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BACKGROUND Lymphomatoid granulomatosis (LyG) is a rare lymphoproliferative disorder associated with Epstein-Barr virus (EBV) in which there is an infection of B cells and numerous reactive T cells. The lymphoproliferative disorder progresses to organ infiltration and resultant dysfunction of affected organs. Histologically, it is characterized by a triad of polymorphic lymphoid infiltrate, angiitis, and granulomatosis. The lungs are the most commonly involved sites for lymphomatoid granulomatosis, but other sites that can be involved include the liver, skin, and central nervous system. The signs and symptoms of LyG can vary, and can produce generalized symptoms such as cough, shortness of breath, and chest tightness, but can vary depending on the location of LyG. CASE REPORT We report a case of a 60-year-old man who presented with altered mental status. Cross-sectional imaging of the brain was negative for any acute intracranial process, but a fine-needle biopsy of a retroperitoneal lymph node revealed nodular polymorphous mononuclear infiltrates containing atypical large EBV-positive B cells with positive EBER and CD30, consistent with lymphomatoid granulomatosis. The patient was started on a regimen of brentuximab/bendamustine, and instructed to follow up with Oncology on an outpatient basis. CONCLUSIONS Treatment options for lymphomatoid granulomatosis are based on the disease grading. Lymphomatoid granulomatosis can be classified by using a grading system determined by the number of EBV-positive large B cell malignant cells, along with necrosis. The most effective treatment for lymphomatoid granulomatosis is unknown, but at this time treatment protocols are based on the grade of the disease. The clinical and histological features of lymphomatoid granulomatosis are discussed in this case report.

Many exciting advances in cancer-related telomere biology have been made in the past decade. Of these recent advances, great progress has also been made with respect to the Alternative Lengthening of Telomeres (ALT) pathway. Along with a better understanding of the molecular mechanism of this unique telomere maintenance pathway, many studies have also evaluated ALT activity in various cancer subtypes. We first briefly review and assess a variety of commonly used ALT biomarkers. Then, we provide both an update on ALT-positive (ALT+) tumor prevalence as well as a systematic clinical assessment of the presently studied ALT+ malignancies. Additionally, we discuss the pathogenetic alterations in ALT+ cancers, for example, the mutation status of ATRX and DAXX , and their correlations with the activation of the ALT pathway. Finally, we highlight important ALT+ clinical associations within each cancer subtype and subdivisions within, as well as their prognoses. We hope this alternative perspective will allow scientists, clinicians, and drug developers to have greater insight into the ALT cancers so that together, we may develop more efficacious treatments and improved management strategies to meet the urgent needs of cancer patients.

Pancreatic ductal adenocarcinoma (PDAC) remains a particularly lethal disease that is resistant to targeted therapies. Tyrosine kinase inhibitors (TKIs), including erlotinib and gefitinib, which block the action of the human epidermal growth factor receptor type 1 receptor, provide small increases in patient survival when administered with gemcitabine. The retinoblastoma (Rb) tumor suppressor protein is an additional target in pancreatic cancer, due to its documented inactivation in PDAC. The present study, using cell number, apoptosis and immunoblotting assays, aimed to evaluate the effects of activation of the Rb tumor suppressor via dephosphorylation by small interfering RNA‑mediated phosphatase activation. In the Panc1, MIAPaCa‑2 and Capan‑2 pancreatic cancer cell lines, and in normal H6c7 cells, the effects of phosphatase activation on Rb were revealed to be dependent on expression of the p16 tumor suppressor, which regulates Rb phosphorylation. Phosphatase activation had no effect on non‑transformed pancreatic epithelial cells. When comparing kinase inhibition with phosphatase activation, it was demonstrated that kinase inhibition reduced proliferation, whereas phosphatase activation induced apoptosis. Both treatments together resulted in a greater reduction of pancreatic cancer cells than either treatment alone. In addition, the effects of combination treatment of phosphatase activation with TKIs on cell number and activation of the signal transducer and activator of transcription 3 (STAT3) resistance pathway were determined. The combination of Rb phosphatase activation with TKIs resulted in a greater reduction in cell number compared with either treatment alone, without STAT3 pathway activation. These data suggested that targeting Rb phosphorylation by activating phosphatase may be a rational strategy to inhibit pancreatic tumor cell growth, without activation of acquired resistance.

