Myxoid epithelioid gastrointestinal stromal tumor harboring an unreported PDGFRA mutation: report of a case and review of the literature

Activating mutations of platelet-derived growth factor receptor α (PDGFRA) are detected in a significant proportion of gastrointestinal stromal tumors (GISTs), in addition to the more frequent mutation in c-kit. GISTs with PDGFRA mutations have been found to have several characteristic morphological features, sometimes allowing to discriminate them from GISTs with c-kit mutations. Among these, epithelioid morphology in tumor cells and tumor-infiltrating mast cells are powerful predictors of PDGFRA mutations. Although myxoid stroma by itself is not so much a reliable predictor of PDGFRA mutation, myxoid stroma in conjunction with epithelioid morphology in tumor cells is a powerful predictor of mutations in this gene. GISTs showing either weak or negative immunoreactivity for c-kit and epithelioid cells with myxoid stroma are called myxoid epithelioid GISTs, which typically show PDGFRA mutation. Herein, we presented a case of a 59-year-old woman with myxoid epithelioid GIST of the stomach. A unique finding in this case was eosinophil infiltration, probably more numerous than mast cells; mast cell infiltration is known to be usually found in myxoid epithelioid GIST. The existence of a similar mechanism in eosinophil and mast cell recruitment via tumor-producing stem cell factor is speculated. Mutational analyses revealed a PDGFRA exon 18 mutation: D842_H845del, D846N. Combined deletion and substitution mutation has been reported in rare instances, but to the best of our knowledge, D846N has not been documented.     

Preliminary phytochemical screening and antimicrobial evaluation of three medicinal plants used in Nigeria

Methanol extract of three Nigerian medicinal plants were screened for antimicrobial activity using modified Kirby-Bauer disc diffusion and agar dilution techniques to determine the diameters of zone of inhibition and minimum inhibitory concentrations (MIC) of the extracts respectively. The extract of each of the plants were tested against five clinical bacterial isolates comprising of two Gram-positive bacteria (Bacillus subtilis and Staphylococcus aureus) and three Gram-negative bacteria (Pseudomonas aeruginosa, Escherichia coli and Klebsiella pneumonia) organisms. All the extracts exhibited moderate to high level of antimicrobial activities against these microorganisms. Phytochemical screening of powdered plant material revealed the presence of some secondary metabolites such as alkaloids, saponins, tannins, anthraquinones and flavonoids. These Nigerian medicinal plants could be developed into cheap, safe and culturally acceptable standardized herbal products and may serve as a source of new molecules for broad-spectrum antimicrobial agents.     

The role of melatonin in parasite biology

Regarded as the circadian hormone in mammals, melatonin is a highly conserved molecule, present in nearly all species. In this review, we discuss the role of this indolamine and its precursors in the cell biology of parasites and the role of the molecule in the physiology of the host. In Plasmodium, melatonin can modulate intracellular concentrations of calcium and cAMP, which in turn can regulate kinase activity and cell cycle. In Trypanosoma infections, modulation of the immune system by melatonin is extremely important in controlling the parasite population. Melatonin also contributes to the inflammatory response to Toxoplasma gondii infection. Thus, there are a number of unique adaptations involving intricate connections between melatonin and the biology of the parasite-host relationship.     

Elevated levels of dehydroepiandrosterone as a potential mechanism of dendritic cell impairment during pregnancy

Background

This study aimed to test the hypothesis that immune dysfunction and the increased risk of spontaneous abortion in pregnant women with hyperandrogenia (HA) are caused by the reduced tolerogenic potential of dendritic cells (DCs) that results from elevated levels of dehydroepiandrosterone sulfate (DHEAS).

Methods

The phenotypic and functional properties of monocyte-derived DCs generated from blood monocytes from non-pregnant women, women with a normal pregnancy, or pregnant women with HA, as well as the in vitro effects of DHEAS on DCs in healthy pregnant women were investigated.

