Epstein-Barr virus-associated inflammatory pseudotumor variant of follicular dendritic cell sarcoma of the liver: a case report and review of the literature.

BACKGROUND: Follicular dendritic cell sarcoma is a rare stromal tumor with no standard treatment. However, some reports have revealed that follicular dendritic cell sarcoma has an inflammatory pseudotumor variant associated with Epstein-Barr virus infection that has a relatively good prognosis. In this report, we present a case of a resected inflammatory pseudotumor variant of follicular dendritic cell sarcoma of the liver, and have reviewed the literature on the clinicopathological, molecular, and genomic features of this tumor. CASE PRESENTATION: The inflammatory pseudotumor variant of follicular dendritic cell sarcoma originates only in the liver or spleen, causes no symptoms, and is more common in middle-aged Asian women. It has no characteristic imaging features, which partially explains why the inflammatory pseudotumor variant of follicular dendritic cell sarcoma is difficult to diagnose. Pathologically, the inflammatory pseudotumor variant of follicular dendritic cell sarcoma has spindle cells mixed with inflammatory cells and is variably positive for follicular dendritic cell markers (CD21, CD23, and CD35) and Epstein-Barr virus-encoded RNA. On genetic analysis, patients with this tumor high levels of latent membrane protein 1 gene expression and extremely low levels of host C-X-C Chemokine Receptor type 7 gene expression, indicating that the inflammatory pseudotumor variant of follicular dendritic cell sarcoma has a latent Epstein-Barr virus type 2 infection. CONCLUSIONS: The inflammatory pseudotumor variant of follicular dendritic cell sarcoma is an Epstein-Barr virus-associated tumor and a favorable prognosis by surgical resection, similar to Epstein-Barr virus-associated gastric cancer.

Fast Heating of Imploded Core with Counterbeam Configuration.

A tailored-pulse-imploded core with a diameter of 70 µm is flashed by counterirradiating 110 fs, 7 TW laser pulses. Photon emission (>40 eV) from the core exceeds the emission from the imploded core by 6 times, even though the heating pulse energies are only one seventh of the implosion energy. The coupling efficiency from the heating laser to the core using counterirradiation is 14% from the enhancement of photon emission. Neutrons are also produced by counterpropagating fast deuterons accelerated by the photon pressure of the heating pulses. A collisional two-dimensional particle-in-cell simulation reveals that the collisionless two counterpropagating fast-electron currents induce mega-Gauss magnetic filaments in the center of the core due to the Weibel instability. The counterpropagating fast-electron currents are absolutely unstable and independent of the core density and resistivity. Fast electrons with energy below a few MeV are trapped by these filaments in the core region, inducing an additional coupling. This might lead to the observed bright photon emissions.

Direct heating of a laser-imploded core by ultraintense laser-driven ions.

A novel direct core heating fusion process is introduced, in which a preimploded core is predominantly heated by energetic ions driven by LFEX, an extremely energetic ultrashort pulse laser. Consequently, we have observed the D(d,n)^{3}He-reacted neutrons (DD beam-fusion neutrons) with the yield of 5×10^{8} n/4π sr. Examination of the beam-fusion neutrons verified that the ions directly collide with the core plasma. While the hot electrons heat the whole core volume, the energetic ions deposit their energies locally in the core, forming hot spots for fuel ignition. As evidenced in the spectrum, the process simultaneously excited thermal neutrons with the yield of 6×10^{7} n/4π sr, raising the local core temperature from 0.8 to 1.8 keV. A one-dimensional hydrocode STAR 1D explains the shell implosion dynamics including the beam fusion and thermal fusion initiated by fast deuterons and carbon ions. A two-dimensional collisional particle-in-cell code predicts the core heating due to resistive processes driven by hot electrons, and also the generation of fast ions, which could be an additional heating source when they reach the core. Since the core density is limited to 2 g/cm^{3} in the current experiment, neither hot electrons nor fast ions can efficiently deposit their energy and the neutron yield remains low. In future work, we will achieve the higher core density (>10 g/cm^{3}); then hot electrons could contribute more to the core heating via drag heating. Together with hot electrons, the ion contribution to fast ignition is indispensable for realizing high-gain fusion. By virtue of its core heating and ignition, the proposed scheme can potentially achieve high gain fusion.

