Fructose Consumption Affects Placental Production of H2S: Impact on Preeclampsia-Related Parameters.

H2S, a gasotransmitter that can be produced both via the transsulfuration pathway and non-enzymatically, plays a key role in vasodilation and angiogenesis during pregnancy. In fact, the involvement of H2S production on plasma levels of sFLT1, PGF, and other molecules related to preeclampsia has been demonstrated. Interestingly, we have found that maternal fructose intake (a common component of the Western diet) affects tissular H2S production. However, its consumption is allowed during pregnancy. Thus, (1) to study whether maternal fructose intake affects placental production of H2S in the offspring, when pregnant; and (2) to study if fructose consumption during pregnancy can increase the risk of preeclampsia, pregnant rats from fructose-fed mothers (10% w/v) subjected (FF) or not (FC) to a fructose supplementation were studied and compared to pregnant control rats (CC). Placental gene expression, H2S production, plasma sFLT1, and PGF were determined. Descendants of fructose-fed mothers (FC) presented an increase in H2S production. However, if they consumed fructose during their own gestation (FF), this effect was reversed so that the increase disappeared. Curiously, placental synthesis of H2S was mainly non-enzymatic. Related to this, placental expression of Cys dioxygenase, an enzyme involved in Cys catabolism (a molecule required for non-enzymatic H2S synthesis), was significantly decreased in FC rats. Related to preeclampsia, gene expression of sFLT1 (a molecule with antiangiogenic properties) was augmented in both FF and FC dams, although these differences were not reflected in their plasma levels. Furthermore, placental expression of PGF (a molecule with angiogenic properties) was decreased in both FC and FF dams, becoming significantly diminished in plasma of FC versus control dams. Both fructose consumption and maternal fructose intake induce changes in molecules that contribute to increasing the risk of preeclampsia, and these effects are not always mediated by changes in H2S production.

Benefits of Using Magnetic Resonance Imaging During Breast Tissue Expansion: Literature Review and Case Series.

Breast cancer results in up to 1.6 million new candidates for yearly breast reconstruction (BR) surgery. Two-stage breast reconstruction surgery with the use of a tissue expander (TE) is a common approach to reconstructing the breast after mastectomy. However, a common disadvantage encountered with the traditional breast TE is the magnetic injection port, which has been reported to cause injuries in patients undergoing magnetic resonance (MR) imaging. Therefore this type of breast TE is labeled "MR unsafe." Recent technological advances have incorporated radio-frequency identification (RFID) technology in the TE to allow for the location of the injection port without magnetic components, resulting in an MR-conditional TE. This paper aims to review the information regarding the safety profile of TEs with magnetic ports and to gather distinct clinical scenarios in which an MR-conditional TE benefits the patient during the BR process. A literature review ranging from 2018 to 2022 was performed with the search terms: "tissue expander" OR "breast tissue expander" AND "magnetic resonance imaging" OR "MRI." Additionally, a case series was collected from each of the authors' practices. The literature search yielded 13 recent peer-reviewed papers, and 6 distinct clinical scenarios were compiled and discussed. Most clinicians find MRI examinations to be the state-of-art diagnostic imaging modality. However, due to the preexisting risks associated with TEs with magnetic ports, the MRI labeling classification should be considered when deciding which TE is the most appropriate for the patient requiring MRI examinations.

Lack of definitive presurgical pathological diagnosis is associated with inadequate surgical margins in breast-conserving surgery.

PURPOSE: To determine the impact of definitive presurgical diagnosis on surgical margins in breast-conserving surgery (BCS) for primary carcinomas; clinicopathological features were also analyzed. METHODS: This retrospective study included women who underwent BCS for primary carcinomas in 2016 and 2017. Definitive presurgical diagnosis was defined as having a presurgical core needle biopsy (CNB) and not being upstaged between biopsy and surgery. Biopsy data and imaging findings including breast density were retrieved. Inadequate surgical margins (IM) were defined per latest ASCO and ASTRO guidelines. Univariable and multivariable analyses were performed. RESULTS: 360 women (median age, 66) met inclusion criteria with 1 having 2 cancers. 82.5% (298/361) were invasive cancers while 17.5% (63/361) were ductal carcinoma in situ (DCIS). Most biopsies were US-guided (284/346, 82.0%), followed by mammographic (60/346, 17.3%), and MRI-guided (2/346, 0.6%). US and mammographic CNB yielded median samples of 2 and 4, respectively, with a 14G needle. 15 patients (4.2%) lacked presurgical CNB. The IM rate was 30.0%. In multivariable analysis, large invasive cancers (>20 mm), dense breasts, and DCIS were associated with IM (p = 0.029, p = 0.010, and p = 0.013, respectively). Most importantly, lack of definitive presurgical diagnosis was a risk factor for IM (OR, 2.35; 95% CI: 1.23-4.51, p = 0.010). In contrast, neither patient age (<50) nor aggressive features (e.g., LVI) were associated with IM. CONCLUSION: Lack of a definitive presurgical diagnosis was associated with a two-fold increase of IM in BCS; other risk factors were dense breasts, large invasive cancers, and DCIS.