Results

In a normal pregnancy, DCs were shown to be immature and are characterized by a reduced number of CD83⁺ and CD25⁺ DCs, the ability to stimulate type 2 T cell responses and to induce T cell apoptosis. By contrast, DCs from pregnant women with HA had a mature phenotype, were able to stimulate both type 1 (IFN-γ) and type 2 (IL-4) T cell responses, and were characterized by lower B7-H1 expression and cytotoxic activity against CD8⁺ T cells. The addition of DHEAS to cultures of DCs from healthy pregnant women induced the maturation of DCs and increased their ability to activate type 1 T cell responses.

Conclusion

Our data demonstrated the reduction in the tolerogenic potential of DCs from pregnant women with HA, and revealed new mechanisms involved in the hormonal regulation of DCs mediated by DHEAS.     

BRAF mutation as a potential marker to identify the proximal colon serrated polyps with malignant potential

A large number of serrated polyps with malignant potential in the proximal colon were underestimated using currently available criteria mostly based on architectural and cytological features, contributing to proximal interval colorectal cancers. Recently, increasing evidences indicate that BRAF^(V600E) mutation is a specific molecular feature and driver of the serrated pathway, and proximal serrated polyps with BRAF^(V600E) mutation have a high risk of progression to malignancy. We proposed that immunohistochemical detection of BRAF^(V600E) using a BRAF^(V600E) mutation-specific antibody is a feasible technique for reproducibly identifying proximal serrated polyps with malignant potential in clinical practice, which may need more aggressive treatment and vigilant clinical monitoring.     

Evaluation of the Chemical Composition of Dacryodes Edulis and Raphia Hookeri Mann and Wendl Exudates used in Herbal Medicine in South Eastern Nigeria

The phytochemical contents and medicinal values of Dacroydes edulis and Raphia hookeri exudates were investigated. Phytochemical screening of the plant showed that they contain the presence of bioactive compounds comprising saponins (2.08–3.98mg 100g⁻¹), alkaloids (0.28–0.49 mg 100g⁻¹), tannins (0.47–0.72 mg 100g⁻¹), flavonoids (0.26–0.39 mg 100g⁻¹), and phenolic compounds (0.01–0.05 mg 100g⁻¹). The carbohydrates, lipids and protein content were 77.42–78.90%, 2.02–4.185% and 16.63–18.38% respectively. The exudates are a good source of water soluble vitamins; ascorbic acid (7.04–26.40 mg 100g⁻¹), niacin (3.12–4.00 mg 100g⁻¹), riboflavin (0.14–0.54 mg 100g⁻¹) and thiamine (0.15–0.22 mg 100g⁻¹),). Both plants exudates are good sources of minerals such as Ca, Mg, P, Fe, Zn, Cu and Mn while Cr and Co were trace. These results indicate that exudates can be potential sources of feedstock for the pharmaceutical industry.     

Prevalence of Chlamydia trachomatis infection among patients attending infertility and sexually transmitted diseases clinic (STD) in Kano,North Western Nigeria

Background

Chlamydia trachomatis is the most common bacterial sexually transmitted disease in the world with severe complications. The aim of this study was to determine the prevalence and possible risk factors of C. trachomatis in Kano. There is dearth of information on this subject in this locality.

Method

Urine samples, Endocervical swabs and Urethral swab were collected from consecutive patients attending the Infertility and STD clinics in Aminu Kano Teaching Hospital (AKTH) between June and December 2012, after administering a questionnaire by the attending physician and also obtaining an informed consent.Samples were analyzed using Diaspot Chlamydia kit, a rapid immunoassay test for the detection of genital chlamydial antigen in urinogenital samples.

Results

A total of 125 consecutive samples were collected, comprising 69 females and 56 males aged between 14 – 55 years. Twelve samples tested positive for C. trachomatis antigen giving a prevalence rate of 9.6%. The age group prevalence were as follows 25 – 29 yrs (17.1%), 20 – 24 (16.7%), 15 – 19 (12.5%), 30 – 34 (11.1%) and > 49 years (9.0%). Married patients were associated with higher infection rate than single (8.3%), and divorced patients (33.3%). A higher percentage of the patients (95.2%) were not aware of the existence of C. trachomatis infection and its complications. Previous STD exposure was associated with increased risk of Chlamydia infection.

