Testicular microlithiasis: The importance of self‐examination

Aim: To explore the issue of appropriate management of testicular microlithiasis. We report the third ever case of tumour arising from a testis previously known to have microlithiasis in childhood and review the literature to provide an evidence‐based approach to management of testicular microlithiasis. Methods: Case report and review of previous literature. Results and Conclusions: Although there is a strong association between testicular microlithiasis and testicular malignancy at diagnosis, there are only three reported cases of subsequent tumour development in childhood. Testicular microlithiasis is an increasingly recognised entity. There is insufficient evidence in the current literature to support any regime of clinical surveillance. Self‐examination is the most important factor in the early detection of testicular malignancy.     

尼莫地平对烫伤大鼠脑内ZO-1 mRNA及血脑屏障通透性的影响

目的:观察尼莫地平对严重烫伤大鼠脑内紧密连接相关蛋白ZO-1mRNA及血脑屏障通透性的影响。方法:实验于2005-04/10在南昌大学基础医学院应用解剖实验室完成。①取健康SD大鼠132只分为正常对照组12只、烫伤组60只,尼莫地平组60只,后两组又设烫伤后1,3,6,12,24h5个时间点,每个时间点12只,其中6只用于脑组织伊文思蓝含量的测定,剩余6只用于ZO-1mRNA的检测。②烫伤组和尼莫地平组大鼠100℃开水烫伤15s,造成背部30%体表总面积Ⅲ度烧伤。尼莫地平组大鼠于烫伤后即刻腹腔注射尼莫地平(0.5mg/kg),其他2组不给药。③各组大鼠于相应的时间点麻醉并处死动物取材,应用化学定量方法检测大鼠脑组织内伊文思蓝含量,运用RT-PCR方法检测大鼠脑内ZO-1mRNA的表达变化。结果:经补充后132只大鼠进入结果分析。①大脑伊文思蓝含量:正常对照组为(10.18±1.79)μg/g,烫伤组伤后1,3,6,12h均高于正常对照组(P<0.05),其高峰在烫伤后6h,为(20.00±0.58)μg/g;尼莫地平组伤后1,6,12h均低于烫伤组(P<0.01),烫伤后6h时为(16.74±0.78)μg/g。②小脑伊文思蓝含量:正常对照组为(12.90±1.32)μg/g,烫伤组伤后1,3,6,12h均高于正常对照组(P<0.05),其高峰在烫伤后6h,为(31.3±1.47)μg/g;尼莫地平组伤后1,3,6,12h均低于烫伤组(P<0.01),烫伤后6h时为(21.05±2.36)μg/g。③脑组织ZO-1mRNA的表达:烫伤组烫伤后3,6,12,24h分别为正常对照组的(0.1235±0.0158),(0.1890±0.0531),(0.2014±0.0412),(0.1555±0.0163)倍(P<0.01);尼莫地平组较烫伤组高,以烫伤后3,6h最为明显,分别为烫伤组的3.96及1.81倍(P<0.01).结论:①严重烫伤后血脑屏障通透性增高,脑内ZO-1mRNA表达下降。②烫伤后早期应用尼莫地平能防止脑内ZO-1mRNA表达下降,并能起到保护血脑屏障功能的作用。     

Prevalence of cytomegalovirus antibody in hemophiliacs and homosexuals infected with human immunodeficiency virus type 1

We determined the prevalence of antibody to cytomegalovirus (CMV) in the sera of non-homosexual hemophilia patients and homosexual men infected with the human immunodeficiency virus type 1 (HIV-1). CMV antibody testing by latex agglutination revealed 33 of 58 HIV-1 infected hemophiliacs (57%) were antibody-positive compared with 54 of 54 HIV-1 infected asymptomatic non-hemophiliac homosexuals (100%) (p less than .001). Nine of 15 hemophiliacs (60%) with symptomatic HIV-1 infection were CMV antibody-positive. We also tested 22 HIV-1 antibody-negative hemophiliacs who had received non-heat treated factor concentrates. 14 of these 22 (64%) were CMV antibody-positive compared with 57% of HIV-1 antibody-positive hemophiliacs. We conclude 1) there is little correlation between transmission of HIV-1 and CMV by factor concentrates, 2) the presence of CMV antibody does not appear to be associated with clinical stage of HIV-1 infection in hemophiliacs, and 3) there may be a significant number of CMV antibody-negative hemophiliacs with HIV-1 infection at risk for primary infection and subsequent disease if CMV seronegative blood products are not provided for future transfusions.     

The dystrophin gene and cognitive function in the general population

The aim of our study is to investigate whether single-nucleotide dystrophin gene (DMD) variants associate with variability in cognitive functions in healthy populations. The study included 1240 participants from the Erasmus Rucphen family (ERF) study and 1464 individuals from the Rotterdam Study (RS). The participants whose exomes were sequenced and who were assessed for various cognitive traits were included in the analysis. To determine the association between DMD variants and cognitive ability, linear (mixed) modeling with adjustment for age, sex and education was used. Moreover, Sequence Kernel Association Test (SKAT) was used to test the overall association of the rare genetic variants present in the DMD with cognitive traits. Although no DMD variant surpassed the prespecified significance threshold (P<1 × 10⁻⁴), rs147546024:A>G showed strong association (β=1.786, P-value=2.56 × 10⁻⁴) with block-design test in the ERF study, while another variant rs1800273:G>A showed suggestive association (β=−0.465, P-value=0.002) with Mini-Mental State Examination test in the RS. Both variants are highly conserved, although rs147546024:A>G is an intronic variant, whereas rs1800273:G>A is a missense variant in the DMD which has a predicted damaging effect on the protein. Further gene-based analysis of DMD revealed suggestive association (P-values=0.087 and 0.074) with general cognitive ability in both cohorts. In conclusion, both single variant and gene-based analyses suggest the existence of variants in the DMD which may affect cognitive functioning in the general populations.     

Evaluation of the Xpert vanA/vanB Assay Using Enriched Inoculated Broths for Direct Detection of vanB Vancomycin-Resistant Enterococci

Rapid and accurate detection of VRE (vancomycin-resistant enterococci) is required for adequate antimicrobial treatment and infection prevention measures. Previous studies using PCR for the detection of VRE, including Cepheid''s Xpert vanA/vanB assay, reported accurate detection of vanA VRE; however, many false-positive results were found for vanB VRE. This is mainly due to nonenterococcal vanB genes, which can be found in the gut flora. Our goal was to optimize the rapid and accurate detection of vanB VRE and to improve the positive predictive value (PPV) by limiting false-positive results. We evaluated the use of the Xpert vanA/vanB assay on rectal swabs and on enriched inoculated broths for the detection of vanB VRE. By adjusting the cycle threshold (C_T) cutoff value to ≤25 for positivity by PCR on enriched broths, the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were 96.9%, 100%, 100%, and 99.5% for vanB VRE, respectively. As shown in this study, C_T values of ≤25 acquired from enriched broths can be considered true positive. For broths with C_T values between 25 and 30, we recommend confirming the results by culture. C_T values of >30 appeared to be true negative. In conclusion, this study shows that the Cepheid''s Xpert vanA/vanB assay performed on enriched inoculated broths with an adjusted cutoff C_T value is a useful and rapid tool for the detection of vanB VRE.     

CHEMO- AND RADIOSENSITIVITY TESTING IN A PATIENT WITH ATAXIA TELANGIECTASIA AND HODGKIN DISEASE

Treatment of Hodgkin disease (HD) in ataxia telangiectasia (AT) patients is hampered by hypersensitivity to radiation and chemotherapy. Most patients die, due to toxicity or, rarely, to progressive disease. The authors report on a 9-year-old girl with stage IIA HD and AT. She was treated with a tailored combined modality approach. No unacceptable toxicity was found, but the girl died of a relapse outside their radiation field. In comparison with fibroblasts of non-AT patients, the fibroblasts of the patient were 3 times as sensitive for radiotherapy but just 1.2 times as sensitive for doxorubicin. A good correlation was shown between in vitro radio- and chemosensitivity testing and the observed clinical toxicity. The authors suggest, therefore, treating AT patients as much as possible according to standard protocols by adjusting the radiotherapy delivery and the chemotherapy regimen to individual doses derived from in vitro radio- and chemosensitivity testing.     

Interaction of platelet plasma membranes with thrombin-activated platelets

This study described the binding of platelet plasma membranes to either control or thrombin-activated platelets. Glycoproteins in plasma membranes isolated from human platelets were labeled by oxidation with periodate followed by reduction with [3H]NaBH4. Labeled membranes were incubated with either control or thrombin-activated platelets. The amount of membranes bound was measured by separating platelets with bound membranes from solution by rapid centrifugation through 27% sucrose and determining the amount of radioactivity associated with platelets. Five- to sevenfold more membranes bound to thrombin- activated platelets than to control platelets. This enhanced binding of labeled membranes was completely inhibited by an excess of unlabeled platelet membranes. Human erythrocyte membranes had little affinity for either washed or thrombin-activated platelets and therefore did not compete for platelet-membrane binding. Binding of platelet membranes to thrombin-treated platelets was inhibited by prior incubation of the platelets with PGI2 suggesting that the enhanced binding of membranes was to activated platelets. This study demonstrates that the purified platelet membranes have functional sites that can mediate membrane binding to platelets and that quantitation of membrane binding appears to reflect the increased aggregation capability of activated platelets.