Experimental evidence of nonthermal acceleration of relativistic electrons by an intensive laser pulse.

Nonthermal acceleration of relativistic electrons is investigated with an intensive laser pulse. An energy distribution function of energetic particles in the universe or cosmic rays is well represented by a power-law spectrum, therefore, nonthermal acceleration is essential to understand the origin of cosmic rays. A possible candidate for the origin of cosmic rays is wakefield acceleration at relativistic astrophysical perpendicular shocks. The wakefield is considered to be excited by large-amplitude precursor light waves in the upstream of the shocks. Substituting an intensive laser pulse for the large amplitude light waves, we performed a model experiment of the shock environments in a laboratory plasma. An intensive laser pulse was propagated in a plasma tube created by imploding a hollow polystyrene cylinder, as the large amplitude light waves propagated in the upstream plasma at an astrophysical shock. Nonthermal electrons were generated, and the energy distribution functions of the electrons have a power-law component with an index of ~2. We described the detailed procedures to obtain the nonthermal components from data obtained by an electron spectrometer.

Postural support improves distress and pain during diaper change in preterm infants.

OBJECTIVE: To determine the effects of a postural support protocol on the physiological and behavioral stability of preterm infants while undergoing a diaper change. STUDY DESIGN: Forty-seven newborns having a birth weight

Absolute calibration of an electron spectrometer using high energy electrons produced by the laser-plasma interaction.

An in situ observation system has been developed to observe the absolute electron energy spectra of electron beams generated by laser-plasma interaction. A phosphor screen (DRZ) coupled with a charge coupled device camera is used to detect the electrons. A new method is proposed to calibrate the absolute sensitivity of the detection system for a wide energy range with a single shot by using an electron beam generated by laser-plasma interaction. The sensitivity of the system is found to be high, which is comparable to that of an imaging plate.

Effects of motor physical therapy on bone mineralization in premature infants: a randomized controlled study.

OBJECTIVE: To study the effect of physical therapy on bone mineralization, weight gain and growth in preterm infants. METHOD: After fulfilling the inclusion criteria, preterm infants were matched for gestational age and birth weight and then randomly assigned to the physiotherapy group (PG, n=15) and control group (CG, n=14). The PG received motor physical therapy for 15 min daily, 5 times per week until hospital discharge. Bone mineralization was measured by total body dual energy X-ray beam absorptiometry (DEXA) at the onset and end of the study. Statistical analysis was realized by ANCOVA and linear correlation tests. RESULT: The physical therapy group (PG) presented greater body weight gain per day (27.4+/-2.4 vs 21.01+/-4.4 g, P<0.001) and length (1.3+/-0.3 vs 0.8+/-0.2 cm week(-1), P<0.001) than did the control group (CG). Body composition values verified by DEXA were greater for the PG. The mean gain in bone mineral content (BMC) (mg) was greater in the PG (434+/-247.5 vs -8.9+/-11.4, P<0.001), as was the mean bone mineral density (BMD) gain (mg cm(-2)) (8.4+/-5.6 vs -3.1+/-5.5, P<0.001). The gain in bone area (BA,cm(2)) was 10.3+/-5 in the PG vs 1.5 +/-2 in the CG (P<0.001). The gain in lean mass (LM) (g) in the PG was also greater than in the CG (271.1+/-21.4 vs 109.1+/-1.0, P<0.009). The fat mass (g) was similar between the groups (P=0.432). CONCLUSION: These results showed that physiotherapy in preterm infants produced greater gains in growth, body weight, BMC, BMD, BA and LM.

