Metachronic malignant transformation of small bowel and rectal endometriosis in the same patient

[ES] Background: Malignant transformation of intestinal endometriosis is a rare event with an unknown rate of incidence. Metachronous progression of endometriosis to adenocarcinoma from two distant intestinal foci happening in the same patient has not been previously reported. Case presentation: We describe a case of metachronic transformation of ileal and rectal endometriosis into an adenocarcinoma occurring in a 45-year-old female without macroscopic pelvic involvement of her endometriosis. First, a right colectomy was performed due to intestinal obstruction by an ileal mass. Pathological examination revealed an ileal endometrioid adenocarcinoma and contiguous microscopic endometriotic foci. Twenty months later, a rectal mass was discovered. An endoscopic biopsy revealed an adenocarcinoma. En bloc anterior rectum resection, hysterectomy and bilateral salpingectomy were performed. A second endometrioid adenocarcinoma arising from a focus of endometriosis within the wall of the rectum was diagnosed. Conclusion: Intestinal endometriosis should be considered a premalignant condition in premenopausal women.

Identified primary hadron spectra with the TOF detector of the ALICE experiment at LHC

In this thesis the analysis to reconstruct the transverse momentum p_{t} spectra for pions, kaons and protons identified with the TOF detector of the ALICE experiment in pp Minimum Bias collisions at $\sqrt{s}=7$ TeV was reported. After a detailed description of all the parameters which influence the TOF PID performance (time resolution, calibration, alignment, matching efficiency, time-zero of the event) the method used to identify the particles, the unfolding procedure, was discussed. With this method, thanks also to the excellent TOF performance, the pion and kaon spectra can be reconstructed in the 0.5the protons can be measured in the interval 0.8the robustness of these results, a comparison with the spectra obtained with a $3\sigma$ cut PID procedure, was reported, showing an agreement within 5%. The estimation of the systematic uncertainties was described. The reported spectra provide very useful information to tune the Monte Carlo generators that, as was shown, are not able to describe $\pi$, $K$ and $p$ production over the full momentum range. The same limitation for the theoretical models in describing the data was observed when comparing with the Monte Carlo predictions the $K/\pi$ and $p/\pi$ ratios, as obtained with the TOF analysis. Finally, the comparison between the TOF results and the spectra obtained with analyses that use other ALICE PID detectors and techniques to extend the identified spectra to a wider $p_{t}$ range was reported, showing an agreement within 6\%.

HLA class II mismatch alleles as targets of the alloreactive CD4 T-cell response

In allogeneic hematopoietic stem cell transplantation (allo-HSCT), alloreactive T lymphocytes of donor origin mediate the beneficial graft-versus-leukemia effect but also induce graft-versus-host disease (GvHD). Since human leukocyte antigens (HLA) mismatch alleles represent major targets of alloreactive T lymphocytes, patient and donor are usually matched for the class I molecules A, B, C, and for the class II molecules DRB1 and DQB1, in order do reduce the risk of GvHD. The HLA-DPB1 locus, however, is still ignored in donor selection. Interestingly, clinical studies have demonstrated that disparities at HLA-DQB1 alleles as well as distinct HLA DPB1 mismatch constellations do not adversely affect the outcome of allo-HSCT. It has also been shown that HLA class II is predominantly expressed on hematopoietic cells under non-inflammatory conditions. Therefore, this PhD thesis focused on the application of CD4 T cells in adoptive immunotherapy of leukemias.rnIn the first part of this thesis we developed a rapid screening approach to detect T-cell reactivity of donors to single HLA class II mismatch alleles. Allo-HLA reactivity was measured in naive, memory, and entire CD4 T cells isolated from PBMC of healthy donors by flow cytometric cell sorting according to expression of the differentiation markers CD45RA, CD45RO, CD62L, and CCR7. T-cell populations were defined by a single marker to facilitate translation into a clinical-grade allo-depletion procedure. Alloreactivity to single HLA-DR/-DQ mismatch alleles was analyzed in short-term mixed lymphocyte reactions (MLR) in vitro. As standard antigen-presenting cells, we used the HLA-deficient cell line K562 upon electroporation with single HLA-DR/-DQ allele mRNA. We observed in IFN-γ ELISpot assays that allo-HLA-reactivity preferentially derived from subsets enriched for naive compared to memory T cells in healthy donors, irrespective of the HLA mismatch allele. This separation was most efficient if CD62L (P=0.008) or CD45RA (P=0.011) were used as marker. Median numbers of allo-HLA-reactive effector cells were 3.5-fold and 16.6-fold lower in CD62Lneg and CD45RAneg memory CD4 T cells than in entire CD4 T cells, respectively. In allele-specific analysis, alloreactivity to single HLA-DR alleles clearly exceeded that to HLA-DQ alleles. In terms of alloproliferation no significant difference could be observed between individual CD4 T-cell subsets. rnThe second part of this thesis dealed with the generation of allo-HLA-DQ/-DP specific CD4 T cells. Naive CD45RApos CD4 T cells isolated from healthy donor PBMC by flow cytometric cell sorting were stimulated in MLR against single allo-HLA-DQ/-DP alleles transfected into autologous mature monocyte-derived dendritic cells by mRNA electroporation. Rapidly expanding HLA-DQ/-DP mismatch reactive T cells significantly recognized and cytolysed primary acute myeloid leukemia (AML) blasts, fibroblasts (FB) and keratinocytes (KC) in IFN-γ ELISpot and 51chromium release assays if the targets carried the HLA DQ/ DP allele used for T cell priming. While AML blasts were recognized independent of pre-incubating them with IFN-γ, recognition of FB and KC required IFN-γ pre treatment. We further investigated HLA class II expression on hematopoietic and non-hematopoietic cells by flow cytometry. HLA class II was not detected on primary FB, KC, and non-malignant kidney cells, but was expressed at significant levels on primary AML blasts and B-LCL. Up-regulation of HLA class II expression was observed on all cell types after pre-incubation with IFN-γ.rnIn summary, the novel K562-HLA based MLR approach revealed that naive-depleted CD4 T-cell subsets of healthy individuals contain decreased allo-HLA reactivity in vitro. We propose the application of CD45RAneg naive-depleted CD4 T cells as memory T cell therapy, which might be beneficial for HLA-mismatched patients at high-risk of GvHD and low-risk of leukemia relapse. Memory T cells might also provide important post-transplant immune functions against infectious agents. Additionally, the screening approach could be employed as test system to detect donors which have low risks for the emergence of GvHD after allo-HSCT. In the second part of this thesis we developed a protocol for the generation of allo-HLA-DQ/-DP specific CD4 T cell lines, which could be applied in situations in which patient and donor are matched in all HLA alleles but one HLA-DQ/-DP allele with low GvHD potential. These T cells showed lytic activity to leukemia cells while presumably sparing non-hematopoietic tissues under non-inflammatory conditions. Therefore, they might be advantageous for allo-HSCT patients with advanced stage AML after reduced-intensity conditioning and T-cell depletion for the replenishment of anti-leukemic reactivity if the risk for disease relapse is high. rn

Influence of the chemokine CXCL12 on the progression and the signaling in colorectal cancer

Das Chemokin CXCL12 (auch bekannt als SDF-1) ist ein kleines Protein (8-14) KDa, das in sechs Isoformen exprimiert wird (SDF-1α, SDF-1β, SDF-1γ, SDF- 1δ, SDF-1ε und SDF-1θ) von einem einzigen Gen, dass die Leukozyten-Wanderung regelt und variabel in einer Reihe von normalen und Krebsgeweben exprimiert wird.rnCXCL12 spielt verschiedene Rollen in der Tumorpathogenese. Es wurde nachgewiesen, dass CXCL12 das Tumorwachstum und die Malignität fördert, die Tumorangiogenese stärkt, sich an der Metastasierung beteiligt und zu immunsuppressiven Netzwerken innerhalb des Tumormikromilieus beiträgt. Daher liegt es nahe, dass der CXCL12/CXCR4-Signalweg ein wichtiges Ziel ist für die Entwicklung von neuartigen Krebstherapien.rnUm Licht auf die Rolle der Chemokin CXCL12 Splicevarianten in der Entwicklung von Krebs zu werfen und die mögliche physiologische Relevanz und ihre möglichen funktionellen Unterschiede bei Darmkrebs zu verstehen, haben wir alle CXCL12 Splicevarianten (alpha, beta, gamma, delta, epsilon und theta) in die kolorektalen Zelllinie SW480 und die Melanomzellinie D05 transfiziert und exprimiert.rnrnDiese Arbeit wurde erstellt, um die folgenden Ziele zu erreichen. Untersuchung der Rolle von CXCL12 Splicevarianten bei der Vermittlung von Tumorprogression, Adhäsion, Migration, Invasion und Metastasierung von Darmkrebs. Untersuchung, ob die CXCL12 Variantenwege ein wichtiges Ziel für die Entwicklung von Krebstherapien darstellen.rn• Um eine in vivo Mausmodell zu entwickeln, um die Rolle der CXCL12 Varianten im Rahmen des Tumorwachstums zu verstehen.rnrnUnsere Ergebnisse zeigen, dass:Der CXCL12 G801A Polymorphismus ist ein Low-Penetranz Risikofaktor für die Entwicklung von Darmkrebs. Der CXCL12-Gen-Polymorphismus rs1801157 ist mit dem T-Status (Tumor-node-Metastasen) assoziiert. Es gab keine Beziehung zwischen CXCL12-Gen-Polymorphismus rs1801157 und Fernmetastisen oder LN metastasen. Alle sechs CXCL12 Splicevarianten werden im Darmkrebs und in gesunder Kolon mucosa exprimiert. Die höchste Expression wird bei SDF-1alpha, dann SDF-1 beta gefunden. Alle sechs CXCL12 Varianten zeigen erhöhte Tumorzellproliferation in vitro. SDF-1beta, gefolgt von SDF-1alpha zeigte die größte Aktivität im Proliferationsassay.rn• Alle sechs CXCL12 Varianten induzieren die Tumorzelladhäsion.SDF-1beta dann SDF-1alpha zeigte die größte Aktivität im Rahmen des Adhäsionsassay. Alle sechs CXCL12 Varianten erhöhten die Zellmigration und Invasion von Tumorzellen in vitro. SDF-1theta und SDF-1epsilon 1theta zeigten die größte Aktivität, während die schwächste Aktivität mit SDF-1alpha und SDF-1beta beobachtet wurde. Alle sechs CXCL12 Varianten aktivieren Akt und (MAPK) Mitogen- acktivatedierte Protein kinase Wege und damit die Regulierung viele essentieller Prozesse in Tumorzellen, wie Proliferation, Migration, Invasion und Adhäsion. Es ist interessant festzustellen, dass AMD3100 die CXCL12 Splicevarianten inhibriert, die AKT-MEK-1/2-Phosphorylierung induzieren.rnDer Inhibitor AMD3100 unterdrückt stark die CXCL12 Varianten -delta, -epsilon und theta-und unterdrückt schwach CXCL12-gamma. während es keine signifikante Wirkung auf CXCL12-alpha und beta hatte. Es hat möglicherweise Auswirkungen auf mehrere große Signalwage in Bezug auf Proliferation, Migration und Invasions.rn• Es ist wichtig anzumerken, dass die Hemmung von CXCL12-Varianten durch AMD3100 einen der möglichen Ansaätze in der Krebstherapie darstellen kann.Wir schlagen vor, dass weitere Studien erwogen werden, die wir brauchen, um die biologische Aktivität dieser neuen CXCL12 Varianten bei verschiedenen Arten von Krebs klar zu verstehen.

Linguistic gender identity construction in political discourse : a corpus-assisted analysis of the primary speeches of Barack Obama and Hillary Clinton

The present study is concerned with exploring the linguistic identity construction of Barack Obama and Hillary Clinton in the context of USA 2008 Democratic Party primaries. Thus, their speeches are examined in order to detect the aspects of identity that each politician resorted to in the process of projecting a political identity. The study, however, takes a special interest in the ways in which gender identity is projected by Obama and Clinton. Moreover, the notions of gender bias as well as gender representations are also investigated.

A new multimodality technique accurately maps the primary lymphatic landing sites of the bladder

Pathoanatomic studies have failed to map accurately the primary lymphatic landing sites of the urinary bladder.

Skin cancers in renal transplant recipients: A description of the renal transplant cohort in Bern

BACKGROUND/AIMS: Skin tumours, in particular squamous-cell carcinomas (SCC), are the most common malignant conditions developing in transplant recipients. The aim of this study is to investigate the frequency and type of skin cancer in patients receiving immunosuppressive therapy after organ transplantation. METHODS: Multivariate logistic regression analysis was performed on data of 243 renal transplant patients who attended the dermatology outpatient clinic for the first time after transplantation in the period January 2002-October 2005. RESULTS: We found an increased risk of actinic keratosis (AK) and SCC in renal transplant recipients with a basal cell carcinoma (BCC) / SCC ratio of 1:7. Older patients had AK more frequently (odds ratio [OR] 1.11, 95% confidence interval [CI] 1.06-1.15; p <0.0001) and SCC (OR 1.14, CI 1.07-1.22; p <0.0001) than younger patients. Men had AK (OR 0.19, CI 0.08-0.45; p = 0.0002) and SCC (OR 0.25, CI 0.07-0.89; p = 0.0332) more frequently than women. The duration of immunosuppressive therapy correlated significantly with the numbers of AKs (OR 1.15, CI 1.08-1.24; p <0.0001) and SCCs (OR 1.16, CI 1.05-1.28; p = 0.0025), and patients with fair skin had more AKs (OR 0.31, CI 0.14-1.24; p <0.0001) and SCCs (OR 0.11, CI 0.02-0.52; p = 0.0054) than darker skinned patients. We could not identify any specific immunosuppressive drug as a distinct risk factor for AK or non-melanoma skin cancer (NMSC). CONCLUSION: Skin cancers are increased in the renal transplant population. Main risk factors for skin cancers are fair skin type and long duration of immunosuppressive therapy. A follow-up programme is necessary for early detection of skin cancer and precancerous conditions. Preventive strategies should include specialist dermatological monitoring and self-examination.

Primary tuberculosis of the TMJ: presentation of a case and literature review

Tuberculosis (TB) is a frequent health problem. The prevalence of extrapulmonary TB has increased in the last couple of years. Head and neck tuberculosis forms nearly 10% of all extrapulmonary manifestations of the disease. TB of the temporomandibular joint (TMJ) is rare; only a few cases have been reported. The clinical appearance of TB infection of the TMJ has been described as unspecific, resembling arthritis, osteomyelitis, cancer or any kind of chronic joint diseases. This article describes a 22-year-old woman with pain and left preauricular swelling. Magnetic resonance imaging and computed tomography showed an expansive process with destruction of the left condyle and condylar fossa. A fine needle aspiration examination of the swelling showed non-specific granulomatous inflammation. In the following days, a preauricular fistula developed, of which a swab and biopsy specimens were taken. Histological and microbiological examinations revealed an infection with Mycobacterium tuberculosis. The initial antituberculosis treatment consisted of a combination of four antibiotics and could be reduced to two antibiotics in the course of treatment. The treatment was completed successfully after 9 months.

Evaluation of the frequency of putative prostate cancer stem cells in primary and metastatic prostate cancer

Tumour cells with a stem cell-like phenotype have recently been identified in prostate tumors and it has been suggested that this population may be responsible for the diversity of cell types within tumors and also for the initiation of metastases. These cells carry a number of defined markers: they are cd133 and cd44+ve and express high levels of alpha2beta1 integrin. In this study we have, for the first time, assessed matched primary and bone marrow biopsies from prostate cancer patients for the distribution of cells carrying these and a number of other putative stem cell markers.

Early antiretroviral therapy during primary HIV-1 infection results in a transient reduction of the viral setpoint upon treatment interruption

Long-term benefits of combination antiretroviral therapy (cART) initiation during primary HIV-1 infection are debated.

Callosal connections of primary visual cortex predict the spatial spreading of binocular rivalry across the visual hemifields

In binocular rivalry, presentation of different images to the separate eyes leads to conscious perception alternating between the two possible interpretations every few seconds. During perceptual transitions, a stimulus emerging into dominance can spread in a wave-like manner across the visual field. These traveling waves of rivalry dominance have been successfully related to the cortical magnification properties and functional activity of early visual areas, including the primary visual cortex (V1). Curiously however, these traveling waves undergo a delay when passing from one hemifield to another. In the current study, we used diffusion tensor imaging (DTI) to investigate whether the strength of interhemispheric connections between the left and right visual cortex might be related to the delay of traveling waves across hemifields. We measured the delay in traveling wave times (ΔTWT) in 19 participants and repeated this test 6 weeks later to evaluate the reliability of our behavioral measures. We found large interindividual variability but also good test-retest reliability for individual measures of ΔTWT. Using DTI in connection with fiber tractography, we identified parts of the corpus callosum connecting functionally defined visual areas V1-V3. We found that individual differences in ΔTWT was reliably predicted by the diffusion properties of transcallosal fibers connecting left and right V1, but observed no such effect for neighboring transcallosal visual fibers connecting V2 and V3. Our results demonstrate that the anatomical characteristics of topographically specific transcallosal connections predict the individual delay of interhemispheric traveling waves, providing further evidence that V1 is an important site for neural processes underlying binocular rivalry.

The location of the primary entry tear in acute type B aortic dissection affects early outcome

The goal of the retrospective study was to relate the site of the primary entry tear in acute type B aortic dissections to the presence or development of complications.