Teratoma of the mediastinum: a case report

Abstract\ud \ud \ud \ud Introduction\ud \ud This case report illustrates a rare case of teratoma of the mediastinum which was continuous to the pericardium and caused extrinsic compression to the right atrium.\ud \ud \ud \ud Case presentation\ud \ud A 22-year-old Caucasian man with no complaints or comorbid conditions presented to our hospital with obliteration of the right cardiophrenic sinus by a mass. A non-invasive investigation demonstrated a tumoral mass which was continuous to the pericardium and caused extrinsic compression to the right atrium. The clinical suspicion was a pericardial or bronchogenic cyst. Surgical and anatomopathologic findings led to the diagnosis of a mature cystic teratoma with atrophic thymic tissue at the external teratoma surface.\ud \ud \ud \ud Conclusion\ud \ud We present an original report of a mature teratoma causing obliteration of the right cardiophrenic sinus with extrinsic heart compression. The diagnosis of this tumor is very difficult through non-invasive investigation

A rapid and robust tri-color flow cytometry assay for monitoring malaria parasite development

Microscopic examination of Giemsa-stained thin blood smears remains the gold standard method used to quantify and stage malaria parasites. However, this technique is tedious, and requires trained microscopists. We have developed a fast and simple flow cytometry method to quantify and stage, various malaria parasites in red blood cells in whole blood or in vitro cultured Plasmodium falciparum. The parasites were stained with dihydroethidium and Hoechst 33342 or SYBR Green I and leukocytes were identified with an antibody against CD45. Depending on the DNA stains used, samples were analyzed using different models of flow cytometers. This protocol, which does not require any washing steps, allows infected red blood cells to be distinguished from leukocytes, as well as allowing non-infected reticulocytes and normocytes to be identified. It also allows assessing the proportion of parasites at different developmental stages. Lastly, we demonstrate how this technique can be applied to antimalarial drug testing

Mini invasive axillary approach and arthroscopic humeral head interference screw !xation for latissimus dorsi transfer in massive and irreparable posterosuperior rotator cuff tears.

Abstract: As the number of shoulder surgeries is increasing, the challenges of treating the massive and irreparable rotator cuff tears pose an operative challenge for the shoulder surgeons. The purpose of this study is to propose a new mini invasive axillary incision (5 cm) for harvesting latissimus dorsi (LD) tendon and arthroscopic-assisted interference screw fixation of the transfer on the humeral head for the treatment of massive and irreparable posterosuperior rotator cuff tears. We describe our technique. The incision is minimized with the help of ultrasound Doppler-guided identification of the LD pedicle preoperatively. This study also makes clear how to maintain the tension on the pedicle of the LD uniform before and after the fixation of the transfer. During our experience of 17 cases from November 2007 to July 2009, we had good-to-excellent results in patient satisfaction. The clinical outcomes were not indifferent from the other methods of fixation. Key Words: latissimus dorsi transfer, massive irreparable posterosuperior cuff tear, iterative cuff tear, interferrence screw latissimus dorsi fixation, arthroscopic latissimus dorsi fixation, mini invasive axillary approach (Tech Should Surg 2010;11: 8--14) T he incidence of the challenges for massive and irreparable rotator cuff tears is on the raise in the patients attending shoulder specialty centers for surgery. Some of these patients have already been operated by open or arthroscopic technique even before the age of 50 years. Gerber et al 1 is the first to publish the latissimus dorsi (LD) tendon transfer for the treatment of these massive irreparable rotator cuff tears. The LD flap is well known and widely used in other specialties such as breast reconstructions and paralytic shoulder owing to birth palsy in pediatric orthopedics. 2 Gerber 3 and Gerber et al 4 discussed in detail regarding the indications and contraindications for the LD transfer. He concluded that when posterosuperior rotator cuff tears were associated with subscapularis tears, the LD transfer is contraindicated. Other authors 5-10 also confirmed bad results in case of subscapularis tears, deltoid anterior deficit, proximal migration of the humeral head, preoperative poor function of the shoulder, and as a salvage procedure. Whereas the patient selection plays an important role in success of this transfer, it remains a viable and effective option for younger patients with massive and irreparable rotator cuff tears. Moreover, constantly great tuberosity is fragile owing to earlier surgery or lack of mechanical stimulus chronically by the absence of rotator cuff musculature. The technical difficulties of fixation of the LD transfer on to osteoporotic bone need to be studied in detail. Gerber et al 1 fixed the transfer to the subscapularis with transosseous sutures. Warner and Parson 6 fixed the transfer on to the greater tuberosity by transosseous sutures. Habermeyer et al, We hypothesized that the reasons for failures of this transfer were not only owing to invasive and open surgery (new deltoid injury), but also owing to lack of adequate strong and stable fixation of the LD tendon on to the greater tuberosity. From the experience of the anterior cruciate ligament (ACL) reconstruction of the knee and from the work of Boileau et al 14 in the tenodesis of long head of biceps into the humeral head, we describe a new mini invasive technique for harvesting the LD tendon, new technique of fixation by tubularization, and interference screw (IFS) fixation into a bone tunnel made in the humeral head. This fixation initially carried out by open procedure now switched to arthroscopically assisted procedure as our experience increased and it was more advantageous. This procedure is a viable alternative to the existing techniques in the hands of surgeon who is skilled in arthroscopic management of shoulder pathology. The specific biomechanical study conducted under the guidance of Jean Grimberg (personal communication) has concluded that the IFS fixation of the LD transfer on the humeral head is equal or slightly better than the multiple anchor fixation technique. Various studies OPERATIVE TECHNIQUE The patient is in lateral position with shoulder in 30 degrees abduction, slightly tilted toward the back, and a 3 kg traction. The operative position allows free wide access to the shoulder, entire scapula, and its apex as this transfer needs free movement of shoulder and arm. This position also allows easy shifting over from open axillary approach for LD tendon harvesting to shoulder arthroscopic fixation of the transfer. It is important at this point to mention that the LD muscle neurovascular pedicle enters from the medial and under surface of the muscle from about 10 cm from humeral insertion of the LD tendon and 2 cm from the lateral scapular border. The exac