[First SIBEN clinical consensus: diagnostic and therapeutic approach to patent ductus arteriosus in premature newborns]. / Primer consenso clínico de SIBEN: enfoque diagnóstico y terapéutico del ductus arterioso permeable en recién nacidos pretérmino.

OBJECTIVE: To report the process and results of the first neonatal clinical consensus of the Ibero-American region. DESIGN AND METHODS: Two recognized experts in the field (Clyman and Van Overmeire) and 45 neonatologists from 23 countries were invited for active participation and collaboration. We developed 46 questions of clinical-physiological relevance in all aspects of patent ductus arteriosus (PDA). Guidelines for consensus process, literature search and future preparation of educational material and authorship were developed, reviewed and agreed by all. Participants from different countries were distributed in groups, and assigned to interact and work together to answer 3-5 questions, reviewing all global literature and local factors. Answers and summaries were received, collated and reviewed by 2 coordinators and the 2 experts. Participants and experts met in Granada, Spain for 4.5 h (lectures by experts, presentations by groups, discussion, all literature available). RESULTS: 31 neonatologists from 16 countries agreed to participate. Presentations by each group and general discussion were used to develop a consensus regarding: general management, availability of drugs (indomethacin vs. ibuprofen), costs, indications for echo/surgery, etc. Many steps were learnt by all present in a collaborative forum. CONCLUSIONS: This first consensus group of Ibero-American neonatologists SIBEN led to active and collaborative participation of neonatologists of 16 countries, improved education of all participants and ended with consensus development on clinical approaches to PDA. Furthermore, it provides recommendations for clinical care reached by consensus. Additionally, it will serve as a useful foundation for future SIBEN Consensus on other topics and it could become valuable as a model to decrease disparity in care and improve outcomes in this and other regions.

Group B streptococcal neonatal infections in Rio Grande do Sul, Brazil.

UNLABELLED: Group B Streptococcus is the most common pathogen found in neonatal sepsis in North America. OBJECTIVES: We describe 15 cases of neonatal infections by Group B Streptococcus (Streptococcus agalactiae) at a Neonatal Intensive Care Unit of a public and teaching hospital. METHODS: We conducted a study at Hospital de Clínicas de Porto Alegre, from January 1st, 1996 to June 30, 1999. Diagnosis of neonatal infection was established according to the findings of Group B Streptococcus in blood culture associated with alterations resembling sepsis on the basis of clinical picture and laboratory findings. RESULTS: Fifteen cases of neonatal infections by Group B Streptococcus were detected. Eleven cases consisted of early-onset sepsis, 2 cases of occult bacteremia and 2 cases of late-onset sepsis. Eight cases had septic shock (53%), 8 cases had pneumonia (53%), and 4 cases had meningitis (27%). Fourteen cases were diagnosed from a positive blood culture, and 1 case from evidence of these bacteria in pulmonary anatomopathological examination. Thirteen cases (87%) were diagnosed before 72 hours of life. We had 3 deaths (20%), and 3 cases of meningitis developing neurological deficits. CONCLUSIONS: Streptococcus Group B is one of the most important pathogens in the etiology of early-onset neonatal sepsis at our hospital, with high mortality and morbidity. However, we do not know the incidence of GBS neonatal infections at other hospitals. More data are needed to establish a basis for trials of different strategies to reduce these infections.

[Biological evaluation of soybean line with low trypsin inhibitor activities]. / Avaliação biológica de soja com baixas atividades de inibidores de tripsina e ausência do inibidor Kunitz.

