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Sample records for metilbutirato hmb aumenta

  1. USEFULNESS OF Β-HYDROXY-Β-METHYLBUTYRATE (HMB) SUPPLEMENTATION IN DIFFERENT SPORTS: AN UPDATE AND PRACTICAL IMPLICATIONS.

    PubMed

    Albert, Francisco J; Morente-Sánchez, Jaime; Ortega, Francisco B; Castillo, Manuel J; Gutiérrez, Ángel

    2015-07-01

    Introducción: aunque el -hidroxi--metilbutirato (HMB) se ha empleado generalmente como suplemento para aumentar la masa muscular y la fuerza, es necesario un mejor entendimiento de su función y averiguar en qué deportes es más efectivo. Objetivos: el objetivo principal de esta revisión es actualizar y resumir el conocimiento existente en torno a la utilización del HMB para clasificarla en función de cada modalidad deportiva, con especial mención a aquellas actividades con un alto grado de destrucción muscular, como pueden ser el fútbol, el rugby o el fútbol americano. Métodos: se utilizó la base de datos PubMed para la búsqueda de artículos. Esta revisión presenta los resultados sobre la utilización de HMB clasificados por deportes. Resultados: la mayoría de los artículos seleccionados sugieren que cuando una persona entrenada o no entrenada se somete a un ejercicio intenso o diferente al habitual, el HMB puede atenuar el catabolismo muscular producido e iniciar los procesos anabólicos necesarios para recuperar lo antes posible. De esta forma, el HMB podría aplicarse en algunos momentos concretos de la temporada deportiva en los que hubiera períodos con entrenamientos de alta intensidad, o durante un periodo con alta densidad competitiva y con poca recuperación entre competiciones, o bien durante las primeras fases de la readaptación física después de una lesión y/o durante cualquier otra situación en la que el rendimiento o la recuperación se pueden ver afectados por un entorno altamente catabólico. Conclusión: esta revisión pretende aclarar y definir los posibles mecanismos por los que la suplementación con HMB puede ser efectiva en deportes de resistencia (ciclismo y carreras de fondo), en deportes de fuerza-potencia (fútbol, yudo, waterpolo, remo, fútbol americano y musculación) y en actividades deportivas recreacionales.

  2. International Society of Sports Nutrition Position Stand: beta-hydroxy-beta-methylbutyrate (HMB).

    PubMed

    Wilson, Jacob M; Fitschen, Peter J; Campbell, Bill; Wilson, Gabriel J; Zanchi, Nelo; Taylor, Lem; Wilborn, Colin; Kalman, Douglas S; Stout, Jeffrey R; Hoffman, Jay R; Ziegenfuss, Tim N; Lopez, Hector L; Kreider, Richard B; Smith-Ryan, Abbie E; Antonio, Jose

    2013-01-01

    Position Statement: The International Society of Sports Nutrition (ISSN) bases the following position stand on a critical analysis of the literature on the use of beta-hydroxy-beta-methylbutyrate (HMB) as a nutritional supplement. The ISSN has concluded the following. 1. HMB can be used to enhance recovery by attenuating exercise induced skeletal muscle damage in trained and untrained populations. 2. If consuming HMB, an athlete will benefit from consuming the supplement in close proximity to their workout. 3. HMB appears to be most effective when consumed for 2 weeks prior to an exercise bout. 4. Thirty-eight mg·kg·BM-1 daily of HMB has been demonstrated to enhance skeletal muscle hypertrophy, strength, and power in untrained and trained populations when the appropriate exercise prescription is utilized. 5. Currently, two forms of HMB have been used: Calcium HMB (HMB-Ca) and a free acid form of HMB (HMB-FA). HMB-FA may increase plasma absorption and retention of HMB to a greater extent than HMB-CA. However, research with HMB-FA is in its infancy, and there is not enough research to support whether one form is superior. 6. HMB has been demonstrated to increase LBM and functionality in elderly, sedentary populations. 7. HMB ingestion in conjunction with a structured exercise program may result in greater declines in fat mass (FM). 8. HMB's mechanisms of action include an inhibition and increase of proteolysis and protein synthesis, respectively. 9. Chronic consumption of HMB is safe in both young and old populations. PMID:23374455

  3. International Society of Sports Nutrition Position Stand: beta-hydroxy-beta-methylbutyrate (HMB)

    PubMed Central

    2013-01-01

    Position Statement: The International Society of Sports Nutrition (ISSN) bases the following position stand on a critical analysis of the literature on the use of beta-hydroxy-beta-methylbutyrate (HMB) as a nutritional supplement. The ISSN has concluded the following. 1. HMB can be used to enhance recovery by attenuating exercise induced skeletal muscle damage in trained and untrained populations. 2. If consuming HMB, an athlete will benefit from consuming the supplement in close proximity to their workout. 3. HMB appears to be most effective when consumed for 2 weeks prior to an exercise bout. 4. Thirty-eight mg·kg·BM-1 daily of HMB has been demonstrated to enhance skeletal muscle hypertrophy, strength, and power in untrained and trained populations when the appropriate exercise prescription is utilized. 5. Currently, two forms of HMB have been used: Calcium HMB (HMB-Ca) and a free acid form of HMB (HMB-FA). HMB-FA may increase plasma absorption and retention of HMB to a greater extent than HMB-CA. However, research with HMB-FA is in its infancy, and there is not enough research to support whether one form is superior. 6. HMB has been demonstrated to increase LBM and functionality in elderly, sedentary populations. 7. HMB ingestion in conjunction with a structured exercise program may result in greater declines in fat mass (FM). 8. HMB’s mechanisms of action include an inhibition and increase of proteolysis and protein synthesis, respectively. 9. Chronic consumption of HMB is safe in both young and old populations. PMID:23374455

  4. Effects of 2-hydroxy-4-(methylthio) butanoic acid (HMB) on microbial growth in continuous culture.

    PubMed

    Noftsger, S M; St-Pierre, N R; Karnati, S K R; Firkins, J L

    2003-08-01

    2-Hydroxy-4-(methylthio) butanoic acid (HMB) positively affects milk composition and yield, potentially through ruminal actions. Four continuous culture fermenters were used to determine the optimal concentration of HMB for digestibility of organic matter (OM), neutral detergent fiber (NDF), acid detergent fiber (ADF), and hemicellulose and synthesis of microbial N. A highly degradable mix of hay and grain was used as a basal diet to simulate a typical lactation diet. Three concentrations of HMB (0, 0.055, and 0.110%) and one concentration of dl-Met (0.097%) were infused into the fermenters according to a 4 x 4 Latin square design. Digesta samples were collected during the last 3 d of each of the four 10-d experimental periods. Digestibility of OM, hemicellulose, and NDF was largely insensitive to treatment. Digestibility of ADF showed a quadratic effect to supplementation of HMB, with 0.055% having lower digestibility than 0 or 0.110%. Total production of VFA was not influenced by HMB supplementation, but differences in concentration and production of individual VFA were seen. Isobutyrate increased linearly with increasing HMB supplementation. Propionate concentration decreased linearly with increased HMB supplementation, but propionate production showed a quadratic trend (P = 0.13). A higher concentration of acetate was detected for dl-Met compared with the highest HMB concentration. There were trends (P < 0.15) for dl-Met to decrease the production of isobutyrate and to lower the concentration of butyrate when compared with HMB. Microbial efficiency was not different among treatments. The proportion of bacterial N produced from NH3-N decreased linearly with increasing HMB, and bacteria receiving dl-Met synthesized more N from NH3-N than those receiving HMB. These data suggest that supplementation of HMB may have a sparing effect on branched chain volatile fatty acids because the fatty acids are not needed to provide carbon for synthesis of valine, isoleucine and

  5. A very rare case of uterine PEComa HMB45 negative: primitive or relapse?

    PubMed Central

    Pecorino, Basilio; Scibilia, Giuseppe; Galia, Antonio; Scollo, Paolo

    2016-01-01

    Perivascular epithelioid cell tumors (PEComas) represent a rare group of tumours with uncertain malignancy potential exhibiting an immunophenotype characterized by actin and Human Melanoma Black 45 (HMB45) immunoreactivity. Our case concerns about a rare malignant uterine perivascular epithelioid cell tumour diagnosed in a patient underwent to subtotal hysterectomy with unclear diagnosis, 12 years before. Histological diagnosis after colposcopic exam with biopsy revealed a perivascular epithelioid cell tumor, with immunohistochemical profle negative for HMB45. Negativity for HMB45, already described in literature, could be due to important cellular modifcations of tumoral tissue. In our case, tumour was unresectable, progression of disease occurred during medical treatment and the patient died after 6 months. Lack of information about frst surgery doesn't allow to surely categorized the tumor as primitive or relapse. Further studies are necessary to understand some immunohistochemical anomaly like negativity for HMB45. PMID:26900338

  6. β-Hydroxy-β-Methylbutyrate (HMB) Promotes Neurite Outgrowth in Neuro2a Cells

    PubMed Central

    Girón, María D.; Cabrera, Elena; Campos, Nefertiti; Manzano, Manuel; Rueda, Ricardo; López-Pedrosa, Jose M.

    2015-01-01

    β-Hydroxy-β-methylbutyrate (HMB) has been shown to enhance cell survival, differentiation and protein turnover in muscle, mainly activating phosphoinositide-3-kinase/protein kinase B (PI3K/Akt) and mitogen-activated protein kinases/ extracellular-signal-regulated kinases (MAPK/ERK) signaling pathways. Since these two pathways are related to neuronal survival and differentiation, in this study, we have investigated the neurotrophic effects of HMB in mouse neuroblastoma Neuro2a cells. In Neuro2a cells, HMB promotes differentiation to neurites independent from any effects on proliferation. These effects are mediated by activation of both the PI3K/Akt and the extracellular-signal-regulated kinases (ERK1/2) signaling as demonstrated by the use of specific inhibitors of these two pathways. As myocyte-enhancer factor 2 (MEF2) family of transcription factors are involved in neuronal survival and plasticity, the transcriptional activity and protein levels of MEF2 were also evaluated. HMB promoted MEF2-dependent transcriptional activity mediated by the activation of Akt and ERK1/2 pathways. Furthermore, HMB increases the expression of brain glucose transporters 1 (GLUT1) and 3 (GLUT3), and mTOR phosphorylation, which translates in a higher protein synthesis in Neuro2a cells. Furthermore, Torin1 and rapamycin effects on MEF2 transcriptional activity and HMB-dependent neurite outgrowth support that HMB acts through mTORC2. Together, these findings provide clear evidence to support an important role of HMB in neurite outgrowth. PMID:26267903

  7. Effect of HMB supplementation on body composition, fitness, hormonal profile and muscle damage indices.

    PubMed

    Portal, Shawn; Eliakim, Alon; Nemet, Dan; Halevy, Orna; Zadik, Zvi

    2010-07-01

    There is a huge market for ergogenic supplements for athletes. However, only a few products have been proven to have ergogenic effects and to be effective at improving muscle strength and body composition. One such supplement is beta-hydroxy beta-methylbutyrate (HMB). Derived from the amino acid leucine and its keto acid alpha-ketoisocaproate (KIC), HMB has been well documented as an oral ergogenic supplement commonly used by athletes. Several studies have shown that combining exercise training with HMB supplementation leads to increased muscle mass and strength, and there is some anecdotal evidence of aerobic improvement. However, HMB supplementation has been found to be effective mainly for untrained individuals. While previous reviews have emphasized three main pathways for HMB's mode of action: 1) enhancement of sarcolemmal integrity via cytosolic cholesterol, 2) inhibition of protein degradation via proteasomes, and 3) increased protein synthesis via the mTOR pathway, more recent studies have suggested additional possible mechanisms for its physiological effects. These include decreased cell apoptosis and enhanced cell survival, increased proliferation, differentiation and fusion via the MAPK/ERK and PI3K/Akt pathways, and enhanced IGF-I transcription. These are described here, and hormonal interactions are discussed, along with HMB dosage and safety issues.

  8. β-Hydroxy-β-Methylbutyrate (HMB) Normalizes Dexamethasone-Induced Autophagy-Lysosomal Pathway in Skeletal Muscle

    PubMed Central

    Girón, María D.; Vílchez, Jose D.; Shreeram, Sathyavageeswaran; Salto, Rafael; Manzano, Manuel; Cabrera, Elena; Campos, Nefertiti; Edens, Neile K.; Rueda, Ricardo; López-Pedrosa, Jose M.

    2015-01-01

    Dexamethasone-induced muscle atrophy is due to an increase in protein breakdown and a decrease in protein synthesis, associated with an over-stimulation of the autophagy-lysosomal pathway. These effects are mediated by alterations in IGF-1 and PI3K/Akt signaling. In this study, we have investigated the effects of β-Hydroxy-β-methylbutyrate (HMB) on the regulation of autophagy and proteosomal systems. Rats were treated during 21 days with dexamethasone as a model of muscle atrophy. Co-administration of HMB attenuated the effects promoted by dexamethasone. HMB ameliorated the loss in body weight, lean mass and the reduction of the muscle fiber cross-sectional area (shrinkage) in gastrocnemius muscle. Consequently, HMB produced an improvement in muscle strength in the dexamethasone-treated rats. To elucidate the molecular mechanisms responsible for these effects, rat L6 myotubes were used. In these cells, HMB significantly attenuated lysosomal proteolysis induced by dexamethasone by normalizing the changes observed in autophagosome formation, LC3 II, p62 and Bnip3 expression after dexamethasone treatment. HMB effects were mediated by an increase in FoxO3a phosphorylation and concomitant decrease in FoxO transcriptional activity. The HMB effect was due to the restoration of Akt signaling diminished by dexamethasone treatment. Moreover, HMB was also involved in the regulation of the activity of ubiquitin and expression of MurF1 and Atrogin-1, components of the proteasome system that are activated or up-regulated by dexamethasone. In conclusion, in vivo and in vitro studies suggest that HMB exerts protective effects against dexamethasone-induced muscle atrophy by normalizing the Akt/FoxO axis that controls autophagy and ubiquitin proteolysis. PMID:25658432

  9. β-Hydroxy-β-methylbutyrate (HMB) normalizes dexamethasone-induced autophagy-lysosomal pathway in skeletal muscle.

    PubMed

    Girón, María D; Vílchez, Jose D; Shreeram, Sathyavageeswaran; Salto, Rafael; Manzano, Manuel; Cabrera, Elena; Campos, Nefertiti; Edens, Neile K; Rueda, Ricardo; López-Pedrosa, Jose M

    2015-01-01

    Dexamethasone-induced muscle atrophy is due to an increase in protein breakdown and a decrease in protein synthesis, associated with an over-stimulation of the autophagy-lysosomal pathway. These effects are mediated by alterations in IGF-1 and PI3K/Akt signaling. In this study, we have investigated the effects of β-Hydroxy-β-methylbutyrate (HMB) on the regulation of autophagy and proteosomal systems. Rats were treated during 21 days with dexamethasone as a model of muscle atrophy. Co-administration of HMB attenuated the effects promoted by dexamethasone. HMB ameliorated the loss in body weight, lean mass and the reduction of the muscle fiber cross-sectional area (shrinkage) in gastrocnemius muscle. Consequently, HMB produced an improvement in muscle strength in the dexamethasone-treated rats. To elucidate the molecular mechanisms responsible for these effects, rat L6 myotubes were used. In these cells, HMB significantly attenuated lysosomal proteolysis induced by dexamethasone by normalizing the changes observed in autophagosome formation, LC3 II, p62 and Bnip3 expression after dexamethasone treatment. HMB effects were mediated by an increase in FoxO3a phosphorylation and concomitant decrease in FoxO transcriptional activity. The HMB effect was due to the restoration of Akt signaling diminished by dexamethasone treatment. Moreover, HMB was also involved in the regulation of the activity of ubiquitin and expression of MurF1 and Atrogin-1, components of the proteasome system that are activated or up-regulated by dexamethasone. In conclusion, in vivo and in vitro studies suggest that HMB exerts protective effects against dexamethasone-induced muscle atrophy by normalizing the Akt/FoxO axis that controls autophagy and ubiquitin proteolysis.

  10. The relationship of endogenous plasma concentrations of β-Hydroxy β-Methyl Butyrate (HMB) to age and total appendicular lean mass in humans.

    PubMed

    Kuriyan, Rebecca; Lokesh, Deepa P; Selvam, Sumithra; Jayakumar, J; Philip, Mamatha G; Shreeram, Sathyavageeswaran; Kurpad, Anura V

    2016-08-01

    The maintenance of muscle mass and muscle strength is important for reducing the risk of chronic diseases. The age- related loss of muscle mass and strength is associated with adverse outcomes of physical disability, frailty and death. β-Hydroxy β-Methyl Butyrate (HMB), a metabolite of leucine, has beneficial effects on muscle mass and strength under various catabolic conditions. The objectives of the present study were to determine if age- related differences existed in endogenous plasma HMB levels, and to assess if HMB levels correlated to total appendicular lean mass and forearm grip strength. Anthropometry, dietary and physical activity assessment, and the estimation of fasting plasma HMB concentrations and handgrip strength were performed on the 305 subjects (children, young adults and older adults). Lean mass, which serves as a surrogate for muscle mass was measured using dual energy X-ray absorptiometry (DEXA). Mean plasma HMB concentrations were significantly lower with increasing age groups, with children having highest mean HMB concentration (p<0.01) followed by young adults and older adults. Female subjects (across all ages) had significantly lower plasma HMB concentrations. A significant positive correlation between HMB concentrations and appendicular lean mass normalized for body weight (%), appendicular lean mass (r=0.37; p<0.001) was observed in the young adults and older adults group. Handgrip strength was positively associated with plasma HMB concentrations in young adults (r=0.58; p<0.01) and the older adults group (r=0.28; p<0.01). The findings of the present study suggest that there is an age- related decline in endogenous HMB concentrations in humans and the HMB concentrations were positively correlated with appendicular lean mass and hand grip strength in young adults and older adults group. PMID:27108182

  11. The relationship of endogenous plasma concentrations of β-Hydroxy β-Methyl Butyrate (HMB) to age and total appendicular lean mass in humans.

    PubMed

    Kuriyan, Rebecca; Lokesh, Deepa P; Selvam, Sumithra; Jayakumar, J; Philip, Mamatha G; Shreeram, Sathyavageeswaran; Kurpad, Anura V

    2016-08-01

    The maintenance of muscle mass and muscle strength is important for reducing the risk of chronic diseases. The age- related loss of muscle mass and strength is associated with adverse outcomes of physical disability, frailty and death. β-Hydroxy β-Methyl Butyrate (HMB), a metabolite of leucine, has beneficial effects on muscle mass and strength under various catabolic conditions. The objectives of the present study were to determine if age- related differences existed in endogenous plasma HMB levels, and to assess if HMB levels correlated to total appendicular lean mass and forearm grip strength. Anthropometry, dietary and physical activity assessment, and the estimation of fasting plasma HMB concentrations and handgrip strength were performed on the 305 subjects (children, young adults and older adults). Lean mass, which serves as a surrogate for muscle mass was measured using dual energy X-ray absorptiometry (DEXA). Mean plasma HMB concentrations were significantly lower with increasing age groups, with children having highest mean HMB concentration (p<0.01) followed by young adults and older adults. Female subjects (across all ages) had significantly lower plasma HMB concentrations. A significant positive correlation between HMB concentrations and appendicular lean mass normalized for body weight (%), appendicular lean mass (r=0.37; p<0.001) was observed in the young adults and older adults group. Handgrip strength was positively associated with plasma HMB concentrations in young adults (r=0.58; p<0.01) and the older adults group (r=0.28; p<0.01). The findings of the present study suggest that there is an age- related decline in endogenous HMB concentrations in humans and the HMB concentrations were positively correlated with appendicular lean mass and hand grip strength in young adults and older adults group.

  12. Expression of microphthalmia transcription factor, S100 protein, and HMB-45 in malignant melanoma and pigmented nevi

    PubMed Central

    Xia, Jianxin; Wang, Yanlong; Li, Fuqiu; Wang, Jinfeng; Mu, Yan; Mei, Xianglin; Li, Xue; Zhu, Wenjing; Jin, Xianhua; Yu, Kai

    2016-01-01

    Malignant melanoma (MM) is a type of malignant tumor, which originates from neural crest melanocytes. MM progresses rapidly and results in a high mortality rate. The present study aims to investigate the expression of microphthalmia transcription factor (MITF), the S100 protein, and HMB-45 in MM and pigmented nevi. A total of 32 MM samples (including three skin metastasis, three lymph node metastasis and two spindle cell MM samples), two Spitz nevus samples, four pigmented nevus samples and two blue nevus samples were collected. The expression levels of S100 protein, HMB-45, and MITF were observed via immunostaining. The S100 protein exhibited high positive rates in MM and pigment disorders (96.7 and 100%, respectively), but with low specificity. The S100 protein was also expressed in fibroblasts, myoepithelial cells, histocytes and Langerhans cells in normal skin samples. HMB-45 had high specificity. Its positive expression was only confined to MM cells and junctional nevus cells. Furthermore, HMB-45 was not expressed in melanocytes in the normal tissue samples around the tumor or in the benign intradermal nevus cells. MITF exhibited high specificity and high sensitivity. It was expressed in the nuclei of melanocytes, MM cells and nevus cells. It was observed to be strongly expressed in metastatic MM and spindle cell MMs. Thus, MITF may present as a specific immunomarker for the diagnosis and differential diagnosis of MM. PMID:27602212

  13. Expression of microphthalmia transcription factor, S100 protein, and HMB-45 in malignant melanoma and pigmented nevi

    PubMed Central

    Xia, Jianxin; Wang, Yanlong; Li, Fuqiu; Wang, Jinfeng; Mu, Yan; Mei, Xianglin; Li, Xue; Zhu, Wenjing; Jin, Xianhua; Yu, Kai

    2016-01-01

    Malignant melanoma (MM) is a type of malignant tumor, which originates from neural crest melanocytes. MM progresses rapidly and results in a high mortality rate. The present study aims to investigate the expression of microphthalmia transcription factor (MITF), the S100 protein, and HMB-45 in MM and pigmented nevi. A total of 32 MM samples (including three skin metastasis, three lymph node metastasis and two spindle cell MM samples), two Spitz nevus samples, four pigmented nevus samples and two blue nevus samples were collected. The expression levels of S100 protein, HMB-45, and MITF were observed via immunostaining. The S100 protein exhibited high positive rates in MM and pigment disorders (96.7 and 100%, respectively), but with low specificity. The S100 protein was also expressed in fibroblasts, myoepithelial cells, histocytes and Langerhans cells in normal skin samples. HMB-45 had high specificity. Its positive expression was only confined to MM cells and junctional nevus cells. Furthermore, HMB-45 was not expressed in melanocytes in the normal tissue samples around the tumor or in the benign intradermal nevus cells. MITF exhibited high specificity and high sensitivity. It was expressed in the nuclei of melanocytes, MM cells and nevus cells. It was observed to be strongly expressed in metastatic MM and spindle cell MMs. Thus, MITF may present as a specific immunomarker for the diagnosis and differential diagnosis of MM.

  14. Dietary HMB and β-alanine co-supplementation does not improve in situ muscle function in sedentary, aged male rats.

    PubMed

    Russ, David W; Acksel, Cara; Boyd, Iva M; Maynard, John; McCorkle, Katherine W; Edens, Neile K; Garvey, Sean M

    2015-12-01

    This study evaluated the effects of dietary β-hydroxy-β-methylbutyrate (HMB) combined with β-alanine (β-Ala) in sedentary, aged male rats. It has been suggested that dietary HMB or β-Ala supplementation may mitigate age-related declines in muscle strength and fatigue resistance. A total of 20 aged Sprague-Dawley rats were studied. At age 20 months, 10 rats were administered a control, purified diet and 10 rats were administered a purified diet supplemented with both HMB and β-Ala (HMB+β-Ala) for 8 weeks (approximately equivalent to 3 and 2.4 g per day human dose). We measured medial gastrocnemius (MG) size, force, fatigability, and myosin composition. We also evaluated an array of protein markers related to muscle mitochondria, protein synthesis and breakdown, and autophagy. HMB+β-Ala had no significant effects on body weight, MG mass, force or fatigability, myosin composition, or muscle quality. Compared with control rats, those fed HMB+β-Ala exhibited a reduced (41%, P = 0.039) expression of muscle RING-finger protein 1 (MURF1), a common marker of protein degradation. Muscle from rats fed HMB+β-Ala also exhibited a 45% reduction (P = 0.023) in p70s6K phosphorylation following fatiguing stimulation. These data suggest that HMB+β-Ala at the dose studied may reduce muscle protein breakdown by reducing MURF1 expression, but has minimal effects on muscle function in this model of uncomplicated aging. They do not, however, rule out potential benefits of HMB+β-Ala co-supplementation at other doses or durations of supplementation in combination with exercise or in situations where extreme muscle protein breakdown and loss of mass occur (e.g., bedrest, cachexia, failure-to-thrive). PMID:26579948

  15. Dietary HMB and β-alanine co-supplementation does not improve in situ muscle function in sedentary, aged male rats.

    PubMed

    Russ, David W; Acksel, Cara; Boyd, Iva M; Maynard, John; McCorkle, Katherine W; Edens, Neile K; Garvey, Sean M

    2015-12-01

    This study evaluated the effects of dietary β-hydroxy-β-methylbutyrate (HMB) combined with β-alanine (β-Ala) in sedentary, aged male rats. It has been suggested that dietary HMB or β-Ala supplementation may mitigate age-related declines in muscle strength and fatigue resistance. A total of 20 aged Sprague-Dawley rats were studied. At age 20 months, 10 rats were administered a control, purified diet and 10 rats were administered a purified diet supplemented with both HMB and β-Ala (HMB+β-Ala) for 8 weeks (approximately equivalent to 3 and 2.4 g per day human dose). We measured medial gastrocnemius (MG) size, force, fatigability, and myosin composition. We also evaluated an array of protein markers related to muscle mitochondria, protein synthesis and breakdown, and autophagy. HMB+β-Ala had no significant effects on body weight, MG mass, force or fatigability, myosin composition, or muscle quality. Compared with control rats, those fed HMB+β-Ala exhibited a reduced (41%, P = 0.039) expression of muscle RING-finger protein 1 (MURF1), a common marker of protein degradation. Muscle from rats fed HMB+β-Ala also exhibited a 45% reduction (P = 0.023) in p70s6K phosphorylation following fatiguing stimulation. These data suggest that HMB+β-Ala at the dose studied may reduce muscle protein breakdown by reducing MURF1 expression, but has minimal effects on muscle function in this model of uncomplicated aging. They do not, however, rule out potential benefits of HMB+β-Ala co-supplementation at other doses or durations of supplementation in combination with exercise or in situations where extreme muscle protein breakdown and loss of mass occur (e.g., bedrest, cachexia, failure-to-thrive).

  16. Cellular and Physiological Effects of Dietary Supplementation with β-Hydroxy-β-Methylbutyrate (HMB) and β-Alanine in Late Middle-Aged Mice.

    PubMed

    Vallejo, Julian; Spence, Madoka; Cheng, An-Lin; Brotto, Leticia; Edens, Neile K; Garvey, Sean M; Brotto, Marco

    2016-01-01

    There is growing evidence that severe decline of skeletal muscle mass and function with age may be mitigated by exercise and dietary supplementation with protein and amino acid ingredient technologies. The purposes of this study were to examine the effects of the leucine catabolite, beta-hydroxy-beta-methylbutyrate (HMB), in C2C12 myoblasts and myotubes, and to investigate the effects of dietary supplementation with HMB, the amino acid β-alanine and the combination thereof, on muscle contractility in a preclinical model of pre-sarcopenia. In C2C12 myotubes, HMB enhanced sarcoplasmic reticulum (SR) calcium release beyond vehicle control in the presence of all SR agonists tested (KCl, P<0.01; caffeine, P = 0.03; ionomycin, P = 0.03). HMB also improved C2C12 myoblast viability (25 μM HMB, P = 0.03) and increased proliferation (25 μM HMB, P = 0.04; 125 μM HMB, P<0.01). Furthermore, an ex vivo muscle contractility study was performed on EDL and soleus muscle from 19 month old, male C57BL/6nTac mice. For 8 weeks, mice were fed control AIN-93M diet, diet with HMB, diet with β-alanine, or diet with HMB and β-alanine. In β-alanine fed mice, EDL muscle showed a 7% increase in maximum absolute force compared to the control diet (202 ± 3vs. 188± 5 mN, P = 0.02). At submaximal frequency of stimulation (20 Hz), EDL from mice fed HMB plus β-alanine showed an 11% increase in absolute force (88.6 ± 2.2 vs. 79.8 ± 2.4 mN, P = 0.025) and a 13% increase in specific force (12.2 ± 0.4 vs. 10.8 ± 0.4 N/cm2, P = 0.021). Also in EDL muscle, β-alanine increased the rate of force development at all frequencies tested (P<0.025), while HMB reduced the time to reach peak contractile force (TTP), with a significant effect at 80 Hz (P = 0.0156). In soleus muscle, all experimental diets were associated with a decrease in TTP, compared to control diet. Our findings highlight beneficial effects of HMB and β-alanine supplementation on skeletal muscle function in aging mice.

  17. Cellular and Physiological Effects of Dietary Supplementation with β-Hydroxy-β-Methylbutyrate (HMB) and β-Alanine in Late Middle-Aged Mice

    PubMed Central

    Vallejo, Julian; Spence, Madoka; Cheng, An-Lin; Brotto, Leticia; Edens, Neile K.; Garvey, Sean M.; Brotto, Marco

    2016-01-01

    There is growing evidence that severe decline of skeletal muscle mass and function with age may be mitigated by exercise and dietary supplementation with protein and amino acid ingredient technologies. The purposes of this study were to examine the effects of the leucine catabolite, beta-hydroxy-beta-methylbutyrate (HMB), in C2C12 myoblasts and myotubes, and to investigate the effects of dietary supplementation with HMB, the amino acid β-alanine and the combination thereof, on muscle contractility in a preclinical model of pre-sarcopenia. In C2C12 myotubes, HMB enhanced sarcoplasmic reticulum (SR) calcium release beyond vehicle control in the presence of all SR agonists tested (KCl, P<0.01; caffeine, P = 0.03; ionomycin, P = 0.03). HMB also improved C2C12 myoblast viability (25 μM HMB, P = 0.03) and increased proliferation (25 μM HMB, P = 0.04; 125 μM HMB, P<0.01). Furthermore, an ex vivo muscle contractility study was performed on EDL and soleus muscle from 19 month old, male C57BL/6nTac mice. For 8 weeks, mice were fed control AIN-93M diet, diet with HMB, diet with β-alanine, or diet with HMB and β-alanine. In β-alanine fed mice, EDL muscle showed a 7% increase in maximum absolute force compared to the control diet (202 ± 3vs. 188± 5 mN, P = 0.02). At submaximal frequency of stimulation (20 Hz), EDL from mice fed HMB plus β-alanine showed an 11% increase in absolute force (88.6 ± 2.2 vs. 79.8 ± 2.4 mN, P = 0.025) and a 13% increase in specific force (12.2 ± 0.4 vs. 10.8 ± 0.4 N/cm2, P = 0.021). Also in EDL muscle, β-alanine increased the rate of force development at all frequencies tested (P<0.025), while HMB reduced the time to reach peak contractile force (TTP), with a significant effect at 80 Hz (P = 0.0156). In soleus muscle, all experimental diets were associated with a decrease in TTP, compared to control diet. Our findings highlight beneficial effects of HMB and β-alanine supplementation on skeletal muscle function in aging mice. PMID

  18. [β-hydroxy-β-methylbutyrate as a dietary supplement (I): metabolism and toxicity].

    PubMed

    Manjarrez-Montes-de-Oca, Rafael; Torres-Vaca, Mateo; González-Gallego, Javier; Alvear-Ordenes, Ildefonso

    2014-11-27

    Introducción: El -hidroxi--metilbutirato (HMB) es un metabolito de la leucina producido a partir del ácido -cetoisocaproico. El HMB se utiliza como suplemento nutricional en el deporte desde 1997, atribuyéndosele una disminución de la proteólisis muscular. En los últimos años, se han descrito efectos positivos del HMB en diversas patologías, lo cual aumenta su probable utilidad para la mejora de la salud. Objetivos: Los objetivos de la presente revisión son: conocer el metabolismo del HMB, así como su absorción y excreción; estudiar la posible toxicidad del HMB; e identificar los mecanismos celulares y moleculares de acción del HMB cuando se utiliza como suplemento nutricional. Métodos: Se utilizaron las bases de datos Web of Science, Pubmed y SportDiscus para realizar la búsqueda de artículos. Los resultados se dividieron en dos partes; en este artículo se abordan el metabolismo y la posible toxicidad del HMB. Resultados: Diversos estudios relacionan al HMB con el metabolismo del colesterol en el músculo esquelético, probablemente reduciendo la proteólisis, a través del 3-hidroxi-3-metilglutaril-coenzima A, que se transforma a mevalonato, actuando como precursor en la síntesis de colesterol. Sin embargo, el HMB podría transformarse en beta-hidroxi-butirato a través del metabolismo del acetoacetato, por medio de la beta-hidroxibutirato dehidrogenasa. Por otra parte, la forma química más habitual en los suplementos nutricionales es la sal de calcio de HMB y la dosis más utilizada, de 3 g de HMB/día. Los estudios realizados en humanos y en animales muestran que no existen efectos adversos por el consumo de HMB. Conclusiones: Los efectos metabólicos y la ausencia de toxicidad del HMB lo hacen adecuado para su uso como suplemento nutricional.

  19. PIXE Analysis of Metal Hull Bolts From HMB DeBraak

    SciTech Connect

    Correll, Francis D.; Cole, Lord K.; Slater, Charles J.; Vanhoy, Jeffrey R.; Fithian, Charles H.

    2009-03-10

    HMB DeBraak was a 16-gun British brig-sloop that sank in a squall on May 25, 1798 off Cape Henlopen, Delaware. Silt covered the wooden hull shortly after it sank, preserving it until DeBraak was raised in 1986. The items recovered from the ship include metal bolts that held the hull together. We used PIXE to measure the compositions of 45 of the bolts and found that they are nearly pure copper (98.3% on average), with most also containing small amounts of iron (0.87%), nickel (0.039%), arsenic (0.43%), silver (0.089%), lead (0.18%), and bismuth (0.12%). A few contain a little indium, tin, or antimony, but none contain zinc above the quantization level. The compositions are similar to those reported for 18th-century English copper, but different from several copper alloys also used to make hull bolts. We conclude that, when DeBraak was last fitted out in 1795-1797, the Royal Navy was still using bolts similar to William Forbes's mechanically hardened pure copper bolts. Forbes's process represents the successful innovation and application of new technology in Royal Navy ships during the wars of the late 18th century.

  20. Renal epithelioid angiomyolipoma with epithelial cysts: demonstration of Melan A and HMB45 positivity in the cystic epithelial lining.

    PubMed

    Filho, José do Egypto Pereira; Meneses de Amorim, Daniele; Sweet, Gloria Maria Maranhão; Rodrigues de Freitas, Luiz Antonio; Athanazio, Paulo Roberto Fontes; Athanazio, Daniel Abensur

    2012-10-01

    Renal angiomyolipoma (AML) may present as rare variants such as epithelioid and AML with epithelial cysts posing difficulties for the diagnosis to the surgical pathologist. We report a case of a 46-year-old male patient presenting a 5-cm solid tumor in the lower pole of the left kidney, with cystic changes at cut surface. The tumor exhibited 95% of epithelioid cells with atypical nuclei. A small focus of typical AML was observed. The immunoprofile of tumor cells was classical of AML including expression of melanocytic markers such as HMB45 and Melan A. We report the immunohistochemical study of the cystic component in an epithelioid AML. In contrast to the immunoreactivity reported in typical AML, the present case shows obvious expression of melanocytic markers in the cystic epithelial lining. This is strong evidence that these cysts are neoplastic and derived from AML, rather than entrapped native collecting duct epithelium.

  1. Nuclear to non-nuclear Pmel17/gp100 expression (HMB45 staining) as a discriminator between benign and malignant melanocytic lesions

    PubMed Central

    Rothberg, Bonnie E Gould; Moeder, Christopher B; Kluger, Harriet; Halaban, Ruth; Elder, David E; Murphy, George F; Lazar, Alexander; Prieto, Victor; Duncan, Lynn McDivitt; Rimm, David L

    2008-01-01

    HMB45 is a mouse monoclonal antibody raised against Pmel17/gp100, a melanoma-specific marker, which is routinely used in the diagnosis of primary cutaneous malignant melanoma. The standard expression pattern for a positive HMB45 staining result on immunohistochemistry is based upon the results of chromogenic-based methods. We re-evaluated patterns of HMB45 staining across the 480-core “SPORE melanoma progression array” containing lesions representing the spectrum of melanocytic lesions ranging from thin nevus to visceral metastasis using the fluorescence-based staining technique and Automated Quantitative Analysis (AQUA) of the obtained digital images. The methods validated the expected cytoplasmic HMB45 staining pattern in 70/108 malignant lesions and in the epithelial components of nevus specimens. However, the fluorescence-based approach revealed a nuclear HMB45 localization present in the dermal component of all nevi that was not seen before. This nuclear localization could not be observed on routine chromogenic stains because the standard hematoxylin nuclear counterstain overwhelms the weak nuclear HMB45 stain. The thin (0.450±0.253) and thick (0.513±0.227) nevi had strongly positive mean ln(nuclear/non-nuclear AQUA score ratios), which are significantly higher than those from the group of malignant lesions (p<0.0001). This finding was reproduced on a smaller but independent progression array composed of nevi and melanomas from the Yale Pathology archives (p<0.01). The odds ratio associated with a sample being a nevus was 2.24 (95% CI: 1.87-2.69, p<0.0001) for each 0.1 unit increase of the ln(nuclear/non-nuclear AQUA score ratio) to yield an ROC curve with 0.93 units of area and a simultaneously maximized sensitivity of 0.92 and specificity of 0.80 for distinguishing benign nevi from malignant melanomas. Based on this preliminary study, we propose that the ratio of nuclear to non-nuclear HMB45 staining may be useful for diagnostic challenges in

  2. Effect of Oral Beta-Hydroxy-Beta-Methylbutyrate (HMB) Supplementation on Physical Performance in Healthy Old Women Over 65 Years: An Open Label Randomized Controlled Trial

    PubMed Central

    Berton, Linda; Bano, Giulia; Carraro, Sara; Veronese, Nicola; Pizzato, Simona; Bolzetta, Francesco; De Rui, Marina; Valmorbida, Elena; De Ronch, Irene; Perissinotto, Egle; Coin, Alessandra; Manzato, Enzo; Sergi, Giuseppe

    2015-01-01

    Although older people are particularly liable to sarcopenia, limited research is available on beta-hydroxy-beta-methylbutyrate (HMB) supplementation in this population, particularly in healthy subjects. In this parallel-group, randomized, controlled, open-label trial, we aimed to evaluate whether an oral supplement containing 1.5 g of calcium HMB for 8 weeks could improve physical performance and muscle strength parameters in a group of community-dwelling healthy older women. Eighty healthy women attending a twice-weekly mild fitness program were divided into two equal groups of 40, and 32 of the treated women and 33 control completed the study. We considered a change in the Short Physical Performance Battery (SPPB) score as the primary outcome and changes in the peak torque (PT) isometric and isokinetic strength of the lower limbs, 6-minute walking test (6MWT), handgrip strength and endurance as secondary outcomes. Body composition was assessed with dual-energy X-ray absorptiometry (DXA) and peripheral quantitative computerized tomography (pQCT). The mean difference between the two groups on pre-post change were finally calculated (delta) for each outcome. After 8 weeks, there were no significant differences between the groups’ SPPB, handgrip strength or DXA parameters. The group treated with HMB scored significantly better than the control group for PT isokinetic flexion (delta = 1.56±1.56 Nm; p = 0.03) and extension (delta = 3.32±2.61 Nm; p = 0.03), PT isometric strength (delta = 9.74±3.90 Nm; p = 0.02), 6MWT (delta = 7.67±8.29 m; p = 0.04), handgrip endurance (delta = 21.41±16.28 s; p = 0.02), and muscle density assessed with pQCT. No serious adverse effects were reported in either group. In conclusion, a nutritional supplement containing 1.5 g of calcium HMB for 8 weeks in healthy elderly women had no significant effects on SPPB, but did significantly improve several muscle strength and physical performance parameters. Trial Registration Clinical

  3. L-leucine, beta-hydroxy-beta-methylbutyric acid (HMB) and creatine monohydrate prevent myostatin-induced Akirin-1/Mighty mRNA down-regulation and myotube atrophy

    PubMed Central

    2014-01-01

    Background The purpose of this study was to examine if L-leucine (Leu), β-hydroxy-β-methylbutyrate (HMB), or creatine monohydrate (Crea) prevented potential atrophic effects of myostatin (MSTN) on differentiated C2C12 myotubes. Methods After four days of differentiation, myotubes were treated with MSTN (10 ng/ml) for two additional days and four treatment groups were studied: 1) 3x per day 10 mM Leu, 2) 3x per day 10 mM HMB, 3) 3x per day 10 mM Crea, 4) DM only. Myotubes treated with DM without MSTN were analyzed as the control condition (DM/CTL). Following treatment, cells were analyzed for total protein, DNA content, RNA content, muscle protein synthesis (MPS, SUnSET method), and fiber diameter. Separate batch treatments were analyzed for mRNA expression patterns of myostatin-related genes (Akirin-1/Mighty, Notch-1, Ski, MyoD) as well as atrogenes (MuRF-1, and MAFbx/Atrogin-1). Results MSTN decreased fiber diameter approximately 30% compared to DM/CTL myotubes (p < 0.001). Leu, HMB and Crea prevented MSTN-induced atrophy. MSTN did not decrease MPS levels compared to DM/CTL myotubes, but MSTN treatment decreased the mRNA expression of Akirin-1/Mighty by 27% (p < 0.001) and MyoD by 26% (p < 0.01) compared to DM/CTL myotubes. shRNA experiments confirmed that Mighty mRNA knockdown reduced myotube size, linking MSTN treatment to atrophy independent of MPS. Remarkably, MSTN + Leu and MSTN + HMB myotubes had similar Akirin-1/Mighty and MyoD mRNA levels compared to DM/CTL myotubes. Furthermore, MSTN + Crea myotubes exhibited a 36% (p < 0.05) and 86% (p < 0.001) increase in Akirin-1/Mighty mRNA compared to DM/CTL and MSTN-only treated myotubes, respectively. Conclusions Leu, HMB and Crea may reduce MSTN-induced muscle fiber atrophy by influencing Akirin-1/Mighty mRNA expression patterns. Future studies are needed to examine if Leu, HMB and Crea independently or synergistically affect Akirin-1/Mighty expression, and how Akirin-1/Mighty

  4. Effects of combined maternal administration with alpha-ketoglutarate (AKG) and β-hydroxy-β-methylbutyrate (HMB) on prenatal programming of skeletal properties in the offspring

    PubMed Central

    2012-01-01

    Background Nutritional manipulations during fetal growth may induce long-term metabolic effects in postnatal life. The aim of the study was to test whether combined treatment of pregnant sows with alpha-ketoglutarate and β-hydroxy-β-methylbutyrate induces additive long-term effects on skeletal system properties in the offspring. Methods The study was performed on 290 pigs obtained from 24 sows divided into 4 equal groups and subjected to experimental treatment during two weeks before delivery. The first group consisted of control sows, while the second group received alpha-ketoglutarate. The third group was treated with β-hydroxy-β-methylbutyrate and the fourth group underwent combined administration of alpha-ketoglutarate and β-hydroxy-β-methylbutyrate. Piglets obtained from sows were reared until slaughter age to perform morphometric, densitometric and mechanical analyses of femur. Serum evaluations of growth hormone, insulin-like growth factor-1, bone-specific alkaline phosphatase and osteocalcin were performed in newborns and 90-day old piglets; additionally, plasma amino acid concentration was measured in newborns. Results Maternal treatment with alpha-ketoglutarate and β-hydroxy-β-methylbutyrate significantly reduced fattening time and increased birth body weight, daily body weight gain, bone weight, volumetric bone mineral density, geometrical parameters and mechanical endurance of femur. These effects were associated with increased serum concentrations of growth hormone, insulin-like growth factor-1, bone-specific alkaline phosphatase and osteocalcin. Furthermore, alpha-ketoglutarate and β-hydroxy-β-methylbutyrate administered solely or in combination significantly increased plasma level of 19 amino acids. Conclusions Hormonal and amino acid evaluations in pigs indicate additive effects of AKG and HMB on systemic growth and development; however, determination of bone properties has not shown such phenomenon. PMID:22578071

  5. [β-hydroxy-β-methylbutyrate as a dietary supplement (II): cell and molecular mechanism of action].

    PubMed

    Manjarrez-Montes-de-Oca, Rafael; Torres-Vaca, Mateo; González-Gallego, Javier; Alvear-Ordenes, Ildefonso

    2014-11-27

    Introducción: En los últimos años el -hidroxi--metilbutirato (HMB) ha sido foco de diversas investigaciones que le atribuyen un efecto sobre la disminución de la proteólisis muscular y un incremento de la masa muscular. Por tanto, se han realizado estudios centrados en los mecanismos celulares y moleculares responsables de dichos efectos. Objetivos: Los objetivos de la presente revisión son: conocer el metabolismo del HMB, así como su absorción y excreción; estudiar la posible toxicidad del HMB; e identificar los mecanismos celulares y moleculares de acción del HMB cuando se utiliza como suplemento nutricional. Métodos: Se utilizaron las bases de datos Web of Science, Pubmed y SportDiscus para realizar la búsqueda de artículos. Los resultados se dividieron en dos partes; en este artículo se presentan los resultados referentes a los mecanismos de acción del HMB. Resultados: No existen suficientes datos que apoyen que la ingesta de HMB incremente la síntesis de colesterol en el músculo. Es posible que existan efectos positivos en el metabolismo muscular a través de la vía mTOR y del sistema ubiquitin-proteasoma, aunque no se conoce su mecanismo de acción. Probablemente, el HMB eleva los niveles sanguíneos de hidroxibutirato y esto podría explicar sus principales efectos sobre la disminución de la proteólisis muscular. Conclusiones: De acuerdo a nuestros resultados, la posibilidad de justificar la acción del HMB a través de la vía del beta-hidroxibutirato abre una interesante línea de investigación para futuros estudios.

  6. Faltar a sesiones de radioterapia aumenta el riesgo de que regrese el cáncer

    Cancer.gov

    Pacientes que faltan a sesiones de radioterapia durante el tratamiento del cáncer tienen un riesgo mayor de que regrese su enfermedad, aun cuando eventualmente completen su plan de tratamiento con radiación, según un nuevo estudio.

  7. Neuropatía persistente aumenta el riesgo de caídas entre supervivientes de cáncer

    Cancer.gov

    Muchas mujeres supervivientes de cáncer tienen problemas de movilidad y de otras funciones físicas como resultado de la neuropatía periférica persistente causada por el tratamiento de quimioterapia, según un estudio nuevo.

  8. Comparison of levonorgestrel-releasing intrauterine device with oral progestins in heavy menstrual bleeding (HMB) cases with uterine leiomyoma (LNG-IUD and oral progestin usage in myoma uteri)

    PubMed Central

    Tosun, Ayse Kavasoglu; Tosun, Ismet; Suer, Necdet

    2014-01-01

    Objective: To compare the effectiveness and acceptability of LNG-IUD with oral progesterone (norethisterone acetate; NETA) in achieving a reduction in volume of the myomas, hemoglobin levels, satisfaction of the women. Methods: This study includes randomized 30 women treated by LNG-IUD and randomized 30 women treated by oral norethisterone (NETA). All these participants in the study have received medical treatment and had been registered as patients in Istanbul Medeniyet University Göztepe Education and Research Hospital. Leiomyoma volumes and hemoglobin levels have been determined. In the third and sixth months, these measurements have been done again. We examined the adverse effects and the treatment continuity. For the statistical analysis of the findings NCSS [Number Cruncher Statistical System] 2007 & PASS 2008 program; student t, Mann Whitney U, Paired Samples t, Wilcoxon Signed Ranks, Ki-Kare, Fisher's Exact Ki-Kare tests have been used. Results: After six months treatment, the reduction of bleeding determined by Visual Bleeding Score (VBS) in LNG-IUD group is 80% and in oral norethisteron group is 56%; in both groups leiomyoma volumes and hemoglobin levels were significantly high. Conclusion: LNG-IUD is a good alternative treatment to the oral progesterone in long term minimizing the hysterectomy for myoma uteri because of the good patient tolerance and easy usage. PMID:25097527

  9. New Variable Stars in the Field of 1RSX J075330.1+044606

    NASA Astrophysics Data System (ADS)

    Moos, Carsten; Hambsch, Josch; Krajci, T.

    2013-04-01

    Based on the observing campaign of the cataclysmic variable 1RSX J075330.1+044606 we have found in the same field eight candidates of new variable stars. The variable type and the elements of each candidate are identified and presented. HMB14= UCAC3-190-083329 is an EW type variable showing the O'Connell effect (succeeding maxima are of unequal height), HMB15= UCAC3-190-083257, HMB17= GSC 00189-01448, HMB18= GSC 00189-01715, HMB19= UCAC3-191-085589 and HMB21= UCAC3-191-085396 are EW type variables, HMB16= UCAC3-190-083374 is an EA type variable of which the period is not yet secured, HMB20= UCAC3-190-083261 is an RRLyrae type RRab variable.

  10. Effect of Beta-Hydroxy Beta-Methylbutyrate on the Onset of Blood Lactate Accumulation and VO2peak in Endurance-Trained Cyclists.

    ERIC Educational Resources Information Center

    Vukovich, Matthew D.; Dreifort, Geri D.

    2001-01-01

    Examined the effect of beta-hydroxy beta-methylbutyrate (HMB) supplementation on maximal oxygen consumption (VO2peak) and onset of blood lactate accumulation (OBLA) in endurance-trained cyclists. Acute exercise did not affect plasma HMB concentrations. OBLA increased with HMB and leucine, with blood glucose significantly greater during the HMB…

  11. A case of hypersensitivity to mosquito bites without peripheral natural killer cell lymphocytosis in a 6-year-old Korean boy.

    PubMed

    Seon, Han-Su; Roh, Ji-Hyeon; Lee, Seung-Ho; Kang, Eun-Kyeong

    2013-01-01

    Hypersensitivity to mosquito bites (HMB) is a rare disease characterized by intense skin reactions such as bulla and necrotic ulcerations at bite sites, accompanied by general symptoms such as high-grade fever and malaise occurred after mosquito bites. It has been suggested that HMB is associated with chronic Epstein-Barr virus (EBV) infection and natural killer (NK) cell leukemia/lymphoma. We describe here a Korean child who presented with 3-yr history of HMB without natural killer cell lymphocytosis. He has been ill for 6 yr with HMB. Close observation and examination for the development of lymphoproliferative status or hematologic malignant disorders is needed.

  12. Protein synthesis in skeletal muscle of neonatal pigs is enhanced by administration of beta-hydroxy-beta-methylbutyrate

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Many low-birth-weight infants experience failure to thrive. The amino acid leucine stimulates protein synthesis in skeletal muscle of the neonate, but less is known about the effects of the leucine metabolite beta-hydroxy-beta-methylbutyrate (HMB). To determine the effects of HMB on protein synthesi...

  13. Protein synthesis in skeletal muscle of neonatal pigs is enhanced by administration of beta-hydroxy-beta-methylbutyrate

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Many low-birth-weight infants experience failure to thrive. The amino acid leucine stimulates protein synthesis in skeletal muscle of the neonate, but less is known about the effects of the leucine metabolite ß-hydroxy-ß-methylbutyrate (HMB). To determine the effects of HMB on protein synthesis and ...

  14. Protein synthesis in skeletal muscle of neonatal pigs is enhanced by administration of Beta-hydroxy-Beta-methylbutyrate

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Many low-birth-weight infants experience failure to thrive. The amino acid leucine stimulates protein synthesis in skeletal muscle of the neonate, but less is known about the effects of the leucine metabolite Beta-hydroxy-Beta-methylbutyrate (HMB). To determine the effects of HMB on protein synthesi...

  15. Knowledge of Latin American Obstetricians and Gynecologists regarding Heavy Menstrual Bleeding.

    PubMed

    Bahamondes, Luis; Marin, Victor; Ciarmatori, Silvia; Silva-Filho, Agnaldo L; Acuña, Juan Manuel; Makuch, Maria Y

    2016-01-01

    Background. Heavy menstrual bleeding (HMB) is a common gynecological complaint affecting quality of life. Objectives. To assess knowledge on diagnosis and treatments of HMB of Latin American (LA) obstetricians and gynecologists (OBGYNs). Methods. A survey was conducted during a scientific meeting, organized to provide updated information on topics of reproductive medicine to OBGYNs from 12 LA countries who were invited to respond to a multiple-choice questionnaire. Results. Of the 210 OBGYNs participating in the survey, from 169 (80.4%) to 203 (96.7%) answered the questions. Most respondents (80%) gave accurate answers regarding the amount of blood loss which defines HMB, underreported the proportion of women who consulted due to HMB, and were aware that the use of combined oral contraceptives (COCs) with ethynyl estradiol is not an adequate treatment in women with HMB. Female OBGYNs and those who worked in the private sector were more prone to report a higher possibility of improvement of HMB with a COC that contained estradiol valerate and dienogest or with a levonorgestrel-releasing intrauterine system. Conclusions. In general, the respondents were aware of the importance of HMB in gynecological practice and of the new medical treatments and underreported the proportion of women who consulted due to HMB. PMID:27648073

  16. Knowledge of Latin American Obstetricians and Gynecologists regarding Heavy Menstrual Bleeding

    PubMed Central

    Marin, Victor; Ciarmatori, Silvia; Silva-Filho, Agnaldo L.; Acuña, Juan Manuel; Makuch, Maria Y.

    2016-01-01

    Background. Heavy menstrual bleeding (HMB) is a common gynecological complaint affecting quality of life. Objectives. To assess knowledge on diagnosis and treatments of HMB of Latin American (LA) obstetricians and gynecologists (OBGYNs). Methods. A survey was conducted during a scientific meeting, organized to provide updated information on topics of reproductive medicine to OBGYNs from 12 LA countries who were invited to respond to a multiple-choice questionnaire. Results. Of the 210 OBGYNs participating in the survey, from 169 (80.4%) to 203 (96.7%) answered the questions. Most respondents (80%) gave accurate answers regarding the amount of blood loss which defines HMB, underreported the proportion of women who consulted due to HMB, and were aware that the use of combined oral contraceptives (COCs) with ethynyl estradiol is not an adequate treatment in women with HMB. Female OBGYNs and those who worked in the private sector were more prone to report a higher possibility of improvement of HMB with a COC that contained estradiol valerate and dienogest or with a levonorgestrel-releasing intrauterine system. Conclusions. In general, the respondents were aware of the importance of HMB in gynecological practice and of the new medical treatments and underreported the proportion of women who consulted due to HMB.

  17. Knowledge of Latin American Obstetricians and Gynecologists regarding Heavy Menstrual Bleeding

    PubMed Central

    Marin, Victor; Ciarmatori, Silvia; Silva-Filho, Agnaldo L.; Acuña, Juan Manuel; Makuch, Maria Y.

    2016-01-01

    Background. Heavy menstrual bleeding (HMB) is a common gynecological complaint affecting quality of life. Objectives. To assess knowledge on diagnosis and treatments of HMB of Latin American (LA) obstetricians and gynecologists (OBGYNs). Methods. A survey was conducted during a scientific meeting, organized to provide updated information on topics of reproductive medicine to OBGYNs from 12 LA countries who were invited to respond to a multiple-choice questionnaire. Results. Of the 210 OBGYNs participating in the survey, from 169 (80.4%) to 203 (96.7%) answered the questions. Most respondents (80%) gave accurate answers regarding the amount of blood loss which defines HMB, underreported the proportion of women who consulted due to HMB, and were aware that the use of combined oral contraceptives (COCs) with ethynyl estradiol is not an adequate treatment in women with HMB. Female OBGYNs and those who worked in the private sector were more prone to report a higher possibility of improvement of HMB with a COC that contained estradiol valerate and dienogest or with a levonorgestrel-releasing intrauterine system. Conclusions. In general, the respondents were aware of the importance of HMB in gynecological practice and of the new medical treatments and underreported the proportion of women who consulted due to HMB. PMID:27648073

  18. Dietary supplementation of β-hydroxy-β-methylbutyrate in animals - a review.

    PubMed

    Szcześniak, K A; Ostaszewski, P; Fuller, J C; Ciecierska, A; Sadkowski, T

    2015-06-01

    The leucine metabolite β-hydroxy-β-methylbutyrate (HMB) has been studied by many researchers over the last two decades. In particular, the utility of HMB supplementation in animals has been shown in numerous studies, which have demonstrated enhanced body weight gain and carcass yield in slaughter animals; positive immunostimulatory effect; decreased mortality; attenuation of sarcopenia in elderly animals; and potential use in pathological conditions such as glucocorticoid-induced muscle loss. The aim of this study was to summarize the body of research on HMB supplementation in animals and to examine possible mechanisms of HMB action. Furthermore, while the safety of HMB supplementation in animals is well documented, studies demonstrating efficacy are less clear. The possible reasons for differences in these findings will also be examined.

  19. Disposition of 2-hydroxy-4-methoxybenzophenone in rats dosed orally, intravenously, or topically.

    PubMed

    el Dareer, S M; Kalin, J R; Tillery, K F; Hill, D L

    1986-01-01

    Administration to rats of oral doses of [14C]-2-hydroxy-4-methoxybenzophenone (HMB) in the range of 3.01-2570 mg/kg revealed that a dose-dependent elimination process was operative at the highest dose. Urinary excretion (63.9-72.9% of the dose in 72 h) was the major route for elimination of radioactivity. An intravenous dose (4.63 mg/kg) distributed rapidly throughout the body of rats and appeared in the urine in an amount (67.4%) similar to those for the oral doses. Rats absorbed large portions of doses of [14C]HMB administered topically, either as an ethanolic solution (50, 200, or 800 micrograms/rat) or formulated in a lotion (50 micrograms/rat). For rats with biliary cannulas, 36.6% of the radioactivity of an intravenous dose (4.46 mg/kg) appeared in the bile in 4 h; the initial half-life for biliary elimination was 40 min. In the bile, at least five radioactive components, none of which was intact HMB, were present. The two major components were glucuronides of HMB and demethylated HMB, and a third was probably a sulfate ester of hydroxylated HMB. In urine, there were nine radioactive components, two of which were unchanged HMB and its glucuronide.

  20. Variation of proteins and proteinases in Entamoeba histolytica lysates containing a protease inhibitor.

    PubMed

    López-Revilla, R; Jiménez-Delgadillo, B; Canto-Ortiz, L; Chávez-Dueñas, L

    1992-01-01

    Sodium dodecyl sulfate (SDS)-lysates of E. histolytica trophozoites were analyzed by electrophoresis in simple and gelatin-containing ("substrate") SDS-polyacrylamide gels. In simple gels, boiled lysates with para hydroxymercuribenzoate (pHMB) had a complex pattern of apparently undegraded proteins; boiled lysates without pHMB showed a major 30 kDa and four minor (43, 46, 63 and 117 kDa) proteins, whereas unheated lysates displayed only the 117 kDa protein. Using substrate gels no gelatinases were detected in heated lysates; unheated lysates without pHMB showed a major 30 kDa and three minor (33, 46 and 68 kDa) gelatinases, whereas those with pHMB presented a major 56 kDa and two minor (70 and 105 kDa) gelatinases. Three caseinase peaks were separated by Sephadex G-75 chromatography from unheated lysates: peak I contained 46, 56 and 117 kDa pHMB-sensitive gelatinases and peaks II and III contained smaller pHMB-resistant caseinases. We conclude that proteins remaining in lysates after SDS-induced proteolysis appear to be mainly proteases relatively resistant to self-digestion whose type and amount changes with the conditions of lysis and the presence of inhibitors; this is exemplified by the finding of the major gelatinase of lysates with pHMB being larger (56 kDa) than in lysates lacking the inhibitor (30 kDa). PMID:1340329

  1. Treatment of Women With an Endometrial Polyp and Heavy Menstrual Bleeding: A Levonorgestrel-Releasing Intrauterine Device or Hysteroscopic Polypectomy?

    PubMed

    van Dijk, Myrthe M; van Hanegem, Nehalennia; de Lange, Maria E; Timmermans, Anne

    2015-01-01

    We performed a literature review of reports comparing a levonorgestrel-releasing intrauterine device (LNG-IUD) with transcervical polyp resection (TCRP) as a treatment for heavy menstrual bleeding (HMB). Our second objective was to investigate the effectiveness of LNG-IUD and TCRP in reducing menstrual bleeding and the patient satisfaction with each technique. No previously reported studies have compared TCRP and LNG-IUD as treatment for HMB in premenopausal women with an endometrial polyp. Likewise, no studies are available on LNG-IUD as a treatment for HMB in the presence of an endometrial polyp. Several studies have found the LNG-IUD to be an effective treatment option for HMB, with high patient satisfaction rates. Evidence of the effectiveness of TCRP as treatment of HMB is scarce. Patient satisfaction is reported relatively good, although persistent or recurrent symptoms appear to be frequent. We conclude that no evidence is available on LNG-IUD as treatment for HMB in women with an endometrial polyp. We hypothesize that LNG-IUD could be a good alternative to TCRP for treating HMB in premenopausal women with a polyp; however, further evidence is needed, and a randomized controlled trial should be performed.

  2. Enteral β-hydroxy-β-methylbutyrate supplementation increases protein synthesis in skeletal muscle of neonatal pigs.

    PubMed

    Kao, Michelle; Columbus, Daniel A; Suryawan, Agus; Steinhoff-Wagner, Julia; Hernandez-Garcia, Adriana; Nguyen, Hanh V; Fiorotto, Marta L; Davis, Teresa A

    2016-06-01

    Many low-birth weight infants are at risk for poor growth due to an inability to achieve adequate protein intake. Administration of the amino acid leucine stimulates protein synthesis in skeletal muscle of neonates. To determine the effects of enteral supplementation of the leucine metabolite β-hydroxy-β-methylbutyrate (HMB) on protein synthesis and the regulation of translation initiation and degradation pathways, overnight-fasted neonatal pigs were studied immediately (F) or fed one of five diets for 24 h: low-protein (LP), high-protein (HP), or LP diet supplemented with 4 (HMB4), 40 (HMB40), or 80 (HMB80) μmol HMB·kg body wt(-1)·day(-1) Cell replication was assessed from nuclear incorporation of BrdU in the longissimus dorsi (LD) muscle and jejunum crypt cells. Protein synthesis rates in LD, gastrocnemius, rhomboideus, and diaphragm muscles, lung, and brain were greater in HMB80 and HP and in brain were greater in HMB40 compared with LP and F groups. Formation of the eIF4E·eIF4G complex and S6K1 and 4E-BP1 phosphorylation in LD, gastrocnemius, and rhomboideus muscles were greater in HMB80 and HP than in LP and F groups. Phosphorylation of eIF2α and eEF2 and expression of SNAT2, LAT1, MuRF1, atrogin-1, and LC3-II were unchanged. Numbers of BrdU-positive myonuclei in the LD were greater in HMB80 and HP than in the LP and F groups; there were no differences in jejunum. The results suggest that enteral supplementation with HMB increases skeletal muscle protein anabolism in neonates by stimulation of protein synthesis and satellite cell proliferation.

  3. Acute β-Hydroxy-β-Methyl Butyrate Suppresses Regulators of Mitochondrial Biogenesis and Lipid Oxidation While Increasing Lipid Content in Myotubes.

    PubMed

    Schnuck, Jamie K; Johnson, Michele A; Gould, Lacey M; Gannon, Nicholas P; Vaughan, Roger A

    2016-10-01

    Leucine modulates synthetic and degradative pathways in muscle, possibly providing metabolic benefits for both athletes and diseased populations. Leucine has become popular among athletes for improving performance and body composition, however little is known about the metabolic effects of the commonly consumed leucine-derived metabolite β-hydroxy-β-methyl butyrate (HMB). Our work measured the effects of HMB on metabolic protein expression, mitochondrial content and metabolism, as well as lipid content in skeletal muscle cells. Specifically, cultured C2C12 myotubes were treated with either a control or HMB ranging from 6.25 to 25 μM for 24 h and mRNA and/or protein expression, oxygen consumption, glucose uptake, and lipid content were measured. Contrary to leucine's stimulatory effect on metabolism, HMB-treated cells exhibited significantly reduced regulators of lipid oxidation including peroxisome proliferator-activated receptor alpha (PPARα) and PPARβ/δ, as well as downstream target carnitine palmitoyl transferase, without alterations in glucose or palmitate oxidation. Furthermore, HMB significantly inhibited activation of the master regulator of energetics, AMP-activated protein kinase. As a result, HMB-treated cells also displayed reduced total mitochondrial content compared with true control or cells equivocally treated with leucine. Additionally, HMB treatment amplified markers of lipid biosynthesis (PPARγ and fatty acid synthase) as well as consistently promoted elevated total lipid content versus control cells. Collectively, our results demonstrate that HMB did not improve mitochondrial metabolism or content, and may promote elevated cellular lipid content possibly through heightened PPARγ expression. These observations suggest that HMB may be most beneficial for populations interested in stimulating anabolic cellular processes.

  4. Acute β-Hydroxy-β-Methyl Butyrate Suppresses Regulators of Mitochondrial Biogenesis and Lipid Oxidation While Increasing Lipid Content in Myotubes.

    PubMed

    Schnuck, Jamie K; Johnson, Michele A; Gould, Lacey M; Gannon, Nicholas P; Vaughan, Roger A

    2016-10-01

    Leucine modulates synthetic and degradative pathways in muscle, possibly providing metabolic benefits for both athletes and diseased populations. Leucine has become popular among athletes for improving performance and body composition, however little is known about the metabolic effects of the commonly consumed leucine-derived metabolite β-hydroxy-β-methyl butyrate (HMB). Our work measured the effects of HMB on metabolic protein expression, mitochondrial content and metabolism, as well as lipid content in skeletal muscle cells. Specifically, cultured C2C12 myotubes were treated with either a control or HMB ranging from 6.25 to 25 μM for 24 h and mRNA and/or protein expression, oxygen consumption, glucose uptake, and lipid content were measured. Contrary to leucine's stimulatory effect on metabolism, HMB-treated cells exhibited significantly reduced regulators of lipid oxidation including peroxisome proliferator-activated receptor alpha (PPARα) and PPARβ/δ, as well as downstream target carnitine palmitoyl transferase, without alterations in glucose or palmitate oxidation. Furthermore, HMB significantly inhibited activation of the master regulator of energetics, AMP-activated protein kinase. As a result, HMB-treated cells also displayed reduced total mitochondrial content compared with true control or cells equivocally treated with leucine. Additionally, HMB treatment amplified markers of lipid biosynthesis (PPARγ and fatty acid synthase) as well as consistently promoted elevated total lipid content versus control cells. Collectively, our results demonstrate that HMB did not improve mitochondrial metabolism or content, and may promote elevated cellular lipid content possibly through heightened PPARγ expression. These observations suggest that HMB may be most beneficial for populations interested in stimulating anabolic cellular processes. PMID:27600148

  5. The Effect of β-Hydroxy-β-Methylbutyrate on Aerobic Capacity and Body Composition in Trained Athletes.

    PubMed

    Durkalec-Michalski, Krzysztof; Jeszka, Jan

    2016-09-01

    Durkalec-Michalski, K and Jeszka, J. The effect of β-hydroxy-β-methylbutyrate on aerobic capacity and body composition in trained athletes. J Strength Cond Res 30(9): 2617-2626, 2016-The aim of this study was to investigate whether supplementation with β-hydroxy-β-methylbutyrate (HMB) affects body composition, aerobic capacity, or intramuscular enzymes activity, as well as in anabolic and/or catabolic hormones and lactate concentrations. A cohort of 58 highly trained males was subjected to 12-week supplementation with HMB (3 × 1 gHMB·d) and a placebo (PLA) in randomized, PLA controlled, double-blind crossover trials, with a 10-day washout period. Body composition and aerobic capacity were recorded, whereas the levels of creatine kinase, lactate dehydrogenase, testosterone, cortisol, and lactate, as well as the T/C ratio, in blood samples were measured. After HMB supplementation, fat-free mass increased (+0.2 kgHMB vs. -1.0 kgPLA, p = 0.021), with a simultaneous reduction of fat mass (-0.8 kgHMB vs. +0.8 kgPLA, p < 0.001). In turn, after HMB supplementation, in comparison to PLA, maximal oxygen uptake (V[Combining Dot Above][Combining Dot Above]O2max: +0.102 L·minHMB vs. -0.063 L·minPLA, p = 0.013), time to reach ventilatory threshold (VT) (TVT: +1.0 minHMB vs. -0.4 minPLA, p < 0.0001), threshold load at VT (WVT: +20 WHMB vs. -7 WPLA, p = 0.001), and the threshold heart rate at VT (HRVT: +8 b·minHMB vs. -1 b·minPLA, p < 0.0001) increased significantly. Analysis of the tested biochemical markers shows significant differences only in relation to the initial concentration. In HMB group, testosterone levels increased (p = 0.047) and in both groups (HMB: p = 0.008; PLA: p = 0.008) higher cortisol levels were observed. The results indicate that supplying HMB promotes advantageous changes in body composition and stimulates an increase in aerobic capacity, although seeming not to significantly affect the levels of the analyzed blood markers. PMID:26849784

  6. Intramolecular charge transfer effects on 4-hydroxy-3-methoxybenzaldehyde

    NASA Astrophysics Data System (ADS)

    Rajendiran, N.; Balasubramanian, T.

    2008-03-01

    The absorption and fluorescence spectral characteristics of 4-hydroxy-3-methoxybenzaldehyde (HMB) have been studied in different solvents, pH and β-cyclodextrin (β-CD) and compared with 4-hydroxy-3,5-dimethoxybenzaldehyde (HDMB). The inclusion complex of HMB with β-CD is analysed by UV-vis, fluorimetry, FT-IR, 1H NMR, SEM and AM1 methods. In HMB, the normal emission (B band) is originates from a locally excited state and the longer emission (A band) is due to intramolecular charge transfer state (ICT). The OH group of HMB is present in the interior part of the β-CD cavity and aldehyde group present in the upper part of the β-CD cavity.

  7. Utilization of supplemental methionine sources by primary cultures of chick hepatocytes

    SciTech Connect

    Dibner, J.J.

    1983-10-01

    Utilization of 2-hydroxy-4-(methylthio) butanoic acid (HMB) as a substrate for protein synthesis was studied by using primary cultures of chick liver cells. Cultures were prepared by enzymatic dissociation of livers from week old Hubbard broiler chicks and were maintained for 4 days under nonproliferative conditions. Hepatocyte differentiation was verified by using dexamethasone induction of tyrosine aminotransferase activity. Conversion of (14C)HMB to L-methionine was shown by chromatographic analysis of hepatocyte protein hydrolysate and incorporation into protein was proven by cycloheximide inhibition of synthesis. When incorporation of HMB was compared to that of DL-methionine (DLM) equimolar quantities of the two sources were found in liver cell protein. These results support, at a cellular level, the conclusion that HMB and DLM are biochemically equivalent sources of methionine for protein synthesis.

  8. Studies on the oxidation of hexamethylbenzene 2: Preparation of dimethylpyromellitic acid

    NASA Technical Reports Server (NTRS)

    Chiba, K.; Tomura, S.

    1986-01-01

    Hexamethylbenzene (HMB) was difficult to be oxidized with an alkaline potassium permanganate solution, since HMB was insoluble in an aqueous alkaline solution. But, when HMB was warmed with 50% nitric acid for a short time, and then treated with aqueous potassium permanganate, the reaction occurred readily and dimethylpyromellitic acid was obtained. When HMB was warmed with 50% nitric acid for 1 to 2 minutes, a yellow material was produced, which was soluble in hot aqueous potassium hydroxide, though free from carboxylic acids. It contained a little amount of bis-(nitromethyl)prehnitene and several unknown compounds. Further, the heat stability of polyimide prepared by the reaction of tetramethyldimethylpyromellitate with 4,4 prime-diaminodiphenylmethane turned out to be nearly equal to that of polyimide prepared from tetramethylpyromellitate.

  9. Effect of β-hydroxy β-methyl butyrate supplementation of sows in late gestation and lactation on sow production of colostrum and milk and piglet performance.

    PubMed

    Flummer, C; Theil, P K

    2012-12-01

    This trial was conducted to investigate whether β-hydroxy β-methyl butyrate (HMB) supplementation during late gestation and throughout lactation would influence colostrum and milk production of sows and neonatal piglet survival (0 to 24 h). Control sows (CON; n = 8) were fed a standard lactation diet from day 108 of gestation and until 28 d after parturition (weaning). Sows fed HMB (n = 8) were fed the CON diet topdressed with 2.5 g Ca(HMB)(2) equally divided at each 2 daily meals throughout the experiment. Litters were standardized to 12 piglets per sow within experimental group on day 1, and both groups weaned on average 11.3 piglets per sow. Blood samples were taken from the sows by jugular vein puncture on days -3, 1, 10, 17, and 28 relative to parturition. Piglets were weighed at birth, after 24 h, and repeatedly throughout lactation to estimate the colostrum and milk yield of the sows. Samples of colostrum and milk were collected and analyzed. Sows fed HMB had a higher colostrum yield (512 vs. 434 ± 30 g/piglet; P = 0.05) estimated based on the piglet weight gain during the colostrum period (132 vs. 76 ± 21 g/piglet; P = 0.05) and the mortality rate of HMB piglets were lower during the colostrum period (0.0 vs. 4.8%, P < 0.05). The HMB supplementation did not affect colostrum composition (P > 0.10). Supplementation with HMB increased milk content of fat (7.40 vs. 6.47 ± 0.30%; P < 0.05), dry matter (19.0 vs. 18.2 ± 0.26; P < 0.05), and energy (4.81 vs. 4.47 ± 0.12 kJ/g; P < 0.05) and reduced the sow backfat at weaning (11.4 vs. 14.5 ± 1.0 mm; P < 0.05). The HMB piglets weighed less at weaning than the control piglets (7.48 vs. 8.30 ± 0.20 kg; P < 0.01), although the milk yield was not reduced. Plasma acetate was higher in HMB sows [202 (175; 233) vs. 158 (141; 179) μM; P < 0.05] whereas plasma 3-hydroxy butyrate was reduced in HMB sows during lactation. In conclusion, HMB supplemented to sows improved the colostrum production but inhibited piglet

  10. β-Hydroxy-β-methylbutyrate attenuates cytokine response during sustained military training.

    PubMed

    Hoffman, Jay R; Gepner, Yiftach; Stout, Jeffrey R; Hoffman, Mattan W; Ben-Dov, Daniel; Funk, Shany; Daimont, Ido; Jajtner, Adam R; Townsend, Jeremy R; Church, David D; Shelef, Ilan; Rosen, Philip; Avital, Guy; Chen, Yacov; Frankel, Hagai; Ostfeld, Ishay

    2016-06-01

    This study tested the hypothesis that of 23 days of β-hydroxy-β-methylbutyrate (HMB) supplementation can maintain muscle mass and attenuate the immune and inflammatory response in combat soldiers during highly intense military training. Soldiers were randomly assigned to either a HMB (n = 6) or placebo (PL; n = 7) group and provided with 3 g · day(-1) of either HMB or PL. During the final week of supplementation soldiers participated in extreme physical training, which included night navigation of 6-8 hours across difficult terrain carrying heavy loads combined with sleep deprivation (3.8 ± 3.0 h per night). Blood draws were performed prior to and following the supplementation period. Magnetic resonance imaging, which included diffusion tensor imaging sequence, was used for muscle fiber tracking analysis. Data was analyzed using a two-way mixed factorial analysis of variance. Magnitude-based inferences were used to provide inferences on the true effects that HMB may have had on the dependent variables compared to PL, calculated from 90% confidence intervals. Changes in tumor necrosis factor-α for HMB (-3.9 ± 8.2 pg · mL(-1)) were significantly lower (P = .043) compared to the change in PL (+4.0 ± 3.7 pg · mL(-1)). HMB ingestion was also very likely (92%-95% Likelihood) to lower granulocyte colony-stimulating factor and interleukin 10 compared to PL. In addition, HMB supplementation was likely (78%-87% likelihood) to reduce interferon-γ, interleukin 8, CX3CL1, and increase muscle volume for the adductor magnus (77% likelihood) compared to PL. In summary, the results of this study provides evidence that HMB supplementation may attenuate the inflammatory response to high intense military training, and maintain muscle quality. PMID:27188901

  11. Seismic stratigraphy of the Heuksan mud belt in the southeastern Yellow Sea, Korea

    NASA Astrophysics Data System (ADS)

    Lee, Gwang-Soo; Yoo, Dong Geun; Bae, Sung Ho; Min, Gun-Hong; Kim, Seong-Pil; Choi, Hunsoo

    2015-12-01

    To establish the seismic stratigraphy of the Heuksan mud belt (HMB) and reconstruct its depositional history, approximately 1,600 km of high-resolution seismic data were newly obtained using chirp acoustic sub-bottom profiler, sparker, and air-gun seismic systems. Based on seismic stratigraphic analysis, the HMB can be divided into three major seismic units (I, II, and III, from top to bottom) and four subunits (II-a, II-b, III-a, and III-b) overlying transgressive sands, pre-last glacial maximum (LGM) deposits, and the acoustic basement. Each unit and subunit show different seismic facies and geometry, being clearly separated from each other by bounding surfaces formed since the LGM. The spatial distribution, thicknesses and volumes of the seismic units were determined and plotted to document the sequential formation of the HMB. The correlation between deep drill core data (HMB-101, HMB-102, HMB-103, YSDP-101, and YSDP-102) and the seismic data suggests that subunits III-b and III-a were formed by the continuous accumulation of fine-grained sediment with partial sandy sediment in an estuarine/deltaic environment during the early to middle transgressive stage, accompanied by landward migration of the shoreline. Subunits II-b and II-a were probably formed by re-deposition of large volumes of sediment eroded from unit III during the middle transgressive to early highstand stage. Unit I is interpreted as the most recent mud deposit representing the highstand systems tract when sea-level rise terminated. The careful definition of seismic units and their interpretation proposed in this study, on the basis of the large and partly new seismic dataset covering the entire HMB together with deep drill core data, have been instrumental in reconstructing the depositional environment and formation mechanisms of the HMB.

  12. Effects of Dietary Supplementation of β-hydroxy-β-methylbutyrate on Sow Performance and mRNA Expression of Myogenic Markers in Skeletal Muscle of Neonatal Piglets.