Charged domain walls as quantum strings living on a lattice

A generic lattice cut-off model is introduced describing the quantum meandering of a single cuprate stripe. The fixed point dynamics is derived, showing besides free string behavior a variety of partially quantum disordered phases, bearing relationships both with quantum spin-chains and surface statistical physics.Comment: 22 page, 17 figure

Cross-species Malaria Immunity Induced By Chemically Attenuated Parasites

Vaccine development for the blood stages of malaria has focused on the induction of antibodies to parasite surface antigens, most of which are highly polymorphic. An alternate strategy has evolved from observations that low-density infections can induce antibody-independent immunity to different strains. To test this strategy, we treated parasitized red blood cells from the rodent parasite Plasmodium chabaudi with secocyclopropyl pyrrolo indole analogs. These drugs irreversibly alkylate parasite DNA, blocking their ability to replicate. After administration in mice, DNA from the vaccine could be detected in the blood for over 110 days and a single vaccination induced profound immunity to different malaria parasite species. Immunity was mediated by CD4(+) T cells and was dependent on the red blood cell membrane remaining intact. The human parasite, Plasmodium falciparum, could also be attenuated by treatment with seco-cyclopropyl pyrrolo indole analogs. These data demonstrate that vaccination with chemically attenuated parasites induces protective immunity and provide a compelling rationale for testing a blood-stage parasite-based vaccine targeting human Plasmodium species