The soybean cultivar BR 36 with conventional levels of trypsin inhibitors activity and the soybean line BRM95-5262, which was genetically selected to contain low activity of trypsin inhibitors were used for biological assays with rats. BR 36 and BRM95-5262 contained 40 and 20, and 30 and 20% of relative residual activity of trypsin inhibitors, respectively. The mean values of PER and NPR showed that treatments with crude soybeans were minor than treatments with soybean thermically processed. However, the treatments of thermically processed soybean did not showed significative differences (p > or = 0.05). When the trypsin inhibitors activity were 8.61 and 8.44 UIT/mg of samples or 20 and 30% of relative residual activity of cultivar BR 36 and line BRM95-5262, respectively, it was observed that mean values of PER and NPR were not significatives. The mean values of CDA and CDV of treatments with crude soybeans were minor than treatment with casein and similar to the treatments with soybean thermically processed. So, it can be concluded that the biological evaluation obtained with soybean protein were dependent of initial trypsin inhibitors activities and of its respective thermical treatment. There was advantage in the use of BRM95-5262 soybean line with low trypsin inhibitors activity.

The suppressive mechanism of histamine release from rat peritoneal mast cells of iodine-enriched eggs.

We investigated the antiallergic activity of iodine-enriched egg by using rat peritoneal exudate cells. The effects were evaluated by the inhibition ratio of these compounds on histamine release from rat peritoneal exudate cells. Lipid and water-soluble fractions, which were separated from iodine-enriched egg yolk, were used for all experiments. Lipid fractionation of iodine-enriched eggs inhibited histamine release by compound-48/80 in a dose-dependent manner. Lipid fractionation of ordinary eggs had no effect. Neither the water-soluble fraction of iodine-enriched eggs nor ordinary eggs inhibited compound-48/80 induced histamine release. Neither lipid nor soluble fraction of iodine-enriched eggs inhibited histamine release in peritoneal exudate cells with Ca ionophore A23187 stimulation. The same fractions of ordinary eggs were also unable to inhibit histamine release. The lipid fraction, furthermore, was isolated to neutral and polar lipid fractionation. Although both neutral and polar lipid fractionation inhibited histamine release, the effect was dose-dependent in only neutral lipid fractionation. Neither fractions of ordinary egg inhibited histamine release. In conclusion, the components inhibiting histamine release in rat peritoneal exudate cells exist in the neutral lipid fraction of iodine-enriched eggs.

A randomized, double-masked, placebo-controlled trial of recombinant granulocyte colony-stimulating factor administration to preterm infants with the clinical diagnosis of early-onset sepsis.

OBJECTIVE: We performed a randomized, double-masked, parallel-groups, placebo-controlled trial of recombinant granulocyte colony-stimulating factor (rG-CSF) administration to 44 preterm neonates who had blood cultures obtained and antibiotics begun because of the clinical diagnosis of early-onset sepsis. Two primary outcome variables were tested 1) mortality and 2) development of nosocomial infections over the 2-week period after dosing. DESIGN AND METHODS: The treatment group (n = 22) received 10 microgram/kg/day of intravenous rG-CSF once daily for 3 days and the placebo group (n = 22) received the same volume of a visually indistinguishable vehicle. Mortality and culture-proven nosocomial infections were recorded. Immediately before the first, second, and third doses, and again 10 days after the first dose, serum concentrations were determined for tumor necrosis factor-alpha, interleukin 6, granulocyte-macrophage colony stimulating factor, and G-CSF, and blood leukocyte counts, absolute neutrophil counts, immature/total neutrophil ratios, platelet counts, and hemoglobin concentrations were measured. RESULTS: The treatment and placebo groups were of similar gestational age (29 +/- 3 vs 31 +/- 3 weeks) and birth weight (1376 +/- 491 vs 1404 +/- 508 g), and had similar Apgar scores and 24-hour Score for Neonatal Acute Physiology scores. The mortality rate was not different between treatment and placebo groups. However, the occurrence of a subsequent nosocomial infection was lower in the rG-CSF recipients (relative risk:.19; 95% confidence interval:.05-.78). rG-CSF treatment did not alter the serum concentrations of the cytokines measured (except for G-CSF). Serum G-CSF levels and blood neutrophil counts were higher in the treatment than in the placebo group 24 hours and 48 hours after dosing. CONCLUSIONS: Administration of 3 daily doses of rG-CSF (10 microgram/kg/day) to premature neonates with the clinical diagnosis of early-onset sepsis did not improve mortality but was associated with acquiring fewer nosocomial infections over the subsequent 2 weeks.