    PubMed

    Wan, H F; Zhu, J T; Shen, Y; Xiang, X; Yin, H J; Fang, Z F; Che, L Q; Lin, Y; Xu, S Y; Feng, B; Wu, D

    2016-02-01

    The effects of dietary β-hydroxy-β-methylbutyrate (HMB) supplementation during gestation on reproductive performance of sows and the mRNA expression of myogenic markers in skeletal muscle of neonatal pigs were determined. At day 35 of gestation, a total of 20 sows (Landrace × Yorkshire, at third parity) were randomly assigned to two groups, with each group receiving either a basal diet or the same diet supplemented with 4 g/day β-hydroxy-β-methylbutyrate calcium (HMB-Ca) until parturition. At parturition, the total and live litter size were not markedly different between treatments, however, the sows fed HMB diet had a decreased rate of stillborn piglets compared with the sows fed the control (CON) diets (p < 0.05). In addition, piglets from the sows fed HMB diet tended to have an increased birth weight (p = 0.08), and a reduced rate of low birth weight piglets (p = 0.05) compared with piglets from the CON sows. Nevertheless, lower feed intake during lactation was observed in the sows fed the HMB diet compared with those on the CON diet (p < 0.01). The relative weights of the longissimus dorsi (LD) and semitendinosus (ST) muscle were higher (p < 0.05) in neonatal pigs from the HMB than the CON sows. Furthermore, maternal HMB treatment increased the mRNA levels of the myogenic genes, including muscle regulatory factor-4 (MRF4, p < 0.05), myogenic differentiation factor (MyoD) and insulin-like growth factor-1 (IGF-1, p < 0.01). In conclusion, dietary HMB supplementation to sows at 4 g/day from day 35 of gestation to term significantly improves pregnancy outcomes and increases the expression of myogenic genes in skeletal muscle of neonatal piglets, but reduces feed intake of sows during lactation.

  13. Increased Plasma Clot Permeability and Susceptibility to Lysis Are Associated with Heavy Menstrual Bleeding of Unknown Cause: A Case-Control Study

    PubMed Central

    Szczepaniak, Piotr; Zabczyk, Michał; Undas, Anetta

    2015-01-01

    Background Formation of compact and poorly lysable clots has been reported in thromboembolic disorders. Little is known about clot properties in bleeding disorders. Objectives We hypothesized that more permeable and lysis-sensitive fibrin clots can be detected in women with heavy menstrual bleeding (HMB). Methods We studied 52 women with HMB of unknown cause and 52 age-matched control women. Plasma clot permeability (Ks), turbidity and efficiency of fibrinolysis, together with coagulation factors, fibrinolysis proteins, and platelet aggregation were measured. Results Women with HMB formed looser plasma fibrin clots (+16% [95%CI 7–18%] Ks) that displayed lower maximum absorbancy (-7% [95%CI -9 – -1%] ΔAbsmax), and shorter clot lysis time (-17% [95%CI -23 – -11%] CLT). The HMB patients and controls did not differ with regard to coagulation factors, fibrinogen, von Willebrand antigen, thrombin generation markers and the proportion of subjects with defective platelet aggregation. The patients had lower platelet count (-12% [95%CI -19 – -2%]), tissue plasminogen activator antigen (-39% [95%CI -41 – -29%] tPA:Ag), and plasminogen activator inhibitor-1 antigen (-28% [95%CI -38 – -18%] PAI-1:Ag) compared with the controls. Multiple regression analysis upon adjustment for age, body mass index, glucose, and fibrinogen showed that decreased tPA:Ag and shortened CLT were the independent predictors of HMB. Conclusions Increased clot permeability and susceptibility to fibrinolysis are associated with HMB, suggesting that altered plasma fibrin clot properties might contribute to bleeding disorders of unknown origin. PMID:25909989

  14. Antibody αPEP13h Reacts With Lymphangioleiomyomatosis Cells in Lung Nodules

    PubMed Central

    Valencia, Julio C.; Steagall, Wendy K.; Zhang, Yi; Fetsch, Patricia; Abati, Andrea; Tsukada, Katsuya; Billings, Eric; Hearing, Vincent J.; Yu, Zu-Xi; Pacheco-Rodriguez, Gustavo

    2015-01-01

    BACKGROUND: Lymphangioleiomyomatosis (LAM) is characterized by the proliferation in the lung, axial lymphatics (eg, lymphangioleiomyomas), and kidney (eg, angiomyolipomas) of abnormal smooth muscle-like LAM cells, which express melanoma antigens such as Pmel17/gp100 and have dysfunctional tumor suppressor tuberous sclerosis complex (TSC) genes TSC2 or TSC1. Histopathologic diagnosis of LAM in lung specimens is based on identification of the Pmel17 protein with the monoclonal antibody HMB-45. METHODS: We compared the sensitivity of HMB-45 to that of antipeptide antibody αPEP13h, which reacts with a C-terminal peptide of Pmel17. LAM lung nodules were laser-capture microdissected to identify proteins by Western blotting. RESULTS: HMB-45 recognized approximately 25% of LAM cells within the LAM lung nodules, whereas αPEP13h identified > 82% of LAM cells within these structures in approximately 90% of patients. Whereas HMB-45 reacted with epithelioid but not with spindle-shaped LAM cells, αPEP13h identified both spindle-shaped and epithelioid LAM cells, providing greater sensitivity for detection of all types of LAM cells. HMB-45 recognized Pmel17 in premelanosomal organelles; αPEP13h recognized proteins in the cytoplasm as well as in premelanosomal organelles. Both antibodies recognized a Pmel17 variant of approximately 50 kDa. CONCLUSIONS: Based on its sensitivity and specificity, αPEP13h may be useful in the diagnosis of LAM and more sensitive than HMB-45. PMID:25411763

  15. Optimization of a Hybrid Magnetic Bearing for a Magnetically Levitated Blood Pump via 3-D FEA

    PubMed Central

    Cheng, Shanbao; Olles, Mark W.; Burger, Aaron F.; Day, Steven W.

    2011-01-01

    In order to improve the performance of a magnetically levitated (maglev) axial flow blood pump, three-dimensional (3-D) finite element analysis (FEA) was used to optimize the design of a hybrid magnetic bearing (HMB). Radial, axial, and current stiffness of multiple design variations of the HMB were calculated using a 3-D FEA package and verified by experimental results. As compared with the original design, the optimized HMB had twice the axial stiffness with the resulting increase of negative radial stiffness partially compensated for by increased current stiffness. Accordingly, the performance of the maglev axial flow blood pump with the optimized HMBs was improved: the maximum pump speed was increased from 6000 rpm to 9000 rpm (50%). The radial, axial and current stiffness of the HMB was found to be linear at nominal operational position from both 3-D FEA and empirical measurements. Stiffness values determined by FEA and empirical measurements agreed well with one another. The magnetic flux density distribution and flux loop of the HMB were also visualized via 3-D FEA which confirms the designers’ initial assumption about the function of this HMB. PMID:22065892

  16. The Prevalence and Impact of Heavy Menstrual Bleeding (Menorrhagia) in Elite and Non-Elite Athletes

    PubMed Central

    Bruinvels, Georgie; Burden, Richard; Brown, Nicola; Richards, Toby; Pedlar, Charles

    2016-01-01

    To identify the prevalence and impact of heavy menstrual bleeding (HMB) in exercising females where anemia may have a significant effect on training and performance a ‘Female Health Questionnaire’ was designed incorporating a validated diagnostic HMB series, demographics, exercise ability data, training status, anemia, iron supplementation and whether the menstrual cycle had affected training and performance. The survey was conducted in two stages; initially online, advertised via social media, and then repeated via face-to-face interviews with runners registered for the 2015 London Marathon. 789 participants responded to the online survey, and 1073 completed the survey at the marathon. HMB was reported by half of those online (54%), and by more than a third of the marathon runners (36%). Surprisingly, HMB was also prevalent amongst elite athletes (37%). Overall, 32% of exercising females reported a history of anemia, and 50% had previously supplemented with iron. Only a minority (22%) had sought medical advice. HMB is highly prevalent in exercising females, associated with self-reported anemia, increased use of iron supplementation and a perceived negative impact on performance. Further research is needed to investigate the impact of HMB, iron deficiency and anemia in exercising females. PMID:26901873

  17. Heavy menstrual bleeding and health-associated quality of life in women with von Willebrand's disease

    PubMed Central

    GOVOROV, IGOR; EKELUND, LENA; CHAIRETI, ROZA; ELFVINGE, PETRA; HOLMSTRÖM, MARGARETA; BREMME, KATARINA; MINTS, MIRIAM

    2016-01-01

    Women with the inherited bleeding disorder von Willebrand's disease (VWD) face gender-specific hemostatic challenges during menstruation. Heavy menstrual bleeding (HMB) can negatively affect their overall life activities and the health-associated quality of life. The purpose of the present study was to investigate whether women with VWD experienced HMB and an impaired health-associated quality of life. The study subjects were recruited from the Coagulation Unit of Karolinska University Hospital. Information was retrieved from various self-administered forms and medical records. Of the 30 women (18–52 years) that were included in the present study, 50% suffered from HMB, although the majority received treatment for HMB. In addition, almost all the included women perceived limitations in the overall life activities due to menstruation. The health-associated quality of life for women with HMB was significantly lower (P<0.10) with regards to ‘bodily pain’ compared with Swedish women of the general population. In conclusion, women with VWD experienced reduced health-associated quality of life as a result of HMB. Therefore, preventing limitations in overall life activities and improving their health-associated quality of life thorough counseling on menstrual bleeding is important for women with VWD. PMID:27168829

  18. Heterogeneous material distribution, an important reason for generation of strain-localized mylonite and frictional slip zones in the Hidaka metamorphic belt, Hokkaido, Japan

    NASA Astrophysics Data System (ADS)

    Tanaka, Hidemi; Shimada, Koji; Toyoshima, Tsuyoshi; Obara, Tomohiro; Niizato, Tadafumi

    2004-12-01

    Lithological heterogeneity of low P/T metamorphic rocks in southern area of Hidaka metamorphic belt (HMB) was formed through historical development of HMB while these rocks had been laid in ductile lower crust. Many strain-localized mylonite zones (<100 m in thickness) are preferentially developed within S-type tonalite and pelitic gneiss, which are characterized by a large modal amount of phyllosilicates (biotite+muscovite+chlorite) and quartz, compared to other lithofacies in HMB. Mylonitic foliations are more conspicuous with close to the center of the shear zone associated with increase in amounts of phyllosilicate minerals, indicating fluidenhanced weakening mechanisms were operated in plastic shear zones. Pseudotachylyte veins are observed exclusively in these mylonite zones, which were generated during exhumation stage of HMB. We conclude the seismic slip zones in southern HMB had been initiated in the ductile lower crust by concentration of localized plastic shear zones within the phyllosilicate- and quartz-rich lithofacies, which were heterogeneously formed by old metamorphic and magmatic events. Then these zones were further weakened by fluid-enhanced plastic deformation, and finally seismic slips occurred at the bottom of seismogenic upper crust, during exhumation of HMB.

  19. Rumen degradation and availability of various amounts of liquid methionine hydroxy analog in lactating dairy cows.

    PubMed

    Koenig, K M; Rode, L M; Knight, C D; Vázquez-Añón, M

    2002-04-01

    Ruminal escape of various amounts of methionine hydroxy analog [D,L-2-hydroxy-4-(methylthio)-butanoic acid (HMB)] was measured in an experiment designed as a 4 x 4 Latin square using four lactating dairy cows with cannula in the rumen and duodenum. The cows were fed a diet composed of corn silage, alfalfa haylage, rolled barley grain, canola meal, and blood meal, three times per day. The cows were fed the liquid analog each day for 1 wk before the experiment was started. On the day of the experiment, each cow received an intraruminal bolus dose of 0, 25, or 50 g of the liquid analog (Alimet feed supplement, 88% HMB) or 51.2 g of a dry calcium salt of the analog (86% HMB; MHA) mixed with 0.5 kg of ground barley grain. A liquid phase marker (Co-EDTA) was administered as a bolus dose into the rumen at the time of administration of the methionine hydroxy analogs. Rumen and duodenal contents, and blood serum were collected at 0, 1, 3, 6, 9, 12, and 24 h relative to the time of dosing. Rumen and duodenal samples were analyzed for Co and HMB, and serum was analyzed for free methionine. Fractional rate constants for the passage of the liquid marker (k(p)) and the decline of HMB concentration in the rumen (k(rHMB)) were determined by nonlinear regression. Liquid passage from the rumen was similar among the four analog treatments (0.136 +/- 0.012/h; mean +/- SEM). Ruminal escape of HMB as a percentage of the dose (100% x k(p)/k(rHMB)) did not differ between cows receiving 25, 50, and 51.2 g of the methionine analogs (42.5, 41.0, and 34.9 +/- 9.0%, respectively) and averaged 39.5%. Duodenal appearance of HMB as a percentage also did not differ between cows receiving 25, 50, and 51.2 g of the methionine analogs (16.2, 26.8, and 22.7%, respectively) and averaged 22%. Omasal absorption of HMB was variable ranging from 12.3 to 26.3% and averaged 17.6%. Serum methionine concentration peaked at 3 and 6 h after dosing and increased in proportion to the amount of the analog

  20. Conversion of leucine to β‐hydroxy‐β‐methylbutyrate by α‐keto isocaproate dioxygenase is required for a potent stimulation of protein synthesis in L6 rat myotubes

    PubMed Central

    Vílchez, José D.; Salto, Rafael; Manzano, Manuel; Sevillano, Natalia; Campos, Nefertiti; Argilés, Josep M.; Rueda, Ricardo; López‐Pedrosa, José M.

    2015-01-01

    Abstract Background L‐Leu and its metabolite β‐hydroxy‐β‐methylbutyrate (HMB) stimulate muscle protein synthesis enhancing the phosphorylation of proteins that regulate anabolic signalling pathways. Alterations in these pathways are observed in many catabolic diseases, and HMB and L‐Leu have proven their anabolic effects in in vivo and in vitro models. The aim of this study was to compare the anabolic effects of L‐Leu and HMB in myotubes grown in the absence of any catabolic stimuli. Methods Studies were conducted in vitro using rat L6 myotubes under normal growth conditions (non‐involving L‐Leu‐deprived conditions). Protein synthesis and mechanistic target of rapamycin signalling pathway were determined. Results Only HMB was able to increase protein synthesis through a mechanism that involves the phosphorylation of the mechanistic target of rapamycin as well as its downstream elements, pS6 kinase, 4E binding protein‐1, and eIF4E. HMB was significantly more effective than L‐Leu in promoting these effects through an activation of protein kinase B/Akt. Because the conversion of L‐Leu to HMB is limited in muscle, L6 cells were transfected with a plasmid that codes for α‐keto isocaproate dioxygenase, the key enzyme involved in the catabolic conversion of α‐keto isocaproate into HMB. In these transfected cells, L‐Leu was able to promote protein synthesis and mechanistic target of rapamycin regulated pathway activation equally to HMB. Additionally, these effects of leucine were reverted to a normal state by mesotrione, a specific inhibitor of α‐keto isocaproate dioxygenase. Conclusion Our results suggest that HMB is an active L‐Leu metabolite able to maximize protein synthesis in skeletal muscle under conditions, in which no amino acid deprivation occurred. It may be proposed that supplementation with HMB may be very useful to stimulate protein synthesis in wasting conditions associated with chronic diseases, such as cancer or

  1. Menstrual cycle distribution of uterine natural killer cells is altered in heavy menstrual bleeding.

    PubMed

    Biswas Shivhare, Sourima; Bulmer, Judith N; Innes, Barbara A; Hapangama, Dharani K; Lash, Gendie E

    2015-11-01

    Heavy menstrual bleeding (HMB) affects 30% of women of reproductive age and significantly interferes with quality of life. Altered endometrial vascular maturation has been reported in HMB and recurrent miscarriage, the latter associated with increased uterine natural killer (uNK) cell numbers. This study compared endometrial leukocyte populations in controls and women with HMB. Formalin-fixed paraffin-embedded endometrial biopsies from controls (without endometrial pathology) and HMB were immunostained for CD14 (macrophages), CD56 (uNK cells), CD83 (dendritic cells), FOXP3 (regulatory T cells/Tregs), CD3 and CD8 (T cells). Leukocyte numbers were analysed as a percentage of total stromal cells in five randomly selected fields of view in the stratum functionalis of each sample. In control women across the menstrual cycle, 2-8% of total stromal cells were CD3(+) cells, 2-4% were CD8(+) T cells and 6-8% were CD14(+) macrophages. Compared with controls, CD3(+) cells were reduced during the mid-secretory phase (4%, P<0.01) and increased in the late secretory phase (12%, P=0.01) in HMB. CD83(+) dendritic cells and FOXP3(+) Tregs were scarce throughout the menstrual cycle in both groups. In controls, 2% of stromal cells in proliferative endometrium were CD56(+) uNK cells, increasing to 17% during the late secretory phase. In HMB, CD56(+) uNK cells were increased in the proliferative (5%, P<0.01) and early secretory (4%, P<0.02) phases, but reduced (10%, P<0.01) in the late secretory phase. This study demonstrates dysregulation of uNK cells in HMB, the functional consequence of which may have an impact on endometrial vascular development and/or endometrial preparation for menstruation.

  2. Challenges of diagnosing and managing the adolescent with heavy menstrual bleeding.

    PubMed

    Zia, Ayesha; Rajpurkar, Madhvi

    2016-07-01

    Unpredictable, prolonged or heavy menstrual bleeding (HMB) may be expected for many adolescents soon after menarche. A decade of clinical experience and research has now established firmly that bleeding disorders (BD) are common in adolescents with HMB. Despite these advances, many questions remain, and several aspects of the diagnosis and management of BDs in adolescents are not supported by rigorous clinical trials. In this overview, four major areas will be discussed. First, we will discuss the frequency of BDs in young women with HMB. Up to 20% of older females with HMB are thought to have an underlying BD. Estimates from retrospective studies in adolescents suggest a prevalence that varies anywhere from 10 to 62%. Prospective studies with uniform hemostatic evaluation are needed to answer this question definitively. Second, we will review existing tools that help screen and diagnose adolescents with HMB with an underlying BD. Although identification of an underlying BD in older women with HMB is relatively straight forward, uncertainties remain for adolescents. Heavy menstrual bleeding in this age group may have different pathophysiological underpinnings than those in older women and may often be disregarded as anovulatory. There is an urgent need to develop novel tools, and evaluate existing diagnostic strategies in adolescents. Third, we will discuss the optimal medical management of HMB in young adolescents. As direct evidence is largely lacking, these areas are also subject to extrapolation from older women. Lastly, an important area- prediction, and management of future bleeding in those adolescents who are diagnosed with a mild BD-will be discussed. Throughout, areas of controversy and opportunities for further research are highlighted. PMID:27208978

  3. Formation of Isobutene from 3-Hydroxy-3-Methylbutyrate by Diphosphomevalonate Decarboxylase▿

    PubMed Central

    Gogerty, David S.; Bobik, Thomas A.

    2010-01-01

    Isobutene is an important commercial chemical used for the synthesis of butyl rubber, terephthalic acid, specialty chemicals, and a gasoline performance additive known as alkylate. Currently, isobutene is produced from petroleum and hence is nonrenewable. Here, we report that the Saccharomyces cerevisiae mevalonate diphosphate decarboxylase (ScMDD) can convert 3-hydroxy-3-methylbutyrate (3-HMB) to isobutene. Whole cells of Escherichia coli producing ScMDD with an N-terminal 6×His tag (His6-ScMDD) formed isobutene from 3-HMB at a rate of 154 pmol h−1 g cells−1. In contrast, no isobutene was detected from control cells lacking ScMDD. His6-ScMDD was purified by nickel affinity chromatography and shown to produce isobutene from 3-HMB at a rate of 1.33 pmol min−1 mg−1 protein. Controls showed that both His6-ScMDD and 3-HMB were required for detectable isobutene formation. Isobutene was identified by gas chromatography (GC) with flame ionization detection as well as by GC-mass spectrometry (MS). ScMDD was subjected to error-prone PCR, and two improved variants were characterized, ScMDD1 (I145F) and ScMDD2 (R74H). Whole cells of E. coli producing ScMDD1 and ScMDD2 produced isobutene from 3-HMB at rates of 3,000 and 5,888 pmol h−1 g cells−1, which are 19- and 38-fold increases compared to rates for cells producing His6-ScMDD. This showed that genetic modifications can be used to increase the rate at which ScMDD converts 3-HMB to isobutene. Because 3-HMB can be produced from l-leucine, ScMDD has a potential application for the production of renewable isobutene. Moreover, isobutene is a gas, which might simplify its purification from a fermentation medium, substantially reducing production costs. PMID:20971863

  4. Effect of excess methionine and methionine hydroxy analogue on growth performance and plasma homocysteine of growing Pekin ducks.

    PubMed

    Xie, M; Hou, S S; Huang, W; Fan, H P

    2007-09-01

    One experiment was conducted to study the effect of excess dl-methionine (DLM) and dl-2-hydroxy-4-methylthiobutanoic acid free acid (dl-HMB-FA) on duck growth. One-day-old male white Pekin ducklings were fed common starter diets from hatch to 21 d of age and then fed the experimental diets from 21 to 42 d of age. Three hundred twenty 21-d-old birds were allotted to 40 raised wire-floor pens with 8 birds per pen according to similar pen weight. There were 5 dietary treatments that included a methionine-adequate control diet and control diets supplemented with 2 levels of dry DLM (1 or 2%) or 2 equimolar levels of liquid dl-HMB-FA (1.13 or 2.26%). Each dietary treatment was replicated 8 times. At 42 d of age, weight gain, feed intake, and gain/feed were measured and plasma was collected to analyze homocysteine. Compared with ducks fed control diets, excess DLM or dl-HMB-FA supplementation reduced weight gain and feed intake of birds significantly. However, on the equimolar basis, at 1 or 2% supplemental methionine activity, dl-HMB-FA was less growth-depressing than DLM. According to the growth response to excess methionine, the tolerable upper limit of dietary methionine for growing ducks may be less than 1.38% when the methionine level of the control diet (0.38%) was considered. On the other hand, plasma homocysteine was elevated markedly when 2% DLM or 2.26% dl-HMB-FA was added to control diets, but plasma homocysteine of ducks fed 2.26% dl-HMB-FA supplemented diets was lower significantly than birds fed equimolar DLM-supplemented diets, which indicated the toxicity of excess methionine sources and less toxicity of dl-HMB-FA relative to DLM.

  5. Dietary supplementation with β-hydroxy-β-methylbutyrate calcium during the early postnatal period accelerates skeletal muscle fibre growth and maturity in intra-uterine growth-retarded and normal-birth-weight piglets.

    PubMed

    Wan, Haifeng; Zhu, Jiatao; Su, Guoqi; Liu, Yan; Hua, Lun; Hu, Liang; Wu, Caimei; Zhang, Ruinan; Zhou, Pan; Shen, Yong; Lin, Yan; Xu, Shengyu; Fang, Zhengfeng; Che, Lianqiang; Feng, Bin; Wu, De

    2016-04-01

    Intra-uterine growth restriction (IUGR) impairs postnatal growth and skeletal muscle development in neonatal infants. This study evaluated whether dietary β-hydroxy-β-methylbutyrate Ca (HMB-Ca) supplementation during the early postnatal period could improve muscle growth in IUGR neonates using piglets as a model. A total of twelve pairs of IUGR and normal-birth-weight (NBW) male piglets with average initial weights (1·85 (sem 0·36) and 2·51 (sem 0·39) kg, respectively) were randomly allotted to groups that received milk-based diets (CON) or milk-based diets supplemented with 800 mg/kg HMB-Ca (HMB) during days 7-28 after birth. Blood and longissimus dorsi (LD) samples were collected and analysed for plasma amino acid content, fibre morphology and the expression of genes related to muscle development. The results indicate that, regardless of diet, IUGR piglets had a significantly decreased average daily weight gain (ADG) compared with that of NBW piglets (P<0·05). However, IUGR piglets fed HMB-Ca had a net weight and ADG similar to that of NBW piglets fed the CON diet. Irrespective of body weight (BW), HMB-Ca supplementation markedly increased the type II fibre cross-sectional area and the mRNA expression of mammalian target of rapamycin (mTOR), insulin-like growth factor-1 and myosin heavy-chain isoform IIb in the LD of piglets (P<0·05). Moreover, there was a significant interaction between the effects of BW and HMB on mTOR expression in the LD (P<0·05). In conclusion, HMB-Ca supplementation during the early postnatal period could improve skeletal muscle growth and maturity by accelerating fast-twitch glycolytic fibre development in piglets.

  6. Effects of maternal and lactational exposure to 2-hydroxy-4-methoxybenzone on development and reproductive organs in male and female rat offspring

    PubMed Central

    Nakamura, Noriko; Inselman, Amy L.; White, Gene A.; Chang, Ching-Wei; Trbojevich, Raul A.; Sepehr, Estatira; Voris, Kristie L.; Patton, Ralph E.; Bryant, Matthew S.; Harrouk, Wafa; McIntyre, Barry; Foster, Paul M.; Hansen, Deborah K.

    2015-01-01

    BACKGROUND 2-hydroxy-4-methoxybenzophenone (HMB) is an ultraviolet (UV)-absorbing compound used in many cosmetic products as a UV-protecting agent and in plastics for preventing UV-induced photodecomposition. HMB has been detected in over 95% of randomly collected human urine samples from adults and from premature infants, and it may have estrogenic potential. METHODS To determine the effects of maternal and lactational exposure to HMB on development and reproductive organs of offspring, time-mated female Harlan Sprague-Dawley rats were dosed with 0, 1,000, 3,000, 10,000, 25,000, or 50,000 ppm HMB (7-8 per group) added to chow from gestation day 6 until weaning on postnatal day (PND) 23. RESULTS AND CONCLUSION Exposure to HMB was associated with reduced body and organ weights in female and male offspring. No significant differences were observed in the number of implantation sites/litter, mean resorptions/litter, % litters with resorptions, number and weights of live fetuses, or sex ratios between the control and HMB dose groups. Normalized anogenital distance in male pups at PND 23 was decreased in the highest dose group. Spermatocyte development was impaired in testes of male offspring in the highest dose group. In females, follicular development was delayed in the highest dose group. However, by evaluating levels of the compound in rat serum, the doses at which adverse events occurred are much higher than usual human exposure levels. Thus, exposure to less than 10,000 ppm HMB does not appear to be associated with adverse effects on the reproductive system in rats. PMID:25707689

  7. Interaction of Beta-Hydroxy-Beta-Methylbutyrate Free Acid and Adenosine Triphosphate on Muscle Mass, Strength, and Power in Resistance Trained Individuals.

    PubMed

    Lowery, Ryan P; Joy, Jordan M; Rathmacher, John A; Baier, Shawn M; Fuller, John C; Shelley, Mack C; Jäger, Ralf; Purpura, Martin; Wilson, Stephanie M C; Wilson, Jacob M

    2016-07-01

    Lowery, RP, Joy, JM, Rathmacher, JA, Baier, SM, Fuller, JC Jr, Shelley, MC II, Jäger, R, Purpura, M, Wilson, SMC, and Wilson, JM. Interaction of beta-hydroxy-beta-methylbutyrate free acid and adenosine triphosphate on muscle mass, strength, and power in resistance trained individuals. J Strength Cond Res 30(7): 1843-1854, 2016-Adenosine-5'-triphosphate (ATP) supplementation helps maintain performance under high fatiguing contractions and with greater fatigue recovery demands also increase. Current evidence suggests that the free acid form of β-hydroxy-β-methylbutyrate (HMB-FA) acts by speeding regenerative capacity of skeletal muscle after high-intensity or prolonged exercise. Therefore, we investigated the effects of 12 weeks of HMB-FA (3 g) and ATP (400 mg) administration on lean body mass (LBM), strength, and power in trained individuals. A 3-phase double-blind, placebo-, and diet-controlled study was conducted. Phases consisted of an 8-week periodized resistance training program (phase 1), followed by a 2-week overreaching cycle (phase 2), and a 2-week taper (phase 3). Lean body mass was increased by a combination of HMB-FA/ATP by 12.7% (p < 0.001). In a similar fashion, strength gains after training were increased in HMB-FA/ATP-supplemented subjects by 23.5% (p < 0.001). Vertical jump and Wingate power were increased in the HMB-FA/ATP-supplemented group compared with the placebo-supplemented group, and the 12-week increases were 21.5 and 23.7%, respectively. During the overreaching cycle, strength and power declined in the placebo group (4.3-5.7%), whereas supplementation with HMB-FA/ATP resulted in continued strength gains (1.3%). In conclusion, HMB-FA and ATP in combination with resistance exercise training enhanced LBM, power, and strength. In addition, HMB-FA plus ATP blunted the typical response to overreaching, resulting in a further increase in strength during that period. It seems that the combination of HMB-FA/ATP could benefit those who

  8. A study on the spectroscopy and photophysics of 4-hydroxy-3-methoxybenzoic acid in different solvents, pH and β-cyclodextrin

    NASA Astrophysics Data System (ADS)

    Stalin, T.; Rajendiran, N.

    2006-08-01

    Effect of solvents, buffer solutions of different pH and β-cyclodextrin (β-CD) on the absorption and fluorescence spectra of 4-hydroxy-3-methoxybenzoic acid (vanillic acid, HMB) have been investigated and compared with 4-hydroxy-3,5-dimethoxybenzoic acid (HDMB). The inclusion complex of β-CD with HMB is investigated by UV-vis, fluorimetry, FT-IR, 1H NMR, scanning electron microscope (SEM) and semiempirical methods. The thermodynamic parameters (Δ G, Δ H and Δ S) of inclusion process are also determined. Solvent study shows in the S 0 state, HMB is more polar than HDMB, whereas the polarity is same in the S 1 state. pH studies suggest proton transfer reactions follow the same trend in HMB and HDMB molecules. β-CD studies indicates (i) HMB forms 1:1 inclusion complex with β-CD and (ii) unusual blue shift of hydroxyl ion (dianion) in the β-CD medium confirms OH group present in the interior part of the β-CD cavity and COOH group present in the upper part of the β-CD cavity. A mechanism is proposed to explain the inclusion process.

  9. Gut immune maturation depends on colonization with a host-specific microbiota.

    PubMed

    Chung, Hachung; Pamp, Sünje J; Hill, Jonathan A; Surana, Neeraj K; Edelman, Sanna M; Troy, Erin B; Reading, Nicola C; Villablanca, Eduardo J; Wang, Sen; Mora, Jorge R; Umesaki, Yoshinori; Mathis, Diane; Benoist, Christophe; Relman, David A; Kasper, Dennis L

    2012-06-22

    Gut microbial induction of host immune maturation exemplifies host-microbe mutualism. We colonized germ-free (GF) mice with mouse microbiota (MMb) or human microbiota (HMb) to determine whether small intestinal immune maturation depends on a coevolved host-specific microbiota. Gut bacterial numbers and phylum abundance were similar in MMb and HMb mice, but bacterial species differed, especially the Firmicutes. HMb mouse intestines had low levels of CD4(+) and CD8(+) T cells, few proliferating T cells, few dendritic cells, and low antimicrobial peptide expression--all characteristics of GF mice. Rat microbiota also failed to fully expand intestinal T cell numbers in mice. Colonizing GF or HMb mice with mouse-segmented filamentous bacteria (SFB) partially restored T cell numbers, suggesting that SFB and other MMb organisms are required for full immune maturation in mice. Importantly, MMb conferred better protection against Salmonella infection than HMb. A host-specific microbiota appears to be critical for a healthy immune system. PMID:22726443

  10. The knowns and unknowns of human milk banking.

    PubMed

    Simmer, Karen; Hartmann, Ben

    2009-11-01

    The PREM Bank has been providing pasteurised donor human milk (PDHM) to very preterm for the past 3 years. It is the first human milk bank (HMB) to operate in Australia in over 20 years. Our community has rapidly embraced the concept of human milk banking, with both donations and demand for PDHM exceeding expectations. Providing PDHM in 'exceptional circumstances' where a mothers' own milk is unavailable is supported by the WHO and UNICEF. We submit that neonatal intensive care is an exceptional circumstance. Although evidence supporting PDHM use from randomised control trial (RCT) is limited, the latest systematic reviews suggest a lower risk of necrotising enterocolitis with PDHM as opposed to artificial formula. Study design and ethical issues may limit future evidence from RCT. We therefore support the ongoing use of PDHM in neonatal care, where provided by an appropriately managed HMB. Internationally many HMBs operate unregulated, and this is also the case in Australia. To ensure safety the PREM Bank has committed to meet the appropriate standards recommended in the Code of Good Manufacturing Practices (Blood and Tissues) in Australia and models risk management during processing on Codex HACCP (Hazard Analysis Critical Control Point) requirements. There is scope to continually re-evaluate the screening of donors and quality standards recommended during HMB. This will be most effective if strong networks of HMBs are developed with regional reference laboratories to encourage compliance with safety guidelines. HMB networks will facilitate collection of evidence for refining HMB practice and improving outcomes for preterm and sick infants.

  11. Clay mineral distribution and provenance in the Heuksan mud belt, Yellow Sea

    NASA Astrophysics Data System (ADS)

    Cho, Hyen Goo; Kim, Soon-Oh; Kwak, Kyeong Yoon; Choi, Hunsoo; Khim, Boo-Keun

    2015-12-01

    The Heuksan mud belt (HMB), located in the southeastern Yellow Sea, runs parallel to the southwest coast of Korea. In this study, the distribution and relative contribution of four major clay minerals are investigated using 101 surface sediment samples collected in the course of KIOST (2001, 2010, 2011) and KIGAM (2012) cruises, as well as 33 river sediment samples (four from the Huanghe River, three from the Changjiang River, and 26 from Korean rivers) in order to clarify the provenance of fine-grained sediments in the HMB. Based on this currently largest and most robust dataset available for interpretation, the clay mineral assemblages of the fine-grained sediments in the HMB are found to be on average composed of 64.7% illite, 17.9% chlorite, 11.4% kaolinite, and 5.9% smectite. Overall, the clay mineral assemblages are similar in both the northern and the southern parts of the HMB, although smectite seems to be relatively enriched in the southern part, whereas kaolinite is slightly more dominant in the northern part. This clearly indicates that the clays are mostly derived from Korean rivers and, in the southern part of the HMB, partly also from the Huanghe River in China. The new data thus confirm and strengthen the tentative interpretation of some earlier work based on a more limited dataset.

  12. Intermediates in the recycling of 5-methylthioribose to methionine in fruits.

    PubMed

    Kushad, M M; Richardson, D G; Ferro, A J

    1983-10-01

    The recycling of 5-methylthioribose (MTR) to methionine in avocado (Persea americana Mill, cv Hass) and tomato (Lycopersicum esculentum Mill, cv unknown) was examined. [(14)CH(3)]MTR was not metabolized in cell free extract from avocado fruit. Either [(14)CH(3)]MTR plus ATP or [(14)CH(3)]5-methylthioribose-1-phosphate (MTR-1-P) alone, however, were metabolized to two new products by these extracts. MTR kinase activity has previously been detected in these fruit extracts. These data indicate that MTR must be converted to MTR-1-P by MTR kinase before further metabolism can occur. The products of MTR-1-P metabolism were tentatively identified as alpha-keto-gamma-methylthiobutyric acid (alpha-KMB) and alpha-hydroxy-gamma-methylthiobutyric acid (alpha-HMB) by chromatography in several solvent systems. [(35)S]alpha-KMB was found to be further metabolized to methionine and alpha-HMB by these extracts, whereas alpha-HMB was not. However, alpha-HMB inhibited the conversion of alpha-KMB to methionine. Both [U-(14)C]alpha-KMB and [U-(14)C]methionine, but not [U-(14)C]alpha-HMB, were converted to ethylene in tomato pericarp tissue. In addition, aminoethoxyvinylglycine inhibited the conversion of alpha-KMB to ethylene. These data suggest that the recycling pathway leading to ethylene is MTR --> MTR-1-P --> alpha-KMB --> methionine --> S-adenosylmethionine --> 1-aminocyclopropane-1-carboxylic acid --> ethylene.

  13. Immunologic difference between hypersensitivity to mosquito bite and hemophagocytic lymphohistiocytosis associated with Epstein-Barr virus infection.

    PubMed

    Lee, Wen-I; Lin, Jainn-Jim; Hsieh, Meng-Ying; Lin, Syh-Jae; Jaing, Tang-Her; Chen, Shih-Hsiang; Hung, Iou-Jih; Yang, Chao-Ping; Chen, Chin-Jung; Huang, Yhu-Chering; Li, Shin-Pai; Huang, Jing-Long

    2013-01-01

    Hemophagocytic lymphohistiocytosis (HLH) is a life-threatening, virus-triggered immune disease. Hypersensitivity to mosquito bite (HMB), a presentation of Chronic Active Epstein-Barr Virus infection (CAEBV), may progress to HLH. This study aimed to investigate the immunologic difference between the HMB episodes and the HLH episodes associated with EBV infection. Immunologic changes of immunoglobulins, lymphocyte subsets, cytotoxicity, intracellular perforin and granzyme expressions, EBV virus load and known candidate genes for hereditary HLH were evaluated and compared. In 12 HLH episodes (12 patients) and 14 HMB episodes (4 patients), there were both decreased percentages of CD4+ and CD8+ and increased memory CD4+ and activated (CD2+HLADR+) lymphocytes. In contrast to HMB episodes that had higher IgE levels and EBV virus load predominantly in NK cells, those HLH episodes with virus load predominantly in CD3+ lymphocyte had decreased perforin expression and cytotoxicity that were recovered in the convalescence period. However, there was neither significant difference of total virus load in these episodes nor candidate genetic mutations responsible for hereditary HLH. In conclusion, decreased perforin expression in the HLH episodes with predominant-CD3+ EBV virus load is distinct from those HMB episodes with predominant-NK EBV virus load. Whether the presence of non-elevated memory CD4+ cells or activated lymphocytes (CD2+HLADR+) increases the mortality rate in the HLH episodes remains to be further warranted through larger-scale studies.

  14. Development of a fluorescent chelating ligand for scandium ion having a Schiff base moiety.

    PubMed

    Yamada, Hiroshi; Kojo, Masahito; Nakahara, Tomomi; Murakami, Kumi; Kakima, Takashi; Ichiba, Hideaki; Yajima, Takehiko; Fukushima, Takeshi

    2012-05-01

    A fluorescent ligand, 1-(2-hydroxy-3-methoxybenzaldehyde)-4-aminosalicylhydrazone (HMB-ASH), was newly designed and synthesized, and its fluorescence characteristics for metal ions were investigated in the pH range 3.0-10.5 (at a difference of 0.5 for each metal). After testing 31 different metal ions, it was found that HMB-ASH was able to emit fluorescence intensely at 512 nm with an excitation wavelength of 353 nm in the presence of Sc(3+), one of the rare earth metals, at pH values around 3.5 and 8.0. The other metal ions hardly showed fluorescence with HMB-ASH. The fluorescence was more intense at pH 8.0, and the detection limit of Sc(3+) in a buffer solution (pH 8.0) was approximately 18.8 nmol L(-1) (0.85 ppb).

  15. Flywheel Energy Storage System Suspended by Hybrid Magnetic Bearing

    NASA Astrophysics Data System (ADS)

    Owusu-Ansah, Prince; Hu, Yefa; Misbawu, Adam

    This work presents a prototype flywheel energy storage system (FESS) suspended by hybrid magnetic bearing (HMB) rotating at a speed of 20000rpm with a maximum storage power capacity of 30W with a maximum tip speed of 300m/s. The design presented is an improvement of most existing FESS, as the design incorporates a unique feature in that the upper and the lower rotor and stator core are tapered which enhances larger thrust and much lower radial force to be exerted on the system. Without any adverse effect being experienced by the model. The work also focuses on the description of developing a prototype FESS suspended by HMB using solid works as a basis of developing in the nearer future a more improved FESS suspended by HMB capable of injecting the ever increasing high energy demand situation in the 21st century and beyond.

  16. Graphene oxide-based fluorescent "on/off" switch for visual bioassay using "molecular beacon"-hosted Hoechst dyes.

    PubMed

    Zhang, Min; Le, Huynh-Nhu; Ye, Bang-Ce

    2013-09-11

    In this study, the fluorescence of Hoechst dyes is significantly lit up by addition of our designed MB probe, forming a complex of "molecular beacon"-hosted Hoechst dyes (HMB). Combined with this property, a novel graphene oxide (GO)-based fluorescent "on/off" switch was developed to visually follow bioassay utilizing HMB as signal indicators and GO as an excellent energy acceptor to efficiently quench the fluorescence of HMB in a label-easy format. We have demonstrated its application for label-easy fluorescence "turn on" detection of sequence-specific DNA and "turn off" detection of exonuclease with sensitivity and selectivity in a single step in homogeneous solution. Compared to traditional molecular beacons, the proposed design is cost-effective and simple to prepare without fluorescence labeling or chemical modification.

  17. Hypersensitivity to mosquito bites as the primary clinical manifestation of an Epstein-Barr virus infection.

    PubMed

    Chiu, Tsu-Man; Lin, Yueh-Min; Wang, Shing-Chuang; Tsai, Yi-Giien

    2016-08-01

    Hypersensitivity to mosquito bites (HMB) is a rare disease characterized by intense local skin reactions with general symptoms, such as high fever and regional lymphadenopathy after mosquito bites. Epstein-Barr virus (EBV) chronic infection and NK cell lymphoproliferative disease have been reported first in diagnosed HMB patients. Here, we present the case of a 6-year-old girl with 2 months' history of bullae and necrotic skin lesions, accompanied by a high temperature, visual hallucinations, and liver dysfunction after mosquito bites. A histopathologic examination of the skin lesion showed vasculitis and EBV infection. We could not detect any findings of hematologic malignancies or NK cell proliferative disease in the patient. Clinicians should closely evaluate HMB patients for possible development of lymphoproliferative status or hematologic malignant disorders.

  18. Basophil activation by mosquito extracts in patients with hypersensitivity to mosquito bites.

    PubMed

    Sakakibara, Yasuhisa; Wada, Taizo; Muraoka, Masahiro; Matsuda, Yusuke; Toma, Tomoko; Yachie, Akihiro

    2015-08-01

    Hypersensitivity to mosquito bites (HMB) is a cutaneous disorder belonging to the group of Epstein-Barr virus (EBV)-associated T/natural killer (NK)-cell lymphoproliferative diseases, and is primarily mediated by EBV-infected NK cells. It is characterized by intense local skin reactions accompanied by general symptoms after mosquito bites, and infiltration of EBV-infected NK cells into the bite sites. However, the mechanisms underlying these reactions have not been fully examined. We recently described the activation of circulating basophils by mosquito extracts in vitro in a patient with HMB. To further investigate this finding, we studied four additional patients with HMB. All patients showed typical clinical features of HMB after mosquito bites and they had NK lymphocytosis and high peripheral blood EBV DNA loads. We found evidence of EBV infection in NK cells through in situ hybridization that detected EBV-encoded small RNA-1, and flow cytometry showed HLA-DR expression on almost all NK cells. Basophil activation tests with the extracts of epidemic mosquitoes Culex pipiens pallens and Aedes albopictus showed positive responses to one or both extracts in all samples from patients with HMB, suggesting the presence of mosquito antigen-specific IgE and its binding to basophils. In particular, the extract of Aedes albopictus was able to activate basophils in all available patient samples. These results indicate that basophils and/or mast cells activated by mosquito bites may be involved in initiation and development of severe skin reactions to mosquito bites in HMB.

  19. Effect of annealing and heat moisture conditioning on the physicochemical characteristics of Bambarra groundnut (Voandzeia subterranea) starch.

    PubMed

    Adebowale, K O; Lawal, O S

    2002-10-01

    Isolated starch of Bambarra groundnut (Voandzeia subterranean) was subjected to hydrothermal modifications through annealing and heat moisture conditioning. Both annealing and heat moisture conditioning reduced the swelling power and solubility of the starch. Water binding capacity reduced after annealing heat moisture conditioning at 18% moisture level (HMB18) and heat moisture conditioning at 21% moisture level (HMB21). Both heat moisture conditioning at 24% moisture level (HMB24) and heat moisture conditioning at 27% moisture level (HMB27) increased the water binding capacity. Hydrothermal modifications reduced the oil absorption capacity of the raw starch. Annealing and heat moisture conditioning reduced the peak viscosity (Pv), viscosity at 95 degrees C (Hv) and viscosity at 95 degrees C after 30 min holding (Hv30). However, viscosity increased on cooling down to 50 degrees C after annealing. Annealing and heat moisture treatments as revealed by scanning electron micrograph and light micrograph did not alter the shape and size of the raw starch. The results indicate a rearrangement within the starch granule following hydrothermal treatments.

  20. Effect of feeding different sources of rumen-protected methionine on milk production and N-utilization in lactating dairy cows

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Objectives of this study were to quantify production responses of lactating dairy cows to supplying absorbable Met as isopropyl-2-hydroxy-4-(methylthio)-butanoic acid (HMBi), or rumen-protected Met (RPM, Smartamine® M) fed with or without 2-hydroxy-4-(methylthio)-butanoic acid (HMB), and to determin...

  1. NTP technical report on the toxicity studies of 2-Hydroxy-4-methoxybenzophenone (CAS No. 131-57-7) Adminstered Topically and in Dosed Feed to F344/N Rats and B6C3F1 Mice.

    PubMed

    French, J.E.

    1992-10-01

    2-Hydroxy-4-methoxybenzophenone (HMB) occurs naturally in flower pigments and is synthesized for use in sunscreens, as a UV stabilizer in various cosmetic products, and in plastic surface coatings and polymers. Toxicity studies of HMB were performed in F344/N rats and B6C3F1 mice, by administering HMB in feed and by topical application, in studies of 2 weeks' (5 animals/sex, dose and species) and 13 weeks' (10 animals/sex, dose and species) duration. Assessments included hematology, clinical chemistry, urinalysis, reproductive toxicity, and histopathologic evaluations. In both 2- and 13-week dosed feed studies, rats received diets containing 0, 3125, 6250, 12500, 25000, or 50000 ppm HMB. One high-dose female rat died during the 2-week study. Body weight gains of high-dose male and female rats were reduced in the 13-week study. Liver and kidney weights were increased in dosed rats in both studies. In the 2-week studies, enlarged livers were associated with a marked hepatocyte cytoplasmic vacuolization in rats receiving diets containing concentrations of 6250 ppm HMB or higher; renal lesions, consisting of dilated tubules and regeneration of tubular epithelial cells, were found primarily in high-dose rats. In the 13-week studies, kidney lesions progressed to include papillary degeneration, or necrosis, and inflammation, while the liver lesion appeared to regress; liver enzymes in serum remained elevated. Rats receiving a diet with 50000 ppm HMB showed markedly lower epididymal sperm density and an increase in the length of the estrous cycle at the end of the 13-week studies. In 2-week dermal studies, rats received topical applications of 1.25 to 20 mg of HMB in an acetone or lotion vehicle. The only effects noted were small and variable increases in liver and kidney weights, reaching statistical significance primarily in the higher dose groups. In 13-week studies, rats received topical doses from 12.5 to 200 mg/kg HMB in acetone. Kidney weights were elevated in dosed

  2. The knowns and unknowns of human milk banking.

    PubMed

    Simmer, Karen

    2011-01-01

    The provision of donor human milk instead of formula is an important contribution to the nutrition and protection from infections for preterm infants. Systematic reviews suggest a lower risk of necrotizing enterocolitis with pasteurized donor human milk (PDHM) as opposed to artificial formula, although evidence supporting PDHM use from randomized control trials is limited. Human milk banks (HMBs) must have a risk management system to maintain a safe product especially as many operate in an unregulated environment. To ensure safety, the HMB in Australia has committed to meet the appropriate standards recommended in the Code of Good Manufacturing Practices (Blood and Tissues) and models risk management during processing on Codex HACCP (Hazard Analysis Critical Control Point) requirements. There is scope to continually reevaluate the screening of donors and quality standards recommended during HMB. This will be most effective if strong networks of HMBs are developed with regional reference laboratories to encourage compliance with safety guidelines. Further research and development is needed to refine technology for treating donor milk such as thermal ultrasound and ultraviolet light, aimed at the retention of full bioactivity. HMB networks will facilitate collection of evidence for refining HMB practice which should translate to improved outcomes for preterm and sick infants. Cost effectiveness is most likely when HMBs are associated with large neonatal intensive care units. PMID:22044891

  3. The knowns and unknowns of human milk banking.

    PubMed

    Simmer, Karen

    2011-01-01

    The provision of donor human milk instead of formula is an important contribution to the nutrition and protection from infections for preterm infants. Systematic reviews suggest a lower risk of necrotizing enterocolitis with pasteurized donor human milk (PDHM) as opposed to artificial formula, although evidence supporting PDHM use from randomized control trials is limited. Human milk banks (HMBs) must have a risk management system to maintain a safe product especially as many operate in an unregulated environment. To ensure safety, the HMB in Australia has committed to meet the appropriate standards recommended in the Code of Good Manufacturing Practices (Blood and Tissues) and models risk management during processing on Codex HACCP (Hazard Analysis Critical Control Point) requirements. There is scope to continually reevaluate the screening of donors and quality standards recommended during HMB. This will be most effective if strong networks of HMBs are developed with regional reference laboratories to encourage compliance with safety guidelines. Further research and development is needed to refine technology for treating donor milk such as thermal ultrasound and ultraviolet light, aimed at the retention of full bioactivity. HMB networks will facilitate collection of evidence for refining HMB practice which should translate to improved outcomes for preterm and sick infants. Cost effectiveness is most likely when HMBs are associated with large neonatal intensive care units.

  4. Origin and depositional environment of fine-grained sediments since the last glacial maximum in the southeastern Yellow Sea: evidence from rare earth elements

    NASA Astrophysics Data System (ADS)

    Um, In Kwon; Choi, Man Sik; Lee, Gwang Soo; Chang, Tae Soo

    2015-12-01

    Despite the well-reconstructed seismic stratigraphy of the Holocene mud deposit in the southeastern Yellow Sea, known as the Heuksan mud belt (HMB), the provenances of these sediments and their depositional environments are unclear, especially for the fine-grained sediments. According to seismic data (extracted from another article in this special issue), the HMB comprises several sedimentary units deposited since the last glacial maximum. Based on analytical results on rare earth elements, fine-grained sediments in all sedimentary units can be interpreted as mixtures of sediments discharged from Chinese and Korean rivers. The proportions of fine-grained sediments from Chinese rivers (74.5 to 80.0%) were constant and higher than those from Korean rivers in all units. This fact demonstrates that all units have the same fine-grained sediment provenance: units III-b and III-a, located in the middle and northern parts of the HMB and directly deposited from Chinese rivers during the sea-level lowstand, could be the sediment source for units II-b and II-a. Unit I, while ambiguous, is of mixed origin combining reworked sediments from nearby mud deposits and Changjiang River-borne material with those of the Keum River. The results of this study indicate that at least 18.6% of bulk sediments in the HMB clearly originate from Chinese rivers, despite its location close to the southwestern coast of Korea.

  5. Direct, simple derivatization of disulfide bonds in proteins with organic mercury in alkaline medium without any chemical pre-reducing agents.

    PubMed

    Campanella, Beatrice; Onor, Massimo; Ferrari, Carlo; D'Ulivo, Alessandro; Bramanti, Emilia

    2014-09-16

    In this work we have studied the derivatization of protein disulfide bonds with p-Hydroxymercurybenzoate (pHMB) in strong alkaline medium without any preliminary reduction. The reaction has been followed by the determination of the protein-pHMB complex using size exclusion chromatography coupled to a microwave/UV mercury oxidation system for the on-line oxidation of free and protein-complexed pHMB and atomic fluorescence spectrometry (SEC-CVG-AFS) detection. The reaction has been optimized by an experimental design using lysozyme as a model protein and applied to several thiolic proteins. The proposed method reports, for the first time, that it is possible to label 75-100% cysteines of proteins and, thus, to determine thiolic proteins without the need of any reducing step to obtain reduced SH groups before mercury labelling. We obtained a detection limit of 100 nmol L(-1) based on a signal-to-noise ratio of 3 for unbound and complexed pHMB, corresponding to a detection limit of proteins ranged between 3 and 360 nmol L(-1), depending on the number of cysteines in the protein sequence.

  6. CHIRONOMID EMERGENCE AND RELATIVE EMERGENT BIOMASS FROM TWO ALABAMA STREAMS

    EPA Science Inventory

    Chironomid pupal exuviae were sampled monthly using drift nets and hand sieves over an annual cycle from Hendrick Mill Branch (HMB; Blount County, AL) and Payne Creek (PC; Hale County, AL). Taxon richness, community composition, and emergence phonologies were similar despite mar...

  7. Solar Cycle Variations in Polar Cap Area Measured by the SuperDARN Radars

    NASA Astrophysics Data System (ADS)

    Imber, S. M.; Milan, S. E.; Lester, M.

    2013-12-01

    We present a long term study, from January 1996 - August 2012, of the latitude of the Heppner-Maynard Boundary (HMB) measured at midnight using the northern hemisphere SuperDARN radars. The HMB represents the equatorward extent of ionospheric convection, and is used in this study as a measure of the global magnetospheric dynamics and activity. We find that the yearly distribution of HMB latitudes is single-peaked at 64° magnetic latitude for the majority of the 17-year interval. During 2003 the envelope of the distribution shifts to lower latitudes and a second peak in the distribution is observed at 61°. The solar wind-magnetosphere coupling function derived by Milan et al. (2012) suggests that the solar wind driving during this year was significantly higher than during the rest of the 17-year interval. In contrast, during the period 2008-2011 HMB distribution shifts to higher latitudes, and a second peak in the distribution is again observed, this time at 68° magnetic latitude. This time interval corresponds to a period of extremely low solar wind driving during the recent extreme solar minimum. This is the first statistical study of the polar cap area over an entire solar cycle, and the results demonstrate that there is a close relationship between the phase of the solar cycle and the area of the polar cap on a large scale statistical basis.

  8. Influence of in ovo injection of disaccharides, glutamine and β-hydroxy-β-methylbutyrate on the development of small intestine in duck embryos and neonates.

    PubMed

    Chen, W; Wang, R; Xiong, X L; Wan, H F; Xu, J; Peng, J

    2010-10-01

    1. The objective of the present study was to examine the effect of in ovo injection of disaccharides (DS), disaccharides and glutamine (DS + Gln) or disaccharides and β-hydroxy-β-methylbutyrate (DS + HMB) at d 23 of incubation on the development of the small intestine. 2. In DS + Gln-injected ducks, the greatest relative small intestine mass and muscularis layer thickness among 4 treatments was observed from d 25 of incubation to 7 d of age. 3. Jejunal sucrase activity in DS-injected ducks was significantly greater than in controls at hatch and on d 7. 4. In DS + HMB-treated ducks, a tendency toward slightly higher jejunal DNA concentration was observed throughout the experiment. 5. Greater body weight was found in DS + Gln and DS + HMB treated ducks in the first two weeks. However, there was no significant difference in the market weight (35 d) of ducks among the 4 treatments. 6. The results of present study suggest that administering disaccharides and Gln, or disaccharides and HMB, to the duck embryos exerted a beneficial effect on the early development of small intestine and on growth performance.

  9. An approach to outreach patients with von Willebrand disease in Egypt by targeting women with heavy menstrual bleeding and/or bleeding symptoms.

    PubMed

    Sherif, N; Goubran, H; Hassan, A; Burnouf, T; El-Ekiaby, M

    2014-03-01

    von Willebrand disease (VWD) is frequently ignored as a cause of menorrhagia. We investigated Egyptian women complaining of heavy menstrual bleeding (HMB) and/or other bleeding symptoms to detect potential VWD cases. Seventy-five female patients complaining of HMB and/or bleeding symptoms and 38 age-matched healthy female controls went through a family history questionnaire, a physical examination and were evaluated for bleeding score, pictorial blood assessment chart (PBAC), complete blood count, serum ferritin, blood group, prothrombin time, activated partial thromboplastin time, factor VIII (FVIII) activity, von Willebrand factor (VWF) ristocetin cofactor (RCo) activity, antigen (Ag), and RCo/Ag ratio. Sixty-eight of 75 patients presented with HMB, out of which 46 had no organic pathology and 7 presented other bleeding symptoms. Six patients were diagnosed with VWD, three with HMB, two with other bleeding symptoms and one with family history of VWD. Two related VWD patients were diagnosed in the control group. There were significant differences in bleeding and PBAC scores, ferritin level, FVIII activity, VWF:RCo and VWF:Ag between VWD patients and controls. This study indicated a high prevalence of VWD among patients with HMB without organic pathology (6.5%) and demonstrated the sensitivity of diagnostic parameters of VWD patients in an outreach campaign. The inexpensive bleeding and PBAC scoring systems are valuable to exclude cases without objective bleeding symptoms. Raising gynaecologists awareness about hereditary bleeding disorders is important to ensure a proper diagnosis and possible referral of these patients. Management of these patients with comprehensive medical care services under a multidisciplinary team would be ideal.

  10. Effects of two training protocols on the forehand drive performance in tennis.

    PubMed

    Genevois, Cyril; Frican, Baptiste; Creveaux, Thomas; Hautier, Christophe; Rogowski, Isabelle

    2013-03-01

    The aim of this study was to examine the effects of 2 training modalities on the tennis forehand drive performance. Forty-four tennis players (mean ± SD: age = 26.9 ± 7.5 years; height = 178.6 ± 6.7 cm; mass = 72.5 ± 8.0 kg; International Tennis Number = 3) were randomly assigned into 3 groups. During 6 weeks, the first group performed handled medicine ball (HMB) throws included in the regular tennis practice, the second group (overweight racket-OWR) played tennis forehand drives with an overweighed racket during the regular tennis practice, and the third group (regular tennis training-RTT) practiced only tennis training as usual. Before and after the 6-week program, velocity and accuracy of tennis crosscourt forehand drives were evaluated in the 3 groups. The main results showed that after 6-week training, the maximal ball velocity was significantly increased in HMB and OWR groups in comparison with RTT (p < 0.001 and p = 0. 001, respectively). The estimated averaged increase in ball velocity was greater in HMB than in OWR (11 vs. 5%, respectively; p = 0.017), but shot accuracy tended to be deteriorated in HMB when compared with OWR and RTT (p = 0.043 and p = 0.027, respectively). The findings of this study highlighted the efficiency of both training modalities to improve tennis forehand drive performance but also suggested that the HMB throws may be incorporated into the preseason program preferably, whereas the OWR forehand drives may be included in the on-season program. PMID:22592176

  11. Therapy of heavy menstrual bleeding in Korea: Subanalysis and results from a multinational clinical trial in the Asian region investigating the levonorgestrel-releasing intrauterine system versus conventional therapy

    PubMed Central

    Ling, Xu; Asif, Shaheena; Kraemer, Peter; Hanisch, Jens Ulrich; Inki, Pirjo; Lee, Jung Eun

    2015-01-01

    Objective To compare real-life clinical outcomes with the levonorgestrel-releasing intrauterine system (LNG-IUS) and conventional medical therapies (CMTs), including combined oral contraceptives and oral progestins in the treatment of idiopathic heavy menstrual bleeding (HMB) in South Korea. Methods This prospective, observational cohort study recruited a total of 647 women aged 18 to 45 years, diagnosed with HMB from 8 countries in Asia, including 209 women from South Korea (LNG-IUS, 169; CMTs, 40), who were followed up to one year. The primary outcome was cumulative continuation rate (still treated with LNG-IUS and CMTs) at 12 months. Secondary outcomes included bleeding pattern, assessment of the treatment efficacy by treating physician and safety profile. Results The continuation rate at 12 months was significantly higher with the LNG-IUS than CMTs (85.1% vs. 48.5%, respectively; P<0.0001). The 51.5% of CMTs patients discontinued treatment and 18.8% of LNG-IUS patients discontinued treatment. The most common reasons for discontinuation for CMTs were switching to another treatment and personal reasons. When compared to CMTs, the LNG-IUS offered better reduction in subjectively assessed menstrual blood loss and the number of bleeding days, tolerability and with better efficacy in HMB, as assessed by physician's final evaluation. Conclusion This study provides novel information on the real-life treatment patterns of HMB in South Korea. The efficacy of CMTs was inferior compared to the LNG-IUS in the clinical outcomes measured in this study. Due to the better compliance with LNG-IUS, the cumulative continuation rate is higher than CMTs. We conclude that the LNG-IUS should be used as the first-line treatment for HMB in Korean women, in line with international guidelines. PMID:25798431

  12. Effects of two training protocols on the forehand drive performance in tennis.

    PubMed

    Genevois, Cyril; Frican, Baptiste; Creveaux, Thomas; Hautier, Christophe; Rogowski, Isabelle

    2013-03-01

    The aim of this study was to examine the effects of 2 training modalities on the tennis forehand drive performance. Forty-four tennis players (mean ± SD: age = 26.9 ± 7.5 years; height = 178.6 ± 6.7 cm; mass = 72.5 ± 8.0 kg; International Tennis Number = 3) were randomly assigned into 3 groups. During 6 weeks, the first group performed handled medicine ball (HMB) throws included in the regular tennis practice, the second group (overweight racket-OWR) played tennis forehand drives with an overweighed racket during the regular tennis practice, and the third group (regular tennis training-RTT) practiced only tennis training as usual. Before and after the 6-week program, velocity and accuracy of tennis crosscourt forehand drives were evaluated in the 3 groups. The main results showed that after 6-week training, the maximal ball velocity was significantly increased in HMB and OWR groups in comparison with RTT (p < 0.001 and p = 0. 001, respectively). The estimated averaged increase in ball velocity was greater in HMB than in OWR (11 vs. 5%, respectively; p = 0.017), but shot accuracy tended to be deteriorated in HMB when compared with OWR and RTT (p = 0.043 and p = 0.027, respectively). The findings of this study highlighted the efficiency of both training modalities to improve tennis forehand drive performance but also suggested that the HMB throws may be incorporated into the preseason program preferably, whereas the OWR forehand drives may be included in the on-season program.

  13. The levonorgestrel-releasing intrauterine system in heavy menstrual bleeding: a benefit-risk review.

    PubMed

    Kaunitz, Andrew M; Inki, Pirjo

    2012-01-22

    Heavy menstrual bleeding (HMB) is a common problem in women of reproductive age and can cause irritation, inconvenience, self-consciousness and fear of social embarrassment. Our objective was to review and appraise literature identified from the MEDLINE and EMBASE databases to evaluate the clinical evidence and provide an update on the risks and benefits of using the levonorgestrel-releasing intrauterine system (LNG-IUS) in the treatment of HMB. The LNG-IUS consistently reduces menstrual blood loss (MBL) in women with HMB, including those with underlying uterine pathology or bleeding disorders. The available data suggest that it reduces MBL to a greater extent than other medical therapies, including combined oral contraceptives, oral progestogens (both short- or long-cycle regimens), tranexamic acid and oral mefenamic acid. In addition, the LNG-IUS and endometrial ablation appear to reduce MBL to a similar extent. The adverse effects reported with the LNG-IUS in women with HMB are similar to those typically observed in women using the system for contraception. Uterine perforations were not reported in any of the studies reviewed, but expulsion rates may be higher than in the general population of LNG-IUS users. Overall, the LNG-IUS has a positive effect on most quality-of-life domains, at least comparable to those achieved with hysterectomy or endometrial ablation, and is consistently a cost-effective option across a variety of countries and settings. In conclusion, the LNG-IUS is an effective treatment option for women with HMB, including those with underlying organic pathology or bleeding disorders.

  14. Studies on the oxidation of hexamethylbenzene 1: Oxidation of hexamethylbenzene with nitric acid

    NASA Technical Reports Server (NTRS)

    Chiba, K.; Tomura, S.; Mizuno, T.

    1986-01-01

    The oxidative reaction of hexamethylbenzene (HMB) with nitric acid was studied, and the hitherto unknown polymethylbenzenepolycarboxylic acids were isolated: tetramethylphthalic anhydride, tetramethylisophthalic acid, 1,3,5-, 1,2,4- and 1,2,3-trimethylbenzenetricarboxylic acids. When HMB was warmed with 50% nitric acid at about 80 C, tetramethylphthalic anhydride and tetramethylisophthalic acid were initially produced. The continued reaction led to the production of trimethylbenzenetricarboxylic acids, but only slight amounts of dimethylbenzenetetracarboxylic acids were detected in the reaction mixture. Whereas tetramethylphthalic anydride and tetramethylisophthalic acid were obtained, pentamethylbenzoic acid, a possible precursor of them, was scarcely produced. On the other hand, a yellow material extracted with ether from the initial reaction mixture contained bis-(nitromethyl)prehnitene (CH3)4C6(CH2NO2)2, which was easily converted into the phthalic anhydride.

  15. [Angiomyolipoma with Epithelial Cysts (AMLEC) of the Kidney].

    PubMed

    Takei, Kazushiro; Shimizu, Shinichi; Otsuki, Yoshiro

    2016-07-01

    A 49-year-old man was demonstrated to have two tumors in the right kidney by computed tomographic scan during an examination for cholelithiasis. One was a fat rich solid tumor which was clinically diagnosed as angiomyolipoma, and the other was an unconfirmed cystic tumor. Cholecystectomy and radical nephrectomy were performed. Based on pathological findings, the solid tumor was diagnosed as common angiomyolipoma and the cystic tumor as angiomyolipoma with epithelial cysts (AMLEC). The cystic tumor consisted of 3 components : an epithelial cyst lined with single flat to cuboidal cells, a subepithelial compact stroma and an external layer of muscle predominant angiomyolipoma. Immunohistochemical examinations showed strong intense staining of pan-cytokeratin in the epithelium lining the cyst. The subepithelial compact stroma was stained with both CD10 and HMB45. The muscle predominant angiomyolipoma exhibited expression of HMB45. AMLEC is a recently recognized rare variant of angiomyolipoma.

  16. Cutaneous angiomyolipoma.

    PubMed

    Val-Bernal, J F; Mira, C

    1996-08-01

    Extrarenal angiomyolipomas are rare lesions. An angiomyolipoma located on the right ear lobe in a 49-year-old man is reported. Pathologic examination showed a well-circumscribed subcutaneous nodule, 2 cm in diameter. The components of the tumor were confirmed by immunohistochemistry. Reactivity for HMB-45 was negative. A review of the twelve published cases, including the present, reveals that the patients age ranged from 33 to 77 years (mean 53.6), the male/female ratio was 11.1. The tumors were solitary, asymptomatic, noninvasive, located most commonly in acral skin or on the ear. The clinical impression is that of a cyst, a lipoma or a vascular tumor. Signs of tuberous sclerosis were absent in all cases. In contrast to the renal form, the cutaneous angiomyolipoma is a tumor differing in sex predominance, clinical associations, circumscription, solitariness, and HMB-45 immunoreactivity. Distinction from other mesenchymal lesions depends on recognition of traditional histologic criteria.

  17. Association of lymphangioleiomyomatosis (LAM) with endosalpingiosis in the retroperitoneal lymph nodes: report of two cases.

    PubMed

    Matsui, K; Travis, W D; Gonzalez, R; Terzian, J A; Rosai, J; Moss, J; Ferrans, V J

    2001-04-01

    We report 2 patients in whom pulmonary lymphangioleiomyomatosis (LAM) affected the retroperitoneal lymph nodes and was associated with endosalpingiosis. These lesions were large, encapsulated masses with multiple cysts containing chylous fluid. Both were characterized by proliferating LAM cells that formed fascicles separated by slit-like channels. Some cysts were lined by ciliated epithelium resembling that of Fallopian tubes. Other cysts were lined either by flattened endothelial cells or by a mixture of these cells and epithelial cells. Many LAM cells gave a positive reaction with HMB-45 antibody. Most LAM cells in fascicles were reactive for alpha-smooth muscle actin and desmin. In 1 patient, many of the epithelial cells and some of the subjacent LAM cells were positive for estrogen and progesterone receptors. In conclusion, immunostaining with HMB-45 antibody and markers for smooth muscle cells can be helpful in the evaluation of problems in the differential diagnosis of lesions of extrapulmonary LAM, particularly those involving the genital system.

  18. Submucosal uterine fibroid prolapsed into vagina in a symptomatic patient with IUS.

    PubMed

    Matytsina-Quinlan, Lyubov; Matytsina, Laura

    2014-04-16

    A female patient in her mid 40s presents with heavy menstrual bleeding (HMB) and a history of spotting/irregular light per vagina (PV) bleeding since intrauterine system (IUS) insertion 1 year ago. She is known to have submucosal uterine fibroid (SMUF). The patient reported abdominal pain and sudden onset of 'miscarriage-like' HMB with clots 2 days ago. On speculum examination there was a smooth round-shaped mass lying over the external cervical os. On bimanual examination PV, a round-shaped smooth mass of a walnut's size was palpable in the upper third of the vagina. Subsequent ultrasound imaging revealed an SMUF prolapsed into the vagina. Further surgical treatment was undertaken. Histology showed a fibroid (leiomyoma) with no evidence of malignancy.

  19. Breast milk donation after neonatal death in Australia: a report.

    PubMed

    Carroll, Katherine E; Lenne, Brydan S; McEgan, Kerri; Opie, Gillian; Amir, Lisa H; Bredemeyer, Sandra; Hartmann, Ben; Jones, Rachel; Koorts, Pieter; McConachy, Helen; Mumford, Patricia; Polverino, Jan

    2014-01-01

    Lactation and breast milk can hold great value and meaning for grieving mothers who have experienced a recent death of an infant. Donation to a human milk bank (HMB) as an alternative to discarding breast milk is one means of respecting the value of breast milk. There is little research, national policy discussion, or organizational representation in Australia on the subject of breast milk donation after infant death. On 29 November 2013 the Mercy Hospital for Women in Melbourne, Australia hosted Australia's first National Stakeholder Meeting (NSM) on the topic of milk donation after neonatal death. The NSM drew together representatives from Australian HMBs, neonatal intensive care units (NICUs) currently using donor human milk, and Australia's chief NICU parent support organization. The NSM was video-recorded and transcribed, and analyzed thematically by researchers. This article reports the seven dominant themes discussed by stakeholders during the NSM: the spectrum of women's lactation and donation experiences after infant death; the roles of the HMB and NICU in meeting the needs of the bereaved donor; how bereaved mothers' lactation autonomy may interface with a HMB's donation guidelines; how milk donation may be discussed with bereaved mothers; the variation between four categories of milk donation after neonatal death; the impact of limited resources and few HMBs on providing donation programs for bereaved mothers in Australia. This article provides evidence from researchers and practitioners that can assist HMB staff in refining their bank's policy on milk donation after infant death, and provides national policy makers with key considerations to support lactation, human milk banking, and bereavement services nation-wide.

  20. Factors controlling mud accumulation in the Heuksan mud belt off southwestern Korea

    NASA Astrophysics Data System (ADS)

    Chang, Tae Soo; Ha, Hun Jun; Chun, Seung Soo

    2015-12-01

    The Heuksan mud belt (hereafter HMB) is 20~50 km wide, ~200 km long, and ~50 m thick, having accumulated in the course of the Holocene transgression on the tide-dominated epicontinental shelf southwest of Korea. The internal architecture of the HMB is characterized by offshore prograding clinoforms. Of particular interest are the depositional processes responsible for this anomalously thick mud accumulation within a relatively short period of time. Tidal currents are important in the dispersal of mud in the HMB, although these alone cannot explain such an enormous mud deposit. In order to understand the formative processes of the HMB, a detailed sedimentary facies analysis, including high-resolution grain-size measurements, has been conducted on more than 30 short cores and three long drill cores recovered from the mud belt. Five major mud facies were identified. Of these, mud sequences showing a thickening-thinning trend of alternating silt and clay laminae suggestive of a tidal origin occur dominantly at inner to mid shelf locations. By contrast, internally structureless muds with sharp bases and no bioturbation, which are interpreted of representing fluid-mud deposits, are widespread at mid to outer shelf locations. Wave-generated mud ripples and storm beds on the inner shelf suggest that storm waves in winter resuspend previously deposited mud to form near-bed fluid-mud suspensions with resulting gravity-driven mud transport across the low-gradient outer shelf. This previously not recognized process is probably a major factor controlling depositional processes on the giant mud belt, enabling rapid accumulation and offshore progradation even during transgression, i.e., at times of sea-level rise.

  1. Satisfaction and health-related quality of life in women with heavy menstrual bleeding; results from a non-interventional trial of the levonorgestrel-releasing intrauterine system or conventional medical therapy

    PubMed Central

    Xu, Ling; Lee, Byung Seok; Asif, Shaheena; Kraemer, Peter; Inki, Pirjo

    2014-01-01

    Purpose To evaluate the patient satisfaction and health related quality of life (HRQoL) for levonorgestrel-releasing intrauterine system (LNG-IUS) versus conventional medical treatments ([CMTs] combined oral contraceptives, oral progestins, and antifibrinolytics, alone or in combination) in Asian women with heavy menstrual bleeding (HMB). Patients and methods A total of 647 patients diagnosed with HMB were recruited to this non-interventional study from the eight participating countries in Asia. Patient satisfaction was recorded at the last visit (at 12 months or premature discontinuation). At each visit (at 3, 6, and 12 months), patients completed the menorrhagia multi-attribute scale (MMAS) to assess HRQoL. Results A total of 83.5% of patients on the LNG-IUS were “very satisfied” or at least “satisfied” with the therapeutic effect of HMB treatment, compared with 59.2% of patients with CMTs (P<0.05). The mean (± standard deviation) MMAS score increased from 41.4±24.5 to 87.7±21.4 in the LNG-IUS arm, and from 44.1±24.9 to 73.1±25.3 in the CMTs arm. This increase was significantly higher in patients on the LNG-IUS, as compared with those on CMTs (P<0.05). The improvement in HRQoL in both treatment groups correlated with the body mass index of the patient, with larger improvement obtained in women with a higher body mass index. Conclusion The majority of women using the LNG-IUS or CMTs for HMB were satisfied with their treatment, and both treatment modalities were associated with significant improvements in HRQoL over time. The improvement was greater with the LNG-IUS, compared with CMTs. PMID:24920936

  2. Melanocytic differentiation is present in a significant proportion of nonpigmented diffuse neurofibromas: a potential diagnostic pitfall.

    PubMed

    Pižem, Jože; Nicholson, Kimberly M; Mraz, Jerica; Prieto, Victor G

    2013-08-01

    Whereas the pigmented (melanotic) variant of diffuse neurofibroma (DNF) with positivity for melanocytic markers is well recognized, expression of melanocytic markers in nonpigmented DNF has not been systematically studied. We analyzed 28 unselected consecutive DNFs for expression of melanocytic markers, including melan A, microphthalmia transcription factor (MITF), and HMB-45 antigen. For comparison, we also analyzed 40 localized skin neurofibromas and 7 intraneural neurofibromas. One case of nonpigmented DNF was analyzed by electron microscopy. Of the 28 DNFs studied by immunohistochemistry, 3 were pigmented and 25 nonpigmented. The 3 pigmented DNFs and 9 of 25 (36%) nonpigmented DNFs expressed melan A, MITF, and HMB-45 antigen. These markers were expressed either focally or more diffusely, typically in a minority of the lesional cells, and usually both in the dermal and subcutaneous portion of the DNF. Melan A was expressed in the largest number of the lesional cells (up to 50%), whereas only a small fraction of the melan A-positive cells (from 5% to 10% in most cases) also expressed HMB-45 antigen. None of the 47 non-DNFs expressed these markers. Ultrastructurally, melanosomes were present in some cells in nonpigmented DNF that expressed the melanocytic markers. Twenty-three of 28 (82%) DNFs, including 10 of 12 (83%) DNFs with melanocytic differentiation, were associated with neurofibromatosis type 1. Expression of melanocytic markers, including melan A, HMB-45 antigen, and MITF in DNF is a potential pitfall in differential diagnosis with melanocytic lesions that may clinically or histopathologically resemble DNF, in particular congenital melanocytic nevus with neurotization and neurofibroma-like melanoma.

  3. Endometrial haemostasis and menstruation.

    PubMed

    Davies, Joanna; Kadir, Rezan A

    2012-12-01

    Under normal physiological circumstances menstruation is a highly regulated, complex process that is under strict hormonal control. During normal menstruation, progesterone withdrawal initiates menstruation. The cessation of menstrual bleeding is achieved by endometrial haemostasis via platelet aggregation, fibrin deposition and thrombus formation. Local endocrine, immunological and haemostatic factors interact at a molecular level to control endometrial haemostasis. Tissue factor and thrombin play a key role locally in the cessation of menstrual bleeding through instigation of the coagulation factors. On the other hand, fibrinolysis prevents clot organisation within the uterine cavity while plasminogen activator inhibitors (PAI) and thrombin-activatable fibrinolysis inhibitors control plasminogen activators and plasmin activity. Abnormalities of uterine bleeding can result from imbalance of the haemostatic factors. The most common abnormality of uterine bleeding is heavy menstrual bleeding (HMB). Modern research has shown that an undiagnosed bleeding disorder, in particular von Willebrand disease (VWD) and platelet function disorders, can be an underlying cause of HMB. This has led to a change in the approach to the management of HMB. While full haemostatic assessment is not required for all women presenting with HMB, menstrual score and bleeding score can help to discriminate women who are more likely to have a bleeding disorder and benefit from laboratory haemostatic evaluation. Haemostatic agents (tranexamic acid and DDAVP) enhance systemic and endometrial haemostasis and are effective in reducing menstrual blood loss in women with or without bleeding disorders. Further research is required to enhance our understanding of the complex interactions of haemostatic factors in general, and specifically within the endometrium. This will lead to the development of more targeted interventions for the management of abnormal uterine bleeding in the future.

  4. Genomic hotspots for adaptation: the population genetics of Müllerian mimicry in the Heliconius melpomene clade.

    PubMed

    Baxter, Simon W; Nadeau, Nicola J; Maroja, Luana S; Wilkinson, Paul; Counterman, Brian A; Dawson, Anna; Beltran, Margarita; Perez-Espona, Silvia; Chamberlain, Nicola; Ferguson, Laura; Clark, Richard; Davidson, Claire; Glithero, Rebecca; Mallet, James; McMillan, W Owen; Kronforst, Marcus; Joron, Mathieu; Ffrench-Constant, Richard H; Jiggins, Chris D

    2010-02-05

    Wing patterning in Heliconius butterflies is a longstanding example of both Müllerian mimicry and phenotypic radiation under strong natural selection. The loci controlling such patterns are "hotspots" for adaptive evolution with great allelic diversity across different species in the genus. We characterise nucleotide variation, genotype-by-phenotype associations, linkage disequilibrium, and candidate gene expression at two loci and across multiple hybrid zones in Heliconius melpomene and relatives. Alleles at HmB control the presence or absence of the red forewing band, while alleles at HmYb control the yellow hindwing bar. Across HmYb two regions, separated by approximately 100 kb, show significant genotype-by-phenotype associations that are replicated across independent hybrid zones. In contrast, at HmB a single peak of association indicates the likely position of functional sites at three genes, encoding a kinesin, a G-protein coupled receptor, and an mRNA splicing factor. At both HmYb and HmB there is evidence for enhanced linkage disequilibrium (LD) between associated sites separated by up to 14 kb, suggesting that multiple sites are under selection. However, there was no evidence for reduced variation or deviations from neutrality that might indicate a recent selective sweep, consistent with these alleles being relatively old. Of the three genes showing an association with the HmB locus, the kinesin shows differences in wing disc expression between races that are replicated in the co-mimic, Heliconius erato, providing striking evidence for parallel changes in gene expression between Müllerian co-mimics. Wing patterning loci in Heliconius melpomene therefore show a haplotype structure maintained by selection, but no evidence for a recent selective sweep. The complex genetic pattern contrasts with the simple genetic basis of many adaptive traits studied previously, but may provide a better model for most adaptation in natural populations that has arisen over

  5. Genetic transformation of Knufia petricola A95 - a model organism for biofilm-material interactions

    PubMed Central

    2014-01-01

    We established a protoplast-based system to transfer DNA to Knufia petricola strain A95, a melanised rock-inhabiting microcolonial fungus that is also a component of a model sub-aerial biofilm (SAB) system. To test whether the desiccation resistant, highly melanised cell walls would hinder protoplast formation, we treated a melanin-minus mutant of A95 as well as the type-strain with a variety of cell-degrading enzymes. Of the different enzymes tested, lysing enzymes from Trichoderma harzianum were most effective in producing protoplasts. This mixture was equally effective on the melanin-minus mutant and the type-strain. Protoplasts produced using lysing enzymes were mixed with polyethyleneglycol (PEG) and plasmid pCB1004 which contains the hygromycin B (HmB) phosphotransferase (hph) gene under the control of the Aspergillus nidulans trpC. Integration and expression of hph into the A95 genome conferred hygromycin resistance upon the transformants. Two weeks after plating out on selective agar containing HmB, the protoplasts developed cell-walls and formed colonies. Transformation frequencies were in the range 36 to 87 transformants per 10 μg of vector DNA and 106 protoplasts. Stability of transformation was confirmed by sub-culturing the putative transformants on selective agar containing HmB as well as by PCR-detection of the hph gene in the colonies. The hph gene was stably integrated as shown by five subsequent passages with and without selection pressure. PMID:25401079

  6. Genetic transformation of Knufia petricola A95 - a model organism for biofilm-material interactions.

    PubMed

    Noack-Schönmann, Steffi; Bus, Tanja; Banasiak, Ronald; Knabe, Nicole; Broughton, William J; Den Dulk-Ras, H; Hooykaas, Paul Jj; Gorbushina, Anna A

    2014-01-01

    We established a protoplast-based system to transfer DNA to Knufia petricola strain A95, a melanised rock-inhabiting microcolonial fungus that is also a component of a model sub-aerial biofilm (SAB) system. To test whether the desiccation resistant, highly melanised cell walls would hinder protoplast formation, we treated a melanin-minus mutant of A95 as well as the type-strain with a variety of cell-degrading enzymes. Of the different enzymes tested, lysing enzymes from Trichoderma harzianum were most effective in producing protoplasts. This mixture was equally effective on the melanin-minus mutant and the type-strain. Protoplasts produced using lysing enzymes were mixed with polyethyleneglycol (PEG) and plasmid pCB1004 which contains the hygromycin B (HmB) phosphotransferase (hph) gene under the control of the Aspergillus nidulans trpC. Integration and expression of hph into the A95 genome conferred hygromycin resistance upon the transformants. Two weeks after plating out on selective agar containing HmB, the protoplasts developed cell-walls and formed colonies. Transformation frequencies were in the range 36 to 87 transformants per 10 μg of vector DNA and 10(6) protoplasts. Stability of transformation was confirmed by sub-culturing the putative transformants on selective agar containing HmB as well as by PCR-detection of the hph gene in the colonies. The hph gene was stably integrated as shown by five subsequent passages with and without selection pressure.

