Metastatic Testicular Seminoma in a Patient With Down Syndrome Presenting As Extensive Deep Venous Thrombosis

Testicular cancer, particularly seminoma, is associated with Down syndrome. In cognitively impaired patients, the typical presenting signs of testicular cancer may be missed, and atypical presenting features may be the only clue to the diagnosis. In this report, we present the case of a 38-year-old male who presented with extensive deep vein thrombosis in the setting of seminoma

Bile acid: a potential inducer of colon cancer stem cells

Background: Although the unconjugated secondary bile acids, specifically deoxycholic acid (DCA) and lithocholic acid (LCA), are considered to be risk factors for colorectal cancer, the precise mechanism(s) by which they regulate carcinogenesis is poorly understood. We hypothesize that the cytotoxic bile acids may promote stemness in colonic epithelial cells leading to generation of cancer stem cells (CSCs) that play a role in the development and progression of colon cancer. Methods: Normal human colonic epithelial cells (HCoEpiC) were used to study bile acid DCA/LCA-mediated induction of CSCs. The expression of CSC markers was measured by real-time qPCR. Flow cytometry was used to isolate CSCs. T-cell factor/lymphoid-enhancing factor (TCF/LEF) luciferase assay was employed to examine the transcriptional activity of β-catenin. Downregulation of muscarinic 3 receptor (M3R) was achieved through transfection of corresponding siRNA. Results: We found DCA/LCA to induce CSCs in normal human colonic epithelial cells, as evidenced by the increased proportion of CSCs, elevated levels of several CSC markers, as well as a number of epithelial– mesenchymal transition markers together with increased colonosphere formation, drug exclusion, ABCB1 and ABCG2 expression, and induction of M3R, p-EGFR, matrix metallopeptidases, and c-Myc. Inhibition of M3R signaling greatly suppressed DCA/LCA induction of the CSC marker ALDHA1 and also c-Myc mRNA expression as well as transcriptional activation of TCF/LEF. Conclusions: Our results suggest that bile acids, specifically DCA and LCA, induce cancer stemness in colonic epithelial cells by modulating M3R and Wnt/β-catenin signaling and thus could be considered promoters of colon cancer

Variation of Seed Traits and Initial Quality among Selected Cowpea, Mungbean, and Soybean Accessions

Seed traits are essential quantitative variables to assess seed quality and are also indicators of crop success. The World Vegetable Center Genebank in Arusha, Tanzania, has an important legume collection; however, there is limited information on seed traits per genotype, i.e., 1000-seed weight, the number of seeds per gram, germination percentage (GP), and mean germination time (MGT). In this study, 8 cowpea, 54 mungbean, and 15 soybean accessions were evaluated for the abovementioned parameters. A significant difference was observed among the genotypes of the selected legumes with respect to all the measured parameters. An intraspecific variation was also observed for the measured seed traits. The 1000-seed weight decreased with an increase in the number of seeds per gram. Unlike cowpea, the GP of mungbean and soybean accessions was significantly and negatively influenced by the number of seeds per 1 g. Hence, the smaller-sized seeds (with many seeds in 1 g) exhibited lower GP. It is concluded that the seed traits and initial quality among the selected legumes are strongly influenced by their genetic makeup. These results are useful to inform seed management, exchange, utilization, and have a high potential in breeding programs, and require further research attention

Establishment of the Causal Agent(s) of Spike Shedding and Stem Wilting of Pepper (Piper nigrum L.) in Morogoro District, Tanzania

Pepper (Piper nigrum L.) serves as a source of income to smallholder spice farmers in Morogoro district of Tanzania. Recently, spike shedding and stem wilting of pepper plants were reported to cause about 30% yield loss of the crop. This study was undertaken to identify the causal agent(s) of the problems. Three pepper gardens in each of the four hamlets (Nyange, Doga, Tandai, and Lukenge) in Tandai village (Kinole ward) were surveyed, and plant tissue and soil samples were collected for laboratory analysis. An experiment was laid out in a randomized complete block design with three replications. Pepper cultivars, Babu kubwa, Babu ndogo, Babu kati, and Ismailia grown in the study area, were used as treatments for evaluation of the prevalence of spike shedding and stem wilting. Treatments mean separation was conducted based on Duncan’s multiple range test at p � 0.05. Regression (R 2 ) and simple correlation (r) analyses between stem wilting (incidence and severity) and termite pest infestation were performed. The identified pathogen in most of the soil and plant tissue samples was Fusarium oxysporum. The nutrients, N, P, Mg, and Cu, concentration in soil and leaf samples was below the optimal ranges. Termite attacks were significantly high in some farmer’s gardens where up to 50.5% of the pepper plants was damaged. Hence, a significant positive correlation was observed between termite pest infestation in gardens and both incidence (r � 0.881, R 2 � 0.74, p < 0.001) and severity of stem wilting (r � 0.918, R 2 � 0.84, p < 0.001) of pepper plants. Most of the termite attacks and damages (70%) were observed on pepper plants supported on silver oak, unlike those trained on Jatropha. A higher percentage of undeveloped berries (36%) and intermediate- size berries (34%) was recorded on cultivars “Babu kati” and “Babu kubwa,” respectively. Multiple factors have been associated to be the causes of spike shedding and stem wilting of pepper, which could be used to develop appropriate control solutions useful to farmers. Confirmation of F. oxysporum pathogenicity is recommended. A comprehensive study is suggested on the repellent or lethal activities of Jatropha against F. oxysporum and termites. Furthermore, studies through field experiments are needed to generate site-specific soil nutrient improvement recommendations and design an integrated approach to control F. oxysporum and termites and to determine existing alternative host plants for these pests

Late homograft valve insertion after transannular patch repair of tetralogy of Fallot.