Observation of spatial asymmetry of THz oscillating electron plasma wave in a laser wakefield

The asymmetric spatial distribution of electron density perturbation is observed by using a frequency-domain interferometry technique. The wake amplitude of the outside bump is enhanced by the elliptical distribution of the pump laser pulse. This asymmetry can be explained with a two-dimensional analytical model expanded from cylindrically symmetric linear theory.

[Assessing the efficacy of the recombinant human granulocyte colony-stimulating factor "rhG-CSF" in the treatment of early neonatal sepsis in premature neonates] / Avaliação da eficácia do fator estimulador recombinante humano de colônias de granulócitos "rhG-CSF" no tratamento da sepse de início precoce, em recém-nascidos prematuros.

OBJECTIVE: To evaluate the efficacy of the recombinant human granulocyte colony-stimulating factor (rhG-CSF) in the treatment of early-onset neonatal sepsis among premature infants.MATERIALS AND METHODS: A double-blind, randomized, placebo-controlled trial was performed among forty-four preterm neonates who had "clinical diagnosis" of early-onset sepsis. The treatment group (n=22) received 10 micro g/kg/d of rhG-CSF, IV once daily for three consecutive days, and the placebo group (n=22) received the same volume of a visually-indistinguishable vehicle. Prior to the first dose, and prior to the second and third doses, and again 10 days after the first dose, we measured tumor necrosis factor-a, interleukin-6, granulocyte-macrophagocyte colony-stimulating factor, G-CSF, leukocyte count, absolute neutrophil count, immature/total neutrophil ratio, platelet count, and hemoglobin concentration. A bone marrow aspiration was performed seven days after the first dose, and both the neutrophil storage pool (NSP) percent and the NSP/NPP (neutrophil proliferative pool) ratios were tabulated.RESULTS: The treatment and placebo groups were of similar gestational age (29-/+ 3 vs 31-/+ 3 weeks) and birth weight (1376 -/+ 491 vs 1404 -/+ 508 grams). They had similar Apgar scores and 24 hour SNAP scores. No deaths occurred during the first week of life among the treatment group while three deaths occurred in the placebo group. RhG-CSF treatment did not alter the serum concentrations of the cytokines measured (except for G-CSF). Serum G-CSF levels, blood leukocyte counts, absolute neutrophil counts, NSP percentages, and NSP/NPP ratios were higher in the treatment group 24 hours and 72 hours after dosing. The occurrence of a subsequent infection over the two week period following dosing was significantly lower in the treatment group (n=2) than in the placebo group (n=9; p<0.02, RR 0.19 [0.05-0.78]). The overall mortality rate during the entire hospitalization was not different between treatment and placebo groups.CONCLUSIONS: Administration of rhG-CSF to premature neonates with the clinical diagnosis of early-onset sepsis was associated with lower incidence of nosocomial infection over the ensuing three weeks period, but it did not change the overall mortality rate.

[Neonatal sepsis: diagnosis and treatment] / Sepse neonatal: diagnóstico e tratamento.

OBJECTIVE: Review the literature on diagnosis and treatment of neonatal sepsis. METHODS: The most important articles on neonatal sepsis were selected through MEDLINE. RESULTS: The present review analyzes the different methods of diagnosis, laboratory and clinical, as well as the different therapeutic managements of neonatal sepsis. CONCLUSION: Neonatal sepsis is a severe disease that must be diagnosed early and properly treated in order to avoid lethal outcome.