  7. Primary oral melanoma: A histopathological and immunohistochemical study of 22 cases of Latin America

    PubMed Central

    Toral-Rizo, Víctor H.; León, Jorge E.; Contreras, Elisa; Carlos, Román; Delgado-Azañero, Wilson; Mosqueda-Taylor, Adalberto; de-Almeida, Oslei P.

    2012-01-01

    Objective: The aim of this study was to analyze the histopathological and immunohistochemical characteristics of 22 cases of primary oral melanomas (OM). Study Design: Twenty two cases of primary oral melanoma were analyzed by description of their histopathological features and immunohistochemical study using the antibodies S-100, HMB-45, Melan-A and Ki-67. Results: The mean age was 58 years and 14 cases were female. The main affected sites were the hard palate, followed by the upper gingiva. Microscopically, 15 cases presented level III of invasion, 2 cases were amelanotic and 13 showed a mixed epithelioid and plasmacytoid or spindle cells composition. Some cases showed necrosis, perivascular and perineural invasion. S-100 and HMB-45 were positive in all cases, but 3 cases were negative for Melan-A. The proliferative index with Ki-67 was high, with labeling index ranging from 15.51% to 63% of positive cells. Conclusion: S-100 and HMB-45 are more frequently expressed than Melan-A in primary oral melanomas and these markers are helpful to confirm the diagnosis. Key words:Oral melanoma, histopathology, immunohistochemistry. PMID:22143732

  8. Metabolism of 5-methylthioribose to methionine

    SciTech Connect

    Miyazaki, J.H.; Yang, S.F.

    1987-06-01

    During ethylene biosynthesis, the H/sub 3/CS-group of S-adenosylmethionine is released as 5'-methylthioadenosine, which is recycled to methionine via 5-methylthioribose (MTR). In mungbean hypocotyls and cell-free extracts of avocado, (/sup 14/C)MTR was converted into labeled methionine via 2-keto-4-methylthiobutyric acid (KMB) and 2-hydroxy-4-methylthiobutyric acid (HMB), as intermediates. Incubation of (ribose-U-/sup 14/C)MTR with avocado extract resulted in the production of (/sup 14/C)formate, indicating the conversion of MTR to KMB involves a loss of formate, presumably from C-1 of MTR. Tracer studies showed that KMB was converted readily in vivo and in vitro to methionine, while HMB was converted much more slowly. The conversion of KMB to methionine by dialyzed avocado extract requires an amino donor. Among several potential donors examined, L-glutamine was the most efficient. Anaerobiosis inhibited only partially the oxidation of MTR to formate, KMB/HMB, and methionine by avocado extract. The role of O/sub 2/ in the conversion of MTR to methionine is discussed.

  9. Impact of a new levonorgestrel intrauterine system, Levosert®, on heavy menstrual bleeding: results of a one-year randomised controlled trial

    PubMed Central

    Nollevaux, Fabrice; Nizet, Dominique; Wijzen, Fabienne; Gordenne, Valérie; Tasev, Niso; Segedi, Dimitrije; Marinescu, Bogdan; Enache, Andreea; Parhomenko, Vadim; Frankenne, Francis; Foidart, Jean-Michel

    2014-01-01

    Objective To evaluate a new levonorgestrel-releasing intrauterine system (LNG-IUS) called Levosert® for the treatment of heavy menstrual bleeding (HMB) in comparison to the reference product Mirena®. Methods A multicentre, randomised, controlled trial, in non-menopausal women diagnosed with functional HMB (defined as menstrual blood loss [MBL] ≥ 80 mL) randomised to either Levosert® or Mirena® and followed for up to one year. MBL was evaluated using a validated modified version of the Wyatt pictogram. Results A total of 280 women were randomised (141 to Levosert® and 139 to Mirena®). During the one-year treatment period, both Levosert® and Mirena® dramatically decreased MBL and increased haemoglobin and ferritin levels. There were no statistically significant differences between Levosert® and Mirena® regarding any of the parameters evaluated during the study. Similar bleeding patterns were observed in both groups. Levosert® was inserted with the same ease as Mirena®. Both treatments were associated with identical expulsion rates and no perforations occurred in either treatment group. Conclusion Levosert®, a new LNG-IUS designed to release the same daily amount of LNG as Mirena®, is highly effective in the treatment of HMB. No differences were observed between Levosert® and Mirena® regarding all evaluated outcomes, including safety profile. PMID:24666176

  10. Angiomyolipoma with epithelial cysts of the kidney in a man.

    PubMed

    Mikami, Shuji; Oya, Mototsugu; Mukai, Makio

    2008-10-01

    Angiomyolipoma (AML) is a well-characterized tumor composed of vascular, smooth muscle and adipose elements. Recently, AML with epithelial cysts (AMLEC) has been described as a cystic variant of AML. Herein is reported an AMLEC in a 55-year-old man, and to the authors' knowledge this is the first case report of AMLEC in Japan. He was referred to hospital because of microhematuria. A left renal tumor was noted and partial nephrectomy was performed. Histology indicated that the tumor was composed of epithelial cysts, compact subepithelial stroma and muscle-predominant AML. Immunohistochemically, the subepithelial compact stroma and muscle-predominant AML were positive for HMB-45, estrogen receptor (ER), progesterone receptor (PR), CD10, smooth-muscle actin and desmin. Epithelial cysts were positive for pancytokeratin but negative for HMB-45, ER and PR. This tumor was diagnosed as AMLEC, mainly based on the immunohistochemical result that subepithelial compact stroma and muscle-predominant AML were positive for HMB-45. The patient was alive with no evidence of recurrence at 2 years postoperatively. This case was very interesting because it suggests that AMLEC should enter into the differential diagnosis of adult renal neoplasms.

  11. An international response to questions about terminologies, investigation, and management of abnormal uterine bleeding: use of an electronic audience response system.

    PubMed

    Munro, Malcolm G; Broder, Michael; Critchley, Hilary O D; Matteson, Kristen; Haththotuwa, Rohana; Fraser, Ian S

    2011-09-01

    More than 600 registrants attended a two-hour interactive symposium on abnormal uterine bleeding (AUB) at the Federation of Gynecology and Obstetrics World Congress in Cape Town, October 2009. Nearly 250 of these participants answered multiple questions through an electronic audience responder system. The audience heard five structured presentations on clinically important and controversial aspects of AUB, including terminologies and definitions, classification of causes, mechanisms of AUB in the absence of structural lesions of the reproductive tract, the potential for a structured menstrual history, and management of heavy menstrual bleeding (HMB) in low-resource settings. Numerous demographic details were collected, and a total of 30 questions to the audience were interspersed through each of the presentations. The audience demonstrated great variation in the way the terms AUB, menorrhagia, and dysfunctional uterine bleeding (DUB) are used, and considerable majorities agreed that the terms menorrhagia and DUB should be abolished. AUB should be the overarching term to describe all symptomatic departures from normal menstruation or the menstrual cycle. HMB is a suitable replacement term for menorrhagia. DUB can be replaced by the three clinical entities comprising "nonstructural" causes of AUB. There was a high consistency across demographic subgroups in answers to most questions. Acute and chronic AUB were defined, and aspects of a classification system for causes of AUB and of a structured menstrual history were explored. Issues related to investigation and hormonal treatment of HMB in low-resource settings were explored by registrants from developing countries.

  12. [Sarcopenia intervention with progressive resistance training and protein nutritional supplements].

    PubMed

    Palop Montoro, M Victoria; Párraga Montilla, Juan Antonio; Lozano Aguilera, Emilio; Arteaga Checa, Milagros

    2015-04-01

    Introducción: El envejecimiento viene acompañado de cambios en la composición corporal entre los que se encuentra una reducción progresiva de la masa muscular, que puede contribuir al desarrollo de limitaciones funcionales en las personas mayores, y donde el estilo de vida juega un papel de especial relevancia. Objetivos: Comprobar la efectividad del entrenamiento de resistencia progresiva, los suplementos nutricionales proteicos y ambas intervenciones combinadas en el tratamiento de la sarcopenia. Método: Revisión de la literatura en las bases de datos Medline, ScienceDirect, CINAHL, ISI WOK y PEDro, mediante la combinación de los descriptores del Medical Subjects Headings (MeSH) referentes a sarcopenia, entrenamiento de fuerza progresiva, suplementos proteicos y personas mayores. Resultados: Un total de 147 estudios fueron encontrados los cuales realizaban ejercicio de resistencia, mediante sesiones de 45-60 minutos, 2-3 veces por semana, y 3-4 series de 8 repeticiones, a una intensidad creciente. Este ejercicio produjo un aumento de la masa muscular y la fuerza, así como incremento en la síntesis de proteínas musculoesqueléticas y tamaño de la fibra muscular. Los suplementos nutricionales tales como el beta-hidroxi-beta-metilbutirato, la leucina y los aminoácidos esenciales produjeron beneficios en la masa muscular. Todos los suplementos aumentaron la fuerza, especialmente cuando se combinaron con el ejercicio de resistencia. Conclusión: La combinación del entrenamiento de resistencia progresiva y las proteínas incluidas en la dieta, o bien en forma de suplementos nutricionales, refuerza los efectos que cada una de estas intervenciones puede tener en el tratamiento de la sarcopenia en las personas mayores.

  13. Combinación de fármacos reduce pólipos del duodeno FAP

    Cancer.gov

    En un estudio clínico pequeño de personas con un padecimiento heredado que aumenta en gran medida el riesgo de cáncer gastrointestinal, una combinación de dos fármacos ha mostrado que reduce lesiones precancerosas en el duodeno.

  14. Is duration of postoperative fasting associated with infection and prolonged length of stay in surgical patients?

    PubMed

    de Assis, Michelli Cristina Silva; Silveira, Carla Rosane de Moraes; Beghetto, Mariur Gomes; de Mello, Daniel Elza

    2014-10-01

    Objetivo: Constatar si el periodo de ayuno postoperatorio aumenta el riesgo de infeccion y prolonga la estancia hospitalaria. Métodos: Estudio de cohorte prospectivo. Fueron incluidos pacientes en cirugia selectiva. Se excluyeron aquellos sin posibilidades de evaluacion nutricional, ingresados a unidades de cuidado minimo y con.

  15. Effects of supplementation with a combination of β-hydroxy-β-methyl butyrate, L-arginine, and L-glutamine on postoperative recovery of quadriceps muscle strength after total knee arthroplasty.

    PubMed

    Nishizaki, Kanae; Ikegami, Hitoshi; Tanaka, Yukio; Imai, Ryutaro; Matsumura, Hajime

    2015-01-01

    目的:有报道称膝关节炎病人全膝关节置换术后,紧接着就是股四头肌肌肉 力量的减小。我们研究了联合补充β羟基β- 甲基丁酸、L-精氨酸和L-谷氨酰 胺(HMB/Arg/Gln)对全膝关节置换患者术后股四头肌肌肉力量恢复的效果。 方法:研究对象为进行全膝关节置换的23 位患者(平均年龄为70.5 岁,其中 12 名为女性)。患者被随机分配进对照组和HMB/Arg/Gln 补充组。手术前补 充5 天和手术后补充28 天的HMB/Arg/Gln 或对照食物。分别在术前7 天,术 后14 天、28 天和42 天测定最大股四头肌力量。在研究过程中,使用一个生 活方式记录装置测定总的能量消耗。随后两组以同样的方式康复。结果:对 照组手术前最大股四头肌力量为1.1±0.62 Nm/Kg,手术后14 天为0.7±0.9 Nm/Kg(p=0.02 ); HMB/Arg/Gln 组手术前最大股四头肌力量为1.1±0.3 Nm/Kg,手术后14 天为0.9±0.4 Nm/Kg。对照组手术后肌肉力量损失显著,但 HMB/Arg/Gln 组没有。两组之间能量消耗没有显著差异。结论: 补充 HMB/Arg/Gln 可以抑制全膝关节置换术后肌肉力量的损失。运动和营养干预 似乎能够让患者保持他们的股四头肌力量。.

  16. Hydroxymethylbilane synthase: Complete genomic sequence and amplifiable polymorphisms in the human gene

    SciTech Connect

    Yoo, Hanwook; Warner, C.A.; Chen, Chiahsiang; Desnick, R.J. )

    1993-01-01

    Acute intermittent porphyria (AIP), an autosomal dominant inborn error of heme biosynthesis, results from the half-normal activity of the heme biosynthetic enzyme hydroxymethylbilane synthase (HMB-synthase). Heterozygous individuals are prone to life-threatening acute neurologic attacks, which are precipitated by certain drugs and other metabolic, hormonal, and nutritional factors. Since the biochemical diagnosis of heterozygous individuals has been problematic, recent efforts have focused on the identification of mutations and diagnostically useful restriction fragment length polymorphisms (RFLPS) in the HMB-synthase gene. To facilitate these endeavors, the human HMB-synthase gene, including 1.1 kb of the 5[prime] flanking region, was isolated and completely sequenced in both orientations. The 10,024-bp gene contained 15 exons ranging in size from 39 to 438 bp and 14 introns ranging from 87 to 2913 bp. All intron/exon boundaries conformed to the GT/AG consensus rule. There were six Alu repetitive elements, one of the J and five of the Sa subfamilies. Analysis of the 1. I -kb 5[prime]flanking region revealed putative regulatory elements for the housekeeping promoter including AP1, AP4, SP1, TRE, ENH, and CAC. This region contained 10 HpaII sites and had an overall GC content of 54%. Three new polymorphic sites were identified by the single-strand conformation polymorphism (SSCP) technique, a common BsmAI site in intron 3 (3581 A/G), a common HinfI RFLP in intron 10 (7064 C/A), and a rare MnlI site in intron 14 (7998G/A). The allele frequencies of five previously known and the new polymorphic sites in a normal Caucasian population indicated that the intron 1 and intron 3 RFLPs were in linkage disequilibrium; however, the Hint I site segregated independently. 54 refs., 6 figs., 3 tabs.

  17. Parameter estimation and actuator characteristics of hybrid magnetic bearings for axial flow blood pump applications.

    PubMed

    Lim, Tau Meng; Cheng, Shanbao; Chua, Leok Poh

    2009-07-01

    Axial flow blood pumps are generally smaller as compared to centrifugal pumps. This is very beneficial because they can provide better anatomical fit in the chest cavity, as well as lower the risk of infection. This article discusses the design, levitated responses, and parameter estimation of the dynamic characteristics of a compact hybrid magnetic bearing (HMB) system for axial flow blood pump applications. The rotor/impeller of the pump is driven by a three-phase permanent magnet brushless and sensorless motor. It is levitated by two HMBs at both ends in five degree of freedom with proportional-integral-derivative controllers, among which four radial directions are actively controlled and one axial direction is passively controlled. The frequency domain parameter estimation technique with statistical analysis is adopted to validate the stiffness and damping coefficients of the HMB system. A specially designed test rig facilitated the estimation of the bearing's coefficients in air-in both the radial and axial directions. Experimental estimation showed that the dynamic characteristics of the HMB system are dominated by the frequency-dependent stiffness coefficients. By injecting a multifrequency excitation force signal onto the rotor through the HMBs, it is noticed in the experimental results the maximum displacement linear operating range is 20% of the static eccentricity with respect to the rotor and stator gap clearance. The actuator gain was also successfully calibrated and may potentially extend the parameter estimation technique developed in the study of identification and monitoring of the pump's dynamic properties under normal operating conditions with fluid. PMID:19566728

  18. Human uroporphyrinogen III synthase: NMR-based mapping of the active site.

    PubMed

    Cunha, Luis; Kuti, Miklos; Bishop, David F; Mezei, Mihaly; Zeng, Lei; Zhou, Ming-Ming; Desnick, Robert J

    2008-05-01

    Uroporphyrinogen III synthase (URO-synthase) catalyzes the cyclization and D-ring isomerization of hydroxymethylbilane (HMB) to uroporphyrinogen (URO'gen) III, the cyclic tetrapyrrole and physiologic precursor of heme, chlorophyl, and corrin. The deficient activity of human URO-synthase results in the autosomal recessive cutaneous disorder, congenital erythropoietic porphyria. Mapping of the structural determinants that specify catalysis and, potentially, protein-protein interactions is lacking. To map the active site and assess the enzyme's possible interaction in a complex with hydroxymethylbilane-synthase (HMB-synthase) and/or uroporphyrinogen-decarboxylase (URO-decarboxylase) by NMR, an efficient expression and purification procedure was developed for these cytosolic enzymes of heme biosynthesis that enabled preparation of special isotopically-labeled protein samples for NMR characterization. Using an 800 MHz instrument, assignment of the URO-synthase backbone (13)C(alpha) (100%), (1)H(alpha) (99.6%), and nonproline (1)H(N) and (15)N resonances (94%) was achieved as well as 85% of the side-chain (13)C and (1)H resonances. NMR analyses of URO-synthase titrated with competitive inhibitors N(D)-methyl-1-formylbilane (NMF-bilane) or URO'gen III, revealed resonance perturbations of specific residues lining the cleft between the two major domains of URO synthase that mapped the enzyme's active site. In silico docking of the URO-synthase crystal structure with NMF-bilane and URO'gen III was consistent with the perturbation results and provided a 3D model of the enzyme-inhibitor complex. The absence of chemical shift changes in the (15)N spectrum of URO-synthase mixed with the homogeneous HMB-synthase holoenzyme or URO-decarboxylase precluded occurrence of a stable cytosolic enzyme complex. PMID:18004775

  19. Parameter estimation and actuator characteristics of hybrid magnetic bearings for axial flow blood pump applications.

    PubMed

    Lim, Tau Meng; Cheng, Shanbao; Chua, Leok Poh

    2009-07-01

    Axial flow blood pumps are generally smaller as compared to centrifugal pumps. This is very beneficial because they can provide better anatomical fit in the chest cavity, as well as lower the risk of infection. This article discusses the design, levitated responses, and parameter estimation of the dynamic characteristics of a compact hybrid magnetic bearing (HMB) system for axial flow blood pump applications. The rotor/impeller of the pump is driven by a three-phase permanent magnet brushless and sensorless motor. It is levitated by two HMBs at both ends in five degree of freedom with proportional-integral-derivative controllers, among which four radial directions are actively controlled and one axial direction is passively controlled. The frequency domain parameter estimation technique with statistical analysis is adopted to validate the stiffness and damping coefficients of the HMB system. A specially designed test rig facilitated the estimation of the bearing's coefficients in air-in both the radial and axial directions. Experimental estimation showed that the dynamic characteristics of the HMB system are dominated by the frequency-dependent stiffness coefficients. By injecting a multifrequency excitation force signal onto the rotor through the HMBs, it is noticed in the experimental results the maximum displacement linear operating range is 20% of the static eccentricity with respect to the rotor and stator gap clearance. The actuator gain was also successfully calibrated and may potentially extend the parameter estimation technique developed in the study of identification and monitoring of the pump's dynamic properties under normal operating conditions with fluid.

  20. Effects of six-month supplementation with beta-hydroxy-beta-methylbutyrate, glutamine, and arginine on vascular endothelial function of older adults

    PubMed Central

    Ellis, Amy; Patterson, Morgan; Dudenbostel, Tanja; Calhoun, David; Gower, Barbara

    2015-01-01

    Background Vascular endothelial function declines with advancing age, due in part to increased oxidative stress and inflammation, and this age-related vascular dysfunction has been identified as an independent risk factor for cardiovascular diseases (CVD). This double-blind, placebo-controlled trial investigated the effects of a dietary supplement containing β-hydroxy-β-methylbutyrate (HMB), glutamine, and arginine on endothelial-dependent vasodilation of older adults. Subjects/Methods Thirty-one community-dwelling men and women aged 65-87 years were randomly assigned to two groups. The treatment group received two doses of the supplement daily (totaling 3g HMB, 14g glutamine, 14g arginine) for six months while the control group received an isocaloric placebo. At baseline and week 24, vascular endothelial function was measured by flow-mediated dilation of the brachial artery, and fasting blood samples were obtained to measure high-sensitivity C-reactive protein (hsCRP) and tumor necrosis factor-α (TNF-α). Results Paired samples t-tests revealed a 27% increase in flow-mediated dilation among the treatment group (p=0.003) while no change was observed in the placebo group (p=0.651). Repeated-measures ANOVA verified a significant time by group interaction (p=0.038). Although no significant changes were observed for hsCRP or TNF-α, a trend was observed for increasing hsCRP among the placebo group only (p=0.059). Conclusions These results suggest that dietary supplementation of HMB, glutamine, and arginine may favorably impact vascular endothelial function in older adults. Additional studies are needed to elucidate whether reduced inflammation or other mechanisms may underlie the benefits of supplementation. PMID:26306566

  1. Surveillance of female patients with inherited bleeding disorders in United States Haemophilia Treatment Centres

    PubMed Central

    Byams, V. R.; Kouides, P. A.; Kulkarni, R.; Baker, J. R.; Brown, D. L.; Gill, J. C.; GRANT, A. M.; James, A. H.; Konkle, B. A.; Maahs, J.; Dumas, M. M.; McAlister, S.; Nance, D.; Nugent, D.; Philipp, C. S.; Soucie, J. M.; Stang, E.

    2015-01-01

    Summary Inherited bleeding disorders are especially problematic for affected girls and women due to the monthly occurrence of menstrual periods and the effects on reproductive health. Although heavy menstrual bleeding (HMB) is the most common manifestation, females with inherited bleeding disorders (FBD) experience other bleeding symptoms throughout the lifespan that can lead to increased morbidity and impairment of daily activities. The purpose of this article is to describe the utility of a female-focused surveillance effort [female Universal Data Collection (UDC) project] in the United States Haemophilia Treatment Centres (HTCs) and to describe the baseline frequency and spectrum of diagnoses and outcomes. All FBD aged 2 years and older receiving care at selected HTCs were eligible for enrolment. Demographic data, diagnoses and historical data regarding bleeding symptoms, treatments, gynaecological abnormalities and obstetrical outcomes were analysed. Analyses represent data collected from 2009 to 2010. The most frequent diagnoses were type 1 von Willebrand’s disease (VWD) (195/319; 61.1%), VWD type unknown (49/319; 15.4%) and factor VIII deficiency (40/319; 12.5%). HMB was the most common bleeding symptom (198/253; 78.3%); however, 157 (49.2%) participants reported greater than four symptoms. Oral contraceptives were used most frequently to treat HMB (90/165; 54.5%), followed by desmopressin [1–8 deamino-D-arginine vasopressin (DDAVP)] (56/165; 33.9%). Various pregnancy and childbirth complications were reported, including bleeding during miscarriage (33/43; 76.7%) and postpartum haemorrhage (PPH) (41/109; 37.6%). FBD experience multiple bleeding symptoms and obstetrical-gynaecological morbidity. The female UDC is the first prospective, longitudinal surveillance in the US focusing on FBD and has the potential to further identify complications and reduce adverse outcomes in this population. PMID:21692922

  2. Immunohistochemical study of melanocyte-melanocyte stem cell lineage in vitiligo; a clue to interfollicular melanocyte stem cell reservoir.

    PubMed

    Seleit, Iman; Bakry, Ola Ahmed; Abdou, Asmaa Gaber; Dawoud, Noha Mohammed

    2014-05-01

    There has been a long lasting controversy over whether melanocytes (MCs) in vitiligo are actually lost or still present but functionally inactive. We aimed to evaluate the MC cell lineage in follicular and interfollicular vitiliginous epidermis through immunohistochemical localization of Human Melanoma Black-45 (HMB-45) and Tyrosinase Related Protein 2 (TRP2) and to correlate it with clinicopathologic parameters. Using immunohistochemical techniques, skin biopsies from 50 vitiligo patients and 20 age- and gender-matched healthy subjects were examined. Differentiated active MCs were detected in 44% of interfollicular epidermis (IFE) and 46.7% of follicular epidermis (FE) in lesional skin. Melanocyte precursors/stem cells were detected in 54% of IFE and 63.3% of FE in lesional skin. Melanocyte precursors/stem cells of IFE were significantly associated with residual melanin pigment (p = 0.007) and with absence of angiogenesis (p = 0.05). HMB-45 percentage of expression in IFE was positively correlated with MC precursors/stem cells percentage in FE (r = +0.65, p < 0.001) and IFE (r = +0.33, p = 0.01). Melanocyte precursors/stem cells positivity (p < 0.001) was progressively decreasing with advanced histopathologic grading. There was no significant association between interfollicular or follicular expression of HMB-45, TRP2 or MC precursors/stem cells and the clinical type of vitiligo or its duration. In conclusion, functioning MCs may exist in vitiligo. The presence of MC precursors/stem cells in IFE may provide an additional reservoir needed for repigmentation.

  3. Neisseria meningitidis tonB, exbB, and exbD genes: Ton-dependent utilization of protein-bound iron in Neisseriae.

    PubMed Central

    Stojiljkovic, I; Srinivasan, N

    1997-01-01

    We have recently cloned and characterized the hemoglobin (Hb) receptor gene, hmbR, from Neisseria meningitidis. To identify additional proteins that are involved in Hb utilization, the N. meningitidis Hb utilization system was reconstituted in Escherichia coli. Five cosmids from N. meningitidis DNA library enabled a heme-requiring (hemA), HmbR-expressing mutant of E. coli to use Hb as both porphyrin and iron source. Nucleotide sequence analysis of DNA fragments subcloned from the Hb-complementing cosmids identified four open reading frames, three of them homologous to Pseudomonas putida, E. coli, and Haemophilus influenzae exbB, exbD, and tonB genes. The N. meningitidis TonB protein is 28.8 to 33.6% identical to other gram-negative TonB proteins, while the N. meningitidis ExbD protein shares between 23.3 and 34.3% identical amino acids with other ExbD and TolR proteins. The N. meningitidis ExbB protein was 24.7 to 36.1% homologous with other gram-negative ExbB and TolQ proteins. Complementation studies indicated that the neisserial Ton system cannot interact with the E. coli FhuA TonB-dependent outer membrane receptor. The N. meningitidis tonB mutant was unable to use Hb, Hb-haptoglobin complexes, transferrin, and lactoferrin as iron sources. Insertion of an antibiotic cassette in the 3' end of the exbD gene produced a leaky phenotype. Efficient usage of heme by N. meningitidis tonB and exbD mutants suggests the existence of a Ton-independent heme utilization mechanism. E. coli complementation studies and the analysis of N. meningitidis hmbR and hpu mutants suggested the existence of another Hb utilization mechanism in this organism. PMID:9006036

  4. Spectroscopic evidence for a 5-coordinate oxygenic ligated high spin ferric heme moiety in the Neisseria meningitidis hemoglobin binding receptor

    PubMed Central

    Mokry, David Z.; Nadia-Albete, Angela; Johnson, Michael K.; Lukat-Rodgers, Gudrun S.; Rodgers, Kenton R.; Lanzilotta, William N.

    2015-01-01

    Background For many pathogenic microorganisms, iron acquisition represents a significant stress during the colonization of a mammalian host. Heme is the single most abundant source of soluble iron in this environment. While the importance of iron assimilation for nearly all organisms is clear, the mechanisms by which heme is acquired and utilized by many bacterial pathogens, even those most commonly found at sites of infection, remain poorly understood. Methods An alternative protocol for the production and purification of the outer membrane hemoglobin receptor (HmbR) from the pathogen Neisseria meningitidis has facilitated a biophysical characterization of this outer membrane transporter by electronic absorption, circular dichroism, electron paramagnetic resonance, and resonance Raman techniques. Results HmbR co-purifies with 5-coordinate high spin ferric heme bound. The heme binding site accommodates exogenous imidazole as a sixth ligand, which results in a 6-coordinate, low-spin ferric species. Both the 5- and 6-coordinate complexes are reduced by sodium hydrosulfite. Four HmbR variants with a modest decrease in binding efficiency for heme have been identified (H87C, H280A, Y282A, and Y456C). These findings are consistent with an emerging paradigm wherein the ferric iron center of bound heme is coordinated by a tyrosine ligand. Conclusion In summary, this study provides the first spectroscopic characterization for any heme or iron transporter in Neisseria meningitidis, and suggests a coordination environment heretofore unobserved in a TonB-dependent hemin transporter. General Significance A detailed understanding of the nutrient acquisition pathways in common pathogens such as N. meningitidis provides a foundation for new antimicrobial strategies. PMID:24968987

  5. Distribution and diversity of the haemoglobin-haptoglobin iron-acquisition systems in pathogenic and non-pathogenic Neisseria.

    PubMed

    Harrison, Odile B; Bennett, Julia S; Derrick, Jeremy P; Maiden, Martin C J; Bayliss, Christopher D

    2013-09-01

    A new generation of vaccines containing multiple protein components that aim to provide broad protection against serogroup B meningococci has been developed. One candidate, 4CMenB (4 Component MenB), has been approved by the European Medicines Agency, but is predicted to provide at most 70-80 % strain coverage; hence there is a need for second-generation vaccines that achieve higher levels of coverage. Prior knowledge of the diversity of potential protein vaccine components is a key step in vaccine design. A number of iron import systems have been targeted in meningococcal vaccine development, including the HmbR and HpuAB outer-membrane proteins, which mediate the utilization of haemoglobin or haemoglobin-haptoglobin complexes as iron sources. While the genetic diversity of HmbR has been described, little is known of the diversity of HpuAB. Using whole genome sequences deposited in a Bacterial Isolate Genome Sequence Database (BIGSDB), the prevalence and diversity of HpuAB among Neisseria were investigated. HpuAB was widely present in a range of Neisseria species whereas HmbR was mainly limited to the pathogenic species Neisseria meningitidis and Neisseria gonorrhoeae. Patterns of sequence variation in sequences from HpuAB proteins were suggestive of recombination and diversifying selection consistent with strong immune selection. HpuAB was subject to repeat-mediated phase variation in pathogenic Neisseria and the closely related non-pathogenic Neisseria species Neisseria lactamica and Neisseria polysaccharea but not in the majority of other commensal Neisseria species. These findings are consistent with HpuAB being subject to frequent genetic transfer potentially limiting the efficacy of this receptor as a vaccine candidate.

  6. Linear arrangement of hypopigmented Spitz nevi on the ear after trauma.

    PubMed

    Wang, Lei; Wang, Gang; Fan, Pingshen; Gao, Tianwen

    2010-04-01

    A 10-year-old boy had multiple papules after surgery on a primary lesion on his left ear. The papules were pink and showed a linear arrangement around the helix. Histopathological examination of two separate lesions showed proliferation of epithelioid cells in the dermis and some of them formed nests. No melanin was found in the epithelioid cells, and immunohistochemistry staining with S100, HMB45 and Melan-A were positive in the neoplasm cells. According to the clinical and histopathological characteristics, it was diagnosed as hypopigmented Spitz nevi with linear arrangement after trauma.

  7. Amelanotic corneally displaced malignant conjunctival melanoma: a case report evaluated with impression cytology.

    PubMed

    Barros, Jeison de Nadai; Motono, Márcia; Costa, Felipe D'Almeida; Cunha, Marcelo Carvalho da; Chojniak, Martha Motono

    2014-01-01

    Here we describe the case of a 65-year-old Caucasian female who presented with an amelanotic malignant conjunctival melanoma and highlight the clinical and pathological features of this rare entity that displayed exclusive corneal invasive growth without evidence of conjunctival tumors other than primary acquired melanosis. Impression cytology aided in the initial diagnosis. The patient underwent surgical treatment. Histopathology and immunohistochemistry revealed an invasive amelanotic melanoma limited to the cornea and exhibiting S-100, Melan A, and HMB-45 positivity. The absence of pigmentation delayed early clinical detection and treatment. Awareness of this nonpigmented melanoma is important for early recognition and appropriate management.

  8. Effect of a Specialized Amino Acid Mixture on Human Collagen Deposition

    PubMed Central

    Williams, Jeremy Z.; Abumrad, Naji; Barbul, Adrian

    2002-01-01

    Objective To examine the effect of arginine, β-hydroxy-β-methylbutyrate (HMB), and glutamine supplementation on wound collagen accumulation in a double-blind, randomized study. Summary Background Data Control of wound collagen synthesis has been an elusive goal for clinicians and scientists alike. In many clinical instances, it is desired to increase collagen deposition as a means of enhancing wound strength and integrity. Arginine, a semiessential amino acid, has been shown to increase wound collagen accumulation in rodents and humans. HMB, a metabolite of leucine, regulates muscle proteolysis in animals and humans and increases collagen deposition in rodents. Methods Thirty-five healthy, nonsmoking human volunteers 70 years or older were enrolled and underwent subcutaneous implantation of two small, sterile polytetrafluoroethylene (PTFE) tubes into the deltoid region under strict aseptic techniques. The tubes were 1 mm in diameter and 6 cm in length with pore size of 90 to 120 μm to allow optimal ingrowth of fibroblasts and the deposition of matrix. Eighteen volunteers (mean age 75.4 years; 2 men, 16 women) were randomized to receive daily supplementation of 14 g arginine, 3 g HMB, and 14 g glutamine (total nitrogen 3.59 g) in two divided doses. The control group (n = 17; mean age 75.3 years; 6 men, 11 women) received an isonitrogenous, isocaloric supplementation of nonessential amino acids. Catheters were removed at 7 and 14 days postimplantation and analyzed for hydroxyproline (OHP, nmol/cm catheter, an index of collagen accumulation) and α-amino nitrogen (α-AN, mmol/cm, an index of total protein deposition). Results Supplements were well tolerated, without any reported side effects. Supplementation with the specialized amino acid mixture led to a significant rise in plasma arginine and ornithine levels. The specialized amino acid supplement led to a significant increase in collagen deposition (as reflected by OHP content) in the PTFE tubes without an

  9. Cellular blue nevus (CBN) lymph node metastases of the neck with no primary skin lesion: a case report and review of literature.

    PubMed

    Scheller, Konstanze; Scheller, Christian; Becker, Susann; Holzhausen, Hans-Jürgen; Schubert, Johannes

    2010-12-01

    A case of cervical lymph node infiltration by a benign cellular blue nevus (CBN) and a 27-year disease history is presented. Dermal dendritic melanocytes and pigmented spindle cells presented no histological evidence of malignancy (CD34-, desmin-, PanCy-, HMB-45+, anti-S-100+, Bcl-2+, MART-1+, focally expression of melan A, 1% Ki-67+ of the tumour cell nucleoli). The differentiation of the benign blue nevus (BN) from a malignant blue nevus (MBN) and a malignant melanoma (MM) is still a challenge. Because of the malignant transformation potential of 5.2-6.3% a histological examination and a conservative surgical approach with close follow up are mandatory.

  10. Use of mixed-treatment-comparison methods in estimating efficacy of treatments for heavy menstrual bleeding

    PubMed Central

    2013-01-01

    Background A variety of pharmacological and surgical treatments have been developed for heavy menstrual bleeding (HMB), which can have negative physical, social, psychological, and economic consequences. We conducted a systematic literature review and mixed-treatment-comparison (MTC) meta-analysis of available data from randomized controlled trials (RCTs) to derive estimates of efficacy for 8 classes of treatments for HMB, to inform health-economic analysis and future studies. Methods A systematic review identified RCTs that reported data on menstrual blood loss (MBL) at baseline and one or more follow-up times. Eight treatment classes were considered: COCs, danazol, endometrial ablation, LNG-IUS, placebo, progestogens given for less than 2 weeks out of 4 during the menstrual cycle, progestogens given for close to 3 weeks out of 4, and TXA. The primary measure of efficacy was the proportion of women who achieved MBL < 80 mL per cycle (month), as measured by the alkaline hematin method. A score less than 100 on an established pictorial blood-loss assessment chart (PBAC) was considered an acceptable substitute for MBL < 80 mL. Estimates of efficacy by treatment class and time were obtained from a Bayesian MTC model. The model also included effects for treatment class, study, and the combination of treatment class and study and an adjustment for baseline mean MBL. Several methodological challenges complicated the analysis. Some trials reported various summary statistics for MBL or PBAC, requiring estimation (with less precision) of % MBL < 80 mL or % PBAC < 100. Also, reported follow-up times varied substantially. Results The evidence network involved 34 RCTs, with follow-up times from 1 to 36 months. Efficacy at 3 months of follow-up (estimated as the posterior median) ranged from 87.5% for the levonorgestrel-releasing intrauterine system (LNG-IUS) to 14.2% for progestogens administered for less than 2 weeks out of 4 in the menstrual cycle. The 95% credible intervals

  11. Anti-hemorrhagic activity of Punica granatum L. flower (Persian Golnar) against heavy menstrual bleeding of endometrial origin: a double-blind, randomized controlled trial

    PubMed Central

    Goshtasebi, Azita; Mazari, Ziba; Behboudi Gandevani, Samira; Naseri, Mohsen

    2015-01-01

    Background: Heavy menstrual bleeding of endometrial origin (HMB) is a major healthcare problem in premenopausal women and affects several aspects of women’s health and quality of life (QoL). The aim of this study was to compare the efficacy of Persian Golnar (PG) and tranexamic acid (TA) on heavy menstrual bleeding of endometrial origin (HMB) and patients’ QoL. Methods: A double-blind randomized controlled trial with parallel design and block randomization technique was conducted. A total of 94 women with HMB were randomly assigned to take either PG or TA for 5 days from day 1 of menses for three consecutive menstrual cycles. Blood loss was measured by the pictorial blood loss assessment chart (PBAC). Hematological assessments were made before the intervention and after treatment. QoL as a secondary outcome was evaluated using SF-36 and the menorrhagia questionnaire (MQ). Statistical analysis was performed using t-test, paired ttest, χ2 test, Mann–Whitney test, and Wilcoxon signed-rank test. Results: In each group, 38 women (80.8%) completed the 3-month follow-up. Both PG and TA reduced blood loss. PBAC mean (SD) score was reduced from 304.92 (176.17) and 304.44 (192.72) to 164.60 (100.24) and 143.13 (96.07) after the third treatment cycle, respectively (p< 0.001). Furthermore, mean hemoglobin, Hb (SD) concentrations in the PG and TA groups increased significantly from 12.06 (0.86) and 11.53 (0.86)mg/dl to 13.02 (0.82) and 12.72 (0.88) mg/dl (p< 0.001). QoL was significantly improved in both groups (p< 0.001). However, there were no significant differences between the groups after the intervention. Conclusion: The results of the present study demonstrate the efficacy of PG in treating HMB in terms of clinical and QoL indicators. PMID:26157717

  12. Improving care and treatment options for women and girls with bleeding disorders.

    PubMed

    Kulkarni, Roshni

    2015-12-01

    Women and girls may experience increased bleeding symptoms as carriers of haemophilia. They can also be affected by other hereditary bleeding diatheses such as von Willebrand disease, platelet dysfunction defects or deficiencies of coagulation factors (F) such as FI, FII, FV, FVII, FX, FXI and FXIII. In addition to general bleeding symptoms, such disorders pose unique problems for women due to their impact on reproductive health. Women and adolescent girls with undiagnosed bleeding disorders frequently experience heavy menstrual bleeding (HMB; menorrhagia), leading to impairment of daily activities. Other gynaecological and obstetric manifestations, for example miscarriage, bleeding during pregnancy and postpartum haemorrhage (PPH), can occur. Treatment for HMB should consider patient wishes relating to preservation of fertility, and management options include hormonal measures, desmopressin, antifibrinolytics, platelet concentrate transfusions and clotting factor therapy. During pregnancy, monitoring clotting factor levels informs the need for prophylactic therapy; subsequent haemostatic cover can minimise PPH. Under-recognition of bleeding disorders in females may lead to inappropriate, or lack of, treatment. This may be avoided by increased disease awareness, prompt and accurate diagnosis, and a multidisciplinary approach to patient care. This review considers the range of hereditary bleeding disorders that may affect women and adolescent girls, and their evaluation and management.

  13. Human Milk Composition and Preservation: Evaluation of High-pressure Processing as a Nonthermal Pasteurization Technology.

    PubMed

    Sousa, Sílvia G; Delgadillo, Ivonne; Saraiva, Jorge A

    2016-01-01

    Human milk is seen not only as a food, but as a functional and dynamic biologic system. It provides nutrients, bioactive components, and immune factors, promoting adequate and healthy growth of newborn infants. When mothers cannot supply their children, donated breast milk is the nutrition recommended by the World Health Organization, as it is a better alternative than infant formula. However, because of the manner in which donor milk is handled in human milk banks (HMB) many of the properties ascribed to mother's own milk are diminished or destroyed. The major process responsible for these losses is Holder pasteurization. High-pressure processing (HPP) is a novel nonthermal pasteurization technology that is being increasingly applied in food industries worldwide, primarily as an alternative to thermal treatment. This is due to its capacity to inactivate microorganisms while preserving both nutritional and bioactive components of foods. This review describes human milk composition and preservation, and critically discusses HMB importance and practices, highlighting HPP as a potential nonthermal pasteurization technology for human milk preservation. HPP technology is described and the few currently existing studies of its effects in human milk are presented.

  14. Differentiating intratumoral melanocytes from Langerhans cells in nonmelanocytic pigmented skin tumors in vivo by label-free third-harmonic generation microscopy

    NASA Astrophysics Data System (ADS)

    Weng, Wei-Hung; Liao, Yi-Hua; Tsai, Ming-Rung; Wei, Ming-Liang; Huang, Hsin-Yi; Sun, Chi-Kuang

    2016-07-01

    Morphology and distribution of melanocytes are critical imaging information for the diagnosis of melanocytic lesions. However, how to image intratumoral melanocytes noninvasively in pigmented skin tumors is seldom investigated. Third-harmonic generation (THG) is shown to be enhanced by melanin, whereas high accuracy has been demonstrated using THG microscopy for in vivo differential diagnosis of nonmelanocytic pigmented skin tumors. It is thus desirable to investigate if label-free THG microscopy was capable to in vivo identify intratumoral melanocytes. In this study, histopathological correlations of label-free THG images with the immunohistochemical images stained with human melanoma black (HMB)-45 and cluster of differentiation 1a (CD1a) were made. The correlation results indicated that the intratumoral THG-bright dendritic-cell-like signals were endogenously derived from melanocytes rather than Langerhans cells (LCs). The consistency between THG-bright dendritic-cell-like signals and HMB-45 melanocyte staining showed a kappa coefficient of 0.807, 84.6% sensitivity, and 95% specificity. In contrast, a kappa coefficient of -0.37, 21.7% sensitivity, and 30% specificity were noted between the THG-bright dendritic-cell-like signals and CD1a staining for LCs. Our study indicates the capability of noninvasive label-free THG microscopy to differentiate intratumoral melanocytes from LCs, which is not feasible in previous in vivo label-free clinical-imaging modalities.

  15. Methionine salvage pathway in relation to ethylene biosynthesis

    SciTech Connect

    Miyazaki, J.H.

    1987-01-01

    The recycling of methionine during ethylene biosynthesis (the methionine cycle) was studied. During ethylene biosynthesis, the H/sub 3/CS-group of S-adenosylmethionine (SAM) is released at 5'-methylthioadenosine (MTA), which is recycled to methionine via 5'-methylthioribose (MTS). In mungbean hypocotyls and cell-free extracts of avocado fruit, (/sup 14/C)MTR was converted to labeled methionine via 2-keto-4-methylthiobutyric acid (KMB) and 2-hydroxy-4-methylthiobutyric acid (HMB) as intermediates. Radioactive tracer studies showed that KMB was converted readily in vivo and in vitro to methionine, while HMB was converted much more slowly. The conversion of KMB to methionine by dialyzed avocado extract required an amino group donor. Among several potential donors tested, L-glutamine was the most efficient. Incubation of (ribose-U-/sup 14/C)MTR with avocado extract resulted in the production of (/sup 14/C)formate, with little evolution of other /sup 14/C-labeled one-carbon compounds, indicating that the conversion of MTR to KMB involves a loss of formate, presumably from C-1 of MTR.

  16. The effectiveness of natural and synthetic immunomodulators in the treatment of inflammatory bowel disease in dogs.

    PubMed

    Rychlik, Andrzej; Nieradka, Renata; Kander, Małgorzata; Nowicki, Marcin; Wdowiak, Michał; Kołodziejska-Sawerska, Anna

    2013-09-01

    The aim of the study was to evaluate the usefulness of immunomodulators in the treatment of inflammatory bowel disease (IBD) in dogs. Twenty-eight dogs diagnosed with IBD took part in the study. The animals received a food containing extruded immunomodulators: β-1,3/1,6-D-glucan, β-hydroxy-β-methyl-butyrate (HMB) and levamisole for 42 days. Whole blood samples were analysed before and after therapy assessing changes in phagocyte activity (respiratory burst activity, RBA and potential killing activity, PKA), evaluation of proliferation response of mitogen-stimulated lymphocytes and serum gamma globulin levels, lysozyme activity, ceruloplasmin levels and interleukin activity (IL-6 and IL-10). In this experiment, β-1,3/1,6-D-glucan delivered the highest level of treatment efficacy by producing the quickest therapeutic effect, lowering Canine Inflammatory Bowel Disease Activity Index (CIBDAI) values to below 3, improving histopathological parameters, decreasing IL-6 levels, increasing IL-10 concentrations, and producing remission periods longer than six months. HMB and levamisole were also effective in lowering CIBDAI scores, but the abatement of clinical symptoms was slower and less pronounced in comparison with β-1,3/1,6-D-glucan. The results indicate that β-1,3/1,6-D-glucan can be useful in the treatment of canine IBD.

  17. Acute intermittent porphyria: A single-base deletion and a nonsense mutation in the human hydroxymethylbilane synthase gene, predicting truncations of the enzyme polypeptide

    SciTech Connect

    Lee, G.L.; Astrin, K.H.; Desnick, R.J.

    1995-08-28

    Acute intermittent porphyria (AIP) is an autosomal-dominant inborn error of metabolism that results from the half-normal activity of the third enzyme in the heme biosynthetic pathway, hydroxymethylbilane synthase (HMB-synthase). AIP is an ecogenetic condition, since the life-threatening acute attacks are precipitated by various factors, including drugs, alcohol, fasting, and certain hormones. Biochemical diagnosis is problematic, and the identification of mutations in the HMB-synthase gene provides accurate detection of presymptomatic heterozygotes, permitting avoidance of the acute precipitating factors. By direct solid-phase sequencing, two mutations causing AIP were identified, an adenine deletion at position 629 in exon 11(629delA), which alters the reading frame and predicts premature truncation of the enzyme protein after amino acid 255, and a nonsense mutation in exon 12 (R225X). These mutations were confirmed by either restriction enzyme analysis or family studies of symptomatic patients, permitting accurate presymptomatic diagnosis of affected relatives. 29 refs., 2 figs.

  18. A distinct histopathological variant of a malignant melanoma with perivascular pseudorosettes: A case report.

    PubMed

    Ishida, Mitsuaki; Iwai, Muneo; Yoshida, Keiko; Kagotani, Akiko; Okabe, Hidetoshi

    2013-09-01

    Although a rare condition, rosette formation in malignant melanoma has been previously documented. The present study describes the second documented case of malignant melanoma with perivascular pseudorosettes. A 38-year-old male presented with a black nodule on his back. Histopathological study revealed diffuse proliferation of neoplastic cells in the dermis and subcutis. A section of the tumor (~30%) was composed of a conventional malignant melanoma component. The remaining area was comprised of medium-sized polygonal cells with slightly eosinophilic cytoplasm and small-to-medium, round nuclei. Melanin pigment was rarely observed. A noteworthy observation was the presence of perivascular pseudorosette formations, which were characterized by their radial arrangement around the blood vessels, with a perivascular, anuclear zone. Immunohistochemically, the neoplastic cells were diffusely positive for S-100 protein and Melan-A and focally positive for HMB-45. Clinicopathological analyses of cases of malignant melanoma with rosette formations revealed that the types of rosette included the Homer-Wright type (two cases), perivascular pseudorosettes (two cases) and an unclassifiable type (one case). Immunohistochemical analysis is a useful method for forming a diagnosis as Melan-A or HMB-45 are generally expressed in all cases. Rosette formation in malignant melanoma is a distinct histopathological variant and may be an under-recognized phenomenon. Therefore, its recognition is significant for obtaining an accurate diagnosis of malignant melanoma.

  19. Characteristics of optical multi-peak solitons induced by higher-order effects in an erbium-doped fiber system

    NASA Astrophysics Data System (ADS)

    Ren, Yang; Yang, Zhan-Ying; Liu, Chong; Xu, Wen-Hao; Yang, Wen-Li

    2016-09-01

    We study multi-peak solitons on a plane-wave background in an erbium-doped fiber system with some higher-order effects, which is governed by a coupled Hirota and Maxwel-Bloch (H-MB) model. The important characteristics of multi-peak solitons induced by the higher-order effects, such as the velocity changes, localization or periodicity attenuation, and state transitions, are revealed in detail. In particular, our results demonstrate explicitly that a multi-peak soliton can be converted to an anti-dark soliton when the periodicity vanishes; on the other hand, a multi-peak soliton is transformed to a periodic wave when the localization vanishes. Numerical simulations are performed to confirm the propagation stability of multi-peak solitons riding on a plane-wave background. Finally, we compare and discuss the similarity and difference of multi-peak solitons in special degenerate cases of the H-MB system with general existence conditions.

  20. Nutritional interventions in sarcopenia: a critical review.

    PubMed

    Hickson, Mary

    2015-11-01

    The aim of the present paper is to critically review the details of the published nutrition intervention trials, with and without exercise, targeting sarcopenia. Sarcopenia is the loss of muscle mass, strength and/or performance with age. Since amino acids and energy are required for muscle synthesis it is possible that nutritional intake influences sarcopenia. Nutritional studies are challenging to carry out because of the complexity of modulating dietary intake. It is very difficult to change one nutrient without influencing many others, which means that many of the published studies are problematic to interpret. The studies included evaluate whole protein, essential amino acids and β-hydroxyl β-methylbutyrate (HMB). Whole-protein supplementation failed to show a consistent effect on muscle mass, strength or function. This can be explained by the variations in study design, composition of the protein supplement and the failure to monitor voluntary food intake, adherence and baseline nutritional status. Essential amino-acid supplements showed an inconsistent effect but there are only two trials that have significant differences in methodology and the supplement used. The HMB studies are suggestive of a beneficial effect on older adults, but larger well-controlled studies are required that measure outcomes relevant to sarcopenia, ideally in sarcopenic populations. The issues of timing and distribution of protein intake, and increased splanchnic amino-acid sequestration are discussed, and recommendations for future trials are made. PMID:25923603

  1. Gastric Angiomyolipoma, a Very Rare Cause of Upper Gastrointestinal Bleeding: A Case Report and a Brief Review of Literature

    PubMed Central

    Veera, Raghava Reddy Levaka; Bemalgi, Swapna Reddy

    2012-01-01

    Angiomyolipoma (AML) is a tumor composed of variable proportions of adipose tissue, spindle and epithelioid smooth muscle-like cells and abnormal thick-walled blood vessels which are usually benign. AML is relatively common in kidney and liver. Gastric angiomyolipoma (GAML) is extremely rare and only 2 cases were reported in the literature. Diagnosis of AML is difficult owing to its rarity and varied immunohistochemical patterns. Here, we report a case of GAML in a 65-year-old male who presented with an episode of hematemesis and intermittent melena for one week. Endoscopy showed a partially obstructing mass arising from gastric antrum with central ulceration. Mass was removed by wedge resection after laparoscopic anterior gastrectomy. Excised specimen showed a benign 6 × 3 × 3 cm homogenous fatty mass with adipose tissue, smooth muscles and prominent vascularity. Immunohistochemistry stains were positive for desmin, smooth muscle actin (SMA), CD34 and negative for human melanoma black (HMB)-45 antigen and CD117. This case reports the largest and HMB-45 negative GAML so far, which can be a very rare cause of upper gastrointestinal bleeding.

  2. Renal angiomyolipoma with epithelial cysts: a rare entity and review of literature.

    PubMed

    Wei, Jianguo; Li, Yan; Wen, Yuanyuan; Li, Lei; Zhang, Renya

    2015-01-01

    Renal angiomyolipoma (AML) with epithelial cysts (AMLEC) is a comparatively rare benign renal tumor that is recently recognized as a distinct entity and there are relatively few reported cases in the English-language literature. To date 19 cases of AMLEC have been reported in 2 case series and a few case reports. AMLEC has been described as a cystic variant of AML. Herein we reported an AMLEC in a 25-year-old female patient, and to the best of our knowledge this is the first case report of AMLEC in Chinese. She was incidentally found to have a kidney-occupying lesion during a routine medical examination for 1 month. CT examination demonstrated a multilocular cystic lesions arising from right-kidney lower pole. The patient underwent the partial nephrectomy. Histological examination of the tumor was composed of epithelial cysts, compact subepithelial mullerian-like stroma and muscle-predominant AML. Immunohistochemically, epithelial cysts were positive for CK but negative for ER, PR, CD10 and HMB-45; the subepithelial stroma and muscle-predominant AML were positive for ER, PR and HMB-45; the subepithelial stroma was negative for SMA, but muscle-predominant AML was positive for SMA. The final histopathological diagnosis was AMLEC.

  3. Renal angiomyolipoma with epithelial cysts: a rare entity and review of literature

    PubMed Central

    Wei, Jianguo; Li, Yan; Wen, Yuanyuan; Li, Lei; Zhang, Renya

    2015-01-01

    Renal angiomyolipoma (AML) with epithelial cysts (AMLEC) is a comparatively rare benign renal tumor that is recently recognized as a distinct entity and there are relatively few reported cases in the English-language literature. To date 19 cases of AMLEC have been reported in 2 case series and a few case reports. AMLEC has been described as a cystic variant of AML. Herein we reported an AMLEC in a 25-year-old female patient, and to the best of our knowledge this is the first case report of AMLEC in Chinese. She was incidentally found to have a kidney-occupying lesion during a routine medical examination for 1 month. CT examination demonstrated a multilocular cystic lesions arising from right-kidney lower pole. The patient underwent the partial nephrectomy. Histological examination of the tumor was composed of epithelial cysts, compact subepithelial mullerian-like stroma and muscle-predominant AML. Immunohistochemically, epithelial cysts were positive for CK but negative for ER, PR, CD10 and HMB-45; the subepithelial stroma and muscle-predominant AML were positive for ER, PR and HMB-45; the subepithelial stroma was negative for SMA, but muscle-predominant AML was positive for SMA. The final histopathological diagnosis was AMLEC. PMID:26617923

  4. Intraglomerular microlesions in renal angiomyolipoma.

    PubMed

    Kiliçaslan, I; Güllüoglu, M G; Dogan, O; Uysal, V

    2000-10-01

    A unique case of bilateral multiple intrarenal angiomyolipomas in a 21-year-old woman with tuberous sclerosis is reported. The microscopic examination showed peculiar intraglomerular microlesions, epithelioid areas, microscopic foci of renal cell carcinoma and renal cysts, and the classical features of angiomyolipoma lesion. HMB-45 positivity was detected within some nodules and epithelioid areas. Intraglomerular microlesions were composed of adipose and smooth-muscle cells within the glomerular capillary tuft. These lesions, which were continuous with the capillary tuft, did not show any attachment to the Bowman's capsule. These findings suggest that these are not a consequence of an infiltration from the outside but were originated from inside the glomerulus. The simultaneous presence of multiple angiomyolipoma nodules either inside or outside the glomeruli, multifocality and bilaterality of these lesions, together with the HMB-45 positivity and the finding of scattered epithelioid areas supports the theory that there is a progenitor cell giving origin to all these lesions, the cell which has been named as perivascular epithelioid cell by most authors.

  5. Angiomyolipoma with epithelial cysts (AMLEC): a rare but distinct variant of angiomyolipoma.

    PubMed

    Armah, Henry B; Yin, Ming; Rao, Uma N M; Parwani, Anil V

    2007-01-01

    Angiomyolipoma with epithelial cysts (AMLEC) is a recently described distinct cystic variant of angiomyolipoma (AML). To date 15 cases of AMLEC have been reported in 2 case series. We report the 16th case in a 39-year-old female. Her left kidney tumor was discovered incidentally. Partial nephrectomy was performed. Histologically, the tumor was composed of three components: 1) epithelial cysts lined by cuboidal to hobnail cells; 2) compact subepithelial mullerian-like AML stroma with admixed chronic inflammation; and 3) muscle-predominant AML with dysmorphic blood vessels exterior to the subepithelial stroma. Immunohistochemically, the subepithelial stroma stained most intensely with HMB-45 and Melan-A, whilst the muscle-predominant AML areas stained most intensely with smooth muscle actin and desmin. Estrogen receptor (ER), progesterone receptor (PR), and CD10 stained most intensely in the subepithelial stroma. The cyst lining was positive for pancytokeratin, but negative for HMB-45, Melan-A, ER, PR, and CD10. The patient is alive with no evidence of disease, 12 months postoperatively, and yearly follow-up CT scans are planned.

  6. Melanosis of the vagina and human papillomavirus infection, an uncommon pathology: case report.

    PubMed

    Núñez-Troconis, José; Delgado, Mariela; González, Gerardo; Rivas, Airiaudis; Molero, Katherine

    2011-09-01

    Benign melanotic lesions of the vagina are uncommon and only a few cases have been reported in the literature. A 34-year-old woman was referred because of a Vaginal Intraepithelial Neoplasia 1 biopsy result. On the gynecological examination, two different hyperpigmented areas were noted in the vagina. The colposcopic visualization of the cervix and vagina found an aceto-white lesion at the right lateral wall of the upper third of the vagina. Biopsies from three areas were taken. Histological study reported a melanosis of the vagina and HPV infection. An immunohistochemical panel of epithelial markers was performed in vaginal samples, such as Cytokeratin AE1/AE3 and epithelial membrane antigen, mesenchymal marker: vimentin; melanocytic makers: protein S-100 and HMB45 (Human Melanoma Black); proliferating cell marker: proliferating cell nuclear antigen (PCNA), and P-53 oncoprotein. High Risk (16, 18, 31, 45) and Low Risk (6, 11) HPV types were studied by In Situ Hybridization using the same vaginal samples. CK, EMA and Vimentin were 2+. Melanocytic markers, HMB45 and S100, and PCNA were 1+ in basal cell layer. P-53 was negative. The melanotic tissue and acetowhite lesion were positives to HPV Types 6,11. In conclusion, melanosis of the vagina is a uncommon benign pathology. Usually, melanosis is present in women over 40 years old. We present a case of melanosis of the vagina in a young woman infected with low-risk HPV types and review the literature.

  7. Minute perivascular epithelioid cell (PEC) nests in the abdominal lymph nodes--a putative precursor of PEComa.

    PubMed

    Nagasaka, Toru; Murakami, Yoshiko; Sasaki, Eiichi; Hosoda, Waki; Nakanishi, Toru; Yatabe, Yasushi

    2015-04-01

    A perivascular epithelioid cell tumor (PEComa) is a peculiar growth defined as a mesenchymal tumor composed of histologically and immunohistochemically distinct perivascular epithelioid cells (PECs). Because neither normal counterparts nor precursor lesions of PEComa have been identified, we examined minute PEC nests, ranged from 0.8 mm to 10 mm, to investigate the possible origin of the PEComa. We examined a total of 80 677 para-aortic and pelvic lymph nodes that were systematically dissected from 1656 patients for gynecological malignancies. The identified lesions were confirmed immunohistochemically with multiple PEC markers, including smooth muscle actin, HMB45, melan-A, MiTF, ER and PgR. A total of 66 minute PEC nests were found in 21 patients (1.3% of the total population) with an average frequency of 3.1 lesions per patient. In cases of multiple involvement, 11 of 13 nests were located at the same level of multiple lymph node or on continuous levels. The lesions were preferentially distributed at the level of para-aortic and high pelvic lymph nodes. All nests were positive for actin and HMB45, whereas the other markers were positive with varying frequencies. The minute PEC nests may be associated with the possible normal counterpart of PEComas.

  8. Nutritional supplements to increase muscle mass.

    PubMed

    Clarkson, P M; Rawson, E S

    1999-07-01

    Although nutritional supplements purported to increase muscle mass are widely available at health food stores, gyms, by mail order, and over the Internet, many of these supplements have little or no data to support their claims. This article reviews the theory and research behind popular nutritional supplements commonly marketed as muscle mass builders. Included are the minerals chromium, vanadyl sulfate, and boron, the steroid hormone dehydroepiandrosterone (DHEA), beta-methyl-hydroxy-beta-methylbutyrate (HMB), creatine, protein supplements, and amino acids. Research has shown that chromium vanadyl sulfate, and boron do not appear to be effective in increasing lean body mass. The few studies examining DHEA have not supported the claim of increased muscle gain. Preliminary work on HMB supports an anticatabolic effect, but only one human study is currently available. Many studies reported increased body mass and several have reported increased lean body mass following creatine ingestion. This weight gain is most likely water retention in muscle but could also be due to some new muscle protein. Although athletes have a greater protein requirement than sedentary individuals, this is easily obtained through the diet, negating the use of protein supplements. Studies on amino acids have not supported their claim to increase growth hormone or insulin secretion. Nutritional supplements can be marketed without FDA approval of safety or effectiveness. Athletes who choose to ingest these supplements should be concerned with unsubstantiated claims, questionable quality control, and safety of long-term use.

  9. "Malignant" uterine perivascular epithelioid cell tumor, pelvic lymph node lymphangioleiomyomatosis, and gynecological pecomatosis in a patient with tuberous sclerosis: a case report and review of the literature.

    PubMed

    Liang, Sharon X; Pearl, Michael; Liu, Jingxuan; Hwang, Sonia; Tornos, Carmen

    2008-01-01

    We report a case of uterine perivascular epithelioid cell tumor (PEComa) with malignant histological features in a 59-year-old woman with tuberous sclerosis (TBS). The patient also had extrapulmonary lymphangioleiomyomatosis involving pelvic lymph nodes, myometrium, cervix, and ovary ("pecomatosis"). The uterine tumor measured 2.6 cm and had marked nuclear pleomorphism, necrosis, and 2 mitoses per 50 high-powered field, with an occasional atypical mitosis and infiltrative borders. The nonneoplastic myometrium, the cervical wall, and the hilum of the ovary had multiple clusters of bland-looking epithelioid clear cells that ranged from 1 to 5 mm (pecomatosis). The uterine tumor cells were positive for HMB-45 (90%), Melan-A (70%), smooth muscle actin (50%), and estrogen receptor (30%). Of the 16 pelvic lymph nodes excised, 3 were involved with lymphangioleiomyomatosis that was positive for HMB-45 and estrogen receptor. This is only the second reported PEComa associated with pecomatosis and the fourth PEComa described in a patient with TBS. The clinical significance of pecomatosis is still uncertain but seems to be seen only in patients with TBS.

  10. Lymphangioma of the small bowel mesentery: a case report and review of the literature.

    PubMed

    Suthiwartnarueput, Worapop; Kiatipunsodsai, Siriphut; Kwankua, Amolchaya; Chaumrattanakul, Utairat

    2012-11-21

    Lymphangioma is a rare benign condition characterized by proliferation of lymphatic spaces. It is usually found in the head and neck of affected children. Lymphangioma of the small-bowel mesentery is rare, having been reported for less than 1% of all lymphangiomas. Importantly, it can cause fatal complications such as volvulus or involvement of the main branch of the mesenteric arteries, requiring emergency surgery. Moreover, the gross and histopathologic findings may resemble benign multicystic mesothelioma and lymphangiomyoma. Immunohistochemical study for factor VIII-related antigen, D2-40, calretinin and human melanoma black-45 (HMB-45) are essential for diagnosis. Factor VIII-related antigen and D2-40 are positive in lymphangioma but negative in benign multicystic mesothelioma. HMB-45 shows positive study in the smooth-muscle cells around the lymphatic spaces of the lymphangiomyoma. We report a case of small-bowel volvulus induced by mesenteric lymphangioma in a 2-year-and-9-mo-old boy who presented with rapid abdominal distension and vomiting. The abdominal computed tomography scan showed a multiseptated mass at the right lower quadrant with a whirl-like small-bowel dilatation, suggestive of a mesenteric cyst with midgut volvulus. The intraoperative findings revealed a huge, lobulated, yellowish pink, cystic mass measuring 20 cm × 20 cm × 10 cm, that was originated from the small bowel mesentery with small-bowel volvulus and small-bowel dilatation. Cut surface of the mass revealed multicystic spaces containing a milky white fluid. The patient underwent tumor removal with small-bowel resection and end-to-end anastomosis. Microscopic examination revealed that the cystic walls were lined with flat endothelial cells and comprised of smooth muscle in the walls. The flat endothelial cells were positive for factor VIII-related antigen and D2-40 but negative for calretinin. HMB-45 showed negative study in the smooth-muscle cells around the lymphatic spaces. Thus

  11. Effects of glutamine on wound healing.

    PubMed

    Kesici, Ugur; Kesici, Sevgi; Ulusoy, Hulya; Yucesan, Fulya; Turkmen, Aygen U; Besir, Ahmet; Tuna, Verda

    2015-06-01

    Studies reporting the need for replacing amino acids such as glutamine (Gln), hydroxymethyl butyrate (HMB) and arginine (Arg) to accelerate wound healing are available in the literature. The primary objective of this study was to present the effects of Gln on tissue hydroxyproline (OHP) levels in wound healing. This study was conducted on 30 female Sprague Dawley rats with a mean weight of 230 ± 20 g. Secondary wounds were formed by excising 2 × 1 cm skin subcutaneous tissue on the back of the rats. The rats were divided into three equal groups. Group C (Control): the group received 1 ml/day isotonic solution by gastric gavage after secondary wound was formed. Group A (Abound): the group received 0·3 g/kg/day/ml Gln, 0·052 g/kg/day/ml HMB and 0·3 g/kg/day/ml Arg by gastric gavage after secondary wound was formed. Group R (Resource): the group received 0·3 g/kg/day/ml Gln by gastric gavage after secondary wound was formed. The OHP levels of the tissues obtained from the upper half region on the 8th day and the lower half region on the 21st day from the same rats in the groups were examined. Statistical analysis was performed using the statistics program SPSS version 17.0. No statistically significant differences were reported with regard to the OHP measurements on the 8th and 21st days (8th day: F = 0·068, P = 0·935 > 0·05; 21st day: F = 0·018, P = 0·983 > 0·05). The increase in mean OHP levels on the 8th and 21st days within each group was found to be statistically significant (F = 1146·34, P = 0·000 < 0·001). We conclude that in adults who eat healthy food, who do not have any factor that can affect wound healing negatively and who do not have large tissue loss at critical level, Gln, Arg and HMB support would not be required to accelerate secondary wound healing.

  12. A Diet Containing Beta-Hydroxy-Beta-Methylbutyrate, L-Glutamine and L-Arginine Ameliorates Chemoradiation-Induced Gastrointestinal Injury in Rats.

    PubMed

    Alsan Cetin, Ilknur; Atasoy, Beste M; Cilaker, Serap; Alicikus, Lutfiye Zumre Arican; Karaman, Meral; Ersoy, Nevin; Demiral, Ayse Nur; Yilmaz, Osman

    2015-10-01

    The aim of this study was to investigate the effects of a specific diet, containing beta-hydroxy-beta-methylbutyrate, L-glutamine and L-arginine (HMB/Glu/Arg), on chemoradiation-induced injuries of the rat gastrointestinal mucosa. Wistar albino rats were divided into 4 groups: control (n = 5); radiation (n = 14); 5-fluorouracil treatment (5-FU; n = 14); and radiation and 5-FU treatment (n = 14). Rats were fed either a standard diet or a specific diet (SpD) containing HMB/Glu/Arg supplementation for 7 days prior to radiation exposure and/or 5-FU treatment. The irradiated groups were exposed to an 1 Gy dose of 6 MV x rays delivered to the who-abdominal. The animals receiving 5-FU treatment were given a 100 mg/kg dose of the drug. In the radiation and 5-FU treatment group, the 5-FU was administered 30 min prior to irradiation. After irradiation and/or 5-FU treatment, feeding with either the standard rat diet or specific diet continued as before. All animals were sacrificed on day 4 after irradiation and 5-FU treatment. Data collected included microbiological, histological and immunohistochemical end points. We found that bacterial colony counts in the ceca and mesenteric lymph nodes of irradiated rats treated with 5-FU were significantly lower in the specific diet (SpD) group than in the standard diet group (P = 0.002-0.05). Morphometrically, gastric, duodenal and colonic mucosal injuries were less severe in the irradiated animals fed the specific diet, as well as the 5-FU-treated animals fed the specific diet, compared to the similarly treated standard diet groups. Apoptosis, measured by TUNEL, revealed significantly lower numbers of TUNEL positive cells in irradiated animals fed the specific diet, and irradiated animals treated with 5-FU and fed the specific diet compared to irradiated animals fed the standard diet, and irradiated animals treated with 5-FU and fed the standard diet. In the 5-Fu-treated and SpD group, the extent of apoptosis was significantly lower

  13. Effects of 4 Weeks of High-Intensity Interval Training and β-Hydroxy-β-Methylbutyric Free Acid Supplementation on the Onset of Neuromuscular Fatigue.

    PubMed

    Miramonti, Amelia A; Stout, Jeffrey R; Fukuda, David H; Robinson, Edward H; Wang, Ran; La Monica, Michael B; Hoffman, Jay R

    2016-03-01

    This study investigated the effects of high-intensity interval training (HIIT) and β-hydroxy-β-methylbutyric free acid (HMB) supplementation on physical working capacity at the onset of neuromuscular fatigue threshold (PWC(FT)). Thirty-seven participants (22 men, 15 women; 22.8 ± 3.4 years) completed an incremental cycle ergometer test (graded exercise test [GXT]); electromyographic amplitude from the right vastus lateralis was recorded. Assessments occurred preceding (PRE) and after 4 weeks of supplementation (POST). Participants were randomly assigned to control (C, n = 9), placebo (P, n = 14), or supplementation (S, n = 14) groups. Both P and S completed 12 HIIT sessions, whereas C maintained normal diet and activity patterns. The PWC(FT) (W) was determined using the maximal perpendicular distance (D(MAX)) method. Electromyographic amplitude (μVrms) over time was used to generate a cubic regression. Onset of fatigue (TF) was the x-value of the point on the regression that was at D(MAX) from a line between the first and last data points. The PWC(FT) was estimated using TF and GXT power-output increments. The 2-way analysis of variance (ANOVA) (group × time) resulted in a significant interaction for PWC(FT) (F = 6.69, p = 0.004). Post hoc analysis with 1-way ANOVA resulted in no difference in PWC(FT) among groups at PRE (F = 0.87, p = 0.43); however, a difference in PWC(FT) was shown for POST (F = 5.46, p = 0.009). Post hoc analysis among POST values revealed significant differences between S and both P (p = 0.034) and C (p = 0.003). No differences (p = 0.226) were noted between P and C. Paired samples t-tests detected significant changes after HIIT for S (p < 0.001) and P (p = 0.016), but no change in C (p = 0.473). High-intensity interval training increased PWC(FT), but HMB with HIIT was more effective than HIIT alone. Furthermore, it seems that adding HMB supplementation with HIIT in untrained men and women may further improve endurance performance

  14. Low-dose dexamethasone as a treatment for women with heavy menstrual bleeding: protocol for response-adaptive randomised placebo-controlled dose-finding parallel group trial (DexFEM)

    PubMed Central

    Warner, P; Weir, C J; Hansen, C H; Douglas, A; Madhra, M; Hillier, S G; Saunders, P T K; Iredale, J P; Semple, S; Walker, B R; Critchley, H O D

    2015-01-01

    Introduction Heavy menstrual bleeding (HMB) diminishes individual quality-of-life and poses substantial societal burden. In HMB endometrium, inactivation of cortisol (by enzyme 11β hydroxysteroid dehydrogenase type 2 (11βHSD2)), may cause local endometrial glucocorticoid deficiency and hence increased angiogenesis and impaired vasoconstriction. We propose that ‘rescue’ of luteal phase endometrial glucocorticoid deficiency could reduce menstrual bleeding. Methods and analysis DexFEM is a double-blind response-adaptive parallel-group placebo-controlled trial in women with HMB (108 to be randomised), with active treatment the potent oral synthetic glucocorticoid dexamethasone, which is relatively resistant to 11βHSD2 inactivation. Participants will be aged over 18 years, with mean measured menstrual blood loss (MBL) for two screening cycles ≥50 mL. The primary outcome is reduction in MBL from screening. Secondary end points are questionnaire assessments of treatment effect and acceptability. Treatment will be for 5 days in the mid-luteal phases of three treatment menstrual cycles. Six doses of low-dose dexamethasone (ranging from 0.2 to 0.9 mg twice daily) will be compared with placebo, to ascertain optimal dose, and whether this has advantage over placebo. Statistical efficiency is maximised by allowing randomisation probabilities to ‘adapt’ at five points during enrolment phase, based on the response data available so far, to favour doses expected to provide greatest additional information on the dose–response. Bayesian Normal Dynamic Linear Modelling, with baseline MBL included as covariate, will determine optimal dose (re reduction in MBL). Secondary end points will be analysed using generalised dynamic linear models. For each dose for all end points, a 95% credible interval will be calculated for effect versus placebo. Ethics and dissemination Dexamethasone is widely used and hence well-characterised safety-wise. Ethical approval has been

  15. Primary mucosal malignant melanoma of the cervix: case report and review of the literature.

    PubMed

    Cetinkaya, Kadir; Benzer, Emine; Dervisoglu, Haluk

    2015-09-09

    The incidence of primary mucosal malignant melanoma (PMMM) is 1.3% among all malignant melanomas (MM). Cervical involvement is very rare; the number of cases of cervical PMMM reported so far is around 80. In our patient, a dark color, 2-cm diameter, nonulcerated tumor formation was observed upon examination of the cervix. Tumoral tissue consisted of atypical melanocytic cells containing numerous mitotic figures. In immunochemical studies, S-100, Melan-A, and HMB-45 positivity were observed. The tumor was 20 mm in invasion depth, Breslow IV, and FIGO stage IB1. Radical surgery was followed by adjuvant radiotherapy, and subsequently interferon treatment was applied. Examination and scans 20 months after surgery were free from tumor.

  16. CFD and Aeroelastic Analysis of the MEXICO Wind Turbine

    NASA Astrophysics Data System (ADS)

    Carrión, M.; Woodgate, M.; Steijl, R.; Barakos, G.; Gómez-Iradi, S.; Munduate, X.

    2014-12-01

    This paper presents an aerodynamic and aeroelastic analysis of the MEXICO wind turbine, using the compressible HMB solver of Liverpool. The aeroelasticity of the blade, as well as the effect of a low-Mach scheme were studied for the zero-yaw 15m/s wind case and steady- state computations. The wake developed behind the rotor was also extracted and compared with the experimental data, using the compressible solver and a low-Mach scheme. It was found that the loads were not sensitive to the Mach number effects, although the low-Mach scheme improved the wake predictions. The sensitivity of the results to the blade structural properties was also highlighted.

  17. A case of cutaneous angiolipoleiomyoma (angiomyolipoma) in a budgerigar (Melopsittacus undulatus).

    PubMed

    Jakab, Csaba; Balka, Gyula; Szabára, Agnes; Csaba, Csintalan; Pazár, Péter

    2013-12-01

    We report a case of cutaneous angiolipoleiomyoma (angiomyolipoma) found on the anterior wall of the ventral part of the abdomen of a three-year-old female budgerigar (Melopsittacus undulatus). Histologic examination of the well-circumscribed, surgically removed tumour (1.5 cm in diameter) showed a benign admixed proliferation of blood vessels of different size, smooth muscle bundles, and mature adipose tissue, without evidence of malignancy. Endothelial cells of the haemangioma component were positive for claudin-5 endothelium-specific immunohistochemical marker, and the leiomyoma component was positive for α-smooth muscle actin. The differentiated lipocytes showed S-100 protein positivity. The Ki-67 labelling index was 2 to 3%. The mesenchymal tumour was negative for HMB45 melanocytic immunhistochemical marker. To the best of our knowledge, this is the first report describing a cutaneous angiolipoleiomyoma in a budgerigar with histological and immunohistochemical analyses. PMID:24106747

  18. Nuclear localization of the testis determining gene product SRY

    PubMed Central

    1995-01-01

    We have studied the expression of the human SRY protein (termed p27SRY) in two different cell lines by using specific antibodies. Confocal microscopy enabled us to localize p27SRY precisely in the nucleus in a discrete punctuate pattern. Furthermore, through microinjection experiments, we have demonstrated that the localization of the p27SRY protein into the nucleus was an event involving the NH2-terminal part of the high mobility group (HMG) domain. With the help of several synthetic peptides and various p27SRY mutants, we have characterized a bipartite basic motif in this part of the protein corresponding to a nuclear localization signal. This nuclear localization signal appears to be highly conserved in SRY box- and HMB box-containing proteins, suggesting common properties of nuclear targeting within the HMG box protein family. PMID:7876301

  19. Hepatic angiomyolipoma: what management?

    PubMed

    Barbier, L; Torrents, J; Hardwigsen, J

    2014-01-01

    An 80-year-old woman was referred for the surgical treatment of a 110-mm right hepatic tumor. The biopsy revealed an adenoma, and a right hepatectomy was performed. Histopathology indicated a major fat component with epitheliod cells, immunoreactivity for HMB45, Melan A, and smooth muscle actin, describing a hepatic epithelioid angiomyolipoma (AML). The AML belongs to the group of tumors with a Perivascular Epithelioid Cell differentiation. Its diagnosis is based on imaging and biopsy, and therefore might be difficult. Hepatic AML are mainly benign tumors; however, some tend to behave in a malignant manner. In case of histological proof, close clinical and radiological monitoring can be proposed if its size is less than 5 cm and no pejorative histological features are found. Nevertheless, follow-up is still required if resection is performed in search of recurrence or metastatic spread. PMID:25073214

  20. Malignant peripheral nerve sheath tumor arising in a traumatic neuroma: a case report.

    PubMed

    Kos, Zuzana; Robertson, Susan J; Purgina, Bibianna M; Verma, Shailendra; Gravel, Denis H

    2013-10-01

    A 67-year-old woman with a history of breast cancer presented with a soft tissue mass at the site of a remote, non-neoplastic lumbar surgery. Excisional biopsy revealed a traumatic neuroma. Five years later she re-presented with a rapidly growing, tender nodule at the same site. An excisional biopsy was again performed and revealed a tumor composed of malignant epithelioid and spindle cells merging imperceptibly with residual traumatic neuroma. The malignant cells were positive for vimentin, S-100 and micropthalmia transcription factor. They were negative for cytokeratins, muscle markers, Melan-A, HMB45, glial fibrillary acidic protein, and myelin basic protein. Electron microscopy showed no melanosomes. The diagnosis of malignant peripheral nerve sheath tumor arising within a long-standing traumatic neuroma was rendered and represents a hitherto unreported origin of this rare, aggressive soft tissue sarcoma.

