A CASE OF ISCHEMIC COLITIS ASSOCIATED WITH PHEOCHROMOCYTOMA

A 40-year-old woman was admitted because of abdominal pain and diarrhea. She sometimes experienced paroxysmal hypertension, sweating, headache, and palpitation. Sigmoidoscopic findings showed well-demarcated diffuse mucosal edema, hyperemia, and easy touch bleeding from distal descending colon up to the splenic flexure area. Barium x-ray showed loss of haustral marking, thumb printing appearance, and diffuse luminal stenosis in the transverse, descending, and sigmoid colon. On the abdominal computed tomogram, a 3.8-cm sized well-enhanced right adrenal mass was incidentally found. Twenty-four hour urinary excretion of vanillyl mandelic acid, norepinephrine, and normetanephrine were increased. Iodine¹³¹ metaiodobenzylguanidine scan showed hot uptake on the right adrenal gland compatible with pheochromocytoma. Exploratory laparotomy was done under the impression of ischemic colitis associated with pheochromocytoma. Adrenalectomy and resection of the stenotic left colon were performed. After surgery, pain subsided, blood pressure fell gradually, blood sugar and catecholamine level became normal, and bowel habit returned to normal.     

Vein transposition in the forearm for autogenous hemodialysis access

Purpose: We describe a technique of superficial venous transposition in the forearm used for the formation of an arteriovenous fistula for hemodialysis access. These modifications of the single-incision radiocephalic fistula are designed to increase options for arteriovenous fistulas by using veins and arteries that are suitable for use but are not in immediate proximity. Methods: Arteries and veins suitable for a primary arteriovenous fistula were identified and mapped using duplex ultrasound in 89 patients. Separate incisions were used in the majority of cases, and the selected forearm vein was mobilized, angiodilated, and transposed into a subcutaneous tunnel on the volar aspect of the forearm. Before initiation of hemodialysis, duplex ultrasound scanning was performed, and the location that was most suitable for cannulation was identified. Repeat scans were performed at 3-month intervals for analysis of patency. Results: Superficial venous transpositions were performed using a single incision in 13 instances in which the vein was in immediate proximity to the radial artery (type A). Dorsal-to-volar forearm transposition (type B) was performed in 30 veins with anastomoses to the radial (n = 26), ulnar (n = 2), or brachial (n = 2) arteries. Volar-to-volar forearm transposition (type C) was performed in the remaining 46 veins, with anastomoses to the radial (n = 42), ulnar (n = 2), or brachial arteries (n = 2). Successful hemodialysis was accomplished in 81 of 89 patients (91%). The primary cumulative patency rate was 84% at 1 year and 69% at 2 years. The mean duration of follow-up was 14.3 months. Conclusions: The use of superficial venous transposition for the formation of autogenous hemoaccess was associated with ease of cannulation by dialysis personnel, high maturation rates, reduced early failure rates, and enhanced patency rates. We recommend the use of these technical modifications to increase the use of autogenous fistulas in the forearm. (J Vasc Surg 1997;26:981-8.)     

血管内皮生长因子基因在人胚胎胰岛干细胞中的表达

目的 构建含血管内皮生长因子(VEGF)基因的慢病毒载体,转染人胚胎来源的胰岛干细胞(hPSC),探讨VEGF在胰岛干细胞中的体外表达水平及其影响因素.方法 将VEGF基因克隆入慢病毒载体,利用293T细胞包装出病毒,按拷贝数分别为2、5、10转染胰岛干细胞,测定不同转染组VEGF的分泌水平.结果 含VEGF的病毒上清可以在体外培养条件下成功转染胰岛干细胞,经潮霉素筛选3 d后,对照组及拷贝数分别为2、5、10的转染组每1×106个细胞每小时VEGF的分泌量分别为(60.3±13.4)、(1622.0±302.0)、(2270.0±340.0)、(3090.0±465.0)ng/L.对照组与转染组间(P＜0.05)以及各转染组之间差异有统计学意义(P＜0.05).结论 含VEGF的慢病毒载体可以成功转染人胚胎来源的胰岛干细胞,使其持续高表达VEGF,通过改变转染拷贝数可在一定水平上控制VEGF的分泌水平.

