (KAP) meters. Occupational doses of the radiologists involved in the survey were also included in the survey. A total of 10 Spanish hospitals with interventional X-ray units were involved. Six hundred and sixty-four patient dose data were collected from 397 diagnostic and 267 therapeutic procedures. Occupational doses were evaluated in a sample of 635 values. The obtained KAP median/mean values (Gy.cm2) for the gathered procedures were: biliary drainage (30.6/68.9), fistulography (4.5/9.8), lower limb arteriography (52.2/60.7), hepatic chemoembolisation (175.8/218.3), iliac stent (45.9/73.2) and renal arteriography (39.1/59.8). Occupational doses (mean monthly values, in mSv) were 1.9 (over apron); 0.3 (under apron) and 4.5 (on hands). With this National experience, a protocol was agreed among the SENTINEL partners to conduct future similar surveys in other European countries.

Pathophysiology and fate of hepatocytes in a mouse model of mitochondrial hepatopathies

BACKGROUND

Although oxidative phosphorylation defects can affect the liver, these conditions are poorly understood, partially because of the lack of animal models.

AIMS

To create and characterise the pathophysiology of mitochondrial hepatopathies in a mouse model.

METHODS

A mouse model of mitochondrial hepatopathies was created by the conditional liver knockout (KO) of the COX10 gene, which is required for cytochrome c oxidase (COX) function. The onset and progression of biochemical, molecular and clinical phenotypes were analysed in several groups of animals, mostly at postnatal days 23, 56, 78 and 155.

RESULTS

Biochemical and histochemical analysis of liver samples from 23-56-day-old KO mice showed liver dysfunction, a severe COX deficiency, marked mitochondrial proliferation and lipid accumulation. Despite these defects, the COX-deficient hepatocytes were not immediately eliminated, and apoptosis followed by liver regeneration could be observed only at age 78 days. Hepatocytes from 56-78-day-old KO mice survived despite very low COX activity but showed a progressive depletion of glycogen stores. In most animals, hepatocytes that escaped COX10 ablation were able to proliferate and completely regenerate the liver between days 78 and 155.

CONCLUSIONS

The results showed that when faced with a severe oxidative phosphorylation defect, hepatocytes in vivo can rely on glycolysis/glycogenolysis for their bioenergetic needs for relatively long periods. Ultimately, defective hepatocytes undergo apoptosis and are replaced by COX-positive cells first observed in the perivascular regions.

Association between polymorphisms of folate-metabolizing enzymes and risk of prostate cancer

Polymorphisms of the genes 5'-10'-methylenetetrahydrofolate reductase (MTHFR, 677CT and 1298AC), methionine synthase (MTR, 2756AC) and methionine synthase reductase (MTRR, 66AC) provoke variations in enzyme activity, which can lead to alterations in the metabolism of folates and in the synthesis of S-adenosyl-methionine (SAM), the most active methyl donor in the body. This could play an important role in carcinogenesis through the degree of DNA methylation and of nucleotide synthesis. In the present study, four polymorphisms were studied, two of the methylenetetrahydrofolate reductase gene, and the other two of methionine synthase and methionine synthase reductase. Our aim was to study the association between prostate carcinoma susceptibility and these polymorphisms. A hospital-based case-control study was conducted in 182 patients (mean age: 70.7+/-7.29 years) with histologically confirmed prostate carcinoma and in 205 control subjects (mean age: 70.3+/-7.82 years) diagnosed with benign prostatic hyperplasia (BPH). Genomic DNA was extracted from peripheral leukocytes. Comparison of the MTHFR CT and TT genotypes in patients and the controls revealed significant differences (0.57 vs 0.38) (OR: 2.19, 95% CI: 1.46-3.30) and (0.06 vs 0.15) (OR: 0.36, 95% CI: 0.17-0.73), respectively. No statistically significant differences were found between patients and controls with respect to the MTHFR 1298AC, the MTR 2756AC and the MTRR 66AC polymorphisms. However, among the patients, the MTR 2756 allele C was related to a high Gleason score. We conclude that the polymorphism MTHFR C677T is clearly related to prostatic carcinogenesis, on the contrary to the other polymorphisms studied, although the MTR 2756 allele C acts as a factor of tumor aggressiveness, this being found in tumors with high carcinogenic potential.

