MUSCLE HEMANGIOMATOSIS PRESENTING AS A SEVERE FEATURE IN A PATIENT WITH THE PTEN MUTATION: EXPANDING THE PHENOTYPE OF VASCULAR MALFORMATIONS IN BANNAYAN-RILEY-RUVALCABA SYNDROME

Bannayan-Riley-Ruvalcaba syndrome (BRRS) is a rare autosomal, dominantly-inherited, hamartoma syndrome with distinct phenotypic features. Mutations in the PTEN gene have been identified in PTEN hamartoma tumor syndromes. Our aim was to determine the correlation of phenotype-genotype relationships in a BRRS case. We have evaluated a PTEN mutation in a patient with vascular anomalies and the phenotypic findings of BRRS. We described an 8-year-old girl with the clinical features of BRRS, specifically with vascular anomalies. The mutation in the PTEN gene was identified by DNA sequencing. In our patient, we defined a de novo nonsense R335X (c. 1003 C>T) mutation in exon 8, which results in a premature termination codon. Due to vascular anomalies and hemangioma, the patient's left leg was amputated 1 year after the hemangioma diagnosis. Bannayan - Riley - Ruvalcaba syndrome patients with macrocephaly and vascular anomalies should be considered for PTEN mutation analysis and special medical care.

Aerobic exercise training induces metabolic benefits in rats with metabolic syndrome independent of dietary changes

OBJECTIVES: We evaluated the effects of aerobic exercise training without dietary changes on cardiovascular and metabolic variables and on the expression of glucose transporter Type 4 in rats with metabolic syndrome. METHODS: Twenty male spontaneously hypertensive rats received monosodium glutamate during the neonatal period. The animals were allocated to the following groups: MS (sedentary metabolic syndrome), MS-T (trained on a treadmill for 1 hour/day, 5 days/week for 10 weeks), H (sedentary spontaneously hypertensive rats) and H-T (trained spontaneously hypertensive rats). The Lee index, blood pressure (tail-cuff system), insulin sensitivity (insulin tolerance test) and functional capacity were evaluated before and after 10 weeks of training. Glucose transporter Type 4 expression was analyzed using Western blotting. The data were compared using analysis of variance (ANOVA) (p<0.05). RESULTS: At baseline, the MS rats exhibited lower insulin sensitivity and increased Lee index compared with the H rats. Training decreased the body weight and Lee index of the MS rats (MS-T vs. MS), but not of the H rats (H-T vs. H). There were no differences in food intake between the groups. At the end of the experiments, the systolic blood pressure was lower in the two trained groups than in their sedentary controls. Whole-body insulin sensitivity increased in the trained groups. Glucose transporter Type 4 content increased in the heart, white adipose tissue and gastrocnemius muscle of the trained groups relative to their respective untrained groups. CONCLUSION: In conclusion, the present study shows that an isolated aerobic exercise training intervention is an efficient means of improving several components of metabolic syndrome, that is, training reduces obesity and hypertension and increases insulin sensitivity

X-Ray studies of the physics of matter around super-massive black-holes in nearby Seyfert galaxies

