Uterine tumor resembling high-grade endometrial mesenchymal sarcoma with GATAD2B-MMRN1 fusion.

Uterine sarcomas are a group of rare malignant tumors of mesenchymal tissue of the uterus, and their diagnosis is often difficult because they have variable morphologies and no typical immunophenotype. This report describes a 48-year-old woman who underwent laparoscopic myomectomy and relapsed within 5 years with a large mass in the pelvic cavity. Morphologically, the tumor was composed of oval cells and small arteries, and the cells showed moderate to severe atypia. Immunohistochemical results showed that the tumor cells expressed desmin, smooth muscle actin, and h-caldesmon, which supported myogenic differentiation. They were strongly positive for Cyclin D1, estrogen receptors (ER), and estrogen receptors (PR), supporting their origin from uterine mesenchymal cells. Next-generation sequencing (NGS) revealed a GATAD2B::MMRN1 rearrangement. The patient was diagnosed with uterine sarcoma resembling high-grade endometrial mesenchymal sarcoma with a GATAD2B-MMRN1 fusion. We review the relevant literature and discuss the diagnostic and differential diagnostic points for this disease.

Dual-color quantum dots nanobeads based suspension microarray for simultaneous detection of dual prostate specific antigens.

Featured with high multiplexibility, suspension microarray technology usually involves the conjugation of second-antibody with organic dye based fluorescent proteins, which are inherently unsuitable for multicolor signaling under single wavelength excitation. In addition, application of single QDs-based fluorescent reporter in suspension microarray is dramatically hampered since its preparation often suffers from poor reproducibility and stability. Herein, a novel suspension microarray system based on dual color quantum dots (QDs) nanobead as fluorescence label was developed for simultaneous detection of prostate specific antigen (PSA) biomarkers. When both antigens are present in sera sample, free (f)-PSA antibody-conjugated green and complexed (c)-PSA antibody-conjugated red QDs nanobeads would be both specifically absorbed onto the surface of total PSA antibody-conjugated magnetic beads, leading to the formation of magnetic fluorescent hybrid that can be purified from the mixture by an external magnet prior to flow cytometry analysis. The proposed method demonstrates simultaneous detection ability for f- and c- PSA antigen assay with high detection sensitivity that is comparable to clinical approaches including ELISA and chemiluminescence assay. Furthermore, result of clinical application of the proposed method is consistency with clinical data, demonstrating its potential in suspension microarray for accurate prostate cancer diagnosis.

Clinical value of abnormal MRI findings in patients with unilateral sudden sensorineural hearing loss.

PURPOSE: We aimed to determine the relationship of abnormal labyrinthine signals on heavily T2-weighted three-dimensional fluid-attenuated inversion recovery imaging (HF sequence) with hearing impairment and prognosis in patients with sudden sensorineural hearing loss (SSNHL). METHODS: Patients with unilateral SSNHL underwent magnetic resonance imaging, including pre-contrast HF sequences and post-contrast HF sequences with a 4-hour scan delay after intravenous gadolinium injection. We measured the signal intensity ratio (SIR) of the vestibule and cochlea relative to the cerebellar medulla on post-contrast HF sequences, and analyzed the relationship of SIR with hearing impairment and prognosis. RESULTS: Of 61 patients, 23 (37.7%) showed signal abnormalities on post-contrast HF sequences. Initial hearing loss and hearing recovery were worse in the HF+ group than in the HF- group (P < 0.05). Profound hearing loss was more common in the HF+ group (52.2% vs. 23.7%), while moderate hearing loss was more common in the HF- group (18.4% vs. 0.0%; P < 0.05 for both). The rate of partial recovery was higher in the HF- group (42.1%) than in the HF+ group (13.0%; P < 0.05). The SIRs of the vestibule and cochlea were positively correlated with the severity of hearing loss and hearing recovery, with higher SIRs indicating more severe hearing loss and poor recovery. CONCLUSION: Labyrinthine signal abnormalities were found on post-contrast HF sequences in 37.7% of patients with SSNHL. These abnormalities were found only in patients with severe-to-profound hearing loss. Increased SIR indicated more severe hearing loss and poor prognosis.

Influence of Emphysema and Air Trapping Heterogeneity on Pulmonary Function in Patients with COPD.

Purpose: To explore the influence of emphysema and air trapping heterogeneity on pulmonary function changes in patients with stable chronic obstructive pulmonary disease (COPD). Patients and methods: One hundred and seventy-nine patients with stable COPD were enrolled in this prospective study. All patients underwent low-dose inspiratory and expiratory CT scanning and pulmonary-function tests. CT quantitative data for the emphysema index (EI) on full-inspiration and air trapping (AT) on full-expiration were measured for the whole lung, the right and left lungs, and the cranial-caudal lung zones. The heterogeneity index (HI) values for emphysema and air trapping were determined as the ratio of the difference to the sum of the respective indexes. The cranial-caudal HI and left-right lung HI were compared between mild-to-moderate (GOLD stage I and II) and severe (GOLD stage III and IV) disease groups. The associations between HI and pulmonary-function measurements adjusted for age, sex, height, smoking history, EI and AT of the total lung were assessed using multiple linear regression analysis. Results: The absolute values for cranial-caudal HI (AT_CC_HI) and left-right lung HI (AT_LR_HI) on full-expiration were significantly larger in the mild-to-moderate group, while no significant intergroup differences were observed on full-inspiration. COPD patients with lower-zone and/or left-lung predominance showed significantly lower pulmonary function than those with upper-zone and/or right-lung predominance on full-expiration, whereas no significant differences were observed on full-inspiration. The absolute values of AT_CC_HI and AT_LR_HI significantly correlated with pulmonary-function measurements. Higher AT_CC_HI and lower AT_LR_HI absolute values indicated better pulmonary function, after adjusting for age, sex, height, smoking history, EI and AT of the total lung. Conclusion: Subjects with more heterogeneous distribution and/or upper-zone predominant and/or right-lung predominant patterns on full-expiration tend to have better pulmonary function. Thus, in comparison with emphysema heterogeneity, AT heterogeneity better reflects the pulmonary function changes in COPD patients.

