Desmoplastic infantile ganglioglioma: MRI and histological findings case report

Desmoplastic infantile gangliogliomas (DIG) are rare intracranial tumors occurring during the 1st year of life. They arise invariably in the supratentorial region and have a great size at presentation, commonly involving more than one lobe. They are composed of a solid peripheral component of variable size, which involves the superficial cerebral cortex and the leptomeninges, and a large cystic part. Despite the great size at presentation and occasional mitotic activity in the variable undifferentiated component, this entity constitutes a distinct clinicopathological entity with benign prognosis. We hereby present the MRI and histological findings of two cases of DIG in infants aged 9 and 10 months, respectively.     

Enteropathogenic Escherichia coli: stimulating neutrophil migration across a cultured intestinal epithelium without altering transepithelial conductance

INTRODUCTION: Migration of neutrophils across the intestinal epithelium is the hallmark of inflammatory conditions of the bowel. In cultured intestinal epithelial monolayer models, neutrophils can be induced to migrate along a chemotactic gradient such as n-formyl-methionyl-leucyl-phenylalanine (fMLP). Physical passage of the neutrophils across the epithelium could disrupt the tight-junctions, possibly leading to a large increase in the transepithelial conductance (G(t)). The goal of this study is to determine whether transepithelial migration of neutrophils induced by enteropathogenic (EPEC) causes changes in G(t) comparable with those seen with fMLP. METHODS: The apical side of T84 monolayers were rapidly infected with EPEC E2348/69 or exposed to 1 microM fMLP. A third group of monolayers exposed to neither EPEC nor fMLP served as control. Indium-labeled neutrophils were added to the serosal side of monolayers grown on a cell culture insert membrane (12 microm pores). G(t) was measured at fixed intervals up to 4 hours. After a 150-minute incubation, radioactivity of the neutrophils that migrated to the apical side was assayed and the number of migrating neutrophils was calculated. RESULTS: At 150 minutes, EPEC induced similar neutrophil chemotactic capability compared to fMLP (231 +/- 34.10(3) and 193 +/- 48.10(3), respectively, n = 13, P > 0.05). However, EPEC-induced neutrophil migration was not associated with significant increase in G(t), 1.13 +/- 0.16 fold of baseline G(t), in distinction with fMLP groups, 13.3 +/- 0.48 fold, n = 7 (P< 0.05). G(t) changes with EPEC were seen after 4 hours of infection, but were not different in the presence or absence of neutrophil migration (1.37 +/- 0.12 fold and 1.42 +/- 0.17 fold of baseline G(t), respectively). CONCLUSIONS: The results indicate that EPEC-induced neutrophil migration can occur without significant disruption of barrier function. In addition, the chemo-attractant recruiting neutrophils during EPEC infection is unlikely to be fMLP; and, the G(t) increase seen with fMLP-driven recruitment may indicate a discretionary compromise of barrier function during neutrophil migration.     

Phospholipids reduce adhesion formation in the rabbit uterine horn model

Objective: To access the ability of intraperitoneal phospholipids to reduce adhesions in a standardized model for gynecologic operations.

Design: A randomized, experimental, blinded study using the double uterine horn model.

Setting: Academic animal research laboratory.

Animal(s): Thirty-three Chinchilla rabbits.

Intervention(s): Phospholipids or Ringer’s lactate were intraperitoneally administered after bilateral uterine horn injury.

Main Outcome Measure(s): After 10 days, adhesions were evaluated concerning area and strength as well as scores describing tenacity and degree.

Result(s): Phospholipids (median 102.1 mm²) significantly reduce adhesion areas in comparison to surgical controls (median 392.2 mm²) and Ringer group (median 323.8 mm²). Scores reflecting severity and degree of adhesions support this finding.

Conclusion(s): These results prove the efficacy of phospholipids in the double uterine horn model. Future clinical studies are recommended.     

Sequential exposure of Aspergillus fumigatus to itraconazole and caspofungin: evidence of enhanced in vitro activity

We investigated the in vitro activity of sequential itraconazole and caspofungin against 10 isolates of Aspergillus fumigatus. Previous exposure of A. fumigatus to itraconazole resulted in dose-dependent enhanced effects of caspofungin and vice versa. Our finding suggests a preferential role for azole-caspofungin sequential combinations and merits further in vivo investigation.     

Lactobacillus plantarum reduces the in vitro secretory response of intestinal epithelial cells to enteropathogenic Escherichia coli infection

OBJECTIVE: Enteropathogenic (EPEC) is a Gram-negative bacillus that causes diarrhea. Secretory responses of intestinal epithelial cells can be seen after EPEC infection. Probiotics, which are live bacteria that have proven benefit to the host, play a role in the treatment and prevention of the different enteric pathogens. The goals of the study were to determine whether the probiotic agent (LBP) strain 299v alters the secretory changes seen in EPEC infection and, if so, what underlying mechanism is possible. METHODS: Caco-2 cell monolayers were rapidly infected with EPEC strain E2348/69 and immediately mounted in Ussing chambers. The monolayers were exposed to LBP before, after, and simultaneously with EPEC infection. Short circuit current (Isc) was measured in the Ussing chamber. RESULTS: EPEC infection caused an increase in short circuit current that was reduced by preincubation with LBP ( < 0.01). No direct bactericidal effect was observed, but LBP reduced the attachment of EPEC to Caco-2 cells. CONCLUSION: LBP can play an important role in reducing the secretory change in response to EPEC infection, possibly through inhibition of its binding. However, the presence of the probiotic agent before the infection is necessary. In this setting, its role is more preventive rather than therapeutic.     

Use of the A(2A) adenosine receptor as a physiological immunosuppressor and to engineer inflammation in vivo

Inflammation must be inhibited in order to treat, e.g., sepsis or autoimmune diseases or must be selectively enhanced to improve, for example, immunotherapies of tumors or the development of vaccines. Predictable enhancement of inflammation depends upon the knowledge of the "natural" pathways by which it is down-regulated in vivo. Extracellular adenosine and A(2A) adenosine (purinergic) receptors were identified recently as anti-inflammatory signals and as sensors of excessive inflammatory tissue damage, respectively (Ohta A and Sitkovsky M, Nature 2001;414:916-20). These molecules may function as an important part of a physiological "metabolic switch" mechanism, whereby the inflammatory stimuli-produced local tissue damage and hypoxia cause adenosine accumulation and signaling through cyclic AMP-elevating A(2A) adenosine receptors in a delayed negative feedback manner. Patterns of A(2A) receptor expression are activation- and differentiation-dependent, thereby allowing for the "acquisition" of an immunosuppressive "OFF button" and creation of a time-window for immunomodulation. Identification of A(2A) adenosine receptors as "natural" brakes of inflammation provided a useful framework for understanding how tissues regulate inflammation and how to enhance or decrease (engineer) inflammation by targeting this endogenous anti-inflammatory pathway. These findings point to the need of more detailed testing of anti-inflammatory agonists of A(2A) receptors and create a previously unrecognized strategy to enhance inflammation and targeted tissue damage by using antagonists of A(2A) receptors. It is important to further identify the contributions of different types of immune cells at different stages of the inflammatory processes in different tissues to enable the "tailored" treatments with drugs that modulate the signaling through A(2A) purinergic receptors.     

Neuropeptide Y Y4 receptor homodimers dissociate upon agonist stimulation

The pancreatic polypeptide-fold family of peptides consists of three 36-amino acid peptides, namely neuropeptide Y (NPY), peptide YY, and pancreatic polypeptide (PP). These peptides regulate important functions, including food intake, circadian rhythms, mood, blood pressure, intestinal secretion, and gut motility, through four receptors: Y1, Y2, Y4, and Y5. Additional receptor subtypes have been proposed based on pharmacology observed in native tissues. Recent studies with other G-protein-coupled receptors have shown that homo- and heterodimerization may be important in determining receptor function and pharmacology. In the present study, the recently cloned rhesus (rh) Y4 receptor was evaluated using radioligand binding, and the pharmacological profile was found to be very similar to the human Y4 receptor. To study homo- and heterodimerization involving the Y4 receptor using bioluminescence resonance energy transfer 2 (BRET(2)), the carboxy termini of the rhesus Y1, Y2, Y4, and Y5 receptors were fused to Renilla luciferase, and rhY4 was also fused to green fluorescent protein. Dimerization was also studied using Western blot analysis. Using both BRET(2) and Western analysis, we found that the rhY4 receptor is present at the cell surface as a homodimer. Furthermore, agonist stimulation using the Y4-selective agonists PP and 1229U91 can dissociate these dimers in a concentration-dependent manner. In contrast, rhY4 did not heterodimerize with other members of the NPY receptor family or with human opioid delta and mu receptors. Therefore, homodimerization is an important component in the regulation of the Y4 receptor.     

Alternative bi-pectoral muscle flaps for postoperative sternotomy mediastinitis

Suppuration, mediastinitis, and disruption of median sternotomy are all rare, but nevertheless severe complications. We propose a simple mobilization of the two pectoralis major muscles for use as flaps to fill the sternal defect without the need for humeral detachment or a second cutaneous incision. These will be supplied from both the thoracoacromial vessels and the perforating arteries of the nongrafted internal mammary artery (IMA). Our technique is quick and easy, giving excellent results. Furthermore, by maintaining the perforating branches, we also preserve the nongrafted IMA.