Maternal Fructose Intake Increases Liver H2 S Synthesis but Exarcebates its Fructose-Induced Decrease in Female Progeny.

SCOPE: Fructose intake from added sugars correlates with the epidemic rise in metabolic syndrome and cardiovascular diseases (CVD). However, consumption of beverages containing fructose is allowed during gestation. Homocysteine (Hcy) is a well-known risk factor for CVD while hydrogen sulfide (H2 S), a product of its metabolism, has been proved to exert opposite effects to Hcy. METHODS AND RESULTS: First, it is investigated whether maternal fructose intake produces subsequent changes in Hcy metabolism and H2 S synthesis of the progeny. Carbohydrates are supplied to pregnant rats in drinking water (10% wt/vol) throughout gestation. Adult female descendants from fructose-fed, control or glucose-fed mothers are studied. Females from fructose-fed mothers have elevated homocysteinemia, hepatic H2 S production, cystathionine γ-lyase (CSE) (the key enzyme in H2 S synthesis) expression and plasma H2 S, versus the other two groups. Second, it is studied how adult female progeny from control (C/F), fructose- (F/F), and glucose-fed (G/F) mothers responded to liquid fructose and compared them to the control group (C/C). Interestingly, hepatic CSE expression and H2 S synthesis are diminished by fructose intake, this effect being more pronounced in F/F females. CONCLUSION: Maternal fructose intake produces a fetal programming that increases hepatic H2 S production and, in contrast, exacerbates its fructose-induced drop in female progeny.

Histological changes secondary to wire coil placement in breast tissue and lymph nodes.

We describe the histological and immunohistochemical features of the changes produced by spiral coil localization wires in the breast parenchyma and lymph nodes of a total of 100 patients undergoing surgery for different breast lesions. Coil wires produced cystic lesions containing a hyaline, mucous-like, PAS-negative fluid. Cavities were lined by cells of variable morphology ranging from synovial-like cells (with a conspicuous epithelial appearance) to mononuclear or multinucleate histiocytic cells that expressed CD68, but were negative for keratins. CD3-positive/CD8-positive T lymphocytes predominated in the inflammatory reaction. Pathologists should be aware of these changes in order to differentiate coil-related lesions from other granulomatous or epithelial lesions, including mucocele-like and ductal carcinoma in situ lesions.

Fructose only in pregnancy provokes hyperinsulinemia, hypoadiponectinemia, and impaired insulin signaling in adult male, but not female, progeny.

PURPOSE: Fructose intake from added sugars correlates with the epidemic rise in metabolic syndrome and cardiovascular diseases. However, consumption of beverages containing fructose is allowed during gestation. Recently, we found that an intake of fructose (10 % wt/vol) throughout gestation produces impaired fetal leptin signaling and hepatic steatosis. Therefore, we have investigated whether fructose intake during pregnancy produces subsequent changes in the progeny, when adult. METHODS: Fed 261-day-old male and female descendants from fructose-fed, control or glucose-fed mothers were used. Plasma was used to analyze glucose, insulin, leptin, and adiponectin. Hepatic expression of proteins related to insulin signaling was determined. RESULTS: Fructose intake throughout pregnancy did not produce alterations in the body weight of the progeny. Adult male progeny of fructose-fed mothers had elevated levels of insulin without a parallel increase in phosphorylation of protein kinase B. However, they displayed an augmented serine phosphorylation of insulin receptor substrate-2, indicating reduced insulin signal transduction. In agreement, adiponectin levels, which have been positively related to insulin sensitivity, were lower in male descendants from fructose-fed mothers than in the other two groups. Furthermore, mRNA levels for insulin-responsive genes were not affected (phosphoenolpyruvate carboxykinase, glucose-6-phosphatase) or they were decreased (sterol response element-binding protein-1c) in the livers of male progeny from fructose-supplemented rats. On the contrary, adult female rats from fructose-fed mothers did not exhibit any of these disturbances. CONCLUSION: Maternal fructose, but not glucose, intake confined to the prenatal stage provokes impaired insulin signal transduction, hyperinsulinemia, and hypoadiponectinemia in adult male, but not female, progeny.