Gamma knife radiosurgery for melanoma/renal cell carcinoma brain metastases 1 -10 lesions with optimized margin dose: Improved tumor control and survival

8581

Background: Radioresistant brain metastases melanoma/renal cell carcinoma cause significant morbidity and mortality: response to whole brain external beam radiotherapy (WBXRT) is minimal, chemotherapy role is investigative, and surgery has its indications and limitations. Reports of survival with Gamma Knife Radiosurgery (GK) is mixed. Reports indicate that 80 to 90% of tumor failure following GK is in the margin: recent multivariate analyses indicate tumor control dependence on margin dose. This study evaluates the impact of better control of brain lesions and consequent reduction of CNS death on overall survival. Methods: Between 10/2002 and 12/2005, 24 consecutive patients with melanoma and renal cell carcinoma male/female radio 14/10, 20 melanoma and 4 renal cell were treated by WBXRT followed by GK radiosurgery utilizing optimized margin dose. Dose was (16 - 20 Gy) to the 50% line with adequate margin to reduce systematic and other associated errors. This was achieved by combining the separate errors associated with the procedure; extent of tumor infiltration beyond gross tumor margin; GK/procedure mechanical precision limitations; MRI image transfer spatial limitations and beam profile margin dose sensitivity. Karnofsky Performance status was 70 - 90%. Follow-up period was 52 months. Results: The mean survival period for the 24 patients with 1 - 10 lesions was 14.11 months: median survival by Kaplan-Meier was 12.0 months. This result is a significant improvement on the 5.5 months reported earlier from this institution for 1 - 5 lesions treated with non-optimized GK dosage; and data by Lavin, et al, at 8 months for predominantly solitary lesions. Conclusions: Melanoma and renal cell carcinoma brain metastases respond very well to GK radiosurgery with optimized margin dose: mean survival for these patients with 1 -3 and 4 - 10 lesions is 14.11 months and comparable to the survival of patients with brain metastases from lung and breast patients: More studies along this line are called for. Patients with multiple metastatic brain lesions from melanoma and renal cell cancers stand to benefit.

No significant financial relationships to disclose.

Scanning probe microscopies applied to the study of the domain wall in a ferroelectric crystal

Scanning near-field optical microscopy is capable of measuring the topography and optical signals at the same time. This fact makes this technique a valuable tool in the study of materials at nanometric scale and, in particular, of ferroelectric materials, as it permits the study of their domains structure without the need of chemical etching and, therefore, not damaging the surface (as will be demonstrated later). We have measured the scanning near-field optical microscopy transmission, as well as the topography, of an RbTiOPO(4) single crystalline slab, which exhibits two different of macroscopic ferroelectric domains. A chemical selective etching has been performed to distinguish between them, obtaining areas with a noticeable roughness (C(-) domain) in comparison with the original flat aspect of the other ones (C(+) domain). The effects of the selective chemical etching have been quantified in topographic images obtained by means of our fibre tip probe, and have been compared to topographic images obtained by Atomic Force Microscopy, with a better resolution. The near-field optical transmission images recorded have been obtained under different excitation wavelengths. These images are modulated by the light scattering due to the grains at the rough surface, which depends on the excitation wavelength used. In addition, they show a significant optical contrast due to the variations of the dielectric constant on the proximity of the ferroelectric domain wall.

Responses to a questionnaire on networking between OIE Reference Laboratories and OIE Collaborating Centres

Two separate questionnaires were distributed to 20 OIE Collaborating Centres and 160 OIE Reference Laboratories to assess the current status of networking and collaboration among OIE Reference Laboratories and between OIE Reference Laboratories and OIE Collaborating Centres. The questionnaire for the OIE Reference Laboratories contained 7 sections with questions on networking between laboratories, reporting of information, biosecurity quality control, and financing. Emphasis was placed in obtaining information on inter-laboratory relationships and exchange of expertise, training needs and sharing of data and information. The questionnaire for the OIE Collaborating Centres contained six sections with the emphasis on aspects related to awareness of services that can be provided, expertise that could be made available, sharing of information and the relationship with the national veterinary services of the countries concerned. The responses to the questionnaires were collated, categorised and statistically evaluated to allow for tentative inferences on the data provided. Valuable information emanated from the data identifying the current status of networking and indicating possible shortcomings that could be addressed to improve networking.

Treatment with adefovir dipivoxil in a renal transplant patient with renal insufficiency and lamivudine-resistant hepatitis B infection

Lamivudine is a safe, effective treatment for hepatitis B virus (HBV) reactivation after renal transplantation. However, prolonged lamivudine therapy can produce resistance to the drug. Adefovir dipivoxil (ADV) has demonstrated efficacy in patients with lamivudine resistance, but there is limited clinical experience in patients with either renal transplants or severe renal insufficiency. A 47-year-old man with asymptomatic HBV infection underwent renal transplantation in November 1995. In September 2000 lamivudine therapy was initiated to treat HBV reactivation. The outcome was good, with negative HBV DNA levels. Two years later, significant viral replication developed again. At that time the patient already had advanced renal insufficiency due to chronic graft nephropathy. The transaminase levels were increased, and the HBV DNA reached greater than 200,000 copies/mL by polymerase chain reaction, with development of ascites and cirrhosis. The patient was started on ADV 10 mg every 72 hours (dose adjusted to renal function). There was rapid normalization of hepatic enzymes and progressive decline of the viral load. HBV DNA became negative after 6 months of ADV treatment. The renal function has since remained stable. This case suggests that ADV can be safe and effective in the treatment of renal transplant patients with lamivudine-resistant hepatitis B, even in the presence of advanced renal insufficiency.