  1. [Simultaneous determination of 9 ultraviolet absorbers in cosmetics by high-performance liquid chromatography].

    PubMed

    Ikarashi, Yoshiaki; Yamada, Mai; Uchino, Tadashi; Tokunaga, Hiroshi

    2007-01-01

    Simultaneous determination for 9 ultraviolet absorbers those set a limit to the amount in cosmetics was performed. Ultraviolet absorbers were extracted from cosmetics with tetrahydrofuran (THF) by ultrasonication. After centrifugation, the supernatant was collected, and the sample solution was injected into the HPLC. Separation was archived using an ODS column with the mixture of THF and water as the mobile phase. Detection wavelength was set at 310 nm. The linearity was obtained between the peak areas and the concentrations of each ultraviolet absorber in the range of 5 - 100 microg/ml. In 70 commercial cosmetic products, such as sunscreen, face powder, foundation, massage cream, moisture lotion, lip balm and essence, 2-ethylhexyl-p-methoxycinnamate (EMC), 2-hydroxy-4-methoxybenzophenone (HMB), 4-tert-butyl-4'-methoxydibenzoylmethane (BMB) and 2-ethylhexyl salicylate (ES) were detected.

  2. Distribution of Acoustic Power Spectra for an Isolated Helicopter Fuselage

    NASA Astrophysics Data System (ADS)

    Kusyumov, A. N.; Mikhailov, S. A.; Garipova, L. I.; Batrakov, A. S.; Barakos, G.

    2016-03-01

    The broadband aerodynamic noise can be studied, assuming isotropic flow, turbulence and decay. Proudman's approach allows practical calculations of noise based on CFD solutions of RANS or URANS equations at the stage of post processing and analysis of the solution. Another aspect is the broadband acoustic spectrum and the distribution of acoustic power over a range of frequencies. The acoustic energy spectrum distribution in isotropic turbulence is non monotonic and has a maximum at a certain value of Strouhal number. In the present work the value of acoustic power peak frequency is determined using a prescribed form of acoustic energy spectrum distribution presented in papers by S. Sarkar and M. Y. Hussaini and by G. M. Lilley. CFD modelling of the flow around isolated helicopter fuselage model was considered using the HMB CFD code and the RANS equations.

  3. Paratesticular solitary fibrous tumor: a case report and review of literature.

    PubMed

    Zhou, Yihong; Gong, Guanghui; Tang, Yuxin; Tang, Jin; Gan, Yu; Dai, Yingbo

    2015-01-01

    Solitary fibrous tumor (SFT) is a rare spindle cell neoplasm that usually arising from the pleura, but has been reported in diverse extrapleural sites. Urogenital localization is rare, and only several cases of paratesticular SFT have been reported. In the present report, we present the case of a 61-year-old male suffering from a paratesticular SFT. A surgical excision of the lesion was performed. The tumor was well circumscribed and consisted of a mixture of bland spindle cells and dense collagen bands. Immunohistochemical studies showed positive reactivity for CD34, CD99 and vimentin, but stained negative for CD117, S100, SMA, HMB45, Desmin and CD68. All these clinicopathologic features are suggestive of the diagnosis of paratesticular SFT.

  4. Solitary fibrous tumor of the kidney. Case report.

    PubMed

    Bozkurt, Suheyla Uyar; Ahiskali, Rengin; Kaya, Handan; Demir, Aslan; Ilker, Yalcin

    2007-03-01

    Solitary fibrous tumors are rare spindle cell neoplasms usually arising in the pleura. They have, however, also been reported at extrapleural locations. Solitary fibrous tumor (SFT) of the kidney is rare. Despite its rarity, histological diagnosis of solitary fibrous tumor is crucial to avoid misdiagnosis with other more aggressive tumors arising in the kidney. We report a solitary fibrous tumor of the left kidney that presented as a malignant tumor in a 51-year-old woman, and include clinical and radiographic findings. The tumor was well circumscribed and composed of spindle cells in a collagenous stroma. Immunohistochemistry showed reactivity for vimentin, CD 34, BCL-2 protein and CD99. Immunohistochemical stains for cytokeratin, S-100, desmin, alpha-smooth muscle actin and HMB-45 were negative. A diagnosis of SFT was made based on light microscopy and immunohistochemistry.

  5. Paratesticular solitary fibrous tumor: a case report and review of literature.

    PubMed

    Zhou, Yihong; Gong, Guanghui; Tang, Yuxin; Tang, Jin; Gan, Yu; Dai, Yingbo

    2015-01-01

    Solitary fibrous tumor (SFT) is a rare spindle cell neoplasm that usually arising from the pleura, but has been reported in diverse extrapleural sites. Urogenital localization is rare, and only several cases of paratesticular SFT have been reported. In the present report, we present the case of a 61-year-old male suffering from a paratesticular SFT. A surgical excision of the lesion was performed. The tumor was well circumscribed and consisted of a mixture of bland spindle cells and dense collagen bands. Immunohistochemical studies showed positive reactivity for CD34, CD99 and vimentin, but stained negative for CD117, S100, SMA, HMB45, Desmin and CD68. All these clinicopathologic features are suggestive of the diagnosis of paratesticular SFT. PMID:26045868

  6. Primary mandibular xanthoma: case report.

    PubMed

    de Araujo, Melissa Rodrigues; Scariot, Rafaela; Uetanabaro, Lucas; Luvison Gomes da Silva, Larissa; Giovanini, Allan Fernando

    2015-10-01

    Xanthoma is a very rare bone tumor, especially in the mandible, that can be associated with metabolic diseases such as hyperlipidemia. A 14-year-old girl presented with a non-corticated unilocular radiolucent lesion observed on panoramic radiography. The lesion was located between the roots of the left first and second premolar teeth, extending from the cervical to the apical region, measuring approximately 1 cm in greatest dimension. An excisional biopsy revealed foam cells and occasional nonfoamy mononuclear macrophage-like cells spread among a discrete fibrous stroma. Immunohistochemically, the xanthomatous cells were CD68 and vimentin positive, focally positive for S100, CD1a, and CD3 and negative for AE1/AE3, CD20, CD117, and HMB45. Hematologic and biochemical investigations ruled out systemic disease.

  7. Quantitative determination of the human breast milk macronutrients by near-infrared Raman spectroscopy

    NASA Astrophysics Data System (ADS)

    Motta, Edlene d. C. M.; Zângaro, Renato A.; Silveira, Landulfo, Jr.

    2012-03-01

    This work proposes the evaluation of the macronutrient constitution of human breast milk based on the spectral information provided by near-infrared Raman spectroscopy. Human breast milk (5 mL) from a subject was collected during the first two weeks of breastfeeding and stocked in -20°C freezer. Raman spectra were measured using a Raman spectrometer (830 nm excitation) coupled to a fiber based Raman probe. Spectra of human milk were dominated by bands of proteins, lipids and carbohydrates in the 600-1800 cm-1 spectral region. Raman spectroscopy revealed differences in the biochemical constitution of human milk depending on the time of breastfeeding startup. This technique could be employed to develop a classification routine for the milk in Human Milk Banking (HMB) depending on the nutritional facts.

  8. Melanotic neuroectodermal tumor of infancy arising in the temporal bone.

    PubMed

    Zhang, Jian-guo; Zhao, Rui-jiao; Kong, Ling-fei

    2015-04-01

    Melanotic neuroectodermal tumor of infancy is a rare melanin-containing neoplasm with locally aggressive and rapid expansile growth, usually involving the maxilla, skull, and mandible of early infancy. Radical surgery is critical for a long-term outcome. We present a case of 14-month-old girl with rapid-growing subcutaneous mass arising in the right temporal bone and extending intracranially on computed tomographic scan. Radical surgery was performed. A brownish-black tumor composed of large pigmented epithelioid cells, positive for cytokeratins and HMB-45, and nests of small neuroblast-like cells positive for neuron-specific enolase and synaptophysin, was diagnosed as melanotic neuroectodermal tumor of infancy. The patient remained well without evidence of recurrence for 1 year after surgery. Clinicopathological features, management alternatives and outcome were discussed.

  9. Embryonal rhabdomyosarcoma of the paranasal sinuses: a case report and review of literature

    PubMed Central

    Wu, Pei-Xue; Liang, Yan-Fang; Zeng, Jin-Cheng; Ruan, Jian-Bo; Kang, Dong-Ping; Chen, Can; Zeng, Tao; Wu, Qiu-Liang; Xu, Wei-Hua

    2014-01-01

    Embryonal rhabdomyosarcoma (ERMS) is a rare malignancy with a poor outcome. In this article, we describe a case of ERMS in the paranasal sinuses from a 60-year-old male patient. ERMS derived from the paranasal sinuses is extremely rare. The diagnosis of ERMS must be based on histological findings and immunohistochemical findings. In this case, microscopic observation showed tumor cells were arranged in flocked sheets, cord-like and acinar-like by hyperplastic fibrous tissue. And ERMS tissues were immunopositive for myogenin, desmin, MSA, CD56, vimentin, CD99, Syn and Ki-67 (40%+), and immunonegative for CK, EMA, LCA, GFAP, NSE, S-100, HMB-45 and Melan-A. Here, the patient was treated with multimodal therapy including endoscopic surgery, chemotherapy and radiation, but the patient’s postoperative recovery is not too smooth. PMID:25232439

  10. Embryonal rhabdomyosarcoma of the paranasal sinuses: a case report and review of literature.

    PubMed

    Wu, Pei-Xue; Liang, Yan-Fang; Zeng, Jin-Cheng; Ruan, Jian-Bo; Kang, Dong-Ping; Chen, Can; Zeng, Tao; Wu, Qiu-Liang; Xu, Wei-Hua

    2014-01-01

    Embryonal rhabdomyosarcoma (ERMS) is a rare malignancy with a poor outcome. In this article, we describe a case of ERMS in the paranasal sinuses from a 60-year-old male patient. ERMS derived from the paranasal sinuses is extremely rare. The diagnosis of ERMS must be based on histological findings and immunohistochemical findings. In this case, microscopic observation showed tumor cells were arranged in flocked sheets, cord-like and acinar-like by hyperplastic fibrous tissue. And ERMS tissues were immunopositive for myogenin, desmin, MSA, CD56, vimentin, CD99, Syn and Ki-67 (40%+), and immunonegative for CK, EMA, LCA, GFAP, NSE, S-100, HMB-45 and Melan-A. Here, the patient was treated with multimodal therapy including endoscopic surgery, chemotherapy and radiation, but the patient's postoperative recovery is not too smooth.

  11. Primary anorectal malignant melanoma: an uncommon anorectal pathology.

    PubMed

    Juanmartiñena Fernández, José Francisco; Fernández-Urien, Ignacio; Córdoba, Alicia

    2016-09-01

    Anorectal malignant melanoma (AMM) is most common primary melanoma of gastrointestinal tract, accounting for 0.05% and 1% of all colorectal and anal cancers. We reported an 85 year-old woman with no significant past medical history who presented two-month period of rectal bleeding, abdominal pain, tenesmus and 2kg weight-loss. Laboratory markers were unremarkable, although rectal examination revealed two small haemorrhoids and a firm, non-obstructing mass in the lower rectum. Colonoscopy confirmed presence of an ulcerated pigmented neoplasm arising at dental line [A,B]. No distant metastases were found on computed tomography [C] although presented metastatic regional lymph nodes on pelvic MRI [D]. Therefore, abdominoperineal resection was performed, confirming loco-regional disease. Histopathology showed malignant melanoma with positive stains in immunohistochemistry for protein S100, HMB-45 and Melan-A [E,F,G,H] and stained negative for c-Kit.

  12. Controlled radical polymerization of an acrylamide containing L-alanine moiety via ATRP.

    PubMed

    Rafiee, Zahra

    2016-02-01

    Homopolymerization of an optically active acrylamide having an amino acid moiety in the side chain, N-acryloyl-L-alanine (AAla) was carried out via atom transfer radical polymerization (ATRP) at room temperature using 2-hydroxyethyl-2'-methyl-2'-bromopropionate (HMB) or sodium-4-(bromomethyl)benzoate (SBB) as initiator in pure water, methanol/water mixture and pure methanol solvents. The polymerization reaction resulted in the optically active biocompatible amino acid-based homopolymer in good yield with narrow molecular weight distribution. The number average molecular weight increased with conversion and polydispersity was low. The structure and molecular weight of synthesized polymer were characterized by (1)H NMR, FT-IR spectroscopic techniques and size-exclusion chromatography.

  13. Amelanotic Melanoma in the Vicinity of Acquired Melanocytic Nevi and not Arising from Agminated Melanocytic Nevi: Masquerading as Pyogenic Granuloma

    PubMed Central

    Rao, Angoori Gnaneshwar; Babu, V Ashok; Koppada, Divya; Haritha, M; Chandana, P; Swapna; Anoosha

    2016-01-01

    Amelanotic melanoma (AMM) presenting as pyogenic granuloma and occurring in the vicinity of acquired melanocytic nevi is rare. Herein, we report such a manifestation in a 68-year-old male who presented with the painful red nodule and multiple pigmented patches involving the left great toe. Histopathological examination of skin biopsy taken from the nodule with an immunohistochemical study using HMB45 and S-100 confirmed the diagnosis of AMM. Biopsy from the pigmented patch near the nodule showed features of melanocytic nevus. Investigative work up revealed metastatic deposits in the left inguinal lymph node with no evidence of systemic involvement, placing him in malignant melanoma Stage IIIC of American Joint Committee on Cancer (AJCC) tumor node metastasis system. The development of AMM in the vicinity of acquired melanocytic nevi and manifesting as granuloma pyogenicum is unique in this case. PMID:26955141

  14. Standard melanoma-associated markers do not identify the MM127 metastatic melanoma cell line

    PubMed Central

    Haridas, Parvathi; McGovern, Jacqui A.; Kashyap, Abhishek S.; McElwain, D. L. Sean; Simpson, Matthew J.

    2016-01-01

    Reliable identification of different melanoma cell lines is important for many aspects of melanoma research. Common markers used to identify melanoma cell lines include: S100; HMB-45; and Melan-A. We explore the expression of these three markers in four different melanoma cell lines: WM35; WM793; SK-MEL-28; and MM127. The expression of these markers is examined at both the mRNA and protein level. Our results show that the metastatic cell line, MM127, cannot be detected using any of the commonly used melanoma-associated markers. This implies that it would be very difficult to identify this particular cell line in a heterogeneous sample, and as a result this cell line should be used with care. PMID:27087056

  15. Hysteroscopic myomectomy: techniques and preoperative assessment.

    PubMed

    Casadio, Paolo; Guasina, Francesca; Morra, Ciro; Talamo, Maria T; Leggieri, Concetta; Frisoni, Jessica; Seracchioli, Renato

    2016-04-01

    Even if usually asymptomatic, uterine myomas have been associated with a number of clinical issues such as abnormal uterine bleeding (AUB), heavy menstrual bleeding (HMB), infertility, recurrent pregnancy loss, especially when these masses are submucous. Golden standard treatment for symptomatic submucous fibroids has long been considered their laparotomic removal or a total hysterectomy. The development of endoscopy has made these fibroids accessible and removable from the inner surface of uterus. Hysteroscopy arose as a diagnostic technique, but then it also became an alternative surgical technique for many diseases, offering therapeutic and irreplaceable possibilities of treatment, avoiding major surgery on the one hand, and allowing the correction of pathologies specifically related to female fertility, on the other hand. Excision by slicing has been described as traditional resectoscopic submucosal myomectomy, but today there are new procedures among which the operator can choose, that allow overcoming the initial limitations of the traditional resectoscopic myomectomy in clinical practice. PMID:26928414

  16. Sclerosing variant of perivascular epithelioid cell tumor in the female genital organs.

    PubMed

    Yamada, Yuichi; Yamamoto, Hidetaka; Ohishi, Yoshihiro; Nishiyama, Kenichi; Fukuhara, Masao; Saitou, Toshiaki; Tsuneyoshi, Masazumi; Oda, Yoshinao

    2011-12-01

    Perivascular epithelioid cell tumor (PEComas), other than angiomyolipoma, clear cell 'sugar' tumor of the lung, and lymphangioleiomyomatosis, is an uncommon mesenchymal neoplasm that arises in the soft tissue and visceral organs. We report herein two cases of sclerosing PEComa; a distinctive variant of PEComa, which is characterized by extensive stromal hyalinization, occurring in the uterus and broad ligament. The patients were 34- and 51-year-old females with no family history of tuberous sclerosis complex. Macroscopically, the tumors had white to gray cut surfaces and were microscopically composed of predominantly spindle- to polygon-shaped cells with clear to slightly eosinophilic cytoplasm and pleomorphic nuclei focally arranged in a perivascular pattern, accompanied by marked stromal hyalinization. These tumor cells were immunohistochemically positive for HMB45 and α-smooth muscle actin. Although this variant of PEComa is very rare, this entity should be considered as a potential primary neoplasm of the female genital organs.

  17. Embryonal rhabdomyosarcoma of the paranasal sinuses: a case report and review of literature.

    PubMed

    Wu, Pei-Xue; Liang, Yan-Fang; Zeng, Jin-Cheng; Ruan, Jian-Bo; Kang, Dong-Ping; Chen, Can; Zeng, Tao; Wu, Qiu-Liang; Xu, Wei-Hua

    2014-01-01

    Embryonal rhabdomyosarcoma (ERMS) is a rare malignancy with a poor outcome. In this article, we describe a case of ERMS in the paranasal sinuses from a 60-year-old male patient. ERMS derived from the paranasal sinuses is extremely rare. The diagnosis of ERMS must be based on histological findings and immunohistochemical findings. In this case, microscopic observation showed tumor cells were arranged in flocked sheets, cord-like and acinar-like by hyperplastic fibrous tissue. And ERMS tissues were immunopositive for myogenin, desmin, MSA, CD56, vimentin, CD99, Syn and Ki-67 (40%+), and immunonegative for CK, EMA, LCA, GFAP, NSE, S-100, HMB-45 and Melan-A. Here, the patient was treated with multimodal therapy including endoscopic surgery, chemotherapy and radiation, but the patient's postoperative recovery is not too smooth. PMID:25232439

  18. Amelanotic Melanoma Masquerading as a Granular Cell Lesion

    PubMed Central

    Pandiar, Deepak; Basheer, Shaini; Shameena, P. M.; Sudha, S.; Dhana, Lakshmi J.

    2013-01-01

    Amelanotic melanoma (AM) presents a diagnostic challenge due to its wide clinical presentations, lack of pigmentation, and varied histological appearances. Immunohistochemistry plays a crucial role in the diagnosis of these lesions. Amelanotic melanoma of oral mucosa is an uncommon lesion. We report a case of a 50-year-old male patient with a growth on the anterior mandibular gingiva of seven-month duration. In the present case, histologically, the tumour resembled a granular cell lesion, which has not been reported previously in AM. Diagnosis was possible by a sequential panel of immunohistochemical markers, of which finally vimentin, S100, HMB45, and Melan-A were positive. The tumor was surgically excised, and postsurgical radiotherapy was given. PMID:23533832

  19. Rectal angiolipoma diagnosed after surgical resection: a case report.

    PubMed

    Ishizuka, Mitsuru; Nagata, Hitoshi; Takagi, Kazutoshi; Horie, Toru; Abe, Akihito; Kubota, Keiichi

    2007-01-21

    Angiolipoma is a common benign tumor with a characteristic vascular component that usually occurs in subcutaneous tissue. Although lipomas are frequently encountered at colonoscopy as submucosal tumors, angiolipomas are rarely found in the gastrointestinal tract including the large intestine. Here we report a 77-year old Japanese man who underwent transanal resection of a tumor that was diagnosed tentatively as a leiomyoma. Histologically, the tumor consisted of mature fat cells and blood vessels. Immunohistochemically, the tumor cells were negative for c-kit and HMB-45, which are consistently expressed in tumors such as gastrointestinal stromal tumor and angiomyolipoma. The tumor was therefore diagnosed as an angiolipoma. This is thought to be the first case report of a surgically resected angiolipoma of the rectum.

  20. Angiomyolipoma With Epithelial Cysts.

    PubMed

    LeRoy, Michael A; Rao, Priya

    2016-06-01

    Angiomyolipoma with epithelial cysts is a rare mesenchymal tumor of the kidney that enters in the differential diagnosis of adult cystic renal neoplasms. These tumors demonstrate a slight female predominance and can present either incidentally or with symptoms, commonly flank pain and hematuria. Unlike conventional angiomyolipoma, this variant is characterized grossly by both solid and cystic areas, and histologically by the presence of single or multiple cysts lined by epithelial cells, a subepithelial "cambium-like" layer of small stromal cells with a prominent capillary vasculature, and a thick exterior wall composed of poorly formed fascicles of smooth muscle and thick-walled dysplastic blood vessels. Tumors show a distinct immunohistochemical profile and are often reactive for melanocytic markers (HMB-45 and Melan-A), as well as estrogen receptor and progesterone receptor. These tumors have an indolent clinical course, with no reports of progression or metastasis in reported cases thus far.

  1. Primary solitary fibrous tumors of liver: a case report and literature review

    PubMed Central

    2013-01-01

    A 42-year-old male presented right upper abdomen pain for more than 6 days, which misdiagnose calculus of intrahepatic duct and acute cholecystitis. An approximately 1.5 cm x 1.0 cm x 1.0 cm nodule was found and resected in left lateral lobe of hepatic. Pathological examination showed spindle cell and fibroblast -like cells within the collagenous stroma. Immunohistochemically, these spindle tumor cells showed diffuse Vim and Bcl-2 positive reactivity, but S-100 protein and HMB45 were negative. The post-operative course was uneventful. Solitary fibrous tumors of the liver, although rare, should be differentiated from mesenchymal lesions of the liver. Virtual slide The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/4214341041091088. PMID:24294990

  2. Targeted liposome-loaded microbubbles for cell-specific ultrasound-triggered drug delivery.

    PubMed

    Geers, Bart; De Wever, Olivier; Demeester, Joseph; Bracke, Marc; De Smedt, Stefaan C; Lentacker, Ine

    2013-12-01

    One of the main problems in cancer treatment is disease relapse through metastatic colonization, which is caused by circulating tumor cells (CTCs). This work reports on liposome-loaded microbubbles targeted to N-cadherin, a cell-cell adhesion molecule expressed by CTCs. It is shown that such microbubbles can indeed bind to N-cadherin at the surface of HMB2 cells. Interestingly, in a mixture of cells with and without N-cadherin expression, binding of the liposome-loaded microbubbles mainly occurs to the N-cadherin-expressing cells. Importantly, applying ultrasound results in the intracellular delivery of a model drug (loaded in the liposomes) in the N-cadherin-expressing cells only. As described in this paper, such liposome-loaded microbubbles may find application as theranostics and in devices aimed for the specific killing of CTCs in blood.

  3. Angiomyolipome épithélioïde rénal mimant un carcinome rénal

    PubMed Central

    Bouaziz, Hanen; Khiari, Ramzi; Dridi, Mohamed; Ghozzi, Samir; Rais, Nawfel Ben

    2016-01-01

    L'angiomyolipome épithélioide est une forme rare d'angiomyolipome à potentiel malin, considéré récemment par l'OMS comme une entité à part dans la classification des tumeurs rénales. Cette lésion pose un problème dans le diagnostic différentiel avec les carcinomes à cellules claires. Il n'y a pas de critère spécifique clinique ou radiologique caractérisant cette tumeur. L'immunohistochimie en révélant la positivité des cellules épithélioide au marqueur HMB45 est essentielle au diagnostic. Le traitement doit être discuté en concertation pluridisciplinaire. PMID:27642438

  4. Unusual clinical presentation of cutaneous malignant melanoma metastatic to the parotid gland; initially discovered by fine needle aspiration: case report and review of literature.

    PubMed

    Elshenawy, Yasmin; Youngberg, George; Al-Abbadi, Mousa A

    2011-05-01

    We report a case of malignant melanoma (MM) metastatic to the parotid gland, initially discovered on fine needle aspiration (FNA). The patient presented with a mass in the parotid gland area with previous history only significant for prostatic carcinoma. The initial FNA impression was melanoma. The smears were hypercellular with bloody necrotic background. The cells were epithelioid with mild nuclear atypia. Discrete cytoplasmic pigmentation was seen. No lymphoglandular bodies were noticed. Fragments of benign salivary gland were also identified. The cytological diagnosis of MM triggered onsite thorough physical examination for potential primary, where a scalp pigmented lesion was discovered hidden by overlying covering hair. Our differential diagnosis included melanoma, metastatic carcinoma, and lymphoma. Further work up for melanoma with S100, HMB45, and Mart 1 confirmed our top differential diagnosis. We emphasize thorough physical examination in such circumstances, and the importance of onsite evaluation guiding clinicians looking for primary.

  5. Inflammatory malignant fibrous histiocytoma of the retroperitoneum.

    PubMed

    Cvjetko, Ivan; Kocman, Branko; Sitić, Sanda

    2011-03-01

    The authors present a case of inflammatory malignant fibrous histiocytoma located in the left retroperitoneum. The tumor was resected enblock with kidney and suprarenal gland. During the resection the system of retractors called the pillars of Kocman was used which allowed wide exposure of the abdominal cavity. The tumor measured 23 x 17 x 10 cm with the left kidney and suprarenal incorporated. The tumor was centrally pseudocystic made of xanthomatous cells, foamy cells and rare giant cells with storiform formations and infiltrated with neutrophils. Imunohistochemically, the tumor cells were vimentin and CD 68 positive and CD 20, CD3, EMA, S-100, HMB 45, CD 34 and CD 1a negative. Neutrophils were CD 15 positive.

  6. Morphological and Morphometrical Characterization of Meloidogyne incognita from Different Host Plants in Four Districts of Punjab, India.

    PubMed

    Kaur, Harpreet; Attri, Rajni

    2013-06-01

    The population of M. incognita, the root knot nematode (RKN) was found infesting five different host plants (okra, banana, sunflower, bottle gourd, and brinjal) out of 24 examined from four districts of Punjab, India (Gurdaspur, Ludhiana, Patiala, and Hoshiarpur). Morphological and morphometrical characterization indicated that in the case of mature female, the characters of body length and width, neck length, ratio 'a', anus to tail terminus (ATT), interphasmid distance (IPD), and perineal pattern were recorded as stable characters. These taxonomic characters can be reliable for identification. All characters of second-stage juvenile (J2) such as body length, stylet length, head to median bulb length (H-MB), distance from median bulb to excretory pore (MB-EP), tail length, anal body width (ABW), and ratios C and C' were highly variable. Analysis of interpopulation morphometric characters of mature female of M. incognita, namely, body length, width, and ratio 'a' were moderately variable characters (CV 0.26% to 20%) and stylet length, neck length, length of median bulb (LMB), and width of median bulb (WMB) were highly variable (CV 1.0% to 36.1%). In the perineal pattern, the two characters ATT and IPD were moderately variable (CV 8.8% to 17.6%) and two characters, anus to vulval slit (AVS) and length of vulval slit (LVS), were highly variable (CV 2.1% to 40.5%). In J2, body length, stylet length, H-MB, MB-EP, ABW, tail length, ratios C, and C' were highly variable characters (CV > 12%). PMID:23833327

  7. Hepatic angiomyolipoma: a series of six cases with emphasis on pathological-radiological correlations and unusual variants diagnosed by core needle biopsy

    PubMed Central

    Agaimy, Abbas; Vassos, Nikolaos; Croner, Roland S; Strobel, Deike; Lell, Michael

    2012-01-01

    Hepatic angiomyolipoma is rare and may pose differential diagnostic difficulty, particularly if encountered in core needle biopsy. We studied 6 cases from 5 males and one female (median age, 48.6 yrs). All presented with non-specific symptoms or an incidentally discovered tumor mass. Two patients had a remote history of chemotherapy for hematological neoplasms (acute lymphoblastic leukemia and Hodgkin lymphoma respectively) and another had clear cell renal cell carcinoma and anaplastic pancreatic carcinoma diagnosed at autopsy without definable syndrome. None of the patients had evidence of the tuberous sclerosis complex or renal or other extra-renal angiomyolipoma. Three tumors were resected completely and three have been only biopsied and followed up. None of the resected cases recurred at a mean follow-up of 35 months. Histologically, tumors were classified as classical triphasic (1), lipomatous (2), epithelioid/oncocytoid (1), epithelioid trabecular (1) and myelolipoma-like (1). The adjacent liver parenchyma was normal in 3 cases, showed pigment cirrhosis in one case and mild fatty change in another case. One case had clinically diagnosed but histologically unverified cirrhosis. The initial diagnostic impression/frozen section was misleading in 5 of the cases and included vascular lesion, focal fatty change, myelolipoma, hepatocellular tumor and oncocytic neoplasm. All tumors expressed HMB45 and variably desmin. One epithelioid lesion expressed HMB45 and TFE3, but lacked desmin expression. In conclusion, hepatic angiomyolipomas are increasingly recognized as incidental findings during surveillance for cirrhosis or investigations for unrelated conditions. Awareness of their diverse morphological spectrum in liver biopsy is necessary to avoid misdiagnosis as hepatocellular carcinoma, metastatic melanoma or other malignant neoplasms. PMID:22949933

  8. Preparation and Surface Property of Fluoroalkyl End-Capped Vinyltrimethoxysilane Oligomer/Talc Composite-Encapsulated Organic Compounds: Application for the Separation of Oil and Water.

    PubMed

    Oikawa, Yuri; Saito, Tomoya; Yamada, Satoshi; Sugiya, Masashi; Sawada, Hideo

    2015-07-01

    Fluoroalkyl end-capped vinyltrimethoxysilane oligomer [R(F)-(CH2-CHSi(OMe)3)n-R(F); n = 2, 3; R(F) = CF(CF3)OC3F7 (R(F)-VM oligomer)] can undergo the sol-gel reaction in the presence of talc particles under alkaline conditions at room temperature to provide the corresponding fluorinated oligomeric silica/talc nanocomposites (RF-VM-SiO2/Talc). A variety of guest molecules such as 2-hydroxy-4-methoxybenzophenone (HMB), bisphenol A (BPA), bisphenol AF, 3-(hydroxysilyl)-1-propanesulfonic acid (THSP), and perfluoro-2-methyl-3-oxahexanoic acid (R(F)-COOH) are effectively encapsulated into the R(F)-VM-SiO2/Talc composite cores to afford the corresponding fluorinated nanocomposites-encapsulated these guest molecules. The R(F)-VM-SiO2/Talc composites encapsulated low molecular weight aromatic compounds such as HMB and BPA can exhibit a superoleophilic-superhydrophobic characteristic on the surfaces; however, the R(F)-VM-SiO2/Talc composite-encapsulated THSP and R(F)-COOH exhibit a superoleophobic-superhydrophilic characteristic on the modified surfaces. In these nanocomposites, the R(F)-VM-SiO2/Talc/THSP composites are applicable to the surface modification of polyester fabric, and the modified polyester fabric possessing a superoleophobic-superhydrophilic characteristic on the surface can be used for the membrane for oil (dodecane)/water separation. In addition, the R(F)-VM-SiO2/Talc composites-encapsulated micrometer-size controlled cross-linked polystyrene particles can be also prepared under similar conditions, and the obtained composite white-colored particle powders are applied to the packing material for the column chromatography to separate water-in-oil (W/O) emulsion.

  9. Abrupt Intralesional Color Change on Dermoscopy as a New Indicator of Early Superficial Spreading Melanoma in a Japanese Woman.

    PubMed

    Sadayasu, Anna; Tanaka, Masaru; Maumi, Yoshifumi; Ikeda, Eriko; Sawada, Mizuki; Ishizaki, Sumiko; Murakami, Yoshiyuki; Fujibayashi, Mariko

    2015-01-01

    Diagnosis of superficial spreading melanoma in the early stage is often difficult, even with dermoscopy. We report the case of a 37-year-old Japanese woman with superficial spreading melanoma in her left buttock. The lesion developed 20 years before becoming visible and gradually enlarged over the past few years without any symptoms. Physical examination showed a well-demarcated dark-brown macule 10 mm in diameter. Dermoscopy demonstrated a central dark area with a blue-grey structureless area, a milky-red area with irregular blue-grey dots or globules suggestive of regression structures, and multifocal black pigmentation with whitish scaly areas. An abrupt intralesional change in color from a central dark area to a peripheral light-brown area was also seen. The peripheral area showed an atypical pigment network with an obscure mesh and holes. Histopathologic examination of the lesion showed acanthosis with melanocytic proliferation and nuclear atypia, a band-like lymphocytic infiltrate, melanophages and a few nests of melanocytes just beneath the epidermis. The epidermal melanocytes were positive for S-100, Melan-A and HMB-45, but the dermal nests of melanocytes were negative for HMB-45 and positive for S-100 and Melan-A. A diagnosis of superficial spreading melanoma with a tumor thickness of 0.4 mm (pT1aN0M0, stage 1A) was established based on the clinical, dermoscopic and histopathologic findings. This case suggests that dermoscopy is useful in the diagnosis of this condition. An abrupt intralesional change of color might be a new indicator of early superficial spreading melanoma. PMID:26269701

  10. Muscle Oxygen Changes following Sprint Interval Cycling Training in Elite Field Hockey Players

    PubMed Central

    Jones, Ben; Hamilton, David K.; Cooper, Chris E.

    2015-01-01

    This study examined the effects of Sprint Interval Cycling (SIT) on muscle oxygenation kinetics and performance during the 30-15 intermittent fitness test (IFT). Twenty-five women hockey players of Olympic standard were randomly selected into an experimental group (EXP) and a control group (CON). The EXP group performed six additional SIT sessions over six weeks in addition to their normal training program. To explore the potential training-induced change, EXP subjects additionally completed 5 x 30s maximal intensity cycle testing before and after training. During these tests near-infrared spectroscopy (NIRS) measured parameters; oxyhaemoglobin + oxymyoglobin (HbO2+ MbO2), tissue deoxyhaemoglobin + deoxymyoglobin (HHb+HMb), total tissue haemoglobin (tHb) and tissue oxygenation (TSI %) were taken. In the EXP group (5.34±0.14 to 5.50±0.14m.s-1) but not the CON group (pre = 5.37±0.27 to 5.39±0.30m.s-1) significant changes were seen in the 30-15IFT performance. EXP group also displayed significant post-training increases during the sprint cycling: ΔTSI (−7.59±0.91 to −12.16±2.70%); ΔHHb+HMb (35.68±6.67 to 69.44±26.48μM.cm); and ΔHbO2+ MbO2 (−74.29±13.82 to −109.36±22.61μM.cm). No significant differences were seen in ΔtHb (−45.81±15.23 to −42.93±16.24). NIRS is able to detect positive peripheral muscle oxygenation changes when used during a SIT protocol which has been shown to be an effective training modality within elite athletes. PMID:25807517

  11. Treating sarcopenia in older and oldest old.

    PubMed

    Martone, Anna Maria; Lattanzio, Fabrizia; Abbatecola, Angela Marie; Carpia, Domenico La; Tosato, Matteo; Marzetti, Emanuele; Calvani, Riccardo; Onder, Graziano; Landi, Francesco

    2015-01-01

    The presence of sarcopenia is not only rapidly rising in geriatric clinical practice and research, but is also becoming a significant concept in numerous medical specialties. This rapidly rising concept has encouraged the need to identify methods for treating sarcopenia. Physical activity measures using resistance training exercise, combined with nutritional interventions (protein and amino acid supplementation) have shown to significantly improve muscle mass and strength in older persons. Moreover, resistance training may improve muscle strength and mass by improving protein synthesis in skeletal muscle cells. Aerobic exercise has also shown to hold beneficial impacts on sarcopenia by improving insulin sensitivity. At the moment, the literature indicates that most significant improvement in sarcopenia is based on exercise programs. Thus, this type of intervention should be implemented in a persistent manner over time in elders, with or at risk of muscle loss. At the same time, physical training exercise should include correcting nutritional deficits with supplementation methods. For example, in older sarcopenic patients with adequate renal function, daily protein intake should be increased to >1. 0 grams of protein per kilogram of body weight. In particular, leucine, - hydroxy β-methylbutyrate (HMB), creatine and some milk-based proteins have been shown to improve skeletal muscle protein balance. In addition, it is also recommended for adjustment of for vitamin D deficiency, if present, considering the crucial role of vitamin D in the skeletal muscle. In this review, we provide evidence regarding the effects of different physical exercise protocols, specific nutritional intervention, and some new metabolic agents (HMB, citrulline malate, ornithine, and others) on clinical outcomes related to sarcopenia in older adults. PMID:25633117

  12. Incidental Nodal Lymphangioleiomyomatosis Is Not a Harbinger of Pulmonary Lymphangioleiomyomatosis: A Study of 19 Cases with Evaluation of Diagnostic Immunohistochemistry

    PubMed Central

    Schoolmeester, J. Kenneth; Park, Kay J.

    2016-01-01

    Lymphangioleiomyomatosis (LAM) is a proliferation of perivascular epithelioid cells typically affecting the lung as a low grade, destructive and progressive disease, but may also be found in lymph nodes and other organs. LAM is sometimes seen as an incidental finding in lymph node dissections performed for staging of gynecologic tumors. To our knowledge, no study has investigated the clinical significance of incidental nodal LAM in relation to subsequent development of pulmonary LAM. We identified 19 patients from our institution with LAM in lymph nodes. Follow up was available for 100% of patients and ranged from 3 to 123 months (mean 33.8 months). All were women and ages ranged from 35 to 71 years (mean 56.3). None had a history of tuberous sclerosis, renal angiomyolipoma or pulmonary LAM. LAM involvement spanned 1 to 6 nodes (mean 2) ranging from 1 to 100% of the total excised lymph nodes. The single largest focus of nodal LAM ranged from 1 to 9 mm (mean 4.3) in 18 patients without evidence of persistent or recurrent nodal LAM. In the one patient with persistent local nodal LAM, the greatest diameter was 25 mm. Affected lymph node sites were regional pelvic and retroperitoneal chains routinely sampled in staging operations. An immunohisotchemical panel of HMB45, A103 and β-catenin was evaluated in 18 cases. HMB45 showed strong, but usually focal staining in every case compared to A103 which was very focally expressed (39%) or negative. β-catenin showed strong, diffuse cytoplasmic and membranous (nonnuclear) reactivity in 100% of cases. At last clinic visit, all 19 patients had no manifestations of pulmonary LAM. In an absence of signs of symptoms of extranodal LAM, patients with incidentally discovered nodal LAM smaller than 10 mm are not at risk for developing pulmonary LAM. PMID:26135558

  13. Prevalence of and interventions for sarcopenia in ageing adults: a systematic review. Report of the International Sarcopenia Initiative (EWGSOP and IWGS)

    PubMed Central

    Cruz-Jentoft, Alfonso J.; Landi, Francesco; Schneider, Stéphane M.; Zúñiga, Clemente; Arai, Hidenori; Boirie, Yves; Chen, Liang-Kung; Fielding, Roger A.; Martin, Finbarr C.; Michel, Jean-Pierre; Sieber, Cornel; Stout, Jeffrey R.; Studenski, Stephanie A.; Vellas, Bruno; Woo, Jean; Zamboni, Mauro; Cederholm, Tommy

    2014-01-01

    Objective: to examine the clinical evidence reporting the prevalence of sarcopenia and the effect of nutrition and exercise interventions from studies using the consensus definition of sarcopenia proposed by the European Working Group on Sarcopenia in Older People (EWGSOP). Methods: PubMed and Dialog databases were searched (January 2000–October 2013) using pre-defined search terms. Prevalence studies and intervention studies investigating muscle mass plus strength or function outcome measures using the EWGSOP definition of sarcopenia, in well-defined populations of adults aged ≥50 years were selected. Results: prevalence of sarcopenia was, with regional and age-related variations, 1–29% in community-dwelling populations, 14–33% in long-term care populations and 10% in the only acute hospital-care population examined. Moderate quality evidence suggests that exercise interventions improve muscle strength and physical performance. The results of nutrition interventions are equivocal due to the low number of studies and heterogeneous study design. Essential amino acid (EAA) supplements, including ∼2.5 g of leucine, and β-hydroxy β-methylbutyric acid (HMB) supplements, show some effects in improving muscle mass and function parameters. Protein supplements have not shown consistent benefits on muscle mass and function. Conclusion: prevalence of sarcopenia is substantial in most geriatric settings. Well-designed, standardised studies evaluating exercise or nutrition interventions are needed before treatment guidelines can be developed. Physicians should screen for sarcopenia in both community and geriatric settings, with diagnosis based on muscle mass and function. Supervised resistance exercise is recommended for individuals with sarcopenia. EAA (with leucine) and HMB may improve muscle outcomes. PMID:25241753

  14. A multimodal assessment of melanin and melanocyte activity in abnormally pigmented hypertrophic scar.

    PubMed

    Travis, Taryn E; Ghassemi, Pejhman; Ramella-Roman, Jessica C; Prindeze, Nicholas J; Paul, Dereck W; Moffatt, Lauren T; Jordan, Marion H; Shupp, Jeffrey W

    2015-01-01

    Using a validated swine model of human scar formation, hyperpigmented and hypopigmented scar samples were examined for their histological and optical properties to help elucidate the mechanisms and characteristics of dyspigmentation. Full-thickness wounds were created on the flanks of red Duroc pigs and allowed to heal. Biopsies from areas of hyperpigmentation, hypopigmentation, and uninjured tissue were fixed and embedded for histological examination using Azure B and primary antibodies to S100B, HMB45, and α-melanocyte-stimulating hormone (α-MSH). Spatial frequency domain imaging (SFDI) was then used to examine the optical properties of scars. Hyperpigmentation was first noticeable in healing wounds around weeks 2 to 3, gradually becoming darker. There was no significant difference in S100B staining for the presence of melanocytes between hyperpigmented and hypopigmented scar samples. Azure B staining of melanin was significantly greater in histological sections from hyperpigmented areas than in sections from both uninjured skin and hypopigmented scar (P < .0001). There was significantly greater staining for α-MSH in hyperpigmented samples compared with hypopigmented samples (P = .0121), and HMB45 staining was positive for melanocytes in hyperpigmented scar. SFDI at a wavelength of 632 nm resulted in an absorption coefficient map correlating with visibly hyperpigmented areas of scars. In a red Duroc model of hypertrophic scar formation, melanocyte number is similar in hyperpigmented and hypopigmented tissues. Hyperpigmented tissues, however, show a greater amount of melanin and α-MSH, along with immunohistochemical evidence of stimulated melanocytes. These observations encourage further investigation of melanocyte stimulation and the inflammatory environment within a wound that may influence melanocyte activity. Additionally, SFDI can be used to identify areas of melanin content in mature, pigmented scars, which may lead to its usefulness in wounds at earlier

  15. The Small Round Blue Cell Tumors of the Sinonasal Area: Histological and Immunohistochemical Findings

    PubMed Central

    J Ashraf, Mohammad; Beigomi, Leila; Azarpira, Negar; Geramizadeh, Bita; Khademi, Bijan; Hakimzadeh, Afsoon; Abedi, Elham

    2013-01-01

    Background Primary Small round blue cell tumors (SRBCT) in sinonasal comprise histogenetically diverse entities with overlapping morphologic features. Because of the limited initial biopsy tissue materials, differential diagnostic difficulties may arise, and as they have different management, exact diagnosis and classification are very important. Objectives In this study, we analyzed the immunohistochemical expression of a panel of markers in the classification and diagnosis of sinonasal SRBCTs. Material and Methods This cross sectional study was performed on 36 paraffin embedded tissue samples. Histologic and immunohistochemical slides from 36 patients with SRBCT were analyzed retrospectively. The patients were admitted in Khalili hospital, Shiraz from 1383 to 1388. Results There were 13 women and 23 men with the mean age of 53 ±12.1. There were 9 malignant melanoma, seven poorly differentiated SCC; six lymphoma (DLBL); 4 SCNEC; three SNUC; two ON; two Ewing/PNET; two embryonal rhabdomyosarcoma, and one plasmacytoma. Pan-cytokeratin was strongly expressed poorly differentiated SCC and all cases of SNUC. Coexpression of desmin and nuclear myoD1 was only detected in rhabdomyosarcoma. HMB45 was only expressed in sinonasal melanoma. CD99 expression was identified only in Ewing/PNET. FLI-1 was detected in 50% of PNET. P63 was expressed in poorly differentiated SCC (2/7) and SNUC (1/3). Conclusions The results of our study indicate that the integration of histopathologic findings with application of limited but highly specific markers led to the separation of carcinomas, lymphoma and melanomas from other small cell tumors. Using a panel of keratin, LCA, desmin, and HMB45 is the most practical and economic approach to accurately classify these tumors. PMID:24349741

  16. New RuII (arene) complexes with halogen-substituted bis- and tris(pyrazol-1-yl)borate ligands.

    PubMed

    Orbisaglia, Serena; Di Nicola, Corrado; Marchetti, Fabio; Pettinari, Claudio; Pettinari, Riccardo; Martins, Luísa M D R S; Alegria, Elisabete C B A; da Silva, M Fátima C Guedes; Rocha, Bruno G M; Kuznetsov, Maxim L; Pombeiro, Armando J L; Skelton, Brian W; Sobolev, Alexandre N; White, Allan H

    2014-03-24

    [RuCl(arene)(μ-Cl)]2 dimers were treated in a 1:2 molar ratio with sodium or thallium salts of bis- and tris(pyrazolyl)borate ligands [Na(Bp(Br3))], [Tl(Tp(Br3))], and [Tl(Tp(iPr, 4Br))]. Mononuclear neutral complexes [RuCl(arene)(κ(2)-Bp(Br3))] (1: arene=p-cymene (cym); 2: arene=hexamethylbenzene (hmb); 3: arene=benzene (bz)), [RuCl(arene)(κ(2)-Tp(Br3))] (4: arene=cym; 6: arene=bz), and [RuCl(arene)(κ(2)-Tp(iPr, 4Br))] (7: arene=cym, 8: arene=hmb, 9: arene=bz) have been always obtained with the exception of the ionic [Ru2 (hmb)2-(μ-Cl)3][Tp(Br3)] (5'), which formed independently of the ratio of reactants and reaction conditions employed. The ionic [Ru-(CH3OH)(cym)(κ(2)-Bp(Br3))][X] (10: X=PF6, 12: X=O3SCF3) and the neutral [Ru(O2CCF3)(cym)(κ(2)-Bp(Br3))] (11) have been obtained by a metathesis reaction with corresponding silver salts. All complexes 1-12 have been characterized by analytical and spectroscopic data (IR, ESI-MS, (1)H and (13)C NMR spectroscopy). The structures of the thallium and calcium derivatives of ligand Tp(Br3), [Tl(Tp(Br3))] and [Ca(dmso)6][Tp(Br3)]2 ⋅2 DMSO, of the complexes 1, 4, 5', 6, 11, and of the decomposition product [RuCl(cym)(Hpz(iPr, 4Br))2][Cl] (7') have been confirmed by using single-crystal X-ray diffraction. Electrochemical studies showed that 1-9 and 11 undergo a single-electron Ru(II) →Ru(III) oxidation at a potential, measured by cyclic voltammetry, which allows comparison of the electron-donor characters of the bis- and tris(pyrazol-1-yl)borate and arene ligands, and to estimate, for the first time, the values of the Lever EL ligand parameter for Bp(Br3), Tp(Br3), and Tp(iPr, 4Br). Theoretical calculations at the DFT level indicated that both oxidation and reduction of the Ru complexes under study are mostly metal-centered with some involvement of the chloride ligand in the former case, and also demonstrated that the experimental isolation of the μ(3)-binuclear complex 5' (instead of the mononuclear 5

  17. Malignant melanotic schwannian tumor: a clinicopathologic, immunohistochemical, and gene expression profiling study of 40 cases, with a proposal for the reclassification of "melanotic schwannoma".

    PubMed

    Torres-Mora, Jorge; Dry, Sarah; Li, Xinmin; Binder, Scott; Amin, Mitual; Folpe, Andrew L

    2014-01-01

    Melanotic schwannomas (MSs), variably associated with the Carney complex, are rare tumors that usually involve spinal nerve roots but may occur in other locations. Clinicopathologic evaluation poorly predicts the behavior of MS. Fewer than 200 cases have been reported. We report a series of 40 well-characterized MSs, one of the largest series to date. The tumors were comprehensively evaluated, and clinical follow-up was obtained. Immunohistochemistry for S100 protein, Melan-A, HMB45, tyrosinase, glial fibrillary acidic protein (GFAP), EMA, SMARCB1, Ki-67 antigen, ASMTL, and the Carney complex-associated PRKAR1A gene product was performed using commercially available antibodies and the Ventana Ultraview detection system. Gene microarray study was conducted on formalin-fixed, paraffin-embedded blocks from 10 MSs and the results compared with previous data from melanoma and schwannoma. Differentially expressed genes were selected at >3-fold and P<0.001. The Fisher exact test was used for statistical analysis. The tumors occurred in 18 male and 22 female patients (mean age 41 y; range, 11 to 84 y) and involved the paravertebral nerve roots (N=31), mediastinum (N=3), sacrum, cauda equina, para-aortic region, fifth cranial nerve, buttock, and cerebellum (N=1 each). Two patients had known Carney complex, and 1 patient also had a cutaneous myxoma, suggestive of Carney complex. The tumors expressed S100 protein (21/25, 84%), Melan-A (23/25, 92%), HMB45 (25/25, 100%), tyrosinase (25/25, 100%), GFAP (0/24, 0%), EMA (0/9, 0%), SMARCB1 (retained in 25/25, 100%), and ASMTL (5/19, 26%); PRKAR1A expression was lost in 7/20 cases (35%). Ki-67-labeling index was <5% in 23/25 cases (92%) and 5% to 10% in 2/25 cases (8%). Gene expression profiling showed significant differences between MS, melanoma, and conventional schwannoma. Clinical follow-up (26/40, 65%; mean 55 mo; range, 1 to 300 mo) showed local recurrences in 9/26 (35%) and metastases in 11/26 (44%) patients. Fourteen

  18. An investigation of the photochemical properties of transition metal arene complexes: Final report for the period July 1, 1983 to June 30, 1987

    SciTech Connect

    Mann, K.R.

    1987-08-01

    The photochemical removal of the arene from CpM(eta/sup 6/-arene)/sup +/ was studied for complexes of Fe(II) and Ru(II); (Fe, arene = p-dichlorobenzene, benzene, toluene, d/sub 8/-toluene, p-xylene, mesitylene, durene, pentamethylbenzene, hexamethylbenzene, hexaethylbenzene, and tri-t-butylbenzene; Ru, p-dichlorobenzene, benzene, toluene, mesitylene, pentamethylbenzene, hexamethylbenzene, and tri-t-butylbenzene). Quantum yields were determined. The photoactive state was identified as the distorted a/sup 3/E/sub 1/ ligand field excited state. The excited state energy of the Fe complexes lies about 14,000 cm/sup -1/ above ground state. A theoretical photophysical model was developed to relate the quantum yield for arene release to the rate of arene release. This model predicts a linear correlation between log((phi/1-phi)) and sigma/sub p/, the Hammett parameter if electronic effects at the arene influence the rate of arene substitution. For chloro and methyl substituted arenes (up to 5 substituents for Fe and 6 substituents for Ru), the linear correlation was verified. The Hammett rho parameter is +1.03 and +0.53 for the Fe complexes in CH/sub 2/Cl/sub 2/ and CH/sub 3/CN solution respectively; for the Ru complexes in CH/sub 3/CN solution rho = +1.38. These data indicate a small negative charge builds up at the arene in the transition state for the arene release reaction. Deviations from the linear correlation of log(phi/(1-phi)) with sigma/sub p/ were found for the sterically hindered CpFe(eta/sup 6/-HMB)/sup +/, CpFe(eta/sup 6/-HEB)/sup +/ and CpFe(eta/sup 6/-1,3,5-tri-t-butylbenzene)/sup +/ complexes (HMB = hexamethylbenzene; HEB = hexaethylbenzene). These deviations result from steric interactions that hinder the interaction of nucleophiles in the transition state and ultimately control the quantum yield of arene release for a given complex.

  19. t(6;11) renal cell carcinoma (RCC): expanded immunohistochemical profile emphasizing novel RCC markers and report of 10 new genetically confirmed cases.

    PubMed

    Smith, Nathaniel E; Illei, Peter B; Allaf, Mohamed; Gonzalez, Nilda; Morris, Kerry; Hicks, Jessica; Demarzo, Angelo; Reuter, Victor E; Amin, Mahul B; Epstein, Jonathan I; Netto, George J; Argani, Pedram

    2014-05-01

    Renal cell carcinomas (RCCs) harboring the t(6;11)(p21;q12) translocation were first described in 2001 and recently recognized by the 2013 International Society of Urological Pathology Vancouver Classification of Renal Neoplasia. Although these RCCs are known to label for melanocytic markers HMB45 and Melan A and the cysteine protease cathepsin K by immunohistochemistry (IHC), a comprehensive IHC profile has not been reported. We report 10 new t(6;11) RCCs, all confirmed by break-apart TFEB fluorescence in situ hybridization. A tissue microarray containing 6 of these cases and 7 other previously reported t(6;11) RCCs was constructed and immunolabeled for 21 different antigens. Additional whole sections of t(6;11) RCC were labeled with selected IHC markers. t(6;11) RCC labeled diffusely and consistently for cathepsin K and Melan A (13 of 13 cases) and almost always at least focally for HMB45 (12 of 13 cases). They labeled frequently for PAX8 (14 of 23 cases), CD117 (10 of 14 cases), and vimentin (9 of 13 cases). A majority of cases labeled at least focally for cytokeratin Cam5.2 (8 of 13 cases) and CD10 and RCC marker antigen (10 of 14 cases each). In contrast to a prior study's findings, only a minority of cases labeled for Ksp-cadherin (3 of 19 cases). The median H score (product of intensity score and percentage labeling) for phosphorylated S6, a marker of mTOR pathway activation, was 101, which is high relative to most other RCC subtypes. In summary, IHC labeling for PAX8, Cam5.2, CD10, and RCC marker antigen supports classification of the t(6;11) RCC as carcinomas despite frequent negativity for broad-spectrum cytokeratins and EMA. Labeling for PAX8 distinguishes the t(6;11) RCC from epithelioid angiomyolipoma, which otherwise shares a similar immunoprofile. CD117 labeling is more frequent in the t(6;11) RCC compared with the related Xp11 translocation RCC. Increased pS6 expression suggests a possible molecular target for the uncommon t(6;11) RCCs that

  20. [Nutritional status in university students: its relation to the number of daily intakes and macronutrients consumption].

    PubMed

    Pi, Romina Antonella; Vidal, Paula Daniela; Brassesco, Bárbara Romina; Viola, Lorena; Aballay, Laura Rosana

    2015-04-01

    Introducción: existe una creciente evidencia científica de que la nutrición ejerce una influencia tanto positiva como negativa en la salud a lo largo de la vida. Diversos autores han destacado que la población universitaria es un grupo especialmente vulnerable desde el punto de vista nutricional ya que se caracteriza por omitir comidas con frecuencia y realizar pequeñas ingestas repetidas veces entre las comidas principales. Objetivo General: establecer la relación existente entre el número de ingestas alimentarias diarias (NIAD), el consumo de macronutrientes y el estado nutricional (EN) en estudiantes de 23-33 años de la Universidad Tecnológica Nacional (UTN), de la ciudad de Córdoba, en el año 2013. Métodos: se utilizó un diseño prospectivo de tipo descriptivo simple correlacional de corte transversal. Se realizó análisis descriptivo e inferencial mediante modelos de regresión logística múltiple. Resultados: de la muestra analizada casi un 50% presentó sobrepeso (SP) y un 40% grasa corporal (GC) elevada. En relación al número de ingestas, los estudiantes que realizaron menos de 4 y más de 6 ingestas tuvieron 2 veces más chance de presentar exceso de peso y de GC. A medida que aumenta la edad también lo hacen los depósitos de GC, y cuando disminuyen los niveles de actividad física (AF) aumenta la chance de presentar un índice de masa corporal (IMC) y GC elevada. Por otro lado, el consumo excesivo de glúcidos aumenta la chance de presentar GC elevada y SP, y el de proteínas y lípidos, el riesgo de GC elevada. Conclusión: Se reconoce al NIAD inferior o superior al recomendado, el bajo nivel de AF, el elevado consumo de carbohidratos, y la edad superior a 29 años como variables relacionados con el SP y la GC elevada.

  1. Persistence, replacement, and rapid clonal expansion of meningococcal carriage isolates in a 2008 university student cohort.

    PubMed

    Bidmos, Fadil A; Neal, Keith R; Oldfield, Neil J; Turner, David P J; Ala'Aldeen, Dlawer A A; Bayliss, Christopher D

    2011-02-01

    A study of meningococcal carriage dynamics was performed with a cohort of 190 first-year students recruited from six residential halls at Nottingham University, United Kingdom. Pharyngeal swabs were obtained on four occasions between November 2008 and May 2009. Direct plating and culture on selective media were succeeded by identification and characterization of meningococci using PCR-based methodologies. Three serogroup Y clones and one serogroup 29E clone were highly prevalent in particular residential halls in November 2008, which is indicative of rapid clonal expansion since the start of the academic year. Persistent carriage of the same meningococcal strain for at least 5 to 6 months was observed in 45% of carriers, with infrequent evidence of antigenic variation in PorA. Sequential carriage of heterologous meningococcal strains occurred in 36% of carriers and involved strains with different capsules and antigenic variants of PorA and FetA in 83% of the cases. These clonal replacement strains also exhibited frequent differences in the presence and antigenic structures of two other surface proteins, NadA and HmbR. This study highlights the low level of antigenic variation associated with persistent carriage but, conversely, the importance of alterations in the repertoire of antigenic variants for sequential carriage of meningococcal strains. Rapid clonal expansion of potentially pathogenic strains in residential halls has implications for the implementation of public health interventions in university populations.

  2. Microscopic endometrial perivascular epithelioid cell nodules: a case report with the earliest presentation of a uterine perivascular epithelioid cell tumor.

    PubMed

    Fang, Chia-Lang; Lin, Yun-Ho; Chen, Wei-Yu

    2012-09-03

    Perivascular epithelioid cell (PEC) tumors (PEComas) are a family of related mesenchymal tumors composed of PECs which co-express melanocytic and smooth muscle markers. Although their distinctive histologic, immunohistochemical, ultrastructural, and genetic features have been clearly demonstrated, their histogenesis and normal counterpart remain largely unknown. Precursor lesions of PEComas have rarely been reported. We herein describe a tuberous sclerosis patient with microscopic PEC nodules in the endometrium of adenomyosis, pelvic endometriosis, an ovarian endometriotic cyst, and the endometrium of the uterine cavity. The nodules showed a mixture of spindle-shaped and epithelioid cells concentrically arranged around small arteries. The cells exhibited uniform nuclei, light eosinophilic cytoplasm, and immunoreactivity with HMB-45 and CD10. Some nodules revealed continuity with a PEComa in the myometrium. These findings support microscopic endometrial PEC nodules possibly being precursor lesions of uterine PEComas. The wide distribution of the nodules in the pelvis may be related to the multicentricity of PEComas in tuberous sclerosis patients. Owing to the immunoreactivity with CD10, microscopic endometrial PEC nodules may be misinterpreted as endothelial stromal cells unless melanocytic markers are stained. To the best of our knowledge, this is a case with the earliest manifestation of PEC lesions occurring in the endometrium. Virtual slides: The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/9658280017862643.

  3. Treatment of an amelanotic melanoma using radiation therapy in a lesser Madagascar hedgehog tenrec (Echinops telfairi).

    PubMed

    Harrison, Tara M; Dominguez, Pedro; Hanzlik, Kim; Sikarskie, James G; Agnew, Dalen; Bergin, Ingrid; Fitzgerald, Scott D; Kitchell, Barbara E; McNiel, Elizabeth

    2010-03-01

    A 15-yr-old, male lesser Madagascar hedgehog tenrec (Echinops telfairi) presented with a mass caudal to the right ear. Cytology suggested a sarcoma. Surgical removal was attempted. Histology was consistent with a soft tissue sarcoma. The mass recurred within 331 days post operation. Radiation therapy was initiated. Computed tomography was used for staging in conjunction with three-dimensional computerized treatment planning software to permit accurate lesion localization and to optimize normal tissue sparing. A total dose of 6,480 cGy was administered in 24 fractions over 46 days. Transient hind limb paresis developed during the course of the radiation therapy, but resolved after 7 days with prednisone treatment. Minimal acute radiation toxicity was observed. The mass responded with at least a 90% reduction in volume following radiation treatment. The animal survived 266 days from the initiation of treatment. On necropsy, a small mass and granulation tissue were found at the site of the initial neoplasm, indicating good regional control of the tumor; however, extensive metastases to the spleen and liver were present. Immunohistochemically, the original, recurrent, and metastatic populations were strongly positive for HMB 45 and weakly positive for S-100, and the final diagnosis was metastatic amelanotic melanoma.

  4. A melanin-bleaching methodology for molecular and histopathological analysis of formalin-fixed paraffin-embedded tissue.

    PubMed

    Chung, Joon-Yong; Choi, Jiyeon; Sears, John D; Ylaya, Kris; Perry, Candice; Choi, Chel H; Hong, Seung-Mo; Cho, Hanbyoul; Brown, Kevin M; Hewitt, Stephen M

    2016-10-01

    Removal of excessive melanin from heavily pigmented formalin-fixed paraffin-embedded (FFPE) melanoma tissues is essential for histomorphological and molecular diagnostic assessments. Although there have been efforts to address this issue, current methodologies remain complex and time-consuming, and are not suitable for multiple molecular applications. Herein, we have developed a robust and rapid melanin-bleaching methodology for FFPE tissue specimens. Our approach is based on quick bleaching (15 min) at high temperature (80 °C) with 0.5% diluted hydrogen peroxide (H2O2) in Tris-HCl, PBS, or Tris/Tricine/SDS buffer. Immunostaining for Ki-67 and HMB45 was enhanced by bleaching with 0.5% H2O2 in Tris/Tricine/SDS and Tris-HCl, respectively. In addition to histopathological applications, our approach also facilitates recovery of protein and nucleic acid from archival melanin-rich FFPE tissue sections. Protein extracted from bleached FFPE tissues was compatible with western blotting using anti-human GAPDH and AKT antibodies. Our bleaching condition significantly improved RNA quality compared with unbleached tissues without compromising the yield. Notably, the RNA/DNA obtained from bleached tissues was suitable for end point PCR and real-time quantitative RT-PCR. In conclusion, this improved melanin-bleaching method enhances and simplifies immunostaining procedures, and facilitates the use of melanin-rich FFPE tissues for histomorphological and PCR amplification-based molecular assays.

  5. [Eating habits of a group of professional volleyball players].

    PubMed

    Gacek, Maria

    2011-01-01

    The aim of the research was an analysis of the eating habits of professional volleyball players according to their sex and age. The research has been carried out on a group of 210 men players and women players at the age of 13-25, representatives of sports clubs in Ostrołeka, Myślenice, Bydgoszcz and Warszawa. The research has revealed a limited realisation of rational diets by both men and women players. The most common mistakes made by them include a smaller number of meals during the day than recommended (especially among men), taking up training on empty stomach and insufficient frequency of consumption of dairy products, fish, vegetables and fruit. The research has also revealed excessive consumption of sweets, sweet sparkling drinks and fast food (mainly among men). The examined players to some extent only apply regular strategies of rehydration of their organisms. A high percentage of them do not pay attention to supplementation of liquids after an effort or they drink a lot of liquids at one time. The most frequently chosen drinks were mineral water and isotonic drinks. Supplementation was applied by a small percentage of the players, mainly men, who most often chose vitamins, Izostar, creatine, L-carnitine and HMB.

  6. Structures and photoactivation of charge-transfer complexes of bis(arene)iron(II) dications with ferrocene and arene donors

    SciTech Connect

    Lehmann, R.E.; Kochi, J.K. )

    1991-01-16

    Ferrocene forms a series of unusual charge-transfer crystals with the isoelectronic bis(arene)iron(II) dication, in which X-ray crystallography establishes the alternate (heterosoric) stacking of sandwich structures comprising the donor-acceptor pairs. In acetonitrile, the 1:1 complex (Cp{sub 2}Fe, Ar{sub 2}Fe{sup 2+}) shows a broad absorption band centered at {lambda}{sub max} {approximately} 630 nm. Bis(arene)iron(II) acceptors also form highly colored crystals with various arene donors, in which the charge-transfer absorption (hv{sub CT}) derives from the same heterosoric stacking of donor-acceptor pairs-despite the structurally divergent nature of the arene (planar) and ferrocene (sandwich) donors. These absorptions undergo a predictable red-shift with increasing acceptor strength in the order (BZ){sub 2}Fe{sup 2+} > (MES){sub 2}Fe{sup 2+} > (DUR){sub 2}Fe{sup 2+} > (HMB){sub 2}Fe{sup 2+}, as judged by the reduction potentials E {sub red} of the benzene, mesitylene, durene, and hexamethylbenzene derivatives, respectively.

  7. Pediatric Papillary Renal Cell Carcinoma in a Horseshoe Kidney: A Case Report with Review of the Literature.

    PubMed

    Loya-Solis, Abelardo; Alemán-Meza, Lucía; Canales-Martínez, Luis Carlos; Franco-Márquez, Rodolfo; Rincón-Bahena, Alim Adriana; Nuñez-Barragán, Karla María; Garza-Guajardo, Raquel; Ponce-Camacho, Marco Antonio

    2015-01-01

    Renal cell carcinoma is the most common malignancy of the kidney in adults. In children, however, it only accounts for an estimated 1.8 to 6.3% of all pediatric malignant renal tumors. Papillary renal cell carcinoma is the second most common type of renal cell carcinoma in children. We present the case of a 12-year-old boy with a 2-month history of abdominal pain, unexplained weight loss, and gross hematuria. Computed tomography revealed a horseshoe kidney and a well-defined mass of 4 cm arising from the lower pole of the right kidney. Microscopically the tumor was composed of papillae covered with cells with abundant eosinophilic cytoplasm and high-grade nuclei with prominent nucleoli. Immunohistochemistry was performed; EMA, Vimentin, and AMACR were strongly positive while CK7, CD10, RCC antigen, TFE3, HMB-45, and WT-1 were negative. Currently, 10 months after the surgical procedure, the patient remains clinically and radiologically disease-free.

  8. Perivascular epithelioid cell tumour of the vagina in an 8 year old girl.

    PubMed

    Ong, Lin Yin; Hwang, Wei Sek; Wong, Adelina; Chan, Mei Yoke; Chui, Chan Hon

    2007-03-01

    Perivascular epithelioid cell tumor (PEComa) is a rare mesenchymal tumor with an unpredictable natural history. We present the first reported case of PEComa of the vagina diagnosed in an 8-year-old girl. This was initially diagnosed on biopsy as an embryonal rhabdomyosarcoma, and the patient underwent 3 cycles of chemotherapy according to the Mesenchymal Malignant Tumour 1989 protocol. A repeat scan, however, revealed an increase in tumor size. Total resection was achieved via a transvaginal (vertical sleeve) partial vaginectomy. The resected tumor had the typical appearance of a PEComa. Immunostains showed positive staining of tumor cells for HMB45, neuron-specific enolase, and calponin but were negative for S100 protein, melaninA, chromogranin, smooth muscle actin, desmin, caldesmon, epithelial membrane antigen, AE1/3, and synaptophysin. Six months after surgery, she remains free of tumor and is on follow-up with regular local examinations under anesthesia and computed tomography scans. Our case highlights the importance of an accurate initial diagnosis, and we stress the importance of regular surveillance over a significant period. PMID:17336201

  9. Pediatric Papillary Renal Cell Carcinoma in a Horseshoe Kidney: A Case Report with Review of the Literature

    PubMed Central

    Loya-Solis, Abelardo; Alemán-Meza, Lucía; Canales-Martínez, Luis Carlos; Franco-Márquez, Rodolfo; Rincón-Bahena, Alim Adriana; Nuñez-Barragán, Karla María; Garza-Guajardo, Raquel; Ponce-Camacho, Marco Antonio

    2015-01-01

    Renal cell carcinoma is the most common malignancy of the kidney in adults. In children, however, it only accounts for an estimated 1.8 to 6.3% of all pediatric malignant renal tumors. Papillary renal cell carcinoma is the second most common type of renal cell carcinoma in children. We present the case of a 12-year-old boy with a 2-month history of abdominal pain, unexplained weight loss, and gross hematuria. Computed tomography revealed a horseshoe kidney and a well-defined mass of 4 cm arising from the lower pole of the right kidney. Microscopically the tumor was composed of papillae covered with cells with abundant eosinophilic cytoplasm and high-grade nuclei with prominent nucleoli. Immunohistochemistry was performed; EMA, Vimentin, and AMACR were strongly positive while CK7, CD10, RCC antigen, TFE3, HMB-45, and WT-1 were negative. Currently, 10 months after the surgical procedure, the patient remains clinically and radiologically disease-free. PMID:26301110

  10. Cellular Neurothekeoma of the Scalp in the Elderly

    PubMed Central

    Park, Min-Cheol

    2016-01-01

    Cellular neurothekeoma (CNT) is an uncommon variant of neurothekeoma that is composed of pithelioid to spindled cells with variable nuclear atypia or pleomorphism but no myxoid stroma. CNT occurs predominantly in the head and neck or upper trunk of children and young adults, with female predominance. The following case is different from typical CNTs. An 88-year-old female presented with a palpable mass on the scalp, which we excised. Histologically, the tumor was non-encapsulated and composed of spindled and epithelioid cells arranged in fascicles and nodules separated by a collagen-rich stroma. Immunohistochemical analysis showed that the epithelioid and spindle-shaped cells were focally positive for vimentin, neuron-specific enolase, smooth muscle actin, CD68, and CD10 but negative for S-100 protein, HMB-45, epithelial membrane antigen, and CD34. We report a new case of CNT that arose in the scalp of an older patient and that was associated with uncommon clinical, histological, and immunohistochemical profiles. PMID:27195257

  11. Hyperosmotic Stress Reduces Melanin Production by Altering Melanosome Formation

    PubMed Central

    Bin, Bum-Ho; Bhin, Jinhyuk; Yang, Seung Ha; Choi, Dong-Hwa; Park, Kyuhee; Shin, Dong Wook; Lee, Ai-Young; Hwang, Daehee; Cho, Eun-Gyung; Lee, Tae Ryong

    2014-01-01

    Many tissues of the human body encounter hyperosmotic stress. The effect of extracellular osmotic changes on melanin production has not yet been elucidated. In this study, we determined that hyperosmotic stress induced by organic osmolytes results in reduced melanin production in human melanoma MNT-1 cells. Under hyperosmotic stress, few pigmented mature melanosomes were detected, but there was an increase in swollen vacuoles. These vacuoles were stained with an anti-M6PR antibody that recognizes late endosomal components and with anti-TA99 and anti-HMB45 antibodies, implying that melanosome formation was affected by hyperosmotic stress. Electron microscopic analysis revealed that the M6PR-positive swollen vacuoles were multi-layered and contained melanized granules, and they produced melanin when L-DOPA was applied, indicating that these vacuoles were still capable of producing melanin, but the inner conditions were not compatible with melanin production. The vacuolation phenomenon induced by hyperosmotic conditions disappeared with treatment with the PI3K activator 740 Y-P, indicating that the PI3K pathway is affected by hyperosmotic conditions and is responsible for the proper formation and maturation of melanosomes. The microarray analysis showed alterations of the vesicle organization and transport under hyperosmotic stress. Our findings suggest that melanogenesis could be regulated by physiological conditions, such as osmotic pressure. PMID:25170965

  12. Fat-forming solitary fibrous tumor of the kidney: a case report and literature review.

    PubMed

    Chen, Yanyang; Wang, Fen; Han, Anjia

    2015-01-01

    Fat-forming solitary fibrous tumor (SFT) is a rare soft tissue tumor. Herein, we reported a 30-year-old woman was found to have a solid mass measuring 60×45 mm in the right kidney on an abdominal computed tomography scan. The tumor was well-circumscribed and composed of cellular nodules with the classic SFT admixed with clusters and lobules of mature adipocytes. Immunohistochemistry staining showed that the tumor cells were diffusely and strongly positive for CD34 and Bcl-2, focally and weakly positive for CD99 and EMA. Mature adipocytes were positive for S-100 protein. Ki-67 expression was found in approximately 2% of tumor cells. However, tumor cells were negative for cytokeratin, S-100 protein, HMB-45, Melan-A, SMA, and CD117. We made the pathological diagnosis of fat-forming SFT of the right kidney. The differential diagnosis includes angiomyolipoma, liposarcoma, spindle cell lipoma, sarcomatoid renal cell carcinoma, synovial sarcoma, and gastrointestinal stromal tumor. The patient was alive and well without evidence of recurrence or metastasis at 19 months after tumor resection.

  13. Angiomyolipomes épithélioïdes rénal bénin: à propos de deux cas

    PubMed Central

    Bagayogo, Tidiani; Othmane, Yddoussalah; Tarik, Karmouni; Khalid, Elkhader; Abdellatif, Koutani; Ahmed, Ibn Attya Andaloussi

    2015-01-01

    Les angiomyolipomes épithélioïdes rénaux (AMLeR) sont des tumeurs rares (identifiées chez moins de 0,1 patients pour 1000 habitants) et représentent 8% des angiomyolipomes (AML) opérés. Il a longtemps été considérécomme un hamartome mais plusieurs articles récents font penser qu'il s'agir d'une tumeur dérivant de cellules épithélioïdespérivasculaires. L'angiomyolipome épithélioïde est une forme rare d'angiomyolipome à potentiel malin, composé decellules épithélioïdes posant des problèmes de diagnostic différentiel avec les carcinomes à cellules rénales. L'immunohistochimie,en révélant la positivité des cellules épithélioïdes au marqueur HMB45 est essentielle au diagnostic. Les auteursrapportent l'aspect tomodensitométrique et histologique d'angiomyolipomes épithélioïdes chez deux patientes. PMID:26953738

  14. Fat-forming solitary fibrous tumor of the kidney: a case report and literature review.

    PubMed

    Chen, Yanyang; Wang, Fen; Han, Anjia

    2015-01-01

    Fat-forming solitary fibrous tumor (SFT) is a rare soft tissue tumor. Herein, we reported a 30-year-old woman was found to have a solid mass measuring 60×45 mm in the right kidney on an abdominal computed tomography scan. The tumor was well-circumscribed and composed of cellular nodules with the classic SFT admixed with clusters and lobules of mature adipocytes. Immunohistochemistry staining showed that the tumor cells were diffusely and strongly positive for CD34 and Bcl-2, focally and weakly positive for CD99 and EMA. Mature adipocytes were positive for S-100 protein. Ki-67 expression was found in approximately 2% of tumor cells. However, tumor cells were negative for cytokeratin, S-100 protein, HMB-45, Melan-A, SMA, and CD117. We made the pathological diagnosis of fat-forming SFT of the right kidney. The differential diagnosis includes angiomyolipoma, liposarcoma, spindle cell lipoma, sarcomatoid renal cell carcinoma, synovial sarcoma, and gastrointestinal stromal tumor. The patient was alive and well without evidence of recurrence or metastasis at 19 months after tumor resection. PMID:26339447

  15. Selective progesterone receptor modulators (SPRMs): progesterone receptor action, mode of action on the endometrium and treatment options in gynecological therapies

    PubMed Central

    Wagenfeld, Andrea; Saunders, Philippa T.K.; Whitaker, Lucy; Critchley, Hilary O.D.

    2016-01-01

    ABSTRACT Introduction: The progesterone receptor plays an essential role in uterine physiology and reproduction. Selective progesterone receptor modulators (SPRMs) have emerged as a valuable treatment option for hormone dependent conditions like uterine fibroids, which have a major impact on women’s quality of life. SPRMs offer potential for longer term medical treatment and thereby patients may avoid surgical intervention. Areas covered: The authors have reviewed the functional role of the progesterone receptor and its isoforms and their molecular mechanisms of action via genomic and non-genomic pathways. The current knowledge of the interaction of the PR and different SPRMs tested in clinical trials has been reviewed. The authors focused on pharmacological effects of selected SPRMs on the endometrium, their anti-proliferative action, and their suppression of bleeding. Potential underlying molecular mechanisms and the specific histological changes in the endometrium induced by SPRMs (PAEC; Progesterone receptor modulator Associated Endometrial Changes) have been discussed. The clinical potential of this compound class including its impact on quality of life has been covered. Expert Opinion: Clinical studies indicate SPRMs hold promise for treatment of benign gynecological complaints (fibroids, heavy menstrual bleeding; HMB). There however remains a knowledge gap concerning mechanism of action. PMID:27138351

  16. Oral Malignant Melanoma Initially Misdiagnosed as a Racial Pigmentation: A Case Report

    PubMed Central

    Martinelli-Kläy, Carla Patrícia; Laporte, Marcel Leandro; Martinelli, Celso Ricardo; Martinelli, Celso; Lombardi, Tommaso

    2016-01-01

    Oral malignant melanoma (OMM) is rare, representing less than 0.5% of all oral malignancies. The most affected sites are the palate and the maxillary gingiva. Histological examination is important to establish the diagnosis of any suspicious pigmented lesion in the oral cavity, mainly if a precise clinical diagnosis is not possible. We present one case of OMM that was initially diagnosed as a racial pigmentation elsewhere 2 years earlier. Clinical examination showed multiple macules and nodules located on the hard and soft palate, gingiva and superior alveolar mucosa. These lesions were painless and presented a color variation going from dark blue to black. Histological analysis showed sheets and nests of atypical melanocytes displaying a range of shapes such as plasmacytoid, epithelioid, and round cells, located in the superficial corium extending to the deep tissues. A few tumor cells contained variable amounts of melanin. There was no invasion of blood vessels or nerve fibers. Immunohistochemical analysis revealed that the neoplastic cells were positive for HMB-45, melan-A, S-100 and negative for AE1/AE3, confirming the diagnosis of melanoma. The Ki-67 labeling index was around 25%. The patient refused any treatment and died 11 months later. PMID:27195264

  17. A case report of pigmented mammary Paget's disease mimicking nevus of the nipple.

    PubMed

    Tang, Xiaoyan; Umemura, Shinobu; Kumaki, Nobue; Izumi, Miki; Saito, Yuki; Suzuki, Yasuhiro; Ozawa, Akira; Tokuda, Yutaka

    2014-05-01

    A 43-year-old Japanese woman consulted our hospital for a pigmented lesion on her right nipple. Two years later, the lesion became enlarged, measuring 5 × 5 mm. It was dark brown, had an irregular shape and relatively clear borders. Incisional biopsy yielded a pathological diagnosis of junctional nevus of the skin. An additional 2 years later, a small mass developed under the right nipple area and core needle biopsy yielded a pathologic diagnosis of invasive ductal carcinoma. Partial resection of the right EC areas included the skin of the nipple and sentinel lymph node biopsy was performed. Histologically, the skin of the nipple demonstrated small clusters of pigmented carcinoma cells that were low molecular weight cytokeratin (CAM5.2) positive. Most of the carcinoma cells were small and did not have abundant cytoplasm, but nuclear enlargement and prominent nucleoli indicated malignancy, and the cytoplasm was pale compared with that of the surrounding squamous epithelial cells. Scattered dendritic melanocytes were identified by S-100 protein and HMB-45 immunohistochemically. In the upper dermis, carcinoma cells also involved the lactiferous ducts. A small focus of carcinoma cells that invaded the fat tissues did not contain melanin pigment. The final diagnosis was pigmented mammary Paget's disease. Pigmented lesions on the nipple should be carefully examined, because pigmented mammary Paget's disease sometimes mimics malignant melanoma or junctional nevus.