Unlabelled: The impact of climate change on surface-level ozone is examined through a multiscale modeling effort that linked global and regional climate models to drive air quality model simulations. Results are quantified in terms of the relative response factor (RRF(E)), which estimates the relative change in peak ozone concentration for a given change in pollutant emissions (the subscript E is added to RRF to remind the reader that the RRF is due to emission changes only). A matrix of model simulations was conducted to examine the individual and combined effects offuture anthropogenic emissions, biogenic emissions, and climate on the RRF(E). For each member in the matrix of simulations the warmest and coolest summers were modeled for the present-day (1995-2004) and future (2045-2054) decades. A climate adjustment factor (CAF(C) or CAF(CB) when biogenic emissions are allowed to change with the future climate) was defined as the ratio of the average daily maximum 8-hr ozone simulated under a future climate to that simulated under the present-day climate, and a climate-adjusted RRF(EC) was calculated (RRF(EC) = RRF(E) x CAF(C)). In general, RRF(EC) > RRF(E), which suggests additional emission controls will be required to achieve the same reduction in ozone that would have been achieved in the absence of climate change. Changes in biogenic emissions generally have a smaller impact on the RRF(E) than does future climate change itself The direction of the biogenic effect appears closely linked to organic-nitrate chemistry and whether ozone formation is limited by volatile organic compounds (VOC) or oxides of nitrogen (NO(x) = NO + NO2). Regions that are generally NO(x) limited show a decrease in ozone and RRF(EC), while VOC-limited regions show an increase in ozone and RRF(EC). Comparing results to a previous study using different climate assumptions and models showed large variability in the CAF(CB)., Implications: We present a methodology for adjusting the RRF to account for the influence of climate change on ozone. The findings of this work suggest that in some geographic regions, climate change has the potential to negate decreases in surface ozone concentrations that would otherwise be achieved through ozone mitigation strategies. In regions of high biogenic VOC emissions relative to anthropogenic NO(x) emissions, the impact of climate change is somewhat reduced, while the opposite is true in regions of high anthropogenic NO(x) emissions relative to biogenic VOC emissions. Further, different future climate realizations are shown to impact ozone in different ways.

Observations of star formation and kinematics in early galaxies at high spatial and spectral resolution have shown that two-thirds are massive rotating disk galaxies, with the remainder being less massive non-rotating objects. The line-of-sight-averaged velocity dispersions are typically five times higher than in today's disk galaxies. This suggests that gravitationally unstable, gas-rich disks in the early Universe are fuelled by cold, dense accreting gas flowing along cosmic filaments and penetrating hot galactic gas halos. These accreting flows, however, have not been observed, and cosmic accretion cannot power the observed level of turbulence. Here we report observations of a sample of rare, high-velocity-dispersion disk galaxies in the nearby Universe where cold accretion is unlikely to drive their high star formation rates. We find that their velocity dispersions are correlated with their star formation rates, but not their masses or gas fractions, which suggests that star formation is the energetic driver of galaxy disk turbulence at all cosmic epochs.

Background: Cerebral abscess commonly occurs secondary to trauma, hematogenous spread from distant infection, or otitis media. Pulmonary AVF is an uncommon cause of recurrent cerebral abscess and is often overlooked. We report 3 cases of cerebral abscesses secondary to pulmonary AVF., Case Description: A 20-year-old man who presented with fever, headache, and vomiting of short duration was diagnosed as having right parietal abscess and underwent burr hole and tapping and antibiotic treatment. He later presented with many episodes of cerebral abscess at various locations involving both sides and required multiple surgical procedures. The routine workup for the source did not reveal any etiology. His hematological examination revealed polycythemia. A pulmonary angiogram was performed, which revealed pulmonary AVF. He underwent embolization of the fistula and had no further recurrence. Two other adult men were treated surgically for cerebral abscess. One patient had polycythemia and hypoxemia, and another had clubbing. Both patients were investigated with CT of the chest and were diagnosed as having pulmonary AVF. None of them had features of HHT., Conclusions: Pulmonary AVF is an unusual cause of cerebral abscess. Patients with multiple recurrences of cerebral abscess, signs of pulmonary disease, and hypoxia should be investigated for pulmonary AVF.

Recent ice core measurements show lead concentrations increasing since 1970, suggesting new nonautomobile-related sources of Pb are becoming important worldwide (1). Developing a full understanding of the major sources of Pb and other metals is critical to controlling these emissions. During the March, 2006 MILAGRO campaign, single particle measurements in Mexico City revealed the frequent appearance of particles internally mixed with Zn, Pb, Cl, and P. Pb concentrations were as high as 1.14 microg/m3 in PM10 and 0.76 microg/m3 in PM2.5. Real time measurements were used to select time periods of interest to perform offline analysis to obtain detailed aerosol speciation. Many Zn-rich particles had needle-like structures and were found to be composed of ZnO and/or Zn(NO3)2 x 6H2O. The internally mixed Pb-Zn-Cl particles represented as much as 73% of the fine mode particles (by number) in the morning hours between 2-5 am. The Pb-Zn-Cl particles were primarily in the submicrometer size range and typically mixed with elemental carbon suggesting a combustion source. The unique single particle chemical associations measured in this study closely match signatures indicative of waste incineration. Our findings also show these industrial emissions play an important role in heterogeneous processing of NO(y) species. Primary emissions of metal and sodium chloride particles emitted by the same source underwent heterogeneous transformations into nitrate particles as soon as photochemical production of nitric acid began each day at approximately 7 am.

Aim: Meningiomas are very rare in children comprising only 0.44.1% of pediatric age tumors and only 1.5-1.8% of all intracranial neoplasms. We analyzed the clinical, pathological and management profile of these rare tumors and elucidated their differences from meningiomas in adults., Methods: From 1990 to 2005, 33 patients belonging to the pediatric age group with intracranial meningiomas were treated in NIMHANS., Results: There were 19 male and 14 female children. The duration of symptoms ranged from 1 to 60 months. The study had a mean follow-up of 23.4 months. The commonest presenting symptoms were headache (90.9%) and visual disturbances (51.5%). Three patients had associated neurofibromatosis. Calcification was noticed in 22% of the tumors. Intraventricular meningiomas were the commonest (24.2%). Gross total or near total resection was possible in 22 out of 33 patients. Nine patients had reversible postoperative motor deficits. Fibrous meningioma was the commonest histological subtype (24.2%). Five patients had atypical or anaplastic subtypes. Adjuvant radiotherapy was administered in 4 patients. Six patients had recurrences and underwent surgery. Ten patients required either staged procedures or multiple surgeries for the recurrence/residual tumors., Conclusion: Pediatric meningiomas are rare tumors and differ from those in adults by their male predominance, atypical locations, higher rates of malignant subtypes, recurrence and association with neurofibromatosis. Surgical management is challenging because of atypical location., ((c) 2008 S. Karger AG, Basel.)

Little information is available on the surgical treatment of movement disorders in Wilson's disease. We report a successful outcome of left-sided stereotactic thalamotomy in a 30-year-old man with Wilson's disease, who had severe postural-kinetic tremor of both hands. The improvement was bilateral. Our case illustrates that stereotactic thalamotomy may be considered as an option in treating severe tremor in selected patients of Wilson's disease and merit further trials., ((c) 2007 Movement Disorder Society.)

Hierarchical galaxy formation is the model whereby massive galaxies form from an assembly of smaller units. The most massive objects therefore form last. The model succeeds in describing the clustering of galaxies, but the evolutionary history of massive galaxies, as revealed by their visible stars and gas, is not accurately predicted. Near-infrared observations (which allow us to measure the stellar masses of high-redshift galaxies) and deep multi-colour images indicate that a large fraction of the stars in massive galaxies form in the first 5 Gyr (refs 4-7), but uncertainties remain owing to the lack of spectra to confirm the redshifts (which are estimated from the colours) and the role of obscuration by dust. Here we report the results of a spectroscopic redshift survey that probes the most massive and quiescent galaxies back to an era only 3 Gyr after the Big Bang. We find that at least two-thirds of massive galaxies have appeared since this era, but also that a significant fraction of them are already in place in the early Universe.

Conventional dissection techniques require the excision of a channel from the cortex through the white matter with suction and bipolar cautery for the excision of deep-seated brain lesions. An alternative approach, using a previously described technique, in four cases is illustrated in this article. After craniotomy and dural opening, the index finger portion of a surgical glove was removed, tied over a brain cannula and gently passed towards the lesion under ultrasound guidance. Once the needle-tip was sonologically confirmed to be on the lesion, the balloon was inflated with about 3 to 5 ml of saline. This created a track through which the lesion could be excised under the microscope. The lesions were satisfactorily excised through the track created without removal of brain tissue. The accuracy of this minimally invasive technique can be enhanced when used in conjunction with intraoperative ultrasound guidance.

Many galaxies have taken on their familiar appearance relatively recently. In the distant Universe, galaxy morphology deviates significantly (and systematically) from that of nearby galaxies at redshifts (z) as low as 0.3. This corresponds to a time approximately 3.5 x 10(9) years in the past, which is only approximately 25% of the present age of the Universe. Beyond z = 0.5 (5 x 10(9) years in the past), spiral arms are less well developed and more chaotic, and barred spiral galaxies may become rarer. At z = 1, around 30% of the galaxy population is sufficiently peculiar that classification on Hubble's traditional "tuning fork" system is meaningless. On the other hand, some characteristics of galaxies have not changed much over time. The space density of luminous disk galaxies has not changed significantly since z = 1, indicating that although the general appearance of these galaxies has continuously changed over time, their overall numbers have been conserved.

Isolated hearts are widely used to study myocardial protection because they allow for rigorous control of parameters that is not readily achievable by the in-vivo heart models. The classic Langendorff system and its modifications using asanguinous perfusates have an obvious limitation in that asanguinous reperfusion is clinically irrelevant. The available blood-perfused heart systems are complicated by the use of pumping circuits. In this study, an isolated rat heart, harvested under cold cardioplegia, is alloperfused with the blood coming from an isogenic support rat. The coronary effluent returns to the support rat by gravity. The model was validated by testing its response to normothermic ischemia and reperfusion, and the expected protective effects of hypothermic-cardioplegia are demonstrated. A marked difference in response to ischemia is shown between this model and the buffer-perfused heart. We conclude that alloperfused isolated rat heart model is an inexpensive and more clinically relevant method of screening various new modes of myocardial protection.