BACKGROUND AND AIMS OF THE STUDY: Transannular patch repair of tetralogy of Fallot leads to pulmonary insufficiency and progressive right ventricular dilatation responsible for a decreased exercise capacity. We studied the impact of late homograft insertion on the regression of the right ventricular volumes in symptomatic patients. METHODS: Between July 1992 and August 1996, 15 consecutive patients (age range: 4 to 24 years) were operated on at a median of 13 years (range: 3 to 20 years) after transannular patch repair of tetralogy of Fallot. All patients complained of exertional dyspnea and fatigue. Syncopes were reported in six patients and four patients had sustained episodes of ventricular tachycardia. Fourteen had pulmonary regurgitation grade 3 or 4 and one had an associated stenosis and insufficiency. All patients had a dilated right ventricle. At reoperation, no patients presented with major aneurysm. The patch was resected and the right ventricular outflow tract reconstructed with a cryopreserved pulmonary homograft. Right ventricular volumes were studied before the procedures and at the last follow up consultation. RESULTS: There was no operative death. One patient who had a concomitant patch repair of a hypoplastic left pulmonary artery needed extracorporeal circulatory support for eight days. After a median follow up of 25 months (range: 3 to 54 months) all patients but one are in NYHA class I. There were no late deaths. The mean end-diastolic diameter of the right ventricle decreased from 36 +/- 9 mm before surgery to 31 +/- 6 mm (not significant). The mean ratio between the end-diastolic diameter of the right and left ventricles decreased from 0.94 +/- 0.3 to 0.74 +/- 0.2 (p < 0.01). CONCLUSION: An increasing number of patients who had transannular patch repair for tetralogy of Fallot will require reoperation for symptomatic long-term pulmonary regurgitation. Homograft reconstruction of the right ventricular outflow tract of these patients induces regression of their right ventricular dilatation and leads to their functional recovery

Early balloon dilatation of the pulmonary valve in infants with tetralogy of Fallot. Risks and benefits.

BACKGROUND: Balloon dilatation, an established treatment for pulmonary valve stenosis, remains a controversial procedure in tetralogy of Fallot. METHODS AND RESULTS: Balloon dilatation of the pulmonary valve was performed in 19 infants with tetralogy of Fallot. Its effects on the severity of cyanosis, the growth of the pulmonary valve and pulmonary arteries, and the need for transannular patching were evaluated. Clinical, echographic, angiographic, hemodynamic, and operative data were analyzed. The procedure was safe in all, without significant complications. After balloon dilatation, systemic oxygen saturation increased from a mean value of 79% to 90%. This increase proved to be short-lasting in 4 patients, who required surgery before the age of 6 months. Balloon dilatation increased pulmonary annulus size in each case, from a mean value of 4.9 to 6.9 mm (P < .001). This gain in size remained stable over time, with a mean Z score of -4.8 SD before dilatation, -3.1 SD immediately after the procedure, and -2.7 SD at preoperative catheterization (P < .001). Pulmonary artery dimensions remained unchanged immediately after balloon dilatation but increased at follow-up from a Z score mean value of -2.5 to -0.06 SD and from -2.2 to 0.04 SD for right and left pulmonary arteries, respectively (P < .001). At the time of corrective surgery, the pulmonary annulus was considered large enough to avoid a transannular patch in 69% of the infants. This represented a 30% to 40% reduction in the need for a transannular patch compared with the incidence of transannular patch expected before balloon dilatation. CONCLUSIONS: Pulmonary valve dilatation in infants with tetralogy of Fallot is a relatively safe procedure and appears to produce adequate palliation in most patients. It allowed the growth of the pulmonary annulus and of the pulmonary arteries, resulting in a mean gain of 2 SD for those structures

Tetralogy of Fallot: transannular and right ventricular patching equally affect late functional status.

BACKGROUND: In tetralogy of Fallot, transannular patching is suspected to be responsible for late right ventricular dilatation. METHODS AND RESULTS: In our institution, 191 patients survived a tetralogy of Fallot repair between 1964 and 1984. Transannular patching was used in 99 patients (52%), patch closure of a right ventriculotomy in 35, and direct closure of a right ventriculotomy in 55. Two had a transatrial-transpulmonary approach. To identify predictive factors of adverse long-term outcome related to right ventricular dilatation, the following events were investigated: cardiac death, reoperation for symptomatic right ventricular dilatation, and NYHA class II or III by Cox regression analysis. Mean follow-up reached 22+/-5 years. The 30-year survival was 86+/-5%. Right ventricular patching, whether transannular or not, was the most significant independent predictor of late adverse event (improvement chi(2)=16.6, P:<0.001). In patients who had direct closure, the ratio between end-diastolic right and left ventricular dimensions on echocardiography was smaller (0.61+/-0.017 versus 0. 75+/-0.23, P:=0.007), with a smaller proportion presenting severe pulmonary insufficiency (9% versus 40%, P:=0.005). There was no difference between right ventricular and transannular patching concerning late outcome (log rank P: value=0.6), right ventricular size (0.70+/-0.28 versus 0.76+/-0.26, P:=0.4), or incidence of severe pulmonary insufficiency (30% versus 43%, P:=0.3). CONCLUSIONS: In tetralogy of Fallot, transannular patching does not result in a worse late functional outcome than patching of an incision limited to the right ventricle. Both are responsible for a similar degree of long-term pulmonary insufficiency and right ventricular dilatation