Effects of lipopolysaccharide on beta-catenin, aromatase, and estrogen production in bovine granulosa cells in vivo and in vitro.

Diseases resulting from Gram-negative bacterial infection can induce an immune response by releasing a lipopolysaccharide (LPS) endotoxin that may lead to impaired fertility in cows. To evaluate the effects of LPS on follicular dynamics in a subacute inflammatory disease state, 14 Angus heifers (BW = 413 kg±14) were blocked by weight and assigned to vehicle (n = 7) or LPS treated (n = 7) groups. Heifers received subcutaneous injections of saline (CON) or 2.0 µg/kg LPS on d 2, 5, and 8 of a select synch plus controlled internal drug release device (CIDR) follicular wave synchronization protocol. Fifty hours following CIDR withdrawal, ovaries were harvested, and follicular fluid was collected for hormone and LPS analysis. Daily blood samples were collected from d 0 to d 7. Beginning on d 8 blood samples were collected at 0, 16, 24, 32, 40, and 50 h following LPS challenge. Rectal temperatures were recorded prior to treatment and at regular intervals after each LPS challenge. Heifers treated with LPS exhibited mild (+0.5 °C) hyperthermia (P < 0.05) at 3, 4, and 8 h after the initial LPS challenge (d 2) when compared to vehicle-treated controls. Follicular fluid concentrations of estradiol (E2) increased (P = 0.04) in LPS-treated heifers compared to controls (1,595 ng/mL and 808 ng/mL±240, respectively), while follicular fluid progesterone (P4) concentrations did not differ (P = 0.27) between treatment groups. Additionally, LPS concentrations tended to be increased (P = 0.59) in dominant follicles of LPS-treated heifers, but no difference was detected (P = 0.81) in small developing follicles. To further delineate the impact of LPS on ovarian signaling pathways, a granulosa cell line (KGN) was incubated in the presence or absence of LPS (10 µg/mL) for 48 h. Cells were then collected for gene expression and protein analysis. Cells in both treatment groups expressed toll-like receptor 4, myeloid differentiation factor-2 receptor, and CD-14 complex genes required for LPS signaling. Cells treated with LPS exhibited decreased mRNA expression of aromatase (P = 0.03) and beta-catenin (P = 0.02). However, no change (P > 0.10) was detected in abundance of total beta-catenin protein or beta-catenin phosphorylated isoforms at serine 552 or 675. Based on results from this in vivo experiment, these investigators concluded that low doses of LPS can alter E2 concentrations and this effect may be modulated in part through beta-catenin regulation of aromatase transcription.

PEEK versus metal cages in posterior lumbar interbody fusion: a clinical and radiological comparative study.

BACKGROUND: Low back pain and sciatica represent a common disabling condition with a significant impact on the social, working and economic lives of patients. Transforaminal lumbar interbody fusion (TLIF) is a surgical procedure used in degenerative spine conditions. Several types of cages were used in the TLIF procedure. PURPOSE: To determine whether there is a difference in terms of symptomatology improvement, return to daily activities and fusion rate between metal cages and polyetheretherketone (PEEK) cages. METHODS: We have retrospectively reviewed 40 patients who have undergone TLIF from October 2015 to May 2016. All patients were clinically evaluated with questionnaires and were assessed with CT scan and standing X-ray films of the full-length spine. RESULTS: We found no significant functional differences in the two groups. At 1-year follow-up, osteolysis was present in 50% of cases of the PEEK cages and in 10% cases of the metal cages. The degree of fusion at 1  year was evaluated as complete in 40% cases of the metal cages and 15% cases of the PEEK cages. CONCLUSIONS: We have found a better fusion rate and prevalence of fusion in the group treated with metal cages, reflecting the well-known osteoinductive properties of titanium and tantalum.

Ankle surgery: focus on arthroscopy.

BACKGROUND: The ankle joint can be affected by several diseases, with clinical presentation varying from mild pain or swelling to inability, becoming in some cases a serious problem in daily life activities. Arthroscopy is a widely performed procedure in orthopedic surgery, due to the low invasivity compared to the more traditional open field surgery. The ankle joint presents anatomical specificities, like small space and tangential view that make arthroscopy more difficult. METHODS: From 2000 more than 600 ankle arthroscopies were performed at our institution. The treated pathologies were mostly impingement syndrome and osteochondral lesions, and in lower percentage instabilities and ankle fractures. RESULTS: In the impingement, the AOFAS scores at FU showed an increase compared to scores collected preoperatively, with improvement of symptoms in most of the cases, good or excellent results in 80 % of cases. In ligament injuries, AOFAS score significatively improved at the maximum follow-up. In fractures all patients had an excellent AOFAS score at maximum follow-up, with complete return to their pre-injury activities. In osteochondral injuries, the clinical results showed a progressive improvement over time with  the different performed procedures. Control MRI and bioptic samples showed a good regeneration of the cartilage and bone tissue in the lesion site. CONCLUSIONS: The encouraging obtained clinical results, in line with the literature, show how the arthroscopic technique, after an adequate learning curve, may represent a precious aid for the orthopedic surgeon and for the patient's outcome. LEVEL OF EVIDENCE: Case series, Level IV.

