Hydatid cysts of the brain stem. Two cases

Cerebral hydatid cysts represent 2-3% of all intracranial masses in endemic countries. Its incidence in posterior fossa is very rare. We report two cases of brainstem location. Clinically, the lesion exhibited signs of brainstem tumor. In two patients, CT scan showed a hypodense lesion. There was no enhancement after contrast administration. One patient was explored by MRI; on precontrast images, the lesion appeared homogeneous with hyposignal intensity and smooth limits. T2 weighted MRI and post contrast examination confirmed the cyst nature of the lesion. Surgery was performed in the two patients. The cyst was first aspirated and its membrane was then removed. Post operatively, one patient died, the other one is still alive but severely affected two years later. CT scan showed total disappearance of the cyst. The clinical presentation, radiological findings and surgical procedures are discussed.     

Guaianolides from Lactuca saligna

The phytochemical investigation of the aerial parts of LACTUCA SALIGNA L. revealed the presence of lactucin, lactucopicrin, and a new guaianolide named 11beta,13-dihydrolactucopicrin. The structural configuration was established through spectral data.     

Studies in NZB IL-10 knockout mice of the requirement of IL-10 for progression of B-cell lymphoma.

NZB mice develop an age-related malignant expansion of a subset of B cells, B-1 cells, with autocrine production of IL-10. IL-10, a pleiotropic cytokine with anti-inflammatory properties, is a potent growth and survival factor for malignant B cells. To further examine the in vivo requirement for IL-10 in the development and expansion of malignant B-1 clones in NZB mice, we developed a strain of homozygous IL-10 knockout (KO) mice on an NZB background. The NZB IL-10 KO mice develop peritoneal B-1 cells with approximately the same frequency as heterozygous and wild-type littermates. In contrast, the development of malignant B-1 cells in the peripheral blood and spleen, observed in wild-type NZB, rarely occurred in the NZB IL-10 KO. Phenotypic analysis of surface marker expression in splenic B cells indicated that, in contrast to the NZB with malignant B-1 splenic lymphoma, the surface marker expression of NZB IL-10 KO splenic B cells indicated that the majority of the B cells were typical B-2 cells. In the absence of IL-10, spontaneously activated B cells and antiapoptotic gene expression were reduced and lymphoma incidence was decreased. These results indicate that IL-10 is a critical factor for the progression of this B-cell malignant disease.     

The potential palliative role and possible immune modulatory effects of low-dose total body irradiation in relapsed or chemo-resistant non-Hodgkin's lymphoma.

In a group of 35 patients with relapsed and/or chemo-resistant non-Hodgkin's lymphoma (NHL), low-dose total body irradiation (LTBI) (+involved-field radiotherapy to bulky sites) achieved a complete remission rate of 29%, 2-years progression-free survival of 32% and a median progression-free survival of 12 months. The 2-year survival was 42% and the median survival was 17 months. Immuno-staining and flow cytometry of peripheral blood in 14 patients showed that LTBI leads to a significant increase in the percentage of CD4+ cells with a consequent significant increase in the CD4+/CD8+ ratio. High lymphocytic percent and a high percentage of CD4+ cells before LTBI were significantly correlated with longer response duration and overall survival. These data may suggest that the palliative potential of LTBI should be investigated as an alternative to chemotherapy in NHL patients. The pre-treatment percentage of lymphocytes and CD4+ cells may be used as predictors for response to LTBI.     

Human endometrial nuclear estrogen receptors among Norplant implant users.

Twenty-four parous women were included in this study. Sixteen cases were using the Norplant implant contraceptive system for more than 6 months (Group A) while eight cases served as matched controls in the secretory phase (Group B). Norplant implant users belonged to one of two equal subgroups according to whether they experienced regular menstrual bleeding (Subgroup A1) or prolonged episodes of amenorrhoea (Subgroup A2). Endometrial samples were processed for nuclear oestrogen receptor assay and for evaluation of the receptor's binding affinity to oestrogen. The results showed marked reduction in endometrial nuclear oestrogen receptors in Norplant users compared with controls as the majority of users had undetectable receptor levels. This down-regulation effect was significantly more pronounced among women with prolonged episodes of amenorrhoea. The affinity section of the study revealed no significant differences between groups or subgroups probably due to the small number of subjects with detectable receptor concentrations for comparison. These data may help in the understanding of contraceptive mechanisms and menstrual associated problems, and in the development of therapeutic measures.     

Estrogen-induced abnormal accumulation of fat cells in the rat penis and associated loss of fertility depends upon estrogen exposure during critical period of penile development.