Exogenous interleukin 37 ameliorates atherosclerosis via inducing the Treg response in ApoE-deficient mice.

Our previous study indicated that interleukin (IL)-37 is involved in atherosclerosis. In the present study, Anterior tibial arteries were collected from diabetes patients and controls. A histopathological analysis showed that IL-37 was over-expressed in human atherosclerotic plaques. Many types of cells including macrophages, vascular smooth muscle cells (VSMCs), endothelial cells and T lymphocyte expressed IL-37 in human atherosclerotic plaques. ApoE-/- mice were divided into a control group and a recombinant human IL-37-treated group. The IL-37 treatment resulted in a significant decrease in macrophages and CD4+ T lymphocytes and a substantial increase in VSMCs and collagen in atherosclerotic plaques, resulting in a reduction in atherosclerotic plaque size. Furthermore, the IL-37 treatment modulated the CD4+ T lymphocyte activity, including a decrease in T helper cell type 1 (Th1) and Th17 cells and an increase in regulatory T (Treg) cells, and inhibited the maturity of dendritic cells both in vivo and in vitro. In addition, treatment with anti-IL-10 receptor monoclonal antibody abrogated the anti-atherosclerotic effects of IL-37. These data suggest that exogenous IL-37 ameliorates atherosclerosis via inducing the Treg response. IL-37 may be a novel therapeutic to prevent and treat atherosclerotic disease.

Increased IL-37 concentrations in patients with arterial calcification.

BACKGROUND: Our previous study indicates that IL-37 plays a critical role in both atherosclerosis and arterial calcification. However, whether IL-37 concentrations are significantly changed in patients with arterial calcification has not yet been investigated. METHODS: Anterior tibial arterial wall specimens were obtained from 8 patients with type 2 diabetes mellitus and 8 patients who experienced a traffic accident. IL-37 expression was measured by immunohistochemistry in the calcified and the normal samples. In addition, plasma IL-37 concentrations were measured in 75 patients with coronary artery calcification (CAC) and 50 patients without coronary artery calcification (NCAC). RESULTS: High concentrations of IL-37 were detected in calcified samples, whereas low concentrations of IL-37 were detected in the normal arteries. Macrophages and vascular smooth muscle cells were the main source of IL-37. Plasma IL-37 concentrations were significantly increased in CAC patients compared with NCAC patients. A correlation analysis showed that IL-37 was positively correlated with age, fasting glucose, alkaline phosphatase, IL-6, TNF-α, C-reactive protein and Agatston scores. Binary logistic regression analyses demonstrated that fasting glucose and IL-37 were independently associated with the presence of CAC. CONCLUSIONS: Increased IL-37 concentrations are associated with the onset of arterial calcification.

[Imaging characteristics of basilar artery hypoplasia].

OBJECTIVE: To determine the imaging characteristics of basilar artery hypoplasia (BAH). METHODS: From October 2009 to August 2013, 10 193 magnetic resonance angiogram (MRA) and 31 716 magnetic resonance imaging (MRI) consecutive cases were retrospectively retrieved from our institutional Picture Archiving and Communication System (PACS) database. BAH was defined as a continuous diameter reduction all over artery and a basilar artery diameter ≤ 2 mm. The same cut-off value was applied for vertebral artery hypoplasia (VAH). We measured the diameters of basilar and vertebral arteries with PACS in all patients according to source imaging and IMP construction of MRA. The carotid arterial computed tomography angiogram (CTA) profiles were reviewed in 50 patients. The fetal-type posterior circle of Willis (FTP) was assessed. The diagnosis of acute cerebral infarction was based on clinical symptoms, signs and a high signal on diffusion-weighted imaging (DWI). Acute cerebral infarction was divided into anterior circulation stroke (ACS) and posterior circulation stroke (PCS). RESULTS: A total of 210 BAH were identified among 10 193 consecutive patients. BAH was more common in females (56.7%) than males (43.3%) in the patient group. They had a fetal-type of posterior cerebral artery (FTP) (175 bilateral (83.3%), 35 unilateral (16.7%)). 99.5% patients had V4 VAH and 56.0% (28/50) V1-V3 VAH. Among 210 BAH, there are 74 patients (mean age 64 years, average 25-91 years, 44 males) with a diagnosis of acute cerebral infarction (ACI). The males were predominant in ACI (59.5% in males vs 40.5% in females, P = 0.021). The frequency of BAH was detected in 74 (2.2%) among 3 294 ACI patients. CONCLUSION: As a relatively rare vascular abnormality, BAH has always unilateral or bilateral FTP and V4 VAH.