A rare case of squamous inclusion cyst in cervical lymph node.

A 38-year-old man, with no history of malignancy, was found to have a 2 cm jugular lymph node, for which a lymph node tuberculosis was suspected. The specimen revealed a cystic structure lined by mature keratinizing squamous epithelium with a prominent granular cell layer consistent with a squamous inclusion cyst in a lymph node, but a metastatic squamous cell carcinoma could not be excluded. This is the first case report of a rapidly enlarging squamous inclusion cyst in a jugular lymph node. Our case demonstrates the diagnostic challenges related to a squamous inclusion cyst in cervical lymph node and serves to inform the readers to consider this lesion in the differential diagnosis for similar situations.

Infection of the equine population by Leishmania parasites.

Infection of equids by Leishmania (L.) parasites was previously described in both the Old and New World, particularly in Central and South America. Equine cutaneous leishmaniasis (CL) is caused by the Leishmania species, L. Viannia (V.) braziliensis and L. infantum, previously identified in humans and other parasite hosts living in the same geographic endemic areas. Sporadic autochthonous clinical cases, with no travel history, were documented in several countries including Germany, Portugal, Spain, Texas and Brazil; L. infantum and L. (Mundinia) martiniquensis were the infectious species. Prevalence of subclinical infections is extremely low and CL is observed in only a small proportion of infected animals with the appearance of single or multiple cutaneous lesions located on the head, external ear, scrotum, legs and the neck. To date, there has been no report of visceral abnormalities. However, the mild clinical profile of the disease and its spontaneous regression may indicate that skin lesions related to Leishmania infection is underdiagnosed. Importantly, although the prevalence of Leishmania infections in the equine population is low, a risk may rise from its potential involvement in the parasite transmission cycles as a source of infection for phlebotomine vectors and susceptible mammalian hosts. This review article summarises our current knowledge of the epidemiology, clinical presentation and diagnosis of Leishmania-infected equids.

[Left atrial intimal sarcoma: A rare cause of acute heart failure]. / Sarcome intimal de l'oreillette gauche : une cause rare d'insuffisance cardiaque aiguë.

Primitive intimal sarcoma is a rare malignant cardiac tumor. Through the observation of a 41-year-old man who presented with an acute heart failure revealing a left atrial intimal sarcoma, we discuss different diagnostic and therapeutic modalities.

Hughes Abdominal Repair Trial (HART) - Abdominal wall closure techniques to reduce the incidence of incisional hernias: study protocol for a randomised controlled trial.

BACKGROUND: Incisional hernias are common complications of midline closure following abdominal surgery and cause significant morbidity, impaired quality of life and increased health care costs. The 'Hughes Repair' combines a standard mass closure with a series of horizontal and two vertical mattress sutures within a single suture. This theoretically distributes the load along the incision length as well as across it. There is evidence to suggest that this technique is as effective as mesh repair for the operative management of incisional hernias; however, no trials have compared the Hughes Repair with standard mass closure for the prevention of incisional hernia formation following a midline incision. METHODS/DESIGN: This is a 1:1 randomised controlled trial comparing two suture techniques for the closure of the midline abdominal wound following surgery for colorectal cancer. Full ethical approval has been gained (Wales REC 3, MREC 12/WA/0374). Eight hundred patients will be randomised from approximately 20 general surgical units within the United Kingdom. Patients undergoing open or laparoscopic (more than a 5-cm midline incision) surgery for colorectal cancer, elective or emergency, are eligible. Patients under the age of 18 years, those having mesh inserted or undergoing musculofascial flap closure of the perineal defect in abdominoperineal wound closure, and those unable to give informed consent will be excluded. Patients will be randomised intraoperatively to either the Hughes Repair or standard mass closure. The primary outcome measure is the incidence of incisional hernias at 1 year as assessed by standardised clinical examination. The secondary outcomes include quality of life patient-reported outcome measures, cost-utility analysis, incidence of complete abdominal wound dehiscence and C-POSSUM scores. The incidence of incisional hernia at 1 year, assessed by computerised tomography, will form a tertiary outcome. DISCUSSION: A feasibility phase has been completed. The results of the study will be used to inform current and future practice and potentially reduce the risk of incisional hernia formation following midline incisions. TRIAL REGISTRATION NUMBER: ISRCTN 25616490 . Registered on 1 January 2012.

[Complication rates after amniocentesis in twin pregnancies: a case control study and review of the literature]. / Evaluation de la fréquence des complications après amniocentèse dans les grossesses gémellaires: étude cas témoins et revue de la literature.

BACKGROUND: Twin pregnancies nave a nigner risk of fetal malformation than singleton pregnancies. The literature suggests a higher risk of fetal loss associated to amniocentesis in twin pregnancies compared to singleton ones. However, published studies are very heterogeneous, rarely controlled or are not taking into account many confounding factors. OBSERVATIONS: To assess all complications that can be associated with amniocentesis in twin pregnancies. MATERIALS AND METHODS: We collected retrospectively medical data concerning twin pregnancies that underwent an amniocentesis in Erasme and Edith Cavell (IMEC) hospitals in Brussels since February 2002. We compared all the complications to those of twin pregnancies that haven't undertaken amniocentesis and singleton pregnancies that underwent amniocentesis. The cases and control groups were matched for age, parity and gestational age at the time of amniocentesis. RESULTS: 94 cases of twin pregnancies that underwent amniocentesis (group I) were included and compared to 94 twin pregnancies that haven't undertaken amniocentesis and 94 singleton pregnancies that underwent amniocentesis. The rate of intra-uterine growth restriction and pregnancies obtained by assisted reproductive medicine was significantly higher in the group I for the latter, the rate of late miscarriage was 2.1%, the rate of overall foetal loss is 2.68%, the rate of overall preterm birth ≤ 37 SA was 59.3% (6.4% ≤ 28 SA and 29.8% ≤ 34 SA). These complications were not significantly higher than those of the control groups after multivariable logistic regression analysis. CONCLUSION: Our data showed no increased risk of foetal loss or preterm birth among twins that underwent amniocentesis compared to controls.

Identification of immunodominant Leishmania major antigenic markers of the early C57BL/6 and BALB/c mice infection stages.

The C57BL/6 mouse strain is resistant to Leishmania (L.) major infection and, unlike susceptible BALB/c, develops small self-healing cutaneous lesions. The specific antibody responses of C57BL/6 and BALB/c mice were previously characterized by the predominance of IgG2a ('resistant' isotype associated with Th1) and IgG1 ('pathogenic' isotype associated with Th2) antibodies, respectively. In this study, we looked for the presence of antigens able to elicit an exclusive or predominant IgG1 production during the early stages of C57BL/6 lesion development and checked whether they are recognized or not by BALB/c mice. We demonstrate first that IgG2a predominance in C57BL/6 sera occurs only late after infection, whereas in BALB/c, IgG1 antibodies dominate mostly in the early stages. Interestingly, soon after inoculation of live amastigotes, C57BL/6 displayed an exclusive IgG1 reactivity against particular L. major antigens but with MWs different from those identified in BALB/c. Furthermore, mice immunized with killed amastigotes displayed striking differences in their immunodetection profiles, particularly for the IgG1 isotype. Taken together, the observed differences in the specific antibody repertoires between infected mice resulted, at least in part, from immunological events independent from those triggered by the replicating parasite, and bring new insights into the selection of future vaccine candidates.

Myostatin and the skeletal muscle atrophy and hypertrophy signaling pathways.

Myostatin, a member of the transforming growth factor-ß superfamily, is a potent negative regulator of skeletal muscle growth and is conserved in many species, from rodents to humans. Myostatin inactivation can induce skeletal muscle hypertrophy, while its overexpression or systemic administration causes muscle atrophy. As it represents a potential target for stimulating muscle growth and/or preventing muscle wasting, myostatin regulation and functions in the control of muscle mass have been extensively studied. A wealth of data strongly suggests that alterations in skeletal muscle mass are associated with dysregulation in myostatin expression. Moreover, myostatin plays a central role in integrating/mediating anabolic and catabolic responses. Myostatin negatively regulates the activity of the Akt pathway, which promotes protein synthesis, and increases the activity of the ubiquitin-proteasome system to induce atrophy. Several new studies have brought new information on how myostatin may affect both ribosomal biogenesis and translation efficiency of specific mRNA subclasses. In addition, although myostatin has been identified as a modulator of the major catabolic pathways, including the ubiquitin-proteasome and the autophagy-lysosome systems, the underlying mechanisms are only partially understood. The goal of this review is to highlight outstanding questions about myostatin-mediated regulation of the anabolic and catabolic signaling pathways in skeletal muscle. Particular emphasis has been placed on (1) the cross-regulation between myostatin, the growth-promoting pathways and the proteolytic systems; (2) how myostatin inhibition leads to muscle hypertrophy; and (3) the regulation of translation by myostatin.

[Diastematomyelia diagnosed prenatally]. / Diastématomyélie diagnostiquée en période prénatale.

We report a case of a 32-week-old foetus affected by diastematomyelia. A third trimester echography suggested a spine abnormality. Further investigations by CT-scanner and MRI were performed to precise the anomaly and to better counsel the couple on the prognosis. We performed a review of the literature about embryological hypotheses, clinical presentations, antenatal investigations and prognosis of such a rare spinal malformation.

Identification of Dirofilaria immitis proteins recognized by antibodies from infected dogs.

The identification of excreted-secreted (ES) proteins of filarial nematodes as potential diagnostic reagents is an important requirement for the development of methods to determine level of infection in the host, especially for human filariae. Dirofilaria immitis, the canine heartworm, is a widespread and important veterinary pathogen and is a useful model for filarial parasites of humans. An analysis of proteins released from adult D. immitis (the secretome) in culture is available. We sought to identify D. immitis ES proteins found in vivo to validate the in vitro secretome and to investigate them as potential diagnostic reagents. Cultures of D. immitis adults obtained from infected dogs were maintained for 72 hr with daily changes of media. Proteins were concentrated from spent media by standard methods and were passed through Protein-A columns containing purified IgG antibodies from heartworm-infected dogs. Following extensive washing, heartworm proteins recognized by the antibodies were eluted from these columns and submitted for analysis by tandem mass spectrometry (MS/MS). As a comparison, somatic proteins from adult D. immitis female parasites and microfilaria were also processed and analyzed by the same protocol. Six, 9, and 12 proteins were identified by MS/MS in the ES, adult female, and microfilaria samples, respectively. The identification of the most abundant parasite proteins present in the serum of infected hosts offers a rational approach to the development of new diagnostic assays that may be applicable across the Filarioidea.

Development of an ergonomics device for maintenance of hydraulic generators of Tucuruí hydropower plant.

This paper aims to present an ergonomic device to assist in the maintenance of the units of Tucuruí Hydropower Plant. The development of this ergonomic device made possible to reduce maintenance time, reduce losses caused by billing, improve performance and reduce the physical strain for labors during the execution of services.

Ergonomics program management in Tucuruí Hydropower Plant using TPM methodology.

This paper aims to present the benefits achieved in the ergonomics process management with the use of the TPM methodology (Total Productive Maintenance) in Tucuruí Hydropower Plant. The methodology is aligned with the corporate guidelines, moreover with the Strategic Planning of the company, it is represented in the TPM Pillars including the Health Pillar in which is inserted the ergonomics process. The results of the ergonomic actions demonstrated a 12% reduction over the absenteeism rate due to musculoskeletal disorders, solving 77,0% of ergonomic non-conformities, what favored the rise of the Organizational Climate in 44,8%, impacting on the overall performance of the company. Awards confirmed the success of the work by the achievement of the Award for TPM Excellence in 2001, Award for Excellence in Consistent TPM Commitment in 2009 and more recently the Special Award for TPM Achievement, 2010. The determination of the high rank administration and workers, allied with the involvement/dynamism of Pillars, has assured the success of this management practice in Tucuruí Hydropower Plant.

Time course of the hemoglobin mass response to natural altitude training in elite endurance cyclists.

To determine the time course of hemoglobin mass (Hb(mass)) to natural altitude training, Hb(mass), erythropoietin [EPO], reticulocytes, ferritin and soluble transferrin receptor (sTfR) were measured in 13 elite cyclists during, and 10 days after, 3 weeks of sea level (n=5) or altitude (n=8, 2760 m) training. Mean Hb(mass), with a typical error of ∼2%, increased during the first 11 days at altitude (mean ± standard deviation 2.9 ± 2.0%) and was 3.5 ± 2.5% higher than baseline after 19 days. [EPO] increased 64.2 ± 18.8% after 2 nights at altitude but was not different from baseline after 12 nights. Hb(mass) and [EPO] did not increase in sea level. Reticulocytes (%) were slightly elevated in altitude at Days 5 and 12 (18.9 ± 17.7% and 20.4 ± 25.3%), sTfR was elevated at Day 12 (18.9 ± 15.0%), but both returned to baseline by Day 20. Hb(mass) and [EPO] decreased on descent to sea level while ferritin increased. The mean increase in Hb(mass) observed after 11 days (∼300 h) of altitude training was beyond the measurement error and consitent with the mean increase after 300 h of simulated live high:train low altitude. Our results suggest that in elite cyclists, Hb(mass) increases progressively with 3 weeks of natural altitude exposure, with greater increases expected as exposure persists.

Physiological and anthropometric characteristics of junior cyclists of different specialties and performance levels.

This study analyzes the anthropometric and physiological characteristics of junior cyclists within different cycling specialties and different performance levels. One hundred and thirty-two junior riders (16.8 ± 0.6 years, 177 ± 6 cm, 66.3 ± 6.7 kg) were tested for anthropometric, aerobic and anaerobic parameters. Cyclists were classified within specialties [uphill (UH) flat terrain (FT) all terrain (AT) and sprint (SP)] and performance levels, based on a seasonal ranking [low level (LL) medium level (ML) and high level (HL)]. The results of the two-way analysis of variance showed that FT and SP have greater body dimensions than UH and AT (P<0.001). Concerning the relative aerobic parameters, AT and UH have higher values (P<0.001) than FT and SP [maximal oxygen uptake (VO(2max) ): 69.4 ± 3.6, 67.5 ± 5.0, 62.8 ± 4.5 and 61.9 ± 4.1 mL/kg/min, respectively] while absolute parameters resulted higher for FT and AT (P≤0.008). The relative power produced in the 5 s test was higher (P<0.001) for AT and SP than FT and UH (16.7 ± 1.1, 16.6 ± 0.6, 14.9 ± 1.7 and 14.4 ± 1.7 W/kg, respectively). Concerning the performance level, only the age and the aerobic parameters resulted differently within levels (VO(2max) : HL=67.3 ± 4.9, ML=65.5 ± 5.1 and LL=63.3 ± 5.2 mL/kg/min), with the highest values for HL (P≤0.007). In conclusion, juniors are specialized in the same way as professional cyclists and the aerobic characteristics are confirmed as significant in the performance level assessment.

Age related efficiency of the leishmanin skin test as a marker of immunity to human visceral leishmaniasis.

This study aimed at investigating whether the efficiency of the leishmanin skin test (LST) to evaluate the immune status of individuals exposed to Leishmania (L.) infantum is age-related. It was conducted in two districts of the governorate of Kairouan, an endemic region for L. infantum infection in Tunisia. Healthy individuals (n = 119) were selected according to two criteria: no current or past history of visceral or cutaneous leishmaniasis, and their age range: 1-6 years (group I), 7-14 years (group II), and 20-66 years old (group III). Assessments comprised LSTs, in vitro lymphoproliferative response, and interferon-gamma (IFN-gamma) productions induced by soluble leishmanial antigens (SLA). LST recorded an overall of 89.07% and 89.9% concordance with T cell proliferation and IFN-gamma production induced by SLA, respectively. Using in vitro tests as gold standards, LST was found more sensitive for screening individuals from group I (96% and 100%, considering T cell proliferation and IFN-gamma production results, respectively), than group II (91% and 97%) and group III (70% and 74%,). Conversely, LST was less specific in group I (84% and 77%) than group II (100% and 94%) and group III (100% for both in vitro tests). Our results suggested that the strength of LST resided in its higher sensitivity, to unravel asymptomatic injections and cell mediated immunity to L. infantum parasite in infants and its higher specificity for screening adult individuals. Negative LST in adults and positive LST in children < 5 years, the population at risk of developing visceral leishmaniasis, remain the weaknesses of LST and should be interpreted with caution.

Formulation development of retrocyclin 1 analog RC-101 as an anti-HIV vaginal microbicide product.

RC-101 is a synthetic microbicide analog of retrocyclin, which has shown in vitro activity against X4 and R5 HIV-1. In an effort to develop a safe and effective RC-101 vaginal microbicide product, we assessed safety in ex vivo macaque and human models and efficacy using in vitro and ex vivo models. A polyvinyl-alcohol vaginal film containing RC-101 (100 µg/film) was developed. Formulation assessment was conducted by evaluating disintegration, drug content, mechanical properties, and stability. Efficacy was evaluated by in vitro peripheral blood mononuclear cells (PBMC) assay and ex vivo human ectocervical tissue explant model. Ex vivo safety studies were conducted by exposing RC-101 to an excised monkey reproductive tract and excised human ectocervical tissue. RC-101 100 µg films were shown to be safe to human and monkey tissue and effective against HIV-1 in vitro and ex vivo in human ectocervical tissue. The 90% inhibitory concentration (IC90) for RC-101 films at 2,000 µg (IC90=57.5 µM) using an ex vivo model was 10-fold higher than the IC90 observed using an in vitro model (IC90=5.0 µM). RC-101 films were stable for 1 month at 25°C, with in vitro bioactivity maintained for up to 6 months. RC-101 was developed in a quick-dissolve film formulation that was shown to be safe in an ex vivo model and effective in in vitro and ex vivo models. RC-101 film formulations were shown to maintain bioactivity for a period of 6 months. Findings from the present study contribute to the development of a safe and effective topical microbicide product.

Immunoregulatory role for a public IgM idiotype in the induction of autoimmune diseases in Mycoplasma pneumoniae infection.

Mycoplasma pneumoniae (MP) infection is associated with the emergence of various autoimmune disorders and autoantibody production. The most common autoantibodies induced are of anti-I specificity and express cold agglutinin (CA) activity. However, the mechanisms by which the microbial infection triggers the appearance of these autoantibodies are still unknown. To investigate these mechanisms, we used BALB/c mice as experimental models. In this paper, we show that BALB/c mice polyclonal antisera to MP react with human CA IgMs, and reciprocally, that BALB/c mice polyclonal antisera to human IgM CA react with MP. However, antibodies directed against MP and against CA IgM triggered by both immunizations represent two separate sets of antibodies. This was also confirmed using monoclonal antibodies derived from the immunized mice. Among these MAb we selected a monoclonal antibody MAb1D3 which reveals a cross-reactive idiotope (CRI) shared by human CA and other MIgMs with various autoantibody activities (anti-MAG and anti-IF). The CRI defined by MAb1D3 is a recurrent interspecies idiotope that is expressed by post infectious IgM antibodies to MP. Hence, we present in this study new data showing that the concomitant appearance of CAs and anti-MP IgM antibodies during acute MP infection is the consequence of a common idiotypic regulation of antibodies to infectious and to self antigens.

Humic substances induce lateral root formation and expression of the early auxin-responsive IAA19 gene and DR5 synthetic element in Arabidopsis.

Humic substances (HS) have positive effects on plant physiology, but the molecular mechanisms underlying these events are only partially understood. HS exert auxin-like activity, but data supporting this hypothesis are under debate. To investigate the auxin-like activity of HS, we studied their biological effect on lateral root initiation in Arabidopsis thaliana. To this aim we characterised HS by means of DRIFT and (13)C CP/MAS NMR spectroscopy, and measured their endogenous content of IAA. We then utilised a combination of genetic and molecular approaches to unravel HS auxin activity in the initiation of lateral roots. The data obtained using specific inhibitors of auxin transport or action showed that HS induce lateral root formation mostly through their 'auxin activity'. These findings were further supported by the fact that HS used in this study activated the auxin synthetic reporter DR5::GUS and enhanced transcription of the early auxin responsive gene IAA19.

High lipolytic activity and dyslipidemia in a spontaneous hypertensive/NIH corpulent (SHR/N-cp) rat: a genetic model of obesity and type 2 diabetes mellitus.

In order to better understand the link between obesity and type 2 diabetes, lipolysis and its adrenergic regulation was investigated in various adipose depots of obese adult females SHR/N-cp rats. Serum insulin, glucose, free fatty acids (FFA), triglycerides (TG) and glycerol were measured. Adipocytes were isolated from subcutaneous (SC), parametrial (PM) and retroperitoneal (RP) fat pads. Total cell number and size, basal lipolysis or stimulated by norepinephrine (NE) and BRL 37344 were measured in each depot. Obese rats were hyperinsulinemic and hyperglycemic, suggesting high insulin resistance. They presented a marked dyslipidemia, attested by increased serum FFA and TG levels. High serum glycerol levels also suggest a strong lipolytic rate. Obese rats showed an excessive development of all fat pads although a more pronounced effect was observed in the SC one. The cellularity of this depot was increased 8 fold when compared to lean rats, but these fat cells were only 1.5 to 2-fold larger. SC adipocytes showed a marked increase in their basal lipolytic activity but a lack of change in responsiveness to NE or BRL 37344. The association between high basal lipolysis and increased cellularity yields to a marked adipose cell lipolytic rate, especially from the SC region. SHR/N-cp rats were characterized by a hyperplasic type of obesity with an excessive development of the SC depot. The dyslipidemia, attested by an altered serum lipid profile could be attributed to excessive lipolysis that contributes to increased FFA levels, and to early development of insulin resistance through a lipotoxicity effect.

Alta actividad lipolítica y dislipidemia en la rata SHR/N-cp: módulo genético de obesidad y diabetes mellitus tipo 2 / High lipolytic activity and dyslipidemia in a Spontaneous Hypertensive/NIH Corpulent (SHR/N-cp) rat: a genetic model of obesity and type 2 diabetes mellitus

In order to better understand the link between obesity and type 2 diabetes, lipolysisand its adrenergic regulation was investigated in various adipose depots of obeseadult females SHR/N-cp rats. Serum insulin, glucose, free fatty acids (FFA), triglycerides(TG) and glycerol were measured. Adipocytes were isolated from subcutaneous(SC), parametrial (PM) and retroperitoneal (RP) fat pads. Total cell numberand size, basal lipolysis or stimulated by norepinephrine (NE) and BRL 37344 weremeasured in each depot. Obese rats were hyperinsulinemic and hyperglycemic, suggestinghigh insulin resistance. They presented a marked dyslipidemia, attested byincreased serum FFA and TG levels. High serum glycerol levels also suggest a stronglipolytic rate. Obese rats showed an excessive development of all fat pads although amore pronounced effect was observed in the SC one. The cellularity of this depot wasincreased 8 fold when compared to lean rats, but these fat cells were only 1.5 to2-fold larger. SC adipocytes showed a marked increase in their basal lipolytic activitybut a lack of change in responsiveness to NE or BRL 37344. The associationbetween high basal lipolysis and increased cellularity yields to a marked adipose celllipolytic rate, especially from the SC region. SHR/N-cp rats were characterized bya hyperplasic type of obesity with an excessive development of the SC depot. Thedyslipidemia, attested by an altered serum lipid profile could be attributed to excessivelipolysis that contributes to increased FFA levels, and to early development ofinsulin resistance through a lipotoxicity effect(AU)