Személyre szabott kezelés szinkrón, nyirokcsomó-pozitív petefészek- és vastagbéldaganatban

Absztrakt A 71 éves nőbetegnél jobb alhasi fájdalom és láz miatt sürgősségi laparotomiára került sor. Makroszkóposan duplex coecum és colon transversum, továbbá szigma/bal petefészek daganatának gyanúja merült fel. A szövettani vizsgálat szinkrón bal petefészek- (papillaris adenocarcinoma) és colon transversum (tubularis adenocarcinoma) daganatot mutatott. Mind a két primer daganat a regionális nyirokcsomóikba adott áttétet, továbbá a petefészek-daganat infiltrálta a szigmabelet és távoli áttétet képzett a coecum területére. Immunhisztokémiával a nyirokcsomóáttétek egyértelműen elkülöníthetők voltak: petefészek-eredetű CK7-pozitív, coloneredetű CK20- és CEA-pozitív. A szikrón primer daganatokat kombinált kemoterápiával kezeltük (FOLFOX-4 és heti paclitaxel). A kombinált kezelést a beteg jól tolerálta. A ritka eset hangsúlyozza annak jelentőségét, hogy a többszörös primer daganatok egyénre szabott kemoterápiás sémával kezelhetők jó hatásfokkal és enyhe mellékhatásokkal. Orv. Hetil., 2015, 156(23), 939–943

A signal sequence suppressor mutant that stabilizes an assembled state of the twin arginine translocase

The twin-arginine protein translocation (Tat) system mediates transport of folded proteins across the cytoplasmic membrane of bacteria and the thylakoid membrane of chloroplasts. The Tat system of Escherichia coli is made up of TatA, TatB and TatC components. TatBC comprise the substrate receptor complex, and active Tat translocases are formed by the substrate-induced association of TatA oligomers with this receptor. Proteins are targeted to TatBC by signal peptides containing an essential pair of arginine residues. We isolated substitutions, locating to the transmembrane helix of TatB that restored transport activity to Tat signal peptides with inactivating twin arginine substitutions. A subset of these variants also suppressed inactivating substitutions in the signal peptide binding site on TatC. The suppressors did not function by restoring detectable signal peptide binding to the TatBC complex. Instead, site specific crosslinking experiments indicate that the suppressor substitutions induce conformational change in the complex and movement of the TatB subunit. The TatB F13Y substitution was associated with the strongest suppressing activity, even allowing transport of a Tat substrate lacking a signal peptide. In vivo analysis using a TatA-YFP fusion showed that the TatB F13Y substitution resulted in signal peptide independent assembly of the Tat translocase. We conclude that Tat signal peptides play roles in substrate targeting and in triggering assembly of the active translocase

Reduced-bias estimator of the Conditional Tail Expectation of heavy-tailed distributions

International audienceSeveral risk measures have been proposed in the literature. In this paper, we focus on the estimation of the Conditional Tail Expectation (CTE). Its asymptotic normality has been first established in the literature under the classical assumption that the second moment of the loss variable is finite, this condition being very restrictive in practical applications. Such a result has been extended by Necir {\it et al.} (2010) in the case of infinite second moment. In this framework, we propose a reduced-bias estimator of the CTE. We illustrate the efficiency of our approach on a small simulation study and a real data analysis

Low specificity of determine HIV1/2 RDT using whole blood in south west Tanzania

Objective: To evaluate the diagnostic performance of two rapid detection tests (RDTs) for HIV 1/2 in plasma and in whole blood samples. Methods: More than 15,000 study subjects above the age of two years participated in two rounds of a cohort study to determine the prevalence of HIV. HIV testing was performed using the Determine HIV 1/2 test (Abbott) in the first (2006/2007) and the HIV 1/2 STAT-PAK Dipstick Assay (Chembio) in the second round (2007/2008) of the survey. Positive results were classified into faint and strong bands depending on the visual appearance of the test strip and confirmed by ELISA and Western blot. Results: The sensitivity and specificity of the Determine RDT were 100% (95% confidence interval = 86.8 to 100%) and 96.8% (95.9 to 97.6%) in whole blood and 100% (99.7 to 100%) and 97.9% (97.6 to 98.1%) in plasma respectively. Specificity was highly dependent on the tested sample type: when using whole blood, 67.1% of positive results were false positive, as opposed to 17.4% in plasma. Test strips with only faint positive bands were more often false positive than strips showing strong bands and were more common in whole blood than in plasma. Evaluation of the STAT-PAK RDT in plasma during the second year resulted in a sensitivity of 99.7% (99.1 to 99.9%) and a specificity of 99.3% (99.1 to 99.4%) with 6.9% of the positive results being false. Conclusions: Our study shows that the Determine HIV 1/2 strip test with its high sensitivity is an excellent tool to screen for HIV infection, but that – at least in our setting – it can not be recommended as a confirmatory test in VCT campaigns where whole blood is used

New national and regional bryophyte records, 52

Marchantia paleacea is a new species for the Umbria Region and is rare in central and southern Italy. This record is in a Site of Community Importance (SCI) IT5220017 and a Special Area of Conservation (SAC) of the Natura 2000 EU-wide network due to the presence of the 7220* ‘Petrifying springs with tufa formation (Cratoneurion)’ Annexe I priority habitat. The particular environment, with a gorge and waterfall, created a very special microclimate that allowed the establishment of interesting liverworts and mosses

Hemophagocytic lymphohistiocytosis secondary to infections:a tertiary care experience

Background: Hemophagocytic lymphohistiocytosis is an uncommon complication of various conditions. It is characterized by immune dysregulation and massive cytokine release causing multiorgan dysfunction. It is classified as primary and secondary to various etiologies like infections, malignancies and autoimmune disease. As it has high mortality, clinician awareness is important for early diagnosis and improved outcome. Aim of the study was to study the etiologies, clinical manifestations, complications and laboratory features in patients diagnosed with infection associated hemophagocytic syndrome (IAHS).Methods: We have done retrospective analysis of all cases diagnosed to have Infection Associated Hemophagocytic Syndrome (IAHS) between March 2012 to November 2015 in a 1000 bedded tertiary care hospital in south India.Results: Total five cases detected. Most of the cases are related to tropical infections (80%). All of them presented with fever, cytopenias and organomegaly. Ferritin and Triglycerides were elevated in all patients. Bone marrow hemophagocytosis was observed in 80% of cases. Diagnostic protocol of HLH 2004 was followed. Only 20% survival observed.Conclusions: IAHS is a rare fulminant complication associated with diagnostic and therapeutic challenges because of overlapping clinical features with sepsis. Increased physician awareness, early diagnosis and therapeutic interventions may improve survival