Conclusion

C. trachomatis infection if unchecked will continue to pose a threat to reproductive life with its established complications. Since asymptomatic cases are common in the population regular screening should be encouraged for every adult especially before commencement of marital life.     

Etiology of invasive bacterial infections in immunocompetent children in Korea (1996-2005): a retrospective multicenter study

The purpose of this study was to identify the major etiological agents responsible for invasive bacterial infections in immunocompetent Korean children. We retrospectively surveyed invasive bacterial infections in immunocompetent children caused by eight major pediatric bacteria, namely Streptococcus pneumoniae, Haemophilus influenzae, Neisseria meningitidis, Staphylococcus aureus, Streptococcus agalactiae, Streptococcus pyogenes, Listeria monocytogenes, and Salmonella species that were diagnosed at 18 university hospitals from 1996 to 2005. A total of 768 cases were identified. S. agalactiae (48.1%) and S. aureus (37.2%) were the most common pathogens in infants younger than 3 months. S. agalactiae was a common cause of meningitis (73.0%), bacteremia without localization (34.0%), and arthritis (50%) in this age group. S. pneumoniae (45.3%) and H. influenzae (20.4%) were common in children aged 3 months to 5 yr. S. pneumoniae was a common cause of meningitis (41.6%), bacteremia without localization (40.0%), and bacteremic pneumonia (74.1%) in this age group. S. aureus (50.6%), Salmonella species (16.9%), and S. pneumoniae (16.3%) were common in older children. A significant decline in H. influenzae infections over the last 10 yr was noted. S. agalactiae, S. pneumoniae, and S. aureus are important pathogens responsible for invasive bacterial infections in Korean children.     

Utility of immunohistochemistry with an antibody against MYC at the initial diagnosis of follicular lymphoma,grade 3A,for predicting a more aggressive clinical course: a case report and review of the literature

Follicular lymphoma (FL) is the most common indolent lymphoma, and associated with the chromosomal translocation t(14;18)(q32;q21). While, FL harboring both BCL2 and MYC translocation at diagnosis is very rare. The evaluation of MYC expression in typical FL at presentation using southern blot, G-banded karyotyping or fluorescence in situ hybridization (FISH) analyses has been described so far. However, there are no reports about the use of immunohistochemistry (IHC) to evaluate MYC protein expression in FL at presentation. Here, we present a FL patient who transformed to a B-cell lymphoma, unclassifiable, with features intermediate between diffuse large B-cell lymphoma and Burkitt’s lymphoma, accompanied by concurrent BCL2, BCL6, and MYC translocations; i.e., triple-hit lymphoma. Paraffin-embedded tissue section-FISH analysis demonstrated that the FL was negative for MYC, but MYC protein expression was subsequently detected in the lymph node specimen obtained at the initial diagnosis using IHC. This case revealed aggressive clinical course and central nervous system involvement. In the literature concerning MYC positive FL five out of 8 patients were dead within 24 months. The detection of MYC protein expression in FL using IHC might be useful to predict more aggressive clinical course.     

Meis1 is an essential and rate-limiting regulator of MLL leukemia stem cell potential

Oncogenic mutations of the MLL histone methyltransferase confer an unusual ability to transform non-self-renewing myeloid progenitors into leukemia stem cells (LSCs) by mechanisms that remain poorly defined. Misregulation of Hox genes is likely to be critical for LSC induction and maintenance but alone it does not recapitulate the phenotype and biology of MLL leukemias, which are clinically heterogeneous--presumably reflecting differences in LSC biology and/or frequency. TALE (three-amino-acid loop extension) class homeodomain proteins of the Pbx and Meis families are also misexpressed in this context, and we thus employed knockout, knockdown, and dominant-negative genetic techniques to investigate the requirements and contributions of these factors in MLL oncoprotein-induced acute myeloid leukemia. Our studies show that induction and maintenance of MLL transformation requires Meis1 and is codependent on the redundant contributions of Pbx2 and Pbx3. Meis1 in particular serves a major role in establishing LSC potential, and determines LSC frequency by quantitatively regulating the extent of self-renewal, differentiation arrest, and cycling, as well as the rate of in vivo LSC generation from myeloid progenitors. Thus, TALE proteins are critical downstream effectors within an essential homeoprotein network that serves a rate-limiting regulatory role in MLL leukemogenesis.     

