[Soft tissue reconstruction strategy for sacral tumor resection].

Objective: To investigate the clinical strategy and effect of soft tissue reconstruction after sacral tumor resection in different planes. Methods: The data of 27 consecutive patients who underwent primary or secondary sacral tumor resection and soft tissue reconstruction from June 2012 to June 2021 at Dongnan Hospital of Xiamen University (the 909th Hospital) were retrospectively analyzed. There were 11 males and 16 females, aged (M(IQR)) (46.2±23.6) years (range: 16 to 72 years). Sacrospinous muscle, gluteus maximus and vertical rectus abdominis muscle flap were selected for soft tissue reconstruction according to the tumor site and the size of tissue defect. the postoperative follow-up was performed. The operative methods, intraoperative conditions, complications and disease outcomes were summarized. Results: Among the 27 patients with sacral tumor, the tumor plane was located in S1 in 8 cases, S2 in 5 cases and S3 or below in 14 cases. There were 12 patients with tumor volume≤400 cm3 and 15 patients with tumor volume>400 cm3. Operation time was 100(90) minutes (range: 70 to 610 minutes), intraoperative blood loss was 800(1 600) ml (range: 400 to 6 500 ml). Soft tissue reconstruction was performed by transabdominal rectus abdominis transfer repair in 2 cases, extraperitoneal rectus abdominis transfer repair in 1 case, gluteus maximus transfer repair in 5 cases, gluteus maximus advancement repair in 13 cases, and sacrospinous muscle transfer repair in 6 cases. Postoperative complications occurred in 6 cases, including 1 case of incision infection, 4 cases of skin border necrosis, and 1 case of delayed infection due to fracture of internal fixator 3 years after operation, all of them were cured. The follow-up time was (35±21) months. Among the patients, 6 patients had recurrence, 2 patients with Ewing sarcoma died of lung metastasis 1 year after operation, 4 patients with metastatic cancer died of primary disease, and the remaining patients survived without disease. Conclusion: Choosing different soft tissue reconstruction strategies according to sacral tumor location and tissue defect size can effectively fill the dead space after sacral tumor resection, reduce postoperative complications and improve the prognosis of patients.

Partial recovery of senescence and differentiation disturbances in CD8+ T cell effector-memory cells in HIV-1 infection after initiation of anti-retroviral treatment.

Immune senescence as well as disturbed CD8+ T cell differentiation are a hallmark of chronic HIV infection. Here, we investigated to what extent immune senescence is reversible after initiation of anti-retroviral treatment (ART). Peripheral blood mononuclear cells (PBMCs) from a cohort of HIV patients with different disease courses, including untreated viral controllers (n = 10), viral non-controllers (n = 16) and patients on ART (n = 20), were analysed and compared to uninfected controls (n = 25) by flow cytometry on bulk and HIV-specific major histocompatibility complex (MHC) class I tetramer+ CD8+ T cells for expression of the memory markers CCR7 and CD45RO, as well as the senescence marker CD57 and the differentiation and survival marker CD127. Furthermore, a subset of patients was analysed longitudinally before and after initiation of ART. Frequencies of CD57+ CD8+ T cells decreased after initiation of ART in central memory (Tcm) but not in effector memory T cell populations (TemRO and TemRA). The frequency of CD127+ CD8+ cells increased in Tcm and TemRO. We observed a reduction of CD127- T cells in Tcm, TemRO and partially in TemRA subsets after initiation of ART. Importantly, HIV-specific CD8+ TemRO cells predominantly displayed a CD127- CD57+ phenotype in untreated HIV-patients, whereas the CD127+ CD57- phenotype was under-represented in these patients. The frequency of the CD127+ CD57- CD8+ T cell subpopulation correlated strongly with absolute CD4+ counts in HIV-infected patients before and after initiation of ART. These findings can be interpreted as a phenotypical correlate of CD8+ memory T cell differentiation and the premature 'ageing' of the immune system, which was even observed in successfully virally suppressed HIV patients.

