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[Clinical and immunohistopathologic study of phosphaturic mesenchymal tumor].
Li, DM, Wu, HW, Li, JD, Xia, WB, Jiang, Y, Zhong, DR
Zhonghua bing li xue za zhi = Chinese journal of pathology. 2018;(6):427-431
Abstract
Objective: To study the clinicopathological characteristics and immunohistochemical phenotype of phosphaturic mesenchymal tumor (PMT) . Methods: The clinicopathological data and immunohistochemical profiles were obtained retrospectively from 206 patients diagnosed with PMT at Peking Union Medical College Hospital (PUMCH) during July 2008 to September 2017, with a review of literature. Results: The mean age of PMT patients was 42 years (range 13 to 70 years), with a male to female ratio of 1.1∶1.0. All patients presented with different degree of bone pain, muscle weakness, shorten of stature, thoracic deformity and pathological fractures, with hypophosphatemia and high serum ALP. Phosphatemia returned to normal within 1 week after operation in all cases underwent complete tumor resection. The duration of osteomalacia before resection (documented in 197 cases) ranged from 20 days to 40 years (average 5.7 years). The average blood phosphorus concentration raised from 0.49 mmol/L to 0.92 mmol/L before and after tumor resection (P<0.01), with 147 cases (84.0%, 147/175) returned to normal range within 2 weeks. The rate or blood phosphorus concentration recovery in 15 days after operation was 79.6% in average, displayed significant differences between patients with complete resection and those with partial resection (85.4% vs. 21.1%, P<0.01). PMT lesions mainly involved lower extremities (55.8%), followed by head and neck (29.1%). In immunohistochemical study, all cases were positive for vimentin (100.0%), while most cases were positive for NSE (96.3%), CD56 (94.2%), FGF23(88.4%), CD68 (88.3%), D2-40 (70.9%), CD34 (23.1%), SMA (55.5%), bcl-2 (59.8%) and CD99 (47.1%). The Ki-67 positive index of tumor varied from less than 2% (51.4%), 3% to 10% (41.3%) to >10% (7.2%). Conclusions: PMT mainly occurs in lower limbs or head and neck, with unique clinical characteristics and blood biochemical indexes. The tumor expresses a variety of immunohistochemical markers, indicating the potential of multi-directional differentiation. Clinical profile, blood biochemistry testing and immunohistochemical phenotype is helpful for diagnosis of PMT.
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Differences in resistance to nitrogen and phosphorus deficiencies explain male-biased populations of poplar in nutrient-deficient habitats.
Song, H, Lei, Y, Zhang, S
Journal of proteomics. 2018;:123-127
Abstract
UNLABELLED In most forest soils, the availability of nitrogen (N) and phosphorus (P) nutrients is low and unable to meet the requirement of tree growth. In the past decades, sex-based differences in poplar have been investigated in morphology and physiology. Proteomic techniques provide new insights into sex-specific differences at the molecular level. This review gives a comparative overview of the effects of N and P deficiencies on poplar physiological and proteomic characteristics. Male poplars are more efficient at photosynthesis and nutrient usage than females. Proteins related to carbohydrate metabolism, defence responses and transcription and translation processes are changed to adapt diversely in males and females. These results provide evidence that male poplar have better resistance to nutrient-limiting conditions than females, which may be reasonable for the male-biased sex ratio in nutrient-deficient habitats. Furthermore, this review also discusses the potential growth-defence trade-offs in male and female poplar coping with nutrient limitations. BIOLOGICAL SIGNIFICANCE In the past decades, the physiological and molecular responses of individual trees exposed to nutrient deficiency have been well studied. An important model woody plant, Populus, is dioecious and shows a male-biased sex ratio in nutrient-deficient habitats. Individually, different responses to nutrient limitation between the sexes determine the bias of population sex ratios. Proteomic techniques provide new insights into sex-based differences in the molecular mechanisms underlying nutrient deficiency. This review gives a comparative overview of the identification of nitrogen and phosphorus deficiency effects on physiological and proteomic characteristics. Male poplars are more resistant and have a smaller range of protein changes than females in response to N and P deficiency, which explains the observed male-biased sex ratios to a certain extent. Furthermore, this review also discusses the possible growth-defense trade-offs in male and female poplars coping with nutrient deficiency.
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Comparison of serum concentration of Ca, P, Mg, and Fe between hemifacial spasm patients and healthy controls; prospective randomized controlled study.
Ulusoy, EK, Ulusoy, DM, Kilic, S
Nigerian journal of clinical practice. 2018;(11):1537-1541
Abstract
PURPOSE In this study, we aimed to measure the serum vitamin D level in hemifacial spasmic (HFS) patients and show the role of HFS in the pathogenesis and place in etiology. MATERIALS AND METHODS This study included 43 prospective newly diagnosed HFS patients and 43 healthy volunteers in the neurology clinic. The serum (Ca, P, Mg, Fe) concentration of 4 essential elements was measured with a biochemical device. The groups were correlated in terms of four essential element concentrations. The severity of the disease was measured using Lee's Quality of Life Scale and correlated with the concentration of four trace elements. The results were compared using the independent t-test and Mann-Whitney U-test. RESULTS Concentration of serum Ca, P, and Mg in the HFS patients was found to be lower in the control group which was statistically significant (P < 0.05). There was no statistically difference between the groups in terms of Fe concentration (P > 0.05). There was no significant correlation between trace element concentration and severity of illness and daily life quality in the patient group. CONCLUSION These results show us the role of HFS in the pathogenesis of these four trace elements and the importance of its location in etiology. We think that changes in the concentration of trace elements in HFS can lead to demyelinization, which may lead to spasm.
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Understanding the growth of the bio-struvite production Brevibacterium antiquum in sludge liquors.
Simoes, F, Vale, P, Stephenson, T, Soares, A
Environmental technology. 2018;(17):2278-2287
Abstract
Biological struvite (bio-struvite) production through biomineralization has been suggested as an alternative to chemically derived struvite production to recover phosphorus from wastewater streams. In this study, statistical experimental design techniques were used to find the optimal growth rate (μ) of Brevibacterium antiquum in sludge liquors. Acetate, oleic acid, NaCl, NH4-N, and Ca2+ were shown to affect the growth rate of B. antiquum. The growth rate reached 3.44 1/d when the bacteria were supplemented with 3.0% w/v NaCl and 1124 mg chemical oxygen demand/L as acetate. However, NaCl was found to hinder the biomineralization of bio-struvite. A two-stage experiment demonstrated that bio-struvite was produced in the presence of acetate. Bio-struvite production was confirmed with X-ray spectroscopy and crystal morphology (prismatic, tabular, and twinned crystal habit) through electron microscope analysis. The bio-struvite production was estimated by measuring phosphate content of the recovered precipitates, reaching 9.6 mg P/L as bio-struvite. Overall, these results demonstrated the optimal conditions required to achieve high growth rates as well as bio-struvite production with B. antiquum. The results obtained in this study could be used to develop a process to grow B. antiquum in wastewater streams in mixed cultures and recover phosphorus-rich products such as struvite.
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Phosphorus concentration coordinates a respiratory bypass, synthesis and exudation of citrate, and the expression of high-affinity phosphorus transporters in Solanum lycopersicum.
Del-Saz, NF, Romero-Munar, A, Cawthray, GR, Palma, F, Aroca, R, Baraza, E, Florez-Sarasa, I, Lambers, H, Ribas-Carbó, M
Plant, cell & environment. 2018;(4):865-875
Abstract
Plants exhibit respiratory bypasses (e.g., the alternative oxidase [AOX]) and increase the synthesis of carboxylates in their organs (leaves and roots) in response to phosphorus (P) deficiency, which increases P uptake capacity. They also show differential expression of high-affinity inorganic phosphorus (Pi) transporters, thus avoiding P toxicity at a high P availability. The association between AOX and carboxylate synthesis was tested in Solanum lycopersicum plants grown at different soil P availability, by using plants grown under P-sufficient and P-limiting conditions and by applying a short-term (24 hr) P-sufficient pulse to plants grown under P limitation. Tests were also performed with plants colonized with arbuscular mycorrhizal fungi, which increased plant P concentration under reduced P availability. The in vivo activities of AOX and cytochrome oxidase were measured together with the concentration of carboxylates and the P concentration in plant organs. Gene transcription of Pi transporters (LePT1 and LePT2) was also studied. A coordinated response between plant P concentration with these traits was observed, indicating that a sufficient P availability in soil led to a suppression of both AOX activity and synthesis of citrate and a downregulation of the transcription of genes encoding high-affinity Pi transporters, presumably to avoid P toxicity.
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Effects of Different Dietary Interventions on Calcitriol, Parathyroid Hormone, Calcium, and Phosphorus: Results from the DASH Trial.
Hassoon, A, Michos, ED, Miller, ER, Crisp, Z, Appel, LJ
Nutrients. 2018;(3)
Abstract
The "Dietary Approaches to Stop Hypertension" (DASH) diet, rich in fiber and low-fat dairy, effectively lowers blood pressure. DASH's effect on calcitriol and other markers of bone-mineral metabolism is unknown. This secondary analysis of the DASH trial aimed to determine the effect of dietary patterns on blood concentrations of calcitriol, parathyroid hormone (PTH), ionized calcium, and urinary excretion of calcium and phosphorus. Outcomes were available in 334 participants in the trial. After a 3-week run-in on the control diet, participants were randomized to control, fruits and vegetables (F&V), or DASH diets. Outcomes were assessed at the end of run-in, and during the last week of the intervention period. Mean age of participants was 45.7 ± 10.7 years, 46% female, and 57% African-American. Mean ± Standard Deviation(SD) baseline serum concentrations of calcitriol, PTH, and ionized calcium were 37.8 ± 9.2 pg/mL, 46.1 ± 18.5 pg/mL and 5.2 ± 0.23 mg/dL, respectively. Mean (±SD) urinary calcium and phosphorus excretions were 150.1 ± 77.8 and 708.0 ± 251.8 mg/24 h, respectively. Compared with control, DASH reduced calcitriol -3.32 pg/mL (p = 0.004). Otherwise, there was no significant effect on other biomarkers. DASH lowered serum calcitriol perhaps more among African-Americans. These results raise important questions about the interpretation and clinical significance of low calcitriol concentrations in the setting of recommended diets.
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Microalgae population dynamics growth with AnMBR effluent: effect of light and phosphorus concentration.
Sanchis-Perucho, P, Duran, F, Barat, R, Pachés, M, Aguado, D
Water science and technology : a journal of the International Association on Water Pollution Research. 2018;(11-12):2566-2577
Abstract
The aim of this study was to evaluate the effect of light intensity and phosphorus concentration on biomass growth and nutrient removal in a microalgae culture and their effect on their competition. The photobioreactor was continuously fed with the effluent from an anaerobic membrane bioreactor pilot plant treating real wastewater. Four experimental periods were carried out at different light intensities (36 and 52 μmol s-1 m-2) and phosphorus concentrations (around 6 and 15 mgP L-1). Four green algae - Scenedesmus, Chlorella, Monoraphidium and Chlamydomonas- and cyanobacterium were detected and quantified along whole experimental period. Chlorella was the dominant species when light intensity was at the lower level tested, and was competitively displaced by a mixed culture of Scenedesmus and Monoraphidium when light was increased. When phosphorus concentration in the photobioreactor was raised up to 15 mgP L-1, a growth of cyanobacterium became the dominant species in the culture. The highest nutrient removal efficiency (around 58.4 ± 15.8% and 96.1 ± 16.5% of nitrogen and phosphorus, respectively) was achieved at 52 μmol s-1 m-2 of light intensity and 6.02 mgP L-1 of phosphorus concentration, reaching about 674 ± 86 mg L-1 of volatile suspended solids. The results obtained reveal how the light intensity supplied and the phosphorus concentration available are relevant operational factors that determine the microalgae species that is able to predominate in a culture. Moreover, changes in microalgae predominance can be induced by changes in the growth medium produced by the own predominant species.
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Personalized Management of Bone and Mineral Disorders and Precision Medicine in End-Stage Kidney Disease.
Jovanovich, A, Kendrick, J
Seminars in nephrology. 2018;(4):397-409
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Abstract
Chronic kidney disease mineral bone disorder (CKD-MBD) is common in end-stage renal disease and is associated with an increased risk of cardiovascular morbidity and mortality. Mainstays of treatment include decreasing serum phosphorus level toward the normal range with dietary interventions and phosphate binders and treating increased parathyroid hormone levels with activated vitamin D and/or calcimimetics. There is significant variation in serum levels of mineral metabolism markers, intestinal absorption of phosphorus, and therapeutic response among individual patients and subgroups of patients with end-stage renal disease. This variation may be partly explained by polymorphisms in genes associated with calcium and phosphorus homeostasis such as the calcium-sensing receptor gene, the vitamin D-binding receptor gene, and genes associated with vascular calcification. In this review, we discuss how personalized medicine may be used for the management of CKD-MBD and how it ultimately may lead to improved clinical outcomes. Although genetic variants may seem attractive targets to tailor CKD-MBD therapy, complete understanding of how these polymorphisms function and their clinical utility and applicability to personalized medicine need to be determined.
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Functional and structural insights into candidate genes associated with nitrogen and phosphorus nutrition in wheat (Triticum aestivum L.).
Kumar, A, Sharma, M, Kumar, S, Tyagi, P, Wani, SH, Gajula, MNVP, Singh, KP
International journal of biological macromolecules. 2018;(Pt A):76-91
Abstract
An extensive bioinformatics based study has been performed to gain insight into the structural and functional aspects of candidate genes involved in Nitrogen and Phosphorus nutrition in wheat. Based on our study, 37 N and P nutrition candidate genes were identified (24 NUE and 13 inorganic phosphate transporters) in wheat genome. 23 gene specific novel microsatellites were discovered using genomic sequences of identified N and P nutrition genes. We also identified the microRNAs that target ten candidate genes including TaAS1-3A, TaAS1-3D, TaASN2-1A, TaASN2-1B, TaANR1-6A, TaANR1-6B, TaNRT2.4-6A, TaNRT2.6-6A, TaNRT2.6-6B and TaPHT1.5-5B. Expression profiling of identified genes showed altered expression under N and P starvation. The proposed 3D structure of wheat N and P nutrition proteins shared high level homology with known experimental structures providing information to understand their functions at the biochemical level. Molecular dynamics simulations of refined modeled structures of wheat N and P nutrition proteins show conformational stability. The identified N and P nutrition candidate genes and their targeting miRNAs may provide resources for the genetic improvement and promote N and P use efficiency. Our study provides first-hand structural prospective of N and P nutrition candidate genes towards development of wheat varieties resilient to N and P stress.
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Phosphate binders for preventing and treating chronic kidney disease-mineral and bone disorder (CKD-MBD).
Ruospo, M, Palmer, SC, Natale, P, Craig, JC, Vecchio, M, Elder, GJ, Strippoli, GF
The Cochrane database of systematic reviews. 2018;(8):CD006023
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Abstract
BACKGROUND Phosphate binders are used to reduce positive phosphate balance and to lower serum phosphate levels for people with chronic kidney disease (CKD) with the aim to prevent progression of chronic kidney disease-mineral and bone disorder (CKD-MBD). This is an update of a review first published in 2011. OBJECTIVES The aim of this review was to assess the benefits and harms of phosphate binders for people with CKD with particular reference to relevant biochemical end-points, musculoskeletal and cardiovascular morbidity, hospitalisation, and death. SEARCH METHODS We searched the Cochrane Kidney and Transplant Register of Studies up to 12 July 2018 through contact with the Information Specialist using search terms relevant to this review. Studies in the Register are identified through searches of CENTRAL, MEDLINE, and EMBASE, conference proceedings, the International Clinical Trials Register (ICTRP) Search Portal and ClinicalTrials.gov. SELECTION CRITERIA We included randomised controlled trials (RCTs) or quasi-RCTs of adults with CKD of any GFR category comparing a phosphate binder to another phosphate binder, placebo or usual care to lower serum phosphate. Outcomes included all-cause and cardiovascular death, myocardial infarction, stroke, adverse events, vascular calcification and bone fracture, and surrogates for such outcomes including serum phosphate, parathyroid hormone (PTH), and FGF23. DATA COLLECTION AND ANALYSIS Two authors independently selected studies for inclusion and extracted study data. We applied the Cochrane 'Risk of Bias' tool and used the GRADE process to assess evidence certainty. We estimated treatment effects using random-effects meta-analysis. Results were expressed as risk ratios (RR) for dichotomous outcomes together with 95% confidence intervals (CI) or mean differences (MD) or standardised MD (SMD) for continuous outcomes. MAIN RESULTS We included 104 studies involving 13,744 adults. Sixty-nine new studies were added to this 2018 update.Most placebo or usual care controlled studies were among participants with CKD G2 to G5 not requiring dialysis (15/25 studies involving 1467 participants) while most head to head studies involved participants with CKD G5D treated with dialysis (74/81 studies involving 10,364 participants). Overall, seven studies compared sevelamer with placebo or usual care (667 participants), seven compared lanthanum to placebo or usual care (515 participants), three compared iron to placebo or usual care (422 participants), and four compared calcium to placebo or usual care (278 participants). Thirty studies compared sevelamer to calcium (5424 participants), and fourteen studies compared lanthanum to calcium (1690 participants). No study compared iron-based binders to calcium. The remaining studies evaluated comparisons between sevelamer (hydrochloride or carbonate), sevelamer plus calcium, lanthanum, iron (ferric citrate, sucroferric oxyhydroxide, stabilised polynuclear iron(III)-oxyhydroxide), calcium (acetate, ketoglutarate, carbonate), bixalomer, colestilan, magnesium (carbonate), magnesium plus calcium, aluminium hydroxide, sucralfate, the inhibitor of phosphate absorption nicotinamide, placebo, or usual care without binder. In 82 studies, treatment was evaluated among adults with CKD G5D treated with haemodialysis or peritoneal dialysis, while in 22 studies, treatment was evaluated among participants with CKD G2 to G5. The duration of study follow-up ranged from 8 weeks to 36 months (median 3.7 months). The sample size ranged from 8 to 2103 participants (median 69). The mean age ranged between 42.6 and 68.9 years.Random sequence generation and allocation concealment were low risk in 25 and 15 studies, respectively. Twenty-seven studies reported low risk methods for blinding of participants, investigators, and outcome assessors. Thirty-one studies were at low risk of attrition bias and 69 studies were at low risk of selective reporting bias.In CKD G2 to G5, compared with placebo or usual care, sevelamer, lanthanum, iron and calcium-based phosphate binders had uncertain or inestimable effects on death (all causes), cardiovascular death, myocardial infarction, stroke, fracture, or coronary artery calcification. Sevelamer may lead to constipation (RR 6.92, CI 2.24 to 21.4; low certainty) and lanthanum (RR 2.98, CI 1.21 to 7.30, moderate certainty) and iron-based binders (RR 2.66, CI 1.15 to 6.12, moderate certainty) probably increased constipation compared with placebo or usual care. Lanthanum may result in vomiting (RR 3.72, CI 1.36 to 10.18, low certainty). Iron-based binders probably result in diarrhoea (RR 2.81, CI 1.18 to 6.68, high certainty), while the risks of other adverse events for all binders were uncertain.In CKD G5D sevelamer may lead to lower death (all causes) (RR 0.53, CI 0.30 to 0.91, low certainty) and induce less hypercalcaemia (RR 0.30, CI 0.20 to 0.43, low certainty) when compared with calcium-based binders, and has uncertain or inestimable effects on cardiovascular death, myocardial infarction, stroke, fracture, or coronary artery calcification. The finding of lower death with sevelamer compared with calcium was present when the analysis was restricted to studies at low risk of bias (RR 0.50, CI 0.32 to 0.77). In absolute terms, sevelamer may lower risk of death (all causes) from 210 per 1000 to 105 per 1000 over a follow-up of up to 36 months, compared to calcium-based binders. Compared with calcium-based binders, lanthanum had uncertain effects with respect to all-cause or cardiovascular death, myocardial infarction, stroke, fracture, or coronary artery calcification and probably had reduced risks of treatment-related hypercalcaemia (RR 0.16, CI 0.06 to 0.43, low certainty). There were no head-to-head studies of iron-based binders compared with calcium. The paucity of placebo-controlled studies in CKD G5D has led to uncertainty about the effects of phosphate binders on patient-important outcomes compared with placebo.It is uncertain whether the effects of binders on clinically-relevant outcomes were different for patients who were and were not treated with dialysis in subgroup analyses. AUTHORS' CONCLUSIONS In studies of adults with CKD G5D treated with dialysis, sevelamer may lower death (all causes) compared to calcium-based binders and incur less treatment-related hypercalcaemia, while we found no clinically important benefits of any phosphate binder on cardiovascular death, myocardial infarction, stroke, fracture or coronary artery calcification. The effects of binders on patient-important outcomes compared to placebo are uncertain. In patients with CKD G2 to G5, the effects of sevelamer, lanthanum, and iron-based phosphate binders on cardiovascular, vascular calcification, and bone outcomes compared to placebo or usual care, are also uncertain and they may incur constipation, while iron-based binders may lead to diarrhoea.