WorldWideScience

Sample records for loomakasvatushoonete hus elektrokeemilise

  1. Arne Jacobsens eget hus

    DEFF Research Database (Denmark)

    Thule Kristensen, Peter

    2007-01-01

    Beskrivelse og analyse af arkitekten Arne Jacobsens eget hus på Godfred Rodes Vej 2. Bogen er udgivet af Relea A/S, der ejer huset, og som i 2007 har restaureret det.......Beskrivelse og analyse af arkitekten Arne Jacobsens eget hus på Godfred Rodes Vej 2. Bogen er udgivet af Relea A/S, der ejer huset, og som i 2007 har restaureret det....

  2. hus + Teknik

    DEFF Research Database (Denmark)

    Marsh, Rob

    Sigtet med denne bog er at anskueliggøre samspillet mellem bygninger og deres tekniske installationer. Bogens tre dele analyserer udviklingen i forholdet mellem råhus og teknik. Den giver et bud på fremtidens kontorbygning, hvor decentrale facadeintegrerede føringsveje anvendes til at skabe innov...

  3. Eget hus - men hvilket?

    DEFF Research Database (Denmark)

    Vedel-Petersen, F.; Ranten, K

    Anvisningen er udarbejdet i tilknytning til Bygningsreglementet for småhuse, 1985. Den gennemgår forhold af betydning for boligens brugsværdi og indeholder oversigter over mål på inventar, almindelige møbler og friarealer. Anvisningen henvender sig til familier, der skal købe eller bygge eget hus...

  4. Hospice, et levende hus

    DEFF Research Database (Denmark)

    Steenfeldt, Vibeke Østergaard

    Det er formålet med afhandlingen Hospice – et levende hus. En analyse af levet liv og omsorg på hospice som bidrag til forståelse af åndelig omsorg at skabe vi¬den om den oplevelse det uhelbredeligt syge menneske, der tilbringer den sidste del af livet på et hospice, har af omsorgspraksis og levet...... liv på hospice, og at bidrage til udvik¬ling af en ny forståelse af åndelig omsorg som sygeplejefagligt begreb. Undersøgelsen, der har en livsverdensfænomenologisk tilgang, gennem¬føres som et etnografisk feltstudie. I en periode på otte måneder, hvor jeg har været deltagende observatør på to hospicer......, der i første om¬gang er udført uden teoretisk indblanding og efterfølgende perspektiveret ved inddragelse af Medard Boss’ daseinsanalytiske tilgang til forståelse af menne¬ske og krop, sundhed og sygdom og af Kari Martinsens omsorgstænkning. Analysen viser, at den uhelbredeligt syge patient på hospice...

  5. HUS and the case for complement.

    Science.gov (United States)

    Conway, Edward M

    2015-10-29

    Hemolytic-uremic syndrome (HUS) is a thrombotic microangiopathy that is characterized by microangiopathic hemolytic anemia, thrombocytopenia, and renal failure. Excess complement activation underlies atypical HUS and is evident in Shiga toxin-induced HUS (STEC-HUS). This Spotlight focuses on new knowledge of the role of Escherichia coli-derived toxins and polyphosphate in modulating complement and coagulation, and how they affect disease progression and response to treatment. Such new insights may impact on current and future choices of therapies for STEC-HUS.

  6. Om det moderne hus - og det klassiske

    DEFF Research Database (Denmark)

    Hauberg, Jørgen

    2010-01-01

    I tekst og illustrationer beskrives det klassiske hus og den klassiske by, repræsenteret ved Andrea Palladio (1508-80) og det moderne hus, den moderne by og byggeopgave, repræsenteret ved Le Corbusier (1887-1965).......I tekst og illustrationer beskrives det klassiske hus og den klassiske by, repræsenteret ved Andrea Palladio (1508-80) og det moderne hus, den moderne by og byggeopgave, repræsenteret ved Le Corbusier (1887-1965)....

  7. [Thrombotic microangiopathies: HUS/TTP. Physiopathological aspects].

    Science.gov (United States)

    Sánchez Avalos, J C

    2000-01-01

    In thrombotic thrombocytopenic purpura (TTP) and in the hemolytic uremic syndrome (HUS) fibrin-platelet thrombi occlude arterioles and capillaries. The mechanism of endothelial cell injury and the mechanism of thrombosis are the most important physiopathological events in this pathology and are largely unknown. In HUS due to the Shiga toxin, the lesion of the endothelial cells is due to penetration of the toxin into the cell via the Gb3 receptor. Endothelial cell death is a consequence of altered protein synthesis at the ribosomal level. Cytokines released during the inflammatory process, possibly enhance the endothelial damage. Genetic and immunologic predisposing factors for the development of HUS have also been postulated. In idiopathic, secondary and familial HUS/TTP the mechanism of endothelial lesion is unknown, but multiple responsible factors have been advocated such as infections, drugs, pregnancy, autoantibodies, apoptosis inducing molecules, etc. and other genetic, hormonal or immunologic predisposing factors may also be involved. Factor H deficiency has been blamed in familiar cases. The most important cause of microcirculation thrombosis is the thrombogenic capacity of endothelial cell "activation" or injury induced by multiple mechanisms. The predominant source of plasma vW factor multimers is apparent in the altered endothelial cell. The unusually large vWF multimers are more effective at binding to platelet glycoprotein Ib-IX and IIb-IIIa complexes and inducing aggregation, as also occurred with the low weight multimers formed with excessive proteolysis, as described in the acute phase of HUS/TTP. The recent report of congenital deficiency of a vWF protease in familial TTP and its functional inhibition by autoantibodies in acquired cases is characteristic of TTP. This protease inhibition has never been described in HUS and might represent pathogenetic differences between TTP and HUS, and contribute to the differential diagnosis, but further

  8. Før Ee bygger eget hus

    DEFF Research Database (Denmark)

    Ankerstjerne, P. (red.); Brixen, J. (red.)

    At bygge eget hus er en stor opgave - større jo mindre huset skal være. I denne anvisning bringes en samlet oversigt over de problemer bygherren må tage stilling til før og under byggeriet. På alle trin af byggesagen - fra idé til regnskabets time efter indflytningen - gøres der i tekst og...

  9. Appreciation of scientific achievements of Jozef Hus.

    Science.gov (United States)

    Spassov, S.; Geeraerts, R.

    2009-04-01

    In 2004, the Geophysical Centre of the Royal Meteorological Institute of Belgium (RMIB) in Dourbes (south Belgium) celebrated its 50th anniversary. Fifty years of top research to which Jozef Hus contributed considerably. When he started his career in this governmental institution more than 40 years ago, palaeomagnetic research was absent at the RIMB. After finishing studies in condensed matter physics at Ghent University (Belgium) in 1963, he became an assistant at the RMIB and developed with Prof. Dr. A. De Vuyst, in charge of the geomagnetic observatory, a method for absolute measurements of all geomagnetic field elements with a proton magnetometer. Wishing to extend the record of geomagnetic field observations in time, Jozef began to set up a laboratory of his own and started to construct and develop instruments for palaeomagnetic research with competence, great enthusiasm and concentrated passion. This world-class laboratory was constructed between 1976 ad 1980. In 1981, he received the title Doctor of Sciences from the Free University of Brussels based on his thesis entitled "De indirecte meting van de seculaire verandering van het geomagnetisch veld". Palaeomagnetism of Quaternary sediments and archaeo- and rock magnetism have been Jozef's most important research fields. In fact, a short sojourn in Prof. E. Thellier's Laboratory of Geomagnetism at Saint-Maur-de-Fossés (Paris) in 1965, raised Jozef's interest in archaeomagnetism. He formed a solid basis for the detailed establishment of reference curves for declination and inclination for the Belgian territory for historical and archaeological times. He studied the suitability of burned archaeological materials to record the Earth's magnetic field as well as effects which influence accurate field registration in archaeological materials, such as magnetic refraction and magnetic anisotropy. During his career, Jozef promoted archaeomagnetism as a valuable dating tool and strengthened the cooperation with the

  10. L-Arginine/NO Pathway Is Altered in Children with Haemolytic-Uraemic Syndrome (HUS

    Directory of Open Access Journals (Sweden)

    Nele Kirsten Kanzelmeyer

    2014-01-01

    Full Text Available The haemolytic uraemic syndrome (HUS is the most frequent cause of acute renal failure in childhood. We investigated L-arginine/NO pathway in 12 children with typical HUS and 12 age-matched healthy control subjects. Nitrite and nitrate, the major NO metabolites in plasma and urine, asymmetric dimethylarginine (ADMA in plasma and urine, and dimethylamine (DMA in urine were determined by GC-MS and GC-MS/MS techniques. Urinary measurements were corrected for creatinine excretion. Plasma nitrate was significantly higher in HUS patients compared to healthy controls P=0.021, whereas urine nitrate was borderline lower in HUS patients compared to healthy controls P=0.24. ADMA plasma concentrations were insignificantly lower, but urine ADMA levels were significantly lower in the HUS patients P=0.019. Urinary DMA was not significantly elevated. In HUS patients, nitrate R=0.91 but not nitrite, L-arginine, or ADMA concentrations in plasma correlated with free haemoglobin concentration. Our results suggest that both NO production and ADMA synthesis are decreased in children with typical HUS. We hypothesize that in the circulation of children with HUS a vicious circle between the L-arginine/NO pathway and free haemoglobin-mediated oxidative stress exists. Disruption of this vicious circle by drugs that release NO and/or sulphydryl groups-containing drugs may offer new therapeutic options in HUS.

  11. Treatment and outcome of Shiga-toxin-associated hemolytic uremic syndrome (HUS).

    Science.gov (United States)

    Scheiring, Johanna; Andreoli, Sharon P; Zimmerhackl, Lothar Bernd

    2008-10-01

    Hemolytic uremic syndrome (HUS) is the most common cause of acute renal failure in childhood and the reason for chronic renal replacement therapy. It leads to significant morbidity and mortality during the acute phase. In addition to acute morbidity and mortality, long-term renal and extrarenal complications can occur in a substantial number of children years after the acute episode of HUS. The most common infectious agents causing HUS are enterohemorrhagic Escherichia coli (EHEC)-producing Shiga toxin (and belonging to the serotype O157:H7) and several non-O157:H7 serotypes. D(+) HUS is an acute disease characterized by prodromal diarrhea followed by acute renal failure. The classic clinical features of HUS include the triad of microangiopathic hemolytic anemia, thrombocytopenia, and acute renal failure. HUS mortality is reported to be between 3% and 5%, and death due to HUS is nearly always associated with severe extrarenal disease, including severe central nervous system (CNS) involvement. Approximately two thirds of children with HUS require dialysis therapy, and about one third have milder renal involvement without the need for dialysis therapy. General management of acute renal failure includes appropriate fluid and electrolyte management, antihypertensive therapy if necessary, and initiation of renal replacement therapy when appropriate. The prognosis of HUS depends on several contributing factors. In general "classic" HUS, induced by EHEC, has an overall better outcome. Totally different is the prognosis in patients with atypical and particularly recurrent HUS. However, patients with severe disease should be screened for genetic disorders of the complement system or other underlying diseases.

  12. Hvite vegger, blanke ark : norske hjem i spanske hus

    OpenAIRE

    Løbach, Christin

    2007-01-01

    ”Hvite vegger, blanke ark” er en avhandling om norske hjem i spanske hus. Tittelen indikerer at noe sorteres bort og at noe nytt kan tre frem. Det å flytte til Spania kan være en måte å bevisstgjøre seg selv om hva man ønsker å bringe med seg videre i livet, slik er det også en mulighet til å realisere seg selv og sine drømmer. Jeg ser det å skape et hjem som målet ved flyttingen. Informantene betrakter og forholder seg til sine liv som åpne ved å bruke sin fortid til å utforske og realisere ...

  13. Is it quinine TTP/HUS or quinine TMA? ADAMTS13 levels and implications for therapy.

    Science.gov (United States)

    Park, Yara A; Hay, Shauna N; King, Karen E; Matevosyan, Karen; Poisson, Jessica; Powers, Amy; Sarode, Ravindra; Shaz, Beth; Brecher, Mark E

    2009-01-01

    Thrombocytopenia with or without microangiopathy following quinine is often referred to as quinine "hypersensitivity." When schistocytes are present it is frequently termed "quinine-associated TTP/HUS." A severe deficiency of the vWF-cleaving protease, ADAMTS13, is associated with idiopathic TTP. A previous study of patients with "quinine-associated TTP/HUS" found that ADAMTS13 activities were not abnormal in 12/12 patients. A retrospective review of TTP patients with quinine-associated thrombotic microangiopathy (TMA) for whom ADAMTS13 was measured before plasma exchange was performed. Six patients were identified. All were females (age range: 43 to 73, mean = 61.7 years) and had taken quinine for leg cramps. Four of the six experienced renal failure requiring dialysis. Five of the patients had D-Dimers levels measured, all were elevated. In four patients the levels were > or = 18 times the upper limit of normal. ADAMTS13 was normal in four patients and mildly decreased in two patients. We conclude that while thrombocytopenia and schistocytosis can be seen in quinine-associated TTP/HUS, the pathophysiology seems to be distinct from that seen in most cases of idiopathic TTP (i.e., severely decreased ADAMTS13 with an inhibitor). We recommend that a TMA in association with quinine be consistently referred to as quinine-associated thrombotic microangiopathy (quinine-TMA) to better distinguish this entity from idiopathic TTP. The use of plasma exchange in quinine-TMA is called into question.

  14. Mellemrummets hus

    DEFF Research Database (Denmark)

    Torp, Kristine Annabell

    2016-01-01

    Afhandlingen undersøger hvilke arkitektoniske potentialer der er i en særlig boligtype, der i afhandlingen betegnet som dobbelthus. Et dobbelthus er i afhandlingen defineret ved, at en isoleret boligkerne er adskilt fra boligens klimaskærm ved hjælp af en uopvarmet mellemzone, hvori der kan tages...

  15. Conditional inactivation of the DNA damage response gene Hus1 in mouse testis reveals separable roles for components of the RAD9-RAD1-HUS1 complex in meiotic chromosome maintenance.

    Directory of Open Access Journals (Sweden)

    Amy M Lyndaker

    Full Text Available The RAD9-RAD1-HUS1 (9-1-1 complex is a heterotrimeric PCNA-like clamp that responds to DNA damage in somatic cells by promoting DNA repair as well as ATR-dependent DNA damage checkpoint signaling. In yeast, worms, and flies, the 9-1-1 complex is also required for meiotic checkpoint function and efficient completion of meiotic recombination; however, since Rad9, Rad1, and Hus1 are essential genes in mammals, little is known about their functions in mammalian germ cells. In this study, we assessed the meiotic functions of 9-1-1 by analyzing mice with germ cell-specific deletion of Hus1 as well as by examining the localization of RAD9 and RAD1 on meiotic chromosomes during prophase I. Hus1 loss in testicular germ cells resulted in meiotic defects, germ cell depletion, and severely compromised fertility. Hus1-deficient primary spermatocytes exhibited persistent autosomal γH2AX and RAD51 staining indicative of unrepaired meiotic DSBs, synapsis defects, an extended XY body domain often encompassing partial or whole autosomes, and an increase in structural chromosome abnormalities such as end-to-end X chromosome-autosome fusions and ruptures in the synaptonemal complex. Most of these aberrations persisted in diplotene-stage spermatocytes. Consistent with a role for the 9-1-1 complex in meiotic DSB repair, RAD9 localized to punctate, RAD51-containing foci on meiotic chromosomes in a Hus1-dependent manner. Interestingly, RAD1 had a broader distribution that only partially overlapped with RAD9, and localization of both RAD1 and the ATR activator TOPBP1 to the XY body and to unsynapsed autosomes was intact in Hus1 conditional knockouts. We conclude that mammalian HUS1 acts as a component of the canonical 9-1-1 complex during meiotic prophase I to promote DSB repair and further propose that RAD1 and TOPBP1 respond to unsynapsed chromatin through an alternative mechanism that does not require RAD9 or HUS1.

  16. Conditional inactivation of the DNA damage response gene Hus1 in mouse testis reveals separable roles for components of the RAD9-RAD1-HUS1 complex in meiotic chromosome maintenance.

    Science.gov (United States)

    Lyndaker, Amy M; Lim, Pei Xin; Mleczko, Joanna M; Diggins, Catherine E; Holloway, J Kim; Holmes, Rebecca J; Kan, Rui; Schlafer, Donald H; Freire, Raimundo; Cohen, Paula E; Weiss, Robert S

    2013-01-01

    The RAD9-RAD1-HUS1 (9-1-1) complex is a heterotrimeric PCNA-like clamp that responds to DNA damage in somatic cells by promoting DNA repair as well as ATR-dependent DNA damage checkpoint signaling. In yeast, worms, and flies, the 9-1-1 complex is also required for meiotic checkpoint function and efficient completion of meiotic recombination; however, since Rad9, Rad1, and Hus1 are essential genes in mammals, little is known about their functions in mammalian germ cells. In this study, we assessed the meiotic functions of 9-1-1 by analyzing mice with germ cell-specific deletion of Hus1 as well as by examining the localization of RAD9 and RAD1 on meiotic chromosomes during prophase I. Hus1 loss in testicular germ cells resulted in meiotic defects, germ cell depletion, and severely compromised fertility. Hus1-deficient primary spermatocytes exhibited persistent autosomal γH2AX and RAD51 staining indicative of unrepaired meiotic DSBs, synapsis defects, an extended XY body domain often encompassing partial or whole autosomes, and an increase in structural chromosome abnormalities such as end-to-end X chromosome-autosome fusions and ruptures in the synaptonemal complex. Most of these aberrations persisted in diplotene-stage spermatocytes. Consistent with a role for the 9-1-1 complex in meiotic DSB repair, RAD9 localized to punctate, RAD51-containing foci on meiotic chromosomes in a Hus1-dependent manner. Interestingly, RAD1 had a broader distribution that only partially overlapped with RAD9, and localization of both RAD1 and the ATR activator TOPBP1 to the XY body and to unsynapsed autosomes was intact in Hus1 conditional knockouts. We conclude that mammalian HUS1 acts as a component of the canonical 9-1-1 complex during meiotic prophase I to promote DSB repair and further propose that RAD1 and TOPBP1 respond to unsynapsed chromatin through an alternative mechanism that does not require RAD9 or HUS1.

  17. Note: Application of a novel 2(3HUS+S) parallel manipulator for simulation of hip joint motion

    Science.gov (United States)

    Shan, X. L.; Cheng, G.; Liu, X. Z.

    2016-07-01

    In the paper, a novel 2(3HUS+S) parallel manipulator, which has two moving platforms, is proposed. The parallel manipulator is adopted to simulate hip joint motion and can conduct an experiment for two hip joints simultaneously. Motion experiments are conducted in the paper, and the recommended hip joint motion curves from ISO14242 and actual hip joint motions during jogging and walking are selected as the simulated motions. The experimental results indicate that the 2(3HUS+S) parallel manipulator can realize the simulation of many kinds of hip joint motions without changing the structure size.

  18. Function of von Willebrand factor in children with diarrhea-associated hemolytic-uremic syndrome (D+ HUS).

    Science.gov (United States)

    Sutor, A H; Thomas, K B; Prüfer, F H; Grohmann, A; Brandis, M; Zimmerhackl, L B

    2001-06-01

    Reports on von Willebrand factor (vWF) in hemolytic-uremic syndrome (HUS) are not unequivocal. Because of potential pathogenic implications, we examined the ability of vWF to bind to collagen in vitro, which reflects its function. Plasma vWF antigen (vWF:Ag) and collagen-binding activity (vWF:CBA) were measured by enzyme-linked immunosorbent assay in children with (1) diarrhea-associated (D+) HUS (n = 27), (2) chronic renal insufficiency (CRI) (n = 8), (3) gastroenteritis (GE) not associated with HUS (n = 15), (4) immune thrombocytopenia (ITP) (n = 40) and from controls (n = 35). Structural vWF was evaluated by multimer analysis. Children with D+ HUS had vWF:Ag of 2.53 and vWF:CBA of 1.98 U/mL. The corresponding values for patients with ITP were 1.35 and 1.82 U/mL, with CRI 1.55 and 1.55 U/mL, and with GE 1.68 and 2.10 U/mL; all values were higher than in controls (1.04 and 1.16 U/mL). The mean ratio of vWF:CBA to vWF:Ag ratio in controls was 1.13; only children with HUS had a dysfunctional vWF, as indicated by a low ratio of 0.78; the ratio was elevated in children with ITP (1.36) and GE (1.27) and was normal in those with CRI (1.06). No ultralarge molecular multimers of vWF were detected in any group, including HUS. The very high concentration of plasma vWF:Ag in HUS probably reflects endothelial cell damage or irritation. In contrast to all other groups, only children with HUS had a dysfunctional vWF, caused either by a primary (due to enterohemorrhagic Escherichia coli) or secondary (due to consumption of functionally active vWF) process. This abnormality was not obvious as structural anomaly by multimer analysis.

  19. [The 2011 HUS epidemic in Germany. Challenges for disease control: what should be improved?].

    Science.gov (United States)

    Krause, G; Frank, C; Gilsdorf, A; Mielke, M; Schaade, L; Stark, K; Burger, R

    2013-01-01

    From May to July 2011 [corrected] the world's largest outbreak of hemolytic uremic syndrome (HUS) occurred in northern Germany with dramatic consequences for the population, the health care system and the food industry. In the following we examine the detection of the outbreak, epidemic management and related public communication aspects based on scientific publications, media reports as well as own and new data analyses. The subsequent 17 recommendations concern issues such as participation in and implementation of existing and new surveillance systems particularly with respect to physicians, broad application of finely tuned microbiological typing, improved personnel capacity and crisis management structures within the public health service and evidence-based communication by administrations and scientific associations. Outbreaks of similar dimensions can inevitably occur again and result in costs which will far exceed investments needed for early detection and control. This societal balance should be taken into account in spite of limited resources in the public health sector.

  20. Radon som sporgas for jordluftindtrængning til hus ved forurenet renserigrund

    DEFF Research Database (Denmark)

    Andersen, C.E.

    2001-01-01

    I nærværende undersøgelse anvendes radon-222, som er en naturligt forekommende radioaktiv gas, som sporgas for jordluftindtrængning til et hus, der er nabo til en forurenet renserigrund. Dette er muligt, da poreluftkoncentrationen af radon i jorden underhuset er omkring 1000 gange højere end...... udeluftens koncentration, og selv en meget lille indtrængning af jordluft til huset kan derfor have stor betydning for dets radonkoncentration. Undersøgelsen bygger bl.a. på kontinuerte målinger af radon,differenstryk, atmosfæretryk, og temperaturer i indeklimaet samt spotmålinger af radon under terrændækket...... indtrængning af radon (dvs. at radon trænger ind med en trykdreven luftstrøm) fra jorden under huset, når vakuumanlægget er slukket. Under en række simplificerende antagelser kan det beregnes, atindtrængningen af luft fra det kapillarbrydende lag (dvs. "jordluft") er omkring 1 m"3/h, når vakuumanlægget er...

  1. Origin Detection During Food-borne Disease Outbreaks - A Case Study of the 2011 EHEC/HUS Outbreak in Germany.

    Science.gov (United States)

    Manitz, Juliane; Kneib, Thomas; Schlather, Martin; Helbing, Dirk; Brockmann, Dirk

    2014-04-01

    The key challenge during food-borne disease outbreaks, e.g. the 2011 EHEC/HUS outbreak in Germany, is the design of efficient mitigation strategies based on a timely identification of the outbreak's spatial origin. Standard public health procedures typically use case-control studies and tracings along food shipping chains. These methods are time-consuming and suffer from biased data collected slowly in patient interviews. Here we apply a recently developed, network-theoretical method to identify the spatial origin of food-borne disease outbreaks. Thereby, the network captures the transportation routes of contaminated foods. The technique only requires spatial information on case reports regularly collected by public health institutions and a model for the underlying food distribution network. The approach is based on the idea of replacing the conventional geographic distance with an effective distance that is derived from the topological structure of the underlying food distribution network. We show that this approach can efficiently identify most probable epicenters of food-borne disease outbreaks. We assess and discuss the method in the context of the 2011 EHEC epidemic. Based on plausible assumptions on the structure of the national food distribution network, the approach can correctly localize the origin of the 2011 German EHEC/HUS outbreak.

  2. ATR, Claspin and the Rad9-Rad1-Hus1 complex regulate Chk1 and Cdc25A in the absence of DNA damage

    DEFF Research Database (Denmark)

    Sørensen, Claus Storgaard; Syljuåsen, Randi G; Lukas, Jiri

    2004-01-01

    The ATR and Chk1 kinases are essential to maintain genomic integrity. ATR, with Claspin and the Rad9-Rad1-Hus1 complex, activates Chk1 after DNA damage. Chk1-mediated phosphorylation of the Cdc25A phosphatase is required for the mammalian S-phase checkpoint. Here, we show that during physiological...... S phase the regulation of the Chk1-Cdc25A pathway depends on ATR, Claspin, Rad9, and Hus1. Human cells with chemically or genetically ablated ATR showed inhibition of Chk1-dependent phosphorylation of Cdc25A, and they accumulated Cdc25A without external DNA damage. Furthermore, si......RNA-mediated depletion of Claspin, Rad9 and Hus1 also stabilized Cdc25A. ATR ablation also inhibited the activatory phosphorylation of Chk1 on serine 345. Thus, the ATR-Chk1-Cdc25A pathway represents an integral part of physiological S-phase progression, and interference with this mechanism undermines viability...

  3. STEC:O111-HUS complicated by acute encephalopathy in a young girl was successfully treated with a set of hemodiafiltration, steroid pulse, and soluble thrombomodulin under plasma exchange.

    Science.gov (United States)

    Yada, Noritaka; Fujioka, Masayuki; Bennett, Charles L; Inoki, Kazuya; Miki, Toyokazu; Watanabe, Akihiko; Yoshida, Toshiko; Hayakawa, Masaki; Matsumoto, Masanori; Fujimura, Yoshihiro

    2015-04-01

    We report a 14-year-old girl, who developed shigatoxin-producing E. coli (STEC)-HUS complicated by encephalopathy. She was successfully treated with hemodiafiltration, high-dose methylprednisolone pulse therapy, and soluble recombinant thrombomodulin under plasma exchange. von Willebrand factor multimers analysis provides potential insights into how the administered therapies might facilitate successful treatment of STEC-HUS.

  4. Dal diario di una piccola comunista. Ricostruzione della vicenda umana nella Cecoslovacchia di Husák

    Directory of Open Access Journals (Sweden)

    Stefania Mella

    2015-12-01

    Full Text Available This article aims to present Dal diario di una piccola comunista (From the diary of a young communist girl, the first novel by the Slovak writer Michaela Šebőková. Through the main character’s voice, the eleven-year-old Alžbeta, Šebőková portrays Czechoslovakian society in the years of “normalization” and also offers a deeper understanding of children’s ideological manipulation under the regime of Gustav Husák through to the Young Pioneers Organization. Growing up as a member of this organization, Alžbeta, initially driven by strong Communist ideals, ends up realizing the undeniable contradiction between Communist rhetoric and its actual behaviour. She will reach awareness that lies and pretence are the only values underpinning the communist system of those years.

  5. Mild encephalitis/encephalopathy with reversible splenial and cerebellar lesions (MERS type II) in a patient with hemolytic uremic syndrome (HUS).

    Science.gov (United States)

    Gawlitza, Matthias; Hoffmann, Karl-Titus; Lobsien, Donald

    2015-01-01

    The typical form of mild encephalitis/encephalopathy with a reversible splenial lesion— called MERS type I—is characterized by a singular, reversible lesion in the midline of the splenium. Very rarely, additional lesions with similar signal characteristics can occur in other brain areas, which is then referred to as MERS type II. We present the case of a patient with a reversible splenial lesion and concomitant reversible cerebellar lesions within the scope of an atypical hemolytic uremic syndrome (HUS).

  6. Arne Jacobsens eget hus

    DEFF Research Database (Denmark)

    Thule Kristensen, Peter

    2007-01-01

    Beskrivelse og analyse af arkitekten Arne Jacobsens eget rækkehus på Strandvejen 413. Bogen er udgivet af Realea A/S, der ejer huset, og som i 2007 har restaureret det.......Beskrivelse og analyse af arkitekten Arne Jacobsens eget rækkehus på Strandvejen 413. Bogen er udgivet af Realea A/S, der ejer huset, og som i 2007 har restaureret det....

  7. János Kádár as an Economic Reformist And Gustáv Husák As An Antireformist

    OpenAIRE

    Horbulák Zsolt

    2016-01-01

    This paper deals with both political and economic history. The main task was to try to compare the attitude of Gustáv Husák and János Kádár about economic reforms in their own countries. The comparison was based on their lives, interests and personalities. Historical evaluation and biographical material was also used. Taking into account that the political circumstances were very similar, the root of the differences between the acts of these politicians had to be the result of individual fact...

  8. Abra esta carta após minha morte: escrita como testamento na correspondência entre Jan Hus e seu discípulo = Open this letter after my death: writing as testament in the correspondence between Jan Hus and his disciple

    Directory of Open Access Journals (Sweden)

    Thiago Borges de Aguiar

    2011-01-01

    Full Text Available O clérigo e educador Jan Hus, morto em 1415 pela fogueira do Concílio de Constança, escreveu duas cartas para seu discípulo Martin de Volyně, nas quais deixou um conjunto de instruções de distribuição de seus bens materiais e um rol de ensinamentos espirituais. As cartas eram semelhantes, sendo que a primeira só deveria ser aberta caso Martin recebesse de fonte segura a notícia da morte de Hus. Este texto analisa o contexto e o conteúdo dessas cartas em busca de indícios (conceito baseado no historiador Carlo Ginzburg de uma ação educativa da parte do remetente e de uma transmissão de seu lugar de mestre para seu discípulo.The priest and educator Jan Hus, who was killed by fire in 1415 the Council of Constance, wrote two letters to his disciple Martin of Volyne, in which left a set of instructions for distribution of their material possessions and an list of spiritual teachings. The letters were similar, and the first should only be opened if Martin received from a reliable source news of the death of Hus. This paper examines the context and content of these letters for clues (concept based on historian Carlo Ginzburg from an educational activity on the part of the sender and the transmission of his place of master to his disciple.

  9. János Kádár as an Economic Reformist And Gustáv Husák As An Antireformist

    Directory of Open Access Journals (Sweden)

    Horbulák Zsolt

    2016-01-01

    Full Text Available This paper deals with both political and economic history. The main task was to try to compare the attitude of Gustáv Husák and János Kádár about economic reforms in their own countries. The comparison was based on their lives, interests and personalities. Historical evaluation and biographical material was also used. Taking into account that the political circumstances were very similar, the root of the differences between the acts of these politicians had to be the result of individual factors. However, it cannot be denied that the difference between the development of Czechoslovakia and Hungary also played a significant role.

  10. Paediatric HUS Cases Related to the Consumption of Raw Milk Sold by Vending Machines in Italy: Quantitative Risk Assessment Based on Escherichia coli O157 Official Controls over 7 years.

    Science.gov (United States)

    Giacometti, F; Bonilauri, P; Piva, S; Scavia, G; Amatiste, S; Bianchi, D M; Losio, M N; Bilei, S; Cascone, G; Comin, D; Daminelli, P; Decastelli, L; Merialdi, G; Mioni, R; Peli, A; Petruzzelli, A; Tonucci, F; Liuzzo, G; Serraino, A

    2016-12-19

    A quantitative risk assessment (RA) was developed to estimate haemolytic-uremic syndrome (HUS) cases in paediatric population associated with the consumption of raw milk sold in vending machines in Italy. The historical national evolution of raw milk consumption phenomenon since 2008, when consumer interest started to grow, and after 7 years of marketing adjustment, is outlined. Exposure assessment was based on the official Shiga toxin-producing Escherichia coli O157:H7 (STEC) microbiological records of raw milk samples from vending machines monitored by the regional Veterinary Authorities from 2008 to 2014, microbial growth during storage, consumption frequency of raw milk, serving size, consumption preference and age of consumers. The differential risk considered milk handled under regulation conditions (4°C throughout all phases) and the worst time-temperature field handling conditions detected. In case of boiling milk before consumption, we assumed that the risk of HUS is fixed at zero. The model estimates clearly show that the public health significance of HUS cases due to raw milk STEC contamination depends on the current variability surrounding the risk profile of the food and the consumer behaviour has more impact than milk storage scenario. The estimated HUS cases predicted by our model are roughly in line with the effective STEC O157-associated HUS cases notified in Italy only when the proportion of consumers not boiling milk before consumption is assumed to be 1%. Raw milk consumption remains a source of E. coli O157:H7 for humans, but its overall relevance is likely to have subsided and significant caution should be exerted for temporal, geographical and consumers behaviour analysis. Health education programmes and regulatory actions are required to educate people, primarily children, on other STEC sources.

  11. Grib muligheden - i mulighedernes hus

    DEFF Research Database (Denmark)

    Nøttrup, Jonna

    2007-01-01

    Metodeudvikling på Bostedet Orion, Hillerød. Et socialpsykiatrisk bosted for sindslidende med multiple problemstillinger. Støttet af SL´s udviklingsfond.......Metodeudvikling på Bostedet Orion, Hillerød. Et socialpsykiatrisk bosted for sindslidende med multiple problemstillinger. Støttet af SL´s udviklingsfond....

  12. Information about TTP-HUS

    Science.gov (United States)

    ... Webmaster (email: Evaren-Page@ouhsc.edu), Department of Biostatistics & Epidemiology, College of Public Health, OUHSC Dee Terrell, PhD, Department of Biostatistics & Epidemiology, College of Public Health, OUHSC

  13. Roles of the checkpoint sensor clamp Rad9-Rad1-Hus1 (911)-complex and the clamp loaders Rad17-RFC and Ctf18-RFC in Schizosaccharomyces pombe telomere maintenance.

    Science.gov (United States)

    Khair, Lyne; Chang, Ya-Ting; Subramanian, Lakxmi; Russell, Paul; Nakamura, Toru M

    2010-06-01

    While telomeres must provide mechanisms to prevent DNA repair and DNA damage checkpoint factors from fusing chromosome ends and causing permanent cell cycle arrest, these factors associate with functional telomeres and play critical roles in the maintenance of telomeres. Previous studies have established that Tel1 (ATM) and Rad3 (ATR) kinases play redundant but essential roles for telomere maintenance in fission yeast. In addition, the Rad9-Rad1-Hus1 (911) and Rad17-RFC complexes work downstream of Rad3 (ATR) in fission yeast telomere maintenance. Here, we investigated how 911, Rad17-RFC and another RFC-like complex Ctf18-RFC contribute to telomere maintenance in fission yeast cells lacking Tel1 and carrying a novel hypomorphic allele of rad3 (DBD-rad3), generated by the fusion between the DNA binding domain (DBD) of the fission yeast telomere capping protein Pot1 and Rad3. Our investigations have uncovered a surprising redundancy for Rad9 and Hus1 in allowing Rad1 to contribute to telomere maintenance in DBD-rad3 tel1 cells. In addition, we found that Rad17-RFC and Ctf18-RFC carry out redundant telomere maintenance functions in DBD-rad3 tel1 cells. Since checkpoint sensor proteins are highly conserved, genetic redundancies uncovered here may be relevant to telomere maintenance and detection of DNA damage in other eukaryotes.

  14. No evidence of the Shiga toxin-producing E. coli O104:H4 outbreak strain or enteroaggregative E. coli (EAEC found in cattle faeces in northern Germany, the hotspot of the 2011 HUS outbreak area

    Directory of Open Access Journals (Sweden)

    Wieler Lothar H

    2011-11-01

    Full Text Available Abstract Background Ruminants, in particular bovines, are the primary reservoir of Shiga toxin-producing E. coli (STEC, but whole genome analyses of the current German ESBL-producing O104:H4 outbreak strain of sequence type (ST 678 showed this strain to be highly similar to enteroaggregative E. coli (EAEC. Strains of the EAEC pathotype are basically adapted to the human host. To clarify whether in contrast to this paradigm, the O104:H4 outbreak strain and/or EAEC may also be able to colonize ruminants, we screened a total of 2.000 colonies from faecal samples of 100 cattle from 34 different farms - all located in the HUS outbreak region of Northern Germany - for genes associated with the O104:H4 HUS outbreak strain (stx2, terD, rfbO104, fliCH4, STEC (stx1, stx2, escV, EAEC (pAA, aggR, astA, and ESBL-production (blaCTX-M, blaTEM, blaSHV. Results The faecal samples contained neither the HUS outbreak strain nor any EAEC. As the current outbreak strain belongs to ST678 and displays an en-teroaggregative and ESBL-producing phenotype, we additionally screened selected strains for ST678 as well as the aggregative adhesion pattern in HEp-2 cells. However, we were unable to find any strains belonging to ST678 or showing an aggregative adhesion pattern. A high percentage of animals (28% shed STEC, corroborating previous knowl-edge and thereby proving the validity of our study. One of the STEC also harboured the LEE pathogenicity island. In addition, eleven animals shed ESBL-producing E. coli. Conclusions While we are aware of the limitations of our survey, our data support the theory, that, in contrast to other Shiga-toxin producing E. coli, cattle are not the reservoir for the O104:H4 outbreak strain or other EAEC, but that the outbreak strain seems to be adapted to humans or might have yet another reservoir, raising new questions about the epidemiology of STEC O104:H4.

  15. Õhus on sammast / Andri Ksenofontov

    Index Scriptorium Estoniae

    Ksenofontov, Andri, 1962-

    2008-01-01

    Mare Mikofi näitus "Ausambad" Tallinna Kunstihoone galeriis kuni 14. XII, Juta Kivimäe koostatud väljapanek "Monument" Enn Roosi loomingust Hobusepea galeriis kuni 1. XII, Aadam Kaarma ja Kärt Ojavee näitus "Põhk ja piksel" ning Eesti Kunstiakadeemia kunstiüliõpilaste näitus (juhendaja Maarit Murka) SooSoo galeriis kuni 2. XII, Ehalill Halliste põimevaipade näitus "Loitsulilled" Vabaduse galeriis kuni10. XII ning Ana Sluga näitus "Aeglane puudutus" Tallinna Linnagaleriis 12.-23. XI

  16. Velkommen til gældens hus

    DEFF Research Database (Denmark)

    Lunde, Jens

    2015-01-01

    De amerikanske professorer, Atif Mian og Amir Sufi, udgav i år den udmærkede og noget oversete bog »House of Debt«, der vender fortællingen om finanskrisen på hovedet. Anmeldelse af: Atif Mian og Amir Sufi: "House of Debt. How They (and You) Caused the Great Recession, and How We Can Prevent...

  17. Õhus on nutikust... / Margit Argus, Maris Kerge

    Index Scriptorium Estoniae

    Argus, Margit

    2009-01-01

    Taaskasutatavast mööblist, mille stiililiselt võib jagada antiik-, retro- ja taaskasutusmööbliks. Baltika Moetänava sisustamiseks valmistas grupp arhitekte, sisearhitekte ja disainereid mööbli taaskasutusmööblist. Kasutati ära vana mööbli detailid või leiti vanale mööblile uus funktsioon

  18. Gymnastikens Hus : Ett referenskoncept för anpassade gymnastikhallar

    OpenAIRE

    2014-01-01

    På Svenska Gymnastikförbundets begäran har detta projekt gjorts som ett koncept för dem att ha som utgångspunkt i diskussioner med såväl föreningar som politiker i frågan om gymnastikens behov av anpassade idrottsanläggningar. En användarstudie av gymnastiken, samt flera discipliner, har gjorts och stått som utgångspunkt för anläggningens utformning. Därtill har även en utvärdering av flertalet befintliga hallar som används för gymnastik gjorts för att motivera beslut gällande anpassningar so...

  19. En praksisundersøgelse af ungdommens hus i Aarhus

    DEFF Research Database (Denmark)

    Westersø, Per; Ehrenreich, Rikke

    Gennem et bredt undersøgelsesarbejde er behovet for og ønsker til Netværksstedet i Aarhus afdækket. Undersøgelsen viser, at der behov for Ungdommenshus, der både er et være-, lære- og væksthus for unge, og samtidig er en indgang til vejledning og støtte. Tilbuddet findes ikke i Aarhus i dag....

  20. Husův odkaz na Jáchyma z Fiore

    Directory of Open Access Journals (Sweden)

    Vít Hlinka

    2015-06-01

    Full Text Available The article attempts to outline the major theological concepts of history by great medieval exegete Joachim of Fiore, it reflects his apocalyptic experience of that time and describes the main features and methodology of his exegesis. Moreover, the article documents, based on the description of Joachim, apocalyptic expressions in the writings of John Huss; it also examines the possible influence of prophecies and tries to answer the question whether it is possible to find any signs of the influence of Joachim of Fiore, or his disciples, on the John Huss’s work.

  1. Indfødsretsprøve / udarbejdet af Ministeriet for Flygtninge, Indvandrere og Integration ; i samarbejde med Det Historiske Hus

    DEFF Research Database (Denmark)

    Jespersen, Knud J.V.; Mortensen, Finn Hauberg; Outzen, Ove;

    200 multiple choice-opgaver inden for Danmarks historie, kultur og samfundsfold samt forholdet til omverdenen. De er beregnet til at bruge i udvalg for den prøve, der skal bestås af ansøgere om dansk indfødsret......200 multiple choice-opgaver inden for Danmarks historie, kultur og samfundsfold samt forholdet til omverdenen. De er beregnet til at bruge i udvalg for den prøve, der skal bestås af ansøgere om dansk indfødsret...

  2. Bliv innovativ og få orden-i-eget-hus via understøttelsen af nye spin-off-virksomheder

    DEFF Research Database (Denmark)

    Clarke, Ann Højbjerg; Evald, Majbritt Rostgaard; Jensen, Kent Wickstrøm;

    2007-01-01

    forældrevirksomheder kan arbejde med spin-off-aktiviteter. Redskabet er opdelt i syv trin. Hvert trin tager fat på konkrete aktiviteter som erhvervskonsulenten i samarbejde med en forældrevirksomhed kan gennemføre for at blive mere bevidst om hvordan forretningsudvikling kan gennemføres i den enkelte virksomhed. Denne...... del af rapporten er oplagt at tage fat på, uanset hvor meget erfaring og viden erhvervskonsulenten har om spin-off-aktiviteter. I indholdsfortegnelsen starter denne del af rapporten med afsnittet "Arbejdsmetoden for de syv trin: Den udførlige model" og ender efter gennemgangen af de syv trin. Denne...

  3. IND UCTION OF SPAW NING IN THE TR OPICAL WALKING CATFISH (C la rias b atr ac hus BY CONTROLLI NG WATER L EVEL AND T EMPERAT URE

    Directory of Open Access Journals (Sweden)

    M. ZAIRIN JR.

    2001-01-01

    Full Text Available This experiment was carried out t o confirm the rol e of water level and w ater temperature i n indu cing t he s pawning o f tr opical walking catfi sh . Ma ture mal es an d females reared un de r 23 - 2 5 °C, were paired and in duced to spa wn by cont rolling w ater level and w ater temperature. Decr easi ng water level and returni ng it to its original level r esulted i n a low spawni ng r ate (l es s t han 6. 7 % at 23 °C . Decreasing water level with simultaneous increase in water temperature, followed by returning the respective levels to their originals gave high spa wning rates ( 41.7 — 50 %; whereas the s ame treatment but without a ny water temperature decrea sed when t he wate r le vel was return ed t o t he initial level, gave a lo w spawning rate (16 .7 %. In creasin g water level only, fail ed to ind uce spa wning . A high spawning rate was obtained also when changes in water level were ca rried out under high t emperature of 28 °C. No fish spawned in the ab sence of the environmental stimulation. From the results, i t is confirmed that water le vel and t emperature play important r oles i n i nducin g spaw ning of tropical walki ng catfish. Changes i n water t emperature probably increas e the sensitivity of fish to th e change in water level. Prolo nged exposure to high water tem perature c ould also improve the sensitivity of fish.

  4. Õhus on elu : barokkmuusika ja nüüdistants Nikkolo peadisaineri loodud kostüümides. Väärtmuusika elamus pealinnast

    Index Scriptorium Estoniae

    2008-01-01

    15.-24. augustini annab kontserdisarjas "Eesti mõisad 2008" kuus kontsertetendust barokkmuusika ansambel Corelli Consort (vt. www.corelli.ee), kontsertetenduste kostüümid on loonud Ivo Nikkolo brändi naisteriiete peadisainer Eve Hanson. 17.-23. augustini toimub Tallinna Raekojas, Rootsi Mihkli kirikus ja Jaani kirikus Tallinna Kammermuusika festival (vt. www.plmf.ee)

  5. Two non-coding transcripts of toxins from the scorpion But-hus martensii Karsch: Evi-dence for the existence of NMD in scorpion venom gland cells

    Institute of Scientific and Technical Information of China (English)

    2002-01-01

    Two non-coding transcripts of toxins were isolated from the venom gland Cdna library of the Chinese scorpion Buthus martensii Karsch, named BmβTX15-SP and BmTXKβ-SP, respectively. Analysis of nucleotide sequences shows that their 5′ sequences are identical to the 5′UTR and upstream open reading frame (ORF) sequences of the cDNAs encoding BmβTX15 and BmTXKβ, two toxins from Buthus martensii Karsch. But no detectable homology exists in other regions. Two polyadenylated non-coding transcripts encode multiple short ORFs with no more than 34 amino acid residues. The tailing signal (AATAAA) is situated at 14 or 18 bp downstream from the poly(A). The data of genomic sequences provides support for Bmβ TX15-SP and BmTXK β-SP not deriving from splicing errors of pre- mRNAs. Our finding provides evidence for the existence of nonsense-mediated Mrna decay (NMD) pathway in scorpion venom gland cells.

  6. An audit analysis of a guideline for the investigation and initial therapy of diarrhea negative (atypical) hemolytic uremic syndrome.

    NARCIS (Netherlands)

    Johnson, S.; Stojanovic, J.; Ariceta, G.; Bitzan, M.; Besbas, N.; Frieling, M.; Karpman, D.; Landau, D.; Langman, C.; Licht, C.; Pecoraro, C.; Riedl, M.; Siomou, E.; Kar, N.C. van de; Walle, J.V.; Loirat, C.; Taylor, C.M.

    2014-01-01

    BACKGROUND: In 2009, the European Paediatric Study Group for Haemolytic Uraemic Syndrome (HUS) published a clinical practice guideline for the investigation and initial therapy of diarrhea-negative HUS (now more widely referred to as atypical HUS, aHUS). The therapeutic component of the guideline (c

  7. Radon as a tracer for soil-gas entry into a house located next to a contaminated dry-cleaning property; Radon som sporgas for jordluftindtraengning til hus ved forurenet renserigrund

    Energy Technology Data Exchange (ETDEWEB)

    Andersen, C.E

    2001-07-01

    This study applies the naturally occurring radioactive gas radon-222 as a tracer for soil-gas entry into a house located next to a dry-cleaners shop. This is possible because the concentration of radon in the soil below the house is about 1000 times higher than the concentration in outdoor air. The study is based on continuous indoor measurement of radon, differential pressures, barometric pressure and temperatures and grab samples of radon below the slab and in the soil in the vicinity of the house. During the investigation, vacuum extraction were used to remove chlorinated solvents (perchloroethylene, PCE) from the unsaturated zone. The study shows that the vacuum extraction influences the radon concentration in and below the house. When the vacuum pump is on, the indoor radon concentration is only 10 Bq/m{sup 3} corresponding to the contribution from radon in outdoor air and exhalation from building materials. When the vacuum pump is set off, the average indoor radon concentration increases to 30 Bq/m{sup 3}. It is believed that the increase is caused by radon entry from the soil. Regression analysis demonstrates that changes in the indoor radon concentration can be explained by changes in indoor-outdoor pressure differences and changes in the atmospheric pressure. This suggests that advection is the primary mode of entry. Under some highly simplifying assumptions the soil-gas entry is found to be around 1 m{sup 3}/h. This, however, is most likely an overestimate. Based on the measured radon concentration in the exhaust air from the vacuum system and a typical radon emanation rate for Danish soil, it is estimated that the soil vapor extraction system ventilates about 10000 m{sup 3} of soil. The investigation is supported by numerical model calculations with the finite-volume model Rnmod3d. (au)

  8. Bokanmeldelse: Planetveien 12: Arne Korsmo og Grete Prytz Kittelsens hus. Et viktig bidrag til en betydningsfull boligs biografi Book Review: Planetveien 12 (Planet Road 12: Arne Korsmo and Grete Prytz Kittelsen’s House

    Directory of Open Access Journals (Sweden)

    Astrid Skjerven

    2013-01-01

    Full Text Available Boken tar for seg et av etterkrigsmodernismens hovedverk som allkunstverk og bolig. Forfatteren behandler husets idégrunnlag, planlegning og konstruksjon, samarbeidspartnere og hvilke endringer som er blitt foretatt gjennom tiden. Spesielt det siste er av høy relevans i forbindelse med vår egen tids praktisering av og diskusjoner omkring gjenbruk og transformasjon av våre kulturminner. Den inneholder også biografi og omtale av hans øvrige virksomhet, samt forfatterens tolkning av Planetveien. Blant det som savnes er en utdypende behandling av husets betydning som internasjonal møteplass og en mer analytisk gjennomgang av forholdet til samarbeidspartnerne, spesielt Grete Prytz Kittelsen. Og ikke minst kunne problematikken knyttet til bruk versus bevaring vært viet større oppmerksomhet. Alt i alt er dette en sjeldent god, engasjerende og viktig utgivelse. Snarere enn noen uttømmende fremstilling er boken en appetittvekker til det som ble skapt i forbindelse med Planetveien, og til det sentrale temaet transformasjon. The book deals with one of postwar modernism masterpieces that complete work of art and housing. The author treats the house’s ideas, planning and construction, cooperation partners and the changes that have been made through time. Especially the latter is of high relevance in relation to our own time’s practicing of and discussions on recycling and transformation of our cultural heritage. It also contains biography and discussion of the architect’s other activities, as well as the author's interpretation of the house. Among the missing are a detailed treatment of the house as a meeting place and a more analytical review of the relationship with the partners, especially Grete Prytz Kittelsen. And not least issues related to the use versus preservation could have been devoting more attention. All in all, this is a rare good, interesting and important book. Rather than an exhaustive presentation, the book is an appetizer to what was created in conjunction with Planetveien 12 as a vehicle, and the central theme of transformation.

  9. Štrasburská hus v Kodani: Náčrt pojmu irónie u Sørena Kierkegaarda (Strasbourg goose in Copenhagen: An outline to the concept of irony in Søren Kierkegaard’s work

    Directory of Open Access Journals (Sweden)

    Česlav Peter Šajda

    2006-09-01

    Full Text Available The author of this text makes clear the circumstances of origin, structure, and content of Kierkegaard´ s master dissertation thesis. He analyses understanding of irony, his relation to Socrates and irony in totality of Kierkegaard’s understanding. The conclusion of this text points to irony of Kierkegaard’s destiny.

  10. [Atypical hemolytic uremic syndrome].

    Science.gov (United States)

    Blasco Pelicano, Miquel; Rodríguez de Córdoba, Santiago; Campistol Plana, Josep M

    2015-11-20

    The hemolytic uremic syndrome (HUS) is a clinical entity characterized by thrombocytopenia, non-immune hemolytic anemia and renal impairment. Kidney pathology shows thrombotic microangiopathy (TMA) with endothelial cell injury leading to thrombotic occlusion of arterioles and capillaries. Traditionally, HUS was classified in 2 forms: Typical HUS, most frequently occurring in children and caused by Shiga-toxin-producing bacteria, and atypical HUS (aHUS). aHUS is associated with mutations in complement genes in 50-60% of patients and has worse prognosis, with the majority of patients developing end stage renal disease. After kidney transplantation HUS may develop as a recurrence of aHUS or as de novo disease. Over the last years, many studies have demonstrated that complement dysregulation underlies the endothelial damage that triggers the development of TMA in most of these patients. Advances in our understanding of the pathogenic mechanisms of aHUS, together with the availability of novel therapeutic options, will enable better strategies for the early diagnosis and etiological treatment, which are changing the natural history of aHUS. This review summarizes the aHUS clinical entity and describes the role of complement dysregulation in the pathogenesis of aHUS. Finally, we review the differential diagnosis and the therapeutic options available to patients with aHUS. Copyright © 2014 Elsevier España, S.L.U. All rights reserved.

  11. Cytokine profiles of patients with enterohemorrhagic Escherichia coli O111-induced hemolytic-uremic syndrome.

    Science.gov (United States)

    Shimizu, Masaki; Kuroda, Mondo; Sakashita, Natsumi; Konishi, Michio; Kaneda, Hisashi; Igarashi, Noboru; Yamahana, Junya; Taneichi, Hiromichi; Kanegane, Hirokazu; Ito, Mika; Saito, Shigeru; Ohta, Kazuhide; Taniguchi, Takumi; Furuichi, Kengo; Wada, Takashi; Nakagawa, Masaru; Yokoyama, Hitoshi; Yachie, Akihiro

    2012-12-01

    Proinflammatory cytokines are related to the pathogenesis of enterohemorrhagic Escherichia coli (EHEC) infection and hemolytic-uremic syndrome (HUS). We assessed the kinetics of the release of cytokines such as neopterin, interleukin (IL)-6, IL-8 and tumour necrosis factor (TNF)-α and the soluble forms of type I and II TNF receptors during EHEC O111-induced HUS (EHEC O111/HUS). Fourteen patients with EHEC O111/HUS were enrolled in this study. Serum concentrations of all cytokines other than TNF-α were significantly elevated in patients with severe HUS compared with those in patients with mild HUS. Although serum concentrations of TNF-α were not significantly higher in patients with severe HUS, most patients with acute encephalopathy showed elevated TNF-α levels. Serum concentrations of these cytokines rapidly and markedly increased, and massive hypercytokinaemia developed 1 day before the diagnosis of HUS in patients with severe HUS. Changes in the number of white blood cells and concentration of serum lactate dehydrogenase were significantly larger between the onset of hemorrhagic colitis and the time of the diagnosis of HUS in patients with severe HUS compared with those in patients with mild HUS. Proinflammatory cytokines play an important role in the pathogenesis of EHEC infection and development of severe complications, including HUS and encephalopathy. Monitoring the cytokine profile may be useful for assessing disease activity of EHEC O111 infections.

  12. Epidemiology, clinical presentation, and pathophysiology of atypical and recurrent hemolytic uremic syndrome.

    NARCIS (Netherlands)

    Zimmerhackl, L.B.; Besbas, N.; Jungraithmayr, T.; Kar, N.C.A.J. van de; Karch, H.; Karpman, D.; Landau, D.; Loirat, C.; Proesmans, W.; Prufer, F.; Rizzoni, G.; Taylor, M.C.

    2006-01-01

    Hemolytic uremic syndrome (HUS) includes a heterogeneous group of hemolytic disorders. Among the identified causes of HUS are infections, particularly infections with Shiga toxin-producing ESCHERICHIA COLI (STEC), complement disorders, and disorders interfering with the degradation of von Willebrand

  13. Epidemiology, clinical presentation, and pathophysiology of atypical and recurrent hemolytic uremic syndrome.

    NARCIS (Netherlands)

    Zimmerhackl, L.B.; Besbas, N.; Jungraithmayr, T.; Kar, N.C.A.J. van de; Karch, H.; Karpman, D.; Landau, D.; Loirat, C.; Proesmans, W.; Prufer, F.; Rizzoni, G.; Taylor, M.C.

    2006-01-01

    Hemolytic uremic syndrome (HUS) includes a heterogeneous group of hemolytic disorders. Among the identified causes of HUS are infections, particularly infections with Shiga toxin-producing ESCHERICHIA COLI (STEC), complement disorders, and disorders interfering with the degradation of von Willebrand

  14. Hemolytic uremic syndrome and Clostridium difficile colitis

    Directory of Open Access Journals (Sweden)

    Maryam Keshtkar-Jahromi

    2012-10-01

    Full Text Available Hemolytic uremic syndrome (HUS can be associated with different infectious etiologies, but the relationship between pseudomembranous colitis and HUS was first described in the 1970s in some childhood patients. There is very limited published literature on Clostridium difficile-associated HUS. We report a case of C. difficile-related HUS in an adult patient and provide a review of the literature.

  15. Hemolytic uremic syndrome and Clostridium difficile colitis

    Science.gov (United States)

    Keshtkar-Jahromi, Maryam; Mohebtash, Mahsa

    2012-01-01

    Hemolytic uremic syndrome (HUS) can be associated with different infectious etiologies, but the relationship between pseudomembranous colitis and HUS was first described in the 1970s in some childhood patients. There is very limited published literature on Clostridium difficile-associated HUS. We report a case of C. difficile-related HUS in an adult patient and provide a review of the literature. PMID:23882375

  16. Idiopathic Atypical Haemolytic Uraemic Syndrome presenting with acute dystonia

    LENUS (Irish Health Repository)

    Maduemem, Rizwan K E

    2017-09-01

    Hemolytic Uremic Syndrome (HUS), a triad of microangiopathic hemolytic anemia, thrombocytopenia and acute kidney injury. The atypical HUS (aHUS) results from over activation of complement system with formation of micro thrombi and damage to endothelial cells resulting in renal impairment in 50 % and death in 25 %, commonly in untreated patients. We report an intriguing case of aHUS presenting with acute onset of movement disorder and fluctuating delirium.

  17. A patient with Crohn's disease who presented with thrombotic thrombocytopenic purpura/hemolytic uremic syndrome.

    Science.gov (United States)

    Unverdi, Selman; Ceri, Mevlut; Öztürk, Mehmet Akif; Akbal, Erdem; Ensari, Arzu; Yılmaz, Rahmi; Kocak, Erdem; Inal, Salih; Koklu, Seyfettin; Duranay, Murat

    2011-01-01

    Thrombotic thrombocytopenic purpura (TTP)/hemolytic uremic syndrome (HUS) is characterized with fever, purpura, anemia due to microangiopathic hemolysis, thrombocytopenia, kidney damage, and neurologic symptoms. The development of TTP/HUS during the course of inflammatory bowel diseases was rarely reported. However, coexistence of TTP/HUS and Crohn's disease in the same patient has not been reported previously. We herein present a case of TTP/HUS who presented with Crohn's disease. He responded to cyclosporine treatment.

  18. Thrombocytopenia is not mandatory to diagnose haemolytic and uremic syndrome

    Directory of Open Access Journals (Sweden)

    Sallée Marion

    2013-01-01

    Full Text Available Abstract Background Hemolytic and uremic syndrome (HUS diagnosis involves association of non immune hemolytic anemia, thrombocytopenia, and renal failure. HUS without thrombocytopenia has been observed, we call it partial HUS. Its real frequency and outcome are unknown. The aim of this study was to determine the prevalence of patients with normal platelets count in two HUS cohorts and to compare their outcome to patients with thrombocytopenia. Methods We retrospectively identified HUS diagnosis in two different cohorts. The first cohort was from a single center and consisted of all cases of HUS whatever the aetiology, the second was multicentric and consisted of atypical HUS patients. These cohorts were divided into two groups depending on the presence or absence of thrombocytopenia. Clinical and biological data were compared between thrombopenic and non thrombopenic group. Results We identified 13% (20/150 of patients with normal platelets count: 10 episodes (18% of HUS in six patients (14% in the monocentric cohort and 14 patients (13% with 17 episodes (12% in the multicentric cohort of atypical HUS. Groups differed in platelets count and LDH level. In both cohorts, renal outcome was similar to patient presenting with thrombocytopenia. Conclusion HUS with normal platelets count is not infrequent. Relative to classical clinical presentation of HUS, partial HUS has similar characteristics and identical poor renal outcome and so must be treated in the same way.

  19. Assesment, treatment and prevention of atypical hemolytic uremic syndrome

    Directory of Open Access Journals (Sweden)

    Azar Nickavar

    2013-01-01

    Full Text Available Hemolytic uremic syndrome (HUS is a heterogeneous group of hemolytic disorders. Different terminologies have been described in HUS, which are as follows: (1 D+ HUS: Presentation with a preceding diarrhea; (2 typical HUS: D+ HUS with a single and self-limited episode; (3 atypical HUS (aHUS: Indicated those with complement dysregulation; (4 recurrent HUS: Recurrent episodes of thrombocytopenia and/or microangiopathic hemolytic anemia (MAHA after improvement of hematologic abnormalities; and (5 familial HUS: Necessary to distinct synchronous outbreaks of D+ HUS in family members and asynchronous disease with an inherited risk factor. aHUS is one of the potential causes of end-stage renal disease (ESRD in children. It has a high recurrence after renal transplantation in some genetic forms. Therefore, recognition of the responsible mechanism and proper prophylactic treatment are recommended to prevent or delay the occurrence of ESRD and prolong the length of survival of the transplanted kidney. A computerized search of MEDLINE and other databases was carried out to find the latest results in pathogenesis, treatment, and prevention of aHUS.

  20. Posttransplantation cytomegalovirus-induced recurrence of atypical hemolytic uremic syndrome associated with a factor H mutation: successful treatment with intensive plasma exchanges and ganciclovir.

    NARCIS (Netherlands)

    Olie, K.H.; Goodship, T.H.; Verlaak, R.; Florquin, S.; Groothoff, J.W.; Strain, L.; Weening, J.J.; Davin, J.C.

    2005-01-01

    Atypical hemolytic uremic syndrome (HUS) can recur after renal transplantation and often leads to graft loss. In some series of familial HUS, the risk of early graft loss due to recurrence of HUS approaches 100% despite any therapy. This led some authors to claim that kidney transplantation is contr

  1. Guideline for the investigation and initial therapy of diarrhea-negative hemolytic uremic syndrome.

    NARCIS (Netherlands)

    Ariceta, G.; Besbas, N.; Johnson, S.; Karpman, D.; Landau, D.; Licht, C.; Loirat, C.; Pecoraro, C.; Taylor, C.M.; Kar, N.C.A.J. van de; Walle, J. van de; Zimmerhackl, L.B.

    2009-01-01

    This guideline for the investigation and initial treatment of atypical hemolytic uremic syndrome (HUS) is intended to offer an approach based on opinion, as evidence is lacking. It builds on the current ability to identify the etiology of specific diagnostic sub-groups of HUS. HUS in children is mos

  2. A new era in the diagnosis and treatment of atypical haemolytic uraemic syndrome.

    NARCIS (Netherlands)

    Westra, D.; Wetzels, J.F.M.; Volokhina, E.B.; Heuvel, L.P.W.J. van den; Kar, N.C.A.J. van de

    2012-01-01

    The haemolytic uraemic syndrome (HUS) is characterised by haemolytic anaemia, thrombocytopenia and acute renal failure. The majority of cases are seen in childhood and are preceded by an infection with Shiga-like toxin producing Escherichia coli (STEC-HUS; so-called typical HUS). Non-STEC or atypica

  3. Hemolytic uremic syndrome.

    Science.gov (United States)

    Canpolat, Nur

    2015-06-01

    Hemolytic uremic syndrome (HUS) is a clinical syndrome characterized by the triad of thrombotic microangiopathy, thrombocytopenia, and acute kidney injury. Hemolytic uremic syndrome represents a heterogeneous group of disorders with variable etiologies that result in differences in presentation, management and outcome. In recent years, better understanding of the HUS, especially those due to genetic mutations in the alternative complement pathway have provided an update on the terminology, classification, and treatment of the disease. This review will provide the updated classification of the disease and the current diagnostic and therapeutic approaches on the complement-mediated HUS in addition to STEC-HUS which is the most common cause of the HUS in childhood.

  4. Prevalence and clinical course of typical hemolytic uremic syndrome among sibling.

    Science.gov (United States)

    Eymann, Alfredo; Coccia, Paula; Raddavero, Claudia; Lafi, Gabriela; Ferraris, Verónica; Ramírez, José; Ferraris, Jorge

    2016-12-01

    Hemolytic uremic syndrome (HUS) isaninfectious disease caused by Shiga toxin-producing Escherichia coli. The objective of this study was to assess the risk of transmission and clinical course between siblings with typical HUS. Medical records of children with typical HUS between 1997 and 2012 were reviewed. Sibling pairs were established as inclusion criteria. A severity score was defined. A total of 133 patients with HUS were recorded; 40 had siblings and 4 progressed to HUS (10%). The mean age of the 4 sibling pairs was 29.3 months old (SD ± 11.5); 5 (62.5%) were girls. The mean time between each case was 5.7 days (SD ± 3). HUS was more severe in the siblings who became infected in the second place. The risk of HUS transmission between siblings was 10%, and the clinical course of the second sibling was less favorable.

  5. Incomplete hemolytic-uremic syndrome in Argentinean children with bloody diarrhea.

    Science.gov (United States)

    López, E L; Contrini, M M; Devoto, S; de Rosa, M F; Graña, M G; Aversa, L; Gómez, H F; Genero, M H; Cleary, T G

    1995-09-01

    Argentina has an exceptionally high frequency of hemolytic-uremic syndrome (HUS). We sought to define prospectively the role of verocytotoxins (Shiga-like toxins [SLTs]) in 254 Argentinean children with grossly bloody diarrhea during spring and summer. Free fecal SLTs (I/II) and/or DNA probe-positive isolates were found in 99 (39%) of the children. During the follow-up period, HUS developed in 6 patients (4 with evidence of recent SLT infection based on stool studies); another 14 patients had some, but not all, of the abnormalities seen in typical HUS. The development of HUS or incomplete HUS in these children was significantly associated with recent SLT-Escherichia coli infection (p = 0.024). The high incidence of SLT-associated bloody diarrhea in Argentina explains, at least partially, the unusually high frequency of HUS. Our data indicate that incomplete forms of HUS may be common in patients with SLT-associated bloody diarrhea.

  6. Habitat Evaluation Procedures Report; Carl Property - Yakama Nation.

    Energy Technology Data Exchange (ETDEWEB)

    Ashley, Paul; Muse, Anthony

    2008-02-01

    A baseline habitat evaluation procedures (HEP) analysis was conducted on the Carl property (160 acres) in June 2007 to determine the number of habitat units to credit Bonneville Power Administration (BPA) for providing funds to acquire the property as partial mitigation for habitat losses associated with construction of McNary Dam. HEP surveys also helped assess the general ecological condition of the property. The Carl property appeared damaged from livestock grazing and exhibited a high percentage of invasive forbs. Exotic grasses, while present, did not comprise a large percentage of the available cover in most areas. Cover types were primarily grassland/shrubsteppe with a limited emergent vegetation component. Baseline HEP surveys generated 356.11 HUs or 2.2 HUs per acre. Habitat units were associated with the following HEP models: California quail (47.69 HUs), western meadowlark (114.78 HUs), mallard (131.93 HUs), Canada goose (60.34 HUs), and mink (1.38 HUs).

  7. Impaired neutrophils in children with the typical form of hemolytic uremic syndrome.

    Science.gov (United States)

    Fernández, Gabriela C; Gómez, Sonia A; Rubel, Carolina J; Bentancor, Leticia V; Barrionuevo, Paula; Alduncín, Marta; Grimoldi, Irene; Exeni, Ramón; Isturiz, Martín A; Palermo, Marina S

    2005-09-01

    Experimental and clinical evidence suggest that activated neutrophils (PMN) could contribute to endothelial damage in Hemolytic Uremic Syndrome (D+HUS). Additionally, while PMN-activating cytokines and PMN-derived products have been found in D+HUS sera, we have demonstrated phenotypic alterations in D+HUS PMN compatible with a deactivation state. Here, we investigated whether D+HUS PMN were actually hyporesponsive, and explored some of the mechanisms probably involved in their derangement. Twenty-two D+HUS children were bled in the acute period, and blood samples from healthy, acute uremic and neutrophilic children were obtained as controls. We evaluated degranulation markers in response to cytokines, intracellular granule content, and reactive oxygen species (ROS) generation in circulating D+HUS and control PMN. The influence of D+HUS-derived plasma and the direct effects of Stx in vitro were evaluated on healthy donors' PMN. We found that D+HUS PMN presented reduced degranulatory capacity in response to cytokines and intracellular granule content, and decreased ROS generation. D+HUS plasma or Stx did not affect the phenotype and function of healthy donors' PMN. These results suggest that upon hospitalization D+HUS PMN are functionally impaired and show features of previous degranulation, indicating a preceding process of activation with release of ROS and proteases involved in endothelial damage.

  8. The functional state of neutrophils correlates with the severity of renal dysfunction in children with hemolytic uremic syndrome.

    Science.gov (United States)

    Fernandez, Gabriela C; Gomez, Sonia A; Ramos, Maria V; Bentancor, Leticia V; Fernandez-Brando, Romina J; Landoni, Veronica I; Lopez, Laura; Ramirez, Flavia; Diaz, Mario; Alduncin, Marta; Grimoldi, Irene; Exeni, Ramon; Isturiz, Martin A; Palermo, Marina S

    2007-01-01

    Hemolytic Uremic Syndrome (HUS) is the main cause of acute renal failure in children. The high percentage of patients who develop long-term sequelae constitutes an important medical concern. The identification of parameters that correlate with the degree of renal failure may be useful to plan the best treatment soon after hospitalization. Here, we investigated the functional state of neutrophils (PMN) from HUS patients on admission, before dialysis and/or transfusion, in relation to the severity of renal impairment reached during the acute period (AP). We found that all PMN activation parameters measured in severe cases of HUS (HUS AP3) were statistically lower comparing to children with mild cases of HUS (HUS AP1). As HUS PMN phenotype and dysfunction is compatible with that of cells undergoing cell death, we also studied spontaneous apoptosis. Not only were HUS PMN not apoptotic, but HUS AP3 PMN showed an increased survival. Almost all phenotypic and functional parameters measured on PMN correlated with severity. Our results revealed a marked deactivation of PMN in severe cases of HUS, and suggest that studying the functional state of PMN could be of prognostic value.

  9. Looking up at "She":A Comparison between Euripides's Heroines in "Medea" and "The Book of Songs (Hus-band)"%“她者”的仰望--欧里庇得斯《美狄亚》与《诗经·氓》中女主人公比较

    Institute of Scientific and Technical Information of China (English)

    孙钊

    2015-01-01

    美狄亚与氓妇皆经历恋爱———结婚———被弃———反抗的婚姻历程,文章正文由“她者”的苦难、“她者”的反抗、“她者”的崛起组成,论述两位女主人公“被弃”的苦难归因于:丈夫的言而无信,女性身份的边缘位置。从她们不同的反抗方式来分析中西文化差异和不同文学体裁对人物言行的影响。最后,阐述她们的苦难和抗争所带来的启示,关注当下女性的社会地位和自我独立的能力。%Medea and the Married Woman have both experienced such a process of marriage:falling in love—getting married—be-ing abandoned—resistance. The articles consist of"her"suffer-ings, resistances and rises. The reason why the two heroines are abandoned is that:the husbands eat their words, the females are marginalized. From their different ways of resistance, this paper analyzes Chinese and Western cultural differences and the influ-ence of different literary genres on the words and behaviors of figures. Finally, it elaborates their sufferings and the enlighten-ment of their resistances. This paper intends to inspire us to pay attention to the social status and independent ability of contem-porary females.

  10. 全媒体时代开放农业视频资源的探索--《农林牧渔视频素材库》述评%Exploration of Agricultur-al Video Resources De-velopment in Omnimedia Era:Review on Video Material Database of A-griculture, Forestry, Hus-bandry and Fishery

    Institute of Scientific and Technical Information of China (English)

    田建国

    2013-01-01

    The contains abundant agri-cultural videos and assisted animations, including ten sublibraries of agricultural science and technology, peasants life, a-gricultural equipment, rural energy ap-plication, etc. It is a practical agricultur-al video database that owns strong video retrieval function, hence, it can be used for making agricultural television pro-gram, teaching courseware, and network video and multimedia products of agri-culture website. Based on this database, part of the domestic publishing corpora-tions cooperated to produce a number of products which promote digitization transformation and upgrading of China's press and publication.%《农林牧渔视频素材库》包含了内容齐全的农业视频资料和辅助动画,全库共分为10大类子库,涵盖了农业科技、农民生活、农用器械、农村能源利用等方面。景别较丰富,视角较全面,有时间积淀,珍贵镜头不少,还具有较强的视频检索功能,使用便捷。既可以用于农业电视节目或者教学课件的制作,也可以用于涉农网站的网络视频和多媒体产品的制作,是一部很有实用价值的农业视频资料库。

  11. An update for atypical haemolytic uraemic syndrome: diagnosis and treatment. A consensus document.

    Science.gov (United States)

    Campistol, Josep M; Arias, Manuel; Ariceta, Gema; Blasco, Miguel; Espinosa, Laura; Espinosa, Mario; Grinyó, Josep M; Macía, Manuel; Mendizábal, Santiago; Praga, Manuel; Román, Elena; Torra, Roser; Valdés, Francisco; Vilalta, Ramón; Rodríguez de Córdoba, Santiago

    2015-01-01

    Haemolytic uraemic syndrome (HUS) is a clinical entity defined as the triad of nonimmune haemolytic anaemia, thrombocytopenia, and acute renal failure, in which the underlying lesions are mediated by systemic thrombotic microangiopathy (TMA). Different causes can induce the TMA process that characterizes HUS. In this document we consider atypical HUS (aHUS) a sub-type of HUS in which the TMA phenomena are the consequence of the endotelial damage in the microvasculature of the kidneys and other organs due to a disregulation of the activity of the complement system. In recent years, a variety of aHUs-related mutations have been identified in genes of the the complement system, which can explain approximately 60% of the aHUS cases, and a number of mutations and polymorphisms have been functionally characterized. These findings have stablished that aHUS is a consequence of the insufficient regulation of the activiation of the complement on cell surfaces, leading to endotelial damage mediated by C5 and the complement terminal pathway. Eculizumab is a monoclonal antibody that inhibits the activation of C5 and blocks the generation of the pro-inflammatory molecule C5a and the formation of the cell membrane attack complex. In prospective studies in patients with aHUS, the use of Eculizumab has shown a fast and sustained interruption of the TMA process and it has been associated with significative long-term improvements in renal function, the interruption of plasma therapy and important reductions in the need of dialysis. According to the existing literature and the accumulated clinical experience, the Spanish aHUS Group published a consensus document with recommendations for the treatment of aHUs (Nefrologia 2013;33[1]:27-45). In the current online version of this document, we update the aetiological classification of TMAs, the pathophysiology of aHUS, its differential diagnosis and its therapeutic management.

  12. Soluble tumor necrosis factor receptor 1 and tissue inhibitor of metalloproteinase-1 in hemolytic uremic syndrome with encephalopathy.

    Science.gov (United States)

    Shiraishi, Masahiro; Ichiyama, Takashi; Matsushige, Takeshi; Iwaki, Takuma; Iyoda, Kuniaki; Fukuda, Ken; Makata, Haruyuki; Matsubara, Tomoyo; Furukawa, Susumu

    2008-05-30

    Enterohemorrhagic Escherichia coli (EHEC) induces hemorrhagic colitis and hemolytic uremic syndrome (HUS). Morbidity and mortality are increased in HUS patients with neurologic complications. To determine the pathogenesis of the central nervous system (CNS) involvement in HUS by EHEC, we determined the serum concentrations of interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-alpha), soluble TNF receptor 1 (sTNFR1), IL-10, interferon-gamma (IFN-gamma), IL-2, IL-4, soluble E-selectin (sE-selectin), matrix metalloproteinase-9 (MMP-9), and tissue inhibitor of metalloproteinase-1 (TIMP-1) during the acute stage in children with HUS with or without CNS involvement. Serum concentrations of IL-6, IL-10, sTNFR1, sE-selectin, MMP-9, and TIMP-1, but not TNF-alpha, IFN-gamma, IL-2, or IL-4, were significantly higher in patients with HUS with encephalopathy compared with controls. Serum IL-6, sTNFR1 and TIMP-1 concentrations were significantly higher in patients with HUS with encephalopathy compared with those with HUS without encephalopathy (P=0.031, P=0.005, and P=0.007, respectively) and those with acute colitis without HUS (P=0.011, Pencephalopathy. Our preliminary study suggests that serum IL-6, sTNFR1 and TIMP-1 levels, particularly sTNFR1 and TIMP-1, are important for predicting neurological complications in patients with HUS.

  13. Architectural Desktop : release 3.3

    DEFF Research Database (Denmark)

    Skauge, Jørn

    2002-01-01

    Øvelser i ADT's mest grundlæggende dele på basis af modellering af et lille og simpelt hus. Der arbejdes primært med værktøjerne i designdelens menu. 1. udgave med titel: Architectural Desktop (Fiskers hus). 2002. 60 sider.......Øvelser i ADT's mest grundlæggende dele på basis af modellering af et lille og simpelt hus. Der arbejdes primært med værktøjerne i designdelens menu. 1. udgave med titel: Architectural Desktop (Fiskers hus). 2002. 60 sider....

  14. Arterial hypertension in children with hemolytic uremic syndrome after kidney transplantation.

    Science.gov (United States)

    Hoenecke, Johannes; Hartmann, Hans; Melk, Anette

    2015-08-01

    The development of arterial hypertension after KTX is a well-known complication. HUS is a systemic disease associated with arterial hypertension during long-term follow-up. Our goal was to report on the severity of arterial hypertension after KTX in patients with typical and atypical HUS. We analyzed the course of 197 patients with HUS, of which 22 (n = 10 with typical HUS; n = 12 with atypical HUS) developed ESRF and received KTX as renal replacement therapy. We analyzed data from 1766 casual BP and 85 24-h ABPM measurements. In addition, we evaluated the used antihypertensive strategy. Comparison between the two patient groups revealed that patients with atypical HUS had significantly higher casual SBP-SDS and DBP-SDS values after KTX despite similar intensity of antihypertensive treatment. These data were supported by analysis of ABPM profiles showing comparable results for the interval 1-5 yr after KTX. Patients with atypical HUS had a greater severity of arterial hypertension despite similar treatment strategies and intensity of treatment. Our observation, even though in a small cohort, supports recent genetic studies showing arterial hypertension closely associated with HUS-causing mutations in patients with atypical HUS.

  15. Atypical hemolytic uremic syndrome: A report of two cases

    Directory of Open Access Journals (Sweden)

    Md. Habibur Rahman

    2016-07-01

    Full Text Available Hemolytic uremic syndrome (HUS is one of the important cause of acute kidney injury in children. There is excellent outcome in patients with typical HUS but atypical HUS is associated with high mortality, risk of recurrence and may lead to end stage renal disease. We report two cases of 5 and 6 year old child having clinical & laboratory characteristics of atypical HUS. These children had a fulminant course of illness with complications involving various systems. The report provides an insight into the etio pathogenesis, diagnoses and treatment of this condition.

  16. [Hemolytic uremic syndrome caused by enterohaemorrhagic Escherichia coli].

    Science.gov (United States)

    Ibarra, Cristina; Goldstein, Jorge; Silberstein, Claudia; Zotta, Elsa; Belardo, Marcela; Repetto, Horacio A

    2008-10-01

    Hemolytic uremic syndrome (HUS) is characterized by microangiopathic hemolytic anemia, plaquetopenia and kidney damage. It is the leading cause of acute renal failure in pediatric age and the second for chronic renal failure. Shiga toxin-producing Escherichia coli (STEC) is the first etiologic agent of HUS being its main reservoir cattle and transmitted via contaminated food. At present, there is no specific treatment to reduce the progression of HUS. The study of the mechanisms by which STEC infects and Shiga toxin induces HUS can help to find new strategies to prevent this disease.

  17. 76 FR 19952 - Not Applying the Mark of Inspection Pending Certain Test Results

    Science.gov (United States)

    2011-04-11

    ... spongiform encephalopathy (BSE) must be controlled by the establishment and are not permitted to enter... or not, develops Hemolytic Uremic Syndrome (HUS) or not, develops End- stage renal disease or not... care) and $7.2 million for a patient who died from Hemolytic Uremic Syndrome (HUS). (2) During 2007...

  18. Angiopoietin-1 and -2 as markers for disease severity in hemolytic uremic syndrome induced by enterohemorrhagic Escherichia coli.

    Science.gov (United States)

    Shimizu, Masaki; Inoue, Natsumi; Kuroda, Mondo; Mizuta, Mao; Sugimoto, Naotoshi; Kaneda, Hisashi; Ohta, Kazuhide; Yachie, Akihiro

    2017-02-01

    Angiopoietin (Ang)-1 and -2 play important roles in maintaining vascular homeostasis. This study aimed to assess the roles of angiopoietin (Ang)-1 and -2 and to investigate the clinical significance of their serum levels in patients with hemolytic uremic syndrome (HUS) induced by enterohemorrhagic Escherichia coli (EHEC). Twenty patients with HUS and 15 healthy controls were studied. Serum Ang-1 and Ang-2 levels were quantified using enzyme-linked immunosorbent assay. The results were compared with the clinical features of HUS. During the HUS phase, serum Ang-1 levels were significantly decreased, whereas serum Ang-2 levels and the Ang-2/Ang-1 ratio were significantly elevated. Compared with patients without encephalopathy, serum Ang-2 levels and Ang-2/Ang-1 ratio were significantly elevated in patients with encephalopathy. Patients with HUS and serum Ang-2 levels of >7061 pg/mL or Ang2/Ang1 ratios of >2.29 were at high risk of encephalopathy. Serum Ang-1 levels were significantly decreased in patients in the pre-HUS phase compared with those in healthy controls. Disruption of homeostasis of vascular endothelial function by Ang-1 and -2 may be closely associated with the development of HUS. Serum Ang-1 and -2 levels and the Ang-2/Ang-1 ratio may be promising indicators of disease activity in HUS and the development of encephalopathy.

  19. Hemolytic-uremic syndrome associated with enterohemorrhagic Escherichia coli O26:H infection and consumption of unpasteurized cow's milk

    NARCIS (Netherlands)

    Allerberger, Franz; Friedrich, Alexander W; Grif, Katharina; Dierich, Manfred P; Dornbusch, Hans-Jürgen; Mache, Cristoph J; Nachbaur, Edith; Freilinger, Michael; Rieck, Petra; Wagner, Martin; Caprioli, Alfredo; Karch, Helge; Zimmerhackl, Lothar B

    2003-01-01

    BACKGROUND: Enterohemorrhagic Escherichia coli (EHEC) O26 has emerged as a significant cause of hemolytic-uremic syndrome (HUS). The source and the vehicle of contamination with EHEC O26 are not often identified. We report two Austrian cases of HUS due to E. coli O26:H- affecting an 11-month-old boy

  20. Hemolytic-uremic syndrome associated with enterohemorrhagic Escherichia coli O26:H infection and consumption of unpasteurized cow's milk

    NARCIS (Netherlands)

    Allerberger, Franz; Friedrich, Alexander W; Grif, Katharina; Dierich, Manfred P; Dornbusch, Hans-Jürgen; Mache, Cristoph J; Nachbaur, Edith; Freilinger, Michael; Rieck, Petra; Wagner, Martin; Caprioli, Alfredo; Karch, Helge; Zimmerhackl, Lothar B

    BACKGROUND: Enterohemorrhagic Escherichia coli (EHEC) O26 has emerged as a significant cause of hemolytic-uremic syndrome (HUS). The source and the vehicle of contamination with EHEC O26 are not often identified. We report two Austrian cases of HUS due to E. coli O26:H- affecting an 11-month-old boy

  1. Hemolytic-uremic syndrome associated with enterohemorrhagic Escherichia coli O26:H infection and consumption of unpasteurized cow's milk

    NARCIS (Netherlands)

    Allerberger, Franz; Friedrich, Alexander W; Grif, Katharina; Dierich, Manfred P; Dornbusch, Hans-Jürgen; Mache, Cristoph J; Nachbaur, Edith; Freilinger, Michael; Rieck, Petra; Wagner, Martin; Caprioli, Alfredo; Karch, Helge; Zimmerhackl, Lothar B

    2003-01-01

    BACKGROUND: Enterohemorrhagic Escherichia coli (EHEC) O26 has emerged as a significant cause of hemolytic-uremic syndrome (HUS). The source and the vehicle of contamination with EHEC O26 are not often identified. We report two Austrian cases of HUS due to E. coli O26:H- affecting an 11-month-old boy

  2. Thrombotic microangiopathy associated with bortezomib treatment in a patient with relapsed multiple myeloma

    Directory of Open Access Journals (Sweden)

    Urpu Salmenniemi

    2012-06-01

    Full Text Available Thrombotic thrombocytopenic purpura (TTP and hemolytic-uremic syndrome (HUS describe microvascular occlusive disorders characterized by thrombocytopenia due to increased platelet aggregation and fragmentation hemolysis. We report here what to our knowledge is the second case of TTP/HUS associated with bortezomib treatment.

  3. Verocytotoxin inhibits mitogenesis and protein synthesis in purified human glomerular mesangial cells without affecting cell viability: Evidence for two distinct mechanisms

    NARCIS (Netherlands)

    Setten, P.A. van; Hinsbergh, V.W.M. van; Heuvel, L.P.W.J. van den; Velden, T.J.A.N. van der; Kar, N.C.A.J. van de; Krebbers, R.J.M.; Karmali, M.A.; Monnens, L.A.H.

    1997-01-01

    Acute renal failure is one of the hallmarks of the hemolytic uremic syndrome (HUS). Infection with a verocytotoxin (VT)- or Shiga-like toxin (SLT)-producing Escherichia coli has been strongly implicated in the etiology of the epidemic form of HUS. The functional receptor for these closely related

  4. Effects of verocytotoxin-1 on nonadherent human monocytes: Binding characteristics, protein synthesis, and induction of cytokine release

    NARCIS (Netherlands)

    Setten, P.A. van; Monnens, L.A.H.; Verstraten, R.G.G.; Heuvel, L.P.W.J. van den; Hinsbergh, V.W.M. van

    1996-01-01

    The epidemic form of the hemolytic uremic syndrome (HUS) has been associated with a verocytotoxin producing Escherichia coli infection. Endothelial cell damage of glomeruli and arterioles of the kidney plays a central role in the pathogenesis of HUS. A number of observations in vivo and in vitro

  5. Tumor necrosis factor and interleukin-1 induce expression of the verocytotoxin receptor globotriaosylceramide on human endothelial cells: Implications for the pathogenesis of the hemolytic uremic syndrome

    NARCIS (Netherlands)

    Kar, N.C.A.J. van de; Monnens, L.A.H.; Karmali, M.A.; Hinsbergh, V.W.M. van

    1992-01-01

    The epidemic form of the hemolytic uremic syndrome (HUS), beginning with an acute gastroenteritis, has been associated with a verocytotoxin-producing Escherichia coli infection. The endothelial cell is believed to play an important role in the pathogenesis of HUS. Endothelial cell damage by

  6. Complement activation patterns in atypical haemolytic uraemic syndrome during acute phase and in remission

    NARCIS (Netherlands)

    Volokhina, E.B.; Westra, D.; Velden, T.J.A.M. van der; Kar, N.C.A.J. van de; Mollnes, T.E.; Heuvel, B. van den

    2015-01-01

    Atypical haemolytic uraemic syndrome (aHUS) is associated with (genetic) alterations in alternative complement pathway. Nevertheless, comprehensive evidence that the complement system in aHUS patients is more prone to activation is still lacking. Therefore, we performed a thorough analysis of comple

  7. CONCURRENT PRESENTATION OF HEMOLYTIC-UREMIC SYNDROME IN 2 ADULT SIBLINGS - EFFECTS OF PLASMA THERAPY ON HEMOLYSIS AND RENAL-FUNCTION

    NARCIS (Netherlands)

    VONGAMEREN, [No Value; RENSMA, PL; ZIJLSTRA, JG; DEWOLF, J; DEJONG, PE

    1994-01-01

    We describe 2 sisters who presented with the hemolytic uremic syndrome (HUS) almost simultaneously In both patients an upper airway infection with Haemophilus influenzae immediately preceding HUS may have been the environmental trigger. Fresh plasma infusion had only minor therapeutic effects but pl

  8. Indflydelse. Hvide evangelister er inde i varmen

    DEFF Research Database (Denmark)

    Olsen, Gorm Rye

    2016-01-01

    ANALYSE De hvide evangelister bar Trump ind i Det Hvide Hus. Det vil få stor betydning for USA's udenrigspolitik.......ANALYSE De hvide evangelister bar Trump ind i Det Hvide Hus. Det vil få stor betydning for USA's udenrigspolitik....

  9. Escherichia coli harboring Shiga toxin 2 gene variants : frequency and association with clinical symptoms

    NARCIS (Netherlands)

    Friedrich, Alexander W; Bielaszewska, Martina; Zhang, Wen-Lan; Pulz, Matthias; Kuczius, Thorsten; Ammon, Andrea; Karch, Helge

    2002-01-01

    Shiga toxin (Stx)-producing Escherichia coli (STEC) from patients with hemolytic-uremic syndrome (HUS), patients with diarrhea without HUS, or asymptomatic subjects were genotyped to assess associations between stx2 variants and clinical manifestations of infection. Neither stx2d nor stx2e was found

  10. Effects of verocytotoxin-1 on nonadherent human monocytes: Binding characteristics, protein synthesis, and induction of cytokine release

    NARCIS (Netherlands)

    Setten, P.A. van; Monnens, L.A.H.; Verstraten, R.G.G.; Heuvel, L.P.W.J. van den; Hinsbergh, V.W.M. van

    1996-01-01

    The epidemic form of the hemolytic uremic syndrome (HUS) has been associated with a verocytotoxin producing Escherichia coli infection. Endothelial cell damage of glomeruli and arterioles of the kidney plays a central role in the pathogenesis of HUS. A number of observations in vivo and in vitro ind

  11. Novel sequence variation affects GPIb α in post-diarrheal hemolytic uremic syndrome

    NARCIS (Netherlands)

    Volokina, E.; Jakobi, A.J.; Urbanus, R.T; Huizinga, E.G.; Sluiter, H.; Middel, C.; Westra, D.; van Heerde, W.L.; van de Kar, N.; van den Heuvel, L.

    2014-01-01

    Background: Hemolytic uremic syndrome (HUS) is one of the major causes of renal failure in children. In most cases the disease is caused by infection with Shiga toxin- producing Escherichia coli (STEC) and preceded by diarrhea. Only in 15% of cases STEC infection leads to HUS. Genetic predisposition

  12. Hemolytic uremic syndrome due to Capnocytophaga canimorsus bacteremia after a dog bite

    NARCIS (Netherlands)

    Tobe, TJM; Franssen, CFM; Zijlstra, JG; de Jong, PE; Stegeman, CA

    1999-01-01

    The hemolytic uremic syndrome (HUS) is known to have several causes, including infectious diseases, drugs, pregnancy, and malignant disease. We report a patient who developed acute renal failure attributable to HUS in the course of Capnocytophaga canimorsus bacteremia. Acute tubular necrosis as well

  13. Atypical relapse of hemolytic uremic syndrome after transplantation.

    NARCIS (Netherlands)

    Olie, K.H.; Florquin, S.; Groothoff, J.W.; Verlaak, R.; Strain, L.; Goodship, T.H.; Weening, J.J.; Davin, J.C.

    2004-01-01

    Atypical hemolytic uremic syndrome (HUS) frequently leads to end-stage renal failure and can relapse after transplantation. A 12-year-old girl presenting with familial atypical HUS with a factor H mutation was successfully transplanted 6 years after a first transplant that had failed because of imme

  14. Jarmers Plads 2

    DEFF Research Database (Denmark)

    Jensen, Thomas Bo

    2008-01-01

    Om Kreditforeningens hus på Jarmers Plads 2, København. Tegnet af arkitekterne Christian, Erik og Aage Holst 1954-59.......Om Kreditforeningens hus på Jarmers Plads 2, København. Tegnet af arkitekterne Christian, Erik og Aage Holst 1954-59....

  15. Concurrent presentation of hemolytic uremic syndrome in two adult siblings : effects of plasma therapy on hemolysis and renal function

    NARCIS (Netherlands)

    von Gameren, I I; Rensma, P L; Zijlstra, J G; de Wolf, J; de Jong, Paul

    1994-01-01

    We describe 2 sisters who presented with the hemolytic uremic syndrome (HUS) almost simultaneously. In both patients an upper airway infection with Haemophilus influenzae immediately preceding HUS may have been the environmental trigger. Fresh plasma infusion had only minor therapeutic effects but p

  16. Diagnosis and treatment of TMA based on Japanese clinical guides.

    Science.gov (United States)

    Wada, Hideo; Hasegawa, Kei; Watanabe, Maki

    Patients with thrombotic microangiopathies (TMAs), which include thrombotic thrombocytopenic purpura (TTP), atypical hemolytic uremic syndrome (aHUS), and Shiga toxin-producing Escherichia coli hemolytic uremic syndrome (STEC-HUS), exhibit multiple symptoms. These include thrombocytopenia (platelet count <15×10(4)/µl), microangiopathic hemolytic anemia (hemoglobin <10 g/dl), and organ damage, such as renal dysfunction or neurological abnormalities. Guidelines for the management of TTP, aHUS, and STEC-HUS have been published. Diagnosis of TTP, STEC-HUS, or aHUS requires ADAMTS13 activity <10%, the detection of STEC or Shiga toxins, or a genetic analysis to investigate the complement regulatory system, respectively. In the established management of TMAs, fresh frozen plasma is used for congenital TTP to supplement ADAMTS13. Plasma exchange (PE) is used in acquired TTP (ATTP) to remove inhibitors and replace ADAMTS13. Steroid therapy is administered in ATTP to suppress inhibitor production, and rituximab is administered in ATTP without response to PE or with high titers of ADAMTS13 inhibitors. Eculizumab, a monoclonal antibody for complement protein 5, is used for the treatment of aHUS. Supportive therapy is required for some TMAs, particularly STEC-HUS, but platelet transfusion is generally contraindicated for other TMAs, such as TTP. Treatments should be administered in accordance with these guidelines to improve the outcome of TMAs.

  17. Hemolytic uremic syndrome due to Capnocytophaga canimorsus bacteremia after a dog bite

    NARCIS (Netherlands)

    Tobe, TJM; Franssen, CFM; Zijlstra, JG; de Jong, PE; Stegeman, CA

    The hemolytic uremic syndrome (HUS) is known to have several causes, including infectious diseases, drugs, pregnancy, and malignant disease. We report a patient who developed acute renal failure attributable to HUS in the course of Capnocytophaga canimorsus bacteremia. Acute tubular necrosis as well

  18. Serum ferritin as an indicator of the development of encephalopathy in enterohemorrhagic Escherichia coli-induced hemolytic uremic syndrome.

    Science.gov (United States)

    Shimizu, Masaki; Inoue, Natsumi; Kuroda, Mondo; Irabu, Hitoshi; Takakura, Maiko; Kaneda, Hisashi; Sugimoto, Naotoshi; Ohta, Kazuhide; Yachie, Akihiro

    2017-03-10

    To investigate the diagnostic value of serum ferritin levels as a marker of disease activity and the development of encephalopathy in hemolytic uremic syndrome (HUS) induced by enterohemorrhagic Escherichia coli. Twenty patients with HUS were studied. Serum ferritin levels were compared with clinical features and serum soluble tumor necrosis factor receptor (sTNFR) I and sTNFRII levels. Serum sTNFRI and sTNFRII levels were quantified by enzyme-linked immunosorbent assays. Serum ferritin levels were significantly elevated at the time of the diagnosis of HUS. Serum ferritin levels were significantly elevated in patients with encephalopathy compared to patients without encephalopathy. HUS patients with serum ferritin levels of >687.5 ng/ml were at high risk of encephalopathy. Serum ferritin levels were significantly positively correlated with serum sTNFRI and sTNFRII levels. Serum ferritin levels are a promising indicator of the development of encephalopathy in HUS.

  19. Differential expression of function-related antigens on blood monocytes in children with hemolytic uremic syndrome.

    Science.gov (United States)

    Fernández, Gabriela C; Ramos, María V; Gómez, Sonia A; Dran, Graciela I; Exeni, Ramón; Alduncín, Marta; Grimoldi, Irene; Vallejo, Graciela; Elías-Costa, Christian; Isturiz, Martín A; Palermo, Marina S

    2005-10-01

    Monocytes (Mo) mediate central functions in inflammation and immunity. Different subpopulations of Mo with distinct phenotype and functional properties have been described. Here, we investigate the phenotype and function of peripheral Mo from children with hemolytic uremic syndrome (HUS). For this purpose, blood samples from patients in the acute period of HUS (HUS AP) were obtained on admission before dialysis and/or transfusion. The Mo phenotypic characterization was performed on whole blood by flow cytometry, and markers associated to biological functions were selected: CD14 accounting for lipopolysaccharide (LPS) responsiveness, CD11b for adhesion, Fc receptor for immunoglobulin G type I (FcgammaRI)/CD64 for phagocytosis and cytotoxicity, and human leukocyte antigen (HLA)-DR for antigen presentation. Some of these functions were also determined. Moreover, the percentage of CD14+ CD16+ Mo was evaluated. We found that the entire HUS AP Mo population exhibited reduced CD14, CD64, and CD11b expression and decreased LPS-induced tumor necrosis factor production and Fcgamma-dependent cytotoxicity. HUS AP showed an increased percentage of CD14+ CD16+ Mo with higher CD16 and lower CD14 levels compared with the same subset from healthy children. Moreover, the CD14++ CD16- Mo subpopulation of HUS AP had a decreased HLA-DR expression, which correlated with severity. In conclusion, the Mo population from HUS AP patients presents phenotypic and functional alterations. The contribution to the pathogenesis and the possible scenarios that led to these changes are discussed.

  20. Induction of Neutrophil Extracellular Traps in Shiga Toxin-Associated Hemolytic Uremic Syndrome.

    Science.gov (United States)

    Ramos, Maria Victoria; Mejias, Maria Pilar; Sabbione, Florencia; Fernandez-Brando, Romina Jimena; Santiago, Adriana Patricia; Amaral, Maria Marta; Exeni, Ramon; Trevani, Analia Silvina; Palermo, Marina Sandra

    2016-01-01

    Hemolytic uremic syndrome (HUS), a vascular disease characterized by hemolytic anemia, thrombocytopenia, and acute renal failure, is caused by enterohemorrhagic Shiga toxin (Stx)-producing bacteria, which mainly affect children. Besides Stx, the inflammatory response mediated by neutrophils (PMN) is essential to HUS evolution. PMN can release neutrophil extracellular traps (NET) composed of DNA, histones, and other proteins. Since NET are involved in infectious and inflammatory diseases, the aim of this work was to investigate the contribution of NET to HUS. Plasma from HUS patients contained increased levels of circulating free-DNA and nucleosomes in comparison to plasma from healthy children. Neutrophils from HUS patients exhibited a greater capacity to undergo spontaneous NETosis. NET activated human glomerular endothelial cells, stimulating secretion of the proinflammatory cytokines IL-6 and IL-8. Stx induced PMN activation as judged by its ability to trigger reactive oxygen species production, increase CD11b and CD66b expression, and induce NETosis in PMN from healthy donors. During HUS, NET can contribute to the inflammatory response and thrombosis in the microvasculature and thus to renal failure. Intervention strategies to inhibit inflammatory mechanisms mediated by PMN, such as NETosis, could have a potential therapeutic impact towards amelioration of the severity of HUS.

  1. Antibiotic therapy in Shiga toxin producing Escherichia coli infection and colonization

    Directory of Open Access Journals (Sweden)

    Knobloch, Johannes K.-M.

    2013-07-01

    Full Text Available The post diarrheal hemolytic uremic syndrome (HUS is a major complication of enteric infections with Shiga toxin producing (STEC. According to the present recommendations, antibiotic therapy of acute bloody diarrhea caused by STEC is generally discouraged. These recommendations are based on historically conflicting results describing the potential induction of HUS by antibiotic treatment during the early phase of infection with enterohemorrhagic O157 whereas no guidelines are available for the use of antibiotics in cases of already fully established HUS or in asymptomatic long term STEC carriers. In 2011, a large outbreak of hemorrhagic colitis complicated by HUS occurred in northern Germany caused by a STEC strain of serotype O104:H4 harbouring both a phage encoding Stx 2 as well as a plasmid mediated enteroaggregative phenotype. The majority of infections were observed in adults, complicated by the highest number of HUS cases ever encountered. Due to different newly introduced therapeutic strategies (e.g. complement blockade antibiotic therapy was used in many patients once HUS was established. The outbreak therefore provided important new insights for the understanding of antibiotic therapy of STEC associated HUS in adults and for decolonization of long term STEC carriers. This review highlights new aspects concerning use of antibiotics in STEC infection and colonization.

  2. Advanced Prostate Cancer Presenting as Hemolytic Uremic Syndrome

    Directory of Open Access Journals (Sweden)

    R. Ramos

    2013-01-01

    Full Text Available Introduction. Hemolytic uremic syndrome (HUS is characterized by endothelial dysfunction, consumption thrombocytopenia, microangiopathic hemolytic anemia, and acute renal failure. HUS generally has a dismal prognosis, except when associated with gastroenteritis caused by verotoxin-producing bacteria. Cancer associated HUS is uncommon, and there are only scarce reports on prostate cancer presenting with HUS. Case Presentation. A 72-year-old man presented to the emergency department with oliguria, hematuria, and hematemesis. Clinical evaluation revealed acute renal failure, hemolysis, normal blood-clotting studies, and prostate-specific antigen value of 1000 ng/mL. The patient was started on hemodialysis, ultrafiltration with plasma exchange, and androgen blockade with bicalutamide and completely recovered from HUS. The authors review the 14 published cases on this association. Conclusion. The association of HUS and prostate cancer occurs more frequently in patients with high-grade, clinically advanced prostate cancer. When readily recognized and appropriately treated, HUS does not seem to worsen prognosis in prostate cancer patients.

  3. Current evidence for the role of complement in the pathogenesis of Shiga toxin haemolytic uraemic syndrome.

    Science.gov (United States)

    Keir, Lindsay S; Saleem, Moin A

    2014-10-01

    Shiga toxin-associated haemolytic uraemic syndrome (Stx HUS) is the leading cause of paediatric acute kidney injury. This toxin-mediated disease carries a significant morbidity and mortality but has no direct treatments. Rare familial atypical HUS (aHUS) is now understood to result from over-activation of the alternative complement pathway causing glomerular endothelial damage. By understanding the pathogenic mechanisms of this disease, the monoclonal antibody eculizumab, which blocks the final common pathway of complement, is now being used to treat aHUS. For this reason, clinicians and scientists are studying the role of the alternative complement pathway in Stx HUS with the aim of targeting treatment in a similar way. There is some evidence suggesting that complement plays a role in the pathogenesis of Stx HUS, but other mechanisms may also be important. Clinically, modulating the complement system using plasma exchange provides no proven benefit in Stx HUS, and the use of eculizumab has provided conflicting results. Understanding the local effect of Stx on the glomerulus, in particular regulation of the complement and coagulation systems, may lead to advances in defining the precise pathogenesis of this disease. Then, targeted treatment strategies could be devised and clinical trials undertaken.

  4. Federal Clinical Guidelines on Rendering Help to Children with Hemolytic Uremic Syndrome

    Directory of Open Access Journals (Sweden)

    A. N. Tsygin

    2015-01-01

    Full Text Available The hemolytic uremic syndrome (HUS is a serious therapeutic problem in pediatrics and pediatric nephrology. HUS is one of the leading causes of acute renal failure with the potential of transforming into terminal chronic renal failure at various periods from the disease onset. The typical form of HUS with a diarrheal prodrome associated with Shiga toxin (STEC is the most common form. Despite this fact, it requires careful confirmation of infectious etiology to exclude atypical HUS and HUS associated with pneumococcal infection in time. In respect of STEC-HUS it is recommended to conduct adequate symptomatic therapy with a timely dialysis connection if needed. The prognosis here will depend on the anuretic period duration and on the related central nervous system injuries. Atypical HUS is often based on genetic mutations leading to the complement cascade disfunction with uncontrolled activation of the alternative pathway. The overall prognosis for this prone to recurrence form is unfavourable, however, it is recommended to conduct aeculizumabum treatment which will block the terminal components of the complement cascade.

  5. The autoimmune disease DEAP-hemolytic uremic syndrome.

    Science.gov (United States)

    Skerka, Christine; Zipfel, Peter F; Müller, Dominik; Micklisch, Sven; Riedl, Magdalena; Zimmerhackl, Lothar-Bernd; Hofer, Johannes

    2010-09-01

    DEAP-HUS (deficiency of CFHR plasma proteins and factor H [FH] autoantibody positive hemolytic uremic syndrome [HUS]) is a new form of HUS characterized by a deletion of genes coding for FH-related proteins and the presence of autoantibodies directed to FH. These disease-associated autoantibodies inhibit FH (CFH) surface binding functions, which results in a defective regulation of the alternative pathway and damage of endothelial cells. Here we describe two representative patients with DEAP-HUS who both developed end-stage renal failure with the background of homozygous deletion of CFHR1 and CFHR3 genes and the presence of FH autoantibodies. Based on the retrospective diagnosis of DEAP-HUS 2 to 12 months after the initial clinical presentation, subsequent immunosuppressive therapy was initiated. The autoantibody titers decreased, and the complement status of the patients improved, as indicated by increased C3 levels. Thus early diagnosis of DEAP-HUS and immunosuppressive treatments are important factors to treat this particular type of HUS.

  6. Bacterial genetic determinants of non-O157 STEC outbreaks and hemolytic-uremic syndrome after infection.

    Science.gov (United States)

    Wickham, Mark E; Lupp, Claudia; Mascarenhas, Mariola; Vazquez, Alejandra; Coombes, Brian K; Brown, Nat F; Coburn, Bryan A; Deng, Wanyin; Puente, Jose L; Karmali, Mohamed A; Finlay, B Brett

    2006-09-15

    Although O157:H7 Shiga toxin-producing Escherichia coli (STEC) are the predominant cause of hemolytic-uremic syndrome (HUS) in the world, non-O157:H7 serotypes are a medically important cause of HUS that are underdetected by current diagnostic approaches. Because Shiga toxin is necessary but not sufficient to cause HUS, identifying the virulence determinants that predict severe disease after non-O157 STEC infection is of paramount importance. Disease caused by O157:H7 STEC has been associated with a 26-gene pathogenicity island known as O island (OI) 122. To assess the public-health significance of this pathogenicity island, we examined the association between OI122 genes and outbreaks and HUS after non-O157 STEC infection. We found that a subset of OI122 genes is independently associated with outbreaks and HUS after infection with non-O157 STEC. The presence of multiple virulence genes in non-O157 serotypes strengthened this association, which suggests that the additive effects of a variable repertoire of virulence genes contribute to disease severity. In vivo, Citrobacter rodentium mutants lacking outbreak- and HUS-associated genes were deficient for virulence in mice; in particular, nleB mutant bacteria were unable to cause mortality in mice. The present study shows that virulence genes associated epidemiologically with outbreaks and HUS after non-O157 STEC infection are pivotal to the initiation, progression, and outcome of in vivo disease.

  7. Timing and utility of ultrasound in diarrhea-associated hemolytic uremic syndrome: 7-year experience of a large tertiary care hospital.

    Science.gov (United States)

    Glatstein, Miguel; Miller, Elka; Garcia-Bournissen, Facundo; Scolnik, Dennis

    2010-05-01

    The authors reviewed the clinical, laboratory, and imaging data from cases of diarrhea-associated hemolytic uremic syndrome (HUS D+), diagnosed at our institution, from 2001 to 2008. The timing and utility of ultrasonographic features of HUS D+ were analyzed. The aim of the study was to determine factors that could aid in the early diagnosis of this disease. A total of 13 children with HUS D+ were identified out of 23 patients with HUS diagnosed during this time period. Evidence of Escherichia coli 0157:H7 was found in 9 cases (70%). Ultrasound studies were ordered in 10 patients (71%), all of which showed renal sonographic findings compatible with HUS. Ultrasound was performed at a mean of 13 days after onset of the diarrhea. Of note, 2 patients whose ultrasounds were performed at the beginning of their diarrheal illness manifested ultrasonographic features suggestive of HUS when there was only a mild increase in serum creatinine and no decrease in hemoglobin or platelets, suggesting that ultrasonography can identify renal involvement early in the course of the disease before other systemic signs appear. Early renal ultrasound may be a useful adjunct in the initial evaluation in children with bloody diarrhea. Evidence of increased renal echogenicity in a patient with bloody diarrhea could aid in early recognition of HUS when other diagnoses such as intussusceptions are being entertained, potentially allowing early intervention.

  8. Shiga toxin activates complement and binds factor H: evidence for an active role of complement in hemolytic uremic syndrome.

    Science.gov (United States)

    Orth, Dorothea; Khan, Abdul Basit; Naim, Asma; Grif, Katharina; Brockmeyer, Jens; Karch, Helge; Joannidis, Michael; Clark, Simon J; Day, Anthony J; Fidanzi, Sonja; Stoiber, Heribert; Dierich, Manfred P; Zimmerhackl, Lothar B; Würzner, Reinhard

    2009-05-15

    Infections with enterohemorrhagic Escherichia coli (EHEC) are a major cause of hemolytic uremic syndrome (HUS). Shiga toxins (Stxs), especially Stx2, are believed to represent major virulence factors of EHEC, contributing to HUS pathogenesis. Beside EHEC-associated HUS, there are hereditary atypical forms of HUS, which are mostly caused by mutations of complement regulators. The aim of the present study was to investigate whether or not complement is also involved in the pathogenesis of EHEC-induced typical HUS, by being activated either directly or indirectly by involvement of its inhibitors. Purified Stx2 markedly activated complement via the alternative pathway and was found to bind to factor H (FH), however, only when it was active. No apparent cleavage or destruction of FH was visible, and cofactor activity in fluid phase was unaffected, but clearly delayed for surface-attached FH, where it is essential for host cell protection. Binding studies using FH constructs revealed that Stx2 binds to short consensus repeats (SCRs) 6-8 and SCRs18-20, but not to SCRs16-17, i.e., to regions involved in the surface recognition function of FH. In conclusion, complement, and in particular FH, not only plays an important role in atypical HUS, but most probably also in EHEC-induced HUS.

  9. Role of non-polio enterovirus infection in pediatric hemolytic uremic syndrome.

    Science.gov (United States)

    De Petris, Laura; Gianviti, Alessandra; Caione, Daniela; Innocenzi, Daniele; Edefonti, Alberto; Montini, Giovanni; De Palo, Tommaso; Tozzi, Alberto Eugenio; Caprioli, Alfredo; Rizzoni, Gianfranco

    2002-10-01

    Verocytotoxin-producing Escherichia coli(VTEC) infections cause most cases of hemolytic uremic syndrome (HUS); 10-30% of patients, however, are negative for VTEC infection. The etiology of HUS in VTEC-negative cases remains poorly understood. Before the association between VTEC infection and HUS was recognized, sporadic cases of HUS with enterovirus infection were reported in the literature. Since May 1988, most cases of HUS in Italy have been reported to the Italian surveillance system, and in 73% of these, evidence of VTEC infection was demonstrated. The aim of this study was to determine whether the frequency of enteroviral infections was different in the acute phase of VTEC-positive and VTEC-negative HUS. Eighty-nine patients were investigated for enteroviral infection, of whom 58 were VTEC positive and 31 VTEC negative. Two serum samples from each patient were examined for seroconversion to enterovirus (coxsackie, echovirus, and picornavirus) by a complement fixation test. Serological evidence of acute infection with non-polio enterovirus was found in 33 patients (37%) [20/58 (34.5%) VTEC positive and 13/31 (41.9%) VTEC negative]. There was no statistically significant difference between the two groups. These results demonstrate that there are no significant differences for enteroviral infection in VTEC-positive and VTEC-negative patients and, therefore, enteroviral infections should not be considered a cause of HUS in VTEC-negative children.

  10. Postoperative Atypical Hemolytic Uremic Syndrome Associated with Complement C3 Mutation

    Directory of Open Access Journals (Sweden)

    Eiji Matsukuma

    2014-01-01

    Full Text Available Atypical hemolytic uremic syndrome (aHUS can be distinguished from typical or Shiga-like toxin-induced HUS. The clinical outcome is unfavorable; up to 50% of affected patients progress to end-stage renal failure and 25% die during the acute phase. Multiple conditions have been associated with aHUS, including infections, drugs, autoimmune conditions, transplantation, pregnancy, and metabolic conditions. aHUS in the nontransplant postsurgical period, however, is rare. An 8-month-old boy underwent surgical repair of tetralogy of Fallot. Neurological disturbances, acute renal failure, thrombocytopenia, and microangiopathic hemolytic anemia developed 25 days later, and aHUS was diagnosed. Further evaluation revealed that his complement factor H (CFH level was normal and that anti-FH antibodies were not detected in his plasma. Sequencing of his CFH, complement factor I, membrane cofactor protein, complement factor B, and thrombomodulin genes was normal. His ADAMTS-13 (a disintegrin-like and metalloprotease with thrombospondin-1 repeats 13 activity was also normal. However, he had a potentially causative mutation (R425C in complement component C3. Restriction fragment length polymorphism analysis revealed that his father and aunt also had this mutation; however, they had no symptoms of aHUS. We herein report a case of aHUS that developed after cardiovascular surgery and was caused by a complement C3 mutation.

  11. Association of haemolytic uraemic syndrome with dysregulation of chemokine receptor expression in circulating monocytes.

    Science.gov (United States)

    Ramos, Maria Victoria; Ruggieri, Matias; Panek, Analia Cecilia; Mejias, Maria Pilar; Fernandez-Brando, Romina Jimena; Abrey-Recalde, Maria Jimena; Exeni, Andrea; Barilari, Catalina; Exeni, Ramon; Palermo, Marina Sandra

    2015-08-01

    Haemolytic uraemic syndrome (HUS) is the major complication of Escherichia coli gastrointestinal infections that are Shiga toxin (Stx) producing. Monocytes contribute to HUS evolution by producing cytokines that sensitize endothelial cells to Stx action and migration to the injured kidney. As CC chemokine receptors (CCRs) are involved in monocyte recruitment to injured tissue, we analysed the contribution of these receptors to the pathogenesis of HUS. We analysed CCR1, CCR2 and CCR5 expression in peripheral monocytes from HUS patients during the acute period, with healthy children as controls. We observed an increased expression of CCRs per cell in monocytes from HUS patients, accompanied by an increase in the absolute number of monocytes CCR1+, CCR2+ and CCR5+. It is interesting that prospective analysis confirmed that CCR1 expression positively correlated with HUS severity. The evaluation of chemokine levels in plasma showed that regulated on activation of normal T-cell-expressed and -secreted (RANTES) protein was reduced in plasma from patients with severe HUS, and this decrease correlated with thrombocytopenia. Finally, the expression of the higher CCRs was accompanied by a loss of functionality which could be due to a mechanism for desensitization to compensate for altered receptor expression. The increase in CCR expression correlates with HUS severity, suggesting that the dysregulation of these receptors might contribute to an increased risk of renal damage. Activated monocytes could be recruited by chemokines and then receptors could be dysregulated. The dysregulation of CCRs and their ligands observed during the acute period suggests that a chemokine pathway would participate in HUS development.

  12. Atypical Hemolytic Uremic Syndrome post Kidney Transplantation: Two Case Reports and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Sami eAlasfar

    2014-12-01

    Full Text Available Atypical hemolytic uremic syndrome (aHUS is a rare disorder characterized by over-activation and dysregulation of the alternative complement pathway. Its estimated prevalence is 1-2 per million. The disease is characterized by thrombotic microangiopathy, which causes anemia, thrombocytopenia, and acute renal failure. aHUS has more severe course compared to typical (Infection-induced HUS and is frequently characterized by relapses that leads to end stage renal disease (ESRD. For a long time, kidney transplantation for these patients was contraindicated because of high rate of recurrence and subsequent renal graft loss. The post-kidney transplantation recurrence rate largely depends on the pathogenetic mechanisms involved. However, over the past several years, advancements in the understanding and therapeutics of aHUS have allowed successful kidney transplantation in these patients. Eculizumab, which is a complement C5 antibody that inhibits complement factor 5a (C5a and subsequent formation of the membrane attack complex, has been used in prevention and treatment of post-transplant aHUS recurrence. In this paper, we present two new cases of aHUS patients who underwent successful kidney transplantation in our center with the use of prophylactic and maintenance eculizumab therapy that have not been published before. The purpose of reporting these two cases is to emphasize the importance of using eculizumab as a prophylactic therapy to prevent aHUS recurrence post transplant in high-risk patients. We will also review the current understanding of the genetics of aHUS, the pathogenesis of its recurrence after kidney transplantation, and strategies for prevention and treatment of post-transplant aHUS recurrence.

  13. Is therapeutic plasma exchange indicated for patients with gemcitabine-induced hemolytic uremic syndrome?

    Science.gov (United States)

    Gore, Ethan McCaleb; Jones, Benjamin Scott; Marques, Marisa B

    2009-01-01

    Atypical hemolytic uremic syndrome (aHUS) has been described as an uncommon complication of gemcitabine. In this review, we discuss the diagnosis of gemcitabine-induced aHUS (GiHUS) and the published experience with therapeutic plasma exchange (TPE). To illustrate GiHUS, we present a patient who developed hypertension and peripheral edema while receiving gemcitabine and subsequently was found to have thrombocytopenia, hemolytic anemia, renal failure, and normal ADAMTS-13 activity. Although laboratory parameters improved on suspending gemcitabine, they worsened after reinstitution of the drug. Thrombocytopenia and hemolysis ceased once the drug was permanently discontinued without therapeutic plasma exchange (TPE). The pathological characteristics of GiHUS suggest damage of the glomeruli endothelial lining, leading to occlusion by fibrin-rich thrombi. Among 26 patients described in the literature not treated with TPE, 56% recovered from GiHUS, whereas only 30% of 18 patients treated with TPE did. The difference in recovery rate may have been confounded by the severity of GiHUS as suggested by the rate of dialysis in each group: 10/26 (38%) patients who did not receive TPE were dialyzed compared with 11/18 (61%) of those who had plasma exchange. Thus, although the currently available evidence is not decisive for use or non use of TPE, we suggest that the most important therapeutic intervention in GiHUS is discontinuation of the drug. Apheresis medicine specialists should be aware of this specific type of aHUS and provide treatment advice based on the currently available evidence.

  14. End-stage kidney disease due to haemolytic uraemic syndrome – outcomes in 241 consecutive ANZDATA registry cases

    Directory of Open Access Journals (Sweden)

    Tang Wen

    2012-12-01

    Full Text Available Abstract Background The aim of this study was to investigate the characteristics and outcomes of patients receiving renal replacement therapy for end-stage kidney disease (ESKD secondary to haemolytic uraemic syndrome (HUS. Methods The study included all patients with ESKD who commenced renal replacement therapy in Australia and New Zealand between 15/5/1963 and 31/12/2010, using data from the ANZDATA Registry. HUS ESKD patients were compared with matched controls with an alternative primary renal disease using propensity scores based on age, gender and treatment era. Results Of the 58422 patients included in the study, 241 (0.4% had ESKD secondary to HUS. HUS ESKD was independently associated with younger age, female gender and European race. Compared with matched controls, HUS ESKD was not associated with mortality on renal replacement therapy (adjusted hazard ratio [HR] 1.14, 95% CI 0.87-1.50, p = 0.34 or dialysis (HR 1.34, 95% CI 0.93-1.93, p = 0.12, but did independently predict recovery of renal function (HR 54.01, 95% CI 1.45-11.1, p = 0.008. 130 (54% HUS patients received 166 renal allografts. Overall renal allograft survival rates were significantly lower for patients with HUS ESKD at 1 year (73% vs 91%, 5 years (62% vs 85% and 10 years (49% vs 73%. HUS ESKD was an independent predictor of renal allograft failure (HR 2.59, 95% CI 1.70-3.95, p  Conclusions HUS is an uncommon cause of ESKD, which is associated with comparable patient survival on dialysis, an increased probability of renal function recovery, comparable patient survival post-renal transplant and a heightened risk of renal transplant graft failure compared with matched ESKD controls.

  15. Atypical hemolytic uremic syndrome triggered by varicella infection

    Directory of Open Access Journals (Sweden)

    Pauline Condom

    2017-01-01

    The current case describes an aHUS associated to varicella infection as demonstrated by the simultaneous occurrence of the viral infection and aHUS manifestations. Apart from typical Hemolytic Uremic Syndrome which is triggered by bacteria mostly Shiga toxin producing Echerichia coli and Streptococcus pneumoniae or Shigella, aHUS may be linked to viral infections such as HIV, EBV and enteroviruses, but very rarely by varicella. This case highlights a possible even rare complication of varicella infection a very common childhood disease. This complication could be avoided by to anti-VZV vaccination.

  16. Recurrent Hemolytic and Uremic Syndrome Induced by Escherichia Coli

    Science.gov (United States)

    Commereuc, Morgane; Weill, Francois-Xavier; Loukiadis, Estelle; Gouali, Malika; Gleizal, Audrey; Kormann, Raphaël; Ridel, Christophe; Frémeaux-Bacchi, Véronique; Rondeau, Eric; Hertig, Alexandre

    2016-01-01

    Abstract A widespread belief is that typical hemolytic and uremic syndrome (HUS) does not recur. We report the case of a patient infected twice with raw milk taken from his own cow and containing a Shiga toxin–producing Escherichia coli O174:H21 that induced recurrent HUS causing severe renal and cerebral disorders. A genomic comparison of the human and bovine Shiga toxin–producing Escherichia coli O174:H21 isolates revealed that they were identical. Typical HUS may recur. Since milk from this animal was occasionally distributed locally, thereby posing a serious threat for the whole village, this particular cow was destroyed. PMID:26735524

  17. Moyamoya vasculopathy in a child after hemolytic uremic syndrome: a possible etiopathogenesis.

    Science.gov (United States)

    Singla, M; John, E; Hidalgo, G; Grewal, D; Macmillan, C

    2008-04-01

    Moyamoya disease is a cerebral vasculopathy of unknown etiology frequently seen in the Asian population. We report a case of moyamoya vasculopathy in an African-American child who had renal failure followed by cerebral ischemia. Our patient presented with hemolytic uremic syndrome (HUS) and renal failure, and later developed seizures. We believe that in this patient HUS led to the pathogenesis of moyamoya disease. We suggest that patients with HUS who develop any neurological symptoms should be investigated for moyamoya vasculopathy for early diagnosis and treatment.

  18. Hemolytic Uremic Syndrome-associated Encephalopathy Successfully Treated with Corticosteroids.

    Science.gov (United States)

    Hosaka, Takashi; Nakamagoe, Kiyotaka; Tamaoka, Akira

    2017-09-25

    The encephalopathy that occurs in association with hemolytic uremic syndrome (HUS), which is caused by enterohemorrhagic Escherichia coli (E. coli), has a high mortality rate and patients sometimes present sequelae. We herein describe the case of a 20-year-old woman who developed encephalopathy during the convalescent stage of HUS caused by E.coli O26. Hyperintense lesions were detected in the pons, basal ganglia, and cortex on diffusion-weighted brain MRI. From the onset of HUS encephalopathy, we treated the patient with methylprednisolone (mPSL) pulse therapy alone. Her condition improved, and she did not present sequelae. Our study shows that corticosteroids appear to be effective for the treatment of some patients with HUS encephalopathy.

  19. Severe pneumococcal hemolytic uremic syndrome in an 8-month-old girl

    Directory of Open Access Journals (Sweden)

    Tahar Gargah

    2012-01-01

    Full Text Available The hemolytic uremic syndrome (HUS, characterized by microangiopathic hemolytic anemia, thrombocytopenia and acute renal failure, represents one of the major causes of acute renal failure in infancy and childhood. The typical form occurring after an episode of diarrhea caused by Escherichia coli is the most frequent in children. Other microorganisms also may be responsible for HUS, such as Streptococcus pneumoniae, which causes more severe forms of the disease. We report an 8-month-old girl who presented with pneumonia and subsequently developed HUS. Renal biopsy showed characteristic lesion of thrombotic microangiopathy and extensive cortical necrosis. She was managed with peritoneal dialysis but did not improve and developed severe sepsis due to staphylococcal peritonitis, resulting in the death of the patient. Streptococcus pneumoniae-induced HUS is uncommon, but results in severe disease in the young. There is a high risk of these patients developing end-stage kidney disease in the long term.

  20. Hemolytic uremic syndrome: pathogenesis and update of interventions.

    Science.gov (United States)

    Palermo, Marina S; Exeni, Ramón A; Fernández, Gabriela C

    2009-08-01

    The typical form of hemolytic uremic syndrome (HUS) is the major complication of Shiga toxin-producing Escherichia coli infections. HUS is a critical health problem in Argentina since it is the main cause of acute renal failure in children and the second cause of chronic renal failure, accounting for 20% of renal transplants in children and adolescents in Argentina. Despite extensive research in the field, the mainstay of treatment for patients with HUS is supportive therapy, and there are no specific therapies preventing or ameliorating the disease course. In this review, we present the current knowledge about pathogenic mechanisms and discuss traditional and innovative therapeutic approaches, with special focus in Argentinean contribution. The hope that a better understanding of transmission dynamics and pathogenesis of this disease will produce better therapies to prevent the acute mortality and the long-term morbidity of HUS is the driving force for intensified research.

  1. Habitat Evaluation Procedures (HEP) Report : Priest River, 2004-2005 Technical Report.

    Energy Technology Data Exchange (ETDEWEB)

    Entz, Ray

    2005-02-01

    On July 6, 2004, the Habitat Evaluation Procedure (HEP) was used to determine baseline habitat suitability on the Priest River property, an acquisition completed by the Kalispel Tribe of Indians in 2001. Evaluation species and appropriate models include bald eagle, black-capped chickadee, Canada goose, mallard, yellow warbler, and white-tailed deer. Habitat Suitability Index (HSI) values were visually estimated and agreed upon by all HEP team members. The Priest River Project provides a total of 105.41 Habitat Units (HUs) for the species evaluated. Conifer forest habitat provides 26.95 HUs for bald eagle, black-capped chickadee, and white-tailed deer. Grassland habitat provides 23.78 HUs for Canada goose and mallard. Scmb-shrub vegetation provides 54.68 HUs for mallard, yellow warbler, and white-tailed deer.

  2. New generation in Estonian animation / Mari-Liis Rebane

    Index Scriptorium Estoniae

    Rebane, Mari-Liis, 1988-

    2010-01-01

    Eesti animafilmide loojate uuest põlvkonnast, animafilmide tegemise võimalustest, uute animafilmide tasemest. Martinus Daane Klemeti animafilmidest "Furry Flurry" (2006) ja "Light My Fire" (2007) ning joonisfilmist "Õhus" (Eesti Joonisfilm, 2009, kunstnik Gerda Märtens)

  3. IFE PsychologIA - Vol 23, No 1 (2015)

    African Journals Online (AJOL)

    Development and Validation of Prison Inmates Self-Harm Urges Scale (IS-HUS): A ... Performance Appraisal Knowledge: An Implication on Workplace ... Care in a Maternity Unit in South-Western Nigeria: Relationship with Self Esteem · EMAIL ...

  4. 40 CFR 205.158 - Labeling requirements.

    Science.gov (United States)

    2010-07-01

    ..., and four spaces for the advertised engine displacement respectively. (7) All motorcycle manufacturers... HOD Honda HON Husqvarna HUS JAWA/CZ JAW Kawasaki KAW KTM KTM Laverda LAV Moto Benilli BEN Moto Guzzi...

  5. Life-threatening pregnancy-associated atypical haemolytic uraemic syndrome and its response to eculizumab.

    Science.gov (United States)

    Gately, Ryan; San, Aye; Kurtkoti, Jagadeesh; Parnham, Alan

    2017-02-01

    Pregnancy-associated atypical haemolytic uraemic syndrome (P-aHUS) is a rare, potentially lethal condition that can complicate pregnancy in up to 1 in 25 000 cases. Without prompt diagnosis and initiation of appropriate treatment, this condition can lead to disastrous consequences for both mother and child. Given the broad spectrum of conditions that can present similarly in the peripartum period, it is often difficult to establish the correct diagnosis in a timely manner. Recently, the terminal complement cascade inhibitor eculizumab has been used with considerable success in non-pregnancy HUS; however, its use in P-aHUS is limited to isolated case reports. Here, we present a case of fulminant P-aHUS in the postpartum period that was successfully treated with eculizumab resulting in significant recovery of renal function.

  6. Mozambique

    African Journals Online (AJOL)

    lieved that a woman should have an average of 6 children, or an indeterminate number ("as many as the hus- band wants" or "according ..... The print and electronic media appeared to be .... out requiring time-consuming and expensive travel.

  7. Clinical grand rounds: atypical hemolytic uremic syndrome.

    Science.gov (United States)

    Hodgkins, Kavita S; Bobrowski, Amy E; Lane, Jerome C; Langman, Craig B

    2012-01-01

    Atypical hemolytic uremic syndrome (aHUS) is a rare, lifethreatening, chronic, genetic disease of uncontrolled alternative pathway complement activation. The understanding of the pathophysiology and genetics of this disease has expanded over recent decades and promising new developments in the management of aHUS have emerged. Regardless of the cause of aHUS, with or without a demonstrated mutation or autoantibody, blockade of terminal complement activation through C5 is of high interest as a mechanism to ameliorate the disease. Eculizumab, an existing monoclonal antibody directed against C5 with high affinity, prevents the perpetuation of the downstream activation of the complement cascade and the damage caused by generation of the anaphylotoxin C5a and the membrane attack complex C5b-9, by blocking C5 cleavage. We report the successful use of eculizumab in a patient after kidney transplantation and discuss the disease aHUS.

  8. Hemolytic uremic syndrome associated with Acinetobacter hemolyticus.

    Science.gov (United States)

    da Silva, Paulo Sérgio Lucas; Lipinski, Rubens Wolfe

    2014-08-01

    Shiga toxin-producing Escherichia coli and Shigella dysenteriae have been associated with bloody diarrhea and hemolytic uremic syndrome (HUS) in humans. However, there have been only a couple of reports describing bloody diarrhea associated with Acinetobacter spp. and there are no reports of these bacteria causing HUS in children. Here, we report the case of a nine-month-old boy with bloody diarrhea who developed non-oliguric renal failure. The clinical and laboratory findings supported the diagnosis of Acinetobacter hemolyticus infection associated with HUS. The patient responded favorably to antibiotic therapy plus conservative treatment. In conclusion, Acinetobacter infection should be considered as a plausible cause of HUS in cases where E. coli infection is not involved. The rapid transformation ability of Acinetobacter is a matter of concern.

  9. Eculizumab for atypical hemolytic-uremic syndrome in India: First report from India and the challenges faced

    Science.gov (United States)

    Sethi, S. K.; Rohatgi, S.; Dragon-Durey, M. A.; Raghunathan, V.; Dhaliwal, M.; Rawat, A.; Jha, P.; Bansal, S. B.; Raina, R.; Kher, V.

    2017-01-01

    Much progress has been made in understanding the pathophysiology and treatment of atypical hemolytic uremic syndrome (aHUS). Plasma therapy is the mainstay of treatment for aHUS. The availability of the first effective anti-complement therapeutic agent, eculizumab, has dramatically changed the outlook of this disease. However, its use in clinical practice raises important questions, such as who should receive the drug, when to start such therapy, and is it safe to stop treatment once the disease is controlled. We describe here for the 1st time in India, use of eculizumab in a 12-year-old boy with aHUS. We also describe in this report challenges faced in procuring the drug, and an ideal, evidence-based method of treating aHUS in children. PMID:28182046

  10. Habitat Evaluation Procedures Report; Graves Property - Yakama Nation.

    Energy Technology Data Exchange (ETDEWEB)

    Ashley, Paul; Muse, Anthony

    2008-02-01

    A habitat evaluation procedures (HEP) analysis was conducted on the Graves property (140 acres) in June 2007 to determine the number of habitat units to credit Bonneville Power Administration (BPA) for providing funds to acquire the property as partial mitigation for habitat losses associated with construction of McNary Dam. HEP surveys also documented the general ecological condition of the property. The Graves property was significantly damaged from past/present livestock grazing practices. Baseline HEP surveys generated 284.28 habitat units (HUs) or 2.03 HUs per acre. Of these, 275.50 HUs were associated with the shrubsteppe/grassland cover type while 8.78 HUs were tied to the riparian shrub cover type.

  11. The Shiga toxin genotype rather than the amount of Shiga toxin or the cytotoxicity of Shiga toxin in vitro correlates with the appearance of the hemolytic uremic syndrome.

    Science.gov (United States)

    Orth, Dorothea; Grif, Katharina; Khan, Abdul B; Naim, Asma; Dierich, Manfred P; Würzner, Reinhard

    2007-11-01

    Shiga toxins (Stx) are believed to play a key role in the pathogenesis of diseases caused by Stx-producing Escherichia coli (STEC), including the potentially life-threatening hemolytic uremic syndrome (HUS). In this study, 201 STEC strains collected from patients and environmental sources were investigated with regard to the stx genotypes and pathogenicity. The stx(2) and stx(2c) alleles were associated with high virulence and the ability to cause HUS, whereas stx(2d), stx(2e,)stx(1), and stx(1c) occurred in milder or asymptomatic infections. Quantification of Stx using an enzyme immunoassay and the Vero cell cytotoxicity assay showed no significant differences between the strains associated with HUS and those causing milder diseases. We hypothesize that the stx genotype and perhaps other yet unknown virulence factors rather than the amount of Stx or the in vitro cytotoxicity correlate with the development of HUS.

  12. Severe transient ADAMTS13 deficiency in pneumococcal-associated hemolytic uremic syndrome.

    Science.gov (United States)

    Pelras, Sybille; Delmas, Yahsou; Lamireau, Delphine; Villega, Frédéric; Nolent, Paul; Ryman, Anne; Llanas, Brigitte; Brissaud, Olivier; Harambat, Jérôme

    2011-04-01

    Thrombotic microangiopathies comprise different entities, including hemolytic uremic syndrome (HUS), thrombotic thrombocytopenic purpura (TTP), and several other conditions. TTP is characterized by hemolytic anemia, thrombocytopenia, and multiorgan failure. TTP is the result of severe von Willebrand factor multimer cleaving protease (ADAMTS13) deficiency that is either inherited or the result of acquired autoantibodies. We report a critically ill 2-year-old girl with invasive pneumococcal disease associated HUS (p-HUS) whose condition was complicated by severe ADAMTS13 deficiency, without detectable inhibitor, in a context of multiple organ failure. The patient recovered with supportive treatment, and ADAMTS13 activity normalized without plasmatherapy. Severe ADAMTS13 deficiency appears to be a manifestation of transient endothelial cell injury in the context of severe sepsis, including invasive p-HUS. The choice of appropriate therapy should not be based on this finding.

  13. Dormaier and Chester Butte 2007 Follow-up Habitat Evaluation Procedures Report.

    Energy Technology Data Exchange (ETDEWEB)

    Ashley, Paul R.

    2008-01-01

    Follow-up habitat evaluation procedures (HEP) analyses were conducted on the Dormaier and Chester Butte wildlife mitigation sites in April 2007 to determine the number of additional habitat units to credit Bonneville Power Administration (BPA) for providing funds to enhance, and maintain the project sites as partial mitigation for habitat losses associated with construction of Grand Coulee Dam. The Dormaier follow-up HEP survey generated 482.92 habitat units (HU) or 1.51 HUs per acre for an increase of 34.92 HUs over baseline credits. Likewise, 2,949.06 HUs (1.45 HUs/acre) were generated from the Chester Butte follow-up HEP analysis for an increase of 1,511.29 habitat units above baseline survey results. Combined, BPA will be credited with an additional 1,546.21 follow-up habitat units from the Dormaier and Chester Butte parcels.

  14. New generation in Estonian animation / Mari-Liis Rebane

    Index Scriptorium Estoniae

    Rebane, Mari-Liis, 1988-

    2010-01-01

    Eesti animafilmide loojate uuest põlvkonnast, animafilmide tegemise võimalustest, uute animafilmide tasemest. Martinus Daane Klemeti animafilmidest "Furry Flurry" (2006) ja "Light My Fire" (2007) ning joonisfilmist "Õhus" (Eesti Joonisfilm, 2009, kunstnik Gerda Märtens)

  15. Case report of atypical hemolytic uremic syndrome with retinal arterial and venous occlusion treated with eculizumab

    Directory of Open Access Journals (Sweden)

    Greenwood GT

    2015-10-01

    Full Text Available Gregory T Greenwood Nephrology Associates, PLLC, Winston-Salem, NC, USA Abstract: Atypical hemolytic uremic syndrome (aHUS is a rare disease caused by chronic, uncontrolled activation of the alternative complement pathway, leading to thrombotic microangiopathy. Renal impairment and progression to end-stage renal disease are common in untreated patients with aHUS, and extrarenal manifestations are being increasingly characterized in the literature. Ocular involvement remains rare in aHUS. This report describes a patient with aHUS with bilateral central retinal artery and vein occlusion, vitreous hemorrhage, and blindness in addition to renal impairment. The patient’s hematologic and renal parameters and ocular manifestation improved following initiation of eculizumab therapy. Keywords: acute kidney injury, complement, dialysis, plasma exchange, thrombotic microangiopathy

  16. Cardiomyopathy: a late complication of hemolytic uremic syndrome.

    Science.gov (United States)

    Walker, A M; Benson, L N; Wilson, G J; Arbus, G S

    1997-04-01

    This report describes a child who presented with classic hemolytic uremic syndrome (HUS) and 4 months later developed a life-threatening but reversible cardiomyopathy with global cardiac dysfunction and a left ventricular ejection fraction of 14%. There was no evidence of electrolyte abnormalities, anemia, hypertension, severe fluid overload, or viral infection. Endomyocardial biopsies were consistent with a dilated cardiomyopathy. This paper highlights the importance of considering the diagnosis of associated cardiomyopathy when presenting with late-onset edema following HUS.

  17. Acute Renal Replacement Therapy in Children with Diarrhea-Associated Hemolytic Uremic Syndrome: A Single Center 16 Years of Experience

    OpenAIRE

    Silviu Grisaru; Morgunov, Melissa A.; Samuel, Susan M.; Julian P Midgley; Wade, Andrew W; Tee, James B.; Hamiwka, Lorraine A.

    2011-01-01

    Acute kidney injury (AKI) is becoming more prevalent among hospitalized children, its etiologies are shifting, and new treatment modalities are evolving; however, diarrhea-associated hemolytic uremic syndrome (D+HUS) remains the most common primary disease causing AKI in young children. Little has been published about acute renal replacement therapy (ARRT) and its challenges in this population. We describe our single center's experience managing 134 pediatric patients with D+HUS out of whom 5...

  18. Antibody response to Shiga toxins in Argentinean children with enteropathic hemolytic uremic syndrome at acute and long-term follow-up periods.

    Directory of Open Access Journals (Sweden)

    Romina J Fernández-Brando

    Full Text Available Shiga toxin (Stx-producing Escherichia coli (STEC infection is associated with a broad spectrum of clinical manifestations that include diarrhea, hemorrhagic colitis, and hemolytic uremic syndrome (HUS. Systemic Stx toxemia is considered to be central to the genesis of HUS. Distinct methods have been used to evaluate anti-Stx response for immunodiagnostic or epidemiological analysis of HUS cases. The development of enzyme-linked immunosorbent assay (ELISA and western blot (WB assay to detect the presence of specific antibodies to Stx has introduced important advantages for serodiagnosis of HUS. However, application of these methods for seroepidemiological studies in Argentina has been limited. The aim of this work was to develop an ELISA to detect antibodies against the B subunit of Stx2, and a WB to evaluate antibodies against both subunits of Stx2 and Stx1, in order to analyze the pertinence and effectiveness of these techniques in the Argentinean population. We studied 72 normal healthy children (NHC and 105 HUS patients of the urban pediatric population from the surrounding area of Buenos Aires city. Using the WB method we detected 67% of plasma from NHC reactive for Stx2, but only 8% for Stx1. These results are in agreement with the broad circulation of Stx2-expressing STEC in Argentina and the endemic behavior of HUS in this country. Moreover, the simultaneous evaluation by the two methods allowed us to differentiate acute HUS patients from NHC with a great specificity and accuracy, in order to confirm the HUS etiology when pathogenic bacteria were not isolated from stools.

  19. Antibody response to Shiga toxins in Argentinean children with enteropathic hemolytic uremic syndrome at acute and long-term follow-up periods.

    Science.gov (United States)

    Fernández-Brando, Romina J; Bentancor, Leticia V; Mejías, María Pilar; Ramos, María Victoria; Exeni, Andrea; Exeni, Claudia; Laso, María del Carmen; Exeni, Ramón; Isturiz, Martín A; Palermo, Marina S

    2011-04-29

    Shiga toxin (Stx)-producing Escherichia coli (STEC) infection is associated with a broad spectrum of clinical manifestations that include diarrhea, hemorrhagic colitis, and hemolytic uremic syndrome (HUS). Systemic Stx toxemia is considered to be central to the genesis of HUS. Distinct methods have been used to evaluate anti-Stx response for immunodiagnostic or epidemiological analysis of HUS cases. The development of enzyme-linked immunosorbent assay (ELISA) and western blot (WB) assay to detect the presence of specific antibodies to Stx has introduced important advantages for serodiagnosis of HUS. However, application of these methods for seroepidemiological studies in Argentina has been limited. The aim of this work was to develop an ELISA to detect antibodies against the B subunit of Stx2, and a WB to evaluate antibodies against both subunits of Stx2 and Stx1, in order to analyze the pertinence and effectiveness of these techniques in the Argentinean population. We studied 72 normal healthy children (NHC) and 105 HUS patients of the urban pediatric population from the surrounding area of Buenos Aires city. Using the WB method we detected 67% of plasma from NHC reactive for Stx2, but only 8% for Stx1. These results are in agreement with the broad circulation of Stx2-expressing STEC in Argentina and the endemic behavior of HUS in this country. Moreover, the simultaneous evaluation by the two methods allowed us to differentiate acute HUS patients from NHC with a great specificity and accuracy, in order to confirm the HUS etiology when pathogenic bacteria were not isolated from stools.

  20. Chronic type B aortic dissection in association with Hemolyticuremic syndrome in a child

    OpenAIRE

    2013-01-01

    Aortic dissection (AD) is a potentially life-threatening medical emergency usually encountered in the elderly. Here, we report a 9-year-old child who was incidentally detected to have asymptomatic chronic type B dissecting aneurysm of aorta when he presented with relapse of Hemolytic uremic syndrome (HUS) without any genetic abnormalities like Marfan or Ehler-Danlos syndrome. To the best of our knowledge, this is the first case of AD associated with HUS in a child without any known associated...

  1. Atypical hemolytic uremic syndrome: update on the complement system and what is new.

    Science.gov (United States)

    Hirt-Minkowski, Patricia; Dickenmann, Michael; Schifferli, Jürg A

    2010-01-01

    Atypical hemolytic uremic syndrome (aHUS) is a rare disease of microangiopathic hemolytic anemia, thrombocytopenia, and predominant renal impairment. It is characterized by the absence of Shiga toxin-producing bacteria as a triggering factor. During the last decade, aHUS has been demonstrated to be a disorder of the complement alternative pathway dysregulation, as there is a growing list of mutations and polymorphisms in the genes encoding the complement regulatory proteins that alone or in combination may lead to aHUS. Approximately 60% of aHUS patients have so-called 'loss-of-function' mutations in the genes encoding the complement regulatory proteins, which normally protect host cells from complement activation: complement factor H (CFH), factor I (CFI) and membrane cofactor protein (MCP or CD46), or have 'gain-of-function' mutations in the genes encoding the complement factor B or C3. In addition, approximately 10% of aHUS patients have a functional CFH deficiency due to anti-CFH antibodies. Recent advances in understanding the pathogenesis of aHUS have led to a revised classification of the syndrome. Normal plasma levels of CFH and CFI do not preclude the presence of a mutation in these genes. Further, genotype-phenotype correlations of aHUS have clinical significance in predicting renal recovery and transplant outcome. Therefore, it is important to make a comprehensive analysis and perform genetic screening of the complement system in patients with aHUS to allow a more precise approach, especially before transplantation. This may also provide opportunities for more specific treatments in the near future, as complement inhibition could represent a therapeutic target in these patients who have a considerably poor prognosis in terms of both mortality and progression to end-stage renal disease and a great risk of disease recurrence after transplantation.

  2. Shiga toxin in enterohemorrhagic E.coli: regulation and novel anti-virulence strategies

    OpenAIRE

    Vanessa eSperandio; Alline Roberta Pacheco

    2012-01-01

    Enterohemorrhagic Escherichia coli (EHEC) are responsible for major outbreaks of bloody diarrhea and hemolytic uremic syndrome (HUS) throughout the world. The mortality associated with EHEC infections stems from the production and release of a potent Shiga toxin (Stx) by these bacteria. Stx induces cell death in endothelial cells, primarily in the urinary tract, causing HUS. Stx was first described in Shigella dysenteriae serotype I by Kiyoshi Shiga and was discovered later in EHEC. Multiple ...

  3. cblE-Type Homocystinuria Presenting with Features of Haemolytic-Uremic Syndrome in the Newborn Period

    OpenAIRE

    Palanca, Daniel; Garcia-Cazorla, Angels; Ortiz, Jessica; Jou, Cristina; Cusí, Victoria; Suñol, Mariona; Toll, Teresa; Perez, Belén; Ormazabal, Aida; Fowler, Brian; Artuch, Rafael

    2012-01-01

    This study describes a cblE type of homocystinuria associated with haemolytic-uremic syndrome (HUS) features. We report on a male infant aged 43 days presenting with failure to thrive, hypotonia, pancytopaenia, HUS symptoms (microangiopathic haemolytic anaemia and thrombocytopaenia with signs of renal involvement) and fatal evolution. An underlying cobalamin disorder was diagnosed after a bone marrow examination revealed megaloblastic changes associated with hyperhomocysteinaemia. An urinary ...

  4. [Perioperative evaluation of cerebral hemodynamics by transcranial Doppler ultrasonography in patient with hemolytic uremic syndrome].

    Science.gov (United States)

    Nishikawa, M; Hayashi, T; Yoshitomi, T; Inoue, T; Ichiyama, T; Furukawa, S

    2000-11-01

    Major central nervous system (CNS) complications such as seizures and coma, occur in about 30% of children with hemolytic uremic syndrome (HUS). Serious CNS involvement is associated with an increased mortality. The purpose of this study was to evaluate intracranial hemodynamics in HUS encephalopathy. We measured mean blood flow velocity and pulsatility index (PI) of the middle cerebral artery (MCA) with transcranial Doppler (TCD) in a two year-old girl with acute encephalopathy, and compared them to those in a one year-old girl with febrile convulsion incidentally complicating HUS (a disease control). In the patient with HUS encephalopathy TCD demonstrated abnormally low PI of 0.58, while the magnetic resonance imaging (MRI) and single-photon emission-computed tomography (SPECT) reveal no abnormal findings in the acute stage. The abnormal TCD findings disappeared with her recovery. In the HUS patient with febrile convulsion alone, TCD demonstrated normal maximal flow velocity and PI. Thus TCD may be useful in evaluating intracranial hemodynamics in HUS encephalopathy in the absence of MRI and SPECT abnormalities at the early stage of illness.

  5. Renal recovery with eculizumab in atypical hemolytic uremic syndrome following prolonged dialysis.

    Science.gov (United States)

    Povey, Hannah; Vundru, Rahul; Junglee, Naushad; Jibani, Mahdi

    2014-11-01

    Hemolytic uremic syndrome (HUS) is a thrombotic microangiopathy (TMA) which encompasses hemolytic anemia, thrombocytopenia, and organ impairment. Around 10% of cases are atypical HUS (aHUS), a rare disease with poor outcomes caused by uncontrolled activation of the alternative complement pathway. This case describes a young woman with clinical manifestations compatible with TMA during childhood and adolescence who was formally diagnosed with aHUS at the age of 21. She was managed with intensive plasma exchange and hemodialysis, which failed to improve her severe acute kidney injury and other hematological manifestations of aHUS. This was further compounded by several episodes of flash pulmonary edema and the posterior reversible encephalopathy syndrome (PRES). Treatment with the monoclonal anti-C5 inhibitor, eculizumab, improved all hematological parameters with almost full renal recovery following 3.5 months of dialysis. So far, long-term use of eculizumab (> 11 months) continues to be effective and without complication. Our case illustrates the difficulty but importance of early consideration of aHUS in patients presenting with TMA. More importantly, we highlight that near-normal renal recovery may be attained with eculizumab in adults even after a long dependence on dialysis - an observation that has not been reported in the literature so far.

  6. West Foster Creek 2007 Follow-up Habitat Evaluation Procedures (HEP) Report.

    Energy Technology Data Exchange (ETDEWEB)

    Ashley, Paul R.

    2008-02-01

    A follow-up habitat evaluation procedures (HEP) analysis was conducted on the West Foster Creek (Smith acquisition) wildlife mitigation site in May 2007 to determine the number of additional habitat units to credit Bonneville Power Administration (BPA) for providing funds to enhance and maintain the project site as partial mitigation for habitat losses associated with construction of Grand Coulee Dam. The West Foster Creek 2007 follow-up HEP survey generated 2,981.96 habitat units (HU) or 1.51 HUs per acre for a 34% increase (+751.34 HUs) above baseline HU credit (the 1999 baseline HEP survey generated 2,230.62 habitat units or 1.13 HUs per acre). The 2007 follow-up HEP analysis yielded 1,380.26 sharp-tailed grouse (Tympanuchus phasianellus) habitat units, 879.40 mule deer (Odocoileus hemionus) HUs, and 722.29 western meadowlark (Sturnella neglecta) habitat units. Mule deer and sharp-tailed grouse habitat units increased by 346.42 HUs and 470.62 HUs respectively over baseline (1999) survey results due largely to cessation of livestock grazing and subsequent passive restoration. In contrast, the western meadowlark generated slightly fewer habitat units in 2007 (-67.31) than in 1999, because of increased shrub cover, which lowers habitat suitability for that species.

  7. Involvement of the fractalkine pathway in the pathogenesis of childhood hemolytic uremic syndrome.

    Science.gov (United States)

    Ramos, María Victoria; Fernández, Gabriela C; Patey, Natasha; Schierloh, Pablo; Exeni, Ramón; Grimoldi, Irene; Vallejo, Graciela; Elías-Costa, Christian; Del Carmen Sasiain, Maria; Trachtman, Howard; Combadière, Christophe; Proulx, François; Palermo, Marina S

    2007-03-15

    Thrombotic microangiopathy and acute renal failure are cardinal features of postdiarrheal hemolytic uremic syndrome (HUS). These conditions are related to endothelial and epithelial cell damage induced by Shiga toxin (Stx) through the interaction with its globotriaosyl ceramide receptor. However, inflammatory processes contribute to the pathogenesis of HUS by sensitizing cells to Stx fractalkine (FKN), a CX(3)C transmembrane chemokine expressed on epithelial and endothelial cells upon activation, is involved in the selective migration and adhesion of specific leukocyte subsets to tissues. Here, we demonstrated a selective depletion of circulating mononuclear leukocytes expressing the receptor for FKN (CX(3)CR1) in patients with HUS. We found a unique phenotype in children with HUS distinct from that seen in healthy, uremic, or infected controls, in which monocytes lost CX(3)CR1, down-modulated CD62L, and increased CD16. In addition, the CD56(dim) natural killer (NK) subpopulation was decreased, leading to an altered peripheral CD56(dim)/CD56(bright) ratio from 10.0 to 4.5. It is noteworthy that a negative correlation existed between the percentage of circulating CX(3)CR1(+) leukocytes and the severity of renal failure. Finally, CX(3)CR1(+) leukocytes were observed in renal biopsies from patients with HUS. We suggest that the interaction of CX(3)CR1(+) cells with FKN present on activated endothelial cells may contribute to renal injury in HUS.

  8. Eculizumab in neonatal hemolytic uremic syndrome with homozygous factor H deficiency.

    Science.gov (United States)

    Michaux, Katell; Bacchetta, Justine; Javouhey, Etienne; Cochat, Pierre; Frémaux-Bacchi, Véronique; Sellier-Leclerc, Anne-Laure

    2014-12-01

    Neonatal atypical hemolytic uremic syndrome (aHUS) is a rare but severe disease that is mainly due to methylmalonic aciduria or genetic complement abnormalities. Traditional management of aHUS includes plasma infusion/exchange, but in small or unstable infants, plasma exchange can be challenging because of high extracorporeal volume and difficulty to obtain an adequate venous access. The C5 complement blocker eculizumab has become a cornerstone of first-line management of aHUS due to complement deregulation in older patients. However, little data are available on its use in neonatal aHUS. We report on an 11-day-old neonate with severe aHUS (myocardial impairment, respiratory failure, acute kidney disease requiring hemodiafiltration) due to homozygous factor-H deficiency. She received early treatment with eculizumab as first-line therapy and completely recovered within 5 days. A second dose of eculizumab was administered 7 days after the first infusion, followed by a dose every 2 weeks for 2 months and then every 3 weeks, at the same dosage (300 mg). With more than 24 months of follow-up, renal function remains normal. We report on the long-term efficacy and safety of eculizumab as first-line therapy in neonatal aHUS. However its use still requires optimization in terms of indications and administration (frequency, dosage).

  9. Shiga Toxin Therapeutics: Beyond Neutralization

    Directory of Open Access Journals (Sweden)

    Gregory Hall

    2017-09-01

    Full Text Available Ribotoxic Shiga toxins are the primary cause of hemolytic uremic syndrome (HUS in patients infected with Shiga toxin-producing enterohemorrhagic Escherichia coli (STEC, a pathogen class responsible for epidemic outbreaks of gastrointestinal disease around the globe. HUS is a leading cause of pediatric renal failure in otherwise healthy children, resulting in a mortality rate of 10% and a chronic morbidity rate near 25%. There are currently no available therapeutics to prevent or treat HUS in STEC patients despite decades of work elucidating the mechanisms of Shiga toxicity in sensitive cells. The preclinical development of toxin-targeted HUS therapies has been hindered by the sporadic, geographically dispersed nature of STEC outbreaks with HUS cases and the limited financial incentive for the commercial development of therapies for an acute disease with an inconsistent patient population. The following review considers potential therapeutic targeting of the downstream cellular impacts of Shiga toxicity, which include the unfolded protein response (UPR and the ribotoxic stress response (RSR. Outcomes of the UPR and RSR are relevant to other diseases with large global incidence and prevalence rates, thus reducing barriers to the development of commercial drugs that could improve STEC and HUS patient outcomes.

  10. Shiga Toxin Therapeutics: Beyond Neutralization

    Science.gov (United States)

    Hall, Gregory; Kurosawa, Shinichiro; Stearns-Kurosawa, Deborah J.

    2017-01-01

    Ribotoxic Shiga toxins are the primary cause of hemolytic uremic syndrome (HUS) in patients infected with Shiga toxin-producing enterohemorrhagic Escherichia coli (STEC), a pathogen class responsible for epidemic outbreaks of gastrointestinal disease around the globe. HUS is a leading cause of pediatric renal failure in otherwise healthy children, resulting in a mortality rate of 10% and a chronic morbidity rate near 25%. There are currently no available therapeutics to prevent or treat HUS in STEC patients despite decades of work elucidating the mechanisms of Shiga toxicity in sensitive cells. The preclinical development of toxin-targeted HUS therapies has been hindered by the sporadic, geographically dispersed nature of STEC outbreaks with HUS cases and the limited financial incentive for the commercial development of therapies for an acute disease with an inconsistent patient population. The following review considers potential therapeutic targeting of the downstream cellular impacts of Shiga toxicity, which include the unfolded protein response (UPR) and the ribotoxic stress response (RSR). Outcomes of the UPR and RSR are relevant to other diseases with large global incidence and prevalence rates, thus reducing barriers to the development of commercial drugs that could improve STEC and HUS patient outcomes. PMID:28925976

  11. Unusual Manifestation of Severe Conjugated Hyperbilirubinemia in an Infant with Streptococcus pneumoniae-associated Hemolytic Uremic Syndrome

    Directory of Open Access Journals (Sweden)

    Jung-Pin Chen

    2007-01-01

    Full Text Available Streptococcus pneumoniae is an uncommon etiologic organism in children with hemolytic uremic syndrome (HUS. Historically, severe S. pneumoniae-associated HUS usually has a poor clinical outcome. The clinical manifestations of marked jaundice and hepatic dysfunction in this form of HUS are extremely rare. We report a 10-month-old female infant with S. pneumoniae-associated HUS who had the unusual manifestation of severely elevated conjugated bilirubin and hepatic transaminases. Screening for viral hepatitis was negative, and evidence of biliary obstruction and hepatotoxic drug exposure was also absent. The patient was treated with antihypertensive agents for 2.5 months and required peritoneal dialysis for a period of 26 days. Hepatic function returned to normal on the 8th day of hospitalization. Renal function was mildly impaired at 1-year follow-up. Our report suggests that severe conjugated hyperbilirubinemia is a rare manifestation of S. pneumoniae-associated HUS in children. It is important for pediatricians that pneumococcal infection with severe hematologic and renal disorders should be investigated for evidence of S. pneumoniae-associated HUS. [J Formos Med Assoc 2007;106(2 Suppl:S17-S22

  12. Recessive mutations in DGKE cause atypical hemolytic-uremic syndrome

    Science.gov (United States)

    Lemaire, Mathieu; Frémeaux-Bacchi, Véronique; Schaefer, Franz; Choi, Murim; Tang, Wai Ho; Le Quintrec, Moglie; Fakhouri, Fadi; Taque, Sophie; Nobili, François; Martinez, Frank; Ji, Weizhen; Overton, John D.; Mane, Shrikant M.; Nürnberg, Gudrun; Altmüller, Janine; Thiele, Holger; Morin, Denis; Deschenes, Georges; Baudouin, Véronique; Llanas, Brigitte; Collard, Laure; Majid, Mohammed A.; Simkova, Eva; Nürnberg, Peter; Rioux-Leclerc, Nathalie; Moeckel, Gilbert W.; Gubler, Marie Claire; Hwa, John; Loirat, Chantal; Lifton, Richard P.

    2013-01-01

    Pathologic thrombosis is a major cause of mortality. Hemolytic-uremic syndrome (HUS) features episodes of small vessel thrombosis resulting in microangiopathic hemolytic anemia, thrombocytopenia and renal failure1. Atypical HUS (aHUS) can result from genetic or autoimmune factors2 that lead to pathologic complement cascade activation3. By exome sequencing we identify recessive mutations in DGKE (diacylglycerol kinase epsilon) that co-segregate with aHUS in 9 unrelated kindreds, defining a distinctive Mendelian disease. Affected patients present with aHUS before age 1, have persistent hypertension, hematuria and proteinuria (sometimes nephrotic range), and develop chronic kidney disease with age. DGKE is found in endothelium, platelets, and podocytes. Arachidonic acid-containing diacylglycerols (DAG) activate protein kinase C, which promotes thrombosis. DGKE normally inactivates DAG signaling. We infer that loss of DGKE function results in a pro-thrombotic state. These findings identify a new mechanism of pathologic thrombosis and kidney failure and have immediate implications for treatment of aHUS patients. PMID:23542698

  13. Recurrence of hemolytic uremic syndrome after renal transplantation.

    Science.gov (United States)

    Seitz, B; Albano, L; Vocila, F; Mzoughi, S; Aoudia, R; Guitard, J; Ribes, D; Vachet-Copponat, H; Mourad, G; Bienaimé, F; Dahan, P; Frémeaux-Bacchi, V; Cassuto, E

    2007-10-01

    Non-Shiga toxin-associated hemolytic uremic syndrome (non-Stx-HUS) is a rare disease. The clinical outcome is often unfavorable: 50% of patients progress to end-stage renal failure. Several mutations in complement regulatory genes predispose to non-Stx-HUS. Transplantation outcomes are poor among patients with either mutation in the genes encoding complement H or I factors, with 80% graft loss due to HUS recurrence. In contrast, patients with mutation in the gene encoding MCP have no disease relapse after transplantation. There are no treatment guidelines for non-Stx-HUS recurrence. Herein we have presented 8 patients with non-Stx-HUS recurrence after transplantation during the last 10 years in the South of France. HUS recurrence, which occurred early after transplantation in all but 1 patient, was treated by plasma exchange (PE) with substitution by fresh frozen plasma (FFP). Three patients still treated with long-term plasma therapy have no recurrence at 15, 19, or 24 months. An international registry would help to define new guidelines.

  14. [Hemolytic uremic syndrome in adults].

    Science.gov (United States)

    Hertig, Alexandre; Ridel, Christophe; Rondeau, Eric

    2010-07-01

    Hemolytic uremic syndrome (HUS) is related to a renal thrombotic microangiopathy, inducing hypertension and acute renal failure (ARF). Its pathogenesis involves an activation/lesion of microvascular endothelial cells, mainly in the renal vasculature, secondary to bacterial toxins, drugs, or autoantibodies. An overactivation of the complement alternate pathway secondary to a heterozygote deficiency of regulatory proteins (factor H, factor I or MCP) or to an activating mutation of factor B or C3 can also result in HUS. Less frequently, renal microthrombi are due to an acquired or a constitutional deficiency in ADAMTS-13, the protease cleaving von Wilebrand factor. Hemolytic anemia with schistocytes, thrombocytopenia without evidence of disseminated intravascular coagulation, and renal failure are consistently found. In typical HUS, a prodromal diarrhea, with blood in the stools, is observed, related to pathogenic enterobacteria, most frequently E. Coli O157:H7. HUS may also occur in the post partum period, and is then related to a factor H or factor I deficiency. HUS may also occur after various treatments such as mitomycin C, gemcitabine, ciclosporin A, or tacrolimus, and as reported more recently bevacizumab, an anti VEGF antibody. Atypical HUS are not associated with diarrhea, may be sporadic or familial, and can be related to an overactivation of the complement alternate pathway. More recently, some of them have been related to a mutation of thrombomodulin, which also regulates the alternate pathway of complement. In adults, several HUS are encountered in the course of chronic nephropathies: nephroangiosclerosis, chronic glomerulonephritis, post irradiation nephropathy, scleroderma, disseminated lupus erythematosus, antiphospholipid syndrome. Overall the prognosis of HUS has improved, with a patient survival greater than 85% at 1 year. Chronic renal failure is observed as a sequella in 20 to 65% of the cases. Plasma infusions and plasma exchanges are effective in

  15. Habitat Evaluation Procedures (HEP) Report : Ladd Marsh Wildlife Area, 2004-2006 Technical Report.

    Energy Technology Data Exchange (ETDEWEB)

    Ashley, Paul; Wagoner, Sara

    2006-05-01

    The Regional HEP Team (RHT) and Oregon Department of Fish and Wildlife (ODFW) staff conducted a follow-up habitat evaluation procedures (HEP) analysis on the Ladd Marsh Wildlife Management Area (LMWA) in May 2005. The 2005 HEP assessment resulted in a total of 647.44 HUs, or 0.76 HUs/acre. This is an increase of 420.34 HUs (0.49 HUs/acre) over 2001 HEP survey results. The most significant increase in HUs occurred on the Wallender and Simonis parcels which increased by 214.30 HUs and 177.49 HUs respectively. Transects were established at or near 2001 HEP analysis transect locations whenever possible. ODFW staff biologists assisted the RHT re-establish transect locations and/or suggested areas for new surveys. Since 2001, significant changes in cover type acreage and/or structural conditions have occurred due to conversion of agriculture cover types to emergent wetland and grassland cover types. Agricultural lands were seeded to reestablish grasslands and wetlands were restored through active management and manipulation of extant water sources including natural stream hydrology/flood regimes and available irrigation. Grasslands increased on the Wallender parcel by 21% (65 acres), 23% (71 acres) at the Simonis site, and 39% (62 acres) at Conley Lake. The emergent wetland cover type also changed significantly increasing 60% (184 acres) at Wallender and 59% (184 acres) on the Simonis tract. Today, agriculture lands (crop and grazed pasture) have been nearly eliminated from Bonneville Power Administration (BPA) mitigation project lands located on the LMWA.

  16. Habitat Evaluation Procedures (HEP) Report; Carey Creek, Technical Report 2005.

    Energy Technology Data Exchange (ETDEWEB)

    Entz, Ray

    2005-05-01

    In August 2002, the Habitat Evaluation Procedure (HEP) was used to determine baseline habitat suitability on the Carey Creek property, an acquisition completed by the Kalispel Tribe of Indians in December 2001. Evaluation species and appropriate models include bald eagle, black-capped chickadee, Canada goose, mallard, yellow warbler, and white-tailed deer. Habitat Suitability Index (HSI) values were visually estimated and agreed upon by all HEP team members. The Carey Creek Project provides a total of 172.95 Habitat Units (HUs) for the species evaluated. Conifer forest habitat provides 4.91 HUs for bald eagle, black-capped chickadee, and white-tailed deer. Forested wetlands provide 52.68 HUs for bald eagle, black-capped chickadee, mallard, and white-tailed deer. Scrub-shrub wetlands provide 2.82 HUs for mallard, yellow warbler and white-tailed deer. Wet meadow and grassland meadow provide 98.13 HUs for mallard and Canada goose. Emergent wetlands provide 11.53 HUs for mallard, muskrat, and Canada goose. Open water provides 2.88 HUs for Canada goose, mallard, and muskrat. The objective of using HEP at the Carey Creek Project and other protected properties is to document the quality and quantity of available habitat for selected wildlife species. In this way, HEP provides information on the relative value of the same area at future points in time so that the effect of management activities on wildlife habitat can be quantified. When combined with other tools, the baseline HEP will be used to determine the most effective on-site management, restoration, and enhancement actions to increase habitat suitability for targeted species. The same process will be replicated every five years to quantitatively evaluate the effectiveness of management strategies in improving and maintaining habitat conditions while providing additional crediting to BPA for enhanced habitat values.

  17. Habitat Evaluation Procedures (HEP) Report, Pend Oreille Wetlands Wildlife II Project, Technical Report 2002.

    Energy Technology Data Exchange (ETDEWEB)

    Holmes, Darren

    2003-06-01

    In 2002, the Habitat Evaluation Procedure (HEP) was used to determine baseline habitat suitability on the Pend Oreille Wetlands Wildlife II Project, an acquisition completed by the Kalispel Tribe of Indians in 1997. Evaluation species and appropriate models include bald eagle, black-capped chickadee, Canada goose, mallard, and yellow warbler. Habitat Suitability Index (HSI) values were visually estimated and agreed upon by all HEP team members. The Pend Oreille Wetlands Wildlife II Project provides a total of 313.91 Habitat Units (HUs) for the species evaluated. Open water habitat provides 16.08 HUs for Canada goose and mallard. Shoreline and island habitat provide 7.36 HUs fore Canada goose and mallard. Wet meadow provides 117.62 HUs for Canada goose and mallard. Scrub-shrub wetlands provide 9.78 HUs for yellow warbler, mallard, and white-tailed deer. Deciduous forested wetlands provide 140.47 HUs for bald eagle, black-capped chickadee, mallard, and white-tailed deer. Conifer forest provides 22.60 HUs for bald eagle, black-capped chickadee, and white-tailed deer. The objective of using HEP at the Pend Oreille Wetlands Wildlife II Project and other protected properties is to document the quality and quantity of available habitat for selected wildlife species. In this way, HEP provides information on the relative value of the same area at future points in time so that the effect of management activities on wildlife habitat can be quantified. When combined with other tools, the baseline HEP will be used to determine the most effective on-site management, restoration, and enhancement actions to increase habitat suitability for targeted species. The same process will be replicated every five years to quantitatively evaluate the effectiveness of management strategies in improving and maintaining habitat conditions while providing additional crediting to BPA for enhanced habitat values.

  18. Habitat Evaluation Procedures (HEP) Report; Beaver Lake, Technical Report 2005.

    Energy Technology Data Exchange (ETDEWEB)

    Entz, Ray

    2005-05-01

    On August 14, 2003, the Habitat Evaluation Procedure (HEP) was used to determine baseline habitat suitability on the Beaver Lake property, an acquisition completed by the Kalispel Tribe of Indians in November 2002. Evaluation species and appropriate models include bald eagle, black-capped chickadee, Canada goose, mallard, muskrat, yellow warbler, and white-tailed deer. Habitat Suitability Index (HSI) values were visually estimated and agreed upon by all HEP team members. The Beaver Lake Project provides a total of 232.26 Habitat Units (HUs) for the species evaluated. Conifer forest habitat provides 136.58 HUs for bald eagle, black-capped chickadee, mallard, and white-tailed deer. Forested wetland habitat provides 20.02 HUs for bald eagle, black-caped chickadee, mallard, and white-tailed deer. Scrub-shrub wetland habitat provides 7.67 HUs for mallard, yellow warbler, and white-tailed deer. Grassland meadow provides 22.69 HUs for Canada goose and mallard. Emergent wetlands provide 35.04 HUs for Canada goose, mallard, and muskrat. Open water provided 10.26 HUs for Canada goose, mallard, and muskrat. The objective of using HEP at the Beaver Lake Project and other protected properties is to document the quality and quantity of available habitat for selected wildlife species. In this way, HEP provides information on the relative value of the same area at future points in time so that the effect of management activities on wildlife habitat can be quantified. When combined with other tools, the baseline HEP will be used to determine the most effective on-site management, restoration, and enhancement actions to increase habitat suitability for targeted species. The same process will be replicated every five years to quantitatively evaluate the effectiveness of management strategies in improving and maintaining habitat conditions while providing additional crediting to BPA for enhanced habitat values.

  19. A Case Report and Literature Review of Eculizumab Withdrawal in Atypical Hemolytic-Uremic Syndrome

    Science.gov (United States)

    Quiroga, Borja; de Lorenzo, Alberto; Vega, Cristina; de Alvaro, Fernando

    2016-01-01

    Patient: Female, 37 Final Diagnosis: SHUa Symptoms: Abdominal discomfort • nausea • weakness Medication: — Clinical Procedure: — Specialty: Nephrology Objective: Unusual clinical course Background: Recent advances in the treatment of atypical hemolytic-uremic syndrome (aHUS) have resulted to better long-term survival rates for patients with this life-threatening disease. However, many questions remain such as whether or not long-term treatment is necessary in some patients and what are the risks of prolonged therapy. Case Report: Here, we discuss the case of a 37-year-old woman with CFH and CD46 genetic abnormalities who developed aHUS with severe renal failure. She was successfully treated with three doses of rituximab and a three month treatment with eculizumab. After eculizumab withdrawal, symptoms of thrombotic micro-angiopathy (TMA) recurred, therefore eculizumab treatment was restarted. The patient exhibited normal renal function and no symptoms of aHUS at one-year follow-up with further eculizumab treatment. Conclusions: This case highlights the clinical challenges of the diagnosis and management of patient with aHUS with complement-mediated TMA involvement. Attention was paid to the consequences of the treatment withdrawal. Exact information regarding genetic abnormalities and renal function associated with aHUS, as well as estimations of the relapse risk and monitoring of complement tests may provide insights into the efficacy of aHUS treatment, which will enable the prediction of therapeutic responses and testing of new treatment options. Improvements in our understanding of aHUS and its causes may facilitate the identification of patients in whom anti-complement therapies can be withdrawn without risk. PMID:27974740

  20. Quantitative risk assessment of verocytotoxin-producing Escherichia coli O157 and Campylobacter jejuni related to consumption of raw milk in a province in Northern Italy.

    Science.gov (United States)

    Giacometti, F; Serraino, A; Bonilauri, P; Ostanello, F; Daminelli, P; Finazzi, G; Losio, M N; Marchetti, G; Liuzzo, G; Zanoni, R G; Rosmini, R

    2012-11-01

    A quantitative risk assessment was developed to describe the risk of campylobacteriosis and hemolytic uremic syndrome (HUS) linked to consumption of raw milk sold in vending machines in Northern Italy. Exposure assessment considered the microbiological status of dairy farms, expected milk contamination, storage conditions from bulk tank to home storage, microbial growth during storage, destruction experiments, consumption frequency of raw milk, age of consumers, serving size, and consumption preference. The differential risk between milk handled under regulation conditions (4°C throughout all phases) and the worst field handling conditions was considered. The probability of Campylobacter jejuni infection was modeled with a single-hit dose-response beta-Poisson model, whereas for HUS an exponential dose-response model was chosen and two probabilities were used to model the higher susceptibility of children younger than 5 years old. For every 10,000 to 20,000 consumers each year, the models predicted for the best and worst storage conditions, respectively, 2.12 and 1.14 campylobacteriosis cases and 0.02 and 0.09 HUS cases in the 0- to 5-year age group and 0.1 and 0.5 HUS cases in the >5-year age group. The expected pediatric HUS cases do not differ considerably from those reported in Italy by the Minister of Health. The model developed may be a useful tool for extending the assessment of the risk of campylobacteriosis and HUS due to raw milk consumption at the national level in Italy. Considering the epidemiological implications of this study, the risk of illness linked to raw milk consumption should not be ignored and could be reduced by the use of simple measures. Boiling milk before consumption and strict control of temperatures by farmers during raw milk distribution have significant effects on campylobacteriosis and HUS and are essential measures for risk management.

  1. Preoperative High-Resolution Ultrasound for the Assessment of Malignant Central Compartment Lymph Nodes in Papillary Thyroid Cancer.

    Science.gov (United States)

    Khokhar, Mamoona T; Day, Kristopher M; Sangal, Rohit B; Ahmedli, Nigar N; Pisharodi, Latha R; Beland, Michael D; Monchik, Jack M

    2015-12-01

    The identification and removal of malignant central compartment lymph nodes (MCLN) is important to minimize the risk of persistent or recurrent local disease in patients with papillary thyroid cancer (PTC). While the diagnostic accuracy of preoperative ultrasound for the assessment of lateral compartment node metastases is well recognized, its role in the identification of central compartment node metastases in patients with PTC is less established. This study delineates the utility of high-resolution ultrasound (HUS) for the assessment of MCLN in patients with PTC. A retrospective chart review was performed of 227 consecutive patients who underwent total thyroidectomy for biopsy-proven PTC by a single endocrine surgeon in an academic tertiary care center between 2004 and 2014. Preoperative sonographic results were compared to postoperative pathology reports to determine the accuracy of HUS for the assessment of MCLN. Statistical analysis also included sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). HUS identified abnormal central compartment nodes in 51 (22.5%) patients. All 227 patients underwent a careful central compartment node exploration. One hundred and four (45.8%) patients had MCLN identified by surgery, of whom 65 (62.5%) had a negative preoperative central compartment HUS. The sensitivity and specificity of preoperative HUS for the assessment of MCLN were 0.38 and 0.90, respectively. The PPV and NPV were 0.76 and 0.63, with an accuracy of 0.66. Preoperative HUS is quite specific for the identification of MCLN in patients with PTC. The present findings emphasize, however, that a negative HUS does not obviate the need for careful exploration of the central compartment to minimize the risk of persistent or recurrent local disease.

  2. Habitat Evaluation Procedures (HEP) Report, Pend Oreille Wetlands Wildlife I Project, Technical Report 2002.

    Energy Technology Data Exchange (ETDEWEB)

    Holmes, Darren

    2003-05-01

    In 2002, the Habitat Evaluation Procedure (HEP) was used to determine baseline habitat suitability on the Pend Oreille Wetlands Wildlife Project, an acquisition completed by the Kalispel Tribe of Indians in 1992. Evaluation species and appropriate models include bald eagle, black-capped chickadee, Canada goose, mallard, muskrat, and yellow warbler. Habitat Suitability Index (HSI) values were visually estimated and agreed upon by all HEP team members. The Pend Oreille Wetlands Wildlife Project provides a total of 936.76 Habitat Units (HUs) for the species evaluated. Open water habitat provides 71.92 HUs for Canada goose, mallard, and muskrat. Shoreline and island habitat provide 12.77 HUs fore Canada goose and mallard. Cattail hemi-marsh provides 308.42 HUs for Canada goose, mallard, and muskrat. Wet meadow provides 208.95 HUs for Canada goose and mallard. Scrub-shrub wetlands provide 14.43 HUs for yellow warbler, mallard, and white-tailed deer. Deciduous forested wetlands provide 148.62 HUs for bald eagle, black-capped chickadee, mallard, and white-tailed deer. Grassland meadow provides 3.38 HUs for Canada goose. Conifer forest provides 160.44 HUs for bald eagle, black-capped chickadee, and white-tailed deer. The objective of using HEP at the Pend Oreille Wetlands Wildlife Project and other protected properties is to document the quality and quantity of available habitat for selected wildlife species. In this way, HEP provides information on the relative value of the same area at future points in time so that the effect of management activities on wildlife habitat can be quantified. When combined with other tools, the baseline HEP will be used to determine the most effective on-site management, restoration, and enhancement actions to increase habitat suitability for targeted species. The same process will be replicated every five years to quantitatively evaluate the effectiveness of management strategies in improving and maintaining habitat conditions while

  3. Risk factors for neurological complications in complete hemolytic uremic syndrome caused by Escherichia coli O157.

    Science.gov (United States)

    Yamamoto, Takehisa; Satomura, Kenichi; Okada, Shintaro; Ozono, Keiichi

    2009-04-01

    The aim of the present study was to investigate the predictive parameters for encephalopathy in complete hemolytic uremic syndrome (HUS) in a large outbreak of O157: H7 infection in 1996. A total of 182 inpatients, 71 of whom had complete HUS, including 12 patients with neurological complications, and 46 colitis patients were studied. Presenting signs and symptoms (n = 115) and laboratory data (n = 69) were analyzed using monovariate and multivariate analysis. After adjusting for age and gender, logistic regression showed that presenting symptoms such as bloody diarrhea (odds ratio [OR] = 7.39), proteinuria (OR = 6.16), hematuria (OR = 8.31), oliguria (OR = 17.4) and a pale face (OR = 10.7) were useful for predicting complete HUS. Also, increased white blood cell counts >12,000 microL/mL (OR = 10.0) and C-reactive protein >1.5 mg/dL (OR = 7.39) at the onset of infection, were useful as predictive laboratory parameters. To predict neurological complications in complete HUS patients, the average daily increase of lactate dehydrase >1200 IU/L per day (OR = 26.3) and creatinine >0.5 mg/dL per day (OR = 12) were found to be useful on multivariate logistic regression. There are useful predictive clinical factors for neurological complications in complete HUS.

  4. Eculizumab Therapy Leads to Rapid Resolution of Thrombocytopenia in Atypical Hemolytic Uremic Syndrome

    Directory of Open Access Journals (Sweden)

    Han-Mou Tsai

    2014-01-01

    Full Text Available Eculizumab is highly effective in controlling complement activation in patients with the atypical hemolytic uremic syndrome (aHUS. However, the course of responses to the treatment is not well understood. We reviewed the responses to eculizumab therapy for aHUS. The results show that, in patients with aHUS, eculizumab therapy, when not accompanied with concurrent plasma exchange therapy, led to steady increase in the platelet count and improvement in extra-renal complications within 3 days. By day 7, the platelet count was normal in 15 of 17 cases. The resolution of hemolytic anemia and improvement in renal function were less predictable and were not apparent for weeks to months in two patients. The swift response in the platelet counts was only observed in one of five cases who received concurrent plasma exchange therapy and was not observed in a case of TMA due to gemcitabine/carboplatin. In summary, eculizumab leads to rapid increase in the platelet counts and resolution of extrarenal symptoms in patients with aHUS. Concurrent plasma exchange greatly impedes the response of aHUS to eculizumab therapy. Eculizumab is ineffective for gemcitabine/carboplatin associated TMA.

  5. Ouabain Protects Human Renal Cells against the Cytotoxic Effects of Shiga Toxin Type 2 and Subtilase Cytotoxin

    Directory of Open Access Journals (Sweden)

    María M. Amaral

    2017-07-01

    Full Text Available Hemolytic uremic syndrome (HUS is one of the most common causes of acute renal failure in children. The majority of cases are associated with Shiga toxin (Stx-producing Escherichia coli (STEC. In Argentina, HUS is endemic and presents the highest incidence rate in the world. STEC strains expressing Stx type 2 (Stx2 are responsible for the most severe cases of this pathology. Subtilase cytotoxin (SubAB is another STEC virulence factor that may contribute to HUS pathogenesis. To date, neither a licensed vaccine nor effective therapy for HUS is available for humans. Considering that Ouabain (OUA may prevent the apoptosis process, in this study we evaluated if OUA is able to avoid the damage caused by Stx2 and SubAB on human glomerular endothelial cells (HGEC and the human proximal tubule epithelial cell (HK-2 line. HGEC and HK-2 were pretreated with OUA and then incubated with the toxins. OUA protected the HGEC viability from Stx2 and SubAB cytotoxic effects, and also prevented the HK-2 viability from Stx2 effects. The protective action of OUA on HGEC and HK-2 was associated with a decrease in apoptosis and an increase in cell proliferation. Our data provide evidence that OUA could be considered as a therapeutic strategy to avoid the renal damage that precedes HUS.

  6. Association among Complement Factor H Autoantibodies, Deletions of CFHR, and the Risk of Atypical Hemolytic Uremic Syndrome.

    Science.gov (United States)

    Jiang, Hong; Fan, Meng-Nan; Yang, Min; Lu, Chao; Zhang, Ming; Liu, Xiao-Hong; Ma, Le

    2016-12-05

    To evaluate the association among complement factor H-related (CFHRs) gene deficiency, complement factor H (CFH) autoantibodies, and atypical hemolytic uremic syndrome (aHUS) susceptibility. EMBASE, PubMed, and the ISI Web of Science databases were searched for all eligible studies on the relationship among CFHRs deficiency, anti-FH autoantibodies, and aHUS risk. Eight case-control studies with 927 cases and 1182 controls were included in this study. CFHR1 deficiency was significantly associated with an increased risk of aHUS (odds ratio (OR) = 3.61, 95% confidence interval (95% CI), 1.96, 6.63, p < 0.001), while no association was demonstrated in individuals with only CFHR1/R3 deficiency (OR = 1.32, 95% CI, 0.50, 3.50, p = 0.56). Moreover, a more significant correlation was observed in people with both FH-anti autoantibodies and CFHR1 deficiency (OR = 11.75, 95% CI, 4.53, 30.44, p < 0.001) in contrast to those with only CFHR1 deficiency. In addition, the results were essentially consistent among subgroups stratified by study quality, ethnicity, and gene detection methods. The present meta-analysis indicated that CFHR1 deletion was significantly associated with the risk of aHUS, particularly when combined with anti-FH autoantibodies, indicating that potential interactions among CFHR1 deficiency and anti-FH autoantibodies might impact the risk of aHUS.

  7. Shiga Toxin in Enterohemorrhagic E.coli: regulation and novel antivirulence strategies

    Directory of Open Access Journals (Sweden)

    Vanessa eSperandio

    2012-06-01

    Full Text Available Enterohemorrhagic Escherichia coli O157:H7 infects about 73,000 people annually in the USA and is a major cause of outbreaks of bloody diarrhea worldwide, and. In 5 to 7% of the cases, the person infected develops the potentially fatal sequelae hemolytic uremic syndrome (HUS, characterized by acute kidney failure. A hallmark of EHEC pathogenesis and cause of HUS is the production of Shiga toxin (Stx. Stx was first described by Kiyoshi Shiga in Shigella dysenterae serotype I and later discovered in EHEC, and it has been linked to HUS since 1983. Many factors regulate the production of Stx, including temperature, growth phase, antibiotics, reactive oxygen species and quorum sensing. Currently, there is no effective treatment or prophylaxis for HUS. Since the use of antibiotics is not advised to treat EHEC infections because it triggers Stx production, alternative antibacterial strategies need to be developed. Quorum sensing inhibitors represent a novel class of antibacterial compounds, which have the advantage of not interfering on bacterial growth, thereby without selective pressure that can lead to appearance of resistant strains. In this review, we discuss factors that regulate Stx production in EHEC as well as novel strategies to fight Stx and minimize development to HUS in EHEC-infected patients.

  8. Atypical hemolytic uremic syndrome secondary to lupus nephritis, responsive to eculizumab

    Directory of Open Access Journals (Sweden)

    Alexander G. Raufi

    2016-09-01

    Full Text Available Among the spectrum of disease manifestations associated with systemic lupus erythematosus, lupus nephritis is particularly concerning due to the potential for renal failure. This autoimmune attack may not, however, be limited to the kidney and is increasingly being recognized as a trigger for atypical Hemolytic Uremic Syndrome (aHUS. Atypical HUS falls under the spectrum of the thrombotic microangiopathies (TMAs – a group of disorders characterized by microangiopathic hemolytic anemia, thrombocytopenia, and end organ damage. Although plasma exchange is considered first-line therapy for thrombotic thrombocytopenic purpura – a TMA classically associated with autoimmune depletion of ADAMTS-13 – aHUS demonstrates less reliable responsiveness to this modality. Instead, use of the late complement inhibitor Eculizumab has emerged as an effective modality for the management of such patients. Diagnosis of aHUS, however, is largely clinically based, relying heavily upon a multidisciplinary approach. Herein we present the case of a patient with atypical HUS successfully treated with Eculizumab in the setting of Class IV-G (A lupus nephritis and hypocomplementemia.

  9. Comparison of hydrocolonic sonograpy accuracy in preoperative staging between colon and rectal cancer

    Institute of Scientific and Technical Information of China (English)

    Hye Won Chung; Jae Bock Chung; Seung Woo Park; Si Young Song; Jin Kyung Kang; Chan Il Park

    2004-01-01

    AIM: To compare the accuracy of hydrocolonic sonography (HUS) in determining the depth of invasion (T stage) in colon and rectal cancer.METHODS: A total of 1 000-2 000 mL of saline was instilled per rectum using a system for barium enemas, and then ultrasonography was conducted by a SSA-270A (Toshiba Co, Japan) sonolayer unit with a 3.75 MHz for 17 patients with colon cancer and 13 patients with rectal cancer before operation. After operation, T stage in HUS was compared with postoperative histological findings.RESULTS: Overall, the accuracy of T stage was 70%. It was 88% in colon cancer and 46% in rectal cancer. In evaluating nodal state, the accuracy of HUS was low in both colon (71%) and rectal cancers (46%) compared with conventional CT or MRI. The overall accuracy of N staging was 60%.CONCLUSION: HUS is valuable to evaluate the depth of invasion in colon cancer, but is less valuable in rectal cancer. Because HUS is low-cost, noninvasive, and readily available at any place, this technique seems to be useful to determine the preoperative staging in colon cancer, but not in rectal cancer.

  10. Atypical Hemolytic Uremic Syndrome Secondary to Lupus Nephritis, Responsive to Eculizumab

    Science.gov (United States)

    Raufi, Alexander G.; Scott, Shruti; Darwish, Omar; Harley, Kevin; Kahlon, Kanwarpal; Desai, Sheetal; Lu, Yuxin; Tran, Minh-Ha

    2016-01-01

    Among the spectrum of disease manifestations associated with systemic lupus erythematosus, lupus nephritis is particularly concerning due to the potential for renal failure. This autoimmune attack may not, however, be limited to the kidney and is increasingly being recognized as a trigger for atypical Hemolytic Uremic Syndrome (aHUS). Atypical HUS falls under the spectrum of the thrombotic microangiopathies (TMAs) – a group of disorders characterized by microangiopathic hemolytic anemia, thrombocytopenia, and end organ damage. Although plasma exchange is considered first-line therapy for thrombotic thrombocytopenic purpura – a TMA classically associated with autoimmune depletion of ADAMTS-13 – aHUS demonstrates less reliable responsiveness to this modality. Instead, use of the late complement inhibitor Eculizumab has emerged as an effective modality for the management of such patients. Diagnosis of aHUS, however, is largely clinically based, relying heavily upon a multidisciplinary approach. Herein we present the case of a patient with atypical HUS successfully treated with Eculizumab in the setting of Class IV-G (A) lupus nephritis and hypocomplementemia.

  11. [Update on the treatment of endemic hemolytic uremic syndrome. Pathogenesis and treatment of the most severe systemic complication of infections by Shiga toxin-producing Escherichia coli].

    Science.gov (United States)

    Fernández-Brando, Romina J; Bentancor, Leticia V; Mejías, María Pilar; Panek, Analía C; Cabrera, Gabriel G; Exeni, Ramón A; Palermo, Marina S

    2011-01-01

    The typical form of hemolytic uremic syndrome (HUS) is the major complication of Shiga toxin-producing Escherichia coli (STEC) infections. HUS is a critical health problem in Argentina since it is the main cause of acute renal failure in children and the second cause of chronic renal failure, giving account for 20% of renal transplants in children and adolescents in our country. In spite of the extensive research in the field, the mainstay of treatment for patients with HUS is supportive therapy, and there are no specific therapies preventing or ameliorating the disease course. In this review, we present the current knowledge about pathogenic mechanisms and discuss traditional and innovative therapeutic approaches, with special focus in national status and contributions made by Argentinean groups.

  12. Role of Polymorphonuclear Leukocytes in the Pathophysiology of Typical Hemolytic Uremic Syndrome

    Directory of Open Access Journals (Sweden)

    Ramón A. Exeni

    2007-01-01

    Full Text Available Thrombotic microangiopathy and acute renal failure are cardinal features of post-diarrheal hemolytic uremic syndrome (HUS. These conditions are related to endothelial and epithelial cell damage induced by Shiga toxin (Stx, through an interaction with its globotriaosylceramide (Gb3 receptor. Although, Stx is the main pathogenic factor and necessary for HUS development, clinical and experimental evidence suggest that the inflammatory response is able to potentiate Stx toxicity. Lipopolysaccharides (LPS and neutrophils (PMN represent two central components of inflammation during a Gram-negative infection. In this regard, patients with high peripheral PMN counts at presentation have a poor prognosis. In the present review, we discuss the contribution of experimental models and patient's studies in an attempt to elucidate the pathogenic mechanisms of HUS.

  13. Role of polymorphonuclear leukocytes in the pathophysiology of typical hemolytic uremic syndrome.

    Science.gov (United States)

    Exeni, Ramón A; Fernández, Gabriela C; Palermo, Marina S

    2007-08-10

    Thrombotic microangiopathy and acute renal failure are cardinal features of post-diarrheal hemolytic uremic syndrome (HUS). These conditions are related to endothelial and epithelial cell damage induced by Shiga toxin (Stx), through an interaction with its globotriaosylceramide (Gb3) receptor. Although, Stx is the main pathogenic factor and necessary for HUS development, clinical and experimental evidence suggest that the inflammatory response is able to potentiate Stx toxicity. Lipopolysaccharides (LPS) and neutrophils (PMN) represent two central components of inflammation during a Gram-negative infection. In this regard, patients with high peripheral PMN counts at presentation have a poor prognosis. In the present review, we discuss the contribution of experimental models and patient's studies in an attempt to elucidate the pathogenic mechanisms of HUS.

  14. [Fenotypic and genotypic characterization of Shiga toxin-producing Escherichia coli O111 strain isolated from patient with hemolytic-uremic syndrome].

    Science.gov (United States)

    Januszkiewicz, Aleksandra; Podsiadły, Edyta; Szych, Jolanta; Semkowicz-Chmielewska, Anna; Demkow, Urszula; Pierzchlewicz, Anna; Rastawicki, Waldemar

    2010-01-01

    Shiga toxin-producing E. coli O157 and non-O157 are important emergance pathogens that can cause diarrhea and hemorrhagic colitis with life-threatening complications, such as hemolytic uremic syndrome (HUS). A few cases of EHEC infections are documented per year in Poland. Among them only one patient with EHEC O157 infection developed HUS. We characterized the first VTEC non-O157 strain isolated from child with HUS in Poland. The VTEC O111 strain produced Stx2 which was cytotoxic for Vero cell. Using DNA microarray analysis we have found set of virulence genes in VTEC O111 strain as: stx2A, stx2B, ehly, eae, tir tccP espA, espJ, cif nleA, nleB, lpfA, iha, efa1, cba. The strain was fenotypic resistant to streptomycin, tetracyclin and sulphonamides (strA, tetA, sul2 genes were detected).

  15. Large Scale Glazed Concrete Panels

    DEFF Research Database (Denmark)

    Bache, Anja Margrethe

    2010-01-01

    Today, there is a lot of focus on concrete surface’s aesthitic potential, both globally and locally. World famous architects such as Herzog De Meuron, Zaha Hadid, Richard Meyer and David Chippenfield challenge the exposure of concrete in their architecture. At home, this trend can be seen...... existing buildings in and around Copenhagen that are covered with mosaic tiles or glazed tiles; buildings such as Nanna Ditzel’s House in Klareboderne, Arne Jacobsen’s gas station, Erik Møller’s Industriens Hus, Bent Helweg Møller’s Berlingske Hus, Arne Jacobsen’s Stellings Hus and Toms Chocolate Factories...... and finally Lene Tranberg and Bøje Lungård’s Elsinore water purification plant. These buildings have qualities that I would like applied, perhaps transformed or most preferably, if possible, interpreted anew, for the large glazed concrete panels I shall develop. The article is ended and concluded...

  16. Complement in hemolytic anemia.

    Science.gov (United States)

    Brodsky, Robert A

    2015-01-01

    Complement is increasingly being recognized as an important driver of human disease, including many hemolytic anemias. Paroxysmal nocturnal hemoglobinuria (PNH) cells are susceptible to hemolysis because of a loss of the complement regulatory proteins CD59 and CD55. Patients with atypical hemolytic uremic syndrome (aHUS) develop a thrombotic microangiopathy (TMA) that in most cases is attributable to mutations that lead to activation of the alternative pathway of complement. For optimal therapy, it is critical, but often difficult, to distinguish aHUS from other TMAs, such as thrombotic thrombocytopenic purpura; however, novel bioassays are being developed. In cold agglutinin disease (CAD), immunoglobulin M autoantibodies fix complement on the surface of red cells, resulting in extravascular hemolysis by the reticuloendothelial system. Drugs that inhibit complement activation are increasingly being used to treat these diseases. This article discusses the pathophysiology, diagnosis, and therapy for PNH, aHUS, and CAD.

  17. Successful isolated liver transplantation in a child with atypical hemolytic uremic syndrome and a mutation in complement factor H.

    Science.gov (United States)

    Haller, W; Milford, D V; Goodship, T H J; Sharif, K; Mirza, D F; McKiernan, P J

    2010-09-01

    A male infant was diagnosed with atypical hemolytic uremic syndrome (aHUS) at the age of 5.5 months. Sequencing of the gene (CFH) encoding complement factor H revealed a heterozygous mutation (c.3644G>A, p.Arg1215Gln). Despite maintenance plasmapheresis he developed recurrent episodes of aHUS and vascular access complications while maintaining stable renal function. At the age of 5 years he received an isolated split liver graft following a previously established protocol using pretransplant plasma exchange (PE) and intratransplant plasma infusion. Graft function, renal function and disease remission are preserved 2 years after transplantation. Preemptive liver transplantation prior to the development of end stage renal disease is a valuable option in the management of aHUS associated with CFH mutations.

  18. Hemolytic uremic syndrome after bone marrow transplantation

    Energy Technology Data Exchange (ETDEWEB)

    Arai, Ayako; Sakamaki, Hisashi; Tanikawa, Shu [Tokyo Metropolitan Komagome Hospital (Japan)] [and others

    1998-06-01

    One hundred and thirteen patients who underwent autologous or allogeneic bone marrow transplantation (BMT) were investigated for the subsequent development of hemolytic uremic syndrome (HUS). HUS developed in seven patients (four males and three females, five acute lymphocytic leukemia (ALL), one acute myelogenous leukemia, one non-Hodgkin`s lymphoma) between 36-196 days after BMT. Four patients were recipients of autologous BMT and three were those of allogeneic BMT. Six patients were preconditioned with the regimens including fractionated total body irradiation (TBI). ALL and preconditioning regimen with TBI were suspected to be the risk factors for the development of HUS. Cyclosporin A (CSP) administration was discontinued in three patients who had been given CSP for graft-versus-host disease prophylaxis. Predonisolone was given to the three patients and plasma exchange was performed in one patient. Both hemolytic anemia and thrombocytopenia were resolved in virtually all patients, while creatinine elevation has persisted along with hypertension in one patient. (author)

  19. EFSA Panel on Biological Hazards (BIOHAZ); Scientific Opinion on VTEC-seropathotype and scientific criteria regarding pathogenicity assessment

    DEFF Research Database (Denmark)

    Hald, Tine; Baggesen, Dorte Lau

    During 2007-2010, 13 545 confirmed human VTEC infections and 777 haemolytic uraemic syndrome (HUS) cases were reported in the EU; isolates from 85 % of cases were not fully serotyped and therefore could not be classified using the Karmali seropathotype concept. Seropathotype group D covered 5...... % of isolates from fully serotyped cases; 14 cases (0.7 %) belonged to seropathotype group E, defined by Karmali et al. (2003) as non-human only. Isolates from around 27 % of cases could not be assigned. There were no HUS cases reported for the serotypes in groups D and E but 17 HUS cases could not be assigned...... of verocytotoxins alone or genes encoding such verocytotoxins does not provide a sound scientific basis on which to assess risk to the consumer because there is no single or combination of marker(s) that fully define a ‘pathogenic’ VTEC. Strains positive for verocytotoxin 2 gene(vtx2)- and eae (intimin production...

  20. Serum tau protein as a marker of disease activity in enterohemorrhagic Escherichia coli O111-induced hemolytic uremic syndrome.

    Science.gov (United States)

    Kuroda, Mondo; Shimizu, Masaki; Inoue, Natsumi; Ikeno, Iku; Nakagawa, Hiroyasu; Yokoi, Ayano; Niida, Yo; Konishi, Michio; Kaneda, Hisashi; Igarashi, Noboru; Yamahana, Junya; Taneichi, Hiromichi; Kanegane, Hirokazu; Ito, Mika; Saito, Shigeru; Furuichi, Kengo; Wada, Takashi; Nakagawa, Masaru; Yokoyama, Hitoshi; Yachie, Akihiro

    2015-01-01

    Tau protein levels in cerebrospinal fluid (CSF) and serum are elevated in patients with various central nervous system diseases. We investigated whether serum tau protein levels are useful for predicting and assessing disease activity of acute encephalopathy (AE) in enterohemorrhagic Escherichia coli (EHEC) O111-induced hemolytic uremic syndrome (HUS; EHEC encephalopathy). Serum samples were obtained from 14 patients with EHEC O111/HUS, 20 patients with non-EHEC-related AE, and 20 age- and sex-matched healthy controls. CSF samples were obtained from 2 patients with EHEC encephalopathy and 20 patients with non-EHEC-related AE. Tau protein levels and levels of several proinflammatory cytokines were quantified by enzyme-linked immunosorbent assays. Results were compared with the clinical features of EHEC encephalopathy, including magnetic resonance image (MRI) findings. Serum tau levels in patients with EHEC encephalopathy were significantly elevated compared with those in patients with EHEC O111/HUS without encephalopathy, patients with non-EHEC-related AE, and healthy controls. The ratio of CSF tau levels to serum tau levels was >1.0 in all patients with non-EHEC-related AE but encephalopathy. Serum tau protein levels increased rapidly and markedly in patients with severe EHEC 0111/HUS and encephalopathy when HUS occurred, but were not elevated in mild patients, even in the HUS phase. Furthermore, changes in serum tau protein levels in patients with EHEC encephalopathy were consistent with abnormalities on brain MRI and were positively correlated with proinflammatory cytokine levels. Our results indicate that serum tau protein might be useful to predict and assess disease activity of EHEC encephalopathy. Copyright © 2015 Elsevier Ltd. All rights reserved.

  1. Interventions for preventing diarrhea-associated hemolytic uremic syndrome: systematic review.

    Science.gov (United States)

    Thomas, Diana E; Elliott, Elizabeth J

    2013-09-03

    Hemolytic Uremic Syndrome (HUS) may follow infection with Shiga-toxin-producing organisms, principally E. coli O157: H7 (STEC), causing high morbidity and mortality. Our aim was to identify interventions to prevent diarrhea-associated HUS. Systematic search of the literature for relevant systematic reviews (SRs), randomised controlled trials (RCTs) and public health guidelines. Of 1097 animal and 762 human studies, 18 animal studies (2 SRs, 2 reviews, plus 14 RCTs) and 6 human studies (3 SRs, plus 3 RCTs) met inclusion criteria. E. coli O157: H7 Type III secreted protein vaccination decreased fecal E. coli O157 shedding in cattle (P = 0.002). E. coli O157: H7 siderophore receptor and porin proteins (SRP) vaccines reduced fecal shedding in cows (OR 0.42 (95% CI 0.25 to 0.73) and increased anti-E. coli 0157: H7 SRP antibodies in their calves (P improved farm hygiene (P diarrhea, HUS rates were similar in children treated with Trimethoprim-sulfamethoxazole and controls (RR 0.57; 95% CI 0.11 to 2.81). In another RCT, HUS rates were similar in children receiving Synsorb-Pk and placebo (RR 0.93; 95% CI 0.39 to 2.22). In one SR, hand washing reduced diarrhea by 39% in institutions (IRR 0.61; 95% CI 0.40 to 0.92) and 32% in community settings (IRR 0.68; 95% CI 0.52 to 0.90) compared to controls. Guidelines contained recommendations to prevent STEC transmission from animals and environments to humans, including appropriate food preparation, personal hygiene, community education, and control of environmental contamination, food and water quality. Animal carriage of STEC is decreased by vaccination and improved farm practices. Treatment of STEC diarrhea with antibiotics and toxin-binders did not prevent HUS. Public health interventions are the key to preventing STEC-associated diarrhea and HUS.

  2. Habitat Evaluation Procedures (HEP) Report; Tacoma Creek South Project, Technical Report 2003-2005.

    Energy Technology Data Exchange (ETDEWEB)

    Entz, Ray

    2005-02-01

    On July 6, 2004, the Habitat Evaluation Procedure (HEP) was used to determine baseline habitat suitability on the Tacoma Creek South property, an acquisition completed by the Kalispel Tribe of Indians in June 2004. Evaluation species and appropriate models include bald eagle, black-capped chickadee, Canada goose, mallard, muskrat, yellow warbler, and white-tailed deer. Habitat Suitability Index (HSI) values were visually estimated and agreed upon by all HEP team members. The Tacoma Creek South Project provides a total of 190.79 Habitat Units (HUs) for the species evaluated. Emergent wetlands provide 20.51 HUs for Canada goose, mallard, and muskrat. Grassland provides 1.65 HUs for Canada goose and mallard. Scrub-shrub vegetation provides 11.76 HUs for mallard, yellow warbler, and white-tailed deer. Conifer forest habitat provides 139.92 HUs for bald eagle, black-capped chickadee, and white-tailed deer. Deciduous forest also provides 19.15 HUs for bald eagle, black-capped chickadee, mallard, and white-tailed deer. The objective of using HEP at the Tacoma Creek South Project and other protected properties is to document the quality and quantity of available habitat for selected wildlife species. In this way, HEP provides information on the relative value of the same area at future points in time so that the effect of management activities on wildlife habitat can be quantified. When combined with other tools, the baseline HEP will be used to determine the most effective on-site management, restoration, and enhancement actions to increase habitat suitability for targeted species. The same process will be replicated every five years to quantitatively evaluate the effectiveness of management strategies in improving and maintaining habitat conditions while providing additional crediting to BPA for enhanced habitat values.

  3. Mutations of factor H impair regulation of surface-bound C3b by three mechanisms in atypical hemolytic uremic syndrome.

    Science.gov (United States)

    Lehtinen, Markus J; Rops, Angelique L; Isenman, David E; van der Vlag, Johan; Jokiranta, T Sakari

    2009-06-05

    Atypical hemolytic uremic syndrome (aHUS) is a thrombotic microangiopathy associated with mutations in complement proteins, most frequently in the main plasma alternative pathway regulator factor H (FH). The hotspot for the FH mutations is in domains 19-20 (FH19-20) that are indispensable for FH activity on C3b bound covalently to host cells. In aHUS, down-regulation of cell-bound C3b by FH is impaired, but it is not clear whether this is due to an altered FH binding to surface-bound C3b or to cell surface structures. To explore the molecular pathogenesis of aHUS we tested binding of 14 FH19-20 point mutants to C3b and its C3d fragment, mouse glomerular endothelial cells (mGEnC-1), and heparin. The cell binding correlated well, but not fully, with heparin binding and the cell binding site was overlapping but distinct from the C3b/C3d binding site that was shown to extend to domain 19. Our results show that aHUS-associated FH19-20 mutants have different combinations of three primary defects: impaired binding to C3b/C3d, impaired binding to the mGEnC-1 cells/heparin, and, as a novel observation, an enhanced mGEnC-1 cell or heparin binding. We propose a model of the molecular pathogenesis of aHUS where all three mechanisms lead eventually to impaired control of C3b on the endothelial cell surfaces. Based on the results with the aHUS patient mutants and the overlap in FH19-20 binding sites for mGEnC-1/heparin and C3b/C3d we conclude that binding of FH19-20 to C3b/C3d is essential for target discrimination by the alternative pathway.

  4. Cost-effectiveness of eculizumab treatment after kidney transplantation in patients with atypical haemolytic uraemic syndrome.

    Science.gov (United States)

    van den Brand, Jan A J G; Verhave, Jacobien C; Adang, Eddy M; Wetzels, Jack F M

    2017-01-01

    Kidney transplantation in patients with atypical haemolytic uraemic syndrome (aHUS) is frequently complicated by recurrence of aHUS, often resulting in graft loss. Eculizumab prophylaxis prevents recurrence, improving graft survival. An alternative treatment strategy has been proposed where eculizumab is administered upon recurrence. We combined available evidence and performed a cost-effectiveness analysis of these competing strategies. A cost-effectiveness analysis using a decision analytical approach with Markov chain analyses was used to compare alternatives for aHUS patients with end-stage renal disease (ESRD): (i) dialysis treatment, (ii) kidney transplantation, (iii) kidney transplantation with eculizumab therapy upon recurrence of aHUS, (iv) kidney transplantation with eculizumab induction consisting of 12 months of prophylaxis and (v) kidney transplantation with lifelong eculizumab prophylaxis. We assumed that all patients received a graft from a living donor and that recurrence probability was 28.4% within the first year of transplantation. At 8.34 quality-adjusted life years (QALYs) gained and a cost of €402 412, kidney transplantation without eculizumab was the least costly alternative. By comparison, dialysis was more costly and resulted in fewer QALYs gained. Eculizumab upon recurrence resulted in 9.55 QALYs gained at a cost of €425 097. The incremental cost-effectiveness ratio (ICER) was €18 748 per QALY. Both eculizumab induction and lifelong eculizumab were inferior to eculizumab upon recurrence, as both resulted in fewer QALYs gained and higher costs. Kidney transplantation is more cost effective than dialysis to treat ESRD due to aHUS. Adding eculizumab treatment results in a substantial gain in QALYs. When compared with eculizumab upon recurrence, neither eculizumab induction nor lifelong eculizumab prophylaxis resulted in more QALYs, but did yield far higher costs. Therefore, eculizumab upon recurrence of aHUS is more acceptable.

  5. EHEC O104:H4 in Germany 2011: Large outbreak of bloody diarrhea and haemolytic uraemic syndrome by shiga toxin-producing E. coli via contaminated food

    OpenAIRE

    2012-01-01

    In the summer of 2011 Germany experienced one of the largest outbreaks of a food-borne infection caused by enterohaemorrhagic Escherichia coli (EHEC) with the serotype O104:H4. A large number of cases with bloody diarrhea and haemolytic uraemic syndrome (HUS) occurred. Never before was such a high rate of HUS cases observed in an outbreak caused by a food-borne pathogen. The events in Germany caused by EHEC O104:H4 in the summer of 2011 show dramatically how rapidly an infectious agent ...

  6. Adjustment of Eculizumab Dosage Pattern in Patients with Atypical Hemolytic Uremic Syndrome with Suboptimal Response to Standard Treatment Pattern

    Science.gov (United States)

    Peralta Roselló, Carmen; Baltar Martín, José María; Castillo Eraso, Lorena; de Álvaro Moreno, Fernando; Martínez Vea, Alberto; Visus-Fernández de Manzanos, María Teresa

    2016-01-01

    In patients with atypical hemolytic uremic syndrome (aHUS), complement blocking by eculizumab rapidly halts the process of thrombotic microangiopathy and it is associated with clear long-term hematologic and renal improvements. Eculizumab treatment consists of a 4-week initial phase with weekly IV administration of 900 mg doses, followed by a maintenance phase with a 1,200 mg dose in the fifth week and every 14 ± 2 days thereafter. We present three patients with aHUS and suboptimal response to eculizumab treatment at the usual administration dosage who showed hematologic and renal improvements after an adjustment in the eculizumab treatment protocol. PMID:28025630

  7. Chronic type B aortic dissection in association with Hemolyticuremic syndrome in a child.

    Science.gov (United States)

    Gera, D N; Ghuge, P P; Gandhi, S; Vanikar, A V; Shrimali, J D; Kute, V B; Trivedi, H L

    2013-11-01

    Aortic dissection (AD) is a potentially life-threatening medical emergency usually encountered in the elderly. Here, we report a 9-year-old child who was incidentally detected to have asymptomatic chronic type B dissecting aneurysm of aorta when he presented with relapse of Hemolytic uremic syndrome (HUS) without any genetic abnormalities like Marfan or Ehler-Danlos syndrome. To the best of our knowledge, this is the first case of AD associated with HUS in a child without any known associated genetic or inherited risk factors.

  8. På sporet af den tabte sans

    DEFF Research Database (Denmark)

    Nielsen, Thomas Rosendal

    2014-01-01

    Analyse af en workshop om interaktive strategier i børneteater for børn. Workshoppen fandt sted på Dramatikkens hus i Oslo og blev ledet af Sara Topsøe-Jensen, kunstneriske leder af teatret Carte Blanche.......Analyse af en workshop om interaktive strategier i børneteater for børn. Workshoppen fandt sted på Dramatikkens hus i Oslo og blev ledet af Sara Topsøe-Jensen, kunstneriske leder af teatret Carte Blanche....

  9. Characterization of a New DGKE Intronic Mutation in Genetically Unsolved Cases of Familial Atypical Hemolytic Uremic Syndrome

    Science.gov (United States)

    Mele, Caterina; Lemaire, Mathieu; Iatropoulos, Paraskevas; Piras, Rossella; Bresin, Elena; Bettoni, Serena; Bick, David; Helbling, Daniel; Veith, Regan; Valoti, Elisabetta; Donadelli, Roberta; Murer, Luisa; Neunhäuserer, Maria; Breno, Matteo; Frémeaux-Bacchi, Véronique; Lifton, Richard; Noris, Marina

    2015-01-01

    Background and objectives Genetic and acquired abnormalities causing dysregulation of the complement alternative pathway contribute to atypical hemolytic uremic syndrome (aHUS), a rare disorder characterized by thrombocytopenia, nonimmune microangiopathic hemolytic anemia, and acute kidney failure. However, in a substantial proportion of patients the disease-associated alterations are still unknown. Design, setting, participants, & measurements Whole-exome and whole-genome sequencing were performed in two unrelated families with infantile recessive aHUS. Sequencing of cDNA from affected individuals was used to test for the presence of aberrant mRNA species. Expression of mutant diacylglycerol kinase epsilon (DGKE) protein was evaluated with western blotting. Results Whole-exome sequencing analysis with conventional variant filtering parameters did not reveal any obvious candidate mutation in the first family. The report of aHUS-associated mutations in DGKE, encoding DGKE, led to re-examination of the noncoding DGKE variants obtained from next-generation sequencing, allowing identification of a novel intronic DGKE mutation (c.888+40A>G) that segregated with disease. Sequencing of cDNA from affected individuals revealed aberrant forms of DGKE mRNA predicted to cause profound abnormalities in the protein catalytic site. By whole-genome sequencing, the same mutation was found in compound heterozygosity with a second nonsense DGKE mutation in all affected siblings of another unrelated family. Homozygous and compound heterozygous patients presented similar clinical features, including aHUS presentation in the first year of life, multiple relapsing episodes, and proteinuria, which are prototypical of DGKE-associated aHUS. Conclusions This is the first report of a mutation located beyond the exon-intron boundaries in aHUS. Intronic mutations such as these are underreported because conventional filtering parameters used to process next-generation sequencing data routinely

  10. Vandrefalken i Sydgrønland

    DEFF Research Database (Denmark)

    Falk, Knud; Møller, Søren

    2009-01-01

    Præsentation i forbindelse med overrækkelse af Bodil Pedersen Fondens Natur- og Miljøpris, Fuglenes hus, 11. juni 2009. Se http://www.dof.dk/index.php?id=nyheder&s=nyheder&m=visning&nyhed_id=638......Præsentation i forbindelse med overrækkelse af Bodil Pedersen Fondens Natur- og Miljøpris, Fuglenes hus, 11. juni 2009. Se http://www.dof.dk/index.php?id=nyheder&s=nyheder&m=visning&nyhed_id=638...

  11. A dual model HU conversion from MRI intensity values within and outside of bone segment for MRI-based radiotherapy treatment planning of prostate cancer

    Energy Technology Data Exchange (ETDEWEB)

    Korhonen, Juha, E-mail: juha.p.korhonen@hus.fi [Clinical Research Institute Helsinki University Central Hospital Ltd., POB-700, 00029 HUS (Finland); Department of Oncology, Helsinki University Central Hospital, POB-180, 00029 HUS (Finland); Kapanen, Mika [Clinical Research Institute Helsinki University Central Hospital Ltd., POB-700, 00029 HUS (Finland); Department of Oncology, Helsinki University Central Hospital, POB-180, 00029 HUS (Finland); Department of Medical Physics, Tampere University Hospital, POB-2000, 33521 Tampere (Finland); Keyriläinen, Jani; Seppälä, Tiina; Tenhunen, Mikko [Department of Oncology, Helsinki University Central Hospital, POB-180, 00029 HUS (Finland)

    2014-01-15

    Purpose: The lack of electron density information in magnetic resonance images (MRI) poses a major challenge for MRI-based radiotherapy treatment planning (RTP). In this study the authors convert MRI intensity values into Hounsfield units (HUs) in the male pelvis and thus enable accurate MRI-based RTP for prostate cancer patients with varying tissue anatomy and body fat contents. Methods: T{sub 1}/T{sub 2}*-weighted MRI intensity values and standard computed tomography (CT) image HUs in the male pelvis were analyzed using image data of 10 prostate cancer patients. The collected data were utilized to generate a dual model HU conversion technique from MRI intensity values of the single image set separately within and outside of contoured pelvic bones. Within the bone segment local MRI intensity values were converted to HUs by applying a second-order polynomial model. This model was tuned for each patient by two patient-specific adjustments: MR signal normalization to correct shifts in absolute intensity level and application of a cutoff value to accurately represent low density bony tissue HUs. For soft tissues, such as fat and muscle, located outside of the bone contours, a threshold-based segmentation method without requirements for any patient-specific adjustments was introduced to convert MRI intensity values into HUs. The dual model HU conversion technique was implemented by constructing pseudo-CT images for 10 other prostate cancer patients. The feasibility of these images for RTP was evaluated by comparing HUs in the generated pseudo-CT images with those in standard CT images, and by determining deviations in MRI-based dose distributions compared to those in CT images with 7-field intensity modulated radiation therapy (IMRT) with the anisotropic analytical algorithm and 360° volumetric-modulated arc therapy (VMAT) with the Voxel Monte Carlo algorithm. Results: The average HU differences between the constructed pseudo-CT images and standard CT images of each

  12. Antibiotic treatment of verocytotoxin-producing Escherichia coli (VTEC) infection

    DEFF Research Database (Denmark)

    Agger, Morten; Scheutz, Flemming; Villumsen, Steen;

    2015-01-01

    OBJECTIVES: A consensus has existed on not to treat verocytotoxin-producing Escherichia coli (VTEC)-infected individuals with antibiotics because of possible subsequent increased risk of developing haemolytic uraemic syndrome (HUS). The aim of this systematic review is to clarify the risk...

  13. Shiga toxin-producing Escherichia coli and rectoanal junction persistence in ruminants: a study of bacterial-epithelial interactions.

    Science.gov (United States)

    Escherichia coli O157:H7 (O157) was the first Shiga toxin-producing E. coli serotype to be associated with bloody diarrhea or hemorrhagic colitis (HC) and hemolytic uremic syndrome (HUS) in humans. It has since been implicated in several outbreaks in the U.S. and globally. Non-O157 STEC have not bee...

  14. How atypical can Atypical Hemolytic Uremic Syndrome be?

    Science.gov (United States)

    Sajan, Thomas; Vinay, Srinivasa; Sonu, Nigam; Alan, Parnham

    2014-04-01

    A 24-year-old man with diarrhea found to have acute renal failure with microangiopathic hemolytic anemia (MAHA). A diagnosis of hemolytic uraemic syndrome (HUS) was made. He was initiated on plasma exchange and hemodialysis. On day 6, he was started on eculizumab. His renal functions progressively improved. His main complication during eculizumab therapy was hypertension-related posterior reversible encephalopathy syndrome.

  15. 75 FR 40925 - National Primary Drinking Water Regulations: Revisions to the Total Coliform Rule

    Science.gov (United States)

    2010-07-14

    ... pathogens can cause a variety of illnesses, including acute gastrointestinal illness (AGI) with diarrhea... syndrome (HUS) (kidney failure), hepatitis, and bloody diarrhea (WHO 2004). Chronic disease such as... to 15 percent of cases are transmitted within households by secondary transmission (Parry and Salmon...

  16. Täna kell 17 avatakse EKA galeriis rahvusvaheline kunstiprojekt Network Baltic

    Index Scriptorium Estoniae

    2005-01-01

    2002. a. alguse saanud kunstiprojekti, mille eesmärk on noore graafika toetamine ja arendamine, käivitaja oli Rootsi graafikakeskus Grafikens Hus, kaasorganisaatorid Helsingi, Trondheimi, Eesti ja Varssavi kunstiakadeemia. Teised projektis osalejad. Projekti kunstiline juht Anders Krueger. Selgitati välja iga maa laureaat (Eestist Kaija Kesa) ja kaks auhinnasaajat (Eestist Helen Tago ja Eveli Varik)

  17. Association of verotoxin-producing E. coli and verotoxin with hemolytic uremic syndrome.

    Science.gov (United States)

    Arbus, G S

    1997-03-01

    It has been over 10 years since we first showed an association [1] between classical hemolytic uremic syndrome (hemolytic anemia, thrombocytopenia, and uremia, following a diarrheal prodome) and certain E. coli [1] capable of producing a toxin, initially called verotoxin (VT) because of its cytopathic effect on Vero cells [2] and later Shiga-like toxin (SLT) because of the toxin's close biological and structural similarity to Shiga toxin. Although we initially reported that 75% of children with idiopathic hemolytic uremic syndrome (HUS) [1] had evidence of a verotoxin-producing E. coli (VTEC) [1], a later study showed that over a seven year period (1980-86), of 86 children seen with HUS, 91% had a classical presentation and 88% of these had evidence of a VTEC infection [3]. This paper traces the path of the incriminating organisms (VTEC) from the time of ingestion, up to and including internalization of the toxin into a target cell; in vitro experiments demonstrating the effect of toxin on endothelial cells are included. It is hoped that we might gain a clearer insight into factors that might predispose an individual to contracting HUS. Once a better understanding of the pathogenesis of VTEC associated HUS is known, areas for therapeutic intervention might be realized.

  18. Human mannose-binding lectin inhibitor prevents Shiga toxin-induced renal injury

    DEFF Research Database (Denmark)

    Ozaki, Masayuki; Kang, Yulin; Tan, Ying Siow

    2016-01-01

    Hemolytic uremic syndrome caused by Shiga toxin-producing Escherichia coli (STEC HUS) is a worldwide endemic problem, and its pathophysiology is not fully elucidated. Here we tested whether the mannose-binding lectin (MBL2), an initiating factor of lectin complement pathway activation, plays a cr...

  19. A classification of hemolytic uremic syndrome and thrombotic thrombocytopenic purpura and related disorders.

    NARCIS (Netherlands)

    Besbas, N.; Karpman, D.; Landau, D.; Loirat, C.; Proesmans, W.; Remuzzi, G.; Rizzoni, G.; Taylor, C.M.; Kar, N.C.A.J. van de; Zimmerhackl, L.B.

    2006-01-01

    The diagnostic terms hemolytic uremic syndrome (HUS) and thrombotic thrombocytopenic purpura (TTP) are based on historical and overlapping clinical descriptions. Advances in understanding some of the causes of the syndrome now permit many patients to be classified according to etiology. The increase

  20. Reference: 729 [Arabidopsis Phenome Database[Archive

    Lifescience Database Archive (English)

    Full Text Available ce plays an important role in optimal plant adaptation to the environment. The plant molybdenum co-factor (M...hus, the regulation of ureide levels by Atxdh1 has general implications for optimal plant survival during nu

  1. [Hemolytic uremic syndrome. Clinical manifestations. Treatment].

    Science.gov (United States)

    Exeni, Ramón A

    2006-01-01

    Clinical manifestation are described in children with epidemic HUS. The intestinal involvement in the prodromic period, is outlined and the most common disturbances such acute renal failure, thrombocytopenia, hemolytic anemia, leucocitosis hypertension, neurological, pancreatic and cardiac manifestations are described. We discuss the acid-base and electrolyte disturbances, metabolic acidosis, hyponatremia, hyperkalemia. The etiopathogenic treatment and the control of renal sequelae are also discussed.

  2. Dicty_cDB: SLE181 [Dicty_cDB

    Lifescience Database Archive (English)

    Full Text Available 70643 |pid:none) Picea sitchensis clone WS02742_A15... 205 7e-52 AM048985_1( AM048985 |pid:none) Micromalt...hus debilis partial mRNA ... 203 2e-51 EU999182_1( EU999182 |pid:none) Artemia fran

  3. Победа над солнцем / Николай Караев

    Index Scriptorium Estoniae

    Караев, Николай, 1978-

    2009-01-01

    PÖFFi alafestivalil Animated Dreams linastus neli uut filmi: Olga ja Priit Pärna "Tuukrid vihmas", Kaspar Jancise "Krokodill", Martinus Daane Klemeti "Õhus" ja Girlin Bassovskaja (Jelena Girlin, Mari-Liis Bassovskaja) "Oranus". Lisaks sõnum animafilmifestivali võitjate kohta

  4. Fatal case of hemolytic-uremic syndrome in an adult due to a rare serogroup O91 Entero hemorrhagic Escherichia coli associated with a Clostridium difficile infection. More than meets the eye

    Directory of Open Access Journals (Sweden)

    Thomas Guillard

    2015-08-01

    Full Text Available Hemolytic-uremic syndrome due to enterohemorrhagic Escherichia coli, belonging to serogroup O91 has rarely been described. We report here a case of post-diarrheal HUS due to EHEC O91 in an elderly patient for whom diagnosis was delayed given a previously diagnosed C. difficile infection. This case highlights the usefulness of Shiga-toxin detection.

  5. Ingested Shiga Toxin 2 (Stx2) Causes Histopathological Changes in Kidney, Spleen and Thymus Tissues and Mortality in Mice

    Science.gov (United States)

    The Shiga toxin (Stxs) producing bacterial strain, Escherichia coli O157:H7, colonizes the distal small intestine and the colon, initiating a very broad spectrum of illnesses such as hemolytic-uremic syndrome (HUS) characterized by microangiopathic hemolytic anemia, thrombocytopenia and acute renal ...

  6. Thrombotic Microangiopathy in Inverted Formin 2-Mediated Renal Disease

    DEFF Research Database (Denmark)

    Challis, Rachel C; Ring, Troels; Xu, Yaobo

    2017-01-01

    and her mother also had Charcot-Marie-Tooth disease. Using whole-exome sequencing, we identified a mutation in the inverted formin 2 gene (INF2) in the mutational hotspot for FSGS. Subsequent analysis of the Newcastle aHUS cohort identified another family with a functionally-significant mutation in INF2...

  7. Gastronomie : [luuletused] / Maarja Kangro, Mart Kangur, Lauri Kitsnik jt

    Index Scriptorium Estoniae

    2006-01-01

    Sisu: Gastronomie ; "Hoian pisaraid tagasi. Ja sõnu..." ; "Olen elanud siiani..." ; Hei, härra motikamees ; "uni nägi mind..." ; "kodunt eemal kauges linnas..." ; "Õhus viniseb ja heliseb..." ; Arhiiv. Suusarada ; Männid ; Masinad surisevad ; Dorian Gray herilane ; Luuletus

  8. Shiga toxin-2 triggers endothelial leukocyte adhesion and transmigration via NF-kappaB dependent up-regulation of IL-8 and MCP-1.

    NARCIS (Netherlands)

    Zoja, C.; Angioletti, S.; Donadelli, R.; Zanchi, C.; Tomasoni, S.; Binda, E.; Imberti, B.; Loo, D.M.W.M. te; Monnens, L.A.H.; Remuzzi, G.; Morigi, M.

    2002-01-01

    BACKGROUND: Shiga toxin (Stx)-producing E. coli is a causative agent of the epidemic form of hemolytic uremic syndrome (HUS), the most common cause of acute renal failure in children. Endothelial injury and leukocyte activation are instrumental to the development of microangiopathic lesions. To obta

  9. Genotype/phenotype correlations in complement factor h deficiency arising from uniparental isodisomy

    DEFF Research Database (Denmark)

    Wilson, Valerie; Darlay, Rebecca; Wong, William;

    2013-01-01

    We report a male infant who presented at 8 months of age with atypical hemolytic uremic syndrome (aHUS) responsive to plasma therapy. Investigation showed him to have complement factor H (CFH) deficiency associated with a homozygous CFH mutation (c.2880delT [p.Phe960fs]). Mutation screening of th...

  10. Distinct Renal Pathology and a Chemotactic Phenotype after Enterohemorrhagic Escherichia coli Shiga Toxins in Non-Human Primate Models of Hemolytic Uremic Syndrome

    Science.gov (United States)

    Stearns-Kurosawa, Deborah J.; Oh, Sun-Young; Cherla, Rama P.; Lee, Moo-Seung; Tesh, Vernon L.; Papin, James; Henderson, Joel; Kurosawa, Shinichiro

    2014-01-01

    Enterohemorrhagic Escherichia coli cause approximately 1.5 million infections globally with 176,000 cases occurring in the United States annually from ingesting contaminated food, most frequently E. coli O157:H7 in ground beef or fresh produce. In severe cases, the painful prodromal hemorrhagic colitis is complicated by potentially lethal hemolytic uremic syndrome (HUS), particularly in children. Bacterial Shiga-like toxins (Stx1, Stx2) are primarily responsible for HUS and the kidney and neurologic damage that ensue. Small animal models are hampered by the inability to reproduce HUS with thrombotic microangiopathy, hemolytic anemia, and acute kidney injury. Earlier, we showed that nonhuman primates (Papio) recapitulated clinical HUS after Stx challenge and that novel therapeutic intervention rescued the animals. Here, we present detailed light and electron microscopic pathology examination of the kidneys from these Stx studies. Stx1 challenge resulted in more severe glomerular endothelial injury, whereas the glomerular injury after Stx2 also included prominent mesangiolysis and an eosinophilic inflammatory infiltration. Both toxins induced glomerular platelet-rich thrombi, interstitial hemorrhage, and tubular injury. Analysis of kidney and other organs for inflammation biomarkers showed a striking chemotactic profile, with extremely high mRNA levels for IL-8, monocyte chemoattractant protein 1, and macrophage inflammatory protein 1α and elevated urine chemokines at 48 hours after challenge. These observations give unique insight into the pathologic consequences of each toxin in a near human setting and present potential pathways for therapeutic intervention. PMID:23402998

  11. Dicty_cDB: SFI612 [Dicty_cDB

    Lifescience Database Archive (English)

    Full Text Available 0.003 1 AW697837 |AW697837.1 EST0020 carnation flower specific cDNA library Diant...hus caryophyllus cDNA clone HM020 5' similar to hypothetical protein, mRNA sequence. 54 0.003 1 AW697825 |AW697825.1 EST0008 carnatio

  12. The Theory for the Mechanism of Chromium Plating: The Theory for the Physical Characteristics of Chromium Plate

    Science.gov (United States)

    1947-01-01

    deposits arc pro- duced as the coll potential is successively raised. The sulfato ion "hus has an extremely important effect in the chromium plating...and sulfato iDU in the bath wore then used in an attempt to obtain more satisfactory hexagonal chromium deposits. The data obtained are summarUod

  13. Stone size limits the use of Hounsfield units for prediction of calcium oxalate stone composition.

    Science.gov (United States)

    Stewart, Gregory; Johnson, Lewis; Ganesh, Halemane; Davenport, Daniel; Smelser, Woodson; Crispen, Paul; Venkatesh, Ramakrishna

    2015-02-01

    To evaluate the role of stone size in predicting urinary calculus composition using Hounsfield units on noncontrasted computed tomography (CT) scan. A retrospective review was performed for all patients who underwent ureteroscopy or percutaneous nephrolithotomy during a 1-year period, had a stone analysis performed, and had CT imaging available for review. All CT scans were reviewed by a board-certified radiologist. Variables evaluated included age, sex, body mass index, stone size, stone location, Hounsfield units (HUs), and stone composition. We identified a total of 91 patients (41 men and 50 women) with CT imaging and stone analysis available for review. Stone analysis showed 41 calcium oxalate monohydrate (CaOxMH), 13 calcium oxalate dihydrate, 29 calcium phosphate, 5 uric acid, 2 struvite, and 1 cystine stone. Average age was 46 years, and average body mass index was 32 kg/m2. Measured HUs varied significantly with size for CaOxMH and calcium oxalate dihydrate stones (P values 10 mm) stones (55%). For calcium stones, the ability of CT HUs to predict stone composition was limited, likely due to the mixed stone composition. Within a cohort of CaOxMH stone formers, measured HUs varied linearly with stone size. All stones <5 mm were below thresholds for CaOxMH composition. Copyright © 2015 Elsevier Inc. All rights reserved.

  14. Disease: H00277 [KEGG MEDICUS

    Lifescience Database Archive (English)

    Full Text Available irst associated with human disease after a multistate outbreak in the United States in 1982 involving contam...ogress to a severe cases called hemolytic uremic syndrome (HUS). Infectious disea...157:H7 strains isolated from humans during disease outbreaks and from healthy cattle. Appl Environ Microbiol

  15. Escherichia coli O157 infections and unpasteurised milk

    NARCIS (Netherlands)

    Allerberger, F; Wagner, M; Schweiger, P; Rammer, H P; Resch, A; Dierich, M P; Friedrich, A W; Karch, H

    2001-01-01

    We report on two children with Escherichia coli O157 infection, one of whom developed haemolytic uraemic syndrome (HUS). Both had drunk raw cows or goats milk in the week before their illness. Molecular subtyping identified a sorbitol fermenting Escherichia coli O157:H isolate from a dairy cow. This

  16. Hellsgate Big Game Winter Range Wildlife Mitigation Project : Annual Report 2008.

    Energy Technology Data Exchange (ETDEWEB)

    Whitney, Richard P.; Berger, Matthew T.; Rushing, Samuel; Peone, Cory

    2009-01-01

    The Hellsgate Big Game Winter Range Wildlife Mitigation Project (Hellsgate Project) was proposed by the Confederated Tribes of the Colville Reservation (CTCR) as partial mitigation for hydropower's share of the wildlife losses resulting from Chief Joseph and Grand Coulee Dams. At present, the Hellsgate Project protects and manages 57,418 acres (approximately 90 miles2) for the biological requirements of managed wildlife species; most are located on or near the Columbia River (Lake Rufus Woods and Lake Roosevelt) and surrounded by Tribal land. To date we have acquired about 34,597 habitat units (HUs) towards a total 35,819 HUs lost from original inundation due to hydropower development. In addition to the remaining 1,237 HUs left unmitigated, 600 HUs from the Washington Department of Fish and Wildlife that were traded to the Colville Tribes and 10 secure nesting islands are also yet to be mitigated. This annual report for 2008 describes the management activities of the Hellsgate Big Game Winter Range Wildlife Mitigation Project (Hellsgate Project) during the past year.

  17. Habitat Evaluation Procedures (HEP) Report; Calispell Creek Project, Technical Report 2004-2005.

    Energy Technology Data Exchange (ETDEWEB)

    Entz, Ray

    2005-02-01

    On July 13, 2004, the Habitat Evaluation Procedure (HEP) was used to determine baseline habitat suitability on the Calispell Creek property, an acquisition completed by the Kalispel Tribe of Indians in February 2004. Evaluation species and appropriate models include Canada goose, mallard, muskrat, yellow warbler, and white-tailed deer. Habitat Suitability Index (HSI) values were visually estimated and agreed upon by all HEP team members. The Calispell Creek Project provides a total of 138.17 Habitat Units (HUs) for the species evaluated. Emergent wetland habitat provides 5.16 HUs for mallard and muskrat. Grassland provides 132.02 HUs for mallard and Canada goose. Scrub-shrub vegetation provides 0.99 HUs for yellow warbler and white-tailed deer. The objective of using HEP at the Calispell Creek Project and other protected properties is to document the quality and quantity of available habitat for selected wildlife species. In this way, HEP provides information on the relative value of the same area at future points in time so that the effect of management activities on wildlife habitat can be quantified. When combined with other tools, the baseline HEP will be used to determine the most effective on-site management, restoration, and enhancement actions to increase habitat suitability for targeted species. The same process will be replicated every five years to quantitatively evaluate the effectiveness of management strategies in improving and maintaining habitat conditions while providing additional crediting to BPA for enhanced habitat values.

  18. Hvad har de gang i?

    DEFF Research Database (Denmark)

    Hansen, Niels-Henrik Møller

    Denne rapport er et resultat af et samarbejdet mellem Holbæk Kommune, repræsenteret ved Ungdommens Hus, og Center for Ungdomsforskning, CeFU, ved Roskilde Universitetscenter. Rapporten præsenterer og beskriver resultaterne af henholdsvis en række fokusgruppeinterviews med udsatte unge i Holbæk sa...

  19. Relapsing or refractory idiopathic thrombotic thrombocytopenic purpura-hemolytic uremic syndrome: the role of rituximab.

    Science.gov (United States)

    Caramazza, Domenica; Quintini, Gerlando; Abbene, Ignazio; Malato, Alessandra; Saccullo, Giorgia; Lo Coco, Lucio; Di Trapani, Rosa; Palazzolo, Roberto; Barone, Rita; Mazzola, Giuseppina; Rizzo, Sergio; Ragonese, Paolo; Aridon, Paolo; Abbadessa, Vincenzo; Siragusa, Sergio

    2010-12-01

    Idiopathic thrombotic thrombocytopenic purpura-hemolytic uremic syndrome (TTP-HUS) is a rare disease responsive to treatment with plasma exchange (PE) but with a high percentage of relapse or refractory patients. A severe deficiency of ADAMTS-13 (<5% of normal activity), congenital or caused by an autoantibody, may be specific for TTP and it has been proposed that severe ADAMTS-13 deficiency now defines TTP. B cells play a key role in both the development and the perpetuation of autoimmunity, suggesting that B-cell depletion could be a valuable treatment approach for patients with idiopathic TTP-HUS. This review of the literature focuses on the role of rituximab, a chimeric monoclonal antibody directed against CD20 antigen expressed by B lymphocytes, in patients with relapsing or refractory TTP-HUS with or without ADAMTS-13 deficiency, suggesting that rituximab may produce clinical remission in a significant proportion of patients. Rituximab therapy reduces plasma requirement and avoids complications related to salvage-immunosuppressive therapy. In conclusion, rituximab provides an effective, well-tolerated, and safe treatment option for patients with idiopathic TTP-HUS, thus giving an alternative approach to the current treatment based on PE.

  20. Detection of apoptosis in kidney biopsies of patients with D+ hemolytic uremic syndrome.

    NARCIS (Netherlands)

    Loo, D.M.W.M. te; Monnens, L.A.H.; Heuvel, L.P.W.J. van den; Gubler, M.C.; Kockx, M.M.

    2001-01-01

    In this study we have investigated the presence of apoptotic cells in renal biopsy material of seven patients with hemolytic uremic syndrome (HUS) by using an improved and stringent terminal deoxynucleotidyl nick-end labeling (TUNEL) technique. Renal biopsy material was taken in the second or third

  1. Familial Atypical Hemolytic Uremic Syndrome: A Review of Its Genetic and Clinical Aspects

    Directory of Open Access Journals (Sweden)

    Fengxiao Bu

    2012-01-01

    Full Text Available Atypical hemolytic uremic syndrome (aHUS is a rare renal disease (two per one million in the USA characterized by microangiopathic hemolytic anemia, thrombocytopenia, and acute renal failure. Both sporadic (80% of cases and familial (20% of cases forms are recognized. The study of familial aHUS has implicated genetic variation in multiple genes in the complement system in disease pathogenesis, helping to define the mechanism whereby complement dysregulation at the cell surface level leads to both sporadic and familial disease. This understanding has culminated in the use of Eculizumab as first-line therapy in disease treatment, significantly changing the care and prognosis of affected patients. However, even with this bright outlook, major challenges remain to understand the complexity of aHUS at the genetic level. It is possible that a more detailed picture of aHUS can be translated to an improved understanding of disease penetrance, which is highly variable, and response to therapy, both in the short and long terms.

  2. The fibrinolytic system in the hemolytic uremic syndrome: In vivo and in vitro studies

    NARCIS (Netherlands)

    Kar, N.C.A.J. van de; Hinsbergh, V.W.M. van; Brommer, E.J.P.; Monnens, L.A.H.

    1994-01-01

    Fibrinolytic parameters and von Willebrand factor (vWF) antigen were measured in the plasma of 10 patients with hemolytic uremic syndrome (HUS). Samples were taken at presentation and again 2 wk later, before and after infusion of 1-desamino-8-arginine vasopressin. Compared with the plasma values of

  3. Som en landsby midt i byen

    DEFF Research Database (Denmark)

    2015-01-01

    Denne artikel tegner et antropologisk portræt af livet i Komponistkvarteret og Humleby anno 2015. To fredfyldte enklaver med hyggelige huse, blomstrende forhaver og børn, der leger i gaderne – og dog stadig midt i byen. Fra at være forslummede arbejderboliger med to eller tre familier per hus er...

  4. Sedimentation: Potential Biological Effects of Dredging Operations in Estuarine and Marine Environments

    Science.gov (United States)

    2005-05-01

    Program, Dr. Robert M. Engler (601-634-3624, Robert.M.Engsler(derdc. usace.armv.mil). This technical note should be cited as follows: Wilber, D. H...U.S. Army Engineer Research Development Center, Vicksburg, MS. Grant, J., Enright , G. A., and Griswold, A. (1990). "Resuspension and growth of Ostrea

  5. Klinisch denken en beslissen in de praktijk. Een man met icterus, nierfunctiestoornissen, trombocytopenie, spierpijn en verwardheid

    NARCIS (Netherlands)

    Huits, R M; van der Werf, T S; Zijlstra, J G

    2004-01-01

    A 51-year-old man became jaundiced, after experiencing flu-like symptoms for a week. On admission anaemia, thrombocytopenia, and hepatic and renal function disorders were present. One month previously he had had sinusitis. Thrombotic thrombocytopenic purpura (TTP)/haemolitic-uraemic syndrome (HUS) w

  6. Atypical Hemolytic Uremic Syndrome Recurrence after Renal Transplantation

    Science.gov (United States)

    Bouatou, Yassine; Bacchi, Véronique Frémeaux; Villard, Jean; Moll, Solange; Martin, Pierre-Yves; Hadaya, Karine

    2015-01-01

    Abstract Risk for atypical hemolytic uremic syndrome (aHUS) recurrence after renal transplantation is low with an isolated membrane cofactor protein mutation (MCP). We report the case of a 32-year-old woman with a MCP who underwent kidney transplantation with a good evolution at 12 months. At 15 and 35 months, 2 episodes of thrombotic microangiopathy (TMA), after a miscarriage and a preeclampsia, were misinterpreted as triggered by tacrolimus. After each episode however serum creatinine returned to baseline. Five years after transplantation, she had a self-limited rhinosinusitis followed 3 weeks later by an oliguric renal failure. Her complement profile was normal. Graft biopsy showed C3 glomerulonephritis with no “humps” on electron microscopy. No significant renal function improvement followed methylprednisolone pulsing. A second biopsy showed severe acute TMA lesions with C3 glomerular deposits. Despite weekly eculizumab for 1 month, dialysis was resumed. A new workup identified the “at-risk” complement factor H haplotype. Thus, aHUS recurrence should be ruled out in aHUS patients considered at low recurrence risk when a TMA is found in graft biopsy. Prompt eculizumab therapy should be considered to avoid graft loss as aHUS recurrence can first present as a C3 glomerulonephritis. PMID:27500215

  7. Phenotypic Expansion of DGKE-Associated Diseases

    Science.gov (United States)

    Westland, Rik; Bodria, Monica; Carrea, Alba; Lata, Sneh; Scolari, Francesco; Fremeaux-Bacchi, Veronique; D’Agati, Vivette D.; Lifton, Richard P.; Gharavi, Ali G.; Ghiggeri, Gian Marco

    2014-01-01

    Atypical hemolytic uremic syndrome (aHUS) is usually characterized by uncontrolled complement activation. The recent discovery of loss-of-function mutations in DGKE in patients with aHUS and normal complement levels challenged this observation. DGKE, encoding diacylglycerol kinase-ε, has not been implicated in the complement cascade but hypothetically leads to a prothrombotic state. The discovery of this novel mechanism has potential implications for the treatment of infants with aHUS, who are increasingly treated with complement blocking agents. In this study, we used homozygosity mapping and whole-exome sequencing to identify a novel truncating mutation in DGKE (p.K101X) in a consanguineous family with patients affected by thrombotic microangiopathy characterized by significant serum complement activation and consumption of the complement fraction C3. Aggressive plasma infusion therapy controlled systemic symptoms and prevented renal failure, suggesting that this treatment can significantly affect the natural history of this aggressive disease. Our study expands the clinical phenotypes associated with mutations in DGKE and challenges the benefits of complement blockade treatment in such patients. Mechanistic studies of DGKE and aHUS are, therefore, essential to the design of appropriate therapeutic strategies in patients with DGKE mutations. PMID:24511134

  8. Vero cytotoxin binding to polymorphonuclear leukocytes among households with children with hemolytic uremic syndrome.

    NARCIS (Netherlands)

    Loo, D.M.W.M. te; Heuvelink, A.E.; Boer, E. de; Nauta, J.; Walle, J. van der; Schröder, C.H.; Hinsbergh, V.W.H. van; Chart, H.; Kar, N.C.A.J. van de; Heuvel, L.P.W.J. van den

    2001-01-01

    Hemolytic uremic syndrome (HUS), the leading cause of acute renal failure in childhood, can be caused by different serotypes of vero cytotoxin (VT; i.e., Shiga toxin)-producing Escherichia coli (VTEC). Recently, VT was shown to bind to polymorphonuclear leukocytes (PMNL) in the systemic circulation

  9. A new immunoassay for detecting all subtypes of Shiga toxins produced by Shiga toxin-producing E. coli in ground beef

    Science.gov (United States)

    Background Shiga toxin (Stx) is a common virulence factor of all Shiga toxin producing E. coli (STEC) that cause a wide spectrum of disease, including hemorrhagic colitis and hemolytic uremic syndrome (HUS). Although several commercial kits are available for detection of Stx produced by STEC, none o...

  10. Verocytotoxin producing E. Coli O157 on farms : prevalences, risk factors and transmission

    NARCIS (Netherlands)

    Schouten, J.M.

    2005-01-01

    Infection with verocytotoxin producing Escherichia coli (VTEC) O157 in humans can lead to mild or bloody diarrhoea, with e.g. the haemolytic uraemic syndrome (HUS) as possible complication. Cattle appear to be important reservoirs of O157 VTEC. The main objectiv

  11. Escherichia coli O157 infections and unpasteurised milk

    NARCIS (Netherlands)

    Allerberger, F; Wagner, M; Schweiger, P; Rammer, H P; Resch, A; Dierich, M P; Friedrich, A W; Karch, H

    2001-01-01

    We report on two children with Escherichia coli O157 infection, one of whom developed haemolytic uraemic syndrome (HUS). Both had drunk raw cows or goats milk in the week before their illness. Molecular subtyping identified a sorbitol fermenting Escherichia coli O157:H isolate from a dairy cow. This

  12. De economische ontwikkeling van de landbouw in Groningen 1800-1910. Een kwalitatieve en kwantitatieve analyse.

    NARCIS (Netherlands)

    Priester, P.R.

    1991-01-01

    This study deals with the causes and consequences of technical change in agriculture. It shows changes in farming methods in the Dutch province of Groningen during the period 1800-1910. The adoption of new methods (such as the cultivation of clover, more frequent hoeing, drainage and convertible hus

  13. Eculizumab as rescue therapy for atypical hemolytic uremic syndrome with normal platelet count.

    NARCIS (Netherlands)

    Dorresteijn, E.M.; Kar, N.C.A.J. van de; Cransberg, K.

    2012-01-01

    BACKGROUND: Atypical hemolytic uremic syndrome (aHUS) in childhood is a rare disease with frequent progression to end-stage renal disease and a high recurrence after kidney transplantation. Eculizumab, a humanized monoclonal antibody that binds to complement protein C5, may be beneficial in the trea

  14. Efficacy and safety of eculizumab in atypical hemolytic uremic syndrome from 2-year extensions of phase 2 studies

    NARCIS (Netherlands)

    Licht, C.; Greenbaum, L.A.; Muus, P.; Babu, S.; Bedrosian, C.L.; Cohen, D.J.; Delmas, Y.; Douglas, K.; Furman, R.R.; Gaber, O.A.; Goodship, T.; Herthelius, M.; Hourmant, M.; Legendre, C.M.; Remuzzi, G.; Sheerin, N.; Trivelli, A.; Loirat, C.

    2015-01-01

    Atypical hemolytic uremic syndrome (aHUS) is a rare, possibly life-threatening disease characterized by platelet activation, hemolysis and thrombotic microangiopathy (TMA) leading to renal and other end-organ damage. We originally conducted two phase 2 studies (26 weeks and 1 year) evaluating eculiz

  15. Atypical relapse of hemolytic uremic syndrome after transplantation.

    Science.gov (United States)

    Olie, Karolien H; Florquin, Sandrine; Groothoff, Jaap W; Verlaak, René; Strain, Lisa; Goodship, Timothy H J; Weening, Jan J; Davin, Jean-Claude

    2004-10-01

    Atypical hemolytic uremic syndrome (HUS) frequently leads to end-stage renal failure and can relapse after transplantation. A 12-year-old girl presenting with familial atypical HUS with a factor H mutation was successfully transplanted 6 years after a first transplant that had failed because of immediate recurrent HUS. Prophylactic plasma exchange before and after transplantation was used. Two months after transplantation, concomitant with a reduction in plasma exchange frequency, the plasma creatinine increased from 70 micro mol/l to 194 micro mol/l in 2 weeks without thrombocytopenia or signs of hemolytic anemia. The patient had minimal clinical symptoms and a presumptive diagnosis of graft rejection was made. Despite treatment with six daily pulses of methylprednisolone, plasma creatinine continued to increase and a graft biopsy was therefore undertaken. This showed the typical appearance of a thrombotic microangiopathy without any evidence of rejection. Despite daily plasmapheresis and replacement of cyclosporine with tacrolimus, there was no improvement and transplant nephrectomy was undertaken. This patient demonstrates that HUS can recur in a kidney transplant without the diagnostic hematological features and emphasizes the need for early transplant biopsy in such patients showing a decline in transplant function.

  16. Eculizumab as rescue therapy for atypical hemolytic uremic syndrome with normal platelet count

    NARCIS (Netherlands)

    E.M. Dorresteijn (Eiske); N.C. van de Kar (Nicole); K. Cransberg (Karlien)

    2012-01-01

    textabstractBackground Atypical hemolytic uremic syndrome (aHUS) in childhood is a rare disease with frequent progression to end-stage renal disease and a high recurrence after kidney transplantation. Eculizumab, a humanized monoclonal antibody that binds to complement protein C5, may be beneficial

  17. Decrease of thrombomodulin contributes to the procoagulant state of endothelium in hemolytic uremic syndrome.

    NARCIS (Netherlands)

    Fernandez, G.C.; Loo, D.M.W.M. te; Velden, T.J.A.M. van der; Heuvel, L.P.W.J. van den; Palermo, M.S.; Monnens, L.L.

    2003-01-01

    The typical form of hemolytic uremic syndrome (D+HUS) is a thrombotic microangiopathy that causes acute renal failure in children. The etiology of this disease is a toxin called Shiga-like toxin (Stx), present in certain strains of gram-negative bacteria. Vascular endothelial cell (EC) injury appear

  18. [Hemolytic uremic syndrome in children

    NARCIS (Netherlands)

    Heuvelink, A.E.; Loo, D.M.W.M. te; Monnens, L.A.H.

    2001-01-01

    In Europe, haemolytic uraemic syndrome (HUS) is the most frequent cause of acute renal insufficiency during childhood. In the Netherlands about 20 children per year are seriously affected. Following a prodromal phase of mostly bloody diarrhoea, the main symptoms become evident, namely, haemolytic an

  19. QTL Information Table: 741 [Q-TARO

    Lifescience Database Archive (English)

    Full Text Available qHUS-1-1 Others Others hull siliconcontent SSR C)Interval RIL Zhenshan 97B Milyang ...huang, J.-Y. (2007). Validating a segment on the short arm of chromosome 6 responsible for genetic variation in the hull silicon

  20. Nationwide study of haemolytic uraemic syndrome : clinical, microbiological, and epidemiological features

    NARCIS (Netherlands)

    Elliott, EJ; Robins-Browne, RM; O'Loughlin, EV; Bennett-Wood, [No Value; Bourke, J; Henning, P; Hogg, GG; Knight, J; Powell, H; Redmond, D

    2001-01-01

    Aims-To establish the incidence and aetiology of haemolytic uraemic syndrome (HUS) in Australia and compare clinical and microbial characteristics of sporadic and outbreak cases. Methods-National active surveillance through the Australian Paediatric Surveillance Unit with monthly case notification f

  1. Blood and marrow transplant clinical trials network toxicity committee consensus summary: thrombotic microangiopathy after hematopoietic stem cell transplantation.

    Science.gov (United States)

    Ho, Vincent T; Cutler, Corey; Carter, Shelly; Martin, Paul; Adams, Roberta; Horowitz, Mary; Ferrara, James; Soiffer, Robert; Giralt, Sergio

    2005-08-01

    The syndrome of microangiopathic hemolysis associated with renal failure, neurologic impairment, or both is a recognized complication of hematopoietic stem cell transplantation. This entity is often called hemolytic uremic syndrome (HUS) or thrombotic thrombocytopenic purpura (TTP), yet it is clear that the pathophysiology of transplant-associated HUS/TTP is different from that of classic HUS or TTP. Furthermore, the incidence of this syndrome varies from 0.5% to 76% in different transplant series, primarily because of the lack of a uniform definition. The toxicity committee of the Blood and Marrow Transplant Clinical Trials Network has reviewed the current literature on transplant-related HUS/TTP and recommends that it be henceforth renamed posttransplantation thrombotic microangiopathy (TMA). An operational definition for TMA based on the presence of microangiopathic hemolysis and renal and/or neurologic dysfunction is proposed. The primary intervention after diagnosis of TMA should be withdrawal of calcineurin inhibitors. Plasma exchange, although frequently used in this condition, has not been proven to be effective. In the absence of definitive trials, plasma exchange cannot be considered a standard of care for TMA. It is hoped that these positions will improve the identification and reporting of this devastating complication after hematopoietic stem cell transplantation and facilitate future clinical studies for its prevention and treatment.

  2. [Microalbuminuria in pediatric patients diagnosed with hemolytic uremic syndrome].

    Science.gov (United States)

    Cubillos C, María Paz; Del Salas, Paulina; Zambrano, Pedro O

    2015-01-01

    Hemolytic uremic syndrome (HUS) is characterized by the presence of microangiopathic hemolytic anemia, thrombocytopenia, and acute kidney failure. It is the leading cause of acute kidney failure in children under 3 years of age. A variable number of patients develop proteinuria, hypertension, and chronic renal failure. To evaluate the renal involvement in pediatric patients diagnosed with HUS using the microalbumin/creatinine ratio. Descriptive concurrent cohort study that analyzed the presence of microalbuminuria in patients diagnosed with HUS between January 2001 and March 2012, who evolved without hypertension and normal renal function (clearance greater than 90ml/min using Schwartz formula). Demographic factors (age, sex), clinical presentation at time of diagnosis, use of antibiotics prior to admission, and need for renal replacement therapy were evaluated. Of the 24 patients studied, 54% were male. The mean age at diagnosis was two years. Peritoneal dialysis was required in 45%, and 33% developed persistent microalbuminuria. Antiproteinuric treatment was introduce in 4 patients, with good response. The mean follow-up was 6 years (range 6 months to 11 years). The serum creatinine returned to normal in all patients during follow up. The percentage of persistent microalbuminuria found in patients with a previous diagnosis of HUS was similar in our group to that described in the literature. Antiproteinuric treatment could delay kidney damage, but further multicenter prospective studies are necessary. Copyright © 2015. Publicado por Elsevier España, S.L.U.

  3. Simulering af dagslys i digitale modeller

    DEFF Research Database (Denmark)

    Villaume, René Domine; Ørstrup, Finn Rude

    2004-01-01

    Projektet undersøger via forskellige simuleringer af dagslys, kvaliteten af visualiseringer af komplekse lysforhold i digitale modeller i forbindelse med formidling af arkitektur via nettet. I en digital 3D model af Utzon Associates Paustians hus, simulers naturligt dagslysindfald med  forskellig...... Renderingsmetoder som: "shaded render" /  ”raytraceing” /  "Final Gather /  ”Global Illumination”...

  4. Blood pressure in the long-term follow-up of children with hemolytic uremic syndrome.

    Science.gov (United States)

    De Petris, Laura; Gianviti, Alessandra; Giordano, Ugo; Calzolari, Armando; Tozzi, Alberto E; Rizzoni, Gianfranco

    2004-11-01

    The hemolytic uremic syndrome (HUS) is the most common cause of acute renal failure (ARF) in young children. Most patients recover from the acute phase of the illness but they may develop arterial hypertension(AH) after many years, even in the absence of signs of renal impairment during short-term follow-up. In this study, we performed casual blood pressure (BP) measurement, 24-h blood pressure monitoring (ABPM), and a Bruce walking treadmill study (ET) in 24 children (aged 5-15 years, 13 males, 11 females) with a history of HUS and normal renal function during follow-up (median 5.8 years, range 1.8-12.4 years). There were 22 children(91%) with prodromal diarrhea associated with HUS and 20 (83%) underwent dialysis during the acute illness. All children had normal casual BP measurement. Of 13 children (54%) with normal ABPM, 5 patients (38%) had an abnormal BP response during the ET study. There were 4 (58%) of the 7 patients with AH by ABPM (29%)and an abnormal BP response during ET. These findings suggest that ET could be a useful means of identifying children with a history of HUS that could be at risk of future AH even if they had normal renal function, casual BP, and ABPM during long-term follow-up. These results should be confirmed with a large prospective clinical study.

  5. Risk factors for poor renal prognosis in children with hemolytic uremic syndrome.

    Science.gov (United States)

    Gianviti, Alessandra; Tozzi, Alberto E; De Petris, Laura; Caprioli, Alfredo; Ravà, Lucilla; Edefonti, Alberto; Ardissino, Gianluigi; Montini, Giovanni; Zacchello, Graziella; Ferretti, Alfonso; Pecoraro, Carmine; De Palo, Tommaso; Caringella, Angela; Gaido, Maurizio; Coppo, Rosanna; Perfumo, Francesco; Miglietti, Nunzia; Ratsche, Ilse; Penza, Rosa; Capasso, Giovambattista; Maringhini, Silvio; Li Volti, Salvatore; Setzu, Carmen; Pennesi, Marco; Bettinelli, Alberto; Peratoner, Leopoldo; Pela, Ivana; Salvaggio, Elio; Lama, Giuliana; Maffei, Salvatore; Rizzoni, Gianfranco

    2003-12-01

    Many factors have been proposed as predictors of poor renal prognosis in children with hemolytic uremic syndrome (HUS), but their role is still controversial. Our aim was to detect the most reliable early predictors of poor renal prognosis to promptly identify children at major risk of bad outcome who could eventually benefit from early specific treatments, such as plasmapheresis. Prognostic factors identifiable at onset of HUS were evaluated by survival analysis and a proportional hazard model. These included age at onset, prodromal diarrhea (D), leukocyte count, central nervous system (CNS) involvement, and evidence of Shiga toxin-producing Escherichia coli (STEC) infection. Three hundred and eighty-seven HUS cases were reported; 276 were investigated for STEC infection and 189 (68%) proved positive. Age at onset, leukocyte count, and CNS involvement were not associated with the time to recovery. Absence of prodromal D and lack of evidence of STEC infection were independently associated with a poor renal prognosis; only 34% of patients D(-)STEC(- )recovered normal renal function compared with 65%-76% of D(+)STEC(+), D(+)STEC(-) and D(-)STEC(+ )patients. In conclusion, absence of both D and evidence of STEC infection are needed to identify patients with HUS and worst prognosis, while D(-) but STEC(+) patients have a significantly better prognosis.

  6. A classification of hemolytic uremic syndrome and thrombotic thrombocytopenic purpura and related disorders.

    NARCIS (Netherlands)

    Besbas, N.; Karpman, D.; Landau, D.; Loirat, C.; Proesmans, W.; Remuzzi, G.; Rizzoni, G.; Taylor, C.M.; Kar, N.C.A.J. van de; Zimmerhackl, L.B.

    2006-01-01

    The diagnostic terms hemolytic uremic syndrome (HUS) and thrombotic thrombocytopenic purpura (TTP) are based on historical and overlapping clinical descriptions. Advances in understanding some of the causes of the syndrome now permit many patients to be classified according to etiology. The

  7. Kiskjakirjanik Atwoodi lihakirves / Kärt Hellerma

    Index Scriptorium Estoniae

    Hellerma, Kärt, 1956-

    2001-01-01

    Arvustus: Atwood, Margaret. Pime palgamõrvar / tlk. Katrin Suursalu. Tallinn : Eesti Raamat, 2001. Ilmunud ka kogumikus: Hellerma, Kärt. Kohanenud kirjandus : valik kirjanduskriitikat 1987-2006. Eesti Keele Sihtasutus : Tallinn, 2006. Lk. 183-185, pealk. Õhus rippuv lihakirves

  8. Postpartum atypical haemolytic uraemic syndrome in a pre-eclamptic patient

    Directory of Open Access Journals (Sweden)

    Efterpi Tingi

    2016-03-01

    Full Text Available Postpartum atypical haemolytic uraemic syndrome (aHUS is a rare manifestation, defined as non-immune haemolytic anaemia, thrombocytopenia, and renal thrombotic microangiopathy (TMA typically following a normal vaginal delivery. Most cases of aHUS are caused by uncontrolled chronic activation of alternative complement pathway, resulting in microvascular thrombosis, organ ischaemia and damage. aHUS has a poor prognosis, hence up to 65 percent of patients require haemodialysis or have kidney damage or die. We report a case of postpartum atypical haemolytic uraemic syndrome in a 30 year old multiparous woman, who presented with orthopnoea, chest and abdominal pain, seven days following emergency caesarean section due to severe preeclampsia. Clinical examination and several investigations revealed anaemia, thrombocytopenia and renal failure, findings suggestive of thrombotic microangiopathy, therefore she was admitted in ITU where total plasma exchanged was initiated. The patient improved 10 days post ITU admission and discharged home. This case highlights that the TMAs may be indistinguishable clinically from each other, making a formal diagnosis difficult. Atypical HUS should be suspected during the postpartum period in any woman who presents with haeomolytic anaemia, thrombocytopenia and severe renal impairment. Aggressive treatment with plasma exchange may limit vascular injury and improve prognosis. [Int J Reprod Contracept Obstet Gynecol 2016; 5(3.000: 894-898

  9. Predictive features of chronic kidney disease in atypical haemolytic uremic syndrome

    Science.gov (United States)

    Jamme, Matthieu; Raimbourg, Quentin; Chauveau, Dominique; Seguin, Amélie; Presne, Claire; Perez, Pierre; Gobert, Pierre; Wynckel, Alain; Provôt, François; Delmas, Yahsou; Mousson, Christiane; Servais, Aude; Vrigneaud, Laurence; Veyradier, Agnès

    2017-01-01

    Chronic kidney disease (CKD) is a frequent and serious complication of atypical haemolytic uremic syndrome (aHUS). We aimed to develop a simple accurate model to predict the risk of renal dysfunction in aHUS based on clinical and biological features available at hospital admission. Renal function at 1-year follow-up, based on an estimated glomerular filtration rate < 60mL/min/1.73m2 as assessed by the Modification of Diet in Renal Disease equation, was used as an indicator of significant CKD. Prospectively collected data from a cohort of 156 aHUS patients who did not receive eculizumab were used to identify predictors of CKD. Covariates associated with renal impairment were identified by multivariate analysis. The model performance was assessed and a scoring system for clinical practice was constructed from the regression coefficient. Multivariate analyses identified three predictors of CKD: a high serum creatinine level, a high mean arterial pressure and a mildly decreased platelet count. The prognostic model had a good discriminative ability (area under the curve = .84). The scoring system ranged from 0 to 5, with corresponding risks of CKD ranging from 18% to 100%. This model accurately predicts development of 1-year CKD in patients with aHUS using clinical and biological features available on admission. After further validation, this model may assist in clinical decision making. PMID:28542627

  10. Dangerous drug interactions leading to hemolytic uremic syndrome following lung transplantation

    Directory of Open Access Journals (Sweden)

    Parissis Haralabos

    2010-09-01

    Full Text Available Abstract Background To report our experience of a rather uncommon drug interaction, resulting in hemolytic uremic syndrome (HUS. Methods Two consecutive cases of hemolytic uremic syndrome were diagnosed in our service. In both patients the use of macrolides in patients taking Tacrolimus, resulted in high levels of Tacrolimus. Results The first patient was a 48 years old female with Bilateral emphysema. She underwent Single Sequential Lung Transplantation. She developed reperfusion injury requiring prolonged stay. Tacrolimus introduced (Day 51. The patient remained well up till 5 months later; Erythromycin commenced for chest infection. High Tacrolimus levels and a clinical diagnosis of HUS were made. She was treated with plasmapheresis successfully. The second case was a 57 years old female with Emphysema & A1 Antithrypsin deficiency. She underwent Right Single Lung Transplantation. A2 rejection with mild Obliterative Bronchiolitis diagnosed 1 year later and she switched to Tacrolimus. She was admitted to her local Hospital two and a half years later with right middle lobe consolidation. The patient commenced on amoxicillin and clarithromycin. Worsening renal indices, high Tacrolimus levels, hemolytic anemia & low Platelets were detected. HUS diagnosed & treated with plasmapheresis. Conclusions There are 21 cases of HUS following lung transplantation in the literature that may have been induced by high tacrolimus levels. Macrolides in patients taking Cyclosporin or Tacrolimus lead to high levels. Mechanism of action could be glomeruloconstrictor effect with reduced GFR increased production of Endothelin-1 and increased Platelet aggregation.

  11. Review of Thrombotic Microangiopathy (TMA, and Post- Renal Transplant TMA

    Directory of Open Access Journals (Sweden)

    Ardalan Mohammad

    2006-01-01

    Full Text Available Thrombotic microangiopathy (TMA is a rare but devastating disorder; it involves small vessels and is characterized by intravascular thrombi of aggregated platelets leading to thrombocytopenia and variable degrees of organ ischemia and anemia, which is due to erythrocyte fragmentation in microcirculation. Childhood cases with predominant renal involvement are referred as the hemolytic uremic syndrome (HUS, and adults with major central neurological involvement are labeled as thrombotic thrombocytopenia purpura (TTP. Endothelial damage due to toxins and/or lack of defense against complement activation have a central role. Recent discovery of the von Willebrand Factor cleaving protease (ADAMTS 13 has offered new insight into the pathogenesis of TMA. TMA is also a well-recognized serious complication of renal transplantation. Clinical features of intravascular hemolysis are not always found. It may occur as de novo or recurrent and the majority of de novo cases are related to cyclosporin therapy. Viral infections, severe renal ischemia and acute vascular rejection are less frequent causes. Recurrence is negligible in diarrhea-associated HUS in childhood, but non-diarrheal HUS recurs in majority of adults following renal transplantation. Renal transplantation is contraindicated in familial/relapsing recurrent forms of HUS.

  12. West Foster Creek Expansion Project 2007 HEP Report.

    Energy Technology Data Exchange (ETDEWEB)

    Ashley, Paul R.

    2008-02-01

    During April and May 2007, the Columbia Basin Fish and Wildlife Authority's (CBFWA) Regional HEP Team (RHT) conducted baseline Habitat Evaluation Procedures (HEP) (USFWS 1980, 1980a) analyses on five parcels collectively designated the West Foster Creek Expansion Project (3,756.48 acres). The purpose of the HEP analyses was to document extant habitat conditions and to determine how many baseline/protection habitat units (HUs) to credit Bonneville Power Administration (BPA) for funding maintenance and enhancement activities on project lands as partial mitigation for habitat losses associated with construction of Grand Coulee and Chief Joseph Dams. HEP evaluation models included mule deer (Odocoileus hemionus), western meadowlark (Sturnella neglecta), sharp-tailed grouse, (Tympanuchus phasianellus), Bobcat (Lynx rufus), mink (Neovison vison), mallard (Anas platyrhynchos), and black-capped chickadee (Parus atricapillus). Combined 2007 baseline HEP results show that 4,946.44 habitat units were generated on 3,756.48 acres (1.32 HUs per acre). HEP results/habitat conditions were generally similar for like cover types at all sites. Unlike crediting of habitat units (HUs) on other WDFW owned lands, Bonneville Power Administration received full credit for HUs generated on these sites.

  13. Kiskjakirjanik Atwoodi lihakirves / Kärt Hellerma

    Index Scriptorium Estoniae

    Hellerma, Kärt, 1956-

    2001-01-01

    Arvustus: Atwood, Margaret. Pime palgamõrvar / tlk. Katrin Suursalu. Tallinn : Eesti Raamat, 2001. Ilmunud ka kogumikus: Hellerma, Kärt. Kohanenud kirjandus : valik kirjanduskriitikat 1987-2006. Eesti Keele Sihtasutus : Tallinn, 2006. Lk. 183-185, pealk. Õhus rippuv lihakirves

  14. Gastronomie : [luuletused] / Maarja Kangro, Mart Kangur, Lauri Kitsnik jt

    Index Scriptorium Estoniae

    2006-01-01

    Sisu: Gastronomie ; "Hoian pisaraid tagasi. Ja sõnu..." ; "Olen elanud siiani..." ; Hei, härra motikamees ; "uni nägi mind..." ; "kodunt eemal kauges linnas..." ; "Õhus viniseb ja heliseb..." ; Arhiiv. Suusarada ; Männid ; Masinad surisevad ; Dorian Gray herilane ; Luuletus

  15. The Autism Diagnostic Observation Schedule, Module 4: Application of the Revised Algorithms in an Independent, Well-Defined, Dutch Sample (N = 93)

    Science.gov (United States)

    de Bildt, Annelies; Sytema, Sjoerd; Meffert, Harma; Bastiaansen, Jojanneke A. C. J.

    2016-01-01

    This study examined the discriminative ability of the revised Autism Diagnostic Observation Schedule module 4 algorithm (Hus and Lord in "J Autism Dev Disord" 44(8):1996-2012, 2014) in 93 Dutch males with Autism Spectrum Disorder (ASD), schizophrenia, psychopathy or controls. Discriminative ability of the revised algorithm ASD cut-off…

  16. 78 FR 10269 - National Primary Drinking Water Regulations: Revisions to the Total Coliform Rule

    Science.gov (United States)

    2013-02-13

    ... Document AGI--Acute Gastrointestinal Illness AIDS--Acquired Immune Deficiency Syndrome AIP--Agreement in... illness (AGI) with diarrhea, abdominal discomfort, nausea, vomiting, and other symptoms. Most AGI cases... pathogens include hemolytic uremic syndrome (HUS) (kidney failure), hepatitis, and bloody diarrhea (WHO...

  17. Shillapoo Wildlife Area 2007 Follow-up HEP Report.

    Energy Technology Data Exchange (ETDEWEB)

    Ashley, Paul R.

    2008-03-01

    In April and May 2007 the Regional HEP Team (RHT) conducted a follow-up HEP analysis on the Egger (612 acres) and Herzog (210 acres) parcels located at the north end of the Shillapoo Wildlife Area. The Egger and Herzog parcels have been managed with Bonneville Power Administration funds since acquired in 1998 and 2001 respectively. Slightly more than 936 habitat units (936.47) or 1.14 HUs per acre was generated as an outcome of the 2007 follow-up HEP surveys. Results included 1.65 black-capped chickadee HUs, 280.57 great blue heron HUs, 581.45 Canada goose HUs, 40 mallard HUs, and 32.80 mink HUs. Introduction A follow-up Habitat Evaluation Procedures (HEP) (USFWS 1980) analysis was conducted by the Columbia Basin Fish and Wildlife Authority's (CBFWA) Regional HEP Team (RHT) during April and May 2007 to document changes in habitat quality and to determine the number of habitat units (HUs) to credit Bonneville Power Administration (BPA) for providing operation and maintenance (O&M) funds since WDFW acquired the parcels. The 2007 follow-up HEP evaluation was limited to Shillapoo Wildlife Area (SWA) parcels purchased with Bonneville Power Administration funds. D. Budd (pers. comm.) reported WDFW purchased the 612 acre Egger Farms parcel on November 2, 1998 for $1,737,0001 and the 210 acre Herzog acquisition on June 21, 2001 for $500,000 with Memorandum of Agreement funds (BPA and WDFW 1996) as partial fulfillment of BPA's wildlife mitigation obligation for construction of Bonneville and John Day Dams (Rasmussen and Wright 1989). Anticipating the eventual acquisition of the Egger and Herzog properties, WDFW conducted HEP surveys on these lands in 1994 to determine the potential number of habitat units to be credited to BPA. As a result, HEP surveys and habitat unit calculations were completed as much as seven years prior to acquiring the sites. The term 'Shillapoo Wildlife Area' will be used to describe only the Herzog and Egger parcels in this

  18. Clinical feature analysis of 24 children with thrombotic microangiopathy%小儿血栓性微血管病24例临床特征分析

    Institute of Scientific and Technical Information of China (English)

    王晓英; 郭红; 罗新辉

    2015-01-01

    Objective To explore the clinical feature and therapeutic strategy for children with thrombotic microangiopathy (TMA). Methods The clinical manifestation, auxiliary examination and treatment of 24 cases of children with TMA was analyzed retrospectively. Hemolysis urine toxin syndrome (HUS)occurred in 22 cases, and thrombotic thrombocytopenic purpura (TTP) occurred 2 cases. Results Sixteen cases was onset from May to July,and 8 cases was onset from September to November. Typical HUS (D+HUS) was 8 cases, and atypical HUS (D-HUS) was 14 cases. In 22 HUS children, 18 cases were given hemodialysis or peritoneal dialysis treatment. The illness were significantly improved, and the platelet count and renal function fully recovered normal. But 1 case appeared neurological symptoms such as headache, facial paralysis on one side, gastrointestinal bleeding, and fever, after getting better. Eventually the patient died of disseminated intravascular coagulation. Two cases of TTP were given plasma exchange , anti-infection, large dose of methylprednisolone and anti- platelet aggregation treatment . After treatment, the level of hemoglobin and blood platelets returned normal and consciousness was recuperated. Conclusions HUS and TTP are similar in pathogenesis and clinical manifestation,and it is necessary to be differentiated. Early diagnosis and proper treatment is the key to save the life of children with TMA. As soon as the diagnosis is clear, hemodialysis or peritoneal dialysis treatment should be given to HUS, and plasma exchange to TTP,to quickly control the condition and improve the clinical symptoms.%目的:探讨小儿血栓性微血管病(TMA)的临床特征、治疗方法及预后。方法对24例TMA患儿的临床表现、辅助检查及治疗方法进行回顾性分析。24例TMA患儿中,溶血尿毒综合征(HUS)22例,血栓性血小板减少性紫癜(TTP)2例。结果16例发病在5~7月,8例发病在9~11月。典型性HUS 8例,非典型性HUS

  19. Atypical haemolytic uraemic syndrome associated with a hybrid complement gene.

    Directory of Open Access Journals (Sweden)

    Julian P Venables

    2006-10-01

    Full Text Available BACKGROUND: Sequence analysis of the regulators of complement activation (RCA cluster of genes at chromosome position 1q32 shows evidence of several large genomic duplications. These duplications have resulted in a high degree of sequence identity between the gene for factor H (CFH and the genes for the five factor H-related proteins (CFHL1-5; aliases CFHR1-5. CFH mutations have been described in association with atypical haemolytic uraemic syndrome (aHUS. The majority of the mutations are missense changes that cluster in the C-terminal region and impair the ability of factor H to regulate surface-bound C3b. Some have arisen as a result of gene conversion between CFH and CFHL1. In this study we tested the hypothesis that nonallelic homologous recombination between low-copy repeats in the RCA cluster could result in the formation of a hybrid CFH/CFHL1 gene that predisposes to the development of aHUS. METHODS AND FINDINGS: In a family with many cases of aHUS that segregate with the RCA cluster we used cDNA analysis, gene sequencing, and Southern blotting to show that affected individuals carry a heterozygous CFH/CFHL1 hybrid gene in which exons 1-21 are derived from CFH and exons 22/23 from CFHL1. This hybrid encodes a protein product identical to a functionally significant CFH mutant (c.3572C>T, S1191L and c.3590T>C, V1197A that has been previously described in association with aHUS. CONCLUSIONS: CFH mutation screening is recommended in all aHUS patients prior to renal transplantation because of the high risk of disease recurrence post-transplant in those known to have a CFH mutation. Because of our finding it will be necessary to implement additional screening strategies that will detect a hybrid CFH/CFHL1 gene.

  20. Habitat Evaluation Procedures (HEP) Report; Gamblin Lake, Technical Report 2005.

    Energy Technology Data Exchange (ETDEWEB)

    Entz, Ray

    2005-05-01

    On August 12, 2003, the Habitat Evaluation Procedure (HEP) was used to determine baseline habitat suitability on the Gamblin Lake property, an acquisition completed by the Kalispel Tribe of Indians in December 2002. Evaluation species and appropriate models include bald eagle, black-capped chickadee, mallard, muskrat, and white-tailed deer. Habitat Suitability Index (HSI) values were visually estimated and agreed upon by all HEP team members. The Gamblin Lake Project provides a total of 273.28 Habitat Units (HUs) for the species evaluated. Conifer forest habitat provides 127.92 HUs for bald eagle, black-capped chickadee, mallard, and white-tailed deer. Forested wetland habitat provides 21.06 HUs for bald eagle, black-caped chickadee, mallard, and white-tailed deer. Wet meadow provides 78.05 HUs for Canada goose and mallard. Emergent wetland habitat provides 46.25 HUs for mallard, muskrat, and Canada goose. The objective of using HEP at the Gamblin Lake Project and other protected properties is to document the quality and quantity of available habitat for selected wildlife species. In this way, HEP provides information on the relative value of the same area at future points in time so that the effect of management activities on wildlife habitat can be quantified. When combined with other tools, the baseline HEP will be used to determine the most effective on-site management, restoration, and enhancement actions to increase habitat suitability for targeted species. The same process will be replicated every five years to quantitatively evaluate the effectiveness of management strategies in improving and maintaining habitat conditions while providing additional crediting to BPA for enhanced habitat values.

  1. Habitat Evaluation Procedures (HEP) Report; Priest River Project, Technical Report 2005.

    Energy Technology Data Exchange (ETDEWEB)

    Entz, Ray

    2005-05-01

    On July 6, 2004, the Habitat Evaluation Procedure (HEP) was used to determine baseline habitat suitability on the Priest River property, an acquisition completed by the Kalispel Tribe of Indians in 2001. Evaluation species and appropriate models include bald eagle, black-capped chickadee, Canada goose, mallard, yellow warbler, and white-tailed deer. Habitat Suitability Index (HSI) values were visually estimated and agreed upon by all HEP team members. The Priest River Project provides a total of 140.73 Habitat Units (HUs) for the species evaluated. Conifer forest habitat provides 60.05 HUs for bald eagle, black-capped chickadee, and white-tailed deer. Grassland meadow habitat provides 7.39 HUs for Canada goose and mallard. Scrub-shrub vegetation provides 71.13 HUs for mallard, yellow warbler, and white-tailed deer. Open water habitat provides 2.16 HUs for Canada goose and mallard. The objective of using HEP at the Priest River Project and other protected properties is to document the quality and quantity of available habitat for selected wildlife species. In this way, HEP provides information on the relative value of the same area at future points in time so that the effect of management activities on wildlife habitat can be quantified. When combined with other tools, the baseline HEP will be used to determine the most effective on-site management, restoration, and enhancement actions to increase habitat suitability for targeted species. The same process will be replicated every five years to quantitatively evaluate the effectiveness of management strategies in improving and maintaining habitat conditions while providing additional crediting to BPA for enhanced habitat values.

  2. Habitat Evaluation Procedures (HEP) Report; North Eaton Lake, Technical Report 2005.

    Energy Technology Data Exchange (ETDEWEB)

    Entz, Ray

    2005-11-01

    On July 6, 2005, the Habitat Evaluation Procedure (HEP) was used to determine baseline habitat suitability on the North Eaton Lake property, an acquisition completed by the Kalispel Tribe of Indians in November 2004. Evaluation species and appropriate models include bald eagle, black-capped chickadee, Canada goose, mallard, muskrat, and white-tailed deer. Habitat Suitability Index (HSI) values were visually estimated and agreed upon by all HEP team members. The North Eaton Lake Project provides a total of 235.05 Habitat Units (HUs) for the species evaluated. Open water habitat provides 9.38 HUs for Canada goose, mallard and muskrat. Emergent wetland habitat provides 11.36 HUs for Canada goose, mallard and muskrat. Forested wetland provides 10.97 HUs for bald eagle, black-capped chickadee, mallard and white-tailed deer. Conifer forest habitat provides 203.34 HUs for bald eagle, black-capped chickadee, mallard, and white-tailed deer. The objective of using HEP at the North Eaton Lake Project and other protected properties is to document the quality and quantity of available habitat for selected wildlife species. In this way, HEP provides information on the relative value of the same area at future points in time so that the effect of management activities on wildlife habitat can be quantified. When combined with other tools, the baseline HEP will be used to determine the most effective on-site management, restoration, and enhancement actions to increase habitat suitability for targeted species. The same process will be replicated every five years to quantitatively evaluate the effectiveness of management strategies in improving and maintaining habitat conditions while providing additional crediting to BPA for enhanced habitat values.

  3. Peripheral gangrene in children with atypical hemolytic uremic syndrome.

    Science.gov (United States)

    Malina, Michal; Gulati, Ashima; Bagga, Arvind; Majid, Mohammad A; Simkova, Eva; Schaefer, Franz

    2013-01-01

    Atypical hemolytic uremic syndrome (aHUS) is a thrombotic microangiopathy with severe clinical manifestation, frequent recurrence, and poor long-term prognosis. It is usually caused by abnormalities in complement regulation. We report 2 cases of children affected by a catastrophic extrarenal complication. A 4-year-old Indian girl developed gangrene of the finger tips 2 days after initial presentation of aHUS. Factor H autoantibodies were identified. Renal function continued to decline despite daily plasma exchanges, and she was started on peritoneal dialysis 5 days after admission. The distal tips of the left hand remained gangrenous with a line of demarcation. Three weeks later, she did not return for follow-up and died at home because of dialysis-related complications. An Arabic girl developed end-stage renal disease due to aHUS in the fourth month after birth. A de novo activating C3 mutation was found. At age 9 months, she suddenly developed ischemic changes in fingers of both hands and several toes. The lesions progressed, and several finger tips became gangrenous despite intense plasma exchange therapy. The decision was made to administer complement blocking therapy with the C5 antibody eculizumab. All nonnecrotic digits rapidly regained perfusion. The 3 already gangrenous fingers healed with loss of the end phalanges. During maintenance, eculizumab aHUS activity subsided completely and some late recovery of renal function was observed. aHUS may present by thrombotic macroangiopathy of small peripheral arteries. Eculizumab appears effective in preserving tissue viability if administered before gangrene occurs and should be considered as first-line rescue therapy in such cases.

  4. Habitat Evaluation Procedures (HEP) Report Wanaket Wildlife Area, Techical Report 2005-2006.

    Energy Technology Data Exchange (ETDEWEB)

    Ashley, Paul

    2006-02-01

    The Regional HEP Team (RHT) and Confederated Tribes of the Umatilla Indian Reservation (CTUIR) Wildlife Program staff conducted a follow-up habitat evaluation procedures (HEP) analysis on the Wanaket Wildlife Management Area in June 2005. The 2005 HEP investigation generated 3,084.48 habitat units (HUs) for a net increase of 752.18 HUs above 1990/1995 baseline survey results. The HU to acre ratio also increased from 0.84:1.0 to 1.16:1.0. The largest increase in habitat units occurred in the shrubsteppe/grassland cover type (California quail and western meadowlark models), which increased from 1,544 HUs to 2,777 HUs (+43%), while agriculture cover type HUs were eliminated because agricultural lands (managed pasture) were converted to shrubsteppe/grassland. In addition to the agriculture cover type, major changes in habitat structure occurred in the shrubsteppe/grassland cover type due to the 2001 wildfire which removed the shrub component from well over 95% of its former range. The number of acres of all other cover types remained relatively stable; however, habitat quality improved in the riparian herb and riparian shrub cover types. The number and type of HEP species models used during the 2005 HEP analysis were identical to those used in the 1990/1995 baseline HEP surveys. The number of species models employed to evaluate the shrubsteppe/grassland, sand/gravel/mud/cobble, and riparian herb cover types, however, were fewer than reported in the McNary Dam Loss Assessment (Rassmussen and Wright 1989) for the same cover types.

  5. Shiga toxin-associated hemolytic uremic syndrome and thrombotic thrombocytopenic purpura: distinct mechanisms of pathogenesis.

    Science.gov (United States)

    Tarr, Phillip I

    2009-02-01

    The hemolytic uremic syndrome (HUS) of childhood is, in its most common form, a non-immune microangiopathic hemolytic anemia. HUS typically follows an enteric infection with a Shiga toxin-producing Escherichia coli, usually belonging to serotype O157:H7. The antecedent infection is almost always manifested as non-bloody diarrhea. In about 80% of cases, the diarrhea becomes bloody between one and five days after the onset of diarrhea. The courses of acute gastrointestinal infections, and of HUS, in adults and children are similar. There are no convincing data that this easily recognizable form of microangiopathy is related to any inborn or acquired deficiency of ADAMTS13, and plasma therapies are not justified on either theoretical or empirical grounds. Similarly, there are no realistic animal data to support use of plasma exchange or infusion in children or adults with, or at risk for, HUS secondary to gastrointestinal infection with E. coli O157:H7. Best clinical practices involve rapid and accurate clinical and microbiological identification of infected patients, volume expansion, and support of the intestinal and extraintestinal complications that can ensue during acute enteric infection and associated HUS. Clinical clues include a sequence of events where the stool becomes bloody after a several-day interval of bloody diarrhea, considerable abdominal pain, five or more stools in the 24 h before presentation, pain on defection, and absence of fever at the time of presentation. Diagnosis should rely primarily on sorbitol MacConkey agar culture. Shiga toxin testing should not be used as the only screen to identify infected patients.

  6. Baseline comparison of three health utility measures and the feeling thermometer among participants in the action to control cardiovascular risk in diabetes trial

    Directory of Open Access Journals (Sweden)

    Raisch Dennis W

    2012-07-01

    Full Text Available Abstract Background Health utility (HU measures are used as overall measures of quality of life and to determine quality adjusted life years (QALYs in economic analyses. We compared baseline values of three HUs including Short Form 6 Dimensions (SF-6D, and Health Utilities Index, Mark II and Mark III (HUI2 and HUI3 and the feeling thermometer (FT among type 2 diabetes participants in the Action to Control Cardiovascular Risk in Diabetes (ACCORD trial. We assessed relationships between HU and FT values and patient demographics and clinical variables. Methods ACCORD was a randomized clinical trial to test if intensive controls of glucose, blood pressure and lipids can reduce the risk of major cardiovascular disease (CVD events in type 2 diabetes patients with high risk of CVD. The health-related quality of life (HRQOL sub-study includes 2,053 randomly selected participants. Interclass correlations (ICCs and agreement between measures by quartile were used to evaluate relationships between HU’s and the FT. Multivariable regression models specified relationships between patient variables and each HU and the FT. Results The ICCs were 0.245 for FT/SF-6D, 0.313 for HUI3/SF-6D, 0.437 for HUI2/SF-6D, 0.338 for FT/HUI2, 0.337 for FT/HUI3 and 0.751 for HUI2/HUI3 (P P P  Conclusions The agreements between the different HUs were poor except for the two HUI measures; therefore HU values derived different measures may not be comparable. The FT had low agreement with HUs. The relationships between HUs and demographic and clinical measures demonstrate how severity of diabetes and other clinical and demographic factors are associated with HUs and FT measures. Trial registration ClinicalTrials.gov Identifier: NCT00000620

  7. Mutations of Factor H Impair Regulation of Surface-bound C3b by Three Mechanisms in Atypical Hemolytic Uremic Syndrome*

    Science.gov (United States)

    Lehtinen, Markus J.; Rops, Angelique L.; Isenman, David E.; van der Vlag, Johan; Jokiranta, T. Sakari

    2009-01-01

    Atypical hemolytic uremic syndrome (aHUS) is a thrombotic microangiopathy associated with mutations in complement proteins, most frequently in the main plasma alternative pathway regulator factor H (FH). The hotspot for the FH mutations is in domains 19–20 (FH19–20) that are indispensable for FH activity on C3b bound covalently to host cells. In aHUS, down-regulation of cell-bound C3b by FH is impaired, but it is not clear whether this is due to an altered FH binding to surface-bound C3b or to cell surface structures. To explore the molecular pathogenesis of aHUS we tested binding of 14 FH19–20 point mutants to C3b and its C3d fragment, mouse glomerular endothelial cells (mGEnC-1), and heparin. The cell binding correlated well, but not fully, with heparin binding and the cell binding site was overlapping but distinct from the C3b/C3d binding site that was shown to extend to domain 19. Our results show that aHUS-associated FH19–20 mutants have different combinations of three primary defects: impaired binding to C3b/C3d, impaired binding to the mGEnC-1 cells/heparin, and, as a novel observation, an enhanced mGEnC-1 cell or heparin binding. We propose a model of the molecular pathogenesis of aHUS where all three mechanisms lead eventually to impaired control of C3b on the endothelial cell surfaces. Based on the results with the aHUS patient mutants and the overlap in FH19–20 binding sites for mGEnC-1/heparin and C3b/C3d we conclude that binding of FH19–20 to C3b/C3d is essential for target discrimination by the alternative pathway. PMID:19351878

  8. Escherichia coli O-157-induced hemolytic uremic syndrome: Usefulness of SCWP score for the prediction of neurological complication.

    Science.gov (United States)

    Teramoto, Takahide; Fukao, Toshiyuki; Hirayama, Kouichiro; Asano, Tsutomu; Aoki, Yusuke; Kondo, Naomi

    2009-02-01

    Hemolytic uremic syndrome (HUS) is commonly caused by hemorrhagic colitis with Shiga toxin-producing Escherichia coli O-157. Central nervous system (CNS) involvements, including seizures, encephalopathy and brain infarction, are serious complications, but there are no useful scores for the prediction of CNS complications. Routine laboratory data at onset of HUS were re-evaluated in 14 patients to find useful parameters for the prediction of CNS complication. Serum sodium and total protein were significantly lower and C-reactive protein (CRP) and white blood cell counts were significantly higher in patients with CNS complications than in patients without. A cumulated score, SCWP score (sodium, CRP, white blood cell count, and total protein) discriminated better between patients with/without CNS complications than individual values. SCWP score would be useful for prediction of CNS complications.

  9. Atypical hemolytic-uremic syndrome: a case report and literature review.

    Science.gov (United States)

    Rafiq, Arsalan; Tariq, Hassan; Abbas, Naeem; Shenoy, Roopalekha

    2015-02-24

    Atypical hemolytic uremic syndrome (aHUS) is a rare disease characterized by hemolysis, thrombocytopenia, and renal dysfunction. It is a disease related to genetic mutations in the alternative complement pathway and has a distinct pathophysiology but is difficult to differentiate from other thrombotic microangiopathies. We present a case of a 59-year-old female patient who presented with accelerated hypertension, acute renal failure, hemolysis, and encephalopathy. She was managed with antihypertensive medication, but her encephalopathy did not improve. Evaluation resulted in our impression of the disease being atypical hemolytic-uremic syndrome. The patient continued to be managed with good blood pressure control and later was started on eculizumab, but evaluation of response to therapy was hindered by the patient's non-compliance with therapy and follow-up appointments. We have a very limited understanding of the genetics and epidemiology of atypical HUS, and the overlapping clinical features sometimes delay diagnosis and initiation of appropriate treatment of this rare disease.

  10. Colville Confederated Tribes' Performance Project Wildlife Mitigation Acquisitions, Annual Report 2006.

    Energy Technology Data Exchange (ETDEWEB)

    Whitney, Richard; Berger, Matthew; Tonasket, Patrick

    2006-12-01

    The Colville Confederated Tribes Wildlife Mitigation Project is protecting lands as partial mitigation for hydropower's share of the wildlife losses resulting from Chief Joseph and Grand Coulee Dams. The Mitigation Project protects and manages 54,606 acres for the biological requirements of managed wildlife species that are important to the Colville Tribes. With the inclusion of 2006 acquisitions, the Colville Tribes have acquired approximately 32,018 habitat units (HUs) towards a total 35,819 HUs lost from original inundation due to hydropower development. This annual report for 2006 briefly describes that four priority land acquisitions that were considered for enrollment into the Colville Tribes Mitigation Project during the 2006 contract period.

  11. Yeast Interacting Proteins Database: YLR288C, YMR159C [Yeast Interacting Proteins Database

    Lifescience Database Archive (English)

    Full Text Available p loader complex; homolog of human and S. pombe Hus1 Rows with this bait as bait (4) Rows with this bait as ...tes to form Atg12p-Atg5p-Atg16p multimers, which localize to the pre-autophagosomal structure and are required for autophagy Row...s with this prey as prey (3) Rows with this prey as bait (3) 42 11 4 7 1 0 0 0 0 - - - -...that forms a sliding clamp, loaded onto partial duplex DNA by a clamp loader complex; homolog of human and S. pombe Hus1 Row...s with this bait as bait Rows with this bait as bait (4) Rows with this bait as prey Row

  12. Therapeutic plasmapheresis using membrane plasma separation.

    Science.gov (United States)

    Sinha, Aditi; Tiwari, Anand Narain; Chanchlani, Rahul; Seetharamanjaneyulu, V; Hari, Pankaj; Bagga, Arvind

    2012-08-01

    The authors present their experience with therapeutic plasmapheresis (TPE) using membrane filters at the pediatric dialysis unit of a referral center. Between January 2006 and December 2010, 486 sessions of TPE were performed in 39 patients (range 6-17 y), chiefly for atypical hemolytic uremic syndrome (HUS, n = 22), crescentic glomerulonephritis (n = 8) and focal segmental glomerulosclerosis (n = 5). Satisfactory response was noted in 32 patients, particularly with HUS (n = 22) or crescentic glomerulonephritis (n = 6). Adverse effects included chills or urticaria (n = 8 sessions), hypocalcemia (n = 6) and hypotension (n = 5). The present findings highlight the safety, efficacy and feasibility of TPE using membrane filtration.

  13. Sestak og Obamas høstak

    DEFF Research Database (Denmark)

    Kurrild-Klitgaard, Peter

    2010-01-01

    I februar fortalte et Demokratisk kongresmedlem, fhv. admiral Joe Sestak i et TV-interview, at »nogen i Det Hvide Hus« havde tilbudt ham »et job«, og han afviste ikke, at det kunne være som flådeminister. Det var nok uden at gennemskue perspektiverne - eller også var det blær.......I februar fortalte et Demokratisk kongresmedlem, fhv. admiral Joe Sestak i et TV-interview, at »nogen i Det Hvide Hus« havde tilbudt ham »et job«, og han afviste ikke, at det kunne være som flådeminister. Det var nok uden at gennemskue perspektiverne - eller også var det blær....

  14. ADAMTS-13 deficiency following Hemiscorpius lepturus scorpion sting

    Directory of Open Access Journals (Sweden)

    Ehsan Valavi

    2011-01-01

    Full Text Available Hemiscorpius lepturus is a lethal scorpion with potentially cytotoxic venom. Various degrees of local and systemic toxicity have been observed after its envenomation ranging from local erythema to disseminated intravascular coagulation, renal failure and severe pulmonary hemorrhage. In this case report, we report on a seven-year-old patient who developed the hemolytic uremic syndrome (HUS after being stung by the scorpion H. lepturus. This condition is characterized by microangiopathic hemolytic anemia, thrombocytopenia, increased serum levels of lactate dehydrogenase and uremia. We evaluated the causes of HUS and found that the levels of C3, C4, CH50 and H factors were normal, but the activity of Von Willebrand factor cleaving protease was decreased (less than 5% of the normal activity. The patient improved after administering therapy with plasma exchange.

  15. Adjustment of Eculizumab Dosage Pattern in Patients with Atypical Hemolytic Uremic Syndrome with Suboptimal Response to Standard Treatment Pattern

    Directory of Open Access Journals (Sweden)

    Camino García Monteavaro

    2016-01-01

    Full Text Available In patients with atypical hemolytic uremic syndrome (aHUS, complement blocking by eculizumab rapidly halts the process of thrombotic microangiopathy and it is associated with clear long-term hematologic and renal improvements. Eculizumab treatment consists of a 4-week initial phase with weekly IV administration of 900 mg doses, followed by a maintenance phase with a 1,200 mg dose in the fifth week and every 14±2 days thereafter. We present three patients with aHUS and suboptimal response to eculizumab treatment at the usual administration dosage who showed hematologic and renal improvements after an adjustment in the eculizumab treatment protocol.

  16. Stop ufolkeligt projekt - mens det går godt

    DEFF Research Database (Denmark)

    Vagnby, Bo Hellisen

    2004-01-01

    Konkurrencen om Musikkens Hus på Aalborg Havn er løbet ind i store vanskeligheder med hensyn til overholdelse af prisoverslaget på ca. 460 mio. kr. Dette har medført en kraftig revision af vinderprojektet udarbejdet af det østrigske arkitektfirma Coop Himmelb(l)au. I indlægget plæderes for at udn......Konkurrencen om Musikkens Hus på Aalborg Havn er løbet ind i store vanskeligheder med hensyn til overholdelse af prisoverslaget på ca. 460 mio. kr. Dette har medført en kraftig revision af vinderprojektet udarbejdet af det østrigske arkitektfirma Coop Himmelb(l)au. I indlægget plæderes...

  17. Chemiluminescence determination of antioxidant property of Zizyphus mistol and Prosopis alba during oxidative stress generated in blood by Hemolytic Uremic Syndrome-producing Escherichia coli.

    Science.gov (United States)

    Albrecht, Claudia; Pellarin, María G; Baronetti, José; Rojas, María J; Albesa, Inés; Eraso, Alberto J

    2011-01-01

    This study was undertaken to elucidate the antioxidant effect of Zizyphus mistol and Prosopis alba, with the hypothesis that these fruits can counteract the induction of reactive oxygen species (ROS) caused by toxins produced by Escherichia coli. In the search of nutrients effective against the Hemolytic Uremic Syndrome (HUS), we detected by chemiluminescence a protective role of both plants, due to their natural antioxidants significantly decreasing the levels of ROS induced by toxins from E. coli in blood. The ferric reducing antioxidant power (FRAP) was found to be higher in Z. mistol than in P. alba. The chemical analyses of the phenols and flavonoids present in the fruit extracts indicated that the FRAP correlated with the amount of phenolic compounds, but not with the flavonoids analyzed. Both fruits studied reduce the induction of ROS, and in this way help to prevent the development of complications related to oxidative stress generated in the blood of patients with HUS.

  18. Belatacept for Maintenance Immunosuppression in Lung Transplantation

    Directory of Open Access Journals (Sweden)

    Christine Hui PharmD

    2014-06-01

    Full Text Available Belatacept is a novel immunosuppressant that blocks a T-cell costimulation pathway and is approved for use in adult kidney transplant recipients. Its safety and efficacy have not been established after lung transplantation. We present a case of a lung transplant recipient treated with belatacept. A 56-year-old man underwent bilateral lung retransplantation for bronchiolitis obliterans syndrome (BOS. In the third year posttransplant, he developed hemolytic uremic syndrome (HUS attributed to tacrolimus. Tacrolimus was changed to sirolimus. One month later, he presented with worsening renal function and HUS attributed to sirolimus. Plasmapheresis and steroid pulse were initiated with clinical improvement, and sirolimus was switched to belatacept. He experienced no episodes of cellular rejection but developed recurrent BOS. Complications during treatment included anemia and recurrent pneumonias. The safety and efficacy of belatacept in lung transplantation remains unclear; further studies are needed.

  19. Habitat Evaluation Procedures (HEP) Report; Upper Trimble Project, Technical Report 2004-2005.

    Energy Technology Data Exchange (ETDEWEB)

    Entz, Ray

    2005-02-01

    On July 13, 2004, the Habitat Evaluation Procedure (HEP) was used to determine baseline habitat suitability on the Upper Trimble property, an acquisition completed by the Kalispel Tribe of Indians in March 2004. Evaluation species and appropriate models include bald eagle, black-capped chickadee, Canada goose, mallard, muskrat, yellow warbler, and white-tailed deer. Habitat Suitability Index (HSI) values were visually estimated and agreed upon by all HEP team members. The Upper Trimble Project provides a total of 250.67 Habitat Units (HUs) for the species evaluated. Wet meadow provides 136.92 HUs for mallard, muskrat, and Canada goose. Mixed forest habitat provides 111.88 HUs for bald eagle, black-capped chickadee, mallard, and white-tailed deer. Scrub-shrub vegetation provides 1.87 HUs for yellow warbler, and white-tailed deer. The objective of using HEP at the Upper Trimble Project and other protected properties is to document the quality and quantity of available habitat for selected wildlife species. In this way, HEP provides information on the relative value of the same area at future points in time so that the effect of management activities on wildlife habitat can be quantified. When combined with other tools, the baseline HEP will be used to determine the most effective on-site management, restoration, and enhancement actions to increase habitat suitability for targeted species. The same process will be replicated every five years to quantitatively evaluate the effectiveness of management strategies in improving and maintaining habitat conditions while providing additional crediting to BPA for enhanced habitat values.

  20. Habitat Evaluation Procedures (HEP) Report; West Beaver Lake Project, Technical Report 2005

    Energy Technology Data Exchange (ETDEWEB)

    Entz, Ray

    2005-05-01

    On September 7, 2004, the Habitat Evaluation Procedure (HEP) was used to determine baseline habitat suitability on the West Beaver Lake property, an acquisition completed by the Kalispel Tribe of Indians in September 2004. Evaluation species and appropriate models include bald eagle, black-capped chickadee, mallard, muskrat, and white-tailed deer. Habitat Suitability Index (HSI) values were visually estimated and agreed upon by all HEP team members. The West Beaver Lake Project provides a total of 82.69 Habitat Units (HUs) for the species evaluated. Emergent wetland habitat provides 8.80 HUs for mallard, muskrat, and Canada goose. Conifer forest habitat provides 70.33 HUs for bald eagle, black-capped chickadee, mallard, and white-tailed deer. Open water provides 3.30 HUs for mallard, muskrat, and Canada goose. The objective of using HEP at the West Beaver Lake Project and other protected properties is to document the quality and quantity of available habitat for selected wildlife species. In this way, HEP provides information on the relative value of the same area at future points in time so that the effect of management activities on wildlife habitat can be quantified. When combined with other tools, the baseline HEP will be used to determine the most effective on-site management, restoration, and enhancement actions to increase habitat suitability for targeted species. The same process will be replicated every five years to quantitatively evaluate the effectiveness of management strategies in improving and maintaining habitat conditions while providing additional crediting to BPA for enhanced habitat values.

  1. NCBI nr-aa BLAST: CBRC-OANA-01-2156 [SEVENS

    Lifescience Database Archive (English)

    Full Text Available CBRC-OANA-01-2156 gb|AAF87984.1|AF252554_1 CC chemokine receptor 5 [Callithrix jacc...hus] gb|AAK43361.1|AF177878_1 C-C chemokine receptor 5 [Callithrix jacchus] gb|AAN14530.1|AF452614_1 chemokine receptor CCR5 [Call...ithrix jacchus] gb|AAQ20011.1| CC chemokine receptor 5 [Callithrix jacchus] AAF87984.1 1e-145 69% ...

  2. NCBI nr-aa BLAST: CBRC-OANA-01-2157 [SEVENS

    Lifescience Database Archive (English)

    Full Text Available CBRC-OANA-01-2157 gb|AAF87984.1|AF252554_1 CC chemokine receptor 5 [Callithrix jacc...hus] gb|AAK43361.1|AF177878_1 C-C chemokine receptor 5 [Callithrix jacchus] gb|AAN14530.1|AF452614_1 chemokine receptor CCR5 [Call...ithrix jacchus] gb|AAQ20011.1| CC chemokine receptor 5 [Callithrix jacchus] AAF87984.1 1e-141 70% ...

  3. NCBI nr-aa BLAST: CBRC-CJAC-01-0968 [SEVENS

    Lifescience Database Archive (English)

    Full Text Available CBRC-CJAC-01-0968 gb|AAF87984.1|AF252554_1 CC chemokine receptor 5 [Callithrix jacc...hus] gb|AAK43361.1|AF177878_1 C-C chemokine receptor 5 [Callithrix jacchus] gb|AAN14530.1|AF452614_1 chemokine receptor CCR5 [Call...ithrix jacchus] gb|AAQ20011.1| CC chemokine receptor 5 [Callithrix jacchus] AAF87984.1 0.0 100% ...

  4. NCBI nr-aa BLAST: CBRC-TBEL-01-2360 [SEVENS

    Lifescience Database Archive (English)

    Full Text Available CBRC-TBEL-01-2360 gb|AAF87984.1|AF252554_1 CC chemokine receptor 5 [Callithrix jacc...hus] gb|AAK43361.1|AF177878_1 C-C chemokine receptor 5 [Callithrix jacchus] gb|AAN14530.1|AF452614_1 chemokine receptor CCR5 [Call...ithrix jacchus] gb|AAQ20011.1| CC chemokine receptor 5 [Callithrix jacchus] AAF87984.1 1e-161 77% ...

  5. Unit 1A: General Approach to the Teaching of Architecture

    DEFF Research Database (Denmark)

    Gammelgaard Nielsen, Anders

    2011-01-01

    An ideal course Ever since the founding of the Aar- hus School of Architecture in 1965 there has been a tradition for lively discussion surrounding the content of the architecture program. The discussion has often been con- ducted from ideological or norma- tive positions, with the tendency to st...... never brought us any closer to the truth about the ideal architectural paradigm. Exper- imentation and the continuing em- pirical construction of knowledge have, on the other hand, constantly developed the degree course....

  6. Molecular microbiological investigation of an outbreak of hemolytic-uremic syndrome caused by dry fermented sausage contaminated with Shiga-like toxin-producing Escherichia coli.

    Science.gov (United States)

    Paton, A W; Ratcliff, R M; Doyle, R M; Seymour-Murray, J; Davos, D; Lanser, J A; Paton, J C

    1996-01-01

    Shiga-like toxin-producing Escherichia coli (SLTEC) strains are a diverse group of organisms which are known to cause diarrhea and hemorrhagic colitis in humans. This can lead to potentially fatal systemic sequelae, such as hemolytic-uremic syndrome (HUS). Strains belonging to more than 100 different O:H serotypes have been associated with severe SLTEC disease in humans, of which only O157 strains (which are uncommon in Australia) have a distinguishable cultural characteristic (sorbitol negative). During an outbreak of HUS in Adelaide, South Australia, a sensitive PCR assay specific for Shiga-like toxin genes (slt) was used to test cultures of feces and suspected foods. This enabled rapid confirmation of infection and identified a locally produced dry fermented sausage (mettwurst) as the source of infection. Cultures of feces from 19 of 21 HUS patients and 7 of 8 mettwurst samples collected from their homes were PCR positive for slt-I and slt-II genes. SLTEC isolates belonging to serotype O111:H- was subsequently isolated from 16 patients and 4 mettwurst samples. Subsequent restriction fragment length polymorphism analysis of chromosomal DNA from these isolates with slt-specific probes indicated that at least three different O111:H- genotypes were associated with the outbreak. Pulsed-field gel electrophoresis of genomic DNA restricted with XbaI showed that two of these restriction fragment length polymorphism types were closely related, but the third was quite distinct. However, SLTEC strains of other serotypes, including O157:H-, were also isolated from some of the HUS patients. PMID:8784557

  7. U.S. Navy Hindcast Spectral Ocean Wave Model Climatic Atlas: North Atlantic Ocean

    Science.gov (United States)

    1983-10-01

    V L BT E N E E T O R N E VL BETWEEN EVENT t6 46 20-1 j341 a w 222M Z17 t2 HOURS NTRVAL BETWEEN EVENTS n 036 42 485 06 27 49~6 HOR NERVAL BETWEEN EVET...USUAI \\[VET V - OR NERVALS -BETWEEN E -- 2z-. t -There wereiB8 12-hour inevlsbtee-vnt\\ ta-? 0.02 persisted 12-hus 3evnspristed \\\\ 1 soe OO6; 2

  8. Detection of attaching and effacing virulence gene of E. coli

    OpenAIRE

    Maratu Soleha

    2013-01-01

    AbstrakLatar belakang: Bakteri Escherichia coli (E. coli) ada yang telah bermutasi menjadi patogen yang menimbulkan berbagai penyakit seperti hemorrhagic colitis (HC), hemolytic uremic syndrome (HUS), sepsis, pnemonia, neonatal meningitis, dan infeksi saluran kemih. Mutasi terjadi karena bakteri ini menerima transfer gen yang virulen dari bakteri lain yang hidup di sekitarnya. E. coli yang biasanya hidup normal di dalam usus manusia telah beradaptasi sehingga bisa hidup di tanah, makanan, dan...

  9. Formação profissional e mediação pedagógica na era digital: educar para os meios e os meios para educar

    OpenAIRE

    Cruz, José Anderson Santos [UNESP

    2015-01-01

    This research had set the growth of postgraduate courses in Didactics and methodology of higher education, techonological advances in a globalised society with educational transformations. hus, to address, discuss and show the necessity of the professor/teacher to understand the current technological advances, in order to integrate with contemporary digital technologies. In this sense it is essential and relevant to the use of information and communication technologies (ICT), particularly the...

  10. Maternal and fetal outcome among pregnant women presenting with thrombocytopenia

    Directory of Open Access Journals (Sweden)

    Vikrant Chauhan

    2016-08-01

    Conclusions: In pregnancy with thrombocytopenia, gestational thrombocytopenia is the commonest and benign condition which does not alter the obstetrical management. Still a vigil should be kept on maternal platelet count in antenatal period to prevent unfavorable outcome in serious conditions that may require specific and urgent management (HELLP syndrome, severe pre-eclampsia, TTP, HUS and acute fatty liver of pregnancy. [Int J Reprod Contracept Obstet Gynecol 2016; 5(8.000: 2736-2743

  11. Sestak og Obamas høstak

    DEFF Research Database (Denmark)

    Kurrild-Klitgaard, Peter

    2010-01-01

    Den næste store skandale i Washington handler om en fortalelse. I februar fortalte et Demokratisk kongresmedlem, fhv. admiral Joe Sestak i et TV-interview, at »nogen i Det Hvide Hus« havde tilbudt ham »et job«, og han afviste ikke, at det kunne være som flådeminister. Det var nok uden at gennemskue...

  12. MO-C-17A-05: A Three-Dimensional Head-And-Neck Phantom for Validation of Kilovoltage- and Megavoltage-Based Deformable Image Registration

    Energy Technology Data Exchange (ETDEWEB)

    Kirby, N; Singhrao, K; Pouliot, J [UC San Francisco, San Francisco, CA (United States)

    2014-06-15

    Purpose: To develop a three-dimensional (3D) deformable head-and-neck (H and N) phantom with realistic tissue contrast for both kilovoltage and megavoltage computed tomography and use it to objectively evaluate deformable image registration (DIR) algorithms. Methods: The phantom represents H and N patient anatomy. It is constructed from thermoplastic, which becomes pliable in boiling water, and hardened epoxy resin. Using a system of additives, the Hounsfield unit (HU) values of these materials were tuned to mimic anatomy for both kilovoltage (kV) and megavoltage (MV) imaging. The phantom opened along a sagittal midsection to reveal nonradiopaque markers, which were used to characterize the phantom deformation. The deformed and undeformed phantom was scanned with kV and MV computed tomography. Additionally, a calibration curve was created to change the HUs of the MV scans to be similar to kV HUs, (MC). The extracted ground-truth deformation was then compared to the results of two commercially available DIR algorithms, from Velocity Medical Solutions and MIM Software. Results: The phantom produced a 3D deformation, representing neck flexion, with a magnitude of up to 8 mm and was able represent tissue HUs for both kV and MV imaging modalities. The two tested deformation algorithms yielded vastly different results. For kV-kV registration, MIM made the lowest mean error, and Velocity made the lowest maximum error. For MV-MV, kV-MV, and kV-MC Velocity produced both the lowest mean and lowest maximum errors. Conclusion: The application of DIR across different imaging modalities is particularly difficult, due to differences in tissue HUs and the presence of imaging artifacts. For this reason, DIR algorithms must be validated specifically for this purpose. The developed H and N phantom is an effective tool for this purpose.

  13. Dicty_cDB: Contig-U05215-1 [Dicty_cDB

    Lifescience Database Archive (English)

    Full Text Available 2 7e-06 DQ888702_1( DQ888702 |pid:none) Odocoileus virginianus SRY (sry) g... 52 7e-06 DQ173697_1( DQ173697 ...hus sex-determin... 52 7e-06 EF062529_1( EF062529 |pid:none) Odocoileus hemionus ...062550_1( EF062550 |pid:none) Odocoileus virginianus isolate WWT... 52 7e-06 AB275394_1( AB275394 |pid:none)

  14. Shiga toxin-induced complement-mediated hemolysis and release of complement-coated red blood cell-derived microvesicles in hemolytic uremic syndrome.

    Science.gov (United States)

    Arvidsson, Ida; Ståhl, Anne-Lie; Hedström, Minola Manea; Kristoffersson, Ann-Charlotte; Rylander, Christian; Westman, Julia S; Storry, Jill R; Olsson, Martin L; Karpman, Diana

    2015-03-01

    Shiga toxin (Stx)-producing Escherichia coli (STEC) cause hemolytic uremic syndrome (HUS). This study investigated whether Stx2 induces hemolysis and whether complement is involved in the hemolytic process. RBCs and/or RBC-derived microvesicles from patients with STEC-HUS (n = 25) were investigated for the presence of C3 and C9 by flow cytometry. Patients exhibited increased C3 deposition on RBCs compared with controls (p microvesicles during the acute phase, which decreased after recovery. Stx2 bound to P1 (k) and P2 (k) phenotype RBCs, expressing high levels of the P(k) Ag (globotriaosylceramide), the known Stx receptor. Stx2 induced the release of hemoglobin and lactate dehydrogenase in whole blood, indicating hemolysis. Stx2-induced hemolysis was not demonstrated in the absence of plasma and was inhibited by heat inactivation, as well as by the terminal complement pathway Ab eculizumab, the purinergic P2 receptor antagonist suramin, and EDTA. In the presence of whole blood or plasma/serum, Stx2 induced the release of RBC-derived microvesicles coated with C5b-9, a process that was inhibited by EDTA, in the absence of factor B, and by purinergic P2 receptor antagonists. Thus, complement-coated RBC-derived microvesicles are elevated in HUS patients and induced in vitro by incubation of RBCs with Stx2, which also induced hemolysis. The role of complement in Stx2-mediated hemolysis was demonstrated by its occurrence only in the presence of plasma and its abrogation by heat inactivation, EDTA, and eculizumab. Complement activation on RBCs could play a role in the hemolytic process occurring during STEC-HUS. Copyright © 2015 by The American Association of Immunologists, Inc.

  15. Commensal E. coli Stx2 lysogens produce high levels of phages after spontaneous prophage induction.

    Science.gov (United States)

    Iversen, Hildegunn; L' Abée-Lund, Trine M; Aspholm, Marina; Arnesen, Lotte P S; Lindbäck, Toril

    2015-01-01

    Enterohemorrhagic E. coli (EHEC) is a food-borne pathogen that causes disease ranging from uncomplicated diarrhea to life-threatening hemolytic uremic syndrome (HUS) and nervous system complications. Shiga toxin 2 (Stx2) is the major virulence factor of EHEC and is critical for development of HUS. The genes encoding Stx2 are carried by lambdoid bacteriophages and the toxin production is tightly linked to the production of phages during lytic cycle. It has previously been suggested that commensal E. coli could amplify the production of Stx2-phages and contribute to the severity of disease. In this study we examined the susceptibility of commensal E. coli strains to the Stx2-converting phage ϕ734, isolated from a highly virulent EHEC O103:H25 (NIPH-11060424). Among 38 commensal E. coli strains from healthy children below 5 years, 15 were lysogenized by the ϕ734 phage, whereas lytic infection was not observed. Three of the commensal E. coli ϕ734 lysogens were tested for stability, and appeared stable and retained the phage for at least 10 cultural passages. When induced to enter lytic cycle by H2O2 treatment, 8 out of 13 commensal lysogens produced more ϕ734 phages than NIPH-11060424. Strikingly, five of them even spontaneously (non-induced) produced higher levels of phage than the H2O2 induced NIPH-11060424. An especially high frequency of HUS (60%) was seen among children infected by NIPH-11060424 during the outbreak in 2006. Based on our findings, a high Stx2 production by commensal E. coli lysogens cannot be ruled out as a contributor to the high frequency of HUS during this outbreak.

  16. Shiga toxin-converting phages and the emergence of new pathogenic Escherichia coli: a world in motion

    Science.gov (United States)

    Tozzoli, Rosangela; Grande, Laura; Michelacci, Valeria; Ranieri, Paola; Maugliani, Antonella; Caprioli, Alfredo; Morabito, Stefano

    2014-01-01

    Shiga toxin (Stx)-producing Escherichia coli (STEC) are pathogenic E. coli causing diarrhea, hemorrhagic colitis (HC) and hemolytic uremic syndrome (HUS). STEC are characterized by a constellation of virulence factors additional to Stx and have long been regarded as capable to cause HC and HUS when possessing the ability of inducing the attaching and effacing (A/E) lesion to the enterocyte, although strains isolated from such severe infections sometimes lack this virulence feature. Interestingly, the capability to cause the A/E lesion is shared with another E. coli pathogroup, the Enteropathogenic E. coli (EPEC). In the very recent times, a different type of STEC broke the scene causing a shift in the paradigm for HUS-associated STEC. In 2011, a STEC O104:H4 caused a large outbreak with more than 800 HUS and 50 deaths. Such a strain presented the adhesion determinants of Enteroaggregative E. coli (EAggEC). We investigated the possibility that, besides STEC and EAggEC, other pathogenic E. coli could be susceptible to infection with stx-phages. A panel of stx2-phages obtained from STEC isolated from human disease was used to infect experimentally E. coli strains representing all the known pathogenic types, including both diarrheagenic E. coli (DEC) and extra-intestinal pathogenic E. coli (ExPEC). We observed that all the E. coli pathogroups used in the infection experiments were susceptible to the infection. Our results suggest that the stx2-phages used may not have specificity for E. coli adapted to the intestinal environment, at least in the conditions used. Additionally, we could only observe transient lysogens suggesting that the event of stable stx2-phage acquisition occurs rarely. PMID:24999453

  17. Fatal case of hemolytic-uremic syndrome in an adult due to a rare serogroup O91 Entero hemorrhagic Escherichia coli associated with a Clostridium difficile infection. More than meets the eye.

    Science.gov (United States)

    Guillard, Thomas; Limelette, Anne; Le Magrex-Debar, Elisabeth; Wynckel, Alain; Gouali, Malika; Mariani-Kurkdjian, Patricia; Guyot-Colosio, Charlotte; de Champs, Christophe

    2015-08-01

    Hemolytic-uremic syndrome due to enterohemorrhagic Escherichia coli, belonging to serogroup O91 has rarely been described. We report here a case of post-diarrheal HUS due to EHEC O91 in an elderly patient for whom diagnosis was delayed given a previously diagnosed C. difficile infection. This case highlights the usefulness of Shiga-toxin detection. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

  18. Enterohemorrhagic E. coli (EHEC) pathogenesis

    OpenAIRE

    Vanessa eSperandio; Y eNguyen

    2012-01-01

    Enterohemorrhagic Escherichia coli (EHEC) serotype O157:H7 is a human pathogen responsible for outbreaks of bloody diarrhea and hemolytic uremic syndrome (HUS) worldwide. Conventional antimicrobials trigger an SOS response in EHEC that promotes the release of the potent Shiga toxin that is responsible for much of the morbidity and mortality associated with EHEC infection. Cattle are a natural reservoir of EHEC, and approximately 75% of EHEC outbreaks are linked to the consumption of contamina...

  19. Action of shiga toxin type-2 and subtilase cytotoxin on human microvascular endothelial cells.

    Directory of Open Access Journals (Sweden)

    María M Amaral

    Full Text Available The hemolytic uremic syndrome (HUS associated with diarrhea is a complication of Shiga toxin (Stx-producing Escherichia coli (STEC infection. In Argentina, HUS is endemic and responsible for acute and chronic renal failure in children younger than 5 years old. The human kidney is the most affected organ due to the presence of very Stx-sensitive cells, such as microvascular endothelial cells. Recently, Subtilase cytotoxin (SubAB was proposed as a new toxin that may contribute to HUS pathogenesis, although its action on human glomerular endothelial cells (HGEC has not been described yet. In this study, we compared the effects of SubAB with those caused by Stx2 on primary cultures of HGEC isolated from fragments of human pediatric renal cortex. HGEC were characterized as endothelial since they expressed von Willebrand factor (VWF and platelet/endothelial cell adhesion molecule 1 (PECAM-1. HGEC also expressed the globotriaosylceramide (Gb3 receptor for Stx2. Both, Stx2 and SubAB induced swelling and detachment of HGEC and the consequent decrease in cell viability in a time-dependent manner. Preincubation of HGEC with C-9 -a competitive inhibitor of Gb3 synthesis-protected HGEC from Stx2 but not from SubAB cytotoxic effects. Stx2 increased apoptosis in a time-dependent manner while SubAB increased apoptosis at 4 and 6 h but decreased at 24 h. The apoptosis induced by SubAB relative to Stx2 was higher at 4 and 6 h, but lower at 24 h. Furthermore, necrosis caused by Stx2 was significantly higher than that induced by SubAB at all the time points evaluated. Our data provide evidence for the first time how SubAB could cooperate with the development of endothelial damage characteristic of HUS pathogenesis.

  20. Inherited complement regulatory protein deficiency predisposes to human disease in acute injury and chronic inflammatory statesthe examples of vascular damage in atypical hemolytic uremic syndrome and debris accumulation in age-related macular degeneration.

    Science.gov (United States)

    Richards, Anna; Kavanagh, David; Atkinson, John P

    2007-01-01

    In this chapter, we examine the role of complement regulatory activity in atypical hemolytic uremic syndrome (aHUS) and age-related macular degeneration (AMD). These diseases are representative of two distinct types of complement-mediated injury, one being acute and self-limited, the other reflecting accumulation of chronic damage. Neither condition was previously thought to have a pathologic relationship to the immune system. However, alterations in complement regulatory protein genes have now been identified as major predisposing factors for the development of both diseases. In aHUS, heterozygous mutations leading to haploinsufficiency and function-altering polymorphisms in complement regulators have been identified, while in AMD, polymorphic haplotypes in complement genes are associated with development of disease. The basic premise is that a loss of function in a plasma or membrane inhibitor of the alternative complement pathway allows for excessive activation of complement on the endothelium of the kidney in aHUS and on retinal debris in AMD. These associations have much to teach us about the host's innate immune response to acute injury and to chronic debris deposition. We all experience cellular injury and, if we live long enough, will deposit debris in blood vessel walls (atherosclerosis leading to heart attacks and strokes), the brain (amyloid proteins leading to Alzheimer's disease), and retina (lipofuscin pigments leading to AMD). These are three common causes of morbidity and mortality in the developed world. The clinical, genetic, and immunopathologic understandings derived from the two examples of aHUS and AMD may illustrate what to anticipate in related conditions. They highlight how a powerful recognition and effector system, the alternative complement pathway, reacts to altered self. A response to acute injury or chronic debris accumulation must be appropriately balanced. In either case, too much activation or too little regulation promotes

  1. Atypical hemolytic uremic syndrome diagnosed four years after ABO-incompatible kidney transplantation.

    Science.gov (United States)

    Kawaguchi, Keiko; Kawanishi, Kunio; Sato, Masayo; Itabashi, Mitsuyo; Fujii, Akiko; Kanetsuna, Yukiko; Huchinoue, Shouhei; Ohashi, Ryuji; Koike, Junki; Honda, Kazuho; Nagashima, Yoji; Nitta, Kosaku

    2015-07-01

    Atypical hemolytic uremic syndrome (aHUS) in allograft kidney transplantation is caused by various factors including rejection, infection, and immunosuppressive drugs. We present a case of a 32 year old woman with aHUS four years after an ABO-incompatible kidney transplantation from a living relative. The primary cause of end-stage renal disease was unknown; however, IgA nephropathy (IgAN) was suspected from her clinical course. She underwent pre-emptive kidney transplantation from her 60 year old mother. The allograft preserved good renal function [serum creatinine (sCr) level 110-130 μmol/L] until a sudden attack of abdominal pain four years after transplant, with acute renal failure (sCr level, 385.3 μmol/L), decreasing platelet count, and hemolytic anemia with schizocytes. On allograft biopsy, there was thrombotic microangiopathy in the glomeruli, with a cellular crescent formation and mesangial IgA and C3 deposition. Microvascular inflammation, such as glomerulitis, peritubular capillaritis, and arteriole endarteritis were also detected. A disintegrin-like and metalloproteinase with thrombospondin type 1 motifs 13 (ADAMTS13) did not decrease and Shiga toxin was not detected. Donor-specific antibodies or autoantibodies, including anti-neutrophil cytoplasmic antibody and anti-glomerular basement membrane (anti-GBM) antibody, were negative. The patient was diagnosed with aHUS and received three sessions of plasmapheresis and methylprednisolone pulse therapy, followed by oral methylprednisolone (0.25-0.5 mg/kg) instead of tacrolimus. She temporarily required hemodialysis (sCr level, 658.3 μmol/L). Thereafter, her sCr level improved to 284.5 μmol/L without dialysis therapy. This case is clinically considered as aHUS after kidney transplantation, associated with various factors, including rejection, glomerulonephritis, and toxicity from drugs such as tacrolimus.

  2. Tumor necrosis factor-α modifies the effects of Shiga toxin on glial cells.

    Science.gov (United States)

    Leu, Hue; Sugimoto, Naotoshi; Shimizu, Masaki; Toma, Tomoko; Wada, Taizo; Ohta, Kunio; Yachie, Akihiro

    2016-09-01

    Shiga toxin (STX) is one of the main factors inducing hemorrhagic colitis and hemolytic-uremic syndrome (HUS) in infections with STX-producing Escherichia coli (STEC). Approximately 62% of patients with HUS showed symptoms of encephalopathy in the 2011 Japanese outbreak of STEC infections. At that time, we reported elevated serum concentrations of tumor necrosis factor (TNF)-α in patients with acute encephalopathy during the HUS phase. In the current study, we investigated whether TNF-α augments the effects of STX in glial cell lines and primary glial cells. We found that TNF-α alone or STX in combination with TNF-α activates nuclear factor-κB (NF-κB) signaling and inhibits growth of glial cells. The magnitude of the NF-κB activation and the inhibition of cell growth by the STX and TNF-α combination was greater than that obtained with TNF-α alone or STX alone. Thus, this in vitro study reveals the role of TNF-α in glial cells during STEC infections. Copyright © 2016 Elsevier B.V. All rights reserved.

  3. Acute Renal Replacement Therapy in Children with Diarrhea-Associated Hemolytic Uremic Syndrome: A Single Center 16 Years of Experience

    Directory of Open Access Journals (Sweden)

    Silviu Grisaru

    2011-01-01

    Full Text Available Acute kidney injury (AKI is becoming more prevalent among hospitalized children, its etiologies are shifting, and new treatment modalities are evolving; however, diarrhea-associated hemolytic uremic syndrome (D+HUS remains the most common primary disease causing AKI in young children. Little has been published about acute renal replacement therapy (ARRT and its challenges in this population. We describe our single center's experience managing 134 pediatric patients with D+HUS out of whom 58 (43% required ARRT over the past 16 years. In our cohort, all but one patient were started on peritoneal dialysis (PD. Most patients, 47 (81%, received acute PD on a pediatric inpatient ward. The most common recorded complications in our cohort were peritoneal fluid leaks 13 (22%, peritonitis 11 (20%, and catheter malfunction 5 (9%. Nine patients (16% needed surgical revision of their PD catheters. There were no bleeding events related to PD despite a mean platelets count of 40.9 (±23.5 × 103/mm3 and rare use of platelets infusions. Despite its methodological limitations, this paper adds to the limited body of evidence supporting the use of acute PD as the primary ARRT modality in children with D+HUS.

  4. Habitat Evaluation Procedures (HEP) Report : West Beaver Lake, 2004-2005 Technical Report.

    Energy Technology Data Exchange (ETDEWEB)

    Entz, Ray

    2005-02-01

    On September 7, 2004, the Habitat Evaluation Procedure (HEP) was used to determine baseline habitat suitability on the West Beaver Lake property, an acquisition completed by the Kalispel Tribe of Indians in September 2004. Evaluation species and appropriate models include bald eagle, black-capped chickadee, mallard, muskrat, and white-tailed deer. Habitat Suitability Index (HSI) values were visually estimated and agreed upon by all HEP team members. The West Beaver Lake Project provides a total of 103.08 Habitat Units (HUs) for the species evaluated. Emergent wetland habitat provides 7.17 HUs for mallard and muskrat. Conifer forest habitat provides 95.91 HUs for bald eagle, black-capped chickadee, mallard, and white-tailed deer. The objective of using HEP at the West Beaver Lake Project and other protected properties is to document the quality and quantity of available habitat for selected wildlife species. In this way, HEP provides information on the relative value of the same area at future points in time so that the effect of management activities on wildlife habitat can be quantified. When combined with other tools, the baseline HEP will be used to determine the most effective on-site management, restoration, and enhancement actions to increase habitat suitability for targeted species. The same process will be replicated every five years to quantitatively evaluate the effectiveness of management strategies in improving and maintaining habitat conditions while providing additional crediting to BPA for enhanced habitat values.

  5. Hemolytic Uremic Syndrome: New Developments in Pathogenesis and Treatment

    Directory of Open Access Journals (Sweden)

    Olivia Boyer

    2011-01-01

    Full Text Available Hemolytic uremic syndrome is defined by the characteristic triad of microangiopathic hemolytic anemia, thrombocytopenia, and acute renal failure. In children, most cases of HUS are caused by Shiga-toxin-producing bacteria, especially Escherichia coli O157:H7. Common vehicles of transmission include ground beef, unpasteurized milk, and municipal or swimming water. Shiga-toxin-associated HUS is a main cause of acute renal failure in young children. Management remains supportive as there is at present no specific therapy to ameliorate the prognosis. Immediate outcome is most often favourable but long-term renal sequelae are frequent due to nephron loss. Atypical HUS represents 5% of cases. In the past 15 years, mutations in complement regulators of the alternative pathway have been identified in almost 60% of cases, leading to excessive complement activation. The disease has a relapsing course and more than half of the patients either die or progress to end-stage renal failure. Recurrence after renal transplantation is frequent.

  6. Defining the genetics of thrombotic microangiopathies.

    Science.gov (United States)

    Vieira-Martins, Paula; El Sissy, Carine; Bordereau, Pauline; Gruber, Aurelia; Rosain, Jeremie; Fremeaux-Bacchi, Veronique

    2016-04-01

    The spectrum of the thrombotic microangiopathies (TMA) encompasses a heterogeneous group of disorders with hereditary and acquired forms. Endothelial cell injury in the microvasculature is common to all TMAs, whatever the pathophysiological process. In this review we describe genetic mutations characteristic of certain TMAs and review their contributions to disease. Recent identification of novel pathologic mutations has been enabled by exome studies. The monogenic forms of TMA are more frequently caused by recessive alterations in von Willebrand factor cleaving protease ADAMST13, leading to congenital thrombotic thrombocytopenic purpura, or cobalamine C and DGKE genes, leading to an atypical hemolytic-uremic syndrome (aHUS)-like TMA. aHUS, whether idiopathic or linked to a known complement amplifying condition, is a TMA that primarily affects kidney function. It often results from a combination of an underlying genetic susceptibility with environmental factors activating the alternative complement pathway. Pathogenic variants in at least five complement genes coding for complement factor H (CFH) complement factor I (CFI), MCP (CD46), C3 and complement factor B (CFB) have been demonstrated to increase the risk of developing aHUS, but several more genes have been implicated. A new challenge is to separate disease-associated genetic variants from the broader background of variants or polymorphisms present in all human genomes that are rare, potentially functional, but may or may not be pathogenic.

  7. Acute Systolic Heart Failure Associated with Complement-Mediated Hemolytic Uremic Syndrome

    Directory of Open Access Journals (Sweden)

    John L. Vaughn

    2015-01-01

    Full Text Available Complement-mediated hemolytic uremic syndrome (otherwise known as atypical HUS is a rare disorder of uncontrolled complement activation that may be associated with heart failure. We report the case of a 49-year-old female with no history of heart disease who presented with microangiopathic hemolytic anemia, thrombocytopenia, and acute kidney injury. Given her normal ADAMSTS13 activity, evidence of increased complement activation, and renal biopsy showing evidence of thrombotic microangiopathy, she was diagnosed with complement-mediated HUS. She subsequently developed acute hypoxemic respiratory failure secondary to pulmonary edema requiring intubation and mechanical ventilation. A transthoracic echocardiogram showed evidence of a Takotsubo cardiomyopathy with an estimated left ventricular ejection fraction of 20%, though ischemic cardiomyopathy could not be ruled out. Treatment was initiated with eculizumab. After several failed attempts at extubation, she eventually underwent tracheotomy. She also required hemodialysis to improve her uremia and hypervolemia. After seven weeks of hospitalization and five doses of eculizumab, her renal function and respiratory status improved, and she was discharged in stable condition on room air and independent of hemodialysis. Our case illustrates a rare association between acute systolic heart failure and complement-mediated HUS and highlights the potential of eculizumab in stabilizing even the most critically-ill patients with complement-mediated disease.

  8. Relationship between Hounsfield Unit in CT Scan and Gray Scale in CBCT

    Directory of Open Access Journals (Sweden)

    Tahmineh Razi

    2014-06-01

    Full Text Available Background and aims. Cone-beam computed tomography (CBCT is an imaging system which has many advantages over computed tomography (CT. In CT scan, Hounsfield Unit (HU is proportional to the degree of x-ray attenuation by the tissue. In CBCT, the degree of x-ray attenuation is shown by gray scale (voxel value. The aim of the present study was to investigate the relationship between gray scale in CBCT and Hounsfield Unit (HU in CT scan. Materials and methods. In this descriptive study, the head of a sheep was scanned with 3 CBCT and one medical CT scanner. Gray scales and HUs were detected on images. Reconstructed data were analyzed to investigate relationship between CBCT gray scales and HUs. Results. A strong correlation between gray scales of CBCT and HUs of CT scan was determined. Conclusion. Considering the fact that gray scale in CBCT is the criteria in measurement of bone density before implant treatments, it is recommended because of the lower dose and cost compared to CT scan.

  9. Severe form of hemolytic-uremic syndrome with multiple organ failure in a child: a case report [v1; ref status: indexed, http://f1000r.es/24q

    Directory of Open Access Journals (Sweden)

    Dino Mijatovic

    2014-03-01

    Full Text Available Introduction: Hemolytic-uremic syndrome (HUS is a leading cause of acute renal failure in infants and young children. It is traditionally defined as a triad of acute renal failure, hemolytic anemia and thrombocytopenia that occur within a week after prodromal hemorrhagic enterocolitis. Severe cases can also be presented by acute respiratory distress syndrome (ARDS, toxic megacolon with ileus, pancreatitis, central nervous system (CNS disorders and multiple organ failure (MOF. Case presentation: A previously healthy 4-year old Caucasian girl developed acute renal failure, thrombocytopenia and hemolytic anemia following a short episode of abdominal pain and bloody diarrhea. In the next week of, what initially appeared as typical HUS, she developed MOF, including ileus, pancreatitis, hepatitis, coma and ARDS, accompanied by hemodynamic instability and extreme leukocytosis. Nonetheless, the girl made a complete recovery after one month of the disease. She was successfully treated in the intensive care unit and significant improvement was noticed after plasmapheresis and continuous veno-venous hemodialysis. Conclusions: Early start of plasmapheresis and meticulous supportive treatment in the intensive care unit, including renal placement therapy, may be the therapy of choice in severe cases of HUS presented by MOF. Monitoring of prognostic factors is important for early performance of appropriate diagnostic and therapeutical interventions.

  10. ANÁLISIS COMPARATIVO DE TRES HIDROGRAMAS UNITARIOS SINTÉTICOS EN DOS CUENCAS MEDITERRÁNEAS DE CHILE, REGIÓN DEL MAULE

    Directory of Open Access Journals (Sweden)

    Roberto Pizarro-Tapia

    2014-01-01

    Full Text Available En el presente artículo se realiza un análisis comparativo de tres métodos para obtener hidrogramas unitarios sintéticos (HUS. Los métodos de Snyder, de “U.S. Bureau of Reclamation” y el de Témez se analizaron en dos cuencas de la zona mediterránea de Chile. Para ello, se realizó una caracterización morfológica y vegetacional de cada cuenca. Además, se utilizó la información de tres tormentas reales con intensidades clasificadas como alta, media y baja, a fin de obtener los hidrogramas de escorrentía directa (HED para ambas cuencas. La escorrentía asociada a los eventos de precipitación se obtuvo utilizando la metodología del número de curva. Los resultados demostraron que, a nivel general, los HUS utilizados no presentaron diferencias estadísticamente significativas (P = 0.05 para ambas cuencas. Por otra parte, la metodología del HUS de Snyder fue la única que detectó diferencias estadísticamente significativas en los HED respecto a los otros métodos y sólo bajo una tormenta de alta intensidad en la cuenca Cunculén.

  11. Two cases of urinary tract infection caused by Shiga toxin-producing Escherichia coli 0157:H7 strains Dos casos de infección del tracto urinario causados por cepas de Escherichia coli 0157:H7 productoras de toxina Shiga.

    Directory of Open Access Journals (Sweden)

    María Del P. Gadea

    2012-06-01

    Full Text Available ABSTRACT STEC strains can infect extra-intestinal sites such as the human urinary tract and sometimes cause severe complications. We report two cases of urinary tract infection caused by STEC in two elderly women with comorbidities. Although both strains belonged to the 0157:H7 serotype and carried genes associated with severe illness, none of the patients developed hemolytic uremic syndrome (HUS. These findings provide additional evidence for the presence of these agents in our country and in the region, and highlight the need to maintain an active surveillance system of HUS cases, placing special emphasis on the study of other sites of infection in patients with non-diarrheal HUS.En los seres humanos, las cepas STEC pueden producir infección en sitios extraintestinales, como el tracto urinario, y causar complicaciones graves. Comunicamos dos casos de infección urinaria por STEC en dos mujeres ancianas con comorbilidades. Aunque ambas cepas correspondieron al serotipo 0157:H7 y portaban los genes asociados con enfermedad grave, ninguna de las pacientes desarrolló síndrome urémico hemolítico (SUH. Estos hallazgos constituyen una evidencia adicional de la presencia de estos agentes en nuestro país y en la región, y destacan la necesidad de mantener un sistema activo de vigilancia, con especial énfasis en el estudio de otros sitios de Infección en pacientes que presentan SUH no asociado a diarrea.

  12. Complement Factor B Mutations in Atypical Hemolytic Uremic Syndrome—Disease-Relevant or Benign?

    Science.gov (United States)

    Marinozzi, Maria Chiara; Vergoz, Laura; Rybkine, Tania; Ngo, Stephanie; Bettoni, Serena; Pashov, Anastas; Cayla, Mathieu; Tabarin, Fanny; Jablonski, Mathieu; Hue, Christophe; Smith, Richard J.; Noris, Marina; Halbwachs-Mecarelli, Lise; Donadelli, Roberta; Fremeaux-Bacchi, Veronique

    2014-01-01

    Atypical hemolytic uremic syndrome (aHUS) is a genetic ultrarare renal disease associated with overactivation of the alternative pathway of complement. Four gain-of-function mutations that form a hyperactive or deregulated C3 convertase have been identified in Factor B (FB) ligand binding sites. Here, we studied the functional consequences of 10 FB genetic changes recently identified from different aHUS cohorts. Using several tests for alternative C3 and C5 convertase formation and regulation, we identified two gain-of-function and potentially disease-relevant mutations that formed either an overactive convertase (M433I) or a convertase resistant to decay by FH (K298Q). One mutation (R178Q) produced a partially cleaved protein with no ligand binding or functional activity. Seven genetic changes led to near-normal or only slightly reduced ligand binding and functional activity compared with the most common polymorphism at position 7, R7. Notably, none of the algorithms used to predict the disease relevance of FB mutations agreed completely with the experimental data, suggesting that in silico approaches should be undertaken with caution. These data, combined with previously published results, suggest that 9 of 15 FB genetic changes identified in patients with aHUS are unrelated to disease pathogenesis. This study highlights that functional assessment of identified nucleotide changes in FB is mandatory to confirm disease association. PMID:24652797

  13. Two cases of kidney transplantation-associated thrombotic microangiopathy successfully treated with eculizumab.

    Science.gov (United States)

    Ikeda, Takashi; Okumi, Masayoshi; Unagami, Kohei; Kanzawa, Taichi; Sawada, Anri; Kawanishi, Kunio; Omoto, Kazuya; Ishida, Hideki; Tanabe, Kazunari

    2016-07-01

    Transplantation-associated thrombotic microangiopathy (TA-TMA) is relatively rare and requires immediate intervention to avoid irreversible organ damage or death; however, consensus regarding the treatment approach is lacking. Atypical haemolytic uraemic syndrome (aHUS) is a rare disease caused by dysregulation of the alternative complement pathway resulting in TMA. aHUS is histologically similar to TA-TMA; approximately 60% of TA-TMA patients have complement dysregulation. Eculizumab, a humanized anti-C5 monoclonal antibody, inhibits terminal membrane-attack complex formation and TMA progression. Eculizumab has been successfully used to treat aHUS post-transplant. We present two cases of kidney TA-TMA due to unknown causes, suspected antibody-mediated rejection, or calcineurin inhibitor (CNI)-related toxicity that developed on day 1 or 2 post-kidney transplantation. Low platelet count and haemoglobin level with red cell fragments were detected. Despite steroid pulse, plasma exchange (PE), and intravenous immunoglobulin therapy, TA-TMA did not improve; therefore, eculizumab was administered despite no genetic testing. Laboratory data, including renal function, improved immediately. TA-TMA treatment primarily involves PE initiation or CNI discontinuation; eculizumab can be used to safely treat TA-TMA and then be ceased in the short term. Therefore, eculizumab administration might be beneficial for kidney TA-TMA as early as the diagnosis of refractory to PE.

  14. Sex steroids do not affect shigatoxin cytotoxicity on human renal tubular or glomerular cells

    Directory of Open Access Journals (Sweden)

    Kohan Donald E

    2002-08-01

    Full Text Available Abstract Background The greater susceptibility of children to renal injury in post-diarrheal hemolytic-uremic syndrome (HUS may be related, at least in part, to heightened renal cell sensitivity to the cytotoxic effect of Shiga toxin (Stx, the putative mediator of kidney damage in HUS. We hypothesized that sexual maturation, which coincides with a falling incidence of HUS, may induce a relatively Stx-resistant state in the renal cells. Methods Cultured human glomerular endothelial (HGEN, human glomerular visceral epithelial (HGEC and human proximal tubule (HPT cells were exposed to Stx-1 after pre-incubation with progesterone, β-estradiol or testosterone followed by determination of cytotoxicity. Results Under basal conditions, Stx-1 potently and dose-dependently killed HPT and HGEC, but had relatively little effect on HGEN. Pre-incubation for 1, 2 or 7 days with physiologic or pharmacologic concentrations of progesterone, β-estradiol or testosterone had no effect on Stx-1 cytotoxicity dose-response on any cell type. In addition, no steroid altered Gb3 expression (Stx receptor by any cell type at any time point. Conclusion These data do not support the notion that hormonal changes associated with puberty induce an Stx-resistant state within kidney cells.

  15. Relationship between Hounsfield Unit in CT Scan and Gray Scale in CBCT.

    Science.gov (United States)

    Razi, Tahmineh; Niknami, Mahdi; Alavi Ghazani, Fakhri

    2014-01-01

    Background and aims. Cone-beam computed tomography (CBCT) is an imaging system which has many advantages over computed tomography (CT). In CT scan, Hounsfield Unit (HU) is proportional to the degree of x-ray attenuation by the tissue. In CBCT, the degree of x-ray attenuation is shown by gray scale (voxel value). The aim of the present study was to investigate the relationship between gray scale in CBCT) and Hounsfield Unit (HU) in CT scan. Materials and methods. In this descriptive study, the head of a sheep was scanned with 3 CBCT and one medical CT scanner. Gray scales and HUs were detected on images. Reconstructed data were analyzed to investigate relationship between CBCT gray scales and HUs. Results. A strong correlation between gray scales of CBCT and HUs of CT scan was determined. Conclusion. Considering the fact that gray scale in CBCT is the criteria in measurement of bone density before implant treatments, it is recommended because of the lower dose and cost compared to CT scan.

  16. Patterns in early diffusion-weighted MRI in children with haemolytic uraemic syndrome and CNS involvement

    Energy Technology Data Exchange (ETDEWEB)

    Donnerstag, Frank; Ding, Xiaoqi; Bueltmann, Eva; Zajaczek, Jan; Lanfermann, Heinrich [Hannover Medical School, Institute of Diagnostic and Therapeutic Neuroradiology, Hannover (Germany); Pape, Lars; Das, Anibh Martin; Ehrich, Jochen; Hartmann, Hans [Hannover Medical School, Clinic for Pediatric Kidney, Liver and Metabolic Diseases, Hannover (Germany); Luecke, Thomas [Hannover Medical School, Clinic for Pediatric Kidney, Liver and Metabolic Diseases, Hannover (Germany); University of Bochum, Department of Neuropediatrics, Pediatric Hospital, Bochum (Germany); Hoy, Ludwig [Hannover Medical School, Institute of Biometrics, Hannover (Germany)

    2012-03-15

    Diffusion-weighted imaging (DWI) in children with diarrhoea associated haemolytic uraemic syndrome (D+HUS) and cerebral involvement was evaluated retrospectively. DWI within 24 h of onset of neurological symptoms. The apparent diffusion coefficient (ADC) was measured in grey/white matter and correlated with clinical and laboratory findings. DWI was abnormal in all. Abnormal ADC was detected in the supratentorial white matter (6/12) and cortex (1/12), the basal ganglia (5/12), the thalami (4/12), and the cerebellum (1/12). ADC was reduced in 5/12, increased in 4/12, and both in 3/12. Mean serum sodium was lower in patients with DWI abnormalities affecting the white matter (6/12), than in those with basal ganglia/thalamic involvement (6/12). Neurological outcome was normal in 4/11 and abnormal in 7/11, and 1 patient died, outcome did not correlate to either localisation or type of DWI abnormality. In D+HUS with neurological symptoms, early DWI may reveal abnormal ADC not only in the basal ganglia/thalami, but also in the white matter/cortex. Besides thrombotic microangiopathy, toxic effects of shiga toxin, azotaemia and hyponatraemia / hypoosmolality may be involved in cerebral involvement in children with D+HUS. Findings on early MRI seem not to predict clinical course or outcome. (orig.)

  17. Hemolytic uremic syndrome recurrence after renal transplantation.

    Science.gov (United States)

    Loirat, Chantal; Fremeaux-Bacchi, Véronique

    2008-09-01

    About 60% of non-Stx-associated aHUS are due to the defect of protection of endothelial cells from complement activation, secondary to mutations in the genes of CFH, MCP, IF, BF, or C3. In addition, 10% of patients have anti-CFH antibodies. While the risk of post-transplant recurrence is less than 1% in Stx-HUS patients, it is approximately 80% in CFH or IF-mutated patients, 20% in MCP-mutated patients, and 30% in patients with no mutation. Patients with anti-CFH antibodies probably also are at risk of recurrence. While MCP-mutated patients can reasonably go to transplantation, recent reports suggest that plasmatherapy started before surgery and maintained life-long may prevent recurrence in CFH-mutated patients. Four successful liver-kidney transplantation utilizing plasmatherapy in CFH-mutated children have been reported recently. In summary, the risk of post-transplant recurrence can now be approached according to genotype. Therefore, aHUS patients should undergo complement determination, screening for anti-CFH antibodies, and genotyping before transplantation. Kidney or kidney + liver transplantation with concomitant plasmatherapy need to be evaluated by prospective trials in patients with hereditary complement abnormalities.

  18. Maintenance of kidney function following treatment with eculizumab and discontinuation of plasma exchange after a third kidney transplant for atypical hemolytic uremic syndrome associated with a CFH mutation.

    Science.gov (United States)

    Davin, Jean-Claude; Gracchi, Valentina; Bouts, Antonia; Groothoff, Jaap; Strain, Lisa; Goodship, Tim

    2010-04-01

    Kidney transplant in patients with atypical hemolytic uremic syndrome (aHUS) is associated with a poor outcome because of recurrent disease, especially in patients known to have a factor H mutation. Long-term prophylactic plasma exchange and combined liver-kidney transplant have prevented graft loss caused by recurrence. However, the mortality associated with liver transplant is not negligible, and prophylactic plasma exchange requires permanent vascular access and regular hospitalization and exposes the patient to potential allergic reactions to plasma. Eculizumab is a high-affinity humanized monoclonal antibody that binds to C5 and thus prevents generation of C5a and the membrane attack complex. We report the case of a 17-year-old girl with aHUS associated with a mutation in the gene for complement factor H (CFH; c.3572C>T, Ser1191Leu) who was highly dependent on plasma exchange. Because of severe allergic reactions to plasma after the third renal graft, eculizumab was introduced in place of plasma exchange without problems. This and other reports suggest that the promise of complement inhibitors in the management of aHUS is going to be fulfilled.

  19. Neurological involvement in a child with atypical hemolytic uremic syndrome.

    Science.gov (United States)

    Koehl, Bérengère; Boyer, Olivia; Biebuyck-Gougé, Nathalie; Kossorotoff, Manoelle; Frémeaux-Bacchi, Véronique; Boddaert, Nathalie; Niaudet, Patrick

    2010-12-01

    We report the case of a 4-year-old boy, diagnosed with atypical hemolytic uremic syndrome (HUS) due to a hybrid factor H. He progressed to end-stage renal failure despite plasmatherapy and underwent bilateral nephrectomy because of uncontrolled hypertension. Three days after, he had partial complex seizures with normal blood pressure, normal blood count and normal magnetic resonance imaging (MRI), which recurred 1 month later. Eight months later, he had a third episode of seizures, with hemoglobin of 10 g/dl without schizocytes, low haptoglobin of 0.18 g/l, and moderate thrombocytopenia (platelets 98 × 10(9)/l). He remained hypertensive and deeply confused for 2 days. The third MRI showed bilateral symmetrical hyperintensities of the cerebral pedunculas, caudate nuclei, putamens, thalami, hippocampi, and insulae suggesting thrombotic microangiopathy secondary to a relapse of HUS rather than reversible posterior leukoencephalopathy syndrome (RPLS), usually occipital and asymmetrical. Plasmatherapy led to a complete neurological recovery within 2 days although hypertension had remained uncontrolled. The fourth MRI 10 weeks after, on maintenance plasmatherapy, was normal and clinical examination remained normal, except for high blood pressure. In conclusion, brain MRI allows differentiating thrombotic microangiopathy lesions from RPLS in atypical HUS, which is crucial since lesions may be reversible with plasmatherapy.

  20. Hemolytic uremic syndrome with ischemic glomerulonephropathy and obliterative vasculopathy in a systemic sclerosis patient treated with cyclosporine-A.

    Science.gov (United States)

    Chen, Wei-Sheng; Young, An-Hang; Wang, Hon-Pin; Huang, De-Feng

    2009-05-01

    Hemolytic uremic syndrome (HUS) is not a commonly reported complication in post-transplantation patients treated with cyclosporine-A (CSA), and is extremely rare in systemic sclerosis (SSc) patients treated with this drug. CSA may contribute to the development of chronic ischemic glomerulonephropathy and vasculopathy, features not easily distinguished from SSc-related nephropathy. Here, we describe a 41-year-old Chinese man with diffuse-type SSc treated with CSA who developed thrombocytopenia, acute renal failure and hemolytic anemia and was diagnosed with HUS. Renal function and thrombocytopenia improved gradually after intensive treatment of plasma exchange (PE) and high-dose steroid therapy. After PE, renal biopsy showed ischemic glomerulonephropathy and obliterative vasculopathy. This case illustrates that PE can improve the hematological disorders and characteristic renal changes of HUS in SSc patients treated with CSA. However, this therapy may not be effective in normalizing serum creatinine level in SSc patients once CSA has triggered the normal kidney to develop glomerulonephropathy and vasculopathy with ischemic and sclerotic changes.

  1. Time-resolved measurement of bubble cavitation by using power Doppler ultrasound image

    Science.gov (United States)

    Koda, Ren; Izumi, Yosuke; Nagai, Hayato; Yamakoshi, Yoshiki

    2017-04-01

    In this study, a novel measurement method for a secondary ultrasound wave irradiated by microbubble cavitation is proposed. High-intensity ultrasound (h-US, 1.0–1.5 MPa), which produces bubble cavitation, is irradiated with a fixed time delay after introducing imaging US, whose frequency is different from that of the h-US. The bubble cavitation signal (BCS) is detected by the signal-processing unit of an ultrasound power Doppler imaging instrument. By this method, both a spatially resolved bubble image (S-image) and the temporal transition of the BCS (T-image) are monitored simultaneously. A feature of the method is that the BCS is observed in situ with sub-µs time resolution. The accuracy of the method is evaluated and it is found that the maximum deviation of the amplitude of the simulated BCS is 4.80%. This method is applied to measure the BCS of ultrasound contrast agent microbubbles. As a result, the dependence of the inherent temporal transition of the BCS on the sound pressure of the h-US (0.6–1.2 MPa) is observed.

  2. [Risk communication of the Federal Institute for Risk Assessment during a food-related outbreak].

    Science.gov (United States)

    Lohmann, M; Epp, A; Röder, B; Böl, G-F

    2013-01-01

    Information about and explanation of risks as well as the initiation of behavioral changes and preventive actions are core tasks of risk communication. During the EHEC/HUS outbreak in spring 2011, the governmental agencies responsible for risk communication mainly focused on these tasks. In general, risk communication is understood as a continuous, long-term process that aims at an adequate handling of risks. In contrast, crisis communication is focused rather on an acute event and aims at timely information and behavioral measures. During the EHEC/HUS outbreak, risk communication partly changed over to crisis communication. The risk communication activities of the Federal Institute for Risk Assessment (Bundesinstitüt für Risikobewertung, BfR) during the EHEC/HUS outbreak are presented here. The results of a representative survey that was conducted in Germany shortly after the outbreak show details of the success of these risk communication activities. Finally, the necessity of communication about scientific uncertainty is addressed and new ways in risk communication with regard to new media are highlighted.

  3. Acoustic property reconstruction of a pygmy sperm whale (Kogia breviceps) forehead based on computed tomography imaging.

    Science.gov (United States)

    Song, Zhongchang; Xu, Xiao; Dong, Jianchen; Xing, Luru; Zhang, Meng; Liu, Xuecheng; Zhang, Yu; Li, Songhai; Berggren, Per

    2015-11-01

    Computed tomography (CT) imaging and sound experimental measurements were used to reconstruct the acoustic properties (density, velocity, and impedance) of the forehead tissues of a deceased pygmy sperm whale (Kogia breviceps). The forehead was segmented along the body axis and sectioned into cross section slices, which were further cut into sample pieces for measurements. Hounsfield units (HUs) of the corresponding measured pieces were obtained from CT scans, and regression analyses were conducted to investigate the linear relationships between the tissues' HUs and velocity, and HUs and density. The distributions of the acoustic properties of the head at axial, coronal, and sagittal cross sections were reconstructed, revealing that the nasal passage system was asymmetric and the cornucopia-shaped spermaceti organ was in the right nasal passage, surrounded by tissues and airsacs. A distinct dense theca was discovered in the posterior-dorsal area of the melon, which was characterized by low velocity in the inner core and high velocity in the outer region. Statistical analyses revealed significant differences in density, velocity, and acoustic impedance between all four structures, melon, spermaceti organ, muscle, and connective tissue (p acoustic properties of the forehead tissues provide important information for understanding the species' bioacoustic characteristics.

  4. Renal thrombotic microangiopathy revisited: When a lesion is not a clinical finding

    Directory of Open Access Journals (Sweden)

    De Serres Sacha

    2010-01-01

    Full Text Available Despite advances in the field of thrombotic microangiopathy (TMA and associated syndromes such as thrombotic thrombocytopenic purpura (TTP and hemolytic uremic syndrome (HUS, they still leave several issues unresolved. For instance, actual diagnostic criteria on which therapeutic decisions rely are relatively narrow and focused on TTP-HUS, with the consequence that non-idiopathic and atypically-presenting TMA are overlooked. In addition, nosologic classifi-cations of TMA disorders have varied substantially over the years, but are still devised from historical rather than mechanistic data. As such, it is perhaps not surprising that even today TMA is erroneously used as an interchangeable term with TTP-HUS, and missed or inappropriately diagnosed on various occasions. Yet, recognizing TMA is of crucial importance given that this lesion often manifests with potentially reversible renal failure. In this editorial, which is presented from a Nephrologist′s perspective, we propose that TMA disorders need to be reclassified to include most types of presentations and confirmed or excluded through more elaborate diagnostic approaches.

  5. Late Onset Cobalamin Disorder and Hemolytic Uremic Syndrome: A Rare Cause of Nephrotic Syndrome

    Directory of Open Access Journals (Sweden)

    Gianluigi Ardissino

    2017-01-01

    Full Text Available Hemolytic uremic syndrome (HUS is an unrare and severe thrombotic microangiopathy (TMA caused by several pathogenetic mechanisms among which Shiga toxin-producing Escherichia coli infections and complement dysregulation are the most common. However, very rarely and particularly in neonates and infants, disorders of cobalamin metabolism (CblC can present with or be complicated by TMA. Herein we describe a case of atypical HUS (aHUS related to CblC disease which first presented in a previously healthy boy at age of 13.6 years. The clinical picture was initially dominated by nephrotic range proteinuria and severe hypertension followed by renal failure. The specific treatment with high dose of hydroxycobalamin rapidly obtained the remission of TMA and the complete recovery of renal function. We conclude that plasma homocysteine and methionine determinations together with urine organic acid analysis should be included in the diagnostic work-up of any patient with TMA and/or nephrotic syndrome regardless of age.

  6. Secondary transmissions during the outbreak of Shiga toxin-producing Escherichia coli O104 in Hesse, Germany, 2011.

    Science.gov (United States)

    Hauri, Am; Gotsch, U; Strotmann, I; Krahn, J; Bettge-Weller, G; Westbrock, Hj; Bellinger, O; Uphoff, H

    2011-08-04

    During the recent outbreak of Shiga toxin-producing Escherichia coli (STEC) O104:H4 in Germany most cases notified in the State of Hesse (6 million inhabitants) were linked to satellite clusters or had travelled to the outbreak area in northern Germany. Intensified surveillance was introduced to rapidly identify cases not linked to known clusters or cases and thus to obtain timely information on possible further contaminated vehicles distributed in Hesse, as well to describe the risk of secondary transmission among known cases. As of 2 August 2011* [corrected], 56 cases of haemolytic uraemic syndrome (HUS) including two fatal cases, and 124 cases of STEC gastroenteritis meeting the national case definitions have been reported in Hesse. Among the 55 HUS and 81 STEC gastroenteritis cases thatmet the outbreak case definition, one HUS case and eight STEC gastroenteritis cases may have acquired their infection through secondary transmission. They include six possible transmissions within the family, two possible nosocomial and one possible laboratory transmission. Our results do not suggest an increased transmissibility of the outbreak strain compared to what is already known about E. coli O157 and other STEC serotypes.

  7. [High vaginal uterosacral ligament suspension for treatment of uterine prolapse].

    Science.gov (United States)

    Lu, Yong-xian; Shen, Wen-jie; Liu, Xin; Liu, Jing-xia; Zhang, Ying-hui; Zhao, Ying; Zhang, Lin; Hu, Man-luo; Ge, Jing; Ke, Niu

    2007-12-01

    To evaluate the physiological and anatomic basis,indications,surgical skills, prevention of ureter injury and clinic outcomes of using high uterosacral ligament suspension (HUS) for correction of advanced uterine prolapse by the vaginal route. Fifty women with advanced uterine prolapse underwent transvaginal HUS after vaginal hysterectomy with reconstruction of pubocervical and rectovaginal fascia to correct their uterine prolapse between June 2003 and September 2007. The average age of the women was 60.1 years. The mean follow-up period was 24 months (range 4-51 months). The degree of pelvic organ prolapse preoperatively and anatomic outcomes postoperatively were assessed with pelvic organ prolapse quantification system (POP-Q). The remnants of the uterosacral ligaments were clearly identified and palpated posterior and medial to the ischial spines by traction with a 24 cm long Allis clamp and used for successful vaginal vault suspension and reconstruction in all 50 consecutive advanced uterine prolapse patients. The ureter injury was avoided by complete knowledge of the ureter's course from the cervix/apex toward its insertion in the sacral region and how far outside of the uterosacral ligament, by uteri palpation and by suturing purposefully placed "deep" dorsally and posteriorly toward the sacrum, as well as by cystoscopy examination of the spillage of urine from both ureters. Mean POP-Q point C improved from 1.5 to -7.5 cm with a median follow-up of 24 months. If the successful HUS was defined as point C prolapse, both the objective and subjective cure rates were as high as 100% with a maximum follow-up of 51 months. None of the 50 patients had repeat operation for recurrence of prolapse. There was no major intra-or postoperative complications, such as ureter and other pelvic organ injury. HUS with fascial reconstruction seems to be a safe, minimal traumatic, tolerable and highly successful procedure for vaginal repair of advanced uterine prolapse. Because of

  8. Actualización en el tratamiento del síndrome urémico hemolítico endémico: Patogénesis y tratamiento de la complicación sistémica más grave de las infecciones por Escherichia coli productor de toxina Shiga Update on the treatment of endemic hemolytic uremic syndrome: Pathogenesis and treatment of the most severe systemic complication of infections by Shiga toxin-producing Escherichia coli

    Directory of Open Access Journals (Sweden)

    Romina J. Fernández-Brando

    2011-08-01

    Full Text Available La forma típica o post-diarreica del síndrome urémico hemolítico (SUH es la complicación más grave de las infecciones por cepas de Escherichia coli productoras de toxina Shiga (STEC. En la Argentina el SUH es un problema crítico de salud pública, ya que representa la principal causa de falla renal aguda en la infancia, la segunda causa de falla renal crónica, y aporta el 20% de los casos de transplante renal durante la infancia y la adolescencia. A pesar de los avances en el conocimiento de su patogénesis, el único tratamiento actual de los pacientes con SUH es de sostén, y no existen terapias específicas ni preventivas. En la presente revisión expondremos los conocimientos básicos de los mecanismos patogénicos y discutiremos los enfoques terapéuticos tradicionales e innovadores, con especial foco en la situación nacional y los aportes hechos por grupos de la Argentina.The typical form of hemolytic uremic syndrome (HUS is the major complication of Shiga toxin-producing Escherichia coli (STEC infections. HUS is a critical health problem in Argentina since it is the main cause of acute renal failure in children and the second cause of chronic renal failure, giving account for 20% of renal transplants in children and adolescents in our country. In spite of the extensive research in the field, the mainstay of treatment for patients with HUS is supportive therapy, and there are no specific therapies preventing or ameliorating the disease course. In this review, we present the current knowledge about pathogenic mechanisms and discuss traditional and innovative therapeutic approaches, with special focus in national status and contributions made by Argentinean groups.

  9. Effect of diet, enalapril, or losartan in post-diarrheal hemolytic uremic syndrome nephropathy.

    Science.gov (United States)

    Caletti, Maria Gracia; Missoni, Mabel; Vezzani, Clarisa; Grignoli, María; Piantanida, Juan Jose; Repetto, Horacio A; Exeni, Ramon; Rasse, Stella Maris

    2011-08-01

    Proteinuria is the main indicator of renal disease progression in many chronic conditions. There is currently little information available on the efficacy, safety, and individual tolerance of patients with post-diarrheal hemolytic uremic syndrome (D+ HUS) nephropathy to therapies involving diet, enalapril, or losartan. A multicenter, double-blind, randomized controlled trail was conducted to evaluate the effect of a normosodic-normoproteic diet (Phase I) and the effect of normosodic-normoproteic diet plus enalapril (0.18-0.27 mg/kg/day) or losartan (0.89-1.34 mg/kg/day) (Phase II) on children with D+ HUS, normal renal function, and persistent, mild (5.1-49.9 mg/kg/day) proteinuria. Dietary intervention reduced the mean protein intake from 3.4 to 2.2 mg/kg/day. Of 137 children, proteinuria normalized in 91 (66.4 %) within 23-45 days; the remaining 46 patients were randomized to diet plus placebo (group 1, n = 16), plus losartan (group 2, n = 16), or enalapril (group 3, n = 14). In groups 1, 2, and 3, proteinuria was reduced by 30.0, 82.0, and 66.3%, respectively, and normalized in six (37.5%), three (81.3%), and 11 (78.6%) patients, respectively (χ(2)= 8.9, p = 0.015). These results suggest that: (1) a normosodic-normoproteic diet can normalize proteinuria in the majority of children with D+ HUS with mild sequelae, (2) the addition of enalapril or losartan to such dietary restrictions of protein further reduces proteinuria, and (3) these therapeutic interventions are safe and well tolerated. Whether these short-term effects can be extended to the long-term remains to be demonstrated.

  10. Molecular characterization and antimicrobial resistance of STEC strains isolated from healthy cattle in 2011 and 2013 in Spain.

    Science.gov (United States)

    Cabal, A; Porrero, M C; DE LA Cruz, M L; Saez, J L; Barcena, C; Lopez, G; Gortazar, C; Dominguez, L; Alvarez, J

    2016-10-01

    Prevention of Shiga toxin-producing Escherichia coli (STEC) foodborne outbreaks is hampered by its complex epidemiology. We assessed the distribution of virulence genes (VGs), main serogroups/serotypes for public health [haemolytic uraemic syndrome (HUS)-related], antimicrobial resistance (AMR) profiles and pulsed-field gel electrophoresis (PFGE) patterns in a collection of STEC isolates obtained from cattle hide (n = 149) and faecal (n = 406) samples collected during a national survey conducted in Spain in 2011 and 2013. Isolates were cultured using McConkey and CT-SMAC agar after enrichment, and confirmed as STEC by PCR. STEC prevalence in hides (15·4%) was higher than in faeces (10·7%) and O157:H7 was more frequent in the former (2·7% vs. 0·99%). Non-O157 HUS-related serogroups were present albeit at low frequencies. The non-O157 isolates were more heterogeneous than O157:H7 in their VG patterns, with 25/64 presenting VGs from both STEC and enterotoxigenic pathotypes (hybrid isolates). Of the STEC isolates, 62·5% were resistant at least to one antimicrobial, and no differences in AMR between O157:H7 and non-O157 were detected. All isolates had different profiles by PFGE and did not form a cluster. Overall, our results demonstrated that STEC in the cattle reservoir is still a matter of concern for human health due to the presence of HUS-related serogroups, the occurrence of certain VGs, AMR and the additional risks that hybrid isolates may pose, and thus warrants further investigation.

  11. Circulating microRNAs in patients with Shiga-Toxin-producing E. coli O104:H4 induced hemolytic uremic syndrome.

    Directory of Open Access Journals (Sweden)

    Johan M Lorenzen

    Full Text Available BACKGROUND: In early May 2011, an outbreak of hemorrhagic colitis associated with hemolytic-uremic syndrome (HUS first developed in Northern Germany and spread to 15 other countries in Europe. The outbreak-strain O104:H4, which combined virulence factors of typical enteroaggregative and Shiga-Toxin-producing E. coli was associated with an unusual high rate of hemolytic uremic syndrome. Also an unexpected high rate of coma and seizures leading to mechanical ventilation and ICU treatment was observed. MicroRNAs are small ribonucleotides orchestrating gene expression. We tested whether circulating microRNAs in serum of HUS patients during the 2011 epidemics are altered in this patient cohort and related to clinical manifestations. METHODOLOGY/PRINCIPAL FINDINGS: We profiled microRNAs using RNA isolated from serum of patients and healthy age-matched controls. The results were validated in 38 patients at baseline, 29 patients during follow-up and 21 age-matched healthy controls by miRNA-specific quantitative RT-PCR. Circulating levels of miR-24, miR-126 were increased in HUS patients versus controls. There was no association between these microRNAs and renal function or the need for renal replacement therapy. In contrast, levels of miR-126 were associated with neurological symptoms at baseline and during follow-up. In addition, miR-126 (on admission and miR-24 (on admission and during follow-up were associated with platelet count. CONCLUSIONS/SIGNIFICANCE: Circulating microRNAs are strongly altered in this patient cohort and associated with neurological symptoms as well as platelet count.

  12. Shiga toxin 1 induces on lipopolysaccharide-treated astrocytes the release of tumor necrosis factor-alpha that alter brain-like endothelium integrity.

    Directory of Open Access Journals (Sweden)

    Verónica I Landoni

    Full Text Available The hemolytic uremic syndrome (HUS is characterized by hemolytic anemia, thrombocytopenia and renal dysfunction. The typical form of HUS is generally associated with infections by Gram-negative Shiga toxin (Stx-producing Escherichia coli (STEC. Endothelial dysfunction induced by Stx is central, but bacterial lipopolysaccharide (LPS and neutrophils (PMN contribute to the pathophysiology. Although renal failure is characteristic of this syndrome, neurological complications occur in severe cases and is usually associated with death. Impaired blood-brain barrier (BBB is associated with damage to cerebral endothelial cells (ECs that comprise the BBB. Astrocytes (ASTs are inflammatory cells in the brain and determine the BBB function. ASTs are in close proximity to ECs, hence the study of the effects of Stx1 and LPS on ASTs, and the influence of their response on ECs is essential. We have previously demonstrated that Stx1 and LPS induced activation of rat ASTs and the release of inflammatory factors such as TNF-α, nitric oxide and chemokines. Here, we demonstrate that rat ASTs-derived factors alter permeability of ECs with brain properties (HUVECd; suggesting that functional properties of BBB could also be affected. Additionally, these factors activate HUVECd and render them into a proagregant state promoting PMN and platelets adhesion. Moreover, these effects were dependent on ASTs secreted-TNF-α. Stx1 and LPS-induced ASTs response could influence brain ECs integrity and BBB function once Stx and factors associated to the STEC infection reach the brain parenchyma and therefore contribute to the development of the neuropathology observed in HUS.

  13. Prevalence, characterization, and genotypic analysis of Escherichia coli O157:H7/NM from selected beef exporting abattoirs of Argentina.

    Science.gov (United States)

    Masana, M O; Leotta, G A; Del Castillo, L L; D'Astek, B A; Palladino, P M; Galli, L; Vilacoba, E; Carbonari, C; Rodríguez, H R; Rivas, M

    2010-04-01

    In Argentina, Escherichia coli O157:H7/NM (STEC O157) is the prevalent serotype associated with hemolytic uremic syndrome (HUS), which is endemic in the country with more than 400 cases per year. In order to estimate the prevalence and characteristics of STEC O157 in beef cattle at slaughter, a survey of 1,622 fecal and carcass samples was conducted in nine beef exporting abattoirs from November 2006 to April 2008. A total of 54 samples were found positive for STEC O157, with an average prevalence of 4.1% in fecal content and 2.6% in carcasses. Calves and heifers presented higher percentages of prevalence in feces, 10.5 and 8.5%, respectively. All STEC O157 isolates harbored stx(2) (Shiga toxin 2), eae (intimin), ehxA (enterohemolysin), and fliC(H7) (H7 flagellin) genes, while stx(1) (Shiga toxin 1) was present in 16.7% of the strains. The prevalent (56%) stx genotype identified was stx(2) combined with variant stx(2c (vh-a)), the combination of which is also prevalent (>90%) in STEC O157 post-enteric HUS cases in Argentina. The clonal relatedness of STEC O157 strains was established by phage typing and pulsed-field gel electrophoresis (PFGE). The 54 STEC isolates were categorized into 12 different phage types and in 29 XbaI-PFGE patterns distributed in 27 different lots. STEC O157 strains isolated from 5 of 21 carcasses were identical by PFGE (100% similarity) to strains of the fecal content of the same or a contiguous bovine in the lot. Five phage type-PFGE-stx profiles of 10 strains isolated in this study matched with the profiles of the strains recovered from 18 of 122 HUS cases that occurred in the same period.

  14. Shiga Toxin 1 Induces on Lipopolysaccharide-Treated Astrocytes the Release of Tumor Necrosis Factor-alpha that Alter Brain-Like Endothelium Integrity

    Science.gov (United States)

    Landoni, Verónica I.; Schierloh, Pablo; de Campos Nebel, Marcelo; Fernández, Gabriela C.; Calatayud, Cecilia; Lapponi, María J.; Isturiz, Martín A.

    2012-01-01

    The hemolytic uremic syndrome (HUS) is characterized by hemolytic anemia, thrombocytopenia and renal dysfunction. The typical form of HUS is generally associated with infections by Gram-negative Shiga toxin (Stx)-producing Escherichia coli (STEC). Endothelial dysfunction induced by Stx is central, but bacterial lipopolysaccharide (LPS) and neutrophils (PMN) contribute to the pathophysiology. Although renal failure is characteristic of this syndrome, neurological complications occur in severe cases and is usually associated with death. Impaired blood-brain barrier (BBB) is associated with damage to cerebral endothelial cells (ECs) that comprise the BBB. Astrocytes (ASTs) are inflammatory cells in the brain and determine the BBB function. ASTs are in close proximity to ECs, hence the study of the effects of Stx1 and LPS on ASTs, and the influence of their response on ECs is essential. We have previously demonstrated that Stx1 and LPS induced activation of rat ASTs and the release of inflammatory factors such as TNF-α, nitric oxide and chemokines. Here, we demonstrate that rat ASTs-derived factors alter permeability of ECs with brain properties (HUVECd); suggesting that functional properties of BBB could also be affected. Additionally, these factors activate HUVECd and render them into a proagregant state promoting PMN and platelets adhesion. Moreover, these effects were dependent on ASTs secreted-TNF-α. Stx1 and LPS-induced ASTs response could influence brain ECs integrity and BBB function once Stx and factors associated to the STEC infection reach the brain parenchyma and therefore contribute to the development of the neuropathology observed in HUS. PMID:22479186

  15. Effects of Escherichia Coli Subtilase Cytotoxin and Shiga Toxin 2 on Primary Cultures of Human Renal Tubular Epithelial Cells

    Science.gov (United States)

    Márquez, Laura B.; Velázquez, Natalia; Repetto, Horacio A.; Paton, Adrienne W.; Paton, James C.; Ibarra, Cristina; Silberstein, Claudia

    2014-01-01

    Shiga toxin (Stx)-producing Escherichia coli (STEC) cause post-diarrhea Hemolytic Uremic Syndrome (HUS), which is the most common cause of acute renal failure in children in many parts of the world. Several non-O157 STEC strains also produce Subtilase cytotoxin (SubAB) that may contribute to HUS pathogenesis. The aim of the present work was to examine the cytotoxic effects of SubAB on primary cultures of human cortical renal tubular epithelial cells (HRTEC) and compare its effects with those produced by Shiga toxin type 2 (Stx2), in order to evaluate their contribution to renal injury in HUS. For this purpose, cell viability, proliferation rate, and apoptosis were assayed on HRTEC incubated with SubAB and/or Stx2 toxins. SubAB significantly reduced cell viability and cell proliferation rate, as well as stimulating cell apoptosis in HRTEC cultures in a time dependent manner. However, HRTEC cultures were significantly more sensitive to the cytotoxic effects of Stx2 than those produced by SubAB. No synergism was observed when HRTEC were co-incubated with both SubAB and Stx2. When HRTEC were incubated with the inactive SubAA272B toxin, results were similar to those in untreated control cells. Similar stimulation of apoptosis was observed in Vero cells incubated with SubAB or/and Stx2, compared to HRTEC. In conclusion, primary cultures of HRTEC are significantly sensitive to the cytotoxic effects of SubAB, although, in a lesser extent compared to Stx2. PMID:24466317

  16. A Translational Murine Model of Sub-Lethal Intoxication with Shiga Toxin 2 Reveals Novel Ultrastructural Findings in the Brain Striatum

    Science.gov (United States)

    Tironi-Farinati, Carla; Geoghegan, Patricia A.; Cangelosi, Adriana; Pinto, Alipio; Loidl, C. Fabian; Goldstein, Jorge

    2013-01-01

    Infection by Shiga toxin-producing Escherichia coli causes hemorrhagic colitis, hemolytic uremic syndrome (HUS), acute renal failure, and also central nervous system complications in around 30% of the children affected. Besides, neurological deficits are one of the most unrepairable and untreatable outcomes of HUS. Study of the striatum is relevant because basal ganglia are one of the brain areas most commonly affected in patients that have suffered from HUS and since the deleterious effects of a sub-lethal dose of Shiga toxin have never been studied in the striatum, the purpose of this study was to attempt to simulate an infection by Shiga toxin-producing E. coli in a murine model. To this end, intravenous administration of a sub-lethal dose of Shiga toxin 2 (0.5 ηg per mouse) was used and the correlation between neurological manifestations and ultrastructural changes in striatal brain cells was studied in detail. Neurological manifestations included significant motor behavior abnormalities in spontaneous motor activity, gait, pelvic elevation and hind limb activity eight days after administration of the toxin. Transmission electron microscopy revealed that the toxin caused early perivascular edema two days after administration, as well as significant damage in astrocytes four days after administration and significant damage in neurons and oligodendrocytes eight days after administration. Interrupted synapses and mast cell extravasation were also found eight days after administration of the toxin. We thus conclude that the chronological order of events observed in the striatum could explain the neurological disorders found eight days after administration of the toxin. PMID:23383285

  17. Therapeutic complement inhibition in complement-mediated hemolytic anemias: Past, present and future.

    Science.gov (United States)

    Risitano, Antonio M; Marotta, Serena

    2016-06-01

    The introduction in the clinic of anti-complement agents represented a major achievement which gave to physicians a novel etiologic treatment for different human diseases. Indeed, the first anti-complement agent eculizumab has changed the treatment paradigm of paroxysmal nocturnal hemoglobinuria (PNH), dramatically impacting its severe clinical course. In addition, eculizumab is the first agent approved for atypical Hemolytic Uremic Syndrome (aHUS), a life-threatening inherited thrombotic microangiopathy. Nevertheless, such remarkable milestone in medicine has brought to the fore additional challenges for the scientific community. Indeed, the list of complement-mediated anemias is not limited to PNH and aHUS, and other human diseases can be considered for anti-complement treatment. They include other thrombotic microangiopathies, as well as some antibody-mediated hemolytic anemias. Furthermore, more than ten years of experience with eculizumab led to a better understanding of the individual steps of the complement cascade involved in the pathophysiology of different human diseases. Based on this, new unmet clinical needs are emerging; a number of different strategies are currently under development to improve current anti-complement treatment, trying to address these specific clinical needs. They include: (i) alternative anti-C5 agents, which may improve the heaviness of eculizumab treatment; (ii) broad-spectrum anti-C3 agents, which may improve the efficacy of anti-C5 treatment by intercepting the complement cascade upstream (i.e., preventing C3-mediated extravascular hemolysis in PNH); (iii) targeted inhibitors of selective complement activating pathways, which may prevent early pathogenic events of specific human diseases (e.g., anti-classical pathway for antibody-mediated anemias, or anti-alternative pathway for PNH and aHUS). Here we briefly summarize the status of art of current and future complement inhibition for different complement-mediated anemias

  18. Optimized Cryopreservation and Banking of Human Bone-Marrow Fragments and Stem Cells.

    Science.gov (United States)

    Carnevale, Gianluca; Pisciotta, Alessandra; Riccio, Massimo; De Biasi, Sara; Gibellini, Lara; Ferrari, Adriano; La Sala, Giovanni B; Bruzzesi, Giacomo; Cossarizza, Andrea; de Pol, Anto

    2016-04-01

    Adult mesenchymal stem cells are a promising source for cell therapies and tissue engineering applications. Current procedures for banking of human bone-marrow mesenchymal stem cells (hBM-MSCs) require cell isolation and expansion, and thus the use of large amounts of animal sera. However, animal-derived culture supplements have the potential to trigger infections and severe immune reactions. The aim of this study was to investigate an optimized method for cryopreservation of human bone-marrow fragments for application in cell banking procedures where stem-cell expansion and use are not immediately needed. Whole trabecular fragments enclosing the bone marrow were stored in liquid nitrogen for 1 year in a cryoprotective solution containing a low concentration of dimethyl sulfoxide and a high concentration of human serum (HuS). After thawing, the isolation, colony-forming-unit ability, proliferation, morphology, stemness-related marker expression, cell senescence, apoptosis, and multi-lineage differentiation potential of hBM-MSCs were tested in media containing HuS compared with hBM-MSCs isolated from fresh fragments. Human BM-MSCs isolated from cryopreserved fragments expressed MSC markers until later passages, had a good proliferation rate, and exhibited the capacity to differentiate toward osteogenic, adipogenic, and myogenic lineages similar to hBM-MSCs isolated from fresh fragments. Moreover, the cryopreservation method did not induce cell senescence or cell death. These results imply that minimal processing may be adequate for the banking of tissue samples with no requirement for the immediate isolation and use of hBM-MSCs, thus limiting cost and the risk of contamination, and facilitating banking for clinical use. Furthermore, the use of HuS for cryopreservation and expansion/differentiation has the potential for clinical application in compliance with good manufacturing practice standards.

  19. Effects of Escherichia coli subtilase cytotoxin and Shiga toxin 2 on primary cultures of human renal tubular epithelial cells.

    Directory of Open Access Journals (Sweden)

    Laura B Márquez

    Full Text Available Shiga toxin (Stx-producing Escherichia coli (STEC cause post-diarrhea Hemolytic Uremic Syndrome (HUS, which is the most common cause of acute renal failure in children in many parts of the world. Several non-O157 STEC strains also produce Subtilase cytotoxin (SubAB that may contribute to HUS pathogenesis. The aim of the present work was to examine the cytotoxic effects of SubAB on primary cultures of human cortical renal tubular epithelial cells (HRTEC and compare its effects with those produced by Shiga toxin type 2 (Stx2, in order to evaluate their contribution to renal injury in HUS. For this purpose, cell viability, proliferation rate, and apoptosis were assayed on HRTEC incubated with SubAB and/or Stx2 toxins. SubAB significantly reduced cell viability and cell proliferation rate, as well as stimulating cell apoptosis in HRTEC cultures in a time dependent manner. However, HRTEC cultures were significantly more sensitive to the cytotoxic effects of Stx2 than those produced by SubAB. No synergism was observed when HRTEC were co-incubated with both SubAB and Stx2. When HRTEC were incubated with the inactive SubAA272B toxin, results were similar to those in untreated control cells. Similar stimulation of apoptosis was observed in Vero cells incubated with SubAB or/and Stx2, compared to HRTEC. In conclusion, primary cultures of HRTEC are significantly sensitive to the cytotoxic effects of SubAB, although, in a lesser extent compared to Stx2.

  20. Changing picture of renal cortical necrosis in acute kidney injury in developing country.

    Science.gov (United States)

    Prakash, Jai; Singh, Vijay Pratap

    2015-11-06

    Renal cortical necrosis (RCN) is characterized by patchy or diffuse ischemic destruction of all the elements of renal cortex resulting from significantly diminished renal arterial perfusion due to vascular spasm and microvascular injury. In addition, direct endothelial injury particularly in setting of sepsis, eclampsia, haemolytic uremic syndrome (HUS) and snake bite may lead to endovascular thrombosis with subsequent renal ischemia. Progression to end stage renal disease is a rule in diffuse cortical necrosis. It is a rare cause of acute kidney injury (AKI) in developed countries with frequency of 1.9%-2% of all patients with AKI. In contrast, RCN incidence is higher in developing countries ranging between 6%-7% of all causes of AKI. Obstetric complications (septic abortion, puerperal sepsis, abruptio placentae, postpartum haemorrhage and eclampsia) are the main (60%-70%) causes of RCN in developing countries. The remaining 30%-40% cases of RCN are caused by non-obstetrical causes, mostly due to sepsis and HUS. The incidence of RCN ranges from 10% to 30% of all cases of obstetric AKI compared with only 5% in non-gravid patients. In the developed countries, RCN accounts for 2% of all cases of AKI in adults and more than 20% of AKI during the third trimester of pregnancy. The reported incidence of RCN in obstetrical AKI varies between 18%-42.8% in different Indian studies. However, the overall incidence of RCN in pregnancy related AKI has decreased from 20%-30% to 5% in the past two decades in India. Currently RCN accounts for 3% of all causes of AKI. The incidence of RCN in obstetrical AKI was 1.44% in our recent study. HUS is most common cause of RCN in non-obstetrical group, while puerperal sepsis is leading cause of RCN in obstetric group. Because of the catastrophic sequelae of RCN, its prevention and aggressive management should always be important for the better renal outcome and prognosis of the patients.

  1. Efectos de la movilización y sedestación progresiva temprana en la duración de la ventilación mecánica y estancia en UCI en el paciente crítico adulto - informe final de pasantía

    OpenAIRE

    Charry Segura, Daniela; Lozano Martínez, Gineth Viviana; Rodríguez Herrera, Yohana Paola

    2013-01-01

    El presente trabajo se realizó bajo la modalidad de pasantía, cuyo objetivo de investigación fue describir los efectos de un protocolo de movilización y sedestación progresiva temprana, en la duración de la Ventilación Mecánica (VM) y estancia en la Unidad de Cuidados Intensivos (UCI) en el paciente adulto. Se realizó un estudio descriptivo ambispectivo, en 27 sujetos críticamente enfermos con VM de la UCI del Hospital Universitario de la Samaritana (HUS), entre Febrero a Abril de 2013. Se le...

  2. Supervivencia de VTEC O157 y no-O157 en agua de bebederos y materia fecal de bovinos

    OpenAIRE

    Rosana Polifroni; Etcheverría, Analía I.; Arroyo, Guillermo H; Padola, Nora L.

    2016-01-01

    Verotoxin-producing E. coli (VTEC) are the etiologic agent of hemolytic-uremic syndrome (HUS), that affect children typically ranged in age from six months old to five years old. The transmission is produced by consumption of contaminated foods, by direct contact with animals or the environment and person to person. In previous studies we determined that the environment of a dairy farm is a non animal reservoir, for that we proposed to study the survival of 4 VTEC isolates (O20:H19; O91:H21; ...

  3. Epidemiology of Shiga toxin producing Escherichia coli in Australia, 2000-2010

    Science.gov (United States)

    2012-01-01

    Background Shiga toxin-producing Escherichia coli (STEC) are an important cause of gastroenteritis in Australia and worldwide and can also result in serious sequelae such as haemolytic uraemic syndrome (HUS). In this paper we describe the epidemiology of STEC in Australia using the latest available data. Methods National and state notifications data, as well as data on serotypes, hospitalizations, mortality and outbreaks were examined. Results For the 11 year period 2000 to 2010, the overall annual Australian rate of all notified STEC illness was 0.4 cases per 100,000 per year. In total, there were 822 STEC infections notified in Australia over this period, with a low of 1 notification in the Australian Capital Territory (corresponding to a rate of 0.03 cases per 100,000/year) and a high of 413 notifications in South Australia (corresponding to a rate of 2.4 cases per 100,000/year), the state with the most comprehensive surveillance for STEC infection in the country. Nationally, 71.2% (504/708) of STEC infections underwent serotype testing between 2001 and 2009, and of these, 58.0% (225/388) were found to be O157 strains, with O111 (13.7%) and O26 (11.1%) strains also commonly associated with STEC infections. The notification rate for STEC O157 infections Australia wide between 2001-2009 was 0.12 cases per 100,000 per year. Over the same 9 year period there were 11 outbreaks caused by STEC, with these outbreaks generally being small in size and caused by a variety of serogroups. The overall annual rate of notified HUS in Australia between 2000 and 2010 was 0.07 cases per 100,000 per year. Both STEC infections and HUS cases showed a similar seasonal distribution, with a larger proportion of reported cases occurring in the summer months of December to February. Conclusions STEC infections in Australia have remained fairly steady over the past 11 years. Overall, the incidence and burden of disease due to STEC and HUS in Australia appears comparable or lower than

  4. Analysis of the Story of an Hour--From the Perspecti ve of Femi ni sm

    Institute of Scientific and Technical Information of China (English)

    李霞

    2014-01-01

    The Story of an Hour is a short story written by Kate Chopin on April 19, 1894, and originally published in Vogue on December 6, 1894. By describing series of emotions that Louise Mallard endures after hearing of the death of her hus-band, it reveals the heroine--Mallard's pursuit of free-dom and enlightenment of feminist thought. The Story of an Hour successfully created a female image of desiring for free-dom, longing for a new life even at the expense of life in a patri-archal society.

  5. Nursing Care for One Patient Suffering from Thrombotic Thrombocytopenic Purpura and Hemolytic Uremic Syndrome After Caesarean Birth%1例剖宫产术后并发TTP-HUS患者的护理

    Institute of Scientific and Technical Information of China (English)

    刘波; 张鹏; 刘丽云

    2009-01-01

    对1例剖宫产术后并发血栓性血小板减少性紫癜-溶血性尿毒综合征(TTP-HUS)患者予激素、血浆置换、抗感染、对症支持等治疗,患者好转出院.提出严密观察病情变化,加强心理、基础、饮食、药物不良反应、血浆置换的护理及健康教育,可促进患者康复.

  6. Laboratory tests for disorders of complement and complement regulatory proteins.

    Science.gov (United States)

    Shih, Angela R; Murali, Mandakolathur R

    2015-12-01

    The complement pathway is a cascade of proteases that is involved in immune surveillance and innate immunity, as well as adaptive immunity. Dysfunction of the complement cascade may be mediated by aberrations in the pathways of activation, complement regulatory proteins, or complement deficiencies, and has been linked to a number of hematologic disorders, including paroxysmal noctural hemoglobinuria (PNH), hereditary angioedema (HAE), and atypical hemolytic-uremic syndrome (aHUS). Here, current laboratory tests for disorders of the complement pathway are reviewed, and their utility and limitations in hematologic disorders and systemic diseases are discussed. Current therapeutic advances targeting the complement pathway in treatment of complement-mediated hematologic disorders are also reviewed.

  7. Complement the hemostatic system: an intimate relationship.

    Science.gov (United States)

    Weitz, Ilene Ceil

    2014-05-01

    The complement system is important part of our innate immune system and interacts directly with the hemostatic system. Disorders of complement activation or dysregulation resulting in excess complement generation, such as Paroxysmal Nocturnal Hemoglobinuria (PNH), atypical Hemolytic uremic Syndrome (aHUS) and antiphospholipid syndrome (APLS) have been associated with significant thrombophilia. Terminal Complement (C5b-9) deposition on endothelial and tumor cell membranes has also been reported in a variety of cancer. Recent developments in complement inhibition have given us new insights into the mechanism of thrombosis in these disorders.

  8. A three-dimensional head-and-neck phantom for validation of multimodality deformable image registration for adaptive radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Singhrao, Kamal; Kirby, Neil; Pouliot, Jean, E-mail: jpouliot@radonc.ucsf.edu [Department of Radiation Oncology, University of California San Francisco, San Francisco, California 94143-1708 (United States)

    2014-12-15

    Purpose: To develop a three-dimensional (3D) deformable head-and-neck (H and N) phantom with realistic tissue contrast for both kilovoltage (kV) and megavoltage (MV) imaging modalities and use it to objectively evaluate deformable image registration (DIR) algorithms. Methods: The phantom represents H and N patient anatomy. It is constructed from thermoplastic, which becomes pliable in boiling water, and hardened epoxy resin. Using a system of additives, the Hounsfield unit (HU) values of these materials were tuned to mimic anatomy for both kV and MV imaging. The phantom opens along a sagittal midsection to reveal radiotransparent markers, which were used to characterize the phantom deformation. The deformed and undeformed phantoms were scanned with kV and MV imaging modalities. Additionally, a calibration curve was created to change the HUs of the MV scans to be similar to kV HUs, (MC). The extracted ground-truth deformation was then compared to the results of two commercially available DIR algorithms, from Velocity Medical Solutions and MIM software. Results: The phantom produced a 3D deformation, representing neck flexion, with a magnitude of up to 8 mm and was able to represent tissue HUs for both kV and MV imaging modalities. The two tested deformation algorithms yielded vastly different results. For kV–kV registration, MIM produced mean and maximum errors of 1.8 and 11.5 mm, respectively. These same numbers for Velocity were 2.4 and 7.1 mm, respectively. For MV–MV, kV–MV, and kV–MC Velocity produced similar mean and maximum error values. MIM, however, produced gross errors for all three of these scenarios, with maximum errors ranging from 33.4 to 41.6 mm. Conclusions: The application of DIR across different imaging modalities is particularly difficult, due to differences in tissue HUs and the presence of imaging artifacts. For this reason, DIR algorithms must be validated specifically for this purpose. The developed H and N phantom is an effective tool

  9. Propuesta de una guía de práctica clínica para la utilización profiláctica de antiulcerosos en el servicio de medicina interna en un hospital de tercer nivel en bogotá

    OpenAIRE

    Bernal Garzón, Lina; López, Jose Julian

    2008-01-01

    Se realizó un estudio observacional analítico de Casos y Controles anidado en una cohorte, de temporalidad prospectiva. Es un estudio de utilización de medicamentos (EUM) de tipo indicación-prescripción, desarrollado para determinar las pautas de profilaxis de antiulcerosos en úlcera por estrés en el Servicio de Medicina Interna (SMI) del Hospital Universitario de la Samaritana (HUS) de la ciudad de Bogotá, institución de tercer nivel de atención. La información se obtuvo a partir de las hist...

  10. Ti år med formidlingspligt

    DEFF Research Database (Denmark)

    Meyer, Gitte

    2014-01-01

    Jubilæet blev markeret ved et symposium - men hvor var journalisterne, og hvor var forskerne? For få uger siden lagde TV 2 hus til et symposium om videnskab, formidling, journalistik og spin. Danske Videnskabsjournalister og Akademiet for de Tekniske Videnskaber tog med arrangementet et behjertet...... initiativ. De ville gøre status efter ti år med lovfæstet formidlingspligt på universiteterne. Samtidig lagde de op til et kritisk blik på universitetsverdenens kommunikationsafdelinger...

  11. Characterisation of Shiga toxin-producing Escherichia coli O157 strains isolated from humans in Argentina, Australia and New Zealand

    Directory of Open Access Journals (Sweden)

    Robins-Browne Roy M

    2008-03-01

    Full Text Available Abstract Background Shiga toxin-producing Escherichia coli (STEC is an important cause of bloody diarrhoea (BD, non-bloody diarrhoea (NBD and the haemolytic uraemic syndrome (HUS. In Argentina and New Zealand, the most prevalent STEC serotype is O157:H7, which is responsible for the majority of HUS cases. In Australia, on the other hand, STEC O157:H7 is associated with a minority of HUS cases. The main aims of this study were to compare the phenotypic and genotypic characteristics of STEC O157 strains isolated between 1993 and 1996 from humans in Argentina, Australia and New Zealand, and to establish their clonal relatedness. Results Seventy-three O157 STEC strains, isolated from HUS (n = 36, BD (n = 20, NBD (n = 10, or unspecified conditions (n = 7 in Argentina, Australia and New Zealand, were analysed. The strains were confirmed to be E. coli O157 by biochemical tests and serotyping. A multiplex polymerase chain reaction (PCR was used to amplify the stx1, stx2 and rfbO157 genes and a genotyping method based on PCR-RFLP was used to determine stx1 and stx2 variants. This analysis revealed that the most frequent stx genotypes were stx2/stx2c (vh-a (91% in Argentina, stx2 (89% in New Zealand, and stx1/stx2 (30% in Australia. No stx1-postive strains were identified in Argentina or New Zealand. All strains harboured the eae gene and 72 strains produced enterohaemolysin (EHEC-Hly. The clonal relatedness of strains was investigated by phage typing and pulsed-field gel electrophoresis (PFGE. The most frequent phage types (PT identified in Argentinian, Australian, and New Zealand strains were PT49 (n = 12, PT14 (n = 9, and PT2 (n = 15, respectively. Forty-six different patterns were obtained by XbaI-PFGE; 37 strains were grouped in 10 clusters and 36 strains showed unique patterns. Most clusters could be further subdivided by BlnI-PFGE. Conclusion STEC O157 strains isolated in Argentina, Australia, and New Zealand differed from each other in terms of

  12. Lexical Coding vs. Syntactic Marking of Homogeneity

    DEFF Research Database (Denmark)

    Høeg Müller, Henrik

    2014-01-01

    and normal, viz. Ole maler hus [Ole paints house]. It is argued that this contrast is a predictable consequence of the premise that, in Spanish, transitive activity verbs impose a mass reading on any bare object noun whereas, in Danish, BNs maintain their lexically encoded denotation as inhomogeneous...... entities. However, contrasting with the leading pattern, the so-called HAVE-verbs (Borthen, 2003) actually license Spanish BNs in object position (cf., e.g., Espinal, 2010; Espinal & Mcnally, 2011), viz. Juan tiene perro [Juan has dog]. It is claimed that the occurrence of BNs in these cases is strongly...

  13. Renoscintigraphy in assessment of renal lesions in children after hemolytic-uremic syndrome; Renoscyntygrafia w ocenie skutkow uszkodzenia nerek u dzieci po przebytym zespole hemolityczno-mocznicowym

    Energy Technology Data Exchange (ETDEWEB)

    Lass, P.; Marczak, E.; Romanowicz, G. [Akademia Medyczna, Gdansk (Poland); and others

    1994-12-31

    The aim of the study was to assess the role of renoscintigraphic examination in monitoring of patients after the hemolytic-uremic syndrome. 27 children mean 9 years the hemolytic-uremic syndrome underwent the complex of biochemical, ultrasound and renoscintigraphic examinations. The abnormal renoscintigraphic was seen in 85.1% of children, while the alternative test described the renal lesion in 29-66%. Renoscintigraphic examination seems to be the most sensitive in monitoring of remote sequel in patients after HUS. Those patients should undergone long-lasting observation, for the sake of possibility of development of renal insufficiency. (author). 14 refs.

  14. Molecular analysis of Shiga toxigenic Escherichia coli O111:H- proteins which react with sera from patients with hemolytic-uremic syndrome.

    Science.gov (United States)

    Voss, E; Paton, A W; Manning, P A; Paton, J C

    1998-04-01

    Western blot analysis was used to assess the reactivity of convalescent-phase sera from patients who were associated with an outbreak of hemolytic-uremic syndrome (HUS) caused by fermented sausage contaminated with Shiga toxin-producing Escherichia coli (STEC). The predominant STEC isolated from HUS patients belonged to serotype O111:H-, and reactivity to O111:H- whole-cell lysates, treated or untreated with proteinase K, was examined. As expected, all five serum samples demonstrated a marked anti-lipopolysaccharide response, but several protein bands were also immunoreactive, particularly one with an apparent size of 94 kDa. One convalescent-phase serum sample was subsequently used to screen an O111:H- cosmid bank and 2 of 900 cosmid clones were found to be positive, both of which contained a similar DNA insert. Western blot analysis of one of these clones identified three major immunoreactive protein bands of approximately 94, 70, and 50 kDa. An immune response to the three proteins was detectable with all five convalescent-phase serum samples but not with healthy human serum. Immunoreactive 94- and 50-kDa species were produced by a deletion derivative of the cosmid containing a 7-kb STEC DNA insert. Sequence analysis of this region indicated that it is part of the locus for enterocyte effacement, including the eaeA gene which encodes intimin. The deduced amino acid sequence of the O111:H- intimin was 88.6% identical to intimin from O157:H7 STEC, and the most divergent region was the 200 residues at the carboxyl terminus, which were only 75% identical. Such variation may be antigenically significant as serum from a HUS patient infected only with the O111:H- STEC reacted with intimin from an enteropathogenic E. coli O111 strain, as well as several other eaeA-positive STEC isolates, but not with an eaeA-positive STEC belonging to serotype O157:H-. Sera from two of the other HUS patients also failed to react with intimin from this latter strain. However, intimin

  15. Molecular Analysis of Shiga Toxigenic Escherichia coli O111:H− Proteins Which React with Sera from Patients with Hemolytic-Uremic Syndrome

    Science.gov (United States)

    Voss, Elena; Paton, Adrienne W.; Manning, Paul A.; Paton, James C.

    1998-01-01

    Western blot analysis was used to assess the reactivity of convalescent-phase sera from patients who were associated with an outbreak of hemolytic-uremic syndrome (HUS) caused by fermented sausage contaminated with Shiga toxin-producing Escherichia coli (STEC). The predominant STEC isolated from HUS patients belonged to serotype O111:H−, and reactivity to O111:H− whole-cell lysates, treated or untreated with proteinase K, was examined. As expected, all five serum samples demonstrated a marked anti-lipopolysaccharide response, but several protein bands were also immunoreactive, particularly one with an apparent size of 94 kDa. One convalescent-phase serum sample was subsequently used to screen an O111:H− cosmid bank and 2 of 900 cosmid clones were found to be positive, both of which contained a similar DNA insert. Western blot analysis of one of these clones identified three major immunoreactive protein bands of approximately 94, 70, and 50 kDa. An immune response to the three proteins was detectable with all five convalescent-phase serum samples but not with healthy human serum. Immunoreactive 94- and 50-kDa species were produced by a deletion derivative of the cosmid containing a 7-kb STEC DNA insert. Sequence analysis of this region indicated that it is part of the locus for enterocyte effacement, including the eaeA gene which encodes intimin. The deduced amino acid sequence of the O111:H− intimin was 88.6% identical to intimin from O157:H7 STEC, and the most divergent region was the 200 residues at the carboxyl terminus, which were only 75% identical. Such variation may be antigenically significant as serum from a HUS patient infected only with the O111:H− STEC reacted with intimin from an enteropathogenic E. coli O111 strain, as well as several other eaeA-positive STEC isolates, but not with an eaeA-positive STEC belonging to serotype O157:H−. Sera from two of the other HUS patients also failed to react with intimin from this latter strain. However

  16. COMPLEMENT REGULATOR FHR-3 IS ELEVATED EITHER LOCALLY OR SYSTEMICALLY IN A SELECTION OF AUTOIMMUNE DISEASES

    OpenAIRE

    Nicole Schäfer; Antje Grosche; Joerg Reinders; Stefanie Hauck; Pouw, Richard B.; Taco W Kuijpers; Diana Wouters; Boris Ehrenstein; Volker Enzmann; Peter Zipfel; Christine Skerka; Diana Pauly

    2016-01-01

    The human complement factor H-related protein-3 (FHR-3) is a soluble regulator of the complement system. Homozygous cfhr3/1 deletion is a genetic risk factor for the autoimmune form of atypical hemolytic-uremic syndrome (aHUS), while also found to be protective in age-related macular degeneration (AMD). The precise function of FHR-3 remains to be fully characterized. We generated four mouse monoclonal antibodies (mAbs) for FHR-3 (RETC) without cross-reactivity to the complement factor H (FH)-...

  17. HAUS 658

    Institute of Scientific and Technical Information of China (English)

    2012-01-01

    HUS 658的名字灵感源於德国着的BAUHAUS国立建筑艺术学校。HAUS 658的每一位设计师心中都充满与BAUHAUS相同的艺术使命感,希望通过对艺术品味的理解,对设计精髓的诠释,体现“设计源於平凡,又超越平凡”,尽显“产品服务於设计,设计服务於人”的人文理念。

  18. Calculating the number of shock waves, expulsion time, and optimum stone parameters based on noncontrast computerized tomography characteristics.

    Science.gov (United States)

    Foda, Khaled; Abdeldaeim, Hussein; Youssif, Mohamed; Assem, Akram

    2013-11-01

    To define the parameters that accompanied a successful extracorporeal shock wave lithotripsy (ESWL), namely the number of shock waves (SWs), expulsion time (ET), mean stone density (MSD), and the skin-to-stone distance (SSD). A total of 368 patients diagnosed with renal calculi using noncontrast computerized tomography had their MSD, diameter, and SSD recorded. All patients were treated using a Siemens lithotripter. ESWL success meant a stone-free status or presence of residual fragments 934 HUs and SSD >99 mm. The required number of SWs and the expected ET can be anticipated. Copyright © 2013 Elsevier Inc. All rights reserved.

  19. An Interpretation of the Origin of Distribution Anomalies of △C

    Institute of Scientific and Technical Information of China (English)

    帅燕华; 周立发

    2001-01-01

    Zonal distribution of seepage hydrocarbon-induced altered carbonates over oil/gas reservoirs is a common phenomenon observed in the field. The authors considered that the con tinuous production of CO2 within the "alteration chimney" gives rise to a significant difference in physical and chemical properties between its interior and the surrounding country rocks.And it is this difference that has promoted the erosion and precipitation of carbonates, t hus leading to the zonal distribution of seepage hydrocarbon-induced altered carbonates over oil/gas reservoirs. This may be a reasonable interpretation of the phenomenon described above.

  20. Current epidemiological status of enterohaemorrhagic Escherichia coli O157:H7 in Africa

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    @@ Enterohaemorrhagic E. Coli (EHEC) has been isolated from human diarrhoeal disease, hemorrhagic colitis (HC), and haemolytic uremic syndrome (HUS). After 20 years since the first description of E. Coli O157: H7 in USA, EHEC has become an important public health problem worldwide.1,2 Given the magnitude and severity of recent outbreaks of E. Coli O157: H7 infection, there is an urgent need to reduce the human hazard caused by this pathogen. Cattle are considered as major reservoir of E. Coli O157:H7 because consumption of undercooked meat products from cattle has been often associated with many human infections.

  1. Microangiopatias trombóticas: púrpura trombocitopênica trombótica e síndrome hemolítico-urêmica Thrombotic microangiopathies: thrombotic thrombocytopenic purpura / hemolytic uremic syndrome

    Directory of Open Access Journals (Sweden)

    Maria Goretti Polito

    2010-09-01

    complemento. Uma série de mutações e polimorfismo em genes que codificam proteínas reguladoras do complemento sozinhas ou em combinação podem levar a SHU atípica. Aproximadamente 60% dos casos de SHU atípica têm mutações do tipo "perda da função" em genes que codificam as proteínas reguladoras do complemento, as quais protegem as células hospedeiras da ativação do complemento: fator H do complemento (FHC, fator I (FIC e proteína cofator de membrana (PCM ou CD46, ou mutações do tipo "ganho da função" em genes que codificam o FHC ou C3. Além disso, aproximadamente 10% dos pacientes com SHU atípica têm deficiência na função do FHC devido a anticorpos anti-FHC. Mesmo que as MATs sejam condições altamente heterogêneas, um terço dos pacientes tem deficiência severa da ADA-MTS13. Transfusões de plaquetas são contraindicadas nesses pacientes. Infusão de plasma ou plasma exchange (PE é o único tratamento eficiente.Thrombotic microangiopathies (TMAs are pathological conditions characterized by generalized microvascular occlusion by platelet thrombi, thrombocytopenia, and microangiopathic hemolytic anemia. Two typical phenotypes of TMAs are hemolytic- uremic syndrome (HUS and thrombotic thrombocytopenic purpura (TTP. Other disorders occasionally present with similar manifestations. Depending on whether renal or brain lesions prevail, two pathologically indistinguishable but somehow clinically different disorders have been described: HUS and TTP. Injury to the endothelial cell is the central and likely inciting factor in the sequence of events leading to TMA. Loss of physiological thromboresistance, leukocyte adhesion to damaged endothelium, complement consumption, abnormal von Willebrand factor release and fragmentation, and increased vascular shear stress may then sustain and amplify the microangiopathic process. Intrinsic abnormalities of the complement system and of the von Willebrand factor pathway may account for a genetic predisposition to the

  2. Investigation of encephalopathy caused by Shiga toxin 2c-producing Escherichia coli infection in mice.

    Directory of Open Access Journals (Sweden)

    Muhammad Yunus Amran

    Full Text Available A large outbreak of Shiga toxin (Stx-producing enteroaggregative Escherichia coli (EAEC O104:H4 occurred in northern Germany. From this outbreak, at least 900 patients developed hemolytic uremic syndrome (HUS, resulting in more than 50 deaths. Thirty percent of the HUS patients showed encephalopathy. We previously established a mouse model with encephalopathy associated with blood brain barrier (BBB damage after oral infection with the Shiga toxin (Stx 2c-producing Escherichia coli O157: H- strain E32511 (E32511. In this model, we detected high expression of the Stx receptor synthase enzyme, glycosphingolipid globotriaosylceramide (Gb3 synthase, in endothelial cells (ECs and neurons in the reticular formation of the medulla oblongata by in situ hybridization. Caspase-3 was activated in neurons in the reticular formation of the medulla oblongata and the anterior horn of the spinal cord. Astrocytes (ASTs were activated in the medulla oblongata and spinal cord, and a decrease in aquaporin 4 around the ECs suggested that BBB integrity was compromised directly by Stx2c or through the activation of ASTs. We also report the effectiveness of azithromycin (AZM in our model. Moreover, AZM strongly inhibited the release of Stx2c from E32511 in vitro.

  3. Investigation of Encephalopathy Caused by Shiga Toxin 2c-Producing Escherichia coli Infection in Mice

    Science.gov (United States)

    Amran, Muhammad Yunus; Fujii, Jun; Suzuki, Satoshi O.; Kolling, Glynis L.; Villanueva, Sharon Y. A. M.; Kainuma, Mosaburo; Kobayashi, Hideyuki; Kameyama, Hideko; Yoshida, Shin-ichi

    2013-01-01

    A large outbreak of Shiga toxin (Stx)-producing enteroaggregative Escherichia coli (EAEC) O104:H4 occurred in northern Germany. From this outbreak, at least 900 patients developed hemolytic uremic syndrome (HUS), resulting in more than 50 deaths. Thirty percent of the HUS patients showed encephalopathy. We previously established a mouse model with encephalopathy associated with blood brain barrier (BBB) damage after oral infection with the Shiga toxin (Stx) 2c-producing Escherichia coli O157: H- strain E32511 (E32511). In this model, we detected high expression of the Stx receptor synthase enzyme, glycosphingolipid globotriaosylceramide (Gb3) synthase, in endothelial cells (ECs) and neurons in the reticular formation of the medulla oblongata by in situ hybridization. Caspase-3 was activated in neurons in the reticular formation of the medulla oblongata and the anterior horn of the spinal cord. Astrocytes (ASTs) were activated in the medulla oblongata and spinal cord, and a decrease in aquaporin 4 around the ECs suggested that BBB integrity was compromised directly by Stx2c or through the activation of ASTs. We also report the effectiveness of azithromycin (AZM) in our model. Moreover, AZM strongly inhibited the release of Stx2c from E32511 in vitro. PMID:23516588

  4. Hemolytic uremic syndrome.

    Science.gov (United States)

    Webster, Kathleen; Schnitzler, Eugene

    2014-01-01

    The thrombotic microangiopathies include both hemolytic uremic syndrome (HUS) and thrombotic thrombocytopenic purpura (TTP). Although debate exists as to whether these are separate entities or a spectrum of disease, both result in the clinical picture of thrombocytopenia, hemolytic anemia, and varying degrees of renal and neurologic involvement. Etiology of HUS includes diarrheal infection due to Shiga toxin-producing bacteria, complement deficiency, pneumococcal infection, and cobalamin deficiency. In disease ascribed to TTP, the main etiologic factor is deficiency of an enzyme known as a disintegrin-like and metalloprotease with thrombospondin type 1 repeats, number 13 (ADAMTS-13). The clinical manifestations may vary, but neurologic involvement can be significant, with reports of hypertensive encephalopathy, seizures, thrombosis and infarct. In nondiarrheal forms of disease, recurrence may occur and clinical diagnosis is essential in order to provide a targeted therapy for the suspected etiology. Therapies include supportive care, cobalamin supplementation, as well as plasma infusion and exchange. End stage renal disease may result and transplantation is curative for some forms of the disease. More recent research focuses on targeted immunotherapy to prevent autoantibody prevention. As of yet, there is no one cure for these potentially devastating diseases, and diagnosis and treatment selection presents a challenge to the clinician. © 2014 Elsevier B.V. All rights reserved.

  5. Epidemiology and Clinical Manifestations of Enteroaggregative Escherichia coli

    Science.gov (United States)

    Hebbelstrup Jensen, Betina; Olsen, Katharina E. P.; Struve, Carsten; Petersen, Andreas Munk

    2014-01-01

    SUMMARY Enteroaggregative Escherichia coli (EAEC) represents a heterogeneous group of E. coli strains. The pathogenicity and clinical relevance of these bacteria are still controversial. In this review, we describe the clinical significance of EAEC regarding patterns of infection in humans, transmission, reservoirs, and symptoms. Manifestations associated with EAEC infection include watery diarrhea, mucoid diarrhea, low-grade fever, nausea, tenesmus, and borborygmi. In early studies, EAEC was considered to be an opportunistic pathogen associated with diarrhea in HIV patients and in malnourished children in developing countries. In recent studies, associations with traveler's diarrhea, the occurrence of diarrhea cases in industrialized countries, and outbreaks of diarrhea in Europe and Asia have been reported. In the spring of 2011, a large outbreak of hemolytic-uremic syndrome (HUS) and hemorrhagic colitis occurred in Germany due to an EAEC O104:H4 strain, causing 54 deaths and 855 cases of HUS. This strain produces the potent Shiga toxin along with the aggregative fimbriae. An outbreak of urinary tract infection associated with EAEC in Copenhagen, Denmark, occurred in 1991; this involved extensive production of biofilm, an important characteristic of the pathogenicity of EAEC. However, the heterogeneity of EAEC continues to complicate diagnostics and also our understanding of pathogenicity. PMID:24982324

  6. Active Shiga-like toxin produced by some Aeromonas spp., isolated in Mexico City

    Directory of Open Access Journals (Sweden)

    Ingrid Palma-Martínez

    2016-09-01

    Full Text Available Shiga-like toxins (Stx represent a group of bacterial toxins involved in human and animal diseases. Stx is produced by enterohemorrhagic Escherichia coli, Shigella dysenteriae type 1, Citrobacter freundii and Aeromonas spp. Stx is an important cause of bloody diarrhea and hemolytic uremic syndrome (HUS. The aim of this study was to identify the stx1/stx2 genes in clinical strains and in outer membrane vesicles (OMVs of Aeromonas spp., 66 strains were isolated from children who live in Mexico City and Shiga-like toxins effects were evaluated on Vero cell cultures.The capacity to express active, Stx1 and Stx2 toxins was determined on Vero cell cultures and the concentration of Shiga-like toxins was evaluated by lethal dose to 50% (LD50 assays, observing inhibition of damaged cells by specific monoclonal antibodies. The results obtained in this study support the hypothesis that the stx gene is another putative virulence factor of Aeromonas, and since this gene can be transferred horizontally through OMVs this genus should be included as a possible causal agents of gastroenteritis and it should be reported as part of standard health surveillance procedures.Furthermore, these results indicate that Aeromonas genus might be a potential causative agent of HUS.

  7. Age-specific frequencies of antibodies to Escherichia coli verocytotoxins (Shiga toxins) 1 and 2 among urban and rural populations in southern Ontario.

    Science.gov (United States)

    Karmali, Mohamed A; Mascarenhas, Mariola; Petric, Martin; Dutil, Lucie; Rahn, Kris; Ludwig, Kerstin; Arbus, Gerald S; Michel, Pascal; Sherman, Philip M; Wilson, Jeff; Johnson, Roger; Kaper, James B

    2003-12-01

    In 173 urban residents and 232 rural dairy-farm residents (age range, 0-70 years) who were stratified for age, the frequency of antiverocytotoxin 2 antibodies (VT2 Abs) (frequency in urban residents, 46%; frequency in rural residents, 65%) was significantly higher than that of antiverocytotoxin 1 antibodies (VT1 Abs) (frequency in urban residents, 12%; frequency in rural residents, 39%) (P< or =.001). The frequency of VT2 Abs (93%) was also significantly higher than that of VT1 Abs (50%) in 14 patients with hemolytic uremic syndrome (HUS) associated with verocytotoxin-producing Escherichia coli (VTEC) strains that expressed both toxins. In urban residents, the frequency of both antibodies tended to decrease between the first and the second decades of life, and it then increased until the fifth decade of life, before, in the case of VT2 Abs, decreasing again. This pattern, which inversely reflects the age-related incidence of HUS, is consistent with a role for antiverocytotoxin antibodies in protective immunity. In dairy-farm residents, peak frequencies of antibodies to both toxins occurred during the first decade of life and remained elevated for 3 decades before decreasing, a pattern consistent with frequent exposure to bovine VTEC from an early age.

  8. Outbreak of verocytotoxin-producing E. coli O145 and O26 infections associated with the consumption of ice cream produced at a farm, Belgium, 2007.

    Science.gov (United States)

    De Schrijver, K; Buvens, G; Possé, B; Van den Branden, D; Oosterlynck, O; De Zutter, L; Eilers, K; Piérard, D; Dierick, K; Van Damme-Lombaerts, R; Lauwers, C; Jacobs, R

    2008-02-14

    In October 2007, an outbreak of verocytotoxin-producing Escherichia coli (VTEC) O145 and E. coli O26 occurred among consumers of ice cream produced and sold in September 2007 at a farm in the province of Antwerp (Belgium). The ice cream was consumed at two birthday parties and also eaten at the farm. Five children, aged between two and 11 years, developed haemolytic uraemic syndrome (HUS), and seven other co-exposed persons contracted severe diarrhoea. In three of the five HUS cases VTEC O145 infections were laboratory confirmed, one in association with VTEC O26. Identical isolates of E. coli O145 and O26 were detected with PCR and PFGE in faecal samples of patients and in ice cream leftovers from one of the birthday parties, in faecal samples taken from calves, and in samples of soiled straw from the farm at which the ice cream was produced. Ice cream was made from pasteurised milk and most likely contaminated by one of food handlers.

  9. Low levels of serum erythropoietin in children with endemic hemolytic uremic syndrome.

    Science.gov (United States)

    Exeni, R; Donato, H; Rendo, P; Antonuccio, M; Rapetti, M C; Grimoldi, I; Exeni, A; de Galvagni, A; Trepacka, E; Amore, A

    1998-04-01

    Serum erythropoietin (EPO) levels were measured in ten previously non-transfused children with hemolytic uremic syndrome (HUS). Complete blood cell count, serum EPO, and renal function tests were carried out upon admission and weekly thereafter. Blood samples were obtained: (1) prior to the first transfusion; (2) after the first transfusion but before recovery from renal failure; (3) during the recovery stage. All patients required transfusions (mean 1.8+/-0.8 per child). Absolute values of EPO correlated positively with the hematocrit during the three stages (r = 0.53, 0.36, and 0.12, respectively) which is opposite to expected results. The observed EPO logarithm/predicted EPO logarithm upon admission was low (0.70+/-0.08), falling further during stage 2 (0.57+/-0.03), but increasing thereafter (0.78+/-0.07) without reaching normal values. The reticulocyte production rate followed a parallel course (0.74+/-0.14, 0.54+/-0.11, and 0.60+/-0.10, respectively). On comparing the observed serum EPO levels with those expected, 9 of 11 pre-transfusion samples showed low values; in stage 2, all samples were below normal; in the recovery phase most (77.8%) were still low. Our results show an inadequate EPO synthesis in children with HUS, which could play an important pathogenic role, since it aggravates the severity of the existing hemolytic anemia; the secondary inhibitory effect of repeated transfusions exacerbates this inadequate synthesis.

  10. Construction and Experimental Validation of a Quantitative Kinetic Model of Nitric Oxide Stress in Enterohemorrhagic Escherichia coli O157:H7

    Directory of Open Access Journals (Sweden)

    Jonathan L. Robinson

    2016-02-01

    Full Text Available Enterohemorrhagic Escherichia coli (EHEC are responsible for large outbreaks of hemorrhagic colitis, which can progress to life-threatening hemolytic uremic syndrome (HUS due to the release of Shiga-like toxins (Stx. The presence of a functional nitric oxide (NO· reductase (NorV, which protects EHEC from NO· produced by immune cells, was previously found to correlate with high HUS incidence, and it was shown that NorV activity enabled prolonged EHEC survival and increased Stx production within macrophages. To enable quantitative study of EHEC NO· defenses and facilitate the development of NO·-potentiating therapeutics, we translated an existing kinetic model of the E. coli K-12 NO· response to an EHEC O157:H7 strain. To do this, we trained uncertain model parameters on measurements of [NO·] and [O2] in EHEC cultures, assessed parametric and prediction uncertainty with the use of a Markov chain Monte Carlo approach, and confirmed the predictive accuracy of the model with experimental data from genetic mutants lacking NorV or Hmp (NO· dioxygenase. Collectively, these results establish a methodology for the translation of quantitative models of NO· stress in model organisms to pathogenic sub-species, which is a critical step toward the application of these models for the study of infectious disease.

  11. 临床疑似TTP-HUS患者血浆置换治疗引起的并发症

    Institute of Scientific and Technical Information of China (English)

    Howard M A; Williams L A; Terrell DR; 李健; 李执如

    2006-01-01

    @@ 由于采用血浆置换(PE)治疗血栓性血小板减少性紫癜-溶血性尿毒综合征(TTP-HUS)频率的增加,PE引起的并发症也成为制定治疗方案时需要考虑的因素.由于TTP-HUS的诊断常常是不确定的,掌握PE治疗利弊之间的平衡已成为制定适当治疗方案的焦点.之前,我们于1996年~2002年间曾两次报道采用PE治疗149例临床疑似TTP HUS,其中42例(28%)发生了严重并发症,包括3例死亡.本文报道随后3年,即2002年到2005年的情况,证明PE治疗TTP-HUS确实存在危险.

  12. Relationship between Hounsfield unit in CT scan and gray scale in CBCT

    Science.gov (United States)

    Kamaruddin, Noorshaida; Rajion, Zainul Ahmad; Yusof, Asilah; Aziz, Mohd Ezane

    2016-12-01

    Cone-beam computed tomography (CBCT) is an imaging system which has advantages over computed tomography (CT). Recently, CBCT has become widely used for oral and maxillofacial imaging. In CT scan, Hounsfield Unit (HU) is proportional to the degree of x-ray attenuation by the tissue. In CBCT, the degree of x-ray attenuation is shown by gray scale (voxel value). The aim of the present (in vitro) study was to investigate the relationship between gray scale in CBCT and HU in CT scan. In this descriptive study, the anthropomorphic head phantom was scanned with CBCT and CT scanner. Gray scales and HUs were detected on images at the crown of the teeth, trabecular and cortical bone of mandible. The images were analyzed to obtain the gray scale value and HU value. The obtained value then used to investigate the relationship between CBCT gray scales and HUs. For the statistical analysis, t-test, Pearson's correlation and regression analysis were used. The differences between the gray scale of CBCT and HU of CT were statistically not significant, whereas the Pearson's correlation coefficients demonstrated a statistically significant correlation between gray scale of CBCT and HU of CT values. Considering the fact that gray scale in CBCT is important in pre assessment evaluation of bone density before implant treatments, it is recommended because of the lower dose and cost compared to CT scan.

  13. Pro-Coagulant Endothelial Dysfunction Results from EHEC Shiga toxins and Host Damage-Associated Molecular Patterns

    Directory of Open Access Journals (Sweden)

    Chad L Mayer

    2015-04-01

    Full Text Available Hemolytic uremic syndrome (HUS from enterohemorrhagic E.coli infection (EHEC is a leading cause of kidney failure in otherwise healthy U.S. children. The bacterial Shiga toxins (Stx induce the characteristic coagulopathy of HUS, but the cell and organ damage during infection likely also releases inflammatory damage-associated molecular patterns (DAMPs that may exacerbate injury in concert with the toxins. To examine this, aortic and renal glomerular cell anticoagulant and barrier functions were studied after in vitro challenge with Stx1, Stx2 and DAMPs. There was significant loss of surface anticoagulant protein C pathway molecules, increased expression of prothrombotic PAR1 and reduced protein C activation capability by 15-27%. Histones nearly completely prevented activated protein C protection of endothelial cells from thrombin-induced permeability. In mice, lethal Stx2 challenge elevated plasma HMGB1 (day 2, 321±118%; p<0.01 and extracellular histones (day 3, 158±62%; p<0.01. Mice colonized with Stx2-expressing Citrobacter rodentium developed increased HMGB1 (day 5, 155±55%; p<0.01 and histones (day 3, 378±188%; p<0.01. Anti-histone antibody reduced both DAMPs to baseline, but was not sufficient to improve survival outcome or kidney function. Together, these data suggest a potential role for both Stx and DAMPs in producing endothelial injury and a prothrombotic environment.

  14. Shiga Toxins and the Pathophysiology of Hemolytic Uremic Syndrome in Humans and Animals

    Directory of Open Access Journals (Sweden)

    Deborah J. Stearns-Kurosawa

    2012-11-01

    Full Text Available Food-borne diseases are estimated at 76 million illnesses and 5000 deaths every year in the United States with the greatest burden on young children, the elderly and immunocompromised populations. The impact of efficient food distribution systems and a truly global food supply ensures that outbreaks, previously sporadic and contained locally, are far more widespread and emerging pathogens have far more frequent infection opportunities. Enterohemorrhagic E. coli is an emerging food- and water-borne pathogen family whose Shiga-like toxins induce painful hemorrhagic colitis with potentially lethal complications of hemolytic uremic syndrome (HUS. The clinical manifestations of Shiga toxin-induced HUS overlap with other related syndromes yet molecular mechanisms differ considerably. As discussed herein, understanding these differences and the novel properties of the toxins is imperative for clinical management decisions, design of appropriate animal models, and choices of adjunctive therapeutics. The emergence of new strains with rapidly aggressive virulence makes clinical and research initiatives in this field a high public health priority.

  15. Shiga Toxins and the Pathophysiology of Hemolytic Uremic Syndrome in Humans and Animals

    Science.gov (United States)

    Mayer, Chad L.; Leibowitz, Caitlin S.; Kurosawa, Shinichiro; Stearns-Kurosawa, Deborah J.

    2012-01-01

    Food-borne diseases are estimated at 76 million illnesses and 5000 deaths every year in the United States with the greatest burden on young children, the elderly and immunocompromised populations. The impact of efficient food distribution systems and a truly global food supply ensures that outbreaks, previously sporadic and contained locally, are far more widespread and emerging pathogens have far more frequent infection opportunities. Enterohemorrhagic E. coli is an emerging food- and water-borne pathogen family whose Shiga-like toxins induce painful hemorrhagic colitis with potentially lethal complications of hemolytic uremic syndrome (HUS). The clinical manifestations of Shiga toxin-induced HUS overlap with other related syndromes yet molecular mechanisms differ considerably. As discussed herein, understanding these differences and the novel properties of the toxins is imperative for clinical management decisions, design of appropriate animal models, and choices of adjunctive therapeutics. The emergence of new strains with rapidly aggressive virulence makes clinical and research initiatives in this field a high public health priority. PMID:23202315

  16. Human Serum is as Efficient as Fetal Bovine Serum in Supporting Proliferation and Differentiation of Human Multipotent Stromal (Mesenchymal) Stem Cells In Vitro and In Vivo

    DEFF Research Database (Denmark)

    Aldahmash, Abdullah; Haack-Sørensen, Mandana; Al-Nbaheen, May

    2011-01-01

    BACKGROUND: Human multipotent stromal (skeletal, mesenchymal) stem cells (hMSC) are employed in an increasing number of clinical trials for tissue regeneration of age-related degenerative diseases. However, routine use of fetal bovine sera (FBS) for their in vitro expansion is not optimal and may...... pose a health risk for patients. METHODS: We carried out a side-by-side comparison of the effects of allogenic pooled human serum (HuS) versus FBS on hMSC proliferation and differentiation in vitro and in vivo. As a model for hMSC, we employed telomerase-immortalized hMSC; hMSC-TERT cell line. RESULTS......) or adipocytic markers (PPAR-gamma2, lipoprotein lipase (LPL), aP2), respectively. In order to test for the functional capacity of hMSC-TERT that have been maintained in long-term cultures in the presence of HuS vs. FBS, the cells were mixed with hydroxyapatite/tricalcium phosphate (HA/TCP) and implanted...

  17. Effect of ultra-low doses, ASIR and MBIR on density and noise levels of MDCT images of dental implant sites

    Energy Technology Data Exchange (ETDEWEB)

    Widmann, Gerlig; Schullian, Peter [Medical University of Innsbruck, Department of Radiology, Innsbruck (Austria); Al-Shawaf, Reema; Al-Sadhan, Ra' ed; Al-Ekrish, Asma' a A. [King Saud University, Department of Oral Medicine and Diagnostic Sciences, College of Dentistry, Riyadh (Saudi Arabia); Hoermann, Romed [Medical University of Innsbruck, Division of Clinical and Functional Anatomy, Innsbruck (Austria)

    2017-05-15

    Differences in noise and density values in MDCT images obtained using ultra-low doses with FBP, ASIR, and MBIR may possibly affect implant site density analysis. The aim of this study was to compare density and noise measurements recorded from dental implant sites using ultra-low doses combined with FBP, ASIR, and MBIR. Cadavers were scanned using a standard protocol and four low-dose protocols. Scans were reconstructed using FBP, ASIR-50, ASIR-100, and MBIR, and either a bone or standard reconstruction kernel. Density (mean Hounsfield units [HUs]) of alveolar bone and noise levels (mean standard deviation of HUs) was recorded from all datasets and measurements were compared by paired t tests and two-way ANOVA with repeated measures. Significant differences in density and noise were found between the reference dose/FBP protocol and almost all test combinations. Maximum mean differences in HU were 178.35 (bone kernel) and 273.74 (standard kernel), and in noise, were 243.73 (bone kernel) and 153.88 (standard kernel). Decreasing radiation dose increased density and noise regardless of reconstruction technique and kernel. The effect of reconstruction technique on density and noise depends on the reconstruction kernel used. (orig.)

  18. Hemolytic uremic syndrome associated with paraquat intoxication.

    Science.gov (United States)

    Jang, Ha Nee; Bae, Eun Jin; Hwang, Kyungo; Kang, Yeojin; Yun, Seongeun; Cho, Hyun Seop; Chang, Se-Ho; Park, Dong Jun

    2014-06-01

    We report a case of a 66-year-old patient with paraquat intoxication resulting in the requirement for hemoperfusion, hemodialysis, and plasma exchange. His initial serum paraquat level was 0.24 µg/mL (0.0-0.1 µg/mL). Activated charcoal (50 g) was administered orally, and high-dose N-acetylcysteine (150 mg/kg) was administered intravenously. In addition, immediate 4 h hemoperfusion was also performed for three consecutive days after admission. Hemodialysis was started on the 4th day after admission because of uremia. On the 9th day after admission, laboratory findings demonstrated hemolytic uremic syndrome (HUS): microangiopathic hemolytic anemia (MAHA), thrombocytopenia, elevated reticulocyte count, and lactate dehydrogenase (LDH). Plasma exchange was performed three times consecutively. Anemia and thrombocytopenia were improved, and LDH was normalized after plasma exchange. Urine output increased to 2240 mL/day on the 18th day after admission, and hemodialysis was discontinued. He is currently being observed at our follow-up clinic without renal impairment or pulmonary dysfunction for 1.5 years since discharge. We should suspect paraquat-associated HUS when thrombocytopenia and anemia are maintained for a long time after paraquat intoxication.

  19. Therapeutic concentrations of antibiotics inhibit Shiga toxin release from enterohemorrhagic E. coli O104:H4 from the 2011 German outbreak

    Directory of Open Access Journals (Sweden)

    Corogeanu Diana

    2012-08-01

    Full Text Available Abstract Background The shiga toxin-producing E. coli (STEC O104:H4 caused a major outbreak in Germany in spring 2011. STEC are usually susceptible to common antibiotics. However, antibiotic treatment of STEC-infected patients is not recommended because STEC may enhance production and release of shiga toxins (STX in response to antibiotics, which eventually enhances the frequency and severity of clinical symptoms, including haemolytic uraemic syndrome (HUS and fatalities. Results We characterized the response to antibiotics of STEC O104:H4 isolates from two HUS patients during the German STEC outbreak in spring 2011 in comparison to the common STEC O157:H7. Liquid cultures of STEC O157:H7 and O104:H4 were incubated with graded dilutions of the antibiotics ciprofloxacin, meropenem, fosfomycin, gentamicin, rifampicin, and chloramphenicol. At defined times of antibiotic treatment, transcriptional activation of the STX2 gene, contents of STX and STX-activity in the culture supernatants were quantified. Unlike the common serotype O157:H7, STEC O104:H4 does not release STX in response to therapeutic concentrations of ciprofloxacin, meropenem, fosfomycin, and chloramphenicol. Conclusions In future outbreaks, the response of the respective epidemiologic STEC strain to antibiotics should be rapidly characterized in order to identify antibiotics that do not enhance the release of STX. This will eventually allow clinical studies tackling the question whether antibiotic treatment impacts on the eradication of STEC, clinical course of disease, and frequency of carriers.

  20. Clostridium sordellii as a Cause of Fatal Septic Shock in a Child with Hemolytic Uremic Syndrome

    Directory of Open Access Journals (Sweden)

    Rebekah Beyers

    2014-01-01

    Full Text Available Clostridium sordellii is a toxin producing ubiquitous gram-positive anaerobe, mainly associated with trauma, soft tissue skin infections, and gynecologic infection. We report a unique case of a new strain of Clostridium sordellii (not present in the Center for Disease Control (CDC database infection induced toxic shock syndrome in a previously healthy two-year-old male with colitis-related hemolytic uremic syndrome (HUS. The patient presented with dehydration, vomiting, and bloody diarrhea. He was transferred to the pediatric critical care unit (PICU for initiation of peritoneal dialysis (PD. Due to increased edema and intolerance of PD, he was transitioned to hemodialysis through a femoral vascular catheter. He subsequently developed severe septic shock with persistent leukocytosis and hypotension, resulting in subsequent death. Stool culture confirmed Shiga toxin producing Escherichia coli 0157:H7. A blood culture was positively identified for Clostridium sordellii. Clostridium sordelli is rarely reported in children; to our knowledge this is the first case described in a pediatric patient with HUS.

  1. Magnetism of quaternary sediments

    Science.gov (United States)

    Heller, Friedrich

    Magnetism of Quaternary sediments was the topic of a well-attended symposium held during the 13th INQUA (International Union of Quaternary Research) congress in Beijing, China, August 2-9. More than 40 papers were delivered by scientists from Belgium, England, France, Germany, Japan, New Zealand, Sweden, Switzerland, Taiwan, the United States, the Soviet Union, Yugoslavia, and other countries. The host country contributed to a productive session that was part of the first large scientific meeting to take place in Beijing after the June 4, 1989, upheaval.Nearly half of the studies focused on paleomagnetic and rock magnetic properties of loess in Alaska, Central Asia, China, and New Zealand. Magnetostratigraphic polarity dating was done at some sections in the western (Shaw et al.) and central Chinese loess plateau (Bai and Hus; Wang and Evans; Yue). The interpretation of the polarity pattern found in the western loess plateau still is not unambiguous. In the central part, certain polarity boundaries, such as the Brunhes/Matuyama (B/M) boundary, are found in slightly different stratigraphic positions (Hus et al.; Yue). In deep-sea sediments the lock-in depth of natural remanent magnetization (NRM) at the B/M boundary seems to be a linear function of sedimentation rate (de Menocal et al.). Although the magnetization process in the Chinese loess is not well understood, detailed records of polarity transitions have been reported for the B/M and the Jaramillo R→N transition (Ma et al.; Rolph).

  2. Crosstalk between platelets and the complement system in immune protection and disease.

    Science.gov (United States)

    Verschoor, A; Langer, H F

    2013-11-01

    Platelets have a central function in repairing vascular damage and stopping acute blood loss. They are equally central to thrombus formation in cardiovascular diseases such as myocardial infarction and ischaemic stroke. Beyond these classical prothrombotic diseases, immune mediated pathologies such as haemolytic uraemic syndrome (HUS) or paroxysmal nocturnal haemoglobinuria (PNH) also feature an increased tendency to form thrombi in various tissues. It has become increasingly clear that the complement system, part of the innate immune system, has an important role in the pathophysiology of these diseases. Not only does complement influence prothrombotic disease, it is equally involved in idiopathic thrombocytopenic purpura (ITP), an autoimmune disease characterised by thrombocytopenia. Thus, there are complex interrelationships between the haemostatic and immune systems, and platelets and complement in particular. Not only does complement influence platelet diseases such as ITP, HUS and PNH, it also mediates interaction between microbes and platelets during systemic infection, influencing the course of infection and development of protective immunity. This review aims to provide an integrative overview of the mechanisms underlying the interactions between complement and platelets in health and disease.

  3. Clinical and Renal Biopsy Findings Predicting Outcome in Renal Thrombotic Microangiopathy: A Large Cohort Study from a Single Institute in China

    Directory of Open Access Journals (Sweden)

    Xiao-Juan YU

    2014-01-01

    Full Text Available Objective. The current study aimed to investigate the spectrum of etiologies and associated disorders of renal biopsy-proven thrombotic microangiopathy (TMA patients. Methods. The clinical, laboratory, and renal histopathological data of patients with renal TMA from 2000 to 2012 in our institute were collected and reviewed. Results. One hundred and nine TMA patients were enrolled in this study. The mean age was 34.0 ± 11.1 years. Seventy patients (64.2% were male and thirty-nine patients (35.8% were female. There were eight patients (7.3% with hemolytic uremic syndrome (HUS. Sixty-one patients (56.0% were secondary to malignant hypertension. Fourteen patients (12.8% were pregnancy-associated TMA. Other associated disorders included 17 patients with connective tissue disorders, 2 patients with hematopoietic stem cell transplantation, 4 patients with Castleman’s disease, 1 patient with cryoglobulinemia, and 2 patients with glomerulopathy. During followup, 8 patients died due to severe infection, 17 patients had doubling of serum creatinine, and 44 had end-stage renal disease. In multivariate analysis, male, elevated serum creatinine, and decreased hemoglobin were independently associated with poor renal outcomes. Conclusions. Renal TMA changes consisted of different disorders with various etiologies. aHUS, pregnancy-associated TMA, and malignant hypertension accounted for the majority of patients in our cohort.

  4. A novel mechanism of bacterial toxin transfer within host blood cell-derived microvesicles.

    Science.gov (United States)

    Ståhl, Anne-lie; Arvidsson, Ida; Johansson, Karl E; Chromek, Milan; Rebetz, Johan; Loos, Sebastian; Kristoffersson, Ann-Charlotte; Békássy, Zivile D; Mörgelin, Matthias; Karpman, Diana

    2015-02-01

    Shiga toxin (Stx) is the main virulence factor of enterohemorrhagic Escherichia coli, which are non-invasive strains that can lead to hemolytic uremic syndrome (HUS), associated with renal failure and death. Although bacteremia does not occur, bacterial virulence factors gain access to the circulation and are thereafter presumed to cause target organ damage. Stx was previously shown to circulate bound to blood cells but the mechanism by which it would potentially transfer to target organ cells has not been elucidated. Here we show that blood cell-derived microvesicles, shed during HUS, contain Stx and are found within patient renal cortical cells. The finding was reproduced in mice infected with Stx-producing Escherichia coli exhibiting Stx-containing blood cell-derived microvesicles in the circulation that reached the kidney where they were transferred into glomerular and peritubular capillary endothelial cells and further through their basement membranes followed by podocytes and tubular epithelial cells, respectively. In vitro studies demonstrated that blood cell-derived microvesicles containing Stx undergo endocytosis in glomerular endothelial cells leading to cell death secondary to inhibited protein synthesis. This study demonstrates a novel virulence mechanism whereby bacterial toxin is transferred within host blood cell-derived microvesicles in which it may evade the host immune system.

  5. Active Shiga-Like Toxin Produced by Some Aeromonas spp., Isolated in Mexico City

    Science.gov (United States)

    Palma-Martínez, Ingrid; Guerrero-Mandujano, Andrea; Ruiz-Ruiz, Manuel J.; Hernández-Cortez, Cecilia; Molina-López, José; Bocanegra-García, Virgilio; Castro-Escarpulli, Graciela

    2016-01-01

    Shiga-like toxins (Stx) represent a group of bacterial toxins involved in human and animal diseases. Stx is produced by enterohemorrhagic Escherichia coli, Shigella dysenteriae type 1, Citrobacter freundii, and Aeromonas spp.; Stx is an important cause of bloody diarrhea and hemolytic uremic syndrome (HUS). The aim of this study was to identify the stx1/stx2 genes in clinical strains and outer membrane vesicles (OMVs) of Aeromonas spp., 66 strains were isolated from children who live in Mexico City, and Stx effects were evaluated in Vero cell cultures. The capacity to express active Stx1 and Stx2 toxins was determined in Vero cell cultures and the concentration of Stx was evaluated by 50% lethal dose (LD50) assays, observing inhibition of damaged cells by specific monoclonal antibodies. The results obtained in this study support the hypothesis that the stx gene is another putative virulence factor of Aeromonas, and since this gene can be transferred horizontally through OMVs this genus should be included as a possible causal agents of gastroenteritis and it should be reported as part of standard health surveillance procedures. Furthermore, these results indicate that the Aeromonas genus might be a potential causative agent of HUS. PMID:27725813

  6. Effects of antibiotics on Shiga toxin 2 production and bacteriophage induction by epidemic Escherichia coli O104:H4 strain.

    Science.gov (United States)

    Bielaszewska, Martina; Idelevich, Evgeny A; Zhang, Wenlan; Bauwens, Andreas; Schaumburg, Frieder; Mellmann, Alexander; Peters, Georg; Karch, Helge

    2012-06-01

    The role of antibiotics in treatment of enterohemorrhagic Escherichia coli (EHEC) infections is controversial because of concerns about triggering hemolytic-uremic syndrome (HUS) by increasing Shiga toxin (Stx) production. During the recent large EHEC O104:H4 outbreak, antibiotic therapy was indicated for some patients. We tested a diverse panel of antibiotics to which the outbreak strain is susceptible to interrogate the effects of subinhibitory antibiotic concentrations on induction of stx(2)-harboring bacteriophages, stx(2) transcription, and Stx2 production in this emerging pathogen. Ciprofloxacin significantly increased stx(2)-harboring phage induction and Stx2 production in outbreak isolates (P values of 0.1) and chloramphenicol, meropenem, azithromycin, rifaximin, and tigecycline significantly decreased them (P ≤ 0.05). Ciprofloxacin and chloramphenicol significantly upregulated and downregulated stx(2) transcription, respectively (P antibiotics had insignificant effects (P > 0.1). Meropenem, azithromycin, and rifaximin, which were used for necessary therapeutic or prophylactic interventions during the EHEC O104:H4 outbreak, as well as tigecycline, neither induced stx(2)-harboring phages nor increased stx(2) transcription or Stx2 production in the outbreak strain. These antibiotics might represent therapeutic options for patients with EHEC O104:H4 infection if antibiotic treatment is inevitable. We await further analysis of the epidemic to determine if usage of these agents was associated with an altered risk of developing HUS.

  7. A novel mechanism of bacterial toxin transfer within host blood cell-derived microvesicles.

    Directory of Open Access Journals (Sweden)

    Anne-lie Ståhl

    2015-02-01

    Full Text Available Shiga toxin (Stx is the main virulence factor of enterohemorrhagic Escherichia coli, which are non-invasive strains that can lead to hemolytic uremic syndrome (HUS, associated with renal failure and death. Although bacteremia does not occur, bacterial virulence factors gain access to the circulation and are thereafter presumed to cause target organ damage. Stx was previously shown to circulate bound to blood cells but the mechanism by which it would potentially transfer to target organ cells has not been elucidated. Here we show that blood cell-derived microvesicles, shed during HUS, contain Stx and are found within patient renal cortical cells. The finding was reproduced in mice infected with Stx-producing Escherichia coli exhibiting Stx-containing blood cell-derived microvesicles in the circulation that reached the kidney where they were transferred into glomerular and peritubular capillary endothelial cells and further through their basement membranes followed by podocytes and tubular epithelial cells, respectively. In vitro studies demonstrated that blood cell-derived microvesicles containing Stx undergo endocytosis in glomerular endothelial cells leading to cell death secondary to inhibited protein synthesis. This study demonstrates a novel virulence mechanism whereby bacterial toxin is transferred within host blood cell-derived microvesicles in which it may evade the host immune system.

  8. Conditioning with total body irradiation for autologous bone marrow transplantation in patients with advanced neuroblastoma

    Energy Technology Data Exchange (ETDEWEB)

    Chin, Motoaki; Mugishima, Hideo; Nagata, Toshihito; Shichino, Hiroyuki; Takamura, Mayumi; Shimada, Toshiaki; Suzuki, Takashi; Fujisawa, Takahito; Harada, Kensuke [Nihon Univ., Tokyo (Japan). School of Medicine

    1996-12-01

    We administered a combination of chemotherapy, autologous bone marrow purged with magnet immunobeads and total body irradiation (TBI) for advanced neuroblastoma (NB). The effect of TBI was retrospectively studied with regard to hematological recovery and complications after autologous bone marrow transplantation (A-BMT). The bone marrow was engrafted in all patients, both recipients and non-recipients of TBI. In patients receiving TBI, the average number or days after A-BMT required for the white blood cell count to exceed 1,000/{mu}l, the neutrophile count to exceed 500/{mu}l and the platelet count to exceed 5.0 x 10{sup 4}/{mu}l was 15.0{+-}6.5, 16.0{+-}6.4 and 59.7{+-}24.4, respectively. In patients not receiving TBI, the corresponding figures were 12.2{+-}6.2, 12.9{+-}6.9 and 43.2{+-}17.8 days, respectively. During hematological recovery after A-BMT, there was no statistical difference between patients having received TBI and those who did not receive TBI. Hemolytic uremic syndrome (HUS) was observed in four patients while receiving TBI, but no HUS developed after shielding the kidney from TBI. In terms or engraftment and complications, A-BMT can be performed on patients receiving TBI as safely as on those patients not receiving TBI. (author)

  9. Detection of Shiga Toxin-Producing Strains of Escherichia coli (O157:H7 isolated from specimens of urinary and stool by Multiplex-PCR method

    Directory of Open Access Journals (Sweden)

    seyed mohammad nayeb Nayeb Aghaee

    2006-06-01

    Full Text Available Background: Infection of shiga toxin-producing Strains of Escherichia coli has some other dangerous and deadly effects such as hemolytic uremic syndrome (HUS in addition to diarrhea. Its diagnosis is difficult and there is no information on It's incidence in Iran. The goal of this study is to evaluate and detect shiga toxinproducing strains of E. coli isolated from urinary and stool specimens by multiplex- PCR method. Materials and Methods: One hundred samples out of 500 collected samples were screened. The selected samples have more chance of heaving different kinds of O157. After DNA extraction from the isolated strains, the multiplex PCR reaction for both stx1 and stx2 genes performed and consequently amplicons were examined by agarose gel electrophoresis. Samples were analyzed after painting by ethidium bromide. Findings: Only 3 cases (3% of the studied sample were positive for the presence of STEC. All three cases were related to stx2. Two of them were related from feces samples and one of them was isolated from the urine samples. Conclusion: Although it seems that the incidence and prevalence of gastrointestinal infections by STEC are low in Iran, But because of the serious complications of the STEC infection such as HUS and HC and failure of detection of these strains by routine methods it is necessary to use molecular and serological diagnostic methods, especially in childhood clinics for recognizing doubtful cases.

  10. Selective Evolution of Ligands by Exponential Enrichment to Identify RNA Aptamers against Shiga Toxins.

    Science.gov (United States)

    Challa, Sreerupa; Tzipori, Saul; Sheoran, Abhineet

    2014-01-01

    Infection with Shiga toxin- (Stx-) producing E. coli causes life threatening hemolytic uremic syndrome (HUS), a leading cause of acute renal failure in children. Of the two antigenically distinct toxins, Stx1 and Stx2, Stx2 is more firmly linked with the development of HUS. In the present study, selective evolution of ligands by exponential enrichment (SELEX) was used in an attempt to identify RNA aptamers against Stx1 and Stx2. After 5 rounds of selection, significant enrichment of aptamer pool was obtained against Stx2, but not against Stx1, using a RNA aptamer library containing 56 random nucleotides (N56). Characterization of individual aptamer sequences revealed that six unique RNA aptamers (mA/pC, mB/pA, mC, mD, pB, and pD) recognized Stx2 in a filter binding assay. None of these aptamers bound Stx1. Aptamers mA/pC, mB/pA, mC, and mD, but not pB and pD, partially blocked binding of Alexa 488-labeled Stx2 with HeLa cells in a flow cytometry assay. However, none of the aptamers neutralized Stx2-mediated cytotoxicity and death of HeLa cells.

  11. Selective Evolution of Ligands by Exponential Enrichment to Identify RNA Aptamers against Shiga Toxins

    Directory of Open Access Journals (Sweden)

    Sreerupa Challa

    2014-01-01

    Full Text Available Infection with Shiga toxin- (Stx- producing E. coli causes life threatening hemolytic uremic syndrome (HUS, a leading cause of acute renal failure in children. Of the two antigenically distinct toxins, Stx1 and Stx2, Stx2 is more firmly linked with the development of HUS. In the present study, selective evolution of ligands by exponential enrichment (SELEX was used in an attempt to identify RNA aptamers against Stx1 and Stx2. After 5 rounds of selection, significant enrichment of aptamer pool was obtained against Stx2, but not against Stx1, using a RNA aptamer library containing 56 random nucleotides (N56. Characterization of individual aptamer sequences revealed that six unique RNA aptamers (mA/pC, mB/pA, mC, mD, pB, and pD recognized Stx2 in a filter binding assay. None of these aptamers bound Stx1. Aptamers mA/pC, mB/pA, mC, and mD, but not pB and pD, partially blocked binding of Alexa 488-labeled Stx2 with HeLa cells in a flow cytometry assay. However, none of the aptamers neutralized Stx2-mediated cytotoxicity and death of HeLa cells.

  12. A community outbreak of haemolytic-uraemic syndrome in children occurring in a large area of northern Italy over a period of several months.

    Science.gov (United States)

    Tozzi, A. E.; Niccolini, A.; Caprioli, A.; Luzzi, I.; Montini, G.; Zacchello, G.; Gianviti, A.; Principato, F.; Rizzoni, G.

    1994-01-01

    From March to October 1993, 15 cases of haemolytic-uraemic syndrome (HUS) in children were detected in a large area of northern Italy, where only 8 cases had occurred in the previous 5 years. Analysis of stool and serum specimens obtained from 14 cases showed evidence of Verotoxin-producing Escherichia coli (VTEC) infection in 13. Serum antibodies to the E. coli O157 lipopolysaccharide (LPS) were found in 8 patients and to the O111 LPS in 2. An O86 VTEC was isolated from another patient. Fourteen children needed dialysis, and 1 died. No obvious epidemiologic link was observed among cases, most of whom lived in small townships. A case-control study did not show an association between HUS and food or exposure to cattle, but suggested an association with contact with chicken coops (OR = 6.5, 95% C.I. 1.2-34.9). However, VTEC were not isolated from stool samples obtained from the chicken coops involved. The risk factors for VTEC infection related to living in rural settlements, including the exposure to live poultry, should be considered in outbreak investigations. PMID:7925660

  13. Quantitative MRI shows cerebral microstructural damage in hemolytic-uremic syndrome patients with severe neurological symptoms but no changes in conventional MRI

    Energy Technology Data Exchange (ETDEWEB)

    Weissenborn, Karin; Worthmann, Hans; Heeren, Meike [Hannover Medical School, Clinic for Neurology, Hannover (Germany); Bueltmann, Eva; Donnerstag, Frank; Giesemann, Anja M.; Goetz, Friedrich; Lanfermann, Heinrich; Ding, Xiao-Qi [Hannover Medical School, Institute of Diagnostic and Interventional Neuroradiology, Hannover (Germany); Kielstein, Jan; Schwarz, Anke [Hannover Medical School, Clinic for Nephrology and Hypertension, Hannover (Germany)

    2013-07-15

    Severe neurological symptoms in Shiga toxin-producing Escherichia coli infection associated hemolytic-uremic syndrome (STEC-HUS) are often accompanied by none or only mild alterations of cerebral magnetic resonance imaging (MRI). This study aims to analyze if quantitative MRI is able to reveal cerebral pathological alterations invisible for conventional MRI. In nine patients with STEC-HUS associated severe neurological symptoms but inconspicuous cerebral MRI findings maps of the parameters T2 relaxation time, relative proton density (PD), apparent diffusion coefficient (ADC), and fractional anisotropy (FA) were generated. Quantitative values of these parameters were measured at the basal ganglia, thalamus, and white matter of the frontal and parietal lobe and compared to those of nine age- and sex-matched controls. Significant T2 prolongation (p < 0.01) was found in the basal ganglia of all patients compared to controls. PD and ADC were not significantly altered. A significant reduction of FA in patients was seen at caput nuclei caudati (p < 0.01). Prolonged T2 relaxation time indicates cerebral microstructural damages in these patients despite their inconspicuous MRI findings. T2 relaxometry could be used as a complementary tool for the assessment of metabolic-toxic brain syndromes. (orig.)

  14. [The drug sensitivity of enterohemorragic Escherichia coli and antibiotics treatment for hemorrhagic enterocolitis--from an outbreak of enterocolitis in Sakai city].

    Science.gov (United States)

    Moriguchi, N; Yagi, K; Yamamoto, T; Yoshioka, K; Kubo, S

    1997-07-01

    In July, 1996, a massive outbreak of hemorrhagic enterocolitis involving more than 5,000 people was caused by enterohemorragic Escherichia coli (EHEC) O157:H7 occurred mainly among elementary school children of Sakai City, Japan. The antibacterial activities in vitro against EHEC from stool specimens were determined. Norfloxacin showed the highest antibacterial activity, and fosfomycin, kanamycin, ampicillin, cefaclor were considered as effective drugs. But doxycycline showed lower antibacterial activities compared to other examined drugs, and it appears necessary to take antibiotic resistance of Escherichia coli into consideration when a treatment regimen is determined. As a result of the oral administration of fosfomycin to 95 patients of hemorrhagic enterocolitis and carrier, no patients developed complications with hemolytic uremic syndrome (HUS). However, a study of 17 patients with HUS demonstrated the fact that most of them were subjected to intravenous administration of fosfomycin. It may be needed to consider oral administration route of effective antibiotics in the treatment of enterocolitis in order to maintain high concentrations of a drug in the intestine.

  15. Technical Note: Radiation properties of tissue- and water-equivalent materials formulated using the stoichiometric analysis method in charged particle therapy

    Energy Technology Data Exchange (ETDEWEB)

    Yohannes, Indra; Vasiliniuc, Stefan [Radiation Oncology, University Hospital Erlangen, Erlangen 91054 (Germany); Hild, Sebastian [Faculty of Medicine, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen 91054, Germany and Department of Biophysics, GSI - Helmholtz Centre for Heavy Ion Research, Darmstadt 64291 (Germany); Langner, Oliver [QRM - Quality Assurance in Radiology and Medicine GmbH, Möhrendorf 91096 (Germany); Graeff, Christian [Department of Biophysics, GSI - Helmholtz Centre for Heavy Ion Research, Darmstadt 64291 (Germany); Bert, Christoph, E-mail: christoph.bert@uk-erlangen.de [Radiation Oncology, University Hospital Erlangen, Erlangen 91054 (Germany); Faculty of Medicine, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen 91054 (Germany); Department of Biophysics, GSI - Helmholtz Centre for Heavy Ion Research, Darmstadt 64291 (Germany)

    2016-01-15

    Purpose: Five tissue- and water-equivalent materials (TEMs) mimicking ICRU real tissues have been formulated using a previously established stoichiometric analysis method (SAM) to be applied in charged particle therapy. The purpose of this study was an experimental verification of the TEMs-SAM against charged particle beam measurements and for different computed tomography (CT) scanners. The potential of the TEMs-SAM to be employed in the dosimetry was also investigated. Methods: Experimental verification with three CT scanners was carried out to validate the calculated Hounsfield units (HUs) of the TEMs. Water-equivalent path lengths (WEPLs) of the TEMs for proton (106.8 MeV/u), helium (107.93 MeV/u), and carbon (200.3 MeV/u) ions were measured to be compared with the computed relative stopping powers. HU calibration curves were also generated. Results: Differences between the measured HUs of the TEMs and the calculated HUs of the ICRU real tissues for all CT scanners were smaller than 4 HU except for the skeletal tissues which deviated up to 21 HU. The measured WEPLs verified the calculated WEPLs of the TEMs (maximum deviation was 0.17 mm) and were in good agreement with the calculated WEPLs of the ICRU real tissues (maximum deviation was 0.23 mm). Moreover, the relative stopping powers converted from the measured WEPLs differed less than 0.8% and 1.3% from the calculated values of the SAM and the ICRU, respectively. Regarding the relative nonelastic cross section per unit of volume for 200 MeV protons, the ICRU real tissues were generally well represented by the TEMs except for adipose which differed 3.8%. Further, the HU calibration curves yielded the mean and the standard deviation of the errors not larger than 0.5% and 1.9%, respectively. Conclusions: The results of this investigation implied the potential of the TEMs formulated using the SAM to be employed for both, beam dosimetry and HU calibration in charged particle therapy.

  16. Simulation of Streamflow and Water Quality to Determine Fecal Coliform and Nitrate Concentrations and Loads in the Mad River Basin, Ohio

    Science.gov (United States)

    Reutter, David C.; Puskas, Barry M.; Jagucki, Martha L.

    2006-01-01

    The Hydrological Simulation Program Fortran (HSPF) was used to simulate the concentrations and loads of fecal coliform and nitrate for streams in the Mad River Basin in west-central Ohio during the period 1999 through 2003. The Mad River Basin was divided into subbasins that were defined either by the 14-digit Hydrologic Unit (HU) boundaries or by streamflow-gaging-station locations used in the model. Model calibration and simulation processes required the formation of nine meteorologic zones to input meteorologic time-series data and water-quality data. Sources of fecal coliform and nitrate from wastewater-treatment discharges and combined sewer overflow discharges (CSOs) within the City of Springfield were point sources simulated in the model. Failing septic systems and cattle with direct access to streams were nonpoint sources included in the study but treated in the model as point sources. Other nonpoint sources were addressed by adjusting interflow and ground-water concentrations in the subsurface and maximum storage capacities and accumulation rates of the simulated constituents on the land surface for each meteorologic zone. Simulation results from the calibrated model show that several HUs exceeded the water-quality standard of 1,000 colony-forming units per 100 mL for fecal coliform based on the maximum 30-day geometric mean. Most HUs with high fecal coliform counts were within or downstream from the City of Springfield. No water-quality standard has been set for instream nitrate concentrations; however, the Ohio Environmental Protection Agency (Ohio EPA) considered a concentration of 5 mg/L or greater to be of concern. Simulation results indicate that several HUs in the agricultural areas of the basin exceeded this level. The calibrated model was modified to create scenarios that simulated loads of fecal coliform and nitrate that were either reduced or eliminated from selected sources. The revised models included the elimination of failing septic systems

  17. Fatty degeneration of the rotator cuff muscles on pre- and postoperative CT arthrography (CTA): is the Goutallier grading system reliable?

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Eugene; Choi, Jung-Ah; Kang, Heung Sik [Seoul National University Bundang Hospital, Department of Radiology, Seongnam-si, Gyeongi-do (Korea, Republic of); Seoul National University College of Medicine, Department of Radiology, 28 Yeongon-dong, Chongno-gu, Seoul (Korea, Republic of); Oh, Joo Han [Seoul National University Bundang Hospital, Department of Orthopedic Surgery, Seongnam-si, Gyeongi-do (Korea, Republic of); Ahn, Soyeon [Seoul National University Bundang Hospital, Medical Research Collaborating Center, Seongnam-si, Gyeongi-do (Korea, Republic of); Hong, Sung Hwan [Seoul National University College of Medicine, Department of Radiology, 28 Yeongon-dong, Chongno-gu, Seoul (Korea, Republic of); Chai, Jee Won [SMG-SNU Boramae Medical Center, Department of Radiology, 425 Shindaebang-dong, Dongjak-gu, Seoul (Korea, Republic of)

    2013-09-15

    To retrospectively evaluate fatty degeneration (FD) of rotator cuff muscles on CTA using Goutallier's grading system and quantitative measurements with comparison between pre- and postoperative states. IRB approval was obtained for this study. Two radiologists independently reviewed pre- and postoperative CTAs of 43 patients (24 males and 19 females, mean age, 58.1 years) with 46 shoulders confirmed as full-thickness tears with random distribution. FD of supraspinatus, infraspinatus/teres minor, and subscapularis was assessed using Goutallier's system and by quantitative measurements of Hounsfield units (HUs) on sagittal images. Changes in FD grades and HUs were compared between pre- and postoperative CTAs and analyzed with respect to preoperative tear size and postoperative cuff integrity. The correlations between qualitative grades and quantitative measurements and their inter-observer reliabilities were also assessed. There was statistically significant correlation between FD grades and HU measurements of all muscles on pre- and postoperative CTA (p < 0.05). Inter-observer reliability of fatty degeneration grades were excellent to substantial on both pre- and postoperative CTA in supraspinatus (0.8685 and 0.8535) and subscapularis muscles (0.7777 and 0.7972), but fair in infraspinatus/teres minor muscles (0.5791 and 0.5740); however, quantitative Hounsfield units measurements showed excellent reliability for all muscles (ICC: 0.7950 and 0.9346 for SST, 0.7922 and 0.8492 for SSC, and 0.9254 and 0.9052 for IST/TM). No muscle showed improvement of fatty degeneration after surgical repair on qualitative and quantitative assessments; there was no difference in changes of fatty degeneration after surgical repair according to preoperative tear size and post-operative cuff integrity (p > 0.05). The average dose-length product (DLP, mGy . cm) was 365.2 mGy . cm (range, 323.8-417.2 mGy . cm) and estimated average effective dose was 5.1 mSv. Goutallier grades

  18. Biodistribution and elimination kinetics of systemic Stx2 by the Stx2A and Stx2B subunit-specific human monoclonal antibodies in mice

    Directory of Open Access Journals (Sweden)

    Sheoran Abhineet

    2012-06-01

    Full Text Available Abstract Background Hemolytic uremic syndrome (HUS leading to acute kidney failure, is a condition linked to the production of primarily Shiga toxin 2 (Stx2 by some E. coli serotypes. We have previously shown that Stx2 A subunit-specific human monoclonal antibody (HuMAb 5C12, and B subunit-specific HuMAb 5H8 inhibit cultured cell death, and protect mice and piglets from fatal Stx2-intoxication. We have also shown that 5H8 blocks binding of Stx2 to its cell-surface receptor globotriaosyl ceramide (Gb3, whereas Stx2 when complexed with 5C12 binds Gb3 with higher affinity than Stx2. The mechanism by which 5C12 neutralizes Stx2 in vitro involves trapping of Stx2 in the recycling endosomes and releasing it into the extracellular environment. Because of the clinical implications associated with the formation of Stx2/antibody complexes and the potential for trapping and clearance through a severely damaged kidney associated with HUS, we investigated the likely site(s of Stx2/antibody localization and clearance in intoxicated mice treated with antibody or placebo. Results Mice were injected with radiolabeled Stx2 (125I-Stx2 4 hours after administration of 5C12, 5H8, or phosphate buffered saline (PBS and the sites of localization of labeled Stx2, were investigated 3, 24 and 48 hours later. The liver recorded statistically much higher concentrations of labeled Stx2 for groups receiving 5C12 and 5H8 antibodies after 3, 24 and 48 hours, as compared with the PBS group. In contrast, highest levels of labeled Stx2 were detected in the kidneys of the PBS group at all 3 sampling times. Mice receiving either of the two HuMAbs were fully protected against the lethal effect of Stx2, as compared with the fatal outcome of the control group. Conclusions The results suggest that HuMAbs 5C12 and 5H8 promoted hepatic accumulation and presumably clearance of toxin/antibody complexes, significantly diverting Stx2 localization in the kidneys, the target of Stx2 and the

  19. Effect of Point Application in Dog Days on Serum IgE, IL-4, IFN-γ in Patients with Allergic Rhinitis%三伏天穴位敷贴疗法对变应性鼻炎患者血清IgE、IL-4、IFN-γ的影响

    Institute of Scientific and Technical Information of China (English)

    林佳静; 何晓华; 胡雨华; 王彦成; 孙伯坚; 韩梅

    2011-01-01

    Objective To establish a prokaryotio expression vector for FcγRIIb extracellular gene, to induce its expression and to purify the protein. Methods The human FcγRIIb extracellular gene was amplified by PCR and inserted into pET32a( + ).The recombinant vector pET -sFcγRIIb was analyzed by PCR,restriction enzyme digestion and DNA sequencing. The recombinant vector pET - sFcγRIIb was transformed into BL21. Through observing protein expression induced by IPTG at different temperature and time, the best induced conditionswere confirmed. The protein was detected by SDS - PAGE and then purified. Results The recombi-nant vector pET - sFcyRIIb was constructed and the husFcγRHb protein was successfully expressed after in-duced 10 hours by IPTG in SOX, and purified. Conclusion We have got the fusion protein of hus FcγRIIb by establishing pET - s FcyRIIb and laid a basis for further study of husFcγRIIb protein.%目的 观察三伏天穴位敷贴疗法对变应性鼻炎患者血清IgE及IL-4、IFN-γ的影响,为经腧穴处皮肤给药刺激经络系统达到调节免疫,治疗变应性疾病提供依据.方法 在农历三伏天对变应性鼻炎患者进行穴位敷贴治疗,采用放射免疫法检测变应性鼻炎患者治疗前后及健康体检者血清IgE、IL-4和IFN-γ.结果 治疗前变应性鼻炎患者血清总IgE及IL-4水平明显高于健康体检者(P<0.01),血清IFN-γ与健康体检者相比差异无统计学意义(P>0.05).经1个疗程穴位敷贴治疗后,患者血清总IgE较治疗前明显降低(P<0.05),但IL-4和IFN-γ无明显变化(P>0.05).结论 穴位敷贴疗法治疗变应性鼻炎可降低血清IgE水平.

  20. International benchmarking of tertiary trauma centers: productivity and throughput approach

    Directory of Open Access Journals (Sweden)

    Matthes Gerrit

    2011-08-01

    Full Text Available Abstract Background Care process in tertiary trauma centers consists of a chain of care phases in different departments from the emergency department (ED to post-operative rehabilitation. The historical evolution of healthcare systems and organizations has led to variations in trauma patient processes in different countries. The present study is aimed at revealing differences in the throughput and productivity of trauma patient processes between German (UKB and Finnish (HUS tertiary trauma centers. Problems related to the comparison of different healthcare systems were also identified. The share of patients discharged was used as a control measure. Results The biggest differences between the hospitals were found in the use of resources in the ED and in post-operative care. Despite problems in defining comparable patients and resources, ED productivity was significantly higher in UKB. Post-operative care was, on average, 41% shorter in HUS. However, the share of patients discharged was significantly higher in UKB (96.5% vs. 68.9%. Differences were also found in the pre-operative length of stay of patients with proximal femoral fractures (UKB: 0.97 days, HUS: 1.57 days. The productivity of the operating unit was quite similar in the hospitals. In terms of ED mortality, no statistically significant differences were found. Conclusions The results of the present study showed significant differences in the use of resources and throughput times in trauma patient processes between Finnish and German hospitals. However, due to system-level differences between German and Finnish healthcare, the results cannot be directly transformed into development proposals for the organizations. On the other hand, in spite of certain differences regarding the healthcare systems, the demographic data of the trauma patients and medical procedures are comparable. Based on the present study, the ED process of severe trauma, pre-operative care, and operating unit processes

  1. Epidemiology and clinical manifestations of enteroaggregative Escherichia coli

    DEFF Research Database (Denmark)

    Hebbelstrup Jensen, Betina; Olsen, Katharina E P; Struve, Carsten

    2014-01-01

    Enteroaggregative Escherichia coli (EAEC) represents a heterogeneous group of E. coli strains. The pathogenicity and clinical relevance of these bacteria are still controversial. In this review, we describe the clinical significance of EAEC regarding patterns of infection in humans, transmission......, reservoirs, and symptoms. Manifestations associated with EAEC infection include watery diarrhea, mucoid diarrhea, low-grade fever, nausea, tenesmus, and borborygmi. In early studies, EAEC was considered to be an opportunistic pathogen associated with diarrhea in HIV patients and in malnourished children...... in developing countries. In recent studies, associations with traveler's diarrhea, the occurrence of diarrhea cases in industrialized countries, and outbreaks of diarrhea in Europe and Asia have been reported. In the spring of 2011, a large outbreak of hemolytic-uremic syndrome (HUS) and hemorrhagic colitis...

  2. Enzyme-linked immunosorbent assay for detection of immunoglobulin G antibodies to Escherichia coli Vero cytotoxin 1.

    Science.gov (United States)

    Karmali, M A; Petric, M; Winkler, M; Bielaszewska, M; Brunton, J; van de Kar, N; Morooka, T; Nair, G B; Richardson, S E; Arbus, G S

    1994-06-01

    The frequency of Vero cytotoxin 1 (VT1)-neutralizing antibody (NAb) in serum specimens from 790 age-stratified (0 to 70 years) control individuals from Toronto was 61 of 790 (7.7%), with a peak of 19% in the 20- to 30-year-old age group and a second peak of 16.7% in the 60- to 70-year-old age group. A total of 568 serum specimens, including 538 from the 790 Toronto control subjects, 21 from patients from three outbreaks of VT-producing Escherichia coli (VTEC) infection, and 9 known VT1-NAb-positive serum specimens from patients with hemolytic-uremic syndrome (HUS), were then tested for the presence of anti-VT1 immunoglobulin G (IgG) by an enzyme-linked immunosorbent assay (ELISA). The mean ELISA values of 522 VT1-NAb-negative serum specimens and 46 VT1-NAb-positive serum specimens were 0.09 +/- 0.06 (range, 0 to 0.56) and 0.78 +/- 0.66 (range, 0.16 to 2.91), respectively (P < 0.001; Student's t test). With a breakpoint of 0.21 (mean ELISA value of the VT1-NAb-negative sera + 2 standard deviations), the sensitivity, specificity, positive predictive value, and negative predictive value of the VT1 IgG ELISA compared with those of the VT1-NAb assay were, respectively, 95.7, 98.7, 86.3, and 99.6%. There were nine discrepant serum specimens, of which seven were anti-VT1 IgG positive and VT1-NAb negative and two were anti-VT1 IgG negative and VT1-NAb positive. The ELISA was also used for testing 238 control serum specimens from The Netherlands, Japan, and India and acute- and convalescent-phase serum specimens from 42 Toronto patients with HUS. The frequencies of anti-VT1 IgG (with VT1-NAb frequencies in parantheses) in control sera from the Netherlands, Japan, and India were 6% (3%), 1.1% (0%), and 12% (10%), respectively, with no age clustering. The frequencies of anti-VT1 IgG seropositivity in HUS patients were 5 of 14 (35.7%) in patients with unknown toxin exposure, 2 of 22 (9.1%) in individuals with known exposure to VT1 plus VT2 or VT1 alone, and 0 of 6 (0%) in

  3. Reduced service of the “IT Service Desk” (Computing Helpdesk) on the after noon of Friday 8 October 2010

    CERN Document Server

    IT Department

    2010-01-01

    Please note that due to relocation, the “IT Service Desk” will be operating a reduced service on Friday 8th October from 12-30. In particular, the telephone line 78888 will not be available and users will be invited to submit their requests by e-mail (Computing.Helpdesk@cern.ch). E-mail requests will be treated as normal, but some delays are possible. In the event of urgent problems you may call the IT Manager on Duty on 163013. We also take this opportunity to remind you about the “IT Service Status Board” where all computing incidents and scheduled interventions are updated online. Please see: http://cern.ch/it-servicestatus. Normal service will be resumed at 8-30 a.m on Monday 11 October. Thank you in advance for your understanding. The CERN “User Support” Team (IT-UDS-HUS)

  4. Catalog of databases and reports

    Energy Technology Data Exchange (ETDEWEB)

    Burtis, M.D. [comp.

    1997-04-01

    This catalog provides information about the many reports and materials made available by the US Department of Energy`s (DOE`s) Global Change Research Program (GCRP) and the Carbon Dioxide Information Analysis Center (CDIAC). The catalog is divided into nine sections plus the author and title indexes: Section A--US Department of Energy Global Change Research Program Research Plans and Summaries; Section B--US Department of Energy Global Change Research Program Technical Reports; Section C--US Department of Energy Atmospheric Radiation Measurement (ARM) Program Reports; Section D--Other US Department of Energy Reports; Section E--CDIAC Reports; Section F--CDIAC Numeric Data and Computer Model Distribution; Section G--Other Databases Distributed by CDIAC; Section H--US Department of Agriculture Reports on Response of Vegetation to Carbon Dioxide; and Section I--Other Publications.

  5. 纤维素分解菌分离纯化与鉴定的研究进展

    Institute of Scientific and Technical Information of China (English)

    李美群; 艾文胜; 杨明; 孟勇; 涂佳; 刘翔博; 蒲湘云

    2014-01-01

    以竹基质、秸秆、堆肥、土壤等为对象,概述分离、筛选、纯化、鉴定纤维素分解菌的研究进展,为菌种的研究、保存和利用纤维素分解菌从事农林牧业生产提供参考。%The research progress of isolation, screening, purification, identification on cellulose decomposition microorgan-isms are studied, using bamboo matrix, straw, compost, soil matrix, and so on, as the object, to provide reference for the study, preservation of strains and utilization of cellulose decomposition microorganisms in agriculture, forestry, animal hus-bandry industry.

  6. Need telomere maintenance? Call 911.

    Science.gov (United States)

    Francia, Sofia; Weiss, Robert S; d'Adda di Fagagna, Fabrizio

    2007-01-17

    "Natura non facit saltum" (nature makes no leap) the Latins used to say, meaning that nature does not like discontinuities. Cells make no exception and indeed any discontinuity in the DNA double helix is promptly detected, triggering an alteration of cell proliferation and an attempt to repair. Yet, linear chromosomes bear DNA ends that are compatible with normal cell proliferation and they escape, under normal conditions, any repair. How telomeres, the chromosomes tips, achieve that is not fully understood. We recently observed that the Rad9/Hus1/Rad1 (911) complex, previously known for its functions in DNA metabolism and DNA damage responses, is constitutively associated with telomeres and plays an important role in their maintenance. Here, we summarize the available data and discuss the potential mechanisms of 911 action at telomeres.

  7. 暇步士,倡导一种生活方式

    Institute of Scientific and Technical Information of China (English)

    乌拉

    2009-01-01

    暇步士(HUsH PUPPIES)品牌始创于1958年,以著名的巴吉度猎犬为标志,产品以休闲服装、服饰、鞋类及相关产品为主。40多年来,这些舒适、自然、物超所值的休闲品已成美国休闲方式的象征,并享誉世界各地。到20世纪未足迹已遍布70多个国家200多个城市。

  8. 美国 暇步士 始终是首选

    Institute of Scientific and Technical Information of China (English)

    2005-01-01

    早在1958年,“休闲”,“舒适”还远没有成为时尚。美国暇步士就已先声夺人,把舒适两个字推为优质皮鞋的品版标南,并成功地设计制作出世界上第一双以舒适为首要的体闲鞋。40多年来,Hush Puppies凭着领先科技。使其产品的品质始终令人信服,在它获得的诸多科技专利中,自动调节智慧气势,超轻鞋底,

  9. siRNA干扰人BMP9重组腺病毒载体的构建及其促进乳腺癌SK-BR-3细胞增殖%Construction of recombinant adenovirus vector interfering the expression of human BMP9 and promoting the proliferation of breast cancer SK-BR-3 cells

    Institute of Scientific and Technical Information of China (English)

    刘月红; 王科; 孙笑笑; 万绍恒; 王维; 陈莹莹; 张彦

    2013-01-01

    目的 筛选特异性干扰人BMP9基因的siRNA序列并制备重组腺病毒AdsiBMP9,探讨RNAi人BMP9基因后对乳腺癌SK-BR-3细胞增殖能力的影响.方法 设计制备3对干扰人BMP9的双链DNA序列,亚克隆至Pses-Hus质粒中获得Pses-Hus-siBMP9质粒,脂质体转染乳腺上皮细胞HBL-100筛选有效干扰质粒,构建重组腺病毒并感染SK-BR-3细胞,RT-PCR,Western blot检测BMP9表达,MTT检测细胞增殖能力.结果 成功构建并筛选出针对人BMP9基因的有效干扰质粒并包装成腺病毒,病毒滴度为1×1010IU/mL,感染SK-BR-3细胞显示BMP9在转录水平和翻译水平表达量显著低于对照组和空白组(P<0.05),第5天AdsiBMP9组细胞的增殖率显著高于AdsiNC组(P<0.05).结论 成功构建特异性沉默人BMP9基因的siRNA腺病毒载体,可有效抑制SK-BR-3细胞中BMP9基因的表达从而促进该细胞增殖.%Objective To screen specific small interfering RNA(siRNA) target human BMP9 gene and to prepare recombinant adenovirus vector AdsiBMP9 for investigation of its effects on the proliferation of breast cancer SK-BR-3 cells. Methods Three pairs of double-stranded DNA fragments for silencing human BMP9 were designed and synthesized, then subcloned into the shuttle plasmid Pses-Hus. The recombinant plasmids Pses-Hus-siBMP9 were transfected into the breast epithelial cells HBL-100 by lipofectamine transfection reagent, screened the effective interfering plasmid, constructed AdsiBMP9 and infected SK-BR-3 cells. The expression level of BMP9 mRNA and protein were detected by RT-PCR and western blot. The proliferation of SK-BR-3 cells were observed with MTT assay. Results The recombinant plasmid Pses-Hus-siBMP9 and recombinant adenovirus AdsiBMP9 were successfully constructed and its titer was 1 × 1010 IU/mL. Compared to the negative and non-infected controls, the expres- sion of BMP9 gene was significantly inhibited after the SK-BR-3 cells were infected by AdsiBMP9. SK-BR-3 cells infected with

  10. The checkpoint clamp protein Rad9 facilitates DNA-end resection and prevents alternative non-homologous end joining.

    Science.gov (United States)

    Tsai, Feng-Ling; Kai, Mihoko

    2014-01-01

    DNA damage activates the cell cycle checkpoint to regulate cell cycle progression. The checkpoint clamp (Rad9-Hus1-Rad1 complex) is recruited to damage sites, and is required for checkpoint activation. While functions of the checkpoint clamp in checkpoint activation have been well studied, its functions in DNA repair regulation remain elusive. Here we show that Rad9 is required for efficient homologous recombination (HR), and facilitates DNA-end resection. The role of Rad9 in homologous recombination is independent of its function in checkpoint activation, and this function is important for preventing alternative non-homologous end joining (altNHEJ). These findings reveal novel function of the checkpoint clamp in HR.

  11. [Characterization of first sorbitol-fermenting shiga toxin-producing Escherichia coli O157:H- strain isolated in Poland].

    Science.gov (United States)

    Jakubczak, Aleksandra; Szych, Jolanta; Januszkiewicz, Kamil

    2008-01-01

    Sorbitol-fermenting shiga toxin-producing E. coli O157:H- strains have emerged as a cause of human disease in many European and non-European countries. The role of SF VTEC O157:H- in the etiology of pediatric HUS and diarrhea is significant. We characterized the first SF VTEC O157:H- strain isolated from 9 year old patient in Poland. Strain possessed many traits characteristics for SF VTEC O157:H-. It fermented sorbitol after overnight incubation and produced beta-glucuronidase. It possessed the stx2, eae-gamma, EhlyA and sfpA genes and did not harbour plasmid-encoded katP and espP genes. Motility was not expressed but the strain possessed the chromosomal fliC locus for H7 antigen. The spread of SF VTEC O157:H- strains demonstrates the need for appropriate procedures for their microbiological diagnosis in Poland.

  12. Campylobacter-Associated Hemolytic Uremic Syndrome Associated with Pulmonary-Renal Syndrome.

    Science.gov (United States)

    Bowen, Emily Elizabeth; Hangartner, Robert; Macdougall, Iain

    2016-03-01

    Common causes of pulmonary-renal syndrome include anti-glomerular basement membrane (anti-GBM) disease anti-neutrophil cytoplasmic antibody (ANCA) positive vasculitis, and systemic lupus erythematosus. We describe a case of life-threatening pulmonary hemorrhage associated with Campylobacter hemolytic uremic syndrome (HUS), which we believe is a new disease entity. We hypothesize that the cause of this pulmonary-renal syndrome was an immunological reaction to Campylobacter; and that the initiation of high-dose steroids was responsible for the rapid reversal of the patient's pulmonary and renal impairment. The aim of this article is to raise awareness of this unusual cause of a pulmonary-renal syndrome, guiding physicians to recognize it as a potential complication, and to consider high-dose steroids in managing the condition.

  13. INFLUENCE OF SUPPLY AND DEMAND FACTORS AT THE DEVELOPMENT OF ENVIRONMENTALLY RESPONSIBLE HOUSING AND UTILITIES SECTOR IN THE RUSSIAN FEDERATION

    Directory of Open Access Journals (Sweden)

    Natalia B. Safronova

    2016-11-01

    Full Text Available Empirical marketing regional research on supply and demand factors of housing and communal services (HCS revealed determinants of customer loyalty and satisfaction with the service level and factors influencing on willingness to purchase additional services. Specific features of housing and utilities sector (HUS as a social significant industry determine requirements to models reflecting reciprocal influence of indices of satisfaction, loyalty and economic indices of operation. The article presents definition of requirements along with development of techniques for modeling influence of satisfaction and loyalty on consumer behaviour of clients. The authors demonstrate trustworthy statistical results of correlative interrelationship of different factors. There have been designed regression models for taking management solutions by executives of management company housing and communal services at the development environmental responsibility. The causes that lead and hamper development of socially oriented services in different regions of the Russian Federation have been identified.

  14. Methodological reflections around anthropological fieldwork in the area of recent history

    Directory of Open Access Journals (Sweden)

    María José Sarrabayrouse Oliveira

    2009-03-01

    Full Text Available This article exposes some methodological problems that arose in the development of my dissertation, in which I carry out an ethnographic work about the practices and proceedings of penal justice during the last military dictatorship in Argentina. The research was structured around the analysis of a judicial trial. This led, on the one hand, to the question about what these documents say and which are the possibilities that anthropology offer for its analysis. The research implied, at the same time, the carrying out of interviews to the social actors that officiated as witnesses and protagonists of the story recounted. T hus, written records and testimonies of the period were available for carrying out this research work, both elements that constitute an important part of the fieldwork on the specific area of the penal justice in the 1970s.

  15. Apheresis therapy in children: an overview of key technical aspects and a review of experience in pediatric renal disease.

    Science.gov (United States)

    Hunt, Elizabeth A K; Jain, Namrata G; Somers, Michael J G

    2013-02-01

    Although there is less experience with its use in children than adults, apheresis can be a life-saving treatment modality in certain pediatric diseases. With attention to specific technical aspects of the treatment, especially circuit volume, apheresis can be safely performed in children of any age or size. Even in pediatric diseases where it is recognized as an important part of therapy, apheresis is unfortunately still underutilized in North America and there needs to be increased awareness of its role and its availability within the pediatric community. Apheresis has been used particularly in children with certain renal diseases, notably ANCA-associated nephritis, anti-GBM disease, and atypical HUS. In addition, it can improve outcomes in transplantation of children with FSGS and can be part of a pre-transplant strategy for children who are highly sensitized and at high risk for graft failure.

  16. The Research Advance in Bacillus Coli (O157 :H-) with Shiga Toxin%产志贺毒素大肠杆菌O157:H-研究进展

    Institute of Scientific and Technical Information of China (English)

    王晓萌

    2004-01-01

    产志贺毒素(Shiga toxin,Stx)大肠杆菌(shiga toxinproducing E.coli,STEC)能引起出血性肠炎(hemorrhasic colitis,HC)、溶血性尿毒综合症(hemolytic uremic syndrome,HUS)。利用病原菌的生物表型特征建立经典的实验室诊断程序对病原的鉴别尤为重要,特别是如O157:H7的山梨醇的迟缓发酵性(sorbitol-fermenting,SF)。但也存在例外,

  17. Arkitektur og energi

    DEFF Research Database (Denmark)

    Marsh, Rob; Grupe Larsen, Vibeke; Lauring, Michael;

    Sigtet med denne bog er at belyse samspillet mellem arkitektur og energi i et helhedsperspektiv med afsæt i de nye energibestemmelser for nybyggeri. Samspillet belyses gennem fire samordnede temaer: Dagslys. Samspillet mellem dagslys og arkitektur. Solvarme. Samspillet mellem solvarme og energi....... Råhus. Samspillet mellem materialer og energi. Teknik. Samspillet mellem teknologi og energi. Temaerne præsenteres på en let tilgængelig og grafisk inspirerende måde, så fremtidens lavenergiarkitektur kan udformes på kvalificeret, afvejet og effektiv vis. Bogen henvender sig primært til arkitekter, men...... kan også læses af ingeniører, bygherrer, myndigheder, studerende og andre der interesserer sig for byggeriets energiforhold. Bogens udgivelse er blevet støttet af Dansk Energi-Net's PSO-midler for 2005. Bogen udgives af Statens Byggeforskningsinstitut i samarbejde med Akademisk Arkitektforening....

  18. Recurrent glomerular disease after kidney transplantation.

    Science.gov (United States)

    Blosser, Christopher D; Bloom, Roy D

    2017-08-21

    With improving short-term kidney transplant outcomes, recurrent glomerular disease is being increasingly recognized as an important cause of chronic allograft failure. Further understanding of the risks and pathogenesis of recurrent glomerular disease enable informed transplant decisions, along with the development of preventive and treatment strategies. Multiple observational studies have highlighted differences in rates and outcomes for various recurrent glomerular diseases, although these rates have not markedly improved over the last decade. Emerging evidence supports use of rituximab to treat recurrent primary membranous nephropathy and possibly focal segmental glomerulosclerosis (FSGS), whereas eculizumab is effective in glomerular diseases associated with complement dysregulation [C3 glomerulopathy (C3G) and atypical hemolytic uremic syndrome (aHUS)]. Despite the potential for recurrence in the allograft, transplant remains the optimal therapy for patients with advanced chronic kidney disease (CKD) secondary to primary glomerular disease. Biomarkers and therapeutic options necessitate accurate pretransplant diagnoses with opportunities for improved surveillance and treatment of recurrent glomerular disease posttransplant.

  19. The epidemiology, microbiology and clinical impact of Shiga toxin-producing Escherichia coli in England, 2009-2012.

    Science.gov (United States)

    Byrne, L; Jenkins, C; Launders, N; Elson, R; Adak, G K

    2015-12-01

    Between 1 January 2009 and 31 December 2012 in England, a total of 3717 cases were reported with evidence of Shiga toxin-producing E. coli (STEC) infection, and the crude incidence of STEC infection was 1·80/100 000 person-years. Incidence was highest in children aged 1-4 years (7·63/100 000 person-years). Females had a higher incidence of STEC than males [rate ratio (RR) 1·24, P < 0·001], and white ethnic groups had a higher incidence than non-white ethnic groups (RR 1·43, P < 0·001). Progression to haemolytic uraemic syndrome (HUS) was more frequent in females and children. Non-O157 STEC strains were associated with higher hospitalization and HUS rates than O157 STEC strains. In STEC O157 cases, phage type (PT) 21/28, predominantly indigenously acquired, was also associated with more severe disease than other PTs, as were strains encoding stx2 genes. Incidence of STEC was over four times higher in people residing in rural areas than urban areas (RR 4·39, P < 0·001). Exposure to livestock and/or their faeces was reported twice as often in cases living in rural areas than urban areas (P < 0·001). Environmental/animal contact remains an important risk factor for STEC transmission and is a significant driver in the burden of sporadic STEC infection. The most commonly detected STEC serogroup in England was O157. However, a bias in testing methods results in an unquantifiable under-ascertainment of non-O157 STEC infections. Implementation of PCR-based diagnostic methods designed to detect all STEC, to address this diagnostic deficit, is therefore important.

  20. Characterisation of the SUMO-like domains of Schizosaccharomyces pombe Rad60.

    Directory of Open Access Journals (Sweden)

    Lara K Boyd

    Full Text Available The S. pombe Rad60 protein is required for the repair of DNA double strand breaks, recovery from replication arrest, and is essential for cell viability. It has two SUMO-like domains (SLDs at its C-terminus, an SXS motif and three sequences that have been proposed to be SUMO-binding motifs (SBMs. SMB1 is located in the middle of the protein, SBM2 is in SLD1 and SBM3 is at the C-terminus of SLD2. We have probed the functions of the two SUMO-like domains, SLD1 and SLD2, and the putative SBMs. SLD1 is essential for viability, while SLD2 is not. rad60-SLD2Δ cells are sensitive to DNA damaging agents and hydroxyurea. Neither ubiquitin nor SUMO can replace SLD1 or SLD2. Cells in which either SBM1 or SBM2 has been mutated are viable and are wild type for response to MMS and HU. In contrast mutation of SBM3 results in significant sensitivity to MMS and HU. These results indicate that the lethality resulting from deletion of SLD1 is not due to loss of SBM2, but that mutation of SBM3 produces a more severe phenotype than does deletion of SLD2. Using chemical denaturation studies, FPLC and dynamic light scattering we show this is likely due to the destabilisation of SLD2. Thus we propose that the region corresponding to the putative SBM3 forms part of the hydrophobic core of SLD2 and is not a SUMO-interacting motif. Over-expression of Hus5, which is the SUMO conjugating enzyme and known to interact with Rad60, does not rescue rad60-SLD2Δ, implying that as well as having a role in the sumoylation process as previously described, Rad60 has a Hus5-independent function.

  1. Correlation of contrast-enhanced MR images with the histopathology of minimally invasive thermal and cryoablation cancer treatments in normal dog prostates

    Science.gov (United States)

    Bouley, D. M.; Daniel, B.; Butts Pauly, K.; Liu, E.; Kinsey, A.; Nau, W.; Diederich, C. J.; Sommer, G.

    2007-02-01

    Magnetic Resonance Imaging (MRI) is a promising tool for visualizing the delivery of minimally invasive cancer treatments such as high intensity ultrasound (HUS) and cryoablation. We use an acute dog prostate model to correlate lesion histopathology with contrast-enhanced (CE) T1 weighted MR images, to aid the radiologists in real time interpretation of in vivo lesion boundaries and pre-existing lesions. Following thermal or cryo treatments, prostate glands are removed, sliced, stained with the vital dye triphenyl tetrazolium chloride, photographed, fixed and processed in oversized blocks for routine microscopy. Slides are scanned by Trestle Corporation at .32 microns/pixel resolution, the various lesions traced using annotation software, and digital images compared to CE MR images. Histologically, HUS results in discrete lesions characterized by a "heat-fixed" zone, in which glands subjected to the highest temperatures are minimally altered, surrounded by a rim or "transition zone" composed of severely fragmented, necrotic glands, interstitial edema and vascular congestion. The "heat-fixed" zone is non-enhancing on CE MRI while the "transition zone" appears as a bright, enhancing rim. Likewise, the CE MR images for cryo lesions appear similar to thermally induced lesions, yet the histopathology is significantly different. Glands subjected to prolonged freezing appear totally disrupted, coagulated and hemorrhagic, while less intensely frozen glands along the lesion edge are partially fragmented and contain apoptotic cells. In conclusion, thermal and cryo-induced lesions, as well as certain pre-existing lesions (cystic hyperplasia - non-enhancing, chronic prostatitis - enhancing) have particular MRI profiles, useful for treatment and diagnostic purposes.

  2. Síndrome Hemolítico-Urêmica Pós-parto: Relato de Caso Postpartum Hemolytic Uremic Syndrome: A Case Report

    Directory of Open Access Journals (Sweden)

    José Geraldo Lopes Ramos

    2002-09-01

    Full Text Available A síndrome hemolítico-urêmica (SHU é processo microangiopático associado a insuficiência renal, determinando alta morbidade e mortalidade. A gestação pode ser um fator precipitante, por meio de mecanismos ainda não bem estabelecidos. Entram no diagnóstico diferencial a pré-eclâmpsia, a síndrome HELLP, o fígado gorduroso agudo da gestação e a púrpura trombocitopênica trombótica. Relatamos um caso de SHU ocorrendo no pós-parto imediato em paciente com diagnóstico inicial de pré-eclâmpsia. O diagnóstico diferencial foi fundamentado na perda abrupta da função renal, acompanhada de instabilidade pressórica e sinais clínicos e laboratoriais de hemólise. São destacados os métodos diagnósticos disponíveis, manejo terapêutico e fatores prognósticos baseados em revisão de literatura.The hemolytic - uremic syndrome (HUS presents with a triad of acute renal failure, microangiopathic hemolytic anemia and thrombocytopenia associated with high morbidity and mortality. On the differential diagnosis, other entities must be considered like preeclampsia, HELLP syndrome, acute fatty liver of pregnancy and thrombotic thrombocytopenic purpura. We report a case of HUS occurring in the immediate postpartum period in a patient initially diagnosed as having preeclampsia. The differential diagnosis was based on abrupt renal failure, blood pressure increase and clinical and laboratorial evidence of hemolysis. Attention is directed to investigation, clinical management and prognosis based on review of the literature.

  3. Pro-Coagulant Endothelial Dysfunction Results from EHEC Shiga Toxins and Host Damage-Associated Molecular Patterns

    Science.gov (United States)

    Mayer, Chad L.; Parello, Caitlin S. L.; Lee, Benjamin C.; Itagaki, Kiyoshi; Kurosawa, Shinichiro; Stearns-Kurosawa, Deborah J.

    2015-01-01

    Hemolytic uremic syndrome (HUS) from enterohemorrhagic Escherichia coli infection is a leading cause of kidney failure in otherwise healthy U.S. children. The bacterial Shiga toxins (Stx) induce the characteristic coagulopathy of HUS, but the damage to toxin-receptor expressing cells and organ injury due to ischemia likely also releases inflammatory damage-associated molecular patterns (DAMPs), which may exacerbate injury along with the toxins. To examine this, human aortic and renal glomerular cell anti-coagulant and barrier functions were studied after in vitro challenge with Stx1, Stx2, and DAMPs. There was significant loss of surface anti-coagulant protein C pathway molecules, increased expression of pro-thrombotic PAR1 and reduced protein C activation capability by 15–27%. Histones nearly completely prevented the activated protein C protection of endothelial cells from thrombin-induced permeability. In mice, lethal Stx2 challenge elevated plasma HMGB1 (day 2, 321 ± 118%; p < 0.01) and extracellular histones (day 3, 158 ± 62%; p < 0.01). Mice colonized with Stx2-expressing Citrobacter rodentium developed increased HMGB1 (day 5, 155 ± 55%; p < 0.01) and histones (day 3, 378 ± 188%; p < 0.01). Anti-histone antibody reduced both DAMPs to baseline, but was not sufficient to improve survival outcome or kidney function. Together, these data suggest a potential role Stx to produce DAMPs, and DAMPs to produce endothelial injury and a pro-thrombotic environment. PMID:25904918

  4. Ecological Impact Assessment of Isfahan’s West Ringway on Ghamishloo Wildlife Refuge Using Habitat Evaluation Procedure (HEP

    Directory of Open Access Journals (Sweden)

    T. Makki

    2013-03-01

    Full Text Available Development of roads through protected areas and ecological sensitive regions can have catastrophic effects on wildlife. In Iran, road construction in sensitive habitats and protected areas has been expanding during the past decades. This study focuses on the ecological impacts of Isfahan’s west ringway, which passes through Ghamishloo wildlife refuge, I.U.C.N category IV, in Isfahan Province. The key affected species of the study area goitered gazelle (Gazella subgutturosa subgutterosa, was considered for impact analysis. We used HEP (Habitat Evaluation Procedure as a habitat-based impact assessment methodology which considers habitat quality and quantity. Habitat quality was measured as habitat suitability index for the species. By literature review and field observations (293 presence points, five effective variables in habitat suitability including vegetation cover, slope, elevation, distance to water and distance to road were identified, and habitat units (HUs were derived from multiplying the HSI for goitered gazelle by the species habitat area at two times (before and after road construction. The results showed that due to the presence of the ringway, 7710 HUs for goitered gazelle have been lost. In addition, we used landscape ecology approach for quantifying landscape pattern change due to road construction and landscape metrics including NP (Number of Patches, MNN (Mean Nearest Neighbor and CONTAG (Contagion. Our results provided quantitative data on habitat loss and landscape fragmentation in Ghamishloo wildlife refuge and indicated negative impacts of the ringway on goitered gazelle populations by restricting their movement between habitat patches in this region, which presents a concern for the conservation of this vulnerable species.

  5. Oral intoxication of mice with Shiga toxin type 2a (Stx2a) and protection by anti-Stx2a monoclonal antibody 11E10.

    Science.gov (United States)

    Russo, L M; Melton-Celsa, A R; Smith, M A; Smith, M J; O'Brien, A D

    2014-03-01

    Shiga toxin (Stx)-producing Escherichia coli (STEC) strains cause food-borne outbreaks of hemorrhagic colitis and, less commonly, a serious kidney-damaging sequela called the hemolytic uremic syndrome (HUS). Stx, the primary virulence factor expressed by STEC, is an AB5 toxin with two antigenically distinct forms, Stx1a and Stx2a. Although both toxins have similar biological activities, Stx2a is more frequently produced by STEC strains that cause HUS than is Stx1a. Here we asked whether Stx1a and Stx2a act differently when delivered orally by gavage. We found that Stx2a had a 50% lethal dose (LD50) of 2.9 μg, but no morbidity occurred after oral intoxication with up to 157 μg of Stx1a. We also compared several biochemical and histological parameters in mice intoxicated orally versus intraperitoneally with Stx2a. We discovered that both intoxication routes caused similar increases in serum creatinine and blood urea nitrogen, indicative of kidney damage, as well as electrolyte imbalances and weight loss in the animals. Furthermore, kidney sections from Stx2a-intoxicated mice revealed multifocal, acute tubular necrosis (ATN). Of particular note, we detected Stx2a in kidney sections from orally intoxicated mice in the same region as the epithelial cell type in which ATN was detected. Lastly, we showed reduced renal damage, as determined by renal biomarkers and histopathology, and full protection of orally intoxicated mice with monoclonal antibody (MAb) 11E10 directed against the toxin A subunit; conversely, an irrelevant MAb had no therapeutic effect. Orally intoxicated mice could be rescued by MAb 11E10 6 h but not 24 h after Stx2a delivery.

  6. Usefulness of helical CT in the diagnosis of strangulation in small bowel obstruction

    Energy Technology Data Exchange (ETDEWEB)

    Kang, Young Hye; Kim, Won Hong; Jeon, Yong Sun; Shin, Dong Jae; Cho, Soon Gu; Lee, Chang Keun; Choi, Sun Keun [College of Medicine, Inha Univ., Incheon (Korea, Republic of)

    2004-12-01

    We wished to evaluate the usefulness of helical CT for the diagnosis of strangulation of the dilated small bowels. The CT scans of 31 patients with small bowel obstruction from various causes were reviewed retrospectively. Thirteen of these patients were confirmed as small bowel strangulation by surgery and pathology. Fourteen patients underwent surgery, but they had no strangulation. Three patients were reduced by using a nasogastric tube and one infant with intussusception was reduced by air reduction. The following CT findings of strangulation were evaluated: reduced bowel wall enhancement by visual assessment and measuring the HU, ascites, thickening of bowel wall, abnormal mesenteric vessel location and whirlpool appearance, and mesenteric venous engorgement. For the precise evaluation of reduced bowel wall enhancement, the HUs were measured by 1 mm{sup 2} of ROI, and the differences of HUs between the well enhanced bowel and poorly enhanced bowel were compared. For the diagnosis of strangulation, measurement of HU of the bowel wall could improve the sensitivity from 69% to 100%. The specificity of both methods, by visual assessment and measurement of HU, was 94%. Ascites had a sensitivity of 69% and specificity of 44%. Thickening of bowel wall had a sensitivity of 38% and specificity of 78%. Abnormal mesenteric vessel location and whirlpool appearance had a sensitivity of 38% and specificity of 83%. Mesenteric venous engorgement had a sensitivity of 31% and specificity of 72%. Measurement of HU of the bowe wall after contrast enhancement can be a useful method in the differential diagnosis between the strangulated and non-strangulated bowels in patients with small bowel obstruction.

  7. Intracerebroventricular administration of Shiga toxin type 2 altered the expression levels of neuronal nitric oxide synthase and glial fibrillary acidic protein in rat brains.

    Science.gov (United States)

    Boccoli, Javier; Loidl, C Fabián; Lopez-Costa, Juan José; Creydt, Virginia Pistone; Ibarra, Cristina; Goldstein, Jorge

    2008-09-16

    Shiga toxin (Stx) from enterohemorrhagic Escherichia coli (STEC) is the main cause of hemorrhagic colitis which may derive into Hemolytic Uremic Syndrome (HUS) and acute encephalopathy, one of the major risk factors for infant death caused by the toxin. We have previously demonstrated that intracerebroventricular administration of Stx2 causes neuronal death and glial cell damage in rat brains. In the present work, we observed that the intracerebroventricular administration of Stx2 increased the expression of glial fibrillary acidic protein (GFAP) leading to astrogliosis. Confocal microscopy showed reactive astrocytes in contact with Stx2-containing neurons. Immunocolocalization of increased GFAP and Stx2 in astrocytes was also observed. This insult in the brain was correlated with changes in the expression and activity of neuronal nitric oxide synthase (nNOS) by using the NADPH-diaphorase histochemical technique (NADPH-d HT). A significant decrease in NOS/NADPH-d-positive neurons and NOS/NADPH-d activity was observed in cerebral cortex and striatum, whereas an opposite effect was found in the hypothalamic paraventricular nucleus. We concluded that the i.c.v. administration of Stx2 promotes a typical pattern of brain injury showing reactive astrocytes and an alteration in the number and activity of nNOS/NADPH-d. According to the functional state of nNOS/NADPH-d and to brain cell morphology data, it could be inferred that the i.c.v. administration of Stx2 leads to either a neurodegenerative or a neuroprotective mechanism in the affected brain areas. The present animal model resembles the encephalopathy developed in Hemolytic Uremic Syndrome (HUS) patients by STEC intoxication.

  8. Intraperitoneal administration of shiga toxin type 2 in rats in the late stage of pregnancy produces premature delivery of dead fetuses.

    Science.gov (United States)

    Burdet, J; Zotta, E; Franchi, A M; Ibarra, C

    2009-06-01

    Infection associated with Shiga toxin-producing Escherichia coli (STEC) and subsequent Hemolytic-Uremic Syndrome (HUS) have become relevant in public health since STEC is considered as one of the most important emergent pathogens. STEC infection may either be asymptomatic or begin with watery diarrhea associated with hemorrhagic colitis and HUS. The major virulence factor of STEC is Shiga toxin type 1 or 2 (Stx1, Stx2) although strains that express only Stx2 are highly prevalent. Up to now, it has not been established whether STEC infection affect pregnant women. In this study, we evaluated the effect of Stx2 on maternal lethality, fetal status and delivery time by injecting Stx2 in rats in the late stage of pregnancy. Stx2 induced fetal resorption, placental abruption, intrauterine hemorrhage and fetal death at 1-2 days post-injection in a dose-dependent manner. With 2ng Stx2/g body weight, placentas and fetuses presented extensive necrotic areas, while uteri and kidneys showed normal histology. Immunolocalization of Stx2 was observed in placentas and fetuses. With 4 and 6ng Stx2/g body weight maternal death was also observed. Those rats that survived after Stx2-treatment were able to become pregnant and deliver normal pups at term. Our results show, for the first time, that the preterm labor with fetal death observed in treated rats may be a consequence of the action of Stx2 on the feto-maternal unit. Although there are no reports of Stx2 effects in human pregnancy, we speculate that STEC infections could be one of the causes not yet determined of fetal morbimortality.

  9. Phylogenetic and molecular analysis of food-borne shiga toxin-producing Escherichia coli.

    Science.gov (United States)

    Hauser, Elisabeth; Mellmann, Alexander; Semmler, Torsten; Stoeber, Helen; Wieler, Lothar H; Karch, Helge; Kuebler, Nikole; Fruth, Angelika; Harmsen, Dag; Weniger, Thomas; Tietze, Erhard; Schmidt, Herbert

    2013-04-01

    Seventy-five food-associated Shiga toxin-producing Escherichia coli (STEC) strains were analyzed by molecular and phylogenetic methods to describe their pathogenic potential. The presence of the locus of proteolysis activity (LPA), the chromosomal pathogenicity island (PAI) PAI ICL3, and the autotransporter-encoding gene sabA was examined by PCR. Furthermore, the occupation of the chromosomal integration sites of the locus of enterocyte effacement (LEE), selC, pheU, and pheV, as well as the Stx phage integration sites yehV, yecE, wrbA, z2577, and ssrA, was analyzed. Moreover, the antibiotic resistance phenotypes of all STEC strains were determined. Multilocus sequence typing (MLST) was performed, and sequence types (STs) and sequence type complexes (STCs) were compared with those of 42 hemolytic-uremic syndrome (HUS)-associated enterohemorrhagic E. coli (HUSEC) strains. Besides 59 STs and 4 STCs, three larger clusters were defined in this strain collection. Clusters A and C consist mostly of highly pathogenic eae-positive HUSEC strains and some related food-borne STEC strains. A member of a new O26 HUS-associated clone and the 2011 outbreak strain E. coli O104:H4 were found in cluster A. Cluster B comprises only eae-negative food-borne STEC strains as well as mainly eae-negative HUSEC strains. Although food-borne strains of cluster B were not clearly associated with disease, serotypes of important pathogens, such as O91:H21 and O113:H21, were in this cluster and closely related to the food-borne strains. Clonal analysis demonstrated eight closely related genetic groups of food-borne STEC and HUSEC strains that shared the same ST and were similar in their virulence gene composition. These groups should be considered with respect to their potential for human infection.

  10. Characterization of the Shiga toxin-producing Escherichia coli O26 isolated from human in Poland between 1996 and 2014.

    Science.gov (United States)

    Januszkiewicz, A; Wołkowicz, T; Chróst, A; Szych, J

    2015-06-01

    Shiga toxin-producing Escherichia coli (STEC) O26 infections can be comparable with STEC O157 infections in severity of the acute haemolytic-uremic syndrome HUS and long-term sequelae. Among O26 STEC isolates, highly virulent clone O26:H11/H- Sequence Type 29 (ST 29) emerged in Germany in mid-1990s and spread to European countries. However, up to date, no STEC O26:H11/H- belonging to ST29 has been documented in Poland. In this study, we determined the relationship and clonal structure, stx genotypes, plasmid gene profiles and antimicrobial resistance of nine human STEC O26:H11/H- strains from human patients in Poland between 1996 and 2014. Of the 9 human STEC O26:H11/H- strains, two belonged to ST29 and were isolated from two children with HUS and renal failure with sepsis respectively. These strains showed the molecular characteristics of the emerging human-pathogenic ST29 clone (stx1-, stx2a+, eae+, ehxA+, etpD+, katP-, espP-). The remaining STEC O26:H11/H- strains examined in this study, belonged to ST21, with plasmid genes profiles frequently reported in ST21 strains in Europe. STEC O26 infections with serious human health consequences highlight the need of continuous surveillance of non-O157 STEC and implementation of the diagnostic approaches focused on their detection. Significance and impact of the study: These study provides the first data on the occurrence of emerging Shiga toxin-producing Escherichia coli O26:H11 ST 29 clone in human patients in Poland. Those strains show the molecular characteristics of highly virulent new ST29 pathotype (stx1-, stx2a+, eae+ ehxA+, etpD+, katP-, espP-). These results demonstrated prompt efforts to implement diagnostic approaches detection of those pathogen in the European countries.

  11. 月季线虫病风险初步分析%Preliminary Study on Nematode Risk to Rose

    Institute of Scientific and Technical Information of China (English)

    王新荣; 谢辉; 冯志新

    2001-01-01

    通过月季线虫种类的调查、鉴定及月季线虫病害危险性分析, 结果表明:国内月季线虫的种类较少, 只有12属14种 ,其中6种线虫即卢兹垫刃线虫(Tylenchus luci)、诺曼琼斯丝尾垫刃线虫(Filench us nor hanjonesi)、卡文斯螺旋线虫(Helicotylenchus cavenessi)、粗尾矮化线虫(T ylenchorhynchus crass icaudatus)、蘑菇滑刃线虫(Aphelenchoides composticola)及燕麦真滑刃线虫( Aphelenc hus avenae)等在国内外首次报道为月季寄生线虫,1种即双宫螺旋线虫(Helicotylenc hus dihystera)为国内首次报道为月季寄生线虫;月季寄生线虫对中国月季生产存在潜在的危险性,特别是以北方根结线虫(Meloidogyne hapla)、伤残短体线虫(Pratylenchus vulus)、双宫螺旋线虫(H. dihystera)、裂尾剑线虫(Xiphinema diversicaudatum)、印度剑线虫 (X. indica)等5种线虫危害最严重.对中国来说,应加强对北方根结线虫(M.hapl a)、伤残短体线虫(P. vulnus)、裂尾剑线虫(X.diversicaudatum)等3种线虫的检疫.

  12. Acute kidney injury in Hemiscorpius lepturus scorpion stung children: Risk factors and clinical features

    Directory of Open Access Journals (Sweden)

    Ehsan Valavi

    2016-01-01

    Full Text Available Acute kidney injury (AKI is frequently seen in Hemiscorpius lepturus scorpion stung children. We have previously reported several victims with hemolytic uremic syndrome (HUS and a disintegrin and metalloproteinase with a thrombospondin type 1 motif, member 13 deficiency. Hence, we conducted this study to identify predictive factors and clinical features of AKI in H. lepturus scorpion stung patients. We included all 215 H. lepturus scorpion stung children with no previous renal diseases in two groups (with and without AKI and compared them based on their clinical and laboratory findings. AKI was found in 27.4% of patients, they were significantly younger and with lower body weight (P = 0.006, P = 0.011, respectively. There was a significant difference between groups with and without AKI in findings such as fever (P = 0.003, hypertension (P <0.001, hemolytic anemia (P <0.001, thrombocytopenia (P <0.001, massive proteinuria (P <0.001, hemoglobinuria (P <0.001, pyuria (P <0.001, and hematuria (P = 0.004. HUS was in 5.5% and disseminated intravascular coagulation in 14.6% which had a significant association with AKI (P <0.001.There were several independent predictors for AKI in a multivariate regression model including thrombocytopenia (P = 0.002, pyuria (P = 0.01, proteinuria (P =0.01, and fever (P = 0.02. Hemodialysis was performed in four patients but kidney function improved in all patients and there was no findings of renal impairment after three months follow-up. We found several predictors for AKI in children following H. lepturus scorpion sting including younger age, delay in receiving medical care, pigmenturia, microangiopathic hemolytic anemia, proteinuria, and pyuria.

  13. Heat induction of a novel Rad9 variant from a cryptic translation initiation site reduces mitotic commitment.

    Science.gov (United States)

    Janes, Simon; Schmidt, Ulrike; Ashour Garrido, Karim; Ney, Nadja; Concilio, Susanna; Zekri, Mohamed; Caspari, Thomas

    2012-10-01

    Exposure of human cells to heat switches the activating signal of the DNA damage checkpoint from genotoxic to temperature stress. This change reduces mitotic commitment at the expense of DNA break repair. The thermal alterations behind this switch remain elusive despite the successful use of heat to sensitise cancer cells to DNA breaks. Rad9 is a highly conserved subunit of the Rad9-Rad1-Hus1 (9-1-1) checkpoint-clamp that is loaded by Rad17 onto damaged chromatin. At the DNA, Rad9 activates the checkpoint kinases Rad3(ATR) and Chk1 to arrest cells in G2. Using Schizosaccharomyces pombe as a model eukaryote, we discovered a new variant of Rad9, Rad9-M50, whose expression is specifically induced by heat. High temperatures promote alternative translation from a cryptic initiation codon at methionine-50. This process is restricted to cycling cells and is independent of the temperature-sensing mitogen-activated protein kinase (MAPK) pathway. While full-length Rad9 delays mitosis in the presence of DNA lesions, Rad9-M50 functions in a remodelled checkpoint pathway to reduce mitotic commitment at elevated temperatures. This remodelled pathway still relies on Rad1 and Hus1, but acts independently of Rad17. Heat-induction of Rad9-M50 ensures that the kinase Chk1 remains in a hypo-phosphorylated state. Elevated temperatures specifically reverse the DNA-damage-induced modification of Chk1 in a manner dependent on Rad9-M50. Taken together, heat reprogrammes the DNA damage checkpoint at the level of Chk1 by inducing a Rad9 variant that can act outside of the canonical 9-1-1 complex.

  14. Heterogeneity in Induction Level, Infection Ability, and Morphology of Shiga Toxin-Encoding Phages (Stx Phages) from Dairy and Human Shiga Toxin-Producing Escherichia coli O26:H11 Isolates

    Science.gov (United States)

    Bonanno, Ludivine; Petit, Marie-Agnès; Loukiadis, Estelle; Michel, Valérie

    2016-01-01

    Shiga toxin (Stx)-producing Escherichia coli (STEC) bacteria are foodborne pathogens responsible for diarrhea and hemolytic-uremic syndrome (HUS). Shiga toxin, the main STEC virulence factor, is encoded by the stx gene located in the genome of a bacteriophage inserted into the bacterial chromosome. The O26:H11 serotype is considered to be the second-most-significant HUS-causing serotype worldwide after O157:H7. STEC O26:H11 bacteria and their stx-negative counterparts have been detected in dairy products. They may convert from the one form to the other by loss or acquisition of Stx phages, potentially confounding food microbiological diagnostic methods based on stx gene detection. Here we investigated the diversity and mobility of Stx phages from human and dairy STEC O26:H11 strains. Evaluation of their rate of in vitro induction, occurring either spontaneously or in the presence of mitomycin C, showed that the Stx2 phages were more inducible overall than Stx1 phages. However, no correlation was found between the Stx phage levels produced and the origin of the strains tested or the phage insertion sites. Morphological analysis by electron microscopy showed that Stx phages from STEC O26:H11 displayed various shapes that were unrelated to Stx1 or Stx2 types. Finally, the levels of sensitivity of stx-negative E. coli O26:H11 to six Stx phages differed among the 17 strains tested and our attempts to convert them into STEC were unsuccessful, indicating that their lysogenization was a rare event. PMID:26826235

  15. Quantitative risk assessment of haemolytic and uremic syndrome linked to O157:H7 and non-O157:H7 Shiga-toxin producing Escherichia coli strains in raw milk soft cheeses.

    Science.gov (United States)

    Perrin, Frédérique; Tenenhaus-Aziza, Fanny; Michel, Valérie; Miszczycha, Stéphane; Bel, Nadège; Sanaa, Moez

    2015-01-01

    Shiga-toxin producing Escherichia coli (STEC) strains may cause human infections ranging from simple diarrhea to Haemolytic Uremic Syndrome (HUS). The five main pathogenic serotypes of STEC (MPS-STEC) identified thus far in Europe are O157:H7, O26:H11, O103:H2, O111:H8, and O145:H28. Because STEC strains can survive or grow during cheese making, particularly in soft cheeses, a stochastic quantitative microbial risk assessment model was developed to assess the risk of HUS associated with the five MPS-STEC in raw milk soft cheeses. A baseline scenario represents a theoretical worst-case scenario where no intervention was considered throughout the farm-to-fork continuum. The risk level assessed with this baseline scenario is the risk-based level. The impact of seven preharvest scenarios (vaccines, probiotic, milk farm sorting) on the risk-based level was expressed in terms of risk reduction. Impact of the preharvest intervention ranges from 76% to 98% of risk reduction with highest values predicted with scenarios combining a decrease of the number of cow shedding STEC and of the STEC concentration in feces. The impact of postharvest interventions on the risk-based level was also tested by applying five microbiological criteria (MC) at the end of ripening. The five MCs differ in terms of sample size, the number of samples that may yield a value larger than the microbiological limit, and the analysis methods. The risk reduction predicted varies from 25% to 96% by applying MCs without preharvest interventions and from 1% to 96% with combination of pre- and postharvest interventions.

  16. Serine protease espP subtype alpha, but not beta or gamma, of Shiga toxin-producing Escherichia coli is associated with highly pathogenic serogroups.

    Science.gov (United States)

    Khan, Abdul Basit; Naim, Asma; Orth, Dorothea; Grif, Katharina; Mohsin, Mashkoor; Prager, Rita; Dierich, Manfred P; Würzner, Reinhard

    2009-04-01

    Besides Shiga toxins (Stx), Stx-producing Escherichia coli (STEC) harbour several other putative virulence factors, including the serine protease EspP. We have investigated 214 STEC strains from Austria belonging to 61 different serotypes from humans, animals, and food for the presence of this serine protease gene and have determined the espP subtypes and their association with clinical outcome. espP was detected in 121 (57%) out of 214 strains. Sixty-five of 68 strains (96%) of non-sorbitol-fermenting (NSF) O157:H7/NM (NM, non-motile) were positive for espP, while none of 8 SF E. coli O157:NM isolates contained this gene. All 9 strains of serotype O145:NM and 17 of 21 strains (81%) of serotype O26:H11/NM were positive for espP. Nineteen STEC serogroups including O103 and O111 serogroups--considered to be highly pathogenic--were completely negative for espP. Only 5 of 12 strains isolated from patients suffering from haemolytic uraemic syndrome (HUS) were espP-positive (all serogroup NSF O157) as well as 28 of 39 strains from patients with bloody diarrhoea, 40 of 63 strains from patients with non-bloody diarrhoea, and 15 of 19 strains from asymptomatic patients. In O157:H7/NM, O26:H11/NM, and O145:NM only espP subtype alpha was found, whereas in most of the other non-O157 serogroups, subtypes beta and gamma were found. Subtype delta was not detected in our strain collection. Regarding the espP subtypes, only subtype alpha, but not beta and gamma, were found in HUS patients. Moreover, we could demonstrate that espP, and in particular subtype alpha, is associated with highly pathogenic serogroups.

  17. Complement Regulator FHR-3 Is Elevated either Locally or Systemically in a Selection of Autoimmune Diseases.

    Science.gov (United States)

    Schäfer, Nicole; Grosche, Antje; Reinders, Joerg; Hauck, Stefanie M; Pouw, Richard B; Kuijpers, Taco W; Wouters, Diana; Ehrenstein, Boris; Enzmann, Volker; Zipfel, Peter F; Skerka, Christine; Pauly, Diana

    2016-01-01

    The human complement factor H-related protein-3 (FHR-3) is a soluble regulator of the complement system. Homozygous cfhr3/1 deletion is a genetic risk factor for the autoimmune form of atypical hemolytic-uremic syndrome (aHUS), while also found to be protective in age-related macular degeneration (AMD). The precise function of FHR-3 remains to be fully characterized. We generated four mouse monoclonal antibodies (mAbs) for FHR-3 (RETC) without cross-reactivity to the complement factor H (FH)-family. These antibodies detected FHR-3 from human serum with a mean concentration of 1 μg/mL. FHR-3 levels in patients were significantly increased in sera from systemic lupus erythematosus, rheumatoid arthritis, and polymyalgia rheumatica but remained almost unchanged in samples from AMD or aHUS patients. Moreover, by immunostaining of an aged human donor retina, we discovered a local FHR-3 production by microglia/macrophages. The mAb RETC-2 modulated FHR-3 binding to C3b but not the binding of FHR-3 to heparin. Interestingly, FHR-3 competed with FH for binding C3b and the mAb RETC-2 reduced the interaction of FHR-3 and C3b, resulting in increased FH binding. Our results unveil a previously unknown systemic involvement of FHR-3 in rheumatoid diseases and a putative local role of FHR-3 mediated by microglia/macrophages in the damaged retina. We conclude that the local FHR-3/FH equilibrium in AMD is a potential therapeutic target, which can be modulated by our specific mAb RETC-2.

  18. COMPLEMENT REGULATOR FHR-3 IS ELEVATED EITHER LOCALLY OR SYSTEMICALLY IN A SELECTION OF AUTOIMMUNE DISEASES

    Directory of Open Access Journals (Sweden)

    Nicole Schäfer

    2016-11-01

    Full Text Available The human complement factor H-related protein-3 (FHR-3 is a soluble regulator of the complement system. Homozygous cfhr3/1 deletion is a genetic risk factor for the autoimmune form of hemolytic uremic syndrome (aHUS, whilst also found to be protective in age-related macular degeneration (AMD. The precise function of FHR-3 remains to be fully characterized.We generated four mouse monoclonal antibodies (mAbs for FHR-3 (RETC without cross-reactivity to the complement factor H (FH-family. These antibodies detected FHR-3 from human serum with a mean concentration of 1 µg/mL. FHR-3 levels in patients were significantly increased in sera from systemic lupus erythematosus, rheumatoid arthritis, and polymyalgia rheumatica but remained almost unchanged in samples from AMD or aHUS patients. Moreover, by immunostaining of an aged human donor retina we discovered a local FHR-3 production by microglia/macrophages. The mAb RETC-2 modulated FHR-3 binding to C3b, but not the binding of FHR-3 to heparin. Interestingly, FHR-3 competed with FH for binding C3b and the mAb RETC-2 reduced the interaction of FHR-3 and C3b, resulting in increased FH binding. Our results unveil a previously unknown systemic involvement of FHR-3 in rheumatoid diseases and a putative local role of FHR-3 mediated by microglia/macrophages in the damaged retina. We conclude that the local FHR-3/FH equilibrium in AMD is a potential therapeutic target, which can be modulated by our specific mAb RETC-2.

  19. De novo post-transplant thrombotic microangiopathy localized only to the graft in autosomal dominant polycystic kidney disease with thrombophilia

    Science.gov (United States)

    Rolla, Davide; Fontana, Iris; Ravetti, Jean Louis; Marsano, Luigina; Bellino, Diego; Panaro, Laura; Ansaldo, Francesca; Mathiasen, Lisa; Storace, Giulia; Trezzi, Matteo

    2015-01-01

    Introduction: Thrombotic microangiopathy (TMA) is a serious complication of renal transplantation and is mostly related to the prothrombotic effect of calcineurin inhibitors (CNIs). A subset of TMA (29%-38%) is localized only to the graft. Case 1: A young woman suffering from autosomal dominant polycystic kidney disease (ADPKD) underwent kidney transplant. After 2 months, she showed slow renal deterioration (serum creatinine from 1.9 to 3.1 mg/dl), without hematological signs of hemolytic-uremic syndrome (HUS); only LDH enzyme transient increase was detected. Renal biopsy showed TMA: temporary withdraw of tacrolimus and plasmapheresis was performed. The renal function recovered (serum creatinine 1.9 mg/dl). From screening for thrombophilia, we found a mutation of the Leiden factor V gene. Case 2: A man affected by ADPKD underwent kidney transplantation, with delay graft function; first biopsy showed acute tubular necrosis, but a second biopsy revealed TMA, while no altered hematological parameters of HUS was detected. We observed only a slight increase of lactate dehydrogenase (LDH) levels. The tacrolimus was halved and plasmapheresis was performed: LDH levels normalized within 10 days and renal function improved (serum creatinine from 9 to 2.9 mg/dl). We found a mutation of the prothrombin gene. Only a renal biopsy clarifies the diagnosis of TMA, but it is necessary to pay attention to light increasing level of LDH. Conclusion: Prothrombotic effect of CNIs and mTOR inhibitor, mutation of genes encoding factor H or I, anticardiolipin antibodies, vascular rejection, cytomegalovirus infection are proposed to trigger TMA; we detected mutations of factor II and Leiden factor V, as facilitating conditions for TMA in patients affected by ADPKD. PMID:26693501

  20. Development and characterization of monoclonal antibodies against Shiga toxin 2 and their application for toxin detection in milk.

    Science.gov (United States)

    He, Xiaohua; McMahon, Stephanie; Skinner, Craig; Merrill, Paul; Scotcher, Miles C; Stanker, Larry H

    2013-03-29

    Human infection by Shiga toxin producing Escherichia coli (STEC) is one of the most prevalent foodborne diseases. Shiga toxin type 2 (Stx2) is the major contributor to hemolytic-uremic syndrome (HUS) and other systemic complications caused by STEC. Although outbreaks of HUS due to the consumption of dairy products occur frequently, very few reports are available on assays for the detection of Stx2 in milk. In this study, we describe the development of five high-affinity monoclonal antibodies (dissociation constants below nM range) against Stx2 using a recombinant toxoid as an immunogen. These antibodies, designated Stx2-1, Stx2-2, Stx2-3, Stx2-4, and Stx2-5 are IgG1 or IgG2a heavy-chain subclass with kappa light-chains, did not cross-react with Stx1 and showed different preferences to variants of Stx2. Western blot analyses demonstrate that mAbs Stx2-2 and Stx2-5 bind both the A- and B-subunits, whereas the other 3 mAbs bind the A-subunit of Stx2a only. All antibodies bound stronger to the native than to the denatured Stx2a except the mAb Stx2-3, which bound equally well to both forms of the toxin. Of the five mAbs, Stx2-5 was capable of neutralizing Stx2a mediated cytotoxicity in Vero cells. Highly sensitive ELISA and immuno-PCR assays, capable of detecting 1 and 0.01 pg/mL of Stx2a in milk, were developed using mAb pair Stx2-1 and Stx2-2. Such assays are useful for routine diagnosis of Stx2 contamination in milk production process, thus reducing the risk of STEC outbreaks. Published by Elsevier B.V.

  1. Analysis of rare variants in the C3 gene in patients with age-related macular degeneration.

    Directory of Open Access Journals (Sweden)

    Maheswara R Duvvari

    Full Text Available Age-related macular degeneration (AMD is a progressive retinal disorder affecting over 33 million people worldwide. Genome-wide association studies (GWASs for AMD identified common variants at 19 loci accounting for 15-65% of the heritability and it has been hypothesized that the missing heritability may be attributed to rare variants with large effect sizes. Common variants in the complement component 3 (C3 gene have been associated with AMD and recently a rare C3 variant (Lys155Gln was identified which exerts a large effect on AMD susceptibility independent of the common variants. To explore whether additional rare variants in the C3 gene are associated with AMD, we sequenced all coding exons in 84 unrelated AMD cases. Subsequently, we genotyped all identified variants in 1474 AMD cases and 2258 controls. Additionally, because of the known genetic overlap between AMD and atypical hemolytic uremic syndrome (aHUS, we genotyped two recurrent aHUS-associated C3 mutations in the entire cohort. Overall, we identified three rare variants (Lys65Gln (P=0.04, Arg735Trp (OR=17.4, 95% CI=2.2-136; P=0.0003, and Ser1619Arg (OR=5.2, 95% CI=1.0-25; P=0.05 at the C3 locus that are associated with AMD in our EUGENDA cohort. However, the Arg735Trp and Ser1619Arg variants were not found to be associated with AMD in the Rotterdam Study. The Lys65Gln variant was only identified in patients from Nijmegen, the Netherlands, and thus may represent a region-specific AMD risk variant.

  2. Role of verocytotoxigenic Escherichia coli in the swine production chain

    Directory of Open Access Journals (Sweden)

    Laura Ercoli

    2015-06-01

    Full Text Available Shiga toxin-producing Escherichia coli (STEC can cause severe clinical diseases in humans, such as haemorrhagic colitis (HC and haemolytic-uremic syndrome (HUS. Although ruminants, primarily cattle, have been suggested as typical reservoirs of STEC, many food products of other origins, including pork products, have been confirmed as vehicles for STEC transmission. Only in rare cases, pork consumption is associated with severe clinical symptoms caused by high pathogenic STEC strains. However, in these outbreaks, it is unknown whether the contamination of food products occurs during swine processing or via cross-contamination from foodstuffs of different sources. In swine, STEC plays an important role in the pathogenesis of oedema disease. In particular a Shiga toxin subtype, named stx2e, it is considered as a key factor involved in the damage of swine endothelial cells. On the contrary, stx2e-producing Escherichia coli has rarely been isolated in humans, and usually only from asymptomatic carriers or from patients with mild symptoms, such as uncomplicated diarrhoea. In fact, the presence of gene stx2e, encoding for stx2e, has rarely been reported in STEC strains that cause HUS. Moreover, stx2e-producing STEC isolated from humans and pigs were found to differ in serogroup, their virulence profile and interaction with intestinal epithelial cells. Because of the limited epidemiologic data of STEC in swine and the increasing role of non-O157 STEC in human illnesses, the relationship between swine STEC and human disease needs to be further investigated.

  3. Postdiarrheal Shiga Toxin-Mediated Hemolytic Uremic Syndrome Similar to Septic Shock Síndrome urémico hemolítico símil shock séptico, posterior a diarrea mediada por toxina shiga

    Directory of Open Access Journals (Sweden)

    Patricia G. Valles

    2005-10-01

    Full Text Available The inflammatory response of host endothelial cells is included in the development of vascular damage observed in enterohemorrhagic Escherichia coli (EHEC infection, resulting in hemolytic uremic syndrome (HUS. The response to a non-conventional treatment for a group of D+ HUS (diarrhea positive HUS patients, with clinical hemodynamic parameters of septic shock was evaluated in this prospective study (1999-2003. Twelve children 2.8 ± 0.6 years old, with D+ HUS produced by E. coli infection with serological evidence of Shiga toxin, presenting severe unstable hemodynamic parameters and neurological dysfunction at onset, were studied. The protocol included fresh frozen plasma infusions, methylprednisolone pulses (10mg/k/day for three consecutive days and plasma exchange for five days, starting after admission to the intensive care unit (ICU. The twelve patients with increased pediatric risk of mortality (PRISM score: 18 ± 2 after admission to intensive care unit (ICU, required dialysis for 17.4 ± 4 days, mechanical ventilator assistance for 10 ± 1 days and early inotropic drugs support for 10.5 ± 1 days. Neurological dysfunction included generalized tonic-clonic seizures lasting for 5.4 ± 1 days, n:8. Focal seizures were present in the remaining patients. Dilated cardiomyopathy was present in 6 children. Eight children suffered hemorrhagic colitis. Nine patients survived. Within one year of the injury, neurological sequelae, Glasgow outcome scale (GOS 3 and 4, were present in two patients, chronic renal failure in one patient. We suggest that early introduction of this protocol could benefit D+ HUS patients with hemodynamic instability and neurological dysfunction at onset. Further studies are likely to elucidate the mechanisms involved in this early adverse clinical presentation of D+ HUS patients.La respuesta inflamatoria de la célula endotelial se incluye en el desarrollo del daño vascular observado en la infección por Escherichia coli

  4. 气压弹道和钬激光治疗输尿管单个结石效果的比较%A study on pneumatic lithotripsy versus holmium laser lithotripsy for the treatment of single ureteral stone

    Institute of Scientific and Technical Information of China (English)

    刘武; 钱坤

    2015-01-01

    ObjectiveThe aim of this study was to analyze the stone-free (SF) rates between pneumatic lithotripsy (PL) and holmium laser lithotripsy (HLL) for the treatment of single ureteral stones and to evaluate potentially single ureteral stones. MethodsFrom January2010 to August2014,131 consecutive patients with single stones were prospectively enrolled, and117 patients were brought into at last, which were divided into PL group(n=57) and HLL group(n=60). Uni- and multivariate logistic regression were performed to estimate predictive factors of a SF status.ResultsThe SF rate in the PL group was80.7 and86.1% in the HLL group. Success rates with regard of stone position were not significantly different between groups. At uni-variate logistic regression, middle ureteral stone (OR3.33,P=0.04), distal ureteral stone (OR4.4,P=0.02), HLL (OR3.05,P=0.04) and Hounsfield units (HUs) (OR1.07,P=0.03) were significantly predictive factors of a SF status. At a multivariate logistic regression, middle ureteral stone, distal ureteral stone, HLL and HUs ≥1200 were significantly associated with a SF status. Conclusion HLL significantly influences the SF status after ureteroscopy, allowing a higher SF rate when compared to PL. HUs may significantly influence this success rate.%目的:对比气压弹道和钬激光治疗输尿管单个结石的无石(SF)率,评价影响SF状态潜在的预测指标。方法:前瞻性选择2010年1月~2014年8月的131个患有输尿管单个结石的患者,最终纳入117人,将其分为气压弹道碎石组(PL组,57人)和钬激光碎石组(HLL组,60人)。应用单变量和多元线性回归分析,评价SF状态潜在的预测指标。结果:PL组的SF率是80.7%,而HLL组的SF率是86.1%,有显著差异。两组的相同位置的输尿管结石的碎石成功率无显著差异。通过单变量线性回归分析,确定输尿管中段结石(OR 3.33,P=0.04)、输尿管下段结石(OR 4.4,P=0.02

  5. [Enterohemorrhagic Escherichia coli as the cause of diarrhea in the Czech Republic, 1965-2013].

    Science.gov (United States)

    Marejková, M; Petráš, P

    2014-09-01

    Enterohemorrhagic Escherichia coli (EHEC) is the cause of diarrhea, bloody diarrhea, and haemolytic uremic syndrome (HUS) worldwide. The role of EHEC in the etiology of HUS in the Czech Republic has recently been described, but the prevalence, characteristics, and epidemiology of EHEC causing diarrhea have not been fully known. Therefore, this study analyzed the serotypes, stx genotypes, and virulence factors in EHEC strains isolated in 1965-2013 from patients with diarrhea or bloody diarrhea and their family contacts. In addition, we characterized diagnostically relevant phenotypes of EHEC strains, their antimicrobial susceptibility, seasonal trends, and distribution by administrative region. Serogrouped E. coli isolates from patients were referred to the National Reference Laboratory (NRL) for E. coli and Shigella for the detection of Stx. Specimens of both human and non-human origin were referred to the NRL for epidemiological investigation. Serotyping was performed by conventional and molecular methods, PCR was applied to stx genotyping and identification of non-stx virulence factors, and standard methods were used for phenotypic analysis and antimicrobial susceptibility testing. The epidemiological link between the human and animal isolates was confirmed using pulsed-field gel electrophoresis (PFGE). Of 50 EHEC strains, 24 were recovered from patients with diarrhea without blood, 19 from patients with bloody diarrhea, six from family contacts, and one from an epidemiologically linked animal. EHEC cases were reported during the whole year, with peaks in May through October, most often in the Central Bohemian and Hradec Králové Regions. EHEC outbreaks occurred in three families: in one of them sheep-to-human transmission of EHEC was detected. The EHEC strains were assigned to five serotypes, with more than half of them being non-sorbitol fermenting (NSF) O157:H7/NM[fliCH7] and a third being strains O26:H11/NM[fliCH11]; serotypes O111:NM[fliCH8], O118:NM

  6. Microangiopatia trombótica en adultos Thrombotic microangiopathy in adults

    Directory of Open Access Journals (Sweden)

    Gonzalo J. Barrientos

    2006-08-01

    Full Text Available Las microangiopatías trombóticas (MAT incluyen la púrpura trombótica trombocitopénica (PTT, el síndrome urémico hemolítico (SUH y las microangiopatías del embarazo. Se describen ocho pacientes adultos con cuadros de microangiopatía trombótica, que fueron atendidos en el Hospital Italiano de Buenos Aires entre 2003 y 2004. El promedio de edad fue de 40 años, con igual proporción de hombres y mujeres. En cuatro de los ocho pacientes descriptos el diagnóstico se realizó al ingreso. Cuatro pacientes evolucionaron con características de SUH, tres como PTT y uno como MAT del embarazo. Todos los pacientes presentaron trombocitopenia y anemia hemolítica microangiopática. La insuficiencia renal fue la tercera característica más frecuente. Aquellos con diagnóstico de PTT presentaron los cuadros de mayor gravedad. Todos los pacientes fueron tratados con plasmaféresis. El tratamiento inmunosupresor también fue utilizado. Cuatro pacientes se recuperaron completamente, 2 fallecieron, 1 permanece con insuficiencia renal crónica con requerimiento de hemodiálisis y 1 fue colectomizado. Las MAT son desórdenes oclusivos de la microcirculación, con repercusión sistémica y/o renal. Existe superposición de los cuadros de PTT/SUH, y éstos pueden ser idiopáticos o secundarios. La importancia de un diagnóstico y tratamiento precoz radica en su elevada morbimortalidad. Entre los diagnósticos diferenciales figuran la sepsis, las enfermedades oncológicas, las vasculitis sistémicas, la eclampsia y otros. La infusión del plasma y principalmente la plasmaféresis son los tratamientos fundamentales. Aún se requiere mejorar el manejo y la evolución de estos síndromes, dada la elevada morbimortalidad que conllevan.Thrombotic microangiopathic hemolytic anemias include thrombotic thrombocytopenic purpura (TTP, hemolytic uremic syndrome (HUS and pregnancy associated thrombotic microangiopathy (TMA. Eight adult patients (four males and four

  7. Escherichia coli enterohemorrágica y síndrome urémico hemolítico en Argentina Enterohemorrhagic Escherichia coli and hemolytic-uremic syndrome in Argentina

    Directory of Open Access Journals (Sweden)

    Mariana A. Rivero

    2004-08-01

    Full Text Available El síndrome urémico hemolítico (SUH.es un desorden multisistémico caracterizado por presentar insuficiencia renal aguda, anemia hemolítica microangiopática y trombocitopenia. Constituye la principal causa de insuficiencia renal aguda y la segunda causa de insuficiencia renal crónica y de transplante renal en niños en la Argentina. Actualmente, nuestro país presenta el registro más alto de SUH en todo el mundo, con aproximadamente 420 casos nuevos declarados anualmente y una incidencia de 12.2/100 000 niños menores de 5 años de edad. Se reconocen múltiples agentes etiológicos, aunque se considera a la infección por Escherichia coli enterohemorrágica (EHEC como la principal etiología de SUH. La gran mayoría de brotes epidémicos y casos esporádicos en humanos se han asociado con el serotipo O157:H7, aunque otros serotipos han sido también aislados, y éstos son un subgrupo de E. coli verocitotoxigénico (VTEC..El bovino es considerado el principal reservorio de VTEC. El contagio al hombre frecuentemente se debe al consumo de alimentos cárneos y lácteos contaminados, deficientemente cocidos o sin pasteurizar, o al contacto directo con los animales o con sus heces, consumo de agua, frutas o verduras contaminadas. También puede producirse contagio mediante el contacto interhumano.The hemolytic-uremic syndrome (HUS is a multisystemic disorder that is characterized by the onset of acute renal failure, microangiopathic hemolytic anemia and thrombocytopenia. It is the most common cause of acute renal failure and the second cause of chronic renal failure and renal transplantation in children in Argentina. Our country has the highest incidence of HUS in the world, with approximately 420 new cases observed each year with an incidence of 12.2 cases per 100 000 children in the age group 0-5 years. Numerous etiologic factors have been associated with HUS but the infection with enterohemorrhagic Escherichia coli (EHEC is considered the

  8. Escherichia coli verocitotoxigénico: varias cuestiones... y los tambos también Verocytotoxigenic Escherichia coli: several aspects... and also the dairy farms

    Directory of Open Access Journals (Sweden)

    Daniel Fernández

    2012-12-01

    Full Text Available Escherichia coli verocitotoxigénico (VTEC es causante de brotes y casos esporádicos de colitis hemorrágica (CH y síndrome urémico hemolítico (SUH. En Argentina el SUH es endémico, con 500 nuevos casos por ano y una incidencia de 17/100 000 ninos menores de 5 anos. El serotipo aislado con mayor frecuencia es el O157:H7, aunque hay serotipos no-O157 que están asociados con la enfermedad en el hombre. VTEC produce verocitotoxinas y factores de virulencia accesorios como intimina, enterohemolisina y una proteína autoaglutinante llamada Saa. Diversos estudios realizados en varios países han confirmado que los bovinos de diferente edad son los principales reservorios de VTEC, y han demostrado altas prevalencias tanto de serotipos O157:H7 como no-O157, muchos de ellos involucrados en brotes de SUH y CH a nivel mundial. La transmisión de VTEC al hombre se produce por el consumo de carne mal cocida, de verduras y agua contaminadas por heces de portadores, así como por el contacto persona-persona y con el medio ambiente contaminado. Los tambos pueden contribuir al riesgo de infección por VTEC en humanos mediante el consumo de leche cruda, de productos lácteos o carne contaminada proveniente de bovinos lecheros, y también a través del propio medio ambiente del tambo. Existe una amplia distribución y una alta prevalencia de serotipos VTEC en bovinos lecheros de Argentina, por lo cual es importante aplicar medidas de control y manejo que eviten la transmisión de cepas entre animales, ambiente y humanos.Verocytotoxigenic Escherichia coli (VTEC is associated with outbreaks and sporadic cases of hemorrhagic colitis (HC and hemolytic-uremic syndrome (HUS, the most severe form of these human diseases. In Argentina HUS is endemic, with 500 new cases per year and an incidence of 17/100,000 in children under 5 years of age. VTEC O157:H7 is the most frequently isolated serotype, although there are non-O157 serotypes that have been associated with

  9. 经阴道子宫骶骨韧带高位悬吊术对重度盆腔器官脱垂的临床治疗探究%Clinical effect of transvaginal high uterosacral ligament suspension on severe pelvic organ prolapse

    Institute of Scientific and Technical Information of China (English)

    曾敏; 谷霞

    2014-01-01

    Objectives:To investigate the clinical treatment effect of transvaginal high uterosacral ligament suspension (HUS)on severe pelvic organ prolapsed (POP).Methods:The 53 severe POP patients in our hospital from March 2010 to March 2012 received transvaginal HUS treatment.Stage changes in the pelvic organ prolapse quantification system (POP-Q)and quality of life was recorded.Results:The average operation time,amount of bleeding,hospitalization time and cost of treatment was (125.7 ±39.5)min,(122.9 ±13)mL,(5.9 ±1.2)d and (9733.7 ±1107.9)Yuan respectively,without ureteral injury,postoperative infection,nerve injury and other complications.All the 53 patients were effectively followed up,with mean follow -up time of (1 1 .7 ±0.8 ) months.There were 52 cases effective,1 cases ineffective,no recurrence,an efficiency of 98.1%;the POP-Q stage of the last follow-up had significantly decreased compared with before,while quality of life was significantly improved (P<0.05 ),no dyspareunia.Conclusion:Transvaginal HUS therapy is safe and reliable and of various other advantages in the treatment of severe POP,which is conducive to the early recovery of patients and can im-prove their quality of life,hereby worthy of clinical application.%目的:探讨经阴道子宫骶骨韧带高位悬吊术(high uterosacral ligament suspension,HUS)对重度盆腔器官脱垂(pelvic organ prolapse,POP)的临床治疗效果。方法:对我院2010年3月至2012年3月收治的53例重度POP患者采取经阴道HUS治疗,观察其盆腔器官脱垂定量系统(POP-Q)分期变化及生活质量评分变化。结果:患者平均手术时间(125.7±39.5)min,术中出血量(122.9±13.0)mL,住院时间(5.9±1.2)d,治疗费用(9733.7±1107.9)元,未见术中输尿管损伤,未见术后感染、神经损伤等并发症,恢复良好;53例患者均获得有效随访,平均随访时间(11.7±0.8)个月,有效52例,无效1

  10. Detección y caracterización de Escherichia coli productor de toxina Shiga a partir de casos clínicos y de alimentos en Uruguay Detection and characterization of Shiga toxin - producing Escherichia coli from clinical cases and food in Uruguay

    Directory of Open Access Journals (Sweden)

    G. Varela

    2008-06-01

    Full Text Available Establecimos la frecuencia de aislamiento de Escherichia coli productor de toxina Shiga (STEC a partir de muestras clínicas y de alimentos, así como las características fenotípicas y genotípicas de las cepas recuperadas. Se analizaron 198 muestras fecales de niños con diarrea sanguinolenta (DS, 14 muestras fecales de niños con síndrome urémico hemolítico (SUH y 220 muestras de carne picada. También se estudiaron 4 cepas STEC aisladas de alimentos embutidos. Se recuperó STEC de 3 (1,5% de los niños con DS, de 1 (7% niño con SUH y de 4 (1,8% de las muestras de carne picada. Todas las cepas fueron eae y ehxA positivas. Los serotipos detectados fueron: O157:H7 (9 cepas, O26:H11 (2 cepas, O111:NM (1 cepa y O145:HNT (1 cepa. Todas las cepas O157:H7 portaron el subtipo eae-g1; las cepas O26:H11 y O145:HNT portaron el subtipo eae-b1 y la cepa O111:NM portó el subtipo eae-g2/q. Las cepas STEC del mismo serogrupo mostraron alta diversidad genética. En Uruguay STEC no sería agente frecuente de diarrea con sangre en niños. Sin embargo, las cepas recuperadas presentaron los genes asociados con enfermedad severa y 2 de los 3 niños infectados con STEC evolucionaron a SUH. La carne picada y otros alimentos serían vehículos importantes de O157:H7.We have assessed the frequency of Shiga toxin-producing Escherichia coli (STEC in clinical and food samples as well as studied the genotypic and phenotypic characteristics of the recovered strains. One hundred ninety eight fecal samples from children with bloody diarrhea (BD, 14 from children with hemolytic uremic syndrome (HUS, 220 ground beef samples and 4 STEC isolates from other beef-derived products were analyzed. The STEC strains were isolated from 3 (1.5% children with bloody diarrhea, 1 (7% from a child with HUS and 4 (1.8% from ground beef samples. All strains were eae and ehxA positive. The serotypes found were: O157:H7 (9 strains, O26:H11 (2, O111: NM (1 and O145:HNT (1. All O157:H7 STEC

  11. Síndrome hemolítico-urêmica esporádica pós-parto Sporadic postpartum hemolytic uremic syndrome

    Directory of Open Access Journals (Sweden)

    Elza M. Moreira

    2008-08-01

    Full Text Available Anemia hemolítica microangiopática associado à trombocitopenia participa de um grupo de doenças que freqüentemente apresentam suas características clínicas muito semelhantes, sendo difícil distingui-las. A síndrome hemolítico-urêmica é dividida em duas apresentações: a forma não esporádica, que acomete comumente crianças após infecção bacteriana causando diarréia sanguinolenta, possui bom prognóstico; e a forma esporádica, que acomete adultos, sendo bem descritos casos em mulheres pósparto, é a forma sistêmica de trombocitopenia microangiopática de pior prognóstico com alta morbidade e mortalidade, cuja falência renal é o distúrbio predominante. Relatamos um caso de síndrome hemolítico-urêmica pós-parto em paciente previamente sadia, que apresentou quadro de insuficiência renal, anemia hemolítica e trombocitopenia. Instituída a terapêutica de suporte adequada e precocemente, a paciente evoluiu satisfatoriamente com normalização dos níveis pressóricos e recuperação da função renal.Microangiopathic hemolytic associated with thrombocytopenia is part of a disease group that frequently show likeness and that's why become difficult to separate them. There are two types of hemolytic uremic syndrome (HUS; the non sporadic type and the epidemic or "typical" type that is common on childreen that is associated with diarrhea and infection caused by verotoxinaproducing E. coli with a good prognostic; and the sporadic postpartum period. It is the systemic type of mocroangiophatic thrombocytopenia of poor prognostic with high morbidity and mortality which renal failure is the main disturb. We reported a case of HUS occuring in postpartum previously healthy, that showed abrupt renal failure, hemolytic anemia and thrombocytopenia. After proper therapy the patient developed a normal blood pressure and recovery renal function.

  12. Diacylglycerol Kinase-ε: Properties and Biological Roles

    Directory of Open Access Journals (Sweden)

    Richard M Epand

    2016-10-01

    Full Text Available In mammals there are at least 10 isoforms of diacylglycerol kinases (DGK. All catalyze the phosphorylation of diacylglycerol (DAG to phosphatidic acid (PA. Among DGK isoforms, DGKε has several unique features. It is the only DGK isoform with specificity for a particular species of DAG, i.e.1-stearoyl-2-arachidonoyl glycerol. The smallest of all known DGK isoforms, DGKε,is also the only DGK devoid of a regulatory domain.DGKε is the only DGK isoform that has a hydrophobic segment that is predicted to form a transmembrane helix. As the only membrane-bound, constitutively active DGK isoform with exquisite specificity for particular molecular species of DAG, the functional overlap between DGKε and other DGKs is predicted to be minimal.DGKε exhibits specificity for DAG containing the same acyl chains as those found in the lipid intermediates of the phosphatidylinositol-cycle. It has also been shown that DGKε affects the acyl chain composition of phosphatidylinositol in whole cells. It is thus likely that DGKε is responsible for catalyzing one step in the phosphatidylinositol-cycle. Steps of this cycle take place in both the plasma membrane and the endoplasmic reticulum membrane.DGKε is likely present in both of these membranes.DGKε is the only DGK isoform that is associated with a human disease. Indeed, recessive loss-of-function mutations in DGKε cause atypical hemolytic-uremic syndrome (aHUS. This condition is characterized by thrombosis in the small vessels of the kidney. It causes acute renal insufficiency in infancy and most patients develop end-stage renal failure before adulthood. Disease pathophysiology is poorly understood and there is no therapy. There are also data suggesting that DGKε may play a role in epilepsy and Huntington disease.Thus,DGKε has many unique molecular and biochemical properties when compared to all other DGK isoforms.DGKε homologs also contain a number of conserved sequence features that are distinctive

  13. Emerging types of Shiga toxin-producing E. coli (STEC O178 present in cattle, deer and humans from Argentina and Germany

    Directory of Open Access Journals (Sweden)

    Angelika eMiko

    2014-06-01

    Full Text Available More than 400 serotypes of Shiga toxin-producing Escherichia coli (STEC have been implicated in outbreaks and sporadic human diseases. In recent years STEC strains belonging to serogroup O178 have been commonly isolated from cattle and food of bovine origin in South America and Europe. In order to explore the significance of these STEC strains as potential human pathogens, 74 German and Argentinean E. coli O178 strains from animals, food and humans were characterized phenotypically and investigated for their serotypes, stx-genotypes and forty-three virulence-associated markers by a real-time PCR-microarray. The majority (n=66 of the O178 strains belonged to serotype O178:H19. The remaining strains divided into O178:H7 (n=6, O178:H10 (n=1 and O178:H16 (n=1. STEC O178:H19 strains were mainly isolated from cattle and food of bovine origin, but one strain was from a patient with hemolytic uremic syndrome (HUS. Genotyping of the STEC O178:H19 strains by pulsed-field gel electrophoresis revealed two major clusters of genetically highly related strains which differ in their stx-genotypes and non-Stx putative virulence traits, including adhesins, toxins and serine-proteases. Cluster A-strains including the HUS-strain (n=35 carried genes associated with severe disease in humans (stx2a, stx2d, ehxA, saa, subAB1, lpfAO113, terE combined with stx1a, espP, iha. Cluster B-strains (n=26 showed a limited repertoire of virulence genes (stx2c, pagC, lpfAO113, espP, iha. Among O178:H7 strains isolated from deer meat and patients with uncomplicated disease a new STEC variant was detected that is associated with the genotype stx1c/stx2b/ehxA/subAB2/espI/[terE]/espP/iha. None of the STEC O178 strains was positive for locus of enterocyte effacement (LEE- and nle-genes. Results indicate that STEC O178:H19 strains belong to the growing group of LEE-negative STEC that should be considered with respect to their potential to cause diseases in humans.

  14. Shiga toxin-producing Escherichia coli (STEC: principal virulence factors and epidemiology Escherichia coli produtora de toxina shiga (STEC: principais fatores de virulência e dados epidemiológicos

    Directory of Open Access Journals (Sweden)

    Halha Ostrensky Saridakis

    2007-10-01

    Full Text Available Shiga toxin producing Escherichia coli is an important food borne pathogen, mainly beef products, and is associated to mild and severe bloody diarrhea. In some individuals, STEC infection can progress to hemolytic-uremic syndrome (HUS, a sequela characterized by renal failure, and thrombotic thrombocytopenic purpura (TTP, with possible central nervous system involvement. Cattle, usually healthy, is the principal reservoir of STEC, although these strains have also been isolated from other domestic animals: sheep, goats, dogs, cats and pigs. The principal virulence feature, the production of Shiga toxins, is not enough to cause diseases, and other factors are considered important, as enterohemolysin and fimbrial and afimbrial adhesions production. Although human diseases associated to STEC have not been frequently reported in Brazil, their presence is frequent in cattle, as well as the correlation between serotypes found in these animals and human patients. Escherichia coli produtora de toxina Shiga (STEC é um importante patógeno veiculado por alimentos, principalmente produtos derivados de carne bovina e está associado a quadros de diarréias leves a severas e sanguinolentas. Em alguns indivíduos, a infecção por STEC pode progredir para a síndrome hemolítico-urêmica (HUS, seqüela caracterizada pela falência renal e a púrpura trombocitopênica trombótica (TTP, com possível envolvimento do sistema nervoso central. O gado bovino, geralmente saudável, é o principal reservatório de STEC, embora estas cepas também tenham sido isoladas de outros animais domésticos: ovelhas, cabras, cães, gatos e suínos. A principal característica de virulência, a produção de toxinas Shiga, não é suficiente para causar doenças e outros fatores são considerados relevantes, como a produção de enterohemolisina e de adesinas fimbriais e afimbriais. Embora as doenças humanas associadas a STEC sejam pouco descritas no Brasil, podemos observar

  15. Automated algorithm for CBCT-based dose calculations of prostate radiotherapy with bilateral hip prostheses.

    Science.gov (United States)

    Almatani, Turki; Hugtenburg, Richard P; Lewis, Ryan D; Barley, Susan E; Edwards, Mark A

    2016-10-01

    Cone beam CT (CBCT) images contain more scatter than a conventional CT image and therefore provide inaccurate Hounsfield units (HUs). Consequently, CBCT images cannot be used directly for radiotherapy dose calculation. The aim of this study is to enable dose calculations to be performed with the use of CBCT images taken during radiotherapy and evaluate the necessity of replanning. A patient with prostate cancer with bilateral metallic prosthetic hip replacements was imaged using both CT and CBCT. The multilevel threshold (MLT) algorithm was used to categorize pixel values in the CBCT images into segments of homogeneous HU. The variation in HU with position in the CBCT images was taken into consideration. This segmentation method relies on the operator dividing the CBCT data into a set of volumes where the variation in the relationship between pixel values and HUs is small. An automated MLT algorithm was developed to reduce the operator time associated with the process. An intensity-modulated radiation therapy plan was generated from CT images of the patient. The plan was then copied to the segmented CBCT (sCBCT) data sets with identical settings, and the doses were recalculated and compared. Gamma evaluation showed that the percentage of points in the rectum with γ algorithms, respectively. Compared with the planning CT (pCT) plan, the MLT algorithm showed -0.46% dose difference with 8 h operator time while the automated MLT algorithm showed -1.3%, which are both considered to be clinically acceptable, when using collapsed cone algorithm. The segmentation of CBCT images using the method in this study can be used for dose calculation. For a patient with prostate cancer with bilateral hip prostheses and the associated issues with CT imaging, the MLT algorithms achieved a sufficient dose calculation accuracy that is clinically acceptable. The automated MLT algorithm reduced the operator time associated with implementing the MLT algorithm to achieve clinically

  16. Contrast Circulation Time to Assess Right Ventricular Dysfunction in Pulmonary Embolism: A Retrospective Pilot Study

    Science.gov (United States)

    Platon, Alexandra; Poletti, Pierre-Alexandre; Perrier, Arnaud; Bendjelid, Karim

    2016-01-01

    Objective To optimize enhancement of pulmonary arteries and facilitate diagnosis of pulmonary embolism (PE), modern computed tomography angiography (CTA) contains a contrast bolus tracking system. We explored the diagnostic accuracy of the time-intensity curves given by this automated system to identify right ventricular dysfunction (RVD) in acute PE. Methods 114 CTAs with a diagnosis of PE were reviewed. RVD was defined as right-to-left ventricular diameter ratio of 1 or greater. Four parameters on time-intensity curves were identified. Parameters between CTAs with and those without RVD were compared with the Wilcoxon rank-sum test. The ability of the four parameters to discriminate patients with RVD was explored by compiling the area under the operating curves (AUC). Results The time needed by the contrast media to reach the pulmonary artery [8 seconds (IQR: 7–9) versus 7 seconds (IQR: 6–8), p<0.01], the time needed to reach 40 Hounsfield units (HU) [11 seconds (IQR: 8.5–14) versus 9.5 seconds (IQR: 8–10.5), p<0.01], and the contrast intensity reached after 10 seconds [19 HU (IQR: 4–67) versus 53 HU (IQR: 32–80), p<0.05] were all statistically different between CTA with and CTA without RVD. Those three parameters changed gradually across severity categories of RVD (p<0.05 for trend). Their AUC to identify RVD ranged from 0.63 to 0.66. The slope of contrast intensity over time was not informative: [31 HU/s (IQR: 20–57) in CTA with, compared to 36 HU/s (IQR: 22.5–53) in CTA without RVD, p = 0.60]. Conclusion Several parameters of the time-intensity curve obtained by the bolus tracking system are associated with RVD assessed on CTA images. Of those, the time needed to reach a predefined threshold seems to be the easiest to obtain in any CTA without additional processing time or contrast injection. However, the performance of those parameters is globally low. PMID:27551831

  17. Infection in burn patients in a referral center in Colombia.

    Science.gov (United States)

    Ramirez-Blanco, Carlos Enrique; Ramirez-Rivero, Carlos Enrique; Diaz-Martinez, Luis Alfonso; Sosa-Avila, Luis Miguel

    2017-05-01

    Worldwide, burns are responsible for more than 300,000 deaths annually; infection is a major cause of morbidity and mortality in these patients. Early identification and treatment of infection improves outcome. Toward this end it's necessary to identify the institutions flora and organisms that most frequently produces infection. To characterize infections developed by burn patients hospitalized at the University Hospital of Santander (HUS). Burn patients hospitalized in the HUS from January 1 to December 2014 were followed. Medical information regarding infections, laboratory and pathology reports were obtained. Statistical analysis with measures of central tendency, proportions, global and specific incidence density plus overall and specific incidence was obtained. For the microbiological profile proportions were established. 402 burn patients were included, 234 (58.2%) men and 168 (41.8%) women, aged between 6 days and 83 years, median 12.5 years. The burn agents include scald (52.5%), fire (10.0%), gasoline (9.2%), electricity (7.5%), among others. Burn area ranged from 1% to 80% TBS. Cumulative mortality was 1.5%. 27.8% of burned patients had one or more infections. Identified infections include folliculitis (27.0%), urinary tract infection (19.0%), infection of the burn wound (10.4%), pneumonia (8.6%), Central venous catheter (7.4%), bloodstream infection (7.4%) and skin grafts infection (4.3%) among others. Bacteria were responsible for 88.5% of the cases and fungi 11.5%. The most frequently isolated germs were P. aeruginosa, A. baumannii, E. coli, S. aureus and K. pneumoniae. Most gram-negative bacteria were sensitive to Amikacin, gram positive bacteria were sensitive to multiple antibiotics. Burns is a severe trauma that occurs in adult and pediatric patients, has several causative agents and can compromise the patient's life. The burned patient is at risk for a variety of infections. According to the type of infection it is possible to infer the most

  18. Detection of attaching and effacing virulence gene of E. coli

    Directory of Open Access Journals (Sweden)

    Maratu Soleha

    2013-07-01

    Full Text Available AbstrakLatar belakang: Bakteri Escherichia coli (E. coli ada yang telah bermutasi menjadi patogen yang menimbulkan berbagai penyakit seperti hemorrhagic colitis (HC, hemolytic uremic syndrome (HUS, sepsis, pnemonia, neonatal meningitis, dan infeksi saluran kemih. Mutasi terjadi karena bakteri ini menerima transfer gen yang virulen dari bakteri lain yang hidup di sekitarnya. E. coli yang biasanya hidup normal di dalam usus manusia telah beradaptasi sehingga bisa hidup di tanah, makanan, dan saluran kemih. Penelitian ini mendeteksi gene yang virulen pada DNA isolat E. coli. Metode: Untuk deteksi E. coli yang virulen pada penelitian ini digunakan metode Real-time PCR dengan mencocokkan hasil sekuensing dengan sekuens E. coli virulen yang telah di publikasikan sebagai rujukan. Hasil: Sekuens RT PCR menggambarkan DNA gen eae pada BLAST mempunyai kesesuaian dengan rujukan segmen E. coli yang virulen. Dari sampel yang berasal dari E. coli di sekitar perairan lingkungan didapatkan gen Eae sebagai gen yang menyebabkan E. coli menjadi virulen sebesar 7,3%. Kesimpulan: E. coli yang virulen ditemukan pada sampel E. coli yang berasal dari perairan lingkungan dengan metode realtime PCR. (Health Science Indones 2013;1:41-6 Kata kunci: gen virulen E. coli, real-time PCR, perairan lingkunganAbstractBackground: Escherichia coli(E. coli bacteria have developed into pathogenic bacteria that caused diseases such as hemorrhagic colitis (HC, hemolytic uremic syndrome (HUS, sepsis, pneumonia, neonatal meningitis, and urinary tract infections. Pathogenic E. coli have acquired pathogenic/virulence genes from other bacteria in their environment. E. coli that normally lived in the human gut had adapted to other niches such as soil, food and the urinary tract. This study investigated the presence of pathogenic E. coli from water samples by examining E. coli virulence genes present in E. coli genomes of water sourced isolates. Methods:This study used Real-time PCR to detect

  19. Contrast Circulation Time to Assess Right Ventricular Dysfunction in Pulmonary Embolism: A Retrospective Pilot Study.

    Science.gov (United States)

    John, Gregor; Platon, Alexandra; Poletti, Pierre-Alexandre; Perrier, Arnaud; Bendjelid, Karim

    2016-01-01

    To optimize enhancement of pulmonary arteries and facilitate diagnosis of pulmonary embolism (PE), modern computed tomography angiography (CTA) contains a contrast bolus tracking system. We explored the diagnostic accuracy of the time-intensity curves given by this automated system to identify right ventricular dysfunction (RVD) in acute PE. 114 CTAs with a diagnosis of PE were reviewed. RVD was defined as right-to-left ventricular diameter ratio of 1 or greater. Four parameters on time-intensity curves were identified. Parameters between CTAs with and those without RVD were compared with the Wilcoxon rank-sum test. The ability of the four parameters to discriminate patients with RVD was explored by compiling the area under the operating curves (AUC). The time needed by the contrast media to reach the pulmonary artery [8 seconds (IQR: 7-9) versus 7 seconds (IQR: 6-8), p<0.01], the time needed to reach 40 Hounsfield units (HU) [11 seconds (IQR: 8.5-14) versus 9.5 seconds (IQR: 8-10.5), p<0.01], and the contrast intensity reached after 10 seconds [19 HU (IQR: 4-67) versus 53 HU (IQR: 32-80), p<0.05] were all statistically different between CTA with and CTA without RVD. Those three parameters changed gradually across severity categories of RVD (p<0.05 for trend). Their AUC to identify RVD ranged from 0.63 to 0.66. The slope of contrast intensity over time was not informative: [31 HU/s (IQR: 20-57) in CTA with, compared to 36 HU/s (IQR: 22.5-53) in CTA without RVD, p = 0.60]. Several parameters of the time-intensity curve obtained by the bolus tracking system are associated with RVD assessed on CTA images. Of those, the time needed to reach a predefined threshold seems to be the easiest to obtain in any CTA without additional processing time or contrast injection. However, the performance of those parameters is globally low.

  20. Characteristics of Metastatic Mediastinal Lymph Nodes of Non-Small Cell Lung Cancer on Preoperative F-18 FDG PET/CT

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Ah Young; Choi, Su Jung; Jung, Kyung Pyo; Park, Ji Sun; Lee, Seok Mo; Bae, Sang Kyun [Inje Univ. College of Medicine, Gimhae (Korea, Republic of)

    2014-03-15

    The aim of this study was to evaluate the characteristics of PET and CT features of mediastinal metastatic lymph nodes on F-18 FDG PET/CT and to determine the diagnostic criteria in nodal staging of non-small cell lung cancer. One hundred four non-small cell lung cancer patients who had preoperative F-18 FDG PET/CT were included. For quantitative analysis, the maximum SUV of the primary tumor, maximum SUV of the lymph nodes (SUVmax), size of the lymph nodes, and average Hounsfield units (aHUs) and maximum Hounsfield units (mHUs) of the lymph nodes were measured. The SUVmax, SUV ratio of the lymph node to blood pool (LN SUV/blood pool SUV), SUV ratio of the lymph node to primary tumor (LN SUV/primary tumor SUV), size, aHU, and mHU were compared between the benign and malignant lymph nodes. Among 372 dissected lymph node stations that were pathologically diagnosed after surgery, 49 node stations were malignant and 323 node stations benign. SUVmax, LN SUV/blood pool SUV, and size were significantly different between the malignant and benign lymph node stations (P <0.0001). However, there was no significant difference in LN SUV/primary tumor SUV (P =0.18), mHU (P =0.42), and aHU (P =0.98). Using receiver-operating characteristic curve analyses, there was no significant difference among these three variables (SUVmax, LN SUV/blood pool SUV, and size). The optimal cutoff values were 2.9 for SUVmax, 1.4 for LN SUV/blood pool SUV, and 5 mm for size. When the cutoff value of SUVmax≥2.9 and size≥5 mm were used in combination, the positive predictive value was 44.2%, and the negative predictive value was 90.9 %. When we evaluated the results based on the histology of the primary tumor, the negative predictive value was 92.3 % in adenocarcinoma (cutoff values of SUVmax≥2.3 and size≥5 mm) and 97.2 % in squamous cell carcinoma (cutoff values of SUVmax≥3.6 and size≥8 mm), separately. In the lymph node staging of non-small cell lung cancer, SUVmax, LN SUV/blood pool SUV

  1. Efecto citotóxico de la toxina shiga tipo 2 y su subunidad b en células epiteliales tubulares renales humanas en cultivo Cytotoxic effect of Shiga toxin type 2 and its B subunit on human renal tubular epithelial cell cultures

    Directory of Open Access Journals (Sweden)

    Virginia Pistone Creydt

    2005-04-01

    Full Text Available Escherichia coli enterohemorrágica productora de toxina Shiga (Stx causa diarrea acuosa, colitis hemorrágica y síndrome urémico hemolítico (SUH. En Argentina, el SUH es la principal causa de insuficiencia renal en niños. El objetivo de este trabajo fue estudiar la toxicidad de Stx tipo 2 (Stx2 y su subunidad B (Stx2B en células epiteliales tubulares renales humanas (CERH, en presencia y ausencia de factores inflamatorios. Los efectos citotóxicos se evaluaron como alteración de la funcionalidad del epitelio; daños histológicos; viabilidad celular; síntesis de proteínas y apoptosis celular. Los resultados muestran que Stx2 regula el pasaje de agua a través de CERH a tiempos menores de 1h de incubación. A tiempos mayores, hasta 72 hs, el estudio de la morfología, la viabilidad, la síntesis de proteínas y la apoptosis demostró que las CERH fueron sensibles a la acción citotóxica de Stx2 y Stx2B de una manera dosis y tiempo dependiente. Estos efectos fueron potenciados por lipopolisacáridos bacterianos (LPS, IL-1b, y butirato.Shiga toxin (Stx-producing E.coli causing watery diarrhea, hemorrhagic colitis and hemolytic-uremic syndrome (HUS. In Argentina, HUS is the most common cause of acute renal failure in children. The purpose of the present study was to examine the cytotoxicity of Stx type 2 (Stx2 and its B subunit (Stx2B on human renal tubular epithelial cells (HRTEC, in the presence and absence of inflammatory factors. Cytotoxic effects were assessed in terms of functionality of the epithelium, histological damage, cell viability, protein synthesis and cellular apoptosis. Results show that Stx2 regulates the passage of water through the HRTEC within an incubation period of 1h. Within longer periods, up to 72 hours, the study of morphology, viability, protein synthesis and apoptosis shows that HRTEC were sensitive to the cytotoxic action of Stx2 and Stx2B in a dose- and time-dependent manner. These effects were potentiated by

  2. Protection from hemolytic uremic syndrome by eyedrop vaccination with modified enterohemorrhagic E. coli outer membrane vesicles.

    Directory of Open Access Journals (Sweden)

    Kyoung Sub Choi

    Full Text Available We investigated whether eyedrop vaccination using modified outer membrane vesicles (mOMVs is effective for protecting against hemolytic uremic syndrome (HUS caused by enterohemorrhagic E. coli (EHEC O157:H7 infection. Modified OMVs and waaJ-mOMVs were prepared from cultures of MsbB- and Shiga toxin A subunit (STxA-deficient EHEC O157:H7 bacteria with or without an additional waaJ mutation. BALB/c mice were immunized by eyedrop mOMVs, waaJ-mOMVs, and mOMVs plus polymyxin B (PMB. Mice were boosted at 2 weeks, and challenged peritoneally with wild-type OMVs (wtOMVs at 4 weeks. As parameters for evaluation of the OMV-mediated immune protection, serum and mucosal immunoglobulins, body weight change and blood urea nitrogen (BUN/Creatinin (Cr were tested, as well as histopathology of renal tissue. In order to confirm the safety of mOMVs for eyedrop use, body weight and ocular histopathological changes were monitored in mice. Modified OMVs having penta-acylated lipid A moiety did not contain STxA subunit proteins but retained non-toxic Shiga toxin B (STxB subunit. Removal of the polymeric O-antigen of O157 LPS was confirmed in waaJ-mOMVs. The mice group vaccinated with mOMVs elicited greater humoral and mucosal immune responses than did the waaJ-mOMVs and PBS-treated groups. Eyedrop vaccination of mOMVs plus PMB reduced the level of humoral and mucosal immune responses, suggesting that intact O157 LPS antigen can be a critical component for enhancing the immunogenicity of the mOMVs. After challenge, mice vaccinated with mOMVs were protected from a lethal dose of wtOMVs administered intraperitoneally, conversely mice in the PBS control group were not. Collectively, for the first time, EHEC O157-derived mOMV eyedrop vaccine was experimentally evaluated as an efficient and safe means of vaccine development against EHEC O157:H7 infection-associated HUS.

  3. Diacylglycerol Kinase-ε: Properties and Biological Roles

    Science.gov (United States)

    Epand, Richard M.; So, Vincent; Jennings, William; Khadka, Bijendra; Gupta, Radhey S.; Lemaire, Mathieu

    2016-01-01

    In mammals there are at least 10 isoforms of diacylglycerol kinases (DGK). All catalyze the phosphorylation of diacylglycerol (DAG) to phosphatidic acid (PA). Among DGK isoforms, DGKε has several unique features. It is the only DGK isoform with specificity for a particular species of DAG, i.e., 1-stearoyl-2-arachidonoyl glycerol. The smallest of all known DGK isoforms, DGKε, is also the only DGK devoid of a regulatory domain. DGKε is the only DGK isoform that has a hydrophobic segment that is predicted to form a transmembrane helix. As the only membrane-bound, constitutively active DGK isoform with exquisite specificity for particular molecular species of DAG, the functional overlap between DGKε and other DGKs is predicted to be minimal. DGKε exhibits specificity for DAG containing the same acyl chains as those found in the lipid intermediates of the phosphatidylinositol-cycle. It has also been shown that DGKε affects the acyl chain composition of phosphatidylinositol in whole cells. It is thus likely that DGKε is responsible for catalyzing one step in the phosphatidylinositol-cycle. Steps of this cycle take place in both the plasma membrane and the endoplasmic reticulum membrane. DGKε is likely present in both of these membranes. DGKε is the only DGK isoform that is associated with a human disease. Indeed, recessive loss-of-function mutations in DGKε cause atypical hemolytic-uremic syndrome (aHUS). This condition is characterized by thrombosis in the small vessels of the kidney. It causes acute renal insufficiency in infancy and most patients develop end-stage renal failure before adulthood. Disease pathophysiology is poorly understood and there is no therapy. There are also data suggesting that DGKε may play a role in epilepsy and Huntington disease. Thus, DGKε has many unique molecular and biochemical properties when compared to all other DGK isoforms. DGKε homologs also contain a number of conserved sequence features that are distinctive

  4. Detection of attaching and effacing virulence gene of E. coli

    Directory of Open Access Journals (Sweden)

    Maratu Soleha

    2013-07-01

    Full Text Available AbstrakLatar belakang: Bakteri Escherichia coli (E. coli ada yang telah bermutasi menjadi patogen yang menimbulkan berbagai penyakit seperti hemorrhagic colitis (HC, hemolytic uremic syndrome (HUS, sepsis, pnemonia, neonatal meningitis, dan infeksi saluran kemih. Mutasi terjadi karena bakteri ini menerima transfer gen yang virulen dari bakteri lain yang hidup di sekitarnya. E. coli yang biasanya hidup normal di dalam usus manusia telah beradaptasi sehingga bisa hidup di tanah, makanan, dan saluran kemih. Penelitian ini mendeteksi gene yang virulen pada DNA isolat E. coli. Metode: Untuk deteksi E. coli yang virulen pada penelitian ini digunakan metode Real-time PCR dengan mencocokkan hasil sekuensing dengan sekuens E. coli virulen yang telah di publikasikan sebagai rujukan. Hasil: Sekuens RT PCR menggambarkan DNA gen eae pada BLAST mempunyai kesesuaian dengan rujukan segmen E. coli yang virulen. Dari sampel yang berasal dari E. coli di sekitar perairan lingkungan didapatkan gen Eae sebagai gen yang menyebabkan E. coli menjadi virulen sebesar 7,3%. Kesimpulan: E. coli yang virulen ditemukan pada sampel E. coli yang berasal dari perairan lingkungan dengan metode realtime PCR. (Health Science Indones 2013;1:41-6 Kata kunci: gen virulen E. coli, real-time PCR, perairan lingkunganAbstractBackground: Escherichia coli(E. coli bacteria have developed into pathogenic bacteria that caused diseases such as hemorrhagic colitis (HC, hemolytic uremic syndrome (HUS, sepsis, pneumonia, neonatal meningitis, and urinary tract infections. Pathogenic E. coli have acquired pathogenic/virulence genes from other bacteria in their environment. E. coli that normally lived in the human gut had adapted to other niches such as soil, food and the urinary tract. This study investigated the presence of pathogenic E. coli from water samples by examining E. coli virulence genes present in E. coli genomes of water sourced isolates. Methods:This study used Real-time PCR to detect

  5. Síndrome urémico hemolítico. Tratamiento de la glomerulopatía secundaria Hemolytic uremic syndrome. Treatment of secondary glomerulopathy

    Directory of Open Access Journals (Sweden)

    María G. Caletti

    2005-12-01

    Full Text Available La insuficiencia renal crónica es la complicación más grave del síndrome urémico hemolítico (SUH. En el año 1996 se publicó la secuencia histológica de su evolución en pacientes con períodos oligoanúricos prolongados. En los últimos años se han propuesto diferentes esquemas terapéuticos para enlentecer la evolución a la insuficiencia renal crónica terminal en distintas nefropatías, diabéticas y no diabéticas, cuya expresión puede comenzar aun en la adolescencia. En este trabajo se comenta la respuesta a dos esquemas terapéuticos de dos grupos de pacientes con SUH que presentaron proteinuria con o sin hipertensión arterial e insuficiencia renal. Se enfatiza la indicación de la dieta hiposódica y controlada en proteínas en el mismo momento del alta del paciente y la incorporación de un inhibidor de la enzima de conversión de angiotensina II, iECA, (enalapril al comienzo de la aparición de la proteinuria.Chronic renal failure (CRF is the most severe complication of hemolytic uremic syndrome (HUS. In 1996, the histological sequence of changes in patients with long lasting oligoanuric periods was clarified. In the last years different therapeutic schemes have been proposed in order to slacken the development of terminal CRF in different renal conditions secondary to diabetes and other diseases. Some of these cases can suffer the onset of renal failure at adolescence. In this review, response to two treatment schemes in different patients with HUS and proteinuria with or without hypertension or renal failure is commented. Early indication of poor sodium diet and strict control of protein intake at the very moment of hospital discharge is strongly recommended, as well as angiotensin II conversion inhibiting enzymes (iACE at the appearance of proteinuria.

  6. Dexamethasone Rescues Neurovascular Unit Integrity from Cell Damage Caused by Systemic Administration of Shiga Toxin 2 and Lipopolysaccharide in Mice Motor Cortex

    Science.gov (United States)

    Pinto, Alipio; Jacobsen, Mariana; Geoghegan, Patricia A.; Cangelosi, Adriana; Cejudo, María Laura; Tironi-Farinati, Carla; Goldstein, Jorge

    2013-01-01

    Shiga toxin 2 (Stx2)-producing Escherichia coli (STEC) causes hemorrhagic colitis and hemolytic uremic syndrome (HUS) that can lead to fatal encephalopathies. Neurological abnormalities may occur before or after the onset of systemic pathological symptoms and motor disorders are frequently observed in affected patients and in studies with animal models. As Stx2 succeeds in crossing the blood-brain barrier (BBB) and invading the brain parenchyma, it is highly probable that the observed neurological alterations are based on the possibility that the toxin may trigger the impairment of the neurovascular unit and/or cell damage in the parenchyma. Also, lipopolysaccharide (LPS) produced and secreted by enterohemorrhagic Escherichia coli (EHEC) may aggravate the deleterious effects of Stx2 in the brain. Therefore, this study aimed to determine (i) whether Stx2 affects the neurovascular unit and parenchymal cells, (ii) whether the contribution of LPS aggravates these effects, and (iii) whether an inflammatory event underlies the pathophysiological mechanisms that lead to the observed injury. The administration of a sub-lethal dose of Stx2 was employed to study in detail the motor cortex obtained from a translational murine model of encephalopathy. In the present paper we report that Stx2 damaged microvasculature, caused astrocyte reaction and neuronal degeneration, and that this was aggravated by LPS. Dexamethasone, an anti-inflammatory, reversed the pathologic effects and proved to be an important drug in the treatment of acute encephalopathies. PMID:23894578

  7. Dexamethasone rescues neurovascular unit integrity from cell damage caused by systemic administration of shiga toxin 2 and lipopolysaccharide in mice motor cortex.

    Directory of Open Access Journals (Sweden)

    Alipio Pinto

    Full Text Available Shiga toxin 2 (Stx2-producing Escherichia coli (STEC causes hemorrhagic colitis and hemolytic uremic syndrome (HUS that can lead to fatal encephalopathies. Neurological abnormalities may occur before or after the onset of systemic pathological symptoms and motor disorders are frequently observed in affected patients and in studies with animal models. As Stx2 succeeds in crossing the blood-brain barrier (BBB and invading the brain parenchyma, it is highly probable that the observed neurological alterations are based on the possibility that the toxin may trigger the impairment of the neurovascular unit and/or cell damage in the parenchyma. Also, lipopolysaccharide (LPS produced and secreted by enterohemorrhagic Escherichia coli (EHEC may aggravate the deleterious effects of Stx2 in the brain. Therefore, this study aimed to determine (i whether Stx2 affects the neurovascular unit and parenchymal cells, (ii whether the contribution of LPS aggravates these effects, and (iii whether an inflammatory event underlies the pathophysiological mechanisms that lead to the observed injury. The administration of a sub-lethal dose of Stx2 was employed to study in detail the motor cortex obtained from a translational murine model of encephalopathy. In the present paper we report that Stx2 damaged microvasculature, caused astrocyte reaction and neuronal degeneration, and that this was aggravated by LPS. Dexamethasone, an anti-inflammatory, reversed the pathologic effects and proved to be an important drug in the treatment of acute encephalopathies.

  8. Posterior Reversible Encephalopathy Syndrome in Henoch-Schonlein Purpura and Hemolytic Uremic Syndrome.

    Science.gov (United States)

    Fidan, Kibriya; Kandur, Yasar; Ucar, Murat; Gucuyener, Kivilcim; Soylemezoglu, Oguz

    2016-07-01

    Posterior reversible encephalopathy syndrome (PRES) is a clinico-radiological syndrome, composed of symptoms such as headache, seizures, visual disturbances, lethargy, confusion, stupor, focal neurologic findings and radiological findings of bilateral gray and white matter abnormalities suggestive of edema in the posterior regions of the cerebral hemispheres. PRES is associated with significant morbidity and mortality if it is not expeditiously recognized. Magnetic resonance image (MRI) represents the most sensitive imaging technique for recognizing PRES. PRES has been seen in various clinical settings including renal disorders such as acute glomerulonephritis, lupus nephritis, nephrotic syndrome, and drug usage such as calcineurin inhibitors. We aimed to present two study cases for such clinical setting. In this report, we present two patients with PRES in whom the primary diagnosis was hemolytic uremic syndrome (HUS) and Henoch-Schonlein purpura (HSP). Both of them were treated with anticonvulsant and proper antihypertensive drugs. A repeated MRI scan of the head, an ophthalmologic assessment, and a follow-up electroencephalogram produced normal results with no sequelae. Early recognition of PRES as a complication during different diseases and therapies in childhood may facilitate the appropriate treatment, so that intensive treatment should be performed as soon as possible to avoid neurological sequelae.

  9. General considerations regarding the infections with the Escherichia coli pathogen

    Directory of Open Access Journals (Sweden)

    Marius Necşulescu

    2017-04-01

    Full Text Available Escherichia coli is the species of the genus Escherichia with the greatest epidemiological impact. Escherichia coli infections are found mainly in places with poor hygiene; the infants with ages between 1 and 3 years old are included in the category with the highest risk. It is a "fecal-oral" transmission mechanism as a result of consumption of contaminated food or water, or by "dirty hands". The foods most commonly implicated in the transmission of the infection are unpasteurized milk and milk products, beef, especially the one insufficiently cooked, unpasteurized fruit juice, lettuce and insufficiently washed vegetables. The disease has been reported worldwide, being described numerous episodes of infection with Escherichia coli that caused multiple illnesses and deaths. Escherichia coli has three types of antigens: antigen "O" (somatic, antigen "H" (flagella and antigen "K" (capsular. Clinical manifestations are present in the form of non-specific diarrhea, a dysentery form of enteritis, choleriform enteritis, hemorrhagic colitis and hemolytic uremic syndrome (HUS. The Escherichia coli infection diagnosis is made by identifying the etiologic agent and/or by highlighting the VTI toxin in the feces. The treatment consists in precautionary antibiotherapy, hydrodynamics and electrolyte rebalancing, blood transfusions and dialysis, if in the case of renal failure. The prevention of infections with Escherichia coli is achieved by personal hygiene, food hygiene and work hygiene.

  10. Survey on the occurrence of shiga toxin producing strains of Escherichia coli (STEC) in drinking water from central Hessia

    Energy Technology Data Exchange (ETDEWEB)

    Stelz, A.; Zschoeck, M. [Untersuchungsamt Hessen, Giessen (Germany); Fels, K.; Alter, E. [Fachhochschule Giessen-Friedberg, Giessen (Germany)

    2001-07-01

    Consumption of unheated bovine food is said to be the main cause of outbreaks of enterohemorrhagic colitis (EC) and hemolytic syndrome (HUS) by E. coli O157 in man. Some cases were attributed to the ingestion of contaminated drinking water. Certain types of resources for drinking water supply are at risk of contamination with cattle faeces or sewage. In routine drinking water control E. coli is an index organism and must not be found in a sample of 100 ml. We investigated a total of 1700 drinking water samples from central Hessia (Germany) for shiga toxin producing strains of E. coli (STEC). A developed sensitive investigation scheme made it possible to detect up to 10 STEC per 100 ml water sample at least. ELISA was used for detection of shiga toxins 1 and 2, m-PCR for the genes encoding stx1, stx2, EHEC-hlyA and eaeA, plating on Enterohemolysin agar for detection of the enterohemolysin phenotype and slide agglutination technique for confirming E. coli O157. In 108 out of 1700 drinking water samples E. coli was detected, but none of the isolates belonged to serotype O157. ST1 and ST2 were not produced by the isolates. Thus, under normal circumstances drinking water in central Hessia seems to be no vehicle for STEC. (orig.)

  11. T. G. Masaryk, Václav Havel a heslo „pravda vítězí“ z československé prezidentské standarty

    Directory of Open Access Journals (Sweden)

    Jaroslaw Kilias

    2017-06-01

    Full Text Available The paper deals with the motto written on the flag of the president of Czechoslovakia, “Truth Prevails”. It is usually associated with T. G. Masaryk, the first president of Czechoslovakia, and Václav Havel, its last president and the first president of Czech Republic. For Masaryk the truth was an ethical ideal and an imperative which obliged him to fight for what he believed to be true. In his writings on the meaning of Czech history he gave it religious connotation, presenting it as a fulfillment of the humanitarian ideal, a heritage of the Czech reformation started by Jan Hus and the Hussites (who used the slogan “God’s truth prevails”. However, the meaning of the motto was in fact polyphonic, as most of the Czech public treated it as a generalized nationalist, perhaps anti-German symbol. For the Communists it symbolized a highly prized, domestic revolutionary tradition. Another meaning the motto received under Václav Havel, a former dissident whose truth aimed against “deceitful” Communism, losing its meaning after the fall of the Communist regime when it turned into an obstacle for critical self-reflection. The history of the motto gives the impression that the idea of truth may be a viable basis for the political ethics of conviction, but it hardly forms a basis for the ethics of responsibility.

  12. A conserved physical and functional interaction between the cell cycle checkpoint clamp loader and DNA ligase I of eukaryotes.

    Science.gov (United States)

    Song, Wei; Levin, David S; Varkey, Johnson; Post, Sean; Bermudez, Vladimir P; Hurwitz, Jerard; Tomkinson, Alan E

    2007-08-03

    DNA ligase I joins Okazaki fragments during DNA replication and completes certain excision repair pathways. The participation of DNA ligase I in these transactions is directed by physical and functional interactions with proliferating cell nuclear antigen, a DNA sliding clamp, and, replication factor C (RFC), the clamp loader. Here we show that DNA ligase I also interacts with the hRad17 subunit of the hRad17-RFC cell cycle checkpoint clamp loader, and with each of the subunits of its DNA sliding clamp, the heterotrimeric hRad9-hRad1-hHus1 complex. In contrast to the inhibitory effect of RFC, hRad17-RFC stimulates joining by DNA ligase I. Similar results were obtained with the homologous Saccharomyces cerevisiae proteins indicating that the interaction between the replicative DNA ligase and checkpoint clamp is conserved in eukaryotes. Notably, we show that hRad17 preferentially interacts with and specifically stimulates dephosphorylated DNA ligase I. Moreover, there is an increased association between DNA ligase I and hRad17 in S phase following DNA damage and replication blockage that occurs concomitantly with DNA damage-induced dephosphorylation of chromatin-associated DNA ligase I. Thus, our results suggest that the in vivo interaction between DNA ligase I and the checkpoint clamp loader is regulated by post-translational modification of DNA ligase I.

  13. La disputa al concilio di Basilea tra Giovanni da Ragusa e Giovanni da Rokycana

    Directory of Open Access Journals (Sweden)

    Giacomo Canobbio

    2015-06-01

    Full Text Available The study is aimed to sketch the dispute which took place on the Council of Basle between the representatives of Czech Church and Roman Catholic Church, namely between John of Rokycany and Ivan of Dubrovnik. The theme of the discussion was mainly the question of communion under both kinds for the laity, which could be regarded just as a disciplinary matter. In: reality, both disputers show that there are ecclesiological consequences: How should the Church be understood? What is Jesus’s relation to this church? The dispute thus reflected the Church reform initiated by John Wycliffe and advanced by John Hus. The question of communion under both kinds for laity provided an opportunity to rethink the nature of the Church, the role of authority in it and the relation between the Church and Eucharist. This would, however, presuppose a certain way of perceiving the Eucharist (a sacrament or a sacrifice?, which both theologians present to justify their notion of the Church. In: order to resolve these questions, it was necessary to face a methodological problem: How to interpret the Bible and who is the supreme authority to offer an authentic interpretation? According to John of Rokycany, it is the Church while Ivan of Dubrovnik claims that it is the authority of the Church. The dispute is thus an example of the relation between the mysteries which theology should pursue.

  14. Hounsfield unit recovery in clinical cone beam CT images of the thorax acquired for image guided radiation therapy

    Science.gov (United States)

    Slot Thing, Rune; Bernchou, Uffe; Mainegra-Hing, Ernesto; Hansen, Olfred; Brink, Carsten

    2016-08-01

    A comprehensive artefact correction method for clinical cone beam CT (CBCT) images acquired for image guided radiation therapy (IGRT) on a commercial system is presented. The method is demonstrated to reduce artefacts and recover CT-like Hounsfield units (HU) in reconstructed CBCT images of five lung cancer patients. Projection image based artefact corrections of image lag, detector scatter, body scatter and beam hardening are described and applied to CBCT images of five lung cancer patients. Image quality is evaluated through visual appearance of the reconstructed images, HU-correspondence with the planning CT images, and total volume HU error. Artefacts are reduced and CT-like HUs are recovered in the artefact corrected CBCT images. Visual inspection confirms that artefacts are indeed suppressed by the proposed method, and the HU root mean square difference between reconstructed CBCTs and the reference CT images are reduced by 31% when using the artefact corrections compared to the standard clinical CBCT reconstruction. A versatile artefact correction method for clinical CBCT images acquired for IGRT has been developed. HU values are recovered in the corrected CBCT images. The proposed method relies on post processing of clinical projection images, and does not require patient specific optimisation. It is thus a powerful tool for image quality improvement of large numbers of CBCT images.

  15. Rapid isolation of pure Complement Factor H from serum for functional studies by the use of a monoclonal antibody that discriminates FH from all the other isoforms.

    Science.gov (United States)

    Berra, Silvia; Clivio, Alberto

    2016-04-01

    Several mutations have been identified in the gene coding for Complement Factor H (FH) from patients with atypical Hemolytic Uraemic Syndrome (aHUS), Age-related Macular Degeneration (AMD) and Membranoproliferative Glomerulonephritis (MPGN). These data allow for a precise description of the structural changes affecting FH, but a simple test for specifically assessing FH function routinely is not yet of common use. We have produced and characterised a monoclonal antibody (5H5) which discriminates between FH and the smaller FH-like 1 and FH-related proteins and show here that it specifically binds to FH without detecting the smaller isoforms. We therefore used this mAb for a quick, one-step micro-purification of FH directly from control sera and showed that this affinity chromatography procedure is not disruptive of its cofactor function. We also developed a modified sheep erythrocytes haemolysis test using our antibody and affinity-purified FH. These tests can be used in conjunction for assessing the function of FH purified from patients affected by FH-related diseases. Moreover we used this mAb to develop a FH-specific ELISA test.

  16. A method for image-based shadow interaction with virtual objects

    Directory of Open Access Journals (Sweden)

    Hyunwoo Ha

    2015-01-01

    Full Text Available A lot of researchers have been investigating interactive portable projection systems such as a mini-projector. In addition, in exhibition halls and museums, there is a trend toward using interactive projection systems to make viewing more exciting and impressive. They can also be applied in the field of art, for example, in creating shadow plays. The key idea of the interactive portable projection systems is to recognize the user׳s gesture in real-time. In this paper, a vision-based shadow gesture recognition method is proposed for interactive projection systems. The gesture recognition method is based on the screen image obtained by a single web camera. The method separates only the shadow area by combining the binary image with an input image using a learning algorithm that isolates the background from the input image. The region of interest is recognized with labeling the shadow of separated regions, and then hand shadows are isolated using the defect, convex hull, and moment of each region. To distinguish hand gestures, Hu׳s invariant moment method is used. An optical flow algorithm is used for tracking the fingertip. Using this method, a few interactive applications are developed, which are presented in this paper.

  17. PCR Based Detection of Shiga Toxin Producing E. coli in Commercial Poultry and Related Environments

    Directory of Open Access Journals (Sweden)

    Homaira Anzum Himi

    2015-03-01

    Full Text Available Shiga toxin (Stx-producing E. coli (STEC is the most important foodborne pathogen which is the causal agent of mild diarrhea, bloody diarrhea, hemolytic-uremic syndrome (HUS in human. The present study was designed to determine the prevalence and identification of Shiga toxin (Stx-producing E. coli in poultry, detection of its source of infection in poultry and transmission pattern to human. For this purpose a total of 150 samples (cloacal swab-60, feed -15, water-15 and egg -60 were collected and analyzed in bacteriology laboratory by cultured in different bacteriological media followed by gram’s staining, biochemical tests and Polymerase Chain reaction (PCR. The PCR was performed by targeting 16s rRNA gene and shiga toxin producing gene in E. coli. Out of 150 collected samples, E. coli was found in 81 (54% samples. Presence of E. coli was 100% in both feed (n=15 and egg (n=60, whereas 10% in cloacal swab (n=6. Water samples were totally free of E. coli. The stx2 gene was detected in all samples whether all samples were negative for stx1 gene. The study revealed that, poultry feed acts as a source of E. coli infection in poultry, which may be transmitted to environment and human via meat or eggs. Antibiotic sensitivity test revealed that isolated bacteria were highly sensitive to Ciprofloxacin.

  18. trt-1 is the Caenorhabditis elegans catalytic subunit of telomerase.

    Directory of Open Access Journals (Sweden)

    Bettina Meier

    2006-02-01

    Full Text Available Mutants of trt-1, the Caenorhabditis elegans telomerase reverse transcriptase, reproduce normally for several generations but eventually become sterile as a consequence of telomere erosion and end-to-end chromosome fusions. Telomere erosion and uncapping do not cause an increase in apoptosis in the germlines of trt-1 mutants. Instead, late-generation trt-1 mutants display chromosome segregation defects that are likely to be the direct cause of sterility. trt-1 functions in the same telomere replication pathway as mrt-2, a component of the Rad9/Rad1/Hus1 (9-1-1 proliferating cell nuclear antigen-like sliding clamp. Thus, the 9-1-1 complex may be required for telomerase to act at chromosome ends in C. elegans. Although telomere erosion limits replicative life span in human somatic cells, neither trt-1 nor telomere shortening affects postmitotic aging in C. elegans. These findings illustrate effects of telomere dysfunction in C. elegans mutants lacking the catalytic subunit of telomerase, trt-1.

  19. Detection of E. coli O157:H7 and Shigella dysenteriae toxins in clinical samples by PCR-ELISA

    Directory of Open Access Journals (Sweden)

    Jafar Amani

    2015-06-01

    Full Text Available Shiga toxin producing bacteria are potential causes of serious human disease such as hemorrhagic colitis, severe inflammations of ileocolonic regions of gastrointestinal tract, thrombocytopenia, septicemia, malignant disorders in urinary ducts, hemolytic uremic syndrome (HUS Shiga toxin 1 (stx1, shiga toxin 2 (stx2, or a combination of both are responsible for most clinical symptoms of these diseases. A lot of methods have been developed so far to detect shiga toxins such as cell culture, ELISA, and RFPLA, but due to high costs and labor time in addition to low sensitivity, they have not received much attention. In this study, PCR-ELISA method was used to detect genes encoding shiga toxins 1 and 2 (stx1 and stx2. To detect stx1 and stx2 genes, two primer pairs were designed for Multiplex-PCR then PCR-ELISA. PCR products (490 and 275, respectively were subsequently verified by sequencing. Sensitivity and specificity of PCR-ELISA method were determined by using genome serial dilution and Enterobacteriastrains. PCR-ELISA method used in this study proved to be a rapid and precise approach to detect different types of shiga toxins and can be used to detect bacterial genes encoding shiga toxins.

  20. ISOLASI DAN IDENTIFIKASI ESCHERICHIA COLI O157:H7 PADA DAGING SAPI DI KABUPATEN BADUNG PROVINSI BALI. ISOLATION AND IDENTIFICATION ESCHERICHIA COLI O157:H7 ON BEEF AT BADUNG REGENCY PROVINCE OF BALI

    Directory of Open Access Journals (Sweden)

    I Wayan Suardana

    2007-03-01

    Full Text Available Keamanan bahan pangan merupakan masalah yang amat penting bagi konsumen dan industri pangan. Cemaran bakteri Escherichia coli dan Coliform dianggap sebagai indikator sanitasi dalam proses pengolahan bahan pangan. Pelacakan bakteri patogen dalam pangan juga telah dilakukan secara rutin, termasuk yang bersifat zoonosis seperti Escherichia coli O157:H7. Bakteri ini menghasilkan toksin yang dikenal dengan Shiga toxin. Toksin ini dapat menimbulkan diare berdarah, colitis haemorrhagi dan hemolytic uremic syndrome (HUS pada manusia. Dalam penelitian ini dipelajari hubungan antara tingkat cemaran dan insidensi Coliform, E.coli, E.coli O157 dan E.coli O157:H7 pada daging sapi. Bakteri pertama ditumbuhkan pada media EMBA, selanjutnya dipupuk pada media SMAC dan diakhiri dengan uji aglutinasi lateks untuk memastikan keberadaan bakteri E.coli O157 dan uji antiserum H7 untuk memastikan isolat yang diisolasi merupakan isolat E.coli O157:H7. Hasil isolasi dan identifikasi terhadap 89 sampel daging sapi diperoleh hasil rata-rata tingkat cemran coliform dan E.coli sebesar 93,01+ 2,64x103 cfu/g dan

  1. Mouse in Vivo Neutralization of Escherichia coli Shiga Toxin 2 with Monoclonal Antibodies

    Directory of Open Access Journals (Sweden)

    Larry H. Stanker

    2013-10-01

    Full Text Available Shiga toxin-producing Escherichia coli (STEC food contaminations pose serious health concerns, and have been the subject of massive food recalls. STEC has been identified as the major cause of the life-threatening complication of hemolytic uremic syndrome (HUS. Besides supportive care, there currently are no therapeutics available. The use of antibiotics for combating pathogenic E. coli is not recommended because they have been shown to stimulate toxin production. Clearing Stx2 from the circulation could potentially lessen disease severity. In this study, we tested the in vivo neutralization of Stx2 in mice using monoclonal antibodies (mAbs. We measured the biologic half-life of Stx2 in mice and determined the distribution phase or t1/2 α to be 3 min and the clearance phase or t1/2 β to be 40 min. Neutralizing mAbs were capable of clearing Stx2 completely from intoxicated mouse blood within minutes. We also examined the persistence of these mAbs over time and showed that complete protection could be passively conferred to mice 4 weeks before exposure to Stx2. The advent of better diagnositic methods and the availability of a greater arsenal of therapeutic mAbs against Stx2 would greatly enhance treatment outcomes of life threatening E. coli infections.

  2. 三峡库区支流蓝藻水华对浮游细菌群落组成的影响%THE EFFECT OF CYANOBACTERIAL BLOOM TO PLANKTONIC BACTERIA COMMUNITY COMPOSITION IN TRIBUTARY OF THE THREE GORGES RESERVOIR

    Institute of Scientific and Technical Information of China (English)

    毛莉; 张明; 白芳; 崔懿安; 施军琼; 吴忠兴

    2016-01-01

    为探究蓝藻水华生消过程对浮游细菌群落组成的影响,对三峡库区小江支流进行了采样检测,结果表明小江采样点的水华优势蓝藻主要为水华鱼腥藻和铜绿微囊藻,水华中期藻细胞密度分别达6.22×109和8.77×108个/L,占总生物量的67%和26%.水华中、末期,浮游细菌群落变化显著.其中,水华中期主要以玫瑰单胞菌(Roseomona)等属细菌为主,水华末期则以芽孢杆菌(BaciHus)等属细菌为优势,且变形菌门(Proteobacteria)及放线菌门(Actinobacteria)细菌相对丰度明显增加,暗示了细菌群落组成与库区支流蓝藻水华生消变化可能具有相关性.

  3. 创新科技推动畜牧业可持续发展%On Sustainable Development of Animal Husbandry by Way of Innovative Technologies

    Institute of Scientific and Technical Information of China (English)

    刘如; 李荣; 赵芳

    2014-01-01

    As a strong power in animal husbandry,China is now facing the challenges of both technical and man-agement modernization. In the paper,existing problems in the animal husbandry industry were discussed to further promote the industry’s sustainable development. Besides,innovative methods of pushing forward the animal hus-bandry industry in China were proposed from the perspectives of high benefit guarantee,scientific breeding, resource utilization of excrements and intelligent management.%我国是一个畜牧业大国,产业发展需依靠技术与管理的现代化。为进一步实现畜牧业的可持续发展,分析了目前我国畜牧业发展中存在的问题,从保证畜牧业的高效益、科学合理喂养、畜禽排泄物资源化利用、畜牧产业智能管理等方面提出了推动我国畜牧业发展的创新方法。

  4. Assessment of the increased calcification of the jaw bone with CT-Scan after dental implant placement

    Energy Technology Data Exchange (ETDEWEB)

    Yunus, Barunawaty [Faculty of Dentistry, Hasanuddin University, Makassar (Malaysia)

    2011-06-15

    This study was performed to evaluate the changes of jaw bone density around the dental implant after placement using computed tomography scan (CT-Scan). This retrospective study consisted of 30 patients who had lost 1 posterior tooth in maxilla or mandible and installed dental implant. The patients took CT-Scan before and after implant placement. Hounsfield Unit (HU) was measured around the implants and evaluated the difference of HU before and after implant installation. The mean HU of jaw bone was 542.436 HU and 764.9 HU before and after implant placement, respectively (p<0.05). The means HUs for male were 632.3 HU and 932.2 HU and those for female 478.2 HU and 645.5 HU before and after implant placement, respectively (p<0.05). Also, the jaw bone with lower density needed longer period for implant procedure and the increased change of HU of jaw bone was less in the cases which needed longer period for osseointegration. CT-Scan could be used to assess the change of bone density around dental implants. Bone density around dental implant was increased after placement. The increased rate of bone density could be determined by the quality of jaw bone before implant placement.

  5. [Survival of VTEC O157 and non-O157 in water troughs and bovine feces].

    Science.gov (United States)

    Polifroni, Rosana; Etcheverría, Analía I; Arroyo, Guillermo H; Padola, Nora L

    2014-01-01

    Verotoxin-producing Escherichia coli (VTEC) is the etiologic agent of hemolytic-uremic syndrome (HUS), which typically affects children ranging in age from six months to five years old. Transmission is produced by consumption of contaminated food, by direct contact with animals or the environment and from person to person. In previous studies we determined that the environment of a dairy farm is a non-animal reservoir; thus, we proposed to study the survival of 4 VTEC isolates (O20:H19; O91:H21; O157:H7 and O178:H19) in sterile water troughs and bovine feces by viable bacteria count and detection of virulence genes by PCR. It was demonstrated that the survival of different VTEC isolates (O157 and non-O157) varied in terms of their own characteristics as well as of the environmental conditions where they were found. The main differences between isolates were their survival time and the maximal counts reached. The competitive and adaptive characteristics of some isolates increase the infection risk for people that are visiting or working on a farm, as well as the risk for reinfection of the animals and food contamination. Copyright © 2014 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

  6. ETAA1 acts at stalled replication forks to maintain genome integrity.

    Science.gov (United States)

    Bass, Thomas E; Luzwick, Jessica W; Kavanaugh, Gina; Carroll, Clinton; Dungrawala, Huzefa; Glick, Gloria G; Feldkamp, Michael D; Putney, Reid; Chazin, Walter J; Cortez, David

    2016-11-01

    The ATR checkpoint kinase coordinates cellular responses to DNA replication stress. Budding yeast contain three activators of Mec1 (the ATR orthologue); however, only TOPBP1 is known to activate ATR in vertebrates. We identified ETAA1 as a replication stress response protein in two proteomic screens. ETAA1-deficient cells accumulate double-strand breaks, sister chromatid exchanges, and other hallmarks of genome instability. They are also hypersensitive to replication stress and have increased frequencies of replication fork collapse. ETAA1 contains two RPA-interaction motifs that localize ETAA1 to stalled replication forks. It also interacts with several DNA damage response proteins including the BLM/TOP3α/RMI1/RMI2 and ATR/ATRIP complexes. It binds ATR/ATRIP directly using a motif with sequence similarity to the TOPBP1 ATR-activation domain; and like TOPBP1, ETAA1 acts as a direct ATR activator. ETAA1 functions in parallel to the TOPBP1/RAD9/HUS1/RAD1 pathway to regulate ATR and maintain genome stability. Thus, vertebrate cells contain at least two ATR-activating proteins.

  7. Variability of runoff-based drought conditions in the conterminous United States

    Science.gov (United States)

    McCabe, Gregory; Wolock, David M.; Austin, Samuel H.

    2016-01-01

    In this study, a monthly water-balance model is used to simulate monthly runoff for 2109 hydrologic units (HUs) in the conterminous United States (CONUS) for water-years 1901 through 2014. The monthly runoff time series for each HU were smoothed with a 3-month moving average, and then the 3-month moving-average runoff values were converted to percentiles. For each HU, a drought was considered to occur when the HU runoff percentile dropped to the 20th percentile or lower. A drought was considered to end when the HU runoff percentile exceeded the 20th percentile. After identifying drought events for each HU, the frequency and length of drought events were examined. Results indicated that (1) the longest mean drought lengths occur in the eastern CONUS and parts of the Rocky Mountain region and the northwestern CONUS, (2) the frequency of drought is highest in the southwestern and central CONUS, and lowest in the eastern CONUS, the Rocky Mountain region, and the northwestern CONUS, (3) droughts have occurred during all months of the year and there does not appear to be a seasonal pattern to drought occurrence, (4) the variability of precipitation appears to have been the principal climatic factor determining drought, and (5) for most of the CONUS, drought frequency appears to have decreased during the 1901 through 2014 period.

  8. Research progress on the pathogenesis of enterohemorrhagic Escherichia coli and its infection%肠出血性大肠埃希菌致病机制及其感染的研究进展

    Institute of Scientific and Technical Information of China (English)

    马亦林

    2011-01-01

    大肠埃希菌是人和动物肠道正常菌群的主要成员,但其中有些带有致病基因的血清型会引起人类肠道感染、泌尿道感染,并可引发致死性并发症,如溶血性尿毒综合征(Haemolytic uraemic syndrome,HUS).根据其血清型别、毒力和临床症状可将致腹泻的大肠埃希菌分为肠毒素型( Enterotoxigenic Escherichia coli,ETEC)、肠致病型(Enteropathogenic Escherichia coli,EPEC)、肠侵袭型(Enteroinvasive Escherichia coli,EIEC)、扩黏型(Diffusely adherent Escherichia coli,DAEC)、肠出血型(Enterohemorrhagic Escherichia coli,EHEC)及肠凝聚型(Enteroaggregative Escherichia coli, EAggEC)六类[1].EHEC为致病性大肠埃希菌中最严重的一种,自1983年以来曾多次在世界各地区广泛流行,对人类健康构成极大威胁.

  9. Red River Wildlife Management Area HEP Report, Habitat Evaluation Procedures, Technical Report 2004.

    Energy Technology Data Exchange (ETDEWEB)

    Ashley, Paul

    2004-11-01

    A habitat evaluation procedures (HEP) analysis conducted on the 314-acre Red River Wildlife Management Area (RRWMA) managed by the Idaho Department of Fish and Game resulted in 401.38 habitat units (HUs). Habitat variables from six habitat suitability index (HSI) models, comprised of mink (Mustela vison), mallard (Anas platyrhynchos), common snipe (Capella gallinago), black-capped chickadee (Parus altricapillus), yellow warbler (Dendroica petechia), and white-tailed deer (Odocoileus virginianus), were measured by Regional HEP Team (RHT) members in August 2004. Cover types included wet meadow, riverine, riparian shrub, conifer forest, conifer forest wetland, and urban. HSI model outputs indicate that the shrub component is lacking in riparian shrub and conifer forest cover types and that snag density should be increased in conifer stands. The quality of wet meadow habitat, comprised primarily of introduced grass species and sedges, could be improved through development of ephemeral open water ponds and increasing the amount of persistent wetland herbaceous vegetation e.g. cattails (Typha spp.) and bulrushes (Scirpus spp.).

  10. Catastrophic APS in the context of other thrombotic microangiopathies.

    Science.gov (United States)

    Rodríguez-Pintó, Ignasi; Espinosa, Gerard; Cervera, Ricard

    2015-01-01

    The catastrophic antiphospholipid syndrome (CAPS) is a rare disease that affects 1 % of cases with antiphospholipid syndrome (APS). CAPS can mimic or overlap with different thrombotic diseases; many patients present with a microthrombotic storm or thrombotic microangiopathic hemolytic anemia (TMHA). Thus, the differential diagnosis of CAPS includes thrombotic thrombocytopenic purpura (TTP), typical and atypical hemolytic uremic syndrome (HUS), systemic infections, malignancies, pregnancy-related disorders, malignant hypertension, heparin-induced thrombocytopenia, and drug-induced thrombotic microangiopathies. Antiphospholipid antibody (aPL) positivity has been proposed as the clue in this differential diagnosis; however, aPL can also occur in healthy people and in those with infections or malignancies. Thus, the differential diagnosis of an aPL-positive patient presenting with a microthrombotic storm is broad; the workup should include a special attention to signs of infection and disseminated malignant disease, assessing the funduscopic signs of malignant hypertension, testing ADAMTS13 activity and anti-heparin-platelet factor 4 (HPF4) antibodies, and searching previous exposure to certain drugs. This article aims to review the main diseases included in the differential diagnosis of CAPS in the context of other thrombotic microangiopathies.

  11. EspA-Intimin chimeric protein, a candidate vaccine against Escherichia coli O157:H7.

    Directory of Open Access Journals (Sweden)

    Hamid Sedighian Rad

    2013-09-01

    Full Text Available Enterohemorrhagic Escherichia coli (EHEC O157:H7 is an important enteric pathogen in human causing bloody or nonbloody diarrhea, which may be complicated by hemolytic uremic syndrome (HUS. Cattle are an important reservoir of EHEC. This research aims at vaccination with a divalent chimer protein composed of EspA120 and Intimin 282 and its preventive effect of EHEC O157 colonization in mice rectal epithelium.A divalent recombinant EspA-Intimin (EI protein containing EspA120 and Intimin280 attached with a linker was amplified from a trivalent construct and cloned in pET-28a (+ vector. The immunization was conducted in mice after expression and purification of the recombinant EI (rEI.Mice subcutaneously immunized with rEI, elicited significant rEI specific serum IgG antibodies and showed significantly decreased E.coli O157:H7 shedding compared to the control group.The chimeric recombinant protein induced strong humoral response as well as protection against oral challenges with live E.coli O157:H7.

  12. Future perspectives, applications and challenges of genomic epidemiology studies for food-borne pathogens: A case study of Enterohemorrhagic Escherichia coli (EHEC) of the O157:H7 serotype.

    Science.gov (United States)

    Eppinger, Mark; Cebula, Thomas A

    2015-01-01

    The shiga-toxin (Stx)-producing human pathogen Escherichia coli serotype O157:H7 is a highly pathogenic subgroup of Stx-producing E. coli (STEC) with food-borne etiology and bovine reservoir. Each year in the U. S., approximately 100,000 patients are infected with enterohemorrhagic E. coli (EHEC) of the O157:H7 serotype. This food-borne pathogen is a global public health threat responsible for widespread outbreaks of human disease. Since its initial discovery in 1982, O157:H7 has rapidly become the dominant EHEC serotype in North America. Hospitalization rates among patients as high as 50% have been reported for severe outbreaks of human disease. Symptoms of disease can rapidly deteriorate and progress to life-threatening complications such as Hemolytic Uremic Syndrome (HUS), the leading cause of kidney failure in children, or Hemorrhagic Colitis. In depth understanding of the genomic diversity that exists among currently circulating EHEC populations has broad applications for improved molecular-guided biosurveillance, outbreak preparedness, diagnostic risk assessment, and development of alternative toxin-suppressing therapeutics.

  13. Complement factor H related proteins (CFHRs).

    Science.gov (United States)

    Skerka, Christine; Chen, Qian; Fremeaux-Bacchi, Veronique; Roumenina, Lubka T

    2013-12-15

    Factor H related proteins comprise a group of five plasma proteins: CFHR1, CFHR2, CFHR3, CFHR4 and CFHR5, and each member of this group binds to the central complement component C3b. Mutations, genetic deletions, duplications or rearrangements in the individual CFHR genes are associated with a number of diseases including atypical hemolytic uremic syndrome (aHUS), C3 glomerulopathies (C3 glomerulonephritis (C3GN), dense deposit disease (DDD) and CFHR5 nephropathy), IgA nephropathy, age related macular degeneration (AMD) and systemic lupus erythematosus (SLE). Although complement regulatory functions were attributed to most of the members of the CFHR protein family, the precise role of each CFHR protein in complement activation and the exact contribution to disease pathology is still unclear. Recent publications show that CFHR proteins form homo- as well as heterodimers. Genetic abnormalities within the CFHR gene locus can result in hybrid proteins with affected dimerization or recognition domains which cause defective functions. Here we summarize the recent data about CFHR genes and proteins in order to better understand the role of CFHR proteins in complement activation and in complement associated diseases.

  14. Theoretical resource of phenomenology%现象学的理论资源

    Institute of Scientific and Technical Information of China (English)

    康洁; 熊和平

    2012-01-01

    现象学的创生与发展借鉴了心理学与美学两大理论资源,它们分别对现象学运动起到了关键作用。胡塞尔在《逻辑研究》中批判心理主义,从心理学那里提取了纯粹现象学的议题,并试图使之成为作为严格科学的哲学的探讨对象。胡塞尔之后的众多现象学家又从文学、绘画等美学活动中获取了发展现象学的契机,并最终使现象学从认识论的主题演变为存在论的主题。%The establishment and development of phenomenology made use of two sorts of theoretical resource: psychology and aesthetics, which both played a crucial role in phenomenology motion. Husserl criticized psychologism in " the logic study", extracted the Pure-phenome- nology topics from psychology, and made them become discussing objects of philosophy as rigorous science. Lots of phenomenologist after Hus- serl got the opportunities of developing phenomenology from aesthetics activities such as literature and painting. , etc. Ultimately the epistemo- logical theme turned into ontological one in phenomenological study.

  15. Enteropathogens Associated with Acute Diarrhea in Children from Households with High Socioeconomic Level in Uruguay

    Directory of Open Access Journals (Sweden)

    Gustavo Varela

    2015-01-01

    Full Text Available Infectious diarrhea, a common disease of children, deserves permanent monitoring in all social groups. To know the etiology and clinical manifestations of acute diarrhea in children up to 5 years of age from high socioeconomic level households, we conducted a descriptive, microbiological, and clinical study. Stools from 59 children with acute community-acquired diarrhea were examined, and their parents were interviewed concerning symptoms and signs. Rotavirus, adenovirus, and norovirus were detected by commercially available qualitative immunochromatographic lateral flow rapid tests. Salmonella, Campylobacter, Yersinia, and Shigella were investigated by standard bacteriological methods and diarrheagenic E. coli by PCR assays. We identified a potential enteric pathogen in 30 children. The most frequent causes of diarrhea were enteropathogenic E. coli (EPEC, viruses, Campylobacter, Salmonella, and Shiga-toxin-producing E. coli (STEC. Only 2 patients showed mixed infections. Our data suggest that children with viral or Campylobacter diarrhea were taken to the hospital earlier than those infected with EPEC. One child infected with STEC O26 developed “complete” HUS. The microbiological results highlight the importance of zoonotic bacteria such as atypical EPEC, Campylobacter, STEC, and Salmonella as pathogens associated with acute diarrhea in these children. The findings also reinforce our previous communications about the regional importance of non-O157 STEC strains in severe infant food-borne diseases.

  16. How Precise Is Dental Volumetric Tomography in the Prediction of Bone Density?

    Directory of Open Access Journals (Sweden)

    Hakan Bilhan

    2012-01-01

    Full Text Available Objectives. The aim of this study was to review the bone density assessment techniques and evaluate the macroscopic structure of bone specimens scored by Hounsfield Units (HUs and decide if they are always in congruence. Methods. The mandible of a formalin-fixed human cadaver was scanned by dental volumetric tomography (DVT for planning of the specimen positions and fabrication of a surgical guide and a surgical stent was fabricated afterwards. Bone cylinders of 3.5 mm diameter and 5 mm length, were excised from the mandible using the surgical stent with a slow speed trephine drill. After removal of the cylinders two more scans were performed and the images of the first scan were used for the determination of the HU values. The removed bone cylinder was inspected macroscopically as well by micro-CT scan. Results. The highest HU values were recorded in the interforaminal region, especially in the midline (408–742. Posterior regions showed lower HU values, especially the first molar regions (22–61 for the right; 14–66 for the left first molar regions. Conclusion. Within the limitations of this pilot study, it can be concluded that HU values alone could be a misleading diagnostic tool for the determination of bone density.

  17. The highly virulent 2006 Norwegian EHEC O103:H25 outbreak strain is related to the 2011 German O104:H4 outbreak strain.

    Directory of Open Access Journals (Sweden)

    Trine M L'Abée-Lund

    Full Text Available In 2006, a severe foodborne EHEC outbreak occured in Norway. Seventeen cases were recorded and the HUS frequency was 60%. The causative strain, Esherichia coli O103:H25, is considered to be particularly virulent. Sequencing of the outbreak strain revealed resemblance to the 2011 German outbreak strain E. coli O104:H4, both in genome and Shiga toxin 2-encoding (Stx2 phage sequence. The nucleotide identity between the Stx2 phages from the Norwegian and German outbreak strains was 90%. During the 2006 outbreak, stx(2-positive O103:H25 E. coli was isolated from two patients. All the other outbreak associated isolates, including all food isolates, were stx-negative, and carried a different phage replacing the Stx2 phage. This phage was of similar size to the Stx2 phage, but had a distinctive early phage region and no stx gene. The sequence of the early region of this phage was not retrieved from the bacterial host genome, and the origin of the phage is unknown. The contaminated food most likely contained a mixture of E. coli O103:H25 cells with either one of the phages.

  18. The C. elegans gene pme-5: molecular cloning and role in the DNA-damage response of a tankyrase orthologue.

    Science.gov (United States)

    Gravel, Catherine; Stergiou, Lilli; Gagnon, Steve N; Desnoyers, Serge

    2004-02-03

    Tankyrases are recently identified proteins characterized by ankyrin repeats and a poly(ADP-ribose) polymerase (PARP) signature motif. In vertebrates, tankyrases mediate protein-protein interactions via the ankyrin domain. Many partners have been identified that could function in telomere maintenance, signal transduction in vesicular transport, and cell death. To further our knowledge of tankyrases and to study their function in development, we sought and found a tankyrase-related gene in Caenorhabditis elegans that we named pme-5 (poly(ADP-ribose) metabolism enzyme-5). The protein encoded includes a large ankyrin domain and a catalytic PARP domain containing the well-conserved PARP signature sequence and the regulatory region. Unlike other tankyrases, PME-5 lacks a sterile-alpha module (SAM), but has a coiled coil domain which may mediate oligomerization. We also found that pme-5 mRNA is alternatively spliced at the fifth exon, producing a long (PME-5L) and a short (PME-5S) transcript. Both isoforms are constitutively expressed during the life cycle of C. elegans. We also show DNA damage increases expression of pme-5, a response that requires the DNA damage checkpoint gene hus-1. Moreover, DNA damage-induced germ cell apoptosis was slightly increased in pme-5(RNAi) hermaphrodites. Altogether, these data indicate that pme-5 is part of a DNA damage response pathway which leads to apoptosis in C. elegans.

  19. Lysine residue 185 of Rad1 is a topological but not a functional counterpart of lysine residue 164 of PCNA.

    Directory of Open Access Journals (Sweden)

    Niek Wit

    Full Text Available Monoubiquitylation of the homotrimeric DNA sliding clamp PCNA at lysine residue 164 (PCNA(K164 is a highly conserved, DNA damage-inducible process that is mediated by the E2/E3 complex Rad6/Rad18. This ubiquitylation event recruits translesion synthesis (TLS polymerases capable of replicating across damaged DNA templates. Besides PCNA, the Rad6/Rad18 complex was recently shown in yeast to ubiquitylate also 9-1-1, a heterotrimeric DNA sliding clamp composed of Rad9, Rad1, and Hus1 in a DNA damage-inducible manner. Based on the highly similar crystal structures of PCNA and 9-1-1, K185 of Rad1 (Rad1(K185 was identified as the only topological equivalent of PCNA(K164. To investigate a potential role of posttranslational modifications of Rad1(K185 in DNA damage management, we here generated a mouse model with a conditional deletable Rad1(K185R allele. The Rad1(K185 residue was found to be dispensable for Chk1 activation, DNA damage survival, and class switch recombination of immunoglobulin genes as well as recruitment of TLS polymerases during somatic hypermutation of immunoglobulin genes. Our data indicate that Rad1(K185 is not a functional counterpart of PCNA(K164.

  20. Antibiotic resistance and integrons in Shiga toxin-producing Escherichia coli (STEC).

    Science.gov (United States)

    Colello, Rocío; Etcheverría, Analía I; Di Conza, Jose A; Gutkind, Gabriel O; Padola, Nora L

    2015-03-01

    Shiga toxin-producing Escherichia coli (STEC) cause hemorrhagic colitis (HC) and hemolytic-uremic syndrome in humans (HUS). Cattle are the main reservoir of STEC and transmission to humans occurs through contaminated food and water. Antibiotics are used in pig production systems to combat disease and improve productivity and play a key role in the dissemination of antibiotic resistance genes to the bacteria. Integrons have been identified in resistant bacteria allowing for the acquisition and dissemination of antibiotic resistance genes. STEC strains isolated from humans and animals have developed antibiotic resistance. In our laboratory, 21 non-157 STEC strains isolated from pigs were analyzed to detect class 1 and 2 integrons by PCR. Eight carried integrons, 7 of them harbored intl2. In another study 545 STEC strains were also analyzed for the presence of intl1 and intl2 . Strains carrying intl1 belonged to isolates from environment (n = 1), chicken hamburger (n = 2), dairy calves (n = 4) and pigs (n = 8). Two strains isolated from pigs harbored intl2 and only one intl1 / intl2 , highlighting the presence of intl2 in pigs. The selection for multiresistant strains may contribute to the emergence of antibiotic resistant pathogens and facilitate the spreading of the mobile resistance elements to other bacteria.