Purification and characterization of a melanin biodegradation enzyme from Geotrichum sp.

OBJECTIVE: Melanin is a black or brown phenolic polymer present mainly in skin and hair. Although melanin can be degraded by some microbial species, the melanin degradation capacity of Geotrichum sp. is unknown. The aim of this study was to characterize a melanin biodegradation enzyme from Geotrichum sp. METHODS: In this study, we assessed the melanin degradation activity of Geotrichum sp. in comparison with the major melanin-degrading enzymes, manganese-dependent peroxidase (MnP), manganese-independent peroxidase, lignin peroxidase and laccase. Furthermore, the effect of several carbohydrates on melanin degradation by Geotrichum sp. was determined. The MnP enzyme was purified using ammonium sulphate precipitation and Sephadex G-200 column chromatography, and then the conditions for optimal enzymatic activity were determined by adjusting the pH, temperature and Tween-80 concentration. RESULTS: Compared with extracellular ligninolytic enzymes of Geotrichum sp., MnP had the highest ligninolytic enzyme activity; and the highest enzymatic activity was observed in the presence of glucose. The final purified MnP enzyme exhibited 6 U mL-1 activity and had a molecular weight of 54.2 kDa. The enzymatic activity was highest at pH 4.5 and 25-35°C in the absence of Tween-80. CONCLUSION: These results indicate the potential of MnP purified from Geotrichum sp. as a skin-lightening agent in the cosmetic industry.

Correlation between polymorphism of platelet alloantigen genes HPA-1-5 and type 2 diabetes complication by carotid atherosclerosis in a Chinese population.

We investigated the association between the polymorphism of human platelet alloantigen genes HPA-1-HPA-5 and the complication of type 2 diabetes mellitus (T2DM) by carotid atherosclerosis (CA) among Han people in Guiyang District, China. Ninety-nine T2DM patients were selected from the Affiliated Hospital of Guiyang Medical College and divided into a CA(+) group and a CA(-) group. A control group comprised 100 healthy people from the medical examination center of the same hospital. Genomic DNA from all the subjects was isolated by phenol-chloroform extraction and target genes were amplified using sequence-specific primer-polymerase chain reaction, followed by gene type detection of HPA. There were significant differences in allele and genotype frequencies of HPA-1, -2, -3, and -5 among the three groups [CA(+), CA(-), and the control group] (P < 0.05), and significant differences in allele and genotype frequencies of HPA-1, -2, and -3 between groups CA(+) and CA(-) and the control group (P < 0.05). Moreover, there was a significant difference in allele and genotype frequencies of HPA-5 between the CA(+) and CA(-) groups (P < 0.05). Logistic regression analysis showed that risk factors for T2DM patients developing a CA complication were age, duration of diabetes, high blood pressure, smoking, overweight, abnormal blood lipid levels, and polymorphism of HPA-5. There may be a correlation between T2DM and polymorphism of HPA-1-3. Polymorphism of HPA- 5 is probably a risk factor for CA complicating T2DM.

Analysis of RAS mutation and PAX8/PPARγ rearrangements in follicular-derived thyroid neoplasms in a Korean population: frequency and ultrasound findings.