Abstract：

Objective To transfect vascular endothelial growth factor (VEGF) gene into human pancreatic stem cells (hPSC) by lentiviral vectors. Methods VEGF gene was sub-cloned into the lentiviral transfer vectors which also encoded hygromycin gene. The recombinant lentiviral vectors were packaged by 293T cells through three plasmids transient co-transfection method using standard lipofectamine reagent.The viral titers were tested by transfecting 293T cells. hPSC were transducted under different multiplicity of infection (MOI). VEGF secretion level was tested by enzyme linked immunosorbent assay (ELISA). Results Lentiviral vectors encoding VEGF and hygromycin resistance gene were constructed. Using lentiviral vectors encoding VEGF, we successfully transfected hPSC, and the transfected hPSC expressed VEGF continuously. On the day 3 after screening by hygromycin, the content of VEGF secreted by 1 × 106 cells per h was (60. 3 ± 13.4), ( 1622.0 ±302. 0), (2270. 0 ±340. 0), (3090. 0 ±465. 0) ng/L respectively when MOI was 0, 2, 5 and 10. The results indicated that VEGF expression was influenced by MOI ( P ＜ 0. 05 ).Conclusion Lentiviral vectors encoding VEGF and hygromycin resistance gene were constructed and could be used to transfect human pancreatic stem cells successfully.     

Differences of chemoresistance assay between invasive micropapillary/low-grade serous ovarian carcinoma and high-grade serous ovarian carcinoma

The objective of this study was to evaluate the pattern of chemoresistance in invasive micropapillary/low-grade serous ovarian carcinoma (invasive MPSC/LGSC) and high-grade serous ovarian carcinoma (HGSC) according to extreme drug resistance (EDR) assay testing. Surgical specimens of 44 recurrent ovarian cancer patients harvested at the time of cytoreductive surgery between August 1999 and February 2004 were identified retrospectively from the tumor registry database. Thirteen patients (29.5%) had recurrent invasive MPSC/LGSC and 31 (70.5%) patients had recurrent HGSC. Eight drugs were evaluated; EDR assay results were compared between LGSC and HGSC groups using Fisher exact tests and exact logistic regression models. Compared to HGSC, invasive MPSC/LGSC were more likely to manifest EDR to the drugs paclitaxel (69% vs 14%, P < 0.001), carboplatin (50% vs 17%, P= 0.05), cyclophosphamide (40% vs 23%, P= 0.41), gemcitabine (36% vs 19%, P= 0.40), and cisplatin (33% vs 28%, P= 0.72) and less likely to be resistant to etoposide (0% vs 44%, P= 0.007), doxorubicin (8% vs 45%, P= 0.03), and topotecan (8% vs 21%, P= 0.65). Exact logistic regression estimates revealed that invasive MPSC/LGSC patients had significantly increased probabilities of paclitaxel resistance odds ratio (OR) = 12.5 (95% CI: 2.3-100.0), P= 0.001 and carboplatin resistance OR = 4.8 (95% CI: 0.9-25.0), P= 0.07, while the HGSC cases were more likely to be resistant to etoposide OR = 12.1 (95% CI: 1.7-infinity), P=0.009 and doxorubicin OR = 8.6 (95% CI: 1.0-413.7), P= 0.05. In this retrospective analysis, patients with recurrent invasive MPSC/LGSC were more likely to manifest EDR to standard chemotherapy agents (platinum and paclitaxel). These observations may help to guide chemotherapeutic decision making in these patients if confirmed in a large-scale study.     