  18. Spitz nevus arising in the eyelid of a teenager.

    PubMed

    Shields, Patrick W; Jakobiec, Frederick A; Stagner, Anna M; Yoon, Michael K

    2016-01-01

    A 16-year-old boy developed over a 2-month interval a lightly pigmented left upper eyelid lesion measuring 1.5 mm in greatest diameter that, when excised, microscopically was hypercellular and composed almost exclusively of nonpigmented epithelioid cells that created florid, large intraepidermal junctional nests and sheets and nests of subepidermal cells. The diagnosis was a Spitz nevus. HMB-45, MART-1, and microphthalmia-associated transcription factor were all positive and established the melanocytic nature of the benign tumor. The Ki-67 proliferation index (5%) and 2 mitoses/mm(2) were both low; p16 protein was immunohistochemically identified in the nevoid cells. We review the clinical, histopathologic, and other immunohistochemical features of this entity and provide a brief differential diagnosis (including separation from a Spitzoid melanoma). This is only the third eyelid Spitz nevus reported in the literature and is the most fully characterized immunohistochemically. At their present stage of development, contemporary immunohistochemical biomarkers, while providing supplemental information, nonetheless remain less than definitive in terms of reliably distinguishing benign from malignant Spitz lesions.

  19. Selected cases from the Arkadi M. Rywlin international pathology slide series: granular cell nevus of congenital type: a melanocytic proliferation exhibiting distinct morphologic, immunohistochemical, and ultrastructural features.

    PubMed

    De Pellegrin, Alessandro; Luzar, Bostjan; Suster, Saul; Falconieri, Giovanni

    2015-07-01

    A case of combined melanocytic nevus characterized by extensive granular cytoplasmic changes is described. Clinically, the lesion presented as an irregular, slightly asymmetric, and raised pigmented lesion of back with indistinct borders. Microscopically, a congenital pattern of distribution of melanocytes could be recognized growing along follicular and adnexal units. Melanocytes were arranged in sheets of epithelioid cells with abundant granular cytoplasm. A minor component featuring conventional dermal melanocytes was also present. Mitotic figures were not recognized. Immunohistochemistry was positive for Melan A and S100 protein in both conventional melanocytes and granular cells. In addition, the granular cells were also strongly positive for HMB45 and NKI-C3. The proliferative marker Ki67/MIB1 was nonreactive. Ultrastructural examination showed large cells with round to oval nuclei and numerous scattered cytoplasmic granules showing features consistent with lysosomes or autophagosomes. No premelanosomes, glycogen, lipid, or other distinctive organelles could be identified. Clinical follow-up at 2 years was uneventful. This unusual lesion may represent a peculiar dermal melanocytic proliferation in which the abundant granular cytoplasm is most likely due to degeneration of melanosomes induced by autophagocytic activity. The striking cytoplasmic granularity observed in this lesion may lead to confusion with other conditions, thus warranting adding granular cell nevus to the phenotypic spectrum of benign melanocytic proliferations.

  20. Langerhans cell histiocytosis of the urinary bladder in a patient with bladder cancer previously treated with intravesical Bacillus Calmette-Guérin therapy.

    PubMed

    Numakura, Satoe; Morikawa, Teppei; Ushiku, Tetsuo; Toyoshima, Toyoaki; Fukayama, Masashi

    2014-02-01

    We report an extremely rare case of Langerhans cell histiocytosis (LCH) of the urinary bladder. A 68-year-old man presented with gross hematuria. Cystoscopy showed multiple papillary tumors in the urinary bladder, and transurethral resection was performed. Pathological diagnosis was high-grade papillary urothelial carcinoma with lamina propria invasion. The patient received six treatments with intravesical Bacillus Calmette-Guérin (BCG) therapy. Seven months after surgery, follow-up cystoscopy showed three elevated lesions in the urinary bladder, two of which were identified histologically as recurrent urothelial carcinoma. Microscopic examination of the lesion at the anterior wall revealed diffuse infiltration of medium to large histiocytoid cells in the lamina propria, many of which had distorted nuclei and nuclear grooves. Dense eosinophilic infiltration was also observed. Immunohistochemically, the histiocytoid cells were diffusely positive for S-100 and CD1a, but negative for cytokeratin AE1/AE3 and melanosome-associated antigen recognized by HMB-45. Based on the histological and immunohistochemical features, we diagnosed the lesion as LCH of the urinary bladder. There was no evidence of recurrence of either bladder cancer or LCH after an 18-month follow-up. To avoid misdiagnosis, urologists and pathologists should be aware that LCH may develop in the urinary bladder after intravesical BCG therapy for bladder cancer.

  1. Non psammomatous melanocytic schwannoma presenting as a subcutaneous nodule: A rare presentation of a rare lesion

    PubMed Central

    Gulati, Harveen Kaur; Joshi, Avinash R.; Anand, Mani; Deshmukh, S. D.

    2016-01-01

    Melanocytic schwannoma (MS) is an extremely rare soft tissue tumor accounting for less than 1% of all primitive nerve sheath tumors, with a predilection for spinal nerve involvement. To date, only 20 cases of cutaneous/subcutaneous MS have been described in literature. Here, we describe a case of MS presenting as a subcutaneous nodule in a 22-year-old male in right thigh. On examination, the nodule measured 2.5 × 2.0 × 1.5 cm with overlying skin showing a bluish hue and an ulcer. With a preoperative diagnosis of hemangioma, the patient was taken up for wide local excision and was diagnosed as a case of non psammomatous melanocytic schwannoma based on clinical, histological, and immunohistochemical studies. Immunohistochemistry revealed positivity with S-100, HMB-45, and Melan A with pericellular Laminin positivity. Carney's syndrome was ruled out. MS needs to be differentiated from other pigmented lesions like pigmented neurofibroma, Bednar tumor, cellular blue neavus, and especially malignant melanoma, which has an obvious ominous prognosis. Since MS can show unpredictable behavior especially in absence of overt malignant features, a long term follow up with or without radiotherapy is recommended. PMID:27366278

  2. Cysts in angiomyolipoma with epithelial cysts may be consisted of entrapped and dilated renal tubules: report of a case with additional immunohistochemical evidence to the pre-existing literature.

    PubMed

    Tajima, Shogo; Yamada, Yukio

    2015-01-01

    Angiomyolipoma with epithelial cysts (AMLEC) is a distinctive variant of angiomyolipoma characterized by grossly apparent epithelial cysts and a cellular, müllerian-like subepithelial stroma. Some authors suspect that the epithelial cysts mainly represent dilated entrapped native renal collecting duct epithelium, while other authors think that they represented true epithelial differentiation of the AML. Recently, it has been reported that obvious immunolabeling of melanocytic markers such as Melan A and HMB45, which are often immunolabeled in classical angiomyolipoma, are present in epithelial cysts in cases of AMLEC. Here, we report the case of a 43-year-old Japanese woman with AMLEC, and attempt to elucidate the significance of melanocytic marker immunolabeling in the cyst's epithelium. In the present case, Melan A was labeled in the cyst's epithelium, and was thought to reflect its labeling in renal tubules existing in the renal parenchyma outside the tumor. This finding may indicate that the cyst epithelium is derived from entrapped renal tubules inside the AML. Non-immunolabeling of the estrogen and progesterone receptors in the cyst epithelium may also suggest that the cyst epithelium is not neoplastic, in contrast to their labeling in neoplastic cells existing in cyst wall. Further examination, such as molecular analysis, is needed to determine whether these epithelial cysts is neoplastic or non-neoplastic.

  3. Ulcerative Granular Cell Tumor: A Clinicopathological and Immunohistochemical Study

    PubMed Central

    El-Khalawany, Mohamed; Mosbeh, Al-Sadat; Abd-Al Salam, Fatma; Abou-Bakr, Amany

    2011-01-01

    Granular cell tumor (GCT) is uncommonly presented with cutaneous ulcer. We examined the clinicopathological and immunohistochemical features of this ulcerative form in fourteen cases that may raise the awareness of this variant. The study included 11 males and 3 females with a mean age 31.5 ± 7.42 years. All cases were presented with large solitary ulcer with indurated base, elevated border, skin colored margin, and necrotic floor. Twelve lesions were located on the extremities and two lesions on the genital region. Histologically, the lesions showed dermal infiltrate composed of large polygonal cells with granular cytoplasm and characteristic infiltration of the dermal muscles in all cases. Immunostaining showed positive reaction for S100 (14/14), NSE (14/14), CD68 (5/14), and Vimentin (7/14) while HMB45, CK, EMA, and Desmin were negative. We hope that this paper increases the awareness of ulcerative GCT and consider it in the differential diagnosis of ulcerative lesions. PMID:22132340

  4. Primary malignant melanoma of cervix and vagina.

    PubMed

    Lee, Jae Hoon; Yun, Jisun; Seo, Jung-Won; Bae, Go-Eun; Lee, Jeong-Won; Kim, Sang Wun

    2016-09-01

    Primary malignant melanoma (MM) accounts for 1% of all cancers, and only 3% to 7% of these tumors occur in the female genital tract. Data are limited with respect to the basis for treatment recommendations because of the rarity of MM. The overall prognosis of melanomas of the female genital tract is very poor. Two cases of MM of the female genital tract are presented. The first case is of a 70-year-old female patient who complained of left thigh pain and underwent magnetic resonance imaging that showed cervical cancer with involvement of the vagina, bladder, and parametrium, in addition to multiple bony metastases of the proximal femur, acetabulum, and both iliac bones. The second case is of a 35-year-old female patient who suffered from vaginal bleeding for 5 months, and she was diagnosed as having primary vaginal melanoma. The patient underwent radical surgery and two additional surgeries because of recurrence of cancer in both inguinal areas. After surgery, the patient received adjuvant immunotherapy, radiation therapy, and chemotherapy. In both the aforementioned cases, the pathologic diagnosis was made after immunohistochemical analysis, i.e., the tumor cells were stained with HMB-45 and S100, and were found to be positive for both immunostains. PMID:27668208

  5. A randomised controlled trial of the clinical effectiveness and cost-effectiveness of the levonorgestrel-releasing intrauterine system in primary care against standard treatment for menorrhagia: the ECLIPSE trial.

    PubMed Central

    Gupta, Janesh K; Daniels, Jane P; Middleton, Lee J; Pattison, Helen M; Prileszky, Gail; Roberts, Tracy E; Sanghera, Sabina; Barton, Pelham; Gray, Richard; Kai, Joe

    2015-01-01

    BACKGROUND Heavy menstrual bleeding (HMB) is a common problem, yet evidence to inform decisions about initial medical treatment is limited. OBJECTIVES To assess the clinical effectiveness and cost-effectiveness of the levonorgestrel-releasing intrauterine system (LNG-IUS) (Mirena®, Bayer) compared with usual medical treatment, with exploration of women's perspectives on treatment. DESIGN A pragmatic, multicentre randomised trial with an economic evaluation and a longitudinal qualitative study. SETTING Women who presented in primary care. PARTICIPANTS A total of 571 women with HMB. A purposeful sample of 27 women who were randomised or ineligible owing to treatment preference participated in semistructured face-to-face interviews around 2 and 12 months after commencing treatment. INTERVENTIONS LNG-IUS or usual medical treatment (tranexamic acid, mefenamic acid, combined oestrogen-progestogen or progesterone alone). Women could subsequently swap or cease their allocated treatment. OUTCOME MEASURES The primary outcome was the patient-reported score on the Menorrhagia Multi-Attribute Scale (MMAS) assessed over a 2-year period and then again at 5 years. Secondary outcomes included general quality of life (QoL), sexual activity, surgical intervention and safety. Data were analysed using iterative constant comparison. A state transition model-based cost-utility analysis was undertaken alongside the randomised trial. Quality-adjusted life-years (QALYs) were derived from the European Quality of Life-5 Dimensions (EQ-5D) and the Short Form questionnaire-6 Dimensions (SF-6D). The intention-to-treat analyses were reported as cost per QALY gained. Uncertainty was explored by conducting both deterministic and probabilistic sensitivity analyses. RESULTS The MMAS total scores improved significantly in both groups at all time points, but were significantly greater for the LNG-IUS than for usual treatment [mean difference over 2 years was 13.4 points, 95% confidence interval (CI) 9

  6. A case of primary clear cell hepatocellular carcinoma in a non-cirrhotic liver: an immunohistochemical and ultrastructural study

    PubMed Central

    Clayton, Erica Fan; Furth, Emma Elizabeth; Ziober, Amy; Xu, Theodore; Yao, Yuan; Hwang, Pil Gyu; Bing, Zhanyong

    2012-01-01

    The clear cell variant of hepatocellular carcinoma is a rare entity, occurring at a frequency of less than 10% of hepatocellular carcinoma, with a female prevalence and usually associated with hepatitis C and cirrhosis. We reported a case of primary clear cell hepatocellular carcinoma occurring in a non-cirrhotic liver without history of hepatitis. Our examination included gross pathology, histopathology, immunohistochemistry, special stains, and electron microscopy evaluation. The tumor was composed of sheets of medium-to-large cells with foamy and reticulated cytoplasm and small-to-medium sized nuclei with variably prominent nucleoli. Oil red O stain showed abundant intracellular lipid. Periodic Acid-Schiff stain confirmed the presence of abundant glycogen deposition. Immunohistochemically the tumor cells were positive for Hep Par1, negative for epithelial membrane antigen, steroidogenic factor-1, HMB45, melan A, CK7 and CK20. Electron microscopy study was performed, which was first done in a clear cell hepatocellular carcinoma occurring in a non-cirrhotic liver without elevation of liver function tests. Ultrastructural evaluation of the clear cells showed scarce cellular organelles, cytoplasmic lipid vacuoles and swollen mitochondria. PMID:22826786

  7. Cellular Blue Nevus Diagnosed following Excision of Melanoma: A Challenge in Diagnosis.

    PubMed

    Jonjić, Nives; Dekanić, Andrea; Glavan, Nedeljka; Prpić-Massari, Larisa; Grahovac, Blaženka

    2016-01-01

    A case of a 41-year-old woman with a history of nodular melanoma (NM), associated with an indurated dome-shaped blue-black nodule with a diameter of 1.2 cm in the gluteal region, is presented. Clinical diagnosis of the lesion, present from birth, was blue nevus. Recently, the nodule has been showing a mild enlargement and thus complete resection was performed. Histological analysis revealed a pigmented lesion with an expansive pattern of extension into the dermis and the subcutaneous adipose tissue. The lesion displayed an alveolar pattern as well as a pigmented dendritic cell pattern. The histology was consistent with cellular blue nevus (CBN); however, the history of NM which was excised one year earlier, as well as the clinical information about the slow growing lesion, included a differential diagnosis of CBN, borderline melanocytic tumor, and malignant blue nevus. Additional immunohistochemical (HMB-45, p16, and Ki-67) and molecular (BRAF V600E mutation) analyses were performed on both lesions: the CBN-like and the previously excised NM. Along with lesion history and histological analyses, p16 staining and BRAF were useful diagnostic tools for confirming the benign nature of CBN in this case.

  8. Cellular Blue Nevus Diagnosed following Excision of Melanoma: A Challenge in Diagnosis

    PubMed Central

    Jonjić, Nives; Dekanić, Andrea; Glavan, Nedeljka; Prpić-Massari, Larisa; Grahovac, Blaženka

    2016-01-01

    A case of a 41-year-old woman with a history of nodular melanoma (NM), associated with an indurated dome-shaped blue-black nodule with a diameter of 1.2 cm in the gluteal region, is presented. Clinical diagnosis of the lesion, present from birth, was blue nevus. Recently, the nodule has been showing a mild enlargement and thus complete resection was performed. Histological analysis revealed a pigmented lesion with an expansive pattern of extension into the dermis and the subcutaneous adipose tissue. The lesion displayed an alveolar pattern as well as a pigmented dendritic cell pattern. The histology was consistent with cellular blue nevus (CBN); however, the history of NM which was excised one year earlier, as well as the clinical information about the slow growing lesion, included a differential diagnosis of CBN, borderline melanocytic tumor, and malignant blue nevus. Additional immunohistochemical (HMB-45, p16, and Ki-67) and molecular (BRAF V600E mutation) analyses were performed on both lesions: the CBN-like and the previously excised NM. Along with lesion history and histological analyses, p16 staining and BRAF were useful diagnostic tools for confirming the benign nature of CBN in this case. PMID:27313934

  9. The histological diagnosis of metastases to the breast from extramammary malignancies

    PubMed Central

    Lee, Andrew H S

    2007-01-01

    This study aims to review histological and immunohistochemical features that are useful in the diagnosis of metastases to the breast. Histological features were compared between non‐haematological metastases to the breast and 100 consecutive core biopsy specimens of primary invasive carcinomas of the breast. 18 non‐haematological metastases to the breast were diagnosed over a 10‐year period (0.3% of malignant mammary tumours). Elastosis and carcinoma in situ were seen only in primary mammary cancers. Two‐thirds of tumours had features raising the possibility of metastasis, such as clear cell carcinoma suggestive of renal origin and small cell carcinoma suggestive of pulmonary origin. The features observed in haematological metastases are also described. Immunohistochemical panels to distinguish mammary carcinoma (oestrogen receptor, gross cystic fluid protein‐15) from common metastases to the breast, including carcinoma of the lung (thyroid transcription factor‐1), malignant melanoma (S100, HMB45, melan‐A) and ovarian serous papillary carcinoma (Wilms' tumour 1), are discussed. The pathologist has a key role in considering the diagnosis of metastasis to the breast if the histological features are unusual for a primary mammary tumour. The clinical history is vital in some cases. Immunohistochemistry plays a useful supplementary role. PMID:18042689

  10. Superficial paramucosal clear cell sarcoma of the soft parts resembling melanoma in a 13-year-old boy.

    PubMed

    Sidiropoulos, Michael; Busam, Klaus; Guitart, Joan; Laskin, William B; Wagner, Annette M; Gerami, Pedram

    2013-02-01

    Clear cell sarcoma (CCS) of tendons and aponeuroses, also known as melanoma of soft parts, represents an aggressive rare malignancy that is characterized by a nested or fascicular pattern of spindled cells and a pathognomonic reciprocal translocation, t(12;22)(q13;q12), that results in the fusion of EWSR1 and ATF1 genes. Numerous recent studies have recognized the importance of a cutaneous CCS variant that can mimic a broad spectrum of entities, including spindle cell melanoma, spindle cell squamous carcinoma, cutaneous leiomyosarcoma and atypical fibroxanthoma. We report a case of a 13-year-old boy with cutaneous CCS who presented with a few months history of an asymptomatic papule on the lower lip that was suggestive of a mucocele. Biopsy of the lesion showed a wedge shaped neoplasm arranged in nests and fascicles of epithelioid- to oval-shaped cells with pale cytoplasm, open chromatin and prominent nucleolus. The superficial component was closely opposed to the basal epithelium resembling the junctional nests of a melanocytic neoplasm. The process extended into and involved the striated muscle of the lip. The cells expressed S-100, CD99 and synaptophysin by immunohistochemistry, and there was focal HMB-45 and microphthalmia transcription factor (MiTF) positivity as well. Fluorescence in situ hybridization confirmed the presence of the t(12;22) (ESWR1-ATF1) translocation. PMID:23228147

  11. A Review of the Literature on Extrarenal Retroperitoneal Angiomyolipoma

    PubMed Central

    Venyo, Anthony Kodzo-Grey

    2016-01-01

    Background. Extrarenal retroperitoneal angiomyolipomas are rare. Aim. To review the literature. Results. Angiomyolipomas, previously classified as hamartomas, are now classified as benign tumours. Thirty cases of primary retroperitoneal angiomyolipomas have been reported. Diagnosis of the disease upon is based radiological and pathological findings of triphasic features of (a) fat and (b) blood vessels and myoid tissue. Immunohistochemistry tends to be positive for HMB45, MART1, HHF35, calponin, NKI-C3, and CD117. The lesion is common in women. Treatment options have included the following: (a) radical surgical excision of the lesion with renal sparing surgery or radical nephrectomy in cases where malignant tumours could not be excluded and (b) selective embolization of the lesion alone or prior to surgical excision. One case of retroperitoneal angiomyolipoma was reported in a patient 15 years after undergoing radical nephrectomy for angiomyolipoma of kidney and two cases of distant metastases of angiomyolipoma have been reported following radical resection of the tumour. Conclusions. With the report of two cases of metastases ensuing surgical resection of the primary lesions there is need for academic pathologists to debate and review angiomyolipomas to decide whether to reclassify angiomyolipomas as slow-growing malignant tumours or whether the reported cases of metastases were de novo tumours or metastatic lesions. PMID:26989509

  12. Parotid involvement by desmoplastic melanoma.

    PubMed

    Jennings, T A; Okby, N T; Schroer, K R; Wolf, B C; Mihm, M C

    1996-08-01

    Desmoplastic malignant melanoma often arises in sun damaged skin of the head and neck and shows frequent neurotropism. Although metastatic melanoma frequently involve the parotid, direct spread to the parotid has been rarely reported. We evaluated five cases of desmoplastic malignant melanoma involving the parotid gland with clinical and pathological evidence of precursor cutaneous lesions in four of the five cases. The parotid involvement in four cases was tumoural, and three of these were not clinically suspected to be melanoma. The histological appearance in all five cases was that of a sarcomatoid tumour. Immunohistochemistry and electronmicroscopy performed on three of the cases showed only evidence of schwannian differentiation: the tumour cells were positive for S-100 protein and vimentin, and negative for cytokeratin and HMB-45. Electronmicroscopy showed no evidence of melanogenesis. All five tumours showed histological evidence of prominent neurotropism with one case demonstrating extension from overlying skin along cutaneous nerves to the superficial parotid. Thus, desmoplastic malignant melanoma may involve the parotid by neurotropic spread and can be pathologically indistinguishable from malignant schwannoma, a diagnosis which may be made erroneously in the absence of clinical information. PMID:8872151

  13. Malignant Melanoma With Osteoclast-Like Differentiation.

    PubMed

    Wasserman, Jason K; Sekhon, Harmanjatinder S; Ayroud, Yasmine

    2015-09-01

    Osteoclast-like giant cells are frequently encountered in nonskeletal malignancies; however, the evidence to date suggests that they represent a tissue response to the lesion rather than neoplastic differentiation. We describe a case of metastatic melanoma demonstrating osteoclast-like differentiation in the lung. The lung nodule was diagnosed as a metastatic melanoma by histological features and confirmed by immunohistochemistry. Resection specimen showed numerous multinucleated giant cells exhibiting osteoclast-like morphology dispersed throughout the lesion. Both the neoplastic melanocytes and giant cells were reactive for HMB-45, Melan-A, and S100. In addition, the multinucleated neoplastic giant cells were also reactive for the monocyte/macrophage lineage markers CD68 and CD163, and alkaline phosphatase, an enzyme present in normal osteoclasts. The neoplastic melanocytes and the multinucleated neoplastic giant cells were also reactive for microphthalmia-associated transcription factor, a protein required for the development of both melanocytes and osteoclasts. Collectively, a co-expression of monocyte/macrophage markers along with melanocytic markers and alkaline phosphatase in the multinucleated neoplastic giant cells in metastatic melanoma suggest that malignant melanocytes are capable of differentiating into osteoclast-like cells and consequently aid invasion into various structures and eliciting the aggressive behavior.

  14. Primary cutaneous PEComa.

    PubMed

    Chaplin, Anna; Conrad, David M; Tatlidil, Cuneyt; Jollimore, Jason; Walsh, Noreen; Covert, Alan; Pasternak, Sylvia

    2010-05-01

    A 48-year-old woman attended a physician because of a solitary cutaneous nodule on the left lower leg. Microscopic examination of the excisional specimen revealed a dermal tumor composed of nests of epithelioid cells exhibiting clear cytoplasm. They had centrally located vesicular nuclei with distinct nucleoli. A rich network of capillaries was present throughout. The tumor showed an infiltrative border. There was no epidermal involvement. Periodic acid-Shif (PAS) and PAS-Diastase stains demonstrated glycogen deposition within the cytoplasm of the clear cells. Immunohistochemical evaluation revealed that the tumor cells were positive for HMB-45 and microftalmia associated transcription factor (MITF). Focal desmin positivity was also seen. The tumor cells were negative for S-100 protein, alfa smooth muscle actin, HHF-35, and various cytokeratins. The case is one of a primary cutaneous pecoma. Pecomas are rare, recently described mesenchymal tumors composed of perivascular epithelioid cells. They constitute a spectrum of lesions in different organs including angiomyolipoma of the kidney and liver, sugar tumor of the lung, lymphangiomatosis, and lymphangiomyoma. Primary cutaneous PEComas are exceptionally rare and have only recently been recognized. To date, these are approximately 22 cases in the English literature. Follow-up data is limited but they appear to behave in a benign fashion. We report an additional case with the goal of alerting dermatopathologists to this distinctive unusual neoplasm.

  15. Primary malignant melanoma of cervix and vagina

    PubMed Central

    Lee, Jae Hoon; Yun, Jisun; Seo, Jung-Won; Bae, Go-Eun; Lee, Jeong-Won

    2016-01-01

    Primary malignant melanoma (MM) accounts for 1% of all cancers, and only 3% to 7% of these tumors occur in the female genital tract. Data are limited with respect to the basis for treatment recommendations because of the rarity of MM. The overall prognosis of melanomas of the female genital tract is very poor. Two cases of MM of the female genital tract are presented. The first case is of a 70-year-old female patient who complained of left thigh pain and underwent magnetic resonance imaging that showed cervical cancer with involvement of the vagina, bladder, and parametrium, in addition to multiple bony metastases of the proximal femur, acetabulum, and both iliac bones. The second case is of a 35-year-old female patient who suffered from vaginal bleeding for 5 months, and she was diagnosed as having primary vaginal melanoma. The patient underwent radical surgery and two additional surgeries because of recurrence of cancer in both inguinal areas. After surgery, the patient received adjuvant immunotherapy, radiation therapy, and chemotherapy. In both the aforementioned cases, the pathologic diagnosis was made after immunohistochemical analysis, i.e., the tumor cells were stained with HMB-45 and S100, and were found to be positive for both immunostains. PMID:27668208

  16. A melanin-bleaching methodology for molecular and histopathological analysis of formalin-fixed paraffin-embedded tissue.

    PubMed

    Chung, Joon-Yong; Choi, Jiyeon; Sears, John D; Ylaya, Kris; Perry, Candice; Choi, Chel H; Hong, Seung-Mo; Cho, Hanbyoul; Brown, Kevin M; Hewitt, Stephen M

    2016-10-01

    Removal of excessive melanin from heavily pigmented formalin-fixed paraffin-embedded (FFPE) melanoma tissues is essential for histomorphological and molecular diagnostic assessments. Although there have been efforts to address this issue, current methodologies remain complex and time-consuming, and are not suitable for multiple molecular applications. Herein, we have developed a robust and rapid melanin-bleaching methodology for FFPE tissue specimens. Our approach is based on quick bleaching (15 min) at high temperature (80 °C) with 0.5% diluted hydrogen peroxide (H2O2) in Tris-HCl, PBS, or Tris/Tricine/SDS buffer. Immunostaining for Ki-67 and HMB45 was enhanced by bleaching with 0.5% H2O2 in Tris/Tricine/SDS and Tris-HCl, respectively. In addition to histopathological applications, our approach also facilitates recovery of protein and nucleic acid from archival melanin-rich FFPE tissue sections. Protein extracted from bleached FFPE tissues was compatible with western blotting using anti-human GAPDH and AKT antibodies. Our bleaching condition significantly improved RNA quality compared with unbleached tissues without compromising the yield. Notably, the RNA/DNA obtained from bleached tissues was suitable for end point PCR and real-time quantitative RT-PCR. In conclusion, this improved melanin-bleaching method enhances and simplifies immunostaining procedures, and facilitates the use of melanin-rich FFPE tissues for histomorphological and PCR amplification-based molecular assays. PMID:27548802

  17. Determination of nitrate and nitrite in Hanford defense waste(HDW) by reverse polarity capillary zone electrophoresis (RPCE)method

    SciTech Connect

    Metcalf, S.G.

    1998-06-10

    This paper describes the first application of reverse polarity capillary zone electrophoresis (RPCE) for rapid and accurate determination of nitrate and nitrite in Hanford Defense Waste (HDW). The method development was carried out by using Synthetic Hanford Waste (SHW), followed by the analysis of 4 real HDW samples. Hexamethonium bromide (HMB) was used as electroosmotic flow modifier in borate buffer at pH 9.2 to decrease the electroosmotic flow (EOF) in order to enhance the speed of analysis and the resolution of nitrate and nitrite in high ionic strength HDW samples. The application of this capillary zone electrophoresis method, when compared with ion chromatography for two major components of HDW, nitrate and nitrite slightly reduced analysis time, eliminated most pre-analysis handling of the highly radioactive sample, and cut analysis wastes by more than 2 orders of magnitude. The analysis of real HDW samples that were validated by using sample spikes showed a concentration range of 1.03 to 1.42 M for both nitrate. The migration times of the real HDW and the spiked HDW samples were within a precision of less than 3% relative standard deviation. The selectivity ratio test used for peak confirmation of the spiked samples was within 96% of the real sample. Method reliability was tested by spiking the matrix with 72.4 mM nitrate and nitrite. Recoveries for these spiked samples were 93-103%.

  18. Primary malignant melanoma of cervix and vagina

    PubMed Central

    Lee, Jae Hoon; Yun, Jisun; Seo, Jung-Won; Bae, Go-Eun; Lee, Jeong-Won

    2016-01-01

    Primary malignant melanoma (MM) accounts for 1% of all cancers, and only 3% to 7% of these tumors occur in the female genital tract. Data are limited with respect to the basis for treatment recommendations because of the rarity of MM. The overall prognosis of melanomas of the female genital tract is very poor. Two cases of MM of the female genital tract are presented. The first case is of a 70-year-old female patient who complained of left thigh pain and underwent magnetic resonance imaging that showed cervical cancer with involvement of the vagina, bladder, and parametrium, in addition to multiple bony metastases of the proximal femur, acetabulum, and both iliac bones. The second case is of a 35-year-old female patient who suffered from vaginal bleeding for 5 months, and she was diagnosed as having primary vaginal melanoma. The patient underwent radical surgery and two additional surgeries because of recurrence of cancer in both inguinal areas. After surgery, the patient received adjuvant immunotherapy, radiation therapy, and chemotherapy. In both the aforementioned cases, the pathologic diagnosis was made after immunohistochemical analysis, i.e., the tumor cells were stained with HMB-45 and S100, and were found to be positive for both immunostains.

  19. Langerhans cell sarcoma arising from the root of tongue: a rare case

    PubMed Central

    Ren, Jian-Jun; Zhao, Yu; Liu, Ming-Juan; Liu, Guo; Chen, Fei

    2015-01-01

    Langerhans cell sarcoma (LCS), a rare malignant disease with markedly malignant cytological features and poor outcome, originates from Langerhans cells and most commonly affects the lymph nodes, skin, and bone. This paper presents the case of a 58-year-old female with LCS at the root of her tongue, with neither local recurrence nor distant metastasis observed during 47 months of follow up following radiotherapy for more than one month after complete tumor resection. Histological and immunophenotypic tests revealed that the malignant tumor cells were positive for S-100 protein, CD1a, and LCA, and partially positive for CD3ε. By contrast, the tumor cells were negative for langenin, CD30, HMB45, PCK, CK5/6, and P63. Their Ki-67proliferation index ranged from 30% to 40%. This neoplasm was diagnosed as LCS according to the classification of WHO2008. This work is the first report on LCS arising from the root of tongue. This rare case may serve as a reference for future clinical studies. PMID:26823886

  20. Simulation and optimization of airlift external circulation membrane bioreactor using computational fluid dynamics.

    PubMed

    Qing, Zhang; Rongle, Xu; Xiang, Zheng; Yaobo, Fan

    2014-01-01

    The airlift external circulation membrane bioreactor (AEC-MBR) is a new MBR consisting of a separated aeration tank and membrane tank with circulating pipes fixed between the two tanks. The circulating pipe is called a H circulating pipe (HCP) because of its shape. With the complex configuration, it was difficult but necessary to master the AEC-MBR's hydraulic characteristics. In this paper, simulation and optimization of the AEC-MBR was performed using computational fluid dynamics. The distance from diffusers to membrane modules, i.e. the height of gas-liquid mixing zone (h(m)), and its effect on velocity distribution at membrane surfaces were studied. Additionally, the role of HCP and the effect of HCP's diameter on circulation were simulated and analyzed. The results showed that non-uniformity of cross-flow velocity existed in the flat-plate membrane modules, and the problem could be alleviated by increasing hm to an optimum range (h(m)/B ≥ 0.55; B is total static depth). Also, the low velocity in the boundary layer on the membrane surface was another reason for membrane fouling. The results also suggested that HCP was necessary and it had an optimum diameter to make circulation effective in the AEC-MBR. PMID:24804658

  1. [A case of malignant melanoma metastasis to the mammary gland].

    PubMed

    Tanaka, Ryota; Kashiwagi, Shinichiro; Ishihara, Sae; Asano, Yuka; Noda, Satoru; Kawajiri, Hidemi; Takashima, Tsutomu; Onoda, Naoyoshi; Ohsawa, Masahiko; Hirakawa, Kosei

    2014-11-01

    Herein, we report a rare case of malignant melanoma metastasis to the mammary gland. A 76-year-old woman had a tumor resection performed for primary malignant melanoma of the epipharynx. The patient subsequently underwent local and lymph node recurrence, for which she received heavy ion radiotherapy and lymph node dissection, respectively. The patient was referred to our hospital for a problem with her right breast. Computed tomography and magnetic resonance imaging showed a mammary tumor and multiple subcutaneous tumors. A biopsy was performed, which proved positive for S100 and Melan A staining, and the diagnosis of malignant melanoma was confirmed. Partial mastectomy was performed; and S100, HMB45, and Melan A positivity was confirmed based on immunohistological findings. The diagnosis was malignant melanoma metastasis to the mammary gland. Malignant melanoma commonly metastasizes to the liver, mediastinum, mediastinal glands, lung, and brain; and metastasis to the mammary gland is rare. To our knowledge, only 2 cases have previously been reported in the Japanese literature.

  2. Progressive Nodular Histiocytosis Associated with Eale's Disease

    PubMed Central

    Williams, Abhilasha; Thomas, Abraham G; Kwatra, Kanwardeep Singh; Jain, Kunal

    2015-01-01

    Progressive nodular histiocytosis (PNH) is a rare normolipemic macrophage disorder and belongs to a subgroup of non-Langerhans cell histiocytosis (LCHs) which is characterized by a progressive course with no sign of spontaneous resolution but without systemic involvement. We report a 30-year-old gentleman who presented with skin lesions all over the body associated with gradual bilateral painless loss of vision. On examination, approximately 30 to 40, skin-colored, firm, non-tender papules and nodules were noted over the body especially on the face and trunk. A skin biopsy revealed a cellular tumor in the dermis composed of oval to spindle-shaped cells, positive for CD68 but negative for S-100, CD34, CD21, CD35 and HMB45, supporting a diagnosis of spindle cell histiocytic tumor. Ophthalmic examination revealed a generalized arteriolar attenuation in both eyes. He received Tab Imatinib 400 mg OD for 5 months followed by Tab Pazopanib 800 mg OD for 4 months and both the drugs were stopped due to lack of any response in the skin lesions. We report this case due to its rarity, characteristic clinical presentation, and its association with Eale's disease. Primary treatment remains surgical excision of bothersome lesions and optimal systemic treatment is still unknown. PMID:26288410

  3. Granulomatous reaction in hepatic inflammatory angiomyolipoma after chemoembolization and spontaneous rupture

    PubMed Central

    Kai, Keita; Miyosh, Atsushi; Aishima, Shinichi; Wakiyama, Kota; Nakashita, Shunya; Iwane, Shinji; Azama, Shinya; Irie, Hiroyuki; Noshiro, Hirokazu

    2015-01-01

    A 77-year-old Japanese woman was transported to a nearby hospital due to sudden abdominal pain and transient loss of consciousness. Abdominal computed tomography (CT) suggested hemoperitoneum and hepatic nodule. She was conservatively treated. Contrast-enhanced CT two months later revealed an increased mass size, and the enhancement pattern suggested the possibility of hepatocellular carcinoma (HCC). Under a clinical diagnosis of HCC, transcatheter arterial chemoembolization (TACE) was performed. A subsequent imaging study revealed that most of the lipiodol used for the embolization was washed out. Therefore, surgical resection was performed. Histologically, the nodule contained numerous inflammatory cells including small lymphocytes, plasma cells and macrophages. Notably, epithelioid granulomatous features with multinucleated giant cells were observed in both the nodule and background liver. Some of the multinucleated giant cells contained oil lipid. Among the infiltrating inflammatory cells, spindle-shaped, histiocytoid or myoid tumor cells with eosinophilic cytoplasm were found. The tumor cells were positive for Melan A and HMB45. The nodule contained many IgG4-positive plasma cells; these were counted and found to number 72.6 cells/HPF (range: 61-80). The calculated IgG4:IgG ratio was 33.2%. The nodule was finally diagnosed as previously ruptured inflammatory angiomyolipoma modified by granulomatous reaction after TACE. PMID:26327777

  4. Molecular structure, NBO analysis, electronic absorption and vibrational spectral analysis of 2-Hydroxy-4-Methoxybenzophenone: reassignment of fundamental modes.

    PubMed

    Joseph, Lynnette; Sajan, D; Chaitanya, K; Suthan, T; Rajesh, N P; Isac, Jayakumary

    2014-01-01

    Vibrational frequencies of 2-Hydroxy-4-Methoxybenzophenone (HMB) have been reassigned with the aid of normal coordinate analysis (NCA) following the scaled quantum mechanical force field (SQMFF) methodology. The conformational analyses were performed and the energies of the different possible conformers were determined. The geometry of different conformers of the compounds were optimized with B3LYP method using 6-311++G(d,p) basis set to characterize all stationary points as minima. The optimized structural parameters of the most stable conformer were used in the vibrational frequency calculations. The force constants obtained from the B3LYP/6-311++G(d,p) method have been utilized in the normal coordinate analysis. The temperature dependence of the thermodynamic properties, heat capacity at constant pressure (Cp), entropy (S) and enthalpy change (ΔH) for the compound was also determined by B3LYP/6-311++G(d,p) method. The total electron density and Molecular electrostatic potential surfaces of the molecules were constructed by Natural Bond Orbital analysis using B3LYP/6-311++G(d,p) method to display electrostatic potential (electron+nuclei) distribution, molecular shape, size, and dipole moments of the molecule. The electronic properties, HOMO and LUMO energies were measured.

  5. Cysts in angiomyolipoma with epithelial cysts may be consisted of entrapped and dilated renal tubules: report of a case with additional immunohistochemical evidence to the pre-existing literature

    PubMed Central

    Tajima, Shogo; Yamada, Yukio

    2015-01-01

    Angiomyolipoma with epithelial cysts (AMLEC) is a distinctive variant of angiomyolipoma characterized by grossly apparent epithelial cysts and a cellular, müllerian-like subepithelial stroma. Some authors suspect that the epithelial cysts mainly represent dilated entrapped native renal collecting duct epithelium, while other authors think that they represented true epithelial differentiation of the AML. Recently, it has been reported that obvious immunolabeling of melanocytic markers such as Melan A and HMB45, which are often immunolabeled in classical angiomyolipoma, are present in epithelial cysts in cases of AMLEC. Here, we report the case of a 43-year-old Japanese woman with AMLEC, and attempt to elucidate the significance of melanocytic marker immunolabeling in the cyst’s epithelium. In the present case, Melan A was labeled in the cyst’s epithelium, and was thought to reflect its labeling in renal tubules existing in the renal parenchyma outside the tumor. This finding may indicate that the cyst epithelium is derived from entrapped renal tubules inside the AML. Non-immunolabeling of the estrogen and progesterone receptors in the cyst epithelium may also suggest that the cyst epithelium is not neoplastic, in contrast to their labeling in neoplastic cells existing in cyst wall. Further examination, such as molecular analysis, is needed to determine whether these epithelial cysts is neoplastic or non-neoplastic. PMID:26617918

  6. Angiomyolipoma of kidney.

    PubMed

    Eble, J N

    1998-02-01

    Angiomyolipoma of the kidney is a clonal neoplasm, apparently part of a family of neoplasms derived from perivascular epithelioid cells. Early angiomyolipomas are small nodules composed of HMB-45-reactive spindle cells in the renal capsule, cortex, or medulla. Most angiomyolipomas are asymptomatic, and they are more common than previously appreciated, approaching 13 per 10,000 adults. They are much more prevalent in patients with tuberous sclerosis, where they often are accompanied by cysts and occasionally by renal cell carcinoma. That they are rarely diagnosed before puberty in patients without tuberous sclerosis, that large ones are more common in women than men, and that they occasionally grow rapidly during pregnancy suggest that hormones may play a role in stimulating the growth of angiomyolipoma. Pathologists should recognize that the presence of multiple angiomyolipomas is, at the least, presumptive evidence for the diagnosis of tuberous sclerosis and include this in their reports. Typical angiomyolipomas are benign but may have alarming properties: nuclear pleomorphism and mitotic activity, extension into the vena cava (21 cases), and spread to regional lymph nodes (39 cases), without malignant progression. The most common serious complication of renal angiomyolipoma is hemorrhage. Epithelioid angiomyolipoma is a recently recognized variant with malignant potential. Angiomyolipoma and lymphangiomyoma are closely related, and tumors with features of both have occurred. Angiomyolipomas have occurred in other organs in association with renal angiomyolipoma.

  7. Unusual sinonasal small-cell neoplasms following radiotherapy for bilateral retinoblastomas

    SciTech Connect

    Frierson, H.F. Jr.; Ross, G.W.; Stewart, F.M.; Newman, S.A.; Kelly, M.D. )

    1989-11-01

    Two patients developed sinonasal small-cell neoplasms that arose 22 years and 37 years, respectively, following radiotherapy for bilateral retinoblastomas. The tumors were composed of small cells with scant cytoplasm and had a few scattered Homer-Wright rosettes. Immunohistochemically, one tumor was positive for keratin (CAM 5.2 and AE1/AE3), epithelial membrane antigen, and neuron-specific enolase. The other neoplasm was immunoreactive for keratin (CAM 5.2 only) and neuron-specific enolase; it also had focal immunopositivity for S-100 protein, desmin, and muscle-specific actin. Both were negative for CEA, vimentin, melanocyte-specific antigen (HMB45), chromogranin A, synaptophysin, Leu-7, 200 kd neurofilament, and retinal S-antigen. Despite aggressive multimodal therapy, the patients died of metastatic tumor 7 months and 10 months following their initial diagnosis, respectively. Although osteosarcoma is the most frequent second cancer following bilateral retinoblastomas, some patients develop clinically aggressive sinonasal small-cell tumors that are difficult to place into conventional classifications. Both of our cases showed evidence of multidirectional differentiation; one tumor labeled with epithelial and neural markers, and the other expressed epithelial, neural, and myogenous antigens.49 references.

  8. Human dermal stem cells differentiate into functional epidermal melanocytes.

    PubMed

    Li, Ling; Fukunaga-Kalabis, Mizuho; Yu, Hong; Xu, Xiaowei; Kong, Jun; Lee, John T; Herlyn, Meenhard

    2010-03-15

    Melanocytes sustain a lifelong proliferative potential, but a stem cell reservoir in glabrous skin has not yet been found. Here, we show that multipotent dermal stem cells isolated from human foreskins lacking hair follicles are able to home to the epidermis to differentiate into melanocytes. These dermal stem cells, grown as three-dimensional spheres, displayed a capacity for self-renewal and expressed NGFRp75, nestin and OCT4, but not melanocyte markers. In addition, cells derived from single-cell clones were able to differentiate into multiple lineages including melanocytes. In a three-dimensional skin equivalent model, sphere-forming cells differentiated into HMB45-positive melanocytes, which migrated from the dermis to the epidermis and aligned singly among the basal layer keratinocytes in a similar fashion to pigmented melanocytes isolated from the epidermis. The dermal stem cells were negative for E-cadherin and N-cadherin, whereas they acquired E-cadherin expression and lost NGFRp75 expression upon contact with epidermal keratinocytes. These results demonstrate that stem cells in the dermis of human skin with neural-crest-like characteristics can become mature epidermal melanocytes. This finding could significantly change our understanding of the etiological factors in melanocyte transformation and pigmentation disorders; specifically, that early epigenetic or genetic alterations leading to transformation may take place in the dermis rather than in the epidermis.

  9. Renal cell carcinomas with t(6;11)(p21;q12) presenting with tubulocystic renal cell carcinoma-like features.

    PubMed

    Rao, Qiu; Zhang, Xiu-Mei; Tu, Pin; Xia, Qiu-Yuan; Shen, Qin; Zhou, Xiao-Jun; Shi, Qun-Li

    2013-01-01

    In this study, we reported an additional genetically confirmed case of renal cell carcinomas (RCCs) with t(6;11)(p21;q12) showing an unusual histological pattern. Histologically, the tumor was entirely composed of small to intermediate sized tubules and cysts. The tubules and cysts were lined by a single layer of flat, hobnail, cuboidal to columnar epithelial cells. Most cells demonstrated abundant eosinophilic cytoplasm with regular, round or oval nuclei and some inconspicuous nucleoli. All these morphological features are suggestive of tubulocystic carcinoma of the kidney. However, the tumor demonstrated moderately (2+) or strongly (3+) positive staining for TFEB, Cathepsin K, Ksp-cadherin, and vimentin but negative for TFE3, CD10, HMB45, melan A, CKpan, and CK7. Using a recently developed TFEB split FISH assay, the presence of TFEB rearrangement was demonstrated. Our results support the clinical application of a TFEB break-apart FISH assay for diagnosis and confirmation of TFEB RCC and further expand the morphologic spectrum that may be present in these neoplasms, sometimes raising a challenging differential diagnosis with other renal tumors.

  10. Coexistent loss of INI1 and BRG1 expression in a rhabdoid renal cell carcinoma (RCC): implications for a possible role of SWI/SNF complex in the pathogenesis of RCC.

    PubMed

    Rao, Qiu; Xia, Qiu-Yuan; Shen, Qin; Shi, Shan-Shan; Tu, Pin; Shi, Qun-Li; Zhou, Xiao-Jun

    2014-01-01

    In this study, we analyzed the immunohistochemical and molecular profiles of an unusual RCC showed coexistent absence of INI1 and BRG1 expression, rhabdoid morphology, and poor prognosis. Histologically, the tumor had rhabdoid features, which were demonstrated by large round to polygonal cells with eccentric nuclei, prominent nucleoli, and eosinophilic cytoplasm varying from abundant to scanty. Immunohistochemically, the tumor were positive for BRM, PBRM1, ARID1A, CD10, CKpan, Vimentin, carbonic anhydrase IX (CA-IX), and P504S (AMACR) but negative for INI1, BRG1, HMB45, melan A, CK7, CD117, Ksp-cadherin, TFEB, TFE3, and Cathepsin K. We detected all three exons status of the VHL gene of the tumor and observed 1 somatic mutations in 1st exon. Chromosome 3p deletion, coupled with polysomy of chromosome 3 was also found. Based on these findings, it is further indicated that in some cases, rhabdoid RCC may arise from clear cell RCC. SWI/SNF chromatin remodeling complex may be an attractive candidate for being the "second hit" in RCCs and may play an important role during tumor progression. The role of SWI/SNF complex in rhabdoid RCC should be further studied on a larger number of cases.

  11. Cell proliferation and expression of connexins differ in melanotic and amelanotic canine oral melanomas.

    PubMed

    Teixeira, Tarso Felipe; Gentile, Luciana Boffoni; da Silva, Tereza Cristina; Mennecier, Gregory; Chaible, Lucas Martins; Cogliati, Bruno; Roman, Marco Antonio Leon; Gioso, Marco Antonio; Dagli, Maria Lucia Zaidan

    2014-03-01

    Melanoma is a malignant neoplasm occurring in several animal species, and is the most frequently found tumor in the oral cavity in dogs. Melanomas are classified into two types: melanotic and amelanotic. Prior research suggests that human amelanotic melanomas are more aggressive than their melanotic counterparts. This study evaluates the behavior of canine melanotic and amelanotic oral cavity melanomas and quantifies cell proliferation and the expression of connexins. Twenty-five melanomas (16 melanotic and 9 amelanotic) were collected from dogs during clinical procedures at the Veterinary Hospital of the School of Veterinary Medicine and Animal Science of the University of São Paulo, Brazil. After diagnosis, dogs were followed until death or euthanasia. Histopathology confirmed the gross melanotic or amelanotic characteristics and tumors were classified according to the WHO. HMB45 or Melan A immunostainings were performed to confirm the diagnosis of amelanotic melanomas. Cell proliferation was quantified both by counting mitotic figures and PCNA positive nuclei. Expressions of connexins 26 and 43 were evaluated by immunohistochemistry, qRT-PCR and Western blot. Dogs bearing amelanotic melanomas presented a shorter lifespan in comparison to those with melanotic melanomas. Cell proliferation was significantly higher in amelanotic melanomas. Expressions of Connexins 26 and 43 were significantly reduced in amelanotic melanomas. The results presented here suggest that oral cavity melanotic and amelanotic melanomas differ regarding their behavior, cell proliferation and connexin expression in dogs, indicating a higher aggressiveness of amelanotic variants. PMID:24126842

  12. Unusual focal keratin expression in plexiform angiomyxoid myofibroblastic tumor

    PubMed Central

    Quero, Giuseppe; Musarra, Teresa; Carrato, Alfredo; Fici, Michelangelo; Martini, Maurizio; Dei Tos, Angelo Paolo; Alfieri, Sergio; Ricci, Riccardo

    2016-01-01

    Abstract Background: Plexiform angiomyxoid myofibroblastic tumor (PAMT), also known as plexiform fibromyxoma, is a rare distinctive benign intramural tumor, typical of gastric antrum, commonly causing mucosal ulceration with upper gastrointestinal bleeding and anemia, effectively treated by complete surgical resection usually accomplished by distal gastrectomy. Methods and Results: We herein report a 47-year-old man presenting with a syncopal episode, regurgitation and epigastric discomfort, bearing a gastric antral myxoid plexiform tumor positive for α-smooth muscle actin, vimentin and, partially, for caldesmon, desmin, and CD10; CD117, DOG1, CD34, S100, CAM5.2, CK20, CK7, EMA, p53, CDX2, chromogranin A, synaptophysin, anaplastic lymphoma kinase, Melan-A, and HMB-45 were all negative. All these features are typical of PAMT. Of note, focal positivity for AE1/AE3 and pan-CK KL1 was also present. Conclusions: The finding of a focal keratin expression in PAMT contributes to enlarge the immunophenotypic spectrum of this tumor type and is relevant for avoiding presurgical misdiagnoses which could ultimately lead to inappropriate overtreatment of patients with PAMT. PMID:27428222

  13. Pulmonary lymphangioleiomyomatosis: unusual manifestations of multiple large pulmonary nodules with retroperitoneal lymph node involvement mimicking metastatic malignancy.

    PubMed

    Kim, Hye-Jung; Lee, Chang-Hoon; Kim, Yong-A; Han, Daehee; Moon, Hyeon Jong; Cheon, Hey Won; Chung, Hee Soon; Kim, Deog Kyeom

    2009-01-01

    Pulmonary lymphangioleiomyomatosis (LAM) is a rare, idiopathic disorder that predominantly affects the lung parenchyma of women of childbearing age. While the characteristic radiographic finding of pulmonary LAM consists of multiple well-defined thin-walled cysts, we describe a very unusual case of pulmonary LAM with multiple bilateral large pulmonary nodules and retroperitoneal involvement mimicking metastatic malignancy. A 48-year-old woman who had never smoked with a history of bilateral pneumothorax presented with progressive exertional dyspnea and abdominal discomfort. Imaging studies revealed multiple enlarged retroperitoneal lymph nodes, ascites and bilateral multiple large pulmonary nodules ranging from 3 to 18 mm in diameter. Exploratory laparoscopic surgery for intra-abdominal lesions and video-assisted thoracoscopic wedge resection of lung nodules were carried out to rule out metastatic malignancy. Pathology showed benign looking smooth muscle cell proliferation and immunoreactivity for α-smooth muscle actin and HMB-45 in both specimens. After treatment with GnRH antagonist, the patient was well over a 6-month period without evidence of disease progression.

  14. [A case of incidentally diagnosed retroperitoneal lymphangioleiomyomatosis with no respiratory symptoms].

    PubMed

    Tanaka, Ken; Miyazaki, Jun; Uchida, Masahiro; Ichioka, Daishi; Kimura, Tomokazu; Oikawa, Takehiro; Suetomi, Takahiro; Kawai, Koji; Uesugi, Noriko; Nasu, Katsuhiro; Nishiyama, Hiroyuki

    2013-11-01

    A 39-year-old woman presented with a large retroperitoneal tumor found incidentally in a routine examination. The 138×37×26 mm mass was located in the left paraaortic region. Blood tests and urinalyses including endocrinological examinations revealed no abnormalities. A chest computed tomography revealed multiple thin-walled pulmonary cysts, which is a characteristic of lymphangioleiomyomatosis (LAM). Because the findings strongly suggested that the retroperitoneal tumor was an extrapulmonary manifestion of LAM, we performed laparoscopic resection of the tumor for diagnosis and treatment. The pathological diagnosis was LAM. The tumor cells were immunohistochemically positive for α -smooth muscle actin and weakly positive for HMB45, which is consistent with LAM. The cells were also positive for estrogen receptor (ER) and progesterone receptor (PgR). LAM is a rare progressive disease that affects mainly the lung, and leads to chronic respiratory failure. Extrapulmonary LAM without respiratory symptoms, is extremely rare. In the past, the prognosis of LAM was poor, with a median survival of 8-10 years, but now 85% survive more than 10 years. In the present case, deterioration of pulmonary lesions was not observed during the 10 months follow-up. Because ERand PgRfindings were positive, we will consider hormonal therapy as a treatment option, when the pulmonary lesions progress in the present case.

  15. [Chronic renal failure and tuberous sclerosis. Report of two clinical cases].

    PubMed

    Granata, A; Sessa, A; Pitangolo, F; Spata, C; Sicurezza, E; Costantino, G; Matera, M; Castellino, S

    2002-12-01

    Tuberous sclerosis complex (TSC) is an autosomal dominant hereditary disease characterized by a high rate of spontaneous mutations involving at least two loci: TSC(1) (9q34) and TSC(2) (16p13). It results in hamartomas or tumours which can affect a variety of organs, most commonly the brain, skin and kidneys. At least half of patients with TSC have underlying renal pathology, most commonly angiomyolipomas (AML) and/or cysts with, more rarely, adenocarcinoma, but oncocytomas, sarcomas, interstitial fibrosis and glomerulosclerosis have all been reported. Renal disorders may be asymptomatic or associated with acute lumbar ache, hematuria, abdominal mass, retroperitoneal hemorrhage. Renal failure is infrequent. The diagnosis of this disease is often performed, as in the present cases, very late and it is made possible by radiological examinations such as TC scan o RMI (when renal failure is present), usually performed after macrohaematuria or abdominal or renal colics or renal failure. When fatty tissue cannot be demonstrated within renal lesion (as in the female case), biopsy can be undertaken to exclude malignancy. Histology at the edge of an AML may look like renal carcinoma, but recent studies suggest that it can be differentiated by staining for HMB-45 which is positive in AML and negative in carcinoma. Two cases of tuberous sclerosis with different neurological fenotype, with bilateral renal angiomyolipomatosis and heavy renal failure, are presented.

  16. Retroperitoneal lymphangioleiomyomatosis associated with endosalpingiosis.

    PubMed

    Fukunaga, Masaharu; Mistuda, Aki; Shibuya, Kazuhiro; Honda, Yoshiko; Shimada, Nagato; Koike, Junichi; Sugimoto, Motonobu

    2007-12-01

    A case of retroperitoneal lymphangioleiomyomatosis (LAM) arising from endosalpingiosis is described. A 25-year-old woman with no history of tuberous sclerosis or hormonal therapy presented with a painless, palpable abdominal mass. Computed tomographic and magnetic resonance imaging studies of the abdomen demonstrated a 4 cm cystic mass in the retroperitoneum. Macroscopically, the excised retroperitoneal cyst was multilocular and measured 4.0 x 3.5 x 3.5 cm. Histologically, the lesion demonstrated three components. The first comprised multiple cysts or glands lined by columnar epithelial cells with cilia. The second component was a condensation of small stromal cells immediately subjacent to the cystic epithelium or glands. The third component was a thick exterior wall composed of plump spindle cells with clear to palely eosinophilic cytoplasm in a fascicular pattern, and slit-like vascular spaces, resembling LAM. Immunohistochemically, the epithelium and glands were positive for cytokeratin 7. The stromal cells were positive for vimentin and CD10. The cells of the LMA-like component showed positive staining for HMB45, alpha-smooth muscle actin, muscle actin and h-caldesmon. The lesion, LAM arising from endosalpingiosis, represents a distinctive pathologic entity that should be recognized and studied further. This type of lesion should be included in the differential diagnosis of retroperitoneal cystic lesions.

  17. Lymphangiomyomatosis arising in the pelvic cavity: a case report.

    PubMed

    Kim, Hun-Soo; Park, Moon-Il; Suh, Kwang-Sun

    2005-10-01

    Lymphangioleiomyomatosis (LAM) is a rare disease usually occurring in young women of child-bearing age. It is characterized by a distinctive proliferation of lymphatic smooth muscle cells, especially occurring in the pulmonary parenchyme. The majority of primary LAM occurs in the lung, but there are a few reports of extrapulmonary cases. We report a case of a 21-yr-old female who first complained of low abdominal pain and was referred from a local clinic with the impression of an ovarian cyst. Gynecologic ultrasonography revealed a large posterior pelvic mass with an irregular echogenicity measuring 9.7 x 4.2 cm in size. Pelviscopy showed a large, thin walled, partly cystic, pelvic mass. The mass was partly removed. Microscopically, the mass was characterized by a haphazard proliferation of smooth muscle cells arranged in fascicular, trabecular, and papillary patterns around a ramifying network of endothelium-lined spaces. The cells were plump or epithelioid with abundant eosinophilic cytoplasm and showed a positive reaction for both alpha-smooth muscle actin and HMB-45 antigen. Surgical and pathological findings were consistent with pelvic retroperitoneal LAM. Despite the numerous treatment attempts, the patient suffered from intractable chylous ascites and developed pulmonary LAM and died due to severe respiratory distress.

  18. Lipomatous Change in Uveal Melanoma: Histopathological, Immunohistochemical and Cytogenetic Analysis

    PubMed Central

    Yavuzyigitoglu, Serdar; Kilic, Emine; Vaarwater, Jolanda; de Klein, Annelies; Paridaens, Dion; Verdijk, Robert M.

    2016-01-01

    Purpose The aim of this study was to describe a case of lipomatous change in uveal melanoma. Procedures The patient presented with a 2-year history of blurry vision. A full examination of the right eye revealed a dome-shaped pigmented subretinal mass in the choroid with a thickness of 9 mm and a diameter of 15 mm. The eye was enucleated and prepared for histopathologic, genetic and molecular investigation. Results Histopathology revealed a small circumscribed area consisting of mature adipocytic appearing cells with abundant clear cytoplasm and small peripheral flattened nuclei within a spindle-cell melanoma of the uvea. The cytoplasm of the adipocytic cells stained negative for periodic acid-Schiff and Alcian blue and positive for Melan-A, HMB-45 and tyrosinase, confirming melanocytic lineage. Fluorescence in situ hybridization analysis confirmed trisomy of chromosome 6p22 and disomy of chromosome 3p13 in the nuclei of both the tumor spindle type B cells and in the nuclei of lipomatous tumor cells. Conclusions Lipomatous change can be added to the many histopathologic faces of uveal melanoma. To our knowledge, this is the first report of lipomatous change in uveal melanoma performed with cytogenetic investigations. PMID:27239451

  19. Clinical categories of exaggerated skin reactions to mosquito bites and their pathophysiology.

    PubMed

    Tatsuno, Kazuki; Fujiyama, Toshiharu; Matsuoka, Hiroyuki; Shimauchi, Takatoshi; Ito, Taisuke; Tokura, Yoshiki

    2016-06-01

    Mosquito bites are skin irritating reactions, which usually resolve spontaneously without intensive medical care. However, in certain situations, mosquito bites may form a more vicious reaction, sometimes accompanying fever and systemic symptoms. In such cases, the presence of rare hematological disorders, abnormalities in eosinophils and/or association with Epstein-Barr virus (EBV) may underlie. Importantly, hypersensitivity to mosquito bites (HMB), which is characterized by necrotic skin reactions to mosquito bites with various systemic symptoms, is often observed in association with EBV infection and natural killer (NK) cell lymphoproliferative disorder. Exaggerated skin reaction to mosquito bites is also seen in Wells' syndrome. While strong Th2-skewing immune dysregulation is apparent in the patients, they also show robust CD4(+) T cell proliferation in response to mosquito salivary gland extracts, indicating close association between Wells' syndrome and mosquito bites. Similar skin reaction to mosquito bites is also noticed in certain types of B cell neoplasm, although the role of B cells in this peculiar reaction to mosquito bites is yet to be elucidated. In this review, we will discuss the current knowledge of exaggerated reaction toward mosquito bites seen in conjunction with these unique hematological disorders, and examine the scientific studies and observations reported in previous literatures to organize our current understanding of the pathogenesis of this distinct disorder.

  20. Cellular Neurothekeoma of the Scalp in the Elderly.

    PubMed

    Park, Min-Cheol; Seung, Won-Bae

    2016-04-01

    Cellular neurothekeoma (CNT) is an uncommon variant of neurothekeoma that is composed of pithelioid to spindled cells with variable nuclear atypia or pleomorphism but no myxoid stroma. CNT occurs predominantly in the head and neck or upper trunk of children and young adults, with female predominance. The following case is different from typical CNTs. An 88-year-old female presented with a palpable mass on the scalp, which we excised. Histologically, the tumor was non-encapsulated and composed of spindled and epithelioid cells arranged in fascicles and nodules separated by a collagen-rich stroma. Immunohistochemical analysis showed that the epithelioid and spindle-shaped cells were focally positive for vimentin, neuron-specific enolase, smooth muscle actin, CD68, and CD10 but negative for S-100 protein, HMB-45, epithelial membrane antigen, and CD34. We report a new case of CNT that arose in the scalp of an older patient and that was associated with uncommon clinical, histological, and immunohistochemical profiles. PMID:27195257

  1. Coexistent loss of INI1 and BRG1 expression in a rhabdoid renal cell carcinoma (RCC): implications for a possible role of SWI/SNF complex in the pathogenesis of RCC.

    PubMed

    Rao, Qiu; Xia, Qiu-Yuan; Shen, Qin; Shi, Shan-Shan; Tu, Pin; Shi, Qun-Li; Zhou, Xiao-Jun

    2014-01-01

    In this study, we analyzed the immunohistochemical and molecular profiles of an unusual RCC showed coexistent absence of INI1 and BRG1 expression, rhabdoid morphology, and poor prognosis. Histologically, the tumor had rhabdoid features, which were demonstrated by large round to polygonal cells with eccentric nuclei, prominent nucleoli, and eosinophilic cytoplasm varying from abundant to scanty. Immunohistochemically, the tumor were positive for BRM, PBRM1, ARID1A, CD10, CKpan, Vimentin, carbonic anhydrase IX (CA-IX), and P504S (AMACR) but negative for INI1, BRG1, HMB45, melan A, CK7, CD117, Ksp-cadherin, TFEB, TFE3, and Cathepsin K. We detected all three exons status of the VHL gene of the tumor and observed 1 somatic mutations in 1st exon. Chromosome 3p deletion, coupled with polysomy of chromosome 3 was also found. Based on these findings, it is further indicated that in some cases, rhabdoid RCC may arise from clear cell RCC. SWI/SNF chromatin remodeling complex may be an attractive candidate for being the "second hit" in RCCs and may play an important role during tumor progression. The role of SWI/SNF complex in rhabdoid RCC should be further studied on a larger number of cases. PMID:24817979

  2. Pediatric Papillary Renal Cell Carcinoma in a Horseshoe Kidney: A Case Report with Review of the Literature.

    PubMed

    Loya-Solis, Abelardo; Alemán-Meza, Lucía; Canales-Martínez, Luis Carlos; Franco-Márquez, Rodolfo; Rincón-Bahena, Alim Adriana; Nuñez-Barragán, Karla María; Garza-Guajardo, Raquel; Ponce-Camacho, Marco Antonio

    2015-01-01

    Renal cell carcinoma is the most common malignancy of the kidney in adults. In children, however, it only accounts for an estimated 1.8 to 6.3% of all pediatric malignant renal tumors. Papillary renal cell carcinoma is the second most common type of renal cell carcinoma in children. We present the case of a 12-year-old boy with a 2-month history of abdominal pain, unexplained weight loss, and gross hematuria. Computed tomography revealed a horseshoe kidney and a well-defined mass of 4 cm arising from the lower pole of the right kidney. Microscopically the tumor was composed of papillae covered with cells with abundant eosinophilic cytoplasm and high-grade nuclei with prominent nucleoli. Immunohistochemistry was performed; EMA, Vimentin, and AMACR were strongly positive while CK7, CD10, RCC antigen, TFE3, HMB-45, and WT-1 were negative. Currently, 10 months after the surgical procedure, the patient remains clinically and radiologically disease-free. PMID:26301110

  3. Renal cell carcinomas with t(6;11)(p21;q12) presenting with tubulocystic renal cell carcinoma-like features.

    PubMed

    Rao, Qiu; Zhang, Xiu-Mei; Tu, Pin; Xia, Qiu-Yuan; Shen, Qin; Zhou, Xiao-Jun; Shi, Qun-Li

    2013-01-01

    In this study, we reported an additional genetically confirmed case of renal cell carcinomas (RCCs) with t(6;11)(p21;q12) showing an unusual histological pattern. Histologically, the tumor was entirely composed of small to intermediate sized tubules and cysts. The tubules and cysts were lined by a single layer of flat, hobnail, cuboidal to columnar epithelial cells. Most cells demonstrated abundant eosinophilic cytoplasm with regular, round or oval nuclei and some inconspicuous nucleoli. All these morphological features are suggestive of tubulocystic carcinoma of the kidney. However, the tumor demonstrated moderately (2+) or strongly (3+) positive staining for TFEB, Cathepsin K, Ksp-cadherin, and vimentin but negative for TFE3, CD10, HMB45, melan A, CKpan, and CK7. Using a recently developed TFEB split FISH assay, the presence of TFEB rearrangement was demonstrated. Our results support the clinical application of a TFEB break-apart FISH assay for diagnosis and confirmation of TFEB RCC and further expand the morphologic spectrum that may be present in these neoplasms, sometimes raising a challenging differential diagnosis with other renal tumors. PMID:23826432

  4. Como Lo Hago Yo: Myelomeningocele

    PubMed Central

    Lazareff, Jorge

    2014-01-01

    Fortificación con ádico fólico es efectiva, pero aún falta conciencia en los jóvenes. La legalidad del aborto aumenta la importancia de la consulta prenatal. Realizo la cirugía bajo microcoscopio por razones didácticas. Irrigación continua para reducir la temperatura del tejido. Trato a la plaqueta como tejido viable. No suturo la plaqueta. No cierro músculo. ATB por una semana después de cirugía. Hidrocefalia: Válvula en todos los casos de ventriculomegalia. Médula anclada: Desanclar una sola vez. Chiari II: Revisar la válvula. Incluir en el seguimiento rendimiento escolar, puede indicar obstrucción de la válvula o médula anclada. PMID:24791217

  5. [TOBACCO CONSUMPTION AMONG ADULTS IN MONTERREY: RELATION TO EXERCISE REGULARLY AND FAMILY].

    PubMed

    Ruiz-Juan, Francisco; Isorna-Folgar, Manuel; Ruiz-Risueño, Jorge; Vaquero-Cristóbal, Raquel

    2015-08-01

    Objetivo: determinar la relación entre práctica físico- deportiva y consumo de tabaco en adultos mexicanos en función de una serie de variables sociodemográficas y la influencia de la familia sobre estos hábitos. Métodos: 978 adultos mexicanos (483 varones y 495 mujeres) fueron entrevistados mediante cuestionario por rutas aleatorias. Se utilizó una regresión logística multinomial para calcular odds ratio (OR) e intervalo de confianza (IC = 95%). Resultados: ser hombre es un factor de riesgo en cuanto a la frecuencia y cantidad de tabaco consumido. La franja de edad en la que aumenta la probabilidad de consumir tabaco es la de 18 a 45 años, siendo el riesgo de fumar menor a medida que la edad aumenta. El riesgo de consumir tabaco se ve significativamente disminuido entre aquellos que no tienen estudios. Los que nunca han realizado ejercicio físico tienen una menor probabilidad de fumar, siendo los que la han abandonado los que con más frecuencia fuman. El contexto familiar constituye un factor de riesgo manifiesto en relación con la frecuencia de consumo de tabaco. Con respecto a la relación con el consumo de alcohol, se ha detectado que los consumidores de alcohol tienen más probabilidad de ser fumadores. Conclusiones: el consumo de tabaco en altas frecuencias y cantidades y la práctica de actividad física son conductas que están inversamente relacionadas. También se ha detectado una relación directamente proporcional entre la frecuencia y la cantidad de consumo de tabaco y alcohol, así como una gran influencia de la familia en el hábito de fumar.

  6. Modeling oxygenation in venous blood and skeletal muscle in response to exercise using near-infrared spectroscopy

    PubMed Central

    Lai, Nicola; Zhou, Haiying; Saidel, Gerald M.; Wolf, Martin; McCully, Kevin; Gladden, L. Bruce; Cabrera, Marco E.

    2009-01-01

    exercise and then increases monotonically. Under hypoxia, Coxy decreases exponentially to a steady state within ∼2 min. In contrast, model simulations of venous oxygen concentration show an exponential decrease under both conditions due to the imbalance between oxygen delivery and consumption at the onset of exercise. Also, model simulations that distinguish the dynamic responses of oxy-and deoxygenated Hb (HbO2, HHb) and Mb (MbO2, HMb) concentrations (Coxy = HbO2 + MbO2; Cdeoxy = HHb + HMb) show that Hb and Mb contributions to the NIRS signal are comparable. Analysis of NIRS signal components during exercise with a mechanistic model of oxygen transport and metabolism indicates that changes in oxygenated Hb and Mb are responsible for different patterns of \\documentclass[10pt]{article} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{pmc} \\usepackage[Euler]{upgreek} \\pagestyle{empty} \\oddsidemargin -1.0in \\begin{document} \\begin{equation*}{\\mathrm{Sm}}_{{\\mathrm{O}}_{2}}\\end{equation*}\\end{document} and SvO2 dynamics observed under normoxia and hypoxia. PMID:19342438

  7. Endothelin-1 in the tumor microenvironment correlates with melanoma invasion.

    PubMed

    Chiriboga, Luis; Meehan, Shane; Osman, Iman; Glick, Michael; de la Cruz, Gelo; Howell, Brittny S; Friedman-Jiménez, George; Schneider, Robert J; Jamal, Sumayah

    2016-06-01

    Endothelin-1 (ET-1) is a vasoactive peptide that also plays a role in the tanning response of the skin. Animal and cell culture studies have also implicated ET-1 in melanoma progression, but no association studies have been performed to link ET-1 expression and melanoma in humans. Here, we present the first in-vivo study of ET-1 expression in pigmented lesions in humans: an ET-1 immunohistochemical screen of melanocytic nevi, melanoma in situ lesions, invasive melanomas, metastatic melanomas, and blue nevi was performed. Twenty-six percent of melanocytic nevi and 44% of melanoma in situ lesions demonstrate ET-1 expression in the perilesional microenvironment, whereas expression in nevus or melanoma cells was rare to absent. In striking contrast, 100% of moderately to highly pigmented invasive melanomas contained numerous ET-1-positive cells in the tumor microenvironment, with 79% containing ET-1-positive melanoma cells, confirmed by co-staining with melanoma tumor marker HMB45. Hypopigmented invasive melanomas had reduced ET-1 expression, suggesting a correlation between ET-1 expression and pigmented melanomas. ET-1-positive perilesional cells were CD68-positive, indicating macrophage origin. Sixty-two percent of highly pigmented metastatic melanomas demonstrated ET-1 expression in melanoma cells, in contrast to 28.2% of hypopigmented specimens. Eighty-nine percent of benign nevi, known as blue nevi, which have a dermal localization, were associated with numerous ET-1-positive macrophages in the perilesional microenvironment, but no ET-1 expression was detected in the melanocytes. We conclude that ET-1 expression in the microenvironment increases with advancing stages of melanocyte transformation, implicating a critical role for ET-1 in melanoma progression, and the importance of the tumor microenvironment in the melanoma phenotype.

  8. Diagnostic Approach to Eosinophilic Renal Neoplasms

    PubMed Central

    Kryvenko, Oleksandr N.; Jorda, Merce; Argani, Pedram; Epstein, Jonathan I.

    2015-01-01

    Context Eosinophilic renal neoplasms include a spectrum of solid and papillary tumors ranging from indolent benign oncocytoma to highly aggressive malignancies. Recognition of the correct nature of the tumor, especially in biopsy specimens, is paramount for patient management. Objective To review the diagnostic approach to eosinophilic renal neoplasms with light microscopy and ancillary techniques. Data Sources Review of the published literature and personal experience. Conclusions The following tumors are in the differential diagnosis of oncocytic renal cell neoplasm: oncocytoma, chromophobe renal cell carcinoma (RCC), hybrid tumor, tubulocystic carcinoma, papillary RCC, clear cell RCC with predominant eosinophilic cell morphology, follicular thyroid-like RCC, hereditary leiomyomatosis–associated RCC, acquired cystic disease–associated RCC, rhabdoid RCC, microphthalmia transcription factor translocation RCC, epithelioid angiomyolipoma, and unclassified RCC. In low-grade nonpapillary eosinophilic neoplasms, distinction between oncocytoma and low-grade RCC mostly rests on histomorphology; however, cytokeratin 7 immunostain may be helpful. In high-grade nonpapillary lesions, there is more of a role for ancillary techniques, including immunohistochemistry for cytokeratin 7, CA9, CD10, racemase, HMB45, and Melan-A. In papillary eosinophilic neoplasms, it is important to distinguish sporadic type 2 papillary RCC from microphthalmia transcription factor translocation and hereditary leiomyomatosis–associated RCC. Histologic and cytologic features along with immunohistochemistry and fluorescence in situ hybridization tests for TFE3 (Xp11.2) and TFEB [t(6;11)] are reliable confirmatory tests. Eosinophilic epithelial neoplasms with architecture, cytology, and/or immunoprofile not qualifying for either of the established types of RCC should be classified as unclassified eosinophilic RCC and arbitrarily assigned a grade (low or high). PMID:25357116

  9. Molecular and biochemical characterization of mannitol-1-phosphate dehydrogenase from the model brown alga Ectocarpus sp.

    PubMed

    Bonin, Patricia; Groisillier, Agnès; Raimbault, Alice; Guibert, Anaïs; Boyen, Catherine; Tonon, Thierry

    2015-09-01

    The sugar alcohol mannitol is important in the food, pharmaceutical, medical and chemical industries. It is one of the most commonly occurring polyols in nature, with the exception of Archaea and animals. It has a range of physiological roles, including as carbon storage, compatible solute, and osmolyte. Mannitol is present in large amounts in brown algae, where its synthesis involved two steps: a mannitol-1-phosphate dehydrogenase (M1PDH) catalyzes a reversible reaction between fructose-6-phosphate (F6P) and mannitol-1-phosphate (M1P) (EC 1.1.1.17), and a mannitol-1-phosphatase hydrolyzes M1P to mannitol (EC 3.1.3.22). Analysis of the model brown alga Ectocarpus sp. genome provided three candidate genes for M1PDH activities. We report here the sequence analysis of Ectocarpus M1PDHs (EsM1PDHs), and the biochemical characterization of the recombinant catalytic domain of EsM1PDH1 (EsM1PDH1cat). Ectocarpus M1PDHs are representatives of a new type of modular M1PDHs among the polyol-specific long-chain dehydrogenases/reductases (PSLDRs). The N-terminal domain of EsM1PDH1 was not necessary for enzymatic activity. Determination of kinetic parameters indicated that EsM1PDH1cat displayed higher catalytic efficiency for F6P reduction compared to M1P oxidation. Both activities were influenced by NaCl concentration and inhibited by the thioreactive compound pHMB. These observations were completed by measurement of endogenous M1PDH activity and of EsM1PDH gene expression during one diurnal cycle. No significant changes in enzyme activity were monitored between day and night, although transcription of two out of three genes was altered, suggesting different levels of regulation for this key metabolic pathway in brown algal physiology. PMID:26232554

  10. Detection of toxin proteins from Bacillus thuringiensis strain 4.0718 by strategy of 2D-LC-MS/MS.

    PubMed

    Yang, Qi; Tang, Sijia; Rang, Jie; Zuo, Mingxing; Ding, Xuezhi; Sun, Yunjun; Feng, Pinghui; Xia, Liqiu

    2015-04-01

    Bacillus thuringiensis is a kind of insecticidal microorganism which can produce a variety of toxin proteins, it is particularly important to find an effective strategy to identify novel toxin proteins rapidly and comprehensively with the discovery of the wild-type strains. Multi-dimensional high-performance liquid chromatography combined with mass spectrometry has become one of the main methods to detect and identify toxin proteins and proteome of B. thuringiensis. In this study, protein samples from B. thuringiensis strain 4.0718 were analyzed on the basis of two-dimensional liquid chromatography-tandem mass spectrometry (2D-LC-MS/MS), and tryptic peptides of whole cell from the late sporulation phase were eluted at different concentration gradients of ammonium chloride and followed by secondary mass spectrum identification. 831 and 894 proteins were identified from two biological replicates, respectively, while 1,770 and 1,859 peptides were detected correspondingly. Among the identified proteins and peptides, 606 proteins and 1,259 peptides were detected in both replicates, which mean that 1,119 proteins and 2,370 peptides were unique to the proteome of this strain. A total of 15 toxins have been identified successfully, and seven of them were firstly discovered in B. thuringiensis strain 4.0718 that were Crystal protein (A1E259), pesticidal protein (U5KS09), Cry2Af1 (A4GVF0), Cry2Ad (Q9RM89), Cry1 (K4HMB5), Cry1Bc (Q45774), and Cry1Ga (Q45746). The proteomic strategy employed in the present study has provided quick and exhaustive identification of toxins produced by B. thuringiensis.