Global gene expression patterns in the post-pneumonectomy lung of adult mice

<p>Abstract</p> <p>Background</p> <p>Adult mice have a remarkable capacity to regenerate functional alveoli following either lung resection or injury that exceeds the regenerative capacity observed in larger adult mammals. The molecular basis for this unique capability in mice is largely unknown. We examined the transcriptomic responses to single lung pneumonectomy in adult mice in order to elucidate prospective molecular signaling mechanisms used in this species during lung regeneration.</p> <p>Methods</p> <p>Unilateral left pneumonectomy or sham thoracotomy was performed under general anesthesia (n = 8 mice per group for each of the four time points). Total RNA was isolated from the remaining lung tissue at four time points post-surgery (6 hours, 1 day, 3 days, 7 days) and analyzed using microarray technology.</p> <p>Results</p> <p>The observed transcriptomic patterns revealed mesenchymal cell signaling, including up-regulation of genes previously associated with activated fibroblasts (Tnfrsf12a, Tnc, Eln, Col3A1), as well as modulation of Igf1-mediated signaling. The data set also revealed early down-regulation of pro-inflammatory cytokine transcripts and up-regulation of genes involved in T cell development/function, but few similarities to transcriptomic patterns observed during embryonic or post-natal lung development. Immunohistochemical analysis suggests that early fibroblast but not myofibroblast proliferation is important during lung regeneration and may explain the preponderance of mesenchymal-associated genes that are over-expressed in this model. This again appears to differ from embryonic alveologenesis.</p> <p>Conclusion</p> <p>These data suggest that modulation of mesenchymal cell transcriptome patterns and proliferation of S100A4 positive mesenchymal cells, as well as modulation of pro-inflammatory transcriptome patterns, are important during post-pneumonectomy lung regeneration in adult mice.</p

Solar wind noble gases - Preliminary results from bulk metallic glass flown on Genesis

The solar wind (SW) is the major source of information to study the solar composition of volatile elements. It provides insights about the Sun's present state, its evolution and the composition of the proto-solar nebula. SW noble gases can be used to study processes causing fractionation between the Sun and the SW. Moreover they are useful to determine compositional variations for distinct SW energy regimes including the high energy SEP component apparently abundant in lunar samples [I]. We will present noble gas data collected on Genesis [2] with a bulk metallic glass target (BMG) [3]

Toll-like receptor polymorphisms and cerebral malaria: <it>TLR2 </it>Δ22 polymorphism is associated with protection from cerebral malaria in a case control study

<p>Abstract</p> <p>Background</p> <p>In malaria endemic areas, host genetics influence whether a <it>Plasmodium falciparum</it>-infected child develops uncomplicated or severe malaria. TLR2 has been identified as a receptor for <it>P. falciparum</it>-derived glycosylphosphatidylinositol (GPI), and polymorphisms within the TLR2 gene may affect disease pathogenesis. There are two common polymorphisms in the 5' un-translated region (UTR) of TLR2, a 22 base pair deletion in the first unstranslated exon (Δ22), and a GT dinucleotide repeat in the second intron (GTn).</p> <p>Methods</p> <p>These polymorphisms were examined in a Ugandan case control study on children with either cerebral malaria or uncomplicated malaria. Serum cytokine levels were analysed by ELISA, according to genotype and disease status. In vitro TLR2 expression was measured according to genotype.</p> <p>Results</p> <p>Both Δ22 and GTn polymorphisms were highly frequent, but only Δ22 heterozygosity was associated with protection from cerebral malaria (OR 0.34, 95% confidence intervals 0.16, 0.73). In vitro, heterozygosity for Δ22 was associated with reduced pam3cys inducible TLR2 expression in human monocyte derived macrophages. In uncomplicated malaria patients, Δ22 homozygosity was associated with elevated serum IL-6 (<it>p </it>= 0.04), and long GT repeat alleles were associated with elevated TNF (<it>p </it>= 0.007).</p> <p>Conclusion</p> <p>Reduced inducible TLR2 expression may lead to attenuated pro-inflammatory responses, a potential mechanism of protection from cerebral malaria present in individuals heterozygous for the TLR2 Δ22 polymorphism.</p

GH safety workshop position paper: A critical appraisal of recombinant human GH therapy in children and adults

Recombinant human GH (rhGH) has been in use for 30 years, and over that time its safety and efficacy in children and adults has been subject to considerable scrutiny. In 2001, a statement from the GH Research Society (GRS) concluded that 'for approved indications, GH is safe'; however, the statement highlighted a number of areas for on-going surveillance of long-Term safety, including cancer risk, impact on glucose homeostasis, and use of high dose pharmacological rhGH treatment. Over the intervening years, there have been a number of publications addressing the safety of rhGH with regard to mortality, cancer and cardiovascular risk, and the need for long-Term surveillance of the increasing number of adults who were treated with rhGH in childhood. Against this backdrop of interest in safety, the European Society of Paediatric Endocrinology (ESPE), the GRS, and the Pediatric Endocrine Society (PES) convened a meeting to reappraise the safety of rhGH. The ouput of the meeting is a concise position statement