A bile based study of Clonorchis sinensis infections in patients with biliary tract diseases in Ulsan, Korea

Stool examination is believed to be the most reliable method for detecting Clonorchis sinensis (CS) eggs. However, it has limited value for diagnosing clonorchiasis when the biliary tract is obstructed or when there is a light infection. We evaluated the infection states of CS in patients with biliary tract diseases using a bile sample. From January 2001 to August 2003, 238 patients who had undergone endoscopic biliary drainage were prospectively included in the study. The patients' bile samples were obtained directly from the nasobiliary drainage tube and then analyzed to detect CS eggs. The overall CS egg positive rate was 28.2% (35.4% in males, 19.4% in females). The egg positive rate was similar in all age groups examined: 26.7% in 30-39 years, 25.0% in 40-49 years, 24.4% in 50-59 years, 30.2% in 60-69 years, 35.3% in 70-79 years, and 25.0% in 80 years of age and over. There were no significant differences in the egg positive rate between the disease groups: 32.6% in bile duct cancer, 38.5% in gallbladder cancer, and 26.4% in gallstone diseases. Our results show that the CS infection rate was very high, regardless of the age, gender, and type of diseases of the patients. Although the study population was limited to patients with biliary tract diseases, it is assumed that clonorchiasis is still an endemic disease in Ulsan, Korea.     

Nasal carriage of multi-drug resistant Staphylococcus aureus in healthy inhabitants of Amassoma in Niger delta region of Nigeria

Background

Nasal Staphylococcus aureus is a major source of community and hospital associated staphylococcal infections. This study determined the prevalence of nasal S. aureus isolates and investigated their antimicrobial resistance profile in healthy volunteers.

Methods

Nasal specimens of healthy volunteers in Amassoma were cultured and screened for S. aureus using standard microbiological protocols and their antibiotic profile susceptibility was investigated using disc diffusion and agar dilution techniques.

Results

A total of 40 (33.3%) S. aureus isolates were obtained from 120 nares specimens screened. Twenty three (57.5%) and 17 (42.5%) of the isolates were from university students and villagers respectively. The isolates showed an overall 75% resistance to ampicillin, 52.5% to doxycycline, 47.5% to chloramphenicol, 35% to erythromycin and 32.5% to cotrimoxazole; with 27.5% methicillin resistant. No isolate was resistant to gentamicin while few isolates were resistant to cefuroxime (2.5%), augmentin (5.0%), ciprofloxacin (10.0%), ofloxacin (10.0%) and vancomycin (7.5%). Twenty one (52.5%) of all the isolates were multi-drug resistant, ten (47.6%) of which were methicillin resistant Staphylococcus aureus (MRSA) and only 3 (7.5%) were fully susceptible to all the tested antimicrobial drugs.

Conclusions

The observation calls for strategies to prevent their spread to more vulnerable populations where the consequences of their infections can be severe.     

Wild isolates of Plasmodium falciparum malaria show decreased sensitivity to in vitro inhibition of parasite growth mediated by autologous host antibodies

Antigenic diversity in field populations of Plasmodium falciparum parasites may delay the acquisition of protective immunity to malaria, the development of which may thus require repeated exposure to infection over a prolonged period of time. In this study we show that P. falciparum parasites may vary in their sensitivity to antibody-mediated invasion/growth inhibition in vitro. Wild isolates of P. falciparum from children living in an endemic area of Burkina Faso were tested for their sensitivity to the growth inhibitory effects of antibodies originating from the same (autologous) and from other donors (heterologous). A significantly lower invasion inhibition activity was obtained when the isolates and antibodies were tested in autologous compared with heterologous combinations. The lower sensitivity to growth inhibition by autologous antibodies may be due to immune pressure in vivo, selecting from a heterogeneous parasite population those with a low expression of the antigens recognized by the host's antibodies. Alternatively, the parasites cultured from each child might represent expanding parasite populations, mainly constituting strains not earlier seen by the immune system of that specific host. The results reinforce the concern about Plasmodium antigenic diversity as a major obstacle towards the development of an effective malaria vaccine.     