OBJECTIVE: To investigate the frequency and ultrasonography (US) findings of RAS mutations and PAX8/PPARγ rearrangements between follicular thyroid adenomas (FTAs) and follicular thyroid carcinomas (FTCs) in a Korean population. METHODS: RAS mutations and PAX8/PPARγ rearrangements in 56 FTAs and 35 FTCs were analyzed. We also analyzed the US findings of FTCs and FTAs. RESULTS: 16 nodules of 35 FTCs (45.7 %) and 19 nodules of 56 FTAs (33.9 %) harbored RAS mutations. Three FTCs and three FTAs showed two point mutations simultaneously. K-RAS codon 12-13 (n = 6, 31.6 %), N-RAS codon 61 (n = 5, 26.3 %), H-RAS codon 61 (n = 4, 21.1 %), K-RAS codon 61 (n = 3, 15.8 %), and N-RAS codon 12-13 (n = 1, 5.3 %) were found in FTCs, and N-RAS codon 61 (n = 10, 45 %), K-RAS codon 12-13 (n = 5, 22.7 %), H-RAS codon 61 (n = 5, 22.7 %), K-RAS codon 61 (n = 1, 4.5 %), and N-RAS codon 12-13 (n = 1, 4.5 %) were observed in FTAs. 4 of 56 (7.1 %) FTAs and 1 of 35 (2.9 %) FTCs represented PAX8/PPARγ rearrangements, respectively (P = 0.645). The absence of a hypoechoic rim (P = 0.021) and presence of calcifications (P = 0.049) were significantly associated with FTCs compared with FTAs. CONCLUSIONS: RAS mutation frequency targeting the Korean population showed a 45.7 % in FTCs and 35.7 % in FTAs, and PAX8/PPARγ rearrangements were more frequently showed in FTAs. K-RAS codon 12-13 was the most common RAS mutation in FTCs, whereas N-RAS codon 61 was more frequent in FTAs. The presence of calcifications and absence of a hypoechoic rim showed more frequently in FTCs.

Changes in cardiac aldosterone and its synthase in rats with chronic heart failure: an intervention study of long-term treatment with recombinant human brain natriuretic peptide

The physiological mechanisms involved in isoproterenol (ISO)-induced chronic heart failure (CHF) are not fully understood. In this study, we investigated local changes in cardiac aldosterone and its synthase in rats with ISO-induced CHF, and evaluated the effects of treatment with recombinant human brain natriuretic peptide (rhBNP). Sprague-Dawley rats were divided into 4 different groups. Fifty rats received subcutaneous ISO injections to induce CHF and the control group (n=10) received equal volumes of saline. After establishing the rat model, 9 CHF rats received no further treatment, rats in the low-dose group (n=8) received 22.5 μg/kg rhBNP and those in the high-dose group (n=8) received 45 μg/kg rhBNP daily for 1 month. Cardiac function was assessed by echocardiographic and hemodynamic analysis. Collagen volume fraction (CVF) was determined. Plasma and myocardial aldosterone concentrations were determined using radioimmunoassay. Myocardial aldosterone synthase (CYP11B2) was detected by quantitative real-time PCR. Cardiac function was significantly lower in the CHF group than in the control group (P<0.01), whereas CVF, plasma and myocardial aldosterone, and CYP11B2 transcription were significantly higher than in the control group (P<0.05). Low and high doses of rhBNP significantly improved hemodynamics (P<0.01) and cardiac function (P<0.05) and reduced CVF, plasma and myocardial aldosterone, and CYP11B2 transcription (P<0.05). There were no significant differences between the rhBNP dose groups (P>0.05). Elevated cardiac aldosterone and upregulation of aldosterone synthase expression were detected in rats with ISO-induced CHF. Administration of rhBNP improved hemodynamics and ventricular remodeling and reduced myocardial fibrosis, possibly by downregulating CYP11B2 transcription and reducing myocardial aldosterone synthesis.

Changes in cardiac aldosterone and its synthase in rats with chronic heart failure: an intervention study of long-term treatment with recombinant human brain natriuretic peptide.