Screening of entomopathogenic Deuteromycetes for activities on targets involved in degenerative diseases of the central nervous system

A selection of 32 fungal strains, belonging to 8 genera of entomopathogenic Deuteromycetes collected in various provinces of China, were screened for activities on targets involved in degenerative diseases of the central nervous system. The strains were grown under various fermentation conditions, and a total of 256 different extracts were obtained. The bioassays included functional screens for NMDA antagonistic activity in stably transfected fibroblasts, for neuritogenic activities in PC-12 cells, and tests for MAO inhibitory and radical scavenging properties. Several extracts with promising activities were identified. Some Paecilomyces extracts induced pronounced axonal-like outgrowths in PC-12 cells. In Paecilomyces militaris RCEF 0095, the neuritogenic activity could be linked to yellow pigments. Three Beauveria and Paecilomyces strains showed radical scavenging properties, which could be localized in the extract by a bioautographic assay on TLC. An extract obtained from the mycelium of Paecilomyces tenuipes RCEF 0275 showed moderate MAO inhibitory activity, whereas extracts of Sporothrix chondracris RCEF 0187 antagonized NMDA receptor mediated cell toxicity.     

信号分子抑制剂对乳腺癌细胞抗失巢凋亡特性的影响

为研究肿瘤细胞抗失巢凋亡(anoikis)的分子机理并探讨其干预措施，以粘附非依赖生长的3种乳腺癌细胞系Bcap-37、MCF-7以及MDA-MB-23l为研究对象，利用一些与细胞存活相关的信号转导分子的特异性抑制剂，包括HER2抑制剂AG825；PDGF受体抑制剂AG17；p38MAPK抑制剂SB203580；P13-K抑制剂LY294002；MAPKK(MEK)抑制剂PD98059以及广谱蛋白酪氨酸激酶抑制剂genistein，通过DNA ladder分析，软琼脂集落形成实验以及流式细胞术分析等方法检测了这些抑制剂对3种乳腺癌细胞抗失巢凋亡特性的影响。研究结果显示，几种抑制剂在短时间(24h)内对悬浮生长的乳腺癌细胞无明显的诱导凋亡作用，表现为琼脂糖凝胶电泳未检测到DNA ladder，流式细胞术检测无凋亡峰出现。而在软琼脂集落形成实验中，Genistein可完全抑制3种乳腺癌细胞在软琼脂中形成集落。AG17对3种细胞在软琼脂中形成集落的能力同样具有明显的抑制作用，PD98059则可部分抑制MDA-MB-231在软琼脂中的生长。     

The promise of methylation on beads for cancer detection and treatment

Despite numerous technical hurdles, the realization of true personalized medicine is becoming a progressive reality for the future of patient care. With the development of new techniques and tools to measure the genetic signature of tumors, biomarkers are increasingly being used to detect occult tumors, determine the choice of treatment and predict outcomes. Methylation of CpG islands at the promoter region of genes is a particularly exciting biomarker as it is cancer-specific. Older methods to detect methylation were cumbersome, operator-dependent and required large amounts of DNA. However, a newer technique called methylation on beads has resulted in a more uniform, streamlined and efficient assay. Furthermore, methylation on beads permits the extraction and processing of miniscule amounts of methylated tumor DNA in the peripheral blood. Such a technique may aid in the clinical detection and treatment of cancers in the future.     

Patterns of Mood and Personality Factors and Associations With STI/HIV-Related Drug and Sex Risk Among African American Male Inmates

Background: Research on the association between antisocial personality disorder (ASPD) with comorbid mental disorders and sexually transmitted infection (STI)/HIV risk among inmates is scant despite the high prevalence of psychopathology and of STI/HIV in this population. Methods: We used baseline data from Project DISRUPT, a cohort study conducted among incarcerated African American men (n = 207), to measure associations between ASPD and STI/HIV risk. We also conducted latent class analyses (LCAs) to identify subgroups defined by ASPD with comorbid stress, depression, and borderline personality disorder symptoms and measured associations between latent class membership and STI/HIV risk. Results: Approximately 15% had ASPD and 39% reported depression. Controlling for sociodemographics, stress, and depression, ASPD was independently associated with illicit [AOR = 3.23, 95% confidence interval (CI): 1.18–8.87] and injection drug use (AOR: 5.49, 95% CI: 1.23–24.42) but not with sexual risk. LCAs suggested that those at high risk of ASPD were likely to experience co-morbid mental disorders. ASPD comorbid with these disorders was linked to drug and sex risk. Conclusions: STI/HIV prevention for inmates should incorporate diagnosis and treatment of ASPD and comorbid disorders, and interventions to address ASPD-related factors (e.g., impulsivity) that drive STI/HIV risk.