Seyfert galaxies are the closest active galactic nuclei. As such, we can use them to test the physical properties of the entire class of objects. To investigate their general properties, I took advantage of different methods of data analysis. In particular I used three different samples of objects, that, despite frequent overlaps, have been chosen to best tackle different topics: the heterogeneous BeppoS AX sample was thought to be optimized to test the average hard X-ray (E above 10 keV) properties of nearby Seyfert galaxies; the X-CfA was thought the be optimized to compare the properties of low-luminosity sources to the ones of higher luminosity and, thus, it was also used to test the emission mechanism models; finally, the XMM–Newton sample was extracted from the X-CfA sample so as to ensure a truly unbiased and well defined sample of objects to define the average properties of Seyfert galaxies. Taking advantage of the broad-band coverage of the BeppoS AX MECS and PDS instruments (between ~2-100 keV), I infer the average X-ray spectral propertiesof nearby Seyfert galaxies and in particular the photon index (~1.8), the high-energy cut-off (~290 keV), and the relative amount of cold reflection (~1.0). Moreover the unified scheme for active galactic nuclei was positively tested. The distribution of isotropic indicators used here (photon index, relative amount of reflection, high-energy cut-off and narrow FeK energy centroid) are similar in type I and type II objects while the absorbing column and the iron line equivalent width significantly differ between the two classes of sources with type II objects displaying larger absorbing columns. Taking advantage of the XMM–Newton and X–CfA samples I also deduced from measurements that 30 to 50% of type II Seyfert galaxies are Compton thick. Confirming previous results, the narrow FeK line is consistent, in Seyfert 2 galaxies, with being produced in the same matter responsible for the observed obscuration. These results support the basic picture of the unified model. Moreover, the presence of a X-ray Baldwin effect in type I sources has been measured using for the first time the 20-100 keV luminosity (EW proportional to L(20-100)^(−0.22±0.05)). This finding suggests that the torus covering factor may be a function of source luminosity, thereby suggesting a refinement of the baseline version of the unifed model itself. Using the BeppoSAX sample, it has been also recorded a possible correlation between the photon index and the amount of cold reflection in both type I and II sources. At a first glance this confirms the thermal Comptonization as the most likely origin of the high energy emission for the active galactic nuclei. This relation, in fact, naturally emerges supposing that the accretion disk penetrates, depending to the accretion rate, the central corona at different depths (Merloni et al. 2006): the higher accreting systems hosting disks down to the last stable orbit while the lower accreting systems hosting truncated disks. On the contrary, the study of the well defined X–C f A sample of Seyfert galaxies has proved that the intrinsic X-ray luminosity of nearby Seyfert galaxies can span values between 10^(38−43) erg s^−1, i.e. covering a huge range of accretion rates. The less efficient systems have been supposed to host ADAF systems without accretion disk. However, the study of the X–CfA sample has also proved the existence of correlations between optical emission lines and X-ray luminosity in the entire range of L_(X) covered by the sample. These relations are similar to the ones obtained if high-L objects are considered. Thus the emission mechanism must be similar in luminous and weak systems. A possible scenario to reconcile these somehow opposite indications is assuming that the ADAF and the two phase mechanism co-exist with different relative importance moving from low-to-high accretion systems (as suggested by the Gamma vs. R relation). The present data require that no abrupt transition between the two regimes is present. As mentioned above, the possible presence of an accretion disk has been tested using samples of nearby Seyfert galaxies. Here, to deeply investigate the flow patterns close to super-massive black-holes, three case study objects for which enough counts statistics is available have been analysed using deep X-ray observations taken with XMM–Newton. The obtained results have shown that the accretion flow can significantly differ between the objects when it is analyzed with the appropriate detail. For instance the accretion disk is well established down to the last stable orbit in a Kerr system for IRAS 13197-1627 where strong light bending effect have been measured. The accretion disk seems to be formed spiraling in the inner ~10-30 gravitational radii in NGC 3783 where time dependent and recursive modulation have been measured both in the continuum emission and in the broad emission line component. Finally, the accretion disk seems to be only weakly detectable in rk 509, with its weak broad emission line component. Finally, blueshifted resonant absorption lines have been detected in all three objects. This seems to demonstrate that, around super-massive black-holes, there is matter which is not confined in the accretion disk and moves along the line of sight with velocities as large as v~0.01-0.4c (whre c is the speed of light). Wether this matter forms winds or blobs is still matter of debate together with the assessment of the real statistical significance of the measured absorption lines. Nonetheless, if confirmed, these phenomena are of outstanding interest because they offer new potential probes for the dynamics of the innermost regions of accretion flows, to tackle the formation of ejecta/jets and to place constraints on the rate of kinetic energy injected by AGNs into the ISM and IGM. Future high energy missions (such as the planned Simbol-X and IXO) will likely allow an exciting step forward in our understanding of the flow dynamics around black holes and the formation of the highest velocity outflows.

Synthetische Glycopeptide mit Sulfatyl-Lewis X-Struktur als potenzielle Inhibitoren der Zelladhäsion

Zelladhäsionsprozesse sind von großer Bedeutung für zahlreiche biologische Prozesse, wie etwa die Immunantwort, die Wundheilung und die Embryogenese. Außerdem spielen sie eine entscheidende Rolle im Verlauf inflammatorischer Prozesse. An der Zelladhäsion sind verschiedene Klassen von Adhäsionsmolekülen beteiligt. Die erste leichte „rollende“ Adhäsion von Leukozyten am Ort einer Entzündung wird durch die Selektine vermittelt. Diese binden über die Kohlenhydrat-Strukturen Sialyl-Lewisx und Sialyl-Lewisa über eine calciumabhängige Kohlenhydrat-Protein-Bindung an ihre spezifischen Liganden und vermitteln so den ersten Zellkontakt, bevor andere Adhäsionsmoleküle (Cadherine, Integrine) die feste Adhäsion und den Durchtritt durch das Endothel bewirken. Bei einer pathogenen Überexpression der Selektine kommt es jedoch zu zahlreichen chronischen Erkrankungen wie z. B. rheumatoider Arthritis, Erkrankungen der Herzkranzgefäße oder dem Reperfusions-syndrom. Außerdem wird eine Beteiligung der durch die Selektine vermittelten Zellkontakte bei der Metastasierung von Karzinomzellen angenommen. Ein Ansatzpunkt für die Behandlung der oben genannten Erkrankungen ist die Gabe löslicher kompetitiver Inhibitoren für die Selektine. Ziel der Arbeit war die Modifikation des Sialyl-Lewisx-Leitmotivs zur Steigerung der metabolischen Stabilität und dessen Einbau in die Peptidsequenz aus der für die Bindung verantwortlichen Domäne des endogenen Selektin-Liganden PSGL-1. Dazu wurden mit einer modifizierten Lewisx-Struktur glycosylierte Aminosäurebausteine dargestellt (Abb.1). Die Verwendung von Arabinose und des Sulfatrestes anstelle von Fusose und Sialinsäure sollte außerdem zu einer gesteigerten metabolischen Stabilität des synthetischen Liganden beitragen. Die so erhaltenen Glycosylaminosäuren sollten nun in die Festphasenpeptidsynthese eingesetzt werden. Aufgrund der großen säurelabilität konnte hier nicht auf das Standartverfahren (Wang-Harz, Abspaltung mit TFA) zurückgegriffen werden. Deshalb kam ein neuartiges UV-labiles Ankersystem zum Einsatz. Dazu wurde ein Protokoll für die Synthese und Abspaltung von Peptiden an diesem neuen System entwickelt. Daran gelang die Synthese des nichtglycosylierten Peptidrückgrats sowie eines mit der dem sulfatierten Lewisx-Motiv versehenen Glycopeptids. Ein vierfach sulfatiertes Glycopeptid, welches durch den Einsatz von im Vorfeld chemisch sulfatierer Tyrosin-Bausteinen dargestellt werden sollte, konnte massenspektrometrisch nachgewiesen werden.

Il filo di Arianna - Una ricerca multi ed interdisciplinare per il superamento degli handicap che la x fragile propone

Il seguente lavoro di tesi verte sulla ricerca-azione formazione triennale “Il Filo di Arianna” realizzata in convenzione tra Associazione Italiana Sindrome X Fragile e Dipartimento Di Scienze dell’Educazione – Università di Bologna, finalizzata alla superamento degli handicap che la X fragile propone. La ricerca ha un fuoco in Pedagogia Speciale e un carattere multidisciplinare e inter istituzionale grazie alla sinergia con l’area neuroriabilitativa (Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) San Raffaele Pisana di Roma) e l’area della Psicologia Clinica (Ospedale Bambin Gesù di Roma). Il lavoro di tesi descrive il percorso per giungere alle linee guida di intervento scaturite dalla ricerca, per il potenziamento cognitivo ed affettivo di bambini e persone con x fragile nei contesti di casa, scuola e tempo libero.

Die Synthese eines Sialyl-Lewis X-Mimetikums als Baustein zur Herstellung von Glycopeptid-Zelladhäsionsinhibitoren für Selektine

Zelladhäsionsphänomene spielen eine wichtige Rolle in vielen biologischen Vorgängen, wie z. B. in der Embryogenese, der Wundheilung, der Immunantwort und Entzündungsprozessen. So wird die inflammatorische Kaskade durch P- und E-Selektin vermittelte Adhäsion der im Blutstrom zirkulierenden Leukozyten an Endothelzellen eingeleitet. Übermäßige Zelladhäsion kann hingegen eine Vielzahl von Krankheiten bewirken. Nachgewiesen ist eine solche Beteiligung der Selektine u. a. bei rheumatoider Arthritis, Erkrankungen der Herzkranzgefäße und dem Reperfusionssyndrom. Ein Ansatz zur Therapie besteht in der Verabreichung löslicher Selektinliganden, die kompetitiv an die Selektine binden und deren Aktivität dadurch mindern. Die wichtigste Leitstruktur für pharmakologisch aktive Selektinliganden stellt hierbei das Tetrasaccharid-Epitop Sialyl-Lewisx (sLex) dar.rnrnIn dieser Arbeit wurde nach einer nicht enzymatischen Strategie ein auf der sLex Struktur basierender Baustein für die Festphasen-Peptidsynthese synthetisiert. Aus diesem sollen nach Schutzgruppen-Manipulationen durch Einsatz in automatisierten Festphasen-Peptidsynthesen, verschiedene Glycopeptide als Zelladhäsionsinhibitoren für Selektine gewonnen werden. Der rasche Abbau der sLex-Struktur im Organismus schränkt die pharmakologische Nutzung von sLex-Derivaten jedoch stark ein. Das synthetisierte Kohlenhydrat Epitop weist daher gegenüber der natürlichen sLex-Struktur mehrere Modifikationen auf, die zu einer erhöhten metabolischen Stabilität führen sollen, ohne die für eine effektive Bindung zum Rezeptor nötigen Wechselwirkungen zu beeinträchtigen. rnrnAus diesem Grund wurde der synthetisch anspruchsvolle Sialinsäure-Baustein durch die L-Cyclohexylmilchsäure substituiert. Die Anbindung des Kohlenhydrat-Epitops an das Peptid wird im Gegensatz zur natürlichen N-glycosidischen Verknüpfung hier über eine zusätzliche Glucosamin-Einheit O-glycosidisch an die Aminosäure L-Threonin bewirkt. Außerdem wird der labile Fucose-Rest durch die D-Arabinose ersetzt, die nicht im menschlichen Organismus vorkommt, jedoch die drei essentiellen pharmakophoren Hydroxylfunktionen in der gleichen dreidimensionalen Orientierung präsentiert wie die L-Fucose.

Molekulare Analyse des Kolumnar-Gens beim Apfel (Malus x domestica)

Das Kolumnarwachstum beim Apfel (Malus x domestica) geht auf eine in den frühen 1960er Jahren entdeckte Zufallsmutation zurück. Die daraus resultierende Sprossmutante ist von großem wirtschaftlichem Interesse, da diese sehr kompakte Wuchsform unter anderem zu einer enormen Ertragssteigerung durch eine hohe Pflanzdichte der Bäume führt. Das Ziel der Arbeit ist die Entschlüsselung der molekularen Ursache dieser Mutation, die bisher weitgehend ungeklärt ist. Die Analyse wurde durch die Erstellung einer Referenzsequenz der Co-Zielregion einer kolumnaren Apfelsorte sowie durch die Konstruktion eng gekoppelter molekularer Marker realisiert. Durch die Konstruktion von genomischen Apfel-BAC-Bibliotheken mit mehrfacher Genomabdeckung und die Erstellung geeigneter Sonden wurde die Co-Region kloniert und deren Sequenz bestimmt. In Kombination zu dieser klassischen positionellen Klonierungsstrategie wurden genomische Illumina „mate pair“-Bibliotheken erstellt, sequenziert und bioinformatisch analysiert, um die genomische Region vollständig zu annotieren. Somit wurde eine vollständige genomische Referenz der Co-Region einer kolumnaren Apfelsorte erstellt, die die Grundlage für weitere Analysen bildet. Auf Basis dieser Referenz konnte die Co-Mutation in Form der Integration des LTR-Retrotransposons Gypsy-44 im kolumnaren Chromosom an Position 18,79 Mbp auf Chromosom 10 lokalisiert werden. Darüber hinaus konnten Transposon-basierende molekulare Marker erstellt werden, die eine verlässliche Genotypisierung von Apfelbäumen in Bezug auf das Kolumnarwachstum ermöglichen und dies unabhängig von der verwendeten Apfelsorte. Der genaue Wirkmechanismus von Gypsy-44, der zur Ausprägung dieses extremen Phänotyps führt, ist bislang unklar. Zusammenfassend lässt sich sagen, dass die molekulare Ursache für das kolumnare Wachstum aufgeklärt werden konnte und zudem die ersten molekularen Marker erstellt wurden, die eine sortenunabhängige Differenzierung zwischen kolumnaren und nicht kolumnaren Apfelbäumen ermöglichen.

WASP plays a novel role in regulating platelet responses dependent on alphaIIbbeta3 integrin outside-in signalling

The most consistent feature of Wiskott Aldrich syndrome (WAS) is profound thrombocytopenia with small platelets. The responsible gene encodes WAS protein (WASP), which functions in leucocytes as an actin filament nucleating agent -yet- actin filament nucleation proceeds normally in patient platelets regarding shape change, filopodia and lamellipodia generation. Because WASP localizes in the platelet membrane skeleton and is mobilized by alphaIIbbeta3 integrin outside-in signalling, we questioned whether its function might be linked to integrin. Agonist-induced alphaIIbbeta3 activation (PAC-1 binding) was normal for patient platelets, indicating normal integrin inside-out signalling. Inside-out signalling (fibrinogen, JON/A binding) was also normal for wasp-deficient murine platelets. However, adherence/spreading on immobilized fibrinogen was decreased for patient platelets and wasp-deficient murine platelets, indicating decreased integrin outside-in responses. Another integrin outside-in dependent response, fibrin clot retraction, involving contraction of the post-aggregation actin cytoskeleton, was also decreased for patient platelets and wasp-deficient murine platelets. Rebleeding from tail cuts was more frequent for wasp-deficient mice, suggesting decreased stabilisation of the primary platelet plug. In contrast, phosphatidylserine exposure, a pro-coagulant response, was enhanced for WASP-deficient patient and murine platelets. The collective results reveal a novel function for WASP in regulating pro-aggregatory and pro-coagulant responses downstream of integrin outside-in signalling.

Preclinical in vitro and in vivo characterization of the fully human monoclonal IgM antibody KBPA101 specific for Pseudomonas aeruginosa serotype IATS-O11

Pseudomonas aeruginosa infection in ventilator-associated pneumonia is a serious and often life-threatening complication in intensive care unit patients, and new treatment options are needed. We used B-cell-enriched peripheral blood lymphocytes from a volunteer immunized with a P. aeruginosa O-polysaccharide-toxin A conjugate vaccine to generate human hybridoma cell lines producing monoclonal antibodies specific for individual P. aeruginosa lipopolysaccharide serotypes. The fully human monoclonal antibody secreted by one of these lines, KBPA101, is an IgM/kappa antibody that binds P. aeruginosa of International Antigenic Typing System (IATS) serotype O11 with high avidity (5.81 x 10(7) M(-1) +/- 2.8 x 10(7) M(-1)) without cross-reacting with other serotypes. KBPA101 specifically opsonized the P. aeruginosa of IATS O11 serotype and mediated complement-dependent phagocytosis in vitro by the human monocyte-like cell line HL-60 at a very low concentration (half-maximal phagocytosis at 0.16 ng/ml). In vivo evaluation of KBPA101 demonstrated a dose-response relationship for protection against systemic infections in a murine burn wound sepsis model, where 70 to 100% of animals were protected against lethal challenges with P. aeruginosa at doses as low as 5 microg/animal. Furthermore, a high efficacy of KBPA101 in protection from local respiratory infections in an acute lung infection model in mice was demonstrated. Preclinical toxicology evaluation on human tissue, in rabbits, and in mice did not indicate any toxicity of KBPA101. Based on these preclinical findings, the first human clinical trials have been initiated.

Ocular involvement in paediatric haemolytic uraemic syndrome

The aim of this study was to estimate the frequency and severity of ocular involvement in paediatric patients with haemolytic uraemic syndrome (HUS).

White-Nose Syndrome-Affected Litttle Brown Myotis (Myotis Lucifugus) Increase Grooming and Other Active Behaviors During Arousals from Hibernation

White-nose syndrome (WNS) is an emerging infectious disease of hibernating bats linked to the death of an estimated 5.7 million or more bats in the northeastern United States and Canada. White-nose syndrome is caused by the cold-loving fungus Pseudogymnoascus destructans (Pd), which invades the skin of the muzzles, ears, and wings of hibernating bats. Previous work has shown that WNS-affected bats arouse to euthermic or near euthermic temperatures during hibernation significantly more frequently than normal and that these too-frequent arousals are tied to severity of infection and death date. We quantified the behavior of bats during these arousal bouts to understand better the causes and consequences of these arousals. We hypothesized that WNS-affected bats would display increased levels of activity (especially grooming) during their arousal bouts from hibernation compared to WNS-unaffected bats. Behavior of both affected and unaffected hibernating bats in captivity was monitored from December 2010 to March 2011 using temperature-sensitive dataloggers attached to the backs of bats and infrared motion-sensitive cameras. The WNS-affected bats exhibited significantly higher rates of grooming, relative to unaffected bats, at the expense of time that would otherwise be spent inactive. Increased self-grooming may be related to the presence of the fungus. Elevated activity levels in affected bats likely increase energetic stress, whereas the loss of rest (inactive periods when aroused from torpor) may jeopardize the ability of a bat to reestablish homeostasis in a number of physiologic systems.

Thyroid function and prevalent and incident metabolic syndrome in older adults: the health, ageing and body composition study

Both subclinical hypothyroidism and the metabolic syndrome have been associated with increased risk of coronary heart disease events. It is unknown whether the prevalence and incidence of metabolic syndrome is higher as TSH levels increase, or in individuals with subclinical hypothyroidism. We sought to determine the association between thyroid function and the prevalence and incidence of the metabolic syndrome in a cohort of older adults.

Decreasing frequency of plasma exchange complications in patients treated for thrombotic thrombocytopenic purpura-hemolytic uremic syndrome, 1996 to 2011

Plasma exchange (PEX) treatment for patients with thrombotic thrombocytopenic purpura-hemolytic uremic syndrome (TTP-HUS) has risk for major complications.

Retrospective evaluation of postoperative nasotracheal tubes for oxygen supplementation in dogs following surgery for brachycephalic syndrome: 36 cases (2003-2007)

OBJECTIVE: To assess the utility of nasotracheal tubes in postoperative oxygen supplementation in dogs following corrective surgery for brachycephalic syndrome. DESIGN: Retrospective study 2003-2007. SETTING: University teaching hospital. ANIMALS: Thirty-six client-owned dogs that underwent corrective surgery for brachycephalic syndrome. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Medical records were reviewed for animals that underwent surgical interventions for brachycephalic syndrome including palatoplasty, ventriculectomy, and rhinoplasty. Data collected included signalment, presenting complaints, analgesic and surgical interventions, type of supplemental oxygen therapy, complications and mortality occurring during hospitalization. A nasotracheal tube (NTT) was placed in 20 dogs at the end of surgery; 16 dogs received other forms of oxygen supplementation (8) or no oxygen supplementation (8) during recovery. The total number of postoperative complications was similar in both groups (8/20 dogs with NTTs and 7/16 in those without NTTs). However, respiratory distress was observed in 5 dogs without NTTs but was not observed in any dog while an NTT was in place. One dog in each group died postoperatively. CONCLUSION: Placement of an NTT was found to be easy and may offer benefit in dogs with brachycephalic syndrome as a noninvasive means of delivering oxygen. The use of NTT may minimize severe postoperative morbidity, in particular by reducing postoperative respiratory distress.