[A five year follow-up of an HHV-8 related lymphoma in an HIV-negative elderly patient]. / Follow-up a 5 anni di un caso di Linfoma Primitivo delle cavità correlato all'HHV-8, in un paziente anziano HIV negativo.

Primary Effusion Lymphoma (PEL) associated with the Human Herpes Virus 8 (HHV-8), is a rare type of non-Hodgkin lymphoma. It mainly strikes HIV-positive men. Five-year follow-up of a case of PEL HHV-8 related in HIV negative elderly man, is described. The patient was admitted to our Department for dyspnea, thoracic pain and persistent slight temperature. Chest radiography showed a left pleural effusion. Cytomorphological, immunohistochemical and molecular assays performed on pleural fluid, demonstrated the presence of a PEL HHV-8 related, in absence of Epstein-Barr virus (EBV) infection in the tumour cells. Serologic test for HIV (ELISA) resulted negative. Chest TC, taken after thoracentesis, showed marked thickening of diaphragmatic pleura. Because patient's age and general conditions, no chemotherapy was performed. Five years after diagnosis, clinical examination and chest tomographyshowed resolution of the described syndrome; particularly chest TC showed complete disappearance of diaphragmatic pleura thickening. This biological behaviour is unusually for PEL: medical literature shows that this lymphoma has a very poor prognosis; this case-report suggests, as already proposed from some authors, that PEL, in HIV-negative EBV-negative patients, is a distinct clinical entity, with a different clinical behaviour.

Alteration of left ventricular filling evaluated by Doppler echocardiography as a potential marker of acute rejection in orthotopic heart transplant.

To evaluate the changes in left ventricular (LV) filling associated with acute cardiac rejection, serial Doppler echocardiographic (ED) examination were performed on the same day as endomyocardial biopsy (EMB) in 40 patients who underwent orthotopic transplantation. The diameters and wall thickness of the left ventricle were measured. The indexes of LV filling in the following parameters were measured by pulsed Doppler: isovolumic relaxation time (IRT), peak early mitral flow velocity (V max E), and pressure half-time (PHT). The patients were classified into three groups on the basis of EMB: Group I (19 patients without rejection), Group II (11 patients with mild or moderate rejection), and Group III (10 patients with severe rejection). In Group III rejection was associated with a significant increase of posterior wall thickness (P < 0.05), with a decrease of IRT (P < 0.05), and an increase of V max E velocity (P < 0.01) in comparison with Group I. In Group II, Doppler indexes were not statistically significant in comparison with Groups I and II. In conclusion, in transplant patients, a diagnosis of acute rejection can be suspected in severe rejection by use of echocardiography when the diagnosis is based on a multiparametric evaluation of different ED indexes (m-mode and Doppler indexes). Doppler echocardiography is a method with an excellent specificity but insufficient sensitivity; this is due to the influence of recipient atrial contraction timing on Doppler indexes of LV filling.

Role of ageing, chronic renal failure and dialysis in the calcification of mitral annulus.

Mitral annulus calcification, a common lesion of the elderly (over age 60 years), has been detected with increased frequency and at younger ages in patients with uraemia. To date a pathogenic role for dialysis and secondary hyperparathyroidism has been suggested only on the basis of older dialytic age and increased serum iPTH observed in the affected individuals. Because this is a potentially dangerous lesion we deemed it useful to evaluate more completely the respective roles of possible pathogenetic factors in uraemic individuals. Evaluation included echocardiography, ECG, limb radiography, and serum assays. A total of 225 dialysis (HD) patients, 67 chronic renal failure (CRF) patients on conservative treatment and 67 normal subjects were studied. Mitral annulus calcification was detected in 87 of 225 (38.6%) HD patients, 11 of 67 (16.4%) CRF and six of 67 (8.9%) normals. In HD, patients with calcification were older and on longer-term renal replacement therapy compared to those without calcification. They also had greater values of iPTH, BGP, AP, and Rx score of secondary hyperparathyroidism. Mitral annulus calcification was associated more frequently (chi 2 = 14.8; P < 0.0001) with rhythm and cardiac conduction defects, but not with ectopic calcifications. Multiple stepwise regression analysis, with mitral annulus calcification score as dependent variable, selected dialysis duration, age, and iPTH (rm = 0.368) as the most predictive parameters, with the first two carrying most of the information. The stratification of patients according with these two parameters showed a progressive increase in the frequency of calcification both with HD duration and age.(ABSTRACT TRUNCATED AT 250 WORDS)

[Bidimensional echocardiographic images of extracardiac tumors. Detection of mediastinal masses by the bidimensional echocardiographic Doppler technique]. / Immagini ecocardiografiche bidimensionali di tumori extracardiaci. Rilevamento di masse mediastiniche tramite tecnica ecocardiografica bidimensionale Doppler.

A mediastinal tumor might mimic tricuspid stenosis, pulmonary stenosis, constrictive pericarditis, producing symptoms and signs of a cardiologic illness. We report 2 cases of mediastinal masses (1 lymphoma and 1 pulmonary cancer) localized in the anterior mediastinum and compressing the cardiac silhouette. Bidimensional echocardiography and Doppler were used to differentiate masses of cardiac origin from extracardiac origin and to study the hemodynamic alterations; moreover these techniques allow to evaluate the efficacy of therapy.