Genetic testing in familial isolated hyperparathyroidism: unexpected results and their implications

Familial hyperparathyroidism is not uncommon in clinical endocrine practice. It encompasses a spectrum of disorders including multiple endocrine neoplasia types 1 (MEN1) and 2A, hyperparathyroidism-jaw tumour syndrome (HPT-JT), familial hypocalciuric hypercalcaemia (FHH), and familial isolated hyperparathyroidism (FIHP). Distinguishing among the five syndromes is often difficult but has profound implications for the management of patient and family. The availability of specific genetic testing for four of the syndromes has improved diagnostic accuracy and simplified family monitoring in many cases but its current cost and limited accessibility require rationalisation of its use. No gene has yet been associated exclusively with FIHP. FIHP phenotypes have been associated with mutant MEN1 and calcium-sensing receptor ( CASR) genotypes and, very recently, with mutation in the newly identified HRPT2 gene. The relative proportions of these are not yet clear. We report results of MEN1, CASR, and HRPT2 genotyping of 22 unrelated subjects with FIHP phenotypes. We found 5 (23%) with MEN1 mutations, four (18%) with CASR mutations, and none with an HRPT2 mutation. All those with mutations had multiglandular hyperparathyroidism. Of the subjects with CASR mutations, none were of the typical FHH phenotype. These findings strongly favour a recommendation for MEN1 and CASR genotyping of patients with multiglandular FIHP, irrespective of urinary calcium excretion. However, it appears that HRPT2 genotyping should be reserved for cases in which other features of the HPT-JT phenotype have occurred in the kindred. Also apparent is the need for further investigation to identify additional genes associated with FIHP.

Spatial gene expression in the T-stage mouse metanephros

The E11.5 mouse metanephros is comprised of a T-stage ureteric epithelial tubule sub-divided into tip and trunk cells surrounded by metanephric mesenchyme (MM). Tip cells are induced to undergo branching morphogenesis by the MM. In contrast, signals within the mesenchyme surrounding the trunk prevent ectopic branching of this region. In order to identify novel genes involved in the molecular regulation of branching morphogenesis we compared the gene expression profiles of isolated tip, trunk and MM cells using Compugen mouse long oligo microarrays. We identified genes enriched in the tip epithelium, sim-1, Arg2, Tacstd1, Crlf-1 and BMP7; genes enriched in the trunk epithelium, Innp1, Itm2b, Mkrn1, SPARC, Emu2 and Gsta3 and genes spatially restricted to the mesenchyme surrounding the trunk, CSPG2 and CV-2, with overlapping and complimentary expression to BMP4, respectively. This study has identified genes spatially expressed in regions of the developing kidney involved in branching morphogenesis, nephrogenesis and the development of the collecting duct system, calyces, renal pelvis and ureter. (c) 2006 Elsevier B.V. All rights reserved.

New era: Prophylactic surgery for patients with multiple endocrine neoplasia-2A

Background: The surgical management of patients with multiple endocrine neoplasia-2A (MEN-2A) continues to evolve with specific genotype-phenotype correlations allowing for a more tailored approach. In this study, we report the surgical management of one of the largest MEN-2A families with a rearranged during transfection (RET) codon 804 mutation. Method: This is a cohort study comprising all at-risk kindred within a single known MEN-2A family. Prophylactic total thyroidectomy with lymph node dissection was recommended to all mutation carriers aged 5 years and older. Results: There were a total of 48 at-risk individuals in the MEN-2A kindred, with 22 patients undergoing thyroidectomy after appropriate preoperative evaluation. A total of 9 patients had medullary thyroid cancer including 5 with a normal preoperative calcitonin level. A total of 11 patients had C-cell hyperplasia and 7 showed histological evidence of parathyroid disease. Only the index case had a phaeochromocytoma. Conclusion: Genetic testing for germline mutations in the RET proto-oncogene has allowed precise identification of affected RET carriers and provided the opportunity for prophylactic or 'preclinical' surgery to treat and in fact to prevent medullary thyroid cancer. This concept of prophylactic surgery based on a genetic test is likely to be applied more widely as the tools of molecular biology advance.

AMBIGUIDADE COMO INVENTIVIDADE: UM ESTUDO SOBRE O SINCRETISMO RELIGIOSO NA FRONTEIRA ENTRE A ANTROPOLOGIA E A TEOLOGIA

Essa tese é um estudo sobre o problema do sincretismo religioso, quando pensado no diálogo entre a antropologia e a teologia. Para tanto, a pesquisa faz um exercício hermenêutico de ressignificação do conceito, a partir das diversas teorias sobre o sincretismo e seus usos antropológicos e teológicos, buscando subsídios no pensamento de Michel de Certeau e Paul Tillich para tal ressignificação. Assim, a perspectiva certeauniana de uma reflexão heterológica da cultura e a noção de demônico na teologia e filosofia do sentido de Tillich fundamentam a percepção do sincretismo como uma teoria da mediação entre religião e cultura. Isso significa que o sincretismo opera uma relação dialética com o seu pólo denominado, nessa tese, de diacretismo , tornando a dinâmica cultural e religiosa um espaço inventivo, posto que manifesta aspectos ambíguos de criações de sentido positivas (experiência de aproximação sincrética) e criações de sentido distorcidas (experiência de fragmentação diacrética ), essência da relação com o sagrado, vivida culturalmente. A cultura, entendida como espaço para a vivência do religioso, exprime-se em uma profunda relação entre táticas e estratégias, denotando a ambigüidade anteriormente afirmada, quando reconhece que os atores sociais em interação, mesmo que marcados por lugares próprios estrategicamente estabelecidos, enquanto lugares de poder, não inibem a formação de ações táticas que subervertem inventivamente esses mesmos lugares, dando a devida dinâmica cultural. A tese analisa, também, como estudo de caso, as implicações dessa compreensão de sincretismo para a interpretação da experiência religiosa de grupos de indígenas Guarani e Kaiowá, na Terra Indígena de Dourados /MS, na fronteira entre tradição e tradução operada pelos indígenas, a partir do Projeto da Igreja Indígena Presbiteriana (IIP), ressignificando sua alteridade religiosa na interface com os múltiplos cristianismos presentes nas aldeias, afirmando a possibilidade de um teko retã ( jeito de ser plural, múltiplo ) religioso, a partir das relações sincréticas e diacréticas propostas.

The Fate of Spermatogonial Stem Cells in the Cryptorchid Testes of RXFP2 Deficient Mice

The environmental niche of the spermatogonial stem cell pool is critical to ensure the continued generation of the germ cell population. To study the consequences of an aberrant testicular environment in cryptorchidism we used a mouse model with a deletion of Rxfp2 gene resulting in a high intra-abdominal testicular position. Mutant males were infertile with the gross morphology of the cryptorchid testis progressively deteriorating with age. Few spermatogonia were identifiable in 12 month old cryptorchid testes. Gene expression analysis showed no difference between mutant and control testes at postnatal day 10. In three month old males a decrease in expression of spermatogonial stem cell (SSC) markers Id4, Nanos2, and Ret was shown. The direct counting of ID4+ cells supported a significant decrease of SSCs. In contrast, the expression of Plzf, a marker for undifferentiated and differentiating spermatogonia was not reduced, and the number of PLZF+ cells in the cryptorchid testis was higher in three month old testes, but equal to control in six month old mutants. The PLZF+ cells did not show a higher rate of apoptosis in cryptorchid testis. The expression of the Sertoli cell FGF2 gene required for SSC maintenance was significantly reduced in mutant testis. Based on these findings we propose that the deregulation of somatic and germ cell genes in the cryptorchid testis, directs the SSCs towards the differentiation pathway. This leads to a depletion of the SSC pool and an increase in the number of PLZF+ spermatogonial cells, which too, eventually decreases with the exhaustion of the stem cell pool. Such a dynamic suggests that an early correction of cryptorchidism is critical for the retention of the SSC pool.

Multi-year weather data in the remote semi-arid to arid mountain region of the Saharan flank of the Atlas Mountains

In 2001, a weather and climate monitoring network was established along the temperature and aridity gradient between the sub-humid Moroccan High Atlas Mountains and the former end lake of the Middle Drâa in a pre-Saharan environment. The highest Automated Weather Stations (AWS) was installed just below the M'Goun summit at 3850 m, the lowest station Lac Iriki was at 450 m. This network of 13 AWS stations was funded and maintained by the German IMPETUS (BMBF Grant 01LW06001A, North Rhine-Westphalia Grant 313-21200200) project and since 2011 five stations were further maintained by the GERMAN DFG Fennec project (FI 786/3-1), this way some stations of the AWS network provided data for almost 12 years from 2001-2012. Standard meteorological variables such as temperature, humidity, and wind were measured at an altitude of 2 m above ground. Other meteorological variables comprise precipitation, station pressure, solar irradiance, soil temperature at different depths and for high mountain station snow water equivalent. The stations produced data summaries for 5-minute-precipitation-data, 10- or 15-minute-data and a daily summary of all other variables. This network is a unique resource of multi-year weather data in the remote semi-arid to arid mountain region of the Saharan flank of the Atlas Mountains. The network is described in Schulz et al. (2010) and its further continuation until 2012 is briefly discussed in Redl et al. (2015, doi:10.1175/MWR-D-15-0223.1) and Redl et al. (2016, doi:10.1002/2015JD024443).

Avaliação da influência de cinza da casca de arroz em cimentos para poços de petróleo submetidos à injeção de vapor

Reservoirs that present highly viscous oils require methods to aid in their recovery to the surface. The elev ated oil viscosity hinders its flow through porous media and conventional recovery methods have not obtained significant efficiency. As such, the injection of steam into the reservoir through an injection well has been the most widely used method of therma l recovery, for it allows elevated volumes of recovery due to the viscosity reduction of the oil, facilitating the oil’s mobility within the rock formation and consequently into the production well where it will be exploited. On the other hand, the injecti on of vapor not only affects the fluids found in the rock pores, but the entire structure that composes the well where it is injected due to the high temperatures used in the process. This temperature increment is conducted to the cement, found in the annu lus, responsible for the isolation of the well and the well casing. Temperatures above 110 ̊C create new fazes rich in calcium in the cement matrix, resulting in the reduction of its permeability and the consequential phenomenon of mechanical resistance ret rogression. These alterations generate faults in the cement, reducing the well’s hydraulic isolation, creating insecurity in the operations in which the well will be submitted as well as the reduction of its economic life span. As a way of reducing this re trograde effect, this study has the objective of evaluating the incorporation of rice husk ash as a mineral additive substitute of silica flour , commercially utilized as a source of silica to reduce the CaO/SiO 2 ratio in the cement pastes submitted to high temperatures in thermal recovery. Cement pastes were formulated containing 20 and 30% levels of ash, apart from the basic paste (water + cement) and a reference paste (water + cement + 40% silica flour) for comparison purposes. The tests were executed th rough compression resistance tests, X - Ray diffraction (XRD) techniques, thermogravimetry (TG), scanning electron microscopy (SEM) and chemical anal ysis BY X - ray fluorescence (EDS) on the pastes submitted to cure at low temperatures (45 ̊C) for 28 days following a cure at 280 ̊C and a pressure of 2,000 PSI for 3 days, simulating vapor injection. The results obtained show that the paste containing 30% r ice shell ash is satisfactory, obtaining mechanical resistance desired and equivalent to that of the paste containing 40% silica flour, since the products obtained were hydrated with low CaO/SiO 2 ratio, like the Tobermorita and Xonotlita fases, proving its applicability in well subject to vapor injection.

Resonance Energy Transfer-Based Molecular Switch Designed Using a Systematic Design Process Based on Monte Carlo Methods and Markov Chains

A RET network consists of a network of photo-active molecules called chromophores that can participate in inter-molecular energy transfer called resonance energy transfer (RET). RET networks are used in a variety of applications including cryptographic devices, storage systems, light harvesting complexes, biological sensors, and molecular rulers. In this dissertation, we focus on creating a RET device called closed-diffusive exciton valve (C-DEV) in which the input to output transfer function is controlled by an external energy source, similar to a semiconductor transistor like the MOSFET. Due to their biocompatibility, molecular devices like the C-DEVs can be used to introduce computing power in biological, organic, and aqueous environments such as living cells. Furthermore, the underlying physics in RET devices are stochastic in nature, making them suitable for stochastic computing in which true random distribution generation is critical.

In order to determine a valid configuration of chromophores for the C-DEV, we developed a systematic process based on user-guided design space pruning techniques and built-in simulation tools. We show that our C-DEV is 15x better than C-DEVs designed using ad hoc methods that rely on limited data from prior experiments. We also show ways in which the C-DEV can be improved further and how different varieties of C-DEVs can be combined to form more complex logic circuits. Moreover, the systematic design process can be used to search for valid chromophore network configurations for a variety of RET applications.

We also describe a feasibility study for a technique used to control the orientation of chromophores attached to DNA. Being able to control the orientation can expand the design space for RET networks because it provides another parameter to tune their collective behavior. While results showed limited control over orientation, the analysis required the development of a mathematical model that can be used to determine the distribution of dipoles in a given sample of chromophore constructs. The model can be used to evaluate the feasibility of other potential orientation control techniques.

A Molecular-scale Programmable Stochastic Process Based On Resonance Energy Transfer Networks: Modeling And Applications

While molecular and cellular processes are often modeled as stochastic processes, such as Brownian motion, chemical reaction networks and gene regulatory networks, there are few attempts to program a molecular-scale process to physically implement stochastic processes. DNA has been used as a substrate for programming molecular interactions, but its applications are restricted to deterministic functions and unfavorable properties such as slow processing, thermal annealing, aqueous solvents and difficult readout limit them to proof-of-concept purposes. To date, whether there exists a molecular process that can be programmed to implement stochastic processes for practical applications remains unknown.

In this dissertation, a fully specified Resonance Energy Transfer (RET) network between chromophores is accurately fabricated via DNA self-assembly, and the exciton dynamics in the RET network physically implement a stochastic process, specifically a continuous-time Markov chain (CTMC), which has a direct mapping to the physical geometry of the chromophore network. Excited by a light source, a RET network generates random samples in the temporal domain in the form of fluorescence photons which can be detected by a photon detector. The intrinsic sampling distribution of a RET network is derived as a phase-type distribution configured by its CTMC model. The conclusion is that the exciton dynamics in a RET network implement a general and important class of stochastic processes that can be directly and accurately programmed and used for practical applications of photonics and optoelectronics. Different approaches to using RET networks exist with vast potential applications. As an entropy source that can directly generate samples from virtually arbitrary distributions, RET networks can benefit applications that rely on generating random samples such as 1) fluorescent taggants and 2) stochastic computing.

By using RET networks between chromophores to implement fluorescent taggants with temporally coded signatures, the taggant design is not constrained by resolvable dyes and has a significantly larger coding capacity than spectrally or lifetime coded fluorescent taggants. Meanwhile, the taggant detection process becomes highly efficient, and the Maximum Likelihood Estimation (MLE) based taggant identification guarantees high accuracy even with only a few hundred detected photons.

Meanwhile, RET-based sampling units (RSU) can be constructed to accelerate probabilistic algorithms for wide applications in machine learning and data analytics. Because probabilistic algorithms often rely on iteratively sampling from parameterized distributions, they can be inefficient in practice on the deterministic hardware traditional computers use, especially for high-dimensional and complex problems. As an efficient universal sampling unit, the proposed RSU can be integrated into a processor / GPU as specialized functional units or organized as a discrete accelerator to bring substantial speedups and power savings.

Commodification of health care systems: The Catalan case

Commodification of the public healthcare system has been a growing process in recent decades, especially in universal healthcare systems and in high-income countries like Spain.  There are substantial differences in the healthcare systems of each autonomous region of Spain, among which Catalonia is characterized by having a mixed healthcare system with complex partnerships and interactions between the public and private healthcare sectors.  Using a narrative review approach, this article addresses various aspects of the Catalan healthcare system, characterizing the privatization and commodification of health processes in Catalonia from a historical perspective with particular attention to recent legislative changes and austerity measures.  The article approximates, the eventual effects that commodification and austerity measures will have on the health of the population and on the structure, accessibility, effectiveness, equity and quality of healthcare services.

Hur planerar lärare sin undervisning i NO? : Tänker de på de olika lärstilarna och använder de sig av närliggande naturområden

Syftet med denna undersökning är att ta reda på hur lärare planerar och varierar undervisningen, hur de olika lärstilarna täcks in samt användningen av den närliggande naturen/skogen/grönområden. De frågor som denna studie sökte svar på var:   Hur planerar lärare sin undervisning i de naturorienterande ämnena? Använder sig lärare av den närliggande naturen/skogen/grön områden? Varieras undervisningen så de olika lärstilarna täcks in?   I denna studie har jag använt mig av en fallstudie för att få djupgående kunskap som man sedan undersöker ”på djupet” till detaljerade kunskaper. Det som kännetecknar fallstudien är att den fokuserar på ett fenomen, som i detta fall är lektionsplaneringen och variationen för lektionerna.   Resultatet har visat på att samtliga lärare planerar och varierar sin undervisning men de gör inte ett medvetet val för att täcka in de fyra olika lärstilarna. De använder sig av den närliggande naturen/skogen/grön områden samt skolgården i stor utsträckning. De använder dessa mest under de varmare årstiderna men några använder dessa året runt. 

Las fuentes clásicas y humanísticas en la obra retórica de Juan Costa y Beltrán

Programa de doctorado: Estudios interdisciplinares de Lengua, Literatura, Cultura, Traducción y Tradición clásica

White Adipose Tissue Re-growth after Partial Lipectomy in High Fat Diet Induced Obese Wistar Rats

The effects of partial removal of epididymal (EPI) and retroperitoneal (RET) adipose tissues (partial lipectomy) on the triacylglycerol deposition of high fat diet induced obese rats were analyzed, aiming to challenge the hypothesized body fat regulatory system. Male 28-day-old wistar rats received a diet enriched with peanuts, milk chocolate and sweet biscuits during the experimental period. At the 90th day of life, rats were submitted to either lipectomy (L) or sham surgery. After 7 or 30 days, RET, EPI, liver, brown adipose tissue (BAT), blood and carcass were obtained and analyzed. Seven days following surgery, liver lipogenesis rate and EPI relative weight were increased in L. After 30 days, L, RET and EPI presented increased lipogenesis, lipolysis and percentage of small area adipocytes. L rats also presented increased liver malic enzyme activity, BAT lipogenesis, and triacylglycerol and corticosterone serum levels. The partial removal of visceral fat pads affected the metabolism of high fat diet obese rats, which leads to excised tissue re-growth and possibly compensatory growth of non-excised depots at a later time.

Exercise Training in Rats Impairs the Replenishment of White Adipose Tissue after Partial Lipectomy

The aim of this study was to evaluate the effect of exercise training on the metabolism of rats following the partial removal of fat pads. Three-month-old male Wistar rats were subjected to the partial removal (L) of retroperitoneal white adipose tissue (RET) and epididymal white adipose tissue (EPI), or a sham operation (Sh). Seven days after surgery, both sets of rats were subdivided into exercised (LE or ShE) (swimming 90 min/day, 5 days/week, 6 weeks) and sedentary (LS or ShS) groups. Partial removal of the fat pads increased the lipogenesis rates in both the RET and EPI and decreased the weight and lypolysis rate of the EPI, while the RET weight was not significantly affected by lipectomy. In both lipectomized and sham-operated groups, exercise training caused a reduction in carcass lipid content, food intake, RET and EPI weights, and RET lipogenesis rate. On the other hand, the exercise training increased the percentage of diet-derived lipid accumulation in both tissues, either in sham and lipectomized rats. These results confirmed that regrowth is not uniform and depends on the particular fat pad that is excised. They also demonstrated that exercise training following the partial removal of fat pads modified adipose tissue metabolism, impaired the replenishment of adipose tissue, and decrease body adiposity.

Étude des gènes de fusion MLL dans les leucémies aigues humaines

Les leucémies aigues sont la conséquence d’une prolifération clonale et maligne des cellules hématopoïétiques. Elles surviennent suite à un évènement oncogénique qui se produit dans une cellule souche hématopoïétique (CSH) ou progénitrice. Cela lui confère une certaine instabilité qui engendre l’accumulation d’autres évènements génétiques et/ou épigénétiques responsables du développement clinique de la maladie. Les leucémies MLL représentent environ 10% des leucémies aigues et aujourd’hui, plus de 70 gènes de fusion ont été caractérisés. Les sangs de cordon sont une source importante de CSH et progénitrices. La purification de ces cellules et leur transformation en cellules leucémiques à l’aide de gènes de fusion MLL nous permettent de générer des leucémies aigues humaines dans des souris immunodéficientes NSG et ainsi étudier le potentiel leucémique de différents gènes de fusion MLL. Dans un premier temps, 4 gènes de fusion MLL ont été étudiés : MLL-AF9, MLL-AF4, MLL-ENL et MLL-ELL. In vitro, nous sommes capables de transformer des CSH en cellules leucémiques capables de proliférer rapidement. Les résultats in vivo nous montrent qu’il est possible de générer des leucémies avec les oncogènes MLL-AF9 et MLL-ENL. Pour les fusions MLL-ELL et MLL-AF4, bien que quelques leucémies ont pu être obtenues, plusieurs problèmes techniques nous empêchent aujourd’hui de disposer d’un modèle adéquat permettant l’étude complète de ces oncogènes. Dans un second temps, les leucémies aigues MLL-AF9 ont été étudiées dans un modèle contrôlé où les cellules souches proviennent d’un donneur unique. Grâce à ce modèle, nous avons pu démontrer que l’oncogène MLL-AF9 est suffisant pour induire le développement de la maladie. En effet aucune nouvelle mutation n’a pu être identifiée au cours du développement de la leucémie. Parmi les leucémies myéloïdes aigues (LMA) MLL-AF9 issues de ce modèle, certains gènes non mutés, dont RET, ont été identifiés comme étant de potentiels biomarqueurs de ce sous-groupe de leucémie.