A giant, rapidly growing intra­abdominal desmoid tumor of mesenteric origin in an adolescent male: A case report and literature review.

A desmoid tumor is a fibroblastic proliferation of mesenchymal origin, which has no metastasizing potential but is locally aggressive. Although treatment has shifted to observation and active surveillance for newly diagnosed patients with desmoid tumors, intra-abdominal mesenteric tumors or tumors that persistently grow and provoke symptoms may need prompt surgical treatment. There have only been a small number of case reports that illustrate large sporadic intra-abdominal mesentery-deriving desmoid tumors in which the longest diameter was ≥19 cm. In the present study, an adolescent male patient with a rapidly growing 38-cm long sporadic intra-abdominal desmoid tumor of mesenchymal origin is reported. The patient was treated with chemotherapy followed by surgical resection due to non-responsiveness and progression of symptoms, then with maintenance adjuvant chemotherapy to prevent recurrence due to the large size of the tumor. Despite the rapid growth of the tumor and its high occupancy in the intra-abdominal cavity, an R0 resection was successful with organ preservation. The patient has been recurrence-free for 2 years, and further follow-up is expected in the future.

Comparison of Programmed Cell Death Ligand 1 Status between Core Needle Biopsy and Surgical Specimens of Triple-Negative Breast Cancer.

PURPOSE: Pembrolizumab is currently used to treat advanced triple-negative breast cancer (TNBC) and high-risk early TNBC with neoadjuvant chemotherapy (NAC). The tumor-infiltrating lymphocyte (TIL) level and programmed cell death ligand 1 (PD-L1) status are predictors of response to NAC and immune checkpoint inhibitor treatment. We aimed to investigate whether the PD-L1 status in core needle biopsies (CNBs) could represent the whole tumor in TNBC. MATERIALS AND METHODS: A total of 49 patients diagnosed with TNBC who received upfront surgery without NAC between January 2018 and March 2021 were included. The PD-L1 expression (SP142 and 22C3 clones) and TIL were evaluated in paired CNBs and resected specimens. The concordance PD-L1 status and TIL levels between CNBs and resected specimens were analyzed. RESULTS: PD-L1 positivity was more frequently observed in resected specimens. The overall reliability of TIL level in the CNB was good [intraclass correlation coefficient (ICC)=0.847, p<0.001]. The agreements of PD-L1 status were good and fair, respectively (SP142, κ=0.503, p<0.001; 22C3, κ=0.380, p=0.010). As the core number of CNB increased, the reliability and agreement also improved, especially from five tumor cores (TIL, ICC=0.911, p<0.001; PD-L1 [22C3], κ=0.750, p=0.028). Regarding PD-L1 (SP142), no further improvement was observed with ≥5 tumor cores (κ=0.600, p=0.058). CONCLUSION: CNBs with ≥5 tumor cores were sufficient to represent the TIL level and PD-L1 (22C3) status in TNBC.

Impact of ABO incompatibility and early antibody-mediated rejection on chronic antibody-mediated rejection in kidney transplant patients.

INTRODUCTION: Early antibody-mediated rejection has been reported to increase chronic antibody-mediated rejection and decrease graft survival in kidney transplantation. However, the impact of early antibody-mediated rejection in ABO-incompatible kidney transplantation remains unclear. METHODS: We retrospectively analyzed living-donor kidney transplantation patients from two Korean centers. Patients were categorized based on ABO compatibility and early antibody-mediated rejection within 1 year. The primary outcome was chronic antibody-mediated rejection. The secondary outcomes were production of de novo donor-specific antibody and composite kidney outcome, defined as graft loss or a decline in estimated glomerular filtration rate to below 30 mL/min/1.73 m2. RESULTS: A total of 1639 patients were analyzed, including 1292 patients who underwent ABO-compatible kidney transplantation and 347 patients who underwent ABO-incompatible kidney transplantation. ABO-incompatible kidney transplantation had a lower risk of de novo donor-specific antibody production (hazard ratio [HR] 0.68, 95% confidence interval [CI] 0.48-0.95) and chronic antibody-mediated rejection (HR 0.33, 95% CI 0.12-0.92) with a comparable risk of the composite kidney outcome (HR 1.06, 95% CI 0.71-1.59) compared to ABO-compatible kidney transplantation. When outcomes of ABO-incompatible kidney transplantation were analyzed according to early antibody-mediated rejection, ABO-incompatible kidney transplantation without antibody-mediated rejection had a lower risk of de novo donor-specific antibody production (HR 0.60, 95% CI 0.41-0.88) and chronic antibody-mediated rejection (HR 0.28, 95% CI 0.09-0.91) than ABO-compatible kidney transplantation without antibody-mediated rejection. However, ABO-incompatible kidney transplantation with antibody-mediated rejection showed a higher risk of de novo donor-specific antibody production and similar risk of chronic antibody-mediated rejection compared to ABO-compatible kidney transplantation without antibody-mediated rejection. CONCLUSIONS: ABO-incompatible kidney transplantation showed a lower risk of de novo donor-specific antibody production and chronic antibody-mediated rejection compared to ABO-compatible kidney transplantation; however, early antibody-mediated rejection abrogated these beneficial effects of ABO-incompatible kidney transplantation.

