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Sample records for pre-existing pyoderma gangrenosum

  1. [Pyoderma gangrenosum].

    PubMed

    Herberger, K

    2016-09-01

    Pyoderma gangrenosum (PG) is an ulcerating, neutrophilic dermatosis of unknown etiology. Clinical appearance is characterized by sudden onset of sterile pustules that rapidly develop into very painful ulcerations with violaceous, undermined borders. Due to the lack of specific diagnostic and therapeutic markers, PG is a diagnosis of exclusion. An association with further diseases such as chronic inflammatory bowel disease, rheumatoid arthritis, diabetes, neoplasms, or metabolic syndrome exists in over 50 % of cases. Treatment of PG consists of suppression of inflammatory disease activity, treatment of associated morbidities, promotion of wound healing, and pain relief. Recommended first-line treatment consists of systemic glucocorticosteroids and additional or alternatively cyclosporine. A controlled trial on infliximab in PG points to efficacy of TNF-alpha antagonists. Due to chronicity, frequent recurrences, and often complicated courses, treatment with good tolerability is important. PMID:27492434

  2. Pyoderma gangrenosum: a Waikato experience.

    PubMed

    Christmas, T I; Duffill, M B

    1987-06-24

    Ten cases of pyoderma gangrenosum were seen over a period of nine years at the Waikato Hospital dermatology clinic. Several associated conditions were found. Four cases were associated with inflammatory bowel disease, three cases with arthritis, one case was found in association with myelofibrosis. Four patients were diabetic, an incidence higher than in previous studies. Most patients were treated with oral steroids but additional therapies were used to achieve disease control and for their steroid-sparing effect.

  3. Pyoderma Gangrenosum Simulating Necrotizing Fasciitis

    PubMed Central

    de Souza, Erik Friedrich Alex; da Silva, Guilherme Almeida Rosa; dos Santos, Gustavo Randow; Motta, Heloisa Loureiro de Sá Neves; Cardoso, Pedro Afonso Nogueira Moisés; de Azevedo, Marcelo Costa Velho Mendes; Pires, Karina Lebeis; Motta, Rogerio Neves; Silva, Walter de Araujo Eyer; Ferry, Fernando Raphael de Almeida; Pinto, Jorge Francisco da Cunha

    2015-01-01

    Pyoderma gangrenosum received this name due to the notion that this disease was related to infections caused by bacteria in the genus Streptococcus. In contrast to this initial assumption, today the disease is thought to have an autoimmune origin. Necrotizing fasciitis was first mentioned around the fifth century AD, being referred to as a complication of erysipelas. It is a disease characterized by severe, rapidly progressing soft tissue infection, which causes necrosis of the subcutaneous tissue and the fascia. On the third day of hospitalization after antecubital venipuncture, a 59-year-old woman presented an erythematous and painful pustular lesion that quickly evolved into extensive ulceration circumvented by an erythematous halo and accompanied by toxemia. One of the proposed etiologies was necrotizing fasciitis. The microbiological results were all negative, while the histopathological analysis showed epidermal necrosis and inflammatory infiltrate composed predominantly of dermal neutrophils. Pyoderma gangrenosum was considered as a diagnosis. After 30 days, the patient was discharged with oral prednisone (60 mg/day), and the patient had complete healing of the initial injury in less than two months. This case was an unexpected event in the course of the hospitalization which was diagnosed as pyoderma gangrenosum associated with myelodysplastic syndrome. PMID:26783395

  4. Sunitinib induced pyoderma gangrenosum-like ulcerations.

    PubMed

    Akanay-Diesel, S; Hoff, N P; Kürle, S; Haes, J; Erhardt, A; Häussinger, D; Schulte, K-W; Bölke, Edwin; Matuschek, C; Budach, W; Gerber, P A; Homey, B

    2011-11-10

    Pyoderma gangrenosum is a non-infectious neutro?philic skin disease commonly associated with underlying systemic diseases. Histopathological and laboratory diagnostics are unspecific in the majority of the cases and the diagnosis is made in accordance with the clinical picture. Here, we report the case of a 69-year old man with progredient pyoderma gangrenosum-like ulcerations under treatment with sunitinib due to hepatocellular carcinoma. A conventional ulcer therapy did not lead to a regression of the lesions. Solely cessation of sunitinib therapy resulted in an improvement of the ulcerations. Sunitinib is a multikinase inhibitor that targets the PDGF-α- and ?β-, VEGF-1-3-, KIT-, FLT3-, CSF-1- and RET-receptor, thereby impairing tumour proliferation, pathological angiogenesis and metastasation. Here, we demonstrate that pyoderma gangrenosum-like ulcers may represent a serious side effect of sunitinib-based anti-cancer treatment. PMID:22027642

  5. Sunitinib induced pyoderma gangrenosum-like ulcerations

    PubMed Central

    2011-01-01

    Pyoderma gangrenosum is a non-infectious neutrophilic skin disease commonly associated with underlying systemic diseases. Histopathological and laboratory diagnostics are unspecific in the majority of the cases and the diagnosis is made in accordance with the clinical picture. Here, we report the case of a 69-year old man with progredient pyoderma gangrenosum-like ulcerations under treatment with sunitinib due to hepatocellular carcinoma. A conventional ulcer therapy did not lead to a regression of the lesions. Solely cessation of sunitinib therapy resulted in an improvement of the ulcerations. Sunitinib is a multikinase inhibitor that targets the PDGF-α - and -β-, VEGF-1-3-, KIT-, FLT3-, CSF-1- and RET-receptor, thereby impairing tumour proliferation, pathological angiogenesis and metastasation. Here, we demonstrate that pyoderma gangrenosum-like ulcers may represent a serious side effect of sunitinib-based anti-cancer treatment. PMID:22027642

  6. Pyoderma gangrenosum: challenges and solutions

    PubMed Central

    Gameiro, Ana; Pereira, Neide; Cardoso, José Carlos; Gonçalo, Margarida

    2015-01-01

    Pyoderma gangrenosum (PG) is a rare disease, but commonly related to important morbidity. PG was first assumed to be infectious, but is now considered an inflammatory neutrophilic disease, often associated with autoimmunity, and with chronic inflammatory and neoplastic diseases. Currently, many aspects of the underlying pathophysiology are not well understood, and etiology still remains unknown. PG presents as painful, single or multiple lesions, with several clinical variants, in different locations, with a non specific histology, which makes the diagnosis challenging and often delayed. In the classic ulcerative variant, characterized by ulcers with inflammatory undermined borders, a broad differential diagnosis of malignancy, infection, and vasculitis needs to be considered, making PG a diagnosis of exclusion. Moreover, there are no definitively accepted diagnostic criteria. Treatment is also challenging since, due to its rarity, clinical trials are difficult to perform, and consequently, there is no “gold standard” therapy. Patients frequently require aggressive immunosuppression, often in multidrug regimens that are not standardized. We reviewed the clinical challenges of PG in order to find helpful clues to improve diagnostic accuracy and the treatment options, namely topical care, systemic drugs, and the new emerging therapies that may reduce morbidity. PMID:26060412

  7. Treatment of pyoderma gangrenosum with benzoyl peroxide.

    PubMed

    Nguyen, L Q; Weiner, J

    1977-06-01

    A fifty-three year old woman presented with pyoderma gangrenosum on the right buttock. She had associated intestinal symptoms, but repeated roentgenologic studies revealed no abnormalities. Local treatment with benzoyl peroxide (20 percent) lotion produced clearing of the cutaneous lesion in about six weeks.

  8. Maggots do not survive in pyoderma gangrenosum.

    PubMed

    Renner, Regina; Treudler, Regina; Simon, Jan C

    2008-01-01

    Application of maggots is well established in wound therapy. We report upon 2 patients with leg ulcers due to pyoderma gangrenosum who received immunosuppressive therapy and in whom a reduced survival of maggots (Lucilia sericata sp.) led to ineffectiveness of this therapy.

  9. A Second Case of Sunitinib-associated Pyoderma Gangrenosum

    PubMed Central

    Dean, Steven M.

    2010-01-01

    Pyoderma gangrenosum is a painful, noninfectious, ulcerative, cutaneous disorder that most commonly affects the lower extremities. The diagnosis is made by recognizing the characteristic clinical manifestations in the setting of a causative systemic disease and excluding other causes of similar-appearing ulcerations. Pyoderma gangrenosum often evolves in the setting of systemic illnesses, such as inflammatory bowel disease, rheumatological disorders, and hematological conditions. However, several medications have rarely been linked to pyoderma gangrenosum. The authors report the second case of sunitinib-associated pyoderma gangrenosum in a 61-year-old patient with recurrent renal cell carcinoma. PMID:20877540

  10. Pyoderma gangrenosum and ulcerative colitis in the tropics.

    PubMed

    Alese, Olatunji B; Irabor, David O

    2008-01-01

    Pyoderma gangrenosum is a rare inflammatory skin condition, characterized by progressive and recurrent skin ulceration. There may be rapidly enlarging, painful ulcers with undermined edges and a necrotic, hemorrhagic base. Disorders classically associated with pyoderma gangrenosum include rheumatoid arthritis, inflammatory bowel disease, paraproteinemia and myeloproliferative disorders. There have been some reports of the occurrence of pyoderma gangrenosum in Africa, and in Nigeria, but only one specifically reported pyoderma gangrenosum in association with ulcerative colitis. We report on a 45-year-old man who presented with pyoderma gangrenosum associated with ulcerative colitis; the second report in Nigeria. The skin lesions were managed with daily honey wound dressings. Oral dapsone and prednisolone were started. The frequency of the bloody diarrhea decreased, and was completely resolved by the second week after admission. The ulcers also showed accelerated healing. The goal of therapy is directed towards the associated systemic disorder, if present.

  11. Severe pyoderma gangrenosum in association with a flame burn

    PubMed Central

    Matsuda, Kaho; Okamoto, Osamu; Sato, Seiichi; Gamachi, Ayako; Hashimoto, Hiroyuki

    2016-01-01

    Abstract We herein report a severe case of pyoderma gangrenosum occurring in a burn patient and discuss the possibility of occult complications of this pathological state in daily treatment. PMID:27583260

  12. Diagnosis and management of parastomal pyoderma gangrenosum

    PubMed Central

    Wu, Xian-rui; Shen, Bo

    2013-01-01

    Parastomal pyoderma gangrenosum (PPG) is an unusual neutrophilic dermatosis characterized by painful, necrotic ulcerations occurring in the area surrounding an abdominal stoma. It typically affects young to middle-aged adults, with a slight female predominance. The underlying etiology for PPG remains enigmatic but aberrant immune response to injury may play a pivotal role. The reported risk factors for the development of PPG include the presence of extra-intestinal manifestations, autoimmune disorders and obesity, along with local factors, such as the presence of parastomal hernia or pressure ulcer. PPG can develop at any time after the stoma construction. The histopathological features of PPG are not pathognomonic and its diagnosis is mainly based on clinical features. The management of PPG often requires a multidisciplinary approach, with a combination of local wound care and systemic medications. PMID:24759661

  13. Successful Treatment of Pyoderma Gangrenosum with Cryoglobulinemia and Hepatitis C

    PubMed Central

    Pourmorteza, Mohsen; Tawadros, Fady; Bader, Gilbert; Al-Tarawneh, Mohammad; Cook, Emilie; Shams, Wael; Young, Mark

    2016-01-01

    Patient: Male, 68 Final Diagnosis: Pyoderma gangrenosum Symptoms: Worsening lower extremity wound Medication: — Clinical Procedure: — Specialty: Infectious Diseases Objective: Rare disease Background: Pyoderma gangrenosum is a rare, ulcerative cutaneous condition that was first described by Brocq in 1916. This diagnosis is quite challenging as the histopathological findings are nonspecific. Pyoderma gangrenosum is usually associated with inflammatory bowel disease, leukemia, and hepatitis C. We describe a rare clinical case of a patient with hepatitis C (HCV), mixed cryoglubinemia, and pyoderma gangrenosum, which was successfully treated with prednisone in combination with the new antiviral medication ledipasvir/sofosbuvir. Case Report: A 68-year-old male with a history of untreated HCV presented to the clinic with a left lower extremity ulcer that had progressively worsened over 4 days after the patient sustained a minor trauma to the left lower extremity. Examination revealed a 2×3 cm purulent ulcer with an erythematous rim on medial aspect of his left lower leg. HCV viral load and genotype analysis revealed genotype 1A with polymerase chain reaction (PCR) showing viral counts of 9,506,048 and cryoglobulinemia. With a worsening and enlarging erythematous ulcer and failure of IV antibiotic therapy, the patient underwent skin biopsy, which showed acanthotic epidermis with superficial and deep perivascular lymphoplasmacytic dermatitis admixed with mild neutrophilic infiltrate. The patient was subsequently started on ledipasvir/sofosbuvir and prednisone with a high suspicion of pyoderma gangrenosum. At one-month follow-up at the hepatology clinic, the patient demonstrated a near resolution of the lower extremity ulcer with undetectable viral load. Conclusions: Pyoderma gangrenosum is an inflammatory process of unknown etiology, and establishing the correct diagnosis can be a difficult task. For this reason it is prudent for clinicians to consider Pyoderma

  14. Nasal septum perforation in patient with pyoderma gangrenosum

    PubMed Central

    Maia, Camilla Bezerra da Cruz; Felix, Felippe; Paes, Vania; de Azevedo, Julia Alves; Grangeiro, Eliza Raquel Negrão; Riccio, Jonatah Lucas N.; Rito, Helen Cruz

    2012-01-01

    Summary Introduction: The cocaine is obtained from the leaves of the coca (Erythroxylon coca). It can be used in many ways, but the most common is the drug inhalation. The Cocaine also causes vasoconstriction at nasal mucous membrane and its chronic use can cause necrosis and nasal septum perforation. Pyoderma gangrenosum is an uncommon idiopathic disease characterized by ulcerations, usually observed on the legs. Its diagnosis is most common an exclusion of others diseases. So far, there is no specific treatment based on evidence by randomized controlled trials. Objective: Describe the rare association between Pyoderma gangrenosum and cocaine. Case Report: E. A., 27-year-old woman with destruction of nasal septum and palate who has been using a big amount of cocaine, been necessary note the difference from which disease cause de damage. Final Comments: Also there are only three cases of Pyoderma gangrenosum complicated with nasal septum perforation in cocaine users. PMID:25991946

  15. Bilateral pyoderma gangrenosum of the hand: treatment with dapsone.

    PubMed

    Brown, R E; Lay, L; Graham, D

    1993-02-01

    The first reported case of bilateral pyoderma gangrenosum of the hands is presented. One lesion was treated with wound care only, with spontaneous healing after two months. The contralateral lesion which occurred one month later was treated with wound care and oral dapsone. Healing occurred between four and six weeks after the start of dapsone. It is suggested that this acts by limiting the necrotizing process, thus allowing earlier epithelialization. Pyoderma gangrenosum is rare, and treatment is non-surgical. It is important that it is recognized to avoid extension of the necrotizing process through ill-advised surgery.

  16. Bromoderma mimicking pyoderma gangrenosum caused by commercial sedatives.

    PubMed

    Oda, Fumiko; Tohyama, Mikiko; Murakami, Akiko; Kanno, Kazuhisa; Sonobe, Naomi; Sayama, Koji

    2016-05-01

    Bromoderma is a rare skin disorder caused by bromide intake. It presents as single or multiple papillomatous nodules or plaques, and ulcers studded with small pustules on the face or limbs. The clinical features of bromoderma are similar to those of pyoderma gangrenosum. A 41-year-old Japanese woman was diagnosed with pyoderma gangrenosum 11 years prior to presentation. Pyoderma had repeatedly appeared over her entire body despite treatment. She also frequently complained of syncopal episodes. She was admitted to our hospital after loss of consciousness and an episode of generalized convulsion. Laboratory tests revealed a negative serum anion gap and hyperchloremia. Her serum bromide level was significantly elevated, suggesting bromide intoxication. The patient had a 10-year history of high serum bromide levels. After the intake of bromide-containing sedatives was stopped, there was no recurrence of pyoderma in the absence of treatment. In conclusion, this case was diagnosed as bromoderma with commercial sedative-induced bromide intoxication. Although the US Food and Drug Administration have banned the use of bromides, over-the-counter (OTC) treatments containing bromides are still used in Japan and other countries. Long-term use of OTC medicines containing bromvalerylurea may result in the development of bromoderma. If unclarified neurological or psychiatric symptoms are associated with pyoderma, we propose measurement of the patient's serum chloride concentration. Determination of hyperchloremia is helpful for the diagnosis of chronic intoxication with bromides. PMID:26507105

  17. Concurrent hidradenitis suppurativa, inflammatory acne, dissecting cellulitis of the scalp, and pyoderma gangrenosum in a 16-year-old boy.

    PubMed

    Koshelev, Misha V; Garrison, Paige A; Wright, Teresa S

    2014-01-01

    We report the case of a 16-year-old boy who presented to our clinic with concomitant hidradenitis suppurativa, inflammatory acne, dissecting cellulitis of the scalp, and pyoderma gangrenosum. Recent reports describe the co-occurrence of pyoderma gangrenosum, acne, and hidradenitis suppurativa. This case further expands the spectrum of concomitant pyoderma gangrenosum and dissecting cellulitis of the scalp. PMID:24118007

  18. Pyoderma Gangrenosum-A New Manifestation of Wilson Disease?

    PubMed

    Freg, George Naiem Ibrahiem; Shah, Venisha; Nagral, Aabha; Jhaveri, Ajay

    2016-03-01

    Seventeen year old girl, a known case of Wilson disease presented to us with a non-healing skin ulcer followed by appearance of jaundice, ascites and progressive fatigue of 1 month duration. She was diagnosed to have Wilson disease 5 years back and had been well controlled on d-penicillamine. On enquiry, she was found to be noncompliant with her medication in the preceding 6 months. On examination, she had severe pallor, icterus with moderate ascites and oedema feet. Investigations revealed severe haemolytic anemia and deranged liver function. The lesion was diagnosed to be pyoderma gangrenosum on skin biopsy. The appearance of a cutaneous lesion followed by deterioration in the liver disease and hemolysis suggested uncontrolled Wilson disease as the triggering factor. Chelation therapy improved her haemoglobin and liver function as well as led to healing of the ulcer. We describe pyoderma gangrenosum as a new manifestation of Wilson disease.

  19. [Pyoderma gangrenosum associated with rheumatoid arthritis: a case report].

    PubMed

    Beber, André Avelino Costa; Knob, Cristiane Faccin; Shons, Karen Regina Rosso; Neumaier, Walter; da Silva, João Carlos Nunes; Monticielo, Odirlei André

    2014-01-01

    Pyoderma gangrenosum is a chronic inflammatory dermatosis, which is associated with non-infectious systemic diseases such as rheumatoid arthritis and inflammatory bowel disease. It is more common in adults and may present with four distinct clinical forms, all leading to ulceration of the skin affected. Its diagnosis is clinical and demands exclusion of other causes. Treatment should be performed with local care and systemic therapy.

  20. CD8-positive Mycosis Fungoides Masquerading as Pyoderma Gangrenosum

    PubMed Central

    Saha, Maitrayee; Jain, Bhawna Bhutoria; Chattopadhyay, Sarbani; Podder, Indrashis

    2016-01-01

    Mycosis fungoides (MF), a primary cutaneous T-cell lymphoma, accounts for <1% of non-Hodgkin lymphomas. The diagnosis of classic MF is based on a constellation of typical clinical presentation, histopathology, immunohistochemistry, and T-cell monoclonality detected by molecular studies. Rarely, atypical clinical presentation may occur. The typical immunohistochemical phenotype is, CD2 +ve, CD3 +ve, CD5 +ve, CD4 +ve, and CD8 − ve. Here, we report a rare case of CD8 +ve MF in a 43-year-male patient who was clinically diagnosed as pyoderma gangrenosum initially. The atypical presentation and rarity of such case have prompted this report.

  1. CD8-positive Mycosis Fungoides Masquerading as Pyoderma Gangrenosum

    PubMed Central

    Saha, Maitrayee; Jain, Bhawna Bhutoria; Chattopadhyay, Sarbani; Podder, Indrashis

    2016-01-01

    Mycosis fungoides (MF), a primary cutaneous T-cell lymphoma, accounts for <1% of non-Hodgkin lymphomas. The diagnosis of classic MF is based on a constellation of typical clinical presentation, histopathology, immunohistochemistry, and T-cell monoclonality detected by molecular studies. Rarely, atypical clinical presentation may occur. The typical immunohistochemical phenotype is, CD2 +ve, CD3 +ve, CD5 +ve, CD4 +ve, and CD8 − ve. Here, we report a rare case of CD8 +ve MF in a 43-year-male patient who was clinically diagnosed as pyoderma gangrenosum initially. The atypical presentation and rarity of such case have prompted this report. PMID:27688458

  2. CD8-positive Mycosis Fungoides Masquerading as Pyoderma Gangrenosum.

    PubMed

    Saha, Maitrayee; Jain, Bhawna Bhutoria; Chattopadhyay, Sarbani; Podder, Indrashis

    2016-01-01

    Mycosis fungoides (MF), a primary cutaneous T-cell lymphoma, accounts for <1% of non-Hodgkin lymphomas. The diagnosis of classic MF is based on a constellation of typical clinical presentation, histopathology, immunohistochemistry, and T-cell monoclonality detected by molecular studies. Rarely, atypical clinical presentation may occur. The typical immunohistochemical phenotype is, CD2 +ve, CD3 +ve, CD5 +ve, CD4 +ve, and CD8 - ve. Here, we report a rare case of CD8 +ve MF in a 43-year-male patient who was clinically diagnosed as pyoderma gangrenosum initially. The atypical presentation and rarity of such case have prompted this report. PMID:27688458

  3. CD8-positive Mycosis Fungoides Masquerading as Pyoderma Gangrenosum.

    PubMed

    Saha, Maitrayee; Jain, Bhawna Bhutoria; Chattopadhyay, Sarbani; Podder, Indrashis

    2016-01-01

    Mycosis fungoides (MF), a primary cutaneous T-cell lymphoma, accounts for <1% of non-Hodgkin lymphomas. The diagnosis of classic MF is based on a constellation of typical clinical presentation, histopathology, immunohistochemistry, and T-cell monoclonality detected by molecular studies. Rarely, atypical clinical presentation may occur. The typical immunohistochemical phenotype is, CD2 +ve, CD3 +ve, CD5 +ve, CD4 +ve, and CD8 - ve. Here, we report a rare case of CD8 +ve MF in a 43-year-male patient who was clinically diagnosed as pyoderma gangrenosum initially. The atypical presentation and rarity of such case have prompted this report.

  4. Multiple cavitary pulmonary nodules in association with pyoderma gangrenosum: case report.

    PubMed

    Bittencourt, Maraya de Jesus Semblano; Soares, Luciana Fontenele Brito; Lobato, Lilia Sampaio; Mançano, Alexandre Dias; Leandro, Helandro Stuart Castro; Fonseca, Diana Mendes da

    2012-01-01

    Pyoderma gangrenosum is a rare neutrophilic disease of unknown origin that is associated with systemic diseases in 50% of cases. It is characterized by erythematous-violaceous nodular lesions that quickly progress to painful ulcers, with undermined edges, necrotic-hemorrhagic, varying in size and depth, located mainly in the lower limbs. Extracutaneous locations of pyoderma gangrenosum are rare, usually involving the lungs; the main differential diagnosis in these cases is Wegener granulomatosis. We report a case of pyoderma gangrenosum, which showed multiple cavitary lung nodules, with good response to high doses of steroids. Once excluded the possibility of Wegener granulomatosis, the authors concluded that it was the manifestation of systemic pyoderma gangrenosum with pulmonary involvement. PMID:22570038

  5. Pyoderma gangrenosum, acne conglobata, suppurative hidradenitis, and axial spondyloarthritis: efficacy of anti-tumor necrosis factor α therapy.

    PubMed

    Bruzzese, Vincenzo

    2012-12-01

    We report the case of a patient with a simultaneous presence of pyoderma gangrenosum, acne conglobata, suppurative hidradenitis, and axial spondyloarthritis. This condition differs from both the PASH (pyoderma gangrenosum, acne, and suppurative hidradenitis) syndrome, in which arthritis is absent, and the PAPA (pyogenic arthritis, pyoderma gangrenosum, and acne) syndrome, in which suppurative hidradenitis is lacking. Our patient failed to respond to etanercept therapy, whereas all dermatologic and rheumatic manifestations completely regressed following infliximab infusion. We therefore propose that simultaneous presence of pyoderma gangrenosum, acne conglobata, suppurative hidradenitis, and seronegative spondyloarthritis might represent a distinct syndrome that could be termed the PASS syndrome. Tumor necrosis factor α therapies seem to play selective roles.

  6. Biologics for the treatment of pyoderma gangrenosum in ulcerative colitis

    PubMed Central

    Arivarasan, K; Bhardwaj, Vaishali; Sud, Sukrit; Sachdeva, Sanjeev

    2016-01-01

    Pyoderma gangrenosum (PG) is an uncommon extra-intestinal manifestation of inflammatory bowel disease (IBD). Despite limited published literature, biologics have caused a paradigm shift in the management of this difficult-to-treat skin condition. The clinical data and outcomes of three patients with active ulcerative colitis and concurrent PG treated with biologics (infliximab two and adalimumab one) are reviewed in this report. Biologics were added because of the sub-optimal response of the colonic symptoms and skin lesions to parenteral hydrocortisone therapy. All three patients showed a dramatic response to the addition of the biologics. In view of the rapid healing of the skin lesions, superior response rate, and the additional benefit of improvement in the underlying colonic disease following treatment, anti-tumor necrosis factor blockers should be considered as a first line therapy in the management of PG with underlying IBD. PMID:27799888

  7. 'Sticky' neutrophils, pathergic arthritis, and response to heparin in pyoderma gangrenosum complicating ulcerative colitis.

    PubMed Central

    Dwarakanath, A D; Yu, L G; Brookes, C; Pryce, D; Rhodes, J M

    1995-01-01

    Pyoderma gangrenosum is strongly associated with inflammatory bowel disease and exhibits pathergy, occurring at sites of previous minor trauma. A patient is presented with a 21 year history of extensive ulcerative colitis, who developed pyoderma gangrenosum and arthralgia while receiving high dose corticosteroids for active ulcerative colitis. The arthralgia exhibited pathergy affecting particularly the left temporomandibular joint, which was stressed by an asymmetric bite, and the left elbow, which had been fractured many years previously. This prompted the hypothesis that neutrophils in this condition may be marginated, as a result of increased stickiness of either the neutrophil or the vascular endothelium. The introduction of heparin therapy was associated with rapid resolution of the arthralgia, pyoderma gangrenosum, and ulcerative colitis. Images Figure 1 Figure 3 PMID:7489951

  8. Perianal pyoderma gangrenosum after excision and fulguration of anal condyloma acuminatum

    PubMed Central

    Agnew, Jennifer L.; Strombom, Paul D.; Fong, Carmen F.; Kelly, Timothy J.; Martz, Joseph E.

    2015-01-01

    Introduction Pyoderma gangrenosum (PG) is a rare, inflammatory skin pathology frequently associated with systemic inflammatory disease. While rare after surgery, recognition of this disease in the post-surgical setting is important as it can mimic wound infection. Presentation of case We herein present a dramatic presentation of perianal PG four days after routine excision and fulguration of anal condyloma acuminatum. The affected area did not improve with broad spectrum antibiotics or surgical debridement. A diagnosis of PG was made from clinical suspicion and pathology findings, and further confirmed with rapid improvement after starting steroids. Diagnosis of this disease in the postoperative period requires high suspicion when the characteristic ulcerative or bullae lesions are seen diffusely and show minimal improvement with antibiotic treatment or debridement. Discussion Our case highlights the importance of recognizing this disease in the post-operative period, to allow for early initiation of appropriate treatment and prevent unnecessary surgical debridement of a highly sensitive area. There have been 32 case reports of PG in the colorectal literature, mostly following stoma creation. There is one case report of idiopathic perianal pyoderma gangrenosum with no known prior trauma. To our knowledge there are no previously reported cases of perianal PG after routine elective anorectal surgery. Conclusion This is the first reported case of perianal pyoderma gangrenosum in the post-surgical setting. Increased awareness of pyoderma gangrenosum in the surgical literature will aid in prompt diagnosis and proper medical management of this uncommon postoperative morbidity. PMID:26547888

  9. Cicatricial ectropion correction in a patient with pyoderma gangrenosum: case report.

    PubMed

    Procianoy, Fernando; Barbato, Mariana Tremel; Osowski, Luiz Eduardo; Bocaccio, Francisco José de Lima; Bakos, Lucio

    2009-01-01

    A 19 year old female with pyoderma gangrenosum was referred to the oculoplastic clinic for evaluation of severe cicatricial ectropion of the right lower eyelid. Examination evidenced important scarring of lower eyelid and malar region with secondary ectropion. A full-thickness skin graft associated with a lateral tarsal strip procedure and scar tissue release was performed. The patient's corticosteroid dose was raised for the procedure, and after surgery there was no healing problem or ulcer formation in the eyelid or in the graft donor site. As pyoderma gangrenosum is associated with a pathergy phenomenon in up to 25% of the cases, the onset of new lesions is a relevant concern when performing surgery in these patients. In this case, the surgery was safely performed under corticosteroid immunosuppression.

  10. Leech Induced Pyoderma Gangrenosum in an Ulcerative Colitis Patient: A Case Report

    PubMed Central

    Sadeghi, Anahita; Navabakhsh, Behrouz; Izadi Vahedi, Niloofar

    2016-01-01

    Pyoderma gangrenosum (PG) is a painful skin lesion that results from excessive inflammatory response to a host of traumatic, inflammatory, or neoplastic processes in susceptible individuals. A clear pathogenetic mechanism as well as an exhaustive list of potential triggers for PG is yet to be fully characterized. This case documents the occurrence of pyoderma gangrenosum following leech-therapy in a patient who is a known case of ulcerative colitis and it deserves attention because leeches have been part of medical armamentarium since ancient times and have re-emerged in the last century relying on their ancient charm and modern research revealing potential benefits of several bioactive substances in their saliva. PMID:26933484

  11. The genetics of pyoderma gangrenosum and implications for treatment: a systematic review.

    PubMed

    DeFilippis, E M; Feldman, S R; Huang, W W

    2015-06-01

    Pyoderma gangrenosum (PG) is a rare neutrophilic dermatosis characterized by painful skin ulcerations for which treatment can be challenging. The genetic basis of PG may provide a better understanding of the disease and new targets for treatment. We systematically reviewed the published literature regarding the syndromes and genetic mutations associated with PG. A literature search was performed through the clinical queries PubMed (National Library of Medicine) database and the Cochrane database. The studies were assessed and then categorized as relating to syndromes or specific gene mutations. Two hundred and eight articles were identified, describing 823 cases of PG. A total of 537 (65·2%) cases were associated with inflammatory bowel disease, 133 (16·1%) with polyarthritis and 103 (12·5%) with haematological disorders. Thirty-one cases of pyogenic arthritis, pyoderma gangrenosum and acne, and its variants, were identified. Two patients had mutations in MTHFR and two had mutations in JAK2. Fourteen (1·7%) cases were familial. PG responded to different treatments depending on the setting. For example, treatment with B vitamins improved PG in cases of mutations in MTHFR, whereas patients with myelodysplastic syndrome improved with thalidomide treatment. PG can occur in isolation, associated with systemic disease or as part of various syndromes. Different genetic causes may be best treated with particular treatments. Understanding its genetic basis can help elucidate new potential targets for drug development. PMID:25350484

  12. A challenging diagnosis: case report of extensive pyoderma gangrenosum at multiple sites

    PubMed Central

    Ye, Mingwei J; Ye, Joshua Mingsheng; Wu, Leonard; Keating, Cameron P; Choi, Wai-Ting

    2014-01-01

    Background Pyoderma gangrenosum (PG) is a rare dermatological condition characterized by the rapid progression of a painful, necrolytic ulcer with an irregular, undermined border and commonly affects the lower extremities, mainly in the pretibial area. The diagnosis of PG is not easy. Due to lack of diagnostic laboratory test and histopathological findings indicative of PG, it is often misdiagnosed as an infection. This results in delayed or inappropriate treatment of the condition, which leads to devastating consequences such as limb amputation and death. Main observations We report a rare case of a 51-year-old female who was initially diagnosed as having infected ulcers and underwent serial debridements, which resulted in extensive PG at three different sites (abdominal, left thigh, and sacral). Conclusion This case highlights the challenges in diagnosing PG, emphasizes the key clinical features to aid diagnosis, and the clinical consequences of delayed or misdiagnosis of this condition. PMID:24741322

  13. [Scleral necrosis after scleral buckling surgery of the patient with pyoderma gangrenosum].

    PubMed

    Kmera-Muszyńska, Maria; Tesla, Piotr; Okruszko, Anna

    2009-01-01

    Pyoderma gangrenosum (PG) is a rare skin disease caused by immune dysfunction. The systemic diseases are often associated. The aim of the study was to report necrotic scleritis which developed after scleral buckling procedure in the case of the 64 years old patient suffered from primary retinal detachment and idiopathic PG. The retinal reattachment was achieved. The conjunctival wound dehiscence, necrotising scleritis and marginal keratitis as a manifestation of the patergic reaction were diagnosed. The treatment with corticosteroids locally (Dexamethason) and systematically (Prednison and Sulfasalazine), was administrated. The improvement and stabilisation of the local condition of ocular surface were observed. After reduction of systemic drugs, the exacerbation of local inflammation and vitritis was observed. The prolonged therapy was necessary. The risk of wound healing disturbances of an ocular surface with aggravated necrotic reaction must be expected after ocular surgery of the patient with PG. The adequate immunosupressive prolonged treatment with proper collaboration with the dermatologist is necessary.

  14. Idiopathic Pyoderma Gangrenosum as a Novel Manifestation of the HIV Immune Reconstitution Inflammatory Syndrome: A Report of Three Cases.

    PubMed

    Nambudiri, Vinod E; Kersellius, Romona; Harp, Joanna; Maniar, J K; Maurer, Toby A

    2015-07-01

    The initiation of antiretroviral treatment for individuals with HIV may be accompanied by a paradoxical flare of underlying inflammatory diseases, the recurrence of dormant infections, or worsening of prior treated opportunistic infections, termed the immune reconstitution inflammatory syndrome (IRIS). Cutaneous manifestations of IRIS are common. Pyoderma gangrenosum is a neutrophilic dermatosis postulated to reflect disrupted innate immune regulation causing altered neutrophil chemotaxis. It is uncommonly reported in association with HIV. In this case series, we present three cases of IRIS manifesting with pyoderma gangrenosum in individuals with HIV from India and the United States to raise awareness of this previously undescribed presentation and discuss the treatment challenges in the management of these patients. PMID:26731836

  15. Association of Pyoderma Gangrenosum, Acne, and Suppurative Hidradenitis (PASH) Shares Genetic and Cytokine Profiles With Other Autoinflammatory Diseases: Erratum.

    PubMed

    2015-02-01

    [In the article "Association of Pyoderma Gangrenosum, Acne, and Suppurative Hidradenitis (PASH) Shares Genetic and Cytokine Profiles With Other Autoinflammatory Diseases", which appeared in Volume 93, Issue 27 of Medicine, one of Orietta M. Borghi's affiliations was omitted. The article should have stated that Orietta M. Borghi is associated with the IRCCS Istituto Auxologico Italiano, Milano, Italy as well as the Dipartimento di Scienze Cliniche e di Comunità, Università di Milano.].

  16. Pyoderma gangrenosum among patients with inflammatory bowel disease: a descriptive cohort study

    PubMed Central

    Weizman, Adam V.; Huang, Brian; Targan, Stephan; Dubinsky, Marla; Fleshner, Phillip; Kaur, Manreet; Ippoliti, Andrew; Panikkath, Deepa; Vasiliauskas, Eric; Shih, David; McGovern, Dermot P.B.; Melmed, Gil Y.