Application of Kohonen maps to kinetic analysis of human gait / Aplicação de mapas de Kohonen à análise cinética da marcha humana

In recent years the use of artificial neural networks for classification and analysis of kinematic and kinetic characteristics of human locomotion has greatly increased. This happens in an attempt to overcome the limitations of traditional dynamic analysis and to find new clinical indicators for interpreting quick and objectively the large amount of information obtained in a gait lab. One of the most widely used neural networks for human gait analysis is the self-organizing or Kohonen map, based on unsupervised learning without prior definition of the formed natural groups. Among the advantages of using this type of neural network is the data dimensionality reduction, with minimal loss of information content, and the grouping of them in function of their similarities. Taking into account this, in this work an application case of a Kohonen map for clustering of locomotion kinetic characteristics in normal and Parkinson's disease individuals is presented. The results indicate that the groups identified by the map are consistent with the classification carried out by experts in function of traditional gait dynamic analysis, showing the potential of this technique for distinguishing between a population of individuals with normal gait and with gait disorders of different etiology.

Nos últimos anos, tem aumentado significativamente o uso de redes neurais artificiais para a classificação e análise cinemática e cinética da marcha humana, em uma tentativa de superar as limitações da análise dinâmica tradicional e de encontrar novos indicadores clínicos para interpretar, de forma rápida e objetiva, a grande quantidade de informação obtida em laboratórios de marcha humana. Uma das redes neurais mais utilizadas para análise de marcha é o mapa de Kohonen ou mapa auto-organizado, baseado em aprendizado não supervisionado, sem uma definição prévia de grupos naturais que se formam. O uso deste tipo de rede neural tem mostrado benefícios significativos associados com a redução da dimensionalidade dos dados com mínima perda de conteúdo de informação e com o agrupamento de dados de acordo com suas semelhanças. Neste contexto, este trabalho apresenta um caso de aplicação de um mapa de Kohonen como classificador das características cinéticas da locomoção em indivíduos normais e com doença de Parkinson. Os resultados indicam que os grupos identificados no mapa são consistentes com a classificação feita por especialistas com base em análise dinâmica tradicional, que mostra o potencial desta técnica para diferenciar populações de indivíduos com marcha normal e de indivíduos com distúrbios da marcha de etiologia diferente.

Bone marrow edema patterns in the ankle and hindfoot: distinguishing MRI features.

OBJECTIVE: Many disorders produce similar or overlapping patterns of bone marrow edema in the ankle. Bone marrow edema may present in a few hindfoot bones simultaneously or in a single bone. The purpose of this pictorial essay is to provide guidelines based on clinical history and specific MRI patterns and locations to accurately identify the cause of ankle bone marrow edema. We will first focus on bone marrow edema in general disease categories involving multiple bones, such as reactive processes, trauma, neuroarthropathy, and arthritides. A discussion of bone marrow edema in individual bones of the ankle and hindfoot including the tibia, fibula, talus, and calcaneus will follow. Helpful hints for arriving at the correct diagnosis will be provided in each section. CONCLUSION: After review of this article, radiologists should be able to use their knowledge of clinical history and specific MRI patterns and locations to accurately distinguish between the various causes of bone marrow edema in the ankle and hindfoot.

Posible rol del contenido iónico y pH plasmáticos sobre la electroafinidad endotelial / Possible role of plasmatic pH and ionic content on endothelial electroaffinity

La ateroscleroris es un proceso multifactorial de gran complejidad cuyo origen es aún desconnocido. Sin embargo, eventos característicos de su patogénesis dan evidencias de una disminuición de la densidad de carga eléctrica exnibida normalmente por el glicocáliz de los elementos parietales y sanguíneos implicados en este proceso. Las investigaciones más recientes indican que el espesor del glicocáliz endotelial es función no sólo de sus moléculas polianiónicas superficiales, sino tambíén de la composición del fluido sanguíneo. Teniendo en cuenta esta dependencia respecto de la composicón de la sangre, el objetivo de este trabajo fue investigar la influencia de la concentración electrolítica y del pH plasmáticos sobre las propiedades electrocinéticas en la interfase pared arterial - fluido sanguíneo. Para lograr esto se evaluó experimentalmente utilizando segmentos aórticos porcinos, el efecto electrocinético que ejerce sobre el endotelio arterial, el flujo de soluciones de contenido iónico y pH variables. Los resultados indicaron que el aumento del contenido iónico normal del plasma podría afectar las propriedades eléctricas de aquellos elementos, favoreciendo su acercamiento. Así también, el decremento del valor del pH fisiológico reduciría la proporción de molécular polianiónicas contenidas en el glicocáliz de dichos elementos, disminuyendo la repulsión electrostática entre ellos. De esta forma, el desarrollo aterogénico asociado con un aumento de la captación de componentes de la sangre, podría estar relacionado con una alteración de las propiedades electrocinéticas de los elementos parietales y sanguíneos involucrados, provocada por cambios de pH o concentración electrolítica plasmática