Radiological diagnosis of endometriomas in young women with chronic pelvic pain

Chronic pelvic pain is a symptom that may represent a disease in a specific organ system, a chronic pain syndrome, or both. Endometriosis is one of the local diseases that cause chronic pelvic pain. Sometimes their diagnosis can become a real challenge. This article presents a series of five cases with clinical and radiological diagnosis of endometriosis, with the aim of describing the most frequent symptoms, signs and radiological findings. Chronic pain in the lower abdomen and lesions of different aspects were identified as a common symptom, although fundamentally cystic, located in the pelvic organs, and identified by ultrasound and pelvic magnetic resonance imaging. The latter technique was the most sensitive for the non-invasive diagnosis of this entity. The updated literature review showed similar findings in works by other authors

反辞書確率モデルを用いた多クラス不整脈の分類

　現代社会では全世界的なレベルで高齢化が急速に進んでおり，それに伴い，死因が悪性新生物に次いで２番目に高い心疾患についても，心臓病理学上のさまざまな不規則性や異変の早期発見の必要性やその手段の開発がより一層求められてきている．本研究では，近年データ圧縮分野で提唱された反辞書符号化法を利用した新しい不整脈の検知ならびにその分類手法を提案し，その手法を組み込んだ無線ウェアラブル端末による常時心電図監視システムについて考察する．　代表的な不整脈パターンである心室性期外収縮（PVC）と心房性期外収縮（PAC）において，出現しない特徴的なパターンの統計的な性質を調べることによって，それらの分類を行なった．ここで，出現しない特徴的なパターンとは，それ自身を少しでも短くすると，もとのデータには出現してしまうという性質をもっており，極小禁止語とも呼ばれる．極小禁止語の抽出には，MIT-BIHより公開提供されている心電図データベースを利用している．このデータベースは専門医による診断結果が付されており，どの心電波形が不整脈であるかを正確に知ることができる．ところで，正常な心電図データから抽出された極小禁止語には，PVC やPAC を含む不整脈パターンが含まれていると考えられる．そこで，本研究では，抽出した極小禁止語から正常な心電図データの変動を表す有限状態遷移確率モデルを作成した．この確率モデルは，観測データに追従しながら内部状態が推移して行くだけでなく，状態が遷移する確率も合わせて計算するので，不整脈パターンの出現を，非常に小さな確率をとる状態遷移の生起として捉えることができる．　状態遷移確率モデルを作成するにあたっては，まず１サンプル11 ビットで表現される心電図データを量子化するために，データの差分化による頻度分布のシェイピングや量子化レベル数について実験検討を行い，モデルの簡略化，実装にあたってのメモリ量の削減を図った．次に，提案法の性能評価のために，MIT-BIHで提供されている不整脈を含む複数の被験者の心電図データについて，心室期外収縮に対する検知率の実験を行なったところ，平均して，既存の不整脈検出法とほぼ同程度の，感度 (sensitivity) 97.53%，特異度（specificity）93.89% の結果が得られた．さらに，IPhone 端末のエミュレータに提案方式プログラムを組み込んだシミュレーション実験を行ない，必要とされる計算リソースについて調査した．その結果は，CPU占有率が65%，メモリ使用量30.5Mバイトであり，提案方式はウェアラブル端末へ十分実装可能であることが示された．加えて，先に示したPVC の二項分類問題に加えて，PVC にPAC を加えた多値分類問題を考え，それぞれのパターンを特徴付ける極小禁止語について考察を行なった．電気通信大学201

Incidentaloma pancreático, um tumor raro. Apresentação de um caso clínico radiológico

Los incidentalomas son hallazgos insospechados de una patología determinada, detectados en exámenes de laboratorio, imagenlógicos o endoscópicos, pueden ser relevantes o no para la salud del paciente, provocando miedo en incertidumbre en los mismos. El caso que traemos es un paciente masculino de 51 años de edad, de Sri Lanka admitido en la sala de ortopedia del Hospital Cubano de Qatar para ser operado de una fractura de falange; en exámenes de rutina se detectó hipoglicemia, interpretada como error de laboratorio, porque el paciente estaba asintomático, sin modificaciones en los controles. Fue valorado por endocrinólogo, detectando elevadas cifras de insulina endógena, por lo que indico una serie de estudios encontrando tumor de cola de páncreas e hígado, sugestivo de tumor neuroendocrino de páncreas con metástasis hepática, corroborado por anatomía patológica; el tumor fue extirpado y la metástasis tratada; actualmente el paciente se encuentra en seguimiento por oncología y endocrinología.Incidentalomas are unsuspected findings of a certain pathology, detected in laboratory, imaging or endoscopic examinations, may or may not be relevant to the patient's health, causing fear in their uncertainty. The case we bring is a 51-year-old male patient from Sri Lanka admitted to the orthopedic ward of the Cuban Hospital of Qatar to be operated on a phalange fracture; in routine examinations, hypoglycemia was detected, interpreted as laboratory error, because the patient was asymptomatic, without changes in controls. He was assessed by endocrinologist, detecting high levels of endogenous insulin, so he indicated a series of studies finding a tumor of the tail of the pancreas and liver, suggestive of neuroendocrine tumor of the pancreas with liver metastases, corroborated by pathological anatomy; the tumor was removed and the metastasis treated; Currently the patient is being monitored by oncology and endocrinology.Incidentalomas são achados não suspeitos de uma determinada patologia, detectada em laboratório, exames de imagem ou endoscópicos, podem ou não ser relevantes para a saúde do paciente, causando medo em suas incertezas. O caso apresentado é um paciente do sexo masculino, 51 anos, do Sri Lanka, admitido na enfermaria ortopédica do Hospital Cubano do Catar para ser operado em uma fratura de falange; Nos exames de rotina, foi detectada hipoglicemia, interpretada como erro laboratorial, pois o paciente era assintomático, sem alterações nos controles. Ele foi avaliado pelo endocrinologista, detectando altos níveis de insulina endógena, e indicou uma série de estudos que descobriram tumor e fígado da cauda pancreática, sugestivos de tumor neuroendócrino pancreático com metástase hepática, corroborados pela anatomia patológica; o tumor foi removido e as metástases tratadas; Atualmente, o paciente está sendo monitorado por oncologia e endocrinologia

Glycan-specific IgG anti-IgE autoantibodies are protective against allergic anaphylaxis in a murine model.

BACKGROUND IgE causes anaphylaxis in type-1 hypersensitivity diseases by activating degranulation of effector cells such as mast cells and basophils. The mechanisms that control IgE activity and prevent anaphylaxis under normal conditions are still enigmatic. OBJECTIVE We aimed to unravel how anti-IgE autoantibodies are induced and understand their role in regulating serum IgE level and allergic anaphylaxis. METHODS We immunized mice with different forms of IgE and tested anti-IgE autoantibody responses and their specificities. We then analysed the effect of those antibodies on serum kinetics and their in vitro and in vivo impact on anaphylaxis. Finally, we investigated anti-IgE autoantibodies in human sera. RESULTS Immunization of mice with IgE-immune complexes induced glycan-specific anti-IgE autoantibodies. The anti-IgE autoantibodies prevented effector cell sensitization, reduced total IgE serum levels, protected mice from passive and active IgE sensitization, and resulted in cross-protection against different allergens. Furthermore, glycan-specific anti-IgE autoantibodies were present in sera from allergic and non-allergic subjects. CONCLUSION In conclusion, we provide first evidence that in the murine model the serum level and anaphylactic activity of IgE may be down-regulated by glycan-specific IgG anti-IgE autoantibodies

Identification and quantification of microplastics in wastewater using focal plane array-based reflectance micro-FT-IR imaging

Microplastics (<5 mm) have been documented in environmental samples on a global scale. While these pollutants may enter aquatic environments via wastewater treatment facilities, the abundance of microplastics in these matrices has not been investigated. Although efficient methods for the analysis of microplastics in sediment samples and marine organisms have been published, no methods have been developed for detecting these pollutants within organic-rich wastewater samples. In addition, there is no standardized method for analyzing microplastics isolated from environmental samples. In many cases, part of the identification protocol relies on visual selection before analysis, which is open to bias. In order to address this, a new method for the analysis of microplastics in wastewater was developed. A pretreatment step using 30% hydrogen peroxide (H2O2) was employed to remove biogenic material, and focal plane array (FPA)-based reflectance micro-Fourier-transform (FT-IR) imaging was shown to successfully image and identify different microplastic types (polyethylene, polypropylene, nylon-6, polyvinyl chloride, polystyrene). Microplastic-spiked wastewater samples were used to validate the methodology, resulting in a robust protocol which was nonselective and reproducible (the overall success identification rate was 98.33%). The use of FPA-based micro-FT-IR spectroscopy also provides a considerable reduction in analysis time compared with previous methods, since samples that could take several days to be mapped using a single-element detector can now be imaged in less than 9 h (circular filter with a diameter of 47 mm). This method for identifying and quantifying microplastics in wastewater is likely to provide an essential tool for further research into the pathways by which microplastics enter the environment.This work is funded by a NERC (Natural Environment Research Council) CASE studentship (NE/K007521/1) with contribution from industrial partner Fera Science Ltd., United Kingdom. The authors would like to thank Peter Vale, from Severn Trent Water Ltd, for providing access to and additionally Ashley Howkins (Brunel University London) for providing travel and assistance with the sampling of the Severn Trent wastewater treatment plant in Derbyshire, UK. We are grateful to Emma Bradley and Chris Sinclair for providing helpful suggestions for our research

Troy+ brain stem cells cycle through quiescence and regulate their number by sensing niche occupancy.

The adult mouse subependymal zone provides a niche for mammalian neural stem cells (NSCs). However, the molecular signature, self-renewal potential, and fate behavior of NSCs remain poorly defined. Here we propose a model in which the fate of active NSCs is coupled to the total number of neighboring NSCs in a shared niche. Using knock-in reporter alleles and single-cell RNA sequencing, we show that the Wnt target Tnfrsf19/Troy identifies both active and quiescent NSCs. Quantitative analysis of genetic lineage tracing of individual NSCs under homeostasis or in response to injury reveals rapid expansion of stem-cell number before some return to quiescence. This behavior is best explained by stochastic fate decisions, where stem-cell number within a shared niche fluctuates over time. Fate mapping proliferating cells using a Ki67iresCreER allele confirms that active NSCs reversibly return to quiescence, achieving long-term self-renewal. Our findings suggest a niche-based mechanism for the regulation of NSC fate and number.This work was supported by NIRM/ Clevers and Stichting Vrienden van het Hubrecht (O.B.), EU/232814-StemCellMark and Skolkovo 077 MPA (J.H.v.E.), NIH/MIT Subaward 5710002735 (to D.E.S.), KWF/PF-HUBR 2007-3956 and Stichting Vrienden van het Hubrecht (M.v.d.W.), European Research Council Advanced Grant ERC-AdG 294325-GeneNoiseControl (to K.W. and A.v.O.), and Wellcome Trust Grant 098357/Z/12/Z (to B.D.S.)