Whole-exome sequencing,without prior linkage,identifies a mutation in LAMB3 as a cause of dominant hypoplastic amelogenesis imperfecta

The conventional approach to identifying the defective gene in a family with an inherited disease is to find the disease locus through family studies. However, the rapid development and decreasing cost of next generation sequencing facilitates a more direct approach. Here, we report the identification of a frameshift mutation in LAMB3 as a cause of dominant hypoplastic amelogenesis imperfecta (AI). Whole-exome sequencing of three affected family members and subsequent filtering of shared variants, without prior genetic linkage, sufficed to identify the pathogenic variant. Simultaneous analysis of multiple family members confirms segregation, enhancing the power to filter the genetic variation found and leading to rapid identification of the pathogenic variant. LAMB3 encodes a subunit of Laminin-5, one of a family of basement membrane proteins with essential functions in cell growth, movement and adhesion. Homozygous LAMB3 mutations cause junctional epidermolysis bullosa (JEB) and enamel defects are seen in JEB cases. However, to our knowledge, this is the first report of dominant AI due to a LAMB3 mutation in the absence of JEB.     

Identification of the Plants Use as Natural Herbal Shampoo in Manipur

Background

A field survey was conducted in the year, 2011 – 12 in Imphal valley of Manipur, on the use of herbs as ingredient sources for the preparation of traditional natural herbal shampoo referred to as ‘Chinghi'', by Meitei community.

Materials & methods

Methodological field survey and personal interview of local people aged between 30–70 years of both sexes using standard questionnaires were carried out to collect information on the plants use in the herbal shampoo preparation.

Results

The survey revealed the therapeutic application of 35 plant species representing 28 genera and 18 families available in the Imphal valley. Tree species contributed immensely, yielding 38%, while herbs 32%, shrubs 27%, and climbing shrubs 3%, respectively being the record of the total number of plants used as ingredient in herbal shampoo preparation. These natural shampoos are used for a wide range of common hair care like anti-ageing of the hair, blackness, shininess and smoothness of the hair. It is prepared from young leaves and tender stalk of shoot of trees or shrubs, or whole plant of the herbs and fresh fruits boiled with local sticky rice water locally called ‘Chinghi’. Fermented lime peel is also used as a herbal shampoo.

Conclusions

The study shows details of their scientific, common, and local names, including their family, parts used, habit of the plants, and the benefit to the hair health as a whole.     

Translocation breakpoint at 7q31 associated with tics: further evidence for IMMP2L as a candidate gene for Tourette syndrome

Gilles de la Tourette syndrome is a complex neuropsychiatric disorder with a strong genetic basis. We identified a male patient with Tourette syndrome-like tics and an apparently balanced de novo translocation [46,XY,t(2;7)(p24.2;q31)]. Further analysis using array comparative genomic hybridisation (CGH) revealed a cryptic deletion at 7q31.1-7q31.2. Breakpoints disrupting this region have been reported in one isolated and one familial case of Tourette syndrome. In our case, IMMP2L, a gene coding for a human homologue of the yeast inner mitochondrial membrane peptidase subunit 2, was disrupted by the breakpoint on 7q31.1, with deletion of exons 1-3 of the gene. The IMMP2L gene has previously been proposed as a candidate gene for Tourette syndrome, and our case provides further evidence of its possible role in the pathogenesis. The deleted region (7q31.1-7q31.2) of 7.2 Mb of genomic DNA also encompasses numerous genes, including FOXP2, associated with verbal dyspraxia, and the CFTR gene.