  11. Molecular confirmation of t(6;11)(p21;q12) renal cell carcinoma in archival paraffin-embedded material using a break-apart TFEB FISH assay expands its clinicopathologic spectrum.

    PubMed

    Argani, Pedram; Yonescu, Raluca; Morsberger, Laura; Morris, Kerry; Netto, George J; Smith, Nathan; Gonzalez, Nilda; Illei, Peter B; Ladanyi, Marc; Griffin, Constance A

    2012-10-01

    A subset of renal cell carcinomas (RCCs) is characterized by t(6;11)(p21;q12), which results in fusion of the untranslated Alpha (MALAT1) gene to the TFEB gene. Only 21 genetically confirmed cases of t(6;11) RCCs have been reported. This neoplasm typically demonstrates a distinctive biphasic morphology, comprising larger epithelioid cells and smaller cells clustered around basement membrane material; however, the full spectrum of its morphologic appearances is not known. The t(6;11) RCCs differ from most conventional RCCs in that they consistently express melanocytic immunohistochemical (IHC) markers such as HMB45 and Melan A and the cysteine protease cathepsin K but are often negative for epithelial markers such as cytokeratins. TFEB IHC has been proven to be useful to confirm the diagnosis of t(6;11) RCCs in archival material, because native TFEB is upregulated through promoter substitution by the gene fusion. However, IHC is highly fixation dependent and has been proven to be particularly difficult for TFEB. A validated fluorescence in situ hybridization (FISH) assay for molecular confirmation of the t(6;11) RCC in archival formalin-fixed, paraffin-embedded material has not been previously reported. We report herein the development of a break-apart TFEB FISH assay for the diagnosis of t(6;11)(p21;q12) RCCs. We validated the assay on 4 genetically confirmed cases and 76 relevant expected negative control cases and used the assay to report 8 new cases that expand the clinicopathologic spectrum of t(6;11) RCCs. An additional previously reported TFEB IHC-positive case was confirmed by TFEB FISH in 46-year-old archival material. In conclusion, TFEB FISH is a robust, clinically validated assay that can confirm the diagnosis of t(6;11) RCC in archival material and should allow a more comprehensive clinicopathologic delineation of this recently recognized neoplastic entity.

  12. Identification of a human melanoma antigen recognized by tumor-infiltrating lymphocytes associated with in vivo tumor rejection.

    PubMed Central

    Kawakami, Y; Eliyahu, S; Delgado, C H; Robbins, P F; Sakaguchi, K; Appella, E; Yannelli, J R; Adema, G J; Miki, T; Rosenberg, S A

    1994-01-01

    The cultured T-cell line TIL1200, established from the tumor-infiltrating lymphocytes (TILs) of a patient with advanced metastatic melanoma, recognized an antigen on most HLA-A2+ melanomas and on all HLA-A2+ cultured neonatal melanocytes in an HLA-A2 restricted manner but not on other types of tissues or cell lines tested. A cDNA encoding an antigen recognized by TIL1200 was isolated by screening an HLA-A2+ breast cancer cell line transfected with an expression cDNA library prepared from an HLA-A2+ melanoma cell line. The nucleotide and amino acid sequences of this cDNA were almost identical to the genes encoding glycoprotein gp100 or Pmel17 previously registered in the GenBank. Expression of this gene was restricted to melanoma and melanocyte cell lines and retina but was not expressed on other fresh or cultured normal tissues or other types of tumor tested. The cell line transfected with this cDNA also expressed antigen recognized by the melanoma-specific antibody HMB45 that bound to gp100. A synthetic 10-amino acid peptide derived from gp100 was recognized by TIL1200 in the context of HLA-A2.1. Since the administration of TIL1200 plus interleukin 2 resulted in regression of metastatic cancer in the autologous patient, gp100 is a possible tumor rejection antigen and may be useful for the development of immunotherapies for patients with melanoma. Images PMID:8022805

  13. TFE3 Translocation Associated Perivascular Epithelioid Cell Neoplasm (PEComa) of the Gynecologic Tract: Morphology, Immunophenotype, Differential Diagnosis

    PubMed Central

    Schoolmeester, J. Kenneth; Dao, Linda N.; Sukov, William R.; Park, Kay J.; Murali, Rajmohan; Hameed, Meera R.; Soslow, Robert A.

    2016-01-01

    TFE3 translocation associated PEComa is a distinct form of perivascular epithelioid cell neoplasm, the features of which are poorly defined owing to their general infrequency and limited prior reports with confirmed rearrangement or fusion totaling nine cases. Recent investigation has found a lack of TSC gene mutation in these tumors compared to their nonrearranged counterparts which underscores the importance of recognizing the translocated variant due to hypothetical ineffectiveness of targeted mTOR inhibitor therapy. Six cases were identified and TFE3 rearrangement was confirmed by FISH. Patient age ranged 46 to 66 years (median 50) and none had a history of tuberous sclerosis complex. Three cases arose in the uterine corpus, one in the vagina, and one pelvic tumor and one pulmonary tumor were likely a recurrence/metastasis from a probable uterine primary. Five cases had purely clear cell epithelioid morphology that showed a spectrum of atypia while one case had a mixture of clear cell epithelioid and spindle cells. A mostly consistent immunophenotype was observed in the purely clear cell epithelioid cases: each demonstrated diffuse TFE3, HMB45, CathepsinK labeling, either focal or no melanA staining and variably weak reactivity to smooth muscle markers. The mixed clear cell epithelioid and spindle cell case had a similar pattern in its epithelioid component, but strong muscle marker positivity in its spindle cell component. Follow up ranged 1 to 57 months. Three cases demonstrated aggressive behavior and three cases had no evidence of recurrence. Both GYN-specific and traditional sets of criteria for malignancy were evaluated. The GYN model showed improved inclusion and specificity in comparison to the traditional model. PMID:25517951

  14. Malignant melanoma in the penguin: characterization of the clinical, histologic, and immunohistochemical features of malignant melanoma in 10 individuals from three species of penguin.

    PubMed

    Duncan, Ann E; Smedley, Rebecca; Anthony, Simon; Garner, Michael M

    2014-09-01

    Malignant melanomas are aggressive neoplasms that are relatively common in penguins compared to other avian species. In this study, the clinical and pathologic characteristics of melanocytic neoplasms in five macaroni (Eudyptes chrysolophus), three rock hopper (Eudyptes chrysocome), and two Humboldt (Spheniscus humboldti) penguins are described. Tumors most commonly occurred in the skin of the foot or hock, and were seen in the subcutaneous muscle, especially near the beak/oral cavity. Gross lesions were usually heavily pigmented, becoming raised and ulcerated over time. Humboldt penguins had a unique presentation, forming variably pigmented, cornified lesions in the inguinal area. Original case materials were obtained from all but two cases, and were assessed to define the characteristics of malignancy, evaluate four immunohistochemical markers for melanoma, and look for factors useful to informing prognosis and clinical decisions. Diagnosis was made histologically, based on morphologic features and pigmentation. Though not necessary for diagnosis, PNL-2 was found to be a useful immunohistochemical marker. HMB-45 showed unreliable positive labelling and S-100, Melan-A and Ki67 were not useful. Several factors were associated with prognosis, including gross surface dimension, mitotic index, depth of neoplastic cell invasion, and degree of surface ulceration. Metastatic spread occurred to the liver, lung, adrenal gland, brain, and bone; all lesions showed positive labelling to PNL-2. The average survival after diagnosis was 7 mo, though complete surgical excision of tumors less than 2.0 cm was curative in two cases and radiation therapy prolonged survival in one penguin. The underlying pathogenesis associated with the high prevalence of melanocytic neoplasms in captive penguins could not be identified. Three different molecular methods were performed to look for viral particles and results were negative. Advanced age is the most probable associated risk factor

  15. Insect bite reactions.

    PubMed

    Singh, Sanjay; Mann, Baldeep Kaur

    2013-01-01

    Insects are a class of living creatures within the arthropods. Insect bite reactions are commonly seen in clinical practice. The present review touches upon the medically important insects and their places in the classification, the sparse literature on the epidemiology of insect bites in India, and different variables influencing the susceptibility of an individual to insect bites. Clinical features of mosquito bites, hypersensitivity to mosquito bites Epstein-Barr virus NK (HMB-EBV-NK) disease, eruptive pseudoangiomatosis, Skeeter syndrome, papular pruritic eruption of HIV/AIDS, and clinical features produced by bed bugs, Mexican chicken bugs, assassin bugs, kissing bugs, fleas, black flies, Blandford flies, louse flies, tsetse flies, midges, and thrips are discussed. Brief account is presented of the immunogenic components of mosquito and bed bug saliva. Papular urticaria is discussed including its epidemiology, the 5 stages of skin reaction, the SCRATCH principle as an aid in diagnosis, and the recent evidence supporting participation of types I, III, and IV hypersensitivity reactions in its causation is summarized. Recent developments in the treatment of pediculosis capitis including spinosad 0.9% suspension, benzyl alcohol 5% lotion, dimethicone 4% lotion, isopropyl myristate 50% rinse, and other suffocants are discussed within the context of evidence derived from randomized controlled trials and key findings of a recent systematic review. We also touch upon a non-chemical treatment of head lice and the ineffectiveness of egg-loosening products. Knockdown resistance (kdr) as the genetic mechanism making the lice nerves insensitive to permethrin is discussed along with the surprising contrary clinical evidence from Europe about efficacy of permethrin in children with head lice carrying kdr-like gene. The review also presents a brief account of insects as vectors of diseases and ends with discussion of prevention of insect bites and some serious adverse effects

  16. Safety, Correlative Markers, and Clinical Results of Adjuvant Nivolumab in Combination with Vaccine in Resected High-Risk Metastatic Melanoma

    PubMed Central

    Gibney, Geoffrey T.; Kudchadkar, Ragini R.; DeConti, Ronald C.; Thebeau, Melissa S.; Czupryn, Maria P.; Tetteh, Leticia; Eysmans, Cabell; Richards, Allison; Schell, Michael J.; Fisher, Kate J.; Horak, Christine E.; Inzunza, H. David; Yu, Bin; Martinez, Alberto J.; Younos, Ibrahim; Weber, Jeffrey S.

    2015-01-01

    Purpose The anti-programmed death-1 (PD-1) antibody nivolumab (BMS-936558) has clinical activity in patients with metastatic melanoma. Nivolumab plus vaccine was investigated as adjuvant therapy in resected stage IIIC and IV melanoma patients. Experimental Design HLA-A*0201 positive patients with HMB-45, NY-ESO-1, and/or MART-1 positive resected tumors received nivolumab (1 mg/kg, 3 mg/kg, or 10 mg/kg i.v.) with a multi-peptide vaccine (gp100, MART-1, and NY-ESO-1 with Montanide ISA 51 VG) every 2 weeks for 12 doses followed by nivolumab maintenance every 12 weeks for 8 doses. Primary objective was safety and determination of a maximum tolerated dose (MTD). Secondary objectives included relapse-free survival (RFS), overall survival (OS), and immunologic correlative studies. Results Thirty-three patients were enrolled. Median age was 47 years; 55% were male. Two patients had stage IIIC disease; 31 patients had stage IV disease. Median follow-up was 32.1 months. MTD was not reached. Most common related adverse events (>40%) were vaccine injection site reaction, fatigue, rash, pruritus, nausea, and arthralgias. Five related grade 3 adverse events [hypokalemia (1), rash (1), enteritis (1), and colitis (2)] were observed. Ten of 33 patients relapsed. Estimated median RFS was 47.1 months; median OS was not reached. Increases in CTLA-4+/CD4+, CD25+Treg/CD4+, and tetramer specific CD8+ T-cell populations were observed with treatment (P < 0.05). Trends for lower baseline myeloid-derived suppressor cell and CD25+Treg/CD4+ populations were seen in nonrelapsing patients; PD-L1 tumor status was not significantly associated with RFS. Conclusions Nivolumab with vaccine is well tolerated as adjuvant therapy and demonstrates immunologic activity with promising survival in high-risk resected melanoma, justifying further study. PMID:25524312

  17. Malignant melanoma in the penguin: characterization of the clinical, histologic, and immunohistochemical features of malignant melanoma in 10 individuals from three species of penguin.

    PubMed

    Duncan, Ann E; Smedley, Rebecca; Anthony, Simon; Garner, Michael M

    2014-09-01

    Malignant melanomas are aggressive neoplasms that are relatively common in penguins compared to other avian species. In this study, the clinical and pathologic characteristics of melanocytic neoplasms in five macaroni (Eudyptes chrysolophus), three rock hopper (Eudyptes chrysocome), and two Humboldt (Spheniscus humboldti) penguins are described. Tumors most commonly occurred in the skin of the foot or hock, and were seen in the subcutaneous muscle, especially near the beak/oral cavity. Gross lesions were usually heavily pigmented, becoming raised and ulcerated over time. Humboldt penguins had a unique presentation, forming variably pigmented, cornified lesions in the inguinal area. Original case materials were obtained from all but two cases, and were assessed to define the characteristics of malignancy, evaluate four immunohistochemical markers for melanoma, and look for factors useful to informing prognosis and clinical decisions. Diagnosis was made histologically, based on morphologic features and pigmentation. Though not necessary for diagnosis, PNL-2 was found to be a useful immunohistochemical marker. HMB-45 showed unreliable positive labelling and S-100, Melan-A and Ki67 were not useful. Several factors were associated with prognosis, including gross surface dimension, mitotic index, depth of neoplastic cell invasion, and degree of surface ulceration. Metastatic spread occurred to the liver, lung, adrenal gland, brain, and bone; all lesions showed positive labelling to PNL-2. The average survival after diagnosis was 7 mo, though complete surgical excision of tumors less than 2.0 cm was curative in two cases and radiation therapy prolonged survival in one penguin. The underlying pathogenesis associated with the high prevalence of melanocytic neoplasms in captive penguins could not be identified. Three different molecular methods were performed to look for viral particles and results were negative. Advanced age is the most probable associated risk factor

  18. An unusual composite pilomatrix carcinoma with intralesional melanocytes: differential diagnosis, immunohistochemical evaluation, and review of the literature.

    PubMed

    Jani, Prashant; Chetty, Runjan; Ghazarian, Danny M

    2008-04-01

    We report a case of an extremely rare histologic combination of pilomatrix or pilomatrical carcinoma with admixed melanocytes within the same tumor mass. Pilomatrix carcinoma is a neoplasm of low-grade malignancy that is characterized by a tendency for recurrence but low risk of metastasis. A 77-year-old male presented with a nodule on the bridge of the nose that was excised. Histologically, it was typified by asymmetry and poor circumscription, the presence of several variably sized and shaped basaloid aggregations, and surface ulceration. The tumors were composed of pleomorphic basaloid cells with prominent nucleoli and frequent mitoses (some of which were atypical) accompanied by central areas with keratotic material, shadow cells, and foci of necrosis. In addition, intermingled with the pilomatrix carcinoma, several easily identified pigmented cells with dendritic processes were present singly and as small aggregates. There was no atypia associated with the melanocytic component. Immunohistochemistry revealed the CK14 to be positive mainly within the keratinizing and the squamous epithelial elements of the tumor. The melanocytic component was strongly immunoreactive for S100, melanoma cocktail (HMB45 and Melan-A), and microphthalmia transcription factor. Pilomatrix carcinoma with melanocytes should be distinguished from the conventional pilomatrixoma with pigmentation, melanocytic matricoma, melanoma, and pigmented basal cell carcinoma with matrical differentiation. Clinicians and pathologists should be aware of the occurrence of pilomatrix carcinoma with melanocytes because of its potential for diagnosis as melanoma. This peculiar lesion recapitulates the intimate relationship existing between matrical epithelium and melanocytes in the embryonal hair follicle or in the anagen stage of the hair cycle. It is possible that sun damage played a role in stimulating migration of melanocytes among matrical cells in this case.

  19. Cutaneous balloon cell dermatofibroma (fibrous histiocytoma).

    PubMed

    Tran, Tien Anh; Hayner-Buchan, Alida; Jones, David M; McRorie, Duane; Carlson, J Andrew

    2007-04-01

    Dermatofibroma (DF) or cutaneous fibrous histiocytoma is a common benign skin tumor that exhibits multiple, distinct histologic variants. Although clear cell DF has been described in the literature, balloon cell degeneration causing a clear cell DF phenotype has been not been reported to date. Herein, we describe the clinicopathologic findings of balloon cell DF arising on the heel of a 43-year-old man. Clinically, it presented as enlarging tan-white, ulcerated, firm 1.5 cm nodule, clinically suspected to be pyogenic granuloma. Excisional biopsy revealed a circumscribed fibrous tumor populated by mostly clear and spindle cells. A zonal arrangement separated the varied tumor cells where the most superficial, polypoid area showed large, clear polygonal balloon cells; the mid-dermal zone demonstrated a transition between balloon cells, epithelioid cells, and spindle cells; and the deep dermal zone had storiform arrangement of spindle cells, with the fascicles separated by coarse collagen bundles. A CD10+ > CD68+ > Factor XIIIa+ immunophenotype was identified with negative immunolabeling for S-100 protein, HMB-45, cytokeratin AE1/AE3, desmin, smooth muscle actin, lysozyme, and leukocyte common antigen (LCA). Ultrastructurally, the clear tumor cells were filled with multiple, empty, nonmembrane bound vacuoles of varying size. No recurrence has been described after complete excision and 7 months of follow up. DF with balloon cell change, likely secondary to persistent irritation, should be added to the differential diagnosis of cutaneous primary and metastatic neoplasms showing balloon cell degeneration such as balloon cell melanocytic nevi and renal cell carcinoma, respectively.

  20. Transmission of human papillomavirus DNA from patient to surgical masks, gloves and oral mucosa of medical personnel during treatment of laryngeal papillomas and genital warts.

    PubMed

    Ilmarinen, Taru; Auvinen, Eeva; Hiltunen-Back, Eija; Ranki, Annamari; Aaltonen, Leena-Maija; Pitkäranta, Anne

    2012-11-01

    The risk of occupational human papillomavirus (HPV) transmission from patient to medical personnel during laser vaporization procedures remains controversial. The purpose of this study was to determine the risk of HPV transmission from the patient to the protective surgical masks, gloves and oral mucosa of medical personnel during the treatment of laryngeal papillomas and genital warts. The study involved five male patients scheduled for the surgical treatment of laryngeal papillomas, and five male patients undergoing carbon dioxide (CO(2)) laser treatment for urethral warts. Oral mucosa specimens were obtained from the study patients and the employees pre- and postoperatively. Samples were collected from the HPV-infected patient tissue, and from the surgical masks and gloves used by the employees. A total of 120 samples were analyzed for the presence of HPV DNA by PCR, using the degenerated MY09/11/HMB01 primers. After the papilloma procedures, the surgeons' gloves tested HPV positive in one of the five cases and those of the surgical nurse in three of the five cases. After the treatment of genital warts, HPV DNA corresponding to the patient tissue specimens was present in all the samples obtained from the surgical gloves of the operators. All oral mucosa samples obtained from 18 different employees tested HPV negative, as did the surgical mask specimens. According to our study, HPV may contaminate protective equipment, most of all surgical gloves, but transmission of HPV DNA to medical personnel is unlikely to occur provided that protective surgical gloves and masks are applied and disposed of properly.

  1. Synthesis, crystal growth, structural and physicochemical studies of novel binary organic complex: 4-chloroaniline-3-hydroxy-4-methoxybenzaldehyde

    SciTech Connect

    Sharma, K.P.; Reddi, R.S.B.; Bhattacharya, S.; Rai, R.N.

    2012-06-15

    The solid-state reaction, which is solvent free and green synthesis, has been adopted to explore the novel compound. The phase diagram of 4-chloroaniline (CA) and 3-hydroxy-4-methoxybenzaldehyde (HMB) system shows the formation of a novel 1:1 molecular complex, and two eutectics on either sides of complex. Thermochemical studies of complex and eutectics have been carried out for various properties such as heat of fusion, entropy of fusion, Jackson's parameters, interfacial energy and excess thermodynamic functions. The formation of molecular complex was also studied by IR, NMR, elemental analysis and UV-Vis absorption spectra. The single crystal of molecular complex was grown and its XRD study confirms the formation of complex and identifies the crystal structure and atomic packing of crystal of complex. Transmission spectra of grown crystal of the complex show 70% transmittance efficiency with cut off wavelength 412 nm. The band gap and refractive index of the crystal of complex have also been studied. - Graphical abstarct: Exploiting phase diagram study and solvent free synthesis a novel compound was synthesized and its single crystal growth, atomic packing, energy band gap and refractive index were studied. Highlights: Black-Right-Pointing-Pointer Novel organic complex was synthesized using Green or solvent free synthesis. Black-Right-Pointing-Pointer Phase diagram study provided the information to identify the worthy composition of novel complex. Black-Right-Pointing-Pointer The single crystal of the sufficient size was grown from the ethanol solution. Black-Right-Pointing-Pointer Crystal analysis suggested that the covalent bond is formed between the two parent compounds. Black-Right-Pointing-Pointer The transmittance of the crystal was found to be 70% and it was transparent from 412 to 850 nm.

  2. Hepatic angiomyolipoma: differential diagnosis from other liver tumors in a special reference to vascular imaging - importance of early drainage vein.

    PubMed

    Yoshioka, Masato; Watanabe, Go; Uchinami, Hiroshi; Kudoh, Kazuhiro; Hiroshima, Yuko; Yoshioka, Toshiaki; Nanjo, Hiroshi; Funaoka, Masato; Yamamoto, Yuzo

    2015-12-01

    A 51-year-old female had been diagnosed with a hemangioma in the hepatic segment 6 (S6). After a 6-year follow-up, enlargement of the tumor was detected. The tumor was clearly enhanced in the arterial phase, and the enhancement remained in the portal phase on computed tomography (CT). Although the primary differential diagnosis on CT was hepatocellular carcinoma (HCC), we worried about the possibility of other vessel system tumors because the tumor remained to be enhanced at the portal phase for HCC and all tumor markers of HCC were negative. We performed angiography to determine the tumor nature and to seek other tumors. Angiography showed tumor stain at the hepatic S6 with an early obvious drainage vein from the tumor flowing through the right hepatic vein into the inferior vena cava. In addition to tumor stain and the drainage vein, there were many small poolings of contrast medium in the whole liver, which were suspected as dilatation of the hepatic peripheral artery. We suspected the tumor as a benign tumor such as hepatocellular adenoma or focal nodular hyperplasia, but the possibility of HCC could not be ruled out. Hepatic posterior sectionectomy was done to completely remove the drainage vein with the tumor. Intraoperative histological examination revealed the tumor as not malignant and not HCC. Later, immunohistochemical analysis uncovered that the tumor had high expression of HMB-45 and, therefore, the final diagnosis was angiomyolipoma. We think that detecting an early drainage vein from the tumor would be a key point for diagnosing hepatic angiomyolipoma. PMID:26943379

  3. Cystic angiomyolipoma of the kidney: a clinicopathologic description of 11 cases.

    PubMed

    Davis, Charles J; Barton, Joel H; Sesterhenn, Isabell A

    2006-05-01

    This report deals with 11 examples of renal angiomyolipomas (AML) which appear to include an epithelial element as a part of the neoplasm in the form of gross or microscopic cysts-usually both. There were seven females and four males between the ages of 20 and 70 years with mean age of 45 years. Three of these were known to be symptomatic: intermittent flank pain and gross hematuria for 2 months; recurrent hematuria both before and after flank trauma and a third patient with acute abdomen due to a ruptured tumor blood vessel. Cysts were described in three of the six cases where radiographic data were available. Seven tumors were in the right kidney and four in the left. In gross descriptions, cysts were mentioned in seven and they ranged from 6.0 to 2.0 cm with a median and mean maximal diameter of 5.0 and 4.0 cm, respectively. Microscopically, virtually all of the tumors included multiple smaller cysts and these were lined by flat, cuboidal or columnar epithelium and occasionally hobnail epithelium. There was usually a subepithelial collar of poorly differentiated cells, but the solid element of all tumors was myomatous angiomyolipoma; only one case had any adipose tissue. A dominant histological feature was the prominent lymphatic channels-identical to those of lymphangiomyomas and myomatous or triphasic AMLs. They are much more conspicuous in these cystic cases. Immunohistochemically, all tumors tested were reactive with actin, desmin and HMB-45, with the latter being more intensely positive in the subepithelial collars. Estrogen and progesterone receptors were usually positive, also. The behavior of these lesions appears to be no different from that of other AMLs.

  4. Skeletal Muscle Regulates Metabolism via Interorgan Crosstalk: Roles in Health and Disease.

    PubMed

    Argilés, Josep M; Campos, Nefertiti; Lopez-Pedrosa, José M; Rueda, Ricardo; Rodriguez-Mañas, Leocadio

    2016-09-01

    Skeletal muscle is recognized as vital to physical movement, posture, and breathing. In a less known but critically important role, muscle influences energy and protein metabolism throughout the body. Muscle is a primary site for glucose uptake and storage, and it is also a reservoir of amino acids stored as protein. Amino acids are released when supplies are needed elsewhere in the body. These conditions occur with acute and chronic diseases, which decrease dietary intake while increasing metabolic needs. Such metabolic shifts lead to the muscle loss associated with sarcopenia and cachexia, resulting in a variety of adverse health and economic consequences. With loss of skeletal muscle, protein and energy availability is lowered throughout the body. Muscle loss is associated with delayed recovery from illness, slowed wound healing, reduced resting metabolic rate, physical disability, poorer quality of life, and higher health care costs. These adverse effects can be combatted with exercise and nutrition. Studies suggest dietary protein and leucine or its metabolite β-hydroxy β-methylbutyrate (HMB) can improve muscle function, in turn improving functional performance. Considerable evidence shows that use of high-protein oral nutritional supplements (ONS) can help maintain and rebuild muscle mass and strength. We review muscle structure, function, and role in energy and protein balance. We discuss how disease- and age-related malnutrition hamper muscle accretion, ultimately causing whole-body deterioration. Finally, we describe how specialized nutrition and exercise can restore muscle mass, strength, and function, and ultimately reverse the negative health and economic outcomes associated with muscle loss. PMID:27324808

  5. Renal disease in adults with TSC2/PKD1 contiguous gene syndrome.

    PubMed

    Martignoni, Guido; Bonetti, Franco; Pea, Maurizio; Tardanico, Regina; Brunelli, Matteo; Eble, John N

    2002-02-01

    The most common renal lesions of tuberous sclerosis complex, an autosomal-dominant syndrome resulting from losses of TSC1 (9q34) or TSC2 (16p13.3), are renal cysts and angiomyolipomas. Epithelial neoplasms are less common. The TSC2 gene lies adjacent to PKD1, the major gene responsible for autosomal-dominant polycystic kidney disease. Recently, a deletion mutation disrupting both TSC2 and PKD1 has been described in young children with tuberous sclerosis complex with severe renal cystic disease. This disease has been termed the TSC2/PKD1 contiguous gene syndrome. We describe the lesions in the resected kidneys of two adults with TSC2/PDK1 contiguous gene syndrome, at the time of the nephrectomies: a 31-year-old man and his 44-year-old mother. The four kidneys were enlarged reniform masses composed of cysts lined by flattened, cuboidal, or, infrequently, large deeply eosinophilic epithelial cells. The kidneys also contained numerous classic angiomyolipomas and rare intraglomerular microlesions. In the son the largest tumor was a monotypic epithelioid angiomyolipoma. In the wall of his left renal pelvis there was a plaque-shaped, HMB-45-positive localized lesion of lymphangioleiomyomatosis. This is the first description of the renal lesions in adults with genetically confirmed TSC2/PDK1 contiguous gene syndrome. The pathologic findings highlight the importance of thorough sampling for histology in polycystic kidney diseases and indicate that the observation of an angiomyolipoma in biopsy material from patients with enlarged cystic kidneys should suggest the diagnosis of TSC2/PKD1 contiguous gene syndrome, even in cases without ultrasonographic and macroscopic evidence of angiomyolipoma.

  6. Melanotic schwannoma of the cervical spine progressing with pulmonary metastasis: case report.

    PubMed

    Faria, Mário Henrique Girão; Dória-Netto, Ricardo Henrique; Osugue, Gustavo Jun; Queiroz, Luciano de Souza; Chaddad-Neto, Feres Eduardo

    2013-01-01

    Melanotic schwannoma (MS) is an unusual variant of nerve sheath neoplasm. Only 10% of these tumors will undergo malignant degeneration, with exceedingly rare reported metastasis. We present a 32-year-old woman with a 6-month history of cervical pain and left arm progressive weakness. Neurological examination showed a left upper limb radicular pain, with pyramidal syndrome at C5 level. The magnetic resonance imaging (MRI) study highlighted an intradural extramedullary heterogeneous mass along the spinal cord at the C4-C5 level, slightly hyperintense with T1 and hypointense with T2-weighted sequences, invading the left neural foramen. The patient underwent C3-C5 laminectomy with total resection of a black tumor. In the postoperative period, a patent deficit of shoulder abduction ensued related to the nervous section. Microscopically, compactly fascicles of spindle-shaped cells with pleomorphic and hypercromatic nuclei, dark brown intracellular pigments, as well as some mitotic figures were seen. Immunohistochemical stains for S-100, Human Melanoma Black-45 (HMB-45), and vimentin were positive, with Ki-67 Labelling Index (LI) of 15% compatible with MS. Six months after radiotherapy she presents local recurrence and lung metastatic dissemination of the MS. She underwent left pulmonary segmentectomy, followed by chemotherapy and radiosurgery. The patient developed a febrile neutropenia and worsening of general status, and died after 3 months due to respiratory complications. MS are rare tumors with potential for local recurrence and distal metastasis. Complete surgical resection remains as the treatment of choice, once the uncommon cases with malignant progression shows low response to chemo and radiotherapy. PMID:24077273

  7. Insect bite reactions.

    PubMed

    Singh, Sanjay; Mann, Baldeep Kaur

    2013-01-01

    Insects are a class of living creatures within the arthropods. Insect bite reactions are commonly seen in clinical practice. The present review touches upon the medically important insects and their places in the classification, the sparse literature on the epidemiology of insect bites in India, and different variables influencing the susceptibility of an individual to insect bites. Clinical features of mosquito bites, hypersensitivity to mosquito bites Epstein-Barr virus NK (HMB-EBV-NK) disease, eruptive pseudoangiomatosis, Skeeter syndrome, papular pruritic eruption of HIV/AIDS, and clinical features produced by bed bugs, Mexican chicken bugs, assassin bugs, kissing bugs, fleas, black flies, Blandford flies, louse flies, tsetse flies, midges, and thrips are discussed. Brief account is presented of the immunogenic components of mosquito and bed bug saliva. Papular urticaria is discussed including its epidemiology, the 5 stages of skin reaction, the SCRATCH principle as an aid in diagnosis, and the recent evidence supporting participation of types I, III, and IV hypersensitivity reactions in its causation is summarized. Recent developments in the treatment of pediculosis capitis including spinosad 0.9% suspension, benzyl alcohol 5% lotion, dimethicone 4% lotion, isopropyl myristate 50% rinse, and other suffocants are discussed within the context of evidence derived from randomized controlled trials and key findings of a recent systematic review. We also touch upon a non-chemical treatment of head lice and the ineffectiveness of egg-loosening products. Knockdown resistance (kdr) as the genetic mechanism making the lice nerves insensitive to permethrin is discussed along with the surprising contrary clinical evidence from Europe about efficacy of permethrin in children with head lice carrying kdr-like gene. The review also presents a brief account of insects as vectors of diseases and ends with discussion of prevention of insect bites and some serious adverse effects

  8. Clear cell renal cell carcinoma with a syncytial-type multinucleated giant tumor cell component: implications for differential diagnosis.

    PubMed

    Williamson, Sean R; Kum, Jennifer B; Goheen, Michael P; Cheng, Liang; Grignon, David J; Idrees, Muhammad T

    2014-04-01

    A component of syncytial-type multinucleated tumor giant cells is uncommon in clear cell renal cell carcinoma, and the histogenesis, incidence, and clinical implications of this finding are not well understood. We retrieved 13 such tumors from our pathology archives in patients with a median age of 60years, comprising 1.5% of clear cell renal cell carcinomas. Stage was typically pT4 or pT3 (each 38%). Microscopically, all tumors included a component of low-grade clear cell renal cell carcinoma with usual features. Syncytial-type giant tumor cells possessed voluminous cytoplasm, usually granular and eosinophilic, and numerous nuclei similar to those of the mononuclear tumor cells. Transition between areas of mononuclear and multinucleated cells was sometimes abrupt. Other findings included necrosis (77%), hyaline globules (46%), emperipolesis (46%), and intranuclear cytoplasmic invaginations (23%). Immunohistochemical staining typically revealed both mononuclear and multinucleated cells to be positive for carbonic anhydrase IX, CD10, epithelial membrane antigen, vimentin, and cytokeratin AE1/AE3 and negative for β human chorionic gonadotropin, TFE3, cathepsin K, cytokeratin 7, cytokeratin 20, HMB45, CD68, smooth muscle actin, and S100. Most patients with available information (7/9) were alive with metastatic disease at the most recent follow-up. Syncytial-type giant cells are an uncommon finding associated with aggressive clear cell renal cell carcinomas. Despite the unusual appearance of this tumor component, its immunoprofile supports an epithelial lineage and argues against trophoblastic, osteoclast-like, or histiocytic differentiation. Reactivity for typical clear cell renal cell carcinoma antigens facilitates discrimination from giant cells of epithelioid angiomyolipoma or other tumors, particularly in a biopsy specimen or a metastatic tumor. PMID:24499686

  9. PAX8 expression in sporadic hemangioblastoma of the kidney supports a primary renal cell lineage: implications for differential diagnosis.

    PubMed

    Zhao, Ming; Williamson, Sean R; Yu, Jingjing; Xia, Wenping; Li, Changshui; Zheng, Jiangjiang; Zhu, Yin; Sun, Ke; Wang, Zhaoming; Cheng, Liang

    2013-10-01

    Hemangioblastoma is a benign, morphologically distinctive neoplasm of disputed histogenesis that typically occurs in the central nervous system either in the setting of von Hippel-Lindau disease or more often sporadically. Extraneural hemangioblastoma is exceptional and raises a challenging differential diagnosis. Herein, we report a primary renal hemangioblastoma occurring in 51-year-old woman without stigmata of von Hippel-Lindau disease. Histologically, the tumor was composed of sheets of polygonal epithelioid stromal cells with ample pale or eosinophilic, vacuolated cytoplasm in an arborizing capillary network. Tumor cells showed variable nuclear pleomorphism, intranuclear cytoplasmic invaginations, scattered hyaline globules, and psammoma-like calcifications. Some areas showed branching hemangiopericytoma-like vessels with tumor cells radiating from the wall, while other areas were edematous and hyalinized with sparse stromal cells and abundant reticular vessels. Immunohistochemically, the tumor cells reacted strongly and diffusely with antibodies to PAX8, CD10, α-inhibin, S100 protein, neuron-specific enolase, and vimentin, and they showed focal positivity with antibodies to epithelial membrane antigen and AE1/AE3. Tumor cells were negative for CK7, CK8/18, RCC antigen, synaptophysin, chromogranin, c-kit, D2-40, HMB45, melan-A, cathepsin K, SMA, desmin, CD31, CD34, and estrogen and progesterone receptors. Positive immunoreactivity for PAX8 is unexpected and contrasts to central nervous system (CNS) hemangioblastomas, which are essentially always negative for PAX8. This novel finding adds support to the hypothesis that the immunoprofile of extraneural hemangioblastoma varies with site of origin, perhaps as a result of tumor cell lineage and retention of organ-specific markers or acquisition of site-specific antigens due to local factors. PMID:23849894

  10. [TOXIC RISK ASSESSMENT OF FLUORIDE PRESENCE IN BOTTLED WATER CONSUMPTION IN THE CANARY ISLANDS].

    PubMed

    Jáudenes Marrero, Juan Ramón; Hardisson de la Torre, Arturo; Gutiérrez Fernández, Angel José; Rubio Armendáriz, Carmen; Revert Gironés, Consuelo

    2015-11-01

    Introducción: el flúor, como hormetina, es necesario en el organismo para evitar las caries, pero en cantidades excesivas puede llevar a efectos tóxicos adversos como la fluorosis dental o la fluorosis invalidante. Así, será importante no sobrepasar de forma crónica las IDR (Ingestas Diarias Recomendadas) para cada rango de edad y sexo. Se asume que la principal fuente de aporte de fluoruros es el agua. Objetivos: establecer las concentraciones de fluoruro en determinadas marcas de agua envasada que se consumen en Canarias, para renovar los datos ya desactualizados, y hacer la correspondiente evaluación del riesgo tóxico. Método: se han utilizado 25 muestras de siete marcas registradas y comercializadas diferentes, siendo analizadas mediante determinación potenciométrica con electrodo ion selectivo de fluoruro. Resultados: todas las marcas de agua analizadas cumplen con los criterios de calidad según la legislación actual española, ninguna puede considerarse “agua fluorada” y todas se pueden usar en la preparación de alimentos infantiles. Además, según las ingestas diarias de agua recomendadas por la EFSA para cada rango de edad, no se supera la IDR para ningún individuo mayor de cuatro años ni para ninguna de las marcas de agua analizadas. Conclusiones: las aguas envasadas producidas en Canarias tienen niveles de fluoruro similares a las producidas en la península (todas en un rango de 0,24 a 0,62 mg/L). Los individuos sobre los que recaen las restricciones más amplias de consumo de agua son los menores de un año, pero en cualquier caso, a medida que el individuo crece va aumentando la permisibilidad del aporte de fluoruros (aumenta hasta los 19 años) y, por tanto, aumenta la variedad de aguas envasadas que se pueden consumir sin superar la IDR. En ciertos lugares de la Comunidad Autónoma Canaria sería recomendable consumir agua envasada respecto al agua de abastecimiento público.

  11. [ASSOCIATION OF OLFACTORY SENSITIVITY WITH ENERGY INTAKE: ROLE IN DEVELOPMENT OF OBESITY].

    PubMed

    Valladares Vega, Macarena; Obregón Rivas, Ana Maria

    2015-12-01

    La obesidad se produce por un desequilibrio entre la energía consumida y el gasto de energía generado. Dentro de los factores que regulan la ingesta no homeostática se encuentra el sentido del olfato, que constituye una importante señal externa que induce la ingesta de alimentos. Los humanos lo utilizan para apreciar la palatabilidad de los alimentos y, en general, para seleccionar alimentos. Materiales y método: se realizó una búsqueda electrónica de artículos en las bases de datos de Pubmed y Scielo, donde se utilizaron las palabras claves: “olfato”, “ingesta energética” y “obesidad”; adicionalmente se sumaron los siguientes límites para restringir la exploración: “animales”, “humanos”, “ensayo clínico” y “metaanálisis”. Resultados: el estado de hambre individual esta modulado por la sensibilidad olfatoria, donde se observa que la sensibilidad del olfato aumenta frente a un estado de ayunas. Existen dos hormonas que han permitido relacionar el sentido del olfato con la ingesta energética: orexina, que aumenta la sensibilidad olfativa y la ingesta, y leptina, que disminuye la sensibilidad olfativa y la ingesta. Las personas obesas con IMC > 45 presentan baja sensibilidad olfativa, situación que no varía después de la cirugía bariátrica. Conclusiones: determinar la relación entre el olfato, la ingesta energética y la obesidad es un campo escasamente estudiado y que abre nuevos caminos para el tratamiento de patologías en las que existen trastornos alimentarios como la obesidad. A futuro es necesario la realización de ensayos clínicos que permitan determinar la causalidad entre ambas variables, así como estudios moleculares para comprender mejor las señales que relacionan el olfato con la ingesta energética.

  12. ORGANIC INFLAMMATORY RESPONSE TO REDUCED PREOPERATIVE FASTING TIME, WITH A CARBOHYDRATE AND PROTEIN ENRICHED SOLUTION; A RANDOMIZED TRIAL.

    PubMed

    de Andrade Gagheggi Ravanini, Guilherme; Portari Filho, Pedro Eder; Abrantes Luna, Renato; Almeida de Oliveira, Vinicius

    2015-08-01

    Introducción: El objetivo de este estudio es la evaluación de la respuesta inflamatoria orgánica a la colecistectomía laparoscópica mediante vídeo con una reducción del tiempo de ayuno preoperatorio a 2h y empleando una solución enriquecida con carbohidratos y proteínas. Métodos: Se trata de un estudio aleatorizado, prospectivo con pacientes divididos en los dos grupos siguientes: grupo A, ayuno convencional y grupo B, ayuno abreviado de 2h con ingesta oral de una solución enriquecida con carbohidratos y proteínas. Antes de la ingesta de la solución, se hicieron mediciones de glucosa sérica, insulina, interleucina 1y TNF-α; también se realizaron mediciones durante la inducción de la anestesia y 4h después de la intervención quirúrgica. Resultados: Treinta y ocho pacientes completaron el estudio sin presentar complicaciones pulmonares relacionadas con el broncoaspirado. La varianza HOMA-IR postoperatoria fue superior en el grupo A (p = 0,001). Conclusión: La reducción del tiempo de ayuno preoperatorio a 2h, empleando soluciones enriquecidas con carbohidratos y proteínas, es segura, reduce la resistencia a la insulina, y no aumenta el riesgo de broncoaspirado.

  13. Discos de acresção em sistemas Be-X

    NASA Astrophysics Data System (ADS)

    Lopes de Oliveira, R.; Janot-Pacheco, E.

    2003-08-01

    Alguns fenômenos de outbursts em Be-X sugerem a existência, mesmo que temporária, de um disco de acresção quando da passagem do objeto compacto pelo periastro orbital. Neste trabalho avaliamos a possibilidade de formação do disco de acresção em sistemas Be+estrela de neutrons e Be+anã branca, e a influência da excentricidade orbital na ocorrência deste fenômeno. Utilizamos a expressão analítica para o momento angular específico da matéria constituinte de um meio em expansão lenta, como é o caso do disco circunstelar das estrelas Be, proposta por Wang(1981), sob a condição básica de que o raio de circularização deva ser maior do que o raio de Alfvén. Concluímos que existe um limite para o período orbital do sistema acima do qual não é possível a formação do disco de acresção, e que este valor aumenta para sistemas com excentricidade orbital maior.

  14. COST-EFFECTIVENESS OF EARLY NUTRITIONAL THERAPY IN MALNOURISHED ADULT PATIENTS IN A HIGH COMPLEXITY HOSPITAL.

    PubMed

    Giraldo Giraldo, Nubia Amparo; Vásquez Velásquez, Johanna; Roldán Cano, Paula Andrea; Ospina Astudillo, Carolina; Sosa Cardona, Yuliet Paulina

    2015-12-01

    Introducción: la malnutrición hospitalaria es un problema frecuente en el mundo que aumenta las complicaciones, los días de estancia, la mortalidad y los costes sanitarios. Objetivos: el objetivo de este estudio fue establecer la coste-efectividad de la terapia nutricional precoz en pacientes malnutridos en un hospital de alta complejidad. Materiales y métodos: este estudio analítico con valoración económica, incluyó 227 adultos hospitalizados y malnutridos según Valoración Global Subjetiva. La cohorte prospectiva recibió Terapia Nutricional Precoz (TNP), mientras que la cohorte retrospectiva recibió Terapia Nutricional Tardía (TNT). Las medidas del coste- efectividad incluyeron costes por: días de estancia, complicaciones y condición de egreso. Resultados: las cohortes fueron similares en cuanto a características clínicas y demográficas, excepto en la mediana de edad; para la TNP fue 61 años (rango intercuartil [RIQ]: 48-71) y para la TNT fue 55 años (RIQ: 44-67) (p=0,024). La TNP se encontró costo-efectiva en la reducción de los días de estancia hospitalaria (11 días, RIQ: 7-17) en comparación con la TNT (18 días, RIQ: 10-28) (p.

  15. Neuroprotective effects of tibolone against oxidative stress induced by ozone exposure.

    PubMed

    Pinto-Almazán, Rodolfo; Rivas-Arancibia, Selva; Farfán-García, Eunice D; Rodríguez-Martínez, Erika; Guerra-Araiza, Christian

    2014-05-16

    Introduccion. El estres oxidativo aumenta la lipoperoxidacion, produce deficits de memoria y de actividad motora asi como una neurodegeneracion progresiva en el sistema nervioso central. La tibolona es un tratamiento para los sintomas de la menopausia que disminuye los niveles de peroxidacion de lipidos y mejora la memoria y el aprendizaje. Objetivo. Estudiar el efecto de la tibolona sobre la peroxidacion de lipidos, los deficits de memoria y motor en el modelo de estres oxidativo inducido por la exposicion cronica al ozono. Materiales y metodos. Se dividieron aleatoriamente 100 ratas adultas Wistar en 10 grupos: control (C), que recibio aire durante 60 dias; (C + tibolona), aire mas 1 mg/kg de tibolona durante 60 dias; los grupos 3-6, ozono durante 7, 15, 30, y 60 dias; y los grupos 7-10, 1 mg/kg de tibolona durante 7, 15, 30 y 60 dias previo a la exposicion al ozono. Se realizaron pruebas de memoria y motoras y se determino el contenido del 4-hidroxinonenal y de la nitrotirosina por Western blot, asi como la muerte neuronal en el hipocampo. Resultados. La administracion de tibolona disminuyo el contenido de lipidos peroxidados, la oxidacion de proteinas y la muerte neuronal en el hipocampo; mejoro la memoria y previno las alteraciones motoras en los animales expuestos a ozono. Conclusion. Nuestros resultados indican un posible papel neuroprotector de la tibolona como un tratamiento util para prevenir la neurodegeneracion inducida por el estres oxidativo.

  16. A comparison of two questionnaires on Informed Consent for extended criteria liver donors.

    PubMed

    Bruzzone, Paolo; Giannarelli, Diana

    2015-01-01

    Un questionario riguardante il consenso informato del ricevente per i cosiddetti donatori marginali di fegato (“extended criteria donors”-ECD) è stato inviato, previa approvazione del Comitato Etico, via e-mail ai membri di 2 società scientifiche, ELPAT(Ethical,Legal and Psychologic Aspects of Organ Transplantation) ed ELITA (European Liver and Intestine Transplant Association)-ELTR(European Liver Transplant Registry). I risultati sono stati pubblicati in diversi lavori apparsi su Transplantation Proceedings. Analizzando statisticamente le tabelle negli articoli 2011 ELPAT e 2013 ELITA, nel lavoro più recente meno Centri Trapianto di fegato (LTC) hanno considerato l’età fino a 80 anni (p<.002) e SGOT>90 IU (p<.02), o tutti i criteri insieme (p<.0001), come indicatori di donatore marginale. Ciò potrebbe riflettere il fatto che nel tempo i LTC sono divenuti meno selettivi, a causa della crescente mortalità dei pazienti in lista di attesa. Considerando che in tutti i nostri studi abbiamo riscontrato un notevole ricorso agli ECD, è necessario che i pazienti ricevano tutte le informazioni che vogliano richiedere sia al momento dell’iscrizione in lista di attesa, sia quando il fegato di un donatore venga effettivamente loro proposto. E’ anche possibile creare una lista di attesa separata, per pazienti che non accettano ECD: tale scelta però ritarda in modo inevitabile il trapianto e quindi, potenzialmente, aumenta la mortalità in lista di attesa.

  17. A correlação índice espectral vs. luminosidade em QSOs e suas implicações

    NASA Astrophysics Data System (ADS)

    Garcia-Rissmann, A.

    2003-08-01

    Estudos de variabilidade de núcleos ativos já demonstraram ser comum o fato de seu contínuo óptico/UV tornar-se mais "duro" à medida que a luminosidade aumenta. Essa tendência ocorre tanto de forma individual quanto global, e pode ter implicações importantes (1) para estudos fotométricos de variabilidade conduzidos numa banda fixa no referencial do observador, comparando objetos a diferentes redshifts, e (2) no cálculo da correção K, com consequente impacto na determinação de massas de buracos negros e bojos de galáxias hospedeiras (através da relação de Magorrian). Confirmo aqui as correlações positivas entre o índice espectral e a luminosidade óptica, utilizando dados espectroscópicos de 11 QSOs monitorados no Brasil e no Chile, durante ~2 anos. O estudo é complementado com parâmetros extraídos de espectros e de dados fotométricos públicos de quasares. Destaco ainda as diferenças observadas em tais correlações para objetos do tipo radio-loud e radio-quiet. Este projeto é financiado pelo I. Milênio/CNPq.

  18. Uso de Sustancias en Mujeres con Desventaja Social: Riesgo para el Contagio de VIH/SIDA

    PubMed Central

    Cianelli, R.; Ferrer, L; Bernales, M.; Miner, S.; Irarrázabal, L.; Molina, Y.

    2009-01-01

    Antecedentes La caracterización epidemiológica en Chile apunta a feminización, pauperización y heterosexualización de la epidemia del VIH, lo que implica un mayor riesgo para las mujeres en desventaja social. Si a esto se suma la utilización de sustancias, la vulnerabilidad de este grupo frente al VIH/SIDA aumenta. Objetivo Describir el uso de sustancias en mujeres con desventaja social e identificar factores de riesgo de contagio de VIH, asociados a este consumo. Material y Método 52 mujeres fueron entrevistadas como parte del proyecto “Testeando una intervención en prevención de VIH/SIDA en mujeres chilenas” GRANT # RO1 TW 006977. Se describen variables sociodemográficas y de consumo de sustancias a través de estadísticas descriptivas y se analiza la relación entre variables a través de pruebas de correlación. Resultados Los resultados indican un perfil sociodemográfico que sitúa a las mujeres en situación de vulnerabilidad frente al contagio de VIH/SIDA, con alto índice de uso de sustancias que acentúa el riesgo. Conclusiones Los hallazgos apuntan a la necesidad de considerar intervenciones que se enfoquen en la prevención de VIH en mujeres, abordando los riesgos asociados al consumo de sustancias. PMID:21197380

  19. Is N-acetylcysteine effective in the treatment of pulmonary fibrosis?

    PubMed

    Jeldres Pulgar, Alejandro; Labarca, Gonzalo

    2016-09-29

    La fibrosis pulmonar idiopática es una enfermedad respiratoria crónica y progresiva, que en etapas finales conlleva una alta mortalidad. Se han planteado múltiples opciones terapéuticas, entre ellas la N-acetilcisteína, pero su rol no está claramente establecido. Utilizando la base de datos Epistemonikos, la cual es mantenida mediante búsquedas en 30 bases de datos, identificamos ocho revisiones sistemáticas que en conjunto incluyen 16 estudios aleatorizados. Realizamos un metanálisis y tablas de resumen de los resultados utilizando el método GRADE. Concluimos que N-acetilcisteína probablemente aumenta el riesgo de hospitalización y exacerbaciones. Si bien no está claro si esto conlleva un aumento de mortalidad porque la certeza de la evidencia es muy baja, en general existe consenso en que no debiera utilizarse, a no ser que sea en el contexto de un nuevo estudio clínico.

  20. Cabergoline or bromocriptine for prolactinoma?

    PubMed

    Triantafilo, Nicolás; Castro-Gutiérrez, Victoria; Rada, Gabriel

    2016-09-15

    Cabergolina y bromocriptina son los fármacos más utilizados en el manejo del prolactinoma. Si bien cabergolina, un agonista dopaminérgico de vida media larga, tendría algunas ventajas desde el punto de vista fisiopatológico, no está claro si esto se traduce en un real beneficio. Utilizando la base de datos Epistemonikos, la cual es mantenida mediante búsquedas en 30 bases de datos, identificamos dos revisiones sistemáticas que en conjunto comprenden 12 estudios relevantes para la pregunta, incluyendo cinco estudios controlados aleatorizados. Realizamos un metanálisis y tablas de resumen de los resultados utilizando el método GRADE. Concluimos que la cabergolina es superior a la bromocriptina en la mejoría de la oligomenorrea/amenorrea y la galactorrea, probablemente aumenta la probabilidad de embarazo, y se asocia a menos efectos adversos. No está claro si cabergolina también es más efectiva sobre el crecimiento del tumor porque la certeza de la evidencia es muy baja.

  1. [Neurological disorders and the blood-brain barrier. Strategies and limitations for drug delivery to the brain].

    PubMed

    Domínguez, Alazne; Álvarez, Antonia; Suárez-Merino, Blanca; Goñi-de-Cerio, Felipe

    2014-03-01

    Introduccion. La incidencia de enfermedades del sistema nervioso central (SNC) aumenta a causa del envejecimiento de la sociedad. Desgraciadamente, los tratamientos clasicos para tratarlas no resultan efectivos debido a la presencia de la barrera hematoencefalica. Objetivo. Abordar las propiedades de la barrera hematoencefalica que impiden el transporte de los farmacos al cerebro y las principales estrategias para tratar las afecciones neurologicas. Desarrollo. La barrera hematoencefalica esta compuesta principalmente por un endotelio vascular especializado y las celulas de la glia. Esta constituye una herramienta a disposicion del organismo para aislar al SNC del resto del cuerpo. Sin embargo, tambien supone un impedimento para que muchos farmacos alcancen su diana en el cerebro. Conclusiones. Para poder tratar las afecciones neurologicas, los farmacos deben ser capaces de alcanzar el cerebro. Los agentes terapeuticos pueden diseñarse para que sean capaces de atravesar esta barrera, o bien facilitar su entrada mediante el uso de sistemas de liberacion. Para evaluar la efectividad de los tratamientos dirigidos a enfermedades del SNC, se emplean los modelos animales de enfermedades neurologicas asi como modelos in vitro de barrera hematoencefalica.

  2. [Drugs having latex and therapeutic alternatives in hospital formulary].

    PubMed

    Damas Fuentes, Rosa María; Pérez León, Moisés; Piñero González, Marta; Sangil Monroy, Nayra; Molero Gómez, Rafael; Domínguez Lantigua, Pablo

    2015-01-01

    Objetivo: Analizar el contenido en látex de los medicamentos en la guía farmacoterapéutica y establecer alternativas en un hospital de tercer nivel. Método: Se seleccionaron los medicamentos susceptibles de contener látex en su material de acondicionamiento, se solicitó al laboratorio fabricante información y se buscaron posibles alternativas incluidas en guía farmacoterapéutica. Resultados: De las 618 especialidades seleccionadas se obtuvo información escrita del laboratorio para 605 (97.9%) y en ficha técnica para 8. De las 57 (9,2%) especialidades con riesgo en pacientes con alergia al látex se encontró una alternativa en guía para el 43,9%. Conclusiones: Conocer las especialidades con látex aumenta la seguridad en la prescripción, mientras que la disponibilidad de una tabla de equivalencias terapéuticas facilita la validación. Los datos publicados vienen a actualizar la información del contenido en látex de los medicamentos para pacientes y personal sanitario, generalmente escasa y variable.

  3. Dietary potential renal Acid load in venezuelan children.

    PubMed

    López-Sayers, Mayerling; Bernal, Jennifer; López, Michelle

    2015-05-01

    Objetivo: Determinar y analizar la carga acida potencial renal de la dieta (Potential Renal Acid Load PRAL) y el patron de alimentacion de ninos entre 1 a 6 anos aparentemente sanos. Métodos: Se seleccionaron segun conveniencia a padres de 52 ninos asistentes a una consulta de ninos sanos. La calidad de la dieta y el patron de alimentacion se evaluo mediante un recordatorio de 24 horas y un cuestionario de frecuencia de alimentos. Se calculo la ingesta de macronutrientes y grupos de alimentos, como carnes, lacteos, frutas y verduras. La ingesta de nutrientes se comparo con las recomendaciones de energia y nutrientes. El PRAL se determino segun el metodo de Remer y Manz, para determinar la carga acida de la dieta. Se aplico estadistica descriptiva y correlaciones entre el PRAL, nutrientes y grupos de alimentos. Resultados: La ingesta de proteinas, de leche y de carnes fue elevada, mientras que la ingesta de rutas y hortalizas fue baja. El PRAL fue positivo en 92% de los ninos, se asocio con mayor ingesta de energia, proteinas, grasas, carne y lacteos. La ingesta de proteinas fue > 2,5 g/kg/ dia en 46,2% de los ninos. Los grupos de alimentos con mayor desequilibrio debido a exceso fueron la carne y los productos lacteos, mientras que por deficit fue el grupo de frutas y hortalizas. Conclusión: La dieta se caracteriza por una elevada carga de acido o PRAL, lo que aumenta el riesgo de acidosis sistemica y sus consecuencias metabolicas.

  4. Extrarenal rhabdoid tumors of soft tissue: a clinicopathologic and immunohistochemical study of 18 cases.

    PubMed

    Fanburg-Smith, J C; Hengge, M; Hengge, U R; Smith, J S; Miettinen, M

    1998-12-01

    Rhabdoid tumor is a well-accepted clincopathologic entity among childhood renal neoplasms; similar tumors have been described in extrarenal locations. We present the clinicopathologic profile and the immunohistochemical features of a series of soft tissue rhabdoid tumors. Twenty-eight cases coded as extrarenal rhabdoid tumor (ERRT), RT, possible ERRT, and "large cell sarcoma" were retrieved from the Armed Forces Institute of Pathology soft tissue registry. The tumors were reclassified according to strict criteria by light microscopy, clinical information, immunohistochemistry, and, in some cases, electron microscopy. Soft tissue rhabdoid tumor (STRT) was defined as (1) a tumor composed of noncohesive single cells, clusters, or sheets of large tumor cells with abundant glassy eosinophilic cytoplasm, an eccentric vesicular nucleus, and an extremely large nucleolus; (2) positivity for vimentin and/or cytokeratin or other epithelial markers by immunostaining; and (3) exclusion of other tumor types with rhabdoid inclusions (melanoma, other sarcomas, carcinoma). Eighteen cases met our criteria for soft tissue rhabdoid tumors. The median patient age was 13 years (range, 6 months to 56 years). Ninety-four percent of STRT cases were positive for vimentin and 59% for pan-cytokeratin. Sixty-three percent and 60% were positive for CAM 5.2 and EMA, respectively. Seventy-nine percent stained for at least one epithelial marker; 76% stained for both vimentin and epithelial markers simultaneously. Forty-two percent stained for MSA, and 14% for CEA and SMA. CD99, synaptophysin, CD57 (Leu-7), NSE, and focal S100 protein were identified in 75%, 66%, 56%, 54%, and 31% of the STRT cases, respectively. All STRT cases examined were negative for HMB-45, chromogranin, BER-EP4, desmin, myoglobin, CD34, and GFAP. Follow-up examination in 61% of the STRT patients revealed that 64% of patients died of disease within a median follow-up interval of 19 months (range, 4 months to 5 years); 82% had

  5. Purification and characterization of α-Amylase from Miswak Salvadora persica

    PubMed Central

    2014-01-01

    Background The miswak (Salvadora persica) is a natural toothbrush. It is well known that very little information has been reported on enzymes in miswak as medicinal plant. Recently, we study peroxidase in miswak. In the present study, the main goal of this work is to purify and characterize α-amylase from miswak. The second goal is to study the storage stability of α-amylase in toothpaste. Method The purification method included chromatographaphy of miswak α-amylase on DEAE-Sepharose column and Sephacryl S-200 column. Molecular weight was determined by gel filtration and SDS-PAGE. Results Five α-amylases A1, A4a, A4b, A5a and A5b from miswak were purified and they had molecular weights of 14, 74, 16, 30 and 20 kDa, respectively. α-Amylases had optimum pH from 6 to 8. Affinity of the substrates toward all enzymes was studied. Miswak α-amylases A1, A4a, A4b, A5a and A5b had Km values for starch and glycogen of 3.7, 3.7, 7.1, 0.52, 4.3 mg/ml and 5.95, 5.9 4.16, 6.3, 6.49 mg/ml, respectively. The optimum temperature for five enzymes ranged 40°C- 60°C. Miswak α-amylases were stable up to 40°C- 60°C after incubation for 30 min. Ca+2 activated all the miswak α-amylases, while Ni2+, Co+2 and Zn+2 activated or inhibited some of these enzymes. The metal chelators, EDTA, sodium citrate and sodium oxalate had inhibitory effects on miswak α-amylases. PMSF, p-HMB, DTNB and 1,10 phenanthroline caused inhibitory effect on α-amylases. The analysis of hydrolytic products after starch hydrolysis by miswak α-amylases on paper chromatography revealed that glucose, maltose, maltotriose and oligosaccharide were the major products. Crude miswak α-amylase in the toothpaste retained 55% of its original activity after 10 months of storage at room temperature. Conclusions From these findings, α-amylases from miswak can be considered as beneficial enzymes for pharmaceuticals. Therefore, we study the storage stability of the crude α-amylase of miswak, which contained the five

  6. Effects of multi-ingredient supplementation on resistance training in young males.

    PubMed

    Willems, Mark Et; Sallis, Chris W; Haskell, Jonathan A

    2012-06-01

    Muscle strength and fatigue resistance increases with resistance training. Resistance training adaptations can be enhanced with single-ingredient or dual-ingredient supplementation but less is known about resistance training adaptations by multi-ingredient supplementation. We examined the effects of a commercial multi-ingredient supplement on resistance training adaptations for training-specific and non-training-specific tasks in young males. Male participants (n = 16, age 21±2 years, body mass 74.5±5.9 kg, body height 177±5 cm) had at least 1 year experience with resistance training exercises. Training (7 muscle groups, 4 sessions/week, weekly adjustments) consisted of two 6 weeks blocks with 4 weeks between blocks. During training, participants consumed placebo (i.e. maltodextrin, n = 7) or the sports nutritional supplement Cyclone (Maximuscle Ltd, UK, n = 9) (main ingredients creatine monohydrate, whey protein, glutamine and HMB) twice daily with one intake <15 min following a training session. Unpaired Student's t-test was used for placebo and Cyclone group comparison of percentage changes with p < 0.05. Effect sizes (Cohen's d) were calculated for the Cyclone group. Cyclone did not enhance maximal voluntary isometric force (MVIF) (p = 0.56), time to fatigue at 70% MVIF (p = 0.41) and peak concentric strength (60°·s(-1)) (p = 0.66) of m.quadriceps femoris (i.e. the non-specific training tasks). For the specific-training tasks, Cyclone did not enhance one-repetition maximum (1-RM) of lateral pull (p = 0.48) but there was a trend and large effect size for 1-RM of bench press (p = 0.07, d = 0.98) and 45° leg press (p = 0.07, d = 1.41). Cyclone resulted in an increase in number of repetitions for 80% pre-training 1-RM for lateral pull (p = 0.02, d = 1.30), bench press (p = 0.03, d = 1.20) with a trend for 45° leg press (p = 0.08, d = 0.96). Cyclone during resistance training enhanced the performance of 1-RM and number of repetitions at 80% of pre-training 1

  7. Metastatic Malignant Melanoma With Complete Loss of Differentiation Markers (Undifferentiated/Dedifferentiated Melanoma): Analysis of 14 Patients Emphasizing Phenotypic Plasticity and the Value of Molecular Testing as Surrogate Diagnostic Marker.

    PubMed

    Agaimy, Abbas; Specht, Katja; Stoehr, Robert; Lorey, Thomas; Märkl, Bruno; Niedobitek, Gerald; Straub, Melanie; Hager, Thomas; Reis, Anna-Carinna; Schilling, Bastian; Schneider-Stock, Regine; Hartmann, Arndt; Mentzel, Thomas

    2016-02-01

    Metastatic malignant melanoma is notorious for its phenotypic diversity and loss of differentiation markers. We herein summarized our experience with 14 metastatic melanomas showing complete loss of immunohistochemical melanocytic markers (with or without heterologous differentiation). Patients included 11 men and 3 women aged 24 to 78 years (median, 67 y). Thirteen patients had histologically confirmed primary skin melanoma, and 1 had metastatic melanoma of unknown primary. Undifferentiated metastasis was diagnosed synchronous to primary tumor (n=1), following skin melanoma by 3 months to 9 years (n=11) and preceding it by 1 year (n=1). Sites of undifferentiated metastases were axillary (3), inguinal (1), or submandibular (1) lymph nodes, digestive tract (2), bone/soft tissue (2), lung/pleura (2), and disseminated (n=3). Histology of metastases mimicked undifferentiated pleomorphic or spindle cell sarcoma with variable myxoid and giant cell areas (n=10) and cytokeratin-positive undifferentiated small cell sarcoma (n=1). Three cases showed heterologous dedifferentiation: pleomorphic rhabdomyosarcoma (n=1), teratocarcinosarcoma-like with prominent rhabdomyoblasts (n=1), and adenocarcinoma-like with metaplastic bone (n=1). All cases were negative for S100, melanoma cocktail, HMB45, Melan A, and SOX10. Other markers showed following results: smooth muscle actin (1/14), p16 (1/14), TP53 (2/12), pancytokeratin (4/14), desmin (5/14), h-caldesmon (0/9), and MDM2/CDK4 (0/5). SMARCB1 was intact in 8/8 cases. Genotyping showed BRAF(V600E) mutation (5/14), NRAS mutation (5/14), and BRAF/NRAS wild-type (4/14). In conclusion, undifferentiated/dedifferentiated metastatic melanoma is likely underrecognized and frequently mistaken for undifferentiated sarcoma or other neoplasms. Diagnosis of undifferentiated sarcoma at sites where melanoma metastasis are frequent (eg, inguinal and axillary region) should be made with great caution and warrants exploration of the remote history

  8. A systematic review: perivascular epithelioid cell tumor of gastrointestinal tract

    PubMed Central

    Chen, Zehong; Han, Siqi; Wu, Jialin; Xiong, Minmin; Huang, Yanqiao; Chen, Jianhui; Yuan, Yujie; Peng, Jianjun; Song, Wu

    2016-01-01

    Abstract Perivascular epithelioid cell tumor (PEComa) is a rare entity with distinctive morphology and of expressing myomelanocytic markers. Gastrointestinal tract (GI) is one of the most common anatomic sites of origin and counts for 20% to 25% of all reported cases of perivascular epithelioid cell tumors not otherwise specified (PEComas-NOS). However, the biologic behavior of perivascular epithelioid cell tumors of gastrointestinal tract (GI PEComas-NOS) is still unclear. The aim of conducting this systematic review is to sum up what is known so far of the epidemiology, natural history, management and prognosis of GI PEComas-NOS. A systematic research was performed on PubMed and EMBASE using the following terms: (“perivascular epithelioid cell tumor” or “PEComa”) and (“gastrointestinal tract” or “GI” or “oral ” or “mouth” or “esophagus” or “gullet” or “gastric” or “stomach” or “duodenum” or “jejunum” or “ileum” or “cecum” or “colon” or “colorectal” or “sigmoid” or “rectum” or “anus” or “mesentery”) up to December 1, 2015. Retrieved GI PEComas-NOS publications, which included these terms, contains case reports, case series to case characteristic researches. A total of 168 articles were reviewed, 41 GI PEComa-NOS English studies among which were retrieved for analysis. We reviewed epidemiology, natural history, management and prognosis of GI PEComa-NOS. Generally GI PEComa-NOS is believed to have women predomination. The most frequently involved location is colon with non-specific clinical signs. Pathologically, GI PEComas-NOS shows epithelioid predominance (70%), meanwhile coexpresses melanocytic and muscle markers characteristically, while immunohistochemistry is a useful tool for identify, which indicates that HMB-45 is regarded as the most sensitive reagent. Complete resection served as mainstay of treatment, while chemotherapy should be unanimously considered to apply in malignant

  9. [New synthesis empathogenic agents].

    PubMed

    Velea, D; Hautefeuille, M; Vazeille, G; Lantran-Davoux, C

    1999-01-01

    The use of synthesis drugs is the object of numerous written articles and TV programs in the last, decade. These synthesis drugs or "designer drugs", are well known for their ability to enhance, reinforce or appease social difficulties and relationships. In the research for empathetic and entactogenic relations one discover an obvious lack of communication and "warmth" in personal or professional relationship. An image of chemical "well being" has become a frequent stereotype of a society with an atrophying of performance and values while supposedly dedicating itself to individual performance. The youths are the first victims of these new drugs, the economical and social environment are the main reinforcing factors of this behaviour. The main characteristic of these drugs, is the non-recognition of their danger, some users go so far as to describe this category of substances as "drugs which are not drugs". As a characteristic, the use of a these synthesis drugs is almost recreative, during the week-end and holiday. The drug addiction is different than that of opiates or cocaine. One can observe some cases of real dependence--corresponding to the DSW IV criterion--when the personality of the users is the main characteristic (narcissic failure, immature personality, family and school problems). Many adverse effects--hypertension, kidney failure, psychoses--were declared. The mass-media has presented many articles concerning Ecstasy (MDMA). This is the most used drug during the rave parties. Its adverse effects are well known and proven. The authors would like to present other more recent synthesis drugs, also known as "analogs". These drugs, a kind of mixture between amphetamine-like (MDMA, MBDB, MDA) and misused medicines (ketamine, gamma OH, atropine) represent a real danger. GHB, 2 CB, HMB, are some of these recent substances. The possibility to procure them on the Web, or to produce them by oneself, add to their danger because of the lack of controls on toxicity

  10. High-intensity interval training and β-hydroxy-β-methylbutyric free acid improves aerobic power and metabolic thresholds

    PubMed Central

    2014-01-01

    Background Previous research combining Calcium β-hydroxy-β-methylbutyrate (CaHMB) and running high-intensity interval training (HIIT) have shown positive effects on aerobic performance measures. The purpose of this study was to examine the effect of β-hydroxy-β-methylbutyric free acid (HMBFA) and cycle ergometry HIIT on maximal oxygen consumption (VO2peak), ventilatory threshold (VT), respiratory compensation point (RCP) and time to exhaustion (Tmax) in college-aged men and women. Methods Thirty-four healthy men and women (Age: 22.7 ± 3.1 yrs ; VO2peak: 39.3 ± 5.0 ml · kg-1 · min-1) volunteered to participate in this double-blind, placebo-controlled design study. All participants completed a series of tests prior to and following treatment. A peak oxygen consumption test was performed on a cycle ergometer to assess VO2peak, Tmax, VT, and RCP. Twenty-six participants were randomly assigned into either a placebo (PLA-HIIT) or 3 g per day of HMBFA (BetaTor™) (HMBFA-HIIT) group. Eight participants served as controls (CTL). Participants in the HIIT groups completed 12 HIIT (80-120% maximal workload) exercise sessions consisting of 5–6 bouts of a 2:1 minute cycling work to rest ratio protocol over a four-week period. Body composition was measured with dual energy x-ray absorptiometry (DEXA). Outcomes were assessed by ANCOVA with posttest means adjusted for pretest differences. Results The HMBFA-HIIT intervention showed significant (p < 0.05) gains in VO2peak, and VT, versus the CTL and PLA-HIIT group. Both PLA-HIIT and HMBFA-HIIT treatment groups demonstrated significant (p < 0.05) improvement over CTL for Tmax, and RCP with no significant difference between the treatment groups. There were no significant differences observed for any measures of body composition. An independent-samples t-test confirmed that there were no significant differences between the training volumes for the PLA-HIIT and HMBFA-HIIT groups. Conclusions Our

  11. Distinctive renal cell tumor simulating atrophic kidney with 2 types of microcalcifications. Report of 3 cases.

    PubMed

    Hes, Ondrej; de Souza, Tulio Geraldo; Pivovarcikova, Kristyna; Grossmann, Petr; Martinek, Petr; Kuroda, Naoto; Kacerovska, Denisa; Svajdler, Marian; Straka, Lubomir; Petersson, Fredrik; Hora, Milan; Michal, Michal

    2014-04-01

    We report 3 cases of primary renal cell tumor simulating atrophic kidney with distinct gross, morphologic, immunohistochemical, and molecular genetic features. The tumors were retrieved out of more than 17 000 renal tumors from the Plzen Tumor Registry. Tissues for light microscopy had been fixed, embedded, and stained with hematoxylin and eosin using routine procedures. The tumors were further analyzed using immunohistochemistry, array comparative genomic hybridization, and human androgen receptor. Analyses of VHL gene and loss of heterozygosity (LOH) 3p were also performed. The patients were 2 women and 1 man, with ages ranging from 29 to 35 years (mean, 31.3 years). Grossly, the neoplasms were encapsulated and round with largest diameter of 3.5 cm (mean, 3.2 cm). Follow-up available for all patients ranged from 2 to 14 years (mean, 8 years). No aggressive behavior was noted. Histologically, akin to atrophic (postpyelonephritic) kidney parenchyma, the tumors were composed of follicles of varying sizes that were filled by eosinophilic secretion. Rare areas contained collapsed follicles. Each follicle was endowed with a small capillary. The stroma was loose, inconspicuous, and focally fibrotic. Two types of calcifications were noted: typical psammoma bodies and amorphous dark-blue stained calcified deposits. Immunohistochemically, tumors were strongly positive for cytokeratins (OSCAR), CD10, and vimentin, with weak immunopositivity for CAM5.2 and AE1-AE3. WT1 and cathepsin K were weakly to moderately focally to diffusely positive. Tumors were negative for cytokeratin 20, carbonic anhydrase IX, parvalbumin, HMB45, TTF1, TFE3, chromogranin A, thyroglobulin, PAX8, and ALK. Only 1 case was suitable for molecular genetic analyses. No mutations were found in the VHL gene; no methylation of VHL promoter was noted. No numerical aberrations were found by array comparative genomic hybridization analysis. LOH for chromosome 3p was not detected. Analysis of clonality (human

  12. Identifying cell and molecular stress after radiation in a three-dimensional (3-D) model of oral mucositis

    SciTech Connect

    Lambros, Maria Polikandritou; Parsa, Cyrus; Mulamalla, HariChandana; Orlando, Robert; Lau, Bernard; Huang, Ying; Pon, Doreen; Chow, Moses

    2011-02-04

    Research highlights: {yields} We irradiated a 3-D human oral cell culture of keratinocytes and fibroblasts with 12 and 2 Gy. {yields} 6 h after irradiation the histopathology and apoptosis of the 3-D culture were evaluated. Microarrays were used to assess the gene expression in the irradiated 3-D tissue. {yields} 12 Gy induced significant histopathologic changes and cellular apoptosis. {yields} 12 Gy significantly affected genes of the NF-kB pathway, inflammatory cytokines and DAMPs. -- Abstract: Mucositis is a debilitating adverse effect of chemotherapy and radiation treatment. It is important to develop a simple and reliable in vitro model, which can routinely be used to screen new drugs for prevention and treatment of mucositis. Furthermore, identifying cell and molecular stresses especially in the initiation phase of mucositis in this model will help towards this end. We evaluated a three-dimensional (3-D) human oral cell culture that consisted of oral keratinocytes and fibroblasts as a model of oral mucositis. The 3-D cell culture model was irradiated with 12 or 2 Gy. Six hours after the irradiation we evaluated microscopic sections of the cell culture for evidence of morphologic changes including apoptosis. We used microarrays to compare the expression of several genes from the irradiated tissue with identical genes from tissue that was not irradiated. We found that irradiation with 12 Gy induced significant histopathologic effects including cellular apoptosis. Irradiation significantly affected the expression of several genes of the NF-kB pathway and several inflammatory cytokines, such as IL-1B, 1L-8, NF-kB1, and FOS compared to tissue that was not irradiated. We identified significant upregulation of several genes that belong to damage-associated molecular patterns (DAMPs) such as HMB1, S100A13, SA10014, and SA10016 in the 3-D tissues that received 12 Gy but not in tissues that received 2 Gy. In conclusion, this model quantifies radiation damage and this

  13. Kinetics of microbial methionine metabolism in continuous cultures administered different methionine sources.

    PubMed

    Firkins, J L; Fowler, C M; Devillard, E; Bequette, B J

    2015-02-01

    The Met precursor 2-hydroxy-4-(methylthio) butanoic acid (HMB) is expected to be more extensively degraded in the rumen than its isopropyl ester (HMBi). A control and 3 isomolar treatments-0.097% dl-methionine, 0.11% HMBi (HMBi), and 0.055% HMBi plus 0.048% Met (Met + HMBi)-were dosed every 8h simultaneously with 3-times-daily feeding into continuous cultures. Starting on d 9, for 6 consecutive doses, both [1-(13)C]-l-Met and [methyl-(2)H3]-l-Met replaced part of the unlabeled dl-Met, [(13)C5]-dl-HMBi replaced a portion of the unlabeled dl-HMBi, and [1-(13)C]-l-Met plus [(13)C5]-dl-HMBi replaced a portion of the respective unlabeled doses for the Met + HMBi treatment. After the sixth dose (d 11), unlabeled Met or HMBi provided 100% of the doses to follow elimination kinetics of the labels in HMBi, free Met, and bacterial Met compartments. The free [1-(13)C]-l-Met recycled more and was recovered in bacterial Met to a lesser extent than was the free [methyl-(2)H3]-l-Met recycling and that was recovered in bacterial Met. Increasing HMBi inclusion (0, 50, and 100% substitution of the exogenously dosed Met on a molar equivalent basis) tended to increase HMBi escape from 54.7 to 71.3% for the 50 and 100% HMBi treatments, respectively. Despite HMBi substituting for and decreasing the dosage of Met, increasing HMBi increased accumulation of free Met in fermenter fluid. The HMBi (after de-esterification of the isopropyl group) presumably produces Met through the intermediate α-ketomethylthyiobutyrate with an aminotransferase that also has high affinity for branched-chain AA. We provide evidence that the HMBi-derived Met is likely released from bacterial cells and accumulates rather than being degraded, potentially as a result of lagging d-stereoisomer metabolism. More research is needed to evaluate racemization and metabolism of stereoisomers of HMBi, Met, and other AA in ruminal microbes.

  14. Metastatic Malignant Melanoma With Complete Loss of Differentiation Markers (Undifferentiated/Dedifferentiated Melanoma): Analysis of 14 Patients Emphasizing Phenotypic Plasticity and the Value of Molecular Testing as Surrogate Diagnostic Marker.