Pediatric Sarcoidosis Misdiagnosed as Hepatosplenic Abscesses: A Case Report and Review.

Sarcoidosis is a systemic granulomatous disorder of unknown etiology characterized by granuloma formation. Due to the limited incidence of sarcoidosis in pediatric patients, little is known about the clinical course of this disease. A combination of clinical, radiologic, and pathologic examination is necessary to exclude other differential diagnoses (i.e., infection and granulomatous inflammatory disorder) and establish a diagnosis of sarcoidosis. Here, we report a case of histologically confirmed sarcoidosis initially misdiagnosed as hepatosplenic abscesses in an 11-year-old male. Treatment with corticosteroids improved his symptoms and resolved his skin and hepatosplenic lesions. A three-year follow-up was uneventful. This study emphasizes the importance of considering sarcoidosis in children presenting with findings of multi-organ involvement in the presence of histologic evidence of granuloma.

Anti-inflammatory effect of lovastatin is mediated via the modulation of NF-κB and inhibition of HDAC1 and the PI3K/Akt/mTOR pathway in RAW264.7 macrophages.

Lovastatin is a 3-hydroxy-3-methylglutaryl-CoA reductase inhibitor that is clinically used for the prevention of cardiovascular diseases. Although it has been reported that lovastatin has anti-inflammatory properties in several studies, how lovastatin regulates the inflammation is still unclear. To evaluate the effect of lovastatin on nitric oxide production (NO) in RAW264.7 macrophages, NO production assay was performed. Also, cell viability was measured to confirm cytotoxicity. Level of tumor necrosis factor-α (TNF-α) transcription was measured by reverse transcription polymerase chain reaction (RT-PCR) from total RNA in RAW264.7 cells. Western blot analysis and immunofluorescence staining were used to investigate the regulation of lovastatin on the expression, phosphorylation, and nuclear translocation of cellular proteins. The results of the present study revealed that lovastatin reduced nitric oxide production via the reduction of inducible nitric oxide synthase (iNOS) expression in lipopolysaccharide (LPS)-stimulated RAW264.7 macrophage cells. The mRNA level of TNF-α was reduced in presence of lovastatin. In addition, lovastatin downregulated histone deacetylase 1 (HDAC1), resulting in the accumulation of acetylated histone H3 and heat shock protein 70. Furthermore, the expression of phosphoinositide 3-kinase catalytic subunits α and ß was reduced under lovastatin treatment, and the phosphorylation of Akt and mammalian target of rapamycin was consequently inhibited. Lovastatin also inhibited the phosphorylation of inhibitor of nuclear factor (NF)-κBα and the translocation of NF-κB into the nucleus. Therefore, the present study demonstrates that lovastatin inhibits the expression of pro-inflammatory mediators, including iNOS and TNF-α, through the suppression of HDAC1 expression, PI3K/Akt phosphorylation and NF-κB translocation in LPS-stimulated RAW264.7 macrophage cells.

Desmethylanhydroicaritin isolated from Sophora flavescens, shows antitumor activities in U87MG cells via inhibiting the proliferation, migration and invasion.