The physiological mechanisms involved in isoproterenol (ISO)-induced chronic heart failure (CHF) are not fully understood. In this study, we investigated local changes in cardiac aldosterone and its synthase in rats with ISO-induced CHF, and evaluated the effects of treatment with recombinant human brain natriuretic peptide (rhBNP). Sprague-Dawley rats were divided into 4 different groups. Fifty rats received subcutaneous ISO injections to induce CHF and the control group (n=10) received equal volumes of saline. After establishing the rat model, 9 CHF rats received no further treatment, rats in the low-dose group (n=8) received 22.5 µg/kg rhBNP and those in the high-dose group (n=8) received 45 µg/kg rhBNP daily for 1 month. Cardiac function was assessed by echocardiographic and hemodynamic analysis. Collagen volume fraction (CVF) was determined. Plasma and myocardial aldosterone concentrations were determined using radioimmunoassay. Myocardial aldosterone synthase (CYP11B2) was detected by quantitative real-time PCR. Cardiac function was significantly lower in the CHF group than in the control group (P<0.01), whereas CVF, plasma and myocardial aldosterone, and CYP11B2 transcription were significantly higher than in the control group (P<0.05). Low and high doses of rhBNP significantly improved hemodynamics (P<0.01) and cardiac function (P<0.05) and reduced CVF, plasma and myocardial aldosterone, and CYP11B2 transcription (P<0.05). There were no significant differences between the rhBNP dose groups (P>0.05). Elevated cardiac aldosterone and upregulation of aldosterone synthase expression were detected in rats with ISO-induced CHF. Administration of rhBNP improved hemodynamics and ventricular remodeling and reduced myocardial fibrosis, possibly by downregulating CYP11B2 transcription and reducing myocardial aldosterone synthesis.

Extraskeletal myxoid chondrosarcoma of the neck.

Extraskeletal myxoid chondrosarcoma is a rare malignant soft-tissue tumour that is typically in the deep soft tissues of the lower extremity. The tumour is usually a well-defined, multinodular soft-tissue mass without calcifications. A 62-year-old woman with a history of nasopharyngeal cancer presented with a palpable mass in the anterior neck. Radiologically, the lesion was a well-defined soft-tissue mass with the extensive calcifications on various imaging examinations. Although this lesion was histopathologically diagnosed as extraskeletal myxoid chondrosarcoma, the unusual imaging findings were challenging and very intriguing.

CT appearance of primary peritoneal serous borderline tumour: a rare epithelial tumour of the peritoneum.

Primary peritoneal serous borderline tumour (PPSBT) is a rare epithelial neoplasm which is histologically identical to serous borderline tumour of the ovary. PPSBT is distinguishable from primary peritoneal serous carcinoma because the tumour cells do not invade the underlying tissue and affected patients have a good prognosis. We report the CT findings of surgically proven PPSBT in which multiple peritoneal cysts were seen. Although rare, PPSBT should be considered in the differential diagnosis of primary peritoneal tumours. Since the prognosis of the disease is good, conservation of the uterus and ovaries should be a consideration in young female patients during surgery.

Relative accuracy of CT and MRI in the differentiation of benign from malignant pancreatic cystic lesions.

AIMS: To assess the diagnostic accuracies of multidetector computed tomography (MDCT) and magnetic resonance imaging (MRI) for differentiating benign from malignant lesions and suggesting the specific diagnoses for pancreatic cystic lesions, and to assess whether review of both MDCT and MRI is beneficial. MATERIALS AND METHODS: Patients with various neoplastic and non-neoplastic pancreatic cystic lesions that were identifiable by biopsy or surgery, who underwent both MRI and MDCT (n=63), were retrospectively reviewed by three reviewers. The likelihood of malignancy was recorded on a five-point scale, and a specific diagnosis was given. ROC analysis was performed and the sensitivity, specificity for the characterization of malignancy, and the accuracy of specific diagnoses were calculated. RESULTS: MDCT and MRI yielded comparable results for the characterization of malignancy (Az: 0.639, 0.735, 0.806 for MDCT and 0.732, 0.753, 0.792 for MRI, for each reviewer). The accuracies of specific diagnosis based on MDCT or MRI were 61.9 versus 55.6% for reviewer 1; 76.2 versus 76.2% for reviewer 2; and 65.1 versus 61.9% for reviewer 3. There was a trend toward better prediction of malignancy (Az: 0.787, 0.745, 0.849 for each reviewer), and better accuracy in suggesting a specific diagnosis (77.8, 73, and 73% for each reviewer) for MDCT+MRI over MDCT or MRI alone, although it was statistically significant for one reviewer in the comparison of MDCT versus MDCT+MRI for the prediction of malignancy, and MRI versus MDCT for suggesting a specific diagnosis. CONCLUSIONS: MDCT and MRI have equivalent accuracy for characterizing pancreatic cystic lesions as benign or malignant, and suggesting a specific diagnosis. Combined review of MDCT and MRI was not significantly better but may have the potential to improve diagnostic accuracy in equivocal cases.