Mortalidade perinatal e neonatal no Hospital de Clínicas de Porto Alegre / Perinatal and neonatal mortality at the Hospital de Clinicas de Porto Alegre, Brazil

Objetivo. Análise epidemiológica da mortalidade neonatal e perinatal de 20.280 crianças nascidas vivas com 500g ou mais e 374 natimortos ocorridas no Hospital de Clínicas de Porto Alegre, no período de 1984 a 1990. Proposta. Comparar dois períodos: A (1984-1987) com B (1988-1990), estabelecendo as mudanças ocorridas. Métodos. É um estudo retrospectivo de revisao dos registros de nascimentos do centro obstétrico, internaçoes e óbitos da unidade neonatal e mortes fetais e dos laudos de necrópsia. Resultados. Faleceram 258 RN, com um coeficiente de mortalidade noenatal de 12,7 por mil. A taxa de natimortalidade foi de 18,4 por mil. O coeficiente de mortalidade perinatal foi de 28,4 por mil. A incidência de baixo peso ao nascer (<2.500g), de 11,2 por cento, e a de muito baixo peso ao nascer (<1.500g) foi de 1,8 por cento. Este último grupo aumentou sua incidência de 1,5 por cento (A) para 2,2 por cento (B). As causas mais freqüentes de morte neonatal foram: a) infecçao intra-uterina (22,4 por cento); b) doença de membrana hialina (20,1 por cento); c) malformaçoes múltiplas (18,2 por cento); d) asfixia perinatal (15,5 por cento); e) infecçoes pós-natais específicas (9,7 por cento). As causas de morte fetal foram: a) asfixia (38,7 por cento); b) infecçoes intra-uterinas (9 por cento); c) toxemia (8,2 por cento); d) malformaçoes múltiplas (7,4 por cento). No período B, foi significativo o aumento de óbitos por infecçoes pós-natais, OR 7 (1,9-30,6) e por malformaçoes congênitas, OR 1,6 (0,8-3,2). Nao houve reduçao significativa na taxa de mortalidade em menores de 1.500g OR 90 (61-118) em A para 54 (37-68) em B. Conclusao. Nao houve reduçao nas taxas de mortalidade neonatal, apesar dos avanços tecnológicos e na capacitaçao técnica.

[Perinatal and neonatal mortality at the Clinicas de Porto Alegre Hospital, Brazil]. / Mortalidade perinatal e neonatal no Hospital de Clínicas de Porto Alegre.

OBJECTIVE: Epidemiological analysis of neonatal and perinatal mortality of 20,280 newborns alive with 500g or more and 374 stillbirths occurred at the Hospital de Clínicas de Porto Alegre from 1984 to 1990. PURPOSE: To compare two periods: A (1984-1987) with B (1988-1990), establishing a relationship between the changes occurred in the causes and the rate of mortality. METHODS: The retrospective study was done with the records of promptuaries of obstetrical and neonatal centers, and review of flow-sheets of the deaths and autopsies. RESULTS: Between 1984 to 1990, 20,280 newborns alive with 500g or more, 374 stillbirths at perinatal unit of Hospital de Clínicas de Porto Alegre were born. 258 deaths occurred, the neonatal mortality rate was 12.7 per thousand. The stillbirth rate was 18.4 per thousand. The perinatal mortality rate was 28.4 per thousand. The incidence of low birth weight (< 2,500g) was 11.2% and very low birth weight (< 1,500 g) was 1.8%, the former group had an increase incidence between 1984-1988 (A) from 1.5% to 2.2% (B). The causes of deaths were distributed as follow: a) intrauterine infections (22.4%); b) hyaline membrane disease (20.1%); c) congenital malformation (18.2%); d) asphyxia (15.5%); e) postnatal infections (9.7%). The causes of stillbirth were: a) perinatal asphyxia (38.7%); b) intrauterine infections (9%); toxemia (8.2%); d) malformation (7.4%). The period B showed changes with an increase of postnatal infections odds ration (OR) 7 (1.9-30.6) and congenital malformations OR 1.6 (0.8-3.2). It did not occurred a decrease in mortality rate for prematures below 1,500g OR 90 (61-118) in A to 54 (37-68) in B. CONCLUSIONS: The advantages in technology and human capacity were not sufficient to reduce significantly the rate of neonatal mortality.