We previously reported that diethylstilbestrol (DES) or estradiol valerate (EV) exposure at a dose of 0.10-0.12 mg/kg, or higher, per day, on alternate days, from postnatal days 2-12, resulted in abnormal penis development and infertility (H. O. Goyal et al., 2005, J. Androl. 26, 32-43). The objective of this study was to identify a critical developmental period(s) during which EV exposure results in the observed penile abnormalities. Male pups received EV at a dose of 0.10-0.12 mg/kg on postnatal day(s) 1, 1-3, 4-6, 1-6, 7-12, 13-18, 19-24, or 25-30. Fertility was tested at 102-115 days of age and tissues were examined at 117-137 days. Both penile morphology and fertility were unaltered in rats treated with EV after 12 days of age. Conversely, except in rats treated on postnatal day 1 only, none of the males treated prior to 12 days of age sired pups, and all had abnormal penises, including varying degrees of abnormal accumulation of fat cells and loss of cavernous spaces and smooth muscle cells in the corpora cavernosa penis, which were maximal in the 1-6-day group. Also, the preputial sheath was partially released or its release was delayed, and the weight of the bulbospongiosus muscle was significantly reduced. Plasma testosterone (T) in the 1-6- and 4-6-day groups and intratesticular T in the 4-6-day group were significantly lower. The testosterone surge, characteristic of controls in the first week of life, was suppressed in the 1-3-day group. Estrogen receptor alpha mRNA expression was enhanced in the body of the penis in the 1-3-day group, but not in the 13-18-day group. Hence, EV exposure prior to 12 days of age (as short as 1-3 days postnatal), but not after 12 days of age, results in long-term abnormal penile morphology, characterized by abnormal accumulation of fat cells in the corpora cavernosa penis and, consequently, loss of fertility.     

The Ukraine–Russia War Is Deepening Food Insecurity,Unhealthy Dietary Patterns and the Lack of Dietary Diversity in Lebanon: Prevalence,Correlates and Findings from a National Cross-Sectional Study

Background: Due to Russia and Ukraine’s key roles in supplying cereals and oilseeds, the Russia–Ukraine war intensifies the current food availability and price challenges in Lebanon, which is a major wheat importer. Given these constraints, we conducted this study to assess the prevalence and correlates of food insecurity, low dietary diversity (DD), unhealthy dietary patterns, and the shifts in households’ food-related habits in response to the Russia–Ukraine war among a representative sample of Lebanese household’s members aged 18 years and above (N = 914). Methods: Data were collected between June and July 2022 using self-administered questionnaires; Results: Findings showed that nearly half of the households consume an undiversified diet (46%), and 55.3% ate fewer than two meals per day. The prevalence of food insecurity among Lebanese households was 74%, with one in every four households being severely food insecure. In addition, the majority of households’ members went out shopping and purchased food less than the pre-war period (68.7% and 70.3%, respectively). Furthermore, almost 68.3% of households’ members highlighted price increases for cereal products, which were the least available and most stocked items. Findings obtained through binary logistic regression also showed that food insecurity was two times higher among households with low monthly income, 35% higher among females, and three times higher among married participants; Conclusions: The impact of the Russia–Ukraine conflict on food security in Lebanon requires a systems-thinking approach as well as international effort to understand the challenges and find solutions to minimize the war’s negative effects.     

MF-AV-Net: an open-source deep learning network with multimodal fusion options for artery-vein segmentation in OCT angiography

This study is to demonstrate the effect of multimodal fusion on the performance of deep learning artery-vein (AV) segmentation in optical coherence tomography (OCT) and OCT angiography (OCTA); and to explore OCT/OCTA characteristics used in the deep learning AV segmentation. We quantitatively evaluated multimodal architectures with early and late OCT-OCTA fusions, compared to the unimodal architectures with OCT-only and OCTA-only inputs. The OCTA-only architecture, early OCT-OCTA fusion architecture, and late OCT-OCTA fusion architecture yielded competitive performances. For the 6 mm×6 mm and 3 mm×3 mm datasets, the late fusion architecture achieved an overall accuracy of 96.02% and 94.00%, slightly better than the OCTA-only architecture which achieved an overall accuracy of 95.76% and 93.79%. 6 mm×6 mm OCTA images show AV information at pre-capillary level structure, while 3 mm×3 mm OCTA images reveal AV information at capillary level detail. In order to interpret the deep learning performance, saliency maps were produced to identify OCT/OCTA image characteristics for AV segmentation. Comparative OCT and OCTA saliency maps support the capillary-free zone as one of the possible features for AV segmentation in OCTA. The deep learning network MF-AV-Net used in this study is available on GitHub for open access.     

Factors affecting single-step transepithelial photorefractive keratectomy outcome in the treatment of mild, moderate, and high myopia: a cohort study

AIM: To investigate the effect of preoperative factors on visual acuity, higher-order aberrations (HOAs), and index of success for spherical change (S.IOS) after transepithelial photorefractive keratectomy (t-PRK) for treating different grades of myopia. METHODS: This was a retrospective one-armed cohort study where patients with high, moderate, or mild myopia treated with single-step t-PRK using Amaris 500 Hz excimer laser were evaluated for visual acuity, refractive status, corneal topography, HOAs, S.IOS, and mean efficiency and safety index before and 6mo after surgery. RESULTS: A total of 154 eyes of 77 patients with mild (n=59), moderate (n=83), and high (n=12) myopia were reviewed. The efficiency and safety indices for vision recovery by single-step t-PRK were 98% and 100%, respectively. The achieved spherical equivalent (SE) was within 1 diopter (D) in 151 (98%) eyes. The median of the S.IOS was 1.18 [interquartile range (IQR) 1.0, 1.4]. The change in S.IOS was significantly correlated with age (P=0.007), 6.5 mm ablation zone (Mann-Whitney U test, P<0.01), and mild and moderate grade of myopia (Kruskal–Wallis test, P<0.001). Trefoil aberration, spherical aberration, and aberration coefficient types of HOA increased significantly (Wilcoxon test, P<0.001) 6mo post-surgery. There was a significant correlation between spherical aberration and aberration coefficient HOAs by myopia grades (P<0.05). CONCLUSION: Single-step t-PRK has promising short-term outcomes for refractive corrections and vision improvement to treat all three grades of myopia.