    PubMed

    Agaimy, Abbas; Specht, Katja; Stoehr, Robert; Lorey, Thomas; Märkl, Bruno; Niedobitek, Gerald; Straub, Melanie; Hager, Thomas; Reis, Anna-Carinna; Schilling, Bastian; Schneider-Stock, Regine; Hartmann, Arndt; Mentzel, Thomas

    2016-02-01

    Metastatic malignant melanoma is notorious for its phenotypic diversity and loss of differentiation markers. We herein summarized our experience with 14 metastatic melanomas showing complete loss of immunohistochemical melanocytic markers (with or without heterologous differentiation). Patients included 11 men and 3 women aged 24 to 78 years (median, 67 y). Thirteen patients had histologically confirmed primary skin melanoma, and 1 had metastatic melanoma of unknown primary. Undifferentiated metastasis was diagnosed synchronous to primary tumor (n=1), following skin melanoma by 3 months to 9 years (n=11) and preceding it by 1 year (n=1). Sites of undifferentiated metastases were axillary (3), inguinal (1), or submandibular (1) lymph nodes, digestive tract (2), bone/soft tissue (2), lung/pleura (2), and disseminated (n=3). Histology of metastases mimicked undifferentiated pleomorphic or spindle cell sarcoma with variable myxoid and giant cell areas (n=10) and cytokeratin-positive undifferentiated small cell sarcoma (n=1). Three cases showed heterologous dedifferentiation: pleomorphic rhabdomyosarcoma (n=1), teratocarcinosarcoma-like with prominent rhabdomyoblasts (n=1), and adenocarcinoma-like with metaplastic bone (n=1). All cases were negative for S100, melanoma cocktail, HMB45, Melan A, and SOX10. Other markers showed following results: smooth muscle actin (1/14), p16 (1/14), TP53 (2/12), pancytokeratin (4/14), desmin (5/14), h-caldesmon (0/9), and MDM2/CDK4 (0/5). SMARCB1 was intact in 8/8 cases. Genotyping showed BRAF(V600E) mutation (5/14), NRAS mutation (5/14), and BRAF/NRAS wild-type (4/14). In conclusion, undifferentiated/dedifferentiated metastatic melanoma is likely underrecognized and frequently mistaken for undifferentiated sarcoma or other neoplasms. Diagnosis of undifferentiated sarcoma at sites where melanoma metastasis are frequent (eg, inguinal and axillary region) should be made with great caution and warrants exploration of the remote history

  15. Angiomyolipoma with epithelial cysts (AMLEC): a distinct cystic variant of angiomyolipoma.

    PubMed

    Fine, Samson W; Reuter, Victor E; Epstein, Jonathan I; Argani, Pedram

    2006-05-01

    Renal angiomyolipoma (AML) is typically a solid lesion, composed of varying amounts of adipose, vascular, and muscular tissue, lacking an epithelial component. Although it is known that entrapped renal tubules may be observed in AML, presentation as a cystic mass has not been previously reported. We report the clinicopathologic and immunohistochemical features of four cystic renal AML. The lesions were found in 2 male and 2 female patients, ranging in age from 37 to 76 years, none with a history of hormonal therapy. One of the four patients had known tuberous sclerosis, and this patient and 1 other presented with bilateral cystic renal lesions. Grossly, the lesions measured between 1.3 and 4.5 cm in greatest dimension. Histologically, the lesions were each composed of three components: 1) epithelial cysts lined by cuboidal to hobnail cells; 2) a compact subepithelial "cambium-like" layer of cellular, müllerian-like AML stroma with prominent admixed chronic inflammation; and 3) muscle-predominant AML with associated dysmorphic blood vessels exterior to the cellular subepithelial stroma. Immunohistochemically, the stromal components of all four lesions labeled with HMB-45 and Melan-A, most intensely in the cellular subepithelial stroma, whereas smooth muscle actin and desmin demonstrated the opposite pattern, with greatest intensity in the muscle-predominant AML areas. Immunoreactivity for estrogen and progesterone receptors (ER, PR) and CD10 was present in all cases, with strongest and most diffuse staining in the subepithelial AML cells. The cyst lining cells were positive for pancytokeratin and soy bean agglutinin (the latter characteristic of distal nephron epithelium) but did not label for ER, PR, or melanocytic markers. Although these distinctive lesions may be confused with mixed epithelial-stromal tumor, their lack of female predominance or association with hormone therapy, their distinctive dysplastic blood vessels and disorganized exterior muscular layer

  16. Triple synchronous neoplasms in one kidney: report of a case and review of the literature.

    PubMed

    Jun, Sun-Young; Cho, Kyung-Ja; Kim, Chung-Su; Ayala, Alberto G; Ro, Jae Y

    2003-12-01

    We report the case of a patient with three synchronous but histologically different primary renal tumors that were all in the same kidney. Two tumors were different subtypes of renal cell carcinoma (RCC), and the third was a variant form of angiomyolipoma. The patient was a 62-year-old man who was receiving antihypertensive drugs and came to our hospital for a regular check-up. Ultrasonography performed during the visit revealed a left renal mass, but the patient had no related symptoms. Subsequent computed tomography revealed two round, high-density masses, one in the mid-portion and the other in the lower pole of the left kidney, and multiple cysts in the right kidney and the liver. The mass in the mid-portion measured 3.3 x 3.0 x 2.8 cm, and the mass in the lower pole measured 1.7 x 1.1 x 0.9 cm. A left radical nephrectomy was performed. On gross examination, an additional ovoid nodule (0.6 cm in the greatest dimension) was found in the lower pole. Microscopically, the largest tumor consisted of a broad alveolar arrangement of large round cells with abundant eosinophilic or clear cytoplasm, distinct cell borders, and perinuclear halos, features consistent with chromophobe RCC. The smallest tumor was a conventional (clear-cell) RCC. The third tumor was composed solely of atypical epithelioid cells with prominent nucleoli and yellowish-brown to black pigments. The tumor cells were positive for melanin (Fontana-Masson stain), the melanoma marker HMB45, vimentin, smooth-muscle actin, and the macrophage marker CD68 and were negative for cytokeratin. This tumor was considered a pigmented epithelioid type of angiomyolipoma. The histologic, histochemical, and immunohistochemical features in this case confirmed the presence of three synchronous primary tumors, a chromophobe and a clear-cell type RCC and a pigmented epithelioid angiomyolipoma, all of which were in the same kidney. This case is the first of its type reported in the literature.

  17. PSF/SFPQ is a very common gene fusion partner in TFE3 rearrangement-associated perivascular epithelioid cell tumors (PEComas) and melanotic Xp11 translocation renal cancers: clinicopathologic, immunohistochemical, and molecular characteristics suggesting classification as a distinct entity.

    PubMed

    Rao, Qiu; Shen, Qin; Xia, Qiu-yuan; Wang, Zi-yu; Liu, Biao; Shi, Shan-shan; Shi, Qun-li; Yin, Hong-lin; Wu, Bo; Ye, Sheng-bing; Li, Li; Chen, Jie-Yu; Pan, Min-hong; Li, Qing; Li, Rui; Wang, Xuan; Zhang, Ru-song; Yu, Bo; Ma, Heng-hui; Lu, Zhen-feng; Zhou, Xiao-jun

    2015-09-01

    An increasing number of TFE3 rearrangement-associated tumors, such as TFE3 rearrangement-associated perivascular epithelioid cell tumors (PEComas), melanotic Xp11 translocation renal cancers, and melanotic Xp11 neoplasms, have recently been reported. We examined 12 such cases, including 5 TFE3 rearrangement-associated PEComas located in the pancreas, cervix, or pelvis and 7 melanotic Xp11 translocation renal cancers, using clinicopathologic, immunohistochemical, and molecular analyses. All the tumors shared a similar morphology, including a purely nested or sheet-like architecture separated by a delicate vascular network, purely epithelioid cells displaying a clear or granular eosinophilic cytoplasm, a lack of papillary structures and spindle cell or fat components, uniform round or oval nuclei containing small visible nucleoli, and, in most cases (11/12), melanin pigmentation. The levels of mitotic activity and necrosis varied. All 12 cases displayed moderately (2+) or strongly (3+) positive immunoreactivity for TFE3 and cathepsin K. One case labeled focally for HMB45 and Melan-A, whereas the others typically labeled moderately (2+) or strongly (3+) for 1 of these markers. None of the cases were immunoreactive for smooth muscle actin, desmin, CKpan, S100, or PAX8. PSF-TFE3 fusion genes were confirmed by reverse transcription polymerase chain reaction in cases (7/7) in which a novel PSF-TFE3 fusion point was identified. All of the cases displayed TFE3 rearrangement associated with Xp11 translocation. Furthermore, we developed a PSF-TFE3 fusion fluorescence in situ hybridization assay for the detection of the PSF-TFE3 fusion gene and detected it in all 12 cases. Clinical follow-up data were available for 7 patients. Three patients died, and 2 patients (cases 1 and 3) remained alive with no evidence of disease after initial resection. Case 2 experienced recurrence and remained alive with disease. Case 5, a recent case, remained alive with extensive abdominal cavity

  18. Distinctive renal cell tumor simulating atrophic kidney with 2 types of microcalcifications. Report of 3 cases.

    PubMed

    Hes, Ondrej; de Souza, Tulio Geraldo; Pivovarcikova, Kristyna; Grossmann, Petr; Martinek, Petr; Kuroda, Naoto; Kacerovska, Denisa; Svajdler, Marian; Straka, Lubomir; Petersson, Fredrik; Hora, Milan; Michal, Michal

    2014-04-01

    We report 3 cases of primary renal cell tumor simulating atrophic kidney with distinct gross, morphologic, immunohistochemical, and molecular genetic features. The tumors were retrieved out of more than 17 000 renal tumors from the Plzen Tumor Registry. Tissues for light microscopy had been fixed, embedded, and stained with hematoxylin and eosin using routine procedures. The tumors were further analyzed using immunohistochemistry, array comparative genomic hybridization, and human androgen receptor. Analyses of VHL gene and loss of heterozygosity (LOH) 3p were also performed. The patients were 2 women and 1 man, with ages ranging from 29 to 35 years (mean, 31.3 years). Grossly, the neoplasms were encapsulated and round with largest diameter of 3.5 cm (mean, 3.2 cm). Follow-up available for all patients ranged from 2 to 14 years (mean, 8 years). No aggressive behavior was noted. Histologically, akin to atrophic (postpyelonephritic) kidney parenchyma, the tumors were composed of follicles of varying sizes that were filled by eosinophilic secretion. Rare areas contained collapsed follicles. Each follicle was endowed with a small capillary. The stroma was loose, inconspicuous, and focally fibrotic. Two types of calcifications were noted: typical psammoma bodies and amorphous dark-blue stained calcified deposits. Immunohistochemically, tumors were strongly positive for cytokeratins (OSCAR), CD10, and vimentin, with weak immunopositivity for CAM5.2 and AE1-AE3. WT1 and cathepsin K were weakly to moderately focally to diffusely positive. Tumors were negative for cytokeratin 20, carbonic anhydrase IX, parvalbumin, HMB45, TTF1, TFE3, chromogranin A, thyroglobulin, PAX8, and ALK. Only 1 case was suitable for molecular genetic analyses. No mutations were found in the VHL gene; no methylation of VHL promoter was noted. No numerical aberrations were found by array comparative genomic hybridization analysis. LOH for chromosome 3p was not detected. Analysis of clonality (human

  19. Extrarenal rhabdoid tumors of soft tissue: a clinicopathologic and immunohistochemical study of 18 cases.

    PubMed

    Fanburg-Smith, J C; Hengge, M; Hengge, U R; Smith, J S; Miettinen, M

    1998-12-01

    Rhabdoid tumor is a well-accepted clincopathologic entity among childhood renal neoplasms; similar tumors have been described in extrarenal locations. We present the clinicopathologic profile and the immunohistochemical features of a series of soft tissue rhabdoid tumors. Twenty-eight cases coded as extrarenal rhabdoid tumor (ERRT), RT, possible ERRT, and "large cell sarcoma" were retrieved from the Armed Forces Institute of Pathology soft tissue registry. The tumors were reclassified according to strict criteria by light microscopy, clinical information, immunohistochemistry, and, in some cases, electron microscopy. Soft tissue rhabdoid tumor (STRT) was defined as (1) a tumor composed of noncohesive single cells, clusters, or sheets of large tumor cells with abundant glassy eosinophilic cytoplasm, an eccentric vesicular nucleus, and an extremely large nucleolus; (2) positivity for vimentin and/or cytokeratin or other epithelial markers by immunostaining; and (3) exclusion of other tumor types with rhabdoid inclusions (melanoma, other sarcomas, carcinoma). Eighteen cases met our criteria for soft tissue rhabdoid tumors. The median patient age was 13 years (range, 6 months to 56 years). Ninety-four percent of STRT cases were positive for vimentin and 59% for pan-cytokeratin. Sixty-three percent and 60% were positive for CAM 5.2 and EMA, respectively. Seventy-nine percent stained for at least one epithelial marker; 76% stained for both vimentin and epithelial markers simultaneously. Forty-two percent stained for MSA, and 14% for CEA and SMA. CD99, synaptophysin, CD57 (Leu-7), NSE, and focal S100 protein were identified in 75%, 66%, 56%, 54%, and 31% of the STRT cases, respectively. All STRT cases examined were negative for HMB-45, chromogranin, BER-EP4, desmin, myoglobin, CD34, and GFAP. Follow-up examination in 61% of the STRT patients revealed that 64% of patients died of disease within a median follow-up interval of 19 months (range, 4 months to 5 years); 82% had

  20. A systematic review: perivascular epithelioid cell tumor of gastrointestinal tract.

    PubMed

    Chen, Zehong; Han, Siqi; Wu, Jialin; Xiong, Minmin; Huang, Yanqiao; Chen, Jianhui; Yuan, Yujie; Peng, Jianjun; Song, Wu

    2016-07-01

    Perivascular epithelioid cell tumor (PEComa) is a rare entity with distinctive morphology and of expressing myomelanocytic markers. Gastrointestinal tract (GI) is one of the most common anatomic sites of origin and counts for 20% to 25% of all reported cases of perivascular epithelioid cell tumors not otherwise specified (PEComas-NOS). However, the biologic behavior of perivascular epithelioid cell tumors of gastrointestinal tract (GI PEComas-NOS) is still unclear. The aim of conducting this systematic review is to sum up what is known so far of the epidemiology, natural history, management and prognosis of GI PEComas-NOS.A systematic research was performed on PubMed and EMBASE using the following terms: ("perivascular epithelioid cell tumor" or "PEComa") and ("gastrointestinal tract" or "GI" or "oral " or "mouth" or "esophagus" or "gullet" or "gastric" or "stomach" or "duodenum" or "jejunum" or "ileum" or "cecum" or "colon" or "colorectal" or "sigmoid" or "rectum" or "anus" or "mesentery") up to December 1, 2015. Retrieved GI PEComas-NOS publications, which included these terms, contains case reports, case series to case characteristic researches.A total of 168 articles were reviewed, 41 GI PEComa-NOS English studies among which were retrieved for analysis. We reviewed epidemiology, natural history, management and prognosis of GI PEComa-NOS. Generally GI PEComa-NOS is believed to have women predomination. The most frequently involved location is colon with non-specific clinical signs. Pathologically, GI PEComas-NOS shows epithelioid predominance (70%), meanwhile coexpresses melanocytic and muscle markers characteristically, while immunohistochemistry is a useful tool for identify, which indicates that HMB-45 is regarded as the most sensitive reagent. Complete resection served as mainstay of treatment, while chemotherapy should be unanimously considered to apply in malignant cases. Eventually, it is necessary for closed and long-term follow-up with endoscope and

  1. Renal cell carcinoma with angioleiomyoma-like stroma: clinicopathological, immunohistochemical, and molecular features supporting classification as a distinct entity.

    PubMed

    Williamson, Sean R; Cheng, Liang; Eble, John N; True, Lawrence D; Gupta, Nilesh S; Wang, Mingsheng; Zhang, Shaobo; Grignon, David J

    2015-02-01

    Rare renal epithelial neoplasms have been recognized to have an angioleiomyoma or leiomyoma-like proliferation of stromal smooth muscle; however, the nature of these tumors and their relationships to other renal cell carcinomas are poorly understood. We analyzed 23 such tumors for their clinicopathological, immunohistochemical, and cytogenetic features using fluorescence in situ hybridization. Twelve showed a homogeneous combination of features and were reclassified as renal cell carcinoma with angioleiomyoma-like stroma. These were composed of neoplastic glandular structures lined by cells with mixed clear, pale, and eosinophilic cytoplasm forming occasional papillary tufts. The stroma resembled smooth muscle and often extended away from the epithelial component, entrapping perinephric fat or non-neoplastic renal elements. Immunohistochemistry showed the epithelium to have reactivity for: carbonic anhydrase IX, CD10, vimentin, cytokeratin 7, cytokeratin 34βE12, and PAX8 but not α-methylacyl-coA-racemase. The stroma labeled for smooth muscle (smooth muscle actin 3+, desmin 1+, caldesmon 3+) but not epithelial antigens. Neither component showed substantial reactivity for HMB45, melan-A, cathepsin K, or TFE3 protein. An interrupted, conspicuous layer of CD34-positive endothelial cells rimmed the epithelium, imparting a two-cell layer pattern resembling myoepithelial or basal cells. Chromosome 3p deletion and trisomy 7 and 17 were uniformly absent. Follow-up was available for three patients, none of whom experienced malignant behavior. Eleven tumors were excluded from this category and considered to be clear cell renal cell carcinoma with a reactive proliferation of smooth muscle (n=4) or tangential sectioning of the pseudocapsule (n=2), renal cell carcinoma unclassified (n=4), or clear cell papillary renal cell carcinoma (n=1). In summary, renal cell carcinoma with angioleiomyoma-like stroma is a distinct neoplasm with characteristic morphological

  2. [SOCIODEMOGRAPHIC AND HEALTH CHARACTERISTICS ASSOCIATED WITH LOW BIRTH WEIGHT IN THE CANARY ISLANDS].

    PubMed

    Bello Lujan, Luis M; Saavedra Santana, Pedro; Gutiérrez García, Luisa Esther; García Hernández, José Angel; Serra Majem, Lluis

    2015-10-01

    Introducción y objetivo: desde 1976, el término bajo peso al nacer (BPN) se aplica a todos los recién nacidos con un peso inferior a 2.500 g. y constituye el factor más importante que afecta a la mortalidad neonatal y a la morbilidad en la infancia. El objetivo de este trabajo es identificar las asociaciones entre los factores biológicos, socioeconómicos y sanitarios y el bajo peso en el recién nacido en las islas Canarias. Material y método: se realizó un estudio epidemiológico transversal, con los ficheros de las gestantes del 2011 y 2012 (n = 11,768) del Complejo Hospitalario Universitario Insular Materno de Gran Canaria, que representó el 66,3% de todos los partos de la provincia para esos años, excluyéndose del análisis los datos correspondientes a los embarazos múltiples (393) (3,3%). Se analizaron la distribución y la frecuencia del peso según características sociodemográficas; los porcentajes se compararon con el test de la 2, las medias con el t-test y las medianas con el test de Wilcoxon para datos independientes. Aquellas variables que mostraron asociación con el bajo peso en el análisis univariado fueron introducidas en un análisis logístico multidimensional. Resultados: en la distribución del peso al nacer se observó un exceso de niños con bajo peso (9,3%), de los cuales el 62,1% fueron pretérmino. Las madres de estos niños son más delgadas, de menor talla y tienen un IMC promedio de < 18,5 kg/m2, así como un promedio de edad de 31,5 años. Se observó igualmente que existe un incremento entre la edad de la madre y el bajo peso, aunque el efecto no es lineal; de hecho, los aumentos del riesgo de BPN se aceleran a medida que aumenta la edad. Cuando el IMC de la madre decrece, aproximadamente por debajo de 25, aumenta linealmente el riesgo de bajo peso. Las OR más elevadas corresponden al retraso fetal en el crecimiento intrauterino (CIR) (OR = 6,3; IC-95% = 5,3; 7,4), la hipertensión/eclampsia (OR = 3,2; IC-95% = 2

  3. [Validity of the 24-h previous day physical activity recall (PDPAR-24) in Spanish adolescents].

    PubMed

    Cancela, José María; Lago, Joaquín; Ouviña, Lara; Ayán, Carlos

    2015-04-01

    Introducción: El control del nivel de práctica de actividad física que realizan los adolescentes, de sus factores determinantes y susceptibilidad al cambio resulta indispensable para intervenir sobre la epidemia de obesidad que afecta a la sociedad española. Sin embargo, el número de cuestionarios validados para valorar la actividad física en adolescentes españoles es escaso. Objetivos: Evaluar la validez del cuestionario24hPrevious Day Physical Activity Recall (PDPAR-24) cuando es aplicado a la población de adolescentes españoles. Método: Participaron en este estudio estudiantes de 14-15 años de dos centros de educación secundaria del norte de Galicia. Como criterio objetivo de la actividad física realizada se utilizó el registro proporcionado por el acelerómetro Actigraph GT3X.Se monitorizó a los sujetos durante un día por medio del acelerómetro y al día siguiente se administró el cuestionario de auto-informe. Resultados: Un total de 79 alumnos (15.16 ± 0.81 años, 39% mujeres) finalizaron el estudio. Se observan correlaciones positivas estadísticamente significativas de tamaño medio a grande en ambos sexos (r=0.50-0.98), para la actividad física ligera y moderada. Las correlaciones observadas son más elevadas a medida que aumenta la intensidad de la actividad física realizada. Conclusiones: El cuestionario de auto-informe PDPAR-24 puede ser considerado como una herramienta válida a la hora de valorar el nivel de actividad física en adolescentes españoles.

  4. [In Process Citation].

    PubMed

    Álvarez, Cristian; Ramírez-Campillo, Rodrigo; Vallejos-Rojas, Andrea; Jaramillo-Gallardo, Javiera; Salas Bravo, Carlos; Cano-Montoya, Johnattan; Celis-Morales, Carlos

    2016-03-25

     Introducción: obesidad e inactividad física son importantes factores de riesgo para el desarrollo de hipertensión en adultos. No obstante, hay poca evidencia sobre el efecto de estos factores de riesgo en el desarrollo de hipertensión en población infantil. Objetivo: investigar la asociación del estado nutricional, niveles de actividad física y etnicidad con niveles de hipertensión en escolares entre 6 y 13 años de edad. Métodos: un total de 418 escolares de ascendencia étnica europea (n = 311) y mapuche (n = 107) fueron participantes de este estudio transversal. Se midió el peso, talla, índice de masa corporal (IMC) y presión arterial, utilizando protocolos estandarizados. Resultados: no se encontraron diferencias significativas en IMC, estado nutricional y presión arterial entre niños con ascendencia europea y mapuche. No obstante, la prevalencia de prehipertensión (21,3% vs. 11,1%) e hipertensión (28,9% vs. 18,6%) fue significativamente mayor en escolares mapuches en comparación con europeos, respectivamente. Escolares con ascendencia mapuche tienen un mayor riesgo de desarrollar prehipertensión o hipertensión que escolares con ascendencia europea (OR: 1,92 [1,19 a 3,06], p < 0,01). La prevalencia de hipertensión aumenta significativamente en ambos grupos étnicos con el incremento de IMC y bajos niveles de actividad física. Conclusiones: el riesgo de desarrollar prehipertensión o hipertensión es mayor en población infantil ascendiente de mapuches que ascendiente de europeos y este riesgo se ve acentuado con el incremento de obesidad y bajos niveles de actividad física.

  5. [The importance of sleep deprivation as a mechanism for activating interictal epileptiform paroxysms].

    PubMed

    Navas, Patricia; Rodríguez-Santos, Lucía; Bauzano-Poley, Enrique; Lara, José Pablo; Barbancho, Miguel Ángel

    2016-04-01

    Introduccion. Aunque la privacion de sueño se ha utilizado durante años en electroencefalografia (EEG) como metodo de activacion de descargas epileptiformes intercriticas (DEI) en pacientes con alta sospecha de epilepsia, su sensibilidad y especificidad estan aun en discusion. Pacientes y metodos. Estudio descriptivo y retrospectivo de pacientes pediatricos derivados a neurofisiologia clinica para valoracion de epilepsia. Se han comparado los resultados de los EEG de privacion de sueño (EEG-PS) con los EEG de vigilia (EEG-V) en cada paciente para describir su rendimiento como mecanismo activador de DEI. Resultados. Se han analizado 500 pacientes (830 EEG-PS y 1.018 EEG-V). En los EEG-V se detectaron DEI en el 44%. El EEG-PS aumento en un 35% la capacidad del test para detectar las DEI. En los EEG-PS en los que se alcanzo sueño espontaneo se observaron DEI (no detectadas en el EEG-V) en un 25,1%. En el grupo de epilepsias focales se constato que el EEG-V detecto DEI en el 60,1% frente al 79,12% demostradas con el EEG-PS. En las epilepsias generalizadas esta diferencia fue mas marcada (27,2% y 77,2%, respectivamente). En los pacientes en los que tras un EEG-PS no se detectaron DEI (23,7%) y la sospecha clinica de epilepsia seguia siendo alta, se realizo polisomnografia nocturna y se llego a objetivar actividad epileptiforme intercritica en un 13,6%. Conclusiones. El EEG-PS aumenta la posibilidad de recoger DEI en un 35% con respecto al EEG-V. La privacion de sueño es un metodo activador de paroxismos epileptiformes, independientemente de si hay sueño o no durante la realizacion del EEG, aunque este efecto es mas marcado en los pacientes que alcanzan sueño.

  6. A giant inguinoscrotal hernia associated with other abdominal wall defects A case report.

    PubMed

    Iovino, Francesco; Auriemma, Pasquale Pio; Dani, Luca; Giordano, Giovanni; Barbarisi, Alfonso

    2016-04-29

    Le ernie giganti sono rare nei Paesi sviluppati ed ancora più raramente sono associate ad altre ernie della parete addominale, come un’ernia inguinale controlaterale o un’ernia ombelicale. La presenza di più difetti di parete facilità il riposizionamento in addome del contenuto di una voluminosa ernia inguinale senza compromettere la funzionalità cardiorespiratoria, ma il rischio di intasamento o strozzamento intestinale negli altri orifizi erniari aumenta. In letteratura non esistono opinioni convergenti se riparare simultaneamente o in maniera sequenziale, cioè in maniera distanziata nel tempo, le diverse ernie di parete, quando sono associate ad un’ernia gigante. Riportiamo in questo lavoro il caso clinico di un uomo di 60 anni, italiano, che si recò nel nostro ambulatorio di chirurgia lamentando da molti anni la presenza di un’ernia inguinale gigante associata ad un’ernia inguinale controlaterale ed un’ernia ombelicale. Il paziente alla visita presentava difficoltà di deambulazione, ma non riferiva disturbi di canalizzazione. Aveva diverse comorbidità e tra queste quella più importante era una insufficienza respiratoria severa. Dopo un accurato studio cardiologico, respiratorio e metabolico il paziente fu sottoposto a riparazione delle ernie a partire da quella gigante, in maniera sequenziale ed in anestesia spinale secondo la tecnica di Lichtenstein. L’ernia ombelicale fu riparata per ultima con tecnica diretta, senza protesi, ed anch’essa in anestesia spinale. Il decorso operatorio fu regolare dopo i tre interventi e non si ebbe alcuna complicanza respiratoria, cardiologica né di canalizzazione. In conclusione riteniamo che nei pazienti con importanti comorbidità la riparazione di un’ernia gigante associata ad altre ernie di parete debba avvenire in maniera sequenziale, monitorando con attenzione la canalizzazione e soprattutto il progressivo adattamento dei visceri in addome attraverso la palpazione degli orifizi erniari. I dati

  7. [Not Available].

    PubMed

    Ballesteros-Pomar, María; Villar-Taibo, Rocío; Calleja-Fernández, Alicia; Pintor-de-la-Maza, Begoña; Álvarez-Del-Campo, Cecilia; Vidal-Casariego, Alfonso; Cano-Rodríguez, Isidoro

    2016-06-03

    Los datos del estudio PREDYCES® nos revelaron que en España la desnutrición relacionada con la enfermedad (DRE) afecta a uno de cada cuatro pacientes hospitalizados. Esta cifra aumenta hasta el 36,8% en los pacientes hematológicos. Se calcula que un 20% de los pacientes oncológicos muere por complicaciones relacionadas con la DRE. Nuestro grupo se planteó en 2011 comenzar la implantación de un cribado nutricional en los servicios con mayor riesgo de DRE. La presente revisión trata de describir todo el proceso que hemos seguido para mejorar la situación nutricional en los pacientes ingresados en el Servicio de Hematología del Complejo Asistencial Universitario de León (CAULE), mayoritariamente con diagnóstico de neoplasias hematológicas. En un primer estudio piloto, detectamos una alta prevalencia de desnutrición, que tendió a aumentar durante la hospitalización. Además, solo el 8,3% los enfermos valorados recibieron algún tipo de soporte nutricional y no se estaban cubriendo sus necesidades ni calóricas ni proteicas, lo que se asociaba a un peor pronóstico. Por este motivo, nos decidimos a implantar de manera sistemática un cribado y una intervención nutricional adecuada, que comenzó en 2011 y que ha recibido el reconocimiento como Buena Práctica del Sistema Nacional de Salud.

  8. Perda de massa em ventos empoeirados de estrelas supergigantes

    NASA Astrophysics Data System (ADS)

    Vidotto, A. A.; Jatenco-Pereira, V.

    2003-08-01

    Em praticamente todas as regiões do diagrama HR, as estrelas apresentam evidências observacionais de perda de massa. Na literatura, pode-se encontrar trabalhos que tratam tanto do diagnóstico da perda de massa como da construção de modelos que visam explicá-la. O amortecimento de ondas Alfvén tem sido utilizado como mecanismo de aceleração de ventos homogêneos. Entretanto, sabe-se que os envelopes de estrelas frias contêm grãos sólidos e moléculas. Com o intuito de estudar a interação entre as ondas Alfvén e a poeira e a sua conseqüência na aceleração do vento estelar, Falceta-Gonçalves & Jatenco-Pereira (2002) desenvolveram um modelo de perda de massa para estrelas supergigantes. Neste trabalho, apresentamos um estudo do modelo acima proposto para avaliar a dependência da taxa de perda de massa com alguns parâmetros iniciais como, por exemplo, a densidade r0, o campo magnético B0, o comprimento de amortecimento da onda L0, seu fluxo f0, entre outros. Sendo assim, aumentando f0 de 10% a partir de valores de referência, vimos que aumenta consideravelmente, enquanto que um aumento de mesmo valor em r0, B0 e L0 acarreta uma diminuição em .

  9. PREVALENCE AND FACTORS ASSOCIATED WITH VITAMIN B12 DEFICIENCY IN ELDERLY FROM VIÇOSA/MG, BRASIL.

    PubMed

    Oliveira Martinho, Karina; Luiz Araújo Tinôco, Adelson; Queiroz Ribeiro, Andréia

    2015-11-01

    La prevalencia de deficiencia nutricional de vitamina B12 aumenta con la edad y es especialmente común en la población mayor. El objetivo de este estudio consistió en determinar su prevalencia y los factores asociados a esta carencia en mayores no institucionalizados de Viçosa, Estado de Minas Gerais, Brasil. Métodos: estudio poblacional interseccional, realizado para identificar la prevalencia y los factores asociados a deficiencia de vitamina B12 entre la población de mayores en Viçosa (MG). Los datos fueron recopilados desde agosto de 2011 hasta junio de 2012 mediante una encuesta en los hogares y pruebas hematológicas y bioquímicas realizadas en 340 mayores. Resultados: la prevalencia de deficiencia de vitamina B12 en este grupo fue del 17,4% (95% CI, 13,4% - 21,4%). La deficiencia cognitiva se presenta como un factor importante relacionado con la deficiencia de vitamina B12. Conclusiones: el informe actual contribuye a los estudios que destacan ciertos factores que podrían afectar al rendimiento de las personas mayores en su proceso de envejecimiento natural, especialmente cuando estos factores están asociados con deficiencia cognitiva y dan lugar a una discapacidad significativa así como pérdida de calidad de vida. Así, los resultados aquí presentados han servido para aportar un conocimiento más comprensivo sobre la relación entre deficiencia de B12 y su impacto sobre este grupo de población. También han demostrado su relevancia de cara a la planificación de programas e iniciativas de salud pública centrados en este grupo de población.

  10. [TRENDS TO INCREASED BODY FAT AND BLOOD PRESSURE OF UNIVERSITY STUDENTS IN TWO COHORTS (2009-2014)].

    PubMed

    Contreras-Mellado, Victor; Vilchez-Avaca, Catalina; Gomez-Campos, Rossana; Luarte-Rocha, Cristian; Cossio Bolaños, Marco A

    2015-12-01

    Objetivo: a) describir los cambios de la adiposidad corporal, b) cuantificar el incremento de la presión arterial y c) verificar si la presión arterial aumenta en función de las categorías de la adiposidad corporal en dos cohortes (2009-2014) en jóvenes universitarios. Métodos: se comparó dos mediciones transversales efectuadas en el año 2009 y 2014. La muestra del 2009 estuvo constituida por 309 universitarios (138 varones y 171 mujeres) y la del 2014 por 319 jóvenes (136 varones y 183 mujeres). Se evaluó peso, estatura, índice de masa corporal (IMC), circunferencia de la cintura (CC) y presión arterial diastólica (PAD) y sistólica (PAS). Resultados: los varones aumentaron significativamente en la adiposidad corporal (IMC = 1,9 kg/m2 y CC = 6,4 cm), (p < 0,001), mientras que las mujeres incrementaron la presión arterial (PAD = 5,7 mmHg y PAS = 6,6 mmHg) en función de la adiposidad corporal en un intervalo de 5 años (p < 0,001). Conclusión: los varones incrementaron su adiposidad corporal, mientras que las mujeres aumentaron la presión arterial. Los resultados sugieren la adopción de estilos de vida saludables para combatir el exceso de peso y la presencia de hipertensión arterial en los jóvenes universitarios.

  11. [Frontal symptoms, self-perceived stress, and subjective memory complaints in substance abusers].

    PubMed

    Terán-Mendoza, Oscar; Sira-Ramos, Diayanny; Guerrero-Alcedo, Jesús; Arroyo-Alvarado, Daniela

    2016-04-01

    Introduccion. La adiccion a sustancias representa un problema de salud publica, teniendo en cuenta que a diario aumenta el numero de individuos que consumen drogas. Resulta de interes el estudio de variables neuropsicologicas que permitan comprender la naturaleza de las adicciones, entendiendo que los circuitos cerebrales estan implicados en su establecimiento, mantenimiento y rehabilitacion. Objetivos. Determinar la influencia de la adiccion sobre la sintomatologia frontal, el estres autopercibido y las quejas subjetivas de memoria; analizar como se relacionan dichas variables en las personas con adicciones y establecer diferencias en cuanto a estas variables entre adictos con y sin quejas subjetivas de memoria. Sujetos y metodos. Se aplico el inventario de sintomas prefrontales (ISP), la escala de estres percibido (EEP-14) y el cuestionario de fallos de memoria de la vida cotidiana (MFE-30) a una muestra compuesta por 115 adictos a sustancias y 115 personas de poblacion no clinica, igualadas en edad, sexo y nivel educativo. Resultados. Se evidencian diferencias significativas entre los adictos a sustancias y los sujetos no clinicos en la escala emocional del ISP y el MFE-30; ademas, en la muestra clinica se observan correlaciones altamente significativas entre todas las escalas. Entre las personas con adicciones que manifestaron quejas de memoria y quienes no, se evidencian diferencias significativas en todas las escalas, a excepcion del estres autopercibido. Conclusiones. Se considera necesario tomar en cuenta los niveles de estres autopercibido, la sintomatologia frontal y las quejas subjetivas de memoria en adictos a sustancias, debido a que los problemas ejecutivos, atencionales y mnesicos podrian afectar diversas variables en el proceso de tratamiento y rehabilitacion.

  12. [In Process Citation].

    PubMed

    Álvarez, Cristian; Ramírez-Campillo, Rodrigo; Vallejos-Rojas, Andrea; Jaramillo-Gallardo, Javiera; Salas Bravo, Carlos; Cano-Montoya, Johnattan; Celis-Morales, Carlos

    2016-01-01

     Introducción: obesidad e inactividad física son importantes factores de riesgo para el desarrollo de hipertensión en adultos. No obstante, hay poca evidencia sobre el efecto de estos factores de riesgo en el desarrollo de hipertensión en población infantil. Objetivo: investigar la asociación del estado nutricional, niveles de actividad física y etnicidad con niveles de hipertensión en escolares entre 6 y 13 años de edad. Métodos: un total de 418 escolares de ascendencia étnica europea (n = 311) y mapuche (n = 107) fueron participantes de este estudio transversal. Se midió el peso, talla, índice de masa corporal (IMC) y presión arterial, utilizando protocolos estandarizados. Resultados: no se encontraron diferencias significativas en IMC, estado nutricional y presión arterial entre niños con ascendencia europea y mapuche. No obstante, la prevalencia de prehipertensión (21,3% vs. 11,1%) e hipertensión (28,9% vs. 18,6%) fue significativamente mayor en escolares mapuches en comparación con europeos, respectivamente. Escolares con ascendencia mapuche tienen un mayor riesgo de desarrollar prehipertensión o hipertensión que escolares con ascendencia europea (OR: 1,92 [1,19 a 3,06], p < 0,01). La prevalencia de hipertensión aumenta significativamente en ambos grupos étnicos con el incremento de IMC y bajos niveles de actividad física. Conclusiones: el riesgo de desarrollar prehipertensión o hipertensión es mayor en población infantil ascendiente de mapuches que ascendiente de europeos y este riesgo se ve acentuado con el incremento de obesidad y bajos niveles de actividad física. PMID:27238776

  13. Life Course Experiences, Pain and Suffering: A Case Study of an Older Mexican American Woman with Mobility Impairment

    PubMed Central

    Walker, Janiece L.; Harrison, Tracie C.; Hendrickson, Sherry G.

    2012-01-01

    There is a dearth of literature examining how adversity shapes the experiences of pain and/or suffering in a middle aged Mexican American women. The purpose of this qualitative descriptive study was to understand pain and suffering from a life course perspective as described by a Mexican American woman aging with early onset mobility impairment. This Hispanic woman experienced episodes of abuse and rejection over the life course, which may have significantly influenced her pain and suffering experience in adulthood. This adds to the literature on how adversity influences later life pain experience and provides insight on why pharmacological treatment alone may not be as successful as a holistic intervention. Hay escasez de literatura que examine cómo la adversidad da forma a las experiencias de dolor y / o sufrimiento en mujeres mexicana-americana mayores de edad. El propósito de este estudio descriptivo cualitativo fue comprender el dolor y el sufrimiento desde una perspectiva de ciclo de vida como descrito por una mujer mexicana-americana envejeciendo con inicio temprano de deterioro de movilidad. Esta Latina experimentó episodios de maltrato y rechazo, que se percibió haber afectado su experiencia de dolor y sufrimiento luego como adulta. Este estudio aumenta la literatura sobre cómo la adversidad influya la experiencia de dolor más tarde en la vida, y nos permite comprender mejor como el tratamiento farmacológico por sí solo no es tan exitoso como pueda ser una intervención integral. PMID:24830728

  14. [The atypical developments of rolandic epilepsy are predictable complications].

    PubMed

    Pesántez-Ríos, Gabriela; Martínez-Bermejo, Antonio; Arcas, Joaquín; Merino-Andreu, Milagros; Ugalde-Canitrot, Arturo

    2015-08-01

    Introduccion. Las evoluciones atipicas de la epilepsia rolandica son parte de un espectro clinico de fenotipos variables, idiopaticos, dependientes de la edad y con una predisposicion geneticamente determinada. Objetivo. Estudiar las caracteristicas electroclinicas sugestivas de una evolucion atipica en la epilepsia rolandica. Pacientes y metodos. Se realizo una busqueda retrospectiva de 133 niños diagnosticados de epilepsia focal benigna atipica (EFBA), sindrome de Landau-Kleffner y epilepsia de punta-onda continua durante el sueño (POCS). Se seleccionaron nueve pacientes que, en el trascurso de su epilepsia rolandica, presentaron un cuadro clinico atipico y un patron electroencefalografico (EEG) de estado epileptico electrico durante el sueño (ESES). Resultados. El inicio de la epilepsia rolandica fue, en promedio, a los 5 años. Los pacientes presentaron un empeoramiento clinico y del EEG año y medio mas tarde en promedio. En tres pacientes se observaron caracteristicas de EFBA, y en seis, de POCS. No se encontraron casos de sindrome de Landau-Kleffner. El EEG en vigilia mostro una focalidad centrotemporal izquierda en seis pacientes, y derecha, en tres. Todos los pacientes presentaron un ESES en el EEG de sueño. En tres de ellos se observo un patron atipico de ESES regional. Ademas, se detectaron alteraciones cognitivas y conductuales por deficits en areas especificas del aprendizaje, como lenguaje, memoria, atencion e inquietud. Conclusiones. El inicio precoz de la epilepsia rolandica, la aparicion de nuevas crisis con un incremento en su frecuencia y una focalidad frontocentrotemporal en el EEG, que aumenta en frecuencia, tanto en vigilia como en sueño, son caracteristicas electroclinicas sugerentes de una evolucion atipica.

  15. Reliability of nutritional assessment in patients with gastrointestinal tumors.

    PubMed

    Poziomyck, Aline Kirjner; Fruchtenicht, Ana Valeria Gonçalves; Kabke, Georgia Brum; Volkweis, Bernardo Silveira; Antoniazzi, Jorge Luiz; Moreira, Luis Fernando

    2016-01-01

    Patients with gastrointestinal cancer and malnutrition are less likely to tolerate major surgical procedures, radiotherapy or chemotherapy. In general, they display a higher incidence of complications such as infection, dehiscence and sepsis, which increases the length of stay and risk of death, and reduces quality of life. The aim of this review is to discuss the pros and cons of different points of view to assess nutritional risk in patients with gastrointestinal tract (GIT) tumors and their viability, considering the current understanding and screening approaches in the field. A better combination of anthropometric, laboratory and subjective evaluations is needed in patients with GIT cancer, since malnutrition in these patients is usually much more severe than in those patients with tumors at sites other than the GIT. RESUMO Pacientes com neoplasia gastrointestinal e desnutridos são menos propensos a tolerar procedimentos cirúrgicos de grande porte, radioterapia ou quimioterapia. Em geral, apresentam maior incidência de complicações, como infecção, deiscência e sepse, o que aumenta o tempo de internação e o risco de morte, e reduz a qualidade de vida. O objetivo desta revisão é abordar os prós e contras de diferentes pontos de vista que avaliam risco nutricional em pacientes com tumores do Trato Gastrointestinal (TGI) e sua viabilidade, considerando o atual entendimento e abordagens de triagem neste campo. Melhor combinação de avaliações antropométricas, laboratoriais e subjetivas se faz necessária em pacientes com câncer do TGI, uma vez que a desnutrição nestes pacientes costuma ser muito mais grave do que naqueles indivíduos com tumores em outros sítios que não o TGI. PMID:27556544

  16. [Incidence and risk factors associated with nosocomial infection in pediatric heart surgery].

    PubMed

    Duarte-Raya, Fidencia; Baeza-Zarco, Fabiola Janet

    2016-01-01

    Introducción: las infecciones nosocomiales son responsables de una elevada tasa de morbilidad y mortalidad en el paciente pediátrico sometido a cirugía cardiaca. Nuestro objetivo fue determinar la incidencia y los factores de riesgo de las infecciones nosocomiales. Métodos: estudio clínico descriptivo, prospectivo, en un hospital de tercer nivel durante un año. Se calculó: la tasa de incidencia, incidencia acumulada y por dispositivos utilizados. Se aplicó el programa EPIDAT 2004 versión 3.1 OPS para la obtención de Chi cuadrada con corrección de Yates para obtener p con una confianza del 95 %, alfa de 0.05 con un grado de libertad, se estimó odds ratio (OR). Se llevó a cabo la identificación de microorganismos, su sensibilidad y resistencia a los antibióticos. Resultados: se calcularon las tasas de: incidencia, incidencia acumulada, mortalidad, letalidad de infectados de y no infectados. Las neumonías con el 44.4 %, asociada a ventilación mecánica 74 %, sonda nasogástrica 100 %. Los microorganismos más frecuentemente aislados: Acinetobacter baumanni, Staphylococcus aureus, Staphylococcus epidermidis y Pseudomonas aeruginosa con elevada resistencia a los antibióticos. Conclusiones: los pacientes pediátricos sometidos a cardiocirugía tienen riesgo elevado de infección, los de cardiopatías cianógenas tienen 5 veces más el riesgo. Se observa una asociación estadística significativa con infección el uso de sonda nasogástrica y cánula orotraqueal, el riesgo aumenta a mayor estancia hospitalaria. Los pacientes infectados tienen 4 veces más el riesgo de muerte.

  17. [EATING HABITS, EXCESS WEIGHT AND WEIGHT SELF-PERCEPTION AT SCHOOL].

    PubMed

    Hernández Camacho, Juan Diego; Rodríguez Lazo, Maria; Bolaños Ríos, Patricia; Ruiz Prieto, Inmaculata; Jáuregui-Lobera, Ignacio

    2015-09-01

    Introducción: en los últimos tiempos se ha observado un aumento exponencial de las tasas de sobrepeso y obesidad en la población infanto-juvenil, a la vez que un abandono del patrón alimentario mediterráneo. Además, gran parte de la población adolescente autopercibe erróneamente su peso. Objetivos: analizar la prevalencia de exceso de peso, la autopercepción del peso y los hábitos alimentarios en una muestra infanto-juvenil. Buscar relaciones entre dichas variables y el bienestar psicosocial. Método: 87 alumnos de la ESO participaron voluntariamente en el proyecto mediante la cumplimentación de cuestionarios y la recogida de peso y talla tanto reales como autopercibidos. Resultados: un 28,73% de la muestra presentaba sobrepeso y un 9,19% obesidad. El 27,48 % del total de los encuestados autopercibía erróneamente su peso y únicamente la cuarta parte de la muestra presentó un patrón alimentario mediterráneo correcto. Se obtiene una mayor frecuencia de control del peso a medida que la autopercepción de este aumenta. Discusión y conclusiones: gran parte de la muestra subestima su peso y existe una posible asociación entre la ausencia de desayuno y mayores tasas de exceso de peso infanto-juvenil. Se observa un aumento progresivo de la prevalencia de sobrepeso y obesidad en adolescentes, así como la necesidad de implementar labores de educación nutricional tras analizar sus hábitos alimentarios.

  18. [Not Available].

    PubMed

    Ballesteros-Pomar, María; Villar-Taibo, Rocío; Calleja-Fernández, Alicia; Pintor-de-la-Maza, Begoña; Álvarez-Del-Campo, Cecilia; Vidal-Casariego, Alfonso; Cano-Rodríguez, Isidoro

    2016-01-01

    Los datos del estudio PREDYCES® nos revelaron que en España la desnutrición relacionada con la enfermedad (DRE) afecta a uno de cada cuatro pacientes hospitalizados. Esta cifra aumenta hasta el 36,8% en los pacientes hematológicos. Se calcula que un 20% de los pacientes oncológicos muere por complicaciones relacionadas con la DRE. Nuestro grupo se planteó en 2011 comenzar la implantación de un cribado nutricional en los servicios con mayor riesgo de DRE. La presente revisión trata de describir todo el proceso que hemos seguido para mejorar la situación nutricional en los pacientes ingresados en el Servicio de Hematología del Complejo Asistencial Universitario de León (CAULE), mayoritariamente con diagnóstico de neoplasias hematológicas. En un primer estudio piloto, detectamos una alta prevalencia de desnutrición, que tendió a aumentar durante la hospitalización. Además, solo el 8,3% los enfermos valorados recibieron algún tipo de soporte nutricional y no se estaban cubriendo sus necesidades ni calóricas ni proteicas, lo que se asociaba a un peor pronóstico. Por este motivo, nos decidimos a implantar de manera sistemática un cribado y una intervención nutricional adecuada, que comenzó en 2011 y que ha recibido el reconocimiento como Buena Práctica del Sistema Nacional de Salud. PMID:27269220

  19. [Satisfaction with body image in a universitary population of the Comunidad de Madrid].

    PubMed

    Téllez Suárez, Elena; Castillo Biscari, Ninfa; García Quesada, Sara; Yagüe Lobo, Isabel; Requena Angulo, María; Olmedilla Ishishi, Yoko Lucía; Arnoriaga Rodríguez, María; Andía Melero, Víctor Manuel

    2014-12-17

    Objetivo: Valorar las características antropométricas y la satisfacción con la propia imagen corporal en un grupo de estudiantes universitarios. Material y métodos: Se estudiaron 64 universitarios entre 21 y 25 años, 36 mujeres y 28 hombres. Se valoró la composición corporal mediante datos antropométricos y bioimpedanciometría. La satisfacción con la propia imagen corporal se valoró con una puntuación de 0 a 10. Resultados: El IMC medio fue de 21,95 y la masa grasa 12,15 ± 5,27 Kg, siendo esta mayor en mujeres. El grado de satisfacción con la imagen corporal fue alto, con una puntuación de 7,15 + 1,15 sobre 10 y solo 3 participantes se valoraron con menos de 5 puntos. No hubo diferencias entre ambos sexos ni se observó una correlación entre la autovaloración y los resultados antropométricos en el grupo total, aunque sí se ha observado una relación inversa entre el grado de satisfacción y el IMC (r = - 0,52), y no tan marcada con el porcentaje de grasa corporal (r = - 0,3) en el grupo de mujeres. Conclusiones: Las características antropométricas de la población estudiada son adecuadas, lo que se refleja en un alto grado de satisfacción con la propia imagen corporal. Sin embargo, en las mujeres hay una cierta tendencia a infravalorarse a medida que aumenta el valor del IMC, que no es tan marcada respecto al aumento de porcentaje de masa grasa, a pesar de que este último valor debería a priori reflejar más fielmente la imagen corporal real.

  20. [Effect of gestational diabetes on adiposity indicators during the first 18 years of life; systematic review].

    PubMed

    Jiménez Cruz, Arturo; Ortega Cisneros, Armando; Bacardí Gascón, Montserrat

    2014-02-01

    Introducción: La diabetes gestacional ha sido asociada con la obesidad en períodos posteriores de la vida. Sin embargo, los resultados no han sido consistentes y algunos estudios contenían debilidades metodológicas. Objetivo: Analizar los resultados de estudios prospectivos y retrospectivos de cohorte que evalúen el efecto de la diabetes gestacional sobre indicadores de adiposidad en los hijos hasta los 18 años de edad. Metodología: Se realizó una búsqueda de estudios prospectivos o retrospectivos de cohorte registrados en la base de datos de Medline/Pubmed, de enero de 2011 a septiembre de 2013, que valoraran el efecto de la Diabetes Gestacional sobre los indicadores de adiposidad al nacimiento o después del nacimiento. Resultados: Once estudios cumplían con los criterios de inclusión. En total se estudiaron a 472.959 pares de madre e hijo. La edad del niño en el momento de la evaluación fue a partir del nacimiento hasta los 18 años. En nueve de once artículos se observó una asociación entre la diabetes gestacional e indicadores de obesidad. En siete de trabajos se realizaron ajustes para más de dos variables de confusión (IMC pre gestacional, edad de la madre), y en cinco de ellos se observó una asociación entre la diabetes gestacional con adiposidad. Conclusión: Los resultados de la revisión indican que la evidencia que demuestra que la diabetes gestacional aumenta el peso de los productos en períodos posteriores de la vida, es moderada.

  1. [Neurological complications in the population of children with leukaemia].

    PubMed

    Martínez-Cayuelas, Elena; Domingo-Jiménez, Rosario; Pascual-Gázquez, Juan F; Martínez-Salcedo, Eduardo; Alarcón-Martínez, Helena; Bermúdez-Cortés, Mar; Fuster-Soler, José L; Pérez-Fernández, Virginia

    2015-02-01

    Introduccion. La leucemia es el cancer mas frecuente en edad pediatrica. Su tasa de curacion es del 80% con quimioterapia intensiva, que mejora la supervivencia, pero que tambien aumenta la frecuencia de efectos adversos, incluyendo los neurologicos. Objetivos. Describir la frecuencia y caracteristicas de las complicaciones neurologicas (CN) en pacientes con leucemia aguda linfoide (LAL) y leucemia aguda mieloide (LAM), e identificar los factores asociados a su presencia, la tasa de morbilidad neurologica y la supervivencia. Pacientes y metodos. Estudio retrospectivo de las CN presentes durante el tratamiento y seguimiento de los pacientes con LAL y LAM entre 1997 y 2012 por la unidad de oncohematologia infantil. Variables analizadas: datos demograficos, diagnostico oncologico, tratamiento y CN. Resultados. Se incluyo un total de 157 pacientes, 145 sin infiltracion de sistema nervioso central al diagnostico y ocho con infiltracion (tasa de CN del 14 y 12%, respectivamente). Las CN mas frecuentes fueron: neuropatias (31%), alteracion del nivel de conciencia (27%), convulsiones (22%) y cefalea (12%). Un 40% de los pacientes con CN ha presentado secuelas, pero ninguno ha fallecido como consecuencia de la CN. Se han detectado mas CN en el grupo de edad menor de 6 años con LAL de alto grado, en niveles de gravedad mas altos y en pacientes que habian recibido trasplante de precursores hematopoyeticos, todas ellas con diferencias estadisticamente significativas. Conclusiones. Las complicaciones neurologicas son frecuentes en los pacientes con leucemia aguda, en especial en aquellos con estadio de riesgo alto (sobre todo si son menores de 6 años) y trasplante de precursores hematopoyeticos. La mortalidad asociada es baja.

  2. [Risk of ventriculitis associated to the care of the ventricular drain in neurocritical patients].

    PubMed

    Rivas-Rodriguez, Aida; Suarez-Mier, Belén; Rivas-Rodriguez, Lidia; Lana, Alberto

    2016-04-16

    Objetivo. Analizar el riesgo de ventriculitis asociada a los cuidados del drenaje ventricular externo. Sujetos y metodos. Estudio de casos y controles en una muestra de pacientes neurocriticos del Hospital Universitario Central de Asturias (España) portadores de drenaje ventricular externo (n = 127; 49 casos y 78 controles). Se consideraron casos (variable dependiente) los pacientes con diagnostico medico de ventriculitis siguiendo criterios establecidos. Las variables independientes fueron los cuidados del drenaje ventricular, como curas de la zona de insercion, administracion de medicacion intratecal, lavados, movilizacion y recambio del drenaje. Se controlo el efecto de variables confusoras: edad, sexo, escala APACHE y diagnostico en el momento del ingreso, comorbilidad, antibioterapia, tiempo hasta la colocacion del drenaje ventricular externo y tiempo de permanencia. Resultados. Las curas del drenaje (odds ratio: 3,8; intervalo de confianza al 95%, IC 95%: 1,1-13,9) y la administracion de medicacion intratecal (odds ratio: 7,1; IC 95%: 2,1-23,6) se asociaron significativamente con la ventriculitis. Cuando se ajusta adicionalmente por el tiempo de permanencia del cateter, el efecto de las curas (odds ratio: 1,4; IC 95%: 0,3-6,6) pierde importancia porque ambas variables estan muy relacionadas. Conclusiones. La medicacion intratecal y las curas parecen asociarse con ventriculitis. La administracion de medicacion por el drenaje realmente refleja que el medico sospecha la ventriculitis antes de su diagnostico y, por esta razon, la prescribe. Sin embargo, como la duracion del drenaje aumenta la frecuencia de curas, parece prudente recomendar no alargar el tiempo de drenaje y mejorar la capacitacion de los profesionales de enfermeria para realizar curas.

  3. [Assessment of nutritional risk among in-school adolescents from Cantabria].

    PubMed

    De-Rufino Rivas, P M; Antolín Guerra, O; Casuso Ruiz, I; Mico Diaz, C; Amigo Lanza, T; Noriega Borge, M J; Santamaría Pablos, A; Sobaler Castañeda, S; Jaen Canser, P; Carrasco Martinez, M; Salcines Medrano, R; Rivero Benito, L A; Redondo Figuero, C

    2014-03-01

    Objetivo: Evaluar el riesgo nutricional, por edad y sexo, que presentan los adolescentes escolarizados en la Comunidad Autónoma de Cantabria. Sujetos: Se realizó un estudio transversal, analizando una muestra de 1101 adolescentes, de los que 51,6% eran varones y 48,4% fueron mujeres de edades comprendidas entre los 10 y los 17 años, escolarizados en centros de enseñanza pública, mediante el cuestionario Krece Plus. Resultados: Se observa un elevado porcentaje de adolescentes que presentan un riesgo nutricional elevado (35%). Los varones presentan un riesgo nutricional alto en un porcentaje ligeramente superior a las mujeres (37,8 % vs 32,1%). Además, el riesgo nutricional alto sufre un notable incremento a medida que la edad de los jóvenes aumenta. Se aprecian diferencias estadísticamente significativas tanto en los grupos de edad de los varones (p = 0,024), de las mujeres (p < 0,001) como en el grupo global (p = 0,001). En los tres casos, la distribución del riego nutricional en los grupos de menor edad es muy similar (entre 35,2 y 35,8% en los h, entre 27,9 y 29,7% en las m, y entre 31,7 y 32,7% en el grupo total). Mientras que en el grupo de mayor edad estos valores prácticamente se duplican (57,1% en los h, 69,0% en las m, y 62,2 % en el grupo total). Conclusión: Los resultados obtenidos muestran una realidad preocupante debido, principalmente, al elevado porcentaje de adolescentes que presentan un riesgo nutricional elevado. Siendo los varones y los adolescentes de mayor edad los sectores en los que este riesgo nutricional elevado es superior.

  4. [Correlation between the use of sodium bicarbonate and intraventricular hemorrhage in preterms].

    PubMed

    García-Pasquel, María José; Iglesias-Leboreiro, José; Bernardez-Zapata, Isabel

    2015-01-01

    Introducción: nacer prematuro conlleva riesgos, como la posibilidad de sufrir hemorragia intraventricular. El 90 % de los casos se presenta dentro de los primeros 4 a 7 días; Se ha relacionado el uso de bicarbonato de sodio con su aparición. El propósito de este estudio fue determinar si el uso de bicarbonato en infusión continua, en las primeras 24 horas, aumenta el riesgo de hemorragia intraventricular. Métodos: cohorte retrospectiva, se revisaron 160 expedientes formándose 2 grupos: uno sin y otro con uso de bicarbonato. Posteriormente, el grupo con uso se dividió en dos: uso terapéutico y profiláctico. Resultados: Del total de los prematuros, 10 % presentaron hemorragia intraventricular, tenían un peso promedio de 1,500 g y una edad gestacional promedio de 31 semanas. La incidencia fue idéntica entre los grupos, aunque en el grupo con bicarbonato había pacientes más prematuros, y clínicamente más inestables. Se realizó una regresión logística donde se observó asociación entre la incidencia de hemorragia intraventricular y el peso al nacimiento (OR de 0.99); así como en el caso del uso de bicarbonato de sodio con una OR 1.22. Conclusiones: Nuestros datos indican la necesidad de evaluación sistemática del uso de bicarbonato, con el fin de determinar si los beneficios sobrepasan el riesgo de hemorragia intraventricular.

  5. Fish consumption patterns and hair mercury levels in children and their mothers in 17 EU countries.

    PubMed

    Castaño, Argelia; Cutanda, Francisco; Esteban, Marta; Pärt, Peter; Navarro, Carmen; Gómez, Silvia; Rosado, Montserrat; López, Ana; López, Estrella; Exley, Karen; Schindler, Birgit K; Govarts, Eva; Casteleyn, Ludwine; Kolossa-Gehring, Marike; Fiddicke, Ulrike; Koch, Holger; Angerer, Jürgen; Den Hond, Elly; Schoeters, Greet; Sepai, Ovnair; Horvat, Milena; Knudsen, Lisbeth E; Aerts, Dominique; Joas, Anke; Biot, Pierre; Joas, Reinhard; Jiménez-Guerrero, José A; Diaz, Gema; Pirard, Catherine; Katsonouri, Andromachi; Cerna, Milena; Gutleb, Arno C; Ligocka, Danuta; Reis, Fátima M; Berglund, Marika; Lupsa, Ioana-Rodica; Halzlová, Katarína; Charlier, Corinne; Cullen, Elizabeth; Hadjipanayis, Adamos; Krsková, Andrea; Jensen, Janne F; Nielsen, Jeanette K; Schwedler, Gerda; Wilhelm, Michael; Rudnai, Peter; Középesy, Szilvia; Davidson, Fred; Fischer, Mark E; Janasik, Beata; Namorado, Sónia; Gurzau, Anca E; Jajcaj, Michal; Mazej, Darja; Tratnik, Janja Snoj; Larsson, Kristin; Lehmann, Andrea; Crettaz, Pierre; Lavranos, Giagkos; Posada, Manuel

    2015-08-01

    , have mercury levels 0.55 μg/g. Thus, the 95th percentile of the distribution in this group is only around half the US-EPA recommended threshold of 1 μg/g mercury in hair. Consumption of freshwater fish played a minor role in contributing to mercury exposure in the studied cohort. The DEMOCOPHES data shows that there are significant differences in MeHg exposure across the EU and that exposure is highly correlated with consumption of fish and marine products. Fish and marine products are key components of a healthy human diet and are important both traditionally and culturally in many parts of Europe. Therefore, the communication of the potential risks of mercury exposure needs to be carefully balanced to take into account traditional and cultural values as well as the potential health benefits from fish consumption. European harmonized human biomonitoring programs provide an additional dimension to national HMB programs and can assist national authorities to tailor mitigation and adaptation strategies (dietary advice, risk communication, etc.) to their country's specific requirements. PMID:25667172

  6. Arc-arc Collision Structure in the Southernmost Part of the Kuril Trench Region -Results from Integrated Analyses of the 1998-2000 Hokkaido Transect Seismic Data-

    NASA Astrophysics Data System (ADS)

    Iwasaki, Takaya; Tsumura, Noriko; Ito, Tanio; Sato, Hiroshi; Kurashimo, Eiji; Hirata, Naoshi; Arita, Kazunori; Noda, Katsuya; Fujiwara, Akira; Abe, Susumu; Kikkuchi, Shunsuke; Suzuki, Kazuko

    2015-04-01

    The Hokkaido Island, located in the southernmost part of the Kuril trench region, has been under a unique tectonic environment of arc-arc collision. Due to the oblique subduction of the Pacific (PAC) plate, the Kuril forearc sliver started to collide against Northeast (NE) Japan arc from the east at the time of middle Miocene to form complicated structures in the Hidaka collision zone (HCZ), as characterized by the westward obduction of the crustal rocks of the Kuril arc (the Hidaka metamorphic belt (HMB)) along the Hidaka main thrust (HMT) and a thick foreland fold-and-thrust belt. In and around the HCZ, a series of seismic reflection/refraction experiments were undertaken from 1994 to 2000, which provided important structural features including crustal delamination in the southern HCZ and a thick fold-and-thrust belt with velocity reversals (low velocity layers) in the northern HCZ. Reprocessing/reinterpretation for these data sets, which started in 2012, is aimed to construct a more detailed collision model through new processing and interpretation techniques. A multi-disciplinary project of the 1998-2000 Hokkaido Transect, crossing the northern part of the HCZ in EW direction, collected high-quality seismic data on a 227-km seismic refraction/wide-angle reflection profile and three seismic reflection lines. Our reanalyses revealed interesting collision structure ongoing in the northern part of the HCZ. The westward obduction of the Kuril arc crust was clearly imaged along the HMT. This obduction occurs at a depth of 27-30 km, much deeper than in the southern HCZ (23-25 km). The CRS/MDRS processing to the reflection data firstly succeeded in imaging clear reflection events at a 30-45 km depth below the obducted Kuril arc crust. These events show an eastward dip, probably corresponding to the lower crust/Moho within the NE Japan arc descending down to the east under the collision zone. Gently eastward dipping structures above these events (in a depth range of 5

  7. Fish consumption patterns and hair mercury levels in children and their mothers in 17 EU countries.

    PubMed

    Castaño, Argelia; Cutanda, Francisco; Esteban, Marta; Pärt, Peter; Navarro, Carmen; Gómez, Silvia; Rosado, Montserrat; López, Ana; López, Estrella; Exley, Karen; Schindler, Birgit K; Govarts, Eva; Casteleyn, Ludwine; Kolossa-Gehring, Marike; Fiddicke, Ulrike; Koch, Holger; Angerer, Jürgen; Den Hond, Elly; Schoeters, Greet; Sepai, Ovnair; Horvat, Milena; Knudsen, Lisbeth E; Aerts, Dominique; Joas, Anke; Biot, Pierre; Joas, Reinhard; Jiménez-Guerrero, José A; Diaz, Gema; Pirard, Catherine; Katsonouri, Andromachi; Cerna, Milena; Gutleb, Arno C; Ligocka, Danuta; Reis, Fátima M; Berglund, Marika; Lupsa, Ioana-Rodica; Halzlová, Katarína; Charlier, Corinne; Cullen, Elizabeth; Hadjipanayis, Adamos; Krsková, Andrea; Jensen, Janne F; Nielsen, Jeanette K; Schwedler, Gerda; Wilhelm, Michael; Rudnai, Peter; Középesy, Szilvia; Davidson, Fred; Fischer, Mark E; Janasik, Beata; Namorado, Sónia; Gurzau, Anca E; Jajcaj, Michal; Mazej, Darja; Tratnik, Janja Snoj; Larsson, Kristin; Lehmann, Andrea; Crettaz, Pierre; Lavranos, Giagkos; Posada, Manuel

    2015-08-01

    , have mercury levels 0.55 μg/g. Thus, the 95th percentile of the distribution in this group is only around half the US-EPA recommended threshold of 1 μg/g mercury in hair. Consumption of freshwater fish played a minor role in contributing to mercury exposure in the studied cohort. The DEMOCOPHES data shows that there are significant differences in MeHg exposure across the EU and that exposure is highly correlated with consumption of fish and marine products. Fish and marine products are key components of a healthy human diet and are important both traditionally and culturally in many parts of Europe. Therefore, the communication of the potential risks of mercury exposure needs to be carefully balanced to take into account traditional and cultural values as well as the potential health benefits from fish consumption. European harmonized human biomonitoring programs provide an additional dimension to national HMB programs and can assist national authorities to tailor mitigation and adaptation strategies (dietary advice, risk communication, etc.) to their country's specific requirements.

  8. Diffuse expression of PAX2 and PAX8 in the cystic epithelium of mixed epithelial stromal tumor, angiomyolipoma with epithelial cysts, and primary renal synovial sarcoma: evidence supporting renal tubular differentiation.

    PubMed

    Karafin, Matthew; Parwani, Anil V; Netto, Georges J; Illei, Peter B; Epstein, Jonathan I; Ladanyi, Marc; Argani, Pedram

    2011-09-01

    and PAX8. Cyst epithelial labeling intensity was similar to that of renal DCT in all cases. The diffuse labeling for PAX2/PAX8 in the epithelial cysts of AMLEC, taken together with their consistent negativity for estrogen receptor and HMB45, supports the hypothesis that this epithelium represents entrapped, cystically dilated renal tubules that commonly herniate beyond the renal capsule. The diffuse labeling of the cyst epithelium of renal SS supports the previously proposed hypothesis that this cyst epithelium represents entrapped dilated renal tubules in a monophasic spindle cell lesion and not neoplastic epithelial differentiation. The diffuse labeling for PAX2/PAX8 in MEST epithelium, coupled with its usual estrogen receptor negativity, is consistent with the hypothesis that the epithelium of MEST demonstrates renal tubular differentiation and undergoes architectural and cytologic changes as it grows along with the stromal component. Whether this complex epithelium represents entrapped or neoplastic renal tubular epithelium remains an open question.

  9. [Not Available].

    PubMed

    Pacheco-Herrera, Javier Darío; Ramírez-Vélez, Robinson; Correa-Bautista, Jorge Enrique

    2016-06-30

    Objetivo: el presente estudio tuvo por objetivos: a) determinar los valores de referencia de la condición muscular mediante el índice general de fuerza (IGF); y b) estudiar si el IGF está asociado con indicadores de adiposidad en niños y adolescentes escolares de Bogotá, Colombia.Métodos: del total de 7.268 niños y adolescentes (9-17,9 años) evaluados en el estudio FUPRECOL, 4.139 (57%) fueron mujeres. Se evaluó el IGF como marcador del desempeño muscular a partir de la tipificación de las pruebas de fuerza prensil (FP) y salto de longitud (SL). El IGF se recodificó en cuartiles (Q), siendo el Q4 la posición con mejor valor del IGF. El índice de masa corporal (IMC), la circunferencia de cintura (CC), el índice cintura/talla (ICT) y el porcentaje de grasa corporal (% GC) por bioimpedancia eléctrica se midieron como marcadores de adiposidad.Resultados: la edad media de los evaluados fue 12,8 ± 2,3 años. Se aprecia una tendencia hacia un incremento del nivel de condición física muscular en los varones conforme aumenta la edad, y hacia la estabilidad o un ligero aumento en el caso de las mujeres. El IGF se relacionóinversamente con el ICT y % GC en los varones (r = -0,280, r = -0,327, p < 0,01), respectivamente. Los escolares ubicados en el Q4 del IGF presentaron menores valores en marcadores de adiposidad IMC, CC, ICT y % GC, p < 0,01, que su contraparte del Q1.Conclusión: se presentan valores de referencia del IGF a partir de la estandarización de los resultados obtenidos en la FP y SL. La evaluación de la fuerza muscular en edades tempranas permitirá implementar programas de prevención de riesgo cardiovascular y metabólico futuro.

  10. Anthropometric obesity indices in relation to age, educational level, occupation and physical activity in Bulgarian men.

    PubMed

    Andreenko, Emiliya; Mladenova, Silviya; Akabaliev, Valentin

    2014-09-12

    Obesity indices. Anthropometry. Men. Factors. Objetivo: El objetivo del presente estudio fue estimar el nivel de obesidad y su relación con la edad, nivel educativo, ocupación y actividad física en los hombres adultos búlgaros de zona urbana. Material y métodos: La muestra incluyó hombres 1010, de 18-50 años de edad, de la ciudad de Plovdiv, Bulgaria. El estudio se realizó en el período 2004-2008. Se midieron la circunferencia del cuerpo altura, peso y cintura. El sobrepeso y la obesidad se definen según los puntos de corte internacional de índice de masa corporal (IMC). La obesidad abdominal fue evaluar las categorías de relación de la altura de la cintura (CT). La edad, nivel educativo, ocupación y actividad física de cada persona se investigaron a través de la consulta. Para el análisis estadístico el SPSS paquete fue utilizado. Resultados: Los resultados muestran que 42,1% de los hombres investigados eran sobrepeso y 19,4% de ellos eran obesos. Con CT irregular y obesidad central fueron 66,1% de los casos. El porcentaje de hombres con obesidad general y central aumenta con la edad. En el caso de la obesidad central y general, las diferencias entre los trabajadores físicos e intelectuales son significación, incluso después de controlar la edad.CT tiene un mayor potencial para diferenciar las personas con diversas ocupaciones que BMI. La edad y la ocupación fueron los factores más importantes que afectan la obesidad general y abdominal. El nivel educativo tiene un impacto significativo en la acumulación de grasa abdominal.La conexión entre el nivel de actividad física e IMC y CT fue menor. Conclusiónes: El estudio encuentra que los hombres trabajan y viven en ese particular área urbana tienen diferencias significativas en términos de sobrepeso y obesidad. El nivel educativo, ocupación y edad tienen un potencial grave influenciado su estado nutricional del cuerpo.

  11. [OVERWEIGHT AND PHYSICAL ACTIVITY PRACTICE ASSOCIATED WITH EATING BEHAVIOR OF BRAZILIAN COLLEGE STUDENTS].

    PubMed

    da Silva Gasparotto, Guilherme; Pereira da Silva, Michael; Miranda Medeiros Cruz, Raphael; de Campos, Wagner

    2015-08-01

    Introducción: la ingestión inadecuada de alimentos puede comprometer la salud cardiovascular de la persona, lo que aumenta las posibilidades de desarrollar una serie de enfermedades. La relación entre la ingesta dietética inadecuada y ciertos factores de riesgo cardiovascular en poblaciones de adultos jóvenes no está clara. Objetivos: el objetivo de este estudio fue investigar la asociación entre los hábitos alimentarios de los estudiantes universitarios, el exceso de peso corporal, la presión arterial alta y la actividad física regular. Material y métodos: se realizó un estudio de corte transversal analítico en estudiantes de una universidad federal brasileña. Se incluyeron 1.599 estudiantes de entre 18 y 25 años. Se aplicó una encuesta tipo entrevista que incluía variables sociodemográficas y el Cuestionario Internacional de Actividad Física (IPAQ). Posteriormente, se realizó la valoración de la composición corporal (talla, peso, índice de masa corporal (IMC), circunferencia de la cintura (CC)). Los hábitos alimentarios y las conductas de riesgo cardiovascular se evaluaron mediante el cuestionario YRBSS-C (Youth Risk Behavior Surveillance). Resultados: utilizando la prueba de chi-cuadrado, se encontró una asociación entre el consumo excesivo de alcohol, el consumo de frutas y el consumo de ensaladas/ verduras con actividad física regular. También se observó la asociación entre el consumo de dulces y salados, con el IMC y la circunferencia de la cintura alta. La regresión logística mostró asociación entre la ingesta de dulces (odds = 1,34) y salados (odds = 1,39) con el IMC alto. También mostró asociación con la circunferencia de la cintura, el consumo de dulces (odds = 1,33) y salados (odds = 1,74). La AFMV estaba relacionada con el consumo excesivo de alcohol (odds = 1,23), el consumo de frutas (1,46) y el consumo de ensaladas/verduras (odds = 1,49). De este modo, se comprobó la asociación entre la conducta alimentaria de

  12. [Morning rise in home blood pressure and target organ damage in hypertensive patients].

    PubMed

    Barochiner, Jessica; Aparicio, Lucas S; Cuffaro, Paula E; Rada, Marcelo A; Morales, Margarita S; Alfie, José; Marin, Marcos J; Galarza, Carlos R; Waisman, Gabriel D

    2014-01-01

    El incremento matutino de la presión arterial (IMPA) aumenta el riesgo cardiovascular. Los estudios que evalúan la asociación entre IMPA domiciliaria y daño de órgano blanco son escasos y casi exclusivamente basados en población asiática. Nuestro objetivo fue caracterizar a los pacientes hipertensos con IMPA domiciliaria y establecer una posible asociación con la presencia de hipertrofia ventricular izquierda (HVI). Métodos: se incluyeron hipertensos medicados ≥18 años que realizaron mediciones de PA domiciliaria (4 días de mediciones por duplicado, a la mañana, tarde y noche) y completaron un cuestionario acerca de sus factores de riesgo y antecedentes de enfermedad cardiovascular. Se revisaron las historias clínicas para extraer datos ecocardiográficos. Se definió como IMPA a una diferencia entre el promedio de PA sistólica domiciliaria matutina – vespertina ≥15 mmHg. Se consideró que los pacientes tenían HVI si el índice de masa ventricular era >95 g/m2 en mujeres y >115 g/m2 en varones. Las variables identificadas como predictores relevantes de IMPA fueron introducidos en un modelo multivariado de regresión logística. Resultados: se incluyeron 216 pacientes, con una edad media de 68 (+13,3) años, 69,4% mujeres y 99,1% caucásicos. La prevalencia de IMPA fue de 13,4% y las variables independientemente asociadas fueron HVI (OR 3,5; 95%CI 1,1-11,4), edad (OR 1,05; 95%CI 1,003-1,1) y antecedente de enfermedad cerebrovascular (OR 3,9; 95%CI 1,1-14,2). En conclusión, el IMPA evaluado por monitoreo domiciliario presenta asociación independiente con HVI, edad y antecedentes de enfermedad cerebrovascular, debiendo esclarecerse las implicancias terapéuticas de esta observación en estudios prospectivos a gran escala.

  13. [Obesity associated metabolic impairment is evident at early ages: Spanish collaborative study].

    PubMed

    Martos-Moreno, Gabriel Á; Gil-Campos, Mercedes; Bueno, Gloria; Bahillo, Pilar; Bernal, Susana; Feliu, Albert; Lechuga-Sancho, Alfonso M; Palomo, Enrique; Ruiz, Rafael; Vela, Amaia

    2014-10-01

    Los objetivos de este estudio son, realizar una descripción de las características demográficas, antropométricas y de las alteraciones metabólicas de niños atendidos por obesidad resaltando las características aquellos casos de obesidad de inicio temprano (< 10 años) y los de inicio precoz (< 5 años), y evaluar la capacidad diagnóstica de la definición de síndrome metabólico (SM) según diferentes criterios. Métodos: Es un estudio retrospectivo, caso-control, transversal, multicéntrico. Han participado un total de 10 Unidades de Endocrinología Pediátrica de diferentes hospitales españoles con un grupo de 469 niños con obesidad de inicio temprano y otro grupo de 30 niños con obesidad de inicio precoz. El grupo control estuvo constituido por 224 niños sanos menores de 10 años. Se realizó una valoración antropométrica y determinación analítica de parámetros del metabolismo de los hidratos de carbono y lipidograma. Resultados: La presencia de alteraciones metabólicas asociadas a la obesidad en la etapa infanto-juvenil en España es notable, de forma aislada, o englobada bajo la definición de SM. La prevalencia de éste aumenta sustancialmente cuando se considera la resistencia periférica a la acción de la insulina como criterio diagnóstico. Se demuestra cómo en niños menores de 10 años, dichas alteraciones están presentes en un porcentaje reseñable, y se encuentran las primeras alteraciones metabólicas ya en niños obesos < 5 años. Conclusión: En los niños españoles existen alteraciones metabólicas asociadas a la obesidad en la etapa infanto- juvenil de forma aislada o englobada bajo la definición de SM, y ya están presentes a edades precoces.

  14. Uma grade de perfis teóricos para estrelas massivas em transição

    NASA Astrophysics Data System (ADS)

    Nascimento, C. M. P.; Machado, M. A.

    2003-08-01

    Na XXVIII Reunião Anual da Sociedade Astronômica Brasileira (2002) apresentamos uma grade de perfis calculados de acordo com os pontos da trajetória evolutiva de metalicidade solar, Z = 0.02 e taxa de perda de massa () padrão, para estrelas com massa inicial de 25, 40, 60, 85 e 120 massas solares. Estes perfis foram calculados com o auxílio de um código numérico adequado para descrever os ventos de objetos massivos, supondo simetria esférica, estacionaridade e homogeneidade. No presente trabalho, apresentamos a complementação da grade com os perfis teóricos relativos às trajetórias de Z = 0.02 com taxa de perda de massa dobrada em relação a padrão (2´), e de metalicidade Z = 0.008. Para cada ponto das três trajetórias obtemos os perfis teóricos de Ha, Hb, Hg e Hd, e como esperado eles se apresentam em pura emissão, pura absorção ou em P-Cygni. Para valores de taxa de perda de massa muito baixos (~10-7) não há formação de linhas, o que é visto nos primeiros pontos em todas as trajetórias. Em geral, para um mesmo ponto a componente de emissão diminui e a absorção aumenta de Ha para Hd. É verificado que as trajetórias com Z = 0.02 e padrão possuem menos circuitos (loops) do que as com metalicidade Z = 0.02 e 2´ padrão, e seus perfis são, em geral, menos intensos. Em relação a trajetória de Z = 0.008, verifica-se menos circuitos e maior variação em luminosidade, e seus perfis mostram-se em, algumas trajetórias, mais intensos. Verificamos também que, pontos distintos em uma mesma trajetória, apresentam perfis diferentes para valores similares de luminosidade e temperatura efetiva. Sendo assim, uma grade de perfis teóricos parece ser útil para fornecer uma informação preliminar sobre o estágio evolutivo de uma estrela massiva.

  15. [In Process Citation].