Thirst changes in offspring of hyperreninemic rat dams

The aim of this study was to investigate the changes in thirst dependence on the renin-angiotensin system (RAS), in offspring of hyperreninemic, hyperdipsic, and natriophilic rat dams. Female rats underwent a partial aortic ligature between the renal arteries (PAL) or were sham-operated (SHAM). At 6 days of age, offspring of PAL (O-PAL) and SHAM (O-SHAM) dams were injected with isoproterenol (subcutaneously, 500 microg/kg body weight) or vehicle. Pretreatment with captopril (intraperitoneally, 50 mg/kg) on isoproterenol-induced thirst was also studied. Plasma renin activity in dams and hematocrit and osmolality in pups were measured. O-PAL had a greater water intake than O-SHAM. However, they responded similarly to isoproterenol or isoproterenol with captopril pretreatment. Only minor differences in hematocrit and osmolality were found between O-SHAM and O-PAL rats after isoproterenol or vehicle treatment. Beta-adrenergic or angiotensinergic responsivity seems not to be altered in offspring of hyperrenimic, hyperdipsic, and natriophilic dams. Nevertheless, other thirst responses of offspring may be critically dependent upon uterine conditions.

Anthrone and oxanthrone C-glycosides from Picramnia latifolia collected in Peru

Cytotoxicity-based, bioassay-guided fractionation of the chloroform-soluble extracts of both the roots and leaves of Picramnia latifolia led to the isolation of two new anthrone C-glycosides, picramniosides G (1) and H (2), two new oxanthrone C-glycosides, mayosides D (3) and E (4), and a new benzanthrone natural product, 6,8-dihydroxy-10-methyl-7H-benz[de]anthracen-7-one (5), together with 10 known compounds, 6,8-dihydroxy-4-methyl-7H-benz[de]anthracen-7-one (6), nataloe-emodin (7), chrysophanein, chrysophanol, 1,5-dihydroxy-7-methoxy-3-methylanthraquinone, pulmatin, 7-hydroxycoumarin, 7-hydroxy-6-methoxycoumarin, beta-sitosterol, and beta-sitosterol glucoside. The structures of 1-5 were established by spectroscopic methods, including 1D and 2D NMR, HRMS, and CD data interpretation. The cytotoxic activity of all isolates was evaluated in a small panel of human cancer cell lines. Compound 7 exhibited significant in vitro cytotoxic activity in the tested cell lines, but no significant activity was observed with an in vivo hollow fiber model at doses of 6.25, 12.5, 25, and 50 mg/kg/injection.

[Neurocysticercosis and immigration]

Formerly an endemic disorder, the frequency of neurocysticercosis (NCC) in Spain has been declining during recent decades until reaching its near extinction. However, the strong migratory flow during recent years towards large cities from countries where NCC is highly prevalent, particularly the Andean area of South America, has been followed by a growing increase ot this infestation among immigrants. Since NCC is commonly acquired by direct contamination from carriers of the tapeworm Taenia solium, there may be an emergence of NCC among Spanish-born population unless preventive measures are taken.

Transvascular ethanol embolization: first option for the management of symptomatic nonfunctioning renal allografts left in situ

BACKGROUND

Transplantectomy has been the conventional therapy for symptomatic failed grafts left in situ (FGLIS). Graft intolerance syndrome (GIS) is a common complication after withdrawal of immunosuppression. Our group first reported transvascular ethanol embolization (TVEE) as an alternative for the management of GIS.

OBJECTIVE

Our goal was to evaluate the efficacy and safety of TVEE in a large series of patients with symptomatic FGLIS.

PATIENTS AND METHODS

From January 1989 to December 2001, 944 patients received cadaveric renal transplants in our center. During this period, 59 patients with FGLIS underwent TVEE (50+/-7 years, 71% men, 15% diabetics). TVEE was performed using a transfemoral approach. A balloon occlusion catheter was inflated in the renal artery before ethanol injection (10-12 cc). The position of coils completed the procedure. No systematic prophylactic antibiotic or steroid treatment was administered.

RESULTS

The main indication for TVEE was GIS (51 patients, 86%). TVEE was initially successful in 39 patients (66%). A second TVEE, which was performed in 9 of 20 unresolved cases, was successful in six. After a second TVEE, the efficacy increased to 76%. The most frequent complication was postembolization syndrome (62%), which was manifested by fever, local pain, and inflammation that generally resolved in 48-72 hours. No major complications or deaths were observed. One of four patients underwent transplantectomy. Histologic examination of the removed graft showed renal tissue necrosis (10 cases) and pyonephrosis (4 cases).

CONCLUSIONS

TVEE, a safe and effective technique, may be considered as the treatment of choice for symptomatic FGLIS.