This study is the first report of the antitumor activities of desmethylanhydroicaritin (DMAI) isolated from Sophora flavescens on U87MG cells. Human glioblastoma is one of the most aggressive malignant type of brain tumors and highly diffuses to around normal brain tissues. DMAI showed anti-proliferation effects on U87MG cells at the concentration of 30µM, however did not affect to HEK-293 cells. DMAI induced anti-proliferation effects via ERK/MAPK, PI3K/Akt/mTOR signal pathway and G2/M phase cell cycle arrest. DMAI led to morphological change and inhibition of filapodia formation through regulation of Rac 1 and Cdc 42. In addition, migration and invasion of U87MG cells were inhibited by DMAI via down-regulation of matrix metalloproteinase (MMP) -2 and MMP -9 expressions and activities. Our results suggest that DMAI has a potential as a therapeutic agent against glioblastoma cells.

The properties of Co- and Fe-doped GDC for low-temperature processing of solid oxide fuel cell by electron-beam evaporation.

This study is transition metal oxides (FeO and CoO) were added to Gd-doped ceria (Gd0.1Ce0.9O1.95, GDC) powder for preparing the thin-film electrolyte used in the Ni-GDC anode-supported intermediate temperature solid oxide fuel cell (SOFC). Recently much attention was aimed at successful powder preparation with high sinter activity and conductivity. However, one of the challenges in preparing the GDC electrolytes is the densification issue. It is difficult to achieve the densification of GDC below 1600 degrees C. To overcome this drawback, attentions of the research on the densification of the GDC electrolyte is paid more on changing of the fabrication technology, the powder properties, and the sintering mechanism. Among them, Fe3+ and Co2+ showed the significant beneficial effect on the grain boundary conductivity. So, electrolyte powder made of Co- and Fe-doped GDC by solid-state reaction method. And thin-film electrolyte was fabricated on the presintered Ni-GDC cermet anode substrate by E-beam evaporating method and then co-sintered to form the electrolyte/anode bilayer. We realized crystal structure of Co and Fe doped Gd0.1Ce0.9O1.95 (GDC) electrolyte by X-ray diffraction (XRD). The morphology was measured by scanning electron microscopy (SEM) for the sintered samples were performed. The performance of the cells was evaluated over 500-800 degrees C using humidified hydrogen as fuel and air as oxidant.

In-use measurement of activity, energy use, and emissions of a plug-in hybrid electric vehicle.

Plug-in hybrid electric vehicles (PHEVs) could reduce transportation air emissions and energy use. However, a method is needed for estimating on-road emissions of PHEVs. To develop a framework for quantifying microscale energy use and emissions (EU&E), measurements were conducted on a Toyota Prius retrofitted with a plug-in battery system on eight routes. Measurements were made using the following: (1) a data logger for the hybrid control system; (2) a portable emissions measurement system; and (3) a global positioning system with barometric altimeter. Trends in EU&E are estimated based on vehicle specific power. Energy economy is quantified based on gasoline consumed by the engine and grid energy consumed by the plug-in battery. Emissions from electricity consumption are estimated based on the power generation mix. Fuel use is approximately 30% lower during plug-in battery use. Grid emissions were higher for CO2, NO(x), SO2, and PM compared to tailpipe emissions but lower for CO and hydrocarbons. EU&E depends on engine and plug-in battery operation. The use of two energy sources must be addressed in characterizing fuel economy; overall energy economy is 11% lower if including grid energy use than accounting only for fuel consumption.

Method for in-use measurement and evaluation of the activity, fuel use, electricity use, and emissions of a plug-in hybrid diesel-electric school bus.

The purpose of this study is to demonstrate a methodology for characterizing at high resolution the energy use and emissions of a plug-in parallel-hybrid diesel-electric school bus (PHSB) to support assessments of sensitivity to driving cycles and comparisons to a conventional diesel school bus (CDSB). Data were collected using onboard instruments for a first-of-a-kind prototype PHSB and a CDSB of the same chassis and engine, operated on actual school bus routes. The engine load was estimated on the basis of vehicle specific power (VSP) and an empirically derived relationship between VSP and engine manifold absolute pressure (MAP). VSP depends on speed, acceleration, and road grade. For the PHSB, the observed electrical discharge or recharge to the traction motor battery was characterized on the basis of VSP. The energy use and emission rates of the PHSB from tailpipe and electricity use were estimated for five real-world driving cycles and compared to the engine fuel use and emissions of the CDSB. The PHSB had the greatest advantage on arterial routes and less advantage on highway or local routes. The coupled VSP-MAP modeling approach enables assessment of a wide variety of driving conditions and comparisons of vehicles with different propulsion technologies.