Characterization of liver metastases: the efficacy of biphasic magnetic resonance imaging with ferucarbotran-enhancement.

AIM: To retrospectively evaluate the efficacy of biphasic magnetic resonance imaging (MRI) of the liver with ferucarbotran-enhancement for the characterization of hepatic metastases. MATERIALS AND METHODS: Thirty-six patients underwent MRI of the liver with separate acquisition of double-contrast enhancement consisting of gadolinium and ferucarbotran. A total of 106 focal hepatic lesions (51 metastases, 31 cysts, 23 haemangiomas, and one eosinophilic abscess) were included. Two sets of MRI were analysed: (1) ferucarbotran set: ferucarbotran-enhanced T1-weighted (T1W) dynamic imaging combined with ferucarbotran-enhanced T2*-weighted (T2*W) delayed imaging and (2) double set: gadolinium-enhanced T1W dynamic imaging combined with ferucarbotran-enhanced T2*W delayed imaging. The diagnostic accuracy of the two sets was evaluated using alternative free-response receiver operating characteristic curve analysis. Sensitivity and specificity were compared using the McNemar test. The enhancement pattern of focal hepatic lesions was analysed on gadolinium and ferucarbotran-enhanced T1W dynamic imaging. RESULTS: There was no significant difference in the accuracy of characterizing hepatic metastases between the two sets. Sensitivity and specificity were not significantly different between the sets (p>0.05). Peripheral rim enhancement was exhibited in 57% of metastatic lesions on ferucarbotran-enhanced T1W dynamic imaging. The majority (96%) of hepatic haemangiomas demonstrated typical peripheral nodular enhancement with progression on ferucarbotran-enhanced T1W dynamic imaging and were easily differentiated from metastases. CONCLUSION: Biphasic MRI of the liver with ferucarbotran-enhancement alone provided comparable diagnostic efficacy to double-contrast MRI for the characterization of hepatic metastases.

Aggressive digital papillary adenocarcinoma: a review.

Vigorous treatment of aggressive digital papillary adenocarcinoma (ADPA), including amputation, has been recommended by most authors, but the appropriateness and effectiveness of excision as an alternative to amputation has not been systematically evaluated. To evaluate the appropriateness and effectiveness of excision as an alternative to amputation in the treatment of ADPA, we reviewed the clinical presentations, treatments and patient outcomes presented in case reports on ADPA available on Ovid MEDLINE. We also assessed the results of immunohistochemical staining for proliferation markers in one patient in order to explain the nonaggressive nature of ADPA noted in that patient. Except for the duration of lesions, there was no significant difference in clinical outcome between the excision and amputation groups. We also found that p63 may be a useful marker for distinguishing primary ADPA from metastatic adenocarcinomas. In addition, the intensity of Ki67 expression in tumour cells may be a marker of aggressive behaviour and thus be helpful in therapeutic decision-making. Wide excision with or without sentinel lymph-node biopsy is a feasible alternative to amputation. It should be considered in patients who present with a long-standing history of ADPA without evidence of underlying bone invasion or distant metastasis and with low-intensity expression of proliferation markers.

Enhancement pattern of the normal facial nerve at 3.0 T temporal MRI.

