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Sample records for acute complex type

  1. Anti-diabetic effects of Inonotus obliquus polysaccharides-chromium (III) complex in type 2 diabetic mice and its sub-acute toxicity evaluation in normal mice.

    Science.gov (United States)

    Wang, Cong; Chen, Zhongqin; Pan, Yuxiang; Gao, Xudong; Chen, Haixia

    2017-10-01

    Polysaccharides are important bioactive ingredients from Inonotus obliquus. This study aimed to synthesize and characterize a novel I. obliquus polysaccharides-chromium (III) complex (UIOPC) and investigate the anti-diabetic effects in streptozotocin (STZ) induced type 2 diabetes mellitus (T2DM) mice and sub-acute toxicity in normal mice. The molecular weight of UIOPC was about 11.5 × 10 4  Da with the chromium content was 13.01% and the chromium was linked with polysaccharides through coordination bond. After treatment of UIOPC for four weeks, the body weight, fasting blood glucose (FBG) levels, plasma insulin levels of the diabetic mice were significantly reduced when compared with those of the diabetic mice (p < 0.05). The results on serum profiles and antioxidant enzymes activities revealed that UIOPC had a positive effect on hypoglycemic and antioxidant ability. Histopathology results showed that UIOPC could effectively alleviate the STZ-lesioned tissues in diabetic mice. Furthermore, high dose administration of UIOPC had no obviously influence on serum profiles levels and antioxidant ability of the normal mice and the organ tissues maintained organized and integrity in the sub-acute toxicity study. These results suggested that UIOPC might be a good candidate for the functional food or pharmaceuticals in the treatment of T2DM. Copyright © 2017 Elsevier Ltd. All rights reserved.

  2. [Type IA glycogenosis with acute pancreatitis].

    Science.gov (United States)

    Herman, T E

    1995-01-01

    Type IA glycogenosis, or von Gierke disease, is the most common among the glycogenoses with enlarged liver. Acute pancreatitis is a rare manifestation of type IA glycogenosis and has been attributed to elevated serum fat levels. We report a case of type IA glycogenosis with acute pancreatitis. The radiologists should be familiar with the computed tomography findings in this rare complications of type IA glycogenosis.

  3. Mitochondrial complex I deactivation is related to superoxide production in acute hypoxia

    Directory of Open Access Journals (Sweden)

    Pablo Hernansanz-Agustín

    2017-08-01

    Full Text Available Mitochondria use oxygen as the final acceptor of the respiratory chain, but its incomplete reduction can also produce reactive oxygen species (ROS, especially superoxide. Acute hypoxia produces a superoxide burst in different cell types, but the triggering mechanism is still unknown. Herein, we show that complex I is involved in this superoxide burst under acute hypoxia in endothelial cells. We have also studied the possible mechanisms by which complex I could be involved in this burst, discarding reverse electron transport in complex I and the implication of PTEN-induced putative kinase 1 (PINK1. We show that complex I transition from the active to ‘deactive’ form is enhanced by acute hypoxia in endothelial cells and brain tissue, and we suggest that it can trigger ROS production through its Na+/H+ antiporter activity. These results highlight the role of complex I as a key actor in redox signalling in acute hypoxia.

  4. High affinity complexes of pannexin channels and L-type calcium channel splice-variants in human lung: Possible role in clevidipine-induced dyspnea relief in acute heart failure.

    Science.gov (United States)

    Dahl, Gerhard P; Conner, Gregory E; Qiu, Feng; Wang, Junjie; Spindler, Edward; Campagna, Jason A; Larsson, H Peter

    2016-08-01

    Clevidipine, a dihydropyridine (DHP) analogue, lowers blood pressure (BP) by inhibiting l-type calcium channels (CaV1.2; gene CACNA1C) predominantly located in vascular smooth muscle (VSM). However, clinical observations suggest that clevidipine acts by a more complex mechanism. Clevidipine more potently reduces pulmonary vascular resistance (PVR) than systemic vascular resistance and its spectrum of effects on PVR are not shared by other DHPs. Clevidipine has potent spasmolytic effects in peripheral arteries at doses that are sub-clinical for BP lowering and, in hypertensive acute heart failure, clevidipine, but not other DHPs, provides dyspnea relief, partially independent of BP reduction. These observations suggest that a molecular variation in CaV1.2 may exist which confers unique pharmacology to different DHPs. We sequenced CACNA1C transcripts from human lungs and measured their affinity for clevidipine. Human lung tissue contains CACNA1C mRNA with many different splice variations. CaV1.2 channels with a specific combination of variable exons showed higher affinity for clevidipine, well below the concentration associated with BP reduction. Co-expression with pannexin 1 further increased the clevidipine affinity for this CaV1.2 splice variant. A high-affinity splice variant of CaV1.2 in combination with pannexin 1 could underlie the selective effects of clevidipine on pulmonary arterial pressure and on dyspnea. Clevidipine lowers blood pressure by inhibiting calcium channels in vascular smooth muscle. In patients with acute heart failure, clevidipine was shown to relieve breathing problems. This was only partially related to the blood pressure lowering actions of clevidipine and not conferred by another calcium channel inhibitor. We here found calcium channel variants in human lung that are more selectively inhibited by clevidipine, especially when associated with pannexin channels. This study gives a possible mechanism for clevidipine's relief of breathing

  5. Contemporary Management of Acute Type B Dissection.

    Science.gov (United States)

    Scott, A J; Bicknell, C D

    2016-03-01

    Growing confidence in thoracic endovascular aortic repair (TEVAR) for the management of acute type B aortic dissection has resulted in controversies regarding optimum patient selection and the timing of intervention. In this review a clinical vignette to present a practical perspective on the contemporary management of acute type B dissection (ABAD) in a specialist vascular centre with particular focus on areas of debate is used. This is a narrative clinical review. Aggressive anti-impulse therapy is the cornerstone of management of all patients with ABAD. However, 20-30% of patients develop complicated ABAD defined by the presence of malperfusion syndromes, acute aortic dilatation, dissection extension, or persistent pain and hypotension. These complicated patients typically require intervention, and non-randomised series suggest TEVAR to be an effective alternative to open repair with a lower morbidity. There is considerable interest and controversy surrounding the use of TEVAR in uncomplicated ABAD patients for whom the intervention-free survival at 6 years is less than 50% for patients managed with anti-impulse therapy. Data regarding this question are sparse, but two randomised trials (ADSORB and INSTEAD) both demonstrated a higher rate of favourable aortic remodelling in patients managed with TEVAR than medical therapy alone. However, it is unclear whether this positive remodelling translates into a reduction in long-term mortality sufficient to balance the early perioperative hazards of endografting. Despite increasing adeptness at endovascular stenting, the long-term outcomes of patients with ABAD leave significant room for improvement. In particular, the optimum management of patients with uncomplicated disease is unclear and guidance from trials powered for long-term mortality is awaited. Until then, the principals of management of ABAD remain aggressive medical therapy for all patients, with TEVAR primarily reserved for those who develop complications

  6. Complex endoscopic treatment of acute gastrointestinal bleeding of ulcer origin

    Directory of Open Access Journals (Sweden)

    V. V. Izbitsky

    2013-06-01

    Full Text Available Gastrointestinal bleeding (GIB is determined in 20-30% of patients with peptic ulcer disease. Acute gastrointestinal bleeding is on the first place as the main cause of deaths from peptic ulcer ahead of the other complications. Rebleeding occurs in 30-38% of patients. Materials and Methods For getting of the objective endoscopic picture in patients with bleeding gastroduodenal ulcers we used the classification of J.A. Forrest in our study: Type I - active bleeding: • I a - pulsating jet; • I b - stream. Type II - signs of recent bleeding: • II a - visible (non-bleeding visible vessel; • II b - fixed thrombus - a clot; • II c - flat black spot (black bottom ulcers. Type III - ulcer with a clean (white down. Integrated endoscopic hemostasis included: irrigation of ulcer defect and area around it with 3% hydrogen peroxide solution in a volume of 10 - 30ml; Injection of 2-4 mL of diluted epinephrine (1:10000 for hemostasis; use of Argon plasma coagulation. Results and Discussion Integrated endoscopic stop of bleeding was performed in 57 patients who were examined and treated at the Department of Surgery from 2006 to 2012. In 16 patients bleeding was caused by gastric ulcer. Gastric ulcer type I localization according to classification (HD Johnson, 1965 was determined in 9 patients, type II - in 2 patients, type III – in 5 patients. In 31 patients bleeding was caused by duodenal peptic ulcer, in 4 patients - erosive gastritis, 1 - erosive esophagitis, and in 5 patients - gastroenteroanastomosis area peptic ulcer. Final hemostasis was achieved in 55 (96.5% patients. In 50 (87.7% patients it was sufficient to conduct a single session of complex endoscopic treatment. In 5 (8.8% patients – it was done two times. In 2 (3.5% cases operation was performed due to the recurrent bleeding. The source of major bleeding in these patients was: chronic, duodenal ulcer penetrating into the head of the pancreas in one case complicated by subcompensated

  7. Management of acute complex traumatic wound with a dermal ...

    African Journals Online (AJOL)

    Management of acute complex traumatic wound with a dermal regeneration template: Case report. ... Methods: A nine-year-old male patient presented to Kimberly Hospital with an extensive soft tissue injury of the leg associated with a tibia fracture caused by a high velocity pedestrian vehicle accident. Results: A ...

  8. Treatment of the complex abdomen and acute intestinal failure

    NARCIS (Netherlands)

    de Vries, F.E.E.

    2018-01-01

    Management of the complex abdomen and acute intestinal failure (IF) is challenging and requires specialized multidisciplinary treatment. Due to the small numbers and heterogeneity of the patient group high-quality evidence for some of the research questions is probably unachievable. Nevertheless,

  9. Acute Inflammatory Demyelinating Neuropathy : Immunoglobulin And Immune Complex Profile

    Directory of Open Access Journals (Sweden)

    Shripad A

    2003-01-01

    Full Text Available Serum immunoglobulins (IgG, IgA and IgM and immune complexes IgG (IcG were measured in 58 cases of acute inflammatory demyelinating neuropathy, popularly known as Guillian Barre′ syndrome, and in 30 healthy controls using single radial immunodiffusion assay. Immunoglobulin and immune complex levels were significantly elevated in patients as compared to controls. The increased levels of immunoglobulins and immune complexes may contribute to the pathogenesis of the disease and provide rationale for therapeutic plasmapheresis.

  10. NNDSS - Table II. Hepatitis (viral, acute, by type) C

    Data.gov (United States)

    U.S. Department of Health & Human Services — NNDSS - Table II. Hepatitis (viral, acute, by type) C - 2018. In this Table, provisional cases of selected notifiable diseases (≥1,000 cases reported during the...

  11. NNDSS - Table II. Hepatitis (viral, acute, by type) A & B

    Data.gov (United States)

    U.S. Department of Health & Human Services — NNDSS - Table II. Hepatitis (viral, acute, by type) A & B - 2018. In this Table, provisional cases of selected notifiable diseases (≥1,000 cases reported...

  12. NNDSS - Table II. Hepatitis (viral, acute, by type) A & B

    Data.gov (United States)

    U.S. Department of Health & Human Services — NNDSS - Table II. Hepatitis (viral, acute, by type) A & B - 2018. In this Table, provisional cases of selected notifiable diseases (≥1,000 cases reported during...

  13. NNDSS - Table II. Hepatitis (viral, acute, by type) C

    Data.gov (United States)

    U.S. Department of Health & Human Services — NNDSS - Table II. Hepatitis (viral, acute, by type) C - 2018. In this Table, provisional cases of selected notifiable diseases (≥1,000 cases reported during the...

  14. New paradigms in the management of acute type B aortic dissection.

    Science.gov (United States)

    Parisi, Rosario; Secco, Gioel Gabrio; Fattori, Rossella

    2015-11-01

    Type B aortic dissection is a relatively uncommon and multifaceted disease, whose management is ongoing debated. Its wide range of clinical presentations and anatomical features hamper the early identification and medical management. In the past few years, the introduction of endovascular techniques opened new paradigms in comprehension and management of aortic diseases. Aim of this review is to discuss contemporary therapeutic approaches of acute type B aortic dissections highlighting the growing role of thoracic endovascular aortic repair (TEVAR) in focusing its complex physiopathology. Prompt medical therapy followed by endovascular repair should be considered as the gold standard in complicated acute type B aortic dissection. Moreover, recent findings also suggest a potential benefit in case of uncomplicated cases. Management of acute type B aortic dissection is progressively shifting into endovascular approach. However, further studies are warranted to define the optimal treatment strategy in each subset of patients and anatomical features.

  15. Blood groups and acute aortic dissection type III.

    Science.gov (United States)

    Fatic, Nikola; Nikolic, Aleksandar; Vukmirovic, Mihailo; Radojevic, Nemanja; Zornic, Nenad; Banzic, Igor; Ilic, Nikola; Kostic, Dusan; Pajovic, Bogdan

    2017-04-01

    Acute aortic type III dissection is one of the most catastrophic events, with in-hospital mortality ranging between 10% and 12%. The majority of patients are treated medically, but complicated dissections, which represent 15% to 20% of cases, require surgical or thoracic endovascular aortic repair (TEVAR). For the best outcomes adequate blood transfusion support is required. Interest in the relationship between blood type and vascular disease has been established. The aim of our study is to evaluate distribution of blood groups among patients with acute aortic type III dissection and to identify any kind of relationship between blood type and patient's survival. From January 2005 to December 2014, 115 patients with acute aortic type III dissection were enrolled at the Clinic of Vascular and Endovascular Surgery in Belgrade, Serbia and retrospectively analyzed. Patients were separated into two groups. The examination group consisted of patients with a lethal outcome, and the control group consisted of patients who survived. The analysis of the blood groups and RhD typing between groups did not reveal a statistically significant difference ( p = 0.220). Our results indicated no difference between different blood groups and RhD typing with respect to in-hospital mortality of patients with acute aortic dissection type III.

  16. Complex regional pain syndromes (CRPS type 1 validating case histories

    Directory of Open Access Journals (Sweden)

    P. Berger

    2003-01-01

    Full Text Available The treatment of patients with complex regional pain syndrome (CRPS type 1 is challenging and unpredictable as the condition presents with vascular and neuropathic symptoms after nil or even minor injury to a peripheral nerve. The condition is one of a pain and motor dysfunction. The pathophysiology is not well understood and the relief of symptoms may change from being sympathetically mediated to sympathetically independent during  the course of the disease. At any stage physiotherapy has been advocated as the corner stone and most important aspect of treatment in the rehabilitation of these individuals but unfortunately it has been difficult to execute when pain is exacerbated due to allodynia (unbearable to touch or move and hyperalgesia. Best results have been obtained if the patients are recognised and treated in the early or acute phase and it has been found that through careful assessment and analysis these patients can be recognised by previous events that have occurred in their initial case history. The treatment in the acute stage with physiotherapy modalities such as electrical stimulation and acupuncture will produce an early cessation of the symptoms and prevention of the disease developing into the fully blown CRPS type 1 with irreversible and possibly atrophic consequences. Case histories have been presented that illustrate these important aspects and demonstrate  the value of early and the appropriate physiotherapy that may be more successful than other pharmacological and physical interventions in this disease.

  17. Acute type II cryoglobulinaemic vasculitis mimicking atherosclerotic peripheral vascular disease.

    LENUS (Irish Health Repository)

    Saeed, A

    2012-01-31

    Atherosclerotic peripheral vascular disease is a common presenting cause for digital ischaemia in life long smokers. Acute severe Type II Cryoglobulinaemic vasculitis is a rare yet important cause, which may present with similar clinical features and which if undiagnosed may be rapidly fatal. Following the instigation of therapy with intravenous methylprednisolone and cyclophosphamide this patient made an excellent recovery.

  18. Acute myonecrosis in horse caused by Clostridium novyi type A.

    Science.gov (United States)

    Farias, Luana D'avila; Azevedo, Marcos Da Silva; Trost, Maria Elisa; De La Côrte, Flávio Desessards; Irigoyen, Luiz Francisco; de Vargas, Agueda Castagna

    2014-01-01

    The objective of this study was to describe the first report involving a case of equine acute myonecrosis caused by C. novyi type A with an emphasis on clinical signs, the pathological and bacteriological analysis, and molecular identification of the microorganisms as the key of the definitive diagnosis.

  19. Acute myonecrosis in horse caused by Clostridium novyi type A

    Directory of Open Access Journals (Sweden)

    Luana D'avila Farias

    2014-01-01

    Full Text Available The objective of this study was to describe the first report involving a case of equine acute myonecrosis caused by C. novyi type A with an emphasis on clinical signs, the pathological and bacteriological analysis, and molecular identification of the microorganisms as the key of the definitive diagnosis.

  20. Paracoccidioidomycosis: acute-subacute clinical form, juvenile type*

    Science.gov (United States)

    Marques, Silvio Alencar; Lastória, Joel Carlos; de Camargo, Rosangela Maria Pires; Marques, Mariangela Esther Alencar

    2016-01-01

    The authors report aspects of paracoccidioidomycosis, acute-subacute clinical form, juvenile type, in a 19-year-old female patient. Paracoccidioidomycosis, juvenile type, classically occurs in young patients, both sexes, with lymphoma-like aspects as initial presentation. However, following the natural history of the disease the lymph nodes assume patterns of infectious disease, as an abscess and fistulae. Systemic dissemination of the disease can occur and lethality and morbidity are significant in this clinical presentation. PMID:27438214

  1. Paracoccidioidomycosis: acute-subacute clinical form, juvenile type*

    OpenAIRE

    Marques, Silvio Alencar; Last?ria, Joel Carlos; de Camargo, Rosangela Maria Pires; Marques, Mariangela Esther Alencar

    2016-01-01

    Abstract: The authors report aspects of paracoccidioidomycosis, acute-subacute clinical form, juvenile type, in a 19-year-old female patient. Paracoccidioidomycosis, juvenile type, classically occurs in young patients, both sexes, with lymphoma-like aspects as initial presentation. However, following the natural history of the disease the lymph nodes assume patterns of infectious disease, as an abscess and fistulae. Systemic dissemination of the disease can occur and lethality and morbidity a...

  2. Paracoccidioidomycosis: acute-subacute clinical form, juvenile type.

    Science.gov (United States)

    Marques, Silvio Alencar; Lastória, Joel Carlos; Camargo, Rosangela Maria Pires de; Marques, Mariangela Esther Alencar

    2016-01-01

    The authors report aspects of paracoccidioidomycosis, acute-subacute clinical form, juvenile type, in a 19-year-old female patient. Paracoccidioidomycosis, juvenile type, classically occurs in young patients, both sexes, with lymphoma-like aspects as initial presentation. However, following the natural history of the disease the lymph nodes assume patterns of infectious disease, as an abscess and fistulae. Systemic dissemination of the disease can occur and lethality and morbidity are significant in this clinical presentation.

  3. High affinity complexes of pannexin channels and L-type calcium channel splice-variants in human lung: Possible role in clevidipine-induced dyspnea relief in acute heart failure

    Directory of Open Access Journals (Sweden)

    Gerhard P. Dahl

    2016-08-01

    Research in Context: Clevidipine lowers blood pressure by inhibiting calcium channels in vascular smooth muscle. In patients with acute heart failure, clevidipine was shown to relieve breathing problems. This was only partially related to the blood pressure lowering actions of clevidipine and not conferred by another calcium channel inhibitor. We here found calcium channel variants in human lung that are more selectively inhibited by clevidipine, especially when associated with pannexin channels. This study gives a possible mechanism for clevidipine's relief of breathing problems and supports future clinical trials testing the role of clevidipine in the treatment of acute heart failure.

  4. Karyotype complexity and prognosis in acute myeloid leukemia.

    Science.gov (United States)

    Stölzel, F; Mohr, B; Kramer, M; Oelschlägel, U; Bochtler, T; Berdel, W E; Kaufmann, M; Baldus, C D; Schäfer-Eckart, K; Stuhlmann, R; Einsele, H; Krause, S W; Serve, H; Hänel, M; Herbst, R; Neubauer, A; Sohlbach, K; Mayer, J; Middeke, J M; Platzbecker, U; Schaich, M; Krämer, A; Röllig, C; Schetelig, J; Bornhäuser, M; Ehninger, G

    2016-01-15

    A complex aberrant karyotype consisting of multiple unrelated cytogenetic abnormalities is associated with poor prognosis in patients with acute myeloid leukemia (AML). The European Leukemia Net classification and the UK Medical Research Council recommendation provide prognostic categories that differ in the definition of unbalanced aberrations as well as the number of single aberrations. The aim of this study on 3526 AML patients was to redefine and validate a cutoff for karyotype complexity in AML with regard to adverse prognosis. Our study demonstrated that (1) patients with a pure hyperdiploid karyotype have an adverse risk irrespective of the number of chromosomal gains, (2) patients with translocation t(9;11)(p21∼22;q23) have an intermediate risk independent of the number of additional aberrations, (3) patients with ⩾4 abnormalities have an adverse risk per se and (4) patients with three aberrations in the absence of abnormalities of strong influence (hyperdiploid karyotype, t(9;11)(p21∼22;q23), CBF-AML, unique adverse-risk aberrations) have borderline intermediate/adverse risk with a reduced overall survival compared with patients with a normal karyotype.

  5. [Outcomes of acute type A aortic dissection repairs in Iceland].

    Science.gov (United States)

    Geirsson, Arnar; Melvinsdottir, Inga Hlif; Arnorsson, Thorarinn; Myrdal, Gunnar; Gudbjartsson, Tomas

    2016-02-01

    Acute type A aortic dissection is a life-threatening disease associated with significant morbidity and mortality. Treatment is challenging and requires emergency surgery. This study presents for the first time the short- and long-term outcome of acute type A aortic dissection repairs in Iceland. A retrospective review of 45 patients (mean age 60.7 ± 13.9 years, 68.9% male) treated for type A aortic dissection at Landspitali University Hospital between 1992 and 2014. Data was gathered from medical records about known risk factors, presenting symptoms, type of procedure, complications and operative mortality. Out of 45 operations the majority (73.3%) was performed in the second half of the study period. Nearly all patients presented with chest pain and 46.7% were in shock on arrival. Malperfusion syndrome was apparent in 26.7% of cases. A variety of operative methods were used, including hypothermic circulatory arrest in 31.1% of the cases and one-third of patients needed aortic root replacement. Reoperation rate for postoperative bleeding was 29.3% and perioperative stroke occurred in 14.6% of patients. The 30-day mortality rate was 22.2% (10 patients) and 5- and 10-year survival was 71.4 ± 8.2% and 65.4 ± 9.4%, respectively. The short-term outcomes of surgical repair for acute type A aortic dissection in Iceland is comparable to neighbouring countries, including 30-day mortality and long-term survival. Complications, however, are common, especially reoperations for bleeding. 1Department of Cardiothoracic Surgery, Landspitali University Hospital, 2Faculty of Medicine, University of Iceland. Aortic dissection type A, aortic aneurysm, open heart surgery, complications, operative mortality, survival. Correspondence: Arnar Geirsson, arnarge@landspitali.is.

  6. Acute leukaemia: making sense of a complex blood cancer.

    LENUS (Irish Health Repository)

    Meenaghan, Teresa

    2012-01-01

    Acute leukaemia represents a diverse group of blood cancers that affect both children and adults. Treatment schedules for these haematology cancers are often prolonged, with many associated side effects and complications. Nurses caring for patients with acute leukaemia require an anticipatory approach, where care is aimed at minimizing the side effects of treatment and being constantly vigilant for any impending adverse effects. Moreover, patients require support for the psychosocial issues that can arise for patients during their illness. This article provides an overview of acute lymphoblastic leukaemia and acute myeloid leukaemia. Nursing considerations in the care of patients being treated for acute leukaemia are also explored.

  7. Evaluation of the hamstring muscle complex following acute injury

    Energy Technology Data Exchange (ETDEWEB)

    Koulouris, George; Connell, David [Department of Radiology, St Francis X Cabrini, Wattletree Rd, 3144, Malvern, Victoria (Australia)

    2003-10-01

    To evaluate the imaging findings following acute hamstring injury. We retrospectively reviewed the imaging findings of hamstring muscle complex (HMC) strain in 170 patients referred to our institution over a 3-year period. A total of 179 injuries to the HMC were demonstrated in 170 patients (154 male, 16 female, mean age 28.2 years). The mean duration of symptoms was 4.7 days (range 1-10 days). MR imaging was performed in 97 cases and sonography in 102 cases (both modalities were performed in 20 examinations). Attention was directed to the frequency of muscle involvement, the location of the injury within the muscle-tendon unit, the extent of the injury and discriminating avulsion from muscle injury. Twenty-one patients had proximal tendon injury, with sixteen avulsions and five partial tears. Sixteen of these patients had surgical confirmation of hamstring avulsion from the ischial tuberosity (14 conjoint, 2 biceps femoris alone) and all were reliably diagnosed with MR imaging (16/16), but less so with sonography (7/12). Four distal tendon avulsions were also observed (three semitendinosus, one biceps femoris). With respect to muscle injury, the biceps femoris was most commonly injured (124/154). Semimembranosus was an uncommon muscle injury (21/154) and semitendinosus rare (9/154). Imaging can discriminate a hamstring tendon avulsion from musculotendinous strain and helps identify which patients necessitate surgical management as opposed to conservative treatment. (orig.)

  8. Prevalence and Classification of Injuries of Anterolateral Complex in Acute Anterior Cruciate Ligament Tears.

    Science.gov (United States)

    Ferretti, Andrea; Monaco, Edoardo; Fabbri, Mattia; Maestri, Barbara; De Carli, Angelo

    2017-01-01

    To report on the prevalence of injuries of the lateral compartment occurring in cases of apparently isolated acute anterior cruciate ligament (ACL) tears and to present a classification system of anterolateral complex injuries based on the data obtained. Sixty patients operated on for an acute apparently isolated ACL tear, revealed by clinical examination and confirmed by magnetic resonance imaging, were prospectively selected. The lateral compartment was exposed and injuries were detected. Based on the data obtained, lesions of the anterolateral complex were classified as follows: Type I: multilevel rupture with individual layers torn at different levels with macroscopic hemorrhage involving the area of the anterolateral ligament (ALL) and extended to the anterolateral capsule. Type II: multilevel rupture with individual layers torn at different levels with macroscopic hemorrhage extended from the area of the ALL and capsule to the posterolateral capsule. Type III: complete transverse tear involving the area of the ALL near its insertion to the lateral tibial plateau, distal to the lateral meniscus. Type IV: bony avulsion (Segond fracture). The pivot-shift test was repeated intraoperatively after repair of lateral tears before the ACL reconstruction. Although magnetic resonance imaging was able to detect only bony injuries (Segond fracture), macroscopic tears of the lateral capsule were clearly identified at surgery in 54 of 60 patients and classified as follows: Type I: 19/60 Type II: 16/60 Type III: 13/60 Type IV: 6/60 In all cases, repair resulted in a marked reduction or apparent disappearance of the pivot-shift phenomenon. Statistical analysis showed a positive correlation between lesions of the lateral compartment, regardless of the type described, and a pivot shift graded 2 or 3. Because injuries of secondary restraints often occur in cases of acute ACL tears, recognition and repair of such lesions could be considered to help ACL reconstruction to better

  9. Cytological features of complex type fibroadenoma in comparison with non-complex type fibroadenoma.

    Science.gov (United States)

    Ohashi, Ryuji; Matsubara, Miyuki; Watarai, Yasuhiko; Yanagihara, Keiko; Yamashita, Koji; Tsuchiya, Shin-Ichi; Takei, Hiroyuki; Naito, Zenya

    2016-09-01

    To determine the cytomorphological features of complex type fibroadenoma (CFA), we reviewed fine needle aspiration (FNA) cytology with correlation to its histopathology findings, and compared them with non-complex type fibroadenoma (NCFA). From excisional biopsy or resected specimens of fibroadenoma (FA) cases treated at our institution from 2004 to 2013, we chose 46 patients who underwent FNA before a diagnosis of FA was established. We histologically re-classified them into two groups: CFA and NCFA. FNA diagnosis was retrospectively re-evaluated from FNA reports. We further re-assessed detailed characteristics of each FNA smears to identify cytomorphological features of CFA. We found that 15 cases fulfilled the diagnostic criteria of CFA, in which 7 (46.7 %) had an FNA diagnosis of "suspicious for malignancy" or "indeterminate" while only 2 NCFA cases had that of "indeterminate" (p = 0.004). FNA smears from CFA cases showed discohesiveness, enlarged nuclei, prominent nucleoli, and fewer myoepithelial cells more often than NCFA. Although no significant difference was noted in patients' age and tumor size between CFA and NCFA, 5 CFA cases (33.3 %) were accompanied by the presence of carcinoma in the same breast or the contralateral breast while no NCFA cases had carcinoma in the breast. FNA of CFA can lead to erroneous or indeterminate interpretation, due to proliferative and/or hyperplastic changes of ductal epithelium with or without atypia. It is important to recognize the disease entity and characteristic cytomorphological findings of CFA to reach accurate FNA diagnosis of breast lesions.

  10. Shoulder arthroplasty in complex acute and chronic proximal humeral fractures

    DEFF Research Database (Denmark)

    Frich, Lars Henrik; Søjbjerg, J.O.; Sneppen, O.

    1991-01-01

    From 1983 to 1988, 42 shoulder arthroplasties were performed on comminuted acute or chronic proximal humeral fractures. Patients were categorized according to the post-fracture operative delay; there were 15 four-part fractures, with median post-fracture delay of 13 days (range: 7 to 21), and 27......-system and classified into four groups. Pain relief was satisfactory in the acute group, but was unpredictable in the chronic group. The results in the acute group were significantly superior (P less than .05). In the acute group, 3 (20%) patients had an excellent result and 6 patients (40%) had a good result, compared...... instability were seen in shoulders formerly treated with osteosynthesis (one acute and four chronic cases). Two of these cases developed an infection. Good results can be expected after prosthetic replacement in acute proximal humeral fractures. Failed primary treatment reduces the possibility of a good...

  11. Interpretation of stream programs: characterizing type 2 polynomial time complexity

    OpenAIRE

    Férée , Hugo; Hainry , Emmanuel; Hoyrup , Mathieu; Péchoux , Romain

    2010-01-01

    International audience; We study polynomial time complexity of type 2 functionals. For that purpose, we introduce a first order functional stream language. We give criteria, named well-founded, on such programs relying on second order interpretation that characterize two variants of type 2 polynomial complexity including the Basic Feasible Functions (BFF). These charac- terizations provide a new insight on the complexity of stream programs. Finally, we adapt these results to functions over th...

  12. Endovascular treatment of acute type B dissection complicating aortic coarctation.

    Science.gov (United States)

    Kassaian, Seyed Ebrahim; Abbasi, Kyomars; Mousavi, Mehdi; Sahebjam, Mohammad

    2013-01-01

    Surgical treatment poses a high risk to patients with concomitant aortic coarctation and dissection, and an interventional approach could be an alternative. We describe the case of a 52-year-old man with a long history of untreated hypertension and aortic coarctation who emergently presented at our institution with an acute Stanford type B dissection. The patient's elevated serum creatinine level, perfusion deficit in the right lower limb, and hypertension did not respond to medical therapy, and he did not consent to surgery. By endovascular means, we used a self-expandable stent-graft to cover the entry point of the dissection; then, we deployed a balloon-expandable bare-metal stent to correct residual stenosis. To our knowledge, this is the first report of the endovascular treatment of aortic coarctation complicated by type B dissection.

  13. EPICS Version 4 - Implementing Complex Data Types

    Energy Technology Data Exchange (ETDEWEB)

    Marty Kraimer,; John dalesio

    2012-11-27

    Through phase 1 and phase 2 SBIR grants, s fully functional I/O Controller and communication protocol for version 4 of EPICS is completed. This new software architecture provides a flexible and extendible architecture. Version 4 is implemented fully in Java. The performance metrics look promising. The final portion of phase 2 is to optimize the communication mechanisms. Subsequent work on different aspects of this are required to provide a viable solutions in various areas. Version 3 of EPICS is able to provide a platform for implementing channel based control, because the channel and attributes for time stamping, alarm, display and control were narrow, well defined, and complete. To extend EPICS functionality beyond this, it is necessary to define attributes needed for archive data, array, image data, and directory services. The proper handling of several array types enables the development of middle layer servers such as orbit and bump control in accelerators. Phase 1 should produce a well defined, reviewed, and agreed upon definition of the metadata required for these services. A Phase 2 grant would provide tools that implemented archiving, general array, imaging, and directory applications.

  14. Social Network Types and Acute Stroke Preparedness Behavior

    Directory of Open Access Journals (Sweden)

    Bernadette Boden-Albala

    2011-08-01

    Full Text Available Objectives: Presence of informal social networks has been associated with favorable health and behaviors, but whether different types of social networks impact on different health outcomes remains largely unknown. We examined the associations of different social network types (marital dyad, household, friendship, and informal community networks with acute stroke preparedness behavior. We hypothesized that marital dyad best matched the required tasks and is the most effective network type for this behavior. Methods: We collected in-person interview and medical record data for 1,077 adults diagnosed with stroke and transient ischemic attack. We used logistic regression analyses to examine the association of each social network with arrival at the emergency department (ED within 3 h of stroke symptoms. Results: Adjusting for age, race-ethnicity, education, gender, transportation type to ED and vascular diagnosis, being married or living with a partner was significantly associated with early arrival at the ED (odds ratio = 2.0, 95% confidence interval: 1.2–3.1, but no significant univariate or multivariate associations were observed for household, friendship, and community networks. Conclusions: The marital/partnership dyad is the most influential type of social network for stroke preparedness behavior.

  15. The complex treatment of acute pancreatitis using miniinvasive surgical treatment

    Directory of Open Access Journals (Sweden)

    G. I. Ohrimenko

    2015-06-01

    Full Text Available Nowadays methods used in acute pancreatitis diagnostic do not allow to find the most optimal indications, terms of surgical drainage approaches in surgical treatment of acute pancreatitis. Aim. In order to develop optimal diagnostic and treatment algorithm 316 patients took part in the study. Methods and results. Surgery outcomes were assessed by the next methods: ultrasound, computed tomography. We determined that destructive changes in pancreas in group of sterile pancreatic necrosis were limited. In cases of infected pancreatic necrosis the damage was spread and the disease course was septic. That’s why the operative treatment in cases of sterile pancreatitis has to be used with strict indications such as fermentative peritonitis, acute liquid formations, acute pseudocysts. Conclusion. In such cases miniinvasive surgery is mainly used while in the cases of infected pancreatic necrosis we ought to choose open surgery treatment.

  16. Prognostic Implications of Acute Renal Failure after Surgery for Type A Acute Aortic Dissection.

    Science.gov (United States)

    Sansone, Fabrizio; Morgante, Alessandro; Ceresa, Fabrizio; Salamone, Giovanni; Patanè, Francesco

    2015-06-01

    "Type A" acute aortic dissection (AAAD) is the most challenging among the emergency operations in cardiac surgery. The aim of this study was the evaluation of the role of acute renal failure (ARF) in postoperative survival of patients operated for AAAD. From February 2010 to April 2012, 37 consecutive patients were operated at our department for AAAD. We studied our population by subdividing the patients within groups according to the presence of ARF requiring continuous veno-venous hemofiltration (CVVH) and according to hypothermic circulatory arrest (HCA) times and degrees. The overall 30-day mortality was 27% (50% group A with ARF, 13% group B no ARF). Acute renal failure requiring CVVH was 37.8%. Multivariate analysis revealed a significant association with 30-day mortality (odds ratio 6.6 and p = 0.020). Preoperative oliguria [urine output less than 30 ml/h (odds ratio 4.7 p = 0.039)], CPB greater than 180 minutes (odds ratio 6.5 p = 0.023) and postoperative bleeding requiring a surgical reopening (odds ratio 12.2 and p = 0.021) were the variables significantly associated with acute kidney injury. The data obtained from our analysis bring out the high incidence of renal injuries after surgery for AAAD, and indicate a negative impact on renal injuries of a preoperative oliguria, longer Cardiopulmonary bypass (CBP)/HCA times, and postoperative bleeding requiring a surgical revision. Our data also suggest a better 30-day survival and better renal outcomes in case of shorter HCA and lesser degree of hypothermia. The option of lesser and shorter hypothermia may be very useful, especially for the elderly patients and octogenarians.

  17. Acute stress influences the discrimination of complex scenes and complex faces in young healthy men.

    Science.gov (United States)

    Paul, M; Lech, R K; Scheil, J; Dierolf, A M; Suchan, B; Wolf, O T

    2016-04-01

    The stress-induced release of glucocorticoids has been demonstrated to influence hippocampal functions via the modulation of specific receptors. At the behavioral level stress is known to influence hippocampus dependent long-term memory. In recent years, studies have consistently associated the hippocampus with the non-mnemonic perception of scenes, while adjacent regions in the medial temporal lobe were associated with the perception of objects, and faces. So far it is not known whether and how stress influences non-mnemonic perceptual processes. In a behavioral study, fifty male participants were subjected either to the stressful socially evaluated cold-pressor test or to a non-stressful control procedure, before they completed a visual discrimination task, comprising scenes and faces. The complexity of the face and scene stimuli was manipulated in easy and difficult conditions. A significant three way interaction between stress, stimulus type and complexity was found. Stressed participants tended to commit more errors in the complex scenes condition. For complex faces a descriptive tendency in the opposite direction (fewer errors under stress) was observed. As a result the difference between the number of errors for scenes and errors for faces was significantly larger in the stress group. These results indicate that, beyond the effects of stress on long-term memory, stress influences the discrimination of spatial information, especially when the perception is characterized by a high complexity. Copyright © 2016 Elsevier Ltd. All rights reserved.

  18. Acute tension type headache, cognitive function and mood

    Directory of Open Access Journals (Sweden)

    Andrew Paul Smith

    2016-03-01

    Full Text Available Background/Aims: Research has shown that migraine is often associated with memory problems. There have, however, been few studies of tension type headache (TTH and cognition. People who report frequent headaches often report high levels of negative affect. However, less is known about the acute effects of tension type headache on mood. To address these gaps in our knowledge, two studies examined the effects of acute TTH on cognitive performance and mood. Methods: Both studies involved one group of participants completing a battery of tasks when they had a TTH and when they had no headache. Another group (the control was headache free on both occasions. Duration of the headache was greater than 30 minutes and less than 4 hours. In the no headache condition the participants were headache free for at least 24 hours. In the first study 12 participants (6 with TTH, 6 controls completed a computerised battery measuring mood and aspects of cognition. In the second study 22 participants (7 TTH, 5 after TTH and10 controls completed paper and pencil mood and cognitive tasks.Results: In the first study having a headache was associated with an increase in negative affect both before and after the tasks. Three performance tasks showed impairments when the participants had headaches: logical reasoning was slower and less accurate; retrieval from semantic memory was slower; and reaction times in the categoric search task were slower. Results from the second study confirmed the global increase in negative affect when the person has a TTH. The results confirmed the impairments in the logical reasoning and semantic processing tasks and also showed that those with a TTH had greater psychomotor slowing and were more easily distracted. Effects did not continue after the headache had gone.Conclusions: Two small-scale studies have shown that TTH is associated with negative affect and impaired cognitive function. It is now of interest to determine whether OTC treatment

  19. [Discussion of Chinese syndrome typing in acute hepatic failure model].

    Science.gov (United States)

    Zhang, Jin-liang; Zeng, Hui; Wang, Xian-bo

    2011-05-01

    To study Chinese syndrome typing of acute hepatic failure (AHF) mice model by screening effective formulae. Lipoplysaccharides (LPS)/D-galactosamine (D-GaIN) was intraperitoneally injected to mice to establish the AHF mice model. Yinchenhao Decoction, Huanglian Jiedu Decoction, Buzhong Yiqi Decoction, and Xijiao Dihuang Decoction were administered to model mice respectively by gastrogavage. The behavior and the survival rate were monitored. The liver function and pathological changes of liver tissues were detected. In all the tested classic recipes, the survival rate was elevated from 10% to 60% by administration of Xijiao Dihuang Decoction. Five h after modeling, the serum alanine aminotransferase (ALT) level was (183.95 +/- 52.00) U/L, and aspartate aminotransferase (AST) (235.70 +/- 34.03) U/L in Xijiao Di-huang Decoction Group, lower than those of the model control group, but with insignificant difference (ALT: 213.32 +/- 71.93 U/L; AST: 299.48 +/- 70.56 U/L, both P > 0.05). Xijiao Dihuang Decoction could obviously alleviate the liver injury. Xijiao Dihuang Decoction was an effective formula for LPS/D-GaIN induced AHF model. According to syndrome typing through formula effect, heat toxin and blood stasis syndrome dominated in the LPS/D-GalN induced AHF mice model.

  20. Genetics Home Reference: acute necrotizing encephalopathy type 1

    Science.gov (United States)

    ... induced acute encephalopathy 3 Related Information How are genetic conditions and genes named? ... National Institute of Allergy and Infectious Diseases: Flu (Influenza) National Institute of Neurological Disorders ...

  1. Complexity on Acute Myeloid Leukemia mRNA Transcript Variant

    Directory of Open Access Journals (Sweden)

    Carlo Cattani

    2011-01-01

    Full Text Available This paper deals with the sequence analysis of acute myeloid leukemia mRNA. Six transcript variants of mlf1 mRNA, with more than 2000 bps, are analyzed by focusing on the autocorrelation of each distribution. Through the correlation matrix, some patches and similarities are singled out and commented, with respect to similar distributions. The comparison of Kolmogorov fractal dimension will be also given in order to classify the six variants. The existence of a fractal shape, patterns, and symmetries are discussed as well.

  2. Acute phase proteins in cattle after exposure to complex stress

    DEFF Research Database (Denmark)

    Lomborg, S. R.; Nielsen, L. R.; Heegaard, Peter M. H.

    2008-01-01

    Abstract Stressors such as weaning, mixing and transportation have been shown to lead to increased blood concentrations of acute phase proteins (APP), including serum amyloid A (SAA) and haptoglobin, in calves. This study was therefore undertaken to assess whether SAA and haptoglobin levels...... concentrations of SAA and haptoglobin increased significantly in response to the stressors (P...... in blood mirror stress in adult cattle. Six clinically healthy Holstein cows and two Holstein heifers were transported for four to six hours to a research facility, where each animal was housed in solitary tie stalls. Blood samples for evaluation of leukocyte counts and serum SAA and haptoglobin...

  3. Fatal acute retropharyngeal hemorrhage in neurofibromatosis type 1.

    Science.gov (United States)

    Peyron, Pierre-Antoine; Pollanen, Michael S

    2017-12-01

    We report the sudden death of a woman with neurofibromatosis type 1 (NF1). The decedent developed acute respiratory distress and died rapidly despite an emergent cricothyroidotomy. An autopsy with postmortem CT scan was performed to determine the cause of the fatal respiratory collapse and to determine if death was related to neurofibromatosis. Postmortem examination revealed the classical external hallmarks of neurofibromatosis, including innumerable cutaneous neurofibromas. In addition, there was a massive retropharyngeal hematoma with fatal extrinsic compression of the airway. On macroscopic examination A localized 3 cm diameter tumor nodule was found in the soft tissues of the neck. Histologic examination of the nodule revealed a neurofibroma. In addition, histologic sections of the hematoma and surrounding soft tissues revealed plexiform neurofibroma with infiltration of the walls of small blood vessels and of the right vertebral artery. The fatal retropharyngeal hemorrhage was caused by diffuse infiltration of the blood vessels of the neck by plexiform neurofibroma. We concluded that the underlying cause of death was NF1. This case underscores the protean nature of neurofibroma, particularly when diffuse interstitial hemorrhage is present. Infiltration of soft tissues by neurofibroma may only be detectable on histologic examination.

  4. Acute coronary syndromes amongst type 2 diabetics with ischaemic ...

    African Journals Online (AJOL)

    Majority had three coronary artery disease (CAD) risk factors: obesity 86%, elevated LDL 73% and hypertension 60%. Therapy in use was OHA 43%, insulin 42%, insulin and OHA 1%; prophylactic aspirin 14.7% and statins 8.4%. Thirty four (35.8%) were classified as acute coronary syndrome (ACS); 29 ( 30.5%) acute ...

  5. Geographic Clustering of Acute Complications and Sociodemographic Factors in Adults with Type 1 Diabetes.

    Science.gov (United States)

    Butalia, Sonia; Patel, Alka B; Johnson, Jeffrey A; Ghali, William A; Rabi, Doreen M

    2017-04-01

    To assess the geographic distribution of acute complications in patients with type 1 diabetes in a large urban centre; and to assess the association between acute complications and community-level sociodemographic factors. Adults (aged ≥18 years old) with type 1 diabetes and acute complications were identified between 2004 and 2008 by using a diabetes centre clinical database or discharge abstracts for acute complications (diabetic ketoacidosis or hypoglycemia). Using a geographic information system, hot-spot analysis was used to identify spatial clusters of acute complications in a large urban centre. The association between acute complications and community-level sociodemographic factors were assessed by Spearman rank correlation. We identified 1779 patients with type 1 diabetes, of whom 456 had been hospitalized for acute complications. The mean age of patients was 40.9±16.0 years, and men were more likely to have acute complications (59.2% vs. 52.3%; p<0.01). Spatial clusters of high values and low values were identified. Higher median family income (r=-0.36; p<0.0001) and higher education levels (r=-0.30; p<0.0001) were associated with lower rates of acute complications. This study demonstrated geographic clusters of hospitalizations for acute complications and important community sociodemographic factors. Prevention strategies and interventions targeting these geographic and sociodemographic disparities need to be explored as a means of minimizing hospitalizations for acute complications. Copyright © 2016 Canadian Diabetes Association. Published by Elsevier Inc. All rights reserved.

  6. Salivirus type 1 and type 2 in patients with acute gastroenteritis, Germany.

    Science.gov (United States)

    Aldabbagh, Souhaib; Eckerle, Isabella; Müller, Andreas; Delwart, Eric L; Eis-Hübinger, Anna M

    2015-11-01

    Salivirus (SaV-A) is a novel member of the family Picornaviridae and has been associated with acute gastroenteritis. Recently, a second type of SaV-A, SaV-A2, was identified in a sewage sample from Bangkok, Thailand. No information is available on the prevalence of SaV-A in Western Europe. Stool samples from patients with symptoms of acute viral gastroenteritis were analyzed for SaV-A and the clinical course of SaV-A-positive individuals was evaluated. A total of 3019 fecal samples collected during 2012-2013 from 1941 hospitalized patients with acute gastroenteritis were screened for SaV-A by a newly designed real-time reverse transcription polymerase chain reaction targeting a conserved sequence in the 5'-untranslated region. Positive results were verified by sequencing the viral capsid protein 1 gene also allowing typing of the virus. Medical records of SaV-A-infected patients were reviewed for clinical features and laboratory data. SaV-A was detected in five patients. Viral RNA concentrations ranged from 7.1×10(6) to 7.2×10(8)copies/g feces. The viruses from four patients were classified as SaV-A1 while SaV-A2 was present in one patient. After reviewing the medical records, SaV-A could not be considered as the sole possible cause of gastroenteritis symptoms given the presence of other plausible causes in all five patients. SaV-A infection can be detected in Germany, Western Europe, albeit at low levels. The detection of SaV-A2 in Europe suggests wider spread of SaV-A2. Presence of SaV-A, even at high concentrations, in a stool sample provides no conclusive evidence that SaV is the major cause of the patient's gastroenteritis symptoms. Copyright © 2015 Elsevier B.V. All rights reserved.

  7. Preoperative renal function and surgical outcomes in patients with acute type A aortic dissection†.

    Science.gov (United States)

    Imasaka, Ken-ichi; Tayama, Eiki; Tomita, Yukihiro

    2015-04-01

    There are few data concerning the impact of preoperative renal function, assessed using estimated glomerular filtration rate, on surgical outcomes following acute type A aortic dissection. We investigated the accuracy of estimated glomerular filtration rate (in ml/min/1.73 m(2)) in predicting in-hospital mortality and postoperative renal replacement therapy in such cases. We reviewed 114 consecutive patients with non-dialysis-dependent renal dysfunction who underwent thoracic aortic surgery for acute type A aortic dissection between 1997 and 2012. Preoperative renal function was categorized as normal (estimated glomerular filtration rate >90; n = 15) or as mild (60-89; n = 39), moderate I (45-59; n = 39), moderate II (30-44; n = 14) or severe (15-29; n = 7) renal dysfunction. In-hospital mortality was 14.9%. Eighteen (15.8%) of 114 patients required renal replacement therapy. A more severe stage stratified by preoperative estimated glomerular filtration rate levels could effectively predict postoperative renal replacement therapy (area under the receiver operating characteristic curve 0.786). The best cut-off value of estimated glomerular filtration rate for predicting postoperative renal replacement therapy was 60 (sensitivity 95%, specificity 59%). On multiple regression analysis, the independent preoperative and intraoperative risk factors for postoperative renal replacement therapy were estimated glomerular filtration rate (P replacement (P replacement therapy (OR, 5.47; P regression analysis. Preoperative estimated glomerular filtration rate can effectively predict the need for renal replacement therapy after surgery for acute type A aortic dissection. However, it is not an effective diagnostic tool to predict in-hospital mortality. The complexity of the characteristics of patients who undergo surgical procedures may make prediction of surgical outcomes difficult. Risk models to predict hospital mortality and morbidities are needed to assist clinicians in

  8. Predicting complex acute wound healing in patients from a wound expertise centre registry: a prognostic study

    OpenAIRE

    Ubbink, Dirk T; Lindeboom, Robert; Eskes, Anne M; Brull, Huub; Legemate, Dink A; Vermeulen, Hester

    2015-01-01

    It is important for caregivers and patients to know which wounds are at risk of prolonged wound healing to enable timely communication and treatment. Available prognostic models predict wound healing in chronic ulcers, but not in acute wounds, that is, originating after trauma or surgery. We developed a model to detect which factors can predict (prolonged) healing of complex acute wounds in patients treated in a large wound expertise centre (WEC). Using Cox and linear regression analyses, we ...

  9. Halide exchanged Hoveyda-type complexes in olefin metathesis

    Directory of Open Access Journals (Sweden)

    Julia Wappel

    2010-11-01

    Full Text Available The aims of this contribution are to present a straightforward synthesis of 2nd generation Hoveyda-type olefin metathesis catalysts bearing bromo and iodo ligands, and to disclose the subtle influence of the different anionic co-ligands on the catalytic performance of the complexes in ring opening metathesis polymerisation, ring closing metathesis, enyne cycloisomerisation and cross metathesis reactions.

  10. Halide exchanged Hoveyda-type complexes in olefin metathesis

    Science.gov (United States)

    Wappel, Julia; Urbina-Blanco, César A; Abbas, Mudassar; Albering, Jörg H; Saf, Robert; Nolan, Steven P

    2010-01-01

    Summary The aims of this contribution are to present a straightforward synthesis of 2nd generation Hoveyda-type olefin metathesis catalysts bearing bromo and iodo ligands, and to disclose the subtle influence of the different anionic co-ligands on the catalytic performance of the complexes in ring opening metathesis polymerisation, ring closing metathesis, enyne cycloisomerisation and cross metathesis reactions. PMID:21160566

  11. Supporting Information Palladium Complexes of a New Type of N ...

    Indian Academy of Sciences (India)

    Prasenjit Ghosh

    Palladium Complexes of a New Type of N-heterocyclic Carbene. Ligand Derived From a Tricyclic Triazolooxazine Framework. Manoj Kumar Gangwar, Alok Ch. Kalita and Prasenjit Ghosh*. Department of Chemistry,. Indian Institute of Technology Bombay, ... 2. Figure S1. 1. H NMR spectrum of the compound 1a in CDCl3.

  12. [Complex regional pain syndrome type 1: negating the myth

    NARCIS (Netherlands)

    Frolke, J.P.M.; Dongen, R.T.M. van; Meent, H. van de

    2015-01-01

    Complex regional pain syndrome type 1 (CRPS-1) was identified in the Netherlands more than 30 years ago, but since then the arguments supporting this diagnosis have become weaker. Incidence has decreased, it is often not possible to make a definite diagnosis, the pathophysiology remains unclear and

  13. Complex regional pain syndromes (CRPS) type 1 validating case histories

    OpenAIRE

    P. Berger

    2003-01-01

    The treatment of patients with complex regional pain syndrome (CRPS) type 1 is challenging and unpredictable as the condition presents with vascular and neuropathic symptoms after nil or even minor injury to a peripheral nerve. The condition is one of a pain and motor dysfunction. The pathophysiology is not well understood and the relief of symptoms may change from being sympathetically mediated to sympathetically independent during  the course of the disease. At any stage physiotherapy has b...

  14. Metformin-associated risk of acute dialysis in patients with type 2 diabetes

    DEFF Research Database (Denmark)

    Carlson, Nicholas; Hommel, Kristine; Olesen, Jonas Bjerring

    2016-01-01

    Recent guidelines governing anti-diabetic medications increasingly advocate metformin as first-line therapy in all patients with type 2 diabetes. However, metformin could be associated with increased risk of acute kidney injury (AKI), acute dialysis and lactate acidosis in marginal patients. In a...

  15. Monosomal karyotype in acute myeloid leukemia: A better indicator of poor prognosis than a complex karyotype

    NARCIS (Netherlands)

    Breems, Dimitri A.; van Putten, Wim L. J.; de Greef, Georgine E.; van Zelderen-Bhola, Shama L.; Gerssen-Schoorl, Klasien B. J.; Mellink, Clemens H. M.; Nieuwint, Aggie; Jotterand, Martine; Hagemeijer, Anne; Beverloo, H. Berna; Lowenberg, Bob

    2008-01-01

    Purpose To investigate the prognostic value of various cytogenetic components of a complex karyotype in acute myeloid leukemia (AML). Patients and Methods Cytogenetics and overall survival (OS) were analyzed in 1,975 AML patients age 15 to 60 years. Results Besides AML with normal cytogenetics (CN)

  16. Usage of low-power laser irradiation in the complex treatment of acute intestinal infections

    Science.gov (United States)

    Khvorostukhina, Alla I.; Shuldyakov, Andrey A.; Brill, Gregory E.; Zaytseva, Irina A.

    2002-07-01

    46 children with acute intestinal infections were studied. The development of pathological process was associated with the activation of lipid peroxidation, the decrease of superoxide dismutase and catalase activities in erythrocytes as well as with the fall of vitamin E content in blood plasma. Vitamin E and IR laser irradiation use in complex treatment showed the best therapeutic effect.

  17. Anaesthesia management of acute aortic dissection type B in Marfan ...

    African Journals Online (AJOL)

    Pregnancy in women with Marfan syndrome (MFS) is linked to approximately a 4.4% risk of acute aortic dissection (AAD). The natural history of pregnancy and the ability to deliver a viable fetus depends on the interaction between the pace of changes in the cardiovascular system and the advancement of pregnancy.

  18. Risk of acute renal failure in patients with Type 2 diabetes mellitus.

    Science.gov (United States)

    Girman, C J; Kou, T D; Brodovicz, K; Alexander, C M; O'Neill, E A; Engel, S; Williams-Herman, D E; Katz, L

    2012-05-01

    Progressive decline in renal function has been well described in patients with Type 2 diabetes mellitus, but few studies have assessed the risk of acute renal failure in a large population of patients with Type 2 diabetes. This study quantified the risk of acute renal failure associated with Type 2 diabetes in the General Practice Research Database from the UK. Patients with Type 2 diabetes (n = 119,966) and patients without diabetes (n = 1,794,516) were identified in the General Practice Research Database. Patients with end-stage renal disease were excluded. Crude incidence and multivariate-adjusted hazard ratios of acute renal failure were estimated for patients with diabetes relative to those without diabetes. Cox regression models were adjusted for a variety of comorbidities. Increase of acute renal failure risk resulting from additive effects of specific co-morbidities with Type 2 diabetes was also assessed. Between 2003 and 2007, acute renal failure incidence was 198 per 100,000 person-years in patients with Type 2 diabetes compared with 27 per 100,000 patients-years among patients without diabetes (crude hazard ratio 8.0, 95% CI 7.4-8.7). Risk of acute renal failure for patients with Type 2 diabetes remained significant, but was attenuated in multivariate analyses adjusting for various comorbidities (adjusted hazard ratio 2.5, 95% CI 2.2-2.7). Age and specific comorbidities (chronic kidney disease, hypertension and congestive heart failure) were also associated with increased risk of acute renal failure in Type 2 diabetes. Patients with Type 2 diabetes have increased risk for acute renal failure compared with patients without diabetes, even after adjustment for known risk factors, particularly in the elderly and those with other comorbidities such as chronic kidney disease, congestive heart failure and hypertension. © 2011 The Authors. Diabetic Medicine © 2011 Diabetes UK.

  19. Acute type A aortic dissection in a patient with paraganglioma.

    Science.gov (United States)

    Dos Santos Borrego, Andreia; Carrilho Ferreira, Pedro; Pinto, Fausto J

    2017-10-01

    Acute aortic dissection is the most common acute aortic syndrome. It is more prevalent in males and in the elderly, and has a high mortality. Hypertension is the main risk factor. Diagnosis is based on clinical features, laboratory tests and imaging exams. Treatment is usually surgical, although in some cases an endovascular approach is an alternative. Paraganglioma is an uncommon neuroendocrine tumor. Most produce catecholamines, and so usually manifest with hypertensive crisis, palpitations, headache and sweating. This tumor is diagnosed by measurement of plasma or urinary catecholamines and by computed tomography, magnetic resonance imaging and 123 I-metaiodobenzylguanidine (MIBG) scintigraphy. Surgery is the only potentially curative treatment. Copyright © 2017 Sociedade Portuguesa de Cardiologia. All rights reserved.

  20. Measuring acute rehabilitation needs in trauma: preliminary evaluation of the Rehabilitation Complexity Scale.

    Science.gov (United States)

    Hoffman, Karen; West, Anita; Nott, Philippa; Cole, Elaine; Playford, Diane; Liu, Clarence; Brohi, Karim

    2013-01-01

    Injury severity, disability and care dependency are frequently used as surrogate measures for rehabilitation requirements following trauma. The true rehabilitation needs of patients may be different but there are no validated tools for the measurement of rehabilitation complexity in acute trauma care. The aim of the study was to evaluate the potential utility of the Rehabilitation Complexity Scale (RCS) version 2 in measuring acute rehabilitation needs in trauma patients. A prospective observation study of 103 patients with traumatic injuries in a Major Trauma Centre. Rehabilitation complexity was measured using the RCS and disability was measured using the Barthel Index. Demographic information and injury characteristics were obtained from the trauma database. The RCS was closely correlated with injury severity (r=0.69, pBarthel Index (r=0.91, pBarthel was poor at discriminating between patients rehabilitation needs, especially for patients with higher injury severities. Of 58 patients classified as 'very dependent' by the Barthel, 21 (36%) had low or moderate rehabilitation complexity. The RCS correlated with acute hospital length of stay (r=0.64, p=Barthel which had a flooring effect (56% of patients classified as very dependent were discharged home) and lacked discrimination despite close statistical correlation. The RCS outperformed the ISS and the Barthel in its ability to identify rehabilitation requirements in relation to injury severity, rehabilitation complexity, length of stay and discharge destination. The RCS is potentially a feasible and useful tool for the assessment of rehabilitation complexity in acute trauma care by providing specific measurement of patients' rehabilitation requirements. A larger longitudinal study is needed to evaluate the RCS in the assessment of patient need, service provision and trauma system performance. Copyright © 2011 Elsevier Ltd. All rights reserved.

  1. Effects of acute alcohol and driving complexity in older and younger adults.

    Science.gov (United States)

    Price, Julianne L; Lewis, Ben; Boissoneault, Jeff; Frazier, Ian R; Nixon, Sara Jo

    2018-03-01

    Our previous work demonstrated differential neurobehavioral effects of low-dose alcohol consumption on older and younger adults in a driving simulator. However, the ability to enhance or suppress a response in such context has yet to be examined. The current study contrasted older and younger drivers' responses to specific stimuli (i.e., relevant, irrelevant) in scenarios of differing complexity following low-dose acute alcohol administration. Healthy older (55-70) and younger (25-35) adults completed two driving scenarios (i.e., country and metropolis) both before and after consuming beverages targeted to reach peak BrACs of 0.00, 0.04, or 0.065%. Throughout the simulation, participants encountered relevant stimuli (e.g., pedestrians walking into the street) and irrelevant stimuli (e.g., pedestrians walking parallel). Peak deceleration, range of steering, and distance until brake application were assessed within a 450-ft window preceding each stimulus. Following low-dose alcohol consumption, older adults shifted from a strategy using both deceleration and steering to relying solely on deceleration in responding to relevant stimuli in the country. Older adults under both low and moderate alcohol conditions displayed an inability to withhold responses to irrelevant stimuli in the metropolis. These findings are consistent with our prior work showing differential effects of low-dose alcohol on older, relative to younger, adults. The interactive effects of age and alcohol, however, depend on stimulus type and environmental complexity. Continued investigation of neurobehavioral mechanisms in ecologically valid paradigms is necessary for understanding the implications of the combined impairing effects of alcohol and older age.

  2. Complex-type penetrating injuries of craniomaxillofacial region.

    Science.gov (United States)

    Agrillo, Alessandro; Alessandro, Agrillo; Sassano, Pierpaolo; Mustazza, Maria Cristina; Filiaci, Fabio; Fabio, Filiaci

    2006-05-01

    Craniofacial traumas are one of the most common clinical events of the 21st century. The possibility of associated injuries of the head and neck may also determine functional and cosmetic problems in these patients. The most frequent pathologic conditions observed are contusions, lacerations, abrasions, avulsions, and the inclusion of foreign bodies. In particular, penetrating injuries represent a rare but complex variety of craniofacial trauma. Generally, the penetrating material is stiff enough to cross through different anatomic structures during a particularly violent collision caused by a road or work accident or during an attack. The therapeutic strategy adopted for this type of patient depends mainly on diagnostic procedures such as skull radiograms in different projections, computerized tomography, magnetic resonance imaging, and, occasionally, echotomography. However, on arrival at the emergency department, the clinical conditions of the patient will determine the type of investigation to be carried out. Last, to prevent any postoperative infections, wide spectrum antibiotic therapy is advisable. Ideally, imaging should be repeated postoperatively to confirm resolution of the initial clinical condition. In this article, the authors describe three unusual clinical cases of patients with penetrating injuries of the head and face together with the protocol adopted for treatment of such complex craniofacial injuries. The three cases described demonstrate that, despite the initial appearance of penetrating wounds, a correct diagnostic assessment followed by a suitable therapeutic protocol can reduce cosmetic and functional defects to a minimum.

  3. Pyruvate dehydrogenase complex and lactate dehydrogenase as targets for therapy of acute liver failure.

    Science.gov (United States)

    Ferriero, Rosa; Nusco, Edoardo; De Cegli, Rossella; Carissimo, Annamaria; Manco, Giuseppe; Brunetti-Pierri, Nicola

    2018-03-23

    Acute liver failure is a rapidly progressive deterioration of hepatic function resulting in high mortality and morbidity. Metabolic enzymes can translocate in the nucleus to regulate histone acetylation and gene expression. Levels and activities of pyruvate dehydrogenase complex (PDHC) and lactate dehydrogenase (LDH) were evaluated in nuclear fractions of livers of mice exposed to various hepatotoxins including CD95-Ab, α-amanitin, and acetaminophen. Whole-genome gene expression profiling by RNA-seq was performed in livers of mice with acute liver failure and analyzed by Gene Ontology Enrichment Analysis. Efficacy of histone acetyltransferase inhibitor garcinol and LDH inhibitor galloflavin at reducing liver damage was evaluated in mice with induced hepatotoxicity. Levels and activities of PDHC and LDH were increased in cytoplasmatic and nuclear fractions of livers of mice with acute liver failure. The increase of nuclear PDHC and LDH was associated with increased concentrations of acetyl-coA and lactate in nuclear fractions, and histone H3 hyper-acetylation. Gene expression in livers of mice with acute liver failure suggested that increased histone H3 acetylation induces the expression of genes related to response to damage. Reduced histone acetylation by the histone acetyltransferase inhibitor garcinol decreased liver damage and improved survival in mice with acute liver failure. Knock-down of PDHC or LDH improved viability in cells exposed to a pro-apoptotic stimulus. Treatment with the LDH inhibitor galloflavin that was also found to inhibit PDHC, reduced hepatic necrosis, apoptosis, and expression of pro-inflammatory cytokines in mice with acute liver failure. Mice treated with galloflavin also showed a dose-response increase in survival. PDHC and LDH translocate to the nucleus and are targets for therapy of acute liver failure. Acute liver failure is a rapidly progressive and life-threatening deterioration of liver function resulting in high mortality and

  4. Superoxide generated at mitochondrial complex III triggers acute responses to hypoxia in the pulmonary circulation.

    Science.gov (United States)

    Waypa, Gregory B; Marks, Jeremy D; Guzy, Robert D; Mungai, Paul T; Schriewer, Jacqueline M; Dokic, Danijela; Ball, Molly K; Schumacker, Paul T

    2013-02-15

    The role of reactive oxygen species (ROS) signaling in the O(2) sensing mechanism underlying acute hypoxic pulmonary vasoconstriction (HPV) has been controversial. Although mitochondria are important sources of ROS, studies using chemical inhibitors have yielded conflicting results, whereas cellular models using genetic suppression have precluded in vivo confirmation. Hence, genetic animal models are required to test mechanistic hypotheses. We tested whether mitochondrial Complex III is required for the ROS signaling and vasoconstriction responses to acute hypoxia in pulmonary arteries (PA). A mouse permitting Cre-mediated conditional deletion of the Rieske iron-sulfur protein (RISP) of Complex III was generated. Adenoviral Cre recombinase was used to delete RISP from isolated PA vessels or smooth muscle cells (PASMC). In PASMC, RISP depletion abolished hypoxia-induced increases in ROS signaling in the mitochondrial intermembrane space and cytosol, and it abrogated hypoxia-induced increases in [Ca(2+)](i). In isolated PA vessels, RISP depletion abolished hypoxia-induced ROS signaling in the cytosol. Breeding the RISP mice with transgenic mice expressing tamoxifen-activated Cre in smooth muscle permitted the depletion of RISP in PASMC in vivo. Precision-cut lung slices from those mice revealed that RISP depletion abolished hypoxia-induced increases in [Ca(2+)](i) of the PA. In vivo RISP depletion in smooth muscle attenuated the acute hypoxia-induced increase in right ventricular systolic pressure in anesthetized mice. Acute hypoxia induces superoxide release from Complex III of smooth muscle cells. These oxidant signals diffuse into the cytosol and trigger increases in [Ca(2+)](i) that cause acute hypoxic pulmonary vasoconstriction.

  5. Acute pancreatitis in patients with type 2 diabetes mellitus treated with dipeptidyl peptidase-4 inhibitors.

    Science.gov (United States)

    Yang, Tzu-Lin; Shen, Mei-Chiou; Yu, Ming-Lung; Huang, Yaw-Bin; Chen, Chung-Yu

    2016-04-01

    Dipeptidyl peptidase (DPP)-4 inhibitors are approved for use in monotherapy or in combination therapy for patients with type 2 diabetes mellitus for acute pancreatitis were made through the US Food and Drug Administration Adverse Event Reporting System, and this led to a revision in the prescribing information for these drugs. Therefore, this study is designed to evaluate DPP-4 inhibitors induced acute pancreatitis via the spontaneous adverse drug reactions (ADRs) reporting system in a medical center. In four of 2305 ADR cases, it is suspected that DPP-4 inhibitors induced moderate to serious acute pancreatitis. Beyond drugs, other factors also contribute to acute pancreatitis and affect the possibility of ADRs assessed using the Naranjo algorithm. Finally, our results indicate that the incidence of DPP-4 inhibitors induced acute pancreatitis is low. Copyright © 2016. Published by Elsevier B.V.

  6. Alogliptin after acute coronary syndrome in patients with type 2 diabetes

    DEFF Research Database (Denmark)

    White, William B; Cannon, Christopher P; Heller, Simon R

    2013-01-01

    BACKGROUND: To assess potentially elevated cardiovascular risk related to new antihyperglycemic drugs in patients with type 2 diabetes, regulatory agencies require a comprehensive evaluation of the cardiovascular safety profile of new antidiabetic therapies. We assessed cardiovascular outcomes...... with alogliptin, a new inhibitor of dipeptidyl peptidase 4 (DPP-4), as compared with placebo in patients with type 2 diabetes who had had a recent acute coronary syndrome. METHODS: We randomly assigned patients with type 2 diabetes and either an acute myocardial infarction or unstable angina requiring...

  7. [Complex regional pain syndrome type 1: negating the myth].

    Science.gov (United States)

    Frölke, Jan Paul M; van Dongen, Robert T; van de Meent, Henk

    2015-01-01

    Complex regional pain syndrome type 1 (CRPS-1) was identified in the Netherlands more than 30 years ago, but since then the arguments supporting this diagnosis have become weaker. Incidence has decreased, it is often not possible to make a definite diagnosis, the pathophysiology remains unclear and treatments are extremely diverse. Since the patient group is so heterogeneous, it is often unclear exactly which patients should be included. Disuse due to immobilization can give an identical clinical picture, including the inflammatory parameters that are seen in CRPS-1. CRPS-1 following injury can be prevented with exercise, and incidence is declining dramatically. Taking these factors into consideration, we support the view that CRPS-1 is not an illness but rather a 'disuse syndrome' as a result of immobilization, or there may be a missed underlying diagnosis.

  8. [Reflex dystrophy. Complex regional pain syndrome type I].

    Science.gov (United States)

    Petersen, Gry Kambskard; Jensen, Michael Reinhold; Dahlin, Lars B; Nielsen, Niels H Søe

    2002-10-21

    Reflex sympathetic dystrophy or complex regional pain syndrome type I is primarily a clinical diagnosis. The syndrome is most common after soft tissue damage or fractures and is more often seen in women than in men. The paramount symptom is pain, but oedema, a limited range of motion, changes in sensibility, and trophic changes are also seen. The pathogenesis is unknown, but most clinicians believe it to be caused by disturbances in the sympathetic or sensory nervous system and/or an excessive inflammatory response, most likely neurogenic inflammation. It seems that early treatment with physiotherapy and corticosteroids has a positive effect on the disease. Despite lack of documentation, the principles of treatment usually prescribed for the treatment of neurogenic pain must be taken into consideration. There is a lack of large double-blind studies on all aspects of the syndrome.

  9. Complex regional pain syndrome type I following pacemaker implantation

    Directory of Open Access Journals (Sweden)

    Sangita Kamath

    2015-12-01

    Full Text Available A 70-year-old woman presented with burning pain and swelling over dorsum of right hand and small joints of the fingers, associated with redness, feeling of warmth, and stiffness of the fingers, with inability to bend the fingers since 2 months. The symptoms were progressively increasing in intensity for the past 1 month. There was no history of fever or trauma to the hand. Two months before her symptoms started, she had permanent pacemaker implanted for complete heart block with syncope. She was hypertensive and was on regular medication. Her X-ray of right hand showed decreased bone density (demineralisation, suggestive of osteopenia. A diagnosis of reflex sympathetic dystrophy syndrome or complex regional pain syndrome type I induced by pacemaker insertion was made. She was treated with amitriptyline and steroids, after which her symptoms improved dramatically.

  10. Acute vitamin C improves cardiac function, not exercise capacity, in adults with type 2 diabetes

    OpenAIRE

    Scalzo, Rebecca L.; Bauer, Timothy A.; Harrall, Kylie; Moreau, Kerrie; Ozemek, Cemal; Herlache, Leah; McMillin, Shawna; Huebschmann, Amy G.; Dorosz, Jennifer; Reusch, Jane E. B.; Regensteiner, Judith G.

    2018-01-01

    Background People with type 2 diabetes (T2D) have impaired exercise capacity, even in the absence of complications, which is predictive of their increased cardiovascular mortality. Cardiovascular dysfunction is one potential cause of this exercise defect. Acute infusion of vitamin C has been separately shown to improve diastolic and endothelial function in prior studies. We hypothesized that acute vitamin C infusion would improve exercise capacity and that these improvements would be associat...

  11. Decreased sleep stage transition pattern complexity in narcolepsy type 1.

    Science.gov (United States)

    Ferri, Raffaele; Pizza, Fabio; Vandi, Stefano; Iloti, Martina; Plazzi, Giuseppe

    2016-08-01

    To analyze the complexity of the nocturnal sleep stage sequence in central disorders of hypersomnolence (CDH), with the hypothesis that narcolepsy type 1 (NT1) might exhibit distinctive sleep stage sequence organization and complexity. Seventy-nine NT1 patients, 22 narcolepsy type 2 (NT2), 22 idiopathic hypersomnia (IH), and 52 patients with subjective hypersomnolence (sHS) were recruited and their nocturnal sleep was polysomnographically recorded and scored. Group between-stage transition probability matrices were obtained and compared. Patients with NT1 differed significantly from all the other patient groups, the latter, in turn, were not different between each other. The individual probability of the R-to-N2 transition was found to be the parameter showing the difference of highest significance between the groups (lowest in NT1) and classified patients with or without NT1 with an accuracy of 78.9% (sensitivity 78.5% and specificity 79.2%), by applying a cut-off value of 0.15. The main result of this study is that the structure of the sleep stage transition pattern of hypocretin-deficient NT1 patients is significantly different from that of other forms of CDH and sHS, with normal hypocretin levels. The lower probability of R-to-N2 transition occurrence in NT1 appears to be a reliable polysomnographic feature with potential application at the individual level, for supportive diagnostic purposes. Copyright © 2016 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.

  12. Complex automated medication systems reduce medication administration errors in a Danish acute medical unit.

    Science.gov (United States)

    Risør, Bettina Wulff; Lisby, Marianne; Sørensen, Jan

    2018-03-24

    The objective of this study was to evaluate the effectiveness of two automated medication systems in reducing medication administration errors. The study was a controlled before-and-after study and included three observation periods with collection of data during a 3-week period as initial baseline and two subsequent follow-up periods at 10 and 20 months. The study was conducted in two Danish acute medical units. Two automated medication systems were implemented: (i) a complex automated medication system (cAMS) consisting of an automated dispensing cabinet, automated unit-dose dispensing and barcode medication administration (BCMA) and (ii) a non-patient-specific automated medication system (npsAMS) consisting of automated unit-dose dispensing and BCMA. The occurrence of administration errors and sub-types; procedural and clinical errors were observed. The proportion of errors was calculated by dividing the number of doses with one or more errors with the number of opportunities for errors. Difference-in-difference analysis using logistic regression was used to assess changes in proportion of errors. Compared with control, the cAMS reduced the overall risk of administration errors in the intervention unit, (odds ratio (OR) 0.53; 95% confidence interval (CI) 0.27-0.90) and procedural errors were significantly reduced as well (OR 0.44; 95% CI 0.126-0.94). The npsAMS effectively reduced the clinical errors in the intervention ward (OR 0.38; 95% CI 0.15-0.96). In line with previous research, this study found that technological interventions in the medication administration process could reduce the occurrence of medication errors.

  13. Differential role of lipocalin-2 during immune-complex mediated acute and chronic inflammation

    Science.gov (United States)

    Shashidharamurthy, Rangaiah; Machiah, Deepa; Aitken, Jesse D; Putty, Kalyani; Srinivasan, Gayathri; Chassaing, Benoit; Parkos, Charles A; Selvaraj, Periasamy; Vijay-Kumar, Matam

    2013-01-01

    Objectives Lipocalin-2 (Lcn2) is an innate immune protein expressed by a variety of cells and is highly upregulated during several pathological conditions including immune-complex (IC) mediated inflammatory/autoimmune disorders. However, the function of Lcn2 during IC-mediated inflammation is largely unknown. Therefore our objective was to investigate the role of Lcn2 in IC-mediated diseases. Methods The upregulation of Lcn2 was determined by ELISA in three different mouse models of IC-mediated autoimmune disease: systemic lupus erythematosus, collagen-induced arthritis and serum-induced arthritis. The in vivo role of Lcn2 during IC-mediated inflammation was investigated using Lcn2 knockout (Lcn2KO) mice and their wild type (WT) littermates. Results Lcn2 levels were significantly elevated in all the three autoimmune disease models. Further, in an acute skin inflammation model, Lcn2KO mice demonstrated a 50% reduction in inflammation with histopathological analysis revealing strikingly reduced immune cell infiltration compared to WT mice. Administration of recombinant Lcn2 to Lcn2KO mice restored inflammation to levels observed in WT mice. Neutralization of Lcn2 using a monoclonal antibody significantly reduced inflammation in WT mice. In contrast, Lcn2KO mice developed more severe serum-induced arthritis compared to WT mice. Histological analysis revealed extensive tissue and bone destruction with significantly reduced neutrophil infiltration but considerably more macrophage migration in Lcn2KO mice when compared to WT. Conclusion These results demonstrate that Lcn2 may regulate immune cell recruitment to the site of inflammation, a process essential for the controlled initiation, perpetuation and resolution of inflammatory processes. Thus, Lcn2 may present a promising target in the treatment of IC-mediated inflammatory/autoimmune diseases. PMID:23280250

  14. Reflex sympathetic dystrophy/complex regional pain syndrome, type 1

    Directory of Open Access Journals (Sweden)

    S.H. Botha

    2004-06-01

    Full Text Available Complex regional pain syndrome (CPRS, type 1 is a pain disorder that develops unpredictably and can follow a minor injury. A 12-year-old boy presented with severe pain in the feet and could not walk or stand weight bearing. Normal X-rays showed osteopenic changes and radiolucent lines, which appeared to be stress fractures. Three-phase bone scintigraphy showed no uptake in the left lower leg on the blood pool phase or on the immediate or delayed images. This indicated typical CPRS type 1 in children. The uptake in the right foot was increased and the stress fracture and other illness could not be differentiated. Computed tomography was done to exclude stress fractures. Only osteopenic changes in both calcaneus bones were found and there was no evidence of cortical stress fractures. Magnetic resonance images revealed oedema in the calcaneus and talus bones of both feet. The patient received epidural narcotic infusion with sympathetic blockage for 1 week combined with extensive physiotherapy. The blood pool phase of the bone scan became normal within 2 weeks, and increased uptake in both feet was noticed. The patient was followed up with MRI every 3 months and the bone marrow oedema disappeared after 6 months.

  15. Serum aminoterminal type III procollagen peptide reflects repair after acute myocardial infarction

    DEFF Research Database (Denmark)

    Jensen, L T; Hørslev-Petersen, K; Toft, P

    1990-01-01

    similar to changes observed during wound healing in humans. PIIINP is cleaved off procollagen type III during the biosynthesis of type III collagen, which characterizes the early stages of repair and inflammation. Our findings suggest that serum PIIINP reflects the repair processes and scar formation...... following acute myocardial infarction. The serum PIIINP alterations in acute myocardial infarction differ essentially from the changes in myocardial enzymes reflecting myocardial injury. Serum PIIINP may therefore provide new and clinically relevant information on the healing of myocardial infarction....

  16. [Various acute phase reactants in different types of proliferative diseases of the uterine appendages].

    Science.gov (United States)

    Zorina, V N; Kozlov, I G; Tret'iakova, T V; Promzeleva, N V; Bazhenova, L G; Zorina, R M; Riabicheva, T G; Zorin, N A

    2009-10-01

    The authors examined serum in patients with ovarian cancer (OC; a disseminated process), ovarian cystadenoma (OCA), or external endometriosis (EM) before treatment and in apparently healthy females (a control) for the content of some acute-phase proteins and cytokines to clarify the specific features of changes in their concentrations in relation to the type of the proliferative process. It was shown that in OC, there were significant reductions in the levels of alpha2-macroglobulin (MG), plasmin (PL), alpha1-antitrypsin (AT) and statistically significantly increases in the content of lactoferrin (LF), interleukin (IL)-6, IL-8, Ig, and the regulatory transport complex of P--M. In M, the concentrations of AT were lower and those of IL-6, IL-8, and PL-MG were higher (to a lesser degree than those in OC). In OCA, the levels of MG and IgA were increased; those of IL-8 and PL-MG were decreased. The concentrations of interferon and IgM were unchanged in all groups. The findings suggest that difefrent proliferative processes initially provoke a number of changes of varying magnitude and even directions in the serum levels of inflammation reactants, which should be borne in mind when conducting clinical tests in the intraoperative and, probably, postoperative periods.

  17. Influence of chitosan and melanin-glucan complex onto gamma-exposure with low doses and acute stressful reaction

    International Nuclear Information System (INIS)

    Senyuk, O.F.; Tarasenko, P.D.; Pazukhin, Eh.M.; Gorovoj, L.F.; Varlamov, V.P.

    2004-01-01

    Possibilities of prevention and reduction of consequences of acute exposure on the background of immobilization stress with the help of chitosan preparations and of melanin - glucan complex of highest bazidiomicetes (fungi) were studied. Tested preparations were capable to protect hematological and immunological homeostasis of line BALB/c mice from stressful reaction provoked by acute exposure and two-hour immobilization. The most expressed normalizing and adapting effect had the mixture composed of chitosan and melanin-glucan complex

  18. Predicting complex acute wound healing in patients from a wound expertise centre registry: a prognostic study.

    Science.gov (United States)

    Ubbink, Dirk T; Lindeboom, Robert; Eskes, Anne M; Brull, Huub; Legemate, Dink A; Vermeulen, Hester

    2015-10-01

    It is important for caregivers and patients to know which wounds are at risk of prolonged wound healing to enable timely communication and treatment. Available prognostic models predict wound healing in chronic ulcers, but not in acute wounds, that is, originating after trauma or surgery. We developed a model to detect which factors can predict (prolonged) healing of complex acute wounds in patients treated in a large wound expertise centre (WEC). Using Cox and linear regression analyses, we determined which patient- and wound-related characteristics best predict time to complete wound healing and derived a prediction formula to estimate how long this may take. We selected 563 patients with acute wounds, documented in the WEC registry between 2007 and 2012. Wounds had existed for a median of 19 days (range 6-46 days). The majority of these were located on the leg (52%). Five significant independent predictors of prolonged wound healing were identified: wound location on the trunk [hazard ratio (HR) 0·565, 95% confidence interval (CI) 0·405-0·788; P = 0·001], wound infection (HR 0·728, 95% CI 0·534-0·991; P = 0·044), wound size (HR 0·993, 95% CI 0·988-0·997; P = 0·001), wound duration (HR 0·998, 95% CI 0·996-0·999; P = 0·005) and patient's age (HR 1·009, 95% CI 1·001-1·018; P = 0·020), but not diabetes. Awareness of the five factors predicting the healing of complex acute wounds, particularly wound infection and location on the trunk, may help caregivers to predict wound healing time and to detect, refer and focus on patients who need additional attention. © 2013 The Authors. International Wound Journal © 2013 Medicalhelplines.com Inc and John Wiley & Sons Ltd.

  19. A robust SNP barcode for typing Mycobacterium tuberculosis complex strains

    KAUST Repository

    Coll, Francesc

    2014-09-01

    Strain-specific genomic diversity in the Mycobacterium tuberculosis complex (MTBC) is an important factor in pathogenesis that may affect virulence, transmissibility, host response and emergence of drug resistance. Several systems have been proposed to classify MTBC strains into distinct lineages and families. Here, we investigate single-nucleotide polymorphisms (SNPs) as robust (stable) markers of genetic variation for phylogenetic analysis. We identify ∼92k SNP across a global collection of 1,601 genomes. The SNP-based phylogeny is consistent with the gold-standard regions of difference (RD) classification system. Of the ∼7k strain-specific SNPs identified, 62 markers are proposed to discriminate known circulating strains. This SNP-based barcode is the first to cover all main lineages, and classifies a greater number of sublineages than current alternatives. It may be used to classify clinical isolates to evaluate tools to control the disease, including therapeutics and vaccines whose effectiveness may vary by strain type. © 2014 Macmillan Publishers Limited.

  20. Using skin surface temperature to differentiate between complex regional pain syndrome type 1 patients after a fracture and control patients with various complaints after a fracture

    NARCIS (Netherlands)

    S.P. Niehof (Sjoerd); A. Beerthuizen (Annemerle); F.J.P.M. Huygen (Frank); F.J. Zijlstra (Freek)

    2008-01-01

    textabstractOBJECTIVE: In this study, we assessed the validity of skin surface temperature recordings, based on various calculation methods applied to the thermographic data, to diagnose acute complex regional pain syndrome type 1 (CRPS1) fracture patients. METHODS: Thermographic recordings of the

  1. Associations Between Complex PCI and Prasugrel or Clopidogrel Use in Patients With Acute Coronary Syndrome Who Undergo PCI: From the PROMETHEUS Study.

    Science.gov (United States)

    Chandrasekhar, Jaya; Baber, Usman; Sartori, Samantha; Aquino, Melissa; Kini, Annapoorna S; Rao, Sunil; Weintraub, William; Henry, Timothy D; Farhan, Serdar; Vogel, Birgit; Sorrentino, Sabato; Ge, Zhen; Kapadia, Samir; Muhlestein, Joseph B; Weiss, Sandra; Strauss, Craig; Toma, Catalin; DeFranco, Anthony; Effron, Mark B; Keller, Stuart; Baker, Brian A; Pocock, Stuart; Dangas, George; Mehran, Roxana

    2018-03-01

    Potent P2Y 12 inhibitors might offer enhanced benefit against thrombotic events in complex percutaneous coronary intervention (PCI). We examined prasugrel use and outcomes according to PCI complexity, as well as analyzing treatment effects according to thienopyridine type. PROMETHEUS was a multicentre observational study that compared clopidogrel vs prasugrel in acute coronary syndrome patients who underwent PCI (n = 19,914). Complex PCI was defined as PCI of the left main, bifurcation lesion, moderate-severely calcified lesion, or total stent length ≥ 30 mm. Major adverse cardiac events (MACE) were a composite of death, myocardial infarction, stroke, or unplanned revascularization. Outcomes were adjusted using multivariable Cox regression for effect of PCI complexity and propensity-stratified analysis for effect of thienopyridine type. The study cohort included 48.9% (n = 9735) complex and 51.1% (n = 10,179) noncomplex patients. Second generation drug-eluting stents were used in 70.1% complex and 66.2% noncomplex PCI patients (P < 0.0001). Complex PCI was associated with greater adjusted risk of 1-year MACE (hazard ratio [HR], 1.29; 95% confidence interval [CI], 1.20-1.39; P < 0.001). Prasugrel was prescribed in 20.7% of complex and 20.1% of noncomplex PCI patients (P = 0.30). Compared with clopidogrel, prasugrel significantly decreased adjusted risk for 1-year MACE in complex PCI (HR, 0.79; 95% CI, 0.68-0.92) but not noncomplex PCI (HR, 0.91; 95% CI, 0.77-1.08), albeit there was no evidence of interaction (P interaction = 0.281). Despite the use of contemporary techniques, acute coronary syndrome patients who undergo complex PCI had significantly higher rates of 1-year MACE. Adjusted magnitude of treatment effects with prasugrel vs clopidogrel were consistent in complex and noncomplex PCI without evidence of interaction. Copyright © 2018. Published by Elsevier Inc.

  2. The aminoterminal propeptide of type III procollagen provides new information on prognosis after acute myocardial infarction

    DEFF Research Database (Denmark)

    Høst, N B; Jensen, L T; Bendixen, P M

    1995-01-01

    The aim of the study was to examine sequential changes in serum levels of the aminoterminal propeptide of type III procollagen (S-PIIINP) after acute myocardial infarction (AMI), and to assess the value of S-PIIINP as a predictor of outcome. The study group comprised 74 patients with AMI, and 24 ...

  3. Lixisenatide in Patients with Type 2 Diabetes and Acute Coronary Syndrome

    DEFF Research Database (Denmark)

    Pfeffer, Marc A; Claggett, Brian; Diaz, Rafael

    2015-01-01

    was placebo. CONCLUSIONS: In patients with type 2 diabetes and a recent acute coronary syndrome, the addition of lixisenatide to usual care did not significantly alter the rate of major cardiovascular events or other serious adverse events. (Funded by Sanofi; ELIXA ClinicalTrials.gov number, NCT01147250.)....

  4. Acute hyperinsulinemia decreases plasma osteoprotegerin with diminished effect in type 2 diabetes and obesity

    DEFF Research Database (Denmark)

    Jørgensen, Gitte Maria; Vind, Birgitte; Nybo, Mads

    2009-01-01

    the acute effects of insulin on plasma OPG concentrations in individuals with type 2 diabetes and obese individuals compared with lean controls. DESIGN: The study population consisted of ten type 2 diabetic, ten obese subjects, and ten lean subjects with no family history of diabetes. METHODS: All subjects...... infusion decreased plasma OPG concentrations in all groups (Pobese and type 2 diabetic individuals (P=0.007). Baseline OPG correlated with fasting insulin, baseline lactate, and low density lipoprotein cholesterol in the diabetic group, and with baseline FFA...... in the lean group. The relative change of OPG in response to insulin correlated inversely with HbA1c and baseline FFA in the lean group. CONCLUSIONS: Acute hyperinsulinemia decreases plasma OPG, but with diminished effect in individuals with type 2 diabetes and obesity. Increased levels of OPG in arteries...

  5. [Intervention priorities in the acute stage of complex emergencies drafted by nine humanitarian aid agencies].

    Science.gov (United States)

    Carrillo Jaimes, Carmen Sofía; Arcos González, Pedro Ignacio

    2004-01-01

    Complex Emergencies are an international Public Health problem currently becoming increasingly more frequent and of growing proportions which lead to major death and disease rates, especially during the acute stage thereof. This study is aimed at identifying and analyzing the top-priority areas of intervention in the acute stage of a complex emergency drafted in the operating manuals of the main aid agencies, as well as the degree of development and structuring of the activities proposed in each area on which priority has been placed. The intervention manuals drafted by nine major aid agencies were used as study material. A quantitative analysis was then made of the 16 intervention priorities set out, as well as of the degree to which each priority was defined based on the development of 73 variables of aspects of the proposals set out in the manuals. The ACNUR manual includes 90% of the 73 variables for further expansion upon the priorities, the UN Humanitarian Affaire Coordination Office manual including 35% of the 73 variables. ACNUR better expands upon the non-healthcare variables, followed by MSF and USAID. Doctors without borders shows a 97.3% degree of expansion of the healthcare variables) followed by ACNUR (94.7%), USAID (92.1%). ACNUR has been found to have the most integral proposal, the UN Humanitarian Affairs Coordination Office having the most discreet. There is a general trend towad further expanding upon and unifying the health indicators, whilst other aspects are not further expanded upon.

  6. Inhibitory effect of aniracetam on N-type calcium current in acutely isolated rat neuronal cells.

    Science.gov (United States)

    Koike, H; Saito, H; Matsuki, N

    1993-04-01

    Effects of aniracetam on whole-cell calcium currents were studied in acutely isolated neuronal cells from postnatal rat ventromedial hypothalamus. There were three types of inward calcium currents, one low-threshold transient current and two high-threshold sustained currents. The nicardipine sensitive L-type current was activated at -20 mV or more depolarized potentials, and the omega-conotoxin sensitive N-type current was recorded at more positive potentials than the L-type. Aniracetam inhibited the N-type current in a dose-dependent manner without affecting the other two types of calcium currents. The effect appeared soon after the addition and lasted for several minutes during washing. Since the N-type current is thought to regulate the release of transmitters, the inhibitory effect may contribute to the nootropic property of aniracetam by modifying the neurotransmission.

  7. Acute decompensation boosts hepatic collagen type III deposition and deteriorates experimental and human cirrhosis

    DEFF Research Database (Denmark)

    Praktiknjo, Michael; Lehmann, Jennifer; Nielsen, Mette J

    2018-01-01

    Patients with end-stage liver disease develop acute decompensation (AD) episodes, which become more frequent and might develop into acute-on-chronic liver failure (ACLF). However, it remains unknown how AD induces acceleration of liver disease. We hypothesized that remodeling of collagen type III...... Pro-C3 levels were associated with injury, disease severity scores (Model for End-Stage Liver Disease, Child-Pugh, chronic liver failure-C AD), ACLF development, and mortality. C3M decreased with AD and the chronic liver failure-C AD score. Collagen type III deposition ratio increased with the risk...... plays a role in the acceleration of liver cirrhosis after AD and analyzed its formation (Pro-C3) and degradation (matrix metalloproteinase-degraded type III collagen [C3M]) markers in animal models and human disease. Bile duct ligation induced different stages of liver fibrosis in rats. Fibrosis...

  8. Influencing factors for acute pancreatitis in patients with type 2 diabetes complicated by hypertriglyceridemia

    Directory of Open Access Journals (Sweden)

    BAI Yunlei

    2017-12-01

    Full Text Available ObjectiveTo investigate the association between hypertriglyceridemia and acute pancreatitis in patients with type 2 diabetes, in order to guide the prevention and treatment of acute pancreatitis in patients with diabetes. MethodsA total of 46 patients with type 2 diabetes complicated by acute pancreatitis who were admitted to The First Hospital of Yulin from January 2013 to December 2016 were enrolled as study group, and 52 patients with type 2 diabetes alone who were admitted to our hospital within the same period of time were enrolled as control group. Related data were recorded, including age, sex, course of diabetes, body height and weight, abdominal circumference, smoking, drinking, gallstones, hypertension, blood glucose, and blood lipids [total cholesterol (TC, triglyceride (TG, high-density lipoprotein cholesterol (HDL-C, and low-density lipoprotein cholesterol (LDL-C]. The incidence rates of complications associated with diabetes were analyzed. The chi-square test was used for comparison of categorical data (general status, blood lipids, and diabetic complications between two groups; and the t-test was used for comparison of such data between two groups. A logistic regression analysis was used for multivariate analysis. ResultsThere were no significant differences between the two groups in age, sex composition, body height and weight, abdominal circumference, smoking and drinking habits, hypertension, gallstones, and course of diabetes (all P>005. The study group had significantly higher levels of TC, TG, and LDL-C than the control group (t=5.122, 4.127, and 3.524, P<0.01, <0.01, and =0.012, while the control group had a significantly higher level of HDL-C than the study group (t=2.231, P=0.037. The study group had a significantly higher incidence rate of diabetic microangiopathy (diabetic retinopathy and chronic diabetic nephropathy than the control group (χ2=92.126, P<0.01. The multivariate analysis showed that

  9. Glutaric Aciduria type I and acute renal failure — Coincidence or causality?

    Directory of Open Access Journals (Sweden)

    Ben Pode-Shakked

    2014-01-01

    Full Text Available Glutaric Aciduria type I (GA-I is a rare organic acidemia, caused by mutations in the GCDH gene, and characterized by encephalopathic crises with neurological sequelae. We report herein a patient with GA-I who presented with severe acute renal failure requiring dialysis, following an acute diarrheal illness. Histopathological evaluation demonstrated acute tubular necrosis, and molecular diagnosis revealed the patient to be homozygous for a previously unreported mutation, p.E64D. As renal impairment is not part of the clinical spectrum typical to GA-I, possible associations of renal failure and the underlying inborn error of metabolism are discussed, including recent advancements made in the understanding of the renal transport of glutaric acid and its derivatives during metabolic disturbance in GA-I.

  10. Acute juvenile cataract in newly diagnosed type 1 diabetic patients: a description of six cases.

    Science.gov (United States)

    Iafusco, Dario; Prisco, Francesco; Romano, Mario R; Dell'omo, Roberto; Libondi, Teodosio; Costagliola, Ciro

    2011-11-01

    Cataract represents one of the most frequent eye complications in type 1 and type 2 patients; contrarily, acute cataract in young diabetic patients occurs very rarely. The aim of this study was to describe six cases of acute cataract in adolescents at the onset of type 1 diabetes. Eight hundred and twenty-six patients with type 1 diabetes were retrospectively studied. A multivariate analysis was applied to verify the weight of the following laboratory findings taken on admission (independent variables): glycemia, glycated hemoglobin (HbA1c), pH, base excess (BE),and on the occurrence of cataract (dependent variable). Six patients (0.7%) presented with acute lens opacities. Cataract development was significantly correlated with HbA1c and glycemia. The relative risk increases about twice for each percentage point from 12.8 to 14.1% of HbA1c; glycemic blood levels represent a moderate risk factor for cataractogenesis. Ketoacidosis and BE were not significantly correlated. © 2011 John Wiley & Sons A/S.

  11. Reflex sympathetic dystrophy/complex regional pain syndrome, type 1

    African Journals Online (AJOL)

    Enrique

    over the left ankle was also present. (Fig. 6 and Figs 7a and 7b). There was contradiction between the two diagnoses of stress fractures and CPRS type 1. As CPRS type 1 is a clinical diagnosis the boy was treated as such. He was admitted into hospital and received epidural narcotic infusion with sympathetic blockage for a ...

  12. Cholesterol level in the circulating immune complexes of subjects suffering from the remote aftereffects of acute radiation sickness

    International Nuclear Information System (INIS)

    Nikitin, G.Yu.; Barabanova, A.V.; Nadezhina, N.M.; Tertov, V.V.; Orekhov, A.N.

    1994-01-01

    The potentiaoity of coronary atherosclerosis was assessed from cholesterol levels in the ciculationg immune complexes (CIC) in 53 subjects who suffered acute radiation sickness in 1986 after the Chernobyl power plant accident. CIC cholesterol levels of the subjects who suffered 3-4 years before acute radiation sickness of the first-second degrees of severity were found elevated as against an adequately matched reference group. Thus, subjects who suffered the second degree of severity acute radiation sickness after the radiation exposure, from 3-4 years later a group at high risk of coronary atherosclerosis

  13. Does HIPE data capture the complexity of stroke patients in an acute hospital setting?

    LENUS (Irish Health Repository)

    Clarke, B

    2010-01-01

    The Hospital Inpatient Enquiry (HIPE) system is currently used as a principle source of national data on discharges from acute hospitals. The Casemix Programme is used to calculate funding for patient care (HIPE activity and Specialty Costs Returns). Th coding is usually undertaken by clerical personnel. We were concerned that the medical complexity of our stroke patients was not captured by the process. The aims of this study were to compare activity coded by HIPE coding staff and medical staff in consecutive stroke patients discharged from the hospital. One hundred consecutive discharged patients with stroke as primary diagnosis were coded by clerical staff [usual practice] and by medical staff. We compared the coding and any differences. We calculated the financial comparison of subsequent differences in Diagnostic Related Groups (DRGs) and Relative Values (RVs). Clinician coded DRGs resulted in a higher assigned RV in 45 cases. The total RV value for HIPE using clerical coding was 595,268.94 euros and using medical coding was 725,252.16 euros. We conclude that medical input is useful in detailing the complications arising in stroke patients. We suggest that physicians should assist in the HIPE coding process in order to capture clinical complexity, so that funding can be appropriately assigned to manage these complex patients.

  14. Bacterial pathogens of acute sinusitis in the osteomeatal complex during common colds and wellness.

    Science.gov (United States)

    Han, Joseph K; Hendley, J Owen; Winther, Birgit

    2011-01-01

    Pathogenic bacteria have been cultured from the osteomeatal complex (OMC) in one-third of adults with apparent acute bacterial sinusitis; however, it is not known whether bacteria are present in the OMC during uncomplicated viral colds in adults. Adult volunteers were recruited for a study during wellness and at the time of acute common cold. Swab cultures were obtained from the OMC and from the nasopharynx by 2 routes (through the nose and through the mouth). Swab eluates were inoculated on selective agars to detect S. pneumoniae, H. influenzae, and M. catarrhalis. Bacterial pathogens were detected in the OMC more frequently during common colds than during wellness (31% vs 8%, p OMC were always present in the nasopharynx of the subject. Bacterial pathogens are present in the OMC in a subgroup of adult patients with uncomplicated upper respiratory illness/common cold. The nasopharynx appears to be the reservoir for bacterial pathogens in the OMC. Copyright © 2011 American Rhinologic Society-American Academy of Otolaryngic Allergy, LLC.

  15. Homotopy Type of Neighborhood Complexes of Kneser Graphs, KG

    Indian Academy of Sciences (India)

    3

    2017-04-12

    Apr 12, 2017 ... Keywords : Hom complexes, Kneser Graphs, Discrete Morse theory. 2000 Mathematics Subject Classification primary 05C15, secondary 57M15. 1 Introduction. Lovász in 1978, proved the Kneser Conjecture ([7]), which states that the chromatic number of the Kneser graph KGn,k is k + 2. In this proof, he.

  16. Homotopy Type of Neighborhood Complexes of Kneser Graphs, KG

    Indian Academy of Sciences (India)

    3

    2017-04-12

    Apr 12, 2017 ... Abstract. Schrijver identified a family of vertex critical subgraphs of the. Kneser graphs called the stable Kneser graphs SGn,k. Björner and de Longueville proved that the neighborhood complex of the stable. Kneser graph SGn,k is homotopy equivalent to a k−sphere. In this article, we prove that the ...

  17. Diagnostic imaging of acute aortic dissection; Evaluation of thrombosed type aortic dissection by CT and angiography

    Energy Technology Data Exchange (ETDEWEB)

    Ohya, Tohru; Kumazaki, Tatsuo (Nippon Medical School, Tokyo (Japan))

    1991-01-01

    One hundred and nineteen patients with aortic dissection who underwent diagnostic imaging were reviewed and angiographic findings as well as those of CT were analysed. Thirty eight cases (43.1%) had non-contrast opacified false lumen, the type of which we call 'thrombosed type aortic dissection'. A comparative study of the thrombosed type with the patent type of false lumens was made particularly from the stand point of the characteristic diagnostic imagings (CT and angiography). At the same time, the pitfalls of these imagings in thrombosed type aortic dissection were studied. At the onset the average age of thrombosed type was 62.3 years old, while that of the patent type was 57.3. A statistical significance between the two groups was p<0.05. Thrombosed type in all cases was caused by atherosclerosis, whereas patent type was caused by the Marfan's syndrome in 11 cases. Other clinical findings, such as initial symptoms and blood pressure revealed no significant differences between the two groups. Pre-contrast CT in acute thrombosed type aortic dissection showed 'hyperdense crescent sign' in 89.4%. However, in 3 cases with thrombosed type in which the pre-contrast CT showed 'hyperdense crescent sign' contrast-enhanced CT detected no clear evidence of aortic dissection in the same site. This was due to obscurity induced by contrast medium. Angiographic findings of thrombosed type were classified into 3 groups: normal type, stenosed true lumen type and ulcer-like projection type. The incidence of normal type was estimated to be 48.4%, whereas stenosed true lumen type was 24.2% and ulcer-like projection was 27.7%. The present study concluded that thrombosed type is not rare in acute aortic dissection and contrast-enhanced CT as well as pre-contrast CT, is of great value in diagnosing thrombosed type. 'Hyperdense crescent sign' in pre-contrast CT is characteristic of intramural hematoma. (author).

  18. Acute liver failure in a pediatric patient with congenital dyserythropoietic anemia type I treated with deferasirox

    Directory of Open Access Journals (Sweden)

    Galina Ling

    2015-09-01

    Full Text Available Congenital dyserythropoietic anemias (CDA represent a heterogeneous group of disorders characterized by morphological abnormalities of erythroid precursor cells and various degrees of hemolysis. Iron overload is a result of continuous hemolysis and recurrent transfusions. It is treated with iron chelators, including deferasirox. We present here a case of acute liver failure in a 12 years old girl with CDA type I treated with deferasirox and discuss the approach to treatment.

  19. Whole body perfusion in patients undergoing frozen elephant trunk for type A acute aortic dissections.

    Science.gov (United States)

    Cappabianca, Giangiuseppe; Roscitano, Claudio; Bichi, Samuele; Cricco, Antonio; Parrinello, Matteo; Beghi, Cesare; Albano, Giovanni; Esposito, Giampiero

    2017-03-01

    The Frozen Elephant Trunk (FET) can be adopted in selected type A acute aortic dissections (TAAAD). During FET, a prolonged distal circulatory arrest exposes the spine and visceral organs to potential ischemic injuries. Antegrade distal aortic perfusion (ADAP) could minimize this risk: we describe the technical aspects of the simultaneous use of antegrade cerebral perfusion (ACP) and ADAP achieving a "Whole Body Perfusion" (WBP) during FET.

  20. Evidence for efficacy of acute treatment of episodic tension-type headache

    DEFF Research Database (Denmark)

    Moore, R Andrew; Derry, Sheena; Wiffen, Philip J

    2014-01-01

    The International Headache Society (IHS) provides guidance on the conduct of trials for acute treatment of episodic tension-type headache (TTH), a common disorder with considerable disability. Electronic and other searches identified randomised, double-blind trials of oral drugs treating episodic....... There was no evidence that any one outcome was better than others. The evidence available for treatment efficacy is small in comparison to the size of the clinical problem....

  1. A systematic review on the treatment of acute ankle sprain: brace versus other functional treatment types.

    Science.gov (United States)

    Kemler, Ellen; van de Port, Ingrid; Backx, Frank; van Dijk, C Niek

    2011-03-01

    Ankle injuries, especially ankle sprains, are a common problem in sports and medical care. Ankle sprains result in pain and absenteeism from work and/or sports participation, and can lead to physical restrictions such as ankle instability. Nowadays, treatment of ankle injury basically consists of taping the ankle. The purpose of this review is to evaluate the effectiveness of ankle braces as a treatment for acute ankle sprains compared with other types of functional treatments such as ankle tape and elastic bandages. A computerized literature search was conducted using PubMed, EMBASE, CINAHL and the Cochrane Clinical Trial Register. This review includes randomized controlled trials in English, German and Dutch, published between 1990 and April 2009 that compared ankle braces as a treatment for lateral ankle sprains with other functional treatments. The inclusion criteria for this systematic review were (i) individuals (sports participants as well as non-sports participants) with an acute injury of the ankle (acute ankle sprains); (ii) use of an ankle brace as primary treatment for acute ankle sprains; (iii) control interventions including any other type of functional treatment (e.g. Tubigrip™, elastic wrap or ankle tape); and (iv) one of the following reported outcome measures: re-injuries, symptoms (pain, swelling, instability), functional outcomes and/or time to resumption of sports, daily activities and/or work. Eight studies met all inclusion criteria. Differences in outcome measures, intervention types and patient characteristics precluded pooling of the results, so best evidence syntheses were conducted. A few individual studies reported positive outcomes after treatment with an ankle brace compared with other functional methods, but our best evidence syntheses only demonstrated a better treatment result in terms of functional outcome. Other studies have suggested that ankle brace treatment is a more cost-effective method, so the use of braces after acute

  2. Phylobetadiversity among forest types in the Brazilian Atlantic Forest complex.

    Science.gov (United States)

    Duarte, Leandro Da Silva; Bergamin, Rodrigo Scarton; Marcilio-Silva, Vinícius; Seger, Guilherme Dubal Dos Santos; Marques, Márcia Cristina Mendes

    2014-01-01

    Phylobetadiversity is defined as the phylogenetic resemblance between communities or biomes. Analyzing phylobetadiversity patterns among different vegetation physiognomies within a single biome is crucial to understand the historical affinities between them. Based on the widely accepted idea that different forest physiognomies within the Southern Brazilian Atlantic Forest constitute different facies of a single biome, we hypothesize that more recent phylogenetic nodes should drive phylobetadiversity gradients between the different forest types within the Atlantic Forest, as the phylogenetic divergence among those forest types is biogeographically recent. We compiled information from 206 checklists describing the occurrence of shrub/tree species across three different forest physiognomies within the Southern Brazilian Atlantic Forest (Dense, Mixed and Seasonal forests). We analyzed intra-site phylogenetic structure (phylogenetic diversity, net relatedness index and nearest taxon index) and phylobetadiversity between plots located at different forest types, using five different methods differing in sensitivity to either basal or terminal nodes (phylogenetic fuzzy weighting, COMDIST, COMDISTNT, UniFrac and Rao's H). Mixed forests showed higher phylogenetic diversity and overdispersion than the other forest types. Furthermore, all forest types differed from each other in relation phylobetadiversity patterns, particularly when phylobetadiversity methods more sensitive to terminal nodes were employed. Mixed forests tended to show higher phylogenetic differentiation to Dense and Seasonal forests than these latter from each other. The higher phylogenetic diversity and phylobetadiversity levels found in Mixed forests when compared to the others likely result from the biogeographical origin of several taxa occurring in these forests. On one hand, Mixed forests shelter several temperate taxa, like the conifers Araucaria and Podocarpus. On the other hand, tropical groups, like

  3. Phylobetadiversity among forest types in the Brazilian Atlantic Forest complex.

    Directory of Open Access Journals (Sweden)

    Leandro Da Silva Duarte

    Full Text Available Phylobetadiversity is defined as the phylogenetic resemblance between communities or biomes. Analyzing phylobetadiversity patterns among different vegetation physiognomies within a single biome is crucial to understand the historical affinities between them. Based on the widely accepted idea that different forest physiognomies within the Southern Brazilian Atlantic Forest constitute different facies of a single biome, we hypothesize that more recent phylogenetic nodes should drive phylobetadiversity gradients between the different forest types within the Atlantic Forest, as the phylogenetic divergence among those forest types is biogeographically recent. We compiled information from 206 checklists describing the occurrence of shrub/tree species across three different forest physiognomies within the Southern Brazilian Atlantic Forest (Dense, Mixed and Seasonal forests. We analyzed intra-site phylogenetic structure (phylogenetic diversity, net relatedness index and nearest taxon index and phylobetadiversity between plots located at different forest types, using five different methods differing in sensitivity to either basal or terminal nodes (phylogenetic fuzzy weighting, COMDIST, COMDISTNT, UniFrac and Rao's H. Mixed forests showed higher phylogenetic diversity and overdispersion than the other forest types. Furthermore, all forest types differed from each other in relation phylobetadiversity patterns, particularly when phylobetadiversity methods more sensitive to terminal nodes were employed. Mixed forests tended to show higher phylogenetic differentiation to Dense and Seasonal forests than these latter from each other. The higher phylogenetic diversity and phylobetadiversity levels found in Mixed forests when compared to the others likely result from the biogeographical origin of several taxa occurring in these forests. On one hand, Mixed forests shelter several temperate taxa, like the conifers Araucaria and Podocarpus. On the other hand

  4. Interaction of hyperalgesia and sensory loss in complex regional pain syndrome type I (CRPS I.

    Directory of Open Access Journals (Sweden)

    Volker Huge

    Full Text Available BACKGROUND: Sensory abnormalities are a key feature of Complex Regional Pain Syndrome (CRPS. In order to characterise these changes in patients suffering from acute or chronic CRPS I, we used Quantitative Sensory Testing (QST in comparison to an age and gender matched control group. METHODS: 61 patients presenting with CRPS I of the upper extremity and 56 healthy subjects were prospectively assessed using QST. The patients' warm and cold detection thresholds (WDT; CDT, the heat and cold pain thresholds (HPT; CPT and the occurrence of paradoxical heat sensation (PHS were observed. RESULTS: In acute CRPS I, patients showed warm and cold hyperalgesia, indicated by significant changes in HPT and CPT. WDT and CDT were significantly increased as well, indicating warm and cold hypoaesthesia. In chronic CRPS, thermal hyperalgesia declined, but CDT as well as WDT further deteriorated. Solely patients with acute CRPS displayed PHS. To a minor degree, all QST changes were also present on the contralateral limb. CONCLUSIONS: We propose three pathomechanisms of CRPS I, which follow a distinct time course: Thermal hyperalgesia, observed in acute CRPS, indicates an ongoing aseptic peripheral inflammation. Thermal hypoaesthesia, as detected in acute and chronic CRPS, signals a degeneration of A-delta and C-fibres, which further deteriorates in chronic CRPS. PHS in acute CRPS I indicates that both inflammation and degeneration are present, whilst in chronic CRPS I, the pathomechanism of degeneration dominates, signalled by the absence of PHS. The contralateral changes observed strongly suggest the involvement of the central nervous system.

  5. Short-term course and outcome of acute and transient psychotic disorders: Differences from other types of psychosis with acute onset.

    Science.gov (United States)

    Castagnini, Augusto C; Munk-Jørgensen, Povl; Bertelsen, Aksel

    2016-02-01

    The category of 'acute and transient psychotic disorders' (ATPDs) appeared in the ICD-10 Classification of Mental and Behavioural Disorders (ICD-10), but its distinctive features remain uncertain. To examine the course and outcome of ATPDs, pointing out differences from other types of psychosis. A one-year follow-up investigation of patients enrolled at the former World Health Organization (WHO) Centre for Research and Training in Mental Health in Aarhus (Denmark) for the WHO collaborative study on acute psychoses. Of 91 patients aged 15-60 years presenting with acute psychosis, 47 (51.6%) were diagnosed with ATPD, and it occurred more commonly in females; yet, the other acute psychoses featured mainly mood disorders and affected equally both genders. After 1 year, the ATPD diagnosis did not change in 28 cases (59.6%); the remaining developed either affective psychoses (27.7%), or schizophrenia and schizoaffective disorder (12.8%). Nearly, all patients with unchanged diagnosis of ATPD enjoyed full recovery, while those with other types of acute psychosis had significantly higher rates of recurrence or incomplete remission. Duration of illness within 4 weeks and stressful events in the 3 months before symptom onset predicted 1-year favourable clinical outcome for acute psychoses. Although ATPDs fared better over the short-term than other acute psychoses, their diagnostic stability is relatively low. © The Author(s) 2015.

  6. FLT-3 ITD Positive Acute Basophilic Leukemia with Rare Complex Karyotype Presenting with Acute Respiratory Failure: Case Report

    Directory of Open Access Journals (Sweden)

    Antohe Ion

    2018-01-01

    Full Text Available Background: Acute basophilic leukemia is a rare subtype of acute myeloid leukemia, as categorized by the 2008 World Health Organization classification of myeloid neoplasms. Acute basophilic leukemia diagnosis requires thorough morphological, cytochemical, immunophenotypic, molecular, and cytogenetic studies and exclusion of other hematological neoplasms associating basophilia. The disease course is defined by histamine driven, occasionally life-threatening respiratory, cardiovascular, cutaneous or digestive complications, as well as primary refractoriness to standard therapy. Clinical presentation: We herein report a case of a 63-year-old asthmatic female patient diagnosed with acute basophilic leukemia, associated with previously unpublished cytogenetic features and FLT-3 ITD mutation, pulmonary leukostasis and spontaneous pulmonary capillary leak syndrome, which worsened immediately following chemotherapy initiation. Respiratory complications were successfully managed, but recrudesced upon emergence of refractory disease and were ultimately fatal. We highlight the likelihood of pulmonary complications induced by basophil degranulation and tumor lysis in hypercellular acute basophilic leukemia and the potential benefit of histamine receptor blockade in this setting.

  7. Diversity in a complex ecological network with two interaction types

    Czech Academy of Sciences Publication Activity Database

    Melián, C. J.; Bascompte, J.; Jordano, P.; Křivan, Vlastimil

    2009-01-01

    Roč. 118, č. 1 (2009), s. 122-130 ISSN 0030-1299 R&D Projects: GA AV ČR IAA100070601 Grant - others:University of California(US) DEB-0553768; The Spanish Ministry of Science and Technology(ES) REN2003-04774; The Spanish Ministry of Science and Technology(ES) REN2003-00273 Institutional research plan: CEZ:AV0Z50070508 Keywords : complex ecological network Subject RIV: EH - Ecology, Behaviour Impact factor: 3.147, year: 2009

  8. Complex Dynamics of an Adnascent-Type Game Model

    Directory of Open Access Journals (Sweden)

    Baogui Xin

    2008-01-01

    Full Text Available The paper presents a nonlinear discrete game model for two oligopolistic firms whose products are adnascent. (In biology, the term adnascent has only one sense, “growing to or on something else,” e.g., “moss is an adnascent plant.” See Webster's Revised Unabridged Dictionary published in 1913 by C. & G. Merriam Co., edited by Noah Porter. The bifurcation of its Nash equilibrium is analyzed with Schwarzian derivative and normal form theory. Its complex dynamics is demonstrated by means of the largest Lyapunov exponents, fractal dimensions, bifurcation diagrams, and phase portraits. At last, bifurcation and chaos anticontrol of this system are studied.

  9. Ansa Pancreatica: A Case Report of a Type of Ductal Variation in a Patient with Idiopathic Acute Recurrent Pancreatitis

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Hye Mi; Park, Jung Yup; Kim, Myeong Jin [Yonsei University College of Medicine, Seoul (Korea, Republic of)

    2010-02-15

    Ansa pancreatica is a rare type of pancreatic ductal variation. Recently, ansa pancreatic has been considered as a predisposing factor in patients with idiopathic acute pancreatitis. To the best of our knowledge, no previously published report in Korea has described ansa pancreatica. We report a case of acute recurrent pancreatitis with ansa pancreatica, which was revealed on magnetic resonance cholangiopancreatography (MRCP)

  10. Association of acute-phase reactants with arterial stiffness in patients with type 2 diabetes mellitus.

    Science.gov (United States)

    Wakabayashi, Ichiro; Masuda, Hiroshi

    2006-03-01

    The relationship between chronic low-grade inflammation and atherosclerotic progress in patients with diabetes mellitus has not been confirmed. We determined whether acute-phase reactants are associated with arterial stiffness in diabetic patients. Relationships of blood inflammatory markers [high-sensitivity C-reactive protein (CRP), amyloid A protein (SAA), sialic acid, fibrinogen and white blood cells (WBC)] with atherosclerosis were investigated in a cross-sectional study using 114 subjects with type 2 diabetes. The degree of atherosclerosis was evaluated by arterial stiffness measured using cardio-ankle vascular index (CAVI), a new index of arterial stiffness, which is compatible with conventional aortic pulse-wave velocity. CRP, SAA, sialic acid, fibrinogen and WBC showed significant correlations with CAVI. CAVI was significantly higher in the highest tertile of sialic acid, fibrinogen and WBC compared with the lowest tertile or lowest and middle tertiles. This association was independent of age, sex and smoking. By logistic regression analysis, the highest levels of these acute-phase reactants showed increased risk of high CAVI, while CRP and SAA were not associated with an increased risk in this analysis. CAVI was also significantly correlated with duration of diabetes, blood pressure and serum total cholesterol. Acute-phase reactants, such as CRP, SAA, sialic acid, fibrinogen and WBC, are associated with arterial stiffness in patients with type 2 diabetes mellitus.

  11. Acute and chronic administration of cannabidiol increases mitochondrial complex and creatine kinase activity in the rat brain

    Directory of Open Access Journals (Sweden)

    Samira S. Valvassori

    2013-12-01

    Full Text Available Objective: To investigate the effects of cannabidiol (CBD on mitochondrial complex and creatine kinase (CK activity in the rat brain using spectrophotometry. Method: Male adult Wistar rats were given intraperitoneal injections of vehicle or CBD (15, 30, or 60 mg/kg in an acute (single dose or chronic (once daily for 14 consecutive days regimen. The activities of mitochondrial complexes and CK were measured in the hippocampus, striatum, and prefrontal cortex. Results: Both acute and chronic injection of CBD increased the activity of the mitochondrial complexes (I, II, II-III, and IV and CK in the rat brain. Conclusions: Considering that metabolism impairment is certainly involved in the pathophysiology of mood disorders, the modulation of energy metabolism (e.g., by increased mitochondrial complex and CK activity by CBD could be an important mechanism implicated in the action of CBD.

  12. Ibuprofen for acute treatment of episodic tension-type headache in adults

    DEFF Research Database (Denmark)

    Derry, Sheena; Wiffen, Philip J; Moore, R Andrew

    2015-01-01

    BACKGROUND: Tension-type headache (TTH) affects about one person in five worldwide. It is divided into infrequent episodic TTH (fewer than one headache per month), frequent episodic TTH (1 to 14 headaches per month), and chronic TTH (15 headaches a month or more). Ibuprofen is one of a number...... of analgesics suggested for acute treatment of headaches in frequent episodic TTH. OBJECTIVES: To assess the efficacy and safety of oral ibuprofen for treatment of acute episodic TTH in adults. SEARCH METHODS: We searched CENTRAL (The Cochrane Library), MEDLINE, EMBASE, and our own in-house database to January......) and number needed to treat for an additional beneficial outcome (NNT) or number needed to treat for an additional harmful outcome (NNH) of oral ibuprofen compared to placebo for a range of outcomes, predominantly those recommended by the International Headache Society (IHS). MAIN RESULTS: We included 12...

  13. Molecular Diagnosis of Chagas Disease in Colombia: Parasitic Loads and Discrete Typing Units in Patients from Acute and Chronic Phases

    Science.gov (United States)

    Hernández, Carolina; Cucunubá, Zulma; Flórez, Carolina; Olivera, Mario; Valencia, Carlos; Zambrano, Pilar; León, Cielo; Ramírez, Juan David

    2016-01-01

    Background The diagnosis of Chagas disease is complex due to the dynamics of parasitemia in the clinical phases of the disease. The molecular tests have been considered promissory because they detect the parasite in all clinical phases. Trypanosoma cruzi presents significant genetic variability and is classified into six Discrete Typing Units TcI-TcVI (DTUs) with the emergence of foreseen genotypes within TcI as TcIDom and TcI Sylvatic. The objective of this study was to determine the operating characteristics of molecular tests (conventional and Real Time PCR) for the detection of T. cruzi DNA, parasitic loads and DTUs in a large cohort of Colombian patients from acute and chronic phases. Methodology/Principal Findings Samples were obtained from 708 patients in all clinical phases. Standard diagnosis (direct and serological tests) and molecular tests (conventional PCR and quantitative PCR) targeting the nuclear satellite DNA region. The genotyping was performed by PCR using the intergenic region of the mini-exon gene, the 24Sa, 18S and A10 regions. The operating capabilities showed that performance of qPCR was higher compared to cPCR. Likewise, the performance of qPCR was significantly higher in acute phase compared with chronic phase. The median parasitic loads detected were 4.69 and 1.33 parasite equivalents/mL for acute and chronic phases. The main DTU identified was TcI (74.2%). TcIDom genotype was significantly more frequent in chronic phase compared to acute phase (82.1% vs 16.6%). The median parasitic load for TcIDom was significantly higher compared with TcI Sylvatic in chronic phase (2.58 vs.0.75 parasite equivalents/ml). Conclusions/Significance The molecular tests are a precise tool to complement the standard diagnosis of Chagas disease, specifically in acute phase showing high discriminative power. However, it is necessary to improve the sensitivity of molecular tests in chronic phase. The frequency and parasitemia of TcIDom genotype in chronic

  14. Predictive value of small ulcers in the evolution of acute type B intramural hematoma

    International Nuclear Information System (INIS)

    Sebastià, C.; Evangelista, A.; Quiroga, S.; Cuellar, H.; Aguilar, R.; Muntanyà, X.

    2012-01-01

    Objective: To assess the long-term evolution and predictive factors of type B intramural hematoma (IMH). Material and methods: 34 patients (33 men), mean age: 67 years (47–87) diagnosed with type B IMH by computed tomography (CT) and followed up clinically and by CT yearly. Mean follow-up was 5.9 years (2–13 years). Two evolution patterns were considered: (a) regression and (b) progression. Clinical and imaging variables were analyzed for assessing their predictor values. Results: Evolution at one year was to regression in 56% and to progression in 44% of cases. There were no association among age, sex, other aortic abnormalities, presence of atherosclerotic disease or blood pressure, initial maximum aortic diameter, indexed maximum aortic diameter, IMH thickness or length, presence or absence of mediastinal hematoma and the evolution of type B IMH. Ten patients had small aortic ulcers in the acute phase. The presence of ulcers was related with progression of IMH. No differences were observed in evolution between the control at first year and the last control. Conclusions: The presence of small ulcers is a strong predictor of evolution in acute type B IMH. In addition, the regression group remains completely stable after the first year of evolution.

  15. Selective Aortic Arch and Root Replacement in Repair of Acute Type A Aortic Dissection.

    Science.gov (United States)

    Fleischman, Fernando; Elsayed, Ramsey S; Cohen, Robbin G; Tatum, James M; Kumar, S Ram; Kazerouni, Kayvan; Mack, Wendy J; Barr, Mark L; Cunningham, Mark J; Hackmann, Amy E; Baker, Craig J; Starnes, Vaughn A; Bowdish, Michael E

    2018-02-01

    Controversy exists regarding the optimal extent of repair for type A aortic dissection. Our approach is to replace the ascending aorta, and only replace the aortic root or arch when intimal tears are present in those areas. We examined intermediate outcomes with this approach to acute type A aortic dissection repair. Between March 2005 and October 2016, 195 patients underwent repair of acute type A aortic dissection. Repair was categorized by site of proximal and distal anastomosis and extent of repair. Mean follow-up was 31.0 ± 30.9 months. Kaplan-Meier analysis was used to assess survival. Multiple variable Cox proportional hazards modeling was utilized to identify factors associated with overall mortality. Overall survival was 85.1%, 83.9%, 79.1%, and 74.4% at 6, 12, 36, and 60 months, respectively. Eight patients required reintervention. The cumulative incidence of aortic reintervention at 1 year with death as a competing outcome was 3.95%. Multiple variable regression analysis identified factors such as age, preoperative renal failure, concomitant thoracic endograft, postoperative myocardial infarction and sepsis, and need for extracorporeal membrane oxygenation as predictive of overall mortality. Neither proximal or distal extent of repair, nor need for reintervention affected overall survival (proximal: hazard ratio 1.63, 95% confidence interval: 0.75 to 3.51, p = 0.22; distal: hazard ratio 1.12, 95% confidence interval: 0.43 to 2.97, p = 0.81; reintervention: hazard ratio 0.03, 95% confidence interval: 0.002 to 0.490, p < 0.01). A selective approach to root and arch repair in acute type A aortic dissection is safe. If aortic reintervention is needed, survival does not appear to be affected. Copyright © 2018 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  16. Virus Type and Genomic Load in Acute Bronchiolitis: Severity and Treatment Response With Inhaled Adrenaline.

    Science.gov (United States)

    Skjerven, Håvard O; Megremis, Spyridon; Papadopoulos, Nikolaos G; Mowinckel, Petter; Carlsen, Kai-Håkon; Lødrup Carlsen, Karin C

    2016-03-15

    Acute bronchiolitis frequently causes infant hospitalization. Studies on different viruses or viral genomic load and disease severity or treatment effect have had conflicting results. We aimed to investigate whether the presence or concentration of individual or multiple viruses were associated with disease severity in acute bronchiolitis and to evaluate whether detected viruses modified the response to inhaled racemic adrenaline. Nasopharyngeal aspirates were collected from 363 infants with acute bronchiolitis in a randomized, controlled trial that compared inhaled racemic adrenaline versus saline. Virus genome was identified and quantified by polymerase chain reaction analyses. Severity was assessed on the basis of the length of stay and the use of supportive care. Respiratory syncytial virus (83%) and human rhinovirus (34%) were most commonly detected. Seven other viruses were present in 8%-15% of the patients. Two or more viruses (maximum, 7) were detected in 61% of the infants. Virus type or coinfection was not associated with disease severity. A high genomic load of respiratory syncytial virus was associated with a longer length of stay and with an increased frequency of oxygen and ventilatory support use. Treatment effect of inhaled adrenaline was not modified by virus type, load or coinfection. In infants hospitalized with acute bronchiolitis, disease severity was not associated with specific viruses or the total number of viruses detected. A high RSV genomic load was associated with more-severe disease. NCT00817466 and EudraCT 2009-012667-34. © The Author 2015. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail journals.permissions@oup.com.

  17. The relationship between clinical feature, complex immunophenotype, chromosome karyotype, and outcome of patients with acute myeloid leukemia in China.

    Science.gov (United States)

    Ding, Bingjie; Zhou, Lanlan; Jiang, Xuejie; Li, Xiaodong; Zhong, Qingxiu; Wang, Zhixiang; Yi, Zhengshan; Zheng, Zhongxin; Yin, Changxin; Cao, Rui; Liao, Libin; Meng, Fanyi

    2015-01-01

    Mixed phenotype acute leukemia (MPAL) is a complex entity expressing both lymphoid and myeloid immunophenotyping. In the present study, 47 MPAL, 60 lymphoid antigen-positive acute myeloid leukemia (Ly(+)AML), and 90 acute myeloid leukemia with common myeloid immunophenotype (Ly(-)AML) patients were investigated. We found that, in MPAL patients, there were high proportions of blast cells in bone marrow and incidence of hepatosplenomegaly, lymphadenopathy, and Philadelphia chromosome. The overall survival (OS) and relapse-free survival (RFS) in MPAL patients were significantly shorter than those in Ly(+)AML and Ly(-)AML. With regard to the patients with normal karyotype only, the OS and RFS of MPAL were significantly lower than those of the Ly(+)AML and Ly(-)AML; but there were no significant differences in OS and RFS among the patients with complex karyotype. The OS rates of 3 groups with complex karyotype were lower than those of patients with normal karyotype. In Cox multivariate analysis, complex karyotype was an independent pejorative factor for both OS and RFS. Therefore, MPAL is confirmed to be a poor-risk disease while Ly(+)AML does not impact prognosis. Complex karyotype is an unfavorable prognosis factor in AML patients with different immunophenotype. Mixed immunophenotype and complex karyotype increase the adverse risk when they coexist.

  18. Synaptonemal Complex Length Variation in Wild-Type Male Mice

    Directory of Open Access Journals (Sweden)

    Neil M. Vranis

    2010-12-01

    Full Text Available Meiosis yields haploid gametes following two successive divisions of a germ cell in the absence of intervening DNA replication. Balanced segregation of homologous chromosomes in Meiosis I is aided by a proteinaceous structure, the synaptonemal complex (SC. The objective of this study was to determine total average autosomal SC lengths in spermatocytes in three commonly used mouse strains (129S4/SvJae, C57BL/6J, and BALB/c. Our experiments revealed that the total autosomal SC length in BALB/c spermatocytes is 9% shorter than in the two other strains. Shorter SCs are also observed in spermatocytes of (BALB/c × 129S4/SvJae and (C57BL/6J × BALB/c F1 hybrids suggesting a genetic basis of SC length regulation. Along these lines, we studied expression of a selected group of genes implicated in meiotic chromosome architecture. We found that BALB/c testes express up to 6-fold less of Rec8 mRNA and 4-fold less of REC8 protein. These results suggest that the mechanism that defines the SC length operates via a REC8‑dependent process. Finally, our results demonstrate that genetic background can have an effect on meiotic studies in mice.

  19. Activity of the Type II JAK2 Inhibitor CHZ868 in B Cell Acute Lymphoblastic Leukemia.

    Science.gov (United States)

    Wu, Shuo-Chieh; Li, Loretta S; Kopp, Nadja; Montero, Joan; Chapuy, Bjoern; Yoda, Akinori; Christie, Amanda L; Liu, Huiyun; Christodoulou, Alexandra; van Bodegom, Diederik; van der Zwet, Jordy; Layer, Jacob V; Tivey, Trevor; Lane, Andrew A; Ryan, Jeremy A; Ng, Samuel Y; DeAngelo, Daniel J; Stone, Richard M; Steensma, David; Wadleigh, Martha; Harris, Marian; Mandon, Emeline; Ebel, Nicolas; Andraos, Rita; Romanet, Vincent; Dölemeyer, Arno; Sterker, Dario; Zender, Michael; Rodig, Scott J; Murakami, Masato; Hofmann, Francesco; Kuo, Frank; Eck, Michael J; Silverman, Lewis B; Sallan, Stephen E; Letai, Anthony; Baffert, Fabienne; Vangrevelinghe, Eric; Radimerski, Thomas; Gaul, Christoph; Weinstock, David M

    2015-07-13

    A variety of cancers depend on JAK2 signaling, including the high-risk subset of B cell acute lymphoblastic leukemias (B-ALLs) with CRLF2 rearrangements. Type I JAK2 inhibitors induce paradoxical JAK2 hyperphosphorylation in these leukemias and have limited activity. To improve the efficacy of JAK2 inhibition in B-ALL, we developed the type II inhibitor CHZ868, which stabilizes JAK2 in an inactive conformation. CHZ868 potently suppressed the growth of CRLF2-rearranged human B-ALL cells, abrogated JAK2 signaling, and improved survival in mice with human or murine B-ALL. CHZ868 and dexamethasone synergistically induced apoptosis in JAK2-dependent B-ALLs and further improved in vivo survival compared to CHZ868 alone. These data support the testing of type II JAK2 inhibition in patients with JAK2-dependent leukemias and other disorders. Copyright © 2015 Elsevier Inc. All rights reserved.

  20. Type 2 diabetes mellitus with early phase acute inflammatory protein on serum protein electrophoresis

    Directory of Open Access Journals (Sweden)

    ET Tuladhar

    2012-03-01

    Full Text Available Background: The onset of Type 2 diabetes has been associated with low grade systemic inflammation. The inflammatory status has been studied by measuring acute phase reactant proteins like hsCRP, α1- antitrypsin, α1-acid glycoprotein, ceruloplasmin, fibrinogen. Most of these acute phase reactants form α1 and α2 bands on electropherogram of serum proteins. The aim of this study was to evaluate inflammatory status in controlled and uncontrolled type 2 diabetes using cellulose acetate electrophoresis and to find the impact of glycemic status as indicated by HbA1c on inflammation process. Materials and Methods: Serum protein electrophoresis was done on serum samples of 60 cases of Diabetes [controlled and uncontrolled] using cellulose acetate paper technique. The electropherogram obtained was stained with Ponseu S and then quantitated using densitometer. Glycemic status was studied by HbA1c analysis. The density of α1and α2 bands in electropherogram were correlated with HbA1c level. Result: A significant increase in the percentage of α1 and α2 band proteins (0.765 and 0.716, p<0.001 were found with the increasing level of HbA1c. With cutoff of HbA1c 7% (American Diabetic Association recommended, the α1 and α2 serum proteins concentration are significantly higher (p<0.001 in uncontrolled diabetes mellitus compared to controlled diabetes mellitus Conclusion: Cellulose acetate electrophoresis of serum proteins show early phase acute inflammatory status in uncontrolled type 2 diabetes mellitus. The process of systemic inflammation worsens with uncontrolled glycemia as indicated by HbA1c. Inflammatory status should be studied adjunct to glycemic status. DOI: http://dx.doi.org/10.3126/jpn.v2i3.6024 JPN 2012; 2(3: 211-214

  1. Evidence for effects on thermoregulation after acute oral exposure to type I and type II pyrethroids in infant rats.

    Science.gov (United States)

    Bardullas, Ulises; Sosa-Holt, Carla Solange; Pato, Alejandro Martín; Nemirovsky, Sergio Iván; Wolansky, Marcelo Javier

    2015-01-01

    Most pyrethroid (PYR) insecticides may be classified either as type-I compounds, which produce whole body tremors and hyperthermia, or type-II compounds, which produce salivation, choreoathetosis, and hypothermia (i.e., producing T and CS neurobehavioral syndromes, respectively). This classification is based on clinical observations in adult rats and mice after intracerebroventricular or intravascular administration of highly effective acute (bolus) doses. PYR neurotoxicity in infant animals is not characterized as much as in adult animals. Endpoints informing on vital determinants of mammal's maturation, such as body temperature may help recognizing age-related differences in susceptibility to PYRs. In this work, body temperature (Tb) was monitored at 30-min intervals after acute oral exposure to T-syndrome PYR bifenthrin (BIF), CS-syndrome PYR cypermethrin (CYPM), and a BIF–CYPM mixture in weanling rats by using a subcutaneous temperature monitoring system. In both single-compound assays, a time- and dose-related decline of Tb was the most evident impact on thermoregulation observed starting at ~2–3 h after dosing.Moreover, 15–18 mg/kg BIF induced a mild increase in Tb before the hypothermic action was apparent. The lowest effective dose for temperature perturbation was 15mg/kg for BIF and 10mg/kg for CYPM, and moderate neurobehavioral alterations were evident at 12 and 10mg/kg, respectively. When low effective doses of BIF and CYPM were co-administered mild behavioral effects and a transient increase in Tb (p=0.02) were observed at 1–2 h, and no Tb decline was apparent afterwards compared to control animals. Noteworthy, the hypothermic action of BIF in infant rats was quite different from the hyperthermia consistently reported in studies using mature animals. Our results suggest that body temperature monitoring may be useful as a complementary assessment to reveal qualitative age-specific pesticide effects in rats.

  2. Complex lipid trafficking in Niemann-Pick disease type C.

    Science.gov (United States)

    Vanier, Marie T

    2015-01-01

    Niemann-Pick disease type C (NPC) is an atypical lysosomal storage disease resulting from mutations in one of two genes, either NPC1 or NPC2. Although a neurovisceral disorder, it is above all a neurodegenerative disease in the vast majority of patients. Not an enzyme deficiency, it is currently conceived as a lipid trafficking disorder. Impaired egress of cholesterol from the late endosomal/lysosomal (LE/L) compartment is a specific and key element of the pathogenesis, but other lipids, more specially sphingolipids, are also involved, and there are indications for further abnormalities. The full function of the NPC1 and NPC2 proteins is still unclear. This review provides a reappraisal of lipid storage and lysosomal enzymes activities in tissues/cells from NPC patients and animal models. It summarizes the current knowledge on the NPC1 and NPC2 proteins and their function in transport of cholesterol within the late endosomal-lysosomal compartment, with emphasis on differences between systemic organs and the brain; it also discusses regulation by membrane lipids of the NPC2-mediated cholesterol trafficking, interplay between cholesterol and sphingomyelin, the metabolic origin of glycosphingolipids stored in brain, and the putative role of free sphingoid bases in pathogenesis. Brief mention is finally made of diseases affecting other genes that were very recently shown to impact the "NPC pathway".

  3. Increasing the complexity: new genes and new types of albinism.

    Science.gov (United States)

    Montoliu, Lluís; Grønskov, Karen; Wei, Ai-Hua; Martínez-García, Mónica; Fernández, Almudena; Arveiler, Benoît; Morice-Picard, Fanny; Riazuddin, Saima; Suzuki, Tamio; Ahmed, Zubair M; Rosenberg, Thomas; Li, Wei

    2014-01-01

    Albinism is a rare genetic condition globally characterized by a number of specific deficits in the visual system, resulting in poor vision, in association with a variable hypopigmentation phenotype. This lack or reduction in pigment might affect the eyes, skin, and hair (oculocutaneous albinism, OCA), or only the eyes (ocular albinism, OA). In addition, there are several syndromic forms of albinism (e.g. Hermansky-Pudlak and Chediak-Higashi syndromes, HPS and CHS, respectively) in which the described hypopigmented and visual phenotypes coexist with more severe pathological alterations. Recently, a locus has been mapped to the 4q24 human chromosomal region and thus represents an additional genetic cause of OCA, termed OCA5, while the gene is eventually identified. In addition, two new genes have been identified as causing OCA when mutated: SLC24A5 and C10orf11, and hence designated as OCA6 and OCA7, respectively. This consensus review, involving all laboratories that have reported these new genes, aims to update and agree upon the current gene nomenclature and types of albinism, while providing additional insights from the function of these new genes in pigment cells. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  4. Association between mixed rotavirus vaccination types of infants and rotavirus acute gastroenteritis.

    Science.gov (United States)

    Mohammed, Anaam; Immergluck, Lilly; Parker, Trisha Chan; Jain, Shabnam; Leong, Traci; Anderson, Evan J; Jerris, Robert C

    2015-10-13

    Rotavirus remains the leading cause of severe diarrhea in children under 5 years worldwide. In the US, Rotarix (RV1) and RotaTeq (RV5), have been associated with reductions in and severity of rotavirus disease. Studies have evaluated the impact of RV1 or RV5 but little is known about the impact of incomplete or mixed vaccination upon vaccine effectiveness. Case control study to examine association of combined RV1 and RV5 and rotavirus acute gastroenteritis, factoring severity of diarrheal disease. Children born after March 1, 2009 with acute gastroenteritis from three pediatric hospitals in Atlanta, Georgia were approached for enrollment. Survey was administered, stool specimen was collected, and vaccination records were obtained. 891 of 1127 children with acute gastroenteritis were enrolled. Stool specimens were collected from 708 for rotavirus testing; 215 stool samples tested positively for rotavirus. Children >12 months of age were more likely to have rotavirus. Children categorized with Vesikari score of >11 were almost twice as likely to be rotavirus positive. Prior rotavirus vaccination decreased the mean Vesikari score, pgastroenteritis. Incomplete rotavirus vaccination either with a single vaccine or mixed vaccination types also provided some protection. Copyright © 2015 Elsevier Ltd. All rights reserved.

  5. Arnold-Chiari 1 malformation type 1 with syringohydromyelia presenting as acute tetraparesis: a case report.

    Science.gov (United States)

    Schneider, Byron; Birthi, Pravardhan; Salles, Sara

    2013-03-01

    A 19-year-old woman who presented to a community hospital after awakening with tetraparesis, generalized paresthesia, and severe neck pain, and was transferred to an acute care hospital. Magnetic resonance imaging of the head and spine was performed and revealed a cystic lesion extending from the C1 level to the C6 level as well as an Arnold-Chiari type 1 malformation. Emergent surgical posterior fossa decompression with duraplasty and C1 laminectomy was undertaken. Most symptoms improved immediately postoperatively. On post-operative day 15, the patient was transferred to our acute rehabilitation hospital for an additional 16 days. With continued aggressive therapy, she demonstrated complete resolution of tetraparesis as well as significant improvement in muscle strength and function in addition to resolution of paresthesia and neck pain. Functional independence measure scores were 69/126 on admission to 110/126 on discharge from the rehabilitation hospital. Her tetraparesis eventually resolved; manual muscle testing scores on follow-up 2 months later were 5/5 in all four extremities. This is the first reported case of Chiari I malformation with syringohydromyelia presenting as acute tetraparesis, generalized paresthesia, and neck pain. Surgical decompression leading to resolution of symptoms made other etiologies extremely unlikely and there was no history of trauma. The different theories on the pathogenesis of syringomyelia are discussed.

  6. Are there differences in acute phase inflammation markers regarding the type of heart failure?

    Directory of Open Access Journals (Sweden)

    Jaime Agüero-Ramón-Llin

    2011-09-01

    Full Text Available This study aimed to determine if there are differences in inflammatory markers in the acute phase between systolic heart failure and heart failure with preserved systolic function. One hundred and thirty-one patients with acute heart failure were recruited consecutively. At admission, plasma fibrinogen, Creactive protein, sialic acid, von Willebrand factor, vascular endothelial growth factor, interleukin-6 and NTproBNP were all evaluated. If the ejection fraction was 45% or over patients were included in the HF-PSF group; the remaining patients were included in the SHF group. The HF-PSF patients were older (72±10 vs 63±12 years, P<0.001, presented a higher rate of atrial fibrillation (56.1 vs 21.3%, P<0.001, and had a lower rate of hemoglobin (12.2±2 vs 13.3±2.1 g/dL, P<0.01. No significant differences were observed in the inflammation markers analyzed among SHF and HFPSF groups. In the acute phase of heart failure there is a marked elevation of inflammatory markers but there are no differences in the inflammatory markers analyzed between the two different types of heart failure

  7. [Acute type A aortic dissection with Birt-Hogg-Dubé syndrome; report of a case].

    Science.gov (United States)

    Sakaguchi, Masayuki; Gotou, Hirohisa; Nakahara, Takashi; Fuke, Megumi; Nishimura, Kazunori; Kuraishi, Hiroshi; Furuya, Mitsuko

    2014-05-01

    We describe a 76-year-old woman with cardiac tamponade who was admitted to our hospital. She underwent ascending and partial arch aortic replacement to treat acute type A aortic dissection. However, postoperative respiratory failure developed and a chest X-ray revealed right lung pneumothorax. The lung was finally expanded after difficulties with prolonged tube drainage. Chest computed tomography(CT) showed multiple cystic changes in the bilateral lungs. Her sister and her daughter also had a history of spontaneous pneumothorax. We finally diagnosed Birt-Hogg-Dube syndrome after deoxyribonucleic asid(DNA)sequencing of folliculin( FLCN) gene.

  8. Complexity and Intensionality in a Type-1 Framework for Computable Analysis

    DEFF Research Database (Denmark)

    Lambov, Branimir Zdravkov

    2005-01-01

    This paper describes a type-1 framework for computable analysis designed to facilitate efficient implementations and discusses properties that have not been well studied before for type-1 approaches: the introduction of complexity measures for type-1 representations of real functions, and ways to...... of machine precision floating point....

  9. Complex Dynamic Scene Perception: Effects of Attentional Set on Perceiving Single and Multiple Event Types

    Science.gov (United States)

    Sanocki, Thomas; Sulman, Noah

    2013-01-01

    Three experiments measured the efficiency of monitoring complex scenes composed of changing objects, or events. All events lasted about 4 s, but in a given block of trials, could be of a single type (single task) or of multiple types (multitask, with a total of four event types). Overall accuracy of detecting target events amid distractors was…

  10. ESSENTIAL OILS INHALATIONS IN COMPLEX TREATMENT AND PROPHYLAXIS OF ACUTE RESPIRATORY VIRAL INFECTIONS IN CHILDREN

    Directory of Open Access Journals (Sweden)

    A. D. Petrushina

    2012-01-01

    Full Text Available The prevalence of respiratory tract infections in children of the Russian Federation is high. That is why the questions of prophylaxis and treatment of acute respiratory viral infections (ARVI are always of a great interest of paediatricians. During epidemic outbreaks essential oils inhalations become a new perspective in treatment of such conditions. In the period of time since September 2011 till February 2012 the research workers of Paediatrics department of Tyumen State Medical Academy have estimated the oil «Dyshi» («Breathe» efficacy in complex treatment of ARVI in children. The usage of this medicine for the prophylaxis of respiratory infectionsdecreased the morbidity rate to 35% during the observation period, while each child in the comparison group had at least one episode of ARVI. The usage of this drug in the group of frequently ill children at the first symptoms of ARVI allowed to relieve the severity of disease and to prevent complications. Furthermore, the oil «Dyshi» has a number of other advantages: it is not irritating and habit-forming, it does not dry the nasal mucous membrane, it is safe for children and can be used for a long period of time.

  11. Acute humoral rejection and C4d immunostaining in ABO blood type-incompatible liver transplantation.

    Science.gov (United States)

    Haga, Hironori; Egawa, Hiroto; Fujimoto, Yasuhiro; Ueda, Mikiko; Miyagawa-Hayashino, Aya; Sakurai, Takaki; Okuno, Tomoko; Koyanagi, Itsuko; Takada, Yasutsugu; Manabe, Toshiaki

    2006-03-01

    Complement C4d deposition in graft capillaries has been reported to be associated with antibody-mediated rejection in kidney and other solid organ transplantation. The correlation of C4d deposits and humoral rejection in liver transplants, however, is not well understood. We investigated the C4d immunostaining pattern in 34 patients whose liver biopsy was taken within the first 3 postoperative weeks for suspected acute rejection after ABO blood type-incompatible liver transplantation. The staining pattern was classified as positive (portal stromal staining), indeterminate (endothelial staining only), and negative (no staining). Positive C4d immunostaining was seen in 17 (50%) patients and was significantly associated with high (x64 or more) postoperative antidonor A/B antibody (immunoglobulin M (IgM)) titers (88 vs. 35%, P = 0.002) and poorer overall survival rate (41 vs. 88%, P = 0.007). Ten of 11 (91%) cases with histological acute humoral rejection (periportal edema and necrosis (PEN) or portal hemorrhagic edema) were positive for C4d, all of which showed high postoperative antibody titers. The other histologies associated with C4d positivity was purulent cholangitis (n = 4), coagulative hepatocyte necrosis (n = 1), acute cellular rejection (n = 1), and hepatocanalicular cholestasis (n = 1). Full clinical recovery was observed in only 6 of 17 (35%) C4d-positive patients, and tended to be associated with a lower rejection activity index (RAI). In conclusion, our study indicates that C4d deposits in the portal stroma can be a hallmark of acute humoral rejection in ABO-incompatible liver transplantation, and allograft damage can be reversible in a minority of cases. Copyright 2006 AASLD

  12. Expression of gluconeogenic enzymes and 11β-hydroxysteroid dehydrogenase type 1 in liver of diabetic mice after acute exercise

    Directory of Open Access Journals (Sweden)

    Brust KB

    2014-10-01

    Full Text Available Korie B Brust,1 Kathryn A Corbell,2 Layla Al-Nakkash,2 Jeganathan Ramesh Babu,3 Tom L Broderick2,4 1Department of Biomedical Sciences, College of Health Sciences, Midwestern University, Glendale, AZ, USA; 2Department of Physiology, College of Osteopathic Medicine, Midwestern University, Glendale, AZ, USA; 3Department of Nutrition, Dietetics, and Hospitality Management, Auburn University, Auburn, AL, USA; 4Laboratory of Diabetes and Exercise Metabolism, Midwestern University, Glendale, AZ, USA Abstract: During acute exercise, normoglycemia is maintained by a precise match between hepatic glucose production and its peripheral utilization. This is met by a complex interplay of hepatic responses and glucose uptake by muscle. However, the effect of a single bout of exercise on hepatic gluconeogenesis, corticosterone (CORT secretion, and glucose homeostasis in the db/db mouse model of type 2 diabetes is poorly understood. Diabetic db/db and lean control littermates were subjected to a 30 minute session of treadmill running and sacrificed either immediately after exercise or 8 hours later. Plasma glucose levels were markedly increased in db/db mice after exercise, whereas no change in glucose was observed in lean mice. Post-exercise measurements revealed that plasma CORT levels were also significantly increased in db/db mice compared to lean mice. Plasma hypothalamic corticotropin releasing hormone and pituitary adrenocorticotropic hormone levels were reciprocally decreased in both db/db and lean mice after exercise, indicating intact feedback mechanisms. Protein expression, determined by Western blot analysis, of the glucocorticoid receptor in liver was significantly increased in db/db mice subjected to prior exercise. In liver of db/db mice, a significant increase in the expression of phosphoenolpyruvate carboxykinase was noted compared to lean mice after exercise. However, no change in the expression of glucose-6-phosphatase (G6Pase α or β was

  13. Disrupted Nitric Oxide Metabolism from Type II Diabetes and Acute Exposure to Particulate Air Pollution.

    Directory of Open Access Journals (Sweden)

    Ashley P Pettit

    Full Text Available Type II diabetes is an established cause of vascular impairment. Particulate air pollution is known to exacerbate cardiovascular and respiratory conditions, particularly in susceptible populations. This study set out to determine the impact of exposure to traffic pollution, with and without particle filtration, on vascular endothelial function in Type II diabetes. Endothelial production of nitric oxide (NO has previously been linked to vascular health. Reactive hyperemia induces a significant increase in plasma nitrite, the proximal metabolite of NO, in healthy subjects, while diabetics have a lower and more variable level of response. Twenty type II diabetics and 20 controls (ages 46-70 years were taken on a 1.5 hr roadway traffic air pollution exposure as passengers. We analyzed plasma nitrite, as a measure of vascular function, using forearm ischemia to elicit a reactive hyperemic response before and after exposure to one ride with and one without filtration of the particle components of pollution. Control subjects displayed a significant increase in plasma nitrite levels during reactive hyperemia. This response was no longer present following exposure to traffic air pollution, but did not vary with whether or not the particle phase was filtered out. Diabetics did not display an increase in nitrite levels following reactive hyperemia. This response was not altered following pollution exposure. These data suggest that components of acute traffic pollution exposure diminish vascular reactivity in non-diabetic individuals. It also confirms that type II diabetics have a preexisting diminished ability to appropriately respond to a vascular challenge, and that traffic pollution exposure does not cause a further measureable acute change in plasma nitrite levels in Type II diabetics.

  14. Alterations of consciousness and mystical-type experiences after acute LSD in humans.

    Science.gov (United States)

    Liechti, Matthias E; Dolder, Patrick C; Schmid, Yasmin

    2017-05-01

    Lysergic acid diethylamide (LSD) is used recreationally and in clinical research. Acute mystical-type experiences that are acutely induced by hallucinogens are thought to contribute to their potential therapeutic effects. However, no data have been reported on LSD-induced mystical experiences and their relationship to alterations of consciousness. Additionally, LSD dose- and concentration-response functions with regard to alterations of consciousness are lacking. We conducted two placebo-controlled, double-blind, cross-over studies using oral administration of 100 and 200 μg LSD in 24 and 16 subjects, respectively. Acute effects of LSD were assessed using the 5 Dimensions of Altered States of Consciousness (5D-ASC) scale after both doses and the Mystical Experience Questionnaire (MEQ) after 200 μg. On the MEQ, 200 μg LSD induced mystical experiences that were comparable to those in patients who underwent LSD-assisted psychotherapy but were fewer than those reported for psilocybin in healthy subjects or patients. On the 5D-ASC scale, LSD produced higher ratings of blissful state, insightfulness, and changed meaning of percepts after 200 μg compared with 100 μg. Plasma levels of LSD were not positively correlated with its effects, with the exception of ego dissolution at 100 μg. Mystical-type experiences were infrequent after LSD, possibly because of the set and setting used in the present study. LSD may produce greater or different alterations of consciousness at 200 μg (i.e., a dose that is currently used in psychotherapy in Switzerland) compared with 100 μg (i.e., a dose used in imaging studies). Ego dissolution may reflect plasma levels of LSD, whereas more robustly induced effects of LSD may not result in such associations.

  15. Acute Gastrocnemius-Soleus Complex Injuries in National Football League Athletes

    Science.gov (United States)

    Werner, Brian C.; Belkin, Nicole S.; Kennelly, Steve; Weiss, Leigh; Barnes, Ronnie P.; Potter, Hollis G.; Warren, Russell F.; Rodeo, Scott A.

    2017-01-01

    Background: Lower extremity muscle injuries are common in professional football. Although less common than hamstring or quadriceps injuries in National Football League (NFL) athletes, calf injuries occur with relative frequency and have not previously been studied. Purpose: To evaluate gastrocnemius-soleus complex muscle injuries over the past 13 years from a single NFL team to determine the incidence of such injuries, their imaging characteristics, and return to play after such injuries and any correlation between imaging findings and prolonged return to play. Study Design: Case series; Level of evidence, 4. Methods: A retrospective review of all acute calf muscle injuries on a single NFL team from 2003 to 2015 was performed. Player demographics and return-to-play data were obtained from the medical records. All available magnetic resonance images (MRIs) were reviewed by a musculoskeletal radiologist for specific imaging findings that correlated with return to play. Results: A total of 27 calf injuries in 24 NFL players were reviewed, yielding an incidence of 2.3 acute calf injuries per year on a single NFL team. Of these 27 injuries, 20 (74%) were isolated injuries to the gastrocnemius muscle, 4 (15%) were isolated injuries to the soleus muscle, and the remaining 3 injuries (11%) involved both. Defensive players were more likely to sustain injuries (P = .043). The mean time to return to play for all 27 players was 17.4 ± 14.6 days (range, 3-62 days). MRIs were available in 14 of the 27 injuries. The average size of the fascial defect (P = .032) and the presence of a fluid collection (P = .031) both correlated with return to play of longer than 2 weeks. Conclusion: Although less common than hamstring or quadriceps muscle injuries, calf muscle injuries occur with relative frequency in the NFL, and more so in defensive players. The majority of these injuries occur in the gastrocnemius and result in significant disability, with at least 2 weeks of missed playing

  16. Managing innovation complexity: About the co-existence of innovation types

    OpenAIRE

    Pohlmann, Philipp Adrian

    2014-01-01

    The purpose of this study is to contribute to the changing innovation management literature by providing an overview of different innovation types and organizational complexity factors. Aiming at a better understanding of effective innovation management, innovation and complexity are related to the formulation of an innovation strategy and interaction between different innovation types is further explored. The chosen approach in this study is to review the existing literature on different inn...

  17. Treatment of Acute Aortic Type B Dissection with Stent-Grafts

    International Nuclear Information System (INIS)

    Hausegger, K.A.; Tiesenhausen, K.; Schedlbauer, P.; Oberwalder, P.; Tauss, J.; Rigler, B.

    2001-01-01

    Purpose: To evaluate the feasibility of endoluminal stent-grafts in the treatment of acute type B aortic dissections.Methods: In five patients with acute aortic type B dissections, sealing of the primary intimal tear with an endoluminal stent-graft was attempted. Indication for treatment was aneurysm formation in two patients and persistent pain in three patients. One of the latter also had an unstable dissection flap compromising the ostium of the superior mesenteric artery. The distance from the intimal tear to the left subclavian artery was <0.5 cm in four patients, who had typical type B dissections. In one patient with an atypical dissection the distance from the primary tear to the left subclavian artery was 4 cm. This patient had no re-entry tear. Talent tube grafts (World Medical Manufacturing Cooperation, Sunrise, FL, USA) were used in all patients.Results: Stent-graft insertion with sealing of the primary tear was successful in all patients. The proximal covered portion of the stent-graft was placed across the left subclavian artery in four patients (1x transposition of the left subclavian artery). Left arm perfusion was preserved via a subclavian steal phenomenon in the patients in whom the stent-graft covered the orifice of the left subclavian artery. The only procedural complication we observed was an asymptomatic segmental renal infarction in one patient. In the thoracic aorta thrombosis of the false aortic lumen occurred in all patients. In one patient the false lumen of the abdominal aorta thrombosed after 4 weeks; in the other three patients the status of the abdominal aorta remained unchanged compared with the situation prior to stent-graft insertion. As a late complication formation of a secondary aneurysm of the thoracic aorta was observed at the distal end of the stent-graft 3 months after the primary intervention. This aneurysm was treated by coaxial insertion of an additional stent-graft without complications.Conclusion: Endoluminal treatment

  18. Predictors of mortality in hospital survivors with type 2 diabetes mellitus and acute coronary syndromes.

    Science.gov (United States)

    Savonitto, Stefano; Morici, Nuccia; Nozza, Anna; Cosentino, Francesco; Perrone Filardi, Pasquale; Murena, Ernesto; Morocutti, Giorgio; Ferri, Marco; Cavallini, Claudio; Eijkemans, Marinus Jc; Stähli, Barbara E; Schrieks, Ilse C; Toyama, Tadashi; Lambers Heerspink, H J; Malmberg, Klas; Schwartz, Gregory G; Lincoff, A Michael; Ryden, Lars; Tardif, Jean Claude; Grobbee, Diederick E

    2018-01-01

    To define the predictors of long-term mortality in patients with type 2 diabetes mellitus and recent acute coronary syndrome. A total of 7226 patients from a randomized trial, testing the effect on cardiovascular outcomes of the dual peroxisome proliferator-activated receptor agonist aleglitazar in patients with type 2 diabetes mellitus and recent acute coronary syndrome (AleCardio trial), were analysed. Median follow-up was 2 years. The independent mortality predictors were defined using Cox regression analysis. The predictive information provided by each variable was calculated as percent of total chi-square of the model. All-cause mortality was 4.0%, with cardiovascular death contributing for 73% of mortality. The mortality prediction model included N-terminal proB-type natriuretic peptide (adjusted hazard ratio = 1.68; 95% confidence interval = 1.51-1.88; 27% of prediction), lack of coronary revascularization (hazard ratio = 2.28; 95% confidence interval = 1.77-2.93; 18% of prediction), age (hazard ratio = 1.04; 95% confidence interval = 1.02-1.05; 15% of prediction), heart rate (hazard ratio = 1.02; 95% confidence interval = 1.01-1.03; 10% of prediction), glycated haemoglobin (hazard ratio = 1.11; 95% confidence interval = 1.03-1.19; 8% of prediction), haemoglobin (hazard ratio = 1.01; 95% confidence interval = 1.00-1.02; 8% of prediction), prior coronary artery bypass (hazard ratio = 1.61; 95% confidence interval = 1.11-2.32; 7% of prediction) and prior myocardial infarction (hazard ratio = 1.40; 95% confidence interval = 1.05-1.87; 6% of prediction). In patients with type 2 diabetes mellitus and recent acute coronary syndrome, mortality prediction is largely dominated by markers of cardiac, rather than metabolic, dysfunction.

  19. Impact of the entry site on late outcome in acute Stanford type B aortic dissection†.

    Science.gov (United States)

    Kitamura, Tadashi; Torii, Shinzo; Oka, Norihiko; Horai, Tetsuya; Itatani, Keiichi; Yoshii, Takeshi; Nakamura, Yuki; Shibata, Miyuki; Tamura, Tomoki; Araki, Haruna; Matsunaga, Yoshikiyo; Sato, Hajime; Miyaji, Kagami

    2015-11-01

    This study aimed to investigate whether the entry site of acute type B aortic dissection affects late outcomes. Inpatient and outpatient records were retrospectively reviewed. We identified 224 cases of acute type B aortic dissection between 1998 and 2013. Of these 224 patients, 168 were men and the age was 64.2 ± 12.6 (range 23-94) years, from which 130 presented with the entry at a location downstream of the distal aortic arch, 67 with the entry at the outer curvature of the distal aortic arch and 27 with the entry at the inner curvature. At the initial presentation, 127 patients had descending false lumen thrombosis. The 30-day mortality rate was 2%, and 8% of patients had malperfusion. The entry at the outer curvature was associated with a higher risk of 30-day mortality. Patients with the entry at a location downstream were significantly older, and had a higher chance for primarily thrombosed descending false lumen and a lower risk of malperfusion. At follow-up (6.0 ± 4.1 years), the actuarial survival rates were 97, 83 and 60%, freedoms from open aortic surgery were 96, 91 and 86%, aortic intervention were 73, 66 and 63% and aortic events were 71, 60 and 52% at 1, 5 and 10 years, respectively. Multivariate logistic regression analysis revealed that the outer curvature entry and maximum aortic diameter were correlated with open aortic surgery, aortic intervention and aortic events. Of the 127 patients with primarily thrombosed false lumen, the outer curvature entry was significantly correlated with aortic events. The primary entry at the outer curvature of the distal aortic arch, as well as the large aortic diameter, is associated with a higher risk of late open aortic surgery, aortic intervention and aortic events in acute type B aortic dissection. Thus, the entry site should be taken into consideration in the establishment of an appropriate treatment indication of type B aortic dissection. © The Author 2015. Published by Oxford University Press on behalf

  20. Tailored support for type 2 diabetes patients after an acute coronary event : The Diacourse-ACE study

    NARCIS (Netherlands)

    Kasteleyn, M.J.

    2015-01-01

    Aims: The aims of this thesis were to define the clinical profile and difficulties encountered by type 2 diabetes patients with a first acute coronary event (ACE), to develop and evaluate a tailored supportive intervention for type 2 diabetes patients with a first ACE and to examine diabetes-related

  1. Amylase, Lipase, and Acute Pancreatitis in People With Type 2 Diabetes Treated With Liraglutide: Results From the LEADER Randomized Trial.

    Science.gov (United States)

    Steinberg, William M; Buse, John B; Ghorbani, Marie Louise Muus; Ørsted, David D; Nauck, Michael A

    2017-07-01

    To evaluate serum amylase and lipase levels and the rate of acute pancreatitis in patients with type 2 diabetes and high cardiovascular risk randomized to liraglutide or placebo and observed for 3.5-5.0 years. A total of 9,340 patients with type 2 diabetes were randomized to either liraglutide or placebo (median observation time 3.84 years). Fasting serum lipase and amylase were monitored. Acute pancreatitis was adjudicated in a blinded manner. Compared with the placebo group, liraglutide-treated patients had increases in serum lipase and amylase of 28.0% and 7.0%, respectively. Levels were increased at 6 months and then remained stable. During the study, 18 (0.4% [1.1 events/1,000 patient-years of observation] [PYO]) liraglutide-treated and 23 (0.5% [1.7 events/1,000 PYO]) placebo patients had acute pancreatitis confirmed by adjudication. Most acute pancreatitis cases occurred ≥12 months after randomization. Liraglutide-treated patients with prior history of pancreatitis ( n = 147) were not more likely to develop acute pancreatitis than similar patients in the placebo group ( n = 120). Elevations of amylase and lipase levels did not predict future risk of acute pancreatitis (positive predictive value pancreatitis among liraglutide-treated patients (regardless of previous history of pancreatitis) compared with the placebo group. Liraglutide was associated with increases in serum lipase and amylase, which were not predictive of an event of subsequent acute pancreatitis. © 2017 by the American Diabetes Association.

  2. Endovascular treatment of acute type B dissection complicating graft-bypass repair for aortic coarctation

    Directory of Open Access Journals (Sweden)

    Serkan Ertugay

    Full Text Available Objectives: The early dissection of the descending aorta after the repair of aortic coarctation is very rare. Herein, we present a special endovascular technique used for acute type B dissection complicating graft bypass for aortic coarctation. Methods: The 48 year-old male patient with the diagnosis of adult type aortic coarctation had bypass procedure between the aortic arch and the descending aorta. Six weeks after the first operation, the patient was readmitted with severe back pain and had the diagnosis of acute type B dissection which involved the descending aorta at the distal part of the graft anastomosis. Results: Two separate stent-grafts were deployed respectively 31 × 150 mm and 34 × 200 mm (C-TAG™ WL Gore&Asc., Flagstaff, AZ, USA. The previous Dacron bypass graft was used as a proximal landing zone for the first stent-graft. The distal landing zone for the second stent was the area between the celiac trunk and superior mesenteric artery. Therefore, the covered stent-graft was implanted to the celiac trunk (Viabahn™ 7 × 50 mm WL Gore&Asc, AZ, USA to maintain its patency before the deployment of the second graft. The segment of coarctation was closed with a vascular plug (Amplatzer™ vascular plug II to prevent persistent perfusion of aneurysmal false lumen. Conclusion: The endovascular approach offers multiple less invasive options based on a patient-specific problem. Keywords: Aortic coarctation, Bypass graft, Endovascular, Vascular plug

  3. Sandwich Technique for Endovascular Repair of Acute Type A Aortic Dissection.

    Science.gov (United States)

    Gao, Feng; Zeng, Qian; Lin, Fangming; Ge, Xiaohu

    2017-10-01

    To describe a new endovascular procedure for acute type A aortic dissection (TAAD) repair. Between 2013 and 2016, 12 patients (average age 54±9.6 years; 10 men) with acute TAAD (mean EURO score 11.4%±3.2%, range 5-17) and unfit for surgery underwent thoracic endovascular aortic repair (TEVAR) with 2 periscope grafts to preserve blood supply to supra-aortic branches plus bypass grafting as needed. If the ascending aorta was dilated to >40 mm, sternotomy was performed to wrap the ascending aorta and reduce its diameter to accommodate the aortic stent-grafts. All patients were successfully treated. Seven patients required bypass grafting, and most of the patients had periscope grafts to the innominate/right common carotid artery and left common carotid artery; only 3 patients had the left subclavian artery preserved. All patients exhibited good hemodynamics and normal pressures after the procedure. The mean procedure time and blood loss were 4.5±1.0 hours and 217±111.5 mL, respectively. Two patients treated emergently died shortly after surgery from multiorgan failure. The average follow-up duration was 17±14.5 months (range 2-42) in the 10 survivors. The remaining patients recovered and none experienced stent-graft thrombosis, stroke, or peripheral artery embolism during follow-up. A procedure that combines sandwich/periscope grafting with TEVAR, wrapping of the aorta, and supra-arch bypass grafting can be used to treat patients with acute TAAD.

  4. B-type natriuretic peptide as a marker for heart failure in patients with acute stroke.

    Science.gov (United States)

    Koenig, Matthew A; Puttgen, H Adrian; Prabhakaran, Vivek; Reich, Daniel; Stevens, Robert D

    2007-09-01

    To determine whether serum N-terminal pro-B-type natriuretic peptide (N-BNP), a biomarker of myocardial wall stress, is specific to acute heart failure (HF) in patients hospitalized with stroke. Case-control study. Tertiary hospital, Neurosciences Critical Care Unit and Stroke Unit. Consecutive patients with acute ischemic or hemorrhagic stroke who were evaluated for HF. None. Cases and controls were classified, respectively, as patients with or without HF, defined according to modified Framingham criteria. Seventy-two patients were evaluated, 39 with ischemic stroke, 22 with aneurysmal subarachnoid hemorrhage (SAH), and 11 with intracerebral hemorrhage (ICH). Thirty-four patients (47%) met criteria for HF, and 47 patients (65%) had systolic or diastolic left ventricular (LV) dysfunction on echocardiogram. Serum N-BNP was measured a median of 48 h following the onset of stroke and was increased (> 900 pg/ml) in 56 patients (78%), with higher levels in non-survivors (11898 +/- 12741 vs 4073 +/-5691; p = 0.001). In a multiple regression model, N-BNP elevation was not independently associated with HF (OR 5.4, 95% CI 0.8-36.0, p = 0.084). At a cut-off of 900 pg/ml, the sensitivity of N-BNP for HF was 94%, specificity 37%, positive predictive value (PPV) 57%, and negative predictive value (NPV) 88%. For systolic or diastolic LV dysfunction, the sensitivity of N-BNP was 89%, specificity 44%, PPV 75%, and NPV 69%. These results demonstrate that N-BNP elevation is not specific to HF or LV dysfunction in patients with acute ischemic stroke, SAH, and ICH.

  5. [Acute cystitis in women with type 2 diabetes. Three antimicrobial schemes].

    Science.gov (United States)

    López-Carmona, Juan Manuel; Salazar-López, María Alejandra; Rodríguez-Moctezuma, José Raymundo; López-Delgado, María Elisa; Manrique-Lizárraga, Juana María

    2007-01-01

    To compare the effectiveness and secondary effects of trimethoprim-sulfamethoxazole (TMP-SMX), ciprofloxacin, and nitrofurantoin in women with type 2 diabetes mellitus (DM2) and acute community-acquired cystitis. A randomized single blind clinical trial was conducted in the family medicine clinic No. 91 of Instituto Mexicano del Seguro Social in Coacalco, Mexico. The study included women with DM2 and acute cystitis who were randomly allocated to one of the following schemes: TMP-SMX (160/800 mg every 12 h), ciprofloxacin (500 mg every 12 h) or nitrofurantoin (100 mg every 6 h) for 10 days. Sixty-one patients fulfilled the inclusion criteria. Bacteriologic eradication at the end of the treatment was observed in 18/23 (78 %) of patients treated with ciprofloxacin; 14/18 (78%) of patients treated with nitrofurantoin; and 9/20 (45 %) of patients treated with TMP-SMX (p = .036). The difference between nitrofurantoin and TMP-SMX, as well as between ciprofloxacin with TMPSMX, was 33 % for both (95 % confidence interval = 4 %, 62 %, and 5 %, 61 % , respectively). The most frequently isolated bacterium was Escherichia coli (75 %), The in vitro resistance rate to TMP-SMX was 76 %, to ciprofloxacin 17 % and to nitrofurantoin 13 % (p = 0.05). The main adverse effects were slight to moderate headache, nausea, and pyrosis in the three groups. ciprofloxacin and nitrofurantoin were more effective than TMP-SMX for the treatment of community-acquired acute cystitis in Mexican women with DM2. This is probably due to differences in the resistance rates and is probably not specific for diabetic patients; All three antimicrobials were safe.

  6. The Role of Task Type in Foreign Language Written Production: Focusing on Fluency, Complexity, and Accuracy

    Science.gov (United States)

    Rezazadeh, Mohsen; Tavakoli, Mansoor; Rasekh, Abbas Eslami

    2011-01-01

    The aim of this study was to investigate the effects of two task types on foreign language written production. Particularly it addressed the issue of how three aspects of language production (i.e. fluency, complexity, and accuracy) vary among two different task types (i.e. argumentative writing task and instruction writing task). One hundred sixty…

  7. Mixed Phenotype Acute Leukemia with Two Immunophenotypically Distinct B and T Blasts Populations, Double Chromosome and Complex Karyotype: Report of an Unusual Case

    Directory of Open Access Journals (Sweden)

    Samah A. Kohla

    2015-01-01

    Full Text Available Mixed phenotype acute leukemia (MPAL is considered as a rare type of leukemia with an incidence of less than 4% of all acute leukemia based on the most recent 2008 WHO classification. Common subtypes are the B/myeloid and T/myeloid; B/T and trilineage MPAL being extremely rare. We present a case of a male in his 20s, whose peripheral blood smears showed 34% blast cells and bone marrow with 70% blasts. Immunophenotyping by multiparametric flow cytometry showed two populations of blasts, the major one with B-lineage and the minor one with T-lineage. Conventional karyotyping revealed complex karyotype with the presence of double Philadelphia chromosome ( Ph + . BCR/ABL1 rearrangement was confirmed by fluorescent in situ hybridization (FISH analysis. The BCR/ABL1 ES probe on interphase cells indicated pl90 minor m-BCR/ABL fusion in 46% and a second abnormal clone with double Ph + in 16% of the cells analyzed confirmed by reverse transcription-PCR (RT-PCR. The case was diagnosed as MPAL with double Philadelphia chromosome Ph + . The patient was treated with dasatinib, four cycle hyper CVAD/methotrexate cytarabin protocol, and allogeneic transplant. He is still alive in complete hematological, cytogenetic, and molecular remission. Mixed phenotype B/T acute leukemia is an extremely rare disease, particularly those with double Philadelphia chromosomes and clinically presents challenges in diagnosis and treatment.

  8. Shock complicating type A acute aortic dissection: Clinical correlates, management, and outcomes.

    Science.gov (United States)

    Bossone, Eduardo; Pyeritz, Reed E; Braverman, Alan C; Peterson, Mark D; Ehrlich, Marek; O'Gara, Patrick; Suzuki, Toru; Trimarchi, Santi; Gilon, Dan; Greason, Kevin; Desai, Nimesh D; Montgomery, Daniel G; Isselbacher, Eric M; Nienaber, Christoph A; Eagle, Kim A

    2016-06-01

    Shock is among the most dreaded and common complications of type A acute aortic dissection (TAAAD). However, clinical correlates, management, and short- and long-term outcomes of TAAAD patients presenting with shock in real-world clinical practice are not known. We evaluated 2,704 patients with TAAAD enrolled in the International Registry of Acute Aortic Dissection between January 1, 1996, and August 18, 2012. On admission, 407 (15.1%) TAAAD patients presented with shock. Most in-hospital complications (coma, myocardial or mesenteric ischemia or infarction, and cardiac tamponade) were more frequent in shock patients. In-hospital mortality was significantly higher in TAAAD patients with than without shock (30.2% vs 23.9%, P=.007), regardless of surgical or medical treatment. Most shock patients underwent surgical repair, with medically managed patients demonstrating older age and more complications at presentation. Estimates using Kaplan-Meier survival analysis indicated that most (89%) TAAAD patients with shock discharged alive from the hospital survived 5years, a rate similar to that of TAAAD patients without shock (82%, P=.609). Shock occurred in 1 of 7 TAAAD patients and was associated with higher rates of in-hospital adverse events and mortality. However, TAAAD survivors with or without shock showed similar long-term mortality. Successful early and aggressive management of shock in TAAAD patients has the potential for improving long-term survival in this patient population. Copyright © 2016 Elsevier Inc. All rights reserved.

  9. Haemolytic anaemia resulting from the surgical repair of acute type A aortic dissection.

    Science.gov (United States)

    Sekine, Yuji; Yamamoto, Shin; Fujikawa, Takuya; Oshima, Susumu; Ono, Makoto; Sasaguri, Shiro

    2014-02-01

    Haemolytic anaemia after acute aortic dissection surgery is extremely rare. We report 4 cases of haemolytic anaemia with different aetiologies. Four patients underwent emergency operation for acute type A aortic dissection and subsequently developed haemolytic anaemia. Case 1: a 41-year old man underwent hemiarch replacement. We performed total arch replacement 3 years postoperatively, which revealed that haemolytic anaemia was induced by proximal anastomotic stenosis caused by inverted internal felt strip. Case 2: a 28-year old man diagnosed with Marfan syndrome underwent total arch replacement. Five months postoperatively, we noted severe stenosis at the previous distal anastomotic site, which caused the haemolytic anaemia, and performed descending thoracic aortic replacement for a residual dissecting aneurysm. Case 3: a 49-year old man underwent hemiarch replacement. Three years postoperatively, we performed total arch replacement for a residual dissecting aortic arch aneurysm and repaired a kinked graft responsible for haemolytic anaemia. Case 4: a 42-year old man underwent total arch replacement. Eighteen months later, we performed descending thoracic aortic replacement. We repaired a portion of the ascending aorta as haemolityc anaemia was induced by kinking of a total arch replacement redundant graft. All the haemolityc anaemia patients were successfully released after surgical reintervention.

  10. Acute toxicity and gastroprotection studies of a new schiff base derived copper (II) complex against ethanol-induced acute gastric lesions in rats.

    Science.gov (United States)

    Hajrezaie, Maryam; Golbabapour, Shahram; Hassandarvish, Pouya; Gwaram, Nura Suleiman; A Hadi, A Hamid; Mohd Ali, Hapipah; Majid, Nazia; Abdulla, Mahmood Ameen

    2012-01-01

    Copper is an essential element in various metabolisms. The investigation was carried out to evaluate acute gastroprotective effects of the Copper (II) complex against ethanol-induced superficial hemorrhagic mucosal lesions in rats. Rats were divided into 7 groups. Groups 1 and 2 were orally administered with Tween 20 (10% v/v). Group 3 was orally administered with 20 mg/kg omeprazole (10% Tween 20). Groups 4-7 received 10, 20, 40, and 80 mg/kg of the complex (10% Tween 20), respectively. Tween 20 (10% v/v) was given orally to group 1 and absolute ethanol was given orally to groups 2-7, respectively. Rats were sacrificed after 1 h. Group 2 exhibited severe superficial hemorrhagic mucosal lesions. Gastric wall mucus was significantly preserved by the pre-treatment complex. The results showed a significant increase in glutathione (GSH), superoxide dismutase (SOD), nitric oxide (NO), and Prostaglandin E2 (PGE(2)) activities and a decrease in malondialdehyde (MDA) level. Histology showed marked reduction of hemorrhagic mucosal lesions in groups 4-7. Immunohistochemical staining showed up-regulation of Hsp70 and down-regulation of Bax proteins. PAS staining of groups 4-7 showed intense stain uptake of gastric mucosa. The acute toxicity revealed the non-toxic nature of the compound. The gastroprotective effect of the Copper (II) complex may possibly be due to preservation of gastric wall mucus; increase in PGE(2) synthesis; GSH, SOD, and NO up-regulation of Hsp70 protein; decrease in MDA level; and down-regulation of Bax protein.

  11. Acute toxicity and gastroprotection studies of a new schiff base derived copper (II complex against ethanol-induced acute gastric lesions in rats.

    Directory of Open Access Journals (Sweden)

    Maryam Hajrezaie

    Full Text Available BACKGROUND: Copper is an essential element in various metabolisms. The investigation was carried out to evaluate acute gastroprotective effects of the Copper (II complex against ethanol-induced superficial hemorrhagic mucosal lesions in rats. METHODOLOGY/PRINCIPAL FINDINGS: Rats were divided into 7 groups. Groups 1 and 2 were orally administered with Tween 20 (10% v/v. Group 3 was orally administered with 20 mg/kg omeprazole (10% Tween 20. Groups 4-7 received 10, 20, 40, and 80 mg/kg of the complex (10% Tween 20, respectively. Tween 20 (10% v/v was given orally to group 1 and absolute ethanol was given orally to groups 2-7, respectively. Rats were sacrificed after 1 h. Group 2 exhibited severe superficial hemorrhagic mucosal lesions. Gastric wall mucus was significantly preserved by the pre-treatment complex. The results showed a significant increase in glutathione (GSH, superoxide dismutase (SOD, nitric oxide (NO, and Prostaglandin E2 (PGE(2 activities and a decrease in malondialdehyde (MDA level. Histology showed marked reduction of hemorrhagic mucosal lesions in groups 4-7. Immunohistochemical staining showed up-regulation of Hsp70 and down-regulation of Bax proteins. PAS staining of groups 4-7 showed intense stain uptake of gastric mucosa. The acute toxicity revealed the non-toxic nature of the compound. CONCLUSIONS/SIGNIFICANCE: The gastroprotective effect of the Copper (II complex may possibly be due to preservation of gastric wall mucus; increase in PGE(2 synthesis; GSH, SOD, and NO up-regulation of Hsp70 protein; decrease in MDA level; and down-regulation of Bax protein.

  12. Soluble urokinase-type plasminogen activator receptor is a novel biomarker predicting acute exacerbation in COPD

    Directory of Open Access Journals (Sweden)

    Gumus A

    2015-02-01

    Full Text Available Aziz Gumus,1 Nejat Altintas,2 Halit Cinarka,1 Aynur Kirbas,3 Muge Haziroglu,1 Mevlut Karatas,1 Unal Sahin1 1Department of Pulmonary Medicine, School of Medicine, Recep Tayyip Erdogan University, Rize, Turkey; 2Department of Pulmonary Medicine, School of Medicine, Namik Kemal University, Tekirdag, Turkey; 3Department of Clinical Biochemistry, School of Medicine, Recep Tayyip Erdogan University, Rize, Turkey Background: Chronic obstructive pulmonary disease (COPD is a chronic inflammatory condition, and progresses with acute exacerbations. (AE. During AE, levels of acute phase reactants such as C-reactive protein (CRP and inflammatory cells in the circulation increase. Soluble urokinase-type plasminogen activator receptor (suPAR levels increase in acute viral and bacterial infections and in diseases involving chronic inflammation. The purpose of this study was to investigate the effectiveness of suPAR in predicting diagnosis of AE of COPD (AE-COPD and response to treatment. Methods: The study population consisted of 43 patients diagnosed with AE-COPD and 30 healthy controls. suPAR, CRP, and fibrinogen levels were measured on the first day of hospitalization and on the seventh day of treatment. Results: We found that fibrinogen (P<0.001, CRP (P<0.001, and suPAR (P<0.001 were significantly higher in patients with AE-COPD than in healthy controls. Fibrinogen (P<0.001, CRP (P=0.001, and suPAR (P<0.001 were significantly decreased by the seventh day of treatment. However, the area under receiver operator characteristic curve showed that suPAR is superior to CRP and fibrinogen in distinguishing AE-COPD. There was a correlation between fibrinogen, CRP, and suPAR. However, only fibrinogen was a powerful predictor of suPAR in multiple linear regression. In multiple logistic regression, only suPAR and fibrinogen were strong predictors of AE-COPD (P=0.002 and P=0.014, respectively. Serum suPAR was negatively correlated with forced expiratory volume in 1

  13. Study on rare earths complexes separation by means of different type of ion exchangers

    International Nuclear Information System (INIS)

    Hubicka, H.

    1990-01-01

    The applicability of different types of ion exchangers for purification and separation of rare earths complexes has been examined. The experimental work has been carried out on 14 chelating ion exchangers. The investigation results proved the great usefulness chelating ion exchangers especially of amino acid and phosphorus-type. Application of that type ion exchangers in column chromatographic process gave the excellent rare earths separation as well as enabled to obtain their preparates of high purity. 218 refs, 21 figs, 27 tabs

  14. Aortic wrapping for stanford type A acute aortic dissection: short and midterm outcome.

    Science.gov (United States)

    Demondion, Pierre; Ramadan, Ramzi; Azmoun, Alexandre; Raoux, François; Angel, Claude; Nottin, Rémi; Deleuze, Philippe

    2014-05-01

    Conventional surgical treatment of Stanford type A acute aortic dissection (AAD) is associated with considerable in-hospital mortality. As regards very elderly or high-risk patients with type A AAD, some may meet the criteria for less invasive surgery likely to prevent the complications associated with aortic replacement. We have retrospectively analyzed a cohort of patients admitted to our center for Stanford type A AAD and having undergone surgery between 2008 and 2012. The outcomes of the patients having had an aortic replacement under cardiopulmonary bypass (group A) have been compared with the outcomes of the patients who underwent off-pump wrapping of the ascending aorta (group B). Among the 54 patients admitted for Stanford type A AAD, 15 with a mean age of 77 years [46 to 94] underwent wrapping of the aorta. Regarding the new standard European system for cardiac operative risk evaluation (EuroSCORE II), the median result in our group B patients was 10.47 [5.02 to 30.07]. In-hospital mortality was 12.80% in group A and 6.6% in group B (p=0.66). For patients who underwent external wrapping of the ascending aorta, follow-up mortality rate was 13.3% with a median follow-up of 15 months [range 0 to 47]. The gold standard in cases of Stanford type A AAD consists of emergency surgical replacement of the dissected ascending aorta. In some cases in which the aortic root is not affected a less invasive surgical approach consisting of wrapping the dissected ascending aorta can be suggested as an alternative. Copyright © 2014 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  15. Differences in nursing practice environment among US acute care unit types: a descriptive study.

    Science.gov (United States)

    Choi, JiSun; Boyle, Diane K

    2014-11-01

    The hospital nursing practice environment has been found to be crucial for better nurse and patient outcomes. Yet little is known about the professional nursing practice environment at the unit level where nurses provide 24-hour bedside care to patients. To examine differences in nursing practice environments among 11 unit types (critical care, step-down, medical, surgical, combined medical-surgical, obstetric, neonatal, pediatric, psychiatric, perioperative, and emergency) and by Magnet status overall, as well as four specific aspects of the practice environment. Cross-sectional study. 5322 nursing units in 519 US acute care hospitals. The nursing practice environment was measured by the Practice Environment Scale of the Nursing Work Index. The Practice Environment Scale of the Nursing Work Index mean composite and four subscale scores were computed at the unit level. Two statistical approaches (one-way analysis of covariance and multivariate analysis of covariance analysis) were employed with a Tukey-Kramer post hoc test. In general, the nursing practice environment was favorable in all unit types. There were significant differences in the nursing practice environment among the 11 unit types and by Magnet status. Pediatric units had the most favorable practice environment and medical-surgical units had the least favorable. A consistent finding across all unit types except neonatal units was that the staffing and resource adequacy subscale scored the lowest compared with all other Practice Environment Scale of the Nursing Work Index subscales (nursing foundations for quality of care, nurse manager ability, leadership, and support, and nurse-physician relations). Unit nursing practice environments were more favorable in Magnet than non-Magnet hospitals. Findings indicate that there are significant variations in unit nursing practice environments among 11 unit types and by hospital Magnet status. Both hospital-level and unit-specific strategies should be considered

  16. Standardizing acute toxicity data for use in ecotoxicology models: influence of test type, life stage, and concentration reporting.

    Science.gov (United States)

    Raimondo, Sandy; Vivian, Deborah N; Barron, Mace G

    2009-10-01

    Ecotoxicological models generally have large data requirements and are frequently based on existing information from diverse sources. Standardizing data for toxicological models may be necessary to reduce extraneous variation and to ensure models reflect intrinsic relationships. However, the extent to which data standardization is necessary remains unclear, particularly when data transformations are used in model development. An extensive acute toxicity database was compiled for aquatic species to comprehensively assess the variation associated with acute toxicity test type (e.g., flow-through, static), reporting concentrations as nominal or measured, and organism life stage. Three approaches were used to assess the influence of these factors on log-transformed acute toxicity: toxicity ratios, log-linear models of factor groups, and comparison of interspecies correlation estimation (ICE) models developed using either standardized test types or reported concentration type. In general, median ratios were generally less than 2.0, the slopes of log-linear models were approximately one for well-represented comparisons, and ICE models developed using data from standardized test types or reported concentrations did not differ substantially. These results indicate that standardizing test data by acute test type, reported concentration type, or life stage may not be critical for developing ecotoxicological models using large datasets of log-transformed values.

  17. Complex regional pain syndrome type 1 predictors - Epidemiological perspective from a national database analysis.

    Science.gov (United States)

    Elsharydah, Ahmad; Loo, Nathaniel H; Minhajuddin, Abu; Kandil, Enas S

    2017-06-01

    Complex regional pain syndrome type 1 is a disabling pain disorder with unclear etiology. It is usually triggered by an injury to a limb with or without specific nerve injury. The objective of this study is to explore the risk factors and predictors for this disease utilizing a large national database. Retrospective analysis of the Nationwide Inpatient Sample database from 2007 to 2011 in the United States. Adult inpatients diagnosed with complex regional pain syndrome type 1. Chi-square, simple and multivariate logistic regression analyses were conducted. The regression model was adjusted to the patient's demographics and comorbidities. There were 22,533 patients with the discharge diagnosis of complex regional pain syndrome type 1 of an inpatient sample of 33,406,123. It peaks between age 45 and 55. Female gender, Caucasian race, higher median household income, headache, depression, drug abuse and private insurance patients (vs Medicaid patients) were associated with higher rate of complex regional pain syndrome type 1. On the other hand, diabetes, obesity, hypothyroidism, and anemia were associated with a lower rate. Utilizing a large database, our study added more information to the risk profile of the complex regional pain syndrome type 1 in an inpatient population. Such information should be useful for physician for early recognition, diagnosis of patients at risk. Copyright © 2017 Elsevier Inc. All rights reserved.

  18. Hospital volumes and later year of operation correlates with better outcomes in acute Type A aortic dissection

    DEFF Research Database (Denmark)

    Geirsson, Arnar; Ahlsson, Anders; Franco-Cereceda, Anders

    2018-01-01

    OBJECTIVES: Acute Type A aortic dissection remains a life-threatening disease, but there are indications that its surgical mortality is decreasing. The aim of this report was to study how surgical mortality has changed and what influences those changes. METHODS: Nordic Consortium for Acute Type...... circulatory arrest was used in 85% of cases and its use increased significantly throughout the study. The 30-day mortality decreased from 24% in 2005 to 13% in 2014 ( P  = 0.003). Independent predictors for 30-day mortality were preoperative cardiac arrest, malperfusion syndrome, Penn Class C, Penn Class B...

  19. Functional genomics study of acute heat stress response in the small yellow follicles of layer-type chickens.

    Science.gov (United States)

    Cheng, Chuen-Yu; Tu, Wei-Lin; Chen, Chao-Jung; Chan, Hong-Lin; Chen, Chih-Feng; Chen, Hsin-Hsin; Tang, Pin-Chi; Lee, Yen-Pai; Chen, Shuen-Ei; Huang, San-Yuan

    2018-01-22

    This study investigated global gene and protein expression in the small yellow follicle (SYF; 6-8 mm in diameter) tissues of chickens in response to acute heat stress. Twelve 30-week-old layer-type hens were divided into four groups: control hens were maintained at 25 °C while treatment hens were subjected to acute heat stress at 36 °C for 4 h without recovery, with 2-h recovery, and with 6-h recovery. SYFs were collected at each time point for mRNA and protein analyses. A total of 176 genes and 93 distinct proteins with differential expressions were identified, mainly associated with the molecular functions of catalytic activity and binding. The upregulated expression of heat shock proteins and peroxiredoxin family after acute heat stress is suggestive of responsive machineries to protect cells from apoptosis and oxidative insults. In conclusion, both the transcripts and proteins associated with apoptosis, stress response, and antioxidative defense were upregulated in the SYFs of layer-type hens to alleviate the detrimental effects by acute heat stress. However, the genomic regulations of specific cell type in response to acute heat stress of SYFs require further investigation.

  20. The water desalination complex based on ABV-type reactor plant

    International Nuclear Information System (INIS)

    Panov, Yu.K.; Fadeev, Yu.P.; Vorobiev, V.M.; Baranaev, Yu.D.

    1997-01-01

    A floating nuclear desalination complex with two barges, one for ABV type reactor plant, with twin reactor 2 x 6 MW(e), and one for reverse osmosis desalination plant, was described. The principal specifications of the ABV type reactor plant and desalination barge were given. The ABV type reactor has a traditional two-circuit layout using an integral type reactor vessel with all mode natural convection of primary coolant. The desalted water cost was estimated to be around US $0.86 per cubic meter. R and D work has been performed and preparations for commercial production are under way. (author)

  1. Structural insight into the quinolone-DNA cleavage complex of type IIA topoisomerases.

    Science.gov (United States)

    Laponogov, Ivan; Sohi, Maninder K; Veselkov, Dennis A; Pan, Xiao-Su; Sawhney, Ritica; Thompson, Andrew W; McAuley, Katherine E; Fisher, L Mark; Sanderson, Mark R

    2009-06-01

    Type II topoisomerases alter DNA topology by forming a covalent DNA-cleavage complex that allows DNA transport through a double-stranded DNA break. We present the structures of cleavage complexes formed by the Streptococcus pneumoniae ParC breakage-reunion and ParE TOPRIM domains of topoisomerase IV stabilized by moxifloxacin and clinafloxacin, two antipneumococcal fluoroquinolones. These structures reveal two drug molecules intercalated at the highly bent DNA gate and help explain antibacterial quinolone action and resistance.

  2. [Use of cytoflavin into the complex intensive therapy of acute cerebral insufficiency caused by poisoning].

    Science.gov (United States)

    Vasilyev, S; Shilov, V; Aleksandrov, M; Batotsyrenov, B; Loladze, A

    2012-02-01

    In the result of treatment of 147 patients with toxic acute brain insufficiency were revealed that the employment of citoflavin (20 ml with 400 ml 5% glucosae twice a day) in 7 days intensive therapy of acute brain insufficiency leaded to decrease of hypoxic brain damages and intensity of brain depression, what was revealed in improvement of brain bioelectric activity. Rehabilitation of central nervous system regulation function and life-support systems leaded to quick rehabilitation of respiratory part of oxygen transport. These changes in acute period leaded to quick reparation of cognitive-mnestic functions and social adaptation. The employment of citoflavin leaded to improvement of clinic of toxicohypoxic encephalopathy and to decrease of secondary lung complications (decrease of coma-period from 45,3 ± 8,2 to 27,7 ± 6,9 hours; decrease of secondary lung complications from 72,7% to 35,9%).

  3. Acute mononeuropathy in a child with newly diagnosed type 1 diabetes mellitus.

    Science.gov (United States)

    Rangel, Maria Adriana; Baptista, Carolina; Santos, Fátima; Real, Marta Vila; Campos, Rosa Arménia; Leite, Ana Luísa

    2015-03-01

    Neuropathy is a frequent complication of diabetes mellitus (DM), increasing with the duration of the disease, poor glycemic control and advanced age. Acute presentation of a neuropathy in the setting of a newly diagnosed type 1 DM is rare and holds a diagnostic challenge. A 10-year-old girl, presented at the emergency service with complaints of polydipsia, polyuria, asthenia and weight lost over the last 15 days, accompanied by difficulties in flexing the right foot, during the previous week. The patient denied any pain, paresthesias, or altered sensibility. There was no fever documented, or recent infectious intercurrence or trauma. On physical examination, she was conscious, collaborative and space and time-orientated, had a diminished strength in the right foot, namely in the dorsiflexion, conditioning a steppage gait ipsilateral. Hyperalgesia was felt in the dorsum of the right feet to the ankle. DM type 1 was diagnosed based on serum glucose of 629 mg/dL and mild ketoacidosis. Investigation for infectious, immune and nutritional aetiologies for the mononeuropathy was negative. Electrophysiological study was suggestive of a lesion of the peroneal nerve on the popliteal cesspit, but was not conclusive. The patient started physiotherapy during her hospital stay and exhibited a slight improvement in the dorsiflexion of the foot. Four months later she was asymptomatic and with good glycaemic control. Diabetic neuropathy is a heterogeneous group that still lacks adequate comprehension. Its approach is empirical and demands exclusion of other etiologies. A definitive diagnosis is not always possible and sometimes is retrospective.

  4. How I do it: transapical cannulation for acute type-A aortic dissection

    Directory of Open Access Journals (Sweden)

    Alexiou Christos

    2008-01-01

    Full Text Available Abstract Aortic dissection is the most frequently diagnosed lethal disease of the aorta. Half of all patients with acute type-A aortic dissection die within 48 hours of presentation. There is still debate as to the optimal site of arterial cannulation for establishing cardiopulmonary bypass in patients with type-A aortic dissection. Femoral artery cannulation with retrograde perfusion is the most common method but because of the risk of malperfusion of vital organs and atheroembolism related to it different sites such as the axillary artery, the innominate artery and the aortic arch are used. Cannulation of these sites is not without risks of atheroembolism, neurovascular complications and can be time consuming. Another yet to be popularised option is the transapical aortic cannulation (TAC described in this article. TAC consists of the insertion of the arterial cannula through the apex of the left ventricle and the aortic valve to lie in the sinus of Valsalva. Trans-oesophageal guidance is necessary to ensure correct placement of the cannula. TAC is an excellent method of establishing cardiopulmonary bypass as it is quick, provides a more physiological method of delivering antegrade arterial flow and is the only method to assure perfusion of the true lumen.

  5. Long-term mortality in patients with diabetes mellitus type 2 after acute myocardial infarction

    Directory of Open Access Journals (Sweden)

    Miljković Dušan

    2014-01-01

    Full Text Available Introduction. Myocardial infarction is the most common cause of death in patients with diabetes, and several studies have shown that people with diabetes have twice the risk of dying from a heart attack compared to non diabetics. Objective. The aim of this study was to determine the mortality of patients that have survived acute myocardial infarction, in population of patients with diabetes mellitus and without diabetes. Method. The study included 135 patients recovered from myocardial infarction, of whom 51 (37.8% had type 2 diabetes mellitus, and 84 (62.2% were without diabetes, mean age 55,4±9,6 years. All patients underwent a complete cardiac and hemodynamic testing, cardiac catheterization with selective coronary angiography, and in most patients the aortocoronary bypass revascularization or percutaneous coronary intervention. Start of follow-up was the date of acute myocardial infarction. The study included only patients who survived at least one month after acute myocardial infarction. All patients with diabetes and without diabetes were monitored for an average of 84 months, i.e. 7 years. Results. The average age of patients with diabetes and myocardial infarction was 57.1±8.7 years, and of patients with myocardial infarction without diabetes 54.5 ± 9.6 years (t=1.62; p>0.05. Among patients with diabetes 14 (27.5% were women and 37 (72.5% were men, and in non-diabetics 15 (17.9% were women and 69 (82.1% were men (χ2=1.66; p>0.05. In the follow-up period died 15 (29.4% patients with diabetes, and 7 (8.3% patients without diabetes. Mortality in patients with diabetes and myocardial infarction was significantly higher than the mortality of patients with myocardial infarction without diabetes (χ2=11.2; p0.05. In the group of 27 patients who were treated with insulin, died five (18.5% and in the group of 24 patients on oral therapy died 10 (41.7%. There was no significant difference in mortality in patients with diabetes treated with

  6. Prognostic Effect of Complex Karyotype, Monosomal Karyotype, and Chromosome 17 Abnormalities in B-Cell Acute Lymphoblastic Leukemia.

    Science.gov (United States)

    Khoral, Priya; Atenafu, Eshetu G; Craddock, Kenneth J; Schimmer, Aaron; Chang, Hong

    2017-04-01

    The effect of monosomal karyotype (MK), complex karyotype (CK), and chromosome 17 abnormalities (abnl 17) on prognosis in B-cell acute lymphoid leukemia (B-ALL) has not yet been established. We conducted a retrospective analysis of prognostic factors on 237 adult patients with B-ALL treated at our institution. Older age (older than 60 years), higher white blood cell count (> 30), and abnl 17 were associated with shorter overall survival in univariate analysis, but multivariable analysis only identified older age as an independent poor prognostic actor. There was a significant correlation between abnl 17 and older age. In contrast to the patients with acute myeloid leukemia, our results show that MK and CK do not play a predictive role in patients with B-ALL, but further study is required to determine whether specific changes on chromosome 17 might have prognostic value when investigated separately. Copyright © 2017 Elsevier Inc. All rights reserved.

  7. Sulfonylureas Improve Outcome in Patients With Type 2 Diabetes and Acute Ischemic Stroke

    Science.gov (United States)

    Kunte, Hagen; Schmidt, Sein; Eliasziw, Michael; del Zoppo, Gregory J.; Simard, J. Marc; Masuhr, Florian; Weih, Markus; Dirnagl, Ulrich

    2009-01-01

    Background and Purpose The sulfonylurea receptor 1-regulated NCCa-ATP channel is upregulated in rodent models of stroke with block of the channel by the sulfonylurea, glibenclamide (glyburide), significantly reducing mortality, cerebral edema, and infarct volume. We hypothesized that patients with type 2 diabetes mellitus taking sulfonylurea agents both at the time of stroke and during hospitalization would have superior outcomes. Methods We reviewed medical records of patients with diabetes mellitus hospitalized within 24 hours of onset of acute ischemic stroke in the Neurology Clinic, Charité Hospital, Berlin, Germany, during 1994 to 2000. After exclusions, the cohort comprised 33 patients taking a sulfonylurea at admission through discharge (treatment group) and 28 patients not on a sulfonylurea (control group). The primary outcome was a decrease in National Institutes of Health Stroke Scale of 4 points or more from admission to discharge or a discharge National Institutes of Health Stroke Scale score of 0. The secondary outcome was a discharge modified Rankin Scale score ≤2. Results No significant differences, other than stroke subtype, were observed among baseline variables between control and treatment groups. The primary outcome was reached by 36.4% of patients in the treatment group and 7.1% in the control group (P=0.007). The secondary outcome was reached by 81.8% versus 57.1% (P=0.035). Subgroup analyses showed that improvements occurred only in patients with nonlacunar strokes and were independent of gender, previous transient ischemic attack, and blood glucose levels. Conclusion Sulfonylureas may be beneficial for patients with diabetes mellitus with acute ischemic stroke. Further investigation of similar cohorts and a prospective randomized trial are recommended to confirm the present observations. PMID:17673715

  8. Acute type A aortic dissection: characteristics and outcomes comparing patients with bicuspid versus tricuspid aortic valve.

    Science.gov (United States)

    Etz, Christian D; von Aspern, Konstantin; Hoyer, Alexandro; Girrbach, Felix F; Leontyev, Sergey; Bakhtiary, Farhad; Misfeld, Martin; Mohr, Friedrich W

    2015-07-01

    The aim of this study is to investigate the clinical characteristics and postoperative outcome of patients with a bicuspid aortic valve (BAV) suffering acute dissection in comparison with their tricuspid peers. Between 1995 and 2011, 460 consecutive patients underwent emergency repair for acute type A aortic dissection. In 379 patients without connective tissue disease, the aortic valve morphology could clearly be specified (91.6% tricuspid and 8.4% bicuspid). At the time of dissection, patients with a bicuspid valve were younger (46.7 ± 13 vs 61.6 ± 12 years, P tricuspid valve (bicuspid: 31.3% vs tricuspid: 6.3%, P tricuspid valve patients (P tricuspid patients (P = 0.166). Hospital mortality was 20.3% and not significantly different between the two valve morphologies, even despite the younger age of bicuspid patients: 28.1% among bicuspids vs 19.6% among tricuspids (P = 0.255). Survival after discharge was 63.3% at 10 years for all patients. BAV patients had a significantly better survival with 100% at 10 years compared with 60.2% in tricuspid valve patients (P = 0.011). Mean follow-up among survivors was comparable for bicuspid and tricuspid patients (3.7 and 4.1 years, respectively). Patients with BAV have a distinctive dissection pattern with the entry tear frequently located in the aortic root and-despite their younger age-are subject to substantial hospital mortality. For bicuspid patients suffering from dissection, composite root replacement yields an excellent outcome equal to an age- and gender-matched normal population. © The Author 2014. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

  9. Treatment of ruptured complex and large/giant ruptured cerebral aneurysms by acute coiling followed by staged flow diversion.

    Science.gov (United States)

    Brinjikji, Waleed; Piano, Mariangela; Fang, Shanna; Pero, Guglielmo; Kallmes, David F; Quilici, Luca; Valvassori, Luca; Lozupone, Emilio; Cloft, Harry J; Boccardi, Edoardo; Lanzino, Giuseppe

    2016-07-01

    OBJECT Flow-diversion treatment has been shown to be associated with high rates of angiographic obliteration; however, the treatment is relatively contraindicated in the acute phase following subarachnoid hemorrhage (SAH) as these patients require periprocedural dual antiplatelet therapy. Acute coiling followed by flow diversion has emerged as an intriguing and feasible treatment option for ruptured complex and giant aneurysms. In this study the authors report outcomes and complications of patients with ruptured aneurysms undergoing coiling in the acute phase followed by planned delayed flow diversion. METHODS This case series includes patients from 2 institutions. All patients underwent standard endovascular coiling in the acute phase after SAH with the intention and plan to proceed with flow diversion at a later date. Outcomes studied included angiographic occlusion, procedure-related complications, and long-term clinical outcome as measured using the modified Rankin Scale. RESULTS A total of 31 patients underwent coiling in the acute phase with the intention to undergo flow diversion at a later date. The mean aneurysm size was 15.8 ± 7.9 mm. Of the 31 patients undergoing coiling, 4 patients could not undergo further flow-diverter therapy: 3 patients (9.7%) died of complications of subarachnoid hemorrhage and 1 patient had permanent morbidity as a result of perioperative ischemic stroke (3.1%). Twenty-seven patients underwent staged placement of flow diverters after adequate recovery. The median time to treatment was 16 weeks. There was one case of aneurysm rebleeding following coil treatment. There were no cases of permanent morbidity or mortality resulting from flow-diverter treatment. Twenty-four patients underwent imaging follow-up; 18 of these patients had aneurysms that were completely or nearly completely occluded (58.1% on an intent-to-treat basis). At last follow-up (mean 18.3 months), 25 patients had mRS scores ≤ 2 (80.6% on an intent-to-treat basis

  10. Predicting complex acute wound healing in patients from a wound expertise centre registry: a prognostic study

    NARCIS (Netherlands)

    Ubbink, Dirk T.; Lindeboom, Robert; Eskes, Anne M.; Brull, Huub; Legemate, Dink A.; Vermeulen, Hester

    2015-01-01

    It is important for caregivers and patients to know which wounds are at risk of prolonged wound healing to enable timely communication and treatment. Available prognostic models predict wound healing in chronic ulcers, but not in acute wounds, that is, originating after trauma or surgery. We

  11. Predicting complex acute wound healing in patients from a wound expertise centre registry : a prognostic study

    NARCIS (Netherlands)

    Ubbink, Dirk T; Lindeboom, Robert; Eskes, Anne M; Brull, Huub; Legemate, Dink A; Vermeulen, Hester

    2015-01-01

    It is important for caregivers and patients to know which wounds are at risk of prolonged wound healing to enable timely communication and treatment. Available prognostic models predict wound healing in chronic ulcers, but not in acute wounds, that is, originating after trauma or surgery. We

  12. Core Transcriptional Regulatory Circuit Controlled by the TAL1 Complex in Human T Cell Acute Lymphoblastic Leukemia

    OpenAIRE

    Sanda, Takaomi; Lawton, Lee N.; Barrasa, M. Inmaculada; Fan, Zi Peng; Kohlhammer, Holger; Gutierrez, Alejandro; Ma, Wenxue; Tatarek, Jessica; Ahn, Yebin; Kelliher, Michelle A.; Jamieson, Catriona H.M.; Staudt, Louis M.; Young, Richard A.; Look, A. Thomas

    2012-01-01

    The oncogenic transcription factor TAL1/SCL is aberrantly expressed in over 40% of cases of human T-cell acute lymphoblastic leukemia (T-ALL), emphasizing its importance in the molecular pathogenesis of T-ALL. Here we identify the core transcriptional regulatory circuit controlled by TAL1 and its regulatory partners HEB, E2A, LMO1/2, GATA3 and RUNX1. We show that TAL1 forms a positive interconnected auto-regulatory loop with GATA3 and RUNX1, and that the TAL1 complex directly activates the MY...

  13. Metformin-treated patients with type 2 diabetes have normal mitochondrial complex I respiration

    DEFF Research Database (Denmark)

    Larsen, Steen; Rabøl, R; Hansen, C N

    2012-01-01

    The glucose-lowering drug metformin has been shown to inhibit complex I of the mitochondrial electron transport chain in skeletal muscle. To investigate this effect in vivo we studied skeletal muscle mitochondrial respiratory capacity and content from patients with type 2 diabetes treated...

  14. Evidence for local inflammation in complex regional pain syndrome type 1

    Directory of Open Access Journals (Sweden)

    Frank J. P. M. Huygen

    2002-01-01

    Full Text Available Background: The pathophysiology of complex regional pain syndrome type 1 (CRPS 1 is still a matter of debate. Peripheral afferent, efferent and central mechanisms are supposed. Based on clinical signs and symptoms (e.g. oedema, local temperature changes and chronic pain local inflammation is suspected.

  15. Player Types, Play Styles, and Play Complexity: Updating the Entertainment Grid

    Science.gov (United States)

    Rademacher Mena, Ricardo Javier

    2012-01-01

    In a previous work the author created the Education and Entertainment Grid by combining various taxonomies from the fields of play and learning. In this paper, a section of this grid known as the Entertainment Grid will be extended by including previously unused elements of Richard Bartle's online player types and Robert Caillois' play complexity.…

  16. Palladium complexes of a new type of N-heterocyclic carbene ligand ...

    Indian Academy of Sciences (India)

    ... Journals; Journal of Chemical Sciences; Volume 126; Issue 5. Palladium complexes of a new type of N-heterocyclic carbene ligand derived from a tricyclic triazolooxazine framework. Manoj Kumar Gangwar Alok Ch Kalita Prasenjit Ghosh. Special issue on Chemical Crystallography Volume 126 Issue 5 September 2014 ...

  17. Therapy-Resistant Complex Regional Pain Syndrome Type I : To Amputate or Not?

    NARCIS (Netherlands)

    Bodde, M.I.; Dijkstra, P.U.; den Dunnen, W.F.A.; Geertzen, J.H.B.

    2011-01-01

    Background: Amputation for the treatment of long-standing, therapy-resistant complex regional pain syndrome type I (CRPS-I) is controversial. An evidence-based decision regarding whether or not to amputate is not possible on the basis of current guidelines. The aim of the current study was to

  18. The Optimal Conditions for Form-Focused Instruction: Method, Target Complexity, and Types of Knowledge

    Science.gov (United States)

    Kim, Jeong-eun

    2012-01-01

    This dissertation investigates optimal conditions for form-focused instruction (FFI) by considering effects of internal (i.e., timing and types of FFI) and external (i.e., complexity and familiarity) variables of FFI when it is offered within a primarily meaning-focused context of adult second language (L2) learning. Ninety-two Korean-speaking…

  19. Predictors of Pain Relieving Response to Sympathetic Blockade in Complex Regional Pain Syndrome Type 1

    NARCIS (Netherlands)

    van Eijs, F.; Geurts, J.; van Kleef, M.; Faber, C.G.; Perez, R.S.G.M.; Kessels, A.G.; van Zundert, J.

    2012-01-01

    BACKGROUND:: Sympathetic blockade with local anesthetics is used frequently in the management of complex regional pain syndrome type 1(CRPS-1), with variable degrees of success in pain relief. The current study investigated which signs or symptoms of CRPS-1 could be predictive of outcome. The

  20. Safety of "pain exposure" physical therapy in patients with complex regional pain syndrome type 1.

    NARCIS (Netherlands)

    Meent, H. van de; Oerlemans, M.; Bruggeman, A.W.A.; Klomp, F.; Dongen, R.T.M. van; Oostendorp, R.A.B.; Frolke, J.P.M.

    2011-01-01

    "Pain exposure" physical therapy (PEPT) is a new treatment for patients with complex regional pain syndrome type 1 (CRPS-1) that consists of a progressive-loading exercise program and management of pain-avoidance behavior without the use of specific CRPS-1 medication or analgesics. The aim of this

  1. Stressful life events and psychological dysfunction in complex regional pain syndrome type I

    NARCIS (Netherlands)

    Geertzen, JHB; de Bruijn-Kofman, AT; de Bruijn, HP; van de Wiel, HBM; Dijkstra, PU

    Objective: To determine to what extent stressful life events and psychological dysfunction play a role in the pathogenesis of Complex Regional Pain Syndrome type I (CRPS). Design: A comparative study between a CRPS group and a control group. Stressful life events and psychological dysfunction

  2. Bilingual Children's Acquisition of English Verb Morphology: Effects of Language Exposure, Structure Complexity, and Task Type

    Science.gov (United States)

    Paradis, Johanne

    2010-01-01

    This study investigated whether bilingual-monolingual differences would be apparent in school-age children's use and knowledge of English verb morphology and whether differences would be influenced by amount of exposure to English, complexity of the morphological structure, or the type of task given. French-English bilinguals (mean age = 6;10)…

  3. Outcome disparities by insurance type for patients with acute myeloblastic leukemia.

    Science.gov (United States)

    Pulte, Dianne; Castro, Felipe A; Brenner, Hermann; Jansen, Lina

    2017-05-01

    Survival for patients with acute myeloblastic leukemia (AML) has increased during the past two decades. However, socioeconomic disparities may affect survival for some patient populations. We examine survival by insurance type for patients with AML. Using data from the Surveillance, Epidemiology, and End Results database we estimated survival according to insurance status (no insurance, Medicaid, and other insurance) for patients diagnosed with AML in the United States in 2007-2013. One, 3-, and 5-year survival was lower for patients with no insurance and Medicaid than for patients with other insurance. Five-year survival estimates were 24.7%, 25.6%, and 35.7%, respectively, for patients with Medicaid, no insurance, and other insurance. After adjustment, hazard ratios of 1.46 for uninsured and 1.35 for Medicaid compared to other insurance for overall survival and 1.50 for uninsured and 1.30 for Medicaid compared to other insurance for AML-specific survival were observed. Similar results were seen in all ages and both genders. Patients with no insurance or Medicaid have lower survival expectations after diagnosis with AML than patients with other insurance. Further research into reasons for the poor outcomes for Medicaid patients and continued reduction of number of uninsured people are urgently needed to improve population-level outcomes for AML. Published by Elsevier Ltd.

  4. Liraglutide acutely suppresses glucagon, lipolysis and ketogenesis in type 1 diabetes.

    Science.gov (United States)

    Garg, Manisha; Ghanim, Husam; Kuhadiya, Nitesh D; Green, Kelly; Hejna, Jeanne; Abuaysheh, Sanaa; Torre, Barrett; Batra, Manav; Makdissi, Antoine; Chaudhuri, Ajay; Dandona, Paresh

    2017-09-01

    In view of the occurrence of diabetic ketoacidosis associated with the use of sodium-glucose transport protein-2 inhibitors in patients with type 1 diabetes (T1DM) and the relative absence of this complication in patients treated with liraglutide in spite of reductions in insulin doses, we investigated the effect of liraglutide on ketogenesis. Twenty-six patients with inadequately controlled T1DM were randomly divided into 2 groups of 13 patients each. After an overnight fast, patients were injected, subcutaneously, with either liraglutide 1.8 mg or with placebo. They were maintained on their basal insulin infusion and were followed up in our clinical research unit for 5 hours. The patients injected with placebo maintained their glucose and glucagon concentrations without an increase, but there was a significant increase in free fatty acids (FFA), acetoacetate and β-hydoxybutyrate concentrations. In contrast, liraglutide significantly reduced the increase in FFA, and totally prevented the increase in acetoacetate and β-hydroxybutyrate concentrations while suppressing glucagon and ghrelin concentrations. Thus, a single dose of liraglutide is acutely inhibitory to ketogenesis. © 2017 John Wiley & Sons Ltd.

  5. Acute effects of different types of aerobic exercise on endothelial function and arterial stiffness.

    Science.gov (United States)

    Siasos, Gerasimos; Athanasiou, Dimitrios; Terzis, Gerasimos; Stasinaki, Aggeliki; Oikonomou, Evangelos; Tsitkanou, Stavroula; Kolokytha, Theodora; Spengos, Konstantinos; Papavassiliou, Athanasios G; Tousoulis, Dimitris

    2016-09-01

    Chronic aerobic exercise training is associated with improved endothelial function and arterial stiffness and favourable long-term cardiovascular effects. We investigated the acute effects of continuous moderate intensity aerobic exercise (CAE) and high intensity interval aerobic exercise (hIAE) on endothelial function and arterial stiffness in healthy participants. Twenty healthy men were recruited to this cross-over study. They participated in two exercise sessions: (a) CAE, volume at 50% of maximum aerobic work for 30 minutes; and (b) hIAE, interval maximum aerobic work for 30 minutes. Endothelial function was evaluated by flow-mediated dilation in the brachial artery. The carotid femoral pulse wave velocity and the femoral dorsalis pedis pulse wave velocity were measured as indices of central aortic and peripheral arterial stiffness. Measurements were carried out before and immediately after each exercise session. There was no statistically significant difference in the baseline measurements before CAE and hIAE with respect to flow-mediated dilation, the carotid femoral pulse wave velocity and the femoral dorsalis pedis pulse wave velocity (p = NS). Both CAE and hIAE significantly improved the flow-mediated dilation compared with baseline (p exercise. These types of aerobic exercise have a different impact on the central and peripheral arterial stiffness. © The European Society of Cardiology 2016.

  6. Changing glucocorticoid action: 11β-hydroxysteroid dehydrogenase type 1 in acute and chronic inflammation.

    Science.gov (United States)

    Chapman, Karen E; Coutinho, Agnes E; Zhang, Zhenguang; Kipari, Tiina; Savill, John S; Seckl, Jonathan R

    2013-09-01

    Since the discovery of cortisone in the 1940s and its early success in treatment of rheumatoid arthritis, glucocorticoids have remained the mainstay of anti-inflammatory therapies. However, cortisone itself is intrinsically inert. To be effective, it requires conversion to cortisol, the active glucocorticoid, by the enzyme 11β-hydroxysteroid dehydrogenase type 1 (11β-HSD1). Despite the identification of 11β-HSD in liver in 1953 (which we now know to be 11β-HSD1), its physiological role has been little explored until recently. Over the past decade, however, it has become apparent that 11β-HSD1 plays an important role in shaping endogenous glucocorticoid action. Acute inflammation is more severe with 11β-HSD1-deficiency or inhibition, yet in some inflammatory settings such as obesity or diabetes, 11β-HSD1-deficiency/inhibition is beneficial, reducing inflammation. Current evidence suggests both beneficial and detrimental effects may result from 11β-HSD1 inhibition in chronic inflammatory disease. Here we review recent evidence pertaining to the role of 11β-HSD1 in inflammation. This article is part of a Special Issue entitled 'CSR 2013'. Copyright © 2013 Elsevier Ltd. All rights reserved.

  7. Moderate Versus Deep Hypothermia With Unilateral Selective Antegrade Cerebral Perfusion for Acute Type A Dissection.

    Science.gov (United States)

    Leshnower, Bradley G; Thourani, Vinod H; Halkos, Michael E; Sarin, Eric L; Keeling, William B; Lamias, Mark J; Guyton, Robert A; Chen, Edward P

    2015-11-01

    Despite improved results with surgical therapy for acute type A aortic dissection (ATAAD), there remains a lack of consensus regarding the optimal method of cerebral protection and circulation management during ATAAD. The purpose of this study is to determine whether in the setting of antegrade cerebral perfusion, moderate hypothermic circulatory arrest (MHCA) provides equivalent cerebral and visceral protection as deep hypothermic circulatory arrest (DHCA) for patients undergoing emergent ATAAD repair. A review of the Emory aortic surgery database from 2004 to 2014 identified 288 patients who underwent ATAAD with right axillary artery cannulation, unilateral selective antegrade cerebral perfusion (uSACP), and hypothermic circulatory arrest (HCA). In all, 88 patients underwent HCA at 24 °C or lower (DHCA), and 206 patients underwent HCA at more than 24 °C (MHCA). Major adverse outcomes of death, stroke, temporary neurologic dysfunction, and dialysis-dependent renal failure were examined. The groups were well matched for age and major comorbidities. The DHCA patients underwent HCA at lower temperatures (DHCA 21.6 ± 3.1 °C vs MHCA 27.4 ± 1.6 °C, p 0.05). Moderate HCA with uSACP is an effective circulation management strategy that provides excellent cerebral and visceral protection during emergent ATAAD repair. In the setting of antegrade cerebral perfusion, deep hypothermia does not provide any additional benefit. Copyright © 2015 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  8. Acute caloric restriction improves glomerular filtration rate in patients with morbid obesity and type 2 diabetes.

    Science.gov (United States)

    Giordani, I; Malandrucco, I; Donno, S; Picconi, F; Di Giacinto, P; Di Flaviani, A; Chioma, L; Frontoni, S

    2014-04-01

    The role of caloric restriction in the improvement of renal function following bariatric surgery is still unclear; with some evidence showing that calorie restriction can reduce proteinuria. However, data on the impact of caloric restriction on renal function are still lacking. Renal function, as measured by glomerular filtration rate (GFR), was evaluated in 14 patients with type 2 diabetes mellitus, morbid obesity and stage 2 chronic kidney disease before and after a 7-day very low-calory diet (VLCD). After the VLCD, both GFR and overall glucose disposal (M value) significantly increased from 72.6 ± 3.8 mL/min/1.73 m(-2) BSA to 86.9 ± 6.1 mL/min/1.73 m(-2) BSA (P=0.026) and from 979 ± 107 μmol/min(1)/m(2) BSA to 1205 ± 94 μmol/min(1)/m(2) BSA (P=0.008), respectively. A significant correlation was observed between the increase in GFR and the rise in M value (r=0.625, P=0.017). Our observation of improved renal function following acute caloric restriction before weight loss became relevant suggesting that calory restriction per se is able to affect renal function. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

  9. Changing glucocorticoid action: 11β-Hydroxysteroid dehydrogenase type 1 in acute and chronic inflammation

    Science.gov (United States)

    Chapman, Karen E.; Coutinho, Agnes E.; Zhang, Zhenguang; Kipari, Tiina; Savill, John S.; Seckl, Jonathan R.

    2013-01-01

    Since the discovery of cortisone in the 1940s and its early success in treatment of rheumatoid arthritis, glucocorticoids have remained the mainstay of anti-inflammatory therapies. However, cortisone itself is intrinsically inert. To be effective, it requires conversion to cortisol, the active glucocorticoid, by the enzyme 11β-hydroxysteroid dehydrogenase type 1 (11β-HSD1). Despite the identification of 11β-HSD in liver in 1953 (which we now know to be 11β-HSD1), its physiological role has been little explored until recently. Over the past decade, however, it has become apparent that 11β-HSD1 plays an important role in shaping endogenous glucocorticoid action. Acute inflammation is more severe with 11β-HSD1-deficiency or inhibition, yet in some inflammatory settings such as obesity or diabetes, 11β-HSD1-deficiency/inhibition is beneficial, reducing inflammation. Current evidence suggests both beneficial and detrimental effects may result from 11β-HSD1 inhibition in chronic inflammatory disease. Here we review recent evidence pertaining to the role of 11β-HSD1 in inflammation. This article is part of a Special Issue entitled ‘CSR 2013’. PMID:23435016

  10. A Type A and Type D Combined Personality Typology in Essential Hypertension and Acute Coronary Syndrome Patients: Associations with Demographic, Psychological, Clinical, and Lifestyle Indicators.

    Directory of Open Access Journals (Sweden)

    Patrizia Steca

    Full Text Available Many studies have focused on Type A and Type D personality types in the context of cardiovascular diseases (CVDs, but nothing is known about how these personality types combine to create new profiles. The present study aimed to develop a typology of Type A and Type D personality in two groups of patients affected by and at risk for coronary disease. The study involved 711 patients: 51.6% with acute coronary syndrome, 48.4% with essential hypertension (mean age = 56.4 years; SD = 9.7 years; 70.7% men. Cluster analysis was applied. External variables, such as socio-demographic, psychological, lifestyle, and clinical parameters, were assessed. Six groups, each with its own unique combined personality profile scores, were identified: Type D, Type A-Negatively Affected, Not Type A-Negatively Affected, Socially Inhibited-Positively Affected, Not Socially Inhibited, and Not Type A-Not Type D. The Type A-Negatively Affected cluster and, to a lesser extent, the Type D cluster, displayed the worst profile: namely higher total cardiovascular risk index, physical inactivity, higher anxiety and depression, and lower self-esteem, optimism, and health status. Identifying combined personality profiles is important in clinical research and practice in cardiovascular diseases. Practical implications are discussed.

  11. Low protein alimentation normalizes renal haemodynamic response to acute protein ingestion in type 1 diabetic children.

    Science.gov (United States)

    Castellino, P; De Santo, N G; Capasso, G; Anastasio, P; Coppola, S; Capodicasa, G; Perna, A; Torella, R; Salvatore, T; Giordano, C

    1989-02-01

    The effect of an acute protein load (2 g kg-1 bodyweight [BW]) was studied in nine type 1 diabetic children. Patients were maintained on two different dietary regimens. In study one, patients were on a high protein diet providing from 2.7 to 1.8 g of protein/kg of BW per day. In study two, patients were reevaluated after three weeks of a diet providing from 1.0 to 1.2 g kg-1 of BW per day of protein. In study one (High Protein Diet), we failed to observe any rise in GFR and RPF following the protein meal (137 +/- 21 basal vs. 110 +/- 14 and 472 +/- 93 basal vs. 494 +/- 93 ml/1.73 m2 of SA min-1 at 60 min. This is in contrast with results from seven age matched controls consuming a free diet, which showed a significant rise in both GFR and RPF. In study two (low protein diet), basal GFR was significantly reduced. However after the protein load, both GFR (92 +/- 11 vs. 126 +/- 18 ml/1.73 m2 of SA min-1) and RPF (467 +/- 83 vs. 705 +/- 102 ml/1.73 m2 min-1) rose significantly (P less than 0.05 vs. basal). The data indicate that: 1. short term protein restriction reduces significantly GFR in type 1 diabetic children; 2. diabetic children maintained on an high protein intake show an altered haemodynamic response to protein ingestion; 3. a normal response to protein ingestion can be restored by short term dietary protein restriction.

  12. Biomechanical comparison of acute Hill-Sachs reduction with remplissage to treat complex anterior instability.

    Science.gov (United States)

    Garcia, Grant H; Degen, Ryan M; Bui, Christopher N H; McGarry, Michelle H; Lee, Thay Q; Dines, Joshua S

    2017-06-01

    Acute Hill-Sachs reduction represents a potential alternative method to remplissage for the treatment of an engaging Hill-Sachs lesion. This study biomechanically compared the stabilizing effects of an acute Hill-Sachs reduction technique and remplissage. Six cadaveric shoulders were tested. For the acute Hill-Sachs lesion, a unique model was used to create a 30% defect, compressing the subchondral bone while preserving the articular surface. Five scenarios were tested: intact specimen, bipolar lesion, Bankart repair, remplissage with Bankart repair, and Hill-Sachs reduction technique with Bankart repair. The Hill-Sachs lesion was reduced through a lateral cortical window with a bone tamp, and the subchondral void was filled with bone cement. At 90° of abduction and external rotation (ER), total translation was 11.6 ± 0.9 mm for the bipolar lesion. This was significantly reduced after remplissage (5.9 ± 1.1 mm; P Hill-Sachs reduction (4.7 ± 0.4 mm; P Hill-Sachs reduction was 1° ± 3° (P = .99). Similar joint stability was conferred after both procedures, with minimal change in range of motion. Remplissage may still be the best way to address chronic Hill-Sachs lesions; however, the reduction technique is a more anatomic alternative and may be a potential option for treating an acutely engaging Hill-Sachs lesion. Published by Elsevier Inc.

  13. The organization of the Golgi complex and microtubules in skeletal muscle is fiber type-dependent

    DEFF Research Database (Denmark)

    Ralston, E; Lu, Z; Ploug, Thorkil

    1999-01-01

    and experimentally denervated. The total number of GC elements, small polarized stacks of cisternae, is quite similar in all fibers, but their intracellular distribution is fiber type-dependent. Thus, in slow-twitch, type I fibers, approximately 75% of all GC elements are located within 1 micrometer from the plasma...... membrane, and each nucleus is surrounded by a belt of GC elements. In contrast, in the fast-twitch type IIB fibers, most GC elements are in the fiber core, and most nuclei only have GC elements at their poles. Intermediate, type IIA fibers also have an intermediate distribution of GC elements...... of the hindlimb muscles, GC elements as well as microtubules converge toward a common pattern, that of the slow-twitch fibers, in all fibers. Our data suggest that innervation regulates the distribution of microtubules, which in turn organize the Golgi complex according to muscle fiber type....

  14. Increased endothelin-1 and diminished nitric oxide levels in blister fluids of patients with intermediate cold type complex regional pain syndrome type 1

    Directory of Open Access Journals (Sweden)

    Niehof Sjoerd

    2006-11-01

    Full Text Available Abstract Background In complex regional pain syndrome type 1 (CRPS1 pro-inflammatory mediators and vascular changes play an important role in the sustained development and outcome of the disease. The aim of this study was to determine the involvement of vasoactive substances endothelin-1 (ET-1 and nitric oxide (NO during early chronic CRPS1. Methods Included were 29 patients with CRPS 1 who were diagnosed during the acute stage of their disease and observed during follow-up visits. Disease activity and impairment were determined and artificial suction blisters were made on the CRPS1 and the contralateral extremities for measurements of IL-6, TNF-α, ET-1 and nitrate/nitrite (NOx. Results The levels of IL-6, TNF-α and ET-1 in blister fluid in the CRPS1 extremity versus the contralateral extremity were significantly increased and correlated with each other, whereas NOx levels were decreased. Conclusion The NOx/ET-1 ratio appears to be disturbed in the intermediate stage of CRPS, resulting in vasoconstriction and consequently in a diminished tissue blood distribution.

  15. Iron and nickel complexes with heterocyclic ligands: stability, synthesis, spectral characterization, antimicrobial activity, acute and subacute toxicity.

    Science.gov (United States)

    Bouchoucha, Afaf; Terbouche, Achour; Zaouani, Mohamed; Derridj, Fazia; Djebbar, Safia

    2013-07-01

    The synthesis and characterization by elemental analysis, emission atomic spectroscopy, TG measurements, magnetic measurements, FTIR, (1)H NMR, UV-visible spectra and conductivity of a series of iron (II) and nickel (II) complexes with two heterocyclic ligands (L(1)(SMX): sulfamethoxazole and L(2)(MIZ): metronidazole) used in pharmaceutical field and with a new ligand derived benzoxazole (L(3)(MPBO): 2-(5-methylpyridine-2-yl)benzoxazole), were reported. The formulae obtained for the complexes are: [M(L(1))2 Cl2]·nH2O, [M(L(2))2Cl2(H2O)2]·H2O and [M(L(3))2(OH)2]·nH2O. Stability constants of these complexes have been determined by potentiometric methods in water-ethanol (90:10, v/v) mixture at a 0.2 mol L(-1) ionic strength (NaCl) and at 25.0±0.1 °C. Sirko program was used to determine the protonation constants as well as the binding constants of three species [ML2H2](2+), [ML2] and [ML](2+). The antimicrobial activity of the ligands and complexes was evaluated in vitro against different human bacteria and fungi using agar diffusion method. Iron sulfamethoxazole complex showed a remarkable inhibition of bacteria growth especially on Staphylococcus aureus and P. aeruginosa. The iron metronidazole complex is active against yeasts especially on Candida tropicalis strain. Nickel complexes presented different antibacterial and antifungal behavior's against bacteria and fungal. The acute toxicity study revealed that the iron complexes are not toxic at 2000 mg/kg dose orally administrated. LD50 for nickel complexes was determined using graphical method. No significant differences in the body weights between the control and the treated groups of both rat sexes in subacute toxicity study using for iron complexes. Hematological and clinical blood chemistry analysis revealed no toxicity effects of the iron complexes. Pathologically, neither gross abnormalities nor histopathological changes were observed for these complexes. Copyright © 2013 Elsevier GmbH. All rights

  16. Complex heterogeneous tissue constructs containing multiple cell types prepared by inkjet printing technology.

    Science.gov (United States)

    Xu, Tao; Zhao, Weixin; Zhu, Jian-Ming; Albanna, Mohammad Z; Yoo, James J; Atala, Anthony

    2013-01-01

    This study was designed to develop a versatile method for fabricating complex and heterogeneous three-dimensional (3D) tissue constructs using simultaneous ink-jetting of multiple cell types. Human amniotic fluid-derived stem cells (hAFSCs), canine smooth muscle cells (dSMCs), and bovine aortic endothelial cells (bECs), were separately mixed with ionic cross-linker calcium chloride (CaCl(2)), loaded into separate ink cartridges and printed using a modified thermal inkjet printer. The three cell types were delivered layer-by-layer to pre-determined locations in a sodium alginate-collagen composite located in a chamber under the printer. The reaction between CaCl(2) and sodium alginate resulted in a rapid formation of a solid composite gel and the printed cells were anchored in designated areas within the gel. The printing process was repeated for several cycles leading to a complex 3D multi-cell hybrid construct. The biological functions of the 3D printed constructs were evaluated in vitro and in vivo. Each of the printed cell types maintained their viability and normal proliferation rates, phenotypic expression, and physiological functions within the heterogeneous constructs. The bioprinted constructs were able to survive and mature into functional tissues with adequate vascularization in vivo. These findings demonstrate the feasibility of fabricating complex heterogeneous tissue constructs containing multiple cell types using inkjet printing technology. Copyright © 2012 Elsevier Ltd. All rights reserved.

  17. Azobenzene Pd(II) complexes with N^N- and N^O-type ligands

    Science.gov (United States)

    Nikolaeva, M. V.; Puzyk, An. M.; Puzyk, M. V.

    2017-05-01

    Methods of synthesis of cyclometalated azobenzene palladium(II) complexes of [Pd(N^N)Azb]ClO4 and [Pd(N^O)Azb]ClO4 types (where Azb- is the deprotonated form of azobenzene; N^N is 2NH3, ethylenediamine, or 2,2'-bipyridine; and (N^O)- is the deprotonated form of amino acid (glycine, α-alanine, β-alanine, tyrosine, or tryptophan)) are developed. The electronic absorption and the electrochemical properties of these complexes are studied.

  18. Influence of distal entry tears in acute type B aortic dissection after thoracic endovascular aortic repair.

    Science.gov (United States)

    Zhu, Chenmou; Huang, Bin; Zhao, Jichun; Ma, Yukui; Yuan, Ding; Yang, Yi; Xiong, Fei; Wang, Tiehao

    2017-08-01

    This study evaluated the clinical influence of distal entry tears in acute type B aortic dissection (ATBAD) after thoracic endovascular aortic repair (TEVAR). From August 2009 to December 2014, the clinical outcomes of 130 patients who underwent TEVAR for ATBAD were retrospectively analyzed. According to whether distal entry tears existed after TEVAR, patients were divided into group A (n = 25, absence of distal entry tears) and group B (n = 105, presence of distal entry tears). We evaluated clinical outcomes, including mortality and morbidity in early and late follow-up, as well as aortic remolding. Late aortic events were defined as aortic dissection-related events occurring >30 days from the initial TEVAR procedures, which consisted of endoleak, retrograde type A aortic dissection, aortic enlargement, late rupture, repeat dissection, and stent-induced new entry tear. The study comprised 130 patients (114 men [87.7%] and 16 women [12.3%)] with a mean age of 53.71 years. The 30-day mortality was 3.1%, and early morbidity included type I endoleak, 3.1%, organ failure, 3.8%; stroke, 3.1%; spinal cord ischemia, 0%; and early rupture 1.5%. The overall survival rate by Kaplan-Meier analysis at 1, 3, and 5 years was 93.8%, 89.5%, and 79.2%, respectively. There were no significant differences in early morbidity and 30-day mortality and late survival between group A and group B. However, group A had a significantly lower rate of late aortic events than group B (P = .028 by log-rank test). Meanwhile, group A had better aortic remolding than group B in complete thrombosis of the thoracic aorta at 12 months postoperatively (100% vs 83.5%; P = .029). This study demonstrated that TEVAR for ATBAD had low perioperative morbidity and mortality and satisfactory midterm outcome. Distal entry tears increase the occurrence of late aortic events and inhibit aortic remolding but do not have a significantly negative effect on late survival. Repairing all entry tears to restore

  19. Advances in diagnosis and treatment of hepatorenal syndrome type of acute kidney injury in patients with liver cirrhosis

    Directory of Open Access Journals (Sweden)

    SONG Tingxue

    2017-03-01

    Full Text Available Acute kidney injury (AKI is a common complication of liver cirrhosis and mainly manifests as a rapidly elevated serum creatinine level, a reduced glomerular filtration rate, and oliguria or anuria. Type 1 hepatorenal syndrome (HRS-1 is a special type of AKI, and patients with untreated HRS-1 have an extremely high risk of death. Early diagnosis and treatment are of great importance. This paper summarizes the latest diagnostic criteria for hepatorenal syndrome (HRS type of AKI and research advances in the treatment of HRS-1.

  20. Aortic root reconstruction by aortic valve-sparing operation (David type I reimplantation) in Marfan syndrome accompanied by annuloaortic ectasia and acute type-A aortic dissection.

    Science.gov (United States)

    Inamura, Shunichi; Furuya, Hidekazu; Yagi, Kentarou; Ikeya, Eriko; Yamaguchi, Masaomi; Fujimura, Takabumi; Kanabuchi, Kazuo

    2006-09-20

    To reconstruct the aortic root for aneurysm of the ascending aorta accompanied by aortic regurgitation, annuloaortic ectasia (AAE) and acute type-A dissection with root destruction, the Bentall operation using a prosthetic valve still is the standard procedure today. Valve-sparing procedures have actively been used for aortic root lesions, and have also been attempted in aortic root reconstruction for Marfan syndrome which may have abnormalities in the valve leaflets. We conducted a valve-sparing procedure in a female patient with Marfan syndrome who had AAE accompanied by type-A acute aortic dissection. The patient was a 37-year-old woman complaining of severe pain from the chest to the back. The limbs were long, and funnel breast was observed. Diastolic murmurs were heard. On chest computed tomography, a dissection cavity was present from the ascending aorta to the left common iliac artery, and the root dilated to 55 mm. Grade II aortic regurgitation was observed on ultrasound cardiography. Regarding her family history, her father had died suddenly at 54 years of age. She was diagnosed with type-A acute dissection concurrent with Marfan syndrome and AAE. The structure of the aortic valve was normal, and root reconstruction by a valve-sparing operation and total replacement of the aortic arch was conducted. On postoperative ultrasound cardiography, the aortic regurgitation was within the allowable range, and the shortterm postoperative results were good.

  1. Disentangling the effect of illness perceptions on health status in people with type 2 diabetes after an acute coronary event.

    Science.gov (United States)

    Vos, Rimke Cathelijne; Kasteleyn, Marise Jeannine; Heijmans, Monique Johanna; de Leeuw, Elke; Schellevis, François Georges; Rijken, Mieke; Rutten, Guy Emile

    2018-03-02

    Chronically ill patients such as people with type 2 diabetes develop perceptions of their illness, which will influence their coping behaviour. Perceptions are formed once a health threat has been recognised. Many people with type 2 diabetes suffer from multimorbidity, for example the combination with cardiovascular disease. Perceptions of one illness may influence perceptions of the other condition. The aim of the current study was to evaluate the effect of an intervention in type 2 diabetes patients with a first acute coronary event on change in illness perceptions and whether this mediates the intervention effect on health status. The current study is a secondary data analysis of a RCT. Two hundred one participants were randomised (1:1 ratio) to the intervention (n = 101, three home visits) or control group (n = 100). Outcome variables were diabetes and acute coronary event perceptions, assessed with the two separate Brief Illness Perceptions Questionnaires (BIPQs); and health status (Euroqol Visual Analog Scale (EQ-VAS)). The intervention effect was analysed using ANCOVA. Linear regression analyses were used to assess whether illness perceptions mediated the intervention effect on health status. A positive intervention effect was found on the BIPQ diabetes items coherence and treatment control (F = 8.19, p = 0.005; F = 14.01, p event, a positive intervention effect on treatment control was found (F = 7.81, p = 0.006). No intervention effect was found on the other items of the acute coronary event BIPQ. Better diabetes coherence was associated with improved health status, whereas perceiving more treatment control was not. The mediating effect of the diabetes perception 'coherence' on health status was not significant. Targeting illness perceptions of people with diabetes after an acute coronary event has no effect on most domains, but can improve the perceived understanding of their diabetes. Discussing perceptions prevents people

  2. [Asthenic syndrome in clinical course of acute period of brain concussion during complex treatment using nootropic agents].

    Science.gov (United States)

    Tkachov, A V

    2008-01-01

    The comparative analysis of a complex examination of 108 persons aged from 16 till 60 years in acute period of closed craniocerebral injury (CCCT) has been done. Every participants have been divided into 2 groups depending on a nootrop medication they receive in a complex treatment. A control group consisted of 30 practically healthy people. Objective examination by means of tests was done on the 1-st, 10-th that 30-th day of treatment. Patients of 1-st (37 persons) group received piracetam in complex treatment and patients of the 2-nd group (71 persons) pramistar. Patients of the first group received a base treatment (analgetics, tranquilizers, vitamins of group B, magnesium sulfate, diuretic preparations) as well as piracetam at dosage 0.2, two tablets three times per day. The Patients of the 2-nd group received a base treatment as well as pramistar at dosage 0.6, one tablet 2 times per day. Specially developed multiaspects scales and questionnaires, MRT of the brain and EEG have been used for objectification of patient, complaints. During a complex clinico-neuropsychological examination it was found that all cases of concussion of the brain are accompanied by those or other asthenic disorders.

  3. Molecular Assembly of Clostridium botulinum progenitor M complex of type E.

    Science.gov (United States)

    Eswaramoorthy, Subramaniam; Sun, Jingchuan; Li, Huilin; Singh, Bal Ram; Swaminathan, Subramanyam

    2015-12-07

    Clostridium botulinum neurotoxin (BoNT) is released as a progenitor complex, in association with a non-toxic-non-hemagglutinin protein (NTNH) and other associated proteins. We have determined the crystal structure of M type Progenitor complex of botulinum neurotoxin E [PTC-E(M)], a heterodimer of BoNT and NTNH. The crystal structure reveals that the complex exists as a tight, interlocked heterodimer of BoNT and NTNH. The crystal structure explains the mechanism of molecular assembly of the complex and reveals several acidic clusters at the interface responsible for association at low acidic pH and disassociation at basic/neutral pH. The similarity of the general architecture between the PTC-E(M) and the previously determined PTC-A(M) strongly suggests that the progenitor M complexes of all botulinum serotypes may have similar molecular arrangement, although the neurotoxins apparently can take very different conformation when they are released from the M complex.

  4. Double lumbosacral lipomas of the dorsal and filar types associated with OEIS complex: case report.

    Science.gov (United States)

    Tokunaga, So; Morioka, Takato; Hashiguchi, Kimiaki; Samura, Kazuhiro; Yoshida, Fumiaki; Miyagi, Yasushi; Yoshiura, Takashi; Yamanouchi, Takeshi; Sasaki, Tomio

    2009-10-01

    A female baby was born at 37 weeks and 6 days gestation by vaginal delivery with omphalocele, exstrophy of the cloaca, and imperforate anus, indicating the presence of OEIS complex, a rare combination of defects consisting of omphalocele (O), exstrophy of the cloaca (E), imperforate anus (I), and spinal deformity (S), associated with lumbosacral lipoma. The most common associated spinal deformity is terminal myelocystocele, and spinal lipoma is rare. Constructive interference in steady-state magnetic resonance imaging clearly revealed double lipomas, a dorsal-type lipoma, located dorsal to the low-lying conus medullaris, and a filar-type lipoma, revealed by a thickened and fatty filum terminale. After recovery from abdominogenital repairs, debulking of the dorsal-type lipoma and untethering of the spinal cord by sectioning of the filar-type lipoma were performed at the age of 14 months. Neurosurgical treatment for occult spinal dysraphism should be undertaken after recovery from the initial series of major abdominogenital procedures.

  5. Determination of entry site for acute type A aortic dissection by initial enhanced CT-scan

    Energy Technology Data Exchange (ETDEWEB)

    Mase, Takenori; Narumiya, Chihiro; Aoyama, Takahiko; Nagata, Yoshihisa [Aichi Medical Univ., Nagakute (Japan). School of Medicine

    2002-01-01

    Acute type A aortic dissection presents a surgical emergency because conservative therapy is not effective in the majority of instances. Enhanced CT-scan of the chest is commonly available and is considered to be an optimal diagnostic method for this disease. The operative strategy is to resect the primary tear to close the entry site of the aortic dissection and replace it with a tubular Dacron graft. Therefore, the existence of the entry site is important in determining the operative procedure. Based on the numerical value of the enhanced CT-scan inspection, the present study seeks to preoperatively identify the location of the presumed entry site in aortic dissection. From May 1996 to June 1999, 21 consecutive patients (Marfan's syndrome excluded) with acute type A aortic dissection underwent surgical treatment. Nineteen patients were preoperatively examined by enhanced CT-scan: 11 men and 8 women, with a mean age of 61 years. CT-scan slices used for early diagnosis were of the ascending aorta, aortic arch, descending aorta, and thoracoabdominal aorta. The largest diameters of the whole and true lumen were measured from cross-sectional aortic images with a personal computer, and the areas of the whole and true lumen were obtained by the manual tracing method. The true ratio was calculated for the largest diameter and area of the whole lumen. The nineteen patients were divided into two groups according to the location of the entry site based on the operating views. Seven patients with the entry site in the ascending aorta were classified as group A, and twelve patients with the entry site further in the aortic arch and descending aorta were classified as group B. Comparisons were performed by non-parametric analysis. Moreover, a discriminant analysis was applied to evaluate the classification between the two groups. The ratio of the largest diameter of the true lumen in group A at the level of the ascending and descending aorta was significantly greater than

  6. Determination of entry site for acute type A aortic dissection by initial enhanced CT-scan

    International Nuclear Information System (INIS)

    Mase, Takenori; Narumiya, Chihiro; Aoyama, Takahiko; Nagata, Yoshihisa

    2002-01-01

    Acute type A aortic dissection presents a surgical emergency because conservative therapy is not effective in the majority of instances. Enhanced CT-scan of the chest is commonly available and is considered to be an optimal diagnostic method for this disease. The operative strategy is to resect the primary tear to close the entry site of the aortic dissection and replace it with a tubular Dacron graft. Therefore, the existence of the entry site is important in determining the operative procedure. Based on the numerical value of the enhanced CT-scan inspection, the present study seeks to preoperatively identify the location of the presumed entry site in aortic dissection. From May 1996 to June 1999, 21 consecutive patients (Marfan's syndrome excluded) with acute type A aortic dissection underwent surgical treatment. Nineteen patients were preoperatively examined by enhanced CT-scan: 11 men and 8 women, with a mean age of 61 years. CT-scan slices used for early diagnosis were of the ascending aorta, aortic arch, descending aorta, and thoracoabdominal aorta. The largest diameters of the whole and true lumen were measured from cross-sectional aortic images with a personal computer, and the areas of the whole and true lumen were obtained by the manual tracing method. The true ratio was calculated for the largest diameter and area of the whole lumen. The nineteen patients were divided into two groups according to the location of the entry site based on the operating views. Seven patients with the entry site in the ascending aorta were classified as group A, and twelve patients with the entry site further in the aortic arch and descending aorta were classified as group B. Comparisons were performed by non-parametric analysis. Moreover, a discriminant analysis was applied to evaluate the classification between the two groups. The ratio of the largest diameter of the true lumen in group A at the level of the ascending and descending aorta was significantly greater than that

  7. Plasma B-type natriuretic peptide concentration for diagnosis of acute heart failure with renal insufficiency

    Directory of Open Access Journals (Sweden)

    Naila Atik Khan

    2016-07-01

    Full Text Available Background : Plasma B-type natriuretic peptide (BNP is the diagnostic tool for acute heart failure (AHF.This natriu­retic peptide level depends on renal function, through renal metabolism and excretion. Therefore we examined the effect ofrenal impairment on plasma BNP level during diagnosis of AHF.Objective: The objective of the study was to assess the effect of renal dysfunction on plasma BNP level and to determine appropriate cutoff value of plasma BNP to diagnose the patients of AHF with renal insufficiency.Methods: This cross sectional analytical study was conducted in the Depart­ment of Biochemistry Bangabandhu Sheikh Mujib Medical University (BSMMU. The study was done among 90 AHF patients selected from cardiology emergency department during the period of July 2012 to June 2013. After enrollment plasma BNP concentration was measured and eGFR was estimated from serum creatinine by the four parameter Modifica­tion of Diet and Renal Disease (MORD equation and then grouped into two groups on the basis of empirical cut off value of eGFR 60 ml/min/1.73 m2Results: In this study a significant negative correlation was found between plasma BNP evel and eGFR (P<0.001 , with higher BNP levels observed as eGFR declined. The optimal BNP cutoff value for diagno­sis of AHF patients with renal insufficiency was 824 pg/ml. At this cutoff level AHF with renal insufficiency could be diagnosed with sensitivity and specificity of 84% and 71 %, respectively.Conclusions: By adjusting the cutoff value, plasma BNP can be used to diagnose AHF with renal insufficiency with an acceptable sensitivity and specificity.

  8. [Types of Care for Adult Patients Diagnosed With Acute and Maintenance Phase Schizophrenia].

    Science.gov (United States)

    Bohórquez Peñaranda, Adriana; Gómez Restrepo, Carlos; Oviedo Lugo, Gabriel Fernando; de la Hoz Bradford, Ana María; Castro Díaz, Sergio Mario; García Valencia, Jenny; Jaramillo González, Luis Eduardo; Ávila-Guerra, Mauricio

    2014-01-01

    To assist the clinician in making decisions about the types of care available for adults with schizophrenia. To determine which are the modalities of treatment associated with better outcomes in adults with schizophrenia. A clinical practice guideline was elaborated under the parameters of the Methodological Guide of the Ministerio de Salud y Protección Social to identify, synthesize and evaluate the evidence and make recommendations about the treatment and follow-up of adult patients with schizophrenia. The evidence of NICE guide 82 was adopted and updated. The evidence was presented to the Guideline Developing Group and recommendations, employing the GRADE system, were produced. Patients who were in Assertive community treatment had a lower risk of new hospitalizations. For the intensive case management, the results favored this intervention in the outcomes: medium term readmissions, social functioning and satisfaction with services. The crisis resolution teams was associated with better outcomes on outcomes of readmissions, social functioning and service satisfaction in comparison with standard care. The use of different modalities of care leads to the need of a comprehensive approach to patients to reduce the overall disability associated with the disease. Evidence shows overall benefit for most outcomes studied without encountering hazards for health of patients. This evaluation is recommended to use the professional ways of providing health services that are community-based and have a multidisciplinary group. It is not recommended the modality "day hospital" during the acute phase of schizophrenia in adults. Copyright © 2014 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

  9. Exploring the Variability in Acute Glycemic Responses to Exercise in Type 2 Diabetes

    Directory of Open Access Journals (Sweden)

    Tasuku Terada

    2013-01-01

    Full Text Available Aim. To explore the factors associated with exercise-induced acute capillary glucose (CapBG changes in individuals with type 2 diabetes (T2D. Methods. Fifteen individuals with T2D were randomly assigned to energy-matched high intensity interval exercise (HI-IE and moderate intensity continuous exercise (MI-CE interventions and performed a designated exercise protocol 5 days per week for 12 weeks. The duration of exercise progressed from 30 to 60 minutes. CapBG was measured immediately before and after each exercise session. Timing of food and antihyperglycemic medication intake prior to exercise was recorded. Results. Overall, the mean CapBG was lowered by 1.9 mmol/L (P<0.001 with the change ranging from −8.9 to +2.7 mmol/L. Preexercise CapBG (44%; P<0.001, medication (5%; P<0.001, food intake (4%; P=0.043, exercise duration (5%; P<0.001, and exercise intensity (1%; P=0.007 were all associated with CapBG changes, explaining 59% of the variability. Conclusion. The greater reduction in CapBG seen in individuals with higher preexercise CapBG may suggest the importance of exercise in the population with elevated glycemia. Lower blood glucose can be achieved with moderate intensity exercise, but prolonging exercise duration and/or including brief bouts of intense exercise accentuate the reduction, which can further be magnified by performing exercise after meals and antihyperglycemic medication. This trial is registered with ClinicalTrial.gov NCT01144078.

  10. Exercise Metabolism in Nonobese Patients with Type 2 Diabetes Following the Acute Restoration of Normoglycaemia

    Directory of Open Access Journals (Sweden)

    Christopher J. Gaffney

    2017-01-01

    Full Text Available This study investigated how acute restoration of normoglycaemia affected energy metabolism during exercise in nonobese patients with type 2 diabetes. Six subjects (mean ± SEM aged 56.2 ± 2.7 years, with a BMI of 24.5 ± 1.5 kg/m2 and a VO2 peak of 28.7 ml/kg/min, attended the lab on two randomised occasions for a four-hour resting infusion of insulin or saline, followed by 30 minutes cycling at 50% VO2 peak. During the 4 h resting infusion, there was a greater (P<0.0001 reduction in blood glucose in insulin treatment (INS (from 11.2 ± 0.6 to 5.6 ± 0.1 mmol/l than in saline treatment/control (CON (from 11.5 ± 0.7 to 8.5 ± 0.6 mmol/l. This was associated with a lower (P<0.05 resting metabolic rate in INS (3.87 ± 0.17 than in CON (4.39 ± 0.30 kJ/min. During subsequent exercise, blood glucose increased significantly in INS from 5.6 ± 0.1 at 0 min to 6.3 ± 0.3 mmol/l at 30 min (P<0.01, which was accompanied by a lower blood lactate response (P<0.05. Oxygen uptake, rates of substrate utilization, heart rate, and ratings of perceived exertion were not different between trials. Insulin-induced normoglycaemia increased blood glucose during subsequent exercise without altering overall substrate utilization.

  11. Perpetual Learning Framework based on Type-2 Fuzzy Logic System for a Complex Manufacturing Process

    OpenAIRE

    Baraka, A.; Panoutsos, G.; Cater, S.

    2016-01-01

    This paper introduces a perpetual type-2 Neuro-Fuzzy modelling structure for continuous learning and its application to the complex thermo-mechanical metal process of steel Friction Stir Welding (FSW). The ‘perpetual’ property refers to the capability of the proposed system to continuously learn from new process data, in an incremental learning fashion. This is particularly important in industrial/manufacturing processes, as it eliminates the need to retrain the model in the presence of new d...

  12. Acute phase reactant dynamics and incidence of microvascular dysfunctions in type 2 diabetes mellitus

    Science.gov (United States)

    Azenabor, Alfred; Ogbera, Anthonia O.; Adejumo, Ngozi E.; Adejare, Adejimi O.

    2011-01-01

    BACKGROUND: Acute Phase Reactants (APRs) have a wide range of activities that contribute to host defense. The aim of this report was to evaluate the dynamics and magnitude of these proteins in various microvascular complications in diabetes mellitus (DM). We also sought to assess the predictive values of APRs and other clinical variables for microvascular complications in DM. METHODS: This was a case control study carried out in 200 Nigerian subjects with type 2 DM and 100 sex and age matched healthy controls. The studied APRs included C-reactive protein, beta 2 microglobulin, fibrinogen and lipoprotein (a). RESULTS: The mean values of the APRs were significantly higher in type 2 DM compared with the controls and were observed in higher concentrations in those with microvascular complications, except beta 2 microglobulin. Presence of microvascular complications was observed in those with dilated fundus examination (retinopathy), symptom score of 3.0 (neuropathy), urea and creatinine levels above 50mg% and 1.5mg%, respectively, with significant proteinuria (nephropathy). Significant increase in mean ± SEM values of lipoprotein (a) was observed in diabetic retinopathy in comparison with those without complications (25.76 ± 1.13 mg/dl vs. 22.37 ± 0.73 mg/dl, p = 0.005). Elevated C-reactive protein was observed in diabetic neuropathy in comparison with those without complications (11.43 ± 2.33 u/ml vs. 8.30 ± 1.15 u/ml, p = 0.048). Increased beta 2 microglobulin levels were observed in patients with diabetic foot ulcers in comparison with those without complications (3.04 ± 0.51 mg/dl vs. 2.54 ± 0.14 mg/dl, p = 0.049). Circulating levels of Lipoprotein (a) predicted retinopathy in DM with both good and poor long-term glycemic control while duration of DM predicted the occurrence of foot ulcers.. CONCLUSIONS: Increased level of APRs was associated with a number of microvascular complications and may play a role in the pathogenesis. PMID:22973323

  13. Gender-Related Differences in Presentation and Outcome of Acute Type a Aortic Dissection

    Directory of Open Access Journals (Sweden)

    Leili Pourafkari

    2017-09-01

    Full Text Available Background: Although acute type-A aortic dissection (AAOD is more common in males, the course of the disease may differ in females. Objectives: We aimed to investigate the gender-related differences in patients with AAOD with regard to clinical presentation, short-term and long-term mortality. Patients and Methods: Medical records of 192 patients with a confirmed diagnosis of AAOD in a University Heart Center from March 2004 through October 2015 were evaluated. Clinical information, hospital mortality, and long-term survival were explored with regard to gender. Propensity matching was performed to adjust for baseline differences. Kaplan-Meier survival analysis was used to determine the impact of gender on long-term mortality. Results: Among 192 patients, 71 (37.0% were females. The women were older (65.7 ± 13.8 vs. 53.9 ± 15.1 years, P < 0.001. Hypertension (77.5% vs. 56.7%; P = 0.006 and diabetes mellitus (12.7% vs. 0.1%; P = 0.001 were more common among women than men, while active smoking was significantly more prevalent in men (46.7% vs. 9.9%; P < 0.001. The frequency of various clinical presentations was not different between the two groups. Among men, 71.7% were surgically managed compared to 67.6% among women. In-hospital mortality was 50.7% in women and 42.1% in men and remained statistically similar after matching. For long-term survival female to male hazard ratio (HR was 1.24 with 95% CI: 0.85 - 1.81 (P = 0.257, which basically remained unchanged after propensity matching, HR was 1.13, 95%CI: 0.73 - 1.73 (P = 0.300. Conclusions: In patients admitted with AAOD, there was no gender-related differences in clinical presentation and type of management. Similarly, hospital and long-term mortality did not differ with regard to gender.

  14. Types and prevalence of carbapenem-resistant Acinetobacter calcoaceticus-Acinetobacter baumannii complex in Northern Taiwan.

    Science.gov (United States)

    Hsieh, Wen-Shyang; Wang, Nai-Yu; Feng, Jou-An; Weng, Li-Chuan; Wu, Hsueh-Hsia

    2014-01-01

    The frequency of the carbapenem-resistant Acinetobacter calcoaceticus-Acinetobacter baumannii (CRACB) complex increases annually in our hospitals. However, the types and prevalence of carbapenemases among isolates still remain unclear. In this study, we identified and collected 672 carbapenem-resistant isolates from a medical center in Northern Taiwan between April and December of 2010. There were 577 genospecies 2 (Acinetobacter baumannii), 79 genospecies 13TU, and 16 genospecies 3 isolates. The isolates had an acquired blaOXA-24-like gene, which was confirmed by sequencing for the encoded OXA-72 carbapenemase, and were often associated with high-level carbapenem resistance. These CRACB complex isolates remained susceptible to colistin (100%). The genotyping of isolates was conducted using pulsed-field gel electrophoresis with ApaI digestion. In most clonally related groups, patients were from both branch hospitals. The results indicate that interhospital dissemination of clones occurred. This study provides updated data on the types and prevalence of the CRACB complex. In addition, it presents a warning on the emergence and spread of CRACB complex harboring blaOXA-24-like genes in northern Taiwan.

  15. The number of cell types, information content, and the evolution of complex multicellularity

    Directory of Open Access Journals (Sweden)

    Karl J. Niklas

    2014-12-01

    Full Text Available The number of different cell types (NCT characterizing an organism is often used to quantify organismic complexity. This method results in the tautology that more complex organisms have a larger number of different kinds of cells, and that organisms with more different kinds of cells are more complex. This circular reasoning can be avoided (and simultaneously tested when NCT is plotted against different measures of organismic information content (e.g., genome or proteome size. This approach is illustrated by plotting the NCT of representative diatoms, green and brown algae, land plants, invertebrates, and vertebrates against data for genome size (number of base-pairs, proteome size (number of amino acids, and proteome functional versatility (number of intrinsically disordered protein domains or residues. Statistical analyses of these data indicate that increases in NCT fail to keep pace with increases in genome size, but exceed a one-to-one scaling relationship with increasing proteome size and with increasing numbers of intrinsically disordered protein residues. We interpret these trends to indicate that comparatively small increases in proteome (and not genome size are associated with disproportionate increases in NCT, and that proteins with intrinsically disordered domains enhance cell type diversity and thus contribute to the evolution of complex multicellularity.

  16. Neurally adjusted ventilatory assist increases respiratory variability and complexity in acute respiratory failure.

    Science.gov (United States)

    Schmidt, Matthieu; Demoule, Alexandre; Cracco, Christophe; Gharbi, Alexandre; Fiamma, Marie-Noëlle; Straus, Christian; Duguet, Alexandre; Gottfried, Stewart B; Similowski, Thomas

    2010-03-01

    Neurally adjusted ventilatory assist (NAVA) is a partial ventilatory support mode where positive pressure is provided in relation to diaphragmatic electrical activity (EAdi). Central inspiratory activity is normally not monotonous, but it demonstrates short-term variability and complexity. The authors reasoned that NAVA should produce a more "natural" or variable breathing pattern than other modes. This study compared respiratory variability and complexity during pressure support ventilation (PSV) and NAVA. Flow and EAdi were recorded during routine PSV (tidal volume approximately 6-8 ml/kg) and four NAVA levels (1-4 cm H2O/microVEAdi) in 12 intubated patients. Breath-by-breath variability of flow and EAdi-related variables was quantified by the coefficient of variation (CV) and autocorrelation analysis. Complexity of flow and EAdi was described using noise titration, largest Lyapunov exponent, Kolmogorov-Sinai entropy, and three-dimensional phase portraits. Switching from PSV to NAVA increased the CV and decreased the autocorrelation for most flow-related variables in a dose-dependent manner (P Kolmogorov-Sinai entropy for flow were greater during NAVA than PSV and increased with NAVA level (P Kolmogorov-Sinai entropy for EAdi were not influenced by ventilator mode. Compared with PSV, NAVA increases the breathing pattern variability and complexity of flow, whereas the complexity of EAdi is unchanged. Whether this improves clinical outcomes remains to be determined.

  17. Acute Type II Aortic Dissection with Severe Aortic Regurgitation and Chronic Descending Aortic Dissection in Pregnant Patient with Marfan Syndrome

    OpenAIRE

    Lee, Seok-Soo; Jung, Tae-Eun; Lee, Dong Hyup

    2012-01-01

    Aortic dilatation and dissection are severe complications during pregnancy that can be fatal to both the mother and the fetus. The risks of these complications are especially high in pregnant patients with Marfan syndrome; however, incidents of descending aortic dissection are very rare. This case report involves a successful Bentall procedure for and recovery from a rare aortic dissection in a pregnant Marfan patient who developed acute type II aortic dissection with severe aortic regurgitat...

  18. Development and validation of a predictive model of acute glucose response to exercise in individuals with type 2 diabetes

    OpenAIRE

    Gibson, Bryan S; Colberg, Sheri R; Poirier, Paul; Vancea, Denise Maria Martins; Jones, Jason; Marcus, Robin

    2013-01-01

    Background Our purpose was to develop and test a predictive model of the acute glucose response to exercise in individuals with type 2 diabetes. Design and methods Data from three previous exercise studies (56 subjects, 488 exercise sessions) were combined and used as a development dataset. A mixed-effects Least Absolute Shrinkage Selection Operator (LASSO) was used to select predictors among 12 potential predictors. Tests of the relative importance of each predictor were conducted using the ...

  19. Developing complex interventions: lessons learned from a pilot study examining strategy training in acute stroke rehabilitation.

    Science.gov (United States)

    Skidmore, Elizabeth R; Dawson, Deirdre R; Whyte, Ellen M; Butters, Meryl A; Dew, Mary Amanda; Grattan, Emily S; Becker, James T; Holm, Margo B

    2014-04-01

    To examine the feasibility of a strategy training clinical trial in a small group of adults with stroke-related cognitive impairments in inpatient rehabilitation, and to explore the impact of strategy training on disability. Non-randomized two-group intervention pilot study. Two inpatient rehabilitation units within an academic health centre. Individuals with a primary diagnosis of acute stroke, who were admitted to inpatient rehabilitation and demonstrated cognitive impairments were included. Individuals with severe aphasia; dementia; major depressive disorder, bipolar, or psychotic disorder; recent drug or alcohol abuse; and anticipated length of stay less than five days were excluded. Participants received strategy training or an attention control session in addition to usual rehabilitation care. Sessions in both groups were 30-40 minutes daily, five days per week, for the duration of inpatient rehabilitation. We assessed feasibility through participants' recruitment and retention; research intervention session number and duration; participants' comprehension and engagement; intervention fidelity; and participants' satisfaction. We assessed disability at study admission, inpatient rehabilitation discharge, 3 and 6 months using the Functional Independence Measure. Participants in both groups (5 per group) received the assigned intervention (>92% planned sessions; >94% fidelity) and completed follow-up testing. Strategy training participants in this small sample demonstrated significantly less disability at six months (M (SE) = 117 (3)) than attention control participants (M(SE) = 96 (14); t 8 = 7.87, P = 0.02). It is feasible and acceptable to administer both intervention protocols as an adjunct to acute inpatient rehabilitation, and strategy training shows promise for reducing disability.

  20. Different Types of nsP3-Containing Protein Complexes in Sindbis Virus-Infected Cells▿

    Science.gov (United States)

    Gorchakov, Rodion; Garmashova, Natalia; Frolova, Elena; Frolov, Ilya

    2008-01-01

    Alphaviruses represent a serious public health threat and cause a wide variety of diseases, ranging from severe encephalitis, which can result in death or neurological sequelae, to mild infection, characterized by fever, skin rashes, and arthritis. In the infected cells, alphaviruses express only four nonstructural proteins, which function in the synthesis of virus-specific RNAs and in modification of the intracellular environment. The results of our study suggest that Sindbis virus (SINV) infection in BHK-21 cells leads to the formation of at least two types of nsP3-containing complexes, one of which was found in association with the plasma membrane and endosome-like vesicles, while the second was coisolated with cell nuclei. The latter complexes could be solubilized only with the cytoskeleton-destabilizing detergent. Besides viral nsPs, in the mammalian cells, both complexes contained G3BP1 and G3BP2 (which were found in different ratios), YBX1, and HSC70. Rasputin, an insect cell-specific homolog of G3BP1, was found in the nsP3-containing complexes isolated from mosquito cells, which was suggestive of a high conservation of the complexes in the cells of both vertebrate and invertebrate origin. The endosome- and plasma membrane-associated complexes contained a high concentration of double-stranded RNAs (dsRNAs), which is indicative of their function in viral-RNA synthesis. The dsRNA synthesis is likely to efficiently proceed on the plasma membrane, and at least some of the protein-RNA complexes would then be transported into the cytosol in association with the endosome-like vesicular organelles. These findings provide new insight into the mechanism of SINV replication and virus-host cell interactions. PMID:18684830

  1. Different types of nsP3-containing protein complexes in Sindbis virus-infected cells.

    Science.gov (United States)

    Gorchakov, Rodion; Garmashova, Natalia; Frolova, Elena; Frolov, Ilya

    2008-10-01

    Alphaviruses represent a serious public health threat and cause a wide variety of diseases, ranging from severe encephalitis, which can result in death or neurological sequelae, to mild infection, characterized by fever, skin rashes, and arthritis. In the infected cells, alphaviruses express only four nonstructural proteins, which function in the synthesis of virus-specific RNAs and in modification of the intracellular environment. The results of our study suggest that Sindbis virus (SINV) infection in BHK-21 cells leads to the formation of at least two types of nsP3-containing complexes, one of which was found in association with the plasma membrane and endosome-like vesicles, while the second was coisolated with cell nuclei. The latter complexes could be solubilized only with the cytoskeleton-destabilizing detergent. Besides viral nsPs, in the mammalian cells, both complexes contained G3BP1 and G3BP2 (which were found in different ratios), YBX1, and HSC70. Rasputin, an insect cell-specific homolog of G3BP1, was found in the nsP3-containing complexes isolated from mosquito cells, which was suggestive of a high conservation of the complexes in the cells of both vertebrate and invertebrate origin. The endosome- and plasma membrane-associated complexes contained a high concentration of double-stranded RNAs (dsRNAs), which is indicative of their function in viral-RNA synthesis. The dsRNA synthesis is likely to efficiently proceed on the plasma membrane, and at least some of the protein-RNA complexes would then be transported into the cytosol in association with the endosome-like vesicular organelles. These findings provide new insight into the mechanism of SINV replication and virus-host cell interactions.

  2. Spectroscopic, thermal analysis and DFT computational studies of salen-type Schiff base complexes

    Science.gov (United States)

    Ebrahimi, Hossein Pasha; Hadi, Jabbar S.; Abdulnabi, Zuhair A.; Bolandnazar, Zeinab

    2014-01-01

    A new series of metal(II) complexes of Co(II), Ni(II), Cu(II), Zn(II), and Pb(II) have been synthesized from a salen-type Schiff base ligand derived from o-vanillin and 4-methyl-1,2-phenylenediamine and characterized by elemental analysis, spectral (IR, UV-Vis, 1H NMR, 13C NMR and EI-mass), molar conductance measurements and thermal analysis techniques. Coats-Redfern method has been utilized to calculate the kinetic and thermodynamic parameters of the metal complexes. The molecular geometry, Mulliken atomic charges of the studied compounds were investigated theoretically by performing density functional theory (DFT) to access reliable results to the experimental values. The theoretical 13C chemical shift results of the studied compounds have been calculated at the B3LYP, PBEPBE and PW91PW91 methods and standard 6-311+G(d,p) basis set starting from optimized geometry. The comparison of the results indicates that B3LYP/6-311+G(d,p) yields good agreement with the observed chemical shifts. The measured low molar conductance values in DMF indicate that the metal complexes are non-electrolytes. The spectral and thermal analysis reveals that all complexes have octahedral geometry except Cu(II) complex which can attain the square planner arrangement. The presence of lattice and coordinated water molecules are indicated by thermograms of the complexes. The thermogravimetric (TG/DTG) analyses confirm high stability for all complexes followed by thermal decomposition in different steps.

  3. Tailor-made rehabilitation approach using multiple types of hybrid assistive limb robots for acute stroke patients: A pilot study.

    Science.gov (United States)

    Fukuda, Hiroyuki; Morishita, Takashi; Ogata, Toshiyasu; Saita, Kazuya; Hyakutake, Koichi; Watanabe, Junko; Shiota, Etsuji; Inoue, Tooru

    2016-01-01

    This article investigated the feasibility of a tailor-made neurorehabilitation approach using multiple types of hybrid assistive limb (HAL) robots for acute stroke patients. We investigated the clinical outcomes of patients who underwent rehabilitation using the HAL robots. The Brunnstrom stage, Barthel index (BI), and functional independence measure (FIM) were evaluated at baseline and when patients were transferred to a rehabilitation facility. Scores were compared between the multiple-robot rehabilitation and single-robot rehabilitation groups. Nine hemiplegic acute stroke patients (five men and four women; mean age 59.4 ± 12.5 years; four hemorrhagic stroke and five ischemic stroke) underwent rehabilitation using multiple types of HAL robots for 19.4 ± 12.5 days, and 14 patients (six men and eight women; mean age 63.2 ± 13.9 years; nine hemorrhagic stroke and five ischemic stroke) underwent rehabilitation using a single type of HAL robot for 14.9 ± 8.9 days. The multiple-robot rehabilitation group showed significantly better outcomes in the Brunnstrom stage of the upper extremity, BI, and FIM scores. To the best of the authors' knowledge, this is the first pilot study demonstrating the feasibility of rehabilitation using multiple exoskeleton robots. The tailor-made rehabilitation approach may be useful for the treatment of acute stroke.

  4. Acute Effects of Morning Light on Plasma Glucose and Triglycerides in Healthy Men and Men with Type 2 Diabetes

    Science.gov (United States)

    Versteeg, Ruth I.; Stenvers, Dirk J.; Visintainer, Dana; Linnenbank, Andre; Tanck, Michael W.; Zwanenburg, Gooitzen; Smilde, Age K.; Fliers, Eric; Kalsbeek, Andries; Serlie, Mireille J.; la Fleur, Susanne E.; Bisschop, Peter H.

    2017-01-01

    Ambient light intensity is signaled directly to hypothalamic areas that regulate energy metabolism. Observational studies have shown associations between ambient light intensity and plasma glucose and lipid levels, but human data on the acute metabolic effects of light are scarce. Since light is the main signal indicating the onset of the diurnal phase of physical activity and food intake in humans, we hypothesized that bright light would affect glucose and lipid metabolism. Therefore, we determined the acute effects of bright light on plasma glucose and lipid concentrations in 2 randomized crossover trials: (1) in 8 healthy lean men and (2) in 8 obese men with type 2 diabetes. From 0730 h, subjects were exposed to either bright light (4000 lux) or dim light (10 lux) for 5 h. After 1 h of light exposure, subjects consumed a 600-kcal mixed meal. Primary endpoints were fasting and postprandial plasma glucose levels. In healthy men, bright light did not affect fasting or postprandial plasma glucose levels. However, bright light increased fasting and postprandial plasma triglycerides. In men with type 2 diabetes, bright light increased fasting and postprandial glucose levels. In men with type 2 diabetes, bright light did not affect fasting triglyceride levels but increased postprandial triglyceride levels. We show that ambient light intensity acutely affects human plasma glucose and triglyceride levels. Our findings warrant further research into the consequences of the metabolic effects of light for the diagnosis and prevention of hyperglycemia and dyslipidemia. PMID:28470119

  5. Acute social stress before the planning phase improves memory performance in a complex real life-related prospective memory task.

    Science.gov (United States)

    Glienke, Katharina; Piefke, Martina

    2016-09-01

    Successful execution of intentions, but also the failure to recall are common phenomena in everyday life. The planning, retention, and realization of intentions are often framed as the scientific concept of prospective memory. The current study aimed to examine the influence of acute stress on key dimensions of complex "real life" prospective memory. To this end, we applied a prospective memory task that involved the planning, retention, and performance of intentions during a fictional holiday week. Forty healthy males participated in the study. Half of the subjects were stressed with the Socially Evaluated Cold Pressor Test (SECPT) before the planning of intentions, and the other half of the participants underwent a control procedure at the same time. Salivary cortisol was used to measure the effectiveness of the SECPT stress induction. Stressed participants did not differ from controls in planning accuracy. However, when we compared stressed participants with controls during prospective memory retrieval, we found statistically significant differences in PM across the performance phase. Participants treated with the SECPT procedure before the planning phase showed improved prospective memory retrieval over time, while performance of controls declined. Particularly, there was a significant difference between the stress and control group for the last two days of the holiday week. Interestingly, control participants showed significantly better performance for early than later learned items, which could be an indicator of a primacy effect. This differential effect of stress on performance was also found in time- and event-dependent prospective memory. Our results demonstrate for the first time, that acute stress induced before the planning phase may improve prospective memory over the time course of the performance phase in time- and event-dependent prospective memory. Our data thus indicate that prospective memory can be enhanced by acute stress. Copyright © 2016

  6. Detection of immune-complex-dissociated nonstructural-1 antigen in patients with acute dengue virus infections

    NARCIS (Netherlands)

    P. Koraka (Penelope); C.P. Burghoorn-Maas; A. Falconar; T.E. Setiati (Tatty); K. Djamiatun; J. Groen (Jan); A.D.M.E. Osterhaus (Albert)

    2003-01-01

    textabstractAccurate and timely diagnosis of dengue virus (DEN) infections is essential for the differential diagnosis of patients with febrile illness and hemorrhagic fever. In the present study, the diagnostic value of a newly developed immune-complex dissociated nonstructural-1 (NS-1) antigen dot

  7. Detection of immune-complex-dissociated nonstructural-1 antigen in patients with acute dengue virus infections.

    NARCIS (Netherlands)

    Koraka, P.; Burghoorn-Maas, C.P.; Falconar, A.; Setiati, T.E.; Djamiatun, K.; Groen, J.; Osterhaus, A.D.

    2003-01-01

    Accurate and timely diagnosis of dengue virus (DEN) infections is essential for the differential diagnosis of patients with febrile illness and hemorrhagic fever. In the present study, the diagnostic value of a newly developed immune-complex dissociated nonstructural-1 (NS-1) antigen dot blot

  8. Type A botulinum neurotoxin complex proteins differentially modulate host response of neuronal cells.

    Science.gov (United States)

    Wang, Lei; Sun, Yi; Yang, Weiping; Lindo, Paul; Singh, Bal Ram

    2014-05-01

    Type A Botulinum neurotoxin (BoNT/A), the most potent poison known to mankind, is produced by Clostridium botulinum type A as a complex with neurotoxin-associated proteins (NAPs). Currently BoNT/A in purified and complex forms are both available in therapeutic and cosmetic applications to treat neuromuscular disorders. Whereas Xeomin(®) (incobotulinumtoxin A, Merz Pharmaceuticals, Germany) is free from complexing proteins, Botox(®) (onabotulinumtoxin A, Allergan, USA) contains NAPs, which by themselves have no known role in the intracellular biochemical process involved in the blockade of neurotransmitter release. Since the fate and possible interactions of NAPs with patient tissues after intramuscular injection are not known, it was the aim of this study to evaluate the binding of BoNT/A and/or the respective NAPs to cells derived from neuronal and non-neuronal human tissues, and to further explore neuronal cell responses to different components of BoNT/A. BoNT/A alone, the complete BoNT/A complex, and the NAPs alone, all bind to neuronal SH-SY5Y cells. The BoNT/A complex and NAPs additionally bind to RMS13 skeletal muscle cells, TIB-152 lymphoblasts, Detroit 551 fibroblasts besides the SH-SY5Y cells. However, no binding to these non-neuronal cells was observed with pure BoNT/A. Although BoNT/A, both in its purified and complex forms, bind to SH-SY5Y, the intracellular responses of the SH-SY5Y cells to these BoNT/A components are not clearly understood. Examination of inflammatory cytokine released from SH-SY5Y cells revealed that BoNT/A did not increase the release of inflammatory cytokines, whereas exposure to NAPs significantly increased release of IL-6, and MCP-1, and exposure to BoNT/A complex significantly increased release of IL-6, MCP-1, IL-8, TNF-α, and RANTES vs. control, suggesting that different components of BoNT/A complex induce significantly differential host response in human neuronal cells. Results suggest that host response to different

  9. Molecular and Structural Analysis of the Helicobacter pylori cag Type IV Secretion System Core Complex.

    Science.gov (United States)

    Frick-Cheng, Arwen E; Pyburn, Tasia M; Voss, Bradley J; McDonald, W Hayes; Ohi, Melanie D; Cover, Timothy L

    2016-01-12

    Bacterial type IV secretion systems (T4SSs) can function to export or import DNA, and can deliver effector proteins into a wide range of target cells. Relatively little is known about the structural organization of T4SSs that secrete effector proteins. In this report, we describe the isolation and analysis of a membrane-spanning core complex from the Helicobacter pylori cag T4SS, which has an important role in the pathogenesis of gastric cancer. We show that this complex contains five H. pylori proteins, CagM, CagT, Cag3, CagX, and CagY, each of which is required for cag T4SS activity. CagX and CagY are orthologous to the VirB9 and VirB10 components of T4SSs in other bacterial species, and the other three Cag proteins are unique to H. pylori. Negative stain single-particle electron microscopy revealed complexes 41 nm in diameter, characterized by a 19-nm-diameter central ring linked to an outer ring by spoke-like linkers. Incomplete complexes formed by Δcag3 or ΔcagT mutants retain the 19-nm-diameter ring but lack an organized outer ring. Immunogold labeling studies confirm that Cag3 is a peripheral component of the complex. The cag T4SS core complex has an overall diameter and structural organization that differ considerably from the corresponding features of conjugative T4SSs. These results highlight specialized features of the H. pylori cag T4SS that are optimized for function in the human gastric mucosal environment. Type IV secretion systems (T4SSs) are versatile macromolecular machines that are present in many bacterial species. In this study, we investigated a T4SS found in the bacterium Helicobacter pylori. H. pylori is an important cause of stomach cancer, and the H. pylori T4SS contributes to cancer pathogenesis by mediating entry of CagA (an effector protein regarded as a "bacterial oncoprotein") into gastric epithelial cells. We isolated and analyzed the membrane-spanning core complex of the H. pylori T4SS and showed that it contains unique proteins

  10. Acute myeloid leukemia induced by MLL-ENL is cured by oncogene ablation despite acquisition of complex genetic abnormalities.

    Science.gov (United States)

    Horton, Sarah J; Walf-Vorderwülbecke, Vanessa; Chatters, Steve J; Sebire, Neil J; de Boer, Jasper; Williams, Owen

    2009-05-14

    Chromosomal translocations involving 11q23 are frequent in infant acute leukemia and give rise to the formation of MLL fusion genes. The mechanism of leukemic transformation by these fusions has been the subject of numerous investigations. However, the dependence of acute leukemia on MLL fusion activity in vivo and the efficacy of targeting this activity to eliminate disease have not been established. We have developed a model for conditional expression of MLL-ENL in hematopoietic progenitor cells, in which expression of the fusion oncogene is turned off by doxycycline. Conditionally immortalized myeloblast cells derived from these progenitors were found to induce leukemia in vivo. Leukemic cells isolated from primary recipient mice were shown to have acquired additional genetic abnormalities and, when transplanted into secondary recipients, induced leukemia with shortened latencies. However, the leukemic cells remained dependent on MLL-ENL expression in vitro and in vivo, and its ablation resulted in regression of established leukemias. This study demonstrates that even genetically complex leukemias can be reversed on inactivation of the initiating MLL fusion and has important implications for the design of novel leukemia therapies.

  11. Latex-protein complexes from an acute phase recombinant antigen of Toxoplasma gondii for the diagnosis of recently acquired toxoplasmosis.

    Science.gov (United States)

    Peretti, Leandro E; Gonzalez, Verónica D G; Marcipar, Iván S; Gugliotta, Luis M

    2014-08-01

    The synthesis and characterization of latex-protein complexes (LPC), from the acute phase recombinant antigen P35 (P35Ag) of Toxoplasma gondii and "core-shell" carboxylated or polystyrene (PS) latexes (of different sizes and charge densities) are considered, with the aim of producing immunoagglutination reagents able to detect recently acquired toxoplasmosis. Physical adsorption (PA) and chemical coupling (CC) of P35Ag onto latex particles at different pH were investigated. Greater amounts of adsorbed protein were obtained on PS latexes than on carboxylated latexes, indicating that hydrophobic forces govern the interactions between the protein and the particle surface. In the CC experiments, the highest amount of bound protein was obtained at pH 6, near the isoelectric point of the protein (IP=6.27). At this pH, it decreased both the repulsion between particle surface and protein, and the repulsion between neighboring molecules. The LPC were characterized and the antigenicity of the P35Ag protein coupled on the particles surface was evaluated by Enzyme-Linked ImmunoSorbent Assay (ELISA). Results from ELISA showed that the P35Ag coupled to the latex particles surface was not affected during the particles sensitization by PA and CC and the produced LPC were able to recognize specific anti-P35Ag antibodies present in the acute phase of the disease. Copyright © 2014 Elsevier B.V. All rights reserved.

  12. PS-022 Complex automated medication systems reduce medication administration error rates in an acute medical ward

    DEFF Research Database (Denmark)

    Risør, Bettina Wulff; Lisby, Marianne; Sørensen, Jan

    2017-01-01

    the medication administration error rate in comparison with current practice. Material and methods This was a controlled before and after study with follow-up after 7 and 14 months. The study was conducted in two acute medical hospital wards. Two automated medication systems were tested: (1) automated dispensing...... cabinet, automated dispensing and barcode medication administration; (2) non-patient specific automated dispensing and barcode medication administration. The occurrence of administration errors was observed in three 3 week periods. The error rates were calculated by dividing the number of doses with one....... The complex automated medication system effectively reduced the overall risk of administration errors in the intervention ward (OR 0.53, 95% CI 0.27–0.90), and the procedural error rate was also significantly reduced (OR 0.44, 95% CI 0.126–0.94). The non-patient specific automated medication system...

  13. Core transcriptional regulatory circuit controlled by the TAL1 complex in human T cell acute lymphoblastic leukemia.

    Science.gov (United States)

    Sanda, Takaomi; Lawton, Lee N; Barrasa, M Inmaculada; Fan, Zi Peng; Kohlhammer, Holger; Gutierrez, Alejandro; Ma, Wenxue; Tatarek, Jessica; Ahn, Yebin; Kelliher, Michelle A; Jamieson, Catriona H M; Staudt, Louis M; Young, Richard A; Look, A Thomas

    2012-08-14

    The oncogenic transcription factor TAL1/SCL is aberrantly expressed in over 40% of cases of human T cell acute lymphoblastic leukemia (T-ALL), emphasizing its importance in the molecular pathogenesis of T-ALL. Here we identify the core transcriptional regulatory circuit controlled by TAL1 and its regulatory partners HEB, E2A, LMO1/2, GATA3, and RUNX1. We show that TAL1 forms a positive interconnected autoregulatory loop with GATA3 and RUNX1 and that the TAL1 complex directly activates the MYB oncogene, forming a positive feed-forward regulatory loop that reinforces and stabilizes the TAL1-regulated oncogenic program. One of the critical downstream targets in this circuitry is the TRIB2 gene, which is oppositely regulated by TAL1 and E2A/HEB and is essential for the survival of T-ALL cells. Copyright © 2012 Elsevier Inc. All rights reserved.

  14. Pregnancy among U.S. women: Differences by presence, type, and complexity of disability

    Science.gov (United States)

    HORNER-JOHNSON, Willi; DARNEY, Blair G.; KULKARNI-RAJASEKHARA, Sheetal; QUIGLEY, Brian; CAUGHEY, Aaron B.

    2016-01-01

    Background Approximately 12% of women of reproductive age have some type of disability. Very little is known about sexual and reproductive health issues among women with disabilities, including what proportion of women with disabilities experience pregnancy. Data on pregnancy are important to inform needs for preconception and pregnancy care for women with disabilities. Objective The purpose of this study was to describe the occurrence of pregnancy among women with various types of disability and with differing levels of disability complexity, compared to women without disabilities, in a nationally representative sample. Study Design We conducted cross-sectional analyses of 2008–2012 Medical Expenditure Panel Survey annualized data to estimate the proportion of women ages 18–44 with and without disabilities who reported a pregnancy during one year of their participation on the survey panel. We used multivariable logistic regression to test the association of pregnancy with presence, type, and complexity of disability, controlling for other factors associated with pregnancy. Results Similar proportions of women with and without disabilities reported a pregnancy (10.8% vs. 12.3%, with 95% confidence intervals overlapping). Women with the most complex disabilities (those that impact activities such as self-care and work) were less likely to have been pregnant (AOR=0.69, 95%CI=0.52–0.93), but women whose disabilities only affected basic actions (seeing, hearing, movement, cognition) did not differ significantly from women with no disabilities. Conclusion Women with a variety of types of disabilities experience pregnancy. Greater attention is needed to the reproductive healthcare needs of this population in order to ensure appropriate contraceptive, preconception, and perinatal care. PMID:26546851

  15. Synthesis, DNA Cleavage Activity, Cytotoxicity, Acetylcholinesterase Inhibition, and Acute Murine Toxicity of Redox-Active Ruthenium(II) Polypyridyl Complexes.

    Science.gov (United States)

    Alatrash, Nagham; Narh, Eugenia S; Yadav, Abhishek; Kim, Mahn-Jong; Janaratne, Thamara; Gabriel, James; MacDonnell, Frederick M

    2017-07-06

    Four mononuclear [(L-L) 2 Ru(tatpp)] 2+ and two dinuclear [(L-L) 2 Ru(tatpp)Ru(L-L) 2 ] 4+ ruthenium(II) polypyridyl complexes (RPCs) containing the 9,11,20,22-tetraazatetrapyrido[3,2-a:2',3'-c:3'',2''-l:2''',3'''-n]pentacene (tatpp) ligand were synthesized, in which L-L is a chelating diamine ligand such as 2,2'-bipyridine (bpy), 1,10-phenanthroline (phen), 3,4,7,8-tetramethyl-1,10-phenanthroline (Me 4 phen) or 4,7-diphenyl-1,10-phenanthroline (Ph 2 phen). These Ru-tatpp analogues all undergo reduction reactions with modest reducing agents, such as glutathione (GSH), at pH 7. These, plus several structurally related but non-redox-active RPCs, were screened for DNA cleavage activity, cytotoxicity, acetylcholinesterase (AChE) inhibition, and acute mouse toxicity, and their activities were examined with respect to redox activity and lipophilicity. All of the redox-active RPCs show single-strand DNA cleavage in the presence of GSH, whereas none of the non-redox-active RPCs do. Low-micromolar cytotoxicity (IC 50 ) against malignant H358, CCL228, and MCF7 cultured cell lines was mainly restricted to the redox-active RPCs; however, they were substantially less toxic toward nonmalignant MCF10 cells. The IC 50 values for AChE inhibition in cell-free assays and the acute toxicity of RPCs in mice revealed that whereas most RPCs show potent inhibitory action against AChE (IC 50 values complexes as a class are surprisingly well tolerated in animals relative to other RPCs. © 2017 Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim.

  16. VHL type 2B mutations retain VBC complex form and function.

    Directory of Open Access Journals (Sweden)

    Kathryn E Hacker

    Full Text Available von Hippel-Lindau disease is characterized by a spectrum of hypervascular tumors, including renal cell carcinoma, hemangioblastoma, and pheochromocytoma, which occur with VHL genotype-specific differences in penetrance. VHL loss causes a failure to regulate the hypoxia inducible factors (HIF-1alpha and HIF-2alpha, resulting in accumulation of both factors to high levels. Although HIF dysregulation is critical to VHL disease-associated renal tumorigenesis, increasing evidence points toward gradations of HIF dysregulation contributing to the degree of predisposition to renal cell carcinoma and other manifestations of the disease.This investigation examined the ability of disease-specific VHL missense mutations to support the assembly of the VBC complex and to promote the ubiquitylation of HIF. Our interaction analysis supported previous observations that VHL Type 2B mutations disrupt the interaction between pVHL and Elongin C but maintain partial regulation of HIF. We additionally demonstrated that Type 2B mutant pVHL forms a remnant VBC complex containing the active members ROC1 and Cullin-2 which retains the ability to ubiquitylate HIF-1alpha.Our results suggest that subtypes of VHL mutations support an intermediate level of HIF regulation via a remnant VBC complex. These findings provide a mechanism for the graded HIF dysregulation and genetic predisposition for cancer development in VHL disease.

  17. Metformin-treated patients with type 2 diabetes have normal mitochondrial complex I respiration.

    Science.gov (United States)

    Larsen, S; Rabøl, R; Hansen, C N; Madsbad, S; Helge, J W; Dela, F

    2012-02-01

    The glucose-lowering drug metformin has been shown to inhibit complex I of the mitochondrial electron transport chain in skeletal muscle. To investigate this effect in vivo we studied skeletal muscle mitochondrial respiratory capacity and content from patients with type 2 diabetes treated with metformin (n = 14) or sulfonylurea (n = 8) and healthy control (n = 18) participants. Mitochondrial respiratory capacity was measured ex vivo in permeabilised muscle fibres obtained from the vastus lateralis muscle of all participants. The respiratory response to in vitro titration with metformin was measured in controls. Citrate synthase (CS) activity, and fasting plasma glucose, insulin and HbA(1c) levels were measured and body composition was determined. Participants were matched for age, BMI and percentage body fat. Fasting plasma glucose concentrations were higher (p muscle at suprapharmacological concentrations. Metformin treatment does not inhibit mitochondrial complex I respiration in the electron transport chain in human skeletal muscle of patients with type 2 diabetes when measured ex vivo. Inhibition of complex I and II respiration in controls was demonstrated by metformin titration in vitro at doses well above those observed during metformin treatment.

  18. Calculation of photoionization differential cross sections using complex Gauss-type orbitals.

    Science.gov (United States)

    Matsuzaki, Rei; Yabushita, Satoshi

    2017-09-05

    Accurate theoretical calculation of photoelectron angular distributions for general molecules is becoming an important tool to image various chemical reactions in real time. We show in this article that not only photoionization total cross sections but also photoelectron angular distributions can be accurately calculated using complex Gauss-type orbital (cGTO) basis functions. Our method can be easily combined with existing quantum chemistry techniques including electron correlation effects, and applied to various molecules. The so-called two-potential formula is applied to represent the transition dipole moment from an initial bound state to a final continuum state in the molecular coordinate frame. The two required continuum functions, the zeroth-order final continuum state and the first-order wave function induced by the photon field, have been variationally obtained using the complex basis function method with a mixture of appropriate cGTOs and conventional real Gauss-type orbitals (GTOs) to represent the continuum orbitals as well as the remaining bound orbitals. The complex orbital exponents of the cGTOs are optimized by fitting to the outgoing Coulomb functions. The efficiency of the current method is demonstrated through the calculations of the asymmetry parameters and molecular-frame photoelectron angular distributions of H2+ and H2 . In the calculations of H2 , the static exchange and random phase approximations are employed, and the dependence of the results on the basis functions is discussed. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

  19. Neurofibromatosis Type 1: A Novel NF1 Mutation Associated with Mitochondrial Complex I Deficiency

    Directory of Open Access Journals (Sweden)

    Sara Domingues

    2014-01-01

    Full Text Available Background. Neurofibromatosis type 1 is a multisystemic, progressive disease, with an estimated incidence of 1/3500-2500. Mitochondrial diseases are generally multisystemic and may be present at any age, and the global prevalence is 1/8500. The diagnosis of these disorders is complex because of its clinical and genetic heterogeneity. Case Report. We present a rare case of the association of these two different genetic diseases, in which a heterozygous missense mutation in the NF1 gene was identified which had not yet been described (p.M1149 V. Additionally, the patient is suspected of carrying an unspecified mutation causing respiratory chain complex I deficiency. Clinical presentation included hypotonia, global development delay, reduced growth rate, progressive microcephaly, and numerous café-au-lait spots. Discussion. To the best of our knowledge this is the first report of complex I deficiency in a patient with neurofibromatosis type 1. It is very important to maintain a high index of suspicion for the diagnosis of mitochondrial disorders. In this patient, both the laboratory screening and muscle histology were normal and only the biochemical study of muscle allowed us to confirm the diagnosis.

  20. Work-related outcome after acute coronary syndrome: Implications of complex cardiac rehabilitation in occupational medicine.

    Science.gov (United States)

    Lamberti, Monica; Ratti, Gennaro; Gerardi, Donato; Capogrosso, Cristina; Ricciardi, Gianfranco; Fulgione, Cosimo; Latte, Salvatore; Tammaro, Paolo; Covino, Gregorio; Nienhaus, Albert; Grazillo, Elpidio Maria; Mallardo, Mario; Capogrosso, Paolo

    2016-01-01

    Coronary heart disease is frequent in the working-age population. Traditional outcomes, such as mortality and hospital readmission, are useful for evaluating prognosis. Fit-for-work is an emerging outcome with clinical as well as socioeconomic significance. We describe the possible benefit of a cardiac rehabilitation (CR) program for return to work (RTW) after acute coronary syndrome (ACS). We evaluated 204 patients with recent ACS. They were divided into 4 groups on the basis of their occupational work load: very light (VL), light (L), moderate (M), and heavy (H). Work-related outcomes were assessed with the Work Performance Scale (WPS) of the Functional Status Questionnaire and as "days missed from work" (DMW) in the previous 4 weeks. The variables considered for outcomes were percent ejection fraction, functional capacity expressed in metabolic equivalents (METs), and participation or non-participation in the CR program (CR+ and CR-). One hundred thirty (66%) patients took part in the CR program. Total WPS scores for CR+ and CR- subgroups were VL group: 18±4 vs. 14±4 (p workplace, in particular among clerical workers. This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.

  1. Assembly and stoichiometry of the core structure of the bacterial flagellar type III export gate complex.

    Science.gov (United States)

    Fukumura, Takuma; Makino, Fumiaki; Dietsche, Tobias; Kinoshita, Miki; Kato, Takayuki; Wagner, Samuel; Namba, Keiichi; Imada, Katsumi; Minamino, Tohru

    2017-08-01

    The bacterial flagellar type III export apparatus, which is required for flagellar assembly beyond the cell membranes, consists of a transmembrane export gate complex and a cytoplasmic ATPase complex. FlhA, FlhB, FliP, FliQ, and FliR form the gate complex inside the basal body MS ring, although FliO is required for efficient export gate formation in Salmonella enterica. However, it remains unknown how they form the gate complex. Here we report that FliP forms a homohexameric ring with a diameter of 10 nm. Alanine substitutions of conserved Phe-137, Phe-150, and Glu-178 residues in the periplasmic domain of FliP (FliPP) inhibited FliP6 ring formation, suppressing flagellar protein export. FliO formed a 5-nm ring structure with 3 clamp-like structures that bind to the FliP6 ring. The crystal structure of FliPP derived from Thermotoga maritia, and structure-based photo-crosslinking experiments revealed that Phe-150 and Ser-156 of FliPP are involved in the FliP-FliP interactions and that Phe-150, Arg-152, Ser-156, and Pro-158 are responsible for the FliP-FliO interactions. Overexpression of FliP restored motility of a ∆fliO mutant to the wild-type level, suggesting that the FliP6 ring is a functional unit in the export gate complex and that FliO is not part of the final gate structure. Copurification assays revealed that FlhA, FlhB, FliQ, and FliR are associated with the FliO/FliP complex. We propose that the assembly of the export gate complex begins with FliP6 ring formation with the help of the FliO scaffold, followed by FliQ, FliR, and FlhB and finally FlhA during MS ring formation.

  2. Reactions, accuracy and response complexity of numerical typing on touch screens.

    Science.gov (United States)

    Lin, Cheng-Jhe; Wu, Changxu

    2013-01-01

    Touch screens are popular nowadays as seen on public kiosks, industrial control panels and personal mobile devices. Numerical typing is one frequent task performed on touch screens, but this task on touch screen is subject to human errors and slow responses. This study aims to find innate differences of touch screens from standard physical keypads in the context of numerical typing by eliminating confounding issues. Effects of precise visual feedback and urgency of numerical typing were also investigated. The results showed that touch screens were as accurate as physical keyboards, but reactions were indeed executed slowly on touch screens as signified by both pre-motor reaction time and reaction time. Provision of precise visual feedback caused more errors, and the interaction between devices and urgency was not found on reaction time. To improve usability of touch screens, designers should focus more on reducing response complexity and be cautious about the use of visual feedback. The study revealed that slower responses on touch screens involved more complex human cognition to formulate motor responses. Attention should be given to designing precise visual feedback appropriately so that distractions or visual resource competitions can be avoided to improve human performance on touch screens.

  3. Involvement of calcium and G proteins in the acute release of tissue- type plasminogen activator and von Willebrand factor from cultured human endothelial cells

    NARCIS (Netherlands)

    Eijnden-Schrauwen, Y. van den; Atsma, D.E.; Lupu, F.; Vries, R.E.M. de; Kooistra, T.; Emeis, J.J.

    1997-01-01

    In this study, we investigated the role of Ca2+ and G proteins in thrombin-induced acute release (regulated secretion) of tissue-type plasminogen activator (TPA) and yon Willebrand factor (vWF), using a previously described system of primary human umbilical vein endothelial cells (HUVECs). The acute

  4. Diabetic ketoacidosis and acute mountain sickness: case report and review of treatment options in type 1 diabetes mellitus.

    Science.gov (United States)

    Miller, Steven C M

    2015-06-01

    A 30-year-old man with a 20-year history of well-controlled type 1 diabetes mellitus and no microvascular complications traveled from near sea level to an altitude of 3000 m within 6 hours. At altitude, his blood glucose levels began to rise, necessitating increased insulin delivery. Typical symptoms of acute mountain sickness (AMS) developed, and he became increasingly hyperglycemic and unwell. Upon presentation to an emergency clinic, diabetic ketoacidosis (DKA) was diagnosed and was managed with insulin, intravenous fluids with potassium, and acetazolamide orally. No other potential causes for diabetic ketoacidosis were identified. Hyperglycemia, ketosis, and acidosis resolved with treatment as expected, but an increased insulin requirement was noted for the next 48 hours, until returning to expected levels when acetazolamide was discontinued. This case describes an episode of mild diabetic ketoacidosis potentially precipitated by moderate to severe acute mountain sickness, and an apparent hyperglycemic effect of acetazolamide. Individuals with type 1 diabetes traveling to altitude and their physicians should be vigilant for this complication and should be aware of the effects of conventional first-line therapies for acute mountain sickness on insulin requirement, glycemic control, and preexisting microvascular diabetes complications. Copyright © 2015 Wilderness Medical Society. Published by Elsevier Inc. All rights reserved.

  5. Topology and organization of the Salmonella typhimurium type III secretion needle complex components.

    Directory of Open Access Journals (Sweden)

    Oliver Schraidt

    2010-04-01

    Full Text Available The correct organization of single subunits of multi-protein machines in a three dimensional context is critical for their functionality. Type III secretion systems (T3SS are molecular machines with the capacity to deliver bacterial effector proteins into host cells and are fundamental for the biology of many pathogenic or symbiotic bacteria. A central component of T3SSs is the needle complex, a multiprotein structure that mediates the passage of effector proteins through the bacterial envelope. We have used cryo electron microscopy combined with bacterial genetics, site-specific labeling, mutational analysis, chemical derivatization and high-resolution mass spectrometry to generate an experimentally validated topographic map of a Salmonella typhimurium T3SS needle complex. This study provides insights into the organization of this evolutionary highly conserved nanomachinery and is the basis for further functional analysis.

  6. Integrated versus fragmented implementation of complex innovations in acute health care

    Science.gov (United States)

    Woiceshyn, Jaana; Blades, Kenneth; Pendharkar, Sachin R.

    2017-01-01

    Background: Increased demand and escalating costs necessitate innovation in health care. The challenge is to implement complex innovations—those that require coordinated use across the adopting organization to have the intended benefits. Purpose: We wanted to understand why and how two of five similar hospitals associated with the same health care authority made more progress with implementing a complex inpatient discharge innovation whereas the other three experienced more difficulties in doing so. Methodology: We conducted a qualitative comparative case study of the implementation process at five comparable urban hospitals adopting the same inpatient discharge innovation mandated by their health care authority. We analyzed documents and conducted 39 interviews of the health care authority and hospital executives and frontline managers across the five sites over a 1-year period while the implementation was ongoing. Findings: In two and a half years, two of the participating hospitals had made significant progress with implementing the innovation and had begun to realize benefits; they exemplified an integrated implementation mode. Three sites had made minimal progress, following a fragmented implementation mode. In the former mode, a semiautonomous health care organization developed a clear overall purpose and chose one umbrella initiative to implement it. The integrative initiative subsumed the rest and guided resource allocation and the practices of hospital executives, frontline managers, and staff who had bought into it. In contrast, in the fragmented implementation mode, the health care authority had several overlapping, competing innovations that overwhelmed the sites and impeded their implementation. Practice Implications: Implementing a complex innovation across hospital sites required (a) early prioritization of one initiative as integrative, (b) the commitment of additional (traded off or new) human resources, (c) deliberate upfront planning and

  7. Acute hepatitis A virus infection is associated with a limited type I interferon response and persistence of intrahepatic viral RNA.

    Science.gov (United States)

    Lanford, Robert E; Feng, Zongdi; Chavez, Deborah; Guerra, Bernadette; Brasky, Kathleen M; Zhou, Yan; Yamane, Daisuke; Perelson, Alan S; Walker, Christopher M; Lemon, Stanley M

    2011-07-05

    Hepatitis A virus (HAV) is an hepatotropic human picornavirus that is associated only with acute infection. Its pathogenesis is not well understood because there are few studies in animal models using modern methodologies. We characterized HAV infections in three chimpanzees, quantifying viral RNA by quantitative RT-PCR and examining critical aspects of the innate immune response including intrahepatic IFN-stimulated gene expression. We compared these infection profiles with similar studies of chimpanzees infected with hepatitis C virus (HCV), an hepatotropic flavivirus that frequently causes persistent infection. Surprisingly, HAV-infected animals exhibited very limited induction of type I IFN-stimulated genes in the liver compared with chimpanzees with acute resolving HCV infection, despite similar levels of viremia and 100-fold greater quantities of viral RNA in the liver. Minimal IFN-stimulated gene 15 and IFIT1 responses peaked 1-2 wk after HAV challenge and then subsided despite continuing high hepatic viral RNA. An acute inflammatory response at 3-4 wk correlated with the appearance of virus-specific antibodies and apoptosis and proliferation of hepatocytes. Despite this, HAV RNA persisted in the liver for months, remaining present long after clearance from serum and feces and revealing dramatic differences in the kinetics of clearance in the three compartments. Viral RNA was detected in the liver for significantly longer (35 to >48 wk) than HCV RNA in animals with acute resolving HCV infection (10-20 wk). Collectively, these findings indicate that HAV is far stealthier than HCV early in the course of acute resolving infection. HAV infections represent a distinctly different paradigm in virus-host interactions within the liver.

  8. Inhibition of autophagy as a treatment strategy for p53 wild-type acute myeloid leukemia

    NARCIS (Netherlands)

    Folkerts, Hendrik; Hilgendorf, Susan; Wierenga, Albertus T J; Jaques, Jennifer; Mulder, André B; Coffer, Paul J; Schuringa, Jan Jacob; Vellenga, Edo

    2017-01-01

    Here we have explored whether inhibition of autophagy can be used as a treatment strategy for acute myeloid leukemia (AML). Steady-state autophagy was measured in leukemic cell lines and primary human CD34(+) AML cells with a large variability in basal autophagy between AMLs observed. The autophagy

  9. Recombination and Insertion Events Involving the Botulinum Neurotoxin Complex Genes in Clostridium botulinum Types A, B, E and F and Clostridium butyricum Type E Strains

    Science.gov (United States)

    2009-10-05

    Clostridium botulinum types A, B, E and F and Clostridium butyricum type E strains Karen K Hill*1, Gary Xie2, Brian T Foley3, Theresa J Smith4, Amy C Munk2...ornl.gov; John C Detter - cdetter@lanl.gov * Corresponding author Abstract Background: Clostridium botulinum is a taxonomic designation for at least... botulinum neurotoxin complex genes in Clostridium botulinum types A, B, E and F and Clostridium butyricum type E strains. BMC Genomics 7:1-18 5a

  10. Acute effect of phosphodiesterase type 5 inhibitor on serum oxidative status and prolidase activities in men with erectile dysfunction

    Directory of Open Access Journals (Sweden)

    Murat Savas

    2010-01-01

    Full Text Available OBJECTIVES: To investigate the acute effect of phosphodiesterase type 5 (PDE5 inhibitor on erectile dysfunction by evaluating serum oxidative status and prolidase activity. METHODS: Serum samples of 36 patients with erectile dysfunction and 30 control cases were analyzed for total antioxidant status, total oxidant status, and prolidase activity, before and after the administration of tadalafil citrate. RESULTS: Before and after tadalafil citrate administration, serum total antioxidant status, total oxidant status, and prolidase were 1.1+0.0 vs. 1.6 + 0.0 umol H2O2 Eq/L, 10.3+1.1 vs. 6.9 + 1.2 umol H2O2 Eq/L, and 236.4+19.5 vs. 228.2 + 19.2 U/L, respectively (p<0.0001 for all. CONCLUSIONS: Evaluation of serum oxidative status and prolidase activity confirmed the beneficial acute effects of PDE5 inhibitor in patients with erectile dysfunction.

  11. Intact initiation of autophagy and mitochondrial fission by acute exercise in skeletal muscle of patients with Type 2 diabetes

    DEFF Research Database (Denmark)

    Kruse, Rikke; Pedersen, Andreas James Thestrup; Kristensen, Jonas Møller

    2017-01-01

    AIMS: Type 2 diabetes (T2D) is characterized by insulin resistance, mitochondrial dysregulation, and, in some studies, exercise resistance in skeletal muscle. Regulation of autophagy and mitochondrial dynamics during exercise and recovery is important for skeletal muscle homeostasis......, and these responses may be altered in T2D. MATERIALS AND METHODS: We examined the effect of acute exercise on markers of autophagy and mitochondrial fusion and fission in skeletal muscle biopsies from patients with T2D (n=13) and weight-matched controls (n=14) before, immediately after and 3h after an acute bout...... of exercise. RESULTS: While mRNA levels of most markers of autophagy ( PIK3C, MAP1LC3B, SQSTM1, BNIP3, BNIP3L ) and mitochondrial dynamics ( OPA1, FIS1 ) remained unchanged, some either increased during and after exercise (GABARAPL1 ), decreased in the recovery period ( BECN1, ATG7, DNM1L ), or both ( MFN2...

  12. The subclonal complexity of STIL-TAL1+ T-cell acute lymphoblastic leukaemia.

    Science.gov (United States)

    Furness, Caroline L; Mansur, Marcela B; Weston, Victoria J; Ermini, Luca; van Delft, Frederik W; Jenkinson, Sarah; Gale, Rosemary; Harrison, Christine J; Pombo-de-Oliveira, Maria S; Sanchez-Martin, Marta; Ferrando, Adolfo A; Kearns, Pamela; Titley, Ian; Ford, Anthony M; Potter, Nicola E; Greaves, Mel

    2018-03-20

    Single-cell genetics were used to interrogate clonal complexity and the sequence of mutational events in STIL-TAL1+ T-ALL. Single-cell multicolour FISH was used to demonstrate that the earliest detectable leukaemia subclone contained the STIL-TAL1 fusion and copy number loss of 9p21.3 (CDKN2A/CDKN2B locus), with other copy number alterations including loss of PTEN occurring as secondary subclonal events. In three cases, multiplex qPCR and phylogenetic analysis were used to produce branching evolutionary trees recapitulating the snapshot history of T-ALL evolution in this leukaemia subtype, which confirmed that mutations in key T-ALL drivers, including NOTCH1 and PTEN, were subclonal and reiterative in distinct subclones. Xenografting confirmed that self-renewing or propagating cells were genetically diverse. These data suggest that the STIL-TAL1 fusion is a likely founder or truncal event. Therapies targeting the TAL1 auto-regulatory complex are worthy of further investigation in T-ALL.

  13. Complexity analyses show two distinct types of nonlinear dynamics in short heart period variability recordings

    Science.gov (United States)

    Porta, Alberto; Bari, Vlasta; Marchi, Andrea; De Maria, Beatrice; Cysarz, Dirk; Van Leeuwen, Peter; Takahashi, Anielle C. M.; Catai, Aparecida M.; Gnecchi-Ruscone, Tomaso

    2015-01-01

    Two diverse complexity metrics quantifying time irreversibility and local prediction, in connection with a surrogate data approach, were utilized to detect nonlinear dynamics in short heart period (HP) variability series recorded in fetuses, as a function of the gestational period, and in healthy humans, as a function of the magnitude of the orthostatic challenge. The metrics indicated the presence of two distinct types of nonlinear HP dynamics characterized by diverse ranges of time scales. These findings stress the need to render more specific the analysis of nonlinear components of HP dynamics by accounting for different temporal scales. PMID:25806002

  14. Phenomenon of statistical instability of the third type systems—complexity

    Science.gov (United States)

    Eskov, V. V.; Gavrilenko, T. V.; Eskov, V. M.; Vokhmina, Yu. V.

    2017-11-01

    The problem of the existence and special properties of third type systems has been formulated within the new chaos-self-organization theory. In fact, a global problem of the possibility of the existence of steady-state regimes for homeostatic systems has been considered. These systems include not only medical and biological systems, but also the dynamics of meteorological parameters, as well as the ambient parameters of the environment in which humans are located. The new approach has been used to give a new definition for homeostatic systems (complexity).

  15. Therapy-Resistant Complex Regional Pain Syndrome Type I: To Amputate or Not?

    OpenAIRE

    Bodde, M.I.; Dijkstra, P.U.; den Dunnen, W.F.A.; Geertzen, J.H.B.

    2011-01-01

    Background: Amputation for the treatment of long-standing, therapy-resistant complex regional pain syndrome type I (CRPS-I) is controversial. An evidence-based decision regarding whether or not to amputate is not possible on the basis of current guidelines. The aim of the current study was to systematically review the literature and summarize the beneficial and adverse effects of an amputation for the treatment of long-standing, therapy-resistant CRPS-I. Methods: A literature search, using Me...

  16. Complex regional pain syndrome type 1 mimicking Raynaud’s phenomenon

    Directory of Open Access Journals (Sweden)

    Serpil Tuna

    2014-09-01

    Full Text Available Complex regional pain syndrome type 1 (CRPS-1 is a chronic pain syndrome characterized by severe pain, swelling, autonomic dysfunction and dystrophic changes in affected extremity. RSDS is a rare disease in children and usually occurs after trauma, however, without trauma may also occur. We were detected CRPS-1 activated by cold and stress and characterized by recurrent attacks in the bilateral upper extremities in 14 year-old girl, which is similar to Raynaud’s phenomenon. We present this case with the literature because of its rarity and atypical course.

  17. Volatile Organic Compound Gamma-Butyrolactone Released upon Herpes Simplex Virus Type -1 Acute Infection Modulated Membrane Potential and Repressed Viral Infection in Human Neuron-Like Cells.

    Science.gov (United States)

    Rochford, Kevin; Chen, Feng; Waguespack, Yan; Figliozzi, Robert W; Kharel, Madan K; Zhang, Qiaojuan; Martin-Caraballo, Miguel; Hsia, S Victor

    2016-01-01

    Herpes Simplex Virus Type -1 (HSV-1) infections can cause serious complications such as keratitis and encephalitis. The goal of this study was to identify any changes in the concentrations of volatile organic compounds (VOCs) produced during HSV-1 infection of epithelial cells that could potentially be used as an indicator of a response to stress. An additional objective was to study if any VOCs released from acute epithelial infection may influence subsequent neuronal infection to facilitate latency. To investigate these hypotheses, Vero cells were infected with HSV-1 and the emission of VOCs was analyzed using two-dimensional gas chromatograph/mass spectrometry (2D GC/MS). It was observed that the concentrations of gamma-butyrolactone (GBL) in particular changed significantly after a 24-hour infection. Since HSV-1 may establish latency in neurons after the acute infection, GBL was tested to determine if it exerts neuronal regulation of infection. The results indicated that GBL altered the resting membrane potential of differentiated LNCaP cells and promoted a non-permissive state of HSV-1 infection by repressing viral replication. These observations may provide useful clues towards understanding the complex signaling pathways that occur during the HSV-1 primary infection and establishment of viral latency.

  18. Acute and subchronic toxicity of metal complex azo acid dye and anionic surfactant oil on fish Oreochromis niloticus.

    Science.gov (United States)

    Amwele, Hilma Rantilla; Papirom, Pittaya; Chukanhom, Kanit; Beamish, Fredrick Henry William; Petkam, Rakpong

    2015-01-01

    The acute toxicity study of metal complex dark green azo acid dye, anionic surfactant oil and their mixture determined the 96 hr LC50, and fish behaviours. Subchronic toxicity determined haematology parameters and concentrations of copper and chromium in blood. The 96 hr LC50 was determined by probit analysis and subchronic toxicity was conducted in 90 days. No mortalities were observed in control and anionic surfactant oil treatments. The 96 hr LC50 value of mixture was 26.7 mg I(-1) (95% CL = 20.7 - 46.8) and that of metal complex dark green azo acid dye was not met as the percentage of dead was below 50% of tested organisms. In a treatment of anionic surfactant oil and that of mixture observed behaviours were respiration response, uncoordinated movement, loss of equilibrium, erratic posture and loss of responsiveness. Subchronic toxicity indicated fluctuations in number of erythrocytes, leukocytes and thrombocytes in all chemical treatments. Erythrocyte morphology such as anisocytosis, erythrocytes hypertrophy, karyolysis, cytoplasm vacuolation, ghost cell were observed in fish blood in all chemical treatments. An inverse relation was observed between total copper and chromium concentration in blood. However, the toxicity effect was chemical dose dependent and length of exposure.

  19. A randomized controlled trial of nurses vs. doctors in the resolution of acute disease of low complexity in primary care.

    Science.gov (United States)

    Iglesias, Begoña; Ramos, Francisca; Serrano, Beatriz; Fàbregas, Mireia; Sánchez, Carmen; García, María José; Cebrian, Hèlia Marta; Aragonés, Rosa; Casajuana, Josep; Esgueva, Neus

    2013-11-01

    To compare the effectiveness of care delivered by nurses to the usual care delivered by general practitioners, in adult patients requesting same day appointments in primary care practices in Catalonia (Spain). Same day appointments conducted by nurses are characterized by high patient satisfaction and a high resolution index. The profile of nursing and the organization of primary care services in our country differ from other countries. Multicentre, randomized, unblinded clinical trial with two parallel groups. Patients were randomized to an intervention group (seen by nurses trained to respond to low complexity problems) or a control group (seen by the general practitioner) using an automatic probabilistic function. 38 primary care practices in Catalonia, 142 general practitioners and 155 nurses participated. Population study: ≥ 18-year-old patients who requested a same day consultation. Recruitment period: January-May, 2009. Of the 1,461 randomized patients, 92.5% completed the study. resolution of symptoms and patient satisfaction 2 weeks after the visit. Seven hundred and fifty-three patients were assigned to the intervention group and 708 to the control group. Nurses successfully solved 86.3% of the cases. We did not observe any differences in resolution of symptoms or patient satisfaction between the groups. Nurses trained specifically to resolve acute health problems of low complexity give comparable quality of care to that provided by general practitioners in terms of resolution of the problem 15 days after the visit and in patient satisfaction with the visit. © 2013 Blackwell Publishing Ltd.

  20. Sleep patterns and acute physical exercise: the effects of gender, sleep disturbances, type and time of physical exercise.

    Science.gov (United States)

    Maculano Esteves, A; Ackel-D'Elia, C; Tufik, S; De Mello, M T

    2014-12-01

    Aim of the study was to determine which factors influence sleep patterns after a single session of physical exercise. Adult sedentary volunteers (N.=221; 104 men and 117 women) aged 31.40±9.40 were randomised into groups with three different types of physical exercise (resistance, aerobic and interval). After the exercise protocol was explained, each volunteer was given the first polysomnographic (PSG) and performed the acute session of physical exercise (resistance: based on a 1RM test; aerobic: based on a maximum effort test (MET) and interval: 10 series with 4-minute intervals between series). The second PSG was performed the day after the acute session of physical exercise. A negative correlation was found between sleep latency and the acute physical exercise session practiced in the evening, and a positive correlation was found between the total sleep time and female gender. The REM sleep stage (%) was positively correlated with the control, obstructive sleep apnea (OSA) and periodic leg movement (PLM) groups and the acute physical exercise session practiced in the morning. Positive correlations were observed in the arousal index and the PLM group and female gender; the PLM index and the control and OSA groups; minimum oxygen saturation and the OSA and PLM groups. Therefore, these results suggested that such factors as gender, the presence of sleep disturbance (PLM and/or OSA), type of physical exercise (aerobic, resistance or interval) and the time that it was practiced (morning, afternoon or evening) can influence sleep patterns after a single session of physical exercise. However, the gender seems to be the most important factor to influence sleep pattern in the situation studied.

  1. Reconstructing Historical Land Cover Type and Complexity by Synergistic Use of Landsat Multispectral Scanner and CORONA

    Directory of Open Access Journals (Sweden)

    Amir Reza Shahtahmassebi

    2017-07-01

    Full Text Available Survey data describing land cover information such as type and diversity over several decades are scarce. Therefore, our capacity to reconstruct historical land cover using field data and archived remotely sensed data over large areas and long periods of time is somewhat limited. This study explores the relationship between CORONA texture—a surrogate for actual land cover type and complexity—with spectral vegetation indices and texture variables derived from Landsat MSS under the Spectral Variation Hypothesis (SVH such as to reconstruct historical continuous land cover type and complexity. Image texture of CORONA was calculated using a mean occurrence measure while image textures of Landsat MSS were calculated by occurrence and co-occurrence measures. The relationship between these variables was evaluated using correlation and regression techniques. The reconstruction procedure was undertaken through regression kriging. The results showed that, as expected, texture based on the visible bands and corresponding indices indicated larger correlation with CORONA texture, a surrogate of land cover (correlation >0.65. In terms of prediction, the combination of the first-order mean of band green, second-order measure of tasseled cap brightness, second-order mean of Normalized Visible Index (NVI and second-order entropy of NIR yielded the best model with respect to Akaike’s Information Criterion (AIC, r-square, and variance inflation factors (VIF. The regression model was then used in regression kriging to map historical continuous land cover. The resultant maps indicated the type and degree of complexity in land cover. Moreover, the proposed methodology minimized the impacts of topographic shadow in the region. The performance of this approach was compared with two conventional classification methods: hard classifiers and continuous classifiers. In contrast to conventional techniques, the technique could clearly quantify land cover complexity and

  2. [Prognostic factors for in-hospital mortality in patients with acute kidney injury requiring continuous renal replacement therapy undergoing surgery for acute Stanford type A aortic dissection].

    Science.gov (United States)

    Jiao, R; Liu, N

    2017-04-01

    Objective: To evaluate prognostic factors for in-hospital mortality in patients with acute kidney injury (AKI) requiring continuous renal replacement therapy (CRRT) undergoing surgery for acute Stanford type A aortic dissection. Methods: Retrospective analysis were conducted for 60 patients diagnosed with AKI requiring CRRT undergoing surgery for acute Stanford type A aortic dissection at Beijing Anzhen Hospital, Capital Medical University from March 2015 to September 2016. There were 43 male and 17 female patients with an mean age of (50±14) years. Demographic characteristics, diagnosis, perioperative periodrelated data, clinical parameters during CRRT were collected to set up a database. The patients were divided into survival group and non-survival group according to in-hospital mortality. The prognostic factors of mortality in-hospital after AKI requiring CRRT were analyzed by multivariate Logistic regression analysis regression. Results: In the 60 adult patients who had received CRRT, 21 patients (35.0%) died. There were significant differences between died and survival patients on proportion of age>60 years (χ(2)=6.851, P =0.003), lactic acid levels at 12-hour after CRRT ( t =-3.631, P =0.004), lactic acid levels at 24 hours after CRRT ( t =-2.986, P =0.032), proportion of body mass index >25 kg/m(2) (χ(2)=5.660, P =0.041), cardiopulmonary bypass time ( t =-2.720, P =0.001). Multivariate Logistic regression analysis revealed that age≥60 years ( OR =16.450, 95% CI: 2.172 to 84.589); high lactic acid levels at 12-hour after CRRT ( OR =1.719, 95% CI: 1.998 to 2.960) and long cardiopulmonary bypass time ( OR =1.028, 95% CI: 1.004 to 1.052) (all P acid levels at 12-hour after CRRT and long cardiopulmonary bypass time were independent prognostic factors of patients with AKI requiring CRRT after aortic surgery. Proper identification and management shall improve the prognosis of patients.

  3. A type III-B CRISPR-Cas effector complex mediating massive target DNA destruction.

    Science.gov (United States)

    Han, Wenyuan; Li, Yingjun; Deng, Ling; Feng, Mingxia; Peng, Wenfang; Hallstrøm, Søren; Zhang, Jing; Peng, Nan; Liang, Yun Xiang; White, Malcolm F; She, Qunxin

    2017-02-28

    The CRISPR (clustered regularly interspaced short palindromic repeats) system protects archaea and bacteria by eliminating nucleic acid invaders in a crRNA-guided manner. The Sulfolobus islandicus type III-B Cmr-α system targets invading nucleic acid at both RNA and DNA levels and DNA targeting relies on the directional transcription of the protospacer in vivo. To gain further insight into the involved mechanism, we purified a native effector complex of III-B Cmr-α from S. islandicus and characterized it in vitro. Cmr-α cleaved RNAs complementary to crRNA present in the complex and its ssDNA destruction activity was activated by target RNA. The ssDNA cleavage required mismatches between the 5΄-tag of crRNA and the 3΄-flanking region of target RNA. An invader plasmid assay showed that mutation either in the histidine-aspartate acid (HD) domain (a quadruple mutation) or in the GGDD motif of the Cmr-2α protein resulted in attenuation of the DNA interference in vivo. However, double mutation of the HD motif only abolished the DNase activity in vitro. Furthermore, the activated Cmr-α binary complex functioned as a highly active DNase to destroy a large excess DNA substrate, which could provide a powerful means to rapidly degrade replicating viral DNA. © The Author(s) 2016. Published by Oxford University Press on behalf of Nucleic Acids Research.

  4. The Chlamydia type III secretion system C-ring engages a chaperone-effector protein complex.

    Directory of Open Access Journals (Sweden)

    Kris E Spaeth

    2009-09-01

    Full Text Available In Gram-negative bacterial pathogens, specialized chaperones bind to secreted effector proteins and maintain them in a partially unfolded form competent for translocation by type III secretion systems/injectisomes. How diverse sets of effector-chaperone complexes are recognized by injectisomes is unclear. Here we describe a new mechanism of effector-chaperone recognition by the Chlamydia injectisome, a unique and ancestral line of these evolutionarily conserved secretion systems. By yeast two-hybrid analysis we identified networks of Chlamydia-specific proteins that interacted with the basal structure of the injectisome, including two hubs of protein-protein interactions that linked known secreted effector proteins to CdsQ, the putative cytoplasmic C-ring component of the secretion apparatus. One of these protein-interaction hubs is defined by Ct260/Mcsc (Multiple cargo secretion chaperone. Mcsc binds to and stabilizes at least two secreted hydrophobic proteins, Cap1 and Ct618, that localize to the membrane of the pathogenic vacuole ("inclusion". The resulting complexes bind to CdsQ, suggesting that in Chlamydia, the C-ring of the injectisome mediates the recognition of a subset of inclusion membrane proteins in complex with their chaperone. The selective recognition of inclusion membrane proteins by chaperones may provide a mechanism to co-ordinate the translocation of subsets of inclusion membrane proteins at different stages in infection.

  5. Activity of the type II JAK2 inhibitor CHZ868 in B-cell acute lymphoblastic leukemia

    Science.gov (United States)

    Wu, Shuo-Chieh; Li, Loretta S.; Kopp, Nadja; Montero, Joan; Chapuy, Bjoern; Yoda, Akinori; Christie, Amanda L.; Liu, Huiyun; Christodoulou, Alexandra; van Bodegom, Diederik; van der Zwet, Jordy; Layer, Jacob V.; Tivey, Trevor; Lane, Andrew A.; Ryan, Jeremy A.; Ng, Samuel Y.; DeAngelo, Daniel J.; Stone, Richard M.; Steensma, David; Wadleigh, Martha; Harris, Marian; Mandon, Emeline; Ebel, Nicolas; Andraos, Rita; Romanet, Vincent; Dölemeyer, Arno; Sterker, Dario; Zender, Michael; Rodig, Scott J.; Murakami, Masato; Hofmann, Francesco; Kuo, Frank; Eck, Michael J.; Silverman, Lewis B.; Sallan, Stephen E.; Letai, Anthony; Baffert, Fabienne; Vangrevelinghe, Eric; Radimerski, Thomas; Gaul, Christoph; Weinstock, David M.

    2015-01-01

    Summary A variety of cancers depend on JAK2 signaling, including the high-risk subset of B-cell acute lymphoblastic leukemias (B-ALLs) with CRLF2 rearrangements. Type I JAK2 inhibitors induce paradoxical JAK2 hyperphosphorylation in these leukemias and have limited activity. To improve the efficacy of JAK2 inhibition in B-ALL, we developed the type II inhibitor CHZ868, which stabilizes JAK2 in an inactive conformation. CHZ868 potently suppressed the growth of CRLF2-rearranged human B-ALL cells, abrogated JAK2 signaling, and improved survival in mice with human or murine B-ALL. CHZ868 and dexamethasone synergistically induced apoptosis in JAK2-dependent B-ALLs and further improved in vivo survival compared to CHZ868 alone. These data support the testing of type II JAK2 inhibition in patients with JAK2-dependent leukemias and other disorders. PMID:26175414

  6. Discrimination in waiting times by insurance type and financial soundness of German acute care hospitals.

    Science.gov (United States)

    Schwierz, Christoph; Wübker, Achim; Wübker, Ansgar; Kuchinke, Björn A

    2011-10-01

    This paper shows that patients with private health insurance (PHI) are being offered significantly shorter waiting times than patients with statutory health insurance (SHI) in German acute hospital care. This behavior may be driven by the higher expected profitability of PHI relative to SHI holders. Further, we find that hospitals offering private insurees shorter waiting times when compared with SHI holders have a significantly better financial performance than those abstaining from or with less discrimination.

  7. EXAFS investigation of uranium(6) complexes formed at Acidithiobacillus ferro oxidans types

    International Nuclear Information System (INIS)

    Merroun, M.; Reich, T.; Hennig, Ch.; Selenska-Pobell, S.

    2002-01-01

    Mining activities have brought excessive amounts of uranium into the environment. In uranium deposits a number of acidophilic chemo-litho-autotrophic bacteria have been identified which are able to oxidize sulphide minerals, elemental sulphur, ferrous iron and also (in the presence of uranium mineral) U(IV). In particular, the interaction of one representative of the group Acidithiobacillus ferro oxidans (new designation of Thiobacillus ferro oxidans) with uranium has been investigated. Uranium(VI) complex formations at the surfaces of Acidithiobacillus ferro oxidans were studied using uranium L III -edge extended X-ray absorption fine structure (EXAFS) spectroscopy. In all samples uranium is co-ordinated by two axial oxygen atoms (O ax ) at a distance of 1.77-1.78 angstrom. The average distance between uranium and the equatorial oxygen atoms (O eq ) is 2.35 angstrom. The co-ordination number for O eq is 5-6. In comparison to the uranium crystal structure data, the U-O eq distance indicates a co-ordination number of the equatorial oxygen of 5. Within the experimental error, there are no differences in the U-O bond distances between samples from the three types of A. ferro oxidans investigated. The fit to the EXAFS data of samples measured as wet pastes gave the same results as for dried samples. No significant structural differences were observed for the uranium complexes formed by the eco-types of A. ferro oxidans. However, the EXAFS spectra do indicate a formation of uranium complexes which are different from those formed by Bacilli where the bond length of 2.28 angstrom indicates a co-ordination number of 4 for the equatorial oxygen atoms. (authors)

  8. Risk factors for prolonged mechanical ventilation after total aortic arch replacement for acute DeBakey type I aortic dissection.

    Science.gov (United States)

    Li, Cheng-Nan; Chen, Lei; Ge, Yi-Peng; Zhu, Jun-Ming; Liu, Yong-Min; Zheng, Jun; Liu, Wei; Ma, Wei-Guo; Sun, Li-Zhong

    2014-09-01

    EuroSCORE II is an objective risk scoring model. The aim of this study was to assess the performance of EuroSCORE II in the prediction of prolonged mechanical ventilation following total aortic arch replacement for acute DeBakey type I aortic dissection and evaluate the risk factors for prolonged mechanical ventilation. Between February 2009 to February 2012, data from 240 patients who underwent total aortic arch replacement for acute DeBakey type I aortic dissection were collected retrospectively. Mechanical ventilation after the surgery longer than 48 hours was defined as postoperative prolonged mechanical ventilation. EuroSCORE II was applied to predict prolonged mechanical ventilation. A C statistic (receiver operating characteristic curve) was used to test discrimination of the model. Calibration was assessed with a Hosmer-Lemeshow goodness-of-fit statistic. Multiple logistic regression analysis was used to identify the final risk factors of prolonged mechanical ventilation. The overall mortality was 10%. The mean length of mechanical ventilation after total aortic arch replacement was 42.72 ± 51.45 hours. Total 74 patients needed prolonged mechanical ventilation. EuroSCORE II showed poor discriminatory ability (C statistic 0.52) and calibration (Hosmer-Lemeshow, pmechanical ventilation. On multivariate analysis, independent risk factors for postoperative prolonged mechanical ventilation were age ≥ 48.5 years (pmechanical ventilation following total aortic arch replacement for acute DeBakey type I aortic dissection. Preoperative high level of leukocyte, age and surgical period from symptom onset are risk factors for prolonged mechanical ventilation. Copyright © 2014 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.V. All rights reserved.

  9. Volumetric analysis of the initial index computed tomography scan can predict the natural history of acute uncomplicated type B dissections.

    Science.gov (United States)

    Lavingia, Kedar S; Larion, Sebastian; Larion, Sebastion; Ahanchi, Sadaf S; Ammar, Chad P; Bhasin, Mohit; Mirza, Aleem K; Dexter, David J; Panneton, Jean M

    2015-10-01

    Our objective was to characterize the predictive impact of computed tomography (CT) scan volumetric analysis on the natural history of acute uncomplicated type B aortic dissections (ADs). We conducted a retrospective review of patients with acute type B ADs from 2009 to 2014. On an iNtuition workstation (TeraRecon, Foster City, Calif), volume measurements were obtained using the true lumen volume (TLV), false lumen volume (FLV), and total aortic volume from the left subclavian artery to the celiac artery. Growth rate was calculated as the change in maximal diameter between first and last available CT scans during the time interval. The primary outcome of the study was delayed aortic intervention. P 14 days) thoracic endovascular aneurysm repair (29) or open repair (3). Mean age was 66 ± 12 years. Mean TLV/FLV ratio on initial CT scan was significantly higher in patients who did not eventually require an operation (1.55 vs 0.82; P = .02). The mean growth rate was higher in those eventually requiring operation (2.47 vs 0.42 mm/mo; P = .003). Patients were divided into three subgroups on the basis of their initial imaging TLV/FLV ratios (1.6). There was a significant difference in the growth rates between these three groups (4.6 vs 2.4 vs 0.8 mm/mo; P 1.6 was highly predictive for freedom from delayed operation (sensitivity, 91%; specificity, 42%; positive predictive value, 61%; negative predictive value, 86%). After Kaplan-Meier analysis, 1-year and 2-year survival free of aortic interventions was 60% and 42% with a TLV/FLV ratio 1.6 (P = .001). Initial CT scan volumetric analysis in patients presenting with uncomplicated acute type B ADs is a useful tool to predict growth and need for future intervention. Copyright © 2015 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.

  10. Shunt malfunction causing acute neurological deterioration in 2 patients with previously asymptomatic Chiari malformation Type I. Report of two cases.

    Science.gov (United States)

    Elliott, Robert; Kalhorn, Stephen; Pacione, Donato; Weiner, Howard; Wisoff, Jeffrey; Harter, David

    2009-08-01

    Patients with symptomatic Chiari malformation Type I (CM-I) typically exhibit a chronic, slowly progressive disease course with evolution of symptoms. However, some authors have reported acute neurological deterioration in the setting of CM-I and acquired Chiari malformations. Although brainstem dysfunction has been documented in patients with CM-II and hydrocephalus or shunt malfunction, to the authors' knowledge only 1 report describing ventriculoperitoneal (VP) shunt malfunction causing neurological deterioration in a patient with CM-I exists. The authors report on their experience with the treatment of previously asymptomatic CM-I in 2 children who experienced quite different manifestations of acute neurological deterioration secondary to VP shunt malfunction. Presumably, VP shunt malfunction created a positive rostral pressure gradient across a stenotic foramen magnum, resulting in tetraparesis from foramen magnum syndrome in 1 patient and acute ataxia and cranial nerve deficits from syringobulbia in the other. Although urgent shunt revisions yielded partial recovery of neurological function in both patients, marked improvement occurred only after posterior fossa decompression.

  11. Molecular typing of environmental Cryptococcus neoformans/C. gattii species complex isolates from Manaus, Amazonas, Brazil.

    Science.gov (United States)

    Alves, Gleica Soyan Barbosa; Freire, Ana Karla Lima; Bentes, Amaury Dos Santos; Pinheiro, José Felipe de Souza; de Souza, João Vicente Braga; Wanke, Bodo; Matsuura, Takeshi; Jackisch-Matsuura, Ani Beatriz

    2016-08-01

    Cryptococcus neoformans and Cryptococcus gattii are the main causative agents of cryptococcosis, a systemic fungal disease that affects internal organs and skin, and which is acquired by inhalation of spores or encapsulated yeasts. It is currently known that the C. neoformans/C. gattii species complex has a worldwide distribution, however, some molecular types seem to prevail in certain regions. Few environmental studies of Cryptococcus have been conducted in the Brazilian Amazon. This is the first ecological study of the pathogenic fungi C. neoformans/C. gattii species complex in the urban area of Manaus, Amazonas, Brazil. A total of 506 samples from pigeon droppings (n = 191), captive bird droppings (n = 60) and tree hollows (n = 255) were collected from June 2012 to January 2014 at schools and public buildings, squares, pet shops, households, the zoo and the bus station. Samples were plated on niger seed agar (NSA) medium supplemented with chloramphenicol and incubated at 25°C for 5 days. Dark-brown colonies were isolated and tested for thermotolerance at 37°C, cycloheximide resistance and growth on canavanine-glycine-bromothymol blue agar. Molecular typing was done by PCR-RFLP. Susceptibility to the antifungal drugs amphotericin B, fluconazole, itraconazole and ketoconazole was tested using Etest(®) strips. In total, 13 positive samples were obtained: one tree hollow (C. gattiiVGII), nine pigeon droppings (C. neoformansVNI) and three captive bird droppings (C. neoformansVNI). The environmental cryptococcal isolates found in this study were of the same molecular types as those responsible for infections in Manaus. © 2016 Blackwell Verlag GmbH.

  12. Uranium exploration target selection for proterozoic iron oxide/breccia complex type deposits in India

    International Nuclear Information System (INIS)

    Dwivedy, K.K.; Sinha, K.K.

    1997-01-01

    Multimetal iron oxide/breccia complex (IOBC) type deposits exemplified by Olympic Dam in Australia, fall under low grade, large tonnage deposits. A multidisciplinary integrated exploration programme consisting of airborne surveys, ground geological surveys, geophysical and geochemical investigations and exploratory drilling, supported adequately by the state of the art analytical facilities, data processing using various software and digital image processing has shown moderate success in the identification of target areas for this type of deposits in the Proterozoic terrains of India. Intracratonic, anorogenic, continental rift to continental margin environment have been identified in a very wide spectrum of rock associations. The genesis and evolution of such associations during the Middle Proterozoic period have been reviewed and applied for target selection in the (i) Son-Narmada rift valley zone; (ii) areas covered by Dongargarh Supergroup of rocks in Madhya Pradesh; (iii) areas exposing ferruginous breccia in the western part of the Singhbhum Shear Zone (SSZ) around Lotapahar; (iv) Siang Group of rocks in Arunachal Pradesh; (v) Crystalline rocks of Garo Hills around Anek; and (vi) Chhotanagpur Gneissic complex in the Bahia-Ulatutoli tract of Ranchi Plateau. Of theses six areas, the Son-Narmada rift area appears to be the most promising area for IOBC type deposits. Considering occurrences of the uranium anomalies near Meraraich, Kundabhati, Naktu and Kudar and positive favourability criteria observed in a wide variety of rocks spatially related to the rifts and shears, certain sectors in Son-Narmada rift zone have been identified as promising for intense subsurface exploration. 20 refs, 4 figs, 1 tab

  13. Acute Type II Aortic Dissection with Severe Aortic Regurgitation and Chronic Descending Aortic Dissection in Pregnant Patient with Marfan Syndrome.

    Science.gov (United States)

    Lee, Seok-Soo; Jung, Tae-Eun; Lee, Dong Hyup

    2012-12-01

    Aortic dilatation and dissection are severe complications during pregnancy that can be fatal to both the mother and the fetus. The risks of these complications are especially high in pregnant patients with Marfan syndrome; however, incidents of descending aortic dissection are very rare. This case report involves a successful Bentall procedure for and recovery from a rare aortic dissection in a pregnant Marfan patient who developed acute type II aortic dissection with severe aortic regurgitation and chronic descending aortic dissection immediately after Cesarean section. Regular follow-up will be needed to monitor the descending aortic dissection.

  14. Glucose Control and Autonomic Response during Acute Stress in Youth with Type 1 Diabetes: A Pilot Study.

    Science.gov (United States)

    Guan, Ling; Metzger, Daniel L; Lavoie, Pascal M; Collet, Jean-Paul

    2018-04-14

    Type 1 diabetes (T1D) is a chronic source of metabolic and neuropsychological stress, which may eventually lead to autonomic neuropathy and other complications related to micro- and macro-vasculopathies. We aimed to investigate the relationship between T1D chronic stress and ANS response to acute stress testing that was expected being affected by chronic stress. Twenty youths with confirmed diagnosis of T1D were assessed. Chronic stress assessment included HbA1c ≥7.5%, psychological stress assessed by perceived stress scale (PSS), hypoglycemic events, and pro-inflammatory cytokines. The acute stress testing used standardized stress video games. Autonomic response to acute stress was assessed by the amplitude and direction of changes in heart rate variability (HRV). Analyses determined correlations between changes in PNS during stress testing and chronic diabetes stressors. A strong correlation was found between the amplitude of High Frequency (HF) changes and HbA1c values (ρ=0.74, p <0.001). Youths with HbA1c ≥7.5% showed a larger amplitude of HF changes during acute stress (49% vs. 16%, p<0.001) and a higher PSS score (22.5 vs. 19.0, p=0.003), compared to those with HbA1c <7.5%. Additionally, among youths with HbA1c ≥7.5%, those with positive changes in HF had a lower level of IL-8 than those with negative changes (5.40 vs. 7.85 pg/mL, p=0.009). Study findings support the need for better understanding the health effects of stress-related autonomic dysfunction in youth with T1D. This article is protected by copyright. All rights reserved.

  15. Stereotypic and complex phrase types provide structural evidence for a multi-message display in humpback whales (Megaptera novaeangliae).

    Science.gov (United States)

    Murray, Anita; Dunlop, Rebecca A; Noad, Michael J; Goldizen, Anne W

    2018-02-01

    Male humpback whales produce a mating display called "song." Behavioral studies indicate song has inter- and/or intra-sexual functionality, suggesting song may be a multi-message display. Multi-message displays often include stereotypic components that convey group membership for mate attraction and/or male-male interactions, and complex components that convey individual quality for courtship. Humpback whale song contains sounds ("units") arranged into sequences ("phrases"). Repetitions of a specific phrase create a "theme." Within a theme, imperfect phrase repetitions ("phrase variants") create variability among phrases of the same type ("phrase type"). The hypothesis that song contains stereotypic and complex phrase types, structural characteristics consistent with a multi-message display, is investigated using recordings of 17 east Australian males (8:2004, 9:2011). Phrase types are categorized as stereotypic or complex using number of unit types, number of phrase variants, and the proportion of phrases that is unique to an individual versus shared amongst males. Unit types are determined using self-organizing maps. Phrase variants are determined by Levenshtein distances between phrases. Stereotypic phrase types have smaller numbers of unit types and shared phrase variants. Complex phrase types have larger numbers of unit types and unique phrase variants. This study supports the hypothesis that song could be a multi-message display.

  16. Acute doxorubicin insult in the mouse ovary is cell- and follicle-type dependent.

    Directory of Open Access Journals (Sweden)

    Elon C Roti Roti

    Full Text Available Primary ovarian insufficiency (POI is one of the many unintended consequences of chemotherapy faced by the growing number of female cancer survivors. While ovarian repercussions of chemotherapy have long been recognized, the acute insult phase and primary sites of damage are not well-studied, hampering efforts to design effective intervention therapies to protect the ovary. Utilizing doxorubicin (DXR as a model chemotherapy agent, we defined the acute timeline for drug accumulation, induced DNA damage, and subsequent cellular and follicular demise in the mouse ovary. DXR accumulated first in the core ovarian stroma cells, then redistributed outwards into the cortex and follicles in a time-dependent manner, without further increase in total ovarian drug levels after four hours post-injection. Consistent with early drug accumulation and intimate interactions with the blood supply, stroma cell-enriched populations exhibited an earlier DNA damage response (measurable at 2 hours than granulosa cells (measurable at 4 hours, as quantified by the comet assay. Granulosa cell-enriched populations were more sensitive however, responding with greater levels of DNA damage. The oocyte DNA damage response was delayed, and not measurable above background until 10-12 hours post-DXR injection. By 8 hours post-DXR injection and prior to the oocyte DNA damage response, the number of primary, secondary, and antral follicles exhibiting TUNEL (terminal deoxynucleotidyl transferase dUTP nick end labeling-positive granulosa cells plateaued, indicating late-stage apoptosis and suggesting damage to the oocytes is subsequent to somatic cell failure. Primordial follicles accumulate significant DXR by 4 hours post-injection, but do not exhibit TUNEL-positive granulosa cells until 48 hours post-injection, indicating delayed demise. Taken together, the data suggest effective intervention therapies designed to protect the ovary from chemotherapy accumulation and induced insult

  17. Genetic variation in the extended major histocompatibility complex and susceptibility to childhood acute lymphoblastic leukemia: a review of the evidence

    Directory of Open Access Journals (Sweden)

    Kevin Y Urayama

    2013-12-01

    Full Text Available The enduring suspicion that infections and immunologic response may play a role in the etiology of childhood leukemia, particularly acute lymphoblastic leukemia (ALL, is now supported, albeit still indirectly, by numerous epidemiological studies. The cumulative evidence includes, for example, descriptive observations of a peculiar peak incidence at age 2-5 years for ALL in economically developed countries, clustering of cases in situations of population mixing associated with unusual patterns of personal contacts, associations with various proxy measures for immune modulatory exposures early in life, and genetic susceptibility conferred by variation in genes involved in the immune system. In this review, our focus is the extended major histocompatibility complex (xMHC, an approximately 7.6 megabase region that is well-known for its high density of expressed genes, extensive polymorphisms exhibiting complex linkage disequilibrium patterns, and its disproportionately large number of immune-related genes, including human leukocyte antigen (HLA. First discovered through the role they play in transplant rejection, the classical HLA class I (HLA-A, -B, and -C and class II (HLA-DR, HLA-DQ, and HLA-DP molecules reside at the epicenter of the immune response pathways and are now the targets of many disease susceptibility studies, including those for childhood leukemia. The genes encoding the HLA molecules are only a minority of the over 250 expressed genes in the xMHC, and a growing number of studies are beginning to evaluate other loci through targeted investigations or utilizing a mapping approach with a comprehensive screen of the entire region. Here, we review the current epidemiologic evidence available to date regarding genetic variation contained within this highly unique region of the genome and its relationship with childhood ALL risk.

  18. Ultrafast third-order optical nonlinearity of several sandwich-type phthalocyaninato and porphyrinato europium complexes

    Science.gov (United States)

    Huang, Wen-Tao; Li, Yan; Xiang, Hong; Yang, Hong; Gong, Qi-Huang; Huang, Yan-Yi; Huang, Chun-Hui; Jiang, Jian-Zhuang

    2005-11-01

    The third-order optical nonlinearity of two sandwich-type phthalocyaninato and porphyrinato europium complexes, including double- and triple-deckers (Eu[Pc(OC5H11)8]2, Eu2(Pc)(TPP)2, Pc=phthalocyanine, TPP=5, 10, 15, 20- tetraphenylporphyrinate), was investigated by using the femtosecond time-resolved optical Kerr gate method at 830 nm wavelength. Their second-order hyperpolarizability is estimated to be 0.74×10-30esu and 3.0×10-30esu respectively. This exhibits an evident enhancement in comparison with 0.47×10-30esu for one-decker Eu(Pc)(acac) (acac=acetylacetonate), which is also measured under the same conditions. The enhancement is attributed to the introduction of lanthanide metal to the large π-conjugated system, intermacrocycle interaction and two-photon resonance etc.

  19. Molecular typing of Burkholderia cepacia complex isolated from patients attending an Italian Cystic Fibrosis Centre.

    Science.gov (United States)

    Teri, Antonio; Sottotetti, Samantha; Biffi, Arianna; Girelli, Daniela; D'Accico, Monica; Arghittu, Milena; Colombo, Carla; Corti, Fabiola; Pizzamiglio, Giovanna; Cariani, Lisa

    2018-03-02

    Bacteria from the Burkholderia cepacia complex (Bcc) are capable of causing severe infections in patients with cystic fibrosis (CF). Bcc infection is often extremely difficult to treat due to its intrinsic resistance to multiple antibiotics. In addition, it seems to speed up the decline of lung function and is considered a contraindication for lung transplantation in CF. This study investigates the species of the Bcc strains recovered from chronically infected CF subjects by means of: isolation, identification methods and complete recA nucleotide sequences of 151 samples. Molecular typing showed that B. cenocepacia III is the dominant strain found in the group of subjects being treated at the Milan CF Centre (Italy) and that the infection is chronically maintained by the same species. Defining species by means of molecular analysis yields important information for the clinician in order to establish the most appropriate therapy and implement correct measures for prevention of transmission among CF subjects.

  20. Efficient and selective hydrogen generation from bioethanol using ruthenium pincer-type complexes.

    Science.gov (United States)

    Sponholz, Peter; Mellmann, Dörthe; Cordes, Christoph; Alsabeh, Pamela G; Li, Bin; Li, Yang; Nielsen, Martin; Junge, Henrik; Dixneuf, Pierre; Beller, Matthias

    2014-09-01

    Catalytic generation of hydrogen from aqueous ethanol solution proceeds in the presence of pincer-type transition metal catalysts. Optimal results are obtained applying a [Ru(H)(Cl)(CO)(iPr2PEtN(H)EtPiPr2)] complex (catalyst TON 80,000) in the presence of water and base. This dehydrogenation reaction provides up to 70% acetic acid in a selective manner. For the first time, it is shown that bioethanol obtained from fermentation processes can be used directly in this protocol without the need for water removal. The produced hydrogen can be directly utilized in proton exchange membrane (PEM) fuel cells, since very low amounts of CO are formed. © 2014 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  1. Stabilization of the soluble, cleaved, trimeric form of the envelope glycoprotein complex of human immunodeficiency virus type 1

    NARCIS (Netherlands)

    Sanders, Rogier W.; Vesanen, Mika; Schuelke, Norbert; Master, Aditi; Schiffner, Linnea; Kalyanaraman, Roopa; Paluch, Maciej; Berkhout, Ben; Maddon, Paul J.; Olson, William C.; Lu, Min; Moore, John P.

    2002-01-01

    The envelope glycoprotein (Env) complex of human immunodeficiency virus type I has evolved a structure that is minimally immunogenic while retaining its natural function of receptor-mediated virus-cell fusion. The Env complex is trimeric; its six individual subunits (three gp120 and three gp41

  2. Postoperative peri-axillary seroma following axillary artery cannulation for surgical treatment of acute type A aortic dissection

    Directory of Open Access Journals (Sweden)

    Katsanos Konstantinos

    2010-05-01

    Full Text Available Abstract The arterial cannulation site for optimal tissue perfusion and cerebral protection during cardiopulmonary bypass (CPB for surgical treatment of acute type A aortic dissection remains controversial. Right axillary artery cannulation confers significant advantages, because it provides antegrade arterial perfusion during cardiopulmonary bypass, and allows continuous antegrade cerebral perfusion during hypothermic circulatory arrest, thereby minimizing global cerebral ischemia. However, right axillary artery cannulation has been associated with serious complications, including problems with systemic perfusion during cardiopulmonary bypass, problems with postoperative patency of the artery due to stenosis, thrombosis or dissection, and brachial plexus injury. We herein present the case of a 36-year-old Caucasian man with known Marfan syndrome and acute type A aortic dissection, who had direct right axillary artery cannulation for surgery of the ascending aorta. Postoperatively, the patient developed an axillary perigraft seroma. As this complication has, not, to our knowledge, been reported before in cardiothoracic surgery, we describe this unusual complication and discuss conservative and surgical treatment options.

  3. German Registry for Acute Aortic Dissection Type A (GERAADA)--new software design, parameters and their definitions.

    Science.gov (United States)

    Weigang, E; Görgen, C; Kallenbach, K; Dapunt, O; Karck, M

    2011-03-01

    The working group for aortic surgery and interventional vascular surgery of the German Society for Thoracic and Cardiovascular Surgery (GSTCVS) initiated the web-based German Registry for Acute Aortic Dissection type A (GERAADA). It is the project's aim to collect standardized data from a large pool of patients with acute aortic dissections type A (AADA) to gain a deeper insight and knowledge to improve surgical therapies and perioperative management for these patients in the future. In addition to new medical insights, the working group has gained more experience over the last 4 years in how to collect valid and high-quality data. This experience led us to revise the database completely. In this article we describe the new version of GERAADA, providing an overview as well as defining the parameters, and explaining the new features. This overview fulfills a request by the users of GERAADA in the participating centers. Since its inception, 50 cardiac centers in Germany, Austria and Switzerland have provided over 2000 records and the first statistical results have been published. GERAADA's new design allows it to stay abreast of changes in medicine and to focus on the essentials necessary for statistically relevant results, while keeping the work load low for the data providers at each cardiac center. © Georg Thieme Verlag KG Stuttgart · New York.

  4. Complex structure of type VI peptidoglycan muramidase effector and a cognate immunity protein

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Tianyu [Institute of Biophysics, Chinese Academy of Sciences, Beijing 100101 (China); University of Chinese Academy of Sciences, Beijing 100049 (China); Ding, Jinjing; Zhang, Ying; Wang, Da-Cheng, E-mail: dcwang@ibp.ac.cn [Institute of Biophysics, Chinese Academy of Sciences, Beijing 100101 (China); Liu, Wei, E-mail: dcwang@ibp.ac.cn [The Third Military Medical University, Chongqing 400038 (China); Institute of Biophysics, Chinese Academy of Sciences, Beijing 100101 (China)

    2013-10-01

    The structure of the Tse3–Tsi3 complex associated with the bacterial type VI secretion system of P. aeruginosa has been solved and refined at 1.9 Å resolution. The structural basis of the recognition of the muramidase effector and its inactivation by its cognate immunity protein is revealed. The type VI secretion system (T6SS) is a bacterial protein-export machine that is capable of delivering virulence effectors between Gram-negative bacteria. The T6SS of Pseudomonas aeruginosa transports two lytic enzymes, Tse1 and Tse3, to degrade cell-wall peptidoglycan in the periplasm of rival bacteria that are competing for niches via amidase and muramidase activities, respectively. Two cognate immunity proteins, Tsi1 and Tsi3, are produced by the bacterium to inactivate the two antibacterial effectors, thereby protecting its siblings from self-intoxication. Recently, Tse1–Tsi1 has been structurally characterized. Here, the structure of the Tse3–Tsi3 complex is reported at 1.9 Å resolution. The results reveal that Tse3 contains a C-terminal catalytic domain that adopts a soluble lytic transglycosylase (SLT) fold in which three calcium-binding sites were surprisingly observed close to the catalytic Glu residue. The electrostatic properties of the substrate-binding groove are also distinctive from those of known structures with a similar fold. All of these features imply that a unique catalytic mechanism is utilized by Tse3 in cleaving glycosidic bonds. Tsi3 comprises a single domain showing a β-sandwich architecture that is reminiscent of the immunoglobulin fold. Three loops of Tsi3 insert deeply into the groove of Tse3 and completely occlude its active site, which forms the structural basis of Tse3 inactivation. This work is the first crystallographic report describing the three-dimensional structure of the Tse3–Tsi3 effector–immunity pair.

  5. Complex permittivity, permeability, magnetic and microwave absorbing properties of Bi3+ substituted U-type hexaferrite

    Science.gov (United States)

    Kumar, Sandeep; Chatterjee, Ratnamala

    2018-02-01

    Bi3+ substituted polycrystalline samples of Barium U-type hexaferrite, (Ba 1 - 3 xBi2x) 4Co2Fe36O60 (0.05 ≤ x ≤ 0.15, in steps of 0.05), were prepared through solid state reaction route. The effect of Bi3+ substitution on the structural properties of Barium hexaferrrite samples was investigated through X-ray diffraction (XRD) studies. Le Bail refinement of XRD patterns confirmed the formation of desired U-type hexaferrite phase in all the prepared samples. The room temperature magnetic hysteresis (M-H) loops shows that the saturation magnetization (Ms) initially increases to 63.5 emu/g for x = 0.10 sample and then reduces to 55.3 emu/g for x = 0.15 sample. Nicholson-Ross-Weir (NRW) algorithm has been employed to calculate the complex permittivity (ε∗ =ε‧ - iε″) and permeability (μ∗ =μ‧ - iμ″) spectra in 2-18 GHz frequency range. The reflection loss (RL) was calculated from the complex permittivity (ε∗) and permeability (μ∗) spectra using transmission line theory. The minimum reflection loss (RLmin) of -35.5 dB (MW absorption of 99.97%) was obtained for (Ba0.55Bi0.30)4Co2Fe36O60 sample at 10.6 GHz MW frequency. Moreover, the broad frequency bandwidth of 8.4 GHz (over X- and Ku-band), for the reflection loss of -10 dB (90% MW absorption) or less, was attained in (Ba0.55Bi0.30)4Co2Fe36O60 sample.

  6. Complexing agents and pH influence on chemical durability of type I moulded glass containers.

    Science.gov (United States)

    Biavati, Alberto; Poncini, Michele; Ferrarini, Arianna; Favaro, Nicola; Scarpa, Martina; Vallotto, Marta

    2017-06-16

    Among the factors that affect the glass surface chemical durability, pH and complexing agents presence in aqueous solution have the main role (1). Glass surface attack can be also related to the delamination issue with glass particles appearance in the pharmaceutical preparation. A few methods to check for glass containers delamination propensity and some control guidelines have been proposed (2,3). The present study emphasizes the possible synergy between a few complexing agents with pH on the borosilicate glass chemical durability. Hydrolytic attack was performed in small volume 23 ml type I glass containers autoclaved according to EP or USP for 1 hour at 121°C, in order to enhance the chemical attack due to time, temperature and the unfavourable surface/volume ratio. 0,048 M or 0.024 M (moles/liter) solutions of the acids citric, glutaric, acetic, EDTA (ethylenediaminetetraacetic acid) and sodium phosphate with water for comparison, were used for the trials. The pH was adjusted ± 0,05 units at fixed values 5,5-6,6-7-7,4-8-9 by LiOH diluted solution. Since silicon is the main glass network former, silicon release into the attack solutions was chosen as the main index of the glass surface attack and analysed by ICPAES. The work was completed by the analysis of the silicon release in the worst attack conditions, of moulded glass, soda lime type II and tubing borosilicate glass vials to compare different glass compositions and forming technologies. Surface analysis by SEM was finally performed to check for the surface status after the worst chemical attack condition by citric acid. Copyright © 2017, Parenteral Drug Association.

  7. The relationship between coronary stenosis severity and compression type coronary artery movement in acute myocardial infarction.

    Science.gov (United States)

    Chan, Kim H; Chawantanpipat, Chirapan; Gattorna, Tim; Chantadansuwan, Thamarath; Kirby, Adrienne; Madden, Ann; Keech, Anthony; Ng, Martin K C

    2010-04-01

    Acute myocardial infarction is thought to occur at sites of minor coronary stenosis. Recent data challenge this and also propose a role for coronary artery movement (CAM) in plaque instability. We examined the relationship between coronary stenosis severity, CAM pattern, and infarct-related lesions (IRLs) in acute myocardial infarction. We investigated 203 consecutive patients with ST-segment elevation myocardial infarction after successful fibrinolysis. Quantitative coronary angiography, CAM pattern, and extent score (atheroma burden) analysis was performed for each coronary artery segment. The IRL stenosis was at least moderate (>50%) and severe (>70%) in 78% and 31% of patients, respectively. Culprit arteries were associated with higher atheroma extent scores (25.2 vs 21.6, P 70% vs Compression CAM was also strongly associated with culprit segments (OR 3.4, 95% CI 2.6-4.5, P compression CAM and stenosis severity were strongly correlated, with the likelihood of a coronary segment having compression CAM progressively increasing with worsening stenosis (OR 56.4, 95% CI 37.9-83.8, P 70% vs relationship between stenosis severity and IRLs. Our study also raises the hypothesis that compression CAM may accelerate atherosclerosis and predispose to plaque vulnerability. Copyright 2010 Mosby, Inc. All rights reserved.

  8. Crystal structure of two new bifunctional nonsubstrate type thrombin inhibitors complexed with human alpha-thrombin.

    Science.gov (United States)

    Féthière, J; Tsuda, Y; Coulombe, R; Konishi, Y; Cygler, M

    1996-06-01

    The crystal structures of two new thrombin inhibitors, P498 and P500, complexed with human alpha-thrombin have been determined at 2.0 A resolution and refined to crystallographic R-factors of 0.170 and 0.169, respectively. These compounds, with picomolar binding constants, belong to a family of potent bifunctional inhibitors that bind thrombin at two remote sites: the active site and the fibrinogen recognition exosite (FRE). The inhibitors incorporate a nonsubstrate type active site binding fragment: Dansyl-Arg-(D)Pipecolic acid (Dns-Arg-(D)Pip), reminiscent of the active-site directed inhibitors MD-805 and MQPA, rendering them resistant to thrombin-induced hydrolysis. The FRE binding fragment of these inhibitors corresponds to the hirudin55-65 sequence. They differ in the chemical nature of the nonpeptidyl linker bridging these two functional activities. In both cases, the active site binding fragment is well defined in the electron density. The DnsH1, ArgH2, and (D)PipH3 groups occupy the S3, S1, and S2 subsites of thrombin, respectively, in a way similar to that observed in the thrombin-MQPA complexes. Binding in the active site of thrombin is characterized by numerous van der Waals contacts and ring-ring system interactions. Unlike in the substrate-like inhibitors, ArgH2 enters the S1 specificity pocket from the P2 position and adopts a bent conformation to make an hydrogen bond to the carboxylate of Asp189. In this noncanonical position, its carbonyl points away from the oxyanion hole, which is now occupied by well-ordered solvent molecules. The linkers fit in the groove extending from the active site to the FRE. The C-terminal fragments of both inhibitors bind in the same way as analogous FRE binding elements in previously described complexes.

  9. Unique cell type-specific junctional complexes in vascular endothelium of human and rat liver sinusoids.

    Directory of Open Access Journals (Sweden)

    Cyrill Géraud

    Full Text Available Liver sinusoidal endothelium is strategically positioned to control access of fluids, macromolecules and cells to the liver parenchyma and to serve clearance functions upstream of the hepatocytes. While clearance of macromolecular debris from the peripheral blood is performed by liver sinusoidal endothelial cells (LSECs using a delicate endocytic receptor system featuring stabilin-1 and -2, the mannose receptor and CD32b, vascular permeability and cell trafficking are controlled by transcellular pores, i.e. the fenestrae, and by intercellular junctional complexes. In contrast to blood vascular and lymphatic endothelial cells in other organs, the junctional complexes of LSECs have not yet been consistently characterized in molecular terms. In a comprehensive analysis, we here show that LSECs express the typical proteins found in endothelial adherens junctions (AJ, i.e. VE-cadherin as well as α-, β-, p120-catenin and plakoglobin. Tight junction (TJ transmembrane proteins typical of endothelial cells, i.e. claudin-5 and occludin, were not expressed by rat LSECs while heterogenous immunreactivity for claudin-5 was detected in human LSECs. In contrast, junctional molecules preferentially associating with TJ such as JAM-A, B and C and zonula occludens proteins ZO-1 and ZO-2 were readily detected in LSECs. Remarkably, among the JAMs JAM-C was considerably over-expressed in LSECs as compared to lung microvascular endothelial cells. In conclusion, we show here that LSECs form a special kind of mixed-type intercellular junctions characterized by co-occurrence of endothelial AJ proteins, and of ZO-1 and -2, and JAMs. The distinct molecular architecture of the intercellular junctional complexes of LSECs corroborates previous ultrastructural findings and provides the molecular basis for further analyses of the endothelial barrier function of liver sinusoids under pathologic conditions ranging from hepatic inflammation to formation of liver metastasis.

  10. Complex formation and functional interaction between adenosine A1 receptor and type-1 metabotropic glutamate receptor

    Directory of Open Access Journals (Sweden)

    Yuji Kamikubo

    2015-07-01

    Full Text Available The adenosine A1 receptor (A1R is a G protein-coupled receptor (GPCR for adenosine, a ubiquitous neuromodulator, and thus regulates neuronal excitability, as well as arousal and sensitivity to pain. In addition, we have previously described a new mode of action for A1R: in cerebellar Purkinje cells, its activation attenuates neuronal responses to glutamate, as mediated by the type-1 metabotropic glutamate receptor (mGluR1. mGluR1 is also a GPCR, and elicits such responses as long-term depression of the postsynaptic response to glutamate, a cellular basis for cerebellar motor learning. Here, we explore in greater detail the interaction between A1R and mGluR1 using non-neuronal cells. Co-immunoprecipitation and Förster resonance energy transfer (FRET analysis reveal that A1R and mGluR1 form a complex. Furthermore, we found that mGluR1 activation inhibits A1R signaling, as measured by changes in intracellular cAMP. These findings demonstrate that A1R and mGluR1 have the intrinsic ability to form a heteromeric complex and mutually modulate signaling. This interaction may represent a new form of intriguing GPCR-mediated cellular responses.

  11. Evidence for an iron-hydrogen complex in p-type silicon

    Energy Technology Data Exchange (ETDEWEB)

    Leonard, S., E-mail: simon.leonard@manchester.ac.uk; Markevich, V. P.; Peaker, A. R.; Hamilton, B. [Photon Science Institute, University of Manchester, Manchester M13 9PL (United Kingdom); Murphy, J. D. [School of Engineering, University of Warwick, Coventry CV4 7AL (United Kingdom)

    2015-07-20

    Interactions of hydrogen with iron have been studied in Fe contaminated p-type Czochralski silicon using capacitance-voltage profiling and deep level transient spectroscopy (DLTS). Hydrogen has been introduced into the samples from a silicon nitride layer grown by plasma enhanced chemical vapor deposition. After annealing of the Schottky diodes on Si:Fe + H samples under reverse bias in the temperature range of 90–120 °C, a trap has been observed in the DLTS spectra which we have assigned to a Fe-H complex. The trap is only observed when a high concentration of hydrogen is present in the near surface region. The trap concentration is higher in samples with a higher concentration of single interstitial Fe atoms. The defect has a deep donor level at E{sub v} + 0.31 eV. Direct measurements of capture cross section of holes have shown that the capture cross section is not temperature dependent and its value is 5.2 × 10{sup −17} cm{sup 2}. It is found from an isochronal annealing study that the Fe-H complex is not very stable and can be eliminated completely by annealing for 30 min at 125 °C.

  12. Attomolar detection of botulinum toxin type A in complex biological matrices.

    Directory of Open Access Journals (Sweden)

    Karine Bagramyan

    Full Text Available BACKGROUND: A highly sensitive, rapid and cost efficient method that can detect active botulinum neurotoxin (BoNT in complex biological samples such as foods or serum is desired in order to 1 counter the potential bioterrorist threat 2 enhance food safety 3 enable future pharmacokinetic studies in medical applications that utilize BoNTs. METHODOLOGY/PRINCIPAL FINDINGS: Here we describe a botulinum neurotoxin serotype A assay with a large immuno-sorbent surface area (BoNT/A ALISSA that captures a low number of toxin molecules and measures their intrinsic metalloprotease activity with a fluorogenic substrate. In direct comparison with the "gold standard" mouse bioassay, the ALISSA is four to five orders of magnitudes more sensitive and considerably faster. Our method reaches attomolar sensitivities in serum, milk, carrot juice, and in the diluent fluid used in the mouse assay. ALISSA has high specificity for the targeted type A toxin when tested against alternative proteases including other BoNT serotypes and trypsin, and it detects the holotoxin as well as the multi-protein complex form of BoNT/A. The assay was optimized for temperature, substrate concentration, size and volume proportions of the immuno-sorbent matrix, enrichment and reaction times. Finally, a kinetic model is presented that is consistent with the observed improvement in sensitivity. CONCLUSIONS/SIGNIFICANCE: The sensitivity, specificity, speed and simplicity of the BoNT ALISSA should make this method attractive for diagnostic, biodefense and pharmacological applications.

  13. Distribution of yeast complexes in the profiles of different soil types

    Science.gov (United States)

    Glushakova, A. M.; Kachalkin, A. V.; Tiunov, A. V.; Chernov, I. Yu.

    2017-07-01

    The number and taxonomic structure of the yeast complexes were investigated in the full profiles of the soddy-podzolic soil (Central Forest State Nature Biosphere Reserve), dark gray forest soil (Kaluzhskie Zaseki Reserve), and chernozem (Privolzhskaya Forest-Steppe Reserve). In all these soils, the number of yeasts was maximal (104 CFU/g) directly under the litter; it drastically decreased with the depth. However, at the depth of 120-160 cm, the number of yeasts significantly increased in all the soils; their maximum was found in the illuvial horizon of the soddy-podzolic soil. Such a statistically significant increase in the number of yeasts at a considerable depth was found for the first time. Different groups of yeasts were present in the yeast communities of different soils. The species structure of yeast communities changed little in each soil: the same species were isolated both from the soil surface and from the depth of more than 2 m. The results showed that yeasts could be used for soil bioindication on the basis of specific yeast complexes in the profiles of different soil types rather than individual indicative species.

  14. Complex endodontic treatment of an immature type III dens invaginatus. A case report.

    Science.gov (United States)

    Fregnani, E R; Spinola, L F B; Sônego, J R O; Bueno, C E S; De Martin, A S

    2008-10-01

    To report the endodontic treatment of an immature maxillary central incisor with dens invaginatus. Dens invaginatus is a rare malformation of teeth, probably resulting from an infolding of the dental papilla during tooth development. The present case describes the complex endodontic treatment of a type III dens invaginatus in an immature maxillary central incisor with a necrotic pulp and abscess formation. The initial treatment goal was to achieve apexification of the pseudocanal root and conservative root canal treatment in the main canal. Following 1-year of treatment with calcium hydroxide dressings, radiography revealed a healing response, but no sign of a hard tissue barrier at the apex. Periapical surgery with the placement of a zinc oxide cement (IRM) root-end filling was considered successful at the 4-year follow-up. The complexity of the canal system and open apex in dens invaginatus present a challenge to endodontic treatment. Correct diagnosis and treatment planning are fundamental to treatment of dens invaginatus. Periapical surgery is indicated in cases of unsuccessful apexification in immature teeth with dens invaginatus and nonvital pulp.

  15. Mechanics of metal-catecholate complexes: The roles of coordination state and metal types

    Science.gov (United States)

    Xu, Zhiping

    2013-01-01

    There have been growing evidences for the critical roles of metal-coordination complexes in defining structural and mechanical properties of unmineralized biological materials, including hardness, toughness, and abrasion resistance. Their dynamic (e.g. pH-responsive, self-healable, reversible) properties inspire promising applications of synthetic materials following this concept. However, mechanics of these coordination crosslinks, which lays the ground for predictive and rational material design, has not yet been well addressed. Here we present a first-principles study of representative coordination complexes between metals and catechols. The results show that these crosslinks offer stiffness and strength near a covalent bond, which strongly depend on the coordination state and type of metals. This dependence is discussed by analyzing the nature of bonding between metals and catechols. The responsive mechanics of metal-coordination is further mapped from the single-molecule level to a networked material. The results presented here provide fundamental understanding and principles for material selection in metal-coordination-based applications. PMID:24107799

  16. Herpes simplex type 1 pneumonitis and acute respiratory distress syndrome in a patient with chronic lymphatic leukemia: a case report.

    Science.gov (United States)

    Luginbuehl, Miriam; Imhof, Alexander; Klarer, Alexander

    2017-11-23

    Pulmonary pathogenicity of herpes simplex virus type 1 in patients in intensive care without classic immunosuppression as well as the necessity of antiviral treatment in the case of herpes simplex virus detection in respiratory specimens in these patients is controversial. We present a case of acute respiratory distress syndrome in a patient with stable chronic lymphatic leukemia not requiring treatment, in whom we diagnosed herpes simplex virus type 1 bronchopneumonitis based on herpes simplex virus type 1 detection in bronchoalveolar lavage fluid and clinical response to antiviral treatment. A 72-year-old white man presented with symptoms of lower respiratory tract infection. His medical history was significant for chronic lymphatic leukemia, which had been stable without treatment, arterial hypertension, multiple squamous cell carcinomas of the scalp, and alcohol overuse. Community-acquired pneumonia was suspected and appropriate broad-spectrum antibacterial treatment was initiated. Within a few hours, rapid respiratory deterioration led to cardiac arrest. He was successfully resuscitated, but developed acute respiratory distress syndrome. Furthermore, he remained febrile and inflammation markers remained elevated despite antibacterial treatment. Polymerase chain reaction from bronchoalveolar lavage fluid and viral culture from tracheobronchial secretions tested positive for herpes simplex virus type 1. We initiated antiviral treatment with acyclovir. Concomitantly we further escalated the antibacterial treatment, although no bacterial pathogen had been isolated at any point. Defervescence occurred rapidly and his C-reactive protein and leukocyte levels decreased. He was successfully weaned from mechanical ventilation, transferred to the ward, and eventually discharged to home. Herpes simplex virus should be considered a cause for lower respiratory tract infection in critically ill patients, especially in the setting of an underlying disease.

  17. Acute effects of different types of oil consumption on endothelial function, oxidative stress status and vascular inflammation in healthy volunteers.

    Science.gov (United States)

    Tousoulis, Dimitris; Papageorgiou, Nikolaos; Antoniades, Charalambos; Giolis, Anastasios; Bouras, George; Gounari, Panagiota; Stefanadi, Elli; Miliou, Antigoni; Psaltopoulou, Theodora; Stefanadis, Christodoulos

    2010-01-01

    Consumption of different types of oil may have different effects on cardiovascular risk. The exact role of maize oil, cod liver oil, soya oil and extra virgin olive oil on endothelial function, oxidative stress and inflammation is unknown. We evaluated the effect of acute consumption of these types of oil on endothelial function, oxidative stress and inflammation in healthy adults. Thirty-seven healthy volunteers were randomised to receive an oral amount of each type of oil or water. Endothelial function was evaluated by gauge-strain plethysmography at baseline and 1, 2 and 3 h after consumption. Oxidative stress status was determined by total lipid peroxides (PEROX), while inflammatory process was estimated by measuring the soluble form of vascular adhesion molecule 1. Serum levels of the two previous markers were measured at baseline and 3 h after oil consumption. Reactive hyperaemia (RH) was significantly decreased after maize oil consumption compared with controls (P type of oil consumption on endothelium-independent dilatation, total lipid PEROX and vascular adhesion molecule 1 serum levels. Consumption of maize oil leads to impaired endothelial function, while soya oil and cod liver oil slightly improve endothelial function. However, all types of oils did not affect inflammatory process and systemic oxidative stress, suggesting that their effect on endothelial function may not be mediated by free radicals bioavailability.

  18. On the new type of thorium-rare metal mineralization related to carbonatite complexes

    International Nuclear Information System (INIS)

    Bargasarov, Yu.A.; Ginzburg, A.I.; Frolov, A.A.

    1974-01-01

    A description is given of a new type of thorium-rare metal mineralization which is genetically associated with alkaline-ultrabasic carbonate complexes and controlled by the same fractured zones as these plutons. Deposits of this type occur over non-outcropping masses of ultrabasic alkaline rocks and carbonatites or on their continuations and are regarded as typical supraintrusive formations, highly characteristic regions in which elements from these rock masses are deposited. Here are concentrated those elements which are removed from the ultrabasic alkaline rocks when carbonatites devlop in them, viz. sodium, silicon, rare earths, thorium, barium, scandium, etc. Such deposits are formed in several stages; the early stages are characterized by intensive processes of silicification (outer aureoles of fenitization) and albitization, with which thorite-xenotime mineralization is associated. The later stages are very similar in composition to the ankerite carbonatites. The localization of all stages of the hydrothermal process along the same tectonic zones is responsible for the development of telescopic phenomena and the highly characteristic nature of such deposits. The occurrence of mineralized zones with rare-earth and thorium mineralization in a number of cases may indicate the presence of deep hidden carbonatite rock masses which have no outcrop, a fact which should be taken into account during prospective work. (author)

  19. Complex regional pain syndrome type i. An analysis of 7 cases in children.

    Science.gov (United States)

    Pedemonte Stalla, V; Medici Olaso, C; Kanopa Almada, V; Gonzalez Rabelino, G

    2015-01-01

    Complex regional pain syndrome (CRPS) is characterised by the presence of pain accompanied by sensory, autonomic and motor symptoms, usually preceded by a lesion or immobilisation. The clinical course is disproportionate to the initial injury in intensity and in duration. Its distribution is regional, predominantly in limbs. It is classified as type I and type II according to the absence or presence of nerve injury. We present the cases of seven children, 6 girls and 1 boy, aged 7 to 15 years. Three had a history of previous trauma. In 5 cases, the symptoms were located in the lower limbs. Time to diagnosis was between 4 and 90 days. Three patients had clinical features of anxiety and depression. Imaging and immunological studies were performed to rule out differential diagnoses in all the children. Interdisciplinary treatment was performed with physiotherapy, psychotherapy, and gabapentin or pregabalin. All patients had a good clinical outcome, with no relapses in the follow-up period (between 4 and 30 months). CRPS is frequently unrecognised in children, leading to family anxiety and unnecessary para-clinical costs. Paediatricians and paediatric neurologists should be aware of this syndrome in order to avoid delay in diagnosis, unnecessary studies, and multiple visits to specialists, with a view to providing effective treatment. Copyright © 2013 Sociedad Española de Neurología. Published by Elsevier España, S.L.U. All rights reserved.

  20. Randomised controlled trial of gabapentin in Complex Regional Pain Syndrome type 1 [ISRCTN84121379

    Directory of Open Access Journals (Sweden)

    Weber Wim EJ

    2004-09-01

    Full Text Available Abstract Background Complex Regional Pain Syndrome type one (CRPS I or formerly Reflex Sympathetic Dystrophy (RSD is a disabling syndrome, in which a painful limb is accompanied by varying symptoms. Neuropathic pain is a prominent feature of CRPS I, and is often refractory to treatment. Since gabapentin is an anticonvulsant with a proven analgesic effect in various neuropathic pain syndromes, we sought to study the efficacy of the anticonvulsant gabapentin as treatment for pain in patients with CRPS I. Methods We did a randomized double blind placebo controlled crossover study with two three-weeks treatment periods with gabapentin and placebo separated by a two-weeks washout period. Patients started at random with gabapentin or placebo, which was administered in identical capsules three times daily. We included 58 patients with CRPS type 1. Results Patients reported significant pain relief in favor of gabapentin in the first period. Therapy effect in the second period was less; finally resulting in no significant effect combining results of both periods. The CRPS patients had sensory deficits at baseline. We found that this sensory deficit was significantly reversed in gabapentin users in comparison to placebo users. Conclusions Gabapentin had a mild effect on pain in CRPS I. It significantly reduced the sensory deficit in the affected limb. A subpopulation of CRPS patients may benefit from gabapentin.

  1. Kyrieleis plaques associated with Herpes Simplex Virus type 1 acute retinal necrosis

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    Neha Goel

    2016-04-01

    Full Text Available We report the case of a 55-year-old immunocompetent male who presented with features typical of acute retinal necrosis (ARN. Polymerase chain reaction of the aqueous tap was positive for Herpes Simplex Virus (HSV – 1. Following therapy with intravenous Acyclovir, followed by oral Acyclovir and steroids, there was marked improvement in the visual acuity and clinical picture. At one week after initiation of treatment, Kyrieleis plaques were observed in the retinal arteries. They became more prominent despite resolution of the vitritis, retinal necrosis and vasculitis and persisted till six weeks of follow-up, when fluorescein angiography was performed. The appearance of this segmental retinal periarteritis also known as Kyrieleis plaques has not been described in ARN due to HSV-1 earlier.

  2. Platelet degranulation and monocyte-platelet complex formation are increased in the acute and convalescent phases after ischaemic stroke or transient ischaemic attack.

    LENUS (Irish Health Repository)

    McCabe, Dominick J H

    2004-06-01

    Flow cytometric studies suggest that platelets are activated in ischaemic stroke or transient ischaemic attack (TIA). However, few studies have measured circulating leucocyte-platelet complexes in this patient population. Whole blood flow cytometry was used to quantify the expression of CD62P-, CD63-, and PAC1-binding, and the percentages of leucocyte-platelet complexes in acute (1-27 d, n = 79) and convalescent (79-725 d, n = 70) ischaemic cerebrovascular disease (CVD) patients compared with controls without CVD (n = 27). We performed a full blood count, and measured plasma levels of soluble P-selectin, soluble E-selectin, and von Willebrand factor antigen (VWF:Ag) as additional markers of platelet and\\/or endothelial cell activation. The median percentage CD62P expression and the median percentage monocyte-platelet complexes were higher in both acute and convalescent CVD patients than controls (P <\\/= 0.02). The mean white cell count and mean VWF:Ag levels were significantly elevated in the acute and convalescent phases after ischaemic stroke or TIA (P <\\/= 0.02). Otherwise, there was no significant increase in any other marker of platelet or endothelial activation in CVD patients. There was a positive correlation between the percentage expression of CD62P and the percentages of both neutrophil-platelet and monocyte-platelet complexes in the acute phase, and the percentages of all leucocyte-platelet complexes in the convalescent phase after ischaemic CVD. This study provides evidence for ongoing excessive platelet and\\/or endothelial activation in ischaemic CVD patients despite treatment with antithrombotic therapy.

  3. Sitagliptin use and risk of acute pancreatitis in type 2 diabetes mellitus: A population-based case-control study in Taiwan.

    Science.gov (United States)

    Liao, Kuan-Fu; Lin, Cheng-Li; Lai, Shih-Wei; Chen, Wen-Chi

    2016-01-01

    There is still lack of definite evidence to establish the association between sitagliptin use and acute pancreatitis. The study aimed to test this issue in Taiwan. This case-control study was designed to analyze the database of the Taiwan National Health Insurance Program. There were 349 subjects with type 2 diabetes mellitus aged 20-84 with a first-attack of acute pancreatitis from 2009 to 2011 as the case group and 1116 randomly selected subjects with type 2 diabetes mellitus without acute pancreatitis as the control group. Both groups were matched with sex, age, comorbidities, and index year of diagnosing acute pancreatitis. Current use of sitagliptin was defined as subjects who had their last tablet of sitagliptin ≤7 days before the date of diagnosing acute pancreatitis. Late use of sitagliptin was defined as subjects who had their last tablet of sitagliptin between 8 and 30 days before the date of diagnosing acute pancreatitis. Never use of sitagliptin was defined as subjects who never had a sitagliptin prescription. The risk of acute pancreatitis associated with sitagliptin use was estimated by the odds ratio (OR) and 95% confidence interval (CI) using the multivariable logistic regression model. After statistical correction for potential confounders, the adjusted OR of acute pancreatitis was 2.47 for subjects with current use of sitagliptin (95% CI 0.84, 7.28), when compared with those never using sitagliptin, but without statistical significance. The adjusted OR decreased to 1.14 for subjects with late use of sitagliptin (95% CI 0.66, 1.98), but without statistical significance. No significant association is detected between sitagliptin use and acute pancreatitis in type 2 diabetes mellitus. Copyright © 2015 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

  4. Acute renal effects of the GLP-1 receptor agonist exenatide in overweight type 2 diabetes patients: a randomised, double-blind, placebo-controlled trial

    NARCIS (Netherlands)

    L. Tonneijck (Lennart); M.M. Smits (Mark M.); M.H.A. Muskiet (Marcel H. A.); T. Hoekstra (Trynke); M.H.H. Kramer (Mark); A.H.J. Danser (Jan); M. Diamant (Michaela); J.A. Joles (Jaap); D.H. van Raalte (Daniël H.)

    2016-01-01

    textabstractAims/hypothesis: This study aimed to investigate the acute renal effects of the glucagon-like peptide-1 receptor agonist (GLP-1RA) exenatide in type 2 diabetes patients. Methods: We included overweight (BMI 25–40 kg/m2) men and postmenopausal women, aged 35–75 years with type 2 diabetes

  5. Acute renal effects of the GLP-1 receptor agonist exenatide in overweight type 2 diabetes patients : a randomised, double-blind, placebo-controlled trial

    NARCIS (Netherlands)

    Tonneijck, Lennart; Smits, Mark M.; Muskiet, Marcel H A; Hoekstra, Trynke; Kramer, Mark H H; Danser, A. H Jan; Diamant, Michaela; Joles, Jaap A.; van Raalte, Daniël H.

    2016-01-01

    Aims/hypothesis: This study aimed to investigate the acute renal effects of the glucagon-like peptide-1 receptor agonist (GLP-1RA) exenatide in type 2 diabetes patients. Methods: We included overweight (BMI 25–40 kg/m2) men and postmenopausal women, aged 35–75 years with type 2 diabetes (HbA1c

  6. Acute renal effects of the GLP-1 receptor agonist exenatide in overweight type 2 diabetes patients : a randomised, double-blind, placebo-controlled trial

    NARCIS (Netherlands)

    Tonneijck, Lennart; Smits, Mark M; Muskiet, Marcel H A; Hoekstra, T.; Kramer, Mark H H; Danser, A H Jan; Diamant, Michaela; Joles, Jaap A; van Raalte, Daniël H

    AIMS/HYPOTHESIS: This study aimed to investigate the acute renal effects of the glucagon-like peptide-1 receptor agonist (GLP-1RA) exenatide in type 2 diabetes patients. METHODS: We included overweight (BMI 25-40 kg/m(2)) men and postmenopausal women, aged 35-75 years with type 2 diabetes (HbA1c

  7. Heart rate acceleration with GLP-1 receptor agonists in type 2 diabetes patients : an acute and 12-week randomised, double-blind, placebo-controlled trial

    NARCIS (Netherlands)

    Smits, Mark M; Tonneijck, Lennart; Muskiet, Marcel H A; Hoekstra, T.; Kramer, Mark H H; Diamant, Michaela; van Raalte, Daniël H

    OBJECTIVE: To examine mechanisms underlying resting heart rate (RHR) increments of GLP-1 receptor agonists in type 2 diabetes patients. DESIGN: Acute and 12-week randomised, placebo-controlled, double-blind, single-centre, parallel-group trial. METHODS: In total, 57 type 2 diabetes patients

  8. Pharmacokinetics and pharmacodynamics of saruplase, an unglycosylated single-chain urokinase-type plasminogen activator, in patients with acute myocardial infarction

    NARCIS (Netherlands)

    Koster, R. W.; Cohen, A. F.; Hopkins, G. R.; Beier, H.; Günzler, W. A.; van der Wouw, P. A.

    1994-01-01

    We examined in patients with acute myocardial infarction (AMI) the pharmacokinetics of saruplase, an unglycosylated, single chain, urokinase-type plasminogen activator (rscu-PA) by measuring urokinase-type plasminogen activator (u-PA) antigen and total u-PA activity, its conversion to active

  9. Dental insurance and dental care among working-age adults: differences by type and complexity of disability.

    Science.gov (United States)

    Horner-Johnson, Willi; Dobbertin, Konrad

    2016-09-01

    People with disabilities experience barriers to dental care, which may vary depending on type of disability and disability complexity (e.g., impact on activities of daily living). The purpose of this study was to examine differences in dental insurance, receipt of dental checkups, and delayed and unmet needs for dental care by type and complexity of disability. We conducted cross-sectional analysis of 2002-2011 data from the Medical Expenditure Panel Survey. Multivariable logistic regression analyses compared adults ages 18-64 in five disability type groups (physical, cognitive, vision, hearing, or multiple disabilities) to those with no disabilities, and compared people with complex activity limitations to those without complex limitations. All disability types except hearing had significantly higher adjusted odds of being without dental insurance, as did people with complex activity limitations. All disability groups except those with cognitive disabilities had increased odds of receiving dental checkups less than once a year. Similarly, all disability groups were at increased risk of both delayed and unmet needs for dental care. Odds ratios were generally highest for people with multiple types of disabilities. There are significant disparities in having dental insurance and receiving dental care for adults with disabilities, especially those with multiple types of disabilities, after controlling for socioeconomic and demographic differences. Further, disparities in care were apparent even when controlling for presence of dental insurance. © 2016 American Association of Public Health Dentistry.

  10. Effects of one year simvastatin and atorvastatin treatments on acute phase reactants in uncontrolled type 2 diabetic patients.

    Science.gov (United States)

    Ukinc, Kubilay; Ersoz, Halil Onder; Erem, Cihangir; Hacihasanoglu, Arif Bayram; Karti, Suleyman Sami

    2009-06-01

    Type 2 diabetes mellitus is the leading cause of macrovascular diseases and related death. Additionally, diabetes mellitus is frequently complicated by other cardiovascular risk factors, such as hypercholesterolemia, hypertension, obesity, hypercoagulability, and inflammation. We wanted to evaluate and compare the effects of treating with a one-year course of atorvastatin or simvastatin on inflammatory markers such as high sensitive C-reactive protein (hsCRP), fibrinogen, and ferritin in uncontrolled type 2 diabetic patients. Also, we planned to investigate the correlation between inflammatory markers and metabolic parameters. Fifty type 2 diabetic patients (30 women, 20 men; mean age: 49.9 +/- 8.5 years) were enrolled into the study. Twenty healthy subjects, matched on body mass index and age, were also included in the study as a control group. Diabetic patients were divided into two groups and received simvastatin or atorvastatin (Group S and A, respectively). After 1 year of statin treatment (Group A), there were significant decreases in total cholesterol (217.3 +/- 46.5-173.8 +/- 37.2 mg/dl; P acute phase reactants in uncontrolled type 2 diabetic patients.

  11. The impact of acute high-intensity interval exercise on biomarkers of cardiovascular health in type 2 diabetes.

    Science.gov (United States)

    Francois, Monique E; Little, Jonathan P

    2017-08-01

    High-intensity interval training (HIIT) interventions improve cardiovascular health, yet the acute effects on circulating and functional biomarkers of cardiovascular function are unclear in individuals with type 2 diabetes (T2D). To explore this, we conducted two investigations to examine the acute response to HIIT in individuals with T2D. Study 1 measured blood pressure, endothelial-dependent dilation, circulating measures of endothelial activation, and troponin T, 30 min and 2 h after HIIT (7 × 1-min intervals) in T2D (n = 8) and age-matched normoglycemic controls (CTL; n = 8). Study 2 assessed circulating measures of endothelial activation and troponin T, 30 min, and 24 h after HIIT (10 × 1-min intervals) in ten previously trained T2D men. In study 1, markers of endothelial function and activation within the first 2 h after HIIT did not differ from baseline between T2D and CTL participants, except at 30 min after HIIT for glucose, which was reduced more in T2D than CTL (by -0.8 ± 1.2 mmol/L, p = 0.04), and VCAM-1, which was reduced more 30 min after HIIT in CTL compared to T2D (by -187 ± 221 ng/mL, p = 0.05). Study 2 saw no significant difference in any circulating markers of endothelial activation and troponin T, 30 min, and 24 h after HIIT in trained T2D males. Exploratory findings from these two studies suggest that acute HIIT does not substantially alter circulating and functional markers of cardio(vascular) health in individuals with T2D who are unaccustomed (study 1) and accustomed to HIIT (study 2).

  12. Comparing the executive function of patients with schizophrenia, acute/chronic type I disorder (manic episode, and healthy controls on Wisconsin Card Sorting Test and Continuous Performance Test

    Directory of Open Access Journals (Sweden)

    Hossein Zare

    2017-05-01

    Full Text Available Introduction: From among various cognitive deficits, deficits in executive processes have an effective role in limiting the patients’ ability to retain, acquire, and re-learn the skills necessary for real-life performance. Thus, the present study aimed to compare the executive function of patients with schizophrenia, acute/chronic type I disorder, and the healthy group. Methods: The present research was an analytical-comparative study. The statistical population consisted of all the outpatients and inpatients with acute/chronic schizophrenia and acute/chronic type I disorder (manic episode visiting Shafa Psychiatric Hospital, Rasht, Iran. Using convenience sampling, 60 male subjects aging 18-49 years old were selected in 2014-2015. They were matched for the variables of sex, age, and education level. The Wisconsin Card Sorting Test, Continuous Performance Test, and Raven’s Progressive Matrices were administered, and the data were analyzed using MANOVA and Tukey post-hoc test. Results: A significant difference was observed between the acute/chronic schizophrenia group, acute/chronic type I disorder (manic episode, and healthy group on the two tests. Patients with schizophrenia had a weaker executive function and attention deficit compared to those with type I disorder and the healthy group (P0.05. Conclusion: Both schizophrenia and type I disorder patients show deficits in executive function and attention. However, the former group manifests higher impairment in cognitive activities, concept formation, cognitive flexibility, and attention deficit.

  13. Complexing Agents and pH Influence on Chemical Durability of Type I Molded Glass Containers.

    Science.gov (United States)

    Biavati, Alberto; Poncini, Michele; Ferrarini, Arianna; Favaro, Nicola; Scarpa, Martina; Vallotto, Marta

    2017-01-01

    Among the factors that affect the glass surface chemical durability, pH and complexing agents present in aqueous solution have the main role. Glass surface attack can be also related to the delamination issue causing glass particles' appearance in the pharmaceutical preparation. A few methods to check for glass containers delamination propensity and some control guidelines have been proposed. The present study emphasizes the possible synergy between a few complexing agents with pH on borosilicate glass chemical durability.Hydrolytic attack was performed in small-volume 23 mL type I glass containers autoclaved according to the European Pharmacopoeia or United States Pharmacopeia for 1 h at 121 °C, in order to enhance the chemical attack due to time, temperature, and the unfavorable surface/volume ratio. Solutions of 0.048 M or 0.024 M (M/L) of the acids citric, glutaric, acetic, EDTA (ethylenediaminetetraacetic acid), together with sodium phosphate with water for comparison, were used for the trials. The pH was adjusted ±0.05 units at fixed values 5.5, 6.6, 7, 7.4, 8, and 9 by LiOH diluted solution.Because silicon is the main glass network former, silicon release into the attack solutions was chosen as the main index of the glass surface attack and analysed by inductively coupled plasma atomic emission spectrophotometry. The work was completed by the analysis of the silicon release in the worst attack conditions of molded glass, soda lime type II glass, and tubing borosilicate glass vials to compare different glass compositions and forming technologies. Surface analysis by scanning electron microscopy was finally performed to check for the surface status after the worst chemical attack condition by citric acid. LAY ABSTRACT: Glass, like every packaging material, can have some usage limits, mainly in basic pH solutions. The issue of glass surface degradation particles that appear in vials (delamination) has forced a number of drug product recalls in recent years

  14. Formation and characterization of zein-propylene glycol alginate-surfactant ternary complexes: Effect of surfactant type.

    Science.gov (United States)

    Dai, Lei; Sun, Cuixia; Wei, Yang; Zhan, Xinyu; Mao, Like; Gao, Yanxiang

    2018-08-30

    In this study, zein, propylene glycol alginate (PGA) and surfactant ternary complexes were fabricated by antisolvent co-precipitation method. Two types of surfactants (rhamnolipid and lecithin) were applied to generate zein-PGA-rhamnolipid (Z-P-R) and zein-PGA-lecithin (Z-P-L) ternary complexes, respectively. Results showed that the surfactant types significantly affected the properties of ternary complexes. The formation of ternary complexes was mainly due to the non-covalent interactions such as hydrogen bonding, electrostatic interaction and hydrophobic interactions among zein, PGA and surfactants. Moreover, the thermal stability of ternary complexes was enhanced with increasing the levels of both surfactants. Notably, ternary complex dispersions exhibited better stability against pH from 2 to 8. Furthermore, a compact network structure was observed in Z-P-R ternary complex, while Z-P-L ternary complex remained the spherical structure. These findings would provide new insights into the development of novel delivery system and expand the options, when zein-based complexes were utilized under different environment conditions. Copyright © 2018 Elsevier Ltd. All rights reserved.

  15. Low light adaptation: energy transfer processes in different types of light harvesting complexes from Rhodopseudomonas palustris.

    Science.gov (United States)

    Moulisová, Vladimíra; Luer, Larry; Hoseinkhani, Sajjad; Brotosudarmo, Tatas H P; Collins, Aaron M; Lanzani, Guglielmo; Blankenship, Robert E; Cogdell, Richard J

    2009-12-02

    Energy transfer processes in photosynthetic light harvesting 2 (LH2) complexes isolated from purple bacterium Rhodopseudomonas palustris grown at different light intensities were studied by ground state and transient absorption spectroscopy. The decomposition of ground state absorption spectra shows contributions from B800 and B850 bacteriochlorophyll (BChl) a rings, the latter component splitting into a low energy and a high energy band in samples grown under low light (LL) conditions. A spectral analysis reveals strong inhomogeneity of the B850 excitons in the LL samples that is well reproduced by an exponential-type distribution. Transient spectra show a bleach of both the low energy and high energy bands, together with the respective blue-shifted exciton-to-biexciton transitions. The different spectral evolutions were analyzed by a global fitting procedure. Energy transfer from B800 to B850 occurs in a mono-exponential process and the rate of this process is only slightly reduced in LL compared to high light samples. In LL samples, spectral relaxation of the B850 exciton follows strongly nonexponential kinetics that can be described by a reduction of the bleach of the high energy excitonic component and a red-shift of the low energetic one. We explain these spectral changes by picosecond exciton relaxation caused by a small coupling parameter of the excitonic splitting of the BChl a molecules to the surrounding bath. The splitting of exciton energy into two excitonic bands in LL complex is most probably caused by heterogenous composition of LH2 apoproteins that gives some of the BChls in the B850 ring B820-like site energies, and causes a disorder in LH2 structure.

  16. The Use of Peptide–Major-Histocompatibility-Complex Multimers in Type 1 Diabetes Mellitus

    Science.gov (United States)

    Gojanovich, Greg S; Murray, Sabrina L; Buntzman, Adam S; Young, Ellen F; Vincent, Benjamin G; Hess, Paul R; DVM

    2012-01-01

    Major histocompatibility complex (MHC) class I and MHC class II molecules present short peptides that are derived from endogenous and exogenous proteins, respectively, to cognate T-cell receptors (TCRs) on the surface of T cells. The exquisite specificity with which T cells recognize particular peptide–major-histocompatibility-complex (pMHC) combinations has permitted development of soluble pMHC multimers that bind exclusively to selected T-cell populations. Because the pathogenesis of type 1 diabetes mellitus (T1DM) is driven largely by islet-reactive T-cell activity that causes β-cell death, these reagents are useful tools for studying and, potentially, for treating this disease. When coupled to fluorophores or paramagnetic nanoparticles, pMHC multimers have been used to visualize the expansion and islet invasion of T-cell effectors during diabetogenesis. Administration of pMHC multimers to mice has been shown to modulate T-cell responses by signaling through the TCR or by delivering a toxic moiety that deletes the targeted T cell. In the nonobese diabetic mouse model of T1DM, a pMHC-I tetramer coupled to a potent ribosome-inactivating toxin caused long-term elimination of a specific diabetogenic cluster of differentiation 8+ T-cell population from the pancreatic islets and delayed the onset of diabetes. This review will provide an overview of the development and use of pMHC multimers, particularly in T1DM, and describe the therapeutic promise these reagents have as an antigen-specific means of ameliorating deleterious T-cell responses in this autoimmune disease. PMID:22768881

  17. Assessment value of transcranial Doppler hemodynamic typing for prognosis of patients with acute middle cerebral artery infarction

    Directory of Open Access Journals (Sweden)

    Jing Xie

    2016-08-01

    Full Text Available Objective: To analyze the assessment value of transcranial Doppler hemodynamic typing for prognosis of patients with acute middle cerebral artery infarction. Methods: A total of 54 cases of patients with acute middle cerebral artery infarction who received treatment in our hospital from January 2014 to June 2015 were included for study, and according to different types, they were divided into total occlusion group 17 cases, partial occlusion group 28 cases and nonocclusion group 9 cases. Differences in levels of infarction-related proteins, coagulation-related indicators, illness-related factors, etc in circulating blood of three groups were compared, and the correlation of middle cerebral arterial systolic velocity (Vs and diastolic velocity (Vd with above indicators was further analyzed. Results: Vs and Vd values of non-occlusion group were higher than those of total occlusion group and partial occlusion group, and Vs and Vd values of partial occlusion group were higher than those of total occlusion group; serum Gelsolin, PT, APTT and TT values of non-occlusion group were higher, SAA, Apo- CⅡ, HbA1c, GSP, A毬, HSP70, FIB, D-D, Copeptin, P-selectin, PTX3, TPO and FFA values were lower, and compared with partial occlusion group and total occlusion group, differences were significant; Gelsolin, PT, APTT and TT values of partial occlusion group were higher than those of total occlusion group, and SAA, Apo- CⅡ, HbA1c, GSP, A毬, HSP70, FIB, D-D, Copeptin, P-selectin, PTX3, TPO and FFA values were lower than those of total occlusion group; middle cerebral arterial Vs and Vd values were directly proportional to Gelsolin, PT, APTT and TT values, and inversely proportional to SAA, Apo- CⅡ, HbA1c, GSP, A毬, HSP70, FIB, D-D, Copeptin, P-selectin, PTX3, TPO and FFA values. Conclusions: Transcranial Doppler hemodynamic typing can be the reliable way to judge the severity of acute middle cerebral artery infarction, and has great value in assessing

  18. The Pseudomonas aeruginosa Type III Secretion System Has an Exotoxin S/T/Y Independent Pathogenic Role during Acute Lung Infection

    Science.gov (United States)

    Galle, Marlies; Jin, Shouguang; Bogaert, Pieter; Haegman, Mira; Vandenabeele, Peter; Beyaert, Rudi

    2012-01-01

    The type III secretion system (T3SS) is a complex nanomachine of many pathogenic Gram-negative bacteria. It forms a proteinaceous channel that is inserted into the host eukaryotic cell membrane for injection of bacterial proteins that manipulate host cell signaling. However, few studies have focused on the effector-independent functions of the T3SS. Using a murine model of acute lung infection with Pseudomonas aeruginosa, an important human opportunistic pathogen, we compared the pathogenicity of mutant bacteria that lack all of the known effector toxins ( ΔSTY), with mutant bacteria that also lack the major translocator protein PopB (ΔSTY/ΔPopB) and so cannot form a functional T3SS channel in the host cell membrane. Mortality was higher among mice challenged with ΔSTY compared to mice challenged with ΔSTY/ΔPopB mutant bacteria. In addition, mice infected with ΔSTY showed decreased bacterial clearance from the lungs compared to those infected with ΔSTY/ΔPopB. Infection was in both cases associated with substantial killing of lung infiltrating macrophages. However, macrophages from ΔSTY-infected mice died by pro-inflammatory necrosis characterized by membrane permeabilization and caspase-1 mediated IL-1β production, whereas macrophages from ΔSTY/ΔPopB infected mice died by apoptosis, which is characterized by annexin V positive staining of the cell membrane and caspase-3 activation. This was confirmed in macrophages infected in vitro. These results demonstrate a T3SS effector toxin independent role for the T3SS, in particular the T3SS translocator protein PopB, in the pathogenicity of P. aeruginosa during acute lung infection. PMID:22844497

  19. Types, Risk Factors, Clinical symptoms and Diagnostic Tests of Acute Adult Meningitis in Northern Iran During 2006-2012

    Science.gov (United States)

    Bagheri-Nesami, Masoumeh; Babamahmoodi, Farhang

    2015-01-01

    Background Acute bacterial meningitis is a medical emergency condition that requires prompt diagnosis and treatment and otherwise associated with serious morbidity and mortality. Aim The aim of this study was to assess types, risk factors, clinical symptoms and diagnostic tests of meningitis in hospitalized patients of Mazandaran University of medical sciences hospitals during 2006-2012. Matherials and Methods This is a retrospective descriptive study. Following approval of the ethics committee of Mazandaran University of Medical Sciences, records of adult patients diagnosed with acute meningitis from 2006 to 2012 were extracted from Mazandaran Provincial Health Center and patients attending hospitals affiliated to Mazandaran University of Medical Sciences. Statistical Analysis Data were analyzed with SPSS-16 using descriptive statistics (frequency, mean, standard deviation, and median). Results In this study, of the 137 patients with meningitis, 73 (53.9%) were viral, 61 (46%) bacterial, 1 (0.7%) fungal, and 2 (1.4%) unknown. The majority of risk factors in patients were head trauma, upper respiratory infection, and drug addiction. The most common clinical signs were headache, fever, nausea and vomiting, and stiff neck. Conclusion In this study, the incidence of meningitis was much lower than any other country. It could be due to geographic variation or incomplete recording of patient's data. It is recommended to perform a longitudinal study during the coming years on patients with meningitis. PMID:26155497

  20. Hybrid approach in an acute type B aortic dissection in a female patient after having a renal transplant.

    Science.gov (United States)

    Janczak, Dariusz; Krajewska, Magdalena; Garcarek, Jerzy; Gancarek, Jerzy; Chabowski, Mariusz

    2014-04-01

    This study describes our experiences with a 44-year-old woman who developed acute type B aortic dissection and elected emergency surgery 3 years after a renal transplant. This led to acute ischemia in the right lower extremity. The first stage of surgery was to implant an extra-anatomic (pretracheal) bypass with a GORE-TEX prosthesis from the brachiocephalic trunk to the left common carotid artery. The second stage was implanting a stent graft into the aortic arch that covered the left common carotid artery and the left subclavian artery. The third stage was to insert a stent graft that involved the entire thoracic aorta and proximal segment of the abdominal aorta to the celiac trunk, with the right axillary and left femoral approach. The fourth stage was an extra-anatomic (suprapubic) bypass with the GORE-TEX prosthesis from the left femoral artery to the right femoral artery. Surgery resulted in normal blood supply to the organs and restored renal function.

  1. Serum acute phase response induced by different vaccination protocols against circovirus type 2 and Mycoplasma hyopneumoniae in piglets.

    Science.gov (United States)

    Hernández-Caravaca, Iván; Gourgues, Sebastian Figueras; Rodríguez, Víctor; Estrada, Edgar Díaz; Cerón, José J; Escribano, Damián

    2017-10-01

    The purpose of this study was to compare the acute phase reaction (APR) induced by different vaccination protocols used against Porcine Circovirus (PCV) type-2 and Mycoplasma hyopneumoniae (M.hyo), studying two acute phase proteins (APPs) and changes in rectal temperature (RT). In addition, the possible influence of the time of vaccination and breed were analysed. In the first experiment, 40 commercial crossbred piglets were vaccinated, on the day of weaning, with FLEXcombo® (group A, n=20) or Porcilis PCV® and Stellamune® One (group B, n=20). The second experiment was performed on two farms, on which 40 commercial crossbred piglets or 40 Iberian piglets were vaccinated, 7days post-weaning. On each farm one group (A, n=20) was vaccinated with FLEXcombo® and another group (B, n=20) with Porcilis® PCV-M.hyo. Blood samples were taken before, 24h and 48h after vaccination, and RT were recorded before and 8h after vaccination. Significantly higher increases in group B in RT (Pvaccination compared with group A. The vaccines that produced greater increases in RT also produced higher APPs increases but no influence of the day of vaccination or of the breed were found. Therefore, serum APPs concentrations differed according to the vaccine used, which may be useful, along with RT, for choosing the vaccine or protocol that produces APR of lower magnitude. Copyright © 2017 Elsevier Ltd. All rights reserved.

  2. Syntheses, Crystal Structures and Thermal Behaviors of Two Supramolecular Salamo-Type Cobalt(II and Zinc(II Complexes

    Directory of Open Access Journals (Sweden)

    Gang Li

    2017-07-01

    Full Text Available This paper reports the syntheses of two new complexes, [Co(L1(H2O2] (1 and [{Zn(L2(μ-OAcZn(n-PrOH}2] (2, from asymmetric halogen-substituted Salamo-type ligands H2L1 and H3L2, respectively. Investigation of the crystal structure of complex 1 reveals that the complex includes one Co(II ion, one (L12− unit and two coordinated water molecules. Complex 1 shows slightly distorted octahedral coordination geometry, forming an infinite 2D supramolecular structure by intermolecular hydrogen bond and π–π stacking interactions. Complex 2 contains four Zn(IIions, two completely deprotonated (L23− moieties, two coordinated μ-OAc− ions and n-propanol molecules. The Zn(II ions in complex 2 display slightly distorted trigonal bipyramidal or square pyramidal geometries.

  3. Angiotensin II type 2 receptor agonist Compound 21 attenuates pulmonary inflammation in a model of acute lung injury

    Directory of Open Access Journals (Sweden)

    Menk M

    2018-05-01

    Full Text Available Mario Menk, Jan Adriaan Graw, Clarissa von Haefen, Hendrik Steinkraus, Burkhard Lachmann, Claudia D Spies, David Schwaiberger Department of Anesthesiology and Operative Intensive Care Medicine, Charité – University Medicine Berlin, FreieUniversität Berlin, Humboldt-Universitätzu Berlin, and Berlin Institute of Health, Germany Purpose: Although the role of the angiotensin II type 2 (AT2 receptor in acute lung injury is not yet completely understood, a protective role of this receptor subtype has been suggested. We hypothesized that, in a rodent model of acute lung injury, stimulation of the AT2 receptor with the direct agonist Compound 21 (C21 might have a beneficial effect on pulmonary inflammation and might improve pulmonary gas exchange. Materials and methods: Male adult rats were divided into a treatment group that received pulmonary lavage followed by mechanical ventilation (LAV, n=9, a group receiving pulmonary lavage, mechanical ventilation, and direct stimulation of the AT2 receptor with C21 (LAV+C21, n=9, and a control group that received mechanical ventilation only (control, n=9. Arterial blood gas analysis was performed every 30 min throughout the 240-min observation period. Lung tissue and plasma samples were obtained at 240 min after the start of mechanical ventilation. Protein content and surface activity of bronchoalveolar lavage fluid were assessed and the wet/dry-weight ratio of lungs was determined. Transcriptional and translational regulation of pro- and antiinflammatory cytokines IL-1β, tumor necrosis factor-alpha, IL-6, IL-10, and IL-4 was determined in lungs and in plasma. Results: Pulmonary lavage led to a significant impairment of gas exchange, the formation of lung edema, and the induction of pulmonary inflammation. Protein content of lavage fluid was increased and contained washed-out surfactant. Direct AT2 receptor stimulation with C21 led to a significant inhibition of tumor necrosis factor-alpha and IL-6

  4. Serum aminoterminal type III procollagen peptide reflects repair after acute myocardial infarction

    DEFF Research Database (Denmark)

    Jensen, L T; Hørslev-Petersen, K; Toft, P

    1990-01-01

    similar to changes observed during wound healing in humans. PIIINP is cleaved off procollagen type III during the biosynthesis of type III collagen, which characterizes the early stages of repair and inflammation. Our findings suggest that serum PIIINP reflects the repair processes and scar formation...... values were observed on the third to seventh postinfarction day. The individual peak changes were correlated to infarction size calculated from serum CK-MB and serum lactate dehydrogenase (p = 0.60, p = 0.02). The changes in distribution of PIIINP-related antigens in serum after gel chromatography were...

  5. Characterization of a rare natural intertypic type 2/type 3 penta-recombinant vaccine-derived poliovirus isolated from a child with acute flaccid paralysis.

    Science.gov (United States)

    Zhang, Yong; Wang, Haiyan; Zhu, Shuangli; Li, Yan; Song, Lizhi; Liu, Yao; Liu, Guifang; Nishimura, Yorihiro; Chen, Li; Yan, Dongmei; Wang, Dongyan; An, Hongqiu; Shimizu, Hiroyuki; Xu, Aiqiang; Xu, Wenbo

    2010-02-01

    A type 2 vaccine-derived poliovirus (VDPV) (strain CHN1025), with a 1.1 % (10/903) difference from Sabin strain in the VP1 coding region, was isolated from a child with poliomyelitis caused by a poliovirus variant infection. The patient was from Shandong Province of China and developed acute flaccid paralysis in 1997. The child was infected with a rare and complicated penta-recombinant poliovirus with the uncommon genomic recombinant organization S2/S3/S1/S3/S1/S3. At least five successive rounds of recombination occurred in the VP1 capsid coding region and in the 2C, 3C (twice) and 3D(pol) non-capsid coding regions, respectively, during virus evolution. Strain CHN1025 had most of the characteristics of the type 2 vaccine strain; it had Sabin-specific epitopes, suggesting that the virus was antigenically indistinguishable from the Sabin 2 reference strain. Typical mutations in the 5'-untranslated region and VP1 associated with reversion to neurovirulence for Sabin 2 poliovirus were found, and the virus showed moderate neurovirulence in transgenic mice. A few nucleotide substitutions were located in the donor sequences, and two donor sequences contained no nucleotide substitutions, suggesting that these sequences were relatively new. The appearance of these mutations within approximately 192 days of at least five successive rounds of recombination events derived from a single ancestral infection illustrates the rapid emergence of new recombinants among VDPVs. This is the first report on the isolation of a type 2/type 3 poliovirus capsid recombinant with one of the five crossover sites located in the VP1 coding region.

  6. Effect of fat type in baked bread on amylose-lipid complex formation and glycaemic response.

    Science.gov (United States)

    Lau, Evelyn; Zhou, Weibiao; Henry, Christiani Jeyakumar

    2016-06-01

    The formation of amylose-lipid complexes (ALC) had been associated with reduced starch digestibility. A few studies have directly characterised the extent of ALC formation with glycaemic response. The objectives of this study were to investigate the effect of using fats with varying degree of saturation and chain length on ALC formation as well as glycaemic and insulinaemic responses after consumption of bread. Healthy men consumed five test breads in a random order: control bread without any added fats (CTR) and breads baked with butter (BTR), coconut oil (COC), grapeseed oil (GRP) or olive oil (OLV). There was a significant difference in glycaemic response between the different test breads (P=0·002), primarily due to COC having a lower response than CTR (P=0·016), but no significant differences between fat types were observed. Insulinaemic response was not altered by the addition of fats/oils. Although BTR was more insulinotropic than GRP (Pbread could lie in the choice of fats/oils, with coconut oil showing the greatest attenuation of glycaemic response.

  7. Bile salt receptor complex activates a pathogenic type III secretion system

    Science.gov (United States)

    Li, Peng; Rivera-Cancel, Giomar; Kinch, Lisa N; Salomon, Dor; Tomchick, Diana R; Grishin, Nick V; Orth, Kim

    2016-01-01

    Bile is an important component of the human gastrointestinal tract with an essential role in food absorption and antimicrobial activities. Enteric bacterial pathogens have developed strategies to sense bile as an environmental cue to regulate virulence genes during infection. We discovered that Vibrio parahaemolyticus VtrC, along with VtrA and VtrB, are required for activating the virulence type III secretion system 2 in response to bile salts. The VtrA/VtrC complex activates VtrB in the presence of bile salts. The crystal structure of the periplasmic domains of the VtrA/VtrC heterodimer reveals a β-barrel with a hydrophobic inner chamber. A co-crystal structure of VtrA/VtrC with bile salt, along with biophysical and mutational analysis, demonstrates that the hydrophobic chamber binds bile salts and activates the virulence network. As part of a family of conserved signaling receptors, VtrA/VtrC provides structural and functional insights into the evolutionarily conserved mechanism used by bacteria to sense their environment. DOI: http://dx.doi.org/10.7554/eLife.15718.001 PMID:27377244

  8. Bile salt receptor complex activates a pathogenic type III secretion system

    Energy Technology Data Exchange (ETDEWEB)

    Li, Peng; Rivera-Cancel, Giomar; Kinch, Lisa N.; Salomon, Dor; Tomchick, Diana R.; Grishin, Nick V.; Orth, Kim

    2016-07-05

    Bile is an important component of the human gastrointestinal tract with an essential role in food absorption and antimicrobial activities. Enteric bacterial pathogens have developed strategies to sense bile as an environmental cue to regulate virulence genes during infection. We discovered thatVibrio parahaemolyticusVtrC, along with VtrA and VtrB, are required for activating the virulence type III secretion system 2 in response to bile salts. The VtrA/VtrC complex activates VtrB in the presence of bile salts. The crystal structure of the periplasmic domains of the VtrA/VtrC heterodimer reveals a β-barrel with a hydrophobic inner chamber. A co-crystal structure of VtrA/VtrC with bile salt, along with biophysical and mutational analysis, demonstrates that the hydrophobic chamber binds bile salts and activates the virulence network. As part of a family of conserved signaling receptors, VtrA/VtrC provides structural and functional insights into the evolutionarily conserved mechanism used by bacteria to sense their environment.

  9. Complexity of mechanisms among human proprotein convertase subtilisin-kexin type 9 variants.

    Science.gov (United States)

    Dron, Jacqueline S; Hegele, Robert A

    2017-04-01

    There are many reports of human variants in proprotein convertase subtilisin-kexin type 9 (PCSK9) that are either gain-of-function (GOF) or loss-of-function (LOF), with downstream effects on LDL cholesterol and cardiovascular disease (CVD) risk. However, data on particular mechanisms have only been minimally curated. GOF variants are individually ultrarare, affect all domains of the protein, act to reduce LDL receptor expression through several mechanisms, are a minor cause of familial hypercholesterolemia, have been reported mainly within families, have variable LDL cholesterol-raising effects, and are associated with increased CVD risk mainly through observational studies in families and small cohorts. In contrast, LOF variants can be either ultrarare mutations or relatively more common polymorphisms seen in populations, affect all domains of the protein, act to increase LDL receptor expression through several mechanisms, have variable LDL cholesterol-lowering effects, and have been associated with decreased CVD risk mainly through Mendelian randomization studies in epidemiologic populations. There is considerable complexity underlying the clinical concept of both LOF and GOF variants of PCSK9. But despite the underlying mechanistic heterogeneity, altered PCSK9 secretion or function is ultimately correlated with plasma LDL cholesterol level, which is also the driver of CVD outcomes.

  10. Is reflex sympathetic dystrophy/complex regional pain syndrome type I a small-fiber neuropathy?

    Science.gov (United States)

    Oaklander, Anne Louise; Fields, Howard L

    2009-06-01

    Neurologist S. Weir Mitchell first described "causalgia" following wartime nerve injury, with its persistent distal limb burning pain, swelling, and abnormal skin color, temperature, and sweating. Similar post-traumatic symptoms were later identified in patients without overt nerve injuries after trauma. This was labeled reflex sympathetic dystrophy (RSD; now complex regional pain syndrome type I [CRPS-I]). The pathophysiology of symptoms is unknown and treatment options are limited. We propose that persistent RSD/CRPS-I is a post-traumatic neuralgia associated with distal degeneration of small-diameter peripheral axons. Small-fiber lesions are easily missed on examination and are undetected by standard electrophysiological testing. Most CRPS features-spreading pain and skin hypersensitivity, vasomotor instability, osteopenia, edema, and abnormal sweating-are explicable by small-fiber dysfunction. Small fibers sense pain and temperature but also regulate tissue function through neuroeffector actions. Indeed, small-fiber-predominant polyneuropathies cause CRPS-like abnormalities, and pathological studies of nerves from chronic CRPS-I patients confirm small-fiber-predominant pathology. Small distal nerve injuries in rodents reproduce many CRPS features, further supporting this hypothesis. CRPS symptoms likely reflect combined effects of axonal degeneration and plasticity, inappropriate firing and neurosecretion by residual axons, and denervation supersensitivity. The resulting tissue edema, hypoxia, and secondary central nervous system changes can exacerbate symptoms and perpetuate pathology. Restoring the interest of neurologists in RSD/CRPS should improve patient care and broaden our knowledge of small-fiber functions.

  11. Passive Immunotherapy for Retroviral Disease: Influence of Major Histocompatibility Complex Type and T-Cell Responsiveness

    Science.gov (United States)

    Hasenkrug, Kim J.; Brooks, Diane M.; Chesebro, Bruce

    1995-11-01

    Administration of virus-specific antibodies is known to be an effective early treatment for some viral infections. Such immunotherapy probably acts by antibody-mediated neutralization of viral infectivity and is often thought to function independently of T-cell-mediated immune responses. In the present experiments, we studied passive antibody therapy using Friend murine leukemia virus complex as a model for an immunosuppressive retroviral disease in adult mice. The results showed that antibody therapy could induce recovery from a well-established retroviral infection. However, the success of therapy was dependent on the presence of both CD4^+ and CD8^+ T lymphocytes. Thus, cell-mediated responses were required for recovery from infection even in the presence of therapeutic levels of antibody. The major histocompatibility type of the mice was also an important factor determining the relative success of antibody therapy in this system, but it was less critical for low-dose than for high-dose infections. Our results imply that limited T-cell responsiveness as dictated by major histocompatibility genes and/or stage of disease may have contributed to previous immunotherapy failures in AIDS patients. Possible strategies to improve the efficacy of future therapies are discussed.

  12. Surgery for acute Type I aortic dissection without resection of supra-aortic entry sites leads to unfavourable aortic remodelling.

    Science.gov (United States)

    Heo, Woon; Song, Suk-Won; Lee, Kwang-Hun; Lee, Shin-Young; Kim, Tae-Hoon; Baek, Min-Young; Yoo, Kyung-Jong

    2018-01-29

    This study aimed to evaluate the impact of remnant re-entries in arch branches on postoperative change in the aortic arch and descending aortic diameters and the rate of major adverse aortic events. Between January 2010 and December 2016, 249 patients underwent surgery for acute Type I aortic dissection. Patients who underwent total arch replacement, had Marfan syndrome or had intramural haematoma were excluded. Seventy-two patients with predischarge and follow-up computed tomography scans were enrolled. Patients with and without re-entries in the arch branches after surgery were assigned to the supra-aortic entry (SAE, n = 21) and no supra-aortic entry (n = 51) groups, respectively. Diameters were measured at 7 levels: the innominate artery, left common carotid artery, left subclavian artery, 20 mm distal to the left subclavian artery, pulmonary artery bifurcation, coeliac axis and maximal diameter of the descending thoracic aorta. Growth rates at the levels of the pulmonary artery bifurcation and 20 mm distal to the left subclavian artery were significantly higher in the SAE group than in the no supra-aortic entry group. The rate of freedom from major adverse aortic events (annual growth >5 mm or maximal diameter of the descending thoracic aorta >50 mm) at 5 years was significantly higher in the no supra-aortic entry group than in the SAE group. Remnant SAE leads to unfavourable aortic remodelling after acute Type I aortic dissection repair. © The Author(s) 2018. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

  13. Acute effects of brisk walking on affect and psychological well-being in individuals with type 2 diabetes.

    Science.gov (United States)

    Kopp, Martin; Steinlechner, Maria; Ruedl, Gerhard; Ledochowski, Larissa; Rumpold, Gerhard; Taylor, Adrian H

    2012-01-01

    To investigate the effects of an acute exercise bout on affect and psychological well-being in individuals with type 2 diabetes. Sixteen patients (mean BMI 28.6 kg/m(2)) took part, on separate days, in two randomly ordered conditions, in a within-subject design: a 20 min semi-self-paced brisk walk or passive control (sitting with the opportunity of reading). Ten minutes before, during (5, 10, 15, 20 min) and following (5, 10, 15, 20, 180 min) each, participants completed the Felt Arousal Scale (FAS) for affective activation and the Feeling Scale (FS) for affective pleasure/valence. The Activation Deactivation Adjective Check List (Tense Arousal and Energetic Arousal) was also completed before and after each condition. Heart rate and Ratings of Perceived Exertion (RPE) were assessed during exercise. Glucose levels were obtained from participants before and after exercise and control. Repeated measures ANOVAs revealed significant condition by time interaction effects for FS, FAS, Energetic Arousal (EA) and Tense Arousal (TA). Brisk walking increased FS (15 min after exercise p=0.020; 20 min after exercise p=0.034) and FAS (all time points after baseline). EA was significantly higher 5 min after the exercise session (p=0.029) in comparison to the control situation. This study demonstrated that an acute exercise bout has positive influences on affect and psychological well-being. The usefulness of exercise to elevate affective responses (activation and pleasure) should be highlighted when promoting exercise interventions in subjects with type 2 diabetes. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  14. Crystal structure of the Csm3-Csm4 subcomplex in the type III-A CRISPR-Cas interference complex.

    Science.gov (United States)

    Numata, Tomoyuki; Inanaga, Hideko; Sato, Chikara; Osawa, Takuo

    2015-01-30

    Clustered, regularly interspaced, short palindromic repeat (CRISPR) loci play a pivotal role in the prokaryotic host defense system against invading genetic materials. The CRISPR loci are transcribed to produce CRISPR RNAs (crRNAs), which form interference complexes with CRISPR-associated (Cas) proteins to target the invading nucleic acid for degradation. The interference complex of the type III-A CRISPR-Cas system is composed of five Cas proteins (Csm1-Csm5) and a crRNA, and targets invading DNA. Here, we show that the Csm1, Csm3, and Csm4 proteins from Methanocaldococcus jannaschii form a stable subcomplex. We also report the crystal structure of the M. jannaschii Csm3-Csm4 subcomplex at 3.1Å resolution. The complex structure revealed the presence of a basic concave surface around their interface, suggesting the RNA and/or DNA binding ability of the complex. A gel retardation analysis showed that the Csm3-Csm4 complex binds single-stranded RNA in a non-sequence-specific manner. Csm4 structurally resembles Cmr3, a component of the type III-B CRISPR-Cas interference complex. Based on bioinformatics, we constructed a model structure of the Csm1-Csm4-Csm3 ternary complex, which provides insights into its role in the Csm interference complex. Copyright © 2014 Elsevier Ltd. All rights reserved.

  15. Acute administration of diosgenin or dioscorea improves hyperglycemia with increases muscular steroidogenesis in STZ-induced type 1 diabetic rats.

    Science.gov (United States)

    Sato, K; Fujita, S; Iemitsu, M

    2014-09-01

    Acute dehydroepiandrosterone (DHEA) administration improves hyperglycemia in rats with streptozotocin (STZ)-induced type 1 diabetes mellitus. Diosgenin, a steroid structurally similar to DHEA (dehydroepiandrosterone), is contained highly levels in dioscorea; however, it is still unclear whether this natural product improves hyperglycemia in the type 1 diabetes model rats through an increase muscular GLUT4 signaling. After 1 week of STZ injection, fasting glucose level was measured in blood taken from the tail vein every 30 min for 150 min after injection of diosgenin or dioscorea (3mg/kg). On another day, muscle was resected 150 min after diosgenin or dioscorea injections. Serum DHEA level increased significantly 120 min after diosgenin or dioscorea injections; concomitantly, blood glucose level decreased significantly. Moreover, GLUT4 translocation, as well as phosphorylation of Akt and PKC ζ/λ, increased significantly by diosgenin or dioscorea administration. However, these effects of diosgenin and dioscorea were blocked by a 5α-reductase inhibitor that inhibits synthesizing dehydrotestosterone (DHT) from testosterone. Additionally, significant correlations were observed between blood glucose level, GLUT4 translocation level, and muscular sex steroid hormone level 150 min after the administrations. These results suggest that the diosgenin-induced increase in the DHEA level may contribute to the improvement of hyperglycemia by activating the muscular GLUT4 signaling pathway in type 1 diabetes model rats. Copyright © 2014 Elsevier Ltd. All rights reserved.

  16. Acute Symptomatic Abdominal Aortic Aneurysm Secondary to Endovascular Stent Graft Associated Type II Endoleak

    Directory of Open Access Journals (Sweden)

    Karen Ka Leung Chan

    2006-07-01

    Full Text Available Endovascular abdominal aneurysm repair (EVAR is popular because of its low invasiveness and feasibility for high-risk patients. Endoleak is common after EVAR and is characterized by blood flow within the aneurysm sac but outside the stent graft. Type II or collateral endoleak commonly results from retrograde filling of the aneurysm from collateral visceral vessels, lumbar, inferior mesenteric, accessory renal or sacral arteries. Collateral leaks are generally thought to be benign and over half of the early leaks will seal spontaneously. Sporadically, collateral endoleak could lead to aneurysm sac pressurization and place the patient at ongoing risk of rupture. Herein, we report an uncommon case of early post-stent graft placement symptomatic abdominal aortic aneurysm associated with type II endoleak.

  17. Ethylene polymerization by PN3-type pincer chromium(III) complexes

    KAUST Repository

    Gong, Dirong

    2014-12-01

    Chromium (III) complexes, Cr1, [2,6-(tBu2PNH) 2C5H4N]CrCl3; Cr2, [2,6-(Ph 2PNH)2C5H4N]CrCl3; Cr3, [2-(tBu2PNH)C5H4N]CrCl3 THF; Cr4, [6-(tBu2PNH)C5H4N-2- CH2NEt2]CrCl3; Cr5, [6-(tBu 2PNH)C5H4N-2-C3H2N 2]CrCl3; Cr6, [6-(tBu2PNH)C 5H4N-2-(3,5-Me2)C3H 2N2]CrCl3; Cr7, [6-(tBu 2PNH)C5H4N-2-(3,5-iPr 2)C3H2N2]CrCl3; Cr8, [6-(tBu2PNH)C5H4N-2-(3,5-Ph 2)C3H2N2]CrCl3, bearing a family of neutral PN3-type pincer ligands have been prepared. The molecular structure of Cr2 was further elucidated by the X-ray crystallographic analysis, showing an octahedral geometry. Treatment of these complexes with MAO or alkylaluminum led to catalysts with moderate activities (about 105 g (PE)/Cr(mol) h) for ethylene polymerization, affording exclusively linear low molecular weight solid PE without any detectable oligomers. Among Cr1-Cr8, the highest activity was achieved for Cr1/MAO at room temperature with production of PE with highest molecular weight, indicating that replacement of both tBu groups in Cr1 with Ph groups, or one PtBu2 with the N (imine) arm, resulted in a lower catalytic activity and lower M w. © 2014 Elsevier B.V.

  18. Acute effects of binary mixtures of Type II pyrethroids and organophosphate insecticides on Oreochromis niloticus.

    Science.gov (United States)

    Fai, Patricia Bi Asanga; Tsobgny Kinfack, Joel Stephane; Tala Towa, Yannick Jordan

    2017-09-01

    Pyrethroid and organophosphate insecticides have been used for more than 20 years worldwide to control a variety of insect pest in different settings. These pesticides have been detected in a variety of environmental samples, including surface waters and sediments and therefore there is significant concern about their potential toxic effects on non-target organisms. Mixtures of compounds from these groups of pesticides have been found to frequently show enhanced toxicity but it has been a challenge to predict whether or not enhanced toxicity will occur for a given combination of compounds. This study therefore studied the effects of binary pyrethroid-organophosphate mixtures using cypermethrin, deltamethrin and dimethoate in an acute toxicity test system with Oreochromis niloticus. The 96 h LC50s for individual insecticides were 9.13 µg/l, 9.42 µg/l and 45.52 mg/l for cypermethrin, deltamethrin and dimethoate respectively. These showed that the pyrethroid insecticides were highly toxic to Oreochromis niloticus and were far more toxic than dimethoate. All mixtures were also more toxic than single insecticides throughout the concentration-response curve with mixtures resulting in mortality at concentrations which the individual pesticides in the mixture were below their respective NOECs. In addition, observed mixture toxicities deviated from the predicted mixture effects based either on the Concentration Addition (CA) or Independent Action (IA) models independent of mixture ratio. However, the extent of observed mixture mortality deviation was dependent on the effect level. Significant deviations (MDR > 2.0) were observed at lower concentrations indicating synergistic effects at lower and possibly environmentally relevant concentrations. This is not unexpected since organophosphate insecticides are known to inhibit acetylcholinesterase as well as inactivate esterase, resulting in reduced detoxification of pyrethroid insecticides and consequently greater

  19. DOES THE PATTERN OF CLONAL EVOLUTION IN THE KARYOTYPE OF PATIENTS WITH ACUTE MYELOID LEUKEMIA AND MYELODYSPLASTIC SYNDROMES DEPEND ON THE TYPE OF THE PRIMARY CHROMOSOMAL ABERRATIONS?

    Science.gov (United States)

    Angelova, S; Spassov, B; Nikolova, V; Christov, I; Tzvetkov, N; Simeonova, M

    2015-01-01

    The aim of our study was to define if the type of primary chromosomal aberrations (CA) of the karyotype of patients with Acute myeloid leukemia (AML) and Myelodysplastic syndromes (MDS) determines the way and the rate of karyotype development. Conventional cytogenetic analysis was carried out on 248 AML and 105 MDS patients at diagnosis. Clonal evolution (CE) was found in 40% (51 of 128) of AML patients and in 47.5% (19 of 40) of MDS patients having CA in their karyotype. The first pattern we established was for the most frequent CA which initiate CE in 28 patients with a complex karyotype. These CA were non-balansed rearrangements in the following regions: 5q, 7q, 11q, 3q, monosomy 5, monosomy 7. The second pattern of CE was regarding the most frequent aneuploidias (+8, +11, +21, -Y, and the third pattern concerned balanced CA. We found significant difference in the distribution of karyotypes in different stages of progression between the first and the other two groups (p 0.5).

  20. Acute exercise and motor memory consolidation: Does exercise type play a role?

    Science.gov (United States)

    Thomas, R; Flindtgaard, M; Skriver, K; Geertsen, S S; Christiansen, L; Korsgaard Johnsen, L; Busk, D V P; Bojsen-Møller, E; Madsen, M J; Ritz, C; Roig, M; Lundbye-Jensen, J

    2017-11-01

    A single bout of high-intensity exercise can augment off-line gains in skills acquired during motor practice. It is currently unknown if the type of physical exercise influences the effect on motor skill consolidation. This study investigated the effect of three types of high-intensity exercise following visuomotor skill acquisition on the retention of motor memory in 40 young (25.3 ±3.6 years), able-bodied male participants randomly assigned to one of four groups either performing strength training (STR), circuit training (CT), indoor hockey (HOC) or rest (CON). Retention tests of the motor skill were performed 1 (R1h) and 24 h (R1d) post acquisition. For all exercise groups, mean motor performance scores decreased at R1h compared to post acquisition (POST) level; STR (P = 0.018), CT (P = 0.02), HOC (P = 0.014) and performance scores decreased for CT compared to CON (P = 0.049). Mean performance scores increased from POST to R1d for all exercise groups; STR (P = 0.010), CT (P = 0.020), HOC (P = 0.007) while performance scores for CON decreased (P = 0.043). Changes in motor performance were thus greater for STR (P = 0.006), CT (P exercise can lead to a decrease in motor performance assessed shortly after motor skill practice (R1h), but enhances offline effects promoting long-term retention (R1d). Given that different exercise modalities produced similar positive off-line effects on motor memory, we conclude that exercise-induced effects beneficial to consolidation appear to depend primarily on the physiological stimulus rather than type of exercise and movements employed. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  1. Effects of acute dietary iron overload in pigs (Sus scrofa) with induced type 2 diabetes mellitus.

    Science.gov (United States)

    Espinoza, A; Morales, S; Arredondo, M

    2014-06-01

    Epidemiological studies have reported an association between high iron (Fe) levels and elevated risk of developing type 2 diabetes mellitus (T2D). It is believed that the formation of Fe-catalyzed hydroxyl radicals may contribute to the development of diabetes. Our goal was to determine the effect of a diet with a high Fe content on type 2 diabetic pigs. Four groups of piglets were studied: (1) control group, basal diet; (2) Fe group, basal diet with 3,000 ppm ferrous sulfate; (3) diabetic group (streptozotocin-induced type 2 diabetes) with basal diet; (4) diabetic/Fe group, diabetic animals/3,000 ppm ferrous sulfate. For 2 months, biochemical and hematological parameters were evaluated. Tissue samples of liver and duodenum were obtained to determine mRNA relative abundance of DMT1, ferroportin (Fpn), ferritin (Fn), hepcidin (Hpc), and transferrin receptor by qRT-PCR. Fe group presented increased levels of hematological (erythrocytes, hematocrit, and hemoglobin) and iron parameters. Diabetic/Fe group showed similar behavior as Fe group but in lesser extent. The relative abundance of different genes in the four study groups yielded a different expression pattern. DMT1 showed a lower expression in the two iron groups compared with control and diabetic animals, and Hpc showed an increased on its expression in Fe and diabetic/Fe groups. Diabetic/Fe group presents greater expression of Fn and Fpn. These results suggest that there is an interaction between Fe nutrition, inflammation, and oxidative stress in the diabetes development.

  2. Acute exercise and motor memory consolidation: Does exercise type play a role?

    DEFF Research Database (Denmark)

    Thomas, Richard; Flindtgaard, Mads; Skriver, Kasper Christen

    2017-01-01

    following visuomotor skill acquisition on the retention of motor memory in 40 young (25.3 ±3.6 years), able-bodied male participants randomly assigned to one of four groups either performing strength training (STR), circuit training (CT), indoor hockey (HOC) or rest (CON). Retention tests of the motor skill......-line effects on motor memory, we conclude that exercise-induced effects beneficial to consolidation appear to depend primarily on the physiological stimulus rather than type of exercise and movements employed....

  3. Glucose homeostasis in type 1 diabetic rats after acute physical activity

    OpenAIRE

    Moura, Leandro [UNESP; Bertolini, Natalia [UNESP; Ghezzi, Ana Carolina [UNESP; Bertucci, Danilo [UNESP; Bonfim, Mariana [UNESP; Serafim, Thais Helena [UNESP; Pereira, Aron [UNESP; Garuffi, Marcelo [UNESP; Mello, Maria Alice [UNESP; Luciano, Eliete [UNESP

    2011-01-01

    Physical activity is considered an extremely effective therapy in cases of type 1 diabetes (DM-1), as it promotes glucose uptake independent of insulin action. However, there are few studies on the effect of a single session of exercise on glucose uptake in DM-1 (i.e., in the absence of insulin). Therefore, the purpose of this study was to assess the effect of a single exercise session on glucose homeostasis in DM-1 rats. For this purpose, 30 male rats were divided into three groups: sedentar...

  4. A nuclear desalination complex with a VK-300 boiling type reactor facility

    International Nuclear Information System (INIS)

    Kuznetzov, Y.N.; Mishanina, Y.A.; Romenkov, A.A.

    2004-01-01

    RDIPE has developed a detailed design of an enhanced safety nuclear steam supply system (NSSS) with a VK-300 boiling water reactor for combined heat and power generation. The thermal power of the reactor is 750 MW. The maximum electrical power in the condensation mode is 250 MWe. The maximum heat generation capacity of 400 Gcal/h is reached at 150 MWe. This report describes, in brief, the basic technical concepts for the VK-300 NSSS and the power unit, with an emphasis on enhanced safety and good economic performance. With relatively small power, good technical and economic performance of the VK-300 reactor that is a base for the desalination complex is attained through: reduced capital costs of the nuclear plant construction thanks to technical approaches ensuring maximum simplicity of the reactor design and the NSSS layout; a single-circuit power unit configuration (reactor-turbine) excluding expensive equipment with a lot of metal, less pipelines and valves; reduced construction costs of the basic buildings thanks to reduced construction volumes due to rational arrangement concepts; higher reliability of equipment and reduced maintenance and repair costs; longer reactor design service life of up to 60 years; selection of the best reactor and desalination equipment interface pattern. The report considers the potential application of the VK-300 reactor as a source of energy for distillation desalination units. The heat from the reactor is transferred to the desalination unit via an intermediate circuit. Comparison is made between variants of the reactor integration with desalination units of the following types: multi-stage flash (MSF technology); multi-effect distillation horizontal-tube film units of the DOU GTPA type (MED technology). The NDC capacity with the VK-300 reactor, in terms of distillate, will be more than 200,000 m 3 /day, with the simultaneous output of electric power from the turbine generator buses of around 150 MWe. The variants of the

  5. Target DNA recognition and cleavage by a reconstituted Type I-G CRISPR-Cas immune effector complex.

    Science.gov (United States)

    Majumdar, Sonali; Ligon, Marianne; Skinner, William Colby; Terns, Rebecca M; Terns, Michael P

    2017-01-01

    CRISPR-Cas immune systems defend prokaryotes against viruses and plasmids. CRISPR RNAs (crRNAs) associate with various CRISPR-associated (Cas) protein modules to form structurally and functionally diverse (Type I-VI) crRNP immune effector complexes. Previously, we identified three, co-existing effector complexes in Pyrococcus furiosus -Type I-A (Csa), Type I-G (Cst), and Type III-B (Cmr)-and demonstrated that each complex functions in vivo to eliminate invader DNA. Here, we reconstitute functional Cst crRNP complexes in vitro from recombinant Cas proteins and synthetic crRNAs and investigate mechanisms of crRNP assembly and invader DNA recognition and destruction. All four known Cst-affiliated Cas proteins (Cas5t, Cst1, Cst2, and Cas3) are required for activity, but each subunit plays a distinct role. Cas5t and Cst2 comprise a minimal set of proteins that selectively interact with crRNA. Further addition of Cst1, enables the four subunit crRNP (Cas5t, Cst1, Cst2, crRNA) to specifically bind complementary, double-stranded DNA targets and to recruit the Cas3 effector nuclease, which catalyzes cleavages at specific sites within the displaced, non-target DNA strand. Our results indicate that Type I-G crRNPs selectively bind target DNA in a crRNA and, protospacer adjacent motif dependent manner to recruit a dedicated Cas3 nuclease for invader DNA destruction.

  6. Identification of novel type III secretion chaperone-substrate complexes of Chlamydia trachomatis.

    Science.gov (United States)

    Pais, Sara V; Milho, Catarina; Almeida, Filipe; Mota, Luís Jaime

    2013-01-01

    Chlamydia trachomatis is an obligate intracellular bacterial pathogen of humans that uses a type III secretion (T3S) system to manipulate host cells through the delivery of effector proteins into their cytosol and membranes. The function of T3S systems depends on small bacterial cytosolic chaperone-like proteins, which bind T3S substrates and ensure their appropriate secretion. To find novel T3S chaperone-substrate complexes of C. trachomatis we first searched its genome for genes encoding proteins with features of T3S chaperones. We then systematically tested for interactions between candidate chaperones and chlamydial T3S substrates by bacterial two-hybrid. This revealed interactions between Slc1 (a known T3S chaperone) or CT584 and several T3S substrates. Co-immunoprecipitation after protein expression in Yersinia enterocolitica and protein overlay binding assays indicated that Slc1 interacted with the N-terminal region of the known T3S substrates Tarp (a previously described substrate of Slc1), CT694, and CT695, and that CT584 interacted with a central region of CT082, which we identified as a C. trachomatis T3S substrate using Y. enterocolitica as a heterologous system. Further T3S assays in Yersinia indicated that Slc1 or CT584 increased the amount of secreted Tarp, CT694, and CT695, or CT082, respectively. Expression of CT584 increased the intra-bacterial stability of CT082, while Slc1 did not affect the stability of its substrates. Overall, this indicated that in C. trachomatis Slc1 is a chaperone of multiple T3S substrates and that CT584 is a chaperone of the newly identified T3S substrate CT082.

  7. Complex regional pain syndrome type I affects brain structure in prefrontal and motor cortex.

    Directory of Open Access Journals (Sweden)

    Burkhard Pleger

    Full Text Available The complex regional pain syndrome (CRPS is a rare but debilitating pain disorder that mostly occurs after injuries to the upper limb. A number of studies indicated altered brain function in CRPS, whereas possible influences on brain structure remain poorly investigated. We acquired structural magnetic resonance imaging data from CRPS type I patients and applied voxel-by-voxel statistics to compare white and gray matter brain segments of CRPS patients with matched controls. Patients and controls were statistically compared in two different ways: First, we applied a 2-sample ttest to compare whole brain white and gray matter structure between patients and controls. Second, we aimed to assess structural alterations specifically of the primary somatosensory (S1 and motor cortex (M1 contralateral to the CRPS affected side. To this end, MRI scans of patients with left-sided CRPS (and matched controls were horizontally flipped before preprocessing and region-of-interest-based group comparison. The unpaired ttest of the "non-flipped" data revealed that CRPS patients presented increased gray matter density in the dorsomedial prefrontal cortex. The same test applied to the "flipped" data showed further increases in gray matter density, not in the S1, but in the M1 contralateral to the CRPS-affected limb which were inversely related to decreased white matter density of the internal capsule within the ipsilateral brain hemisphere. The gray-white matter interaction between motor cortex and internal capsule suggests compensatory mechanisms within the central motor system possibly due to motor dysfunction. Altered gray matter structure in dorsomedial prefrontal cortex may occur in response to emotional processes such as pain-related suffering or elevated analgesic top-down control.

  8. Complex regional pain syndrome type I affects brain structure in prefrontal and motor cortex.

    Science.gov (United States)

    Pleger, Burkhard; Draganski, Bogdan; Schwenkreis, Peter; Lenz, Melanie; Nicolas, Volkmar; Maier, Christoph; Tegenthoff, Martin

    2014-01-01

    The complex regional pain syndrome (CRPS) is a rare but debilitating pain disorder that mostly occurs after injuries to the upper limb. A number of studies indicated altered brain function in CRPS, whereas possible influences on brain structure remain poorly investigated. We acquired structural magnetic resonance imaging data from CRPS type I patients and applied voxel-by-voxel statistics to compare white and gray matter brain segments of CRPS patients with matched controls. Patients and controls were statistically compared in two different ways: First, we applied a 2-sample ttest to compare whole brain white and gray matter structure between patients and controls. Second, we aimed to assess structural alterations specifically of the primary somatosensory (S1) and motor cortex (M1) contralateral to the CRPS affected side. To this end, MRI scans of patients with left-sided CRPS (and matched controls) were horizontally flipped before preprocessing and region-of-interest-based group comparison. The unpaired ttest of the "non-flipped" data revealed that CRPS patients presented increased gray matter density in the dorsomedial prefrontal cortex. The same test applied to the "flipped" data showed further increases in gray matter density, not in the S1, but in the M1 contralateral to the CRPS-affected limb which were inversely related to decreased white matter density of the internal capsule within the ipsilateral brain hemisphere. The gray-white matter interaction between motor cortex and internal capsule suggests compensatory mechanisms within the central motor system possibly due to motor dysfunction. Altered gray matter structure in dorsomedial prefrontal cortex may occur in response to emotional processes such as pain-related suffering or elevated analgesic top-down control.

  9. CD7 in acute myeloid leukemia: correlation with loss of wild-type CEBPA, consequence of epigenetic regulation

    Directory of Open Access Journals (Sweden)

    Drexler Hans G

    2010-04-01

    Full Text Available Abstract Background CD7 is a negative prognostic marker in myeloid malignancies. In acute myeloid leukemia (AML, an inverse correlation exists between expression of wild-type CEBPA and CD7. Aim of this study was to find out whether C/EBPα is a negative regulator of CD7 and which other regulatory mechanisms might be involved. Results As already described for primary AML cells, the majority of AML cell lines tested were either C/EBPα+/CD7- or C/EBPα-/CD7+. However, the existence of isolated CD7+ cell lines expressing wild-type C/EBPα challenges the notion that C/EBPα acts as a unique repressor of CD7. Furthermore, ectopic expression of CEBPA did not reduce CD7 in CD7+ cells and knock-down of C/EBPα failed to induce CD7 in CD7- cells. In contrast, the DNA demethylating agent Aza-2'deoxycytidine triggered CD7 expression in CD7- AML and in T-cell lines suggesting epigenetic regulation of CD7. Bisulfite sequencing data confirmed that CpGs in the CD7 exon1 region are methylated in CD7- cell lines, and unmethylated in CD7+ cell lines. Conclusion We confirmed an inverse correlation between the expression of wild-type CEBPA and of CD7 in AML cells. Our results contradict the hypothesis that C/EBPα acts as repressor for CD7, and instead show that epigenetic mechanisms are responsible for CD7 regulation, in AML cells as well as in T-cells, the typical CD7 expressing cell type.

  10. Clinical Predictors for Delayed or Inappropriate Initial Diagnosis of Type A Acute Aortic Dissection in the Emergency Room.

    Science.gov (United States)

    Hirata, Kazuhito; Wake, Minoru; Takahashi, Takanori; Nakazato, Jun; Yagi, Nobuhito; Miyagi, Tadayoshi; Shimotakahara, Junichi; Mototake, Hidemitsu; Tengan, Toshiho; Takara, Tsuyoshi R; Yamaguchi, Yutaka

    2015-01-01

    Initial diagnosis of acute aortic dissection (AAD) in the emergency room (ER) is sometimes difficult or delayed. The aim of this study is to define clinical predictors related to inappropriate or delayed diagnosis of Stanford type A AAD. We conducted a retrospective analysis of 127 consecutive patients with type A AAD who presented to the ER within 12 h of symptom onset (age: 69.0 ± 15.4 years, male/female = 49/78). An inappropriate initial diagnosis (IID) was considered if AAD was not included in the differential diagnosis or if chest computed tomography or echocardiography was not performed as initial imaging tests. Clinical variables were compared between IID and appropriate diagnosis group. The time to final diagnosis (TFD) was also evaluated. Delayed diagnosis (DD) was defined as TFD > third quartile. Clinical factors predicting DD were evaluated in comparison with early diagnosis (defined as TFD within the third quartile). In addition, TFD was compared with respect to each clinical variable using a rank sum test. An IID was determined for 37% of patients. Walk-in (WI) visit to the ER [odds ratio (OR) 2.6, 95% confidence interval (CI) = 1.01-6.72, P = 0.048] and coronary malperfusion (CM, OR = 6.48, 95% CI = 1.14-36.82, P = 0.035) were predictors for IID. Overall, the median TFD was 1.5 h (first/third quartiles = 0.5/4.0 h). DD (>4.5 h) was observed in 27 cases (21.3%). TFD was significantly longer in WI patients (median and first/third quartiles = 1.0 and 0.5/2.85 h for the ambulance group vs. 3.0 and 1.0/8.0 h for the WI group, respectively; P = 0.003). Multivariate analysis revealed that WI visit was the only predictor for DD (OR = 3.72, 95% CI = 1.39-9.9, P = 0.009). TFD was significantly shorter for appropriate diagnoses than for IIDs (1.0 vs. 6.0 h, respectively; P < 0.0001). WI visit to the ER and CM were predictors for IID, and WI was the only predictor for DD in acute type A AAD in the community hospital.

  11. Clinical Predictors for Delayed or Inappropriate Initial Diagnosis of Type A Acute Aortic Dissection in the Emergency Room.

    Directory of Open Access Journals (Sweden)

    Kazuhito Hirata

    Full Text Available Initial diagnosis of acute aortic dissection (AAD in the emergency room (ER is sometimes difficult or delayed. The aim of this study is to define clinical predictors related to inappropriate or delayed diagnosis of Stanford type A AAD.We conducted a retrospective analysis of 127 consecutive patients with type A AAD who presented to the ER within 12 h of symptom onset (age: 69.0 ± 15.4 years, male/female = 49/78. An inappropriate initial diagnosis (IID was considered if AAD was not included in the differential diagnosis or if chest computed tomography or echocardiography was not performed as initial imaging tests. Clinical variables were compared between IID and appropriate diagnosis group. The time to final diagnosis (TFD was also evaluated. Delayed diagnosis (DD was defined as TFD > third quartile. Clinical factors predicting DD were evaluated in comparison with early diagnosis (defined as TFD within the third quartile. In addition, TFD was compared with respect to each clinical variable using a rank sum test.An IID was determined for 37% of patients. Walk-in (WI visit to the ER [odds ratio (OR 2.6, 95% confidence interval (CI = 1.01-6.72, P = 0.048] and coronary malperfusion (CM, OR = 6.48, 95% CI = 1.14-36.82, P = 0.035 were predictors for IID. Overall, the median TFD was 1.5 h (first/third quartiles = 0.5/4.0 h. DD (>4.5 h was observed in 27 cases (21.3%. TFD was significantly longer in WI patients (median and first/third quartiles = 1.0 and 0.5/2.85 h for the ambulance group vs. 3.0 and 1.0/8.0 h for the WI group, respectively; P = 0.003. Multivariate analysis revealed that WI visit was the only predictor for DD (OR = 3.72, 95% CI = 1.39-9.9, P = 0.009. TFD was significantly shorter for appropriate diagnoses than for IIDs (1.0 vs. 6.0 h, respectively; P < 0.0001.WI visit to the ER and CM were predictors for IID, and WI was the only predictor for DD in acute type A AAD in the community hospital.

  12. Antagonistic jacalin-related lectins regulate the size of ER body-type beta-glucosidase complexes in Arabidopsis thaliana.

    Science.gov (United States)

    Nagano, Atsushi J; Fukao, Yoichiro; Fujiwara, Masayuki; Nishimura, Mikio; Hara-Nishimura, Ikuko

    2008-06-01

    PYK10/BGLU23 is a beta-glucosidase that is a major protein of ER bodies, which are endoplasmic reticulum (ER)-derived organelles that may be involved in defense systems. PYK10 has active and inactive forms. Active PYK10 molecules form large complexes with diameters ranging from 0.65 microm to > 70 microm. We identified three beta-glucosidases (PYK10, BGLU21 and BGLU22), five jacalin-related lectins (JALs) and a GDSL lipase-like protein (GLL) in the purified PYK10 complex. Expression levels of JALs and GLLs were lower in the nai1-1 mutant, which has no ER bodies, than in Col-0. The subcellular localization of PYK10 is predicted to be different from the localizations of JALs and GLLs. This suggests that PYK10 interacts with its partners (JALs and GLLs) when the subcellular structure is destroyed by pathogens. The PYK10 complex was found to be larger in the pbp1-1 and jal22-1 mutants than in Col-0, while it was smaller in the jal23-1, jal31-1 and jal31-2 mutants than in Col-0. These results show that two types of JALs having opposite roles regulate the size of the PYK10 complex antagonistically. We define the two types of lectins as a 'polymerizer-type lectin' and an 'inhibitor-type lectin'. Interestingly, the closest homologs of polymerizer-type lectins (JAL31 and JAL23) were inhibitor-type lectins (PBP1/JAL30 and JAL22). The pairs of polymerizer-type and inhibitor-type lectins reported here are good examples of genes that have evolved new functions after gene duplication (neofunctionalization).

  13. Simultaneous acute shoulder arthritis and multiple mononeuropathy in a newly diagnosed type 2 diabetes patient - First case report.

    Science.gov (United States)

    Kotlęga, Dariusz; Gołąb-Janowska, Monika; Zaborowski, Grzegorz; Ciećwież, Sylwester; Nowacki, Przemysław

    Diabetes is a common disorder that leads to the musculoskeletal symptoms such as the shoulder arthritis. The involvement of peripheral nervous system is one of the troublesome for the patients as it provokes chronic sensory symptoms, lower motor neuron involvement and autonomic symptoms. In the course of the disease there has been several types of neuropathies described. A 41-year-old male patient was admitted to the internal medicine department because of the general weakness, malaise, polydypsia and polyuria since several days. The initial blood glucose level was 780mg/dl. During the first day the continuous insulin infusion was administered. On the next day when he woke up, the severe pain in the right shoulder with limited movement, right upper extremity weakness and burning pain in the radial aspect of this extremity appeared. On examination right shoulder joint movement limitation was found with the muscle weakness and sensory symptoms in the upper limbs. The clinical picture indicated on the right shoulder arthritis and the peripheral nervous system symptoms such as the right musculocutaneous, supraspinatus, right radial nerve and left radial nerve damage. We present a first case report of simultaneous, acute involvement of the shoulder joint and multiple neuropathy in a patient with newly diagnosed type 2 diabetes, presumably in the state of ketoacidosis. Copyright © 2016 Polish Neurological Society. Published by Elsevier Urban & Partner Sp. z o.o. All rights reserved.

  14. Risk factors and early outcomes of acute renal injury after thoracic aortic endograft repair for type B aortic dissection

    Directory of Open Access Journals (Sweden)

    Luo S

    2017-08-01

    Full Text Available Songyuan Luo,* Huanyu Ding,* Jianfang Luo, Wei Li, Bing Ning, Yuan Liu, Wenhui Huang, Ling Xue, Ruixin Fan, Jiyan Chen Cardiology Department, Guangdong Cardiovascular Institute, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China *These authors contributed equally to this work Background: Thoracic endovascular aortic repair (TEVAR has become an emerging treatment modality for acute type B aortic dissection (TBAD patients in recent years. The risk factors and impacts of acute kidney injury (AKI after percutaneous TEVAR, however, have not been widely established.Methods: We retrospectively studied the clinical records of 305 consecutive patients who admitted to our institution and had TEVAR for TBAD between December 2009 and June 2013. The patients were routinely monitored for their renal functions preoperatively until 7 days after TEVAR. The Kidney Disease Improving Global Guidelines (KDIGO criteria were used for AKI.Results: Of the total 305 consecutive patients, 84 (27.5% developed AKI after TEVAR, comprising 66 (21.6% patients in KDIGO stage 1, 6 (2.0% patients in stage 2 and 12 (3.9% patients in stage 3. From the logistic regression analysis, systolic blood pressure (SBP on admission >140 mmHg (odds ratio [OR], 2.288; 95% CI, 1.319–3.969 and supra-aortic branches graft bypass hybrid surgery (OR, 3.228; 95% CI, 1.526–6.831 were independent risk factors for AKI after TEVAR. Local anesthesia tended to be a protective factor (OR, 0.563; 95% CI, 0.316–1.001. The preoperative renal function, angiotensin-converting enzyme inhibitor/angiotensin receptor blocker or statin administration, volume of contrast agent, range of TBAD and false lumen involving renal artery were not associated with post-operation AKI. The in-hospital mortality and major adverse events were markedly increased with the occurrence of AKI (7.1% vs 0.9%, P=0

  15. Effects of acute exercise on pancreatic endocrine function in subjects with type 2 diabetes

    DEFF Research Database (Denmark)

    Knudsen, Sine H; Karstoft, Kristian; Winding, Kamilla

    2015-01-01

    We determined the effects of exercise on pancreatic endocrine responses to metabolic stimuli in type 2 diabetic (T2D) subjects and examined the influence of the diabetic status. Fourteen subjects underwent a hyperglycaemic clamp with GLP-1 infusion and arginine injection, the morning after a one......-hour walk or no exercise. Subjects were stratified by high and low quantiles of fasting plasma glucose (FPG) and HbA1c as well as current use/non-use of anti-diabetic medication. In the entire cohort, exercise did not alter insulin secretion, while glucagon levels were increased in all clamp phases (P ....05-P exercise increased GLP-1-stimulated insulin secretion (P exercise increased GLP-1- and arginine-stimulated insulin secretion (P diabetic...

  16. Acute multi-sgRNA knockdown of KEOPS complex genes reproduces the microcephaly phenotype of the stable knockout zebrafish model.

    Directory of Open Access Journals (Sweden)

    Tilman Jobst-Schwan

    Full Text Available Until recently, morpholino oligonucleotides have been widely employed in zebrafish as an acute and efficient loss-of-function assay. However, off-target effects and reproducibility issues when compared to stable knockout lines have compromised their further use. Here we employed an acute CRISPR/Cas approach using multiple single guide RNAs targeting simultaneously different positions in two exemplar genes (osgep or tprkb to increase the likelihood of generating mutations on both alleles in the injected F0 generation and to achieve a similar effect as morpholinos but with the reproducibility of stable lines. This multi single guide RNA approach resulted in median likelihoods for at least one mutation on each allele of >99% and sgRNA specific insertion/deletion profiles as revealed by deep-sequencing. Immunoblot showed a significant reduction for Osgep and Tprkb proteins. For both genes, the acute multi-sgRNA knockout recapitulated the microcephaly phenotype and reduction in survival that we observed previously in stable knockout lines, though milder in the acute multi-sgRNA knockout. Finally, we quantify the degree of mutagenesis by deep sequencing, and provide a mathematical model to quantitate the chance for a biallelic loss-of-function mutation. Our findings can be generalized to acute and stable CRISPR/Cas targeting for any zebrafish gene of interest.

  17. A single-center experience of hemofiltration treatment for acute aortic dissection (Stanford type A) complicated with postoperative acute renal failure.

    Science.gov (United States)

    Qi, Peng; Zhang, Xi-Quan; Pang, Xin-Yan; Cao, Guang-Qing; Fang, Chang-Cun; Wu, Shu-Ming

    2015-01-01

    To investigate the effect of continuous venovenous hemofiltration (CVVH) for aortic dissection patients with acute renal failure after surgery in retrospective manner. A total of thirty-seven aortic dissection patients with postoperative acute renal failure accepted CVVH therapy. The effect of CVVH was evaluated by analyzing clinical condition changes and laboratory examination results. After treatment of CVVH, renal function and clinical symptoms were significantly improved in thirty patients. Eight of the thirty patients got completely renal function recovery within two weeks after CVVH therapy; and twenty-two of the thirty patients got completely renal function recovery within four weeks after CVVH therapy. Nevertheless, seven patients got no benefit from CVVH therapy with poor prognosis. CVVH is an effective treatment to most aortic dissection patients with postoperative acute renal failure. The effect of CVVH was correlated with original renal function, early CVVH therapy, and continuous intensive care.

  18. Giant phaeochromocytoma presenting with an acute stroke: reappraising phaeochromocytoma surveillance for the neurofibromatosis type 1 phakomatosis.

    Science.gov (United States)

    Lee, Yingshan; Tan, Leon Yuan Rui; Ho, Yong Howe; Leow, Melvin Khee Shing

    2017-11-03

    Neurofibromatosis type 1 (NF1) is a multisystem genetic disorder associated with reduced lifespan attributed largely to malignancy and vascular causes. One of the tumours associated with NF1 is phaeochromocytoma. The phaeochromocytoma has earned the moniker, a 'great mimicker', due to its varied means of presentation. We present a patient with NF1 who was diagnosed with a giant 20 cm phaeochromocytoma after suffering from an ischaemic stroke. Current guidelines do not advocate surveillance of phaeochromocytoma in asymptomatic patients with NF1, unlike other genetic syndromes associated with phaeochromocytoma. However, there is increasing evidence that this approach may not help in the early detection and treatment of this potentially life-threatening disease. Our patient remained hypertensive after surgery despite achieving biochemical cure. The suggested chronicity of the underlying tumour in our patient is a reminder to practising clinicians to rethink our strategy in identifying phaeochromocytoma in adults with NF1. © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  19. Impact of spinal cord stimulation on sensory characteristics in complex regional pain syndrome type I - A randomized trial

    NARCIS (Netherlands)

    Kemler, MA; Reulen, JPH; Barendse, GAM; van Kleef, M; de Vet, HCW; van den Wildenberg, FAJM

    Background: A randomized trial was performed to assess the effect of spinal cord stimulation (SCS) on detection and pain thresholds for pressure, warmth, and cold and on the extent of mechanical hyperalgesia in patients with chronic complex regional pain syndrome type I. Methods: Fifty-four chronic

  20. First worldwide proficiency study on variable-number tandem-repeat typing of Mycobacterium tuberculosis complex strains.

    NARCIS (Netherlands)

    Beer, J.L. de; Kremer, K.; Kodmon, C.; Supply, P.; Soolingen, D. van

    2012-01-01

    Although variable-number tandem-repeat (VNTR) typing has gained recognition as the new standard for the DNA fingerprinting of Mycobacterium tuberculosis complex (MTBC) isolates, external quality control programs have not yet been developed. Therefore, we organized the first multicenter proficiency

  1. Reproducible association with type 1 diabetes in the extended class I region of the major histocompatibility complex

    DEFF Research Database (Denmark)

    Viken, M.K.; Blomhoff, A.; Olsson, M.

    2009-01-01

    The high-risk human leukocyte antigen (HLA)-DRB1, DQA1 and DQB1 alleles cannot explain the entire type 1 diabetes (T1D) association observed within the extended major histocompatibility complex. We have earlier identified an association with D6S2223, located 2.3 Mb telomeric of HLA-A, on the DRB1...

  2. Effects of acute caffeine supplementation on reducing exercise-associated hypoglycaemia in individuals with Type 1 diabetes mellitus.

    Science.gov (United States)

    Zaharieva, D P; Miadovnik, L A; Rowan, C P; Gumieniak, R J; Jamnik, V K; Riddell, M C

    2016-04-01

    To determine the effects of acute caffeine ingestion on glycaemia during moderate to vigorous intensity aerobic exercise and in recovery in individuals with Type 1 diabetes. A total of 13 patients with Type 1 diabetes [eight women, five men: mean ± sd age 25.9 ± 8.8 years, BMI 71.9 ± 11.0 kg, maximal oxygen consumption 46.6 ± 12.7 ml/kg/min, body fat 19.9 ± 7.2%, duration of diabetes 14.4 ± 10.1 years and HbA1c 55 ± 8 mmol/mol (7.4 ± 0.8%)] were recruited. Participants ingested capsules that contained gelatin or pure caffeine (6.0 mg/kg body mass) and performed afternoon exercise for 45 min at 60% maximal oxygen consumption on two separate visits with only circulating basal insulin levels. The main finding was that a single caffeine dose attenuates the drop in glycaemia by 1.8 ± 2.8 mmol/l compared with placebo intake during exercise (P=0.056). Continuous glucose monitoring data, however, showed that caffeine was associated with elevated glycaemia at bedtime after exercise, compared with placebo, but lower glucose concentrations in the early morning the next day. Caffeine intake should be considered as another strategy that may modestly attenuate hypoglycaemia in individuals with Type 1 diabetes during exercise, but should be taken with precautionary measures as it may increase the risk of late-onset hypoglycaemia. © 2015 Diabetes UK.

  3. Tailored support for type 2 diabetes patients with an acute coronary event after discharge from hospital - design and development of a randomised controlled trial

    NARCIS (Netherlands)

    Kasteleyn, M.J.; Gorter, K.J.; Stellato, R.K.; Rijken, M.; Nijpels, G.; Rutten, G.E.H.M.

    2014-01-01

    Background: Type 2 diabetes mellitus patients with an acute coronary event (ACE) experience decreased quality of life and increased distress. According to the American Diabetes Association, discharge from the hospital is a time of increased distress for all patients. Tailored support specific to

  4. Tailored support for type 2 diabetes patients with an acute coronary event after discharge from hospital: design and development of a randomised controlled trial.

    NARCIS (Netherlands)

    Kasteleyn, M.J.; Gorter, K.J.; Stellato, R.K.; Rijken, M.; Nijpels, G.; Rutten, G.E.H.M.

    2014-01-01

    Background: Type 2 diabetes mellitus patients with an acute coronary event (ACE) experience decreased quality of life and increased distress. According to the American Diabetes Association, discharge from the hospital is a time of increased distress for all patients. Tailored support specific to

  5. Impact of endothelin blockade on acute exercise-induced changes in blood flow and endothelial function in type 2 diabetes mellitus.

    NARCIS (Netherlands)

    Schreuder, T.H.A.; Lotringen, J.H. van; Hopman, M.T.E.; Thijssen, D.H.J.

    2014-01-01

    Positive vascular effects of exercise training are mediated by acute increases in blood flow. Type 2 diabetes patients show attenuated exercise-induced increases in blood flow, possibly mediated by the endothelin pathway, preventing an optimal stimulus for vascular adaptation. We examined the impact

  6. Evidence, lack of evidence, controversy, and debate in the provision and performance of the surgery of acute type A aortic dissection

    DEFF Research Database (Denmark)

    Bonser, Robert S; Ranasinghe, Aaron M; Loubani, Mahmoud

    2011-01-01

    Acute type A aortic dissection is a lethal condition requiring emergency surgery. It has diverse presentations, and the diagnosis can be missed or delayed. Once diagnosed, decisions with regard to initial management, transfer, appropriateness of surgery, timing of operation, and intervention for ...

  7. Inulin-Type Fructans Modulates PancreaticGut Innate Immune Responses and Gut Barrier Integrity during Experimental Acute Pancreatitis in a Chain Length-Dependent Manner

    NARCIS (Netherlands)

    He, Yue; Wu, Chengfei; Li, Jiahong; Li, Hongli; Sun, Zhenghua; Zhang, Hao; de Vos, Paul; Pan, Li-Long; Sun, Jia

    2017-01-01

    Acute pancreatitis (AP) is a common abdominal inflammatory disorder and one of the leading causes of hospital admission for gastrointestinal disorders. No specific pharmacological or nutritional therapy is available but highly needed. Inulin-type fructans (ITFs) are capable of modifying gut immune

  8. The costs of acute readmissions to a different hospital - Does the effect vary across provider types?

    Science.gov (United States)

    Møller Dahl, Christian; Planck Kongstad, Line

    2017-06-01

    Treatment costs are found to vary substantially and systematically within DRGs. Several factors have been shown to contribute to the variation in costs within DRGs. We argue that readmissions might also explain part of the observed variation in costs. A substantial number of all readmissions occur to a different hospital. The change in hospital indicates that a progression of the illness has occurred since the initial hospitalisation. As a result, different-hospital readmissions might be more costly compared to same-hospital admissions. The aim of this paper is twofold. Firstly, to analyse differences in costs between different-hospital readmissions and same-hospital readmissions within the same DRG. Secondly, to investigate whether the effect of different-hospital readmission on costs vary depending of provider type (general versus teaching hospital). We use a rich Danish patient-level administrative data set covering inpatient stays in the period 2008-2010. We exploit the fact that some patients are readmitted within the same DRG and that some of these readmissions occur at different hospitals in a propensity score difference-in-difference design. The estimates are based on a restricted sample of n = 328 patients. Our results show that the costs of different-hospital readmissions are significantly higher relative to the costs of same-hospital readmission (approx. €777). Furthermore, the cost difference is found to be almost twice the size for patients readmitted to a teaching hospital (approx. €1016) (P different general hospital (approx. €511) (P different-hospital readmissions, and that the financial consequences are highest among teaching hospitals. If teaching hospitals are not compensated for the additional costs of treating different-hospital readmission patients, they might be unfairly funded under a DRG-based payment scheme. Copyright © 2017 Elsevier Ltd. All rights reserved.

  9. Is type D personality an independent risk factor for recurrent myocardial infarction or all-cause mortality in post-acute myocardial infarction patients?

    Science.gov (United States)

    Condén, Emelie; Rosenblad, Andreas; Wagner, Philippe; Leppert, Jerzy; Ekselius, Lisa; Åslund, Cecilia

    2017-03-01

    Background Type D personality refers to a combination of simultaneously high levels of negative affectivity and social inhibition. The present study aimed to examine whether type D personality was independently associated with recurrent myocardial infarction or all-cause mortality in post-acute myocardial infarction patients, using any of the previously proposed methods for measuring type D personality. Design This was a prospective cohort study. Methods Utilising data from the Västmanland Myocardial Infarction Study, 946 post-acute myocardial infarction patients having data on the DS14 instrument used to measure type D personality were followed-up for recurrent myocardial infarction and all-cause mortality until 9 December 2015. Data were analysed using Cox regression, adjusted for established risk factors. Results In total, 133 (14.1%) patients suffered from type D personality. During a mean follow-up time for recurrent myocardial infarction of 5.7 (3.2) years, 166 (17.5%) patients were affected by recurrent myocardial infarction, of which 26 (15.7%) had type D personality, while during a mean follow-up time for all-cause mortality of 6.3 (2.9) years, 321 (33.9%) patients died, of which 42 (13.1%) had type D personality. After adjusting for established risk factors, type D personality was not significantly associated with recurrent myocardial infarction or all-cause mortality using any of the previously proposed methods for measuring type D personality. A weak association was found between the social inhibition part of type D personality and a decreased risk of all-cause mortality, but this association was not significant after taking missing data into account in a multiple imputation analysis. Conclusions No support was found for type D personality being independently associated with recurrent myocardial infarction or all-cause mortality in post-acute myocardial infarction patients, using any of the previously proposed methods for measuring type D personality.

  10. Hemiarch versus total aortic arch replacement in acute type A dissection: a systematic review and meta-analysis.

    Science.gov (United States)

    Poon, Shi Sum; Theologou, Thomas; Harrington, Deborah; Kuduvalli, Manoj; Oo, Aung; Field, Mark

    2016-05-01

    Despite recent advances in aortic surgery, acute type A aortic dissection remains a surgical emergency associated with high mortality and morbidity. Appropriate management is crucial to achieve satisfactory outcomes but the optimal surgical approach is controversial. The present systematic review and meta-analysis sought to access cumulative data from comparative studies between hemiarch and total aortic arch replacement in patients with acute type A aortic dissection. A systematic review of the literature using six databases. Eligible studies include comparative studies on hemiarch versus total arch replacement reporting short, medium and long term outcomes. A meta-analysis was performed on eligible studies reporting outcome of interest to quantify the effects of hemiarch replacement on mortality and morbidity risk compared to total arch replacement. Fourteen retrospective studies met the inclusion criteria and 2,221 patients were included in the final analysis. Pooled analysis showed that hemiarch replacement was associated with a lower risk of post-operative renal dialysis [risk ratio (RR) =0.72; 95% confidence interval (CI): 0.56-0.94; P=0.02; I(2)=0%]. There was no significant difference in terms of in-hospital mortality between the two groups (RR =0.84; 95% CI: 0.65-1.09; P=0.20; I(2)=0%). Cardiopulmonary bypass, aortic cross clamp and circulatory arrest times were significantly longer in total arch replacement. During follow up, no significant difference was reported from current studies between the two operative approaches in terms of aortic re-intervention and freedom from aortic reoperation. Within the context of publication bias by high volume aortic centres and non-randomized data sets, there was no difference in mortality outcomes between the two groups. This analysis serves to demonstrate that for those centers doing sufficient total aortic arch activity to allow for publication, excellent and equivalent outcomes are achievable. Conclusions on

  11. Acute Hepatopancreatic Necrosis Disease-Causing Vibrio parahaemolyticus Strains Maintain an Antibacterial Type VI Secretion System with Versatile Effector Repertoires.

    Science.gov (United States)

    Li, Peng; Kinch, Lisa N; Ray, Ann; Dalia, Ankur B; Cong, Qian; Nunan, Linda M; Camilli, Andrew; Grishin, Nick V; Salomon, Dor; Orth, Kim

    2017-07-01

    Acute hepatopancreatic necrosis disease (AHPND) is a newly emerging shrimp disease that has severely damaged the global shrimp industry. AHPND is caused by toxic strains of Vibrio parahaemolyticus that have acquired a "selfish plasmid" encoding the deadly binary toxins PirA vp /PirB vp To better understand the repertoire of virulence factors in AHPND-causing V. parahaemolyticus , we conducted a comparative analysis using the genome sequences of the clinical strain RIMD2210633 and of environmental non-AHPND and toxic AHPND isolates of V. parahaemolyticus Interestingly, we found that all of the AHPND strains, but none of the non-AHPND strains, harbor the antibacterial type VI secretion system 1 (T6SS1), which we previously identified and characterized in the clinical isolate RIMD2210633. This finding suggests that the acquisition of this T6SS might confer to AHPND-causing V. parahaemolyticus a fitness advantage over competing bacteria and facilitate shrimp infection. Additionally, we found highly dynamic effector loci in the T6SS1 of AHPND-causing strains, leading to diverse effector repertoires. Our discovery provides novel insights into AHPND-causing pathogens and reveals a potential target for disease control. IMPORTANCE Acute hepatopancreatic necrosis disease (AHPND) is a serious disease that has caused severe damage and significant financial losses to the global shrimp industry. To better understand and prevent this shrimp disease, it is essential to thoroughly characterize its causative agent, Vibrio parahaemolyticus Although the plasmid-encoded binary toxins PirA vp /PirB vp have been shown to be the primary cause of AHPND, it remains unknown whether other virulent factors are commonly present in V. parahaemolyticus and might play important roles during shrimp infection. Here, we analyzed the genome sequences of clinical, non-AHPND, and AHPND strains to characterize their repertoires of key virulence determinants. Our studies reveal that an antibacterial type

  12. Consideration of QRS complex in addition to ST-segment abnormalities in the estimation of the "risk region" during acute anterior or inferior myocardial infarction.

    Science.gov (United States)

    Vervaat, F E; Bouwmeester, S; van Hellemond, I E G; Wagner, G S; Gorgels, A P M

    2014-01-01

    The myocardial area at risk (MaR) is an important aspect in acute ST-elevation myocardial infarction (STEMI). It represents the myocardium at the onset of the STEMI that is ischemic and could become infarcted if no reperfusion occurs. The MaR, therefore, has clinical value because it gives an indication of the amount of myocardium that could potentially be salvaged by rapid reperfusion therapy. The most validated method for measuring the MaR is (99m)Tc-sestamibi SPECT, but this technique is not easily applied in the clinical setting. Another method that can be used for measuring the MaR is the standard ECG-based scoring system, Aldrich ST score, which is more easily applied. This ECG-based scoring system can be used to estimate the extent of acute ischemia for anterior or inferior left ventricular locations, by considering quantitative changes in the ST-segment. Deviations in the ST-segment baseline that occur following an acute coronary occlusion represent the ischemic changes in the transmurally ischemic myocardium. In most instances however, the ECG is not available at the very first moments of STEMI and as times passes the ischemic myocardium becomes necrotic with regression of the ST-segment deviation along with progressive changes of the QRS complex. Thus over the time course of the acute event, the Aldrich ST score would be expected to progressively underestimate the MaR, as was seen in studies with SPECT as gold standard; anterior STEMI (r=0.21, p=0.32) and inferior STEMI (r=0.17, p=0.36). Another standard ECG-based scoring system is the Selvester QRS score, which can be used to estimate the final infarct size by considering the quantitative changes in the QRS complex. Therefore, additional consideration of the Selvester QRS score in the acute phase could potentially provide the "component" of infarcted myocardium that is missing when the Aldrich ST score alone is used to determine the MaR in the acute phase, as was seen in studies with SPECT as gold

  13. Surgical versus conservative treatment for acute injuries of the lateral ligament complex of the ankle in adults

    NARCIS (Netherlands)

    Kerkhoffs, G. M. M. J.; Handoll, H. H. G.; de Bie, R.; Rowe, B. H.; Struijs, P. A. A.

    2002-01-01

    BACKGROUND: Inversion injuries, primarily sprains, of the ankle are one of the most commonly treated injuries. The three main treatment modalities for acute lateral ankle ligament injuries are immobilisation with plaster cast or splint, 'functional treatment' comprising early mobilisation and the

  14. Finite element modeling of aponeurotomy: altered intramuscular myofascial force transmission yields complex sarcomere length distributions determining acute effects

    NARCIS (Netherlands)

    Yucesoy, C.A.; Koopman, B.H.; Grootenboer, H.J.; Huijing, P.A.J.B.M.

    2007-01-01

    Finite element modeling of aponeurotomized rat extensor digitorium longus muscle was performed to investigate the acute effects of proximal aponeurotomy. The specific goal was to assess the changes in lengths of sarcomeres within aponeurotomized muscle and to explain how the intervention leads to

  15. Preliminary investigation of phosphorus adsorption onto two types of iron oxide-organic matter complexes.

    Science.gov (United States)

    Yan, Jinlong; Jiang, Tao; Yao, Ying; Lu, Song; Wang, Qilei; Wei, Shiqiang

    2016-04-01

    Iron oxide (FeO) coated by natural organic matter (NOM) is ubiquitous. The associations of minerals with organic matter (OM) significantly changes their surface properties and reactivity, and thus affect the environmental fate of pollutants, including nutrients (e.g., phosphorus (P)). In this study, ferrihydrite/goethite-humic acid (FH/GE-HA) complexes were prepared and their adsorption characteristics on P at various pH and ionic strength were investigated. The results indicated that the FeO-OM complexes showed a decreased P adsorption capacity in comparison with bare FeO. The maximum adsorption capacity (Qmax) decreased in the order of FH (22.17 mg/g)>FH-HA (5.43 mg/g)>GE (4.67 mg/g)>GE-HA (3.27 mg/g). After coating with HA, the amorphous FH-HA complex still showed higher P adsorption than the crystalline GE-HA complex. The decreased P adsorption observed might be attributed to changes of the FeO surface charges caused by OM association. The dependence of P adsorption on the specific surface area of adsorbents suggests that the FeO component in the complexes is still the main contributor for the adsorption surfaces. The P adsorptions on FeO-HA complexes decreased with increasing initial pH or decreasing initial ionic strength. A strong dependence of P adsorption on ionic strength and pH may demonstrate that outer-sphere complexes between the OM component on the surface and P possibly coexist with inner-sphere surface complexes between the FeO component and P. Therefore, previous over-emphasis on the contributions of original minerals to P immobilization possibly over-estimates the P loading capacity of soils, especially in humic-rich areas. Copyright © 2015. Published by Elsevier B.V.

  16. Acute fiber supplementation with inulin-type fructans curbs appetite sensations: a randomized, double-blind, placebo-controlled study

    Science.gov (United States)

    Salmean, Younis A.

    2017-01-01

    ABSTRACT Background: Research points to a benefit of inulin fiber on appetite and weight regulation but results remain mixed. Objectives: To test the impact of 16 g/d of Inulin-type fructans (ITFs) on appetite and food intake in acute settings. Design: Forty college age females received either a fiber drink with 16 g of ITFs in 330 ml water or placebo. On the 8th day of the study, appetite sensations were assessed using visual analogue scale (VAS) along with food intake. Repeated-measures ANOVA were performed comparing VAS ratings during test day. Energy consumption was compared using paired t-tests. Significance was determined at p<0.05. Results: On the 8th day, the fiber group reported lower ratings for hunger, desire to eat, and prospective food consumption with significantly higher ratings for satisfaction and fullness. Subsequently, the fiber group consumed 21% less kcal from food at lunch (453 ± 47 kcal) compared to controls (571 ± 39 kcal) (p<0.05). Conclusions: Consuming 16 g/d of ITFs in the morning for 7 days, and after an overnight fast, curbed appetite sensations and helped reduce food intake during lunch meal. These findings highlight the potential of using ITFs in weight management. Future studies should explore ITFs long term benefits. PMID:28747861

  17. Cohesive taping and short-leg casting in acute low-type ankle sprains in physically active patients.

    Science.gov (United States)

    Uslu, Mustafa; Inanmaz, Mustafa E; Ozsahin, Mustafa; Isık, Cengiz; Arıcan, Mehmet; Gecer, Yavuz

    2015-07-01

    Cohesive taping is commonly used for the prevention or treatment of ankle sprain injuries. Short-leg cast immobilization or splinting is another treatment option in such cases. To determine the clinical efficacy and antiedema effects of cohesive taping and short-leg cast immobilization in acute low-type ankle sprains of physically active patients, we performed a preliminary clinical study to assess objective evidence for edema and functional patient American Orthopaedic Foot and Ankle Society (AOFAS) scores with these alternative treatments. Fifty-nine physically active patients were included: 32 in the taping group and 27 in the short-leg cast group within a year. If a sprain was moderate (grade II) or mild (grade I), we used functional taping or short-leg cast immobilization for 10 days. We evaluated the edema and the functional scores of the injured ankle using the AOFAS Clinical Rating System on days 1, 10, and 100. In each group, edema significantly decreased and AOFAS scores increased indicating that both treatment methods were effective. With the numbers available, no statistically significant difference could be detected. Each treatment method was effective in decreasing the edema and increasing the functional scores of the ankle. At the beginning of treatment, not only the level of edema but also the initial functional scores of the ankle and examinations are important in making decisions regarding the optimal treatment option.

  18. Release kinetics of N-terminal pro-B-type natriuretic peptide in a clinical model of acute myocardial infarction.

    Science.gov (United States)

    Liebetrau, Christoph; Gaede, Luise; Dörr, Oliver; Troidl, Christian; Voss, Sandra; Hoffmann, Jedrzej; Paszko, Agata; Weber, Michael; Rolf, Andreas; Hamm, Christian; Nef, Holger; Möllmann, Helge

    2014-02-15

    N-terminal segment of B-type natriuretic peptide prohormone (NT-proBNP) is elevated in patients with acute myocardial infarction (AMI) thus providing both diagnostic information and prognostic information. The aim of the present study was to determine the time course of NT-proBNP release in patients undergoing transcoronary ablation of septal hypertrophy (TASH) a procedure mimicking AMI. We analyzed the release kinetics of NT-proBNP in 18 consecutive patients with hypertrophic obstructive cardiomyopathy undergoing TASH. Serum samples were collected prior to and at 15, 30, 45, 60, 75, 90, and 105 min, and 2, 4, 8, and 24h after TASH. NT-proBNP concentrations showed a continuous increase during the first 75 min with a significant percent change compared to baseline value already 15 min after TASH (105.6% [IQR 102.2-112.7]; Pmax]: 103.5-137.2%; range of absolute increase [min-max]: 23.5-304.0 ng/L). NT-proBNP concentrations decreased below the baseline value until the 8th h after initiation of myocardial infarction. NT-proBNP concentration increases immediately after induction of myocardial infarction proving early evidence of myocardial injury despite the decrease of the left ventricular wall stress due to the TASH related reduction of the left ventricular outflow gradient. Copyright © 2013 Elsevier B.V. All rights reserved.

  19. Genome sequence of human adenovirus type 55, a re-emergent acute respiratory disease pathogen in China.

    Science.gov (United States)

    Zhang, Qiwei; Seto, Donald; Cao, Bin; Zhao, Suhui; Wan, Chengsong

    2012-11-01

    Human adenovirus type 55 (HAdV-B55) is an acute respiratory disease (ARD) pathogen first completely characterized in China (2006). This is a unique Trojan horse microbe with the virus neutralization attribute of a renal pathogen and the cell tropism and clinical attributes of a respiratory pathogen, bypassing herd immunity. It appeared to be an uncommon pathogen, with earlier putative, sporadic occurrences in Spain (1969) and Turkey (2004); these isolates were incompletely characterized using only two epitopes. Reported here is the genome of a second recent isolate (China, 2011), indicating that it may occur more frequently. The availability of this HAdV-B55 genome provides a foundation for studying adenovirus molecular evolution, the dynamics of epidemics, and patterns of pathogen emergence and re-emergence. These data facilitate studies to predict genome recombination between adenoviruses, as well as sequence divergence rates and hotspots, all of which are important for vaccine development and because HAdVs are used for epitope and/or gene delivery vectors.

  20. Membrane Type-1 Matrix Metalloproteinase Expression in Acute Myeloid Leukemia and Its Upregulation by Tumor Necrosis Factor-α

    Directory of Open Access Journals (Sweden)

    Anna Janowska-Wieczorek

    2012-07-01

    Full Text Available Membrane type-1 matrix metalloproteinase (MT1-MMP has been implicated in tumor invasion, as well as trafficking of normal hematopoietic cells, and acts as a physiologic activator of proMMP-2. In this study we examined MT1-MMP expression in primary acute myeloid leukemia (AML cells. Because tumor necrosis factor (TNF-α is known to be elevated in AML, we also investigated the effect of TNF-α on MT1-MMP expression. We found (i MT1-MMP mRNA expression in 41 out of 43 primary AML samples tested; (ii activation of proMMP-2 in co-cultures of AML cells with normal bone marrow stromal cells; and (iii inhibition of proMMP-2 activation and trans-Matrigel migration of AML cells by gene silencing using MT1-MMP siRNA. Moreover, recombinant human TNF-α upregulated MT1-MMP expression in AML cells resulting in enhanced proMMP-2 activation and trans-Matrigel migration. Thus, AML cells express MT1-MMP and TNF-α enhances it leading to increased MMP-2 activation and most likely contributing to the invasive phenotype. We suggest that MT1-MMP, together with TNF-α, should be investigated as potential therapeutic targets in AML.

  1. Acute myeloid leukemia (AML with erythroid predominance exhibits clinical and molecular characteristics that differ from other types of AML.

    Directory of Open Access Journals (Sweden)

    Zhuang Zuo

    Full Text Available The clinical importance of erythroid predominance in bone marrow of patients with acute myeloid leukemia (AML is controversial. These cases represent a heterogeneous group of diseases that historically have been classified into different categories. We studied 313 AML patients and specifically compared the clinical, cytogenetic, and molecular features of cases of AML with erythroid predominance, arbitrarily defined as ≥50% erythroid precursors, to AML cases without erythroid predominance. We also assessed 51 patients with a high-grade myelodysplastic syndrome (MDS, refractory anemia with excess blasts (RAEB. All neoplasms were classified according to the World Health Organization classification. With the exception of therapy-related AML/MDS, the presence of erythroid predominance in variously classified categories of AML was associated with a survival advantage. In addition, AML with erythroid predominance had a lower frequency of cytogenetic abnormalities as well as a lower frequency of mutations involving NPM1, NRAS and FLT3 as compared with AML without erythroid predominance. We conclude that the clinical, cytogenetic, and molecular features of AML with erythroid predominance in the non-therapy-related setting are much closer to those of a high-grade myelodysplastic syndrome than they are to other types of AML.

  2. Inhibition of serotonin receptor type 1 in acute myeloid leukemia impairs leukemia stem cell functionality: a promising novel therapeutic target.

    Science.gov (United States)

    Etxabe, A; Lara-Castillo, M C; Cornet-Masana, J M; Banús-Mulet, A; Nomdedeu, M; Torrente, M A; Pratcorona, M; Díaz-Beyá, M; Esteve, J; Risueño, R M

    2017-11-01

    Acute myeloid leukemia (AML) is a clinically and molecularly heterogeneous neoplasia with poor outcome, organized as a hierarchy initiated and maintained by a sub-population with differentiation and self-renewal capacities called leukemia stem cells (LSCs). Although currently used chemotherapy is capable of initially reducing the tumor burden producing a complete remission, most patients will ultimately relapse and will succumb to their disease. As such, new therapeutic strategies are needed. AML cells differentially expressed serotonin receptor type 1 (HTR1) compared with healthy blood cells and the most primitive hematopoietic fraction; in fact, HTR1B expression on AML patient samples correlated with clinical outcome. Inhibition of HTR1s activated the apoptosis program, induced differentiation and reduced the clonogenic capacity, while minimal effect was observed on healthy blood cells. In vivo regeneration capacity of primary AML samples was disrupted upon inhibition of HTR1. The self-renewal capacity remaining in AML cells upon in vivo treatment was severely reduced as demonstrated by serial transplantation. Thus, treatment with HTR1 antagonists showed antileukemia effect, especially anti-LSC activity while sparing healthy blood cells. Our results highlight the importance of HTR1 in leukemogenesis and LSC survival and identify this receptor family as a new target for therapy in AML with prognostic value.

  3. Contemporary management and outcomes of acute type A aortic dissection: An analysis of the STS adult cardiac surgery database.

    Science.gov (United States)

    Lee, Teng C; Kon, Zachary; Cheema, Faisal H; Grau-Sepulveda, Maria V; Englum, Brian; Kim, Sunghee; Chaudhuri, Paramita S; Thourani, Vinod H; Ailawadi, Gorav; Hughes, G Chad; Williams, Matthew L; Brennan, J Matthew; Svensson, Lars; Gammie, James S

    2018-01-01

    Management of acute type A aortic dissection (AAAD) is challenging and operative strategies are varied. We used the STS Adult Cardiac Surgery Database (STS ACSD) to describe contemporary surgical strategies and outcomes for AAAD. Between July 2011 and September 2012, 2982 patients with AAAD underwent operations at 640 centers in North America. In this cohort, median age was 60 years old, 66% were male, and 80% had hypertension. The most common arterial cannulation strategies included femoral (36%), axillary (27%), and direct aortic (19%). The median perfusion and cross-clamp times were 181 and 102 min, respectively. The lowest temperature on bypass showed significant variation. Hypothermic circulatory arrest (HCA) was used in 78% of cases. Among those undergoing HCA, brain protection strategies included antegrade cerebral perfusion (31%), retrograde cerebral perfusion (25%), both (4%), and none (40%). Median HCA plus cerebral perfusion time was 40 min. Major complications included prolonged ventilation (53%), reoperation (19%), renal failure (18%), permanent stroke (11%), and paralysis (3%). Operative mortality was 17%. The median intensive care unit and hospital length of stays were 4.7 and 9.0 days, respectively. Among 640 centers, the median number of cases performed during the study period was three. Resuscitation, unresponsive state, cardiogenic shock, inotrope use, age >70, diabetes, and female sex were found to be independent predictors of mortality. These data describe contemporary patient characteristics, operative strategies, and outcomes for AAAD in North America. Mortality and morbidity for AAAD remain high. © 2018 Wiley Periodicals, Inc.

  4. Development of A Chimeric Antigen Receptor Targeting C-Type Lectin-Like Molecule-1 for Human Acute Myeloid Leukemia

    Directory of Open Access Journals (Sweden)

    Eduardo Laborda

    2017-10-01

    Full Text Available The treatment of patients with acute myeloid leukemia (AML with targeted immunotherapy is challenged by the heterogeneity of the disease and a lack of tumor-exclusive antigens. Conventional immunotherapy targets for AML such as CD33 and CD123 have been proposed as targets for chimeric antigen receptor (CAR-engineered T-cells (CAR-T-cells, a therapy that has been highly successful in the treatment of B-cell leukemia and lymphoma. However, CD33 and CD123 are present on hematopoietic stem cells, and targeting with CAR-T-cells has the potential to elicit long-term myelosuppression. C-type lectin-like molecule-1 (CLL1 or CLEC12A is a myeloid lineage antigen that is expressed by malignant cells in more than 90% of AML patients. CLL1 is not expressed by healthy Hematopoietic Stem Cells (HSCs, and is therefore a promising target for CAR-T-cell therapy. Here, we describe the development and optimization of an anti-CLL1 CAR-T-cell with potent activity on both AML cell lines and primary patient-derived AML blasts in vitro while sparing healthy HSCs. Furthermore, in a disseminated mouse xenograft model using the CLL1-positive HL60 cell line, these CAR-T-cells completely eradicated tumor, thus supporting CLL1 as a promising target for CAR-T-cells to treat AML while limiting myelosuppressive toxicity.

  5. The influence of type 2 diabetes mellitus on the frequency and complexity of ventricular arrhythmias and heart rate variability in patients after myocardial infarction

    Directory of Open Access Journals (Sweden)

    Stoičkov Viktor

    2016-01-01

    Full Text Available Background/Aim. After myocardial infarction arrhythmic cardiac deaths are significantly more frequent compared to non-arrhythmic ones. The aim of the study was to investigate the influence of type 2 diabetes mellitus (T2DM on the frequency and complexity of ventricular arrhythmias after myocardial infarction. Methods. The study included 293 patients, mean age 59.5 ± 9.21 years, who were at least six months after acute myocardial infarction with the sinus rhythm, without atrioventricular blocks and branch blocks. In the clinical group 95 (32.42% patients were with T2DM, while 198 (67.57% patients were without diabetes. All of the patients were subjected to the following procedures: standard ECG according to which the corrected QT dispersion (QTdc was calculated, exercise stress test, and 24-hour holter monitoring according to which, the four parameters of time domain of heart rate variability (HRV were analyzed: standard deviation of all normal RR intervals during 24 hours (SDNN, standard deviation of the averages of normal RR intervals in all five-minute segments during 24 hours (SDANN, the square root of the mean of the sum of the squares of differences between adjacent normal (RMS-SD, and percentage of consequtive RR intervals which differed for more than 50 ms during 24 hours (NN > 50 ms. Results. In patients after myocardial infarction, patients with T2DM had significantly higher percentage of frequent and complex ventricular arrhythmias compared to the patients without diabetes (p 50 ms (p < 0.001, and significantly higher values of QTdc (p < 0.001 compared to the patients without diabetes. Conclusion. The study showed that type 2 diabetes mellitus has significant influence on ventricular arrhythmias, HRV parameters and QT dispersion in patients after myocardial infarction.

  6. Structure of the mycobacterial ESX-5 type VII secretion system membrane complex by single-particle analysis.

    Science.gov (United States)

    Beckham, Katherine S H; Ciccarelli, Luciano; Bunduc, Catalin M; Mertens, Haydyn D T; Ummels, Roy; Lugmayr, Wolfgang; Mayr, Julia; Rettel, Mandy; Savitski, Mikhail M; Svergun, Dmitri I; Bitter, Wilbert; Wilmanns, Matthias; Marlovits, Thomas C; Parret, Annabel H A; Houben, Edith N G

    2017-04-10

    Mycobacteria are characterized by their impermeable outer membrane, which is rich in mycolic acids 1 . To transport substrates across this complex cell envelope, mycobacteria rely on type VII (also known as ESX) secretion systems 2 . In Mycobacterium tuberculosis, these ESX systems are essential for growth and full virulence and therefore represent an attractive target for anti-tuberculosis drugs 3 . However, the molecular details underlying type VII secretion are largely unknown, due to a lack of structural information. Here, we report the molecular architecture of the ESX-5 membrane complex from Mycobacterium xenopi determined at 13 Å resolution by electron microscopy. The four core proteins of the ESX-5 complex (EccB 5 , EccC 5 , EccD 5 and EccE 5 ) assemble with equimolar stoichiometry into an oligomeric assembly that displays six-fold symmetry. This membrane-associated complex seems to be embedded exclusively in the inner membrane, which indicates that additional components are required to translocate substrates across the mycobacterial outer membrane. Furthermore, the extended cytosolic domains of the EccC ATPase, which interact with secretion effectors, are highly flexible, suggesting an as yet unseen mode of substrate interaction. Comparison of our results with known structures of other bacterial secretion systems demonstrates that the architecture of type VII secretion system is fundamentally different, suggesting an alternative secretion mechanism.

  7. Resistance Controllability in Alkynylgold(III) Complex-Based Resistive Memory for Flash-Type Storage Applications.

    Science.gov (United States)

    Wang, Peng; Fang, Yu; Jiang, Jun; Ji, Yujin; Li, Youyong; Zheng, Junwei; Xu, Qingfeng; Lu, Jianmei

    2017-07-18

    Owing to the demands of state-of-the-art information technologies that are suitable for vast data storage, the necessity for organic memory device (OMD) materials is highlighted. However, OMDs based on metal complexes are limited to several types of transition-metal complex systems containing nitrogen-donor ligands. Herein, attempts are made to introduce novel alkynylgold(III) materials into memory devices with superior performance. In this respect, an alkynyl-containing coumarin gold(III) complex, [(C 19 N 5 H 11 )Au-C≡C-C 9 H 5 O], has been synthesized and integrated into a sandwiched Al/[(C 19 N 5 H 11 )Au-C≡C-C 9 H 5 O]/indium tin oxide device. By precisely controlling the compliance current (I cc ), the devices show different switching characteristics from flash-type binary resistance switching (I cc ≤10 -3  A) to WORM-type (WORM=write once read many times) ternary resistance switching (I cc =10 -2  A). This work explores electrical gold(III) complex based memories for potential use in organic electronics. © 2017 Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim.

  8. Trained breathing-induced oxygenation acutely reverses cardiovascular autonomic dysfunction in patients with type 2 diabetes and renal disease.

    Science.gov (United States)

    Esposito, Pasquale; Mereu, Roberto; De Barbieri, Giacomo; Rampino, Teresa; Di Toro, Alessandro; Groop, Per-Henrik; Dal Canton, Antonio; Bernardi, Luciano

    2016-04-01

    Cardiovascular autonomic dysfunction, evaluated as baroreflex sensitivity (BRS), could be acutely corrected by slow breathing or oxygen administration in patients with type 1 diabetes, thus suggesting a functional component of the disorder. We tested this hypothesis in patients with the type 2 diabetes with or without renal impairment. Twenty-six patients with type 2 diabetes (aged 61.0 ± 0.8 years, mean ± SEM; duration of diabetes 10.5 ± 2 years, BMI 29.9 ± 0.7 kg/m(2), GFR 68.1 ± 5.6 ml/min) and 24 healthy controls (aged 58.5 ± 1.0 years) were studied. BRS was obtained from recordings of RR interval and systolic blood pressure fluctuations during spontaneous and during slow, deep (6 breaths/min) controlled breathing in conditions of normoxia or hyperoxia (5 l/min oxygen). During spontaneous breathing, diabetic patients had lower RR interval and lower BRS compared with the control subjects (7.1 ± 1.2 vs. 12.6 ± 2.0 ms/mmHg, p breathing and oxygen administration significantly increased arterial saturation, reduced RR interval and increased BRS in both groups (to 9.6 ± 1.8 and 15.4 ± 2.4 ms/mmHg, respectively, p breathing and hyperoxia (p breathing during normoxia). Autonomic dysfunction present in patients with type 2 diabetes can be partially reversed by slow breathing, suggesting a functional role of hypoxia, also in patients with DKD. Interventions known to relieve tissue hypoxia and improve autonomic function, like physical activity, may be useful in the prevention and management of complications in patients with diabetes.

  9. Multistability of delayed complex-valued recurrent neural networks with discontinuous real-imaginary-type activation functions

    International Nuclear Information System (INIS)

    Huang Yu-Jiao; Hu Hai-Gen

    2015-01-01

    In this paper, the multistability issue is discussed for delayed complex-valued recurrent neural networks with discontinuous real-imaginary-type activation functions. Based on a fixed theorem and stability definition, sufficient criteria are established for the existence and stability of multiple equilibria of complex-valued recurrent neural networks. The number of stable equilibria is larger than that of real-valued recurrent neural networks, which can be used to achieve high-capacity associative memories. One numerical example is provided to show the effectiveness and superiority of the presented results. (paper)

  10. Chemodynamics of metal ion complexation by charged nanoparticles: a dimensionless rationale for soft, core-shell and hard particle types.

    Science.gov (United States)

    Duval, Jérôme F L

    2017-05-17

    Soft nanoparticulate complexants are defined by a spatial confinement of reactive sites and electric charges inside their 3D body. In turn, their reactivity with metal ions differs significantly from that of simple molecular ligands. A revisited form of the Eigen mechanism recently elucidated the processes leading to metal/soft particle pair formation. Depending on e.g. particle size and metal ion nature, chemodynamics of nanoparticulate metal complexes is controlled by metal conductive diffusion to/from the particles, by intraparticulate complex formation/dissociation kinetics, or by both. In this study, a formalism is elaborated to achieve a comprehensive and systematic identification of the rate-limiting step governing the overall formation and dissociation of nanoparticulate metal complexes. The theory covers the different types of spherical particulate complexants, i.e. 3D soft/permeable and core-shell particles, and hard particles with reactive sites at the surface. The nature of the rate-limiting step is formulated by a dynamical criterion involving a power law function of the ratio between particle radius and an intraparticulate reaction layer thickness defined by the key electrostatic, diffusional and kinetic components of metal complex formation/dissociation. The analysis clarifies the intertwined contributions of particle properties (size, soft or hard type, charge, density or number of reactive sites) and aqueous metal ion dehydration kinetics in defining the chemodynamic behavior of nanoparticulate metal complexes. For that purpose, fully parameterized chemodynamic portraits involving the defining features of particulate ligand and metal ion as well as the physicochemical conditions in the local intraparticulate environment, are constructed and thoroughly discussed under conditions of practical interest.

  11. Twenty years' delay of fellow eye involvement in herpes simplex virus type 2-associated bilateral acute retinal necrosis syndrome

    NARCIS (Netherlands)

    Schlingemann, R. O.; Bruinenberg, M.; Wertheim-van Dillen, P.; Feron, E.

    1996-01-01

    PURPOSE: To describe a case of acute retinal necrosis with concurrent encephalitis and determine the causative virus. The patient had a history of presumed acute retinal necrosis in the left eye at the age of 8 years and recurrent genital herpes. METHODS: Diagnostic anterior chamber puncture of the

  12. Multicenter Study of Adverse Events After Intravenous Tissue-Type Plasminogen Activator Treatment of Acute Ischemic Stroke.

    Science.gov (United States)

    Fernandez-Gotico, Hannah; Lightfoot, Tiffany; Meighan, Melissa

    2017-02-01

    The approved treatment by the Food and Drug Administration for acute ischemic stroke is intravenous tissue-type plasminogen activator (IV tPA). After IV tPA administration, patients are monitored for adverse events using an American Heart Association/American Stroke Association guideline instituted in 1996. There is limited evidence describing the safest and most efficient method to monitor patients during the first 24 hours after tPA administration. Although the overall rates of adverse events have been reported, the time when patients may be at most risk for an event has not been studied. The purpose of this study was to identify the time of adverse event occurrences in the first 24 hours after IV tPA administration. This was a descriptive, retrospective chart review study of patients admitted to an integrated health system and treated with IV tPA for acute stroke between July 2010 and July 2012. Charts were reviewed for adverse events using the Institute for Healthcare Improvement's Global Trigger Tool for Measuring Adverse Events. Possible chart indicators of adverse events or "triggers" included neurological decline, vital signs elevated above specified parameters, and emergent imaging. Adverse events included episodes of neurological decline, angioedema, allergic reactions, bleeding, and intracerebral hemorrhage (ICH). The timing of each detected event was determined, and descriptive statistics were used for data analysis. Fourteen adverse events (2.8%) were detected in a population of 498 patients. Reactions consisted of allergic reaction (n = 1), angioedema (n = 1), neurological decline without ICH (n = 1), gastrointestinal bleeding (n = 1), bleeding gums (n = 1), and high-risk ICH (n = 9). Thirteen of the 14 adverse events (92.9%) occurred within the first 12 hours after IV tPA administration. Close monitoring during the first 12 hours after IV tPA treatment may be essential. However, close monitoring after 12 hours may not contribute significantly to

  13. Complex Regional Pain Syndrome (CRPS Type II After Carpal Tunnel Release Surgery: Case Report

    Directory of Open Access Journals (Sweden)

    Hakan Tunç

    2010-08-01

    Full Text Available Summary Complex regional pain syndrome is a chronic syndrome characterised with dystrophic changes and neurovascular disordes of bone and skin of extremities. The most common etiological factors are trauma, ischemic heart disease, cerebral lesions, servical region disorders, infections, and surgical treatments. Carpal tunnel syndrome is the most common compressive neuropaty of the upper extremity. There are various surgical and conservative alternatives in the treatment of carpal tunnel syndrome. Complex regional pain syndrome has been reported as a complication of surgical carpal tunnel release in 2-5% of patients. In this case report clinical characteristics and rehabilitation outcomes of a patient with complex regional pain syndrome after carpal tunnel release surgery is presented. (Osteoporoz Dünyasından 2010;16:41-3

  14. Complexing of Copper (II) by Four Types of Polyphenols of Nutritional Origin

    International Nuclear Information System (INIS)

    AL-Joubbeh, M.

    2009-01-01

    The complexing of Cu + + by quercetin, rutin, galangin and apigenin was carried out in order to determine the stoichiometry of each reaction. The coordination sites of copper in the four ligands were located and the stability constants were calculated. The effects of these compounds as antioxidants were investigated. All measurement were carried out in methanol/water solution at pH=6.41 and recorded using UV-VIS spectrophotometer. The stoichiometry, the coordination sites and the stability constants of the flavonoids and copper complexes were deduced from their optical absorption spectra.(author)

  15. A Type-2 fuzzy data fusion approach for building reliable weighted protein interaction networks with application in protein complex detection.

    Science.gov (United States)

    Mehranfar, Adele; Ghadiri, Nasser; Kouhsar, Morteza; Golshani, Ashkan

    2017-09-01

    Detecting the protein complexes is an important task in analyzing the protein interaction networks. Although many algorithms predict protein complexes in different ways, surveys on the interaction networks indicate that about 50% of detected interactions are false positives. Consequently, the accuracy of existing methods needs to be improved. In this paper we propose a novel algorithm to detect the protein complexes in 'noisy' protein interaction data. First, we integrate several biological data sources to determine the reliability of each interaction and determine more accurate weights for the interactions. A data fusion component is used for this step, based on the interval type-2 fuzzy voter that provides an efficient combination of the information sources. This fusion component detects the errors and diminishes their effect on the detection protein complexes. So in the first step, the reliability scores have been assigned for every interaction in the network. In the second step, we have proposed a general protein complex detection algorithm by exploiting and adopting the strong points of other algorithms and existing hypotheses regarding real complexes. Finally, the proposed method has been applied for the yeast interaction datasets for predicting the interactions. The results show that our framework has a better performance regarding precision and F-measure than the existing approaches. Copyright © 2017 Elsevier Ltd. All rights reserved.

  16. Differences in the behavior and ecology of wild type medaka (Oryzias latipes complex) and an orange commercial variety (himedaka).

    Science.gov (United States)

    Nakao, Ryohei; Kitagawa, Tadao

    2015-07-01

    Genetic disturbance in wild populations of medaka (Oryzias latipes complex) has been mainly caused by the introduction of the orange-red commercial variety medaka (himedaka) in Japan. To examine whether survival, reproduction, and species recognition would be influenced by this difference in body coloration, we conducted three laboratory experiments (predatory pressure, mate choice, schooling behavior) using wild type medaka and himedaka. In the predation experiment using dark chub (Candidia temminckii) as a predator, himedaka were predated upon more often than wild type medaka. However, individuals did not choose mates or select schooling groups based on himedaka or wild type medaka phenotypes. The results indicate that himedaka receive higher predation pressure but are able to easily mate with wild type medaka in a natural environment. To conserve the genetic diversity of wild medaka populations, we need to control the risk of genetic disturbance caused by himedaka. © 2015 Wiley Periodicals, Inc.

  17. Geographically predominant genotypes of Aspergillus terreus species complex in Austria: s microsatellite typing study

    NARCIS (Netherlands)

    Lackner, M.; Coassin, S.; Haun, M.; Binder, U.; Kronenberg, F.; Haas, H. de; Jank, M.; Maurer, E.; Meis, J.F.; Hagen, F.; Lass-Florl, C.

    2016-01-01

    Aspergillus terreus species complex is recognized as a frequent agent of invasive aspergillosis in Tyrol. The reason for this specific epidemiological situation is unclear. Aspergillus terreus strains isolated from environmental and clinical sources were genotyped using a novel panel of short tandem

  18. Theoretical Predictions of Redox Potentials of Fischer-Type Chromium Anninocarbene Complexes

    Czech Academy of Sciences Publication Activity Database

    Kvapilová, Hana; Hoskovcová, Irena; Ludvík, Jiří; Záliš, Stanislav

    2014-01-01

    Roč. 33, č. 18 (2014), s. 4964-4972 ISSN 0276-7333 R&D Projects: GA MŠk LD14129; GA ČR GA13-04630S Institutional support: RVO:61388955 Keywords : standard hydrogen electrode * density functional theory * metal carbene complexes Subject RIV: CG - Electrochemistry Impact factor: 4.126, year: 2014

  19. Polycation-Sodium Lauryl Ether Sulfate-Type Surfactant Complexes : Influence of Ethylene Oxide Length

    NARCIS (Netherlands)

    Vleugels, Leo F. W.; Pollet, Jennifer; Tuinier, Remco

    2015-01-01

    Poiyelectrolyte-surfactant complexes (PESC) are a class of materials which form spontaneously by self-assembly driven by electrostatic and hydrophobic interactions. PESC containing sodium lauryl ether Sulfates (SLES) have found wide application in hair care products like shampoo. Typically, SLES

  20. Dinuclear ruthenium sawhorse-type complexes containing carboxylato bridges and ferrocenyl substituents: Synthesis and electrochemistry

    Czech Academy of Sciences Publication Activity Database

    Auzias, M.; Süss-Fink, G.; Štěpnička, P.; Ludvík, Jiří

    2007-01-01

    Roč. 360, č. 6 (2007), s. 2023-2028 ISSN 0020-1693 Institutional research plan: CEZ:AV0Z40400503 Keywords : carboxylato bridges * dinuclear complexes * ruthenium * electrochemistry Subject RIV: CG - Electrochemistry Impact factor: 1.713, year: 2007

  1. The organization of the Golgi complex and microtubules in skeletal muscle is fiber type-dependent

    DEFF Research Database (Denmark)

    Ralston, E; Lu, Z; Ploug, Thorkil

    1999-01-01

    Skeletal muscle has a nonconventional Golgi complex (GC), the organization of which has been a subject of controversy in the past. We have now examined the distribution of the GC by immunofluorescence and immunogold electron microscopy in whole fibers from different rat muscles, both innervated a...

  2. Comprehensive analysis of the transcriptional profile of the Mediator complex across human cancer types.

    Science.gov (United States)

    Syring, Isabella; Klümper, Niklas; Offermann, Anne; Braun, Martin; Deng, Mario; Boehm, Diana; Queisser, Angela; von Mässenhausen, Anne; Brägelmann, Johannes; Vogel, Wenzel; Schmidt, Doris; Majores, Michael; Schindler, Anne; Kristiansen, Glen; Müller, Stefan C; Ellinger, Jörg; Shaikhibrahim, Zaki; Perner, Sven

    2016-04-26

    The Mediator complex is a key regulator of gene transcription and several studies demonstrated altered expressions of particular subunits in diverse human diseases, especially cancer. However a systematic study deciphering the transcriptional expression of the Mediator across different cancer entities is still lacking.We therefore performed a comprehensive in silico cancer vs. benign analysis of the Mediator complex subunits (MEDs) for 20 tumor entities using Oncomine datasets. The transcriptional expression profiles across almost all cancer entities showed differentially expressed MEDs as compared to benign tissue. Differential expression of MED8 in renal cell carcinoma (RCC) and MED12 in lung cancer (LCa) were validated and further investigated by immunohistochemical staining on tissue microarrays containing large numbers of specimen. MED8 in clear cell RCC (ccRCC) associated with shorter survival and advanced TNM stage and showed higher expression in metastatic than primary tumors. In vitro, siRNA mediated MED8 knockdown significantly impaired proliferation and motility in ccRCC cell lines, hinting at a role for MED8 to serve as a novel therapeutic target in ccRCC. Taken together, our Mediator complex transcriptome proved to be a valid tool for identifying cancer-related shifts in Mediator complex composition, revealing that MEDs do exhibit cancer specific transcriptional expression profiles.

  3. The role of human adenoviruses type 41 in acute diarrheal disease in Minas Gerais after rotavirus vaccination

    Directory of Open Access Journals (Sweden)

    Thaís Aparecida Vieira Reis

    2016-03-01

    Full Text Available Abstract Human adenovirus species F (HAdV-F type 40 and 41 are commonly associated with acute diarrheal disease (ADD across the world. Despite being the largest state in southeastern Brazil and having the second largest number of inhabitants, there is no information in the State of Minas Gerais regarding the role of HAdV-F in the etiology of ADD. This study was performed to determine the prevalence, to verify the epidemiological aspects of infection, and to characterize the strains of human adenoviruses (HAdV detected. A total of 377 diarrheal fecal samples were obtained between January 2007 and August 2011 from inpatient and outpatient children of age ranging from 0 to 12 years. All samples were previously tested for rotavirus, norovirus, and astrovirus, and 314 of 377 were negative. The viral DNA was extracted, amplified using the polymerase chain reaction and the HAdV-positive samples were sequenced and phylogenetically analyzed. Statistical analyses were performed using the Chi-square test (p < 0.05, considering two conditions: the total of samples tested (377 and the total of negative samples for the remaining viruses tested (314. The overall prevalence of HAdV was 12.47% (47/377; and in 76.60% (36/47 of the positive samples, this virus was the only infectious agent detected. The phylogenetic analysis of partial sequences of 32 positive samples revealed that they all clustered with the HAdV-F type 41. The statistical analysis showed that there was no correlation between the onset of the HAdV infection and the origin of the samples (inpatients or outpatients in the two conditions tested: the total of samples tested (p = 0.598 and the total of negative samples for the remaining viruses tested (p = 0.614. There was a significant association in the occurrence of infection in children aged 0–12 months for the condition 1 (p = 0.030 as well as condition 2 (p = 0.019. The occurrence of infections due to HAdV did not coincide with a pattern of

  4. A two-locus DNA sequence database for typing plant and human pathogens within the Fusarium oxysporum species complex

    DEFF Research Database (Denmark)

    O'Donnell, Kerry; Gueidan, C; Sink, S

    2009-01-01

    We constructed a two-locus database, comprising partial translation elongation factor (EF-1alpha) gene sequences and nearly full-length sequences of the nuclear ribosomal intergenic spacer region (IGS rDNA) for 850 isolates spanning the phylogenetic breadth of the Fusarium oxysporum species complex...... (FOSC). Of the 850 isolates typed, 101 EF-1alpha, 203 IGS rDNA, and 256 two-locus sequence types (STs) were differentiated. Analysis of the combined dataset suggests that two-thirds of the STs might be associated with a single host plant. This analysis also revealed that the 26 STs associated with human...

  5. A Comparison of Molecular Typing Methods Applied to Enterobacter cloacae complex: hsp60 Sequencing, Rep-PCR, and MLST

    Directory of Open Access Journals (Sweden)

    Roberto Viau

    2017-02-01

    Full Text Available Molecular typing using repetitive sequenced-based PCR (rep-PCR and hsp60 sequencing were applied to a collection of diverse Enterobacter cloacae complex isolates. To determine the most practical method for reference laboratories, we analyzed 71 E. cloacae complex isolates from sporadic and outbreak occurrences originating from 4 geographic areas. While rep-PCR was more discriminating, hsp60 sequencing provided a broader and a more objective geographical tracking method similar to multilocus sequence typing (MLST. In addition, we suggest that MLST may have higher discriminative power compared to hsp60 sequencing, although rep-PCR remains the most discriminative method for local outbreak investigations. In addition, rep-PCR can be an effective and inexpensive method for local outbreak investigation.

  6. Synthesis of nanostructured LiTi2(PO4)3 powder by a Pechini-type polymerizable complex method

    International Nuclear Information System (INIS)

    Mariappan, C.R.; Galven, C.; Crosnier-Lopez, M.-P.; Le Berre, F.; Bohnke, O.

    2006-01-01

    The nanostructured NASICON-type LiTi 2 (PO 4 ) 3 (LTP) material has been synthesized by Pechini-type polymerizable complex method. The use of water-soluble ammonium citratoperoxotitanate (IV) metal complex instead of alkoxides as precursor allows to prepare monophase material. Thermal analyses have been carried out on the powder precursor to check the weight loss and synthesis temperature. X-ray powder diffraction analysis (XRD) has been performed on the LTP powder obtained after heating the powder precursor over a temperature range from 550 to 1050 deg. C for 2 h. By varying the molar ratio of citric acid to metal ion (CA/Ti) and citric acid to ethylene glycol (CA/EG), the grain size of the LTP powder could be modified. The formation of small and well-crystalline grains, in the order of 50-125 nm in size, has been determined from the XRD patterns and confirmed by transmission electron microscopy

  7. Reconstructing Historical Land Cover Type and Complexity by Synergistic Use of Landsat Multispectral Scanner and CORONA

    OpenAIRE

    Amir Reza Shahtahmassebi; Yue Lin; Lin Lin; Peter M. Atkinson; Nathan Moore; Ke Wang; Shan He; Lingyan Huang; Jiexia Wu; Zhangquan Shen; Muye Gan; Xinyu Zheng; Yue Su; Hongfen Teng; Xiaoyan Li

    2017-01-01

    Survey data describing land cover information such as type and diversity over several decades are scarce. Therefore, our capacity to reconstruct historical land cover using field data and archived remotely sensed data over large areas and long periods of time is somewhat limited. This study explores the relationship between CORONA texture—a surrogate for actual land cover type and complexity—with spectral vegetation indices and texture variables derived from Landsat MSS under the Spectral Var...

  8. Direct Asymmetric Vinylogous and Bisvinylogous Mannich-Type Reaction Catalyzed by a Copper(I) Complex.

    Science.gov (United States)

    Zhang, Hai-Jun; Shi, Chang-Yun; Zhong, Feng; Yin, Liang

    2017-02-15

    A direct catalytic asymmetric vinylogous Mannich-type reaction has been disclosed in good yield, excellent regio-, diastereo- and enantioselectivity. The key to control the regioselectivity is the combination of a bulky N-acylpyrazole and a bulky bisphosphine ligand. The catalytic system was extended to a bisvinylogous Mannich-type reaction by changing the ligand. The synthetic utility of the vinylogous products was demonstrated by several transformations.

  9. Enantioselective Direct Mannich-Type Reactions Catalyzed by Frustrated Lewis Acid/Brønsted Base Complexes.

    Science.gov (United States)

    Shang, Ming; Cao, Min; Wang, Qifan; Wasa, Masayuki

    2017-10-16

    An enantioselective direct Mannich-type reaction catalyzed by a sterically frustrated Lewis acid/Brønsted base complex is disclosed. Cooperative functioning of the chiral Lewis acid and achiral Brønsted base components gives rise to in situ enolate generation from monocarbonyl compounds. Subsequent reaction with hydrogen-bond-activated aldimines delivers β-aminocarbonyl compounds with high enantiomeric purity. © 2017 Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim.

  10. ELISA for complexes between urokinase-type plasminogen activator and its receptor in lung cancer tissue extracts

    DEFF Research Database (Denmark)

    de Witte, H; Pappot, H; Brünner, N

    1997-01-01

    A sandwich-type ELISA has been developed for the assessment of complexes between urokinase-type plasminogen activator (uPA) and its receptor (uPAR) in extracts of squamous cell lung carcinomas. The assay is based on a combination of rabbit polyclonal anti-uPA antibodies and a biotinylated mouse...... anti-uPAR monoclonal antibody (MAb). The detection limit of the assay is approximately 0.5 fmol/ml. A linear dose-response is obtained with up to 40 fmol/ml of uPA:uPAR complexes, while uPA and uPAR separately do not cause any response in the ELISA. A buffer which has been used previously for optimal...... extraction of uPAR yields the highest amounts of uPA:uPAR complexes. Absorption of tumor extracts with anti-uPA or anti-uPAR MAbs results in a complete disappearance of the ELISA signal, demonstrating the specificity of the ELISA. The recovery of chemically cross-linked uPA:uPAR complexes added to tumor...

  11. Acute dyspnea

    International Nuclear Information System (INIS)

    Shekhter, A.I.

    1991-01-01

    Radiodiagnosis is applied to determine the causes of acute dyspnea. Acute dyspnea is shown to aggravate the course of pulmonary diseases (bronchial asthma, obstructive bronchitis, pulmonary edema, throboembolism of pulmonary arteries etc) and cardiovascular diseases (desiseas of myocardium). The main tasks of radiodiagnosis are to determine volume and state of the lungs, localization and type of pulmonary injuries, to verify heart disease and to reveal concomitant complications

  12. Changes in plasma levels of B-type natriuretic peptide with acute exacerbations of chronic obstructive pulmonary disease

    Directory of Open Access Journals (Sweden)

    Nishimura K

    2014-02-01

    Full Text Available Koichi Nishimura,1 Takashi Nishimura,2 Katsuya Onishi,3 Toru Oga,4 Yoshinori Hasegawa,5 Paul W Jones61Department of Pulmonary Medicine, National Center for Geriatrics and Gerontology, Obu, Japan; 2Kyoto-Katsura Hospital, Kyoto, Japan; 3Onishi Heart Clinic, Tsu, Japan; 4Department of Respiratory Care and Sleep Control Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan; 5Division of Respiratory Medicine, Department of Medicine, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan; 6Division of Clinical Science, St George's Hospital Medical School, London, EnglandBackground: Elevated plasma B-type natriuretic peptide (BNP levels and their association with heart failure have been reported in subjects with acute exacerbations of chronic obstructive pulmonary disease (AECOPD.Purpose: To examine and compare plasma BNP levels and diastolic and systolic dysfunction in subjects with AECOPD and stable chronic obstructive pulmonary disease (COPD.Methods: In all, 87 unselected consecutive hospitalizations due to AECOPD in 61 subjects and a total of 190 consecutive subjects with stable COPD were recruited. Plasma BNP levels were compared cross-sectionally and longitudinally. Transthoracic echocardiographic examinations were also performed in the hospitalized subjects.Results: In the hospitalized subjects, the median plasma BNP level (interquartile range was 55.4 (26.9–129.3 pg/mL and was higher than that of patients with stable COPD: 18.3 (10.0–45.3 for Global Initiative for Chronic Obstructive Lung Disease grade I; 25.8 (11.0–53.7 for grade II; 22.1 (9.1–52.6 for grade III; and 17.2 (9.6–22.9 pg/mL for grade IV, all P<0.001. In 15 subjects studied prospectively, the median plasma BNP level was 19.4 (9.8–32.2 pg/mL before AECOPD, 72.7 (27.7–146.3 pg/mL during AECOPD, and 14.6 (12.9–39.0 pg/mL after AECOPD (P<0.0033 and P<0.0013, respectively. Median plasma BNP levels during AECOPD were significantly higher in

  13. Synchronization criterion for Lur'e type complex dynamical networks with time-varying delay

    International Nuclear Information System (INIS)

    Ji, D.H.; Park, Ju H.; Yoo, W.J.; Won, S.C.; Lee, S.M.

    2010-01-01

    In this Letter, the synchronization problem for a class of complex dynamical networks in which every identical node is a Lur'e system with time-varying delay is considered. A delay-dependent synchronization criterion is derived for the synchronization of complex dynamical network that represented by Lur'e system with sector restricted nonlinearities. The derived criterion is a sufficient condition for absolute stability of error dynamics between the each nodes and the isolated node. Using a convex representation of the nonlinearity for error dynamics, the stability condition based on the discretized Lyapunov-Krasovskii functional is obtained via LMI formulation. The proposed delay-dependent synchronization criterion is less conservative than the existing ones. The effectiveness of our work is verified through numerical examples.

  14. High-Throughput CRISPR Typing of Mycobacterium tuberculosis Complex and Salmonella enterica Serotype Typhimurium

    OpenAIRE

    Sola, Christophe; Abadia, Edgar; Le Hello, Simon; Weill, François-Xavier

    2015-01-01

    International audience; Spoligotyping was developed almost 18 years ago and still remains a popular fi rst-lane genotyping technique to identify and subtype Mycobacterium tuberculosis complex (MTC) clinical isolates at a phylogeo-graphic level. For other pathogens, such as Salmonella enterica , recent studies suggest that specifi cally designed spoligotyping techniques could be interesting for public health purposes. Spoligotyping was in its original format a reverse line-blot hybridization m...

  15. Still's Disease and Recurrent Complex Regional Pain Syndrome Type-I: The First Description

    Science.gov (United States)

    Faillace, César; de Carvalho, Jozélio Freire

    2012-01-01

    Complex regional pain syndrome (CRPS) is a chronic neuropathic pain disorder characterized by neuropathic pain associated with local edema and changes suggestive of autonomic involvement such as altered sweating, skin color, and skin temperature of the affected region. CRPS was described associated with several diseases, such as trauma, psychiatric conditions, and cancer. However, no case associated with Still's disease has been previously described. In this paper, the authors describe the first case of CRPS associated with Still's disease. PMID:22162802

  16. On computational complexity and Gallai-type theorems involving graph domination parameters

    DEFF Research Database (Denmark)

    Pedersen, Anders Sune

    2008-01-01

    In this paper we consider the problem of characterizing graphs with $\\mu + \\Delta = n$ or $\\mu + \\delta = n$, where $n$ denotes the number of vertices, $\\delta$ the minimum degree, $\\Delta$ the maximum degree, and $\\mu$ a domination parameter. The computational complexity of the corresponding dec...... decision problems are shown to be co-NP-complete for the total domination number, the restrained domination number, and the irredundance number....

  17. Investigation of Microphysical Parameters within Winter and Summer Type Precipitation Events over Mountainous [Complex] Terrain

    International Nuclear Information System (INIS)

    Stalker, James R.; Bossert, James E.

    1997-10-01

    In this study we investigate complex terrain effects on precipitation with RAMS for both in winter and summer cases from a microphysical perspective. We consider a two dimensional east-west topographic cross section in New Mexico representative of the Jemez mountains on the west and the Sangre de Cristo mountains on the east. Located between these two ranges is the Rio Grande Valley. In these two dimensional experiments, variations in DSDs are considered to simulate total precipitation that closely duplicate observed precipitation

  18. A note on propositional proof complexity of some Ramsey-type statements

    Czech Academy of Sciences Publication Activity Database

    Krajíček, Jan

    2011-01-01

    Roč. 50, 1-2 (2011), s. 245-255 ISSN 1432-0665 R&D Projects: GA AV ČR IAA100190902; GA MŠk LC505 Institutional research plan: CEZ:AV0Z10190503 Keywords : proof complexity * Ram sey theorem * resolution Subject RIV: BA - General Mathematics Impact factor: 0.341, year: 2011 http://www.springerlink.com/content/q27255801x225772/

  19. The Impact of Intimal Tear Location and Partial False Lumen Thrombosis in Acute Type B Aortic Dissection.

    Science.gov (United States)

    Girish, Apoorva; Padala, Muralidhar; Kalra, Kanika; McIver, Bryant V; Veeraswamy, Ravi K; Chen, Edward P; Leshnower, Bradley G

    2016-12-01

    Partial false lumen (FL) thrombosis is a risk factor for long-term mortality in acute type B aortic dissection (ATBAD). This study investigates FL pressures in models of ATBAD with patent and partially thrombosed FL. Twenty-five porcine aortas were used to create five models of ATBAD that were connected to a pulsatile flow loop. Models A through C had a patent FL with the following morphologies: model A, single proximal tear; model B, single distal tear; and model C, single proximal and single distal tear. Models D and E had a single proximal and a single distal tear, with partial FL thrombosis. Model D had FL occlusion of the proximal tear, and model D had FL occlusion of the distal tear. True lumen (TL) and FL pressures were measured at 90 to 150 mm Hg. In model A, FL pressures were 6 mm Hg higher than TL pressures (p < 0.01). In model B, FL pressures were 10 mm Hg lower than TL pressures (p ≤ 0.01). In model C, TL and FL pressures were equivalent. In model D, FL pressures were 40 mm Hg lower than TL pressures (p < 0.001). In model E, FL pressures were 10 mm Hg higher than TL pressures (p < 0.01). In a biologic model of ATBAD, the number, location, and FL thrombosis status determine FL pressure. In the setting of partial FL thrombosis, the FL pressure is reduced with proximal tear occlusion and increased with distal tear occlusion. Reduced FL pressure is related to retrograde flow. Copyright © 2016 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  20. Risk factors of pre-operational aortic rupture in acute and subacute Stanford type A aortic dissection patients.

    Science.gov (United States)

    Li, Zhuo-Dong; Liu, Yang; Zhu, Jiang; Wang, Jun; Lu, Fang-Lin; Han, Lin; Xu, Zhi-Yun

    2017-12-01

    Aortic rupture is one of the main causes of early death in acute and subacute Stanford type A aortic dissection (ATAAD) patients. This study aimed to analyze potential risk factors for pre-operational aortic rupture in ATAAD patients. We retrospectively reviewed aortic dissection cases treated between May 2013 and May 2016 in Changhai Hospital, Shanghai. A total of 329 patients with ATAAD were included in the final analysis, and 31 patients died of aortic rupture before surgery. Clinical data on basic characteristics, clinical presentation, and biochemical measurements for all 329 patients were analyzed. The in-hospital aortic rupture rate was 9.4% (31/329), and the rupture accounted for 47% (31/66) of all in-hospital deaths of ATAAD patients. Patients who experienced rupture were significantly older (Prisk factors: shock [odds ratio (OR): 8.12; 95% confidence interval (CI), 1.10-59.85, P=0.040], pain requiring medication (OR: 12.67; 95% CI, 2.43-66.09; P=0.003), troponin level >0.7 ng/mL (OR: 9.28; 95% CI, 1.72-50.06; P=0.010), and D-dimer level ≥10 µg/mL (OR: 13.37; 95% CI, 2.18-81.97; P=0.005). Aortic rupture accounted for 47% of all in-hospital deaths among patient with ATAAD. Shock, pain requiring medication, a troponin level >0.7 ng/mL and a D-dimer level ≥10 µg/mL are independent risk factors for aortic rupture in these patients.

  1. Antegrade versus retrograde cerebral perfusion in relation to postoperative complications following aortic arch surgery for acute aortic dissection type A.

    Science.gov (United States)

    Apostolakis, Efstratios; Koletsis, Efstratios N; Dedeilias, Panagiotis; Kokotsakis, John N; Sakellaropoulos, George; Psevdi, Argini; Bolos, Konstantin; Dougenis, Dimitrios

    2008-01-01

    Aortic arch surgery is impossible without the temporary interruption of brain perfusion and therefore is associated with high incidence of neurologic injury. The deep hypothermic circulatory arrest (HCA), in combination with antegrade or retrograde cerebral perfusion (RCP), is a well-established method of brain protection in aortic arch surgery. In this retrospective study, we compare the two methods of brain perfusion. From 1998 to 2006, 48 consecutive patients were urgently operated for acute type A aortic dissection and underwent arch replacement under deep hypothermic circulatory arrest (DHCA). All distal anastomoses were performed with open aorta, and the arch was replaced totally in 15 cases and partially in the remaining 33 cases. Our patient cohort is divided into those protected with antegrade cerebral perfusion (ACP) (group A, n = 23) and those protected with RCP (group B, n = 25). No significant difference was found between groups A and B with respect to cardiopulmonary bypass-time, brain-ischemia time, cerebral-perfusion time, permanent neurologic dysfunction, and mortality. The incidence of temporary neurologic dysfunction was 16.0% for group A and 43.50% for group B (p = 0.04). The mean extubation time was 3.39 +/- 1.40 days for group A and 4.96 +/- 1.83 days for group B (p = 0.0018). The mean ICU-stay was 4.4 +/- 2.3 days for group A and 6.9 +/- 2.84 days for group B (p = 0.0017). The hospital-stay was 14.38 +/- 4.06 days for group A and 19.65 +/- 6.91 days for group B (p = 0.0026). The antegrade perfusion seems to be related with significantly lower incidence of temporary neurological complications, earlier extubation, shorter ICU-stay, and hospitalization, and hence lower total cost.

  2. Acute effects of sildenafil on flow mediated dilatation and cardiovascular autonomic nerve function in type 2 diabetic patients.

    Science.gov (United States)

    Stirban, Alin; Laude, Dominique; Elghozi, Jean-Luc; Sander, Denise; Agelink, Marcus W; Hilz, Max J; Ziegler, Dan

    2009-02-01

    Sildenafil, frequently used as on demand medication for the treatment of erectile dysfunction (ED), has been suggested to improve endothelial function but also to alter blood pressure (BP) and induce sympathetic activation. In people with type 2 diabetes mellitus (T2DM), a high-risk population, the safety profile and the effects on endothelial function of a maximal sildenafil dose (100 mg) have not been investigated and therefore constituted the aim of our study. A double-blind, placebo-controlled, cross-over trial using a single dose of 100 mg sildenafil or placebo has been conducted in 40 subjects with T2DM without known CVD. Haemodynamic parameters, flow mediated dilatation (FMD) in brachial artery, cardiovascular autonomic function tests and spontaneous baroreflex sensitivity (BRS) were measured. Sixty minutes after administration of sildenafil but not placebo, a fall of supine systolic blood pressure (SBP) (-5.41 +/- 1.87 vs. + 0.54 +/- 1.71 mmHg) and diastolic blood pressure (DBP) (-4.46 +/- 1.13 vs. + 0.89 +/- 0.94 mmHg), as well as orthostatic SBP (-7.41 +/- 2.35 vs. + 0.94 +/- 2.06 mmHg) and DBP (-5.65 +/- 1.45 vs. + 1.76 +/- 1.00 mmHg) during standing occurred, accompanied by an increase in heart rate (+1.98 +/- 0.69 vs. - 2.42 +/- 0.59 beats/min) (all p < 0.01 vs. placebo). Changes in BP to standing up, FMD, time domain and frequency domain indices of heart rate variability (HRV) and BRS were comparable between sildenafil and placebo. Sildenafil administered at a maximum single dose to T2DM men results in a mild increase in heart rate and decrease in BP, but it induces neither an acute improvement of FMD nor any adverse effects on orthostatic BP regulation, HRV and BRS. Copyright (c) 2008 John Wiley & Sons, Ltd.

  3. Association of Admission Glucose Level and Improvement in Pulmonary Artery Pressure in Patients with Submassive-type Acute Pulmonary Embolism.

    Science.gov (United States)

    Gohbara, Masaomi; Hayakawa, Keigo; Hayakawa, Azusa; Akazawa, Yusuke; Yamaguchi, Yukihiro; Furihata, Shuta; Kondo, Ai; Fukushima, Yusuke; Tomari, Sakie; Mitsuhashi, Takayuki; Endo, Tsutomu; Kimura, Kazuo

    2018-03-01

    Objective The admission glucose level is a predictor of mortality even in patients with acute pulmonary embolism (APE). However, whether or not the admission glucose level is associated with the severity of APE itself or the underlying disease of APE is unclear. Methods This study was a retrospective observational study. A pulmonary artery (PA) catheter was used to accurately evaluate the severity of APE. The percentage changes in the mean PA pressure (PAPm) upon placement and removal of the inferior vena cava filter (IVCF) were evaluated. We hypothesized that the admission glucose level was associated with the improvement in the PA pressure in patients with APE. Patients A total of consecutive 22 patients with submassive APE who underwent temporary or retrievable IVCF insertion on admission and repetitive PA catheter measurements upon placement and removal of IVCFs were enrolled. Results There was a significant positive correlation between the admission glucose levels and the percentage changes in the PAPm (r=0.543, p=0.009). A univariate linear regression analysis showed that the admission glucose level was the predictor of the percentage change in PAPm (β coefficient=0.169 per 1 mg/dL; 95% confidence interval, 0.047-0.291; p=0.009). A multivariate linear regression analysis with the forced inclusion model showed that the admission glucose level was the predictor of the percentage change in PAPm independent of diabetes mellitus, PAPm on admission, troponin positivity, and brain natriuretic peptide level (all plevel was associated with the improvement in the PAPm in patients with submassive-type APE.

  4. Charcot Marie Tooth disease type 4J with complex central nervous system features.

    Science.gov (United States)

    Orengo, James P; Khemani, Pravin; Day, John W; Li, Jun; Siskind, Carly E

    2018-02-01

    We describe a family with Charcot Marie Tooth disease type 4J presenting with features of Charcot Marie Tooth disease plus parkinsonism and aphemia. Genetic testing found two variants in the FIG4 gene: c.122T>C (p.I41T) - the most common Charcot Marie Tooth disease type 4J variant - and c.1949-10T>G (intronic). Proband fibroblasts showed absent FIG4 protein on western blot, and skipping of exon 18 by RT-PCR. As most patients with Charcot Marie Tooth disease type 4J do not have central nervous system deficits, we postulate the intronic variant and I41T mutation together are causing loss of FIG4 protein and subsequently the central nervous system findings in our family.

  5. In Vitro Activation of the IκB Kinase Complex by Human T-cell Leukemia Virus Type-1 Tax*

    Science.gov (United States)

    Mukherjee, Sohini; Negi, Veera S.; Keitany, Gladys; Tanaka, Yuetsu; Orth, Kim

    2008-01-01

    Human T-cell leukemia virus type-I expresses Tax, a 40-kDa oncoprotein that activates IκB kinase (IKK), resulting in constitutive activation of NFκB. Herein, we have developed an in vitro signaling assay to analyze IKK complex activation by recombinant Tax. Using this assay in combination with reporter assays, we demonstrate that Tax-mediated activation of IKK is independent of phosphatases. We show that sustained activation of the Tax-mediated activation of the NFκB pathway is dependent on an intact Hsp90-IKK complex. By acetylating and thereby preventing activation of the IKK complex by the Yersinia effector YopJ, we demonstrate that Tax-mediated activation of the IKK complex requires a phosphorylation step. Our characterization of an in vitro signaling assay system for the mechanism of Tax-mediated activation of the IKK complex with a variety of mutants and inhibitors results in a working model for the biochemical mechanism of Tax-induced activation. PMID:18223255

  6. Target RNA capture and cleavage by the Cmr type III-B CRISPR–Cas effector complex

    Science.gov (United States)

    Hale, Caryn R.; Cocozaki, Alexis; Li, Hong

    2014-01-01

    The effector complex of the Cmr/type III-B CRISPR (clustered regularly interspaced short palindromic repeat)–Cas (CRISPR-associated) system cleaves RNAs recognized by the CRISPR RNA (crRNA) of the complex and includes six protein subunits of unknown functions. Using reconstituted Pyrococcus furiosus Cmr complexes, we found that each of the six Cmr proteins plays a critical role in either crRNA interaction or target RNA capture. Cmr2, Cmr3, Cmr4, and Cmr5 are all required for formation of a crRNA-containing complex detected by native gel electrophoresis, and the conserved 5′ repeat sequence tag and 5′-OH group of the crRNA are essential for the interaction. Interestingly, capture of the complementary target RNA additionally requires both Cmr1 and Cmr6. In detailed functional studies, we determined that P. furiosus Cmr complexes cleave target RNAs at 6-nucleotide (nt) intervals in the region of complementarity, beginning 5 nt downstream from the crRNA tag and continuing to within ∼14 nt of the 3′ end of the crRNA. Our findings indicate that Cmr3 recognizes the signature crRNA tag sequence (and depends on protein–protein interactions with Cmr2, Cmr4, and Cmr5), each Cmr4 subunit mediates a target RNA cleavage, and Cmr1 and Cmr6 mediate an essential interaction between the 3′ region of the crRNA and the target RNA. PMID:25367038

  7. CD16+ monocytes and skewed macrophage polarization toward M2 type hallmark heart transplant acute cellular rejection

    NARCIS (Netherlands)

    T.P.P. van den Bosch (Thierry); K. Caliskan (Kadir); M.D. Kraaij (Marina); A.A. Constantinescu (Alina); O.C. Manintveld (Olivier); P.J. Leenen (Pieter); J. von der Thusen (Jan); M.C. Clahsen-van Groningen (Marian); C.C. Baan (Carla); A.T. Rowshani (Ajda)

    2017-01-01

    textabstractBackground: During acute heart transplant rejection, infiltration of lymphocytes and monocytes is followed by endothelial injury and eventually myocardial fibrosis. To date, no information is available on monocyte-macrophage-related cellular shifts and their polarization status during

  8. Molecular studies reveal a MLL-MLLT3 gene fusion displaced in a case of childhood acute lymphoblastic leukemia with complex karyotype.

    Science.gov (United States)

    Ney Garcia, Daniela Ribeiro; Liehr, Thomas; Emerenciano, Mariana; Meyer, Claus; Marschalek, Rolf; Pombo-de-Oliveira, Maria do Socorro; Ribeiro, Raul C; Poirot Land, Marcelo Gerardin; Macedo Silva, Maria Luiza

    2015-04-01

    Rearrangement of the mixed lineage-leukemia gene (MLL-r) is common in hematological diseases and is generally associated with poor prognosis. The mixed-lineage leukemia gene translocated to, 3 (MLLT3) gene (9p22) is a frequent MLL-r partner (∼18% of leukemias with MLL rearrangement) and is characterized by the translocation t(9;11) (p22;q23), forming an MLL-MLLT3 gene fusion. MLL-r are usually simple reciprocal translocations between two different chromosomes, although karyotypes with complex MLL-r have been observed. We present a rare case of a child with acute lymphoblastic leukemia with a complex karyotype in which the classical t(9;11) (p22;q23) was cryptically relocated into a third chromosome in a balanced three-way translocation. At the genome level, however, the MLL-MLLT3 three-way translocation still displayed both reciprocal fusion transcripts. This argues in favor for a model where a simple two-way t(9;11) (p22;q23) was likely the first step that then evolved in to a more complex karyotype. Multicolor banding techniques can be used to greatly refine complex karyotypes and its chromosomal breakpoints. Also in the presence of putative new rearrangements, Long distance inverse-PCR is an important tool to identify which gene fusion is involved. Copyright © 2015 Elsevier Inc. All rights reserved.

  9. Metabolic consequences of acute and chronic empagliflozin administration in treatment-naive and metformin pretreated patients with type 2 diabetes.

    Science.gov (United States)

    Muscelli, Elza; Astiarraga, Brenno; Barsotti, Elisabetta; Mari, Andrea; Schliess, Freimut; Nosek, Leszek; Heise, Tim; Broedl, Uli C; Woerle, Hans-Juergen; Ferrannini, Ele

    2016-04-01

    Sodium glucose co-transporter 2 (SGLT2) inhibitors lower glycaemia by inducing glycosuria, but raise endogenous glucose production (EGP). Metformin lowers glycaemia mainly by suppressing EGP. We compared the effects of the SGLT2 inhibitor empagliflozin in treatment-naive (TN) and metformin pretreated (Met) patients with type 2 diabetes. A total of 32 TN and 34 patients on a stable dose of metformin, two subgroups of a study that we previously reported, received a mixed meal with double-tracer glucose administration and indirect calorimetry at baseline, after a single 25 mg dose of empagliflozin, and after 4 weeks of treatment with empagliflozin 25 mg/day. At baseline, compared with the TN group, the Met group had higher fasting glycaemia (9.1 ± 1.7 vs 8.2 ± 1.3 mmol/l), lower fasting and postmeal insulin secretion, lower beta cell glucose sensitivity (37 [18] vs 58 [43] pmol min(-1) m(-2) [mmol/l](-1), median [interquartile range]) and insulin:glucagon ratio, and higher fasting EGP (15.9 [4.3] vs 12.1 [2.7] μmol kgFFM (-1) min(-1)). Change from baseline in fasting EGP after single dose and 4 weeks of treatment with empagliflozin was similar in the Met and TN groups (19.6 [4.2] and 19.0 [2.3] in Met vs 16.2 [3.6] and 15.5 [3.2] μmol kgFFM (-1) min(-1) in TN for acute and chronic dosing, respectively). Beta cell glucose sensitivity increased less in Met than TN patients, whereas substrate utilisation shifted from carbohydrate to fat more in Met than TN patients. At baseline, Met patients with type 2 diabetes had more advanced disease than TN patients, featuring worse beta cell function and higher EGP. Empagliflozin induced similar glycosuria and metabolic and hormonal responses in Met and TN patients. ClinicalTrials.gov NCT01248364; European Union Clinical Trials Register 2010-018708-99.

  10. Predicting Patterns of Grammatical Complexity across Language Exam Task Types and Proficiency Levels

    Science.gov (United States)

    Biber, Douglas; Gray, Bethany; Staples, Shelley

    2016-01-01

    In the present article, we explore the extent to which previous research on register variation can be used to predict spoken/written task-type variation as well as differences across score levels in the context of a major standardized language exam (TOEFL iBT). Specifically, we carry out two sets of linguistic analyses based on a large corpus of…

  11. Ru complexes of Hoveyda–Grubbs type immobilized on lamellar zeolites: activity in olefin metathesis reactions

    Czech Academy of Sciences Publication Activity Database

    Balcar, Hynek; Žilková, Naděžda; Kubů, Martin; Mazur, Michal; Bastl, Zdeněk; Čejka, Jiří

    2015-01-01

    Roč. 11, NOV 2015 (2015), s. 2087-2096 ISSN 1860-5397 Institutional support: RVO:61388955 Keywords : Hoveyda-Grubbs type catalyst * hybrid catalysts * lamellar zeolites Subject RIV: CF - Physical ; Theoretical Chemistry Impact factor: 2.697, year: 2015

  12. What makes a rhythm complex? The influence of musical training and accent type on beat perception

    NARCIS (Netherlands)

    Bouwer, F.L.; Burgoyne, J.A.; Odijk, D.; Honing, H.; Grahn, J.A.

    2018-01-01

    Perception of a regular beat in music is inferred from different types of accents. For example, increases in loudness cause intensity accents, and the grouping of time intervals in a rhythm creates temporal accents. Accents are expected to occur on the beat: when accents are “missing” on the beat,

  13. COMPLEX TRAINING: A BRIEF REVIEW

    Directory of Open Access Journals (Sweden)

    William P. Ebben

    2002-06-01

    Full Text Available The effectiveness of plyometric training is well supported by research. Complex training has gained popularity as a training strategy combining weight training and plyometric training. Anecdotal reports recommend training in this fashion in order to improve muscular power and athletic performance. Recently, several studies have examined complex training. Despite the fact that questions remain about the potential effectiveness and implementation of this type of training, results of recent studies are useful in guiding practitioners in the development and implementation of complex training programs. In some cases, research suggests that complex training has an acute ergogenic effect on upper body power and the results of acute and chronic complex training include improved jumping performance. Improved performance may require three to four minutes rest between the weight training and plyometrics sets and the use of heavy weight training loads

  14. The membrane attack complex as an indicator of complement hyperactivation in type 2 diabetes mellitus

    OpenAIRE

    Elina Aleksandrovna Arakelova; Meri Robertovna Ovsepyan; Anna Surenovna Boyadzhyan; Arsen Artashesovich Arakelyan; Astkhik Artavazdovna Gevorkyan; Ashot Andreevich Mamikonyan

    2011-01-01

    Aim. Comparative analysis of the levels of the membrane attack complex (MAC) - an end product of complement activation, and of hemolytic activities of C1 and C3 complement components in sera of patients with diabetes mellitus 2 (DM2) and healthy subjects. Materials and methods. 37 DM2 patients (7 men, 26 women, mean age 58±9 years (M±б) and 37 healthy subjects without a family history of hereditary diabetes (17 men, 20 women, mean age 52±12 years). Serum MAC levels were measured by E...

  15. Distributed Adaptive Synchronization for Complex Dynamical Networks with Uncertain Nonlinear Neutral-Type Coupling

    Directory of Open Access Journals (Sweden)

    Shi Miao

    2013-01-01

    Full Text Available Distributed adaptive synchronization control for complex dynamical networks with nonlinear derivative coupling is proposed. The distributed adaptive strategies are constituted by directed connections among nodes. By means of the parameters separation, the nonlinear functions can be transformed into the linearly form. Then effective distributed adaptive techniques are designed to eliminate the effect of time-varying parameters and made the considered network synchronize a given trajectory in the sense of square error norm. Furthermore, the coupling matrix is not assumed to be symmetric or irreducible. An example shows the applicability and feasibility of the approach.

  16. A new type of polymeric heavy metal complexing precipitant used as fishery disinfectant and antiparasitic drug

    Science.gov (United States)

    Liu, Y. C.; Zhang, A. N.; Wang, X. B.; Xu, J.; Zeng, X. H.; Wang, H. M.

    2017-08-01

    This paper presents a technique to produce a new kind of fishery drug that is water emulsion suspending agent containing polymeric calcium-iron-dithiocarbamate with heavy metal complexing precipitate ability, good disinfection and auxiliary insecticidal efficacy. The product has good dispersion, high efficiency and low toxicity, as well as no pollution and no harmful residues. It not only can be used in the pond waters and ornamental waters, but also can meet the high requirements of the aquaculture waters. There is non-pollutant emission in the production, which is a green environment-friendly technique without three waste discharges. This technology belongs to the ecological and environmental protection.

  17. Acute Oral Toxicity Evaluations of Some Zinc(II Complexes Derived from 1-(2-Salicylaldiminoethylpiperazine Schiff Bases in Rats

    Directory of Open Access Journals (Sweden)

    Mahmood Ameen Abdulla

    2012-01-01

    Full Text Available The current study described the synthesis and the in vivo acute oral toxicity evaluations in Sprague Dawley rats. The compounds were characterized by elemental analyses, LC-MS, FTIR, 1H NMR, 13C NMR and UV-visible spectroscopy. In the acute toxicity study, a single administration of the compounds was performed orally to the rats at the single doses of 2000 mg/kg and they were then monitored for possible side effects, mortality or behavioral changes up to 14 days. The serum level of aspartate (AST, alanine aminotransferases (ALT, alkaline phosphate (ALP, triglyceride, high density lipoprotein (HDL, immunoglobulins (GAM and the C-reactive proteins did not significantly change. The hematological indices white blood cells (WBC, haematocrit (HCT, red blood cells (RBC, mean corpuscular volume (MCV, mean corpuscular haemoglobin concentration (MCHC, and mean corpuscular hemoglobin (MCH were within the normal range. The renal function indices examined were also within the reference range. Generally, the compounds exhibited low toxic effects as required for further in vivo therapeutic studies.

  18. Availability of treatment resources for the management of acute toxic exposures and poisonings in emergency departments among various types of hospitals in Palestine: a cross-sectional study

    OpenAIRE

    Zyoud, Sa’ed H; Al-Jabi, Samah W; Bali, Yara I; Al-Sayed, Afnan M; Sweileh, Waleed M; Awang, Rahmat

    2014-01-01

    Background Poisoning exposures continue to be a significant cause of morbidity and mortality worldwide. The lack of facilities, treatment resources, and antidotes in hospitals may affect the treatments provided and outcomes. This study aimed to determine the availability of gastrointestinal (GI) decontamination, stabilisation, elimination enhancement resources, and antidotes for the management of acute toxic exposures and poisonings in emergency departments (EDs) among various types of govern...

  19. A serum biomarker reflecting collagen type I degradation (C1M) is an independent risk factor for acute myocardial infarction in postmenopausal women: results from the PERF study

    DEFF Research Database (Denmark)

    Bertelsen, D.M.; Nielsen, Signe Holm; Neergaard, J.S.

    2017-01-01

    Cardiovascular disease (CVD) is the leading cause of death in postmenopausal women, and symptoms of ischemic heart disease (IHD) and acute myocardial infarction (AMI) are often overlooked. With the loss of estrogen production collagen stability is affected with potential of an increased risk of u...... of unstable plaques in coronary vessels. Collagen type I, a major component of the cardiac extracellular matrix (ECM), is cleaved by matrix metalloproteinases (MMPs) and known to be active remodeled in CVD....

  20. Fixed Differences in the paralytic Gene Define Two Lineages within the Lutzomyia longipalpis Complex Producing Different Types of Courtship Songs

    Science.gov (United States)

    Lins, Rachel M. M. A.; Souza, Nataly A.; Brazil, Reginaldo P.; Maingon, Rhayza D. C.; Peixoto, Alexandre A.

    2012-01-01

    The sand fly Lutzomyia longipalpis (Diptera: Psychodidae: Phlebotominae), the most important vector of American visceral leishmaniasis, is widely distributed in Latin America. There is currently a consensus that it represents a species complex, however, the number and distribution of the different siblings is still uncertain. Previous analyses have indicated that Brazilian populations of this vector can be divided into two main groups according to the type of courtship song (Burst vs. Pulse) males produce during copulation. Nevertheless, no diagnostic differences have been observed between these two groups with most molecular markers used to date. We analyzed the molecular divergence in a fragment of the paralytic (para) gene, a locus involved in the control of courtship songs in Drosophila, among a number of Lu. longipalpis populations from Brazil producing Burst and Pulse-type songs. Our results revealed a very high level of divergence and fixed differences between populations producing the two types of songs. We also compared Lu. longipalpis with a very closely related species, Lutzomyia cruzi, which produces Burst-type songs. The results indicated a higher number of fixed differences between Lu. cruzi and the Pulse-type populations of Lu. longipalpis than with those producing Burst-type songs. The data confirmed our previous assumptions that the presence of different sibling species of the Lu. longipalpis complex in Brazil can be divided into two main groups, one representing a single species and a second more heterogeneous group that probably represents a number of incipient species. We hypothesize that para might be one of the genes directly involved in the control of the courtship song differences between these two groups or that it is linked to other loci associated with reproductive isolation of the Brazilian species. PMID:22970200

  1. Fixed differences in the paralytic gene define two lineages within the Lutzomyia longipalpis complex producing different types of courtship songs.

    Directory of Open Access Journals (Sweden)

    Rachel M M A Lins

    Full Text Available The sand fly Lutzomyia longipalpis (Diptera: Psychodidae: Phlebotominae, the most important vector of American visceral leishmaniasis, is widely distributed in Latin America. There is currently a consensus that it represents a species complex, however, the number and distribution of the different siblings is still uncertain. Previous analyses have indicated that Brazilian populations of this vector can be divided into two main groups according to the type of courtship song (Burst vs. Pulse males produce during copulation. Nevertheless, no diagnostic differences have been observed between these two groups with most molecular markers used to date. We analyzed the molecular divergence in a fragment of the paralytic (para gene, a locus involved in the control of courtship songs in Drosophila, among a number of Lu. longipalpis populations from Brazil producing Burst and Pulse-type songs. Our results revealed a very high level of divergence and fixed differences between populations producing the two types of songs. We also compared Lu. longipalpis with a very closely related species, Lutzomyia cruzi, which produces Burst-type songs. The results indicated a higher number of fixed differences between Lu. cruzi and the Pulse-type populations of Lu. longipalpis than with those producing Burst-type songs. The data confirmed our previous assumptions that the presence of different sibling species of the Lu. longipalpis complex in Brazil can be divided into two main groups, one representing a single species and a second more heterogeneous group that probably represents a number of incipient species. We hypothesize that para might be one of the genes directly involved in the control of the courtship song differences between these two groups or that it is linked to other loci associated with reproductive isolation of the Brazilian species.

  2. The Gd{sub 14}Ag{sub 51} structure type and its relation to some complex amalgam structures

    Energy Technology Data Exchange (ETDEWEB)

    Tambornino, Frank; Sappl, Jonathan; Hoch, Constantin, E-mail: constantin.hoch@cup.uni-muenchen.de

    2015-01-05

    Highlights: • The Gd{sub 14}Ag{sub 51} structure type has been revisited on the basis of single crystal diffraction data. • Symmetry analysis from electron density and TEM shows the space group P6/m to be true. • Gd{sub 14}Ag{sub 51} shows good metallic behaviour. • Structure relations to alkali, alkaline-earth and rare-earth metal amalgams can be established. • Complexity values for the RE{sub 14}Ag{sub 51} structure family were calculated. - Abstract: A plethora of binary and ternary intermetallic compounds has been assigned to the Gd{sub 14}Ag{sub 51} structure type, crystallising in the hexagonal system (space group P6/m, a = 1264.30(18) pm, c = 933.58(11) pm for Gd{sub 14}Ag{sub 51}). Starting in the late 1960s, much work has been invested in the structural elucidation of these crystal structures. However, reliable single crystal data are scarce, and most structure type assignments have been performed merely on the basis of powder data. We have redetermined four representatives of the binary RE{sub 14}Ag{sub 51} structure type (RE = Y, Ce, Gd, Tb) with modern high-precision single crystal X-ray methods. The assignment of the Gd{sub 14}Ag{sub 51} structure type to space group P6/m was additionally verified by careful analysis of high resolution transmission electron micrographs. We emphasise the close relation of the Gd{sub 14}Ag{sub 51} structure type to the structures of some recently described amalgams of similar composition focussing on disorder phenomena and structural complexity. Furthermore, we provide detailed information on synthesis as well as electrical and magnetic properties for Gd{sub 14}Ag{sub 51}, the parent compound of this structure family.

  3. [Intervention of pyrrolidine dithiocarbamate on expressions of connective tissue growth factor, type I collagen, and type III collage in acute paraquat poisoned rats].

    Science.gov (United States)

    Huang, Min; Yang, Hui-fang; Zhang, Ping; Chang, Xiu-li; Zhou, Zhi-jun

    2013-01-01

    To observe the changes in the expression of connective tissue growth factor (CTGF), type I collagen (Col I), and type III collagen (Col III) among the rats with acute paraquat (PQ) poisoning and the intervention effect of pyrrolidine dithiocarbamate (PDTC) on their expression, and to investigate the mechanism of PQ-induced pulmonary fibrosis and the intervention effect of PDTC on the disease. Sprague-Dawley rats were randomly divided into control group (n = 6), PQ group (n = 36), and PQ + PDTC group (n = 36). The PQ group and PQ + PDTC group were given a single dose of saline-diluted PQ (80 mg/kg) by gavage; 2 h later, the PQ + PDTC group was intraperitoneally injected with a single dose of PDTC (100 mg/kg), and the PQ group was intraperitoneally injected with the same amount of saline. The control group was given saline (1 ml/kg) by gavage and was intraperitoneally injected with the same amount of saline 2h later. At 1, 3, 7, 14, 25, and 56 days after operation, the protein expression of CTGF was evaluated by Western blot; the mRNA expression of CTGF, Col I, and Col III was analyzed by real-time quantitative PCR; the content of hydroxyproline in lung tissue was measured, and the pathological changes of lung tissue of the poisoned rats were observed. The protein expression of CTGF in the PQ group increased as the time went on, slowly from the 3rd to the 14th day and rapidly from the 28th to the 56th day, significantly higher than that in the control group at each time point (P < 0.05 or P < 0.01). The mRNA expression of CTGF in the PQ group began to rise markedly on the 1st day, increased rapidly from the 3rd to the 14th day, and remained at a relatively high level from the 28th to the 56th day, significantly higher than that in the control group at each time point (P < 0.01). The mRNA expression of Col I in the PQ group changed little on the 1st and 3rd day, increased slightly on the 7th day, and increased greatly from the 14th to the 56th day, significantly

  4. Ru complexes of Hoveyda-Grubbs type immobilized on lamellar zeolites: activity in olefin metathesis reactions.

    Science.gov (United States)

    Balcar, Hynek; Žilková, Naděžda; Kubů, Martin; Mazur, Michal; Bastl, Zdeněk; Čejka, Jiří

    2015-01-01

    Hoveyda-Grubbs type catalysts with cationic tags on NHC ligands were linker-free immobilized on the surface of lamellar zeolitic supports (MCM-22, MCM-56, MCM-36) and on mesoporous molecular sieves SBA-15. The activity of prepared hybrid catalysts was tested in olefin metathesis reactions: the activity in ring-closing metathesis of citronellene and N,N-diallyltrifluoroacetamide decreased in the order of support MCM-22 ≈ MCM-56 > SBA-15 > MCM-36; the hybrid catalyst based on SBA-15 was found the most active in self-metathesis of methyl oleate. All catalysts were reusable and exhibited low Ru leaching (<1% of Ru content). XPS analysis revealed that during immobilization ion exchange between Hoveyda-Grubbs type catalyst and zeolitic support occurred in the case of Cl(-) counter anion; in contrast, PF6 (-) counter anion underwent partial decomposition.

  5. [Long-term destiny of adolescents and young adults with de novo acute lymphoblastic leukemia treated with a pediatric protocol type].

    Science.gov (United States)

    López-Hernández, Manuel Antonio; Alvarado-Ibarra, Martha; Álvarez-Veral, José Luis; Ortiz-Zepeda, Maricela; Guajardo-Leal, Martha Lilia; Cota-Range, Xochitl

    The prognosis, in the long term, of adolescents and young adults with acute de novo lymphoblastic leukemia, treated with a pediatric type protocol. To analyze the efficacy and tolerability of a chemotherapy regimen of pediatric type on patients 15-35 years old with de novo acute lymphoblastic leukemia, Ph(-). A retrospective study of patients received from 2001 to 2013, without initial infiltration of the central nervous system. They received the regimen called LALÍN. Terminal goals: frequency of initial remission, probability of survival free of leukemia and event-free survival for five years. We included 101 patients; there were 29 relapses and 19 deaths. There was initial remission in 97% of the cases; survival free of leukemia of 0.58 and event-free survival 0.44. No difference in patients aged 16-21 years vs. 22-35 (p > 0.55). Negative prognostic factors: abnormal karyotypes, except hyperdiploids (p = 0.001); > 5% of blasts, on 14 day induction (p = 0. 0001); delay in the punctuality of the courses of the chemotherapy regimen (p = 0.0001). A pediatric type regimen is applicable to patients aged from 16 to 35 years with acute lymphoblastic leukemia, without greater toxicity and a best survival free of leukemia. The count of > 5% of blasts and the delay in the execution of the stages of the chemotherapy regimen are the stronger negative prognostic factors.

  6. What makes a rhythm complex? The influence of musical training and accent type on beat perception

    Science.gov (United States)

    Burgoyne, J. Ashley; Odijk, Daan; Honing, Henkjan; Grahn, Jessica A.

    2018-01-01

    Perception of a regular beat in music is inferred from different types of accents. For example, increases in loudness cause intensity accents, and the grouping of time intervals in a rhythm creates temporal accents. Accents are expected to occur on the beat: when accents are “missing” on the beat, the beat is more difficult to find. However, it is unclear whether accents occurring off the beat alter beat perception similarly to missing accents on the beat. Moreover, no one has examined whether intensity accents influence beat perception more or less strongly than temporal accents, nor how musical expertise affects sensitivity to each type of accent. In two experiments, we obtained ratings of difficulty in finding the beat in rhythms with either temporal or intensity accents, and which varied in the number of accents on the beat as well as the number of accents off the beat. In both experiments, the occurrence of accents on the beat facilitated beat detection more in musical experts than in musical novices. In addition, the number of accents on the beat affected beat finding more in rhythms with temporal accents than in rhythms with intensity accents. The effect of accents off the beat was much weaker than the effect of accents on the beat and appeared to depend on musical expertise, as well as on the number of accents on the beat: when many accents on the beat are missing, beat perception is quite difficult, and adding accents off the beat may not reduce beat perception further. Overall, the different types of accents were processed qualitatively differently, depending on musical expertise. Therefore, these findings indicate the importance of designing ecologically valid stimuli when testing beat perception in musical novices, who may need different types of accent information than musical experts to be able to find a beat. Furthermore, our findings stress the importance of carefully designing rhythms for social and clinical applications of beat perception, as

  7. Large-Scale Association Study Confirms Genetic Complexity Underlying Type 2 Diabetes

    OpenAIRE

    Barroso, Inês; Luan, Jian'an; Middelberg, Rita P. S; Harding, Anne-Helen; Franks, Paul W; Jakes, Rupert W; Clayton, David; Schafer, Alan J; O'Rahilly, Stephen; Wareham, Nicholas J

    2003-01-01

    Type 2 diabetes is an increasingly common, serious metabolic disorder with a substantial inherited component. It is characterised by defects in both insulin secretion and action. Progress in identification of specific genetic variants predisposing to the disease has been limited. To complement ongoing positional cloning efforts, we have undertaken a large-scale candidate gene association study. We examined 152 SNPs in 71 candidate genes for association with diabetes status and related phenoty...

  8. Mirror box therapy added to cognitive behavioural therapy in three chronic complex regional pain syndrome type I patients : a pilot study

    NARCIS (Netherlands)

    Tichelaar, Y. I. G. Vladimir; Geertzen, Jan H. B.; Keizer, Doeke; van Wilgen, C. Paul

    Complex regional pain syndrome type I is a disorder of the extremities with disability and pain as the most prominent features. This paper describes the results of cognitive behavioural therapy combined with mirror box therapy in three patients with chronic complex regional pain syndrome type I.

  9. Structural studies of P-type ATPase–ligand complexes using an X-ray free-electron laser

    Energy Technology Data Exchange (ETDEWEB)

    Bublitz, Maike; Nass, Karol; Drachmann, Nikolaj D.; Markvardsen, Anders J.; Gutmann, Matthias J.; Barends, Thomas R. M.; Mattle, Daniel; Shoeman, Robert L.; Doak, R. Bruce; Boutet, Sébastien; Messerschmidt, Marc; Seibert, Marvin M.; Williams, Garth J.; Foucar, Lutz; Reinhard, Linda; Sitsel, Oleg; Gregersen, Jonas L.; Clausen, Johannes D.; Boesen, Thomas; Gotfryd, Kamil; Wang, Kai-Tuo; Olesen, Claus; Møller, Jesper V.; Nissen, Poul; Schlichting, Ilme

    2015-06-11

    Membrane proteins are key players in biological systems, mediating signalling events and the specific transport ofe.g.ions and metabolites. Consequently, membrane proteins are targeted by a large number of currently approved drugs. Understanding their functions and molecular mechanisms is greatly dependent on structural information, not least on complexes with functionally or medically important ligands. Structure determination, however, is hampered by the difficulty of obtaining well diffracting, macroscopic crystals. Here, the feasibility of X-ray free-electron-laser-based serial femtosecond crystallography (SFX) for the structure determination of membrane protein–ligand complexes using microcrystals of various native-source and recombinant P-type ATPase complexes is demonstrated. The data reveal the binding sites of a variety of ligands, including lipids and inhibitors such as the hallmark P-type ATPase inhibitor orthovanadate. By analyzing the resolution dependence of ligand densities and overall model qualities, SFX data quality metrics as well as suitable refinement procedures are discussed. Even at relatively low resolution and multiplicity, the identification of ligands can be demonstrated. This makes SFX a useful tool for ligand screening and thus for unravelling the molecular mechanisms of biologically active proteins.

  10. Implementing the LIM code: the structural basis for cell type-specific assembly of LIM-homeodomain complexes

    Energy Technology Data Exchange (ETDEWEB)

    Bhati, Mugdha; Lee, Christopher; Nancarrow, Amy L.; Lee, Mihwa; Craig, Vanessa J.; Bach, Ingolf; Guss, J. Mitchell; Mackay, Joel P.; Matthews, Jacqueline M. (UMASS, MED); (Sydney)

    2008-09-03

    LIM-homeodomain (LIM-HD) transcription factors form a combinatorial 'LIM code' that contributes to the specification of cell types. In the ventral spinal cord, the binary LIM homeobox protein 3 (Lhx3)/LIM domain-binding protein 1 (Ldb1) complex specifies the formation of V2 interneurons. The additional expression of islet-1 (Isl1) in adjacent cells instead specifies the formation of motor neurons through assembly of a ternary complex in which Isl1 contacts both Lhx3 and Ldb1, displacing Lhx3 as the binding partner of Ldb1. However, little is known about how this molecular switch occurs. Here, we have identified the 30-residue Lhx3-binding domain on Isl1 (Isl1{sub LBD}). Although the LIM interaction domain of Ldb1 (Ldb1{sub LID}) and Isl1{sub LBD} share low levels of sequence homology, X-ray and NMR structures reveal that they bind Lhx3 in an identical manner, that is, Isl1{sub LBD} mimics Ldb1{sub LID}. These data provide a structural basis for the formation of cell type-specific protein-protein interactions in which unstructured linear motifs with diverse sequences compete to bind protein partners. The resulting alternate protein complexes can target different genes to regulate key biological events.

  11. On the stability of a POCsp3OP-type pincer ligand in nickel(II) complexes.

    Science.gov (United States)

    Hao, Jingjun; Mougang-Soumé, Berline; Vabre, Boris; Zargarian, Davit

    2014-03-17

    We describe the results of a study on the stabilities of pincer-type nickel complexes relevant to catalytic hydroalkoxylation and hydroamination of olefins, C-C and C-X couplings, and fluorination of alkyl halides. Complexes [(POCsp3 OP)NiX] are stable for X=OSiMe3 , OMes (Mes=1,3,5-Me3 C6 H2), NPh2, and CC-H, whereas the O(tBu) and N(SiMe3)2 derivatives decompose readily. The phenylacetylide derivative transforms gradually into the zero-valent species cis-[{κ(P),κ(C),κ(C')-(iPr2 POCH2 CHCH2 )}Ni{η(2),κ(C),κ(C')-(iPr2 P(O)CCPh)}]. Likewise, attempts to prepare [(POCsp3 OP)NiF] gave instead the zwitterionic trinuclear species [{(η(3) -allyl)Ni}2-{μ,κ(P),κ(O)-(iPr2 PO)4 Ni}]. Characterization of these two complexes provides concrete examples of decomposition processes that can dismantle POCsp3 OP-type pincer ligands by facile C-O bond rupture. These results serve as a cautionary tale for the inherent structural fragility of pincer systems bearing phosphinite donor moieties, and provide guidelines on how to design more robust analogues. © 2014 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  12. Structural studies of P-type ATPase–ligand complexes using an X-ray free-electron laser

    Directory of Open Access Journals (Sweden)

    Maike Bublitz

    2015-07-01

    Full Text Available Membrane proteins are key players in biological systems, mediating signalling events and the specific transport of e.g. ions and metabolites. Consequently, membrane proteins are targeted by a large number of currently approved drugs. Understanding their functions and molecular mechanisms is greatly dependent on structural information, not least on complexes with functionally or medically important ligands. Structure determination, however, is hampered by the difficulty of obtaining well diffracting, macroscopic crystals. Here, the feasibility of X-ray free-electron-laser-based serial femtosecond crystallography (SFX for the structure determination of membrane protein–ligand complexes using microcrystals of various native-source and recombinant P-type ATPase complexes is demonstrated. The data reveal the binding sites of a variety of ligands, including lipids and inhibitors such as the hallmark P-type ATPase inhibitor orthovanadate. By analyzing the resolution dependence of ligand densities and overall model qualities, SFX data quality metrics as well as suitable refinement procedures are discussed. Even at relatively low resolution and multiplicity, the identification of ligands can be demonstrated. This makes SFX a useful tool for ligand screening and thus for unravelling the molecular mechanisms of biologically active proteins.

  13. Multiscale complexity analysis of the cardiac control identifies asymptomatic and symptomatic patients in long QT syndrome type 1.

    Directory of Open Access Journals (Sweden)

    Vlasta Bari

    Full Text Available The study assesses complexity of the cardiac control directed to the sinus node and to ventricles in long QT syndrome type 1 (LQT1 patients with KCNQ1-A341V mutation. Complexity was assessed via refined multiscale entropy (RMSE computed over the beat-to-beat variability series of heart period (HP and QT interval. HP and QT interval were approximated respectively as the temporal distance between two consecutive R-wave peaks and between the R-wave apex and T-wave end. Both measures were automatically taken from 24-hour electrocardiographic Holter traces recorded during daily activities in non mutation carriers (NMCs, n = 14 and mutation carriers (MCs, n = 34 belonging to a South African LQT1 founder population. The MC group was divided into asymptomatic (ASYMP, n = 11 and symptomatic (SYMP, n = 23 patients according to the symptom severity. Analyses were carried out during daytime (DAY, from 2PM to 6PM and nighttime (NIGHT, from 12PM to 4AM off and on beta-adrenergic blockade (BBoff and BBon. We found that the complexity of the HP variability at short time scale was under vagal control, being significantly increased during NIGHT and BBon both in ASYMP and SYMP groups, while the complexity of both HP and QT variability at long time scales was under sympathetic control, being smaller during NIGHT and BBon in SYMP subjects. Complexity indexes at long time scales in ASYMP individuals were smaller than those in SYMP ones regardless of therapy (i.e. BBoff or BBon, thus suggesting that a reduced complexity of the sympathetic regulation is protective in ASYMP individuals. RMSE analysis of HP and QT interval variability derived from routine 24-hour electrocardiographic Holter recordings might provide additional insights into the physiology of the cardiac control and might be fruitfully exploited to improve risk stratification in LQT1 population.

  14. Orai1 enhances muscle endurance by promoting fatigue-resistant type I fiber content but not through acute store-operated Ca2+ entry

    Science.gov (United States)

    Carrell, Ellie M.; Coppola, Aundrea R.; McBride, Helen J.; Dirksen, Robert T.

    2016-01-01

    Orai1 is a transmembrane protein that forms homomeric, calcium-selective channels activated by stromal interaction molecule 1 (STIM1) after depletion of intracellular calcium stores. In adult skeletal muscle, depletion of sarcoplasmic reticulum calcium activates STIM1/Orai1-dependent store-operated calcium entry. Here, we used constitutive and inducible muscle-specific Orai1-knockout (KO) mice to determine the acute and long-term developmental effects of Orai1 ablation on muscle structure and function. Skeletal muscles from constitutive, muscle-specific Orai-KO mice exhibited normal postnatal growth and fiber type differentiation. However, a significant reduction in fiber cross-sectional area occurred by 3 mo of age, with the most profound reduction observed in oxidative, fatigue-resistant fiber types. Soleus muscles of constitutive Orai-KO mice exhibited a reduction in unique type I fibers, concomitant with an increase in hybrid fibers expressing both type I and type IIA myosins. Additionally, ex vivo force measurements showed reduced maximal specific force and in vivo exercise assays revealed reduced endurance in constitutive muscle-specific Orai-KO mice. Using tamoxifen-inducible, muscle-specific Orai-KO mice, these functional deficits were found to be the result of the delayed fiber changes resulting from an early developmental loss of Orai1 and not the result of an acute loss of Orai1-dependent store-operated calcium entry.—Carrell, E. M., Coppola, A. R., McBride, H. J., Dirksen, R. T. Orai1 enhances muscle endurance by promoting fatigue-resistant type I fiber content but not through acute store-operated Ca2+ entry. PMID:27587568

  15. Complex regional pain syndrome – type I: What’s in a name?

    Science.gov (United States)

    Coderre, Terence J.

    2015-01-01

    Within a two year period in the 1940’s, two Boston physicians published dramatically opposing views on the underlying nature of a syndrome now known as complex regional pain syndrome (CRPS). Evans suggested, in several papers in 1946–1947, that sympathetic reflexes maintain pain and dystrophy in affected limbs. Foisie, in 1947, suggested arterial vasospasms were key in the etiology of this pain syndrome. Evans’ hypothesis established the nomenclature for this syndrome for 60 years, and his term “reflex sympathetic dystrophy” guided clinical treatment and research activities over the same period. Foisie’s proposed nomenclature was unrecognized, and had virtually no impact on the field. Recent evidence suggests that Evans’ contribution to the field may have in fact lead clinicians and researchers astray all those years. This focus article on CRPS compares recent observations with these 2 earlier theories and asks the question -- what if we had adopted Foisie’s nomenclature from the beginning? PMID:20634146

  16. High-resolution metagenomics targets major functional types in complex microbial communities

    Energy Technology Data Exchange (ETDEWEB)

    Kalyuzhnaya, Marina G.; Lapidus, Alla; Ivanova, Natalia; Copeland, Alex C.; McHardy, Alice C.; Szeto, Ernest; Salamov, Asaf; Grigoriev, Igor V.; Suciu, Dominic; Levine, Samuel R.; Markowitz, Victor M.; Rigoutsos, Isidore; Tringe, Susannah G.; Bruce, David C.; Richardson, Paul M.; Lidstrom, Mary E.; Chistoserdova, Ludmila

    2009-08-01

    Most microbes in the biosphere remain uncultured and unknown. Whole genome shotgun (WGS) sequencing of environmental DNA (metagenomics) allows glimpses into genetic and metabolic potentials of natural microbial communities. However, in communities of high complexity metagenomics fail to link specific microbes to specific ecological functions. To overcome this limitation, we selectively targeted populations involved in oxidizing single-carbon (C{sub 1}) compounds in Lake Washington (Seattle, USA) by labeling their DNA via stable isotope probing (SIP), followed by WGS sequencing. Metagenome analysis demonstrated specific sequence enrichments in response to different C{sub 1} substrates, highlighting ecological roles of individual phylotypes. We further demonstrated the utility of our approach by extracting a nearly complete genome of a novel methylotroph Methylotenera mobilis, reconstructing its metabolism and conducting genome-wide analyses. This approach allowing high-resolution genomic analysis of ecologically relevant species has the potential to be applied to a wide variety of ecosystems.

  17. Complex genetic architecture of cardiac disease in a wild type inbred strain of Drosophila melanogaster.

    Directory of Open Access Journals (Sweden)

    Zhi Zhang

    Full Text Available Natural populations of the fruit fly, Drosophila melanogaster, segregate genetic variation that leads to cardiac disease phenotypes. One nearly isogenic line from a North Carolina peach orchard, WE70, is shown to harbor two genetically distinct heart phenotypes: elevated incidence of arrhythmias, and a dramatically constricted heart diameter in both diastole and systole, with resemblance to restrictive cardiomyopathy in humans. Assuming the source to be rare variants of large effect, we performed Bulked Segregant Analysis using genomic DNA hybridization to Affymetrix chips to detect single feature polymorphisms, but found that the mutant phenotypes are more likely to have a polygenic basis. Further mapping efforts revealed a complex architecture wherein the constricted cardiomyopathy phenotype was observed in individual whole chromosome substitution lines, implying that variants on both major autosomes are sufficient to produce the phenotype. A panel of 170 Recombinant Inbred Lines (RIL was generated, and a small subset of mutant lines selected, but these each complemented both whole chromosome substitutions, implying a non-additive (epistatic contribution to the "disease" phenotype. Low coverage whole genome sequencing was also used to attempt to map chromosomal regions contributing to both the cardiomyopathy and arrhythmia, but a polygenic architecture had to be again inferred to be most likely. These results show that an apparently simple rare phenotype can have a complex genetic basis that would be refractory to mapping by deep sequencing in pedigrees. We present this as a cautionary tale regarding assumptions related to attempts to map new disease mutations on the assumption that probands carry a single causal mutation.

  18. Importance of brood maintenance terms in simple models of the honeybee - Varroa destructor - acute bee paralysis virus complex

    Directory of Open Access Journals (Sweden)

    Hermann J. Eberl

    2010-09-01

    Full Text Available We present a simple mathematical model of the infestation of a honeybee colony by the Acute Paralysis Virus, which is carried by parasitic varroa mites (Varroa destructor. This is a system of nonlinear ordinary differential equations for the dependent variables: number of mites that carry the virus, number of healthy bees and number of sick bees. We study this model with a mix of analytical and computational techniques. Our results indicate that, depending on model parameters and initial data, bee colonies in which the virus is present can, over years, function seemingly like healthy colonies before they decline and disappear rapidly (e.g. Colony Collapse Disorder, wintering losses. This is a consequence of the fact that a certain number of worker bees is required in a colony to maintain and care for the brood, in order to ensure continued production of new bees.

  19. Whole genome typing of the recently emerged Canadian serogroup W Neisseria meningitidis sequence type 11 clonal complex isolates associated with invasive meningococcal disease

    Directory of Open Access Journals (Sweden)

    Raymond S.W. Tsang

    2018-04-01

    Full Text Available Objectives: This study was performed to analyze the Canadian invasive serogroup W Neisseria meningitidis (MenW sequence type 11 (ST-11 clonal complex (CC isolates by whole genome typing and to compare Canadian isolates with similar isolates from elsewhere. Methods: Whole genome typing of 30 MenW ST-11 CC, 20 meningococcal group C (MenC ST-11 CC, and 31 MenW ST-22 CC isolates was performed on the Bacterial Isolate Genome Sequence database platform. Canadian MenW ST-11 CC isolates were compared with the 2000 MenW Hajj outbreak strain, as well as with MenW ST-11 CC from other countries. Results: Whole genome typing showed that the Canadian MenW ST-11 CC isolates were distinct from the traditional MenW ST-22 CC; they were not capsule-switched contemporary MenC strains that incorporated MenW capsules. While some recent MenW disease cases in Canada were caused by MenW ST-11 CC isolates showing relatedness to the 2000 MenW Hajj strain, many were non-Hajj isolates similar to current MenW ST-11 isolates found globally. Geographical and temporal variations in genotypes and surface protein antigen genes were found among the MenW ST-11 CC isolates. Conclusions: The current MenW ST-11 isolates did not arise by capsule switching from contemporary MenC ST-11 isolates. Both the Hajj-related and non-Hajj MenW ST-11 CC strains were associated with invasive meningococcal disease in Canada. Keywords: Neisseria meningitidis, Invasive meningococcal disease, Whole genome typing

  20. B lineage acute lymphoblastic leukemia transformation in a child with juvenile myelomonocytic leukemia, type 1 neurofibromatosis and monosomy of chromosome 7. Possible implications in the leukemogenesis

    DEFF Research Database (Denmark)

    Scrideli, Carlos Alberto; Baruffi, Marcelo Razera; Rogatto, Silvia Regina

    2003-01-01

    This report describes the case of an 8-month-old infant with a diagnosis of juvenile myelomonocytic leukemia (JMML) and type 1 neurofibromatosis that presented progression to B lineage acute lymphoid leukemia (ALL). The same rearrangement of gene T-cell receptor gamma (TCR gamma) was detected upon...... diagnosis of JMML and ALL, suggesting that both neoplasias may have evolved from the same clone. Our results support the theory that JMML may derive from pluripotential cells and that the occurrence of monosomy of chromosome 7 within a clone of cells having an aberrant neurofibromatosis type 1 (NF1) gene...

  1. Biodegradation pattern of hydrocarbons from a fuel oil-type complex residue by an emulsifier-producing microbial consortium.

    Science.gov (United States)

    Nievas, M L; Commendatore, M G; Esteves, J L; Bucalá, V

    2008-06-15

    The biodegradation of a hazardous waste (bilge waste), a fuel oil-type complex residue from normal ship operations, was studied in a batch bioreactor using a microbial consortium in seawater medium. Experiments with initial concentrations of 0.18 and 0.53% (v/v) of bilge waste were carried out. In order to study the biodegradation kinetics, the mass of n-alkanes, resolved hydrocarbons and unresolved complex mixture (UCM) hydrocarbons were assessed by gas chromatography (GC). Emulsification was detected in both experiments, possibly linked to the n-alkanes depletion, with differences in emulsification start times and extents according to the initial hydrocarbon concentration. Both facts influenced the hydrocarbon biodegradation kinetics. A sequential biodegradation of n-alkanes and UMC was found for the higher hydrocarbon content. Being the former growth associated, while UCM biodegradation was a non-growing process showing enzymatic-type biodegradation kinetics. For the lower hydrocarbon concentration, simultaneous biodegradation of n-alkanes and UMC were found before emulsification. Nevertheless, certain UCM biodegradation was observed after the medium emulsification. According to the observed kinetics, three main types of hydrocarbons (n-alkanes, biodegradable UCM and recalcitrant UCM) were found adequate to represent the multicomponent substrate (bilge waste) for future modelling of the biodegradation process.

  2. On twisting type [N] ⊗ [N] Ricci flat complex spacetimes with two homothetic symmetries

    Science.gov (United States)

    Chudecki, Adam; Przanowski, Maciej

    2018-04-01

    In this article, H H spaces of type [N] ⊗ [N] with twisting congruence of null geodesics defined by the 4-fold undotted and dotted Penrose spinors are investigated. It is assumed that these spaces admit two homothetic symmetries. The general form of the homothetic vector fields is found. New coordinates are introduced, which enable us to reduce the H H system of partial differential equations to one ordinary differential equation (ODE) on one holomorphic function. In a special case, this is a second-order ODE and its general solution is explicitly given. In the generic case, one gets rather involved fifth-order ODE.

  3. Complex association of serum alanine aminotransferase with the risk of future cardiovascular disease in type 2 diabetes.

    Science.gov (United States)

    Afarideh, Mohsen; Aryan, Zahra; Ghajar, Alireza; Noshad, Sina; Nakhjavani, Manouchehr; Baber, Usman; Mechanick, Jeffrey I; Esteghamati, Alireza

    2016-11-01

    We aimed to determine the prospective association between baseline serum levels of alanine aminotransferase (ALT) and the incident cardiovascular disease (CVD) in people with type 2 diabetes. In an open cohort setting, people with type 2 diabetes were followed for their first ever CVD presentation from 1995 to 2015. Statistical methods included Cox regression analysis for reporting of hazard ratios (HRs), artificial neural network modelings, and risk reclassification analyses. We found a nearly constant CVD hazard with baseline serum ALT levels below the 30 IU/L mark, whereas baseline serum ALT levels ≥ 30 IU/L remained an independent predictor of lower CVD rates in patients with type 2 diabetes in the final multivariate Cox proportional hazards regression model (HR: 0.204, 95%CI [0.060-0.689], p for trend value = 0.006). Age, male gender and fasting plasma insulin levels independently predicted baseline serum ALT ≥ 30 IU/L among the population cohort. Augmentation of serum ALT into the weighted Framingham risk score resulted in a considerable net reclassification improvement (NRI) of coronary heart disease (CHD) risk prediction in the study population (NRI = 9.05% (8.01%-10.22%), p value < 0.05). Serum ALT could successfully reclassify about 9% of the population with type 2 diabetes across the CHD-affected and CHD-free categories. Overall, our findings demonstrate a complex and nonlinear relationship for the risk of future CVD by baseline serum ALT levels in patients with type 2 diabetes. Further studies are warranted to confirm whether this complex association could be translated into a clearly visible U or J-shaped figure. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  4. Life-Threatening Ventricular Arrhythmia and Brugada-Type ST-Segment Elevation Associated With Acute Ischemia of the Right Ventricular Outflow Tract.

    Science.gov (United States)

    Nakamura, Rena; Nishizaki, Mitsuhiro; Lee, Kiko; Shimizu, Masato; Fujii, Hiroyuki; Yamawake, Noriyoshi; Sakurada, Harumizu; Hiraoka, Masayasu; Isobe, Mitsuaki

    2017-02-24

    Brugada-type ECG (Br-ECG) is occasionally observed during acute myocardial ischemia of the right ventricular outflow tract (RVOT). No studies have explored, however, the association of ventricular tachyarrhythmia and development of Br-ECG due to acute ischemia of the RVOT.Methods and Results:The study included 13 consecutive patients with acute ischemia of the RVOT during coronary catheterization. Patients were divided into 2 groups: those with Br-ECG (group B) and those without (group N). The proportion of male patients was higher in group B than in group N (100% vs. 25%, Pright ventricular (RV) branch of the right coronary artery and no VT/VF was seen in patients with organic coronary stenosis despite Br-ECG. Acute myocardial ischemia of the RVOT caused Br-ECG predominantly in male patients and subsequent development of VT/VF in some patients. VT/VF was seen in patients without any obstructive lesion but arrhythmic events were not observed in RVOT ischemia in the case of pre-existing coronary occlusion or stenosis of the conus or RV branch, suggesting the effects of precondition.

  5. Spatiotemporal Characteristics of QRS Complexes Enable the Diagnosis of Brugada Syndrome Regardless of the Appearance of a Type 1 ECG.

    Science.gov (United States)

    Guillem, Maria S; Climent, Andreu M; Millet, José; Berne, Paola; Ramos, Rafael; Brugada, Josep; Brugada, Ramon

    2016-05-01

    The diagnosis of Brugada syndrome based on the ECG is hampered by the dynamic nature of its ECG manifestations. Brugada syndrome patients are only 25% likely to present a type 1 ECG. The objective of this study is to provide an ECG diagnostic criterion for Brugada syndrome patients that can be applied consistently even in the absence of a type 1 ECG. We recorded 67-lead body surface potential maps from 94 Brugada syndrome patients and 82 controls (including right bundle branch block patients and healthy individuals). The spatial propagation direction during the last r' wave and the slope at the end of the QRS complex were measured and compared between patients groups. Receiver-operating characteristic curves were constructed for half of the database to identify optimal cutoff values; sensitivity and specificity for these cutoff values were measured in the other half of the database. A spontaneous type 1 ECG was present in only 30% of BrS patients. An orientation in the sagittal plane syndrome with a sensitivity of 69% and a specificity of 97% in non-type 1 Brugada syndrome patients. Spatiotemporal characteristics of surface ECG recordings can enable a robust identification of BrS even without the presence of a type 1 ECG. © 2016 Wiley Periodicals, Inc.

  6. Complexity of Type 2 Diabetes Mellitus Data Sets Emerging from Nutrigenomic Research: A Case for Dimensionality Reduction?

    Science.gov (United States)

    Kaput, Jim; Dawson, Kevin

    2007-01-01

    Nutrigenomics promises personalized nutrition and an improvement in preventing, delaying, and reducing the symptoms of chronic diseases such as diabetes. Nutritional genomics is the study of how foods affect the expression of genetic information in an individual and how an individual's genetic makeup affects the metabolism and response to nutrients and other bioactive components in food. The path to those promises has significant challenges, from experimental designs that include analysis of genetic heterogeneity to the complexities of food and environmental factors. One of the more significant complications in developing the knowledge base and potential applications is how to analyze high-dimensional datasets of genetic, nutrient, metabolomic (clinical), and other variables influencing health and disease processes. Type 2 diabetes mellitus (T2DM) is used as an illustration of the challenges in studying complex phenotypes with nutrigenomics concepts and approaches. PMID:17559889

  7. Complexity of type 2 diabetes mellitus data sets emerging from nutrigenomic research: a case for dimensionality reduction?

    Science.gov (United States)

    Kaput, Jim; Dawson, Kevin

    2007-09-01

    Nutrigenomics promises personalized nutrition and an improvement in preventing, delaying, and reducing the symptoms of chronic diseases such as diabetes. Nutritional genomics is the study of how foods affect the expression of genetic information in an individual and how an individual's genetic makeup affects the metabolism and response to nutrients and other bioactive components in food. The path to those promises has significant challenges, from experimental designs that include analysis of genetic heterogeneity to the complexities of food and environmental factors. One of the more significant complications in developing the knowledge base and potential applications is how to analyze high-dimensional datasets of genetic, nutrient, metabolomic (clinical), and other variables influencing health and disease processes. Type 2 diabetes mellitus (T2DM) is used as an illustration of the challenges in studying complex phenotypes with nutrigenomics concepts and approaches.

  8. Type I Interferon Induced Epigenetic Regulation of Macrophages Suppresses Innate and Adaptive Immunity in Acute Respiratory Viral Infection.

    Directory of Open Access Journals (Sweden)

    Danielle N Kroetz

    2015-12-01

    Full Text Available Influenza A virus (IAV is an airborne pathogen that causes significant morbidity and mortality each year. Macrophages (Mϕ are the first immune population to encounter IAV virions in the lungs and are required to control infection. In the present study, we explored the mechanism by which cytokine signaling regulates the phenotype and function of Mϕ via epigenetic modification of chromatin. We have found that type I interferon (IFN-I potently upregulates the lysine methyltransferase Setdb2 in murine and human Mϕ, and in turn Setdb2 regulates Mϕ-mediated immunity in response to IAV. The induction of Setdb2 by IFN-I was significantly impaired upon inhibition of the JAK-STAT signaling cascade, and chromatin immunoprecipitation revealed that both STAT1 and interferon regulatory factor 7 bind upstream of the transcription start site to induce expression. The generation of Setdb2LacZ reporter mice revealed that IAV infection results in systemic upregulation of Setdb2 in myeloid cells. In the lungs, alveolar Mϕ expressed the highest level of Setdb2, with greater than 70% lacZ positive on day 4 post-infection. Silencing Setdb2 activity in Mϕ in vivo enhanced survival in lethal IAV infection. Enhanced host protection correlated with an amplified antiviral response and less obstruction to the airways. By tri-methylating H3K9, Setdb2 silenced the transcription of Mx1 and Isg15, antiviral effectors that inhibit IAV replication. Accordingly, a reduced viral load in knockout mice on day 8 post-infection was linked to elevated Isg15 and Mx1 transcript in the lungs. In addition, Setdb2 suppressed the expression of a large number of other genes with proinflammatory or immunomodulatory function. This included Ccl2, a chemokine that signals through CCR2 to regulate monocyte recruitment to infectious sites. Consistently, knockout mice produced more CCL2 upon IAV infection and this correlated with a 2-fold increase in the number of inflammatory monocytes and

  9. GLP-1-Based Therapies Have No Microvascular Effects in Type 2 Diabetes Mellitus: An Acute and 12-Week Randomized, Double-Blind, Placebo-Controlled Trial.

    Science.gov (United States)

    Smits, Mark M; Tonneijck, Lennart; Muskiet, Marcel H A; Hoekstra, Trynke; Kramer, Mark H H; Diamant, Michaela; Serné, Erik H; van Raalte, Daniël H

    2016-10-01

    To assess the effects of glucagon-like peptide (GLP)-1-based therapies (ie, GLP-1 receptor agonists and dipeptidyl peptidase-4 inhibitors) on microvascular function in patients with type 2 diabetes mellitus. We studied 57 patients with type 2 diabetes mellitus (mean±SD age: 62.8±6.9 years; body mass index: 31.8±4.1 kg/m(2); HbA1c [glycated hemoglobin] 7.3±0.6%) in an acute and 12-week randomized, placebo-controlled, double-blind trial conducted at the Diabetes Center of the VU University Medical Center. In the acute study, the GLP-1 receptor agonist exenatide (therapeutic concentrations) or placebo (saline 0.9%) was administered intravenously. During the 12-week study, patients received the GLP-1 receptor agonist liraglutide (1.8 mg daily), the dipeptidyl peptidase-4 inhibitor sitagliptin (100 mg daily), or matching placebos. Capillary perfusion was assessed by nailfold skin capillary videomicroscopy and vasomotion by laser Doppler fluxmetry, in the fasting state and after a high-fat mixed meal. In neither study, treatment affected fasting or postprandial capillary perfusion compared with placebo (P>0.05). In the fasting state, acute exenatide infusion increased neurogenic vasomotion domain power, while reducing myogenic domain power (both P2-week study, no effects on vasomotion were observed. Despite modest changes in vasomotion, suggestive of sympathetic nervous system activation and improved endothelial function, acute exenatide infusion does not affect skin capillary perfusion in type 2 diabetes mellitus. Twelve-week treatment with liraglutide or sitagliptin has no effect on capillary perfusion or vasomotion in these patients. Our data suggest that the effects of GLP-1-based therapies on glucose are not mediated through microvascular responses. © 2016 American Heart Association, Inc.

  10. Detection of Immune-Complex Dissociated Nonstructural-1 (NS-1) Antigen in Patients with Acute Dengue Virus Infections

    NARCIS (Netherlands)

    P. Koraka (Penelope); C.P. Burghoorn-Maas; A. Falconar; T.E. Setiati (Tatty); K. Djamiatun; J. Groen (Jan); A.D.M.E. Osterhaus (Albert)

    2003-01-01

    textabstractAccurate and timely diagnosis of dengue virus (DEN) infections is essential for the differential diagnosis of patients with febrile illness and hemorrhagic fever. In the present study, the diagnostic value of a newly developed immune-complex dissociated nonstructural-1 (NS-1) antigen dot

  11. Structures, microfabrics and textures of the Cordilleran-type Rechnitz metamorphic core complex, Eastern Alps☆

    Science.gov (United States)

    Cao, Shuyun; Neubauer, Franz; Bernroider, Manfred; Liu, Junlai; Genser, Johann

    2013-01-01

    Rechnitz window group represents a Cordilleran-style metamorphic core complex, which is almost entirely located within nearly contemporaneous Neogene sediments at the transition zone between the Eastern Alps and the Neogene Pannonian basin. Two tectonic units are distinguished within the Rechnitz metamorphic core complex (RMCC): (1) a lower unit mainly composed of Mesozoic metasediments, and (2) an upper unit mainly composed of ophiolite remnants. Both units are metamorphosed within greenschist facies conditions during earliest Miocene followed by exhumation and cooling. The internal structure of the RMCC is characterized by the following succession of structure-forming events: (1) blueschist relics of Paleocene/Eocene age formed as a result of subduction (D1), (2) ductile nappe stacking (D2) of an ophiolite nappe over a distant passive margin succession (ca. E–W to WNW–ESE oriented stretching lineation), (3) greenschist facies-grade metamorphism annealing dominant in the lower unit, and (4) ductile low-angle normal faulting (D3) (with mainly NE–SW oriented stretching lineation), and (5) ca. E to NE-vergent folding (D4). The microfabrics are related to mostly ductile nappe stacking to ductile low-angle normal faulting. Paleopiezometry in conjunction with P–T estimates yield high strain rates of 10− 11 to 10− 13 s− 1, depending on the temperature (400–350 °C) and choice of piezometer and flow law calibration. Progressive microstructures and texture analysis indicate an overprint of the high-temperature fabrics (D2) by the low-temperature deformation (D3). Phengitic mica from the Paleocene/Eocene high-pressure metamorphism remained stable during D2 ductile deformation as well as preserved within late stages of final sub-greenschist facies shearing. Chlorite geothermometry yields two temperature groups, 376–328 °C, and 306–132 °C. Chlorite is seemingly accessible to late-stage resetting. The RMCC underwent an earlier large-scale coaxial

  12. SHOP-type nickel complexes with alkyl substituents on phosphorus, synthesis and catalytic ethylene oligomerization.

    Science.gov (United States)

    Kermagoret, Anthony; Braunstein, Pierre

    2008-02-14

    The beta-keto phosphorus ylides (n-Bu)3P=CHC(O)Ph 6, (t-Bu)2PhP=CHC(O)Ph 7, (t-Bu)Ph2P=CHC(O)Ph 8, (n-Bu)2PhP=CHC(O)Ph 9, (n-Bu)Ph2P=CHC(O)Ph 10, Me2PhP=CHC(O)Ph 11 and Ph3P=CHC(O)(o-OMe-C6H4) 12 have been synthesized in 80-96% yields. The Ni(II) complexes [NiPh{Ph2PCH...C(...O)(o-OMeC6H4)}(PPh3)] 13, [NiPh{Ph(t-Bu)PCHC(O)Ph}(PPh3)] 15, [NiPh{(n-Bu)2PCH...C(...O)Ph}(PPh3)] 16 and [NiPh{Ph(n-Bu)PCH...C(...O)Ph}(PPh3)] 17 have been prepared by reaction of equimolar amounts of [Ni(COD)2] and PPh3 with the beta-keto phosphorus ylides 12 or 8-10, respectively, and characterized by 1H and 31P{1H} NMR spectroscopy. NMR studies and the crystal structure determination of 13 indicated an interaction between the hydrogen atom of the C-H group alpha to phosphorus and the ether function. The complexes [NiPh{Ph2PCHC(O)Ph}(Py)] 18, [NiPh{Ph(t-Bu)PCHC(O)Ph}(Py)] 19, [NiPh{(n-Bu)2PCH...C(...O)Ph}(Py)] 20, [NiPh{Ph(n-Bu)PCH...C(...O)Ph}(Py)] 21 and [NiPh{Me2PCH...C(...O)Ph}(Py)] 22 have been isolated from the reactions of [Ni(COD)2] and an excess of pyridine with the -keto phosphorus ylides Ph3PCH=C(O)Ph 3 or 8-11, respectively, and characterized by 1H and 31P{1H} NMR spectroscopy. Ligands 3, 8, 10 and 12 have been used to prepare in situ oligomerization catalysts by reaction with one equiv. of [Ni(COD)2] and PPh3 under an ethylene pressure of 30 or 60 bar. The catalyst prepared in situ from 12, [Ni(COD)2] and PPh3 was the most active of the series with a TON of 12700 mol C2H4 (mol Ni)-1 under 30 bar ethylene. When the beta-keto phosphorus ylide 8 was reacted in situ with three equiv. of [Ni(COD)2] and one equiv. of PPh3 under 30 bar of ethylene, ethylene polymerization was observed with a TON of 5500 mol C2H4 (mol Ni)-1.

  13. Effects of Mirror Therapy in Stroke Patients With Complex Regional Pain Syndrome Type 1: A Randomized Controlled Study.

    Science.gov (United States)

    Pervane Vural, Secil; Nakipoglu Yuzer, Guldal Funda; Sezgin Ozcan, Didem; Demir Ozbudak, Sibel; Ozgirgin, Nese

    2016-04-01

    To investigate the effects of mirror therapy on upper limb motor functions, spasticity, and pain intensity in patients with hemiplegia accompanied by complex regional pain syndrome type 1. Randomized controlled trial. Training and research hospital. Adult patients with first-time stroke and simultaneous complex regional pain syndrome type 1 of the upper extremity at the dystrophic stage (N=30). Both groups received a patient-specific conventional stroke rehabilitation program for 4 weeks, 5 d/wk, for 2 to 4 h/d. The mirror therapy group received an additional mirror therapy program for 30 min/d. We evaluated the scores of the Brunnstrom recovery stages of the arm and hand for motor recovery, wrist and hand subsections of the Fugl-Meyer Assessment (FMA) and motor items of the FIM-motor for functional status, Modified Ashworth Scale (MAS) for spasticity, and visual analog scale (VAS) for pain severity. After 4 weeks of rehabilitation, both groups had significant improvements in the FIM-motor and VAS scores compared with baseline scores. However, the scores improved more in the mirror therapy group than the control group (P<.001 and P=.03, respectively). Besides, the patients in the mirror therapy arm showed significant improvement in the Brunnstrom recovery stages and FMA scores (P<.05). No significant difference was found for MAS scores. In patients with stroke and simultaneous complex regional pain syndrome type 1, addition of mirror therapy to a conventional stroke rehabilitation program provides more improvement in motor functions of the upper limb and pain perception than conventional therapy without mirror therapy. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  14. Effective half metallocene type titanium complex catalyst for the olefin polymerization; Orefuin jugo ni yukona hafu metarosen gata chitan sakutai shokubai

    Energy Technology Data Exchange (ETDEWEB)

    Nomura, Kotohiro [Nara Institute of Sience and Technology, Nara (Japan)

    1999-10-01

    From the conventional metallocene complex catalyst, ethylene system copolymer of the wide alpha olefin content can efficiently synthesize titanium complex catalyst of the half metallocene type, when it is used. It became clear that the monomer arrangement differed by the substituent on using ligand, when the non-cross-linking complex catalyst was used, while the monomer arrangement of the copolymer was a statistical random array in the cross-linking cyclopentadienyl - amide (CGC) complex catalyst. (NEDO)

  15. The evolution of complex type B Allende inclusion - An ion microprobe trace element study

    Science.gov (United States)

    Macpherson, Glenn J.; Crozaz, Ghislaine; Lundberg, Laura L.

    1989-01-01

    Results are presented of a detailed trace-element and isotopic analyses of the constituent phases in each of the major textural parts (mantle, core, and islands) of a Type B refractory inclusion, the USNM 5241 inclusion from Allende, first described by El Goresy et al. (1985). The REE data on 5241 were found to be largely consistent with a model in which the mantle and the core of 5241 formed sequentially out of a single melt by fractional crystallization. The numerical models of REE evolution in the 5241 melt, especially that of Eu, require that a significant mass of spinel-free island material was assimilated into the evolving melt during the last half of the solidification history of 5241. The trace element results pbtained thus strongly support the interpretation of El Goresy et al. (1985) that the spinel-free islands in the 5241 are trapped xenoliths.

  16. Ru complexes of Hoveyda–Grubbs type immobilized on lamellar zeolites: activity in olefin metathesis reactions

    Directory of Open Access Journals (Sweden)

    Hynek Balcar

    2015-11-01

    Full Text Available Hoveyda–Grubbs type catalysts with cationic tags on NHC ligands were linker-free immobilized on the surface of lamellar zeolitic supports (MCM-22, MCM-56, MCM-36 and on mesoporous molecular sieves SBA-15. The activity of prepared hybrid catalysts was tested in olefin metathesis reactions: the activity in ring-closing metathesis of citronellene and N,N-diallyltrifluoroacetamide decreased in the order of support MCM-22 ≈ MCM-56 > SBA-15 > MCM-36; the hybrid catalyst based on SBA-15 was found the most active in self-metathesis of methyl oleate. All catalysts were reusable and exhibited low Ru leaching (− counter anion; in contrast, PF6− counter anion underwent partial decomposition.

  17. Folylpolyglutamate Synthetase Gene Transcription is Regulated by a Multiprotein Complex that Binds the TEL-AML1 Fusion in Acute Lymphoblastic Leukemia

    Science.gov (United States)

    Leclerc, Guy J.; Sanderson, Christopher; Hunger, Stephen; Devidas, Meenakshi; Barredo, Julio C.

    2010-01-01

    Acute Lymphoblastic Leukemia (ALL) non-random fusions influence clinical outcome and alter the accumulation of MTX-PGs in vivo. Analysis of primary ALL samples uncovered subtype-specific patterns of folate gene expression. Using an FPGS-luciferase reporter gene assay, we determined that E2A-PBX1 and TEL-AML1 expression decreased FPGS transcription. ChIP assays uncovered HDAC1,AML1, mSin3A, E2F, and Rb interactions with the FPGS promoter region. We demonstrate that FPGS expression is epigenetically regulated through binding of selected ALL fusions to a multiprotein complex, which also controls the cell cycle dependence of FPGS expression. This study provides insights into the pharmacogenomics of MTX in ALL subtypes. PMID:20538338

  18. Target RNA capture and cleavage by the Cmr type III-B CRISPR-Cas effector complex.

    Science.gov (United States)

    Hale, Caryn R; Cocozaki, Alexis; Li, Hong; Terns, Rebecca M; Terns, Michael P

    2014-11-01

    The effector complex of the Cmr/type III-B CRISPR (clustered regularly interspaced short palindromic repeat)-Cas (CRISPR-associated) system cleaves RNAs recognized by the CRISPR RNA (crRNA) of the complex and includes six protein subunits of unknown functions. Using reconstituted Pyrococcus furiosus Cmr complexes, we found that each of the six Cmr proteins plays a critical role in either crRNA interaction or target RNA capture. Cmr2, Cmr3, Cmr4, and Cmr5 are all required for formation of a crRNA-containing complex detected by native gel electrophoresis, and the conserved 5' repeat sequence tag and 5'-OH group of the crRNA are essential for the interaction. Interestingly, capture of the complementary target RNA additionally requires both Cmr1 and Cmr6. In detailed functional studies, we determined that P. furiosus Cmr complexes cleave target RNAs at 6-nucleotide (nt) intervals in the region of complementarity, beginning 5 nt downstream from the crRNA tag and continuing to within ∼14 nt of the 3' end of the crRNA. Our findings indicate that Cmr3 recognizes the signature crRNA tag sequence (and depends on protein-protein interactions with Cmr2, Cmr4, and Cmr5), each Cmr4 subunit mediates a target RNA cleavage, and Cmr1 and Cmr6 mediate an essential interaction between the 3' region of the crRNA and the target RNA. © 2014 Hale et al.; Published by Cold Spring Harbor Laboratory Press.

  19. Probing the magnetic superexchange couplings between terminal CuII ions in heterotrinuclear bis(oxamidato type complexes

    Directory of Open Access Journals (Sweden)

    Mohammad A. Abdulmalic

    2017-04-01

    Full Text Available The reaction of one equivalent of [n-Bu4N]2[Ni(opboR2] with two equivalents of [Cu(pmdta(X2] afforded the heterotrinuclear CuIINiIICuII containing bis(oxamidato type complexes [Cu2Ni(opboR2(pmdta2]X2 (R = Me, X = NO3– (1; R = Et, X = ClO4– (2; R = n-Pr, X = NO3– (3; opboR2 = o-phenylenebis(NR-substituted oxamidato; pmdta = N,N,N’,N”,N”-pentamethyldiethylenetriamine. The identities of the heterotrinuclear complexes 1–3 were established by IR spectroscopy, elemental analysis and single-crystal X-ray diffraction studies, which revealed the cationic complex fragments [Cu2Ni(opboR2(pmdta2]2+ as not involved in any further intermolecular interactions. As a consequence thereof, the complexes 1–3 possess terminal paramagnetic [Cu(pmdta]2+ fragments separated by [NiII(opboR2]2– bridging units representing diamagnetic SNi = 0 states. The magnetic field dependence of the magnetization M(H of 1–3 at T = 1.8 K has been determined and is shown to be highly reproducible with the Brillouin function for an ideal paramagnetic spin = 1/2 system, verifying experimentally that no magnetic superexchange couplings exists between the terminal paramagnetic [Cu(pmdta]2+ fragments. Susceptibility measurements versus temperature of 1–3 between 1.8–300 K were performed to reinforce the statement of the absence of magnetic superexchange couplings in these three heterotrinuclear complexes.

  20. Heart Failure Therapeutics on the Basis of a Biased Ligand of the Angiotensin-2 Type 1 Receptor Rationale and Design of the BLAST-AHF Study (Biased Ligand of the Angiotensin Receptor Study in Acute Heart Failure)

    NARCIS (Netherlands)

    Felker, G. Michael; Butler, Javed; Collins, Sean P.; Cotter, Gad; Davison, Beth A.; Ezekowitz, Justin A.; Filippatos, Gerasimos; Levy, Phillip D.; Metra, Marco; Ponikowski, Piotr; Soergel, David G.; Teerlink, John R.; Violin, Jonathan D.; Voors, Adriaan A.; Pang, Peter S.

    The BLAST-AHF (Biased Ligand of the Angiotensin Receptor Study in Acute Heart Failure) study is designed to test the efficacy and safety of TRV027, a novel biased ligand of the angiotensin-2 type 1 receptor, in patients with acute heart failure (AHF). AHF remains a major public health problem, and

  1. Serum levels of N-terminal proB-type natriuretic peptide in mechanically ventilated critically ill patients--relation to tidal volume size and development of acute respiratory distress syndrome

    NARCIS (Netherlands)

    Determann, Rogier M.; Royakkers, Annick A. N. M.; Schaefers, Jacqueline; de Boer, Anita M.; Binnekade, Jan M.; van Straalen, Jan P.; Schultz, Marcus J.

    2013-01-01

    Serum levels of N-terminal proB-type natriuretic peptide (NT-proBNP) are elevated in patients acute respiratory distress syndrome (ARDS). Recent studies showed a lower incidence of acute cor pulmonale in ARDS patients ventilated with lower tidal volumes. Consequently, serum levels of NT-proBNP may

  2. Elusive silane-alane complex [Si-H⋅⋅⋅Al]: isolation, characterization, and multifaceted frustrated Lewis pair type catalysis.

    Science.gov (United States)

    Chen, Jiawei; Chen, Eugene Y-X

    2015-06-01

    The super acidity of the unsolvated Al(C6F5)3 enabled isolation of the elusive silane-alane complex [Si-H⋅⋅⋅Al], which was structurally characterized by spectroscopic and X-ray diffraction methods. The Janus-like nature of this adduct, coupled with strong silane activation, effects multifaceted frustrated-Lewis-pair-type catalysis. When compared with the silane-borane system, the silane-alane system offers unique features or clear advantages in the four types of catalytic transformations examined in this study, including: ligand redistribution of tertiary silanes into secondary and quaternary silanes, polymerization of conjugated polar alkenes, hydrosilylation of unactivated alkenes, and hydrodefluorination of fluoroalkanes. © 2015 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  3. Effects of Acute Exercise and Chronic Exercise on the Liver Leptin-AMPK-ACC Signaling Pathway in Rats with Type 2 Diabetes

    Directory of Open Access Journals (Sweden)

    Xuejie Yi

    2013-01-01

    Full Text Available Aim. To investigate the effects of acute and chronic exercise on glucose and lipid metabolism in liver of rats with type 2 diabetes caused by a high fat diet and low dose streptozotocin (STZ. Methods. Animals were classified into control (CON, diabetes (DC, diabetic chronic exercise (DCE, and diabetic acute exercise (DAE groups. Results. Compared to CON, the leptin levels in serum and liver and ACC phosphorylation were significantly higher in DC, but the levels of liver leptin receptor, AMPKα1/2, AMPKα1, and ACC proteins expression and phosphorylation were significantly lower in DC. In addition, the levels of liver glycogen reduced significantly, and the levels of TG and FFA increased significantly in DC compared to CON. Compared to DC, the levels of liver AMPKα1/2, AMPKα2, AMPKα1, and ACC phosphorylation significantly increased in DCE and DAE. However, significant increase of the level of liver leptin receptor and glycogen as well as significant decrease of the level of TG and FFA were observed only in DEC. Conclusion. Our study demonstrated that both acute and chronic exercise indirectly activated the leptin-AMPK-ACC signaling pathway and increased insulin sensitivity in the liver of type 2 diabetic rats. However, only chronic and long-term exercise improved glucose and lipid metabolism of the liver.

  4. Mortality and Cardiovascular Complications in Older Complex Chronic Patients with Type 2 Diabetes

    Directory of Open Access Journals (Sweden)

    J. L. Clua-Espuny

    2017-01-01

    Full Text Available Aims/Introduction. Determining the prevalence of diabetes and its cardiovascular complications and all-cause mortality in older chronic complex patients. Materials and Methods. We carried out a multicenter retrospective study and included a randomized sample of 932 CCP people. We assessed the prevalence of diabetes according to World Health Organization criteria. Data included demographics and functional, comorbidity, cognitive, and social assessment. Results. The prevalence of diabetes was 53% and average age 81.16±8.93 years. There were no significant differences in the survival of CCP patients with or without DM, with or without ischaemic cardiopathy, and with or without peripheral vascular disease. The prognostic factors of all-cause mortality in patients with DM were age ≥ 80 years [HR 1.47, 95% CI 1.02–2.13, p  0.038], presence of heart failure [HR 1.73, 95% CI 1.25–2.38, p  0.001], Charlson score [HR 1.20, 95% CI 1.06–1.36, p  0.003], presence of cognitive impairment [HR 1.73, 95% CI 1.24–2.40, p  0.001], and no treatment with statins [HR 1.49, 95% CI 1.08–2.04, p  0.038]. Conclusions. We found high prevalence of DM among CCP patients and the relative importance of traditional risk factors seemed to wane with advancing age. Recommendations may include relaxing treatment goals, providing family/patient education, and enhanced communication strategies.

  5. Effect of a homeopatic complex on the behavior of mice under acute stress Homeopátia no comportamento de camundongos sob estresse agudo

    Directory of Open Access Journals (Sweden)

    Albert Schiaveto de Souza

    2009-12-01

    Full Text Available This experiment intended to evaluate the effect of homeopathic commercial complex (Convert H® on the performance and behavior of mice (Mus musculus submitted to acute stres. The agent stressor employee was the immobilization of the animals for 60 minutes in mini pipes of PVC immediately before the start of the behavioral evidence. The behavioral assessments, involved aspects associated with anxiety and mobility in evidence in the elevated plus-maze test, the spontaneous mobility in the open-field test and the aggressiveness in the resident-intruder paradigm. It was not identified interaction between the stresses caused acute and complex homeopathic on behavioral variables observed in the elevated plus-maze test and the open-field test. The used complex had an anxiogenic effect on animals not submitted to the stressing agent, however, in animals submitted to stress the anxiogenic effect of the complex was not the expected. The two groups that received homeopathy showed decreased motor activity, it is not possible to prove in this paper the response expected about reduction of the negative effects of stress on this behavior.Este experimento teve como objetivo avaliar o efeito do complexo homeopático comercial (Convert H® sobre o comportamento de camundongos (Mus musculus submetidos a estresse agudo. O agente estressor empregado foi a imobilização dos animais por 60 minutos em minitubos de PVC imediatamente antes do início das provas comportamentais. As avaliações comportamentais envolveram aspectos associados à ansiedade e mobilidade na prova do Labirinto em Cruz Elevado (LCE, à mobilidade espontânea no Teste de Campo Aberto (TCA e à agressividade na Prova do Combatente Isolado (PCI. Não se identificou interação entre o estresse agudo provocado e o complexo homeopático sobre as variáveis comportamentais observadas na prova do LCE e no TCA. O complexo utilizado teve um efeito ansiogênico nos animais não submetidos ao agente

  6. ONE ANTIGEN MISMATCHED RELATED VS. HLA-MATCHED UNRELATED DONOR HEMATOPOIETIC TRANSPLANTATION IN ADULTS WITH ACUTE LEUKEMIA: CIBMTR RESULTS IN THE ERA OF MOLECULAR HLA TYPING

    Science.gov (United States)

    Valcárcel, David; Sierra, Jorge; Wang, Tao; Kan, Fangyu; Gupta, Vikas; Hale, Gregory A.; Marks, David I.; McCarthy, Philip L; Oudshoorn, Machteld; Petersdorf, Effie W; Ringdén, Olle; Setterholm, Michelle; Spellman, Stephen R; Waller, Edmund K.; Gajewski, James L; Marino, Susana R.; Senitzer, David; Lee, Stephanie J.

    2012-01-01

    Purpose Approximately 13% of patients lacking an HLA-identical sibling have a 1-antigen-mismatched related donor (MMRD). Historically, outcomes using a 1-antigen MMRD were considered equivalent to a matched unrelated donor (UD). Recent improvements in unrelated donor (UD) stem cell transplantation (SCT) due to better molecular HLA-matching justifies investigating if UD should be preferred to MMRD in adult patients with acute leukemia. Patients and Methods The outcomes of MMRD (n=89) and HLA-A, B, C, DRB1 allele matched UD (n=700) SCT reported to the CIBMTR between 1995 and 2005 were compared. Patients were transplanted for acute myeloid leukemia (AML) or acute lymphoid leukemia (ALL) in first or second complete remission. Results Donor type was not associated with hematological recovery. Univariate and multivariate comparisons of MMRD vs. HLA-matched UD transplants showed no statistically significant differences in overall survival, disease free survival, transplant related mortality, relapse, and 100-day grade III–IV acute graft-versus-host disease (GVHD). MMRD SCT was associated with a lower rate of chronic GVHD at 1-year, 35% vs 47% p=0.03, which was confirmed in multivariate analysis (RR 0.58, 95% CI 0.39-0.85, p<0.01). Conclusion HLA-matched UD and MMRD SCT are associated with comparable survival. Since less chronic GVHD was observed in MMRD, this option when available remains the first choice in acute leukemia patients without an HLA-identical sibling in need of allogeneic transplantation. PMID:20674756

  7. Post-Discharge Worsening Renal Function in Patients with Type 2 Diabetes and Recent Acute Coronary Syndrome

    NARCIS (Netherlands)

    Morici, Nuccia; Savonitto, Stefano; Ponticelli, Claudio; Schrieks, Ilse C; Nozza, Anna; Cosentino, Francesco; Stähli, Barbara E; Perrone Filardi, Pasquale; Schwartz, Gregory G.; Mellbin, Linda; Lincoff, A. Michael; Tardif, Jean-Claude; Grobbee, Diederick E

    BACKGROUND: Worsening renal function during hospitalization for an acute coronary syndrome is strongly predictive of in-hospital and long-term outcome. However, the role of post-discharge worsening renal function has never been investigated in this setting. METHODS: We considered the placebo cohort

  8. C-type lectin-like molecule-1: a novel myeloid cell surface marker associated with acute myeloid leukemia

    NARCIS (Netherlands)

    Bakker, Alexander B. H.; van den Oudenrijn, Sonja; Bakker, Arjen Q.; Feller, Nicole; van Meijer, Marja; Bia, Judith A.; Jongeneelen, Mandy A. C.; Visser, Therese J.; Bijl, Nora; Geuijen, Cecilia A. W.; Marissen, Wilfred E.; Radosevic, Katarina; Throsby, Mark; Schuurhuis, Gerrit Jan; Ossenkoppele, Gert J.; de Kruif, John; Goudsmit, Jaap; Kruisbeek, Ada M.

    2004-01-01

    Acute myeloid leukemia (AML) has a poor prognosis due to treatment-resistant relapses. A humanized anti-CD33 antibody (Mylotarg) showed a limited response rate in relapsed AML. To discover novel AML antibody targets, we selected a panel of single chain Fv fragments using phage display technology

  9. Glucagon-like peptide-1 receptor agonists and risk of acute pancreatitis in patients with type 2 diabetes

    DEFF Research Database (Denmark)

    Storgaard, Heidi; Cold, Frederik; Gluud, Lise L

    2017-01-01

    Glucagon-like peptide-1 receptor agonist (GLP-1RAs) labels warn about acute pancreatitis (AP) and impose upon doctors the obligation to inform patients about symptoms of AP. Here we systematically reviewed the risk of AP in randomized placebo-controlled trials (RCTs) investigating the effect of GLP...

  10. Virus elimination in acute lymphocytic choriomeningitis virus infection. Correlation with virus-specific delayed-type hypersensitivity rather than cytotoxicity

    DEFF Research Database (Denmark)

    Thomsen, Allan Randrup; Volkert, M; Bro-Jørgensen, K

    1983-01-01

    The immunological effector mechanism responsible for the elimination of virus in murine acute non-fatal extracranial lymphocytic choriomeningitis virus infection was studied. In this infection virus clearance is generally regarded as the result of a direct action of virus-specific cytotoxic T cells...

  11. Structure of a microsporidian methionine aminopeptidase type 2 complexed with fumagillin and TNP-470

    Energy Technology Data Exchange (ETDEWEB)

    Alvarado, J.; Nemkal, A; Sauder, J; Russell, M; Akiyoshi, D; Shi, W; Almo, S; Weiss, L

    2009-01-01

    Microsporidia are protists that have been reported to cause infections in both vertebrates and invertebrates. They have emerged as human pathogens particularly in patients that are immunosuppressed and cases of gastrointestinal infection, encephalitis, keratitis, sinusitis, myositis and disseminated infection are well described in the literature. While benzimidazoles are active against many species of microsporidia, these drugs do not have significant activity against Enterocytozoon bieneusi. Fumagillin and its analogues have been demonstrated to have activity in vitro and in animal models of microsporidiosis and human infections due to E. bieneusi. Fumagillin and its analogues inhibit methionine aminopeptidase type 2. Encephalitozoon cuniculi MetAP2 (EcMetAP2) was cloned and expressed as an active enzyme using a baculovirus system. The crystal structure of EcMetAP2 was determined with and without the bound inhibitors fumagillin and TNP-470. This structure classifies EcMetAP2 as a member of the MetAP2c family. The EcMetAP2 structure was used to generate a homology model of the E. bieneusi MetAP2. Comparison of microsporidian MetAP2 structures with human MetAP2 provides insights into the design of inhibitors that might exhibit specificity for microsporidian MetAP2.

  12. The connection between typological complexes of properties of the nervous system, temperaments, and personality types in the professions and sports

    Directory of Open Access Journals (Sweden)

    Drozdovski AK

    2015-05-01

    Full Text Available Aleksandr K Drozdovski Sports Training Center for Russian Teams, Moscow, Russia Abstract: Based on experimental studies in education, professions and sports, an attempt was made to combine the following two historically disconnected research directions in the study of the natural human traits into a single coordinate system: Pavlov’s theory on the properties of the nervous system, as well as the types of higher nervous activity, and Jung’s theory on psychological types. It is noted that Pavlov’s school of thought was developed by his followers in Russia within the scientific school of differential psychophysiology, while Yung’s theory was developed through the works of well-known American researchers Myers and Keirsey. The spatial model that is presented here rests on the knowledge of the properties of the human nervous system and enables the prediction of psychological characteristics, temperament, and psychological types of individuals belonging to a wide age range. Keywords: differential psychophysiology, properties of the nervous system, typological complex of properties, psychological properties, temperament and psychological type

  13. Propagation and Interaction Properties of Successive Coronal Mass Ejections in Relation to a Complex Type II Radio Burst

    Science.gov (United States)

    Liu, Y. D.; Zhao, X.; Zhu, B.

    2017-12-01

    We examine the propagation and interaction properties of three successive coronal mass ejections (CMEs) from 2001 November 21-22, with a focus on their connection with the behaviors of the associated long-duration complex type II radio burst. In combination with coronagraph and multi-point in situ observations, the long-duration type II burst provides key features that help resolve the propagation and interaction complexities of the three CMEs. The two CMEs from November 22 interacted first and then overtook the November 21 CME at a distance of about 0.85 AU from the Sun. The time scale that the shock originally driven by the last CME spent inside the preceding two CMEs is estimated to be about 14 and 6 hr, respectively. We present a simple analytical model without any free parameters to characterize the whole Sun-to-Earth propagation of the shock, which shows a remarkable consistency with all the available data and MHD simulations even out to the distance of Ulysses (2.34 AU). The coordination of in situ measurements at the Earth and Ulysses, which were separated by 73o in latitude, gives important clues for the understanding of shock structure and the interpretation of in situ signatures. The results also indicate means to increase geo-effectiveness with three CMEs, similar to the the ``perfect storm" scenario proposed by te{liu14a} although the current case is not ``super" in the same sense as the 2012 July 23 event.

  14. Oligomeric adiponectin forms and their complexes in the blood of healthy donors and patients with type 2 diabetes mellitus.

    Science.gov (United States)

    Kogan, Alexander E; Filatov, Vladimir L; Kolosova, Olga V; Katrukha, Ivan A; Mironova, Ekaterina V; Zhuravleva, Natalya S; Nagibin, Oleg A; Kara, Andrei N; Bereznikova, Anastasiya V; Katrukha, Alexey G

    2013-01-01

    Adiponectin (Adn) is a protein that circulates in the blood in several oligomeric forms, namely low-, medium-, and high-molecular-weight forms. Adn may serve as a risk factor for type 2 diabetes mellitus (T2DM). The aims of this work were (1) to produce monoclonal antibodies (MAbs) specific to different Adn oligomeric forms, (2) to design immunoassays suitable for measuring the Adn forms present in human blood, and (3) to investigate the changes in Adn forms that occur in patients with T2DM. Gel filtration, fluoroimmunoassays, and Western blotting were utilized as major techniques in this study. MAbs recognizing various oligomeric forms of Adn were obtained. Complexes between Adn and complement component C1q and between the low molecular weight form of Adn and albumin were described in human blood. A decrease in the total Adn and Adn-albumin complex levels in the blood of patients with T2DM and no difference in the levels of the Adn-C1q complex in comparison with healthy volunteers were demonstrated. An Adn94-Adn63 fluoroimmunoassay was selected as the technique that most accurately measured the mass ratio of Adn oligomers in blood samples, and an Adn214-Adn27 assay that measured the low-molecular-weight form of Adn only.

  15. Annotation of Differential Gene Expression in Small Yellow Follicles of a Broiler-Type Strain of Taiwan Country Chickens in Response to Acute Heat Stress.

    Science.gov (United States)

    Cheng, Chuen-Yu; Tu, Wei-Lin; Wang, Shih-Han; Tang, Pin-Chi; Chen, Chih-Feng; Chen, Hsin-Hsin; Lee, Yen-Pai; Chen, Shuen-Ei; Huang, San-Yuan

    2015-01-01

    This study investigated global gene expression in the small yellow follicles (6-8 mm diameter) of broiler-type B strain Taiwan country chickens (TCCs) in response to acute heat stress. Twelve 30-wk-old TCC hens were divided into four groups: control hens maintained at 25°C and hens subjected to 38°C acute heat stress for 2 h without recovery (H2R0), with 2-h recovery (H2R2), and with 6-h recovery (H2R6). Small yellow follicles were collected for RNA isolation and microarray analysis at the end of each time point. Results showed that 69, 51, and 76 genes were upregulated and 58, 15, 56 genes were downregulated after heat treatment of H2R0, H2R2, and H2R6, respectively, using a cutoff value of two-fold or higher. Gene ontology analysis revealed that these differentially expressed genes are associated with the biological processes of cell communication, developmental process, protein metabolic process, immune system process, and response to stimuli. Upregulation of heat shock protein 25, interleukin 6, metallopeptidase 1, and metalloproteinase 13, and downregulation of type II alpha 1 collagen, discoidin domain receptor tyrosine kinase 2, and Kruppel-like factor 2 suggested that acute heat stress induces proteolytic disintegration of the structural matrix and inflamed damage and adaptive responses of gene expression in the follicle cells. These suggestions were validated through gene expression, using quantitative real-time polymerase chain reaction. Functional annotation clarified that interleukin 6-related pathways play a critical role in regulating acute heat stress responses in the small yellow follicles of TCC hens.

  16. Long-term outcome and quality of life following emergency surgery for acute aortic dissection type A: a comparison between young and elderly adults.

    Science.gov (United States)

    Jussli-Melchers, Jill; Panholzer, Bernd; Friedrich, Christine; Broch, Ole; Renner, Jochen; Schöttler, Jan; Rahimi, Aziz; Cremer, Jochen; Schoeneich, Felix; Haneya, Assad

    2017-03-01

    Innovations in surgical techniques and perioperative management have continuously improved survival rates for acute aortic dissection type A (AADA). The aim of our study was to evaluate long-term outcome and quality of life (QoL) after surgery for AADA in elderly patients compared with younger patients. We retrospectively evaluated 242 consecutive patients, who underwent surgery for AADA between January 2004 and April 2014. Patients were divided into two groups: those aged 70 years and older (elderly group; n  = 78, mean age, 76 ± 4 years) and those younger than 70 years (younger group; n  = 164, mean age, 56 ± 10 years). QoL was assessed with the Short Form Health Survey Questionnaire (SF-36) 1 year after surgery. The questionnaire return rate was 91.0%. There were already significant differences noted between the two groups with regard to preoperative risk factors on admission. The clinical presentation with a cardiac tamponade was higher in the elderly group (62.8% vs 47.6%; P  = 0.03). Intraoperatively, complex procedures were more common in the younger group (21.3% vs 5.2%; P  = 0.001). Accordingly, cardiopulmonary bypass and cross-clamping times were significantly longer in the younger group. The operative mortality was similar in both groups (3.8% vs 1.2%; P  = 0.33). In the elderly population, 30-day mortality was higher (21.8% vs 7.9%; P  = 0.003). One-year (72% vs 85%), 3-year (68% vs 84%) and 5-year (63% vs 79%) survival rates were satisfactory for the elderly group, but significantly lower compared with the younger group ( P  = 0.008). The physical component summary score also was similar between the groups (39.14 ± 11.12 vs 39.12 ± 12.02; P  = 0.99). However, the mental component summary score might be slightly higher in the elderly group but not statistically significant (51.61 ± 10.73 vs 48.63 ± 11.25; P  = 0.12). Satisfactory long-term outcome and the general perception of well

  17. Acute pneumonia

    International Nuclear Information System (INIS)

    Rozenshtraukh, L.S.

    1983-01-01

    It is shown, that in the detailed study of various types of acute pneumonia s the roentgenologic method plays a great role. The most characteristic roentge nological signs of primary (bacterial, viral, rickettsial, parasitogenic and fun gous) and secondary pneumonias (in the case of lessions in lesser circulation, changes in bronchi, aspirational and other diseases of organism) are presented