Interaction of arylsulfatases A and B with maspin: A possible explanation for dysregulation of tumor cell metabolism and invasive potential of colorectal cancer.

BACKGROUND: Although it has been shown that arylsulfatases are lost in colorectal cancer (CRC) cell lines, their exact role in the carcinogenesis and behavior of this cancer was not elucidated. No data about the correlation between serum and immunohistochemical (IHC) level of arylsulfatases (ARSA, ARSB) in patients with CRC were published yet. AIM: To evaluate the possible prognostic value of ARSA and/or ARSB in CRC, at circulating and protein levels. METHODS: The present study included 45 consecutive patients who were prospectively diagnosed with CRC. For IHC stains (protein expression) ARSA, ARSB and maspin expression were quantified. For these markers, cytoplasmic expression was taken into account. For gene expression study, circulating mRNA was isolated from all patients, before surgery. A group of 45 healthy patients without inflammatory or tumor pathologies was used as control group. Reverse transcription and Taqman Gene Expression Array were used for ARSB gene expression. RESULTS: The preoperative circulating RNA level of the ARSB gene was significantly decreased in patients with CRC (RQ < 1), compared with the control group (RQ > 1). A more significant decrease (RQ < 0.5) occurred in ulcero-infiltrative maspin-positive adenocarcinomas, with a higher degree of tumor budding, diagnosed in locally advanced stages (pT3/4). ARSA/maspin immunopositivity indicated a higher risk for lymph node metastasis, while triple positivity for maspin/ARSA/ARSB and ARSB gene expression level < 0.5 were indicators of CRC aggressive behavior, independent of lymph node status. CONCLUSION: The significant independent negative prognostic factors of CRC are the ulcero-infiltrative aspect, high budding degree, triple positivity for maspin, ARSA and ARSB, and low ARSB gene expression.

Fatal endocarditis with methicilin-sensible Staphylococcus aureus and major complications: rhabdomyolysis, pericarditis, and intracerebral hematoma: A case report and review of the literature.

BACKGROUND: Over the last decades Staphylococcus aureus (SA) has become the dominant etiology of native valve infective endocarditis, with the community-acquired methicillin-sensible Staphylococcus aureus (CA-MSSA) strains being the prevailing type. CASE: We report here a case of extremely severe CA-MSSA aortic valve acute endocarditis associated with persistent Staphylococcus aureus bacteremia (SAB) in a previously healthy man and include a literature review.The patient developed severe and rare complications (purpura, purulent pericarditis, intracerebral hematoma, and rhabdomyolysis) through systemic embolism; they required drainage of pericardial empyema and cerebral hematoma, the latter eventually caused a fatal outcome. The strains recovered from sequential blood culture sets and pericardial fluid were MSSA negative for genes encoding for staphylococcal toxic shock syndrome toxin (TSST)-1 and Panton-Valentine leukocidin. C, G, and I enterotoxin genes were detected. CONCLUSIONS: This case with unusually severe evolution underlines the limited ability of vancomycin to control some MSSA infections, possibly due to potential involvement of SA virulence factors, hence the importance of clinical vigilance for community SAB cases.

Correlations between anthropometric and serologic elements of metabolic syndrome and histopathologic features of nonalcoholic fatty liver disease.

AIM OF THE STUDY: Studying the correlation between elements of metabolic syndrome and histological changes of the liver in nonalcoholic fatty liver disease. PATIENTS AND METHODS: Thirty-nine patients with nonalcoholic fatty liver disease were included in our study. Inclusion criteria were: presence of liver steatosis on ultrasound in patients with waist circumference over 94 cm in men and over 80 cm in women and with serologic elements of metabolic syndrome. Exclusion criteria were: chronic viral hepatitis, autoimmune hepatitis, Wilson disease, hemochromatosis, regular alcohol consumption. Body mass index, waist circumference, fasting plasma glucose, serum triglyceride and cholesterol levels and serum ALT were determined. On liver biopsy specimens, performed in each patient, the NASH score, representing the sum of fibrosis, steatosis, lobular inflammation and ballooning, was calculated. RESULTS: Necroinflammation was mild in 15 patients, medium in 19 patients and severe in five patients. Mild fibrosis was present in four cases, medium in 14 cases, severe in six, and two patients were diagnosed with cirrhosis. We found statistically significant correlation between waist circumference and the grade of histological activity, the presence of diabetes and both fibrosis grade and histological activity, and the serum ALT and histological activity. CONCLUSIONS: Noninvasive assessment of the severity of hepatic histological changes in nonalcoholic fatty liver disease could be made by anthropometric parameters or by serologic components of metabolic syndrome, but it is not an accurate method to identify patients with high-risk for disease progression. These noninvasive parameters cannot replace liver biopsy.