The purpose of this study was to evaluate the enhancement pattern of the normal facial nerve at 3.0 T temporal MRI. We reviewed the medical records of 20 patients and evaluated 40 clinically normal facial nerves demonstrated by 3.0 T temporal MRI. The grade of enhancement of the facial nerve was visually scaled from 0 to 3. The patients comprised 11 men and 9 women, and the mean age was 39.7 years. The reasons for the MRI were sudden hearing loss (11 patients), Méniàre's disease (6) and tinnitus (7). Temporal MR scans were obtained by fluid-attenuated inversion-recovery (FLAIR) and diffusion-weighted imaging of the brain; three-dimensional (3D) fast imaging employing steady-state acquisition (FIESTA) images of the temporal bone with a 0.77 mm thickness, and pre-contrast and contrast-enhanced 3D spoiled gradient record acquisition in the steady state (SPGR) of the temporal bone with a 1 mm thickness, were obtained with 3.0 T MR scanning. 40 nerves (100%) were visibly enhanced along at least one segment of the facial nerve. The enhanced segments included the geniculate ganglion (77.5%), tympanic segment (37.5%) and mastoid segment (100%). Even the facial nerve in the internal auditory canal (15%) and labyrinthine segments (5%) showed mild enhancement. The use of high-resolution, high signal-to-noise ratio (with 3 T MRI), thin-section contrast-enhanced 3D SPGR sequences showed enhancement of the normal facial nerve along the whole course of the nerve; however, only mild enhancement was observed in areas associated with acute neuritis, namely the canalicular and labyrinthine segment.

Analysis of community structure of a microbial consortium capable of degrading benzo(a)pyrene by DGGE.

A microbial consortium was obtained by enrichment culture of sea water samples collected from Botan oil port in Xiamen, China, using the persistent high concentration of a mixture of polycyclic aromatic hydrocarbons enrichment strategy. Denaturing gradient gel electrophoresis (DGGE) was used to investigate the bacterial composition and community dynamic changes based on PCR amplification of 16S rRNA genes during batch culture enrichment. Using the spray-plate method, three bacteria, designated as BL01, BL02 and BL03, which corresponded to the dominant bands in the DGGE profiles, were isolated from the consortium. Sequence analysis showed that BL01, BL02 and BL03 were phylogenetically close to Ochrobactrum sp., Stenotrophomonas maltophilia and Pseudomonas fluorescens, respectively. The degradation of benzo(a)pyrene (BaP), a model high-molecular-weight polycyclic aromatic hydrocarbon (HMW PAH) compound was investigated using individual isolates, a mixture of the three isolates, and the microbial consortium (BL) originally isolated from the oil port sea water. Results showed that the order of degradative ability was BL>the mixture of the three isolates>individual isolates. BL degraded 44.07% of the 10 ppm BaP after 14 days incubation, which showed the highest capability for HMW PAH compound degradation.Our results revealed that this high selective pressure strategy was feasible and effective in enriching the HMW PAH-degraders from the original sea water samples.

RAGE regulates BACE1 and Abeta generation via NFAT1 activation in Alzheimer's disease animal model.

The receptor for advanced glycation end products (RAGE) is a multiligand cell surface receptor, and amyloid beta peptide (Abeta) is one of the ligands for RAGE. Because RAGE is a transporter of Abeta from the blood to the brain, RAGE is believed to play an important role in Alzheimer's disease (AD) pathogenesis. In the present study, the role of RAGE in Abeta production was examined in the brain tissue of an AD animal model, Tg2576 mice, as well as cultured cells. Because beta-site APP-cleaving enzyme 1 (BACE1), an essential protease for Abeta production, is up-regulated in cells overexpressing RAGE and in RAGE-injected brains of Tg2576 mice, the molecular mechanisms underlying RAGE, BACE1 expression, and Abeta production were examined. Because RAGE stimulates intracellular calcium, nuclear factor of activated T-cells 1 (NFAT1) was examined. NFAT1 was activated following RAGE-induced BACE1 expression followed by Abeta generation. Injection of soluble RAGE (sRAGE), which acts as a competitor with full-length RAGE (fRAGE), into aged Tg2576 mouse brains reduced the levels of plaques, Abeta, BACE1, and the active form of NFAT1 compared with fRAGE-injected Tg2576 mice. Taken together, RAGE stimulates functional BACE1 expression through NFAT1 activation, resulting in more Abeta production and deposition in the brain.