    PubMed

    Ballesteros Pomar, María D; Suárez Gutiérrez, Alfonso; Calleja Fernández, Alicia; Pintor de la Maza, Begoña; Urioste Fondo, Ana; Vidal Casariego, Alfonso; Villar Taibo, Rocío; Otero Redondo, Concepción; Herrero Moratiel, Manuel; Cano Rodríguez, Isidoro; Burón Llamazares, Juan Luis

    2016-02-16

    Introducción: la desnutrición relacionada con la enfermedad (DRE) afecta al menos a una cuarta parte de los pacientes hospitalizados, aumentando la morbimortalidad del paciente durante su hospitalización y al alta. Sin embargo, su repercusión en la actividad hospitalaria no está bien cuantificada.Objetivo: determinar el impacto de una adecuada codificación de la DRE y los procedimientos empleados para revertirla en el peso medio del hospital y otros índices hospitalarios.Material y métodos: estudio comparativo realizado en todos los pacientes subsidiarios de soporte nutricional artificial seguidos por la Unidad de Nutrición Clínica y Dietética de la Sección de Endocrinología y Nutrición (UNCyD-SEyN) del Complejo Asistencial Universitario de León durante los años 2008 y 2013. Se realizó un informe de codificación nutricional del diagnóstico, el tratamiento nutricional y la vía de acceso según la CIE-9-MC. Se comparó el peso medio depurado del hospital, el índice de estancia media ajustada (IEMA), la casuística e índice de funcionamiento previo a la codificación nutricional y tras la misma.Resultados: el peso medio depurado del hospital se incrementó tras la codificación, tanto en 2008 (+ 4,1%) como en 2013 (+1,7%) y especialmente en aquellos servicios en los que se realiza cribado nutricional (Hematología, +10,5%). El IEMA se redujo por debajo de 1 (-5,7% y -0,2% en 2008 y 2013), indicando un mejor funcionamiento, y también disminuyó el índice funcional (-5,6% y -0,4% en 2008 y 2013), lo que supondría una mayor eficiencia.Conclusión: la correcta codificación del diagnóstico y el tratamiento nutricional del paciente con desnutrición aumenta el peso medio depurado de un hospital de tercer nivel, y mejora el IEMA y el índice de funcionamiento.

  16. [Not Available].

    PubMed

    Pacheco-Herrera, Javier Darío; Ramírez-Vélez, Robinson; Correa-Bautista, Jorge Enrique

    2016-01-01

    Objetivo: el presente estudio tuvo por objetivos: a) determinar los valores de referencia de la condición muscular mediante el índice general de fuerza (IGF); y b) estudiar si el IGF está asociado con indicadores de adiposidad en niños y adolescentes escolares de Bogotá, Colombia.Métodos: del total de 7.268 niños y adolescentes (9-17,9 años) evaluados en el estudio FUPRECOL, 4.139 (57%) fueron mujeres. Se evaluó el IGF como marcador del desempeño muscular a partir de la tipificación de las pruebas de fuerza prensil (FP) y salto de longitud (SL). El IGF se recodificó en cuartiles (Q), siendo el Q4 la posición con mejor valor del IGF. El índice de masa corporal (IMC), la circunferencia de cintura (CC), el índice cintura/talla (ICT) y el porcentaje de grasa corporal (% GC) por bioimpedancia eléctrica se midieron como marcadores de adiposidad.Resultados: la edad media de los evaluados fue 12,8 ± 2,3 años. Se aprecia una tendencia hacia un incremento del nivel de condición física muscular en los varones conforme aumenta la edad, y hacia la estabilidad o un ligero aumento en el caso de las mujeres. El IGF se relacionóinversamente con el ICT y % GC en los varones (r = -0,280, r = -0,327, p < 0,01), respectivamente. Los escolares ubicados en el Q4 del IGF presentaron menores valores en marcadores de adiposidad IMC, CC, ICT y % GC, p < 0,01, que su contraparte del Q1.Conclusión: se presentan valores de referencia del IGF a partir de la estandarización de los resultados obtenidos en la FP y SL. La evaluación de la fuerza muscular en edades tempranas permitirá implementar programas de prevención de riesgo cardiovascular y metabólico futuro. PMID:27513488

  17. [The university stage does not favor the healthy life style in women students from Granada].

    PubMed

    Gallardo-Escudero, Alba; Muñoz Alférez, María José; Planells del Pozo, Elena María; López Aliaga, Inmaculada

    2014-11-15

    Objetivo: La etapa universitaria conlleva una serie de cambios emocionales, fisiológicos y ambientales que van a determinar unas costumbres y hábitos de riesgoque en muchos casos serán mantenidos a lo largo de la vida y repercutirán en su estado de salud. El objetivo del presente estudio es analizar el estilo de vida (consumo de alcohol, tabaco y niveles de actividad física) de mujeres estudiantes de la Universidad de Granada. Metodología: Se trata de un estudio transversal/descriptivo y analítico en el que han participado 55 estudiantes de dos grupos de edad (18-24 y 25-31años). Se aplicó un cuestionario de estilo de vida evaluando el tipo de alcohol y frecuencia de consumo, cantidad de cigarrillos consumidos diariamente y niveles de actividad física (sedentaria, ligera, moderada e intensa). Resultados: El consumo de alcohol es mayor en el grupo de mayor edad, y con preferencia beben cerveza/vino, sin embargo el grupo más joven muestra un patrón de consumo centrado en los fines de semana siendo las bebidas destiladas las consumidas preferentemente. Una tercera parte de la población fuma con un incremento en el número de cigarros conforme aumenta la edad. Existe una correlación positiva entre tabaco y alcohol. El 88.9% del grupo de menor edad y el 52.7% del grupo de mayor edad tienen una actividad física sedentaria-ligera. Conclusión: Se sugiere la necesidad de concienciar a la población femenina universitaria sobre los beneficios del abandono del consumo de alcohol y tabaco y la práctica regular de ejercicio físico. Además, sería aconsejable desarrollar protocolos de intervención educativa en el ámbito universitario potenciando los hábitos de vida saludables.

  18. [Nutritional risk factors to users in dysmorphia muscular strength of room].

    PubMed

    Martínez-Segura, Asier; Cortés Castell, Ernesto; Martínez-Amorós, Natalia; Rizo-Baeza, María Mercedes

    2015-04-01

    Objetivo: Se muestra un estudio novedoso en el cual se han analizado la prevalencia y el tipo de suplementos consumidos entre usuarios de gimnasio de la provincia de Alicante que padecen dismorfia muscular (DM). Metodología: Se analizaron gimnastas de varias salas de musculación de Alicante (zona urbana del sureste español), donde se recogieron las medidas de 141 varones de edad comprendida entre 18-45 años, que persiguen el aumento de su masa muscular. Se tuvieron en cuenta el IMC (kg/m2), si consumían suplementos y que tipos. Y se ha determinado si padecían o no DM, a través de la Escala de satisfacción muscular. Resultados: La muestra está constituida por 141 varones, de los cuales 45 son DM y 96 no lo son. Un 89,9% y un 71,9% consumen o han consumido suplementos respectivamente. El consumo de los suplementos: proteínas, hidratos de carbono y creatina han resultado significativamente mayores entre los DM (p=0,007, p=0,016 y p=0,016 respectivamente). Los resultados del test Kidmed no han resultado significativos según el test Chi-cuadrado, pero con un porcentaje de dieta mediterránea superior en el grupo de los que padecen DM. Según el análisis multivariante son factores de riesgo el consumo de suplementos con una OR = 3.4 (IC95% = 1.1-10.9; p=0,041), el estar en sobrepeso con una OR = 20.9 (IC95% = 2.2-195.6; p=0,008) y ser obesos con OR = 15.5 (IC95% = 1.6-145.8; p=0,017). Conclusión: La prevalencia de consumo de suplementos tanto en DM como en no DM ha dado valores relativamente altos con respecto a la mayoría de estudios. Los suplementos mas consumidos fueron proteínas, creatina e hidratos de carbono. El riesgo de padecer DM aumenta con el grado de obesidad y el grado en que se consumen suplementos.

  19. [Prevalence of asthma and determination of symptoms as risk indicators].

    PubMed

    Mancilla-Hernández, Eleazar; Medina-Ávalos, Miguel Alejandro; Barnica-Alvarado, Raúl Humberto; Soto-Candia, Diego; Guerrero-Venegas, Rosario; Zecua-Nájera, Yahvéh

    2015-01-01

    Antecedentes: el asma es una enfermedad inflamatoria crónica de las vías aéreas, su prevalencia se ha incrementado especialmente en países industrializados. Los resultados de estudios de prevalencia del asma son variables en diferentes poblaciones y aun en un mismo país; en México hay fluctuaciones de la prevalencia del asma de 7 a 33%. Objetivo: determinar la prevalencia del asma y la magnitud de los síntomas como indicadores de riesgo en población escolar en ciudades de varios estados de México. Material y método: estudio descriptivo de la detección de prevalencia del asma y analítico-observacional comparativo de la determinación de los síntomas de esta afección. Se realizaron encuestas a población de los niveles educativos preescolar, primaria, secundaria y preparatoria en las ciudades de Puebla, Puebla; Tulancingo, Hidalgo; Tlaxcala, Tlaxcala, y Cancún, Quintana Roo. Como instrumento se usó un nuevo cuestionario validado: Cuestionario Diagnóstico de Asma para Estudios Epidemiológicos, conformado por ocho preguntas con valor sumatorio para su diagnóstico. Resultados: se obtuvieron 8,754 encuestas que mostraron una prevalencia en Puebla de 14%, en Tulancingo de 17%, en Tlaxcala de 7% y en Cancún de 14%; el promedio en las cuatro ciudades fue de 13%. La fuerza de asociación de los síntomas con asma en orden decreciente con razón de momios significativa fue: sibilancias recurrentes, dificultad respiratoria, opresión torácica, tos recurrente, tos con frío, cuadros catarrales recurrentes, tos de predominio nocturno y tos que aumenta con el ejercicio. Conclusiones: el promedio de la prevalencia del asma en las ciudades contempladas para las encuestas fue de 13% y los principales síntomas indicadores de riesgo de asma en población escolar fueron: sibilancias recurrentes, dificultad respiratoria, opresión torácica y tos recurrente.

  20. Safety in the hypertriglyceridemia treatment with N-3 polyunsaturated fatty acids on glucose metabolism in subjects with type 2 diabetes mellitus.

    PubMed

    Reis, Caio Eduardo Gonçalves; Landim, Karla Câmara; Nunes, Aline Costa Santos; Dullius, Jane

    2014-10-06

    Introducción: Diabetes mellitus tipo 2 aumenta el riesgo de hipertrigliceridemia y es un factor de riesgo independiente para las enfermedades cardiovasculares. La literatura actual revela efectos beneficiosos de n-3 ácidos grasos poliinsaturados (n-3 AGPI) en el tratamiento de la hipertrigliceridemia, sin embargo, la seguridad de este tratamento en los sujetos diabéticos tipo 2 es discutible. Esta revisión de la literatura discute la seguridad del n-3 PUFA la suplementación sobre el metabolismo de la glucosa en el tratamiento de la hipertrigliceridemia en pacientes con diabetes mellitus tipo 2. Métodos: Se ha realizado una revisión de la literatura en la base de datos MEDLINE y EMBASE del los ensayos clínicos publicados con fecha posterior al 1990 hasta Junio de 2014 sobre los efectos de la ingesta / suplementos del n-3 AGPI en el tratamiento de la hipertrigliceridemia en pacientes con diabetes mellitus tipo 2. Resultados y Discusión: Catorce estudios clínicos (n = 2105) se incluyeron en esta revisión. Del estudios informaron una reducción en los niveles de triglicéridos entre 12 a 34% en interior del grupo comparación y de 15 a 36% en entre grupos análisis. Cuatro estudios mostraron un aumento significativo en el LDL-c (6-18%) y otros cuatro en los niveles de HDL-c (4 - 15%). No se encontraron cambios significativos en el colesterol total, VLDL-c, la glucosa, HbA1c y el índice de sensibilidad a la insulina. Conclusión: El n-3 AGPI suplementación lleva una mejora en los niveles de triglicéridos y no arrojaron deterioro en el metabolismo de la glucosa en pacientes con hipertrigliceridemia con diabetes mellitus tipo 2 siendo una opción segura para el tratamiento de la población diabética.

  1. Prevalencia y factores de riesgo para infecciones del tracto urinario de inicio en la comunidad causadas por Escherichia coli productor de betalactamasas de espectro extendido en Colombia

    PubMed Central

    Blanco, Victor M.; Maya, Juan J.; Correa, Adriana; Perenguez, Marcela; Muñoz, Juan S.; Motoa, Gabriel; Pallares, Christian J.; Rosso, Fernando; Matta, Lorena; Celis, Yamile; Garzon, Martha; Villegas, y María V.

    2016-01-01

    RESUMEN Introducción Las infecciones del tracto urinario (ITU) son frecuentes en la comunidad. Sin embargo, la información de aislamientos resistentes en este contexto es limitada en Latinoamérica. Este estudio tiene como objetivo determinar la prevalencia y los factores de riesgo asociados con ITU de inicio en la comunidad (ITU-IC) causadas por Escherichia coli productor de betalactamasas de espectro extendido (BLEE) en Colombia. Materiales y métodos Entre agosto y diciembre de 2011 se realizó un estudio de casos y controles en 3 instituciones de salud de tercer nivel en Colombia. Se invitó a participar a todos los pacientes admitidos a urgencias con diagnóstico probable de ITU-IC, y se les pidió una muestra de orina. En los aislamien-tos de E. coli se realizaron pruebas confirmatorias para BLEE, susceptibilidad antibiótica, caracterización molecular (PCR en tiempo real para genes bla, repetitive element palindromic PCR [rep-PCR], multilocus sequence typing [MLST] y factores de virulencia por PCR). Se obtuvo información clínica y epidemiológica, y posteriormente se realizó el análisis estadístico. Resultados De los 2.124 pacientes seleccionados, 629 tuvieron un urocultivo positivo, en 431 de estos se aisló E. coli, 54 fueron positivos para BLEE y 29 correspondieron a CTX-M-15. La mayoría de los aislamientos de E. coli productor de BLEE fueron sensibles a ertapenem, fosfomicina y amikacina. La ITU complicada se asoció fuertemente con infecciones por E. coli productor de BLEE (OR = 3,89; IC 95%: 1,10–13,89; p = 0,03). E. coli productor de CTX-M-15 mostró 10 electroferotipos diferentes; de estos, el 65% correspondieron al ST131. La mayoría de estos aislamientos tuvieron 8 de los 9 factores de virulencia analizados. Discusión E. coli portador del gen blaCTX-M-15 asociado al ST131 sigue siendo frecuente en Colombia. La presencia de ITU-IC complicada aumenta el riesgo de tener E. coli productor de BLEE, lo cual debe tenerse en cuenta para ofrecer

  2. Reconexión magnética en una región activa en decaimiento

    NASA Astrophysics Data System (ADS)

    Mandrini, C. H.; Démoulin, P.; van Driel-Gesztelyi, L.; Schmieder, B.; Bagalá, L. G.; Rovira, M. G.

    Se han obtenido observaciones desde Tierra (Hα y magnetogramas) coordinadas con el Soft X-ray Telescope (SXT), a bordo del satélite japonés Yohkoh, de una región activa bipolar en decaimiento. Estos datos constituyen la base para el estudio de un punto brillante en rayos X (PBX) y de la actividad relacionada con el mismo en distintas capas de la atmósfera solar. Las observaciones muestran que el PBX está relacionado con la aparición de un bipolo menor (~ 1020 Mx) y que su abrillantamiento continuo, así como sus aumentos de brillo esporádicos (``fulguraciones"), son el resultado de la reconexión entre el pequeño arco emergente (visto en Hα como un sistema de filamentos arqueados, SFA) y arcos mayores asociados al campo facular preexistente. Se ha extrapolado el campo magnético observado en la aproximación libre de fuerzas lineal y se ha seguido su evolución a lo largo de la vida del PBX. Se ha calculado la posición de las cuasiseparatrices (CSs) a partir del campo modelado. Las líneas de campo extrapoladas, cuyas bases fotosféricas se encuentran a ambos lados de las CSs, están de acuerdo con las estructuras cromosféricas y coronales observadas. Se ha calculado el espesor de la CD ubicada a lo largo de la polaridad negativa emergente, encontrándose que su variación está de acuerdo con la evolución de la intensidad del PBX; la CS es muy delgada durante la vida del PBX (~ 100 m), mientras que su espesor aumenta considerablemente (>= 10^4 m) cuando el PBX desaparece de las imágenes del SXT. Estos resultados señalan que el abrillantamiento y las ``fulguraciones" de este PBX se deben al proceso de reconexión en 3D que tiene lugar en las CSs.

  3. Effects of large pressure amplitude low frequency noise in the parotid gland perivasculo-ductal connective tissue.

    PubMed

    Oliveira, Pedro; Brito, José; Mendes, João; da Fonseca, Jorge; Águas, Artur; Martins dos Santos, José

    2013-01-01

    Introdução: Em tecidos e órgãos expostos a ruído de baixa frequência de alta amplitude ocorre fibrose na ausência de sinais inflamatórios, que se pensa ser uma resposta protetora. No tecido conjuntivo perivasculo-ductal da glândula parótida seguem artérias, veias e a árvore ductal. Crê-se que o tecido conjuntivo perivasculo-ductal funcione como um estabilizador mecânico do tecido glandular.Material e Métodos: Para quantificar a proliferação de tecido conjuntivo perivasculo-ductal em ratos expostos a ruído de baixafrequência de alta amplitude foram utilizados 60 ratos Wistar igualmente divididos em seis grupos. Um grupo mantido em silêncio, e os restantes 5 expostos a ruído de baixa frequência de alta amplitude continuamente: g1-168h (1 semana); g2-504h (3 semanas); g3-840h (5semanas); g4-1512h (9 semanas) e g5-2184h (13 semanas). Após a exposição, as parótidas foram removidas e o tecido conjuntivo perivasculo-ductal foi medido em todos os grupos. Foi efectuada análise estatística com ANOVA por SPSS 13.0.Resultados: A tendência é um aumento global das áreas do tecido conjuntivo perivasculo-ductal, que se desenvolve de forma linear e significativa com o tempo de exposição (p < 0,001).Discussão: Tem sido sugerido que a resposta biológica à exposição ao ruído de baixa frequência de alta amplitude está associada à necessidade de manter a integridade estrutural. O reforço estrutural seria conseguido através do aumento do tecido conjuntivo perivasculo-ductal.Conclusões: Assim, estes resultados mostram que o tecido conjuntivo perivasculo-ductal aumenta em resposta à exposição ao ruído de baixa frequência de alta amplitude.

  4. Ambiente e formação estelar em galáxias

    NASA Astrophysics Data System (ADS)

    Mateus, A., Jr.; Sodré, L., Jr.

    2003-08-01

    Estudamos o ambiente de galáxias com formação estelar inicialmente a partir de uma amostra limitada em volume proveniente do 2dF Galaxy Redshift Survey. Discriminamos as galáxias com formação estelar com base em distintas classes espectrais, utilizando para esta classificação as larguras equivalentes das linhas [OII]l3727 e Hd. O ambiente é caracterizado pela densidade espacial local de galáxias. Mostramos que a fração de galáxias com formação estelar é bastante reduzida em ambientes densos, enquanto a de galáxias passivas aumenta nestas regiões. Por outro lado, quando analisamos a fração de galáxias que apresentam um surto recente de formação estelar, notamos que ela independe do ambiente, sendo que em regiões mais densas alguns destes objetos apresentam distorções em sua morfologia. Estes resultados são confrontados com a análise da dependência ambiental da taxa de formação estelar, estimada pela emissão em Ha, de uma amostra extraída do Sloan Digital Sky Survey. Um declínio gradual da formação estelar também é observado nesta análise, sugerindo que as interações por efeitos de maré sejam responsáveis pela redução da formação estelar em ambientes densos através da remoção do reservatório de gás das galáxias. No entanto, estas interações também podem induzir surtos de formação estelar nas galáxias, além de peculiaridades morfológicas observadas nos objetos que habitam regiões mais densas.

  5. [Utility of self-reported anthropometric data for evaluation of obesity in the Spanish population; study EPINUT-ARKOPHARMA].

    PubMed

    Marrodán, María Dolores; Martínez-Álvarez, Jesús Román; Villarino, Antonio; Alférez-García, Irene; González-Montero de Espinosa, Marisa; López-Ejeda, Noemí; Sánchez-Álvarez, María; Cabañas, María Dolores

    2013-01-01

    Introducción: En epidemiología es frecuente recabar el peso y talla mediante cuestionario, pero la inexactitud de los datos auto-referidos puede sesgar el resultado de la evaluación. El objetivo es validar el auto-reporte en población adulta española enfatizando el efecto de la edad y la condición nutricional de los sujetos. Material y métodos: La muestra consta de 9.294 adultos (8.072 mujeres y 1.222 varones) reclutados en centros de orientación dietética dependientes de los laboratorios Arkopharma en 46 provincias españolas. Se preguntaron peso y talla midiéndose posteriormente y calculando las diferencias entre parámetros auto-referidos y reales. Se evaluó el error en la estima del Índice de Masa Corporal (IMC) considerando el efecto de la edad y la condición nutricional (T de Student y regresión lineal múltiple). Se analizó la concordancia entre la clasificación realizada a partir del IMC auto-referido y antropométrico mediante el test de Kappa. Resultados y discusión: Utilizando datos auto-referidos, el IMC se infravalora (2,62% en varones; 3,10% en mujeres). El error aumenta con la edad y en las categorías nutricionales extremas. El acuerdo en la evaluación nutricional a partir del IMC auto-referido y real es bueno, clasificándose de manera correcta el 74,71% de los varones y el 89,5 % de las mujeres (Kappa: 0,695 y 0,782 respectivamente). Conclusiones: Teniendo en cuenta el efecto de la edad y de la condición nutricional sobre el auto-conocimiento del tamaño corporal, se recomienda cautela en el empleo de cuestionarios encaminados a la valoración epidemiológica.

  6. Nutritional assessment in hepatic cirrhosis; clinical, anthropometric, biochemical and hematological parameters.

    PubMed

    Vieira, Patricia M; De-Souza, Daurea A; Oliveira, Luiz Carlos M

    2013-01-01

    Introducción: Desde la malnutrición es común en pacientes con cirrosis hepática (CH) es necesario investigar la interferencia de los cambios fisiopatológicos de hígado en los métodos de diagnóstico del estado nutricional. Objetivo: Evaluar la frecuencia de desnutrición en los pacientes con CH ambulatoria, utilizando diferentes métodos de evaluación del estado nutricional. Métodos: El estado nutricional se determinó mediante la valoración global subjetiva (VGS), índice de masa corporal (IMC), porcentaje de peso corporal ideal (% PCI), el pliegue del tríceps (% PT), circunferencia del brazo (% CB) y de la ideales mediados de circunferencia muscular del brazo (% CMB), albúmina de suero (ALB) y recuento total de linfocitos (RTL). Resultados: Setenta y ocho pacientes fueron evaluados, el 56,4% eran varones y la edad media fue 53,0 ± 7,7 años. La etiología fue alcohólica CH en el 56,4% de los casos. De acuerdo con la clasificación de Child-Pugh, el 48,7% eran A, el 26,9% fueron el B y el 24,4% fueron C. Grados variables de desnutrición fueron diagnosticados en un 61,5% (VGS), 16,7% (IMC), 17,9% (% PCI), 93,6% (% PT), 62,8% (% CB) y 38,5% (CMB%) de los pacientes. Los niveles de ALB y RTL fueron compatibles con el diagnóstico de la desnutrición en 43,6% y 69,2% de los pacientes, respectivamente. La frecuencia de diagnóstico de la malnutrición aumenta de acuerdo con la gravedad de CH y también aumentó en los pacientes con etiología alcohólica. Una disminución mayor de tejido adiposo en las mujeres y de tejido muscular en los hombres fue demostrada. Conclusiones: La frecuencia de diagnóstico de la malnutrición en ambulatorio de pacientes tratados varía de acuerdo con el método de evaluación nutricional utilizado. La prevalencia de desnutrición es mayor en las etapas más avanzadas de la CH y de etiología alcohólica.

  7. [Association of consumption of carbonated beverages and decalcification in woman on reproductive and non-reproductive age of Mexico City].

    PubMed

    Sámano, Reyna; Rodríguez Ventura, Ana Lilia; Godínez Martínez, Estela Ytelina; Rivera, Bertha; Medina Flores, Mayra; Sánchez, Bernarda; Martínez Rojano, Hugo; Ramirez, Cristina

    2013-01-01

    Introducción y objetivo: No hay información suficiente sobre el consumo de bebidas carbonatadas (BC) y su asociación con la densidad mineral ósea (DMO) en mexicanas. El objetivo fue identificar la asociación del consumo de BC con la DMO en dos grupos de mujeres mexicanas. Métodos: Estudio transversal con 328 mujeres en edad reproductiva (MER) y no reproductiva (MENR), con evaluación dietética, antropométrica y DMO. Resultados: Edad promedio de 18,7 años en MER y 47 años en MENR. El porcentaje de adecuación del consumo de energía fue inferior en MENR (98 ± 28% vs 144 ± 55) (p = 0,001), el consumo de calcio fue < 700 mg/día en mujeres con osteopenia de ambos grupos y la mediana del consumo de BC fue mayor en MER, con 200 mL/día (0- 462) vs 0 (0-250) en MENR (p = 0,001), las MER con osteo penia bebían 500 mL/día (253-750 mL/día) de BC/día vs 100 (0-200 mL/día) en las que no la presentaron (p = 0,001). Los parámetros antropométricos fueron superiores en MENR (p =?0.002) y la DMO en cuello de fémur fue inferior 1,031 ± 0,14 vs 1,107 ± 0,10 (p = 0,001), en MER fue mayor en L2-L4: 1,114 ± 0,13 vs 1,003 ± 0,09 (p = 0,001). Variables asociadas al riesgo de osteopenia: beber BC (OR 11,186; p = 0,001), consumir < 700 mg de calcio (OR 5,774; p = 0,001) y no cenar leche (OR 1,942; p = 0,042). Conclusiones: Beber BC aumenta el riesgo de osteopenia en ambos grupos, las MER consumen más BC que las MENR y tienen aún más probabilidad de fracturas a edades más tempranas.

  8. [Nutritional screening in heart failure patients: 5 methods review].

    PubMed

    Guerra-Sánchez, Luis; Martínez-Rincón, Carmen; Fresno-Flores, Mar

    2014-01-01

    Introduccion: La malnutrición aumenta la mortalidad y la estancia hospitalaria. Cada vez más instituciones sanitarias adoptan medidas de cribado nutricional con el fin de detectar precozmente la malnutrición o el riesgo de desarrollarla. No existe un método universalmente aceptado para la valoración nutricional. Objetivo: Determinar un método rápido y fiable, que no precise de entrenamiento previo, para el cribado nutricional de pacientes con insuficiencia cardiaca. Métodos: Estudio observacional, transversal, en el que se evaluaron mediante la valoración subjetiva global (VSG), el Mini nutritional assesment (MNA) tanto en su versión abreviada o de cribado (MNA-SF) como en su versión extendida o de valoración (MNA-LF), el nutritional Risk Screnning (NRS 2002), el Conocimiento nutricional o método Ulibarri (CONUT), el método Cardona y el Malnutrition Universal Screening Tool (MUST), el estado nutricional de 242 pacientes ingresados en un hospital terciario de alta complejidad con diagnósticos compatibles con descompensación de insuficiencia cardiaca crónica. Se analizaron la sensibilidad, especificidad, los valores predictivos, las razones de verosimilitud, la odds ratio diagnostica y el índice de correlación kappa, de los distintos métodos comparados con la valoración subjetiva global, que fue considerada como prueba cierta. Resultados: La edad media fue de 75±9. El 50,8% (n=123) fueron hombres. El índice de correlación kappa de los distintos métodos de cribado con respecto a la valoración subjetiva global fueron MNA valoración =0,637; MNA cribado =0,556; NRS =0,483; MUST =0,197; Cardona =0,188; CONUT =0,076. Discusión: El Mini Nutritional Assesment fue el método que mejor relación ofreció, tanto en su etapa de cribado como en la de valoración con la Valoración subjetiva global.

  9. [Profile of sensitization to allergens in children with atopic dermatitis assisting to Allergology Service of University Hospital, Nuevo Leon, Mexico].

    PubMed

    Yong-Rodríguez, Adrián; Macías-Weinmann, Alejandra; Palma-Gómez, Samuel; Arias-Cruz, Alfredo; Pérez-Vanzzini, Rafael; Gutiérrez-Mujica, José Julio; González-Díaz, Sandra Nora

    2015-01-01

    Antecedentes: la sensibilización a alergenos observada en la dermatitis atópica aumenta el riesgo del niño a padecer rinitis alérgica y asma. Los estudios recientes indican que entre mayor actividad de proteasas haya en los alergenos a los que se está sensibilizado, hay mayor defecto en la barrera cutánea y mayor gravedad de la enfermedad. Objetivos: conocer el patrón de sensibilización a los alergenos en niños con dermatitis atópica atendidos en el Servicio de Alergología del Hospital Universitario de la Universidad Autónoma de Nuevo León y conocer si estos niños tienen mayor sensibilización a los antígenos con actividad proteolítica. Material y método: estudio retrospectivo en el que revisamos los reportes de las pruebas cutáneas por punción realizadas en nuestro servicio a niños de 5 meses a 16 años de edad, con diagnóstico de dermatitis atópica, de enero de 2012 a enero de 2014. Evaluamos la frecuencia de sensibilización a aeroalergenos y alimentos, así como el tamaño de la roncha en la respuesta cutánea para cada alergeno en particular. Resultados: se incluyeron los reportes de pruebas cutáneas de 66 niños, 30 hombres y 36 mujeres. Cuarenta y seis pacientes estaban sensibilizados a aeroalergenos y 38 a alimentos. Los ácaros del polvo de casa (Dermatophagoides pteronyssinus/Dermatophagoides farinae) fueron los alergenos con mayor frecuencia de respuesta positiva en las pruebas cutáneas. De los niños con sensibilización a alimentos, sólo los niños sensibilizados a la leche de vaca, al huevo y al pescado tuvieron una roncha mayor de 6 mm de diámetro. CONCLUSIÓN: en los niños con dermatitis atópica es común la sensibilización a aeroalergenos con alta actividad de proteasas y la polisensibilización es muy común. La sensibilización a alimentos es común en estos pacientes, pero sólo un pequeño porcentaje de ellos muestra respuestas cutáneas lo suficientemente grandes para relacionarlas con gravedad de la enfermedad.

  10. [Vitamin D intake in a representative sample of Spanish population aged 7-16 years. Differences in the contribution and in the food sources of the vitamin according to age].

    PubMed

    Aparicio Vizuete, Aránzazu; López-Sobaler, Ana María; López Plaza, Bricia; Perea Sánchez, José Miguel; Ortega Anta, Rosa M

    2013-01-01

    Introducción: La vitamina D juega un importante papel en el mantenimiento de la salud ósea y prevención de la aparición de diversas enfermedades. Muy pocos alimentos son fuente natural de esta vitamina y, además, éstos no se consumen de manera habitual, siendo las fuentes dietéticas más importantes el pescado azul y la yema del huevo. Objetivos: Analizar la ingesta y las fuentes de vitamina D en escolares de 7-16 años. Métodos: Se estudió una muestra representativa de la población española de 7 a 16 años (n = 1.976), seleccionada en diez provincias españolas. El estudio dietético se realizó por registro del consumo de alimentos durante 3 días. Los parámetros antropométricos estudiados fueron el peso y la talla. Resultados y discusión: La ingesta media de vitamina D (1,63 (0,96-3,35) μg/día) fue inferior a la recomendada (IR) en un 85,4% de los estudiados, estando influenciada por la edad (OR = 0,935; IC: 0,889-0,983; p < 0,01). La principal fuente de vitamina D fueron los huevos (27,7%) seguidos de cereales (25,8%), pescados (20,9%) y lácteos (12,7%). Además, se ha observado que es más fácil cubrir las ingestas recomendadas de vitamina D cuanto mayor es el consumo de pescado (r = 0,734; p < 0,001), y que por cada ración que aumenta el consumo de este grupo de alimentos el riesgo de no cubrir las IR de vitamina D disminuye un 72,5%. Conclusiones: La ingesta de vitamina D es inferior a la recomendada en un elevado porcentaje de los estudiados. Teniendo en cuenta que los pescados juegan un importante papel en el aporte de vitamina D de los niños y adolescentes españoles, aumentar el consumo de este grupo de alimentos resulta deseable. Los niños de menor edad merecen atención especial.

  11. Review of complementary feeding practices in Mexican children.

    PubMed

    Pantoja-Mendoza, Itzayana Y; Meléndez, Guillermo; Guevara-Cruz, Martha; Serralde-Zúñiga, Aurora E

    2014-10-19

    Antecedentes: El inicio de la alimentación complementaria temprana coincide con un aumento significativo en la prevalencia de sobrepeso y obesidad especialmente en los niños, lo cual se debe entre otras causas a los cambios en los patrones de alimentación que se han experimentado. El objetivo del estudio fue describir las prácticas de alimentación complementaria en niños mexicanos. Métodos: Se realizó una búsqueda de los estudios que evaluaron las prácticas alimentarias en menores de 2 años en México en Medline, Lilacs y de forma manual con los siguientes términos: alimentación complementaria, alimentación suplementaria, México, ablactación y destete. Se recabó la edad de inicio de la alimentación complementaria, tipo de alimento consumido, frecuencia de consumo de los alimentos y motivo por el que iniciaban la alimentación complementaria. Se realizó un análisis cualitativo de la información recolectada y los datos en las gráficas son mostrados como proporciones. Resultados: Se incluyeron 7 estudios que mostraron que los niños inician la alimentación complementaria antes de los 6 meses predominantemente con frutas, aunque también consumieron jugos industrializados, refrescos y frituras. El consumo de estos productos aumenta con el crecimiento de los niños, aunado a un bajo consumo de alimentos con proteína de alto valor biológico, especialmente las carnes rojas. Conclusiones: Los resultados de los estudios incluidos mostraron que los menores reciben alimentos con alta densidad energética, mientras que es bajo el consumo de aquellos que aportan proteína animal y hierro en particular, lo que puede contribuir a problemas de salud como sobrepeso, obesidad, desnutrición y anemia.

  12. [Abpm and duration of the antihypertensive effect: a study with a new formulation of sustained release losartan (CRONOS)].

    PubMed

    Bendersky, Mario; Juncos, Luis; Waisman, Gabriel Dario; Piskorz, Daniel; Lopez-Santi, Ricardo; Montaña, Oscar; Caruso, Gustavo; Kotetzky, Martin; Penna, Maria; Gomez, Roberto

    2012-01-01

    Antecedentes: una de las características relevantes de las drogas antihipertensivas es que su acción cubra 24 hs. Administrar una sola dosis diaria aumenta la adherencia al tratamiento, y redunda en mejorar el impacto sobre morbimortalidad, principal objetivo de todo tratamiento antihipertensivo. El MAPA permite valorar la duración del efecto. Losartán es un antagonista de receptores At1 de AII, de comprobada eficacia. Distintos estudios sugieren una cobertura antihipertensiva menor de 24 hs. La aparición de una nueva forma farmacéutica (Cronos) que libera 50 mg en forma regular y otros 50 mg en forma prolongada favorece una cobertura de 50 mg durante 24 hs. Objetivo: 1) Evaluar la eficacia de Losartán Cronos, en el control de 24 horas de la TA en hipertensos esenciales, utilizando MAPA. 2) Analizar tasa de respuesta ambulatoria, homogeneidad del efecto y rigidez arterial ambulatoria (AASI). Material y métodos: fueron incluidos 142 hipertensos esenciales de ambos sexos; Se trataron 105 pacientes con Losartán Cronos en monodosis matinal durante 8 semanas, momento del segundo MAPA. 97 pacientes con MAPAs válidos fueron evaluados. Resultados: se observó un descenso significativo tanto de TAS como TAD en todos los periodos evaluados: 24 hs, día, noche, y las últimas 4 hs interdosis. No hubo cambios significativos en la frecuencia cardíaca 24 hs. El ascenso matinal de la TA (mmHg/hora) descendió de 4.53 a 3,68 (p=0.03). La relación Valle:Pico fue 0.91 para TAS y 1.14 para TAD. El Índice de Alisado fue 2.86 para TAS y 3.17 para TAD. 19 pacientes tuvieron EA, todos fueron leves. Conclusión: Losartán Cronos mostró eficacia y seguridad. Desciende la TA sin efectos significativos sobre la FC, reduce la PP, y su efecto perdura 24 hs evaluado por relación Valle:Pico, por efecto de las ultimas 4 hs interdosis, y por descenso de la velocidad de ascenso matinal tensional, por lo que sugiere su administración en monodosis diaria.

  13. Meyerson Phenomenon as a Component of Melanoma in situ.

    PubMed

    Sezer, Engin; Özturk Durmaz, Emel; Çetin, Emel; Şahin, Sedef

    2016-04-01

    Meyerson phenomenon (MP) is characterized by a symmetrical area of erythema and scales encircling a central lesion, which is most commonly a banal melanocytic nevus. Herein, we describe an unusual case with MP representing an eczematized response to a melanoma in situ and review the literature covering this entity. A 56-year-old man presented with a 6-month history of a pruritic, pigmented lesion on the trunk. The patient had no other significant medical history and no notable family history of similar lesions. Physical examination revealed an irregular, hyperpigmented plaque, 1 cm in diameter, with a surrounding halo of erythematous, scaly areas on the right abdominal region (Figure 1, a). On dermatoscopical examination, an irregular, broadened pigment network, radial streaming, and a focal blue-white veil, encircled by a homogenous, erythematous zone was observed (Figure 1, b). Based on clinical and dermatoscopical findings, a presumptive diagnosis of MP occurring on an early melanoma was made and the lesion was excised with a 5 mm safety margin. Histopathological examination of the excised material revealed a central intraepidermal atypical, confluent melanocytic proliferation with angular, hyperkeratotic, and irregular nuclei and a prominent fixation artifact around the cells (Figure 1, c). Human melanoma black (HMB-45) immunostaining highlighted the confluence of the neoplastic melanocytic proliferation. Lymphohistiocytic infiltration with melanophages was also identified in the upper dermis. An interesting feature was the presence of subacute spongiotic dermatitis around the melanocytic lesions (i.e. parakeratosis, serum/crusting, spongiosis, lymphocyte exocytosis, and acanthosis). Immunohistochemical staining with the Langerhans cell marker, CD1a, revealed an increased cell population in the perilesional, erythematous halo (Figure 1, d). A diagnosis of MP existing on melanoma in situ was established with clinical and histopathological findings. No recurrence

  14. [REBOUND EFFECT OF INTERVENTION PROGRAMS TO REDUCE OVERWEIGHT AND OBESITY IN CHILDREN AND ADOLESCENTS; SYSTEMATIC REVIEW].

    PubMed

    Aguilar Cordero, María José; Ortegón Piñero, Alberto; Baena García, Laura; Noack Segovia, Jessica Pamela; Levet Hernández, María Cristina; Sánchez López, Antonio Manuel

    2015-12-01

    tratamiento de la obesidad infantil, haciendo hincapié en sus alentadores efectos a largo plazo. Conclusiones: hay estudios en los que se evidencia el efecto rebote, en los programas de corta duración o cuando la intervención se hace al margen de la rutina diaria de los niños. Durante las intervenciones se reduce considerablemente el IMC, pero después aumenta de forma rápida hasta llegar a niveles iniciales o incluso superiores de peso. El tipo de actuaciones más efectivas suelen ser aquellas con una duración superior a un año y que tienen carácter multidisciplinar, con inclusión de la familia y de los centros escolares.

  15. [Transobturator slings for female stress urinary incontinence].

    PubMed

    Sousa, Ana; Jesus, André; Carvalho, Maria; Carvalho, Giselda; Marques, João; Falcão, Francisco; Torgal, Isabel

    2014-01-01

    Introdução: A incontinência urinária de esforço afeta 20 a 40% das mulheres. Os slings colocados sob a uretra média, aplicados por via transobturadora, são a terapêutica consensualmente aceite na atualidade. O objetivo do estudo foi avaliar a eficácia e possíveis complicações associadas à aplicação dos slings colocados por via transobturadora no tratamento da incontinência urinária de esforço. Material e Métodos: Avaliaram-se retrospetivamente 363 doentes submetidas a cirurgia de incontinência urinária de esforço por via transobturadora, nos Hospitais da Universidade de Coimbra do Centro Hospitalar e Universitário de Coimbra, no período de 1 Janeiro de 2008 a 1 Julho de 2010. Resultados: A média das idades das doentes foi de 56 anos [28-86]. Além da correção da incontinência urinária de esforço, em 13,5% das mulheres foi associada outra cirurgia vaginal. A maioria (95,3%) das mulheres apresentou hipermobilidade da uretra. Ocorreram complicações per-operatórias em 0,8%, complicações pós-operatórias imediatas em 5,2% e complicações pós-operatórias tardias em 15,7%. A taxa de sucesso global foi de 93,7%. A taxa de sucesso nas doentes com uretra fixa foi 77,8%, verificando-se melhores resultados (94,5%) naquelas com hipermobilidade da uretra (p = 0,02). A taxa de sucesso foi comparável nas doentes com e sem cirurgias vaginais associadas. Discussão: As técnicas transobturadoras têm taxas de sucesso elevadas, tendo-se tornado o tratamento de primeira linha para as doentes com IUE, independentemente se tratadas pela técnica outside-in (TOT®) ou pela inside-out (TVT-O®). Ambas as técnicas foram concebidas com o intuito de evitar a passagem no espaço retropúbico, reduzindo assim o número de complicações. Conclusão: As taxas de cura para as abordagens transobturadoras oscilam entre 80 e 95%. A taxa de cura aumenta quando o mecanismo responsável pela incontinência urinária de esforço é a hipermobilidade da uretra

  16. Current Clinical Indications for Small Bowel Capsule Endoscopy.

    PubMed

    Rosa, Bruno; Cotter, José

    2015-01-01

    Introdução: A enteroscopia por cápsula é o exame de primeira linha no diagnóstico de diversas patologias do intestino delgado. Este artigo tem por objectivo rever e analisar criticamente as indicações actuais para enteroscopia por cápsula na prática clínica. Material e Métodos: Revisão bibliográfica suportada em artigos indexados na PubMed. Resultados e Discussão: A enteroscopia por cápsula permite a avaliação não invasiva da mucosa do intestino delgado, com elevado rendimento diagnóstico. Em doentes com hemorragia digestiva de causa obscura, o rendimento da enteroscopia por cápsula aumenta quando realizada precocemente após o evento hemorrágico. O tratamento das angiectasias com enteroscopia assistida por balão permite diminuir a recidiva hemorrágica, enquanto o risco de recidiva em doentes com enteroscopia por cápsula 'negativa' é controverso. A entero-TC/entero-RM podem superiorizar-se à enteroscopia por cápsula no diagnóstico de alguns tumores. O 'Smooth Protruding Index on Capsule Endoscopy' (score SPICE) auxilia na diferenciação entre verdadeiros tumores submucosos e abaulamentos não patológicos. A enteroscopia por cápsula é valiosa em doentes com suspeita de doença de Crohn quando a ileocolonoscopia não é diagnóstica, permitindo também estadiar a extensão e actividade das lesões em doentes com diagnóstico prévio de doença de Crohn, com potenciais implicações prognósticas e terapêuticas. A enteroscopia por cápsula permite ainda o diagnóstico de complicações em doentes com doença celíaca refractária. Conclusões: Actualmente, a importãncia da enteroscopia por cápsula é reconhecida no contexto da hemorragia digestiva de causa obscura e/ou suspeita de tumores do intestino delgado, bem como na suspeita de doença de Crohn ou em doentes com doença de Crohn conhecida para determinar a localização, extensão e actividade da doença, e ainda para a investigação de doentes com doença celíaca refractária.

  17. [In Process Citation].

    PubMed

    Cuerda, Cristina; Álvarez, Julia; Ramos, Primitivo; Abánades, Juan Carlos; García-de-Lorenzo, Abelardo; Gil, Pedro; De-la-Cruz, Juan José

    2016-03-25

    Introducción: la desnutrición relacionada con la enfermedad (DRE) es un problema sociosanitario frecuente que afecta preferentemente a los mayores de 65 años, que aumenta la morbimortalidad y disminuye la calidad de vida.  Objetivo: estudiar la prevalencia de DRE en mayores de 65 años en diferentes centros sociosanitarios del Servicio Regional de Bienestar Social de la Comunidad de Madrid. Métodos: estudio transversal en 33 centros sociosanitarios de Madrid (6 centros de atención primaria [AP], 9 centros de mayores [CM], 9 hospitales [H] y 9 residencias [R]) seleccionados mediante muestreo polietápico. Las variables estudiadas fueron edad, sexo, nivel de dependencia según la escala de incapacidad de la Cruz Roja, motivo de ingreso y enfermedad de base, hábitat (urbano-periurbano-rural) y distribución geográfica (norte centro-sur). Como herramienta de cribado nutricional se utilizó el Mini Nutritional Assessment (MNA-cribaje) en todos los centros. En los pacientes con cribado positivo (en riesgo-desnutrición) se realizó el MNA-evaluación. El estudio estadístico se realizó con el paquete SSS 21.0 e incluyó estadística descriptiva, test de Chi-cuadrado y prueba exacta de Fisher, ANOVA de un factor, Kruskal-Wallis y análisis de regresión logística (RL) binaria univariante y multivariante. Se consideró significación estadística p < 0,05. Resultados: se reclutaron 1.103 sujetos (275 AP, 278 CM, 281 H, 269 R), edad media de 79,5 ± 8,4 años (41,2% varones, 58,8% mujeres). Los sujetos procedentes de H y R tuvieron un mayor grado de incapacidad (p < 0,001). La prevalencia global de DRE fue del 10%, encontrándose un 23,3% en riesgo de desnutrición, con diferencias entre los cuatro tipos de centros sociosanitarios (p < 0,001). El análisis univariante de RL mostró diferencia significativas en la prevalencia de desnutrición según la edad, sexo, grado de dependencia, tipo de centro sociosanitario, hábitat y zona geográfica. Sin embargo, en el

  18. SUITABILITY OF VISCERAL ADIPOSITY INDEX AS A MARKER FOR CARDIOMETABOLIC RISKS IN JORDANIAN ADULTS.

    PubMed

    Numan Ahmad, Mousa; Halim Haddad, Fares

    2015-12-01

    Introducción: el índice de adiposidad visceral (VAI) ha sido propuesto recientemente como predictor de riesgo cardiometabólico, pero su utilidad no ha sido confirmada. Objetivos: evaluar la asociación entre VAI y los índices de adiposidad y riesgo cardiometabólico convencionales y examinar la capacidad predictiva del riesgo VAI en comparación con otros índices de adiposidad. Métodos: en este estudio se incluyeron un total de 1.622 adultos de Jordania, 686 hombres y 936 mujeres, de edad entre 20 y 80 años. Fueron examinados el VAI, el índice de masa corporal (BMI), la circunferencia de la cintura (WC), la relación cintura-cadera (WHR) y la relación cintura-estatura (WHtR) y se determinaron el colesterol de lipoproteínas de alta densidad (HDL-C), los triglicéridos (TG), la glucosa sérica en ayunas (FSG), y la presión arterial sistólica (SBP) y diastólica (DBP). Se evaluaron las asociaciones, la distribución por edad y género y las diferencias. El receptor de funcionamiento característico (ROC) y el área bajo la curva (AUC) se utilizaron para comparar la capacidad de predicción del riesgo. Resultados: el VAI de las mujeres (6,82 ± 6,43) fue mayor que el de los hombres (4,15 ± 4,62). El VAI severidad aumenta con la edad en una tendencia dosis-respuesta (p < 0,001) en ambos sexos. Las mujeres tuvieron mayor prevalencia que los hombres de alto riesgo de VAI y todos los índices de adiposidad y cardiometabólicos. VAI marcadamente asociado con TG, HDL-C, FSG, SBP y DBP o WHR, WC, WHtR y el BMI en orden respectivo de la potencia de correlación para los índices de riesgo cardiometabólico o adiposidad. En hombres y mujeres, respectivamente, el AUC era más grande para VAI (0,79 vs. 0,77), seguido por WHR (0,73 vs. 0,75), aseo (0,69 vs. 0,74), WHtR (0,65 vs. 0,71) y el BMI (0,53 vs. 0,51). Conclusiones: los hallazgos sugieren que el VAI potencialmente se asocia con riesgos cardiometabólicos y demuestra que es superior a otros índices de

  19. Cut-off values of waist circumference to predict metabolic syndrome in obese adolescents.

    PubMed

    Masquio, Deborah Cristina Landi; Ganen, Aline de Piano; Campos, Raquel Munhoz da Silveira; Sanches, Priscila de Lima; Corgosinho, Flávia Campos; Caranti, Danielle; Tock, Lian; de Mello, Marco Túlio; Tufik, Sergio; Dâmaso, Ana R

    2015-04-01

    Introducción: El síndrome metabólico es una constelación de alteraciones metabólicas relacionadas con la obesidad abdominal, la inflamación y la resistencia a la insulina, lo que aumenta las enfermedades cardiovasculares y la mortalidad. Los objetivos del presente estudio fueron determinar la prevalencia de comorbilidades y parámetros alterados en adolescentes obesos con y sin SM, y determinar los puntos de corte de la circunferencia de cintura para predecir SM. Métodos: 195 adolescentes obesos y se los dividió según síndrome metabólico diagnóstico basado en criterios de la IDF. Los análisis de sangre se midieron de glucosa, lípidos, enzimas hepáticas, la adiponectina y leptina. Resistencia a la insulina se evaluó mediante HOMA-IR, QUICKI y HOMA-AD. Se obtuvieron ecografía visceral, subcutánea y grasa hepática. La composición corporal se calcula por el sistema BOD POD. Resultados: Se observó una prevalencia del 25% de síndrome metabólico Mets (n = 50). El grupo grupo con síndrome metabólico presentó mayor masa corporal, índice de masa corporal, grasa corporal (kg), sin grasa masa significativa (kg), circunferencia de la cintura, la grasa visceral, la glucosa, la insulina, resistencia a la insulina, colesterol total, LDL-c, VLDL-c, triglicéridos, enzimas hepáticas, enfermedad no alcohólica del hígado graso (EHNA) y la presión arterial. Se observaron QUICKI significativamente menor y la adiponectina en el grupo con síndrome metabólico. El grupo con síndrome metabólico presentaron significativa proporción de leptina / adiponectina mayor en comparación con los que no tienen síndrome metabólico. Puntos de corte de 111,5 cm para los niños y 104,6 cm para las niñas de la circunferencia de cintura se sugirieron para predecir el síndrome metabólico. Además, la circunferencia de la cintura fue positivamente correlacionada con la grasa visceral y el número de parámetros del síndrome metabólico. Conclusión: El grupo con s

  20. Breakfast of champions or kiss of death? Survival and sexual performance of protein-fed, sterile Mediterranean fruit flies (Diptera: Tephritidae)

    SciTech Connect

    Yuval, B.; Maor, M.; Levy, K.; Kaspi, R.; Taylor, P.; Shelly, T.

    2007-03-15

    The sterile insect technique (SIT) is increasingly being used around the world to control Ceratitis capitata (Wiedemann) (Diptera: Tephritidae), the Mediterranean fruit fly as part of an area-wide integrated approach. One option that may improve the effectiveness of the SIT, by increasing the sexual competitiveness of released sterile males, consists of feeding males protein during the post-teneral stage, a diet that increases sexual performance of wild males. We examine the effects of diet on the successive hurdles males must overcome in order to inseminate females, i.e., joining leks, copulating females, having their sperm stored and inhibition of female remating. In addition, we address the effects of diet on post-release foraging success, longevity, and the ability to withstand starvation. While protein feeding universally increases the sexual success of wild males, its effect on sterile males varies with strain, experimental settings, and environmental conditions. In some cases, treatments that resulted in the best sexual performance were significantly associated with increased vulnerability to starvation. However, no particular diet affected the ability of sterile males to find nutrients in the field when these where available. We suggest it may be better to release relatively short-lived flies that are highly competitive, rather than long-lived, sexually ineffective ones. (author) [Spanish] El uso de la tecnica de insecto esteril (TIE) esta aumentando alrededor del mundo para el control de Ceratitis capitata (Wiedemann) (Diptera: Tephritidae), la mosca mediterranea de la fruta como parte de un enfoque integrado por toda el area. Una opcion que puede mejorar la eficiencia de TIE, por medio del aumento de la capacidad de los machos esteriles liberados para competir, consiste en la alimentacion de los machos con proteina durante la etapa de pos-teneral, una dieta que aumenta el desempeno sexual de los machos naturales. Nosotros examinamos los efectos de la

  1. Compatibility and competitiveness of a laboratory strain of Anastrepha Fraterculus (Diptera: Tephritidae) after irradiation treatment

    SciTech Connect

    Allinghi, A.; Calcagno, G.; Gomez Cendra, P.; Vilardi, J.C.; Petit-Marty, N.; Segura, D.; Cladera, J.; Vera, T.; Gramajo, C.; Willink, E.

    2007-03-15

    salvaje (TUC) de Anastrepha fraterculus (Wiedemann). La linea de laboratorio se produce en condiciones de cria semi-masiva en las instalaciones de la Estacion Experimental Agroindustrial Obispo Colombres (Tucuman, Argentina). Las moscas salvajes se obtuvieron de frutas infestadas de guayabos en Horco Molle (Tucuman, Argentina). Las pupas de laboratorio fueron irradiadas ({sup 60}Co) 48 horas antes de la emergencia del adulto. Las dosis utilizadas fueron 0 (control), 40, 70, y 100 Gy. Se liberaron 25 machos y 25 hembras de TUC y LAB dentro de las jaulas y se recolectaron las parejas formadas. Solo se considero 1 dosis de irradiacion por vez. Las hembras apareadas fueron separadas y se les permitio poner huevos en frutas artificiales para estimar la esterilidad inducida a traves del porcentaje de eclosion. La hora de inicio de la copula no difirio significativamente entre poblaciones ni entre los tratamientos de irradiacion. La duracion de la copula mostro grandes diferencias entre dosis de irradiacion pero no entre cepas. Los indices ISI (aislamiento) y el RSI (esterilidad relativa) indican que LAB y TUC son totalmente compatibles, los machos de TUC y LAB no difieren en su competitividad y la irradiacion dentro del rango de dosis utilizadas tampoco afecto este indice. Las hembras LAB no irradiadas muestran una mayor propension para el apareamiento que las hembras de TUC. Sin embargo se observo una reduccion significativa del indice FRPI (actuacion relativa de hembras) a medida que se aumenta la dosis de irradiacion. El analisis de la esterilidad inducida indica que con dosis de 40 Gy la fertilidad disminuye del 80% al 0.75%, y con dosis mayores la esterilidad fue total. Las hembras irradiadas con dosis de 40 Gy tienen una fertilidad de aproximadamente 2% y con dosis mayores no ponen huevos. (author)

  2. Are Amyotrophic Lateral Sclerosis Caregivers at Higher Risk for Health Problems?

    PubMed

    Pinho, Ana Catarina; Gonçalves, Edna

    2016-01-01

    Introdução: A esclerose lateral amiotrófica é uma doença neuro-degenerativa rara que afeta os neurónios motores. Os doentes apresentam-se com incapacidade motora progressiva e, por vezes, alterações neuro-comportamentais e a principal causa de morte é a falência respiratória. Com o agravamento da incapacidade funcional, os pacientes tornam-se altamente dependentes da família, que assume o papel de cuidador primário, expondo-se ao stress e outras potenciais causas de doença como insónias, o esforço físico realizado para a mobilização dos pacientes e alterações nos hábitos alimentares. O principal objetivo do nosso trabalho é perceber se cuidar de doentes com esclerose lateral amiotrófica aumenta os níveis de doença ou problemas de saúde nos cuidadores. Material e Métodos: Através de uma revisão exaustiva, analisámos a bibliografia publicada nas bases de dados eletrónicas PubMed e Scopus entre 2010 e 2015. Resultados: Verificámos que os cuidadores têm níveis mais elevados de sobrecarga, depressão e ansiedade, assim como menor qualidade de vida. Estes resultados relacionam-se com a idade e o género do cuidador e a duração dos cuidados, para além da incapacidade e das alterações neuro-comportamentais do doente. Uma elevada perceção de suporte e a espiritualidade do cuidador promovem o bem-estar. Discussão: No nosso trabalho foi-nos possível perceber que diversos factores influenciam a qualidade de vida dos cuidadores e afetam a sua saúde. Para além disso, pudemos perceber também que os diversos parâmetros avaliados estão relacionados entre si e, como visto em alguns dos estudos, relacionados com a própria qualidade de vida dos doentes. Consequentemente, tornou-se essencial adotar uma abordagem holística destes pacientes e das suas famílias, combatendo os factores prejudiciais e investindo nos promotores da saúde. Conclusão: Apesar de toda a investigação realizada sobre cuidadores de doentes com esclerose lateral

  3. [The geography of diabetes mellitus in Portugal: how context influence the risk of dying].

    PubMed

    Santana, Paula; Costa, Cláudia; Loureiro, Adriana; Raposo, João; Boavida, José Manuel

    2014-01-01

    Introdução: A Diabetes Mellitus é um problema de saúde pública em crescimento em todo o mundo e também em Portugal. Pretendemos identificar a evolução do padrão geográfico desta causa de morte e a associação com a privação sociomaterial, em Portugal. Material e Métodos: Estudo ecológico transversal dos óbitos por Diabetes Mellitus ocorridos nos municípios portugueses em três períodos (1989-1993, 1999-2003 e 2006-2010). Aplicámos um modelo hierárquico bayesiano, de modo a obter a Razão Padronizada de Mortalidade Suavizada e o Risco Relativo, de mortalidade por diabetes associado à privação sociomaterial. Resultados: Observámos os valores da Razão Padronizada de Mortalidade Suavizada mais elevados, em 1989-1993, nos municípios urbanos do litoral (80% dos municípios com Razão Padronizada de Mortalidade Suavizada ≥ 161, sendo 60% urbanos); em 2006-2010 verificámos o oposto, destacando-se, pelos valores de Razão Padronizada de Mortalidade Suavizada elevados, as áreas rurais localizadas no interior sul do país (76,9% dos municípios com Razão Padronizada de Mortalidade Suavizada ≥ 161 sendo 69,2% rurais), principalmente no Alentejo. O Risco Relativo de mortalidade por Diabetes Mellitus aumenta com o aumento da vulnerabilidade associada às condições sociais e económicas da área de residência, principalmente nos dois últimos períodos (Risco Relativo: 1,00; IC95%: 0,98-1,02). Discussão: A Diabetes Mellitus apresenta um padrão geográfico marcado pela assimetria litoral-interior e urbano-rural, que tem vindo a alterar-se ao longo dos últimos vinte anos, verificando-se uma transição geográfica: 48% da população reside em municípios em que a Razão Padronizada de Mortalidade Suavizada aumentou nos últimos vinte anos, com destaque para as áreas rurais do interior de Portugal. Conclusão: As Razões Padronizadas de Mortalidade Suavizada mais elevadas verificam-se, actualmente, em municípios rurais, com índice de priva

  4. Nanoparticulas basadas en complejos de Fe(II) con transicion de espin: sintesis, caracterizacion y aplicaciones en electronica molecular

    NASA Astrophysics Data System (ADS)

    Monrabal Capilla, Maria

    Esta tesis doctoral esta organizada en 5 capitulos y esta destinada al estudio de sistemas de Fe (II) que presentan el fenomeno de la transicion de espin a escala nanometrica. El capitulo 1 contiene una introduccion general sobre materiales moleculares multifuncionales, destacando aquellos ejemplos mas importantes. Por otro lado, se explicara el fenomeno de la transicion de espin, tratando aspectos conceptuales, los antecedentes mas importantes y la situacion actual. En el capitulo 2 se describen los diferentes procesos existentes para la obtencion de diferentes tipos de nanoparticulas. Ademas, se presenta la sintesis y caracterizacion de nanoparticulas del polimero de coordinacion unidimensional [Fe(Htrz)2(trz)]BF4, obtenidas mediante el metodo de micelas inversas. Estas nanoparticulas, con una estrecha distribucion de tamanos centrada alrededor de los 11 nm, presentan una transicion de espin muy abrupta, con un ancho ciclo de histeresis termica de unos 40K. En el capitulo 3 se describe el proceso de modificacion del tamano de las nanoparticulas descritas en el capitulo anterior, llevado a cabo variando la proporcion de surfactante/H2O en el medio. Ademas, con el objetivo de modificar las propiedades magneticas de las nanoparticulas obtenidas en el capitulo 2, se lleva a cabo la sintesis de nanoparticulas de polimeros de la misma familia del [Fe(Htrz)2(trz)]BF4. En concreto se sintetizaron 3 nuevos tipos de nanoparticulas basadas en el polimero [Fe(Htrz)1-x(NH2trz)x](ClO4)2, siendo x = 0.05, 0.15 y 0.3, en cada caso. Estas nanoparticulas siguen presentando una estrecha distribucion de tamanos y una transicion de espin muy abrupta y con un ancho ciclo de histeresis. Ademas, se observa que este ciclo se desplaza a temperaturas mas proximas a la temperatura ambiente a medida que se aumenta el porcentaje de 4-amino-1, 2, 4- triazol en la muestra. Pero al mismo tiempo se produce una disminucion de la anchura de este ciclo. Por ultimo, en este capitulo se presenta la

  5. Reduction of serum advanced glycation end-products with a low calorie Mediterranean diet.

    PubMed

    Rodríguez, Juan Manuel; Leiva Balich, Laura; Concha, M J; Mizón, C; Bunout Barnett, Daniel; Barrera Acevedo, Gladys; Hirsch Birn, Sandra; Jiménez Jaime, Teresa; Henríquez, Sandra; Uribarri, Jaime; de la Maza Cave, María Pía

    2015-06-01

    La ingesta dietaria de productos finales de glicación avanzada (AGEs) aumenta los niveles séricos y tisulares de estas sustancias, lo que contribuye a un estado de mayor estrés oxidativo e inflamación. Una intervención dietaria con bajo contenido de AGEs ha demostrado reducir el contenido de AGEs en el cuerpo. La dieta mediterránea (DM) se considera teóricamente baja en AGEs, pero los efectos específicos de este tipo de intervención en los niveles séricos de AGEs no ha sido probado. Metodología: cuarenta y siete mujeres premenopáusicas con sobrepeso u obesidad se sometieron a tres meses de restricción calórica (20 kcal por kg de peso corporal inicial) con una dieta de tipo mediterráneo que excluía la ingesta de vino. La adherencia a la DM se evaluó al comienzo y al final del tratamiento utilizando una encuesta on-line, con puntuaciones de 0 a 14 (mínima a máxima adherencia a la DM). La composición corporal, la resistencia a la insulina, los niveles séricos de lipoproteínas y carboximetil-lisina (CML) se midieron en ambos períodos. El CML sérico se evaluó mediante ELISA (ensayo inmunoenzimático). La adherencia a la restricción calórica se evaluó de acuerdo con la pérdida de peso (< o > 5% del peso inicial). Resultados: la media de peso corporal, grasa corporal, circunferencia de la cintura, colesterol total, triglicéridos y CML sérica disminuyeron significativamente, junto con un aumento en el puntaje de adherencia a la DM, aunque ninguno de los pacientes alcanzó la máxima puntuación. Hubo cambios significativos en los niveles de CML y de resistencia a la insulina en 17 mujeres clasificadas como adherentes a la restricción calórica, pero no en las 27 participantes que fueron consideradas adherentes a la DM (de acuerdo con la mejoría en el puntaje de la encuesta). Conclusiones: los niveles séricos de CML disminuyeron tras la restricción calórica con una dieta tipo mediterránea. Dado que no se pudo alcanzar la puntuación m

  6. [In Process Citation].

    PubMed

    Cuerda, Cristina; Álvarez, Julia; Ramos, Primitivo; Abánades, Juan Carlos; García-de-Lorenzo, Abelardo; Gil, Pedro; De-la-Cruz, Juan José

    2016-01-01

    Introducción: la desnutrición relacionada con la enfermedad (DRE) es un problema sociosanitario frecuente que afecta preferentemente a los mayores de 65 años, que aumenta la morbimortalidad y disminuye la calidad de vida.  Objetivo: estudiar la prevalencia de DRE en mayores de 65 años en diferentes centros sociosanitarios del Servicio Regional de Bienestar Social de la Comunidad de Madrid. Métodos: estudio transversal en 33 centros sociosanitarios de Madrid (6 centros de atención primaria [AP], 9 centros de mayores [CM], 9 hospitales [H] y 9 residencias [R]) seleccionados mediante muestreo polietápico. Las variables estudiadas fueron edad, sexo, nivel de dependencia según la escala de incapacidad de la Cruz Roja, motivo de ingreso y enfermedad de base, hábitat (urbano-periurbano-rural) y distribución geográfica (norte centro-sur). Como herramienta de cribado nutricional se utilizó el Mini Nutritional Assessment (MNA-cribaje) en todos los centros. En los pacientes con cribado positivo (en riesgo-desnutrición) se realizó el MNA-evaluación. El estudio estadístico se realizó con el paquete SSS 21.0 e incluyó estadística descriptiva, test de Chi-cuadrado y prueba exacta de Fisher, ANOVA de un factor, Kruskal-Wallis y análisis de regresión logística (RL) binaria univariante y multivariante. Se consideró significación estadística p < 0,05. Resultados: se reclutaron 1.103 sujetos (275 AP, 278 CM, 281 H, 269 R), edad media de 79,5 ± 8,4 años (41,2% varones, 58,8% mujeres). Los sujetos procedentes de H y R tuvieron un mayor grado de incapacidad (p < 0,001). La prevalencia global de DRE fue del 10%, encontrándose un 23,3% en riesgo de desnutrición, con diferencias entre los cuatro tipos de centros sociosanitarios (p < 0,001). El análisis univariante de RL mostró diferencia significativas en la prevalencia de desnutrición según la edad, sexo, grado de dependencia, tipo de centro sociosanitario, hábitat y zona geográfica. Sin embargo, en el

  7. [Complete process of implantation of a nutritional risk screening system in the University Hospital La Paz, Madrid].

    PubMed

    Gómez-Candela, Carmen; Serrano Labajos, Ruth; García-Vazquez, Natalia; Valero Pérez, Marlhyn; Morato Martínez, Marina; Santurino Fontecha, Cristina; González Madroño, Ana; Palma-Milla, Samara

    2013-11-01

    ón especializada por parte de la Unidad de Nutrición Clínica y Dietética. Posteriormente, conforme hemos ido detectando posibles causas que justificaran que el sistema no funcionase adecuadamente, el sistema de cribado ha sido objeto de diversas modificaciones. En este sentido, se ha realizado una evaluación retrospectiva en 233 pacientes ingresados en las plantas de Cirugía General y se ha documentado que aquellos que ingresan para cirugía programada y presentan una alarma alta o moderada de desnutrición (el 50 % de los casos), la presencia de la misma aumenta significativamente los días de ingreso y la mortalidad. Conclusiones. La implantación del cribado nutricional ha favorecido un cambio en la cultura de nuestro centro con respecto a la malnutrición asociada a la enfermedad y la mayoría de nuestros profesionales, tanto médicos como enfermeras e incluso el equipo directivo, comprenden la importancia del proceso y saben que disponemos de herramientas y de conocimiento suficiente para indicar un soporte nutricional adecuado y precoz.

  8. [Risk factors for catheter-related bloodstream infection in non-critical patients with total parenteral nutrition].

    PubMed

    Ocón Bretón, María Julia; Mañas Martínez, Ana Belén; Medrano Navarro, Ana Lidia; García García, Blanca; Gimeno Orna, José Antonio

    2013-01-01

    Introducción: La bacteriemia asociada al catéter (BAC) es una de las complicaciones más importantes en pacientes portadores de un catéter venoso central (CVC) debido a su asociación con un incremento en la mortalidad, morbilidad y gasto sanitario. La administración de nutrición parenteral total (NPT) aumenta el riesgo de aparición de BAC. El objetivo de nuestro estudio fue determinar la tasa de incidencia y los factores de riesgo de BAC en pacientes con NPT hospitalizados en plantas médico-quirúrgicas. Métodos: Estudio observacional, analítico, retrospectivo donde se analizaron a todos los pacientes adultos no críticos que precisaron NPT desde enero de 2010 hasta noviembre de 2011. El punto final clínico fue la BAC. La tasa de incidencia de BAC se calculó en forma de episodios por cada 1.000 pacientes-día de cateterización. Los factores predictivos independientes de BAC se determinaron mediante regresión logística. Resultados: Durante el periodo de estudio precisaron NPT un total de 331 pacientes. La duración media del CVC fue de 12,4 (DE 8,7) días y la NPT fue infundida durante un periodo medio de 10,4 (DE 8,3) días. 47 pacientes presentaron BAC, con una tasa de incidencia de 11,4/1.000 pacientes- día de CVC y de 13,7/1.000 pacientes-día de NPT. Los factores predictores univariantes de aparición de BAC fueron la permanencia del CVC superior a 20 días (OR = 2,48; IC 95%: 1,16-5,26), la duración de la NPT superior a 2 semanas (OR = 4,63; IC 95%: 2,16-9,90) y la presencia de fístulas (OR = 3,08; IC 95%: 1,24-7,63). En análisis multivariante, el único predictor independiente de BAC fue la duración de la NPT (OR para una duración superior a 14 días = 4,9; IC 95%: 2,2-10,9; p < 0,0001). Conclusiones: En pacientes adultos hospitalizados en plantas diferentes a UCI, hemos demostrado que la duración de la infusión de la NPT incrementa el riesgo de BAC. El incremento de riesgo es especialmente marcado, llegando a multiplicarse por 5, con

  9. Contributions of groundwater conditions to soil and water salinization

    NASA Astrophysics Data System (ADS)

    Salama, Ramsis B.; Otto, Claus J.; Fitzpatrick, Robert W.

    piézométrique. Le ou les ensembles salins se sont formés par évaporation couplée à la précipitation d'un carbonate alcalino-terreux et à la dissolution de sels par capillarité. Resumen La salinización es el proceso por el cual la concentración de sales disueltas en el agua o el suelo aumenta por causas naturales o antrópicas. El contenido de agua se reduce por uno o una combinación de los siguientes mecanismos: evaporación, evapotranspiración, hidrólisis y goteo entre acuíferos. La salinidad aumenta en la dirección del flujo subterráneo, desde los puntos de recarga hacia los de descarga. La salinización se puede explicar por dos modelos químicos que se pueden definir como erosión y deposición y que están de acuerdo con los clásicos procesos geológicos que tienen los mismos nombres. Se conocen cinco procesos de salinización de suelos ligados al agua o a la extracción de la misma en climas áridos o semiáridos. En todos los casos que se presentan el agua subterránea es el principal agente geológico de transmisión, acumulación y descarga de sales. A escala de pequeña cuenca, en Australia Occidental y del Sur, el agua se pierde mediante evapotranspiración e hidrólisis. El agua subterránea salina fluye a lo largo de los cauces de los arroyos y se acumula en los paleocanales, que actúan como depósitos, hasta que finalmente descarga en los lagos, donde se acumula la mayor parte de la salinidad. En los hummocks de la Zona Norte de los Grandes Llanos de Canadá y EEUU, la recarga localizada y el tipo de descarga provocan que la salinización tenga lugar fundamentalmente en las depresiones. A escala regional y en cuencas cerradas este mismo mecanismo provoca playas o lagos salinos. En los acuíferos continentales de los rift del Sudán, la salinidad se incrementa a lo largo de las líneas de flujo subterráneo y se concentra en el límite distal. La zona salina en cada rift forma una cresta cerrada que se manifiesta en los mapas piezom

  10. Application of the groundwater-balance equation to indicate interbasin and vertical flow in two semi-arid drainage basins, Mexico

    NASA Astrophysics Data System (ADS)

    Carrillo-Rivera, J. J.

    2000-09-01

    coeficiente de almacenamiento (S). En particular, la ecuación de balance de agua subterránea proporciona resultados poco fiables cuando el flujo vertical es ignorado o no puede ser evaluado de forma adecuada. El flujo vertical se identifica por un incremento de temperatura del agua subterránea, que puede llegar a superar la temperatura ambiental en hasta 23 °C. La presencia de fallas regionales y las extracciones pueden favorecer el flujo vertical. Cuando éste es ignorado, aumenta la incertidumbre en la estimación del coeficiente de almacenamiento mediante un balance de agua subterránea. El valor obtenido con este médodo (S=0,19) es característico de acuíferos libres, pero resulta varios órdenes de magnitud mayor que el que sería esperable teniendo en cuenta las condiciones hidrogeológicas. Estos hallazgos son útiles para evaluar si los recursos de agua subterránea están siendo "sobreexplotados". Las conclusiones obtenidas son instructivas de cara a la aplicación de modelos numéricos de flujo transitorio que no consideran el flujo vertical por densidad.

  11. The conceptualization model problem—surprise

    NASA Astrophysics Data System (ADS)

    Bredehoeft, John

    2005-03-01

    que le modèle conceptuel peut bien changer lorsque des nouvelles informations apparaissent. Dans l'analyse finale le hydrogéologue prend une décision subjective sur le modèle conceptuel approprié. Le problème du le modèle conceptuel ne doit pas rendre le modèle inutilisable. Ce problème introduit une incertitude qui n'est pas toujours reconnue. Les incertitudes du modèle conceptuel deviennent plus importantes dans les cases de prévisions à long terme dans l'analyse de performance. La base para hacer un análisis de un modelo es el modelo conceptual. Se define aquí la sorpresa como los datos nuevos que convierten en incoherente al modelo conceptual previamente aceptado; tal como se define aquí esto representa un cambio de paradigma. Los datos empíricos limitados indican que estas sorpresas suceden entre un 20 a un 30% de los análisis de modelos. Esto sugiere que los analistas de modelos de agua subterránea tienen dificultades al seleccionar el modelo conceptual apropiado. No hayotra solución disponible a este problema del modelo conceptual diferente de: (1) Recolectar tanta información como sea posible, mediante la utilización de todos los métodos aplicables, lo cual puede resultar en que esta nueva información ayude a cambiar el modelo conceptual vigente, y (2) Que el analista de modelos se mantenga siempre abierto al hecho de que un modelo conceptual puede cambiar de manera total, en la medida en que se colecte mas información. En el análisis final el hidrogeólogo toma una decisión subjetiva en cuanto al modelo conceptual apropiado. El problema de la conceptualización no produce modelos inútiles. El problema presenta una incertidumbre, la cual a menudo no es tenida en cuentade manera adecuada. Esta incertidumbre en los modelos conceptuales se aumenta, cuando se hacen predicciones a largo plazo del comportamiento de un sistema dado.

  12. [Secondary hypothyroidism after cervical irradiation: systematic evaluation of thyroid function in follow-up].

    PubMed

    Gonçalves, Sara Monteiro; Ferreira, Brígida Costa; Guardado, Maria João; Marques, Rui; Serra, Tânia; Serra, Maria João; Roda, Domingos; Brandão, Joana; Melo, Gilberto; Lopes, Maria Carmo; Khouri, Leila

    2014-01-01

    18,6%. Em 51,9% dos doentes foi efetuado o diagnóstico de hipotiroidismo entre os 9 e os 12 meses após o tratamento de radioterapia. Discussão: Da análise da literatura publicada, o hipotiroidismo constitui a complicação tiroideia radioinduzida mais frequente e afeta uma grande percentagem de doentes submetidos a radioterapia cervical com intenção curativa. Foi demonstrado que o risco de hipotiroidismo aumenta com o tempo após a exposição, contudo a incidência mais elevada parece ser nos dois primeiros anos após o tratamento. Da nossa análise obtivemos, aos 12 meses uma taxa de incidência global de hipotiroidismo de 18,6%, (grau 1 de 16,55% e grau 2 de 2,1%). Conclusão: Neste estudo foi encontrada uma incidência de hipotiroidismo correspondente aos valores mais baixos descritos em outros estudos publicados. O curto tempo de follow-up considerado nesta análise poderá justificar os resultados obtidos. Face aos resultados obtidos, e correlacionando-os com a literatura disponível, os autores consideram justificável e recomendável a inserção da avaliação sistemática da função tiroideia no protocolo de follow-up destes doentes.

  13. Agricultural contaminants in Quaternary aquitards: A review of occurrence and fate in North America

    NASA Astrophysics Data System (ADS)

    Rodvang, S. J.; Simpkins, W. W.

    2001-01-01

    como nutrientes, pesticidas, sales, elementos traza y patógenos) en las aguas subterráneas. Los depósitos cuaternarios de till, de origen glaciolacustre y de loess constituyen la mayor parte de los terrenos aprovechados desde el punto de vista agrícola en Norteamérica. Los acuitardos cuaternarios contienen normalmente concentraciones más elevadas que los acuíferos en carbono orgánico sólido (COS, con hasta un 1,4%), carbono orgánico disuelto (COD, hasta 205 mg/L) y sulfuro reducido (hasta un 0,9%). Su potencial para absorber pesticidas aumenta con el porcentaje de COS más antiguo, ya que la diagénesis incrementa el coeficiente de partición, Koc. El nitrato se reduce por denitrificación hasta alcanzar valores no detectables en acuitardos cuanternarios no meteorizados. El carbono orgánico de la Edad Cuaternaria es un dador de electrones más lábil que el carbono presente en los clastos de esquisto. La pirita es un dador de electrones más lábil que el carbono en muchas circunstancias. Los acuitardos no meteorizados del Cuaternario proporcionan un alto grado de protección para los acuíferos subyacentes, puesto que tienen grandes reservas de COS y sulfuro reducido para sorción y denitrificación, además de conductividades hidráulicas normalmente bajas. Por el contrario, los contaminantes agrícolas son más habituales en acuitardos meteorizados del Cuaternario, donde la capacidad para atenuar nitratos y pesticidas se ve limitada por unas reservas menores de sulfuro reducido y de carbono orgánico sorbible/lábil, así como por la elevada conductividad hidráulica promedio debido a las fracturas. El drenaje subsuperficial, que es común en los acuitardos cuaternarios que tienen niveles freáticos altos, evita la capacidad de atenuación propia de dichos acuitardos y facilita el transporte de los contaminantes de origen agrícola hacia las aguas superficiales.

  14. Farmyard Manure and Fertilizer Effects on Seed Potato (Solanum tuberosum L.) Yield in Green House Production

    NASA Astrophysics Data System (ADS)

    László, M.

    2009-04-01

    ção máximas, principalmente em solos mais ácidos e pobres em matéria orgânico. A adubação fosfatada é muito importante no crescimento inicial da planta e, além de aumentar a produção de tuberculos em peso e números, aumenta também a quantidade e qualidade do amido neles contidos e reduz perdas durante o armazenamento dos mesmos. A quantidade de fósforo a aplicar dependerá da análise do solo considerando- se principalmente o nível de P existente e a textura do solo. Solos de textura média e arenosa necessitam maior conteúdo de fósforo do que os de textura argilosa para serem considerandos solos de baixo, médio ou alto teor de fósfato. Efeito da potássica Embora seja o elemento mais absorbido pela batateira, nem sempre há resposta positiva da aduba potássica sobre o rendimento da cultura. Provavelmente isto esteja relacionado com níveis elevados deste elemento no solo (Kurnik et all. 2001.). Entretanto, em solos com médios e baixos teores de potássio, aumentos significativos são conseguidos. Por isto, as recomendações de adubação com potássio, nas diversas regiões do mundo, variam de 50-300 kg ha-1 de K2O. Resultados de trabalhos em brasiléiros têm demonstrado que a aduba potássica pode ser substituída pela aplicação de 150 m3 ha-1 de vinhaça de cana de açúcar. Ao elevar- se a dose de fertilização potássica deverá haver precaução para que a adubação magnesiana seja suficiente. O K além de aumentar a produção, em solos deficientes, aumenta também o tamanho dos tubérculos produzidos, e a proporção de tubérculos grandes. Deficiência no suprimento de potássio á planta pode acarretar produção de tubérculos com elevada susceptibilidade aos danos mecánicos pós-colheita. Os tubérculos injuriados enegrecem facilmente e este enegrecimento é inversamente proporcional á quantidade de potássio nos tuberculos. Ademais, quando fritos dão origem a um produto escuro, de baixa valor comercial. Manejo de aduba