Thyroid-stimulating hormone elevation misdiagnosed as subclinical hypothyroidism following non-convulsive status epilepticus: a case report

<p>Abstract</p> <p>Introduction</p> <p>Non-convulsive status epilepticus is a form of epileptic seizure that occurs without convulsions. Recent reviews suggest that the diagnosis of non-convulsive status epilepticus remains difficult. Here, we report the case of a patient with thyroid-stimulating hormone elevation misdiagnosed as subclinical hypothyroidism following non-convulsive status epilepticus.</p> <p>Case presentation</p> <p>Our patient was a 68-year-old Japanese woman. The results of endocrine testing after her first episode of non-convulsive status epilepticus suggested latent subclinical hypothyroidism: she had elevated thyroid-stimulating hormone with normal levels of free tri-iodothyronine and free thyroxine. On examination, a diagnosis of thyroid disorder was not supported by other test results and our patient remained untreated. A follow-up examination revealed that her thyroid-stimulating hormone levels had spontaneously normalized. When she consulted another doctor for confusion, the transient increase in thyroid-stimulating hormone levels following non-convulsive status epilepticus was mistaken for subclinical hypothyroidism, and unfortunately treated with levothyroxine. Our patient then experienced levothyroxine-induced non-convulsive status epilepticus.</p> <p>Conclusions</p> <p>In this report, we suggested possible mechanisms for latent hypothyroid-like hormone abnormality following epileptic seizures and the possibility of provoking epileptic seizures by administering levothyroxine for misdiagnosed subclinical hypothyroidism.</p

Accelerator and Reactor Neutrino Oscillation Experiments in a Simple Three-Generation Framework

We present a new approach to the analysis of neutrino oscillation experiments, in the one mass-scale limit of the three-generation scheme. In this framework we reanalyze and recombine the most constraining accelerator and reactor data, in order to draw precise bounds in the new parameter space. We consider our graphical representations as particularly suited to show the interplay among the different oscillation channels. Within the same framework, the discovery potential of future short and long baseline experiments is also investigated, in the light of both the recent signal from the LSND experiment and the atmospheric neutrino anomaly.Comment: uuencoded compressed tar file. Figures (13) available by ftp to ftp://eku.sns.ias.edu/pub/lisi/ (192.16.204.30). Submitted to Physical Review

Constraining Almost Degenerate Three-Flavor Neutrinos

We discuss constraints on a scenario of almost degenerate three-flavor neutrinos imposed by the solar and the atmospheric neutrino anomalies, hot dark matter, and neutrinoless double $\beta$ decays. It is found that in the Majorana version of the model the region with relatively large $\theta_{13}$ is favored and a constraint on the CP violating phases is obtained.Comment: 19 pages (uses revtex), including 6 figures (uses epsf

Characterization of Aspergillus species on Brazil nut from the Brazilian Amazonian region and development of a PCR assay for identification at the genus level.

Brazil nut is a protein-rich extractivist tree crop in the Amazon region. Fungal contamination of shells and kernel material frequently includes the presence of aflatoxigenic Aspergillus species from the section Flavi. Aflatoxins are polyketide secondary metabolites, which are hepatotoxic carcinogens in mammals. The objectives of this study were to identify Aspergillus species occurring on Brazil nut grown in different states in the Brazilian Amazon region and develop a specific PCR method for collective identification of member species of the genus Aspergillus. Results:Polyphasic identification of 137 Aspergillus strains isolated from Brazil nut shell material from cooperatives across the Brazilian Amazon states of Acre, Amapá and Amazonas revealed five species, with Aspergillus section Flavi species A. nomius and A. flavus the most abundant. PCR primers ASP_GEN_MTSSU_F1 and ASP_GEN_MTSSU_R1 were designed for the genus Aspergillus, targeting a portion of the mitochondrial small subunit ribosomal RNA gene. Primer specificity was validated through both electronic PCR against target gene sequences at Genbank and in PCR reactions against DNA from Aspergillus species and other fungal genera common on Brazil nut. Collective differentiation of the observed section Flavi species A. flavus, A. nomius and A. tamarii from other Aspergillus species was possible on the basis of RFLP polymorphism. Conclusions:Given the abundance of Aspergillus section Flavi species A. nomius and A. flavus observed on Brazil nut, and associated risk of mycotoxin accumulation, simple identification methods for such mycotoxigenic species are of importance for Hazard Analysis Critical Control Point system implementation. The assay for the genus Aspergillus represents progress towards specific PCR identification and detection of mycotoxigenic species

Quantification of SLIT-ROBO transcripts in hepatocellular carcinoma reveals two groups of genes with coordinate expression

<p>Abstract</p> <p>Background</p> <p>SLIT-ROBO families of proteins mediate axon pathfinding and their expression is not solely confined to nervous system. Aberrant expression of <it>SLIT-ROBO </it>genes was repeatedly shown in a wide variety of cancers, yet data about their collective behavior in hepatocellular carcinoma (HCC) is missing. Hence, we quantified <it>SLIT-ROBO </it>transcripts in HCC cell lines, and in normal and tumor tissues from liver.</p> <p>Methods</p> <p>Expression of <it>SLIT-ROBO </it>family members was quantified by real-time qRT-PCR in 14 HCC cell lines, 8 normal and 35 tumor tissues from the liver. ANOVA and Pearson's correlation analyses were performed in R environment, and different clinicopathological subgroups were pairwise compared in Minitab. Gene expression matrices of cell lines and tissues were analyzed by Mantel's association test.</p> <p>Results</p> <p>Genewise hierarchical clustering revealed two subgroups with coordinate expression pattern in both the HCC cell lines and tissues: <it>ROBO1</it>, <it>ROBO2</it>, <it>SLIT1 </it>in one cluster, and <it>ROBO4</it>, <it>SLIT2</it>, <it>SLIT3 </it>in the other, respectively. Moreover, <it>SLIT-ROBO </it>expression predicted <it>AFP</it>-dependent subgrouping of HCC cell lines, but not that of liver tissues. <it>ROBO1 </it>and <it>ROBO2 </it>were significantly up-regulated, whereas <it>SLIT3 </it>was significantly down-regulated in cell lines with high-<it>AFP </it>background. When compared to normal liver tissue, <it>ROBO1 </it>was found to be significantly overexpressed, while <it>ROBO4 </it>was down-regulated in HCC. We also observed that <it>ROBO1 </it>and <it>SLIT2 </it>differentiated histopathological subgroups of liver tissues depending on both tumor staging and differentiation status. However, <it>ROBO4 </it>could discriminate poorly differentiated HCC from other subgroups.</p> <p>Conclusion</p> <p>The present study is the first in comprehensive and quantitative evaluation of <it>SLIT-ROBO </it>family gene expression in HCC, and suggests that the expression of <it>SLIT-ROBO </it>genes is regulated in hepatocarcinogenesis. Our results implicate that <it>SLIT-ROBO </it>transcription profile is bi-modular in nature, and that each module shows intrinsic variability. We also provide quantitative evidence for potential use of <it>ROBO1</it>, <it>ROBO4 </it>and <it>SLIT2 </it>for prediction of tumor stage and differentiation status.</p

Three-flavor atmospheric neutrino anomaly

We investigate the indications of flavor oscillations that come from the anomalous flavor composition of the atmospheric neutrino flux observed in some underground experiments. We study the information coming from the neutrino-induced $\mu$-like and $e$-like events both in the sub-GeV energy range (Kamiokande, IMB, Fr{\'e}jus, and NUSEX experiments) and in the multi-GeV energy range (Kamiokande experiment). First we analyze all the data in the limits of pure $\nu_\mu\leftrightarrow\nu_\tau$ and $\nu_\mu\leftrightarrow\nu_e$ oscillations. We obtain that $\nu_\mu\leftrightarrow\nu_e$ oscillations provide a better fit, in particular to the multi-GeV data. Then we perform a three-flavor analysis in the hypothesis of dominance of one neutrino square mass difference, $m^2$, implying that the neutrino mixing is parametrized by two angles, $(\psi,\,\phi)\in[0,\,\pi/2]$. We explore the space $(m^2,\,\psi,\,\phi)$ exhaustively, and find the regions favored by the oscillation hypothesis. The results are displayed in a form suited to the comparison with other flavor oscillation searches at accelerator, reactor, and solar $\nu$ experiments. In the analysis, we pay particular attention to the earth matter effects, to the correlation of the uncertainties, and to the symmetry properties of the oscillation probability.Comment: 25 pages (RevTeX) + 12 figures, requires epsfig.sty. All the figures are bitmapped. Postscript figures with full resolution are available at ftp://ftp.sns.ias.edu/pub/lisi/atmpaper

An unusual location of retroperitoneal epidermoid cyst in a child: case report and a review of the literature

We report the case of a 4-year-old girl presenting with the retroperitoneal epidermoid cyst. The lesion presented as an intra-abdominal cyst on physical examination and was followed up with more specific investigations by ultrasound and computed tomographic scanning. The final diagnosis was obtained only after laparotomy where the cystic mass was completely excised and pathological examination was done. The patient is well at 3-year follow-up. epidermoid cyst of the reteroperitoneal space, although rare, should be considered in the differential diagnosis of incidentally discovered intra-abdominal cysts during investigation of irrelevant illnesses or during routine abdominal ultrasound scan

Status of global fits to neutrino oscillations

We review the present status of global analyses of neutrino oscillations, taking into account the most recent neutrino data including the latest KamLAND and K2K updates presented at Neutrino2004, as well as state-of-the-art solar and atmospheric neutrino flux calculations. We give the two-neutrino solar + KamLAND results, as well as two-neutrino atmospheric + K2K oscillation regions, discussing in each case the robustness of the oscillation interpretation against departures from the Standard Solar Model and the possible existence of non-standard neutrino physics. Furthermore, we give the best fit values and allowed ranges of the three-flavour oscillation parameters from the current worlds' global neutrino data sample and discuss in detail the status of the small parameters \alpha \equiv \Dms/\Dma as well as $\sin^2\theta_{13}$, which characterize the strength of CP violating effects in neutrino oscillations. We also update the degree of rejection of four-neutrino interpretations of the LSND anomaly in view of the most recent developments.Comment: v6: In the last Appendix we provide updated neutrino oscillation results which take into account the relevant oscillation data released by the MINOS and KamLAND collaboration

The degradation of p53 and its major E3 ligase Mdm2 is differentially dependent on the proteasomal ubiquitin receptor S5a.

p53 and its major E3 ligase Mdm2 are both ubiquitinated and targeted to the proteasome for degradation. Despite the importance of this in regulating the p53 pathway, little is known about the mechanisms of proteasomal recognition of ubiquitinated p53 and Mdm2. In this study, we show that knockdown of the proteasomal ubiquitin receptor S5a/PSMD4/Rpn10 inhibits p53 protein degradation and results in the accumulation of ubiquitinated p53. Overexpression of a dominant-negative deletion of S5a lacking its ubiquitin-interacting motifs (UIM)s, but which can be incorporated into the proteasome, also causes the stabilization of p53. Furthermore, small-interferring RNA (siRNA) rescue experiments confirm that the UIMs of S5a are required for the maintenance of low p53 levels. These observations indicate that S5a participates in the recognition of ubiquitinated p53 by the proteasome. In contrast, targeting S5a has no effect on the rate of degradation of Mdm2, indicating that proteasomal recognition of Mdm2 can be mediated by an S5a-independent pathway. S5a knockdown results in an increase in the transcriptional activity of p53. The selective stabilization of p53 and not Mdm2 provides a mechanism for p53 activation. Depletion of S5a causes a p53-dependent decrease in cell proliferation, demonstrating that p53 can have a dominant role in the response to targeting S5a. This study provides evidence for alternative pathways of proteasomal recognition of p53 and Mdm2. Differences in recognition by the proteasome could provide a means to modulate the relative stability of p53 and Mdm2 in response to cellular signals. In addition, they could be exploited for p53-activating therapies. This work shows that the degradation of proteins by the proteasome can be selectively dependent on S5a in human cells, and that this selectivity can extend to an E3 ubiquitin ligase and its substrate