    2016-01-01

    BACKGROUND Pyoderma gangrenosum (PG) is a severe extra-intestinal manifestation of inflammatory bowel disease (IBD). OBJECTIVE To better characterize PG features and management among an IBD cohort. METHODS Subjects with PG were identified using a large database at a tertiary center. Patient demographics and clinical characteristics were summarized using descriptive statistics. RESULTS 80 patients with an episode(s) of PG were identified, yielding an overall prevalence of 1.9%. Overall, 93% of patients with PG had some degree of colonic involvement. Thirty-one (39%) patients required hospitalization for PG. Underlying bowel disease was active at the time of PG episode(s) in 52 (65%) patients. PG location was variable, with the lower extremity being the most common. Most patients (71.3%) required multiple therapies to achieve PG healing. CONCLUSIONS We have described one of the largest case series of PG among patients with IBD. The variety of treatment strategies used highlights the lack of clear guidelines in managing this complex group of patients. PMID:25277124

  17. Pyoderma Gangrenosum: A Rare Cause of Cutaneous Ulceration and One Easily Misdiagnosed

    PubMed Central

    Walsh, Maureen Y.; Hoey, Susannah E.; O'Kane, Donal

    2016-01-01

    Pyoderma gangrenosum (PG) is a rare inflammatory neutrophilic dermatosis often misdiagnosed. It is uncommon in infants and children accounting for 4% of cases. A one-year-old male in paediatric ICU ventilated for bronchopneumonia was referred with ulcerated areas on his neck and axilla corresponding to sites of recent removal of central and arterial lines. Examination revealed areas of deep ulceration with violaceous undermined borders in keeping with PG. This was supported by a skin biopsy showing a neutrophilic infiltrate in the deeper dermis. Topical clobetasol propionate was commenced and a dramatic improvement within 24 hours noted. Blood results showed a leucocytosis of 29.7; a differential WCC showed toxic granulation in neutrophils with myeloid left shift; immunoglobulins showed elevated IgG 23 and IgA 4.86. The elevated WCC made us consider a leukaemic trigger; however, they settled with treatment of the underlying infection. PG in children is more likely to have an atypical distribution involving the head and neck (26.6%) or buttocks (15%). An interesting feature in this case is the presence of pathergy, a term used to describe the induction or exacerbation of PG at sites of iatrogenic or incidental trauma. It is seen in 31% of patients with PG. PMID:27738542

  18. Hyperbaric Oxygen Therapy for the Adjunctive Treatment of Pyoderma Gangrenosum: A Case Report.

    PubMed

    Chiang, I-Han; Liao, Yi-Shu; Dai, Niann-Tzyy; Chiao, Hao-Yu; Chou, Chang-Yi; Chen, Shyi-Gen; Chen, Tim-Mo; Chang, Shun-Cheng

    2016-05-01

    Pyoderma gangrenosum (PG) is a neutrophilic dermatosis of unknown etiology characterized by an ulcerative skin condition and confirmed through a diagnosis of exclusion. Management usually consists of systemic drug therapy, such as corticosteroids, sulfones, or immunosuppressants, either alone or in combination. Long-term use of these medications often has untold side effects. Hyperbaric oxygen therapy (HBOT) has been shown effective in the treatment of PG, reducing pain and tempering the need for medication. A case is presented of a 54-year-old woman with diabetes, hypertension, and a peptic ulcer who presented with painful, purulent ulcers on her buttocks, hands, and lower extremities of 2 weeks' duration. She was ultimately diagnosed with PG and provided 20 mg/day of oral prednisone for 1 week, tapered to 10 mg/day in the next week and then stopped. In addition, she received 12 sessions of HBOT - she breathed in 100% oxygen under 2.5 atmospheres absolute pressure for 90 minutes over 2 weeks. Her wounds healed without scarring. This excellent outcome including good wound healing, decreased pain, and reduced doses of systemic corticosteroids warrants additional study of the adjunctive use of HBOT for PG. PMID:27192719

  19. Treatment of pyoderma gangrenosum with thalidomide in a myelodysplastic syndrome case

    PubMed Central

    Malkan, Umit Yavuz; Gunes, Gursel; Eliacik, Eylem; Haznedaroglu, Ibrahim Celalettin

    2016-01-01

    Thalidomide may be used as a treatment option for pyoderma gangrenosum (PG) and myelodysplastic syndrome (MDS). Herein, we aimed to report a patient who was treated well with thalidomide and whose diagnosis was PG with MDS. A 61-year-old man with painless ecchymotic lesions in his right upper extremity was admitted to the hospital in Isparta, Turkey, in January 2015. The lesions were diagnosed as PG. In his anamnesis, it was found that he was diagnosed with MDS 6 years ago and had been treated with cyclosporine at 2×100 mg for 5 years, which was stopped in January 2015. Aspiration from liver lesion revealed the presence of Mycobacterium tuberculosis, so antituberculosis treatment was started. Bone marrow investigation revealed MDS-refractory anemia with excess blasts (7%). For lesions in bilateral upper extremities, thalidomide treatment was started at 50 mg/d. After 1 month from the initiation of thalidomide treatment, the lesions in upper extremities had disappeared. In the literature, there are some reports of patients with PG who were successfully treated with thalidomide. Our patient is a complicated case who simultaneously has MDS, PG, and tuberculosis infection. The reason for thalidomide usage in our patient was the need of immune modulation without immune suppression. Our patient has tolerated the drug well, and excellent response was obtained after 1 month of initiation of thalidomide treatment. To conclude, thalidomide is a very effective drug acting as an immune modulator, which is useful in the clinical management of both MDS and PG. PMID:27051318

  20. Large pyoderma gangrenosum-like ulcers: a rare presentation of granulomatosis with polyangiitis.

    PubMed

    Tashtoush, Basheer; Memarpour, Roya; Johnston, Yasmin; Ramirez, Jose

    2014-01-01

    Granulomatosis with polyangiitis (GPA), formerly known as Wegener's granulomatosis (WG), is a rare systemic vasculitis that classically manifests as necrotizing granulomas of the upper and lower respiratory tract, kidneys, and blood vessels; however, it may affect any organ system, including the skin. Cutaneous manifestations occur in up to 45% of patients during the disease course, and are the presenting feature in 9% to 14% of patients. The most common skin lesion specific to GPA is palpable purpura, with the histopathologic correlate of leukocytoclastic vasculitis. However, a wide range of clinical and histologic features may be seen. We herein report a case of a previously healthy 52-year-old Caucasian man who presented with multiple progressively enlarging painful ulcers on his face, upper extremities, back, and abdomen over a two-month period. Skin biopsies revealed pyoderma gangrenosum-like features. Serological tests were positive for PR3/c-ANCA. Six months later, the patient developed recurrent episodes of sinusitis associated with nasal bleeds and eventually nasal septum perforation. Despite aggressive treatment with Cyclophosphamide and steroids over one year, the patient had persistent nonhealing large ulcers and developed multiple lung nodules with cavitary lesions. PMID:24955278

  1. Multiple pulmonary cavitary nodules with pyoderma gangrenosum in patient with rheumatoid arthritis.

    PubMed

    Be, Miae; Cha, Hee Jeong; Park, Chanho; Park, Yongtae; Jung, Hwasik; Lee, Yoeunim; Jegal, Yangjin

    2016-01-01

    Pyoderma gangrenosum (PG) is a rare ulcerative neutrophilic disorder of skin. Its pulmonary manifestations are uncommon and only less than forty cases have been reported in the literature previously. PG is associated with variable systemic diseases, most commonly inflammatory bowel disease and hematologic malignancies. It reported rarely in rheumatoid arthritis (RA). We report a case of PG lung involvement in patient with RA associated interstitial lung disease. A 66-year-old woman presented with productive cough and recurrent ulcerative lesion on her left ankle. She had a 15-year history of RA associated interstitial lung disease and treated with methotrexate, sulfasalazine, hydroxychloroquine and methylprednisolone. On physical examination, there were a few tender, erythematous subcutaneous nodules ranging from 1 to 3 cm in diameter on her left thigh and left elbow. Anti-neutrophil cytoplasmic antibodies (ANCAs) are negative. Her chest CT scan demonstrated multifocal cavitary consolidations on the background of reticular opacity and honeycombing. Punch biopsy of erythematous nodule on thigh showed neutrophilic abscess with necrotic debris. The skin and lung lesions were rapidly improved with 0.5 mg/kg/day of prednisolone. PMID:26889492

  2. Multiple pulmonary cavitary nodules with pyoderma gangrenosum in patient with rheumatoid arthritis

    PubMed Central

    Be, Miae; Cha, Hee Jeong; Park, Chanho; Park, Yongtae; Jung, Hwasik; Lee, Yoeunim

    2016-01-01

    Pyoderma gangrenosum (PG) is a rare ulcerative neutrophilic disorder of skin. Its pulmonary manifestations are uncommon and only less than forty cases have been reported in the literature previously. PG is associated with variable systemic diseases, most commonly inflammatory bowel disease and hematologic malignancies. It reported rarely in rheumatoid arthritis (RA). We report a case of PG lung involvement in patient with RA associated interstitial lung disease. A 66-year-old woman presented with productive cough and recurrent ulcerative lesion on her left ankle. She had a 15-year history of RA associated interstitial lung disease and treated with methotrexate, sulfasalazine, hydroxychloroquine and methylprednisolone. On physical examination, there were a few tender, erythematous subcutaneous nodules ranging from 1 to 3 cm in diameter on her left thigh and left elbow. Anti-neutrophil cytoplasmic antibodies (ANCAs) are negative. Her chest CT scan demonstrated multifocal cavitary consolidations on the background of reticular opacity and honeycombing. Punch biopsy of erythematous nodule on thigh showed neutrophilic abscess with necrotic debris. The skin and lung lesions were rapidly improved with 0.5 mg/kg/day of prednisolone. PMID:26889492

  3. Multiple pulmonary cavitary nodules with pyoderma gangrenosum in patient with rheumatoid arthritis.

    PubMed

    Be, Miae; Cha, Hee Jeong; Park, Chanho; Park, Yongtae; Jung, Hwasik; Lee, Yoeunim; Jegal, Yangjin

    2016-01-01

    Pyoderma gangrenosum (PG) is a rare ulcerative neutrophilic disorder of skin. Its pulmonary manifestations are uncommon and only less than forty cases have been reported in the literature previously. PG is associated with variable systemic diseases, most commonly inflammatory bowel disease and hematologic malignancies. It reported rarely in rheumatoid arthritis (RA). We report a case of PG lung involvement in patient with RA associated interstitial lung disease. A 66-year-old woman presented with productive cough and recurrent ulcerative lesion on her left ankle. She had a 15-year history of RA associated interstitial lung disease and treated with methotrexate, sulfasalazine, hydroxychloroquine and methylprednisolone. On physical examination, there were a few tender, erythematous subcutaneous nodules ranging from 1 to 3 cm in diameter on her left thigh and left elbow. Anti-neutrophil cytoplasmic antibodies (ANCAs) are negative. Her chest CT scan demonstrated multifocal cavitary consolidations on the background of reticular opacity and honeycombing. Punch biopsy of erythematous nodule on thigh showed neutrophilic abscess with necrotic debris. The skin and lung lesions were rapidly improved with 0.5 mg/kg/day of prednisolone.

  4. Remission of refractory pyoderma gangrenosum, severe acne, and hidradenitis suppurativa (PASH) syndrome using targeted antibiotic therapy in 4 patients.

    PubMed

    Join-Lambert, Olivier; Duchatelet, Sabine; Delage, Maïa; Miskinyte, Snaigune; Coignard, Hélène; Lemarchand, Nicolas; Alemy-Carreau, Murielle; Lortholary, Olivier; Nassif, Xavier; Hovnanian, Alain; Nassif, Aude

    2015-11-01

    Pyoderma gangrenosum, severe acne, and suppurative hidradenitis (PASH) syndrome can prove refractory to treatment and is characterized by relapses and recurrences. The combination of antibiotic therapy and surgery can produce success in the management of the syndrome. Acute treatment is required, but maintenance therapy is also necessary to prevent disease relapse. The response to antibiotic therapy is hypothesis generating, raising the issue of a modified host response. To date, anecdotal reports support the use of surgery and medical therapy, but controlled investigations with extended follow-up are necessary to substantiate preliminary data observed with individual cases.

  5. Coexistence of pyoderma gangrenosum and sweet's syndrome in a patient with ulcerative colitis

    PubMed Central

    Ajili, Faida; Souissi, Asmahan; Bougrine, Fathi; Boussetta, Najah; Abdelhafidh, Nadia Ben; Sayhi, Sameh; Louzir, Bassem; Doss, Nejib; Laabidi, Janet; Othmani, Salah

    2015-01-01

    Pyoderma gangrenosum (PG) and Sweet's Syndrome (SS) are inflammatory skin diseases caused by the accumulation of neutrophils in the skin and, rarely, in internal organs. These neutrophilic dermatosis (NDs) are distinguished by the existence of forms of transition or overlap. They are frequently associated to systemic diseases especially hematologic and gastrointestinal ones. We report a case of a patient with ulcerative colitis (UC) who successively developed two types of NDs: PG then SS. A 66 years old patient with a history of UC consulted in July 2012 for an erythematous swelling of the back of the right hand treated with antibiotics without improvement. At that time, bacteriological samples were negative. In October 2012, he was hospitalized for polyarthralgia and impaired general condition. In physical examination, he had vesiculobullous plaque of 10 cm long of the right hand and wrist, infiltrated erythematous plaque on the right leg and another topped with a large pustule at the left ankle. Skin biopsy showed at the back of the right hand an aspect of PG and at the infiltrated plaques of the ankle an aspect of SS. Prednisone was started with improvement of the skin lesions and a recovery condition. The combination of PG and SS has already been described in cases of hematologic malignancy and rarely in UC. There is also the notion of passage from a neutrophilic dermatosis to another. Indeed, a typical lesion initially of SS can evolve to a future PG. This case demonstrates that neutrophilic dermatoses form a continous spectrum of entities that may occur in UC. PMID:26327988

  6. Pyoderma gangrenosum preceding the onset of extranodal natural killer/T-cell lymphoma

    PubMed Central

    Yang, Ting-Hua; Hu, Chung-Hong; Tsai, Hsiou-Hsin

    2016-01-01

    Abstract Introduction: Pyoderma gangrenosum (PG) is a neutrophilic dermatosis that may be associated with systemic diseases. The association of PG with lymphoid malignancies has rarely been reported. Extranodal natural killer/T-cell lymphoma (ENKTL) is a rare but aggressive entity with a poor prognosis. Here, we report the case of a patient who had idiopathic PG refractory to systemic steroids and subsequently developed ENKTL. Case report: A 70-year-old man presented with a 2-month history of intermittent fever and multifocal painful papules, plaques, and ulcerations on his extremities. The histological and culture results of the lesions were consistent with those of PG. A thorough work-up was performed and did not demonstrate any underlying systemic diseases including malignancy. The PG lesions were refractory to systemic steroid therapy. An enlarging nodule was observed over his right infraorbital area 4 months after the onset of the skin eruptions. The nodule was later biopsied and diagnosed as ENKTL by using histopathological and immunohistochemical studies. Fludeoxyglucose positron emission tomography/computed tomography revealed multiple intense fludeoxyglucose-avid masses in the bones and lungs, suggesting multiorgan metastases. The patient rejected chemotherapy and died 4 weeks after the diagnosis. Conclusion: The present case indicates that in any patient with idiopathic PG refractory to conventional therapy, the presence of any underlying disease or malignancy must be thoroughly evaluated. The present case serves as a reminder that when assessing patients with PG, clinicians should increase their awareness regarding the delayed association with malignancy, even in the absence of a concomitant systemic disease at presentation. Furthermore, the prompt evaluation of any suspicious lesions in the context of PG for the possibility of a malignant nature can improve the prognosis, particularly in cases of aggressive malignancy. Understanding the cutaneous

  7. Case with pyoderma gangrenosum abruptly emerging around the wound of cesarean section for placenta previa with placenta accrete.

    PubMed

    Nonaka, Taro; Yoshida, Kunihiko; Yamaguchi, Masayuki; Aizawa, Atsuko; Fujiwara, Hiroshi; Enomoto, Takayuki; Takakuwa, Koichi

    2016-09-01

    A 39-year-old woman underwent emergency cesarean section (CS) due to placenta previa totalis with massive bleeding. Two major problems emerged in this patient after CS was carried out. One was partial retention of the placenta due to placenta accreta. Another major and more serious problem was pyoderma gangrenosum (PG) widely appearing at the skin of the abdomen around the CS wound. Conservative treatment was performed for the retained placenta, and it had completely disappeared by 76 days after the CS. The diagnosis of PG was promptly made in consultation with a plastic surgeon and a dermatologist when a wide ulcer emerged around the CS wound, and high-dose prednisolone was administered as treatment. At 90 days following the CS, near-complete epithelialization was achieved. This extremely rare case reflects the importance of rapid diagnosis and treatment of PG.

  8. A Case Series of 4 Patients With Peristomal Pyoderma Gangrenosum: Review of Risk Factors and Treatment Response.

    PubMed

    Turrión-Merino, L; Hermosa-Zarza, E; Miguel, L; Muñoz-Zato, E

    2016-04-01

    The literature on peristomal pyoderma gangrenosum (PPD) is scarce, and studies to date have included few patients. It is therefore difficult to determine the incidence of PPD, investigate risk factors, or evaluate the effectiveness of the different treatments available. We report on a series of 4 patients diagnosed with PPD at our hospital in 2013 and 2014, and review the clinical characteristics and responses to treatment. Three of the patients had inflammatory bowel disease and 1 had rectal cancer. Three patients responded favorably to initial treatment with 0.1% tacrolimus ointment (administered as monotherapy in 2 cases and combined with immunosuppressants in the other). However, on withdrawal of tacrolimus, the disease recurred in all 3 patients, requiring treatment reintroduction or modification.

  9. Healing of a pyoderma gangrenosum at the site of a percutaneous endoscopically sited gastrostomy tube without tube removal

    PubMed Central

    Davis, Charles; Wright, Bethany

    2014-01-01

    Pyoderma gangrenosum (PG) is a rare but important cause of pain and morbidity, and is associated with malignancy and shows pathergy. Occurrence at a percutaneous endoscopic gastrostomy (PEG) site is rare and may prompt PEG tube removal. This case describes management of PG at a PEG site in a man with squamous cell carcinoma of the orophayrnx. Successful healing of the lesion was achieved despite the PEG tube remaining in situ. Care was delivered within the hospice setting with support from the local dermatology service. Infection of the wound was treated with a recently licensed antimicrobial with a novel action. This allowed nutrition to continue, promoting healing further and ensuring a route of delivery for medications, avoiding intravenous therapy. PMID:25239986

  10. A Case Series of 4 Patients With Peristomal Pyoderma Gangrenosum: Review of Risk Factors and Treatment Response.

    PubMed

    Turrión-Merino, L; Hermosa-Zarza, E; Miguel, L; Muñoz-Zato, E

    2016-04-01

    The literature on peristomal pyoderma gangrenosum (PPD) is scarce, and studies to date have included few patients. It is therefore difficult to determine the incidence of PPD, investigate risk factors, or evaluate the effectiveness of the different treatments available. We report on a series of 4 patients diagnosed with PPD at our hospital in 2013 and 2014, and review the clinical characteristics and responses to treatment. Three of the patients had inflammatory bowel disease and 1 had rectal cancer. Three patients responded favorably to initial treatment with 0.1% tacrolimus ointment (administered as monotherapy in 2 cases and combined with immunosuppressants in the other). However, on withdrawal of tacrolimus, the disease recurred in all 3 patients, requiring treatment reintroduction or modification. PMID:26626501

  11. Pyogenic Arthritis, Pyoderma Gangrenosum, Acne, Suppurative Hidradenitis (PA-PASH) Syndrome: An Atypical Presentation of a Rare Syndrome.

    PubMed

    Ursani, Mohammad A; Appleyard, Joan; Whiteru, Onome

    2016-08-17

    BACKGROUND Pyogenic arthritis, pyoderma gangrenosum (PG), acne, and suppurative hidradenitis (PA-PASH) syndrome has been linked to an auto-inflammatory pathway. We report a case that is an atypical presentation of a rare syndrome, which supports literature suggesting that different phenotypes of PG-related syndromes may be a variation of the same pathogenic spectrum. Interestingly, our patient displayed a positive proteinase-3 antibody (PR-3). The clinical relevance of this is unclear. In recent literature, antineutrophil cytoplasmic autoantibodies (ANCA) positivity has been reported in various inflammatory conditions other than ANCA-associated vasculitis (AAV). CASE REPORT A 44-year-old African American male with history of pyogenic arthritis, acne, suppurative hidradenitis, and chronic diarrhea presented for evaluation of painful ulcers located on the bilateral lower extremities, bilateral proximal interphalangeal joints, buttocks, and scrotum, and chronic diarrhea. Infectious etiologies for the ulcers were ruled out. Biopsy of an ulcer revealed PG. Colonoscopy revealed inflammation and ulceration with biopsy consistent with ulcerative colitis (UC). After treatment with prednisone, the ulcers healed within 4 weeks, and the chronic diarrhea resolved. CONCLUSIONS Our patient displayed a variation of PA-PASH syndrome and UC. Previously reported cases of similar phenotypes of PG-related syndromes have not presented in this fashion. Furthermore, the literature does not report cases of PG-related syndromes with an elevation in PR-3 antibody. Elevation in PR-3 has been reported in various inflammatory disorders aside from AAV. The relevance of this is currently unclear. It may be possible that the milieus of these various auto-inflammatory disorders may share pathogenic commonalities.

  12. Association of pyoderma gangrenosum, acne, and suppurative hidradenitis (PASH) shares genetic and cytokine profiles with other autoinflammatory diseases.

    PubMed

    Marzano, Angelo V; Ceccherini, Isabella; Gattorno, Marco; Fanoni, Daniele; Caroli, Francesco; Rusmini, Marta; Grossi, Alice; De Simone, Clara; Borghi, Orietta M; Meroni, Pier Luigi; Crosti, Carlo; Cugno, Massimo

    2014-12-01

    The association of pyoderma gangrenosum, acne, and suppurative hidradenitis (PASH) has recently been described and suggested to be a new entity within the spectrum of autoinflammatory syndromes, which are characterized by recurrent episodes of sterile inflammation, without circulating autoantibodies and autoreactive T-cells. We conducted an observational study on 5 patients with PASH syndrome, analyzing their clinical features, genetic profile of 10 genes already known to be involved in autoinflammatory diseases (AIDs), and cytokine expression pattern both in lesional skin and serum. In tissue skin samples, the expressions of interleukin (IL)-1β and its receptors I and II were significantly higher in PASH (P = 0.028, 0.047, and 0.050, respectively) than in controls. In PASH patients, chemokines such as IL-8 (P = 0.004), C-X-C motif ligand (CXCL) 1/2/3 (P = 0.028), CXCL 16 (P = 0.008), and regulated on activation, normal T cell expressed and secreted (RANTES) (P = 0.005) were overexpressed. Fas/Fas ligand and cluster of differentiation (CD)40/CD40 ligand systems were also overexpressed (P = 0.016 for Fas, P = 0.006 for Fas ligand, P = 0.005 for CD40, and P = 0.004 for CD40 ligand), contributing to tissue damage and inflammation. In peripheral blood, serum levels of the main proinflammatory cytokines, that is, IL-1β, tumor necrosis factor-α, and IL-17, were within the normal range, suggesting that in PASH syndrome, the inflammatory process is mainly localized into the skin. Four out of our 5 PASH patients presented genetic alterations typical of well-known AIDs, including inflammatory bowel diseases, and the only patient lacking genetic changes had clinically evident Crohn disease. In conclusion, overexpression of cytokines/chemokines and molecules amplifying the inflammatory network, along with the genetic changes, supports the view that PASH syndrome is autoinflammatory in origin.

  13. Associated factors and comorbidities in patients with pyoderma gangrenosum in Germany: a retrospective multicentric analysis in 259 patients

    PubMed Central

    2013-01-01

    Background Pyoderma gangrenosum (PG) is a rarely diagnosed ulcerative neutrophilic dermatosis with unknown origin that has been poorly characterized in clinical studies so far. Consequently there have been significant discussions about its associated factors and comorbidities. The aim of our multicenter study was to analyze current data from patients in dermatologic wound care centers in Germany in order to describe associated factors and comorbidities in patients with PG. Methods Retrospective clinical investigation of patients with PG from dermatologic wound care centers in Germany. Results We received data from 259 patients with PG from 20 different dermatologic wound care centers in Germany. Of these 142 (54.8%) patients were female, 117 (45.2%) were male; with an age range of 21 to 95 years, and a mean of 58 years. In our patient population we found 45.6% with anemia, 44.8% with endocrine diseases, 12.4% with internal malignancies, 9.3% with chronic inflammatory bowel diseases and 4.3% with elevated creatinine levels. Moreover 25.5% of all patients had a diabetes mellitus with some aspects of potential association with the metabolic syndrome. Conclusions Our study describes one of the world’s largest populations with PG. Beside the well-known association with chronic bowel diseases and neoplasms, a potentially relevant new aspect is an association with endocrine diseases, in particular the metabolic syndrome, thyroid dysfunctions and renal disorders. Our findings represent clinically relevant new aspects. This may help to describe the patients’ characteristics and help to understand the underlying pathophysiology in these often misdiagnosed patients. PMID:24010984

  14. Pyogenic Arthritis, Pyoderma Gangrenosum, Acne, Suppurative Hidradenitis (PA-PASH) Syndrome: An Atypical Presentation of a Rare Syndrome

    PubMed Central

    Ursani, Mohammad A.; Appleyard, Joan; Whiteru, Onome

    2016-01-01

    Patient: Male, 44 Final Diagnosis: PAPASH syndrome Symptoms: Recurrent skin ulcers • diarrhea • inflammatory arthritis Medication: Prednisone • anti-tumor necrosis factor Clinical Procedure: N/A Specialty: Rheumatology Objective: Rare disease Background: Pyogenic arthritis, pyoderma gangrenosum (PG), acne, and suppurative hidradenitis (PA-PASH) syndrome has been linked to an auto-inflammatory pathway. We report a case that is an atypical presentation of a rare syndrome, which supports literature suggesting that different phenotypes of PG-related syndromes may be a variation of the same pathogenic spectrum. Interestingly, our patient displayed a positive proteinase-3 antibody (PR-3). The clinical relevance of this is unclear. In recent literature, antineutrophil cytoplasmic autoantibodies (ANCA) positivity has been reported in various inflammatory conditions other than ANCA-associated vasculitis (AAV). Case Report: A 44-year-old African American male with history of pyogenic arthritis, acne, suppurative hidradenitis, and chronic diarrhea presented for evaluation of painful ulcers located on the bilateral lower extremities, bilateral proximal interphalangeal joints, buttocks, and scrotum, and chronic diarrhea. Infectious etiologies for the ulcers were ruled out. Biopsy of an ulcer revealed PG. Colonoscopy revealed inflammation and ulceration with biopsy consistent with ulcerative colitis (UC). After treatment with prednisone, the ulcers healed within 4 weeks, and the chronic diarrhea resolved. Conclusions: Our patient displayed a variation of PA-PASH syndrome and UC. Previously reported cases of similar phenotypes of PG-related syndromes have not presented in this fashion. Furthermore, the literature does not report cases of PG-related syndromes with an elevation in PR-3 antibody. Elevation in PR-3 has been reported in various inflammatory disorders aside from AAV. The relevance of this is currently unclear. It may be possible that the milieus of these various

  15. Pyogenic Arthritis, Pyoderma Gangrenosum, Acne, Suppurative Hidradenitis (PA-PASH) Syndrome: An Atypical Presentation of a Rare Syndrome.

    PubMed

    Ursani, Mohammad A; Appleyard, Joan; Whiteru, Onome

    2016-01-01

    BACKGROUND Pyogenic arthritis, pyoderma gangrenosum (PG), acne, and suppurative hidradenitis (PA-PASH) syndrome has been linked to an auto-inflammatory pathway. We report a case that is an atypical presentation of a rare syndrome, which supports literature suggesting that different phenotypes of PG-related syndromes may be a variation of the same pathogenic spectrum. Interestingly, our patient displayed a positive proteinase-3 antibody (PR-3). The clinical relevance of this is unclear. In recent literature, antineutrophil cytoplasmic autoantibodies (ANCA) positivity has been reported in various inflammatory conditions other than ANCA-associated vasculitis (AAV). CASE REPORT A 44-year-old African American male with history of pyogenic arthritis, acne, suppurative hidradenitis, and chronic diarrhea presented for evaluation of painful ulcers located on the bilateral lower extremities, bilateral proximal interphalangeal joints, buttocks, and scrotum, and chronic diarrhea. Infectious etiologies for the ulcers were ruled out. Biopsy of an ulcer revealed PG. Colonoscopy revealed inflammation and ulceration with biopsy consistent with ulcerative colitis (UC). After treatment with prednisone, the ulcers healed within 4 weeks, and the chronic diarrhea resolved. CONCLUSIONS Our patient displayed a variation of PA-PASH syndrome and UC. Previously reported cases of similar phenotypes of PG-related syndromes have not presented in this fashion. Furthermore, the literature does not report cases of PG-related syndromes with an elevation in PR-3 antibody. Elevation in PR-3 has been reported in various inflammatory disorders aside from AAV. The relevance of this is currently unclear. It may be possible that the milieus of these various auto-inflammatory disorders may share pathogenic commonalities. PMID:27530224

  16. Clinical, serologic, and genetic factors associated with pyoderma gangrenosum and erythema nodosum in inflammatory bowel disease patients

    PubMed Central

    Weizman, Adam; Huang, Brian; Berel, Dror; Targan, Stephan R.; Dubinsky, Marla; Fleshner, Phillip; Ippoliti, Andrew; Kaur, Manreet; Panikkath, Deepa; Brant, Steve; Oikonomou, Ioannis; Duerr, Rick; Rioux, John; Silverberg, Mark; Rotter, Jerome I; Vasiliauskas, Eric; Haritunians, Talin; Shih, David; Li, Dalin; Melmed, Gil Y.; McGovern, Dermot P.B.

    2014-01-01

    Objective Pyoderma gangrenosum (PG) and erythema nodosum (EN) are the most common cutaneous manifestations of inflammatory bowel disease (IBD) but little is known regarding their etiopathogenesis. Design We performed a case control study comparing characteristics between IBD patients with a documented episode of PG (PG+) and/or EN (EN+) with those without PG (PG-) and EN (EN-). Data on clinical features were obtained by chart review. IBD related serology was determined using ELISA and genome-wide data generated using Illumina technology. Standard statistical tests for association were used. Results We identified a total 92 cases of PG and 103 cases of EN with genetic and clinical characteristics, of which 64 PG and 55 EN were available for serological analyses. Fewer male subjects were identified in the PG(+) (OR 0.6, p=0.009) and EN(+) groups (OR 0.31, p=0<0.0001). Colonic disease, previous IBD related surgery, and non-cutaneous extra-intestinal manifestations were more common among both PG(+) and EN(+) patients compared to controls. PG(+) was associated with ANCA seropositivity (p=0.03) and higher ANCA level (p=0.02) in CD. Genetic associations with PG included known IBD loci (IL8RA (p=0.00003), and PRDM1 (0.03)) as well as with USP15 (4.8×10−6) and TIMP3 (5.6 ×10−7). Genetic associations with EN included known IBD susceptibility genes (PTGER4 (p=8.8×10−4), ITGAL (0.03)) as well as SOCS5 (9.64×10−6), CD207 3.14×10−6), ITGB3 (7.56×10−6) and rs6828740 (4q26)(p <5.0 × 10−8). Multivariable models using clinical, serologic, and genetic parameters predicted PG (AUC 0.8) and EN (AUC 0.97). Conclusion Cutaneous manifestations in IBD are associated with distinctive genetic characteristics as well as with the similar clinical characteristics including the development of other extra-intestinal manifestations suggesting shared and distinct etiologies. PMID:24487271

  17. Association of Pyoderma Gangrenosum, Acne, and Suppurative Hidradenitis (PASH) Shares Genetic and Cytokine Profiles With Other Autoinflammatory Diseases

    PubMed Central

    Marzano, Angelo V.; Ceccherini, Isabella; Gattorno, Marco; Fanoni, Daniele; Caroli, Francesco; Rusmini, Marta; Grossi, Alice; De Simone, Clara; Borghi, Orietta M.; Meroni, Pier Luigi; Crosti, Carlo; Cugno, Massimo

    2014-01-01

    Abstract The association of pyoderma gangrenosum, acne, and suppurative hidradenitis (PASH) has recently been described and suggested to be a new entity within the spectrum of autoinflammatory syndromes, which are characterized by recurrent episodes of sterile inflammation, without circulating autoantibodies and autoreactive T-cells. We conducted an observational study on 5 patients with PASH syndrome, analyzing their clinical features, genetic profile of 10 genes already known to be involved in autoinflammatory diseases (AIDs), and cytokine expression pattern both in lesional skin and serum. In tissue skin samples, the expressions of interleukin (IL)-1β and its receptors I and II were significantly higher in PASH (P = 0.028, 0.047, and 0.050, respectively) than in controls. In PASH patients, chemokines such as IL-8 (P = 0.004), C-X-C motif ligand (CXCL) 1/2/3 (P = 0.028), CXCL 16 (P = 0.008), and regulated on activation, normal T cell expressed and secreted (RANTES) (P = 0.005) were overexpressed. Fas/Fas ligand and cluster of differentiation (CD)40/CD40 ligand systems were also overexpressed (P = 0.016 for Fas, P = 0.006 for Fas ligand, P = 0.005 for CD40, and P = 0.004 for CD40 ligand), contributing to tissue damage and inflammation. In peripheral blood, serum levels of the main proinflammatory cytokines, that is, IL-1β, tumor necrosis factor-α, and IL-17, were within the normal range, suggesting that in PASH syndrome, the inflammatory process is mainly localized into the skin. Four out of our 5 PASH patients presented genetic alterations typical of well-known AIDs, including inflammatory bowel diseases, and the only patient lacking genetic changes had clinically evident Crohn disease. In conclusion, overexpression of cytokines/chemokines and molecules amplifying the inflammatory network, along with the genetic changes, supports the view that PASH syndrome is autoinflammatory in origin. PMID:25501066

  18. UK Dermatology Clinical Trials Network’s STOP GAP trial (a multicentre trial of prednisolone versus ciclosporin for pyoderma gangrenosum): protocol for a randomised controlled trial

    PubMed Central

    2012-01-01

    Background Pyoderma gangrenosum (PG) is a rare inflammatory skin disorder characterised by painful and rapidly progressing skin ulceration. PG can be extremely difficult to treat and patients often require systemic immunosuppression. Recurrent lesions of PG are common, but the relative rarity of this condition means that there is a lack of published evidence regarding its treatment. A systematic review published in 2005 found no randomised controlled trials (RCTs) relating to the treatment of PG. Since this time, one small RCT has been published comparing infliximab to placebo, but none of the commonly used systemic treatments for PG have been formally assessed. The UK Dermatology Clinical Trials Network’s STOP GAP Trial has been designed to address this lack of trial evidence. Methods The objective is to assess whether oral ciclosporin is more effective than oral prednisolone for the treatment of PG. The trial design is a two-arm, observer-blind, parallel-group, randomised controlled trial comparing ciclosporin (4 mg/kg/day) to prednisolone (0.75 mg/kg/day). A total of 140 participants are to be recruited over a period of 4 years, from up to 50 hospitals in the UK and Eire. Primary outcome of velocity of healing at 6 weeks is assessed blinded to treatment allocation (using digital images of the ulcers). Secondary outcomes include: (i) time to healing; (ii) global assessment of improvement; (iii) PG inflammation assessment scale score; (iv) self-reported pain; (v) health-related quality of life; (vi) time to recurrence; (vii) treatment failures; (viii) adverse reactions to study medications; and (ix) cost effectiveness/utility. Patients with a clinical diagnosis of PG (excluding granulomatous PG); measurable ulceration (that is, not pustular PG); and patients aged over 18 years old who are able to give informed consent are included in the trial. Randomisation is by computer generated code using permuted blocks of randomly varying size, stratified by

  19. Nasal septum perforation in patient with pyoderma gangrenosum.

    PubMed

    Maia, Camilla Bezerra da Cruz; Felix, Felippe; Paes, Vania; de Azevedo, Julia Alves; Grangeiro, Eliza Raquel Negrão; Riccio, Jonatah Lucas N; Rito, Helen Cruz

    2012-04-01

    Introdução: A cocaína é extraída das folhas do arbusto da coca (Erythroxylon coca), podendo ser consumida de várias formas, mas o modo mais comum é pela aspiração da droga, sendo absorvida pela mucosa nasal, causando vasoconstricção, levando o seu uso crônico à perfuração de septo nasal. Pioderma gangrenoso é uma doença inflamatória rara, idiopática que se caracteriza pela presença de úlceras destrutivas principalmente em membros inferiores. Seu diagnóstico clínico é muitas vezes de exclusão.Objetivo: Descrever a raridade de associação entre Pioderma Gangrenoso e cocaína.Relato de Caso: E. A., 27 anos, com apresentação atípica de Pioderma Gangrenoso com perfurações de septo nasal e palato duro usuária de grande quantidade de cocaína, sendo necessário diferenciar qual patologia causou esse dano.Comentários Finais: Além da necessidade dessa diferenciação, apenas existem três casos relatados na literatura, envolvendo o Pioderma Gangrenoso complicado com perfuração de septo nasal em usuários de cocaína.

  20. 15 CFR 922.47 - Pre-existing authorizations or rights and certifications of pre-existing authorizations or rights.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 15 Commerce and Foreign Trade 3 2010-01-01 2010-01-01 false Pre-existing authorizations or rights and certifications of pre-existing authorizations or rights. 922.47 Section 922.47 Commerce and Foreign Trade Regulations Relating to Commerce and Foreign Trade (Continued) NATIONAL OCEANIC...

  1. 15 CFR 922.47 - Pre-existing authorizations or rights and certifications of pre-existing authorizations or rights.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 15 Commerce and Foreign Trade 3 2011-01-01 2011-01-01 false Pre-existing authorizations or rights and certifications of pre-existing authorizations or rights. 922.47 Section 922.47 Commerce and Foreign Trade Regulations Relating to Commerce and Foreign Trade (Continued) NATIONAL OCEANIC AND ATMOSPHERIC ADMINISTRATION, DEPARTMENT OF COMMERCE...

  2. [Ecthyma gangrenosum caused by Staphylococcus aureus].

    PubMed

    Jaque, Alejandra; Moll-Manzur, Catherina; Dossi, María Teresa; Berroeta-Mauriziano, Daniela; Araos-Baeriswyl, Esteban; Monsalve, Ximena

    2016-06-01

    Ecthyma gangrenosum is an uncommon necrotizing vasculitis, in most cases secondary to sepsis by Pseudo-mona aeruginosa in immunocompromised patients. However, there have been several reports of ecthyma gangre-nosum caused by other infectious etiologies. We report an unusual case of ecthyma gangrenosum associated with methicillin-resistant Staphylococcus aureus infection in a patient without the classic immunological risk factors described in the literature. PMID:27598286

  3. Recognizing pyoderma: more difficult than it may seem.

    PubMed

    Gortel, Kinga

    2013-01-01

    Although bacterial pyoderma is among the most commonly encountered dermatologic conditions in dogs, some cases present diagnostic challenges even to experienced clinicians. This article presents several unusual manifestations of pyoderma, including bullous impetigo, superficial spreading pyoderma, mucocutaneous pyoderma, and post-grooming furunculosis. Conditions mimicking pyoderma, including juvenile cellulitis, immunomodulatory-responsive lymphocytic-plasmacytic pododermatitis, and pemphigus foliaceus are also described. Diagnostic techniques used for diagnosing and characterizing pyoderma are also discussed. PMID:23182321

  4. Intercontinental travel and its effect on pre-existing illnesses.

    PubMed

    Steffen, R; van der Linde, F

    1981-01-01

    Over 12,000 European air passengers were interviewed as to whether the status of any pre-existing illness changed as a result of their vacation in the tropics or in North America (United States or Canada). Of the travelers to tropical destinations, 1.6% reported their disease had improved, which significantly exceeded the rate of 0.5% in visitors to North America, mainly due to a more favourable influence in chronic respiratory tract infections and chronic rheumatologic impairment. Aggravation of pre-existing disease occurred in 0.9 and 0.7%, respectively, of the travelers in the two groups and was only rarely severe. In the tropics, patients below the age of 30 and those who suffered from digestive problems were most frequently adversely affected.

  5. Mammalian heart renewal by pre-existing cardiomyocytes.

    PubMed

    Senyo, Samuel E; Steinhauser, Matthew L; Pizzimenti, Christie L; Yang, Vicky K; Cai, Lei; Wang, Mei; Wu, Ting-Di; Guerquin-Kern, Jean-Luc; Lechene, Claude P; Lee, Richard T

    2013-01-17

    Although recent studies have revealed that heart cells are generated in adult mammals, the frequency of generation and the source of new heart cells are not yet known. Some studies suggest a high rate of stem cell activity with differentiation of progenitors to cardiomyocytes. Other studies suggest that new cardiomyocytes are born at a very low rate, and that they may be derived from the division of pre-existing cardiomyocytes. Here we show, by combining two different pulse-chase approaches--genetic fate-mapping with stable isotope labelling, and multi-isotope imaging mass spectrometry--that the genesis of cardiomyocytes occurs at a low rate by the division of pre-existing cardiomyocytes during normal ageing, a process that increases adjacent to areas of myocardial injury. We found that cell cycle activity during normal ageing and after injury led to polyploidy and multinucleation, but also to new diploid, mononucleate cardiomyocytes. These data reveal pre-existing cardiomyocytes as the dominant source of cardiomyocyte replacement in normal mammalian myocardial homeostasis as well as after myocardial injury.

  6. Gate dielectric degradation: Pre-existing vs. generated defects

    NASA Astrophysics Data System (ADS)

    Veksler, Dmitry; Bersuker, Gennadi

    2014-01-01

    We consider the possibility that degradation of the electrical characteristics of high-k gate stacks under low voltage stresses of practical interest is caused primarily by activation of pre-existing defects rather than generation of new ones. In nFETs in inversion, in particular, defect activation is suggested to be associated with the capture of an injected electron: in this charged state, defects can participate in a fast exchange of charge carriers with the carrier reservoir (substrate or gate electrode) that constitutes the physical process underlying a variety of electrical measurements. The degradation caused by the activation of pre-existing defects, as opposed to that of new defect generation, is both reversible and exhibits a tendency to saturate through the duration of stress. By using the multi-phonon assisted charge transport description, it is demonstrated that the trap activation concept allows reproducing a variety of experimental results including stress time dependency of the threshold voltage, leakage current, charge pumping current, and low frequency noise. Continuous, long-term degradation described by the power law time dependency is shown to be determined by the activation of defects located in the interfacial SiO2 layer of the high-k gate stacks. The findings of this study can direct process optimization efforts towards reduction of as-grown precursors of the charge trapping defects as the major factor affecting reliability.

  7. A case of perineal ecthyma gangrenosum

    PubMed Central

    Akkurt, Zeynep Meltem; Fidan, Veysi; Uçmak, Derya; Dal, Tuba; Kelekçi, Selvi; Uçak, Haydar

    2016-01-01

    Ecthyma gangrenosum is a skin lesion associated with Pseudomonas aeruginosa. A previously healthy one-year-old boy who had been diagnosed with varicella 10 days ago was admitted to our hospital with complaints of diarrhea, green ear discharge and new lesions in the diaper area. Intravenous meropenem and amikacin had been previously initiated. Physical examination revealed greenish, well bordered necrotic ulcers on both gluteal areas and the perianal area. Pseudomonas aeruginosa grew in wound culture. A colostomy was opened due to recalcitrant diarrhea and ulcers. The patient remitted in one month and was discharged. T lymphocyte subgroups and immunoglobulins were found to be normal on immunologic evaluation. We presented this case to draw attention to the fact that ecthyma gangrenosum due to Pseudomonas aeruginosa may occur in the diaper area and that sepsis due to Pseudomonas should be investigated. PMID:27103864

  8. Ecthyma Gangrenosum Caused by Escherichia coli in a Previously Healthy Girl.

    PubMed

    Mouna, Korbi; Akkari, Hayet; Faten, Hammedi; Yosra, Kadri; Hichem, Belhadjali; Maha, Mastouri; Abdelfatteh, Zakhama; Jamelledine, Zili

    2015-01-01

    Ecthyma gangrenosum is a characteristic lesion of Pseudomonas aeruginosa sepsis in immunocompromised patients. Only eight cases of ecthyma gangrenosum caused by Escherichia coli have been reported. We report a case of ecthyma gangrenosum due to E. coli without bacteremia in a previously healthy girl.

  9. Metabolic effects of milk protein intake strongly depend on pre-existing metabolic and exercise status.

    PubMed

    Melnik, Bodo C; Schmitz, Gerd; John, Swen; Carrera-Bastos, Pedro; Lindeberg, Staffan; Cordain, Loren

    2013-01-01

    Milk protein intake has recently been suggested to improve metabolic health. This Perspective provides evidence that metabolic effects of milk protein intake have to be regarded in the context of the individual's pre-existing metabolic and exercise status. Milk proteins provide abundant branched-chain amino acids (BCAAs) and glutamine. Plasma BCAAs and glutamine are increased in obesity and insulin resistance, but decrease after gastric bypass surgery resulting in weight loss and improved insulin sensitivity. Milk protein consumption results in postprandial hyperinsulinemia in obese subjects, increases body weight of overweight adolescents and may thus deteriorate pre-existing metabolic disturbances of obese, insulin resistant individuals. PMID:24225036

  10. Metabolic effects of milk protein intake strongly depend on pre-existing metabolic and exercise status

    PubMed Central

    2013-01-01

    Milk protein intake has recently been suggested to improve metabolic health. This Perspective provides evidence that metabolic effects of milk protein intake have to be regarded in the context of the individual’s pre-existing metabolic and exercise status. Milk proteins provide abundant branched-chain amino acids (BCAAs) and glutamine. Plasma BCAAs and glutamine are increased in obesity and insulin resistance, but decrease after gastric bypass surgery resulting in weight loss and improved insulin sensitivity. Milk protein consumption results in postprandial hyperinsulinemia in obese subjects, increases body weight of overweight adolescents and may thus deteriorate pre-existing metabolic disturbances of obese, insulin resistant individuals. PMID:24225036

  11. When people with pre-existing disabilities age in place: implications for social work practice.

    PubMed

    Gilson, S F; Netting, F E

    1997-11-01

    We focus on a population of people with disabilities who are "aging in place," that is, individuals aging with pre-existing physical disabilities. We distinguish between those who experience prolonged aging and others who experience accelerated aging. A brief overview of people aging with disabilities and selected background information on the increasing linkages between the aging and disability communities is provided. Four case examples illustrate the practice implications faced by social workers in partnering with people with pre-existing disabilities and in being sensitive to their desires concerning aging in place.

  12. Ecthyma gangrenosum in an infant after liver transplantation.

    PubMed

    Hizli, Şamil; Işikay, Sedat; Arikan, Çiğdem

    2016-09-01

    Ecthyma gangrenosum is a rare, necrotizing, bacterial infection of the skin most commonly caused by Pseudomonas aeruginosa. It has a characteristic clinical picture starting with maculopapular eruption followed by hemorrhagic vesicle and evolving into gangrenous ulcer. Although direct skin inoculation without septicemia is also probable, usually ecthyma gangrenosum is pathognomonic for Pseudomonas septicemia, which has a mortality rate of 38-96%. Herein, we report on the case of a 9-month-old male infant diagnosed with ecthyma gangrenosum who had undergone liver transplantation approximately 6 months previously and who was under immunosuppressive treatment, in order to highlight the importance of the early diagnosis and treatment of this disease. PMID:27682614

  13. Contributions Made by a Strengths-Oriented Intervention to Trusting Relationships within Pre-Existing Teams

    ERIC Educational Resources Information Center

    King, W. Bernt

    2012-01-01

    This qualitative study spotlighted a grounded theory regarding contributions to affect- and cognition-based trust by a strengths-oriented intervention in pre-existing teams. Using purposeful and convenience sampling, 18 participants in a strengths-oriented intervention from 2 different regions of the Pacific Northwest were selected. A…

  14. 26 CFR 20.2045-1 - Applicability to pre-existing transfers or interests.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 26 Internal Revenue 14 2013-04-01 2013-04-01 false Applicability to pre-existing transfers or interests. 20.2045-1 Section 20.2045-1 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED) ESTATE AND GIFT TAXES ESTATE TAX; ESTATES OF DECEDENTS DYING AFTER AUGUST 16, 1954 Gross...

  15. 26 CFR 20.2045-1 - Applicability to pre-existing transfers or interests.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 26 Internal Revenue 14 2010-04-01 2010-04-01 false Applicability to pre-existing transfers or interests. 20.2045-1 Section 20.2045-1 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED) ESTATE AND GIFT TAXES ESTATE TAX; ESTATES OF DECEDENTS DYING AFTER AUGUST 16, 1954 Gross...

  16. 26 CFR 20.2045-1 - Applicability to pre-existing transfers or interests.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 26 Internal Revenue 14 2012-04-01 2012-04-01 false Applicability to pre-existing transfers or interests. 20.2045-1 Section 20.2045-1 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED) ESTATE AND GIFT TAXES ESTATE TAX; ESTATES OF DECEDENTS DYING AFTER AUGUST 16, 1954 Gross...

  17. 26 CFR 20.2045-1 - Applicability to pre-existing transfers or interests.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 26 Internal Revenue 14 2014-04-01 2013-04-01 true Applicability to pre-existing transfers or interests. 20.2045-1 Section 20.2045-1 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED) ESTATE AND GIFT TAXES ESTATE TAX; ESTATES OF DECEDENTS DYING AFTER AUGUST 16, 1954 Gross...

  18. 26 CFR 20.2045-1 - Applicability to pre-existing transfers or interests.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 26 Internal Revenue 14 2011-04-01 2010-04-01 true Applicability to pre-existing transfers or interests. 20.2045-1 Section 20.2045-1 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED) ESTATE AND GIFT TAXES ESTATE TAX; ESTATES OF DECEDENTS DYING AFTER AUGUST 16, 1954 Gross...

  19. Using an Electronic Highlighter to Eliminate the Negative Effects of Pre-Existing, Inappropriate Highlighting

    ERIC Educational Resources Information Center

    Gier, Vicki; Kreiner, David; Hudnell, Jason; Montoya, Jodi; Herring, Daniel

    2011-01-01

    The purpose of the present experiment was to determine whether using an active learning technique, electronic highlighting, can eliminate the negative effects of pre-existing, poor highlighting on reading comprehension. Participants read passages containing no highlighting, appropriate highlighting, or inappropriate highlighting. We hypothesized…

  20. Are There Pre-Existing Neural, Cognitive, or Motoric Markers for Musical Ability?

    ERIC Educational Resources Information Center

    Norton, Andrea; Winner, Ellen; Cronin, Karl; Overy, Katie; Lee, Dennis J.; Schlaug, Gottfried

    2005-01-01

    Adult musician's brains show structural enlargements, but it is not known whether these are inborn or a consequence of long-term training. In addition, music training in childhood has been shown to have positive effects on visual-spatial and verbal outcomes. However, it is not known whether pre-existing advantages in these skills are found in…

  1. When People with Pre-Existing Disabilities Age in Place: Implications for Social Work Practice.

    ERIC Educational Resources Information Center

    Gilson, Stephen French; Netting, F. Ellen

    1997-01-01

    Focuses on a population of disabled people who are aging with pre-existing physical disabilities. Distinguishes between those who experience prolonged aging and those who experience accelerated aging. Provides four case examples to illustrate the practice implications faced by social workers in partnering with people with pre-existing…

  2. An Extraordinary Cause of the Sucking Difficulty: Ecthyma Gangrenosum

    PubMed Central

    Demir, Nihat; Kocaman, Selami; Peker, Erdal; Tuncer, Oğuz

    2016-01-01

    Ecthyma gangrenosum is a cutaneous lesion often associated with pseudomonas aeruginosa bacteremia, even though it may develop without bacteremia and may originate from other bacterial and fungal organisms. Pseudomonas aeruginosa bacteremia or sepsis, which mainly affects immunocompromised patients, frequently occurs in hospitals. This lesion typically occurs on the extremities and gluteal and perineal regions. In this report we present a case of ecthyma gangrenosum in a premature newborn occurring secondary to pseudomonas sepsis causing sucking dysfunction due to tissue loss in the lip, soft palate, and tongue. PMID:27143976

  3. Normal fault growth above pre-existing structures: insights from discrete element modelling

    NASA Astrophysics Data System (ADS)

    Wrona, Thilo; Finch, Emma; Bell, Rebecca; Jackson, Christopher; Gawthorpe, Robert; Phillips, Thomas

    2016-04-01

    In extensional systems, pre-existing structures such as shear zones may affect the growth, geometry and location of normal faults. Recent seismic reflection-based observations from the North Sea suggest that shear zones not only localise deformation in the host rock, but also in the overlying sedimentary succession. While pre-existing weaknesses are known to localise deformation in the host rock, their effect on deformation in the overlying succession is less well understood. Here, we use 3-D discrete element modelling to determine if and how kilometre-scale shear zones affect normal fault growth in the overlying succession. Discrete element models use a large number of interacting particles to describe the dynamic evolution of complex systems. The technique has therefore been applied to describe fault and fracture growth in a variety of geological settings. We model normal faulting by extending a 60×60×30 km crustal rift-basin model including brittle and ductile interactions and gravitation and isostatic forces by 30%. An inclined plane of weakness which represents a pre-existing shear zone is introduced in the lower section of the upper brittle layer at the start of the experiment. The length, width, orientation and dip of the weak zone are systematically varied between experiments to test how these parameters control the geometric and kinematic development of overlying normal fault systems. Consistent with our seismic reflection-based observations, our results show that strain is indeed localised in and above these weak zones. In the lower brittle layer, normal faults nucleate, as expected, within the zone of weakness and control the initiation and propagation of neighbouring faults. Above this, normal faults nucleate throughout the overlying strata where their orientations are strongly influenced by the underlying zone of weakness. These results challenge the notion that overburden normal faults simply form due to reactivation and upwards propagation of pre-existing

  4. U.S. Military Discharges and Pre-existing Personality Disorders: A Health Policy Review.

    PubMed

    Leroux, Todd C

    2015-11-01

    The Department of Defense (DoD) is facing allegations service members were wrongfully discharged for pre-existing personality disorders. From 2001 to 2007, 26,000 enlisted service members were discharged for a pre-existing personality disorder (2.6 % of total discharges). With national media attention of the issue, personality disorder discharges were reduced by 31 % in 2008 with new discharge procedures issued by the DoD. Even with the reduction, a government review found the DoD did not adhere to its discharge protocols. The objective of this paper is to explore personality disorders in the military, analyze various costs to stakeholders, and identify potential policy alternatives. PMID:25378127

  5. Deterioration of pre-existing hemiparesis brought about by subsequent ipsilateral lacunar infarction.

    PubMed

    Ago, T; Kitazono, T; Ooboshi, H; Takada, J; Yoshiura, T; Mihara, F; Ibayashi, S; Iida, M

    2003-08-01

    Mechanisms of post-stroke recovery are still poorly understood. Recent evidence suggests that cortical reorganisation in the unaffected hemisphere plays an important role. A 59 year old man developed a small lacunar infarct in the left corona radiata, which then caused marked deterioration in a pre-existing left hemiparesis that had resulted from an earlier right putaminal haemorrhage. Functional magnetic resonance imaging showed that the paretic left hand grip activated the ipsilateral left motor areas, but not the right hemispheric motor areas. This suggests that partial recovery of the left hemiparesis had been brought about by cortical reorganisation of the left hemisphere and intensification of the uncrossed corticospinal tract. The subsequent small infarct may have damaged the uncrossed tract, thereby causing the pre-existing hemiparesis to deteriorate even further.

  6. Discrete modeling of hydraulic fracturing processes in a complex pre-existing fracture network

    NASA Astrophysics Data System (ADS)

    Kim, K.; Rutqvist, J.; Nakagawa, S.; Houseworth, J. E.; Birkholzer, J. T.

    2015-12-01

    Hydraulic fracturing and stimulation of fracture networks are widely used by the energy industry (e.g., shale gas extraction, enhanced geothermal systems) to increase permeability of geological formations. Numerous analytical and numerical models have been developed to help understand and predict the behavior of hydraulically induced fractures. However, many existing models assume simple fracturing scenarios with highly idealized fracture geometries (e.g., propagation of a single fracture with assumed shapes in a homogeneous medium). Modeling hydraulic fracture propagation in the presence of natural fractures and homogeneities can be very challenging because of the complex interactions between fluid, rock matrix, and rock interfaces, as well as the interactions between propagating fractures and pre-existing natural fractures. In this study, the TOUGH-RBSN code for coupled hydro-mechanical modeling is utilized to simulate hydraulic fracture propagation and its interaction with pre-existing fracture networks. The simulation tool combines TOUGH2, a simulator of subsurface multiphase flow and mass transport based on the finite volume approach, with the implementation of a lattice modeling approach for geomechanical and fracture-damage behavior, named Rigid-Body-Spring Network (RBSN). The discrete fracture network (DFN) approach is facilitated in the Voronoi discretization via a fully automated modeling procedure. The numerical program is verified through a simple simulation for single fracture propagation, in which the resulting fracture geometry is compared to an analytical solution for given fracture length and aperture. Subsequently, predictive simulations are conducted for planned laboratory experiments using rock-analogue (soda-lime glass) samples containing a designed, pre-existing fracture network. The results of a preliminary simulation demonstrate selective fracturing and fluid infiltration along the pre-existing fractures, with additional fracturing in part

  7. Are there pre-existing neural, cognitive, or motoric markers for musical ability?

    PubMed

    Norton, Andrea; Winner, Ellen; Cronin, Karl; Overy, Katie; Lee, Dennis J; Schlaug, Gottfried

    2005-11-01

    Adult musician's brains show structural enlargements, but it is not known whether these are inborn or a consequence of long-term training. In addition, music training in childhood has been shown to have positive effects on visual-spatial and verbal outcomes. However, it is not known whether pre-existing advantages in these skills are found in children who choose to study a musical instrument nor is it known whether there are pre-existing associations between music and any of these outcome measures that could help explain the training effects. To answer these questions, we compared 5- to 7-year-olds beginning piano or string lessons (n=39) with 5- to 7-year-olds not beginning instrumental training (n=31). All children received a series of tests (visual-spatial, non-verbal reasoning, verbal, motor, and musical) and underwent magnetic resonance imaging. We found no pre-existing neural, cognitive, motor, or musical differences between groups and no correlations (after correction for multiple analyses) between music perceptual skills and any brain or visual-spatial measures. However, correlations were found between music perceptual skills and both non-verbal reasoning and phonemic awareness. Such pre-existing correlations suggest similarities in auditory and visual pattern recognition as well a sharing of the neural substrates for language and music processing, most likely due to innate abilities or implicit learning during early development. This baseline study lays the groundwork for an ongoing longitudinal study addressing the effects of intensive musical training on brain and cognitive development, and making it possible to look retroactively at the brain and cognitive development of those children who emerge showing exceptional musical talent. PMID:16054741

  8. Pre-existing condition insurance plan program. Amendment to interim final rule with request for comments.

    PubMed

    2012-08-30

    This document contains an amendment regarding program eligibility to the interim final regulation implementing the Pre-Existing Condition Plan program under provisions of the Patient Protection and Affordable Care Act. In light of a new process recently announced by the Department of Homeland Security, eligibility for the program is being amended so that the program does not inadvertently expand the scope of that process.

  9. Numerical Modelling of Extended Leak-Off Test with a Pre-Existing Fracture

    NASA Astrophysics Data System (ADS)

    Lavrov, A.; Larsen, I.; Bauer, A.

    2016-04-01

    Extended leak-off test (XLOT) is one of the few techniques available for stress measurements in oil and gas wells. Interpretation of the test is often difficult since the results depend on a multitude of factors, including the presence of natural or drilling-induced fractures in the near-well area. Coupled numerical modelling of XLOT has been performed to investigate the pressure behaviour during the flowback phase as well as the effect of a pre-existing fracture on the test results in a low-permeability formation. Essential features of XLOT known from field measurements are captured by the model, including the saw-tooth shape of the pressure vs injected volume curve, and the change of slope in the pressure vs time curve during flowback used by operators as an indicator of the bottomhole pressure reaching the minimum in situ stress. Simulations with a pre-existing fracture running from the borehole wall in the radial direction have revealed that the results of XLOT are quite sensitive to the orientation of the pre-existing fracture. In particular, the fracture initiation pressure and the formation breakdown pressure increase steadily with decreasing angle between the fracture and the minimum in situ stress. Our findings seem to invalidate the use of the fracture initiation pressure and the formation breakdown pressure for stress measurements or rock strength evaluation purposes.

  10. Strain Accommodation and its Relationship to Pre-existing Structures along the Karonga Fault, Malawi

    NASA Astrophysics Data System (ADS)

    Dawson, S.; Laó-Dávila, D. A.; Atekwana, E. A.; Clappe, B.; Johnson, T.; Hull, C. D.; Nyalugwe, V.; Abdelsalam, M. G.; Chindandali, P. R. N.; Salima, J.

    2015-12-01

    The Livingstone border fault, with its 7 km of total displacement, accommodates most of the strain in the northern portion of the Malawi Rift. Its hanging wall is also breaking up, as suggested by the 2009 earthquake sequence in Karonga. This hanging wall block is underlain in part by the NW- and N-striking Mughese Shear Zone. The superposition of new faults on the pre-existing structures makes this area an ideal location to study the effect of the orientation of pre-existing structures on the accommodation of strain in the hanging wall in the western flank of the northern Malawi Rift. We used gravity and aeromagnetic data and remote sensing to map the Precambrian macro-scale structural fabric of the greater Karonga region. Moreover, we mapped mesostructures within the Precambrian and younger rocks. In the northern portion of the Karonga fault, a single east-dipping fault zone with a mean strike of 32° and a 59° dip cuts the Precambrian foliation that has a mean strike of 301° and 79° dip, accommodating the majority of strain in this region. South of the city of Karonga, the Precambrian foliation assumes a NNW average strike that is steeply dipping. Here the Karonga fault disperses from a single fault with a 2 km damage zone to several distinct east- and west-dipping faults over 6 km that strike in the same overall direction as the foliation planes from the Mughese Shear Zone. Karoo rift structures (horsts and grabens) and their associated rock formations could also be reactivated in this area. These relationships suggest that within the Malawi Rift, strain can be accommodated differently based on the nature and orientation of pre-existing structures. The structural fabric surrounding the southern portion of the Karonga fault seems to favor reactivation and strain distribution, whereas strain is localized in the northern portion of the fault zone.

  11. 5 CFR 894.102 - If I have a pre-existing dental or vision condition, may I join FEDVIP?

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 5 Administrative Personnel 2 2014-01-01 2014-01-01 false If I have a pre-existing dental or vision... MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS (CONTINUED) FEDERAL EMPLOYEES DENTAL AND VISION INSURANCE PROGRAM Administration and General Provisions § 894.102 If I have a pre-existing dental or...

  12. 5 CFR 894.102 - If I have a pre-existing dental or vision condition, may I join FEDVIP?

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 5 Administrative Personnel 2 2013-01-01 2013-01-01 false If I have a pre-existing dental or vision... MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS (CONTINUED) FEDERAL EMPLOYEES DENTAL AND VISION INSURANCE PROGRAM Administration and General Provisions § 894.102 If I have a pre-existing dental or...

  13. 5 CFR 894.102 - If I have a pre-existing dental or vision condition, may I join FEDVIP?

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 5 Administrative Personnel 2 2011-01-01 2011-01-01 false If I have a pre-existing dental or vision... MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS (CONTINUED) FEDERAL EMPLOYEES DENTAL AND VISION INSURANCE PROGRAM Administration and General Provisions § 894.102 If I have a pre-existing dental or...

  14. 5 CFR 894.102 - If I have a pre-existing dental or vision condition, may I join FEDVIP?

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 5 Administrative Personnel 2 2012-01-01 2012-01-01 false If I have a pre-existing dental or vision... MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS (CONTINUED) FEDERAL EMPLOYEES DENTAL AND VISION INSURANCE PROGRAM Administration and General Provisions § 894.102 If I have a pre-existing dental or...

  15. 5 CFR 894.102 - If I have a pre-existing dental or vision condition, may I join FEDVIP?

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false If I have a pre-existing dental or vision... MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS (CONTINUED) FEDERAL EMPLOYEES DENTAL AND VISION INSURANCE PROGRAM Administration and General Provisions § 894.102 If I have a pre-existing dental or...

  16. 40 CFR Appendix B to Part 434 - Baseline Determination and Compliance Monitoring for Pre-existing Discharges at Remining Operations

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... Monitoring for Pre-existing Discharges at Remining Operations B Appendix B to Part 434 Protection of.... B Appendix B to Part 434—Baseline Determination and Compliance Monitoring for Pre-existing... per year. d. Accommodating Data Below the Maximum Daily Limit at subpart C of this part. In the...

  17. 40 CFR Appendix B to Part 434 - Baseline Determination and Compliance Monitoring for Pre-existing Discharges at Remining Operations

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... Monitoring for Pre-existing Discharges at Remining Operations B Appendix B to Part 434 Protection of.... B Appendix B to Part 434—Baseline Determination and Compliance Monitoring for Pre-existing... per year. d. Accommodating Data Below the Maximum Daily Limit at subpart C of this part. In the...

  18. Ionization-induced annealing of pre-existing defects in silicon carbide

    PubMed Central

    Zhang, Yanwen; Sachan, Ritesh; Pakarinen, Olli H.; Chisholm, Matthew F.; Liu, Peng; Xue, Haizhou; Weber, William J.

    2015-01-01

    A long-standing objective in materials research is to effectively heal fabrication defects or to remove pre-existing or environmentally induced damage in materials. Silicon carbide (SiC) is a fascinating wide-band gap semiconductor for high-temperature, high-power and high-frequency applications. Its high corrosion and radiation resistance makes it a key refractory/structural material with great potential for extremely harsh radiation environments. Here we show that the energy transferred to the electron system of SiC by energetic ions via inelastic ionization can effectively anneal pre-existing defects and restore the structural order. The threshold determined for this recovery process reveals that it can be activated by 750 and 850 keV Si and C self-ions, respectively. The results conveyed here can contribute to SiC-based device fabrication by providing a room-temperature approach to repair atomic lattice structures, and to SiC performance prediction as either a functional material for device applications or a structural material for high-radiation environments. PMID:26264864

  19. Kinetic Dissection of the Pre-existing Conformational Equilibrium in the Trypsin Fold*

    PubMed Central

    Vogt, Austin D.; Chakraborty, Pradipta; Di Cera, Enrico

    2015-01-01

    Structural biology has recently documented the conformational plasticity of the trypsin fold for both the protease and zymogen in terms of a pre-existing equilibrium between closed (E*) and open (E) forms of the active site region. How such plasticity is manifested in solution and affects ligand recognition by the protease and zymogen is poorly understood in quantitative terms. Here we dissect the E*-E equilibrium with stopped-flow kinetics in the presence of excess ligand or macromolecule. Using the clotting protease thrombin and its zymogen precursor prethrombin-2 as relevant models we resolve the relative distribution of the E* and E forms and the underlying kinetic rates for their interconversion. In the case of thrombin, the E* and E forms are distributed in a 1:4 ratio and interconvert on a time scale of 45 ms. In the case of prethrombin-2, the equilibrium is shifted strongly (10:1 ratio) in favor of the closed E* form and unfolds over a faster time scale of 4.5 ms. The distribution of E* and E forms observed for thrombin and prethrombin-2 indicates that zymogen activation is linked to a significant shift in the pre-existing equilibrium between closed and open conformations that facilitates ligand binding to the active site. These findings broaden our mechanistic understanding of how conformational transitions control ligand recognition by thrombin and its zymogen precursor prethrombin-2 and have direct relevance to other members of the trypsin fold. PMID:26216877

  20. From Pre-Existing Renal Failure to Perioperative Renal Protection: The Anesthesiologist’s Dilemmas

    PubMed Central

    Domi, Rudin; Huti, Gentian; Sula, Hektor; Baftiu, Nehat; Kaci, Myzafer; Bodeci, Artan; Pesha, Albert

    2016-01-01

    Context Pre-existing renal dysfunction presents specific features that anesthesiologists must deal with. Anesthesia and renal function are connected and can interfere with each other. Induced hypotension anesthesia and the toxic effects of anesthetic drugs can further deteriorate renal function. Evidence Acquisition Decreased renal function can prolong anesthetic drug effects by decreased elimination of these drugs. Anesthesia can deteriorate renal function and decreased renal function can interfere with drug elimination leading to their prolonged effect. The anesthesiologist must understand all the physiological aspects of the patient, renal protection, and the relationships between anesthetic drugs and renal function. This review article aims to summarize these aspects. Results Perioperative renal failure and renal protection is a crucial moment in clinical practice of every anesthesiologist. Conclusions Good knowledges for renal function remain a hallmark of daily practice of the anesthesiologist, considering renal function as an important determinant factor in anesthesia practice. PMID:27642570

  1. Pre-existing diabetes and breast cancer prognosis among elderly women

    PubMed Central

    Luo, J; Hendryx, M; Virnig, B; Wen, S; Chlebowski, R; Chen, C; Rohan, T; Tinker, L; Wactawski-Wende, J; Lessin, L; Margolis, K L

    2015-01-01

    Background: The objective of this study was to assess the impact of pre-existing diabetes on breast cancer prognosis. Methods: Women (n=2833) with centrally confirmed invasive breast cancer in the Women's Health Initiative, who were linked to Medicare claims data (CMS) were followed from the date of breast cancer diagnosis to date of death or 20 September 2013. Information on diabetes was identified through the CMS Chronic Condition Warehouse algorithm. Cox proportional hazard regression was used to estimate adjusted hazard ratios for overall mortality. A competing risks model (proportional subdistribution) model was used to estimate hazard ratios for breast cancer-specific mortality. Results: Women with diabetes were more likely to have factors related to delayed diagnosis (less recent mammograms, and more advanced cancer stage) and were less likely to receive radiation therapy. Compared with women without diabetes, women with diabetes had significantly increased risk of overall mortality (HR=1.57, 95% CI: 1.23–2.01) and had nonsignificantly increased risk for breast cancer-specific mortality (HR=1.36, 95% CI: 0.86–2.15) before adjustment for factors related to delayed diagnosis and treatment. Adjustment for these factors resulted in a little change in the association of diabetes with overall mortality risk, but further attenuated the point estimate for breast cancer-specific mortality. Conclusions: Our study provides additional evidence that pre-existing diabetes increases the risk of total mortality among women with breast cancer. Very large studies with data on breast cancer risk factors, screening and diagnostic delays, treatment choices, and the biological influence of diabetes on breast cancer will be needed to determine whether diabetes also increases the risk for breast cancer-specific mortality. PMID:26158425

  2. Severity of pre-existing psychiatric illness and response to the Great East Japan Earthquake.

    PubMed

    Funayama, Michitaka; Mizushima, Jin

    2013-10-01

    Reports have described how psychiatric patients respond to disasters. However, previous reports on the response depending on diagnostic categories have provided no clear consensus. Here we analyzed response to the Great East Japan Earthquake of March 11, 2011, among psychiatric patients in light of severity of pre-existing psychiatric illness. We studied psychiatric change among a population of psychiatric outpatients in Tochigi prefecture, located ~160 km (~100 miles) southeast of the Fukushima nuclear power plant, in an area that suffered moderate damage from the earthquake and radiation. A total of 294 psychiatric outpatients was assessed using the Global Assessment of Functioning (GAF-F). A change of ≥10 points in the GAF-F score was counted as a change in symptoms. The data were stratified by disease category, gender, and GAF-F score and analyzed using the Fisher's exact test. In the 2 months after the earthquake, 5.4% of patients showed evidence of a change in symptoms, with 4.1% worsening and 1.4% improving. Compared with patients having a GAF-F score ≤50, significantly more patients with a score >50 showed evidence of worsening symptoms. No significant difference was found with respect to gender or diagnostic category for patients with worsened or improved symptoms. Our findings reveal that a relatively small percent of patients with pre-existing psychiatric diseases showed evidence of a change in symptoms and that patients with mild-to-moderate psychiatric illness are potentially vulnerable to the impacts of a natural disaster.

  3. Pre-existing astrocytes form functional perisynaptic processes on neurons generated in the adult hippocampus.

    PubMed

    Krzisch, Marine; Temprana, Silvio G; Mongiat, Lucas A; Armida, Jan; Schmutz, Valentin; Virtanen, Mari A; Kocher-Braissant, Jacqueline; Kraftsik, Rudolf; Vutskits, Laszlo; Conzelmann, Karl-Klaus; Bergami, Matteo; Gage, Fred H; Schinder, Alejandro F; Toni, Nicolas

    2015-07-01

    The adult dentate gyrus produces new neurons that morphologically and functionally integrate into the hippocampal network. In the adult brain, most excitatory synapses are ensheathed by astrocytic perisynaptic processes that regulate synaptic structure and function. However, these processes are formed during embryonic or early postnatal development and it is unknown whether astrocytes can also ensheathe synapses of neurons born during adulthood and, if so, whether they play a role in their synaptic transmission. Here, we used a combination of serial-section immuno-electron microscopy, confocal microscopy, and electrophysiology to examine the formation of perisynaptic processes on adult-born neurons. We found that the afferent and efferent synapses of newborn neurons are ensheathed by astrocytic processes, irrespective of the age of the neurons or the size of their synapses. The quantification of gliogenesis and the distribution of astrocytic processes on synapses formed by adult-born neurons suggest that the majority of these processes are recruited from pre-existing astrocytes. Furthermore, the inhibition of astrocytic glutamate re-uptake significantly reduced postsynaptic currents and increased paired-pulse facilitation in adult-born neurons, suggesting that perisynaptic processes modulate synaptic transmission on these cells. Finally, some processes were found intercalated between newly formed dendritic spines and potential presynaptic partners, suggesting that they may also play a structural role in the connectivity of new spines. Together, these results indicate that pre-existing astrocytes remodel their processes to ensheathe synapses of adult-born neurons and participate to the functional and structural integration of these cells into the hippocampal network.

  4. Effects of Pre-Existing Target Structure on the Formation of Large Craters

    NASA Technical Reports Server (NTRS)

    Barnouin-Jha, O. S.; Cintala, M. J.; Crawford, D. A.

    2003-01-01

    The shapes of large-scale craters and the mechanics responsible for melt generation are influenced by broad and small-scale structures present in a target prior to impact. For example, well-developed systems of fractures often create craters that appear square in outline, good examples being Meteor Crater, AZ and the square craters of 433 Eros. Pre-broken target material also affects melt generation. Kieffer has shown how the shock wave generated in Coconino sandstone at Meteor crater created reverberations which, in combination with the natural target heterogeneity present, created peaks and troughs in pressure and compressed density as individual grains collided to produce a range of shock mineralogies and melts within neighboring samples. In this study, we further explore how pre-existing target structure influences various aspects of the cratering process. We combine experimental and numerical techniques to explore the connection between the scales of the impact generated shock wave and the pre-existing target structure. We focus on the propagation of shock waves in coarse, granular media, emphasizing its consequences on excavation, crater growth, ejecta production, cratering efficiency, melt generation, and crater shape. As a baseline, we present a first series of results for idealized targets where the particles are all identical in size and possess the same shock impedance. We will also present a few results, whereby we increase the complexities of the target properties by varying the grain size, strength, impedance and frictional properties. In addition, we investigate the origin and implications of reverberations that are created by the presence of physical and chemical heterogeneity in a target.

  5. 40 CFR Appendix B to Part 434 - Baseline Determination and Compliance Monitoring for Pre-existing Discharges at Remining Operations

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS COAL MINING POINT... establishing effluent limitations for pre-existing discharges at coal remining operations, in accordance with the requirements set forth in Subpart G; Coal Remining. The requirements specify that...

  6. 40 CFR Appendix B to Part 434 - Baseline Determination and Compliance Monitoring for Pre-existing Discharges at Remining Operations

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS COAL MINING POINT... establishing effluent limitations for pre-existing discharges at coal remining operations, in accordance with the requirements set forth in subpart G; Coal Remining. The requirements specify that...

  7. Gene Therapy for Mucopolysaccharidosis Type VI Is Effective in Cats Without Pre-Existing Immunity to AAV8

    PubMed Central

    Ferla, Rita; O'Malley, Thomas; Calcedo, Roberto; O'Donnell, Patricia; Wang, Ping; Cotugno, Gabriella; Claudiani, Pamela; Wilson, James M.; Haskins, Mark

    2013-01-01

    Abstract Liver gene transfer with adeno-associated viral (AAV) 2/8 vectors is being considered for therapy of systemic diseases like mucopolysaccharidosis type VI (MPS VI), a lysosomal storage disease due to deficiency of arylsulfatase B (ARSB). We have previously reported that liver gene transfer with AAV2/8 results in sustained yet variable expression of ARSB. We hypothesized that the variability we observed could be due to pre-existing immunity to wild-type AAV8. To test this, we compared the levels of AAV2/8-mediated transduction in MPS VI cats with and without pre-existing immunity to AAV8. In addition, since levels of lysosomal enzymes as low as 5% of normal are expected to be therapeutic, we evaluated the impact of pre-existing immunity on MPS VI phenotypic rescue. AAV2/8 administration to MPS VI cats without pre-existing neutralizing antibodies to AAV8 resulted in consistent and dose-dependent expression of ARSB, urinary glycosaminoglycan (GAG) reduction, and femur length amelioration. Conversely, animals with pre-existing immunity to AAV8 showed low levels of ARSB expression and limited phenotypic improvement. Our data support the use of AAV2/8-mediated gene transfer for MPS VI and other systemic diseases, and highlight that pre-existing immunity to AAV8 should be considered in determining subject eligibility for therapy. PMID:23194248

  8. Pre-existing diseases of patients increase susceptibility to hypoxemia during gastrointestinal endoscopy.

    PubMed

    Long, Yanhua; Liu, Hui-Hui; Yu, Changhong; Tian, Xia; Yang, Yi-Ran; Wang, Cheng; Pan, Yajuan

    2012-01-01

    Hypoxemia is the most common adverse event that happened during gastrointestinal endoscopy. To estimate risk of hypoxemia prior to endoscopy, American Society of Anesthesiology (ASA) classification scores were used as a major predictive factor. But the accuracy of ASA scores for predicting hypoxemia incidence was doubted here, considering that the classification system ignores much information about general health status and fitness of patient that may contribute to hypoxemia. In this retrospective review of clinical data collected prospectively, the data on 4904 procedures were analyzed. The Pearson's chi-square test or the Fisher exact test was employed to analyze variance of categorical factors. Continuous variables were statistically evaluated using t-tests or Analysis of variance (ANOVA). As a result, only 245 (5.0%) of the enrolled 4904 patients were found to present hypoxemia during endoscopy. Multivariable logistic regressions revealed that independent risk factors for hypoxemia include high BMI (BMI 30 versus 20, Odd ratio: 1.52, 95% CI: 1.13-2.05; P = 0.0098), hypertension (Odd ratio: 2.28, 95% CI: 1.44-3.60; P = 0.0004), diabetes (Odd ratio: 2.37, 95% CI: 1.30-4.34; P = 0.005), gastrointestinal diseases (Odd ratio: 1.77, 95% CI: 1.21-2.60; P = 0.0033), heart diseases (Odd ratio: 1.97, 95% CI: 1.06-3.68; P = 0.0325) and the procedures that combined esophagogastroduodenoscopy (EGD) and colonoscopy (Odd ratio: 4.84, 95% CI: 1.61-15.51; P = 0.0292; EGD as reference). It is noteworthy that ASA classification scores were not included as an independent predictive factor, and susceptibility of youth to hypoxemia during endoscopy was as high as old subjects. In conclusion, some certain pre-existing diseases of patients were newly identified as independent risk factors for hypoxemia during GI endoscopy. High ASA scores are a confounding predictive factor of pre-existing diseases. We thus recommend that youth (≤18 yrs), obese patients and

  9. Pre-existing discontinuities and oblique rifting in the Kenya Rift: Comparisons with analogue models.

    NASA Astrophysics Data System (ADS)

    Rolet, J.; Gloaguen, R.; Gloaguen, R.; Dooley, T.; McClay, K.

    2001-12-01

    Oblique rift structures such as the SSE-trending Aswa Transverse Zone in the Kenya rift are poorly understood and are rarely taken into account in geometric and kinematic models for the origin of this rift zone. However, remote sensing demonstrates that transverse structures are quite numerous and have a significant influence on the geometry and segmentation of the rift and the development of faults within or at the boundaries of the oblique zones. The importance of these transverse zones varies depending on their orientation and position with respect to the main rift. The origin of these oblique zones can be directly related to pre-existing fabrics and shear zones in the Precambrian basement and thus act as mechanically distinct structural domains during later extensional events. In order to assess the importance and role of these oblique structures we used optical (SPOT, LANDSAT) and microwave (RADARSAT, ERS) data combined with field observations and measurements. Collected structural data were then compared with scaled physical models of orthogonal and oblique rifting in order to refine the rift model. The data and comparison with physical models suggest that these transverse zones are best described as oblique rift zones where the rift border faults are parallel to the basement grain whereas intra-rift fault systems form orthogonal to the extension direction. This model also implies that the present day extension direction in Kenya is oriented E-W.

  10. Psychological distress in an earthquake-devastated area with pre-existing high rate of suicide.

    PubMed

    Tachibana, Akira; Kitamura, Hideaki; Shindo, Masanobu; Honma, Hiroko; Someya, Toshiyuki

    2014-10-30

    On 12 March 2011 an earthquake devastated the Matsunoyama and Matsudai districts of Tōkamachi City, Niigata, Japan. These areas had high pre-existing suicide rates, especially among the elderly. We investigated whether mental health status became worse among the sufferers 5 months after the earthquake, and what kind of factors were implicated in any changes. A 15-item questionnaire that tapped earthquake-related variables and the Kessler 10 Psychological Distress Scale to measure psychological distress were distributed to 1923 residents aged over 40 years. The mean age (S.D.) of the total 1731 respondents (male, 805; female, 926) was 68.2 (13.1) years. Of these, we assessed K10 scores from 1346 respondents. The mean scores (S.D.) for K10 and K6 (six selected items from the K10) were 5.8 (6.3) and 3.4 (3.9), respectively. Among the respondents, 9.1% and 3.2% obtained a score of K10 ≥15 and K6 ≥13, respectively. These scores showed slightly higher psychological distress, especially among the elderly, in comparison with existing community-based data. Categorical regression analysis revealed significant and relatively strong effects of initial psychological impact, decrease in sleep hours, advanced age, and decrease in interpersonal relationships within the community on the K10 score. The last item suggests the importance of socio-environmental factors in post-disaster mental health.

  11. Pre-existing coronary stenoses in patients with first myocardial infarction are not necessarily severe.

    PubMed

    Hackett, D; Davies, G; Maseri, A

    1988-12-01

    The sudden, often unheralded, onset of symptoms in acute myocardial infarction suggests that pre-existing coronary stenoses susceptible to acute thrombosis in the infarct-related artery may not necessarily have been severe. We investigated the severity of residual coronary stenoses after successful thrombolytic recanalization and the relationship to previous symptoms, collateral vessels and the extent of coronary artery disease in 60 consecutive patients at the time of presentation of their first acute myocardial infarction by performing quantitative coronary arteriography before, during and after intracoronary thrombolytic therapy. Recanalization was achieved in 48 (80%) patients with a residual stenosis of 58.1 +/- 10.8% (mean +/- ISD; range 33-82%) obstruction diameter and a minimum lumen calibre of 1.10 +/- 0.3 mm (range 0.39-1.95 mm). A residual stenosis of less than 60% obstruction diameter was present in 28 (47%) patients. When residual stenoses were mild, no acute collateral filling of the occluded artery was observed. After thrombolysis, residual infarct-related coronary stenoses in patients with their first acute myocardial infarction are not necessarily severely obstructive. This raises the problem of identifying which non-obstructive coronary stenoses are likely to occlude suddenly and why they do so.

  12. "Stress" hyperglycaemia during acute myocardial infarction: an indicator of pre-existing diabetes?

    PubMed

    Husband, D J; Alberti, K G; Julian, D G

    1983-07-23

    Hyperglycaemia occurring at admission in patients with suspected acute myocardial infarction is generally held to represent stress hyperglycaemia. 26 patients, not previously known to be diabetic, had blood glucose values greater than or equal to 10 mmol/l on admission to a coronary care unit. 16 survived for 2 months at which time a 75 g oral glucose tolerance test (OGTT) showed diabetes in 10 (63%) and impaired glucose tolerance in 1 (WHO criteria). All those with abnormal glucose tolerance at 2 months had had raised glycosylated haemoglobin (HbA1) (greater than 7.5%) on admission, indicating pre-existing diabetes. All those with a HbA1 level over 8% had abnormal glucose tolerance. 7 of the 10 who died or did not have an OGTT also had raised HbA1 at admission. An admission blood glucose greater than or equal to 10 mmol/l in patients with severe chest pain is more likely to indicate previously undiagnosed diabetes than "stress" hyperglycaemia. There is no evidence that myocardial infarction precipitates diabetes. The glycosylated haemoglobin concentration can be used to distinguish between stress hyperglycaemia and hyperglycaemia caused by diabetes.

  13. Flash-ionization of pre-existing circumstellar material around Nova Oph 2015

    NASA Astrophysics Data System (ADS)

    Munari, U.; Walter, F. M.

    2016-01-01

    We have obtained daily high-resolution Echelle spectroscopy of Nova Oph 2015 during its initial evolution. It reveals the presence of pre-existing circumstellar material around the nova, which can be interpreted as the wind of an evolved companion. On earliest observations, the emission line profiles of Nova Oph 2015 displayed a very narrow emission component (full width at half-maximum [FWHM] ˜ 60 km s-1), recombining over a time-scale of 5 days and showing constant low velocity (RV⊙ = -4.5 km s-1), that we interpret as coming from the wind of the secondary recombining after the ionization from the initial UV-flash of the nova. The underlying broad component underwent a marked reduction in both FWHM and width at zero intensity (the latter declining from 4000 to 2000 km s-1 in 10 days) while increasing by six times in flux, that we believe is the result of the high-velocity ejecta of the nova being slowed down while trying to expand within the surrounding wind of the companion. Nova Oph 2015 is possibly unique among novae with evolved companions in having displayed a long rise to maximum brightness and a slow decline from it, an Fe II-type classification, and a probable sub-giant luminosity class for the secondary.

  14. Phenolic acids in neem (Azadirachta indica): a major pre-existing secondary metabolites.

    PubMed

    Singh, U P; Maurya, S; Singh, D P

    2005-01-01

    High Performance Liquid Chromatographic (HPLC) analyses of various parts (fresh and dry bark of stem, mature and tender leaves, flower and different parts of fruit, i.e., raw and ripe fruit epicarp, mesocarp and seed) of neem (Azadirachta indica), which occupies an important place in socio-cultural-religious life in Indian communities, indicate that neem is rich in pre-existing secondary metabolites (phenolic acids). Dry bark showed only tannic acid but in fresh bark three phenolic acids were observed, i.e., gallic, tannic, and ferulic acids. In tender leaves only gallic and ferulic acids were detected, but the levels of these phenolic acids in mature leaves were about three times and fifty times greater, respectively. Flowers had only two phenolic acids in which gallic acid was maximum followed by chlorogenic acid. The level of phenolic acid was maximum in seeds followed by epicarp and pulp. In raw and ripe fruit seeds four phenolic acids were detected. Raw fruit seeds were rich in phenolic acids than ripe fruit seeds. Fruit epicarp was relatively richer than seed, seed pulp and flowers of the plants. Neem flowers were also rich in gallic and chlorogenic acids. PMID:16093234

  15. The Influence of Pre-existing Deformation on GMA Welding Distortion in Thin Steel Plates

    NASA Astrophysics Data System (ADS)

    Davies, C. M.; Ahn, J.; Tsunori, M.; Dye, D.; Nikbin, K. M.

    2015-01-01

    Weld distortion is particularly problematic for large thin structures that are used in the assembly of ships. The drive toward lighter ships and thinner plate is restricted by the significant increase in distortion as the plate thickness decreases. The influence of pre-existing deformation in the plates to be joined on the resultant distortion in gas metal arc welded structure has been studied. DH-36 steel plate surface profiles were measured before and after the butt welding of two plates 1000 × 500 × 4 mm in size. Three dimensional finite element models that incorporate the initial plate profile have been created to simulate the welding process and to examine the relationship between the final welded plate profiles and the initial deformation present in the plates. Both symmetric and asymmetric models were considered. A significant variation in the unwelded base plates' initial distortion was observed. Generally, it has been found that if an out-of-plane deformation exists in a plate prior to welding, the level of distortion further increases in the same direction following welding. The final distortions are strongly related to the initial plate profiles. The residual stress distributions in the plates are also to some extent affected by the level of distortion initially present.

  16. EVIDENCE FOR PRE-EXISTING DUST IN THE BRIGHT TYPE IIn SN 2010jl

    SciTech Connect

    Andrews, J. E.; Clayton, Geoffrey C.; Clem, J.; Landolt, A. E-mail: landolt@phys.lsu.edu E-mail: jclem@phys.lsu.edu

    2011-08-15

    SN 2010jl was an extremely bright, Type IIn supernova (SN) which showed a significant infrared (IR) excess no later than 90 days after explosion. We have obtained Spitzer 3.6 and 4.5 {mu}m and JHK observations of SN 2010jl {approx}90 days post-explosion. Little to no reddening in the host galaxy indicated that the circumstellar material lost from the progenitor must lie in a torus inclined out of the plane of the sky. The likely cause of the high mid-IR flux is the reprocessing of the initial flash of the SN by pre-existing circumstellar dust. Using a three-dimensional Monte Carlo radiative-transfer code, we have estimated that between 0.03 and 0.35 M{sub sun} of dust exists in a circumstellar torus around the SN located 6 x 10{sup 17} cm away from the SN and inclined between 60 deg. and 80 deg. to the plane of the sky. On day 90, we are only seeing the illumination of approximately 5% of this torus, and expect to see an elevated IR flux from this material up until day {approx} 450. It is likely this dust was created in a luminous blue variable (LBV) like mass-loss event of more than 3 M{sub sun}, which is large but consistent with other LBV progenitors such as {eta} Carinae.

  17. Solid particle impingement erosion characteristics of cylindrical surfaces, pre-existing holes and slits

    NASA Technical Reports Server (NTRS)

    Rao, P. V.; Buckley, D. H.

    1983-01-01

    The erosion characteristics of aluminum cylinders sand-blasted with both spherical and angular erodent particles were studied and compared with results from previously studied flat surfaces. The cylindrical results are discussed with respect to impact conditions. The relationship between erosion rate and pit morphology (width, depth, and width to depth ratio) is established. The aspects of (1) erosion rate versus time curves on cylindrical surfaces; (2) long-term exposures; and (3) erosion rate versus time curves with spherical and angular particles are presented. The erosion morphology and characteristics of aluminum surfaces with pre-existing circular cylindrical and conical holes of different sizes were examined using weight loss measurements, scanning electron microscopy, a profilometer, and a depth gage. The morphological features (radial and concentric rings) are discussed with reference to flat surfaces, and the erosion features with spherical microglass beads. The similarities and differences of erosion and morphological features are highlighted. The erosion versus time curves of various shapes of holes are discussed and are compared with those of a flat surface. The erosion process at slits is considered.

  18. Condensational uptake of semivolatile organic compounds in gasoline engine exhaust onto pre-existing inorganic particles

    NASA Astrophysics Data System (ADS)

    Li, S.-M.; Liggio, J.; Graham, L.; Lu, G.; Brook, J.; Stroud, C.; Zhang, J.; Makar, P.; Moran, M. D.

    2011-01-01

    This paper presents the results of laboratory studies on the condensational uptake of gaseous organic compounds in the exhaust of a light-duty gasoline engine onto preexisting sulfate and nitrate seed particles. Significant condensation of the gaseous organic compounds in the exhaust occurs onto pre-existing inorganic particles on a time scale of 2-5 min. The amount of condensed organic mass (COM) is proportional to the seed particle mass, suggesting that the uptake is due to dissolution, not adsorption. The solubility decreases as a power function with increased dilution of the exhaust, ranging from 0.23 g/g at a dilution ratio of 81, to 0.025 g/g at a dilution ratio of 2230. The solubility increases nonlinearly with increasing concentration of the total hydrocarbons in the gas phase (THC), rising from 0.12 g/g to 0.26 g/g for a CTHC increase of 1 to 18 μg m-3, suggesting that more organics are partitioned into the particles at higher gas phase concentrations. In terms of gas-particle partitioning, the condensational uptake of THC gases in gasoline engine exhaust can account for up to 30% of the total gas+particle THC. By incorporating the present findings, regional air quality modelling results suggest that the condensational uptake of THC onto sulfate particles alone can be comparable to the primary particle mass under moderately polluted ambient conditions. These findings are important for modelling and regulating the air quality impacts of gasoline vehicular emissions.

  19. Modulation of a pre-existing conformational equilibrium tunes adenylate kinase activity.

    PubMed

    Ådén, Jörgen; Verma, Abhinav; Schug, Alexander; Wolf-Watz, Magnus

    2012-10-10

    Structural plasticity is often required for distinct microscopic steps during enzymatic reaction cycles. Adenylate kinase from Escherichia coli (AK(eco)) populates two major conformations in solution; the open (inactive) and closed (active) state, and the overall turnover rate is inversely proportional to the lifetime of the active conformation. Therefore, structural plasticity is intimately coupled to enzymatic turnover in AK(eco). Here, we probe the open to closed conformational equilibrium in the absence of bound substrate with NMR spectroscopy and molecular dynamics simulations. The conformational equilibrium in absence of substrate and, in turn, the turnover number can be modulated with mutational- and osmolyte-driven perturbations. Removal of one hydrogen bond between the ATP and AMP binding subdomains results in a population shift toward the open conformation and a resulting increase of k(cat). Addition of the osmolyte TMAO to AK(eco) results in population shift toward the closed conformation and a significant reduction of k(cat). The Michaelis constants (K(M)) scale with the change in k(cat), which follows from the influence of the population of the closed conformation for substrate binding affinity. Hence, k(cat) and K(M) are mutually dependent, and in the case of AK(eco), any perturbation that modulates k(cat) is mirrored with a proportional response in K(M). Thus, our results demonstrate that the equilibrium constant of a pre-existing conformational equilibrium directly affects enzymatic catalysis. From an evolutionary perspective, our findings suggest that, for AK(eco), there exists ample flexibility to obtain a specificity constant (k(cat)/K(M)) that commensurate with the exerted cellular selective pressure.

  20. Co-option of pre-existing vascular beds in adipose tissue controls tumor growth rates and angiogenesis.

    PubMed

    Lim, Sharon; Hosaka, Kayoko; Nakamura, Masaki; Cao, Yihai

    2016-06-21

    Many types of cancer develop in close association with highly vascularized adipose tissues. However, the role of adipose pre-existing vascular beds on tumor growth and angiogenesis is unknown. Here we report that pre-existing microvascular density in tissues where tumors originate is a crucial determinant for tumor growth and neovascularization. In three independent tumor types including breast cancer, melanoma, and fibrosarcoma, inoculation of tumor cells in the subcutaneous tissue, white adipose tissue (WAT), and brown adipose tissue (BAT) resulted in markedly differential tumor growth rates and angiogenesis, which were in concordance with the degree of pre-existing vascularization in these tissues. Relative to subcutaneous tumors, WAT and BAT tumors grew at accelerated rates along with improved neovascularization, blood perfusion, and decreased hypoxia. Tumor cells implanted in adipose tissues contained leaky microvessel with poor perivascular cell coverage. Thus, adipose vasculature predetermines the tumor microenvironment that eventually supports tumor growth.

  1. Prevalence of methicillin-resistant staphylococci in canine pyoderma cases in primary care veterinary practices in Canada: A preliminary study

    PubMed Central

    Joffe, Daniel; Goulding, Fiona; Langelier, Ken; Magyar, Gabor; McCurdy, Les; Milstein, Moe; Nielsen, Kia; Villemaire, Stephanie

    2015-01-01

    Pyoderma in dogs is most commonly caused by Staphylococcus spp., and significant emergence of methicillin resistance in staphylococcal pyoderma has been reported. This preliminary study of the prevalence of methicillin resistance in canine pyoderma cases in Canadian primary care veterinary practices revealed that methicillin-resistant Staphylococcus spp. were present in 12.1% of 149 staphylococcal positive skin culture cases. PMID:26483585

  2. Palmoplantar keratoderma with progressive gingivitis and recurrent pyodermas.

    PubMed

    Moss, Tyler A; Spillane, Anne P; Almquist, Sam F; McCleskey, Patrick E; Wisco, Oliver J

    2014-04-01

    Papillon-Lefèvre syndrome (PLS) is a rare inherited palmoplantar keratoderma (PPK) that is associated with progressive gingivitis and recurrent pyodermas. We present a case exhibiting classic features of this autosomal-recessive condition and review the current understanding of its pathophysiology, diagnosis, and treatment. Additionally, a review of pertinent transgredient PPKs is undertaken, with key and distinguishing features of each syndrome highlighted.

  3. Skin disorders, including pyoderma, scabies, and tinea infections.

    PubMed

    Andrews, Ross M; McCarthy, James; Carapetis, Jonathan R; Currie, Bart J

    2009-12-01

    Pyoderma, scabies, and tinea are common childhood skin disorders too often considered to be merely of nuisance value. More than 111 million children are believed to have pyoderma, with many also co-infected with scabies, tinea, or both. These skin disorders cannot be differentiated by ethnicity or socioeconomic status but, in high-prevalence areas, poverty and overcrowded living conditions are important underlying social determinants. Each is transmitted primarily through direct skin-to-skin contact. For many Indigenous children, these skin conditions are part of everyday life. Although rarely directly resulting in hospitalization or death, there is a high and largely unmet demand for effective management at the primary health-care level, particularly for pyoderma and scabies. Despite particularly high prevalence in some settings, treatment is not sought for many children, and when sought, the clinical benefit from such consultations is variable. The lack of standard, evidence-based recommendations is of much concern. The current evidence base for clinical diagnosis and treatment of these common childhood skin disorders is highlighted.

  4. Increased Susceptibility to Chemical Toxicity with (Pre-existing) Diseases: Case Studies with Particulate Matter, Cadmium, Mercury, Trichloroethylene and Dioxin

    EPA Science Inventory

    Numerous host and environmental factors may modulate vulnerability and risk. An area of increasing interest to risk assessors is the potential for chemicals to interact with pre-existing diseases and aging that may yield cumulative damage, altered chemical response, and increas...

  5. Increased Susceptibility to Chemical Toxicity with Pre-existing Diseases: Case Studies with Particulate Matter, Cadmium, Mercury, Trichloroethylene and Dioxin

    EPA Science Inventory

    Numerous host and environmental factors may modulate vulnerability and risk. An area of increasing interest to risk assessors is the potential for chemicals to interact with pre-existing diseases and aging that may yield cumulative damage, altered chemical response, and increase...

  6. Parasitic folds with wrong vergence: How pre-existing geometrical asymmetries can be inherited during multilayer buckle folding

    NASA Astrophysics Data System (ADS)

    Frehner, Marcel; Schmid, Timothy

    2016-06-01

    Parasitic folds are typical structures in geological multilayer folds; they are characterized by a small wavelength and are situated within folds with larger wavelength. Parasitic folds exhibit a characteristic asymmetry (or vergence) reflecting their structural relationship to the larger-scale fold. Here we investigate if a pre-existing geometrical asymmetry (e.g., from sedimentary structures or folds from a previous tectonic event) can be inherited during buckle folding to form parasitic folds with wrong vergence. We conduct 2D finite-element simulations of multilayer folding using Newtonian materials. The applied model setup comprises a thin layer exhibiting the pre-existing geometrical asymmetry sandwiched between two thicker layers, all intercalated with a lower-viscosity matrix and subjected to layer-parallel shortening. When the two outer thick layers buckle and amplify, two processes work against the asymmetry: layer-perpendicular flattening between the two thick layers and the rotational component of flexural flow folding. Both processes promote de-amplification and unfolding of the pre-existing asymmetry. We discuss how the efficiency of de-amplification is controlled by the larger-scale fold amplification and conclude that pre-existing asymmetries that are open and/or exhibit low amplitude are prone to de-amplification and may disappear during buckling of the multilayer system. Large-amplitude and/or tight to isoclinal folds may be inherited and develop type 3 fold interference patterns.

  7. A Clinico-Bacteriological Study of Pyodermas at a Tertiary Health Center in Southwest Rajasthan

    PubMed Central

    Singh, Ajit; Gupta, Lalit Kumar; Khare, Ashok Kumar; Mittal, Asit; Kuldeep, CM; Balai, Manisha

    2015-01-01

    Background: The spectrum of pyoderma changes constantly, and so does the antibiotic susceptibility pattern. Aims: This study was done to assess the magnitude and clinical patterns of pyodermas, their causative micro-organisms, and the antibiotic susceptibility patterns. Materials and Methods: Five hundred consecutive, clinically diagnosed and untreated cases of pyoderma, attending the Dermatology OPD of RNT Medical College and MB Government Hospital, Udaipur, from October 2010 to September 2011 were the subjects of this study. A detailed clinical examination, and relevant investigations including bacterial culture and sensitivity, were carried out and recorded. Statistical Analysis: For statistical analysis of data, the software ‘EPI-INFO Version 6’ was used, and Chi-square (χ2) test was applied. Results: Of 19576 cases attending skin OPD during the study period, pyoderma was seen in 500 patients; the incidence being 2.55%. Males outnumbered females. The highest number of cases (109; 21.8%) was observed in 1st decade. Lower extremities were the commonest site of predilection. Primary pyodermas outnumbered secondary pyodermas. Furuncle (136; 27.2%) and infectious eczematoid dermatitis (62; 12.4%) were the commonest entities among primary and secondary pyoderma respectively. Staphylococcus aureus was the commonest causative agent in both primary and secondary pyoderma. It showed high susceptibility to amoxycillin + sulbactam, aminoglycosides and cefoperazone, moderate susceptibility to linezolid, while low susceptibility to fluoroquinolones and cephalexin. Conclusion: Such studies help to assess the changing trend of bacterial infections, their causative organisms and antibiotic susceptibility pattern. PMID:26538696

  8. Spontaneous pre-existing hypoxia does not affect brain damage after global cerebral ischaemia in late-gestation fetal sheep.

    PubMed

    Davidson, Joanne O; Yuill, Caroline A; Wassink, Guido; Bennet, Laura; Gunn, Alistair J

    2015-01-01

    There is considerable evidence that a mild, non-injurious insult can protect (precondition) against a subsequent injurious insult. Typically, protection is seen when the gap between insults is several days to a week. However, the effect of mild but persistent hypoxia is unknown. In this study we examined the hypothesis that mild pre-existing hypoxia (PaO2<17 mm Hg) would reduce neural injury in chronically instrumented late-gestation (0.85 gestation) fetal sheep exposed to 30 min of global cerebral ischaemia induced by bilateral carotid artery occlusion (normoxia: n=9 vs. pre-existing hypoxia: n=9) or normoxia plus sham ischaemia (sham controls: n=9). Histopathology was assessed after 7 days of recovery. Fetuses with pre-existing hypoxia had lower PaO2 values (16.1±0.6 vs. 26.0±1.1 mm Hg) and were lighter at post-mortem (4,033±412 vs. 5,261±238 g) compared to normoxic fetuses. Cerebral ischaemia was associated with secondary cortical oedema and seizures, reduced final EEG power, loss of sleep state cycling, and significant loss of neurons and oligodendrocytes, with no significant effect of pre-existing hypoxia. Pre-existing hypoxia was associated with a significantly attenuated rise in mean arterial pressure between 18 and 36 h and slower resolution of cortical oedema between 96 and 150 h after ischaemia. These data suggest that chronic hypoxia is not associated with a significant preconditioning effect.

  9. The experience of altered states of consciousness in shamanic ritual: the role of pre-existing beliefs and affective factors.

    PubMed

    Polito, Vince; Langdon, Robyn; Brown, Jac

    2010-12-01

    Much attention has been paid recently to the role of anomalous experiences in the aetiology of certain types of psychopathology, e.g. in the formation of delusions. We examine, instead, the top-down influence of pre-existing beliefs and affective factors in shaping an individual's characterisation of anomalous sensory experiences. Specifically we investigated the effects of paranormal beliefs and alexithymia in determining the intensity and quality of an altered state of consciousness (ASC). Fifty five participants took part in a sweat lodge ceremony, a traditional shamanic ritual which was unfamiliar to them. Participants reported significant alterations in their state of consciousness, quantified using the 'APZ' questionnaire, a standardized measure of ASC experience. Participants endorsing paranormal beliefs compatible with shamanic mythology, and those showing difficulty identifying feelings scored higher on positive dimensions of ASC experience. Our findings demonstrate that variation in an individual's characterisation of anomalous experiences is nuanced by pre-existing beliefs and affective factors.

  10. Rapid selective sweep of pre-existing polymorphisms and slow fixation of new mutations in experimental evolution of Desulfovibrio vulgaris

    PubMed Central

    Zhou, Aifen; Hillesland, Kristina L; He, Zhili; Schackwitz, Wendy; Tu, Qichao; Zane, Grant M; Ma, Qiao; Qu, Yuanyuan; Stahl, David A; Wall, Judy D; Hazen, Terry C; Fields, Matthew W; Arkin, Adam P; Zhou, Jizhong

    2015-01-01

    To investigate the genetic basis of microbial evolutionary adaptation to salt (NaCl) stress, populations of Desulfovibrio vulgaris Hildenborough (DvH), a sulfate-reducing bacterium important for the biogeochemical cycling of sulfur, carbon and nitrogen, and potentially the bioremediation of toxic heavy metals and radionuclides, were propagated under salt stress or non-stress conditions for 1200 generations. Whole-genome sequencing revealed 11 mutations in salt stress-evolved clone ES9-11 and 14 mutations in non-stress-evolved clone EC3-10. Whole-population sequencing data suggested the rapid selective sweep of the pre-existing polymorphisms under salt stress within the first 100 generations and the slow fixation of new mutations. Population genotyping data demonstrated that the rapid selective sweep of pre-existing polymorphisms was common in salt stress-evolved populations. In contrast, the selection of pre-existing polymorphisms was largely random in EC populations. Consistently, at 100 generations, stress-evolved population ES9 showed improved salt tolerance, namely increased growth rate (2.0-fold), higher biomass yield (1.8-fold) and shorter lag phase (0.7-fold) under higher salinity conditions. The beneficial nature of several mutations was confirmed by site-directed mutagenesis. All four tested mutations contributed to the shortened lag phases under higher salinity condition. In particular, compared with the salt tolerance improvement in ES9-11, a mutation in a histidine kinase protein gene lytS contributed 27% of the growth rate increase and 23% of the biomass yield increase while a mutation in hypothetical gene DVU2472 contributed 24% of the biomass yield increase. Our results suggested that a few beneficial mutations could lead to dramatic improvements in salt tolerance. PMID:25848870

  11. Pre-existing differences in motivation for food and sensitivity to cocaine-induced locomotion in obesity-prone rats.

    PubMed

    Vollbrecht, Peter J; Nobile, Cameron W; Chadderdon, Aaron M; Jutkiewicz, Emily M; Ferrario, Carrie R

    2015-12-01

    Obesity is a significant problem in the United States, with roughly one third of adults having a body mass index (BMI) over thirty. Recent evidence from human studies suggests that pre-existing differences in the function of mesolimbic circuits that mediate motivational processes may promote obesity and hamper weight loss. However, few preclinical studies have examined pre-existing neurobehavioral differences related to the function of mesolimbic systems in models of individual susceptibility to obesity. Here, we used selectively bred obesity-prone and obesity-resistant rats to examine 1) the effect of a novel "junk-food" diet on the development of obesity and metabolic dysfunction, 2) over-consumption of "junk-food" in a free access procedure, 3) motivation for food using instrumental procedures, and 4) cocaine-induced locomotor activity as an index of general mesolimbic function. As expected, eating a sugary, fatty, "junk-food" diet exacerbated weight gain and increased fasted insulin levels only in obesity-prone rats. In addition, obesity-prone rats continued to over-consume junk-food during discrete access testing, even when this same food was freely available in the home cage. Furthermore, when asked to press a lever to obtain food in an instrumental task, rates of responding were enhanced in obesity-prone versus obesity-resistant rats. Finally, obesity-prone rats showed a stronger locomotor response to 15 mg/kg cocaine compared to obesity-resistant rats prior to any diet manipulation. This enhanced sensitivity to this dose of cocaine is indicative of basal differences in the function of mesolimbic circuits in obesity-prone rats. We speculate that pre-existing differences in motivational systems may contribute to over-consumption and enhanced motivation in susceptible individuals. PMID:26423787

  12. Pre-existing differences in motivation for food and sensitivity to cocaine-induced locomotion in obesity-prone rats.

    PubMed

    Vollbrecht, Peter J; Nobile, Cameron W; Chadderdon, Aaron M; Jutkiewicz, Emily M; Ferrario, Carrie R

    2015-12-01

    Obesity is a significant problem in the United States, with roughly one third of adults having a body mass index (BMI) over thirty. Recent evidence from human studies suggests that pre-existing differences in the function of mesolimbic circuits that mediate motivational processes may promote obesity and hamper weight loss. However, few preclinical studies have examined pre-existing neurobehavioral differences related to the function of mesolimbic systems in models of individual susceptibility to obesity. Here, we used selectively bred obesity-prone and obesity-resistant rats to examine 1) the effect of a novel "junk-food" diet on the development of obesity and metabolic dysfunction, 2) over-consumption of "junk-food" in a free access procedure, 3) motivation for food using instrumental procedures, and 4) cocaine-induced locomotor activity as an index of general mesolimbic function. As expected, eating a sugary, fatty, "junk-food" diet exacerbated weight gain and increased fasted insulin levels only in obesity-prone rats. In addition, obesity-prone rats continued to over-consume junk-food during discrete access testing, even when this same food was freely available in the home cage. Furthermore, when asked to press a lever to obtain food in an instrumental task, rates of responding were enhanced in obesity-prone versus obesity-resistant rats. Finally, obesity-prone rats showed a stronger locomotor response to 15 mg/kg cocaine compared to obesity-resistant rats prior to any diet manipulation. This enhanced sensitivity to this dose of cocaine is indicative of basal differences in the function of mesolimbic circuits in obesity-prone rats. We speculate that pre-existing differences in motivational systems may contribute to over-consumption and enhanced motivation in susceptible individuals.

  13. Effects of pre-existing discontinuities on the residual strength of rock mass - Insight from a discrete element method simulation

    NASA Astrophysics Data System (ADS)

    Gao, F. Q.; Kang, H. P.

    2016-04-01

    When rock failure is unavoidable, the designer of engineering structures must know and account for the residual strength of the rock mass. This is particularly relevant in underground coal mine openings. Pre-existing discontinuities play an important role in the mechanical behavior of rock masses and thus it is important to understand the effects of such pre-existing discontinuities on the residual strength. For this purpose, the present study demonstrates a numerical analysis using a discrete element method simulation. The numerical results indicate that fracture intensity has no significant influence on the residual strength of jointed rock masses, independent of confining conditions. As confining pressures increase, both peak and residual strengths increase, with residual strength increasing at a faster rate. The finding was further demonstrated by analyzing documented laboratory compressive test data from a variety of rocks along with field data from coal pillars. A comprehensive interpretation of the finding was conducted using a cohesion-weakening-friction-strengthening (CWFS) model. The effect of rock bolts on rock mass strength was also evaluated by using a discrete element method model which suggested that rock bolts can significantly increases residual strength but have limited effect on increasing the peak strength of rock masses.

  14. Induction of mixed chimerism depletes pre-existing and de novo-developed autoreactive B cells in autoimmune NOD mice.

    PubMed

    Racine, Jeremy J; Wang, Miao; Zhang, Mingfeng; Zeng, Defu

    2014-06-01

    Destruction of pancreatic islet β-cells in type 1 diabetes (T1D) is mainly mediated by autoimmune T and B lymphocytes. We reported that induction of major histocompatibility complex (MHC)-mismatched mixed chimerism reversed autoimmunity and reestablished thymic negative selection of autoreactive T cells in NOD mice, but it is still unclear how mixed chimerism tolerizes autoreactive B cells. The current studies were designed to reveal the mechanisms on how mixed chimerism tolerizes autoreactive B cells in T1D. Accordingly, mixed chimerism was induced in NOD mice through radiation-free nonmyeloablative anti-CD3/CD8 conditioning and infusion of donor CD4(+) T cell-depleted spleen and whole bone marrow (BM) cells or through myeloablative total body irradiation conditioning and reconstitution with T cell-depleted BM cells from donor and host. Kinetic analysis of percentage and yield of preplasma and plasma B cells, newly developed B-cell subsets, and their apoptosis was performed 30-60 days after transplantation. Induction of MHC-mismatched mixed chimerism results in depleting host-type pre-existing preplasma and plasma B cells as well as augmenting apoptosis of immature transitional T1 B cells, including insulin-specific B cells in a donor B cell-dependent manner. Therefore, induction of MHC-mismatched mixed chimerism depletes pre-existing and de novo-developed autoreactive B cells.

  15. Sports Dermatology: Part 1 of 2 Traumatic or Mechanical Injuries, Inflammatory Conditions, and Exacerbations of Pre-existing Conditions

    PubMed Central

    Sivek, Rachel; Marciniak, Brian

    2015-01-01

    Competitive athletes endure extreme bodily stress when participating in sports-related activities. An athlete’s skin is particularly susceptible to a wide array of repetitive physical and environmental stressors that challenge the skin’s protective function. Many unique dermatoses are well-known to the serious athlete due to countless hours of intense physical training, but are frequently unrecognized by many healthcare professionals. Sports dermatology is a distinctive, budding field of dermatology that focuses on dermatoses frequently encountered in athletes. Athletic skin problems are notoriously infectious in nature due to the inherent environment of close-contact physical activity. Nonetheless, other skin conditions can manifest or worsen with recurring mechanical or traumatic injury or exposure to environmental hazards. Additionally, sports-related activities may exacerbate other pre-existing dermatological conditions that may possibly be unknown to the athlete or clinician. The objective of this two-part review is to arm the astute physician with the fundamental knowledge of the range of dermatological conditions distinct to the competitive athlete. Knowledge of these cutaneous conditions in the context of specific sporting events will permit the clinician to manage these unique patients most effectively. Part one will focus on traumatic or mechanical injuries, inflammatory conditions, and exacerbations of pre-existing conditions frequently seen in athletes. PMID:26060516

  16. Investigation on the Automatic Geo-Referencing of Archaeological UAV Photographs by Correlation with Pre-Existing Ortho-Photos

    NASA Astrophysics Data System (ADS)

    Karel, W.; Doneus, M.; Briese, C.; Verhoeven, G.; Pfeifer, N.

    2014-06-01

    We present a method for the automatic geo-referencing of archaeological photographs captured aboard unmanned aerial vehicles (UAVs), termed UPs. We do so by help of pre-existing ortho-photo maps (OPMs) and digital surface models (DSMs). Typically, these pre-existing data sets are based on data that were captured at a widely different point in time. This renders the detection (and hence the matching) of homologous feature points in the UPs and OPMs infeasible mainly due to temporal variations of vegetation and illumination. Facing this difficulty, we opt for the normalized cross correlation coefficient of perspectively transformed image patches as the measure of image similarity. Applying a threshold to this measure, we detect candidates for homologous image points, resulting in a distinctive, but computationally intensive method. In order to lower computation times, we reduce the dimensionality and extents of the search space by making use of a priori knowledge of the data sets. By assigning terrain heights interpolated in the DSM to the image points found in the OPM, we generate control points. We introduce respective observations into a bundle block, from which gross errors i.e. false matches are eliminated during its robust adjustment. A test of our approach on a UAV image data set demonstrates its potential and raises hope to successfully process large image archives.

  17. [Carcinoma in pre-existing Warthin tumors (cystadenolymphoma) of the parotid gland. Classification, pathogenesis and differential diagnosis].

    PubMed

    Seifert, G

    1997-09-01

    Malignant transformation of pre-existing Warthin tumours of the parotid gland in carcinomas is very rare compared with the development of carcinomas in pre-existing pleomorphic adenomas. Five cases examined in the Salivary Gland Register of Hamburg 1965-1996 were classified in 2 cases as mucoepidermoid carcinoma and in each of one case as oncocytic carcinoma, squamous cell carcinoma and acinic cell carcinoma. In the pathogenesis the benign oncocytic epithelial formations at the surface of the cystic spaces are restricted by malignant neoplastic epithelial cells in the course of which transitions of squamous cell metaplasia or goblet cell metaplasia can be observed. In the further course an infiltrating spread of the carcinoma takes place into the lymphoid stromal component of the Warthin tumour, sometimes also an infiltration of the surrounding tissue und rarely to cervical lymph node metastases. The own findings are analysed concerning the classification of the carcinomas and the differential diagnosis under consideration of the until now reported cases of the literature.

  18. Intractable Postoperative Wounds Caused by Self-Inflicted Trauma in a Patient with Cutaneous Munchausen Syndrome Presenting as a Pyoderma Gangrenosum-Like Lesion

    PubMed Central

    Inui, Keiko; Hanafusa, Takaaki; Namiki, Takeshi; Ueno, Makiko; Igawa, Ken; Yokozeki, Hiroo

    2016-01-01

    A 50-year-old Japanese woman consulted the emergency department of our hospital for bleeding due to an intractable postoperative wound on the lower abdomen; the postoperative wound was owing to a laparoscopic cholecystectomy performed 1 year previously for acute cholecystitis. She presented with a painful ulcer on her right lower abdomen. She also presented with multiple scars, skin grafts on the extremities, and a missing left lower leg, the causes for all of which were unexplained. The results of her blood test were normal, except for the hemoglobin level. Histology of the skin biopsy specimen from the ulcer did not show any specific findings. The previous surgeon who had performed the laparoscopic cholecystectomy revealed that surgical wound dehiscence had occurred during her admission. After a body restraint had been applied, the ulcer improved. Medical records indicated that she had been admitted to the department of plastic surgery at our hospital for skin grafting of a leg ulcer. During that admission, she refused to consult with the department of psychiatry, al-though the staff suspected mental disorders. Therefore, we diagnosed her with cutaneous Munchausen syndrome. After vacuum-assisted closure (VAC) therapy had been performed to prevent her from traumatizing the ulcer again, it rapidly became granulated and reepithelialized. Munchausen syndrome is characterized by feigning physical symptoms to seek attention. Patients self-inflict numerous lesions, keep getting admitted to different hospitals, and feign acute illness, usually spectacular diseases. VAC therapy may be effective for preventing patients with cutaneous Munchausen syndrome from traumatizing their wounds. PMID:27194978

  19. Intractable Postoperative Wounds Caused by Self-Inflicted Trauma in a Patient with Cutaneous Munchausen Syndrome Presenting as a Pyoderma Gangrenosum-Like Lesion.

    PubMed

    Inui, Keiko; Hanafusa, Takaaki; Namiki, Takeshi; Ueno, Makiko; Igawa, Ken; Yokozeki, Hiroo

    2016-01-01

    A 50-year-old Japanese woman consulted the emergency department of our hospital for bleeding due to an intractable postoperative wound on the lower abdomen; the postoperative wound was owing to a laparoscopic cholecystectomy performed 1 year previously for acute cholecystitis. She presented with a painful ulcer on her right lower abdomen. She also presented with multiple scars, skin grafts on the extremities, and a missing left lower leg, the causes for all of which were unexplained. The results of her blood test were normal, except for the hemoglobin level. Histology of the skin biopsy specimen from the ulcer did not show any specific findings. The previous surgeon who had performed the laparoscopic cholecystectomy revealed that surgical wound dehiscence had occurred during her admission. After a body restraint had been applied, the ulcer improved. Medical records indicated that she had been admitted to the department of plastic surgery at our hospital for skin grafting of a leg ulcer. During that admission, she refused to consult with the department of psychiatry, al-though the staff suspected mental disorders. Therefore, we diagnosed her with cutaneous Munchausen syndrome. After vacuum-assisted closure (VAC) therapy had been performed to prevent her from traumatizing the ulcer again, it rapidly became granulated and reepithelialized. Munchausen syndrome is characterized by feigning physical symptoms to seek attention. Patients self-inflict numerous lesions, keep getting admitted to different hospitals, and feign acute illness, usually spectacular diseases. VAC therapy may be effective for preventing patients with cutaneous Munchausen syndrome from traumatizing their wounds. PMID:27194978

  20. Pre-existing Pulmonary Diseases and Survival in Patients With Stage-dependent Lung Adenocarcinoma: A STROBE-compliant Article.

    PubMed

    Jian, Zhi-Hong; Huang, Jing-Yang; Nfor, Oswald Ndi; Jhang, Kai-Ming; Ku, Wen-Yuan; Ho, Chien-Chang; Lung, Chia-Chi; Pan, Hui-Hsien; Liang, Yu-Chiu; Wu, Ming-Fang; Liaw, Yung-Po

    2016-03-01

    Asthma, chronic obstructive pulmonary disease (COPD), and pulmonary tuberculosis (TB) are common lung diseases associated with lung cancer mortality. This study evaluated sex disparities in pre-existing pulmonary diseases and stage-dependent lung adenocarcinoma survival.Patients newly diagnosed with lung adenocarcinoma between 2003 and 2008 were identified using the National Health Insurance Research Database and Cancer Registry. Cases with lung adenocarcinoma were followed until the end of 2010. Survival curves were estimated by the Kaplan-Meier method. Cox proportional-hazard regression was used to calculate the hazard ratio (HR) of pre-existing asthma, COPD, and/or TB, and to estimate all-cause mortality risk in patients with different stages of lung adenocarcinoma.A total of 14,518 cases were identified with lung adenocarcinoma. Specifically, among men, the HRs for TB were 1.69 (95% confidence interval [CI], 1.10-2.58), 1.48 (95% CI, 1.14-1.93), and 1.27 (95% CI, 1.08-1.49) for individuals with stage I + II, III, and IV diseases, respectively. The HRs for asthma were 1.41 (95% CI, 1.00-1.99) in women with stage I + II and 1.14 (95% CI, 1.04-1.26) in men with stage IV disease. For pulmonary disease combinations in men, the HRs were 1.45 (95% CI, 1.12-1.89) for asthma + COPD + TB, 1.35 (95% CI, 1.12-1.63) for COPD + TB, 1.28 (95% CI, 1.01-1.63) for TB, and 1.15 (95%CI, 1.04-1.27) for asthma + COPD, respectively. For women with stage I + II disease, the HR was 6.94 (95% CI, 2.72-17.71) for asthma + COPD + TB.Coexistence of pre-existing pulmonary diseases increased mortality risk in men with adenocarcinoma. TB is at elevated risk of mortality among men with different stages of adenocarcinoma. Asthmatic women with early-stage adenocarcinoma had increased risk of mortality.

  1. Pre-existing Pulmonary Diseases and Survival in Patients With Stage-dependent Lung Adenocarcinoma: A STROBE-compliant Article.

    PubMed

    Jian, Zhi-Hong; Huang, Jing-Yang; Nfor, Oswald Ndi; Jhang, Kai-Ming; Ku, Wen-Yuan; Ho, Chien-Chang; Lung, Chia-Chi; Pan, Hui-Hsien; Liang, Yu-Chiu; Wu, Ming-Fang; Liaw, Yung-Po

    2016-03-01

    Asthma, chronic obstructive pulmonary disease (COPD), and pulmonary tuberculosis (TB) are common lung diseases associated with lung cancer mortality. This study evaluated sex disparities in pre-existing pulmonary diseases and stage-dependent lung adenocarcinoma survival.Patients newly diagnosed with lung adenocarcinoma between 2003 and 2008 were identified using the National Health Insurance Research Database and Cancer Registry. Cases with lung adenocarcinoma were followed until the end of 2010. Survival curves were estimated by the Kaplan-Meier method. Cox proportional-hazard regression was used to calculate the hazard ratio (HR) of pre-existing asthma, COPD, and/or TB, and to estimate all-cause mortality risk in patients with different stages of lung adenocarcinoma.A total of 14,518 cases were identified with lung adenocarcinoma. Specifically, among men, the HRs for TB were 1.69 (95% confidence interval [CI], 1.10-2.58), 1.48 (95% CI, 1.14-1.93), and 1.27 (95% CI, 1.08-1.49) for individuals with stage I + II, III, and IV diseases, respectively. The HRs for asthma were 1.41 (95% CI, 1.00-1.99) in women with stage I + II and 1.14 (95% CI, 1.04-1.26) in men with stage IV disease. For pulmonary disease combinations in men, the HRs were 1.45 (95% CI, 1.12-1.89) for asthma + COPD + TB, 1.35 (95% CI, 1.12-1.63) for COPD + TB, 1.28 (95% CI, 1.01-1.63) for TB, and 1.15 (95%CI, 1.04-1.27) for asthma + COPD, respectively. For women with stage I + II disease, the HR was 6.94 (95% CI, 2.72-17.71) for asthma + COPD + TB.Coexistence of pre-existing pulmonary diseases increased mortality risk in men with adenocarcinoma. TB is at elevated risk of mortality among men with different stages of adenocarcinoma. Asthmatic women with early-stage adenocarcinoma had increased risk of mortality. PMID:26962806

  2. The Concept of Ecthyma Gangrenosum Illustrated by a Fusarium oxysporum Infection in an Immunocompetent Individual.

    PubMed

    Jiang, Yanping; Al-Hatmi, Abdullah M S; Xiang, Yining; Cao, Yu; van den Ende, Albert H G Gerrits; Curfs-Breuker, Ilse; Meis, Jacques F; Lu, Hongguang; de Hoog, G Sybren

    2016-10-01

    Ecthyma gangrenosum (EG) involves necrotic cutaneous lesions caused by bacteria, mainly Pseudomonas aeruginosa, and is usually seen in immunocompromised patients with septicemia. However, clinically similar infections have been published with fungi as etiologic agents. We present a case of an EG-like lesion due to Fusarium oxysporum confirmed by clinical diagnosis, culture and molecular identification and discuss the definition of EG. PMID:27324372

  3. The Association between Pre-existing Diabetes Mellitus and Pressure Ulcers in Patients Following Surgery: A Meta-analysis.

    PubMed

    Kang, Zhou-Qing; Zhai, Xiao-Jie

    2015-08-11

    Uncertainty exists about the role of diabetes in the development of surgery-related pressure ulcers. Therefore, we conducted a meta-analysis to explore the association between pre-existing diabetes mellitus and pressure ulcers among patients after surgery. Summary odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using random effects models. Thirteen eligible studies of 2367 patients in total and 12,053 controls were included in the final analysis. Compared with patients without diabetes, the pooled odds ratio (OR) of the incidence of pressure ulcers in diabetic patients was 1.74 [95% confidence interval (CI) = 1.40-2.15, I(2 )= 51.1%]. Estimates by type of surgery suggested similar results in cardiac surgery [OR = 2.00, 95% CI = 1.42-2.82, I(2 )= 0%], in general surgery [OR = 1.75, 95% CI = 1.42-2.15, I(2 )= 0%], and in major lower limb amputations [OR = 1.65, 95% CI = 1.01-2.68, I(2 )= 0%] for diabetic patients versus non-diabetic controls. We did not find an increased incidence of pressure ulcers in diabetic patients undergoing hip surgery compared with non-diabetic controls [OR = 1.46, 95% CI = 0.62-3.47, I(2 )= 93.1%]. The excess risk of pressure ulcers associated with pre-existing diabetes was significantly higher in patients undergoing surgery, specifically in patients receiving cardiac surgery. Further studies should be conducted to examine these associations in other types of surgery.

  4. Numerical modeling of the seismic response of a large pre-existing landslide in the Marmara region

    NASA Astrophysics Data System (ADS)

    Bourdeau, Céline; Lenti, Luca; Martino, Salvatore

    2015-04-01

    Turkey is one of the geologically most active regions of Europe prone to natural hazards in particular earthquakes and landslides. Detailed seismological studies show that a catastrophic event is now expected in the Marmara region along the North Anatolian Fault Zone (NAFZ). On the shores of the Marmara sea, about 30km East of Istanbul and 15km North from the NAFZ, urbanization is fastly growing despite the presence of pre-existing large landslides. Whether such landslides could be reactivated under seismic shaking is a key question. In the framework of the MARsite European project, we selected one of the most critical landslides namely the Büyükçekmece landslide in order to assess its local seismic response. Based on detailed geophysical and geotechnical field investigations, a high-resolution engineering-geological model of the landslide slope was reconstructed. A numerical modeling was carried out on a longitudinal cross section of this landslide with a 2D finite difference code FLAC in order to assess the local seismic response of the slope and to evaluate the consistency of conditions suitable for the earthquake-induced reactivation of the landslide. The obtained ground-motion amplification pattern along the slope surface is very complex and is strongly influenced by properties changes between the pre-existing landslide mass and the surrounding material. Further comparisons of 2D versus 1D ground-motion amplifications on the one hand and 2D versus topographic site effects on the other hand will shed light on the parameters controlling the spatial variations of ground-motion amplifications along the slope surface.

  5. Pre-existing immunity against swine-origin H1N1 influenza viruses in the general human population

    PubMed Central

    Greenbaum, Jason A.; Kotturi, Maya F.; Kim, Yohan; Oseroff, Carla; Vaughan, Kerrie; Salimi, Nima; Vita, Randi; Ponomarenko, Julia; Scheuermann, Richard H.; Sette, Alessandro; Peters, Bjoern

    2009-01-01

    A major concern about the ongoing swine-origin H1N1 influenza virus (S-OIV) outbreak is that the virus may be so different from seasonal H1N1 that little immune protection exists in the human population. In this study, we examined the molecular basis for pre-existing immunity against S-OIV, namely the recognition of viral immune epitopes by T cells or B cells/antibodies that have been previously primed by circulating influenza strains. Using data from the Immune Epitope Database, we found that only 31% (8/26) of B-cell epitopes present in recently circulating H1N1 strains are conserved in the S-OIV, with only 17% (1/6) conserved in the hemagglutinin (HA) and neuraminidase (NA) surface proteins. In contrast, 69% (54/78) of the epitopes recognized by CD8+ T cells are completely invariant. We further demonstrate experimentally that some memory T-cell immunity against S-OIV is present in the adult population and that such memory is of similar magnitude as the pre-existing memory against seasonal H1N1 influenza. Because protection from infection is antibody mediated, a new vaccine based on the specific S-OIV HA and NA proteins is likely to be required to prevent infection. However, T cells are known to blunt disease severity. Therefore, the conservation of a large fraction of T-cell epitopes suggests that the severity of an S-OIV infection, as far as it is determined by susceptibility of the virus to immune attack, would not differ much from that of seasonal flu. These results are consistent with reports about disease incidence, severity, and mortality rates associated with human S-OIV. PMID:19918065

  6. A Model for Subglacial Flooding Along a Pre-Existing Hydrological Network during the Rapid Drainage of Supraglacial Lakes

    NASA Astrophysics Data System (ADS)

    Adhikari, S.; Tsai, V. C.

    2014-12-01

    Increasingly large numbers of supraglacial lakes form and drain every summer on the Greenland Ice Sheet. Presently, about 15% of the lakes drain rapidly within the timescale of a few hours, and the vertical discharge of water during these events may find a pre-existing subglacial hydrological network, particularly late in the melt season. Here, we present a model for subglacial flooding applied specifically to such circumstances. Given the short timescale of events, we treat ice and bed as purely elastic and assume that the fluid flow in the subglacial conduit is fully turbulent. We evaluate the effect of initial conduit opening, wi, on the rate of flood propagation and along-flow profiles of field variables. We find that floods propagate much faster, particularly in early times, for larger wi. For wi = 10 and 1 cm, for example, floods travel about 68% and 50% farther than in the fully coupled ice/bed scenario after 2 hours of drainage, respectively. Irrespective of the magnitude of wi, we also find that there exists a region of positive pressure gradient. This reversal of pressure gradient draws water in from the farfield and causes the conduit to narrow, respecting mass continuity. While the general shape of the profiles appears similar, greater conduit opening is found for larger wi. For wi = 10 and 1 cm, for example, the elastostatic conduit opening at the point of injection is about 1.39 and 1.26 times that of the fully coupled ice/bed scenario after 2 hours of drainage. The hypothesis of a pre-existing thin film of water is consistent with the spirit of contemporary state-of-the-art continuum models for subglacial hydrology. This also results in avoiding the pressure singularity, which is inherent in classical hydro-fracture models applied to fully coupled ice/bed scenarios, thus opening an avenue for integrating the likes of our model within continuum hydrological models. Furthermore, we foresee that the theory presented can be used to potentially infer

  7. Retargeting pre-existing human antibodies to a bacterial pathogen with an alpha-Gal conjugated aptamer

    PubMed Central

    Kristian, Sascha A.; Hwang, John H.; Hall, Bradley; Leire, Emma; Iacomini, John; Old, Robert; Galili, Uri; Roberts, Charles; Mullis, Kary B.; Westby, Mike; Nizet, Victor

    2015-01-01

    The ever-increasing threat of multi-drug resistant bacterial infections has spurred renewed interest in alternative approaches to classical antibiotic therapy. In contrast to other mammals, humans do not express the galactose-α-1,3-galactosyl-β-1,4-N-acetyl-glucosamine (α-Gal) epitope. As a result of exposure of humans to α-Gal in the environment, a large proportion of circulating antibodies are specific for the trisaccharide. In this study, we examine whether these anti-Gal antibodies can be recruited and redirected to exert anti-bacterial activity. We show that a specific DNA aptamer conjugated to an α-Gal epitope at its 5′ end, herein termed an alphamer, can bind to group A Streptococcus (GAS) bacteria by recognition of a conserved region of the surface-anchored M protein. The anti-GAS alphamer was shown to recruit anti-Gal antibodies to the streptococcal surface in an α-Gal-specific manner, elicit uptake and killing of the bacteria by human phagocytes, and slow growth of invasive GAS in human whole blood. These studies provide a first in vitro proof of concept that alphamers have the potential to redirect pre-existing antibodies to bacteria in a specific manner and trigger an immediate antibacterial immune response. Further validation of this novel therapeutic approach of applying α-Gal technology in in vivo models of bacterial infection is warranted. PMID:25940316

  8. Pre-existing interleukin 10 in cerebral arteries attenuates subsequent brain injury caused by ischemia/reperfusion.

    PubMed

    Liang, Qiu-Juan; Jiang, Mei; Wang, Xin-Hong; Le, Li-Li; Xiang, Meng; Sun, Ning; Meng, Dan; Chen, Si-Feng

    2015-09-01

    Recurrent stroke is difficult to treat and life threatening. Transfer of anti-inflammatory gene is a potential gene therapy strategy for ischemic stroke. Using recombinant adeno-associated viral vector 1 (rAAV1)-mediated interleukin 10 (IL-10), we investigated whether transfer of beneficial gene into the rat cerebral vessels during interventional treatment for initial stroke could attenuate brain injury caused by recurrent stroke. Male Wistar rats were administered rAAV1-IL-10, rAAV1-YFP, or saline into the left cerebral artery. Three weeks after gene transfer, rats were subjected to occlusion of the left middle cerebral artery (MCAO) for 45 min followed by reperfusion for 24 h. IL-10 levels in serum were significantly elevated 3 weeks after rAAV1-IL-10 injection, and virus in the cerebral vessels was confirmed by in situ hybridization. Pre-existing IL-10 but not YFP decreased the neurological dysfunction scores, brain infarction volume, and the number of injured neuronal cells. AAV1-IL-10 transduction increased heme oxygenase (HO-1) mRNA and protein levels in the infarct boundary zone of the brain. Thus, transduction of the IL-10 gene in the cerebral artery prior to ischemia attenuates brain injury caused by ischemia/reperfusion in rats. This preventive approach for recurrent stroke can be achieved during interventional treatment for initial stroke.

  9. Characteristics of Memory B Cells Elicited by a Highly Efficacious HPV Vaccine in Subjects with No Pre-existing Immunity

    PubMed Central

    Scherer, Erin M.; Smith, Robin A.; Simonich, Cassandra A.; Niyonzima, Nixon; Carter, Joseph J.; Galloway, Denise A.

    2014-01-01

    Licensed human papillomavirus (HPV) vaccines provide near complete protection against the types of HPV that most commonly cause anogenital and oropharyngeal cancers (HPV 16 and 18) when administered to individuals naive to these types. These vaccines, like most other prophylactic vaccines, appear to protect by generating antibodies. However, almost nothing is known about the immunological memory that forms following HPV vaccination, which is required for long-term immunity. Here, we have identified and isolated HPV 16-specific memory B cells from female adolescents and young women who received the quadrivalent HPV vaccine in the absence of pre-existing immunity, using fluorescently conjugated HPV 16 pseudoviruses to label antigen receptors on the surface of memory B cells. Antibodies cloned and expressed from these singly sorted HPV 16-pseudovirus labeled memory B cells were predominantly IgG (>IgA>IgM), utilized diverse variable genes, and potently neutralized HPV 16 pseudoviruses in vitro despite possessing only average levels of somatic mutation. These findings suggest that the quadrivalent HPV vaccine provides an excellent model for studying the development of B cell memory; and, in the context of what is known about memory B cells elicited by influenza vaccination/infection, HIV-1 infection, or tetanus toxoid vaccination, indicates that extensive somatic hypermutation is not required to achieve potent vaccine-specific neutralizing antibody responses. PMID:25330199

  10. Multi-epitope Models Explain How Pre-existing Antibodies Affect the Generation of Broadly Protective Responses to Influenza

    PubMed Central

    Zarnitsyna, Veronika I.; Lavine, Jennie; Ellebedy, Ali; Ahmed, Rafi; Antia, Rustom

    2016-01-01

    The development of next-generation influenza vaccines that elicit strain-transcendent immunity against both seasonal and pandemic viruses is a key public health goal. Targeting the evolutionarily conserved epitopes on the stem of influenza’s major surface molecule, hemagglutinin, is an appealing prospect, and novel vaccine formulations show promising results in animal model systems. However, studies in humans indicate that natural infection and vaccination result in limited boosting of antibodies to the stem of HA, and the level of stem-specific antibody elicited is insufficient to provide broad strain-transcendent immunity. Here, we use mathematical models of the humoral immune response to explore how pre-existing immunity affects the ability of vaccines to boost antibodies to the head and stem of HA in humans, and, in particular, how it leads to the apparent lack of boosting of broadly cross-reactive antibodies to the stem epitopes. We consider hypotheses where binding of antibody to an epitope: (i) results in more rapid clearance of the antigen; (ii) leads to the formation of antigen-antibody complexes which inhibit B cell activation through Fcγ receptor-mediated mechanism; and (iii) masks the epitope and prevents the stimulation and proliferation of specific B cells. We find that only epitope masking but not the former two mechanisms to be key in recapitulating patterns in data. We discuss the ramifications of our findings for the development of vaccines against both seasonal and pandemic influenza. PMID:27336297

  11. Influence of pre-existing topography on downflow lava discharge rates estimated from thermal infrared airborne data

    NASA Astrophysics Data System (ADS)

    Lombardo, V.

    2016-04-01

    Remote sensing thermal data of active lava flows allow the evaluation of effusion rates. This is made possible by a simple formula relating the lava effusion rate to the heat flux radiated per unit time from the surface of the flow. Due to the assumptions of the model, this formula implies that heat flux, surface temperature and lava temperature vary as a function of the flow thickness. These relationships, never verified or validated before, have been used by several authors as a proof of the weakness of the model. Here, multispectral infrared and visible imaging spectrometer (MIVIS) high spatial resolution (5-10 m) thermal data acquired during Etna's 2001 eruption were used to investigate downflow heat flux variations in the lava flow emitted from a vent located at 2100 m a.s.l. A high correlation between the downflow heat flux and the lava flow thickness (measured from a pre-existing digital elevation model) was found. Topography beneath the flow appears to play an important role both in lava emplacement mechanisms and flow dynamics. MIVIS-derived downflow effusion rates are consistent with the law of conservation of mass assessing the reliability of remote sensing techniques.

  12. Cross-reactive and pre-existing antibodies to therapeutic antibodies--Effects on treatment and immunogenicity.

    PubMed

    van Schie, Karin A; Wolbink, Gerrit-Jan; Rispens, Theo

    2015-01-01

    The potential for immunogenicity is an ever-present concern during the development of biopharmaceuticals. Therapeutic antibodies occasionally elicit an antibody response in patients, which can result in loss of response or adverse effects. However, antibodies that bind a drug are sometimes found in pre-treatment serum samples, with the amount depending on drug, assay, and patient population. This review summarizes published data on pre-existing antibodies to therapeutic antibodies, including rheumatoid factors, anti-allotype antibodies, anti-hinge antibodies, and anti-glycan antibodies. Unlike anti-idiotype antibodies elicited by the drug, pre-formed antibodies in general appear to have little consequences during treatment. In the few cases where (potential) clinical consequences were encountered, antibodies were characterized and found to bind a distinct, unusual epitope of the therapeutic. Immunogenicity testing strategies should therefore always include a proper level of antibody characterization, especially when pre-formed antibodies are present. This minimizes false-positives, particularly due to rheumatoid factors, and helps to judge the potential threat in case a genuine pre-dose antibody reactivity is identified.

  13. Combinatorial RNA Interference Therapy Prevents Selection of Pre-existing HBV Variants in Human Liver Chimeric Mice.

    PubMed

    Shih, Yao-Ming; Sun, Cheng-Pu; Chou, Hui-Hsien; Wu, Tzu-Hui; Chen, Chun-Chi; Wu, Ping-Yi; Enya Chen, Yu-Chen; Bissig, Karl-Dimiter; Tao, Mi-Hua

    2015-01-01

    Selection of escape mutants with mutations within the target sequence could abolish the antiviral RNA interference activity. Here, we investigated the impact of a pre-existing shRNA-resistant HBV variant on the efficacy of shRNA therapy. We previously identified a highly potent shRNA, S1, which, when delivered by an adeno-associated viral vector, effectively inhibits HBV replication in HBV transgenic mice. We applied the "PICKY" software to systemically screen the HBV genome, then used hydrodynamic transfection and HBV transgenic mice to identify additional six highly potent shRNAs. Human liver chimeric mice were infected with a mixture of wild-type and T472C HBV, a S1-resistant HBV variant, and then treated with a single or combined shRNAs. The presence of T472C mutant compromised the therapeutic efficacy of S1 and resulted in replacement of serum wild-type HBV by T472C HBV. In contrast, combinatorial therapy using S1 and P28, one of six potent shRNAs, markedly reduced titers for both wild-type and T472C HBV. Interestingly, treatment with P28 alone led to the emergence of escape mutants with mutations in the P28 target region. Our results demonstrate that combinatorial RNAi therapy can minimize the escape of resistant viral mutants in chronic HBV patients.

  14. The role of pre-existing disturbances in the effect of marine reserves on coastal ecosystems: a modelling approach.

    PubMed

    Savina, Marie; Condie, Scott A; Fulton, Elizabeth A

    2013-01-01

    We have used an end-to-end ecosystem model to explore responses over 30 years to coastal no-take reserves covering up to 6% of the fifty thousand square kilometres of continental shelf and slope off the coast of New South Wales (Australia). The model is based on the Atlantis framework, which includes a deterministic, spatially resolved three-dimensional biophysical model that tracks nutrient flows through key biological groups, as well as extraction by a range of fisheries. The model results support previous empirical studies in finding clear benefits of reserves to top predators such as sharks and rays throughout the region, while also showing how many of their major prey groups (including commercial species) experienced significant declines. It was found that the net impact of marine reserves was dependent on the pre-existing levels of disturbance (i.e. fishing pressure), and to a lesser extent on the size of the marine reserves. The high fishing scenario resulted in a strongly perturbed system, where the introduction of marine reserves had clear and mostly direct effects on biomass and functional biodiversity. However, under the lower fishing pressure scenario, the introduction of marine reserves caused both direct positive effects, mainly on shark groups, and indirect negative effects through trophic cascades. Our study illustrates the need to carefully align the design and implementation of marine reserves with policy and management objectives. Trade-offs may exist not only between fisheries and conservation objectives, but also among conservation objectives. PMID:23593432

  15. Discovery of a pre-existing molecular filament associated with supernova remnant G127.1+0.5

    SciTech Connect

    Zhou, Xin; Yang, Ji; Fang, Min; Su, Yang

    2014-08-20

    We performed millimeter observations in CO lines toward the supernova remnant (SNR) G127.1+0.5. We found a molecular filament at 4-13 km s{sup –1} consisting of two distinct parts: a straight part coming out of the remnant region and a curved part in the remnant region. The curved part is coincides well with the bright SNR shell detected in 1420 MHz radio continuum and mid-infrared observations in the northeastern region. In addition, redshifted line wing broadening is found only in the curved part of the molecular filament, which indicates a physical interaction. These provide strong evidences, for the first time, to confirm the association between an SNR and a pre-existing long molecular filament. Multi-band observations in the northeastern remnant shell could be explained by the interaction between the remnant shock and the dense molecular filament. RADEX radiative transfer modeling of the quiet and shocked components yield physical conditions consistent with the passage of a non-dissociative J-type shock. We argue that the curved part of the filament is fully engulfed by the remnant's forward shock. A spatial correlation between aggregated young stellar objects (YSOs) and the adjacent molecular filament close to the SNR is also found, which could be related to the progenitor's activity.

  16. Evolution of a fold-thrust belt deforming a unit with pre-existing linear asperities: Insights from analog models

    NASA Astrophysics Data System (ADS)

    Burberry, Caroline M.; Swiatlowski, Jerlyn L.

    2016-06-01

    Heterogeneity, whether geometric or rheologic, in crustal material undergoing compression affects the geometry of the structures produced. This study documents the thrust fault geometries produced when discrete linear asperities are introduced into an analog model, scaled to represent bulk upper crustal properties, and compressed. Varying obliquities of the asperities are used, relative to the imposed compression, and the resultant development of thrust fault traces and branch lines in map view is tracked. Once the model runs are completed, cross-sections are created and analyzed. The models show that asperities confined to the base layer promote the clustering of branch lines in the surface thrusts. Strong clustering in branch lines is also noted where several asperities are in close proximity or cross. Slight reverse-sense reactivation of asperities cut through the sedimentary sequence is noted in cross-section, where the asperity and the subsequent thrust belt interact. The model results are comparable to the situation in the Dinaric Alps, where pre-existing faults to the SW of the NE Adriatic Fault Zone contribute to the clustering of branch lines developed in the surface fold-thrust belt. These results can therefore be used to evaluate the evolution of other basement-involved fold-thrust belts worldwide.

  17. Cross-reactive and pre-existing antibodies to therapeutic antibodies—Effects on treatment and immunogenicity

    PubMed Central

    van Schie, Karin A; Wolbink, Gerrit-Jan; Rispens, Theo

    2015-01-01

    The potential for immunogenicity is an ever-present concern during the development of biopharmaceuticals. Therapeutic antibodies occasionally elicit an antibody response in patients, which can result in loss of response or adverse effects. However, antibodies that bind a drug are sometimes found in pre-treatment serum samples, with the amount depending on drug, assay, and patient population. This review summarizes published data on pre-existing antibodies to therapeutic antibodies, including rheumatoid factors, anti-allotype antibodies, anti-hinge antibodies, and anti-glycan antibodies. Unlike anti-idiotype antibodies elicited by the drug, pre-formed antibodies in general appear to have little consequences during treatment. In the few cases where (potential) clinical consequences were encountered, antibodies were characterized and found to bind a distinct, unusual epitope of the therapeutic. Immunogenicity testing strategies should therefore always include a proper level of antibody characterization, especially when pre-formed antibodies are present. This minimizes false-positives, particularly due to rheumatoid factors, and helps to judge the potential threat in case a genuine pre-dose antibody reactivity is identified. PMID:25962087

  18. Efficacy of cefpodoxime with clavulanic Acid in the treatment of recurrent pyoderma in dogs.

    PubMed

    Sudhakara Reddy, B; Nalini Kumari, K; Vaikunta Rao, V; Rayulu, V C

    2014-01-01

    In the present study on recurrent pyoderma, dogs with a history of more than three episodes of skin infections in a period of one year were selected. The associated conditions and (or) underlying factors revealed upon thorough investigation were demodicosis, Malassezia dermatitis, flea infestation, hypothyroidism, keratinization disorder (seborrhea), combination of Malassezia dermatitis and tick infestation, and a combination of scabies and tick infestation. Therapy was given with cefpodoxime with clavulanic acid along with appropriate simultaneous medication for the underlying associated conditions. In all the cases response to therapy was excellent. Improvement was noticed by 9 to 19 days and 17 to 21 days in recurrent superficial and deep pyoderma, respectively. In one dog, relapse occurred by 45 days due to the associated condition of hypothyroidism which was confirmed through laboratory findings. Cefpodoxime with clavulanic acid proved to be an effective, safe, and convenient antibiotic for the treatment of recurrent pyoderma in dogs without any side effects. PMID:24977045

  19. Efficacy of cefpodoxime with clavulanic Acid in the treatment of recurrent pyoderma in dogs.

    PubMed

    Sudhakara Reddy, B; Nalini Kumari, K; Vaikunta Rao, V; Rayulu, V C

    2014-01-01

    In the present study on recurrent pyoderma, dogs with a history of more than three episodes of skin infections in a period of one year were selected. The associated conditions and (or) underlying factors revealed upon thorough investigation were demodicosis, Malassezia dermatitis, flea infestation, hypothyroidism, keratinization disorder (seborrhea), combination of Malassezia dermatitis and tick infestation, and a combination of scabies and tick infestation. Therapy was given with cefpodoxime with clavulanic acid along with appropriate simultaneous medication for the underlying associated conditions. In all the cases response to therapy was excellent. Improvement was noticed by 9 to 19 days and 17 to 21 days in recurrent superficial and deep pyoderma, respectively. In one dog, relapse occurred by 45 days due to the associated condition of hypothyroidism which was confirmed through laboratory findings. Cefpodoxime with clavulanic acid proved to be an effective, safe, and convenient antibiotic for the treatment of recurrent pyoderma in dogs without any side effects.

  20. Efficacy of Cefpodoxime with Clavulanic Acid in the Treatment of Recurrent Pyoderma in Dogs

    PubMed Central

    Sudhakara Reddy, B.; Nalini Kumari, K.; Vaikunta Rao, V.; Rayulu, V. C.

    2014-01-01

    In the present study on recurrent pyoderma, dogs with a history of more than three episodes of skin infections in a period of one year were selected. The associated conditions and (or) underlying factors revealed upon thorough investigation were demodicosis, Malassezia dermatitis, flea infestation, hypothyroidism, keratinization disorder (seborrhea), combination of Malassezia dermatitis and tick infestation, and a combination of scabies and tick infestation. Therapy was given with cefpodoxime with clavulanic acid along with appropriate simultaneous medication for the underlying associated conditions. In all the cases response to therapy was excellent. Improvement was noticed by 9 to 19 days and 17 to 21 days in recurrent superficial and deep pyoderma, respectively. In one dog, relapse occurred by 45 days due to the associated condition of hypothyroidism which was confirmed through laboratory findings. Cefpodoxime with clavulanic acid proved to be an effective, safe, and convenient antibiotic for the treatment of recurrent pyoderma in dogs without any side effects. PMID:24977045

  1. The effect of pre-existing affect on the sexual responses of women with and without a history of childhood sexual abuse.

    PubMed

    Rellini, Alessandra H; Elinson, Samantha; Janssen, Erick; Meston, Cindy M

    2012-04-01

    Women with a history of childhood sexual abuse (CSA) are at greater risk for experiencing sexual problems in their adult lives. Yet, little is known about the possible role of cognitive and affective mechanisms in the development of sexual arousal difficulties in this population. This study investigated the role of pre-existing affect (affect prior to exposure to sexual stimuli) on genital responses, subjective sexual arousal, and affect elicited during the presentation of erotic film excerpts in a community sample of 25 women with and 25 women without a history of CSA. The CSA group showed greater pre-existing negative affect and smaller genital responses to the erotic film stimuli compared to the NSA group. Findings support a moderating effect of CSA, in that pre-existing negative affect was associated with strength of genital responses in the NSA but not in the CSA group. The results did not support a mediation model of pre-existing negative affect as an explanation for smaller physiological sexual responses in the CSA group. Taken together, the findings suggest that pre-existing affect may be more relevant for women with no history of CSA and call for more research on factors implicated in impaired sexual responses in women with a history of CSA. PMID:21667233

  2. The effect of pre-existing affect on the sexual responses of women with and without a history of childhood sexual abuse.

    PubMed

    Rellini, Alessandra H; Elinson, Samantha; Janssen, Erick; Meston, Cindy M

    2012-04-01

    Women with a history of childhood sexual abuse (CSA) are at greater risk for experiencing sexual problems in their adult lives. Yet, little is known about the possible role of cognitive and affective mechanisms in the development of sexual arousal difficulties in this population. This study investigated the role of pre-existing affect (affect prior to exposure to sexual stimuli) on genital responses, subjective sexual arousal, and affect elicited during the presentation of erotic film excerpts in a community sample of 25 women with and 25 women without a history of CSA. The CSA group showed greater pre-existing negative affect and smaller genital responses to the erotic film stimuli compared to the NSA group. Findings support a moderating effect of CSA, in that pre-existing negative affect was associated with strength of genital responses in the NSA but not in the CSA group. The results did not support a mediation model of pre-existing negative affect as an explanation for smaller physiological sexual responses in the CSA group. Taken together, the findings suggest that pre-existing affect may be more relevant for women with no history of CSA and call for more research on factors implicated in impaired sexual responses in women with a history of CSA.

  3. Is noma neonatorum a presentation of ecthyma gangrenosum in the newborn?

    PubMed

    Freeman, Alexandra F; Mancini, Anthony J; Yogev, Ram

    2002-01-01

    Noma neonatorum was suggested as a distinct entity characterized by a gangrenous process of the nose, oral cavity, eyelids and perineum that was almost universally fatal in premature infants with Pseudomonas sepsis. We report the first case of noma neonatorum in a 26-week-gestation twin born in the United States. Our case is consistent with previous descriptions of noma neonatorum; however, we question the distinction between noma neonatorum and a neonatal presentation of ecthyma gangrenosum.

  4. Pre-existing adversity, level of child protection involvement, and school attendance predict educational outcomes in a longitudinal study.

    PubMed

    Maclean, Miriam J; Taylor, Catherine L; O'Donnell, Melissa

    2016-01-01

    Maltreatment largely occurs in a multiple-risk context. The few large studies adjusting for confounding factors have raised doubts about whether low educational achievement results from maltreatment or co-occurring risk factors. This study examined prevalence, risk and protective factors for low educational achievement among children involved with the child protection system compared to other children. We conducted a population-based record-linkage study of children born in Western Australia who sat national Year 3 reading achievement tests between 2008 and 2010 (N=46,838). The longitudinal study linked data from the Western Australian Department of Education, Department of Child Protection and Family Support, Department of Health, and the Disability Services Commission. Children with histories of child protection involvement (unsubstantiated maltreatment reports, substantiations or out-of-home care placement) were at three-fold increased risk of low reading scores. Adjusting for socio-demographic adversity partially attenuated the increased risk, however risk remained elevated overall and for substantiated (OR=1.68) and unsubstantiated maltreatment (OR=1.55). Risk of low reading scores in the out-of-home care group was fully attenuated after adjusting for socio-demographic adversity (OR=1.16). Attendance was significantly higher in the out-of-home care group and served a protective role. Neglect, sexual abuse, and physical abuse were associated with low reading scores. Pre-existing adversity was also significantly associated with achievement. Results support policies and practices to engage children and families in regular school attendance, and highlight a need for further strategies to prevent maltreatment and disadvantage from restricting children's opportunities for success.

  5. Differentiation of pre-existing trapped methane from thermogenic methane in an igneous-intruded coal by hydrous pyrolysis

    USGS Publications Warehouse

    Dias, Robert F.; Lewan, Michael D.; Birdwell, Justin E.; Kotarba, Maciej J.

    2014-01-01

    So as to better understand how the gas generation potential of coal changes with increasing rank, same-seam samples of bituminous coal from the Illinois Basin that were naturally matured to varying degrees by the intrusion of an igneous dike were subjected to hydrous pyrolysis (HP) conditions of 360 °C for 72 h. The accumulated methane in the reactor headspace was analyzed for δ13C and δ2H, and mol percent composition. Maximum methane production (9.7 mg/g TOC) occurred in the most immature samples (0.5 %Ro), waning to minimal methane values at 2.44 %Ro (0.67 mg/g TOC), and rebounding to 3.6 mg/g TOC methane in the most mature sample (6.76 %Ro). Methane from coal with the highest initial thermal maturity (6.76 %Ro) shows no isotopic dependence on the reactor water and has a microbial δ13C value of −61‰. However, methane from coal of minimal initial thermal maturity (0.5 %Ro) shows hydrogen isotopic dependence on the reaction water and has a δ13C value of −37‰. The gas released from coals under hydrous pyrolysis conditions represents a quantifiable mixture of ancient (270 Ma) methane (likely microbial) that was generated in situ and trapped within the rock during the rapid heating by the dike, and modern (laboratory) thermogenic methane that was generated from the indigenous organic matter due to thermal maturation induced by hydrous pyrolysis conditions. These findings provide an analytical framework for better assessment of natural gas sources and for differentiating generated gas from pre-existing trapped gas in coals of various ranks.

  6. Recrystallization fabrics of sheared quartz veins with a strong pre-existing crystallographic preferred orientation from a seismogenic shear zone

    NASA Astrophysics Data System (ADS)

    Price, Nancy A.; Song, Won Joon; Johnson, Scott E.; Gerbi, Christopher C.; Beane, Rachel J.; West, David P.

    2016-07-01

    Microstructural investigations were carried out on quartz veins in schist, protomylonite, and mylonite samples from an ancient seismogenic strike-slip shear zone (Sandhill Corner shear zone, Norumbega fault system, Maine, USA). We interpret complexities in the microstructural record to show that: (1) pre-existing crystallographic preferred orientations (CPO) in the host rock may persist in the new CPO patterns of the shear zone and (2) the inner and outer parts of the shear zone followed diverging paths of fabric development. The host rocks bounding the shear zone contain asymmetrically-folded quartz veins with a strong CPO. These veins are increasingly deformed and recrystallized with proximity to the shear zone core. Matrix-accommodated rotation and recrystallization may position an inherited c-axis maximum in an orientation coincident with rhomb < a > or basal < a > slip. This inherited CPO likely persists in the shear zone fabric as a higher concentration of poles in one hemisphere of the c-axis pole figure, leading to asymmetric crossed girdle or paired maxima c-axis patterns about the foliation plane. Three observed quartz grain types indicate a general trend of localization with decreasing temperature: (1) large (> 100 μm), low aspect ratio (<~5) and (2) high aspect ratio (~ 5-20) grains overprinted by (3) smaller (<~80 μm), low aspect ratio (<~4) grains through subgrain rotation-dominated recrystallization. In the outer shear zone, subgrain rotation recrystallization led to a well-developed c-axis crossed girdle pattern. In the inner shear zone, the larger grains are completely overprinted by smaller grains, but the CPO patterns are relatively poorly developed and are associated with distinctively different misorientation angle histogram profiles ("flat" neighbor-pair profile with similar number fraction for angles from 10 to 90°). This may reflect the preferential activation of grain size sensitive deformation processes in the inner-most part of the

  7. Evaluation of a pre-existing, 3-year household water treatment and handwashing intervention in rural Guatemala

    PubMed Central

    Arnold, Benjamin; Arana, Byron; Mäusezahl, Daniel; Hubbard, Alan; Colford, John M

    2009-01-01

    Background The promotion of household water treatment and handwashing with soap has led to large reductions in child diarrhoea in randomized efficacy trials. Currently, we know little about the health effectiveness of behaviour-based water and hygiene interventions after the conclusion of intervention activities. Methods We present an extension of previously published design (propensity score matching) and analysis (targeted maximum likelihood estimation) methods to evaluate the behavioural and health impacts of a pre-existing but non-randomized intervention (a 3-year, combined household water treatment and handwashing campaign in rural Guatemala). Six months after the intervention, we conducted a cross-sectional cohort study in 30 villages (15 intervention and 15 control) that included 600 households, and 929 children <5 years of age. Results The study design created a sample of intervention and control villages that were comparable across more than 30 potentially confounding characteristics. The intervention led to modest gains in confirmed water treatment behaviour [risk difference = 0.05, 95% confidence interval (CI) 0.02–0.09]. We found, however, no difference between the intervention and control villages in self-reported handwashing behaviour, spot-check hygiene conditions, or the prevalence of child diarrhoea, clinical acute lower respiratory infections or child growth. Conclusions To our knowledge this is the first post-intervention follow-up study of a combined household water treatment and handwashing behaviour change intervention, and the first post-intervention follow-up of either intervention type to include child health measurement. The lack of child health impacts is consistent with unsustained behaviour adoption. Our findings highlight the difficulty of implementing behaviour-based household water treatment and handwashing outside of intensive efficacy trials. PMID:19574492

  8. Programmed death ligand 1 as an indicator of pre-existing adaptive immune responses in human hepatocellular carcinoma.

    PubMed

    Xie, Qian-Kun; Zhao, Yu-Jie; Pan, Tao; Lyu, Ning; Mu, Lu-Wen; Li, Shao-Long; Shi, Mu-De; Zhang, Zhen-Feng; Zhou, Peng-Hui; Zhao, Ming

    2016-07-01

    It is well known that the aberrant expression of programmed death ligand 1 (PD-L1) on tumor cells impairs antitumor immunity. To date, in hepatocellular carcinoma (HCC), the relationship between PD-L1 expression and host-tumor immunity is not well defined. Here, the expression levels of PD-L1 and CD8(+) T cell infiltration were analyzed by immunohistochemistry (IHC) in formalin fixed paraffin embedded (FFPE) specimens from 167 HCC patients undergoing resection. A significant positive association was found between PD-L1 expression and the presence of CD8(+) T cell (p < 0.0001). Moreover, constitutive PD-L1 protein expression was not detected by western blot in HepG2, Hep3B, and 7402 HCC cancer cell lines; but co-cultured these cell lines with INFγ, a cytokine produced by activated CD8(+) T cells, remarkably upregulated PD-L1 expression. In fresh frozen HCC specimens, INFγ was found to be significantly correlated with PD-L1 and CD8(+) gene expression, as evaluated by quantitative reverse transcriptase polymerase chain reaction (RT-PCR). These findings indicate that increased PD-L1 level may represent an adaptive immune resistance mechanism exerted by tumor cells in response to endogenous antitumor activity. Both increased intratumoral PD-L1 and CD8(+) were significantly associated with superior DFS (CD8(+): p = 0.03; PD-L1: p = 0.023) and OS (CD8(+): p = 0.001 and PD-L1: p = 0.059), but PD-L1 expression was not independently prognostic. In conclusions, PD-L1 upregulation is mainly induced by activated CD8(+) cytotoxic T cells pre-existing in HCC milieu rather than be constitutively expressed by the tumor cells, and it is a favorable prognostic factor for HCC. PMID:27622038

  9. The role of pre-existing Precambrian structures in rift evolution: The Albertine and Rhino grabens, Uganda

    NASA Astrophysics Data System (ADS)

    Katumwehe, Andrew B.; Abdelsalam, Mohamed G.; Atekwana, Estella A.

    2015-04-01

    We integrated Shuttle Radar Topography Mission (SRTM) Digital Elevation Models (DEM), airborne magnetic, radiometric and three-dimensional Full Tensor Gravity Gradiometry (3D-FTG) data to investigate the role of Precambrian structures in the evolution of the largely amagmatic Miocene-Recent aged Albertine and Rhino grabens in Uganda. These grabens represent the northern segment of the Western Branch of the East African Rift System (EARS). The two NE-trending grabens are connected by a right-stepping transfer zone and they extend within the Archean-Paleoproterozoic Northeast Congo block which represents the northeastern extension of the Congo craton. Our results show the following and highlight the importance of pre-existing structures in the evolution of continental rift systems: (1) The NE-extent of the Albertine full-graben is controlled by NE-trending Precambrian fabric and the graben terminates at its northeastern end when it encounters a multiply folded Precambrian basement terrain with poorly-developed NW-trending structural grain. Additionally, the northeastern termination of the Albertine graben coincides with the presence of NW-trending right-stepping high-density bodies within the Precambrian terrain. (2) The transfer zone between the Albertine and Rhino grabens is controlled by NE-trending Precambrian structures which might have facilitated the development of relay ramp faults. (3) Strain localization within the better-developed southeastern border fault of the Rhino half-graben is facilitated by the presence of Precambrian structures better aligned in a NE-direction in the southeastern part of the basin compared to its northwestern part. (4) Further to the northeast, the Rhino graben is segmented and transitions into a narrower ENE-trending half-graben with a better-developed border fault on its northwestern side. This segmentation coincides with the presence of N-trending Precambrian structures. (5) The Rhino graben terminates farther northeast against

  10. Effects of Mining-Induced Stress Perturbations on Pre-Existing Faults Near a Deep South African Gold Mine

    NASA Astrophysics Data System (ADS)

    Lucier, A. M.; Heesakkers, V.; Zoback, M. D.; Reches, Z.

    2007-12-01

    For over a century, mining-induced earthquakes have been recorded in the deep underground mining region of Witwatersrand Basin in South Africa. The TauTona gold mine experiences an appreciable number of mining- induced earthquakes and is the site of the Natural Earthquake Laboratory in South African Mines (NELSAM) project. In this work, we constrain the virgin (i.e. unperturbed) state of stress near the TauTona gold mine using an iterative forward modeling approach that combines observations of drilling induced borehole failures in borehole images, boundary element modeling of the mining-induced stress perturbations, and forward modeling of borehole failures based on the results of the boundary element modeling. We find that the state of stress is a normal faulting regime with principal stress orientations that are slightly deviated from vertical and horizontal and therefore denoted with a (*). The maximum principal stress, Sv*, is deviated 0° to 20° from vertical towards the NNW and has a magnitude gradient of 27 ± 0.3 MPa/km. The intermediate principal stress, SHmax*, is inclined 0° to 20° from horizontal with an azimuth of 145° to 168° and has a magnitude gradient of 21.5 to 26 MPa/km. The least principal stress, Shmin*, is inclined 0° to 10° from horizontal with an azimuth of 235° to 258° and has a magnitude gradient of 13 to 15.5 MPa/km. Using this constrained stress state, we investigate the likelihood of faulting to occur both on pre-existing fault planes that are optimally-oriented to the virgin stress state and on faults affected by the mining-perturbed stress field, the latter of which is calculated with boundary element modeling. The far-field stress state indicates that the crust is in a state of frictional faulting equilibrium, such that normal faulting is likely to occur on faults striking SSE and NNW and have a dip angle of approximately 45° to 80°. The mining-induced stress perturbation affects faults relatively closer to the mining

  11. The impact of pre-existing antibody on subsequent immune responses to meningococcal A-containing vaccines.

    PubMed

    Idoko, Olubukola T; Okolo, Seline N; Plikaytis, Brian; Akinsola, Adebayo; Viviani, Simonetta; Borrow, Ray; Carlone, George; Findlow, Helen; Elie, Cheryl; Kulkarni, Prasad S; Preziosi, Marie-Pierre; Ota, Martin; Kampmann, Beate

    2014-07-16

    -vaccination titers attained ≥4-fold responses as compared to 76% with high titers where study vaccine was received. Our data confirm the presence of high pre-vaccination Men A antibody concentrations/titers within the African meningitis belt, with significantly higher concentrations in older individuals. Although all participants had significant increase in antibody levels following vaccination, the four-fold or greater response in antibody titers were significantly higher in individuals with lower pre-existing antibody titers, especially after receiving PsA-TT. This finding may have some implications for vaccination strategies adopted in the future. PMID:24863486

  12. A case of methicillin-resistant Staphylococcus pseudintermedius (MRSP) pyoderma in a Labrador retriever dog.

    PubMed

    Wan, Jennifer

    2014-11-01

    An 8-year-old, neutered male Labrador retriever dog with generalized pruritis had a history of recurring atopic dermatitis and superficial pyoderma. Cocci and yeast were found on cytology and methicillin-resistant Staphylococcus pseudintermedius was cultured. A regimen of marbofloxacin, dexamethasone, ketoconazole, and cyclosporine in addition to bathing with 2% chlorhexidine shampoo resulted in marked improvement.

  13. A case of methicillin-resistant Staphylococcus pseudintermedius (MRSP) pyoderma in a Labrador retriever dog.

    PubMed

    Wan, Jennifer

    2014-11-01

    An 8-year-old, neutered male Labrador retriever dog with generalized pruritis had a history of recurring atopic dermatitis and superficial pyoderma. Cocci and yeast were found on cytology and methicillin-resistant Staphylococcus pseudintermedius was cultured. A regimen of marbofloxacin, dexamethasone, ketoconazole, and cyclosporine in addition to bathing with 2% chlorhexidine shampoo resulted in marked improvement. PMID:25392557

  14. Efficacy of a surgical scrub including 2% chlorhexidine acetate for canine superficial pyoderma.

    PubMed

    Murayama, Nobuo; Nagata, Masahiko; Terada, Yuri; Shibata, Sanae; Fukata, Tsuneo

    2010-12-01

    The clinical efficacy of a surgical scrub containing 2% chlorhexidine acetate (2CA; Nolvasan® Surgical Scrub; Fort Dodge Animal Health, USA) was evaluated for the topical management of canine superficial pyoderma. The first study was a randomized, double-blind, controlled trial. The control was a shampoo containing 4% chlorhexidine gluconate (4CG; Skin Clinic Shampoo; CHD MEDICS, Goyang, Korea). Ten dogs with symmetrical lesions of canine superficial pyoderma were allocated to receive either 2CA or the control shampoo applied to either side of the body twice weekly for 1 week. Both the owners and the investigators subjectively scored skin lesions including pruritus, erythema, crusted papules and scales on a scale of 0-3. The 2CA and 4CG resulted in almost the same degree of improvement of skin lesions, and there were no significant differences between the two groups. The second study was an open trial of 2CA monotherapy in eight dogs with cefalexin-resistant Staphylococcus intermedius group-associated superficial pyoderma. The 2CA monotherapy was applied every 2 days for 2 weeks. Five dogs improved with 2CA monotherapy, one partially improved and two did not. No adverse reactions were seen in either trial. This suggests that a 2CA surgical scrub could be a useful and safe topical adjunct therapy for dogs with superficial pyoderma involving cefalexin-resistant Staphylococcus intermedius group.

  15. A case of methicillin-resistant Staphylococcus pseudintermedius (MRSP) pyoderma in a Labrador retriever dog

    PubMed Central

    Wan, Jennifer

    2014-01-01

    An 8-year-old, neutered male Labrador retriever dog with generalized pruritis had a history of recurring atopic dermatitis and superficial pyoderma. Cocci and yeast were found on cytology and methicillin-resistant Staphylococcus pseudintermedius was cultured. A regimen of marbofloxacin, dexamethasone, ketoconazole, and cyclosporine in addition to bathing with 2% chlorhexidine shampoo resulted in marked improvement. PMID:25392557

  16. Effect of the pre-existing carbides on the grain boundary network during grain boundary engineering in a nickel based alloy

    SciTech Connect

    Liu, Tingguang; Xia, Shuang; Li, Hui; Zhou, Bangxin; Bai, Qin

    2014-05-01

    Grain boundary engineering was carried out on an aging-treated nickel based Alloy 690, which has precipitated carbides at grain boundaries. Electron backscatter diffraction technique was used to investigate the grain boundary networks. Results show that, compared with the solution-annealed samples, the aging-treated samples with pre-existing carbides at grain boundaries need longer duration or higher temperature during annealing after low-strain tensile deformation for forming high proportion of low-Σ coincidence site lattice grain boundaries (more than 75%). The reason is that the primary recrystallization is inhibited or retarded owing to that the pre-existing carbides are barriers to grain boundaries migration. - Highlights: • Study of GBE as function of pre-existing GB carbides, tensile strain and annealing • Recrystallization of GBE is inhibited or retarded by the pre-existing carbides. • Retained carbides after annealing show the original GB positions. • More than 80% of special GBs were formed after the modification of GBE processing. • Multiple twinning during recrystallization is the key process of GBE.

  17. A dairy-based high calcium diet improves glucose homeostasis and reduces steatosis in the context of pre-existing obesity

    Technology Transfer Automated Retrieval System (TEKTRAN)

    High dietary calcium (Ca) in the context of a dairy food matrix has been shown to reduce obesity development and associated inflammation in diet-induced obese (DIO) rodents. The influence of Ca and dairy on these phenotypes in the context of pre-existing obesity is not known. Furthermore, interpre...

  18. A dairy-based high calcium diet improves glucose homeostasis and reduces further weight gain in high fat fed mice in the context of pre-existing obesity

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Background: High dietary calcium (Ca) in the context of a dairy food matrix has been shown to reduce obesity development and associated inflammation in diet-induced obese (DIO) mice. However, the influence of Ca and dairy on these phenotypes in the context of pre-existing obesity is not known. Met...

  19. Exploring mucosal immunization with a recombinant influenza virus carrying an HIV-polyepitope in mice with pre-existing immunity to influenza.

    PubMed

    Garulli, Bruno; Di Mario, Giuseppina; Stillitano, Maria Giuseppina; Kawaoka, Yoshihiro; Castrucci, Maria Rita

    2014-05-01

    HIV-1 vaccines based on recombinant vectors have been developed to elicit immune responses; however, the failure of the STEP HIV-1 vaccine trial has caused concern regarding the impact on vaccine efficacy of pre-existing vector seropositivity in humans. By using a mouse model of infection, we evaluated the immune responses elicited by intranasal and vaginal immunization with the recombinant influenza virus WSN/CKG carrying the PCLUS3-P18 peptide and a Gag epitope in its hemagglutinin, and the impact of pre-existing vector immunity on protection against recombinant vaccinia virus challenge. We found that despite the protective immunity induced in naïve mice by the WSN/CKG virus via either route, the vaginal immunization of mice with pre-existing influenza immunity restricted vPE16 replication more significantly in the ovaries than intranasal immunization. Thus, successful vaccination strategies under limiting conditions, such as pre-existing vector immunity, require the local induction of mucosal immunity at the site of virus infection.

  20. An immunoinhibition approach to overcome the impact of pre-existing antibodies on cut point establishment for immunogenicity assessment of moxetumomab pasudotox.

    PubMed

    Schneider, Amy K; Vainshtein, Inna; Roskos, Lorin K; Chavez, Carlos; Sun, Bo; Liang, Meina

    2016-08-01

    Immunogenicity can impact PK, PD, efficacy and safety of biopharmaceuticals, and is often evaluated as a secondary objective in clinical studies. Methods to detect anti-drug antibodies (ADA) and neutralizing ADA (NAb) are semi-quantitative and utilize cut points to determine positive or negative samples. Assay cut points are established by the statistical analysis of treatment-naïve subject specimens that are assumed ADA and NAb-negative. Pre-existing antibodies to various biopharmaceuticals have been observed in treatment-naïve subjects and may artificially elevate the cut point, resulting in compromised assay sensitivities, inaccuracy in immunogenicity reporting and ultimately misleading assessment of the impact of immunogenicity on clinical outcomes. Although several approaches such as removal of pre-existing antibody samples or increasing the sample dilution could be used for cut point establishment to mitigate impact of pre-existing antibodies, they each have limitations, especially when a high prevalence of pre-existing antibodies is observed. Here we describe an innovative approach used to establish cut points for ADA and NAb assays of moxetumomab pasudotox (moxetumomab), a recombinant anti-CD22 immunotoxin, to which a high prevalence of pre-existing antibodies was observed. In order to overcome the challenges associated with this high prevalence and prevent establishment of an artificially elevated cut point, we developed an immunoinhibition approach that allowed generation of pseudo ADA and NAb-negative populations for cut point determination. Immunoinhibition was performed by adding excess moxetumomab (for ADA) or a non-CD22 binding PE38-containing immunotoxin, CAT-5001 (for NAb), to treatment-naive samples prior to evaluating samples for cut point establishment. This approach successfully eliminated pre-existing antibody activity in treatment-naive samples, enabling establishment of more accurate ADA and NAb assay cut points. A comparative analysis of

  1. Lateral propagation of active normal faults throughout pre-existing fault zones: an example from the Southern Apennines, Italy

    NASA Astrophysics Data System (ADS)

    Agosta, Fabrizio; Prosser, Giacomo; Ivo Giano, Salvatore

    2013-04-01

    top, unconformably covered by Miocene clastic deposits. The lower thrust sheet is made up of deep-sea deposits of late Triassic to Eocene age, which include pelagic limestones, radiolarites, marls and turbiditic calcarenites. The relay ramp area is comprised of two main fault sets, which are NW-trending (N120-140E) and NE-trending (N60-70E). Minor E-trending (N90-100E) and NNW-trending (N160-170E) faults are also present. Maximum throws of the most developed faults, which are also characterized by the longest traces, are in the order of 300-400 m. Crosscutting relationships and morphotectonic analyses generally show that the NW-trending faults are the most recent, as also shown by the involvement of Quaternary breccias and near surface fault rocks. Our data indicate that propagation of NW-trending normal faults in the relay ramp area took place thanks to the breaking of a pre-existing structural grain made up, mainly, of NE-trending normal faults. This process determined the different multi-scale properties to the two fault sets, and somehow inhibited the lateral growth of the NW-trending normal faults.

  2. Clinico-bacteriological profile of primary pyodermas in Kashmir: a hospital-based study.

    PubMed

    Bhat, Y J; Hassan, I; Bashir, S; Farhana, A; Maroof, P

    2016-03-01

    Pyodermas are a common group of infectious dermatological conditions on which few studies have been conducted. This study aimed to characterise the clinical and bacteriological profile of pyodermas, and to determine the prevalence of methicillin-resistant Staphylococcus aureus (MRSA) infection in primary pyodermas in a dermatology outpatient department in Kashmir. Methods We conducted a hospital based cross-sectional study in the outpatient Department of Dermatology, Sexually Transmitted Diseases and Leprosy of Shri Maharaja Hari Singh Hospital, Srinagar, Jammu and Kashmir, India. Patients presenting with primary pyodermas were included in the study. A detailed history and complete physical and cutaneous examination was carried out along with microbiological testing to find aetiological microorganisms and their respectiveantimicrobial susceptibility patterns. Antimicrobial susceptibility testing, including that for methicillin resistance, was carried out by standard methods as outlined in the current Clinical and Laboratory Standards Institute guidelines. Results In total, 110 patients were included; the age of the study population ranged from 3 to 65 years (mean age 28 years); 62% were male. Poor personal hygiene was noted in 76 (69%). Furunculosis (56; 51%) was the most common clinical presentation. Staphylococcus aureus was isolated in 89 (81%) of cases, and MRSA formed 54/89 (61%) of Staphylococcus aureus isolates. All MRSA strains were sensitive to vancomycin. Conclusion The prevalence of MRSA was high in this sample of communityacquired primary pyodermas. It is therefore important to monitor the changing trends in bacterial infection and their antimicrobial susceptibility patterns and to formulate a definite antibiotic policy which may be helpful in decreasing the incidence of MRSA infection.

  3. The Effects of Pre-Existing Hyponatremia and Subsequent-Developing Acute Kidney Injury on In-Hospital Mortality: A Retrospective Cohort Study

    PubMed Central

    Lee, Sung Woo; Baek, Seon Ha; Ahn, Shin Young; Na, Ki Young; Chae, Dong-Wan; Chin, Ho Jun; Kim, Sejoong

    2016-01-01

    Background and Objectives Both hyponatremia and acute kidney injury (AKI) are common and harmful in hospitalized patients. However, their combined effects on patient mortality have been little studied. Methods We retrospectively enrolled 19191 adult patients who were admitted for 1 year. Pre-existing hyponatremia was defined as a serum sodium level < 135 mmol/L on the first measurement of their admission. AKI was defined as a rise in serum creatinine by ≥ 26.5 μmol/L or ≥ 1.5 times of the baseline value of creatinine during the hospital stay. Results The prevalence of pre-existing hyponatremia was 8.2%. During a median 6.0 days of hospital stay, the incidence rates of AKI and in-hospital patient mortality were 5.1% and 0.9%, respectively. Pre-existing hyponatremia independently predicted AKI development and in-hospital mortality (adjusted hazard ratio [HR] 1.300, P = 0.004; HR 2.481, P = 0.002, respectively). Pre-existing hyponatremia and subsequent development of AKI increased in-hospital mortality by 85 times, compared to the patients with normonatremia and no AKI. In subgroup analysis, the AKI group showed higher rates of de novo hypernatremia than the non-AKI group during the admission. De novo hypernatremia, which might be associated with over-correction of hyponatremia, increased in-hospital mortality (HR 3.297, P <0.001), and patients with AKI showed significantly higher rates of de novo hypernatremia than patients without AKI (16.2% vs. 1.4%, P < 0.001, respectively). Conclusion Pre-existing hyponatremia may be associated with the development of AKI in hospitalized patients, and both hyponatremia and hospital-acquired AKI could have a detrimental effect on short term patient mortality, which might be related to the inappropriate correction of hyponatremia in AKI patients. PMID:27622451

  4. Ecthyma gangrenosum: a rare cutaneous manifestation caused by pseudomonas aeruginosa without bacteraemia in a leukaemic patient--a case report.

    PubMed

    Singh, T N; Devi, K M; Devi, K S

    2005-10-01

    Ecthyma gangrenosum is a rare and invasive cutaneous infection caused by Pseudomonas aeruginosa in the majority of cases, typically affecting immunocompromised patients, particularly those with neutropenia. We report a rare case of ecthyma gangrenosum in the absence of bacteraemia presenting as a solitary necrotic ulcer in a female patient with acute lymphoblastic leukaemia. A culture from the ecthyma lesion revealed the presence of Pesudomonas aeruginosa, but the results of repeated blood cultures were negative. The patient responded well to amikacin to which the isolate was susceptible in vitro. Considering high rate of mortality, early diagnosis and prompt effective treatment is mandatory. PMID:16327125

  5. Reconstructive procedure of lower lip defect due to ecthyma gangrenosum--a rare complication of acute lymphoblastic leukemia.

    PubMed

    Özkaya, Özay; Üsçetin, İlker; Egemen, Onur; Bingöl, Derya; Akan, Mithat

    2012-05-01

    Ecthyma gangrenosum is a rare invasive cutaneous infection mostly caused by Pseudomonas aeruginosa in immunosuppressed patients, especially during neutropenic states. Embolic lesions usually accompanying with septicemia of P. aeruginosa are typically painless, round, and centrally necrotic with a surrounding erythematous halo. Facial involvement occurred only in 6% of the patients, which may result to complicated defects for reconstruction. In this article, we aimed to present a case with relapse of acute lymphoblastic leukemia presented to our clinic with 50% defect of the lower lip due to ecthyma gangrenosum and its late-term reconstruction. PMID:22627426

  6. Clinical prognosis, pre-existing conditions and the use of reperfusion therapy for patients with ST segment elevation acute myocardial infarction

    PubMed Central

    Parker, Andrea B; Naylor, C David; Chong, Alice; Alter, David A

    2006-01-01

    BACKGROUND Some evidence-based therapies are underused in patients with a poor prognosis despite the fact that the survival gains would be highest among such patient subgroups. The extent to which this applies for acute, life-saving therapies is unknown. The impact of prognostic characteristics and pre-existing conditions on the use of reperfusion therapy among eligible patients with acute ST segment elevation myocardial infarction is examined. METHODS Of 2829 acute myocardial infarction patients prospectively identified in 53 acute care hospitals across Ontario, 987 presented with ST segment elevation within 12 h of symptom onset and without any absolute contraindications to reperfusion therapy. The baseline prognosis for each patient was derived from a validated risk-adjustment model of 30-day mortality. Multiple logistical regression was used to examine the relationships among reperfusion therapy, prognosis and the number of pre-existing chronic conditions after adjusting for factors such as age, sex, time since symptom onset and socioeconomic status. RESULTS Of the 987 appropriate candidates, 725 (73.5%) received reperfusion therapy (70.8% fibrinolysis, 2.6% primary angioplasty). The adjusted odds ratio of reperfusion therapy fell 4% with each 1% increase in baseline risk of death (adjusted OR 0.96, 95% CI 0.92 to 1.00, P=0.04) and fell 18% with each additional pre-existing condition (adjusted OR 0.82, 95% CI 0.76 to 0.90, P<0.001). The number rather than the type of pre-existing conditions inversely correlated with the use of reperfusion therapy. While the impact of baseline risk and pre-existing conditions was additive, pre-existing conditions exerted a greater impact on the nonuse of reperfusion therapy than did baseline risk. CONCLUSIONS A treatment-risk paradox is demonstrable even within a cohort of lower risk patients with ST segment elevation myocardial infarction. These findings are consistent with the view that these clinical decisions are more likely

  7. The 1970 yellow fever epidemic in Okwoga District, Benue Plateau State, Nigeria. 3. Serological responses in persons with and without pre-existing heterologous group B immunity.

    PubMed

    Monath, T P; Wilson, D C; Casals, J

    1973-01-01

    Serological studies of persons infected with yellow fever (YF) during the 1970 epidemic in Okwoga District, Nigeria, indicated that epidemic YF occurred despite a high prevalence of pre-existing group B arbovirus immunity, which increased with age. The viruses involved were primarily dengue, Zika, and Wesselsbron. Patterns of responses of haemagglutination-inhibiting, complement-fixing, and neutralizing antibodies in primary YF and in superinfections are defined in this paper.

  8. Mathematical Modelling of a Brain Tumour Initiation and Early Development: A Coupled Model of Glioblastoma Growth, Pre-Existing Vessel Co-Option, Angiogenesis and Blood Perfusion.

    PubMed

    Cai, Yan; Wu, Jie; Li, Zhiyong; Long, Quan

    2016-01-01

    We propose a coupled mathematical modelling system to investigate glioblastoma growth in response to dynamic changes in chemical and haemodynamic microenvironments caused by pre-existing vessel co-option, remodelling, collapse and angiogenesis. A typical tree-like architecture network with different orders for vessel diameter is designed to model pre-existing vasculature in host tissue. The chemical substances including oxygen, vascular endothelial growth factor, extra-cellular matrix and matrix degradation enzymes are calculated based on the haemodynamic environment which is obtained by coupled modelling of intravascular blood flow with interstitial fluid flow. The haemodynamic changes, including vessel diameter and permeability, are introduced to reflect a series of pathological characteristics of abnormal tumour vessels including vessel dilation, leakage, angiogenesis, regression and collapse. Migrating cells are included as a new phenotype to describe the migration behaviour of malignant tumour cells. The simulation focuses on the avascular phase of tumour development and stops at an early phase of angiogenesis. The model is able to demonstrate the main features of glioblastoma growth in this phase such as the formation of pseudopalisades, cell migration along the host vessels, the pre-existing vasculature co-option, angiogenesis and remodelling. The model also enables us to examine the influence of initial conditions and local environment on the early phase of glioblastoma growth.

  9. Mathematical Modelling of a Brain Tumour Initiation and Early Development: A Coupled Model of Glioblastoma Growth, Pre-Existing Vessel Co-Option, Angiogenesis and Blood Perfusion

    PubMed Central

    Cai, Yan; Wu, Jie; Li, Zhiyong; Long, Quan

    2016-01-01

    We propose a coupled mathematical modelling system to investigate glioblastoma growth in response to dynamic changes in chemical and haemodynamic microenvironments caused by pre-existing vessel co-option, remodelling, collapse and angiogenesis. A typical tree-like architecture network with different orders for vessel diameter is designed to model pre-existing vasculature in host tissue. The chemical substances including oxygen, vascular endothelial growth factor, extra-cellular matrix and matrix degradation enzymes are calculated based on the haemodynamic environment which is obtained by coupled modelling of intravascular blood flow with interstitial fluid flow. The haemodynamic changes, including vessel diameter and permeability, are introduced to reflect a series of pathological characteristics of abnormal tumour vessels including vessel dilation, leakage, angiogenesis, regression and collapse. Migrating cells are included as a new phenotype to describe the migration behaviour of malignant tumour cells. The simulation focuses on the avascular phase of tumour development and stops at an early phase of angiogenesis. The model is able to demonstrate the main features of glioblastoma growth in this phase such as the formation of pseudopalisades, cell migration along the host vessels, the pre-existing vasculature co-option, angiogenesis and remodelling. The model also enables us to examine the influence of initial conditions and local environment on the early phase of glioblastoma growth. PMID:26934465

  10. Mathematical Modelling of a Brain Tumour Initiation and Early Development: A Coupled Model of Glioblastoma Growth, Pre-Existing Vessel Co-Option, Angiogenesis and Blood Perfusion.

    PubMed

    Cai, Yan; Wu, Jie; Li, Zhiyong; Long, Quan

    2016-01-01

    We propose a coupled mathematical modelling system to investigate glioblastoma growth in response to dynamic changes in chemical and haemodynamic microenvironments caused by pre-existing vessel co-option, remodelling, collapse and angiogenesis. A typical tree-like architecture network with different orders for vessel diameter is designed to model pre-existing vasculature in host tissue. The chemical substances including oxygen, vascular endothelial growth factor, extra-cellular matrix and matrix degradation enzymes are calculated based on the haemodynamic environment which is obtained by coupled modelling of intravascular blood flow with interstitial fluid flow. The haemodynamic changes, including vessel diameter and permeability, are introduced to reflect a series of pathological characteristics of abnormal tumour vessels including vessel dilation, leakage, angiogenesis, regression and collapse. Migrating cells are included as a new phenotype to describe the migration behaviour of malignant tumour cells. The simulation focuses on the avascular phase of tumour development and stops at an early phase of angiogenesis. The model is able to demonstrate the main features of glioblastoma growth in this phase such as the formation of pseudopalisades, cell migration along the host vessels, the pre-existing vasculature co-option, angiogenesis and remodelling. The model also enables us to examine the influence of initial conditions and local environment on the early phase of glioblastoma growth. PMID:26934465

  11. Scrum kidney: epidemic pyoderma caused by a nephritogenic Streptococcus pyogenes in a rugby team.

    PubMed

    Ludlam, H; Cookson, B

    1986-08-01

    In December, 1984, an outbreak of pyoderma affected five scrum players in the St Thomas' Hospital rugby team. The causative organism, Streptococcus pyogenes, was acquired during a match against a team experiencing an outbreak of impetigo, and was transmitted to two front row players of another team a week later, and to two girlfriends of affected St Thomas' players a month later. The strain was M-type 49, tetracycline-resistant, and virulent. It caused salpingitis in a girlfriend and acute glomerulonephritis in one rugby player. No case of subclinical glomerulonephritis was detected in eight patients with pyoderma. Screening of the St Thomas' Hospital team revealed four further cases of non-streptococcal skin infection, with evidence for contemporaneous spread of Staphylococcus aureus. Teams should not field players with sepsis, and it may be advisable to apply a skin antiseptic to traumatised skin after the match. PMID:2874337

  12. The role of normal skin in the spread of streptococcal pyoderma

    PubMed Central

    Dudding, B. A.; Burnett, J. W.; Chapman, S. S.; Wannamaker, L. W.

    1970-01-01

    The primary body site of acquisition of group A streptococci was examined prospectively in a population with endemic streptococcal pyoderma. Weekly cultures were obtained during the skin infection season from apparently normal upper respiratory and cutaneous sites (and from skin lesions when present) in 44 children and adults living on the Red Lake Indian Reservation. During the 9-week period of the study 705 of a total of 2305 cultures were positive for group A streptococci. The percentage of positive cultures from the various sites were: throat (20%); nose (24%); wrist (32%); ankle (35%); back (22%); and skin lesions (81%). Group A streptococci were also isolated from fingernail dirt, clothing and bedding as well as from a few household pets and insects. Analysis of serial cultures obtained from the same individuals at weekly intervals suggested that the strains isolated from skin lesions first appeared on normal skin in the 2 weeks preceding the lesion. Spread to the nose and throat followed skin acquisition and/or skin lesions. The high prevalence of group A streptococci on normal skin in the absence as well as the presence of pyoderma, and their appearance on normal skin before recovery from either skin lesions or the upper respiratory tract are consistent with the view that skin acquisition was a primary predisposing factor to pyoderma. Since the literature indicates that group A streptococci are rarely part of the normal skin flora, these findings raise the possibility of unique biological properties of these and perhaps other pyoderma strains, as distinct from other group A streptococci. PMID:5266583

  13. The Global Epidemiology of Impetigo: A Systematic Review of the Population Prevalence of Impetigo and Pyoderma

    PubMed Central

    Bowen, Asha C.; Mahé, Antoine; Hay, Roderick J.; Andrews, Ross M.; Steer, Andrew C.; Tong, Steven Y. C.; Carapetis, Jonathan R.

    2015-01-01

    Objective We conducted a comprehensive, systematic review of the global childhood population prevalence of impetigo and the broader condition pyoderma. Methods PubMed was systematically searched for impetigo or pyoderma studies published between January 1 1970 and September 30 2014. Two independent reviewers extracted data from each relevant article on the prevalence of impetigo. Findings Sixty-six articles relating to 89 studies met our inclusion criteria. Based on population surveillance, 82 studies included data on 145,028 children assessed for pyoderma or impetigo. Median childhood prevalence was 12·3% (IQR 4·2–19·4%). Fifty-eight (65%) studies were from low or low-middle income countries, where median childhood prevalences were 8·4% (IQR 4·2–16·1%) and 14·5% (IQR 8·3–20·9%), respectively. However, the highest burden was seen in underprivileged children from marginalised communities of high-income countries; median prevalence 19·4%, (IQR 3·9–43·3%). Conclusion Based on data from studies published since 2000 from low and low-middle income countries, we estimate the global population of children suffering from impetigo at any one time to be in excess of 162 million, predominantly in tropical, resource-poor contexts. Impetigo is an under-recognised disease and in conjunction with scabies, comprises a major childhood dermatological condition with potential lifelong consequences if untreated. PMID:26317533

  14. Treatment of canine pyoderma with ibafloxacin and marbofloxacin--fluoroquinolones with different pharmacokinetic profiles.

    PubMed

    Horspool, L J I; van Laar, P; van den Bos, R; Mawhinney, I

    2004-06-01

    Dogs with superficial or deep pyoderma (n = 228) presented to first opinion veterinarians (n = 20) were treated orally with either ibafloxacin, at a dosage of 15 mg/kg, or marbofloxacin, at a dosage of 2 mg/kg, once daily for 3-16 weeks. On initial presentation, 35% of the cases were classified as having recurrent pyoderma and 40% as having deep pyoderma. Staphylococci (mainly Staphylococcus intermedius) were isolated from over 90% of the cases. The average treatment periods were 41 +/- 26 and 38 +/- 21 days in the ibafloxacin and marbofloxacin groups, respectively. One week after the cessation of treatment, 74 and 81% of dogs (P > 0.05) in the ibafloxacin and marbofloxacin groups, respectively, were classified as having responded to treatment. One month after the cessation of treatment, 70% of the dogs in each group were still classified as cured or improved, and 3 and 11% (P < 0.05) in the ibafloxacin and marbofloxacin groups, respectively, were classified as having relapsed. Despite having different pharmacokinetic profiles, ibafloxacin and marbofloxacin produced similar results when used under field conditions at the recommended dosages.

  15. Pre-existing hyperlipidaemia increased the risk of new-onset anxiety disorders after traumatic brain injury: a 14-year population-based study

    PubMed Central

    Ho, Chung-Han; Hsieh, Kuang-Yang; Liang, Fu-Wen; Li, Chia-Jung; Wang, Jhi-Joung; Chio, Chung-Ching; Chang, Chin-Hung; Kuo, Jinn-Rung

    2014-01-01

    Objectives Anxiety disorders (ADs) are common after traumatic brain injury (TBI). However, the risk factors of new-onset ADs remain unclear. This study was aimed at evaluating the incidence and risk factors for new-onset ADs, including pre-existing hyperlipidaemia and three major comorbidities (diabetes mellitus, hypertension and cardiovascular disease), in patients with TBI. Setting A matched cohort study was conducted using the Taiwan Longitudinal Health Insurance Database between January 1997 and December 2010. Participants A total of 3822 participants (1274 patients with TBI with hyperlipidaemia and 2548 age-matched and gender-matched patients with TBI without hyperlipidaemia). Outcome measures The incidence and HRs for the development of new-onset ADs after TBI were compared between the two groups. Results The overall incidence rate of new-onset ADs for patients with TBI with hyperlipidaemia is 142.03/10 000 person-years (PYs). Patients with TBI with hyperlipidaemia have a 1.60-fold incidence rate ratio (p<0.0001) and increased HR of ADs (1.58, 95% CI 1.24 to 2.02) compared with those without hyperlipidaemia. The incidence rates of ADs for males and females with hyperlipidaemia, respectively, were 142.12 and 292.32/10 000 PYs, which were higher than those without hyperlipidaemia (93.03 and 171.68/10 000 PYs, respectively). Stratified by age group, hyperlipidaemia is a risk factor of ADs for patients with TBI aged 65 years or younger. Conclusions Pre-existing hyperlipidaemia is an independent predictor of new-onset ADs in patients with TBI, even when controlling for other demographic and clinical variables. Female patients with pre-existing hyperlipidaemia had significantly higher risk of new-onset ADs than males, especially between the ages of 35 and 65 years. PMID:25034630

  16. Pre-existing Epithelial Diversity in Normal Human Livers: A Tissue-tethered Cytometric Analysis in Portal/Periportal Epithelial Cells

    PubMed Central

    Isse, Kumiko; Lesniak, Andrew; Grama, Kedar; Maier, John; Specht, Susan; Castillo-Rama, Marcela; Lunz, John; Roysam, Badrinath; Michalopoulos, George; Demetris, Anthony J.

    2012-01-01

    Routine light microscopy identifies two distinct epithelial cell populations in normal human livers: hepatocytes and biliary epithelial cells (BEC). Considerable epithelial diversity, however, arises during disease states when a variety of hepatocyte-BEC hybrid cells appear. This has been attributed to activation and differentiation of putative hepatic progenitor cells (HPC) residing in the Canals of Hering and/or metaplasia of pre-existing mature epithelial cells. A novel analytic approach consisting of multiplex labeling, high resolution whole slide imaging (WSI), and automated image analysis was used to determine if more complex epithelial cell phenotypes pre-existed in normal adult human livers, which might provide an alternative explanation for disease-induced epithelial diversity. “Virtually digested” WSI enabled quantitative cytometric analyses of individual cells displayed in a variety of formats (e.g. scatter plots) while still tethered to the WSI and tissue structure. We employed biomarkers specifically-associated with mature epithelial forms (HNF4α for hepatocytes, CK19 and HNF1β for BEC) and explored for the presence of cells with hybrid biomarker phenotypes. Results showed abundant hybrid cells in portal bile duct BEC, canals of Hering, and immediate periportal hepatocytes. These bi-potential cells likely serve as a reservoir for the epithelial diversity of ductular reactions, appearance of hepatocytes in bile ducts, and the rapid and fluid transition of BEC to hepatocytes, and vice versa. Conclusion Novel imaging and computational tools enable increased information extraction from tissue samples and quantify the considerable pre-existent hybrid epithelial diversity in normal human liver. This computationally-enabled tissue analysis approach offers much broader potential beyond the results presented here. PMID:23150208

  17. The effects of pre-existing discontinuities on the surface expression of normal faults: Insights from wet-clay analog modeling

    NASA Astrophysics Data System (ADS)

    Bonini, Lorenzo; Basili, Roberto; Toscani, Giovanni; Burrato, Pierfrancesco; Seno, Silvio; Valensise, Gianluca

    2016-08-01

    We use wet-clay analog models to investigate how pre-existing discontinuities (i.e. structures inherited from previous tectonic phases) affect the evolution of a normal fault at the Earth's surface. To this end we first perform a series of three reference experiments driven by a 45° dipping master fault unaffected by pre-existing discontinuities to generate a mechanically isotropic learning set of models. We then replicate the experiment six times introducing a 60°-dipping precut in the clay cake, each time with a different attitude and orientation with respect to an initially-blind, 45°-dipping, master normal fault. In all experiments the precut intersects the vertical projection of the master fault halfway between the center and the right-hand lateral tip. All other conditions are identical for all seven models. By comparing the results obtained from the mechanically isotropic experiments with results from experiments with precuts we find that the surface evolution of the normal fault varies depending on the precut orientation. In most cases the parameters of newly-forming faults are strongly influenced. The largest influence is exerted by synthetic and antithetic discontinuities trending respectively at 30° and 45° from the strike of the master fault, whereas a synthetic discontinuity at 60° and an antithetic discontinuity at 30° show moderate influence. Little influence is exerted by a synthetic discontinuity at 45° and an antithetic discontinuity at 60° from the strike of the master fault. We provide a ranking chart to assess fault-to-discontinuity interactions with respect to essential surface fault descriptors, such as segmentation, vertical-displacement profile, maximum displacement, and length, often used as proxies to infer fault properties at depth. Considering a single descriptor, the amount of deviation induced by different precuts varies from case to case in a rather unpredictable fashion. Multiple observables should be taken into

  18. Investigating the Influence of Pre-Existing Basement Structures on the Propagation of the Malawi Rift using SRTM, RADARSAT, and Aeromagnetic Data

    NASA Astrophysics Data System (ADS)

    Robertson, K.; Atekwana, E. A.; Abdelsalam, M. G.; Laó-Dávila, D. A.

    2015-12-01

    The Malawi rift is a Neogene, amagmatic rift located where the Western Branch of the East Africa Rift System (EARS) terminates. In more mature rifts, magmatism is frequently recognized as a driving factor in rift propagation; however, the amagmatic nature of the Malawi rift permits investigation into the relationship between pre-existing structures and current rift propagation, without the influence of magmatism. To map surface structures, we used Shuttle Radar Topography Mission (SRTM) Digital Elevation Model (DEM) and RADARSAT imagery over southern Malawi. To process the SRTM data, we applied edge enhancing filters and derivatives, and extracted topographic profiles to examine scarp height and minimum vertical exposed displacement. We mapped morphologically-defined structures by filtering the RADARSAT imagery using an enhanced lee filter to reduce noise and a Laplacian filter for edge enhancement. To examine Precambrian basement structures, we filtered aeromagnetic data using vertical and horizontal derivatives, tilt derivative, and analytic signal to create magnetic anomaly maps. Surface mapping indicated three primary trends in the southern Malawi rift: NW-SE (dominant), NE-SW, both of which are most likely the remnants of Mesozoic Karoo rifting, and a NNE-SSW trend seen in Neogene rifting. The Precambrian basement structural mapping also reveals three primary trends: WNW-ESE, NE-SW, and NW-SE. Ductile deformation causes the dominant basement fabric to change, switching polarity as the rift propagated southward from NE-SW orientation to NW-SE and WNW-ESE orientations, and back to a NE-SW orientation. In general, the surficial structures follow this trend. In some areas, however, the more recent rifting cut across pre-existing basement structures, possibly due to rheological heterogeneities or selective strain partitioning. Nonetheless, pre-existing basement structures played a critical role in strain localization and fault propagation in Malawi. However

  19. Platypnea-orthodeoxia syndrome in a patient with a pre-existing patent foramen ovale successfully treated with an atrial septal occluder

    PubMed Central

    Zhang, Ting-Ting; Cheng, Ge-Sheng; Wang, Jun; Wang, Xing-Ye; Xie, Xue-Gang; Du, Ya-Juan; Zhang, Yu-Shun

    2015-01-01

    Platypnea orthodeoxia syndrome is associated with dyspnea and arterial oxygen desaturation accentuated by an upright posture. It can be secondary to an intracardiac shunt. We report a case of platypnea-orthodeoxia syndrome (POS) in a 58-year old male patient who had a pre-existing patent foramen ovale (PFO) and substantial pulmonary pathologies. He was successfully treated by percutaneous transcatheter closure of the PFO. Our case highlights the importance of recognition of this rare syndrome in patients who present with unexplained hypoxia for whom transcatheter closure of the interatrial shunt can be safely carried out. PMID:26089859

  20. Lack of efficacy of pre bronchoscopy inhaled salbutamol on symptoms and lung functions in patients with pre-existing airway obstruction

    PubMed Central

    Mohan, Anant; Momin, Indrajit; Poulose, Rosemary; Mohan, Charu; Madan, Karan; Hadda, Vijay; Guleria, Randeep; Pandey, RM

    2016-01-01

    Background: Fiberoptic bronchoscopy (FOB) may exaggerate symptoms and lung functions in patients with pre-existing airway obstruction. Interventions which can alleviate or minimize this procedure-related bronchospasm, especially in this high-risk group are, therefore, required. Methods: A double-blinded randomized controlled trial was conducted to evaluate the efficacy of 400 μg of inhaled salbutamol on patients with spirometric evidence of airflow obstruction planned for FOB. Patient's dyspnea, procedure tolerability, and change in spirometry were assessed before and after the procedure. Results: A total of 50 patients were enrolled (78% males), with a mean (standard deviation) age of 49.8 (6.2) years. There was a significant fall in % predicted FEV1 within each group compared to their respective pre-bronchoscopy values. However, no significant difference in the % predicted or absolute FEV1 level was observed between the two groups. Similarly, although both groups experienced increased dyspnea immediately following FOB, this difference was not significant between the two groups either on the Borg or visual analog scale scales. Pre-FOB anxiety levels and the tolerability of the procedure as assessed by the bronchoscopist were similar in both groups. Conclusion: FOB in patients with pre-existing airway obstruction aggravates cough and dyspnea, with a concomitant decline in FEV1 and FVC. The administration of pre-FOB inhaled salbutamol does not have any significant beneficial effect on procedure-related outcomes. PMID:27578926

  1. Reduction in noise-induced functional loss of the cochleae in mice with pre-existing cochlear dysfunction due to genetic interference of prestin.

    PubMed

    Cai, Qunfeng; Wang, Bo; Coling, Donald; Zuo, Jian; Fang, Jie; Yang, Shiming; Vera, Krystal; Hu, Bo Hua

    2014-01-01

    Various cochlear pathologies, such as acoustic trauma, ototoxicity and age-related degeneration, cause hearing loss. These pre-existing hearing losses can alter cochlear responses to subsequent acoustic overstimulation. So far, the knowledge on the impacts of pre-existing hearing loss caused by genetic alteration of cochlear genes is limited. Prestin is the motor protein expressed exclusively in outer hair cells in the mammalian cochlea. This motor protein contributes to outer hair cell motility. At present, it is not clear how the interference of prestin function affects cochlear responses to acoustic overstimulation. To address this question, a genetic model of prestin dysfunction in mice was created by inserting an internal ribosome entry site (IRES)-CreERT2-FRT-Neo-FRT cassette into the prestin locus after the stop codon. Homozygous mice exhibit a threshold elevation of auditory brainstem responses with large individual variation. These mice also display a threshold elevation and a shift of the input/output function of the distortion product otoacoustic emission, suggesting a reduction in outer hair cell function. The disruption of prestin function reduces the threshold shifts caused by exposure to a loud noise at 120 dB (sound pressure level) for 1 h. This reduction is positively correlated with the level of pre-noise cochlear dysfunction and is accompanied by a reduced change in Cdh1 expression, suggesting a reduction in molecular responses to the acoustic overstimulation. Together, these results suggest that prestin interference reduces cochlear stress responses to acoustic overstimulation.

  2. Cladodes, leaf-like organs in Asparagus, show the significance of co-option of pre-existing genetic regulatory circuit for morphological diversity of plants.

    PubMed

    Nakayama, Hokuto; Yamaguchi, Takahiro; Tsukaya, Hirokazu

    2012-08-01

    Plants in the genus Asparagus have determinate leaf-like organs called cladodes in the position of leaf axils. Because of their leaf-like morphology, axillary position, and morphological variation, it has been unclear how this unusual organ has evolved and diversified. In the previous study, we have shown that cladodes in the genus Asparagus are modified axillary shoots and proposed a model that cladodes have arisen by co-option and deployment of genetic regulatory circuit (GRC) involved in leaf development. Moreover, we proposed that the alteration of the expression pattern of genes involved in establishment of adaxial/abaxial polarity has led to the morphological diversification from leaf-like to rod-like form of cladodes in the genus. Thus, these results indicated that the co-option and alteration of pre-existing GRC play an important role in acquisition and subsequent morphological diversification. Here, we present data of further expression analysis of A. asparagoides. The results suggested that only a part of the GRC involved in leaf development appears to have been co-opted into cladode development. Based on our study and several examples of the morphological diversification, we briefly discuss the importance of co-option of pre-existing GRC and its genetic modularity in the morphological diversity of plants during evolution.

  3. Pre-existing oblique transfer zones and transfer/transform relationships in continental margins: New insights from the southeastern Gulf of Aden, Socotra Island, Yemen

    NASA Astrophysics Data System (ADS)

    Bellahsen, N.; Leroy, S.; Autin, J.; Razin, P.; d'Acremont, E.; Sloan, H.; Pik, R.; Ahmed, A.; Khanbari, K.

    2013-11-01

    Transfer zones are ubiquitous features in continental rifts and margins, as are transform faults in oceanic lithosphere. Here, we present a structural study of the Hadibo Transfer Zone (HTZ), located in Socotra Island (Yemen) in the southeastern Gulf of Aden. There, we interpret this continental transfer fault zone to represent a reactivated pre-existing structure. Its trend is oblique to the direction of divergence and it has been active from the early up to the latest stages of rifting. One of the main oceanic fracture zones (FZ), the Hadibo-Sharbithat FZ, is aligned with and appears to be an extension of the HTZ and is probably genetically linked to it. Comparing this setting with observations from other Afro-Arabian rifts as well as with passive margins worldwide, it appears that many continental transfer zones are reactivated pre-existing structures, oblique to divergence. We therefore establish a classification system for oceanic FZ based upon their relationship with syn-rift structures. Type 1 FZ form at syn-rift structures and are late syn-rift to early syn-OCT. Type 2 FZ form during the OCT formation and Type 3 FZ form within the oceanic domain, after the oceanic spreading onset. The latter are controlled by far-field forces, magmatic processes, spreading rates, and oceanic crust rheology.

  4. Efficacy of orbifloxacin tablets for the treatment of superficial and deep pyoderma due to Staphylococcus intermedius infection in dogs

    PubMed Central

    Scott, Danny W.; Peters, Jeanine; Miller, William H.

    2006-01-01

    Orbifloxacin tablets were administered orally to 23 dogs with superficial and/or deep staphylococcal pyoderma. Response to therapy was excellent in 95.6% of the dogs. Duration of therapy varied from 21 to 40 days (average 29 days) for dogs having only superficial infections, and from 25 to 150 days (average 72 days) for dogs having deep infections. Relapses occurred in 18% of the dogs within a 3-month period. One dog developed a presumed adverse cutaneous drug reaction. Under the conditions of this study, orbifloxacin was an effective, safe, and convenient antibiotic for the treatment of superficial and deep staphylococcal pyoderma in dogs. PMID:17078249

  5. Efficacy of orbifloxacin tablets for the treatment of superficial and deep pyoderma due to Staphylococcus intermedius infection in dogs.

    PubMed

    Scott, Danny W; Peters, Jeanine; Miller, William H

    2006-10-01

    Orbifloxacin tablets were administered orally to 23 dogs with superficial and/or deep staphylococcal pyoderma. Response to therapy was excellent in 95.6% of the dogs. Duration of therapy varied from 21 to 40 days (average 29 days) for dogs having only superficial infections, and from 25 to 150 days (average 72 days) for dogs having deep infections. Relapses occurred in 18% of the dogs within a 3-month period. One dog developed a presumed adverse cutaneous drug reaction. Under the conditions of this study, orbifloxacin was an effective, safe, and convenient antibiotic for the treatment of superficial and deep staphylococcal pyoderma in dogs.

  6. Efficacy of Suvaxyn CSF Marker (CP7_E2alf) in the presence of pre-existing antibodies against Bovine viral diarrhea virus type 1.

    PubMed

    Dräger, Carolin; Schröder, Charlotte; König, Patricia; Tegtmeyer, Birthe; Beer, Martin; Blome, Sandra

    2016-09-01

    Classical swine fever (CSF) is still one of the most important viral diseases of pigs worldwide and outbreaks are notifiable to the OIE. The different control options also include (emergency) vaccination, preferably with a vaccine that allows differentiation of infected from vaccinated animals (DIVA principle). Recently, the chimeric pestivirus "CP7_E2alf" (Suvaxyn® CSF Marker, Zoetis) was licensed as live attenuated marker vaccine by the European Medicines Agency (EMA). In the context of risk assessments for an emergency vaccination scenario, the question has been raised whether pre-existing anti-pestivirus antibodies, especially against the vaccine backbone Bovine viral diarrhea virus type 1 (BVDV-1), would interfere with "CP7_E2alf" vaccination and the accompanying DIVA diagnostics. To answer this question, a vaccination-challenge-trial was conducted with Suvaxyn® CSF Marker and the "gold-standard" of live-modified CSF vaccines C-strain (RIEMSER® Schweinepestvakzine) as comparator. Pre-existing antibodies against BVDV-1 were provoked in a subset of animals through intramuscular inoculation of a recent field isolate from Germany (two injections with an interval of 2weeks). Twenty-seven days after the first injection, intramuscular vaccination of pre-exposed and naïve animals with either "CP7_E2alf" or C-strain "Riems" was performed. Seven days later, all vaccinated animals and two additional controls were oro-nasally challenged with highly virulent CSF virus (CSFV) strain Koslov. It was demonstrated that pre-existing BVDV-1 antibodies do not impact on the efficacy of live attenuated vaccines against CSF. Both C-strain "Riems" and marker vaccine "CP7_E2alf" were able to confer full protection against highly virulent challenge seven days after vaccination. However, slight interference was seen with serological DIVA diagnostics accompanying the vaccination with CP7_E2alf. Amended sample preparation and combination of test systems was able to resolve most cases

  7. Lymphocyte transformation suppression caused by pyoderma--failure to demonstrate it in uncomplicated demodectic mange.

    PubMed

    Barta, O; Waltman, C; Oyekan, P P; McGrath, R K; Hribernik, T N

    1983-01-01

    Three dogs with demodectic mange uncomplicated by a bacterial infection and 9 dogs with demodectic mange and pyoderma were tested for their lymphocyte response to phytomitogens in vitro and for the presence of the serum's lymphocyte immunoregulatory factors (SLIF) suppressing blastogenesis. None of the 3 dogs with uncomplicated demodectic mange showed any detectable dysfunction of their lymphocytes or presence of the blastogenesis suppressing SLIF. Their lymphocytes generally responded to the mitogens with more blastogenesis than lymphocytes from healthy controls. On the other hand, in the group of 9 dogs with demodicosis complicated by a bacterial infection, high levels of the blastogenesis suppressing SLIF for concanavalin A-sensitive cells were detected in 4 dogs, for phytohemagglutinin-sensitive cells in 2 dogs, and for pokeweed mitogen-sensitive cells in 1 (of only 3 tested) dog. Dysfunction of lymphocytes per se (detected by a decreased blastogenesis in nonsuppressive normal canine and bovine sera) was detected in 3 dogs with demodicosis with pyoderma. The success of the treatment of demodectic mange or the bacterial skin infection did not correlate with the previous presence or absence of the blastogenesis suppressing SLIF. The treatment of pyoderma was less successful in dogs with an increase in blastogenesis of unstimulated cells in fresh normal canine serum over that in autologous serum. All 3 dogs with a detected dysfunction of their lymphocytes either died or were euthanatized as untreatable cases. It is concluded that the development of demodectic mange per se did not cause the appearance of the blastogenesis suppressing SLIF, which was primarily related to the appearance and extent of the secondary bacterial skin infection.

  8. Manganese [III] Tetrakis [5,10,15,20]-Benzoic Acid Porphyrin Reduces Adiposity and Improves Insulin Action in Mice with Pre-Existing Obesity

    PubMed Central

    Brestoff, Jonathan R.; Brodsky, Tim; Sosinsky, Alexandra Z.; McLoughlin, Ryan; Stansky, Elena; Fussell, Leila; Sheppard, Aaron; DiSanto-Rose, Maria; Kershaw, Erin E.; Reynolds, Thomas H.

    2015-01-01

    The superoxide dismutase mimetic manganese [III] tetrakis [5,10,15,20]-benzoic acid porphyrin (MnTBAP) is a potent antioxidant compound that has been shown to limit weight gain during short-term high fat feeding without preventing insulin resistance. However, whether MnTBAP has therapeutic potential to treat pre-existing obesity and insulin resistance remains unknown. To investigate this, mice were treated with MnTBAP or vehicle during the last five weeks of a 24-week high fat diet (HFD) regimen. MnTBAP treatment significantly decreased body weight and reduced white adipose tissue (WAT) mass in mice fed a HFD and a low fat diet (LFD). The reduction in adiposity was associated with decreased caloric intake without significantly altering energy expenditure, indicating that MnTBAP decreases adiposity in part by modulating energy balance. MnTBAP treatment also improved insulin action in HFD-fed mice, a physiologic response that was associated with increased protein kinase B (PKB) phosphorylation and expression in muscle and WAT. Since MnTBAP is a metalloporphyrin molecule, we hypothesized that its ability to promote weight loss and improve insulin sensitivity was regulated by heme oxygenase-1 (HO-1), in a similar fashion as cobalt protoporphyrins. Despite MnTBAP treatment increasing HO-1 expression, administration of the potent HO-1 inhibitor tin mesoporphyrin (SnMP) did not block the ability of MnTBAP to alter caloric intake, adiposity, or insulin action, suggesting that MnTBAP influences these metabolic processes independent of HO-1. These data demonstrate that MnTBAP can ameliorate pre-existing obesity and improve insulin action by reducing caloric intake and increasing PKB phosphorylation and expression. PMID:26397111

  9. Early colonoscopy confers survival benefits on colon cancer patients with pre-existing iron deficiency anemia: a nationwide population-based study.

    PubMed

    Teng, Chieh-Lin Jerry; Yu, Jui-Ting; Chen, Yi-Huei; Lin, Ching-Heng; Hwang, Wen-Li

    2014-01-01

    This study aimed to examine the prognostic significance of pre-existing iron deficiency anemia (IDA) and the benefits of early colonoscopy in patients with colon cancer, since these have not been clearly established to date. Using the Taiwanese National Health Insurance Research Database, we retrieved and retrospectively reviewed the records of patients aged ≥ 55 years who were diagnosed with colon cancer between 2000 and 2005. The patient cohort was divided into two groups: patients with (n = 1,260) or without (n = 15,912) an IDA diagnosis during ≤ 18 months preceding the date of colon cancer diagnosis. We found that diabetes (27.9% vs. 20.3%, p<0.0001), cardiovascular disease (61.6% vs. 54.7%, p<0.001), and chronic kidney disease (4.6% vs. 2.2%, p<0.0001) were more common among patients with IDA than among those without IDA. The median overall survival times for patients with IDA and those without IDA were 4.6 and 5.7 years, respectively (p = 0.002). Patients who underwent colonoscopy ≤ 30 days, 31-90, and ≥ 91 days after IDA diagnosis showed median overall survival times of 5.79, 4.43, and 4.04 years, respectively (p = 0.003). Delayed colonoscopy was an independent factor associated with poor overall survival (adjusted hazard ratio, 1.28; 95% confidence interval, 1.07-1.53; p = 0.01). In conclusion, colon cancer patients with IDA were more likely to experience comorbidities than were those without IDA. Pre-existing IDA was a poor prognostic factor in adult men and postmenopausal women who had colon cancer. Early colonoscopy could improve overall survival possibly by facilitating early diagnosis and treatment. PMID:24466209

  10. Enhancing the performance of multi-crystalline silicon photovoltaic module by encapsulating high efficient Eu3+ complex into its pre-existing EVA layer

    NASA Astrophysics Data System (ADS)

    Wang, Tongxin; Yu, Bo; Hu, Zhijia; Wang, Xin; Zou, Gang; Zhang, Qijin

    2013-03-01

    Luminescent down shifting (LDS) technique is one effective way to improve the poor response of multi-crystalline silicon (mc-Si) photovoltaic (PV) modules at short wavelength less than 400 nm. Eu3+ complexes are effective LDS species for PV modules due to their large stokes' shift and high luminescent quantum efficiency (LQE). Although Eu3+ complexes have been utilized in PV modules as LDS species widely, they have not been encapsulated into the pre-existing poly-ethylene vinyl acetate (EVA) layer of modules between glass and solar cell by now. The aim of our work is to enhance the performance of mc-Si PV modules by encapsulating high efficient Eu3+ complexes into their pre-existing EVA layers which would not modify the well-established manufacturing process for PV modules. In this work, two Eu3+ complexes with different absorption spectrum were encapsulated into the commercial EVA layer by soaking method for the first time and used in the encapsulation of mc-Si PV modules. Hereinto, Eu(TTA)3(TPPO)2 (TTA = 2-thenoyltrifluoroacetonate, TPPO = triphenylphosphine oxide) (EuTT) with absorption spectrum less than 400 nm and high LQE (0.73) improves the external quantum efficiency of mc-Si PV module from 0.05 to 0.20, which produces a 0.42% increases in its power conversion efficiency. In addition, it is found that the enhancement brought by Eu(TTA)3(TPPO)2 can reduce cost of power generated by mc-Si devices from US1/Wp to US0.98/Wp according to the calculation. Therefore, Eu(TTA)3(TPPO)2 as LDS species with high LQE and low cost is promising for enhancing the performance of mc-Si PV modules in practical application.

  11. Myocardial infarction worsens glomerular injury and microalbuminuria in rats with pre-existing renal impairment accompanied by the activation of ER stress and inflammation.

    PubMed

    Dong, Zhifeng; Wu, Penglong; Li, Yongguang; Shen, Yuan; Xin, Ping; Li, Shuai; Wang, Zhihua; Dai, Xiaoyan; Zhu, Wei; Wei, Meng

    2014-12-01

    Deterioration of renal function occurs after chronic heart failure in approximately one-third of patients, particularly in those with pre-existing renal impairment such as diabetic nephropathy. Impaired renal function in these patients is always associated with a worse prognosis. However, the mechanisms underlying such deterioration of renal function are still largely unknown. In three separate protocols, we compared 1) sham operation (Ctr, n = 10) with surgically induced myocardial infarction (MI, n = 10); 2) unilateral nephrectomy (UNX, n = 10) with UNX + MI (n = 10); and 3) STZ-induced type 1 diabetes (DB, n = 10) with DB + MI (n = 10). The differences between combined injury models (UNX + MI, DB + MI) and simple MI were also examined. Renal remodeling, function, ER stress (CHOP and GRP78) and inflammation (infiltration of inflammatory cells, NF-κB p65) were evaluated 12 weeks after MI. In common SD rats, MI activated less glomerular ER stress and inflammation, resulting in a minor change of glomerular remodeling and microalbuminuria. However, MI significantly increased the glomerular expression of GRP78 and CHOP in UNX and DB rats. In addition, it also promoted the infiltration of CD4+ T cells, particularly inflammatory cytokine (IFN-γ, IL-17, IL-4)-producing CD4+ T cells, and the expression of NF-κB p65 in the glomeruli. By contrast, significant glomerular fibrosis, glomerulosclerosis, podocyte injury and microalbuminuria were found in rats with UNX + MI and DB + MI. MI significantly increased chronic glomerular injury and microalbuminuria at 12 weeks in rats with pre-existing renal impairment, i.e., UNX and DB, but not common SD rats. These changes were accompanied by increased glomerular ER stress and immune-associated inflammation.

  12. Bovine adenoviral vector-based H5N1 influenza vaccine overcomes exceptionally high levels of pre-existing immunity against human adenovirus.

    PubMed

    Singh, Neetu; Pandey, Aseem; Jayashankar, Lakshmi; Mittal, Suresh K

    2008-05-01

    Because of the high prevalence of adenovirus (Ad) infections in humans, it is believed that pre-existing Ad-neutralizing antibodies (vector immunity) may negatively impact the immune response to vaccine antigens when delivered by human Ad (HAd) vectors. In order to evaluate whether bovine Ad subtype 3 (BAd3), a non-HAd vector, can effectively elude high levels of pre-existing vector immunity, naïve and HAd serotype 5 (HAd)-primed mice were immunized with BAd-H5HA [BAd3 vector expressing the hemagglutinin (HA) gene from H5N1 influenza virus]. Even in the presence of very high levels of HAd-specific neutralizing antibody, no significant reductions in HA-specific humoral and cell-mediated immune (CMI) responses were observed in HAd-primed mice immunized with BAd-H5HA. In naïve mice immunized with HAd-H5HA (HAd5 vector expressing H5N1 HA) and boosted with BAd-H5HA, the humoral responses elicited were significantly higher (P < 0.01) than with either HAd-H5HA or BAd-H5HA alone, while the CMI responses were comparable in the groups. This finding underlines the importance of a heterologous prime-boost approach for achieving an enhanced immune response. The immunization of naïve or HAd-primed mice with BAd-H5HA bestowed full protection from morbidity and mortality following a potentially lethal challenge with A/Hong Kong/483/97. These results demonstrate the importance of BAd vectors as an alternate or supplement to HAd vectors for influenza pandemic preparedness.

  13. A distinct pre-existing inflammatory tumour microenvironment is associated with chemotherapy resistance in high-grade serous epithelial ovarian cancer

    PubMed Central

    Koti, M; Siu, A; Clément, I; Bidarimath, M; Turashvili, G; Edwards, A; Rahimi, K; Masson, A-M M; Squire, J A

    2015-01-01

    Background: Chemotherapy resistance is a major determinant of poor overall survival rates in high-grade serous ovarian cancer (HGSC). We have previously shown that gene expression alterations affecting the NF-κB pathway characterise chemotherapy resistance in HGSC, suggesting that the regulation of an immune response may be associated with this phenotype. Methods: Given that intrinsic drug resistance pre-exists and is governed by both tumour and host factors, the current study was performed to examine the cross-talk between tumour inflammatory microenvironment and cancer cells, and their roles in mediating differential chemotherapy response in HGSC patients. Expression profiling of a panel of 184 inflammation-related genes was performed in 15 chemoresistant and 19 chemosensitive HGSC tumours using the NanoString nCounter platform. Results: A total of 11 significantly differentially expressed genes were found to distinguish the two groups. As STAT1 was the most significantly differentially expressed gene (P=0.003), we validated the expression of STAT1 protein by immunohistochemistry using an independent cohort of 183 (52 resistant and 131 sensitive) HGSC cases on a primary tumour tissue microarray. Relative expression levels were subjected to Kaplan–Meier survival analysis and Cox proportional hazard regression models. Conclusions: This study confirms that higher STAT1 expression is significantly associated with increased progression-free survival and that this protein together with other mediators of tumour–host microenvironment can be applied as a novel response predictive biomarker in HGSC. Furthermore, an overall underactive immune microenvironment suggests that the pre-existing state of the tumour immune microenvironment could determine response to chemotherapy in HGSC. PMID:25826225

  14. Vaccines expressing the innate immune modulator EAT-2 elicit potent effector memory T lymphocyte responses despite pre-existing vaccine immunity.

    PubMed

    Aldhamen, Yasser Ali; Seregin, Sergey S; Schuldt, Nathaniel J; Rastall, David P W; Liu, Chyong-Jy J; Godbehere, Sarah; Amalfitano, Andrea

    2012-08-01

    The mixed results from recent vaccine clinical trials targeting HIV-1 justify the need to enhance the potency of HIV-1 vaccine platforms in general. Use of first-generation recombinant adenovirus serotype 5 (rAd5) platforms failed to protect vaccinees from HIV-1 infection. One hypothesis is that the rAd5-based vaccine failed due to the presence of pre-existing Ad5 immunity in many vaccines. We recently confirmed that EAT-2-expressing rAd5 vectors uniquely activate the innate immune system and improve cellular immune responses against rAd5-expressed Ags, inclusive of HIV/Gag. In this study, we report that use of the rAd5-EAT-2 vaccine can also induce potent cellular immune responses to HIV-1 Ags despite the presence of Ad5-specific immunity. Compared to controls expressing a mutant SH2 domain form of EAT-2, Ad5 immune mice vaccinated with an rAd5-wild-type EAT-2 HIV/Gag-specific vaccine formulation significantly facilitated the induction of several arms of the innate immune system. These responses positively correlated with an improved ability of the vaccine to induce stronger effector memory T cell-biased, cellular immune responses to a coexpressed Ag despite pre-existing anti-Ad5 immunity. Moreover, inclusion of EAT-2 in the vaccine mixture improves the generation of polyfunctional cytolytic CD8(+) T cell responses as characterized by enhanced production of IFN-γ, TNF-α, cytotoxic degranulation, and increased in vivo cytolytic activity. These data suggest a new approach whereby inclusion of EAT-2 expression in stringent human vaccination applications can provide a more effective vaccine against HIV-1 specifically in Ad5 immune subjects.

  15. Comparison of a chlorhexidine and a benzoyl peroxide shampoo as sole treatment in canine superficial pyoderma.

    PubMed

    Loeffler, A; Cobb, M A; Bond, R

    2011-09-01

    The clinical and antibacterial efficacy of two shampoos used as a sole antibacterial treatment in dogs with superficial pyoderma were investigated and compared. In a randomised, partially blinded study, a 3 per cent chlorhexidine gluconate shampoo (Chlorhex 3; Leo Animal Health) was compared against a 2.5 per cent benzoyl peroxide shampoo (Paxcutol; Virbac) in 22 dogs with superficial pyoderma. Dogs were washed two to three times weekly with a 10-minute contact time over 21 days. Clinical scores and bacterial counts were assessed on days 1, 8 and 22 and compared within and between treatment groups; overall response was assessed at the end of the study. Twenty dogs completed the study; 15 (68.2 per cent) showed an overall clinical improvement and the clinical signs resolved in three chlorhexidine-treated dogs. In the chlorhexidine-treated group, scores for papules/pustules (P<0.001), investigator-assessed pruritus (P=0.003), total bacterial counts (P=0.003) and counts for coagulase-positive staphylococci (P=0.003) were reduced after three weeks. Scores and bacterial counts did not vary significantly in the benzoyl peroxide-treated group.

  16. An Integral Effects Test in a zion-like geometry to investigate the effects of pre-existing hydrogen on direct containment heating in the Surtsey Test Facility

    SciTech Connect

    Allen, M.D.; Blanchat, T.K.; Pilch, M. ); Nichols, R.T. )

    1993-01-01

    The sixth experiment of the Integral Effects Test (IET-6) series was conducted to investigate the effects of high pressure melt ejection on direct containment heating. Scale models of the Zion reactor pressure vessel (RPV), cavity, instrument tunnel, and subcompartment structures were constructed in the Surtsey Test Facility at Sandia National Laboratories. The RPV was modeled with a melt generator that consisted of a steel pressure barrier, a cast MgO crucible, and a thin steel inner liner. The melt generator/crucible had a hemispherical bottom head containing a graphite limitor plate with a 4-cm exit hole to simulate the ablated hole in the RPV bottom head that would be formed by ejection of an instrument guide tube in a severe nuclear power plant accident. The cavity contained 3.48 kg of water, which corresponds to condensate levels in the Zion plant, and the containment basement floor was dry. A 43-kg initial charge of iron oxide/aluminum/chromium thermite was used to simulate corium debris on the bottom head of the RPV. Molten thermite was ejected by steam at an initial pressure of 6.3 MPa into the reactor cavity. The Surtsey vessel atmosphere contained pre-existing hydrogen to represent partial oxidation of the zirconium in the Zion core. The initial composition of the vessel atmosphere was 87.1 mol.% N[sub 2], 9.79 mol.% O[sub 2], and 2.59 mol.% H[sub 2], and the initial absolute pressure was 198 kPa. A partial hydrogen burn occurred in the Surtsey vessel. The peak vessel pressure increase was 279 kPa in IET-6, compared to 246 kPa in the IET-3 test. The total debris mass ejected into the Surtsey vessel in IET-6 was 42.5 kg. The gas grab sample analysis indicated that there were 180 g[center dot] moles of pre-existing hydrogen, and that 308[center dot]moles of hydrogen were produced by steam/metal reactions. About 335 g[center dot]moles of hydrogen burned, and 153 g[center dot]moles remained unreacted.

  17. The effects of aerobic- versus strength-training on body image among young women with pre-existing body image concerns.

    PubMed

    Martin Ginis, Kathleen A; Strong, Heather A; Arent, Shawn M; Bray, Steven R; Bassett-Gunter, Rebecca L

    2014-06-01

    This experiment compared the effects of aerobic-training (AT) versus strength-training (ST) on body image among young women with pre-existing body image concerns. Theory-based correlates of body image change were also examined. Participants were 46 women (M age=21.5 years), randomly assigned to an 8-week AT or ST intervention consisting of supervised exercise 3 days/week. Multidimensional measures of body image were administered pre- and post-intervention, along with measures of physical fitness, perceived fitness, and exercise self-efficacy. Women in the AT condition reported greater reductions in social physique anxiety (p=.001) and tended to report greater improvements in appearance evaluation (p=.06) than women in the ST condition. Changes in perceived fatness, perceived aerobic endurance and aerobic self-efficacy were significantly correlated with body image change (ps<.003). Results provide direction for prescribing exercise to improve body image and advancing theory to account for the effects of exercise. PMID:24958656

  18. Effects of blending of desalinated and conventionally treated surface water on iron corrosion and its release from corroding surfaces and pre-existing scales.

    PubMed

    Liu, Haizhou; Schonberger, Kenneth D; Peng, Ching-Yu; Ferguson, John F; Desormeaux, Erik; Meyerhofer, Paul; Luckenbach, Heidi; Korshin, Gregory V

    2013-07-01

    This study examined effects of blending desalinated water with conventionally treated surface water on iron corrosion and release from corroding metal surfaces and pre-existing scales exposed to waters having varying fractions of desalinated water, alkalinities, pH values and orthophosphate levels. The presence of desalinated water resulted in markedly decreased 0.45 μm-filtered soluble iron concentrations. However, higher fractions of desalinated water in the blends were also associated with more fragile corroding surfaces, lower retention of iron oxidation products and release of larger iron particles in the bulk water. SEM, XRD and XANES data showed that in surface water, a dense layer of amorphous ferrihydrite phase predominated in the corrosion products. More crystalline surface phases developed in the presence of desalinated water. These solid phases transformed from goethite to lepidocrocite with increased fraction of desalinated water. These effects are likely to result from a combination of chemical parameters, notably variations of the concentrations of natural organic matter, calcium, chloride and sulfate when desalinated and conventionally treated waters are blended.

  19. A critical shock mach number for particle acceleration in the absence of pre-existing cosmic rays: M=√5

    SciTech Connect

    Vink, Jacco

    2014-01-10

    It is shown that, under some generic assumptions, shocks cannot accelerate particles unless the overall shock Mach number exceeds a critical value M>√5. The reason is that for M≤√5 the work done to compress the flow in a particle precursor requires more enthalpy flux than the system can sustain. This lower limit applies to situations without significant magnetic field pressure. In case that the magnetic field pressure dominates the pressure in the unshocked medium, i.e., for low plasma beta, the resistivity of the magnetic field makes it even more difficult to fulfill the energetic requirements for the formation of shock with an accelerated particle precursor and associated compression of the upstream plasma. We illustrate the effects of magnetic fields for the extreme situation of a purely perpendicular magnetic field configuration with plasma beta β = 0, which gives a minimum Mach number of M = 5/2. The situation becomes more complex, if we incorporate the effects of pre-existing cosmic rays, indicating that the additional degree of freedom allows for less strict Mach number limits on acceleration. We discuss the implications of this result for low Mach number shock acceleration as found in solar system shocks, and shocks in clusters of galaxies.

  20. Lack of variant specific CD8+ T-cell response against mutant and pre-existing variants leads to outgrowth of particular clones in acute hepatitis C

    PubMed Central

    2013-01-01

    Background CTL escape mutations have been described during acute hepatitis C in patients who developed chronic disease later on. Our aim was to investigate the mutual relationship between HCV specific CD8+ T cells and evolution of the viral sequence during early acute HCV infection. Results We sequenced multiple clones of NS3 1406 epitope in 4 HLA-A*02 patients with acute hepatitis C genotype 1b infection. Pentamers specific for the variants were used to monitor the corresponding CD8+ T cell response. We observed outgrowth of mutations, which induced only a weak and thus potentially insufficient CD8+ T cell response. In one patient we observed outgrowth of variant epitopes with similarities to a different genotype rather than de novo mutations most probably due to a lack of responsiveness to these likely pre-existing variants. We could show that in acute hepatitis C CTL escape mutations occur much earlier than demonstrated in previous studies. Conclusions The adaption of the virus to a new host is characterized by a high and rapid variability in epitopes under CD8+ T cell immune pressure. This adaption takes place during the very early phase of acute infection and strikingly some sequences were reduced below the limit of detection at some time points but were detected at high frequency again at later time points. Independent of the observed variability, HCV-specific CD8+ T cell responses decline and no adaption to different or new antigens during the course of infection could be detected. PMID:24073713

  1. The effects of aerobic- versus strength-training on body image among young women with pre-existing body image concerns.

    PubMed

    Martin Ginis, Kathleen A; Strong, Heather A; Arent, Shawn M; Bray, Steven R; Bassett-Gunter, Rebecca L

    2014-06-01

    This experiment compared the effects of aerobic-training (AT) versus strength-training (ST) on body image among young women with pre-existing body image concerns. Theory-based correlates of body image change were also examined. Participants were 46 women (M age=21.5 years), randomly assigned to an 8-week AT or ST intervention consisting of supervised exercise 3 days/week. Multidimensional measures of body image were administered pre- and post-intervention, along with measures of physical fitness, perceived fitness, and exercise self-efficacy. Women in the AT condition reported greater reductions in social physique anxiety (p=.001) and tended to report greater improvements in appearance evaluation (p=.06) than women in the ST condition. Changes in perceived fatness, perceived aerobic endurance and aerobic self-efficacy were significantly correlated with body image change (ps<.003). Results provide direction for prescribing exercise to improve body image and advancing theory to account for the effects of exercise.

  2. Pre-existing cross-reactive antibodies to avian influenza H5N1 and 2009 pandemic H1N1 in US military personnel.

    PubMed

    Pichyangkul, Sathit; Krasaesub, Somporn; Jongkaewwattana, Anan; Thitithanyanont, Arunee; Wiboon-Ut, Suwimon; Yongvanitchit, Kosol; Limsalakpetch, Amporn; Kum-Arb, Utaiwan; Mongkolsirichaikul, Duangrat; Khemnu, Nuanpan; Mahanonda, Rangsini; Garcia, Jean-Michel; Mason, Carl J; Walsh, Douglas S; Saunders, David L

    2014-01-01

    We studied cross-reactive antibodies against avian influenza H5N1 and 2009 pandemic (p) H1N1 in 200 serum samples from US military personnel collected before the H1N1 pandemic. Assays used to measure antibodies against viral proteins involved in protection included a hemagglutination inhibition (HI) assay and a neuraminidase inhibition (NI) assay. Viral neutralization by antibodies against avian influenza H5N1 and 2009 pH1N1 was assessed by influenza (H5) pseudotyped lentiviral particle-based and H1N1 microneutralization assays. Some US military personnel had cross-neutralizing antibodies against H5N1 (14%) and 2009 pH1N1 (16.5%). The odds of having cross-neutralizing antibodies against 2009 pH1N1 were 4.4 times higher in subjects receiving more than five inactivated whole influenza virus vaccinations than those subjects with no record of vaccination. Although unclear if the result of prior vaccination or disease exposure, these pre-existing antibodies may prevent or reduce disease severity.

  3. An Analytical Model for Assessing Stability of Pre-Existing Faults in Caprock Caused by Fluid Injection and Extraction in a Reservoir

    NASA Astrophysics Data System (ADS)

    Wang, Lei; Bai, Bing; Li, Xiaochun; Liu, Mingze; Wu, Haiqing; Hu, Shaobin

    2016-07-01

    Induced seismicity and fault reactivation associated with fluid injection and depletion were reported in hydrocarbon, geothermal, and waste fluid injection fields worldwide. Here, we establish an analytical model to assess fault reactivation surrounding a reservoir during fluid injection and extraction that considers the stress concentrations at the fault tips and the effects of fault length. In this model, induced stress analysis in a full-space under the plane strain condition is implemented based on Eshelby's theory of inclusions in terms of a homogeneous, isotropic, and poroelastic medium. The stress intensity factor concept in linear elastic fracture mechanics is adopted as an instability criterion for pre-existing faults in surrounding rocks. To characterize the fault reactivation caused by fluid injection and extraction, we define a new index, the "fault reactivation factor" η, which can be interpreted as an index of fault stability in response to fluid pressure changes per unit within a reservoir resulting from injection or extraction. The critical fluid pressure change within a reservoir is also determined by the superposition principle using the in situ stress surrounding a fault. Our parameter sensitivity analyses show that the fault reactivation tendency is strongly sensitive to fault location, fault length, fault dip angle, and Poisson's ratio of the surrounding rock. Our case study demonstrates that the proposed model focuses on the mechanical behavior of the whole fault, unlike the conventional methodologies. The proposed method can be applied to engineering cases related to injection and depletion within a reservoir owing to its efficient computational codes implementation.

  4. Immunogenicity and Safety of Trivalent Split Influenza Vaccine in Healthy Korean Adults with Low Pre-Existing Antibody Levels: An Open Phase I Trial

    PubMed Central

    Kang, Kyuri; Han, Seunghoon; Hong, Taegon; Jeon, Sangil; Paek, Jeongki; Kang, Jin Han

    2016-01-01

    Purpose A phase I clinical trial was conducted to evaluate the immunogenicity and safety of newly developed egg-cultivated trivalent inactivated split influenza vaccine (TIV) in Korea. Materials and Methods The TIV was administered to 43 healthy male adults. Subjects with high pre-existing titers were excluded in a screening step. Immune response was measured by a hemagglutination inhibition (HI) assay. Results The seroprotection rates against A/California/7/2009 (H1N1), A/Perth/16/2009 (H3N2) and B/Brisbane/60/2009 were 74.42% [95% confidence interval (CI): 61.38–87.46], 72.09% (95% CI: 58.69–85.50), and 86.05% (95% CI: 75.69–96.40), respectively. Calculated seroconversion rates were 74.42% (95% CI: 61.38–87.46), 74.42% (95% CI: 61.38–87.46), and 79.07% (95% CI: 66.91–91.23), respectively. There were 25 episodes of solicited local adverse events in 21 subjects (47.73%), 21 episodes of solicited general adverse events in 16 subjects (36.36%) and 5 episodes of unsolicited adverse events in 5 subjects (11.36%). All adverse events were grade 1 or 2 and disappeared within three days. Conclusion The immunogenicity and safety of TIV established in this phase I trial are sufficient to plan a larger scale clinical trial. PMID:27593862

  5. Effects of blending of desalinated and conventionally treated surface water on iron corrosion and its release from corroding surfaces and pre-existing scales.

    PubMed

    Liu, Haizhou; Schonberger, Kenneth D; Peng, Ching-Yu; Ferguson, John F; Desormeaux, Erik; Meyerhofer, Paul; Luckenbach, Heidi; Korshin, Gregory V

    2013-07-01

    This study examined effects of blending desalinated water with conventionally treated surface water on iron corrosion and release from corroding metal surfaces and pre-existing scales exposed to waters having varying fractions of desalinated water, alkalinities, pH values and orthophosphate levels. The presence of desalinated water resulted in markedly decreased 0.45 μm-filtered soluble iron concentrations. However, higher fractions of desalinated water in the blends were also associated with more fragile corroding surfaces, lower retention of iron oxidation products and release of larger iron particles in the bulk water. SEM, XRD and XANES data showed that in surface water, a dense layer of amorphous ferrihydrite phase predominated in the corrosion products. More crystalline surface phases developed in the presence of desalinated water. These solid phases transformed from goethite to lepidocrocite with increased fraction of desalinated water. These effects are likely to result from a combination of chemical parameters, notably variations of the concentrations of natural organic matter, calcium, chloride and sulfate when desalinated and conventionally treated waters are blended. PMID:23651514

  6. Atypical presentation of pioderma gangrenosum complicating ulcerative colitis: Rapid disappearance with methylprednisolone

    PubMed Central

    Aseni, Paolo; Sandro, Stefano Di; Mihaylov, Plamen; Lamperti, Luca; Carlis, Luciano Gregorio De

    2008-01-01

    Piodermal gangrenosum (PG) is an uncommon ulcerative cutaneous dermatosis associated with a variety of systemic diseases, including inflammatory bowel disease (IBD), arthritis, leukaemia, hepatitis, and primary biliary cirrhosis. Other cutaneous ulceration resembling PG had been described in literature. There has been neither laboratory finding nor histological feature diagnostic of PG, and diagnosis of PG is mainly made based on the exclusion criteria. We present here a patient, with ulcerative colitis (UC) who was referred to the emergency section with a large and rapidly evolving cutaneous ulceration. Laboratory and microbiological investigation associated with histological findings of the ulcer specimen allowed us to exclude autoimmune and systemic diseases as well as immuno-proliferative disorders. An atypical presentation of PG with UC was diagnosed. Pulse boluses of i.v. methyl-prednisolone were started, and after tapering steroids, complete resolution of the skin lesion was achieved in 3 wk. The unusual rapid healing of the skin ulceration with steroid mono-therapy and the atypical cutaneous presentation in this patient as well as the risk of misdiagnosis of PG in the clinical practice were discussed. PMID:18803362

  7. Reservoir Stimulation Experiments at the Grimsel Test Site: Stress Measurements using Hydraulic fracturing, Hydraulic Tests on Pre-existing Fractures and Overcoring

    NASA Astrophysics Data System (ADS)

    Doetsch, J.; Gischig, V.; Amann, F.; Madonna, C.; Jalali, M.; Valley, B.; Evans, K. F.

    2015-12-01

    A decameter-scale in-situ hydraulic stimulation and circulation experiment has been planned in the Deep Underground rock Laboratory (DUG Lab) at the Grimsel Test Site, Switzerland. The general objective of this experiment is to improve our understanding of the pressure, temperature and stress changes in the rock mass due to hydraulic stimulation. In this context, the main goal is to investigate the effect of hydro-shearing on the local stress variation as well as transient and permanent permeability changes with comprehensive thermo-hydro-mechanical (THM) and acoustic emission monitoring. This experiment is designed such that stimulation processes are recorded in a dataset that is unique in THM coupled processes and induced seismicity research. In preparation to the hydro-shearing experiments, the experimental rock volume has been studied in detail using geological tunnel mapping, optical televiewer in existing boreholes, hydraulic tests, geophysical imaging and review of the extensive literature on experiments at the Grimsel Test Site. The geophysical investigations include reflection and transmission ground penetrating radar (GPR) and seismic measurements between the tunnels to image shear zones and reveal heterogeneity of the rock mass. The orientation and magnitude of the principal stresses of the rock volume and its surroundings has been analyzed using hydraulic fracturing, hydraulic tests on pre-existing fractures and overcoring. The hydraulic fracturing tests for stress measurements were monitored using a 32-channel acoustic emission monitoring system and a regional seismic monitoring network. Here, we present the results of the pre-investigations and stress measurements, and give an outlook for the hydro-shearing experiments planned for spring 2016.

  8. Mechanical Behavior of Brittle Rock-Like Specimens with Pre-existing Fissures Under Uniaxial Loading: Experimental Studies and Particle Mechanics Approach

    NASA Astrophysics Data System (ADS)

    Cao, Ri-hong; Cao, Ping; Lin, Hang; Pu, Cheng-zhi; Ou, Ke

    2016-03-01

    Joints and fissures with similar orientation or characteristics are common in natural rocks; the inclination and density of the fissures affect the mechanical properties and failure mechanism of the rock mass. However, the strength, crack coalescence pattern, and failure mode of rock specimens containing multi-fissures have not been studied comprehensively. In this paper, combining similar material testing and discrete element numerical method (PFC2D), the peak strength and failure characteristics of rock-like materials with multi-fissures are explored. Rock-like specimens were made of cement and sand and pre-existing fissures created by inserting steel shims into cement mortar paste and removing them during curing. The peak strength of multi-fissure specimens depends on the fissure angle α (which is measured counterclockwise from horizontal) and fissure number ( N f). Under uniaxial compressional loading, the peak strength increased with increasing α. The material strength was lowest for α = 25°, and highest for α = 90°. The influence of N f on the peak strength depended on α. For α = 25° and 45°, N f had a strong effect on the peak strength, while for higher α values, especially for the 90° sample, there were no obvious changes in peak strength with different N f. Under uniaxial compression, the coalescence modes between the fissures can be classified into three categories: S-mode, T-mode, and M-mode. Moreover, the failure mode can be classified into four categories: mixed failure, shear failure, stepped path failure, and intact failure. The failure mode of the specimen depends on α and N f. The peak strength and failure modes in the numerically simulated and experimental results are in good agreement.

  9. Paraoxonase 1 gene transfer lowers vascular oxidative stress and improves vasomotor function in apolipoprotein E-deficient mice with pre-existing atherosclerosis

    PubMed Central

    Guns, P-J; Van Assche, T; Verreth, W; Fransen, P; Mackness, B; Mackness, M; Holvoet, P; Bult, H

    2007-01-01

    Background and purpose: Transgenesis of human paraoxonase 1 (PON1), a HDL-associated enzyme that destroys lipid peroxides, has been reported to reduce early atherogenesis in mice. The present study explored the therapeutic potential of human PON1 gene transfer in old apolipoprotein E-deficient (apoE−/−) mice with advanced atherosclerosis. Experimental approach: ApoE−/− mice (18 months, regular chow) were transfected with PON1 adenovirus (AdPON1, n=10) or control adenovirus (AdRR5, n=10). Non-transfected apoE−/− (n=9) and C57Bl/6J (WT, n=6) mice served as controls. Three weeks later, plaque size and composition, and endothelial cell (EC) and smooth muscle cell (SMC) function were assessed in the aorta. Key results: PON1 gene transfer raised total PON1 serum activity 13-15 fold during the 3-week study period, without affecting hypercholesterolaemia or lesion size. However, PON1 decreased the oxLDL content of the plaque. Plaque-free thoracic aorta rings from apoE−/− mice displayed, like rings from WT mice, complete relaxation to acetylcholine (ACh, 86±2%), ATP (90±2%) or UTP (83±3%). In contrast, in plaque-bearing segments amplitude (55±7%, 68±8%, 52±8% respectively) and sensitivity were decreased. EC function was completely (ATP, UTP) or largely (ACh) restored by AdPON1. Furthermore, apoE−/− SMCs released less intracellular calcium than WT upon sarco-endoplasmic reticulum calcium ATPase (SERCA) inhibition by cyclopiazonic acid. This defect was also restored by AdPON1 transfection. Conclusions and implications: These data indicate that AdPON1 gene transfer improved vascular wall oxidative stress, EC function, and SMC Ca2+ homeostasis in segments with pre-existing atherosclerosis, independently of an effect on plaque size. PMID:18059326

  10. A case of blastomycosis-like pyoderma caused by mixed infection of Staphylococcus epidermidis and Trichophyton rubrum.

    PubMed

    Ouchi, Takeshi; Tamura, Mai; Nishimoto, Shuhei; Sato, Tomotaka; Ishiko, Akira

    2011-06-01

    Blastomycosis-like pyoderma (BLP) is a type of chronic pyoderma characterized histologically by specific epidermal changes namely: pseudoepitheliomatous hyperplasia and intraepithelial abscesses. These epidermal changes are also seen in blastomycosis (referred to as deep dermatophytosis in North America). Here, we describe the case of a 53-year-old male with prurigo nodularis, diabetes, and chronic lymphocytic leukemia who presented with multiple yellowish-red colored papules that coalesced to form a vegetating plaque. In addition to the typical features of BLP, spores with budding were seen histopathologically in a biopsy specimen. Cultures of a skin specimen grew Staphylococcus epidermidis and Trichophyton rubrum. Antibiotic therapy was effective but failed to eliminate the lesion until antifungal therapy using terbinafine was administered concurrently. Past reports suggest that BLP is mainly caused by bacterial infection, but our case suggests that fungal infection can also be involved as the causative organism in BLP.

  11. Characterization of a New Epidemic Necrotic Pyoderma in Fur Animals and Its Association with Arcanobacterium phocae Infection

    PubMed Central

    Nordgren, Heli; Aaltonen, Kirsi; Sironen, Tarja; Kinnunen, Paula M.; Kivistö, Ilkka; Raunio-Saarnisto, Mirja; Moisander-Jylhä, Anna-Maria; Korpela, Johanna; Kokkonen, Ulla-Maija; Hetzel, Udo; Sukura, Antti; Vapalahti, Olli

    2014-01-01

    A new type of pyoderma was detected in Finnish fur animals in 2007. The disease continues to spread within and between farms, with severe and potentially fatal symptoms. It compromises animal welfare and causes considerable economic losses to farmers. A case-control study was performed in 2010–2011 to describe the entity and to identify the causative agent. Altogether 99 fur animals were necropsied followed by pathological and microbiological examination. The data indicated that the disease clinically manifests in mink (Neovison vison) by necrotic dermatitis of the feet and facial skin. In finnraccoons (Nyctereutes procyonoides), it causes painful abscesses in the paws. Foxes (Vulpes lagopus) are affected by severe conjunctivitis and the infection rapidly spreads to the eyelids and facial skin. A common finding at necropsy was necrotic pyoderma. Microbiological analysis revealed the presence of a number of potential causative agents, including a novel Streptococcus sp. The common finding from all diseased animals of all species was Arcanobacterium phocae. This bacterium has previously been isolated from marine mammals with skin lesions but this is the first report of A. phocae isolated in fur animals with pyoderma. The results obtained from this study implicate A. phocae as a potential causative pathogen of fur animal epidemic necrotic pyoderma (FENP) and support observations that the epidemic may have originated in a species -shift of the causative agent from marine mammals. The variable disease pattern and the presence of other infectious agents (in particular the novel Streptococcus sp.) suggest a multifactorial etiology for FENP, and further studies are needed to determine the environmental, immunological and infectious factors contributing to the disease. PMID:25302603

  12. Characterization of meticillin-resistant and meticillin-susceptible isolates of Staphylococcus pseudintermedius from cases of canine pyoderma in Australia.

    PubMed

    Siak, Meng; Burrows, Amanda K; Coombs, Geoffrey W; Khazandi, Manouchehr; Abraham, Sam; Norris, Jacqueline M; Weese, J Scott; Trott, Darren J

    2014-09-01

    Meticillin-resistant Staphylococcus pseudintermedius (MRSP) has recently emerged as a worldwide cause of canine pyoderma. In this study, we characterized 22 S. pseudintermedius isolates cultured from 19 dogs with pyoderma that attended a veterinary dermatology referral clinic in Australia in 2011 and 2012. Twelve isolates were identified as MRSP by mecA real-time PCR and phenotypic resistance to oxacillin. In addition to β-lactam resistance, MRSP isolates were resistant to erythromycin (91.6 %), gentamicin (83.3 %), ciprofloxacin (83.3 %), chloramphenicol (75 %), clindamycin (66 %), oxytetracycline (66 %) and tetracycline (50 %), as shown by disc-diffusion susceptibility testing. Meticillin-susceptible S. pseudintermedius isolates only showed resistance to penicillin/ampicillin (90 %) and tetracycline (10 %). PFGE using the SmaI restriction enzyme was unable to type nine of the 12 MRSP isolates. However the nine isolates provided the same PFGE pulsotype using the Cfr91 restriction enzyme. Application of the mec-associated direct repeat unit (dru) typing method identified the nine SmaI PFGE-untypable isolates as dt11cb, a dru type that has only previously been associated with MRSP sequence type (ST)45 isolates that possess a unique SCCmec element. The dt11cb isolates shared a similar multidrug-resistant antibiogram phenotype profile, whereas the other MRSP isolates, dt11a, dt11af (dt11a-associated) and dt10h, were resistant to fewer antibiotic classes and had distinct PFGE profiles. This is the first report of MRSP causing pyoderma in dogs from Australia. The rapid intercontinental emergence and spread of multidrug-resistant MRSP strains confirms the urgent need for new treatment modalities for recurrent canine pyoderma in veterinary practice.

  13. Photosynthetic traits around budbreak in pre-existing needles of Sakhalin spruce (Picea glehnii) seedlings grown under elevated CO2 concentration assessed by chlorophyll fluorescence measurements.

    PubMed

    Kitao, Mitsutoshi; Tobita, Hiroyuki; Utsugi, Hajime; Komatsu, Masabumi; Kitaoka, Satoshi; Maruyama, Yutaka; Koike, Takayoshi

    2012-08-01

    To assess the effects of elevated CO(2) concentration ([CO(2)]) on the photosynthetic properties around spring budbreak, we monitored the total leaf sugar and starch content, and chlorophyll fluorescence in 1-year-old needles of Sakhalin spruce (Picea glehnii Masters) seedlings in relation to the timing of budbreak, grown in a phytotron under natural daylight at two [CO(2)] levels (ambient: 360 μmol mol(-1) and elevated: 720 μmol mol(-1)). Budbreak was accelerated by elevated [CO(2)] accompanied with earlier temporal declines in the quantum yield of PSII electron transport (Φ(PSII)) and photochemical quenching (q(L)). Plants grown under elevated [CO(2)] showed pre-budbreak leaf starch content twice as high with no significant difference in Φ(PSII) from ambient-CO(2)-grown plants when compared at the same measurement [CO(2)], i.e., 360 or 720 μmol mol(-1), suggesting that the enhanced pre-budbreak leaf starch accumulation might not cause down-regulation of photosynthesis in pre-existing needles under elevated [CO(2)]. Conversely, lower excitation pressure adjusted for the efficiency of PSII photochemistry ((1 - q(P)) F(v)'/F(m)') was observed in plants grown under elevated [CO(2)] around budbreak when compared at their growth [CO(2)] (i.e., comparing (1 - q(P)) F(v)'/F(m)' measured at 720 μmol mol(-1) in elevated-CO(2)-grown plants with that at 360 μmol mol(-1) in ambient-CO(2)-grown plants), which suggests lower rate of photoinactivation of PSII in the elevated-CO(2)-grown plants around spring budbreak. The degree of photoinhibition, as indicated by the overnight-dark-adapted F(v)/F(m), however, showed no difference between CO(2) treatments, thereby suggesting that photoprotection during the daytime or the repair of PSII at night was sufficient to alleviate differences in the rate of photoinactivation.

  14. I-type granitoids associated with the early Paleozoic intracontinental orogenic collapse along pre-existing block boundary in South China

    NASA Astrophysics Data System (ADS)

    Yu, Yang; Huang, Xiao-Long; He, Peng-Li; Li, Jie

    2016-04-01

    the block boundary by mantle-derived melt during the orogenic collapse. The pre-existing block boundary might have promoted asthenosphere upwelling and basaltic underplating during the intracontinental orogenic collapse.

  15. Pre-existing Type 2 Diabetes Mellitus Is an Independent Risk Factor for Mortality and Progression in Patients With Renal Cell Carcinoma

    PubMed Central

    Vavallo, Antonio; Simone, Simona; Lucarelli, Giuseppe; Rutigliano, Monica; Galleggiante, Vanessa; Grandaliano, Giuseppe; Gesualdo, Loreto; Campagna, Marcello; Cariello, Marica; Ranieri, Elena; Pertosa, Giovanni; Lastilla, Gaetano; Selvaggi, Francesco Paolo; Ditonno, Pasquale; Battaglia, Michele

    2014-01-01

    Abstract Malignancies are one of the main causes of mortality in diabetic patients; however, to date, very limited data have been reported on the specific influence of type 2 diabetes mellitus (T2DM) on the survival of patients with renal cell carcinoma (RCC). In the present long-term retrospective study, we investigated whether T2DM may influence the overall survival (OS), cancer-specific survival (CSS), and progression-free survival (PFS) in patients with surgically treated RCC. Medical records of 924 patients treated by radical or partial nephrectomy for sporadic, unilateral RCC were reviewed. Patients with type-1 DM and with T2 DM receiving insulin treatment were excluded. Survival estimates were calculated according to the Kaplan–Meier method and compared with the log-rank test. Univariate and multivariate analyses were performed using the Cox regression model. Of the 924 RCC patients, 152 (16.5%) had T2DM. Mean follow-up was 68.5 months. Mean OS was 41.3 and 96.3 months in T2DM and non-T2DM patients, respectively (P < 0.0001). The estimated CSS rates at 1, 3, and 5 years in T2DM versus non-T2DM patients were 63.4% versus 76.7%, 30.4% versus 56.6%, and 16.3% versus 48.6%, respectively (P = 0.001). Mean PFS was significantly lower (31.5 vs 96.3 months; P < 0.0001) in the T2DM group. At multivariate analysis, T2DM was an independent adverse prognostic factor for OS (hazard ratio [HR] = 3.44; 95% confidence interval [CI]:2.40–4.92), CSS (HR = 6.39; 95% CI: 3.78–10.79), and PFS (HR = 4.71; 95% CI: 3.11–7.15). In conclusion, our findings suggest that patients with RCC and pre-existing T2DM have a shorter OS, increased risk of recurrence, and higher risk for kidney cancer mortality than those without diabetes. PMID:25501064

  16. Determination of plasma and skin concentrations of orbifloxacin in dogs with clinically normal skin and dogs with pyoderma.

    PubMed

    Kay-Mugford, Patricia A; Weingarten, Allan J; Ngoh, Maureen; Zolynas, Robert; White, Amy; Katz, Terry; Simmons, Robert; Varma, Kanwal J

    2002-01-01

    Plasma and skin concentrations of orbifloxacin (Orbax tablets, Schering-Plough Animal Health) were assessed in 14 clinically normal dogs and 14 dogs with pyoderma following oral administration of the drug at 7.5 mg/kg once daily for 5 to 7 days. Skin biopsies and whole blood samples were obtained before dosing and at the time of the expected maximum concentration in skin (3 hours after dosing) on the first and on the fifth to seventh day of dosing. Skin biopsies and plasma were analyzed for orbifloxacin concentrations by high-performance liquid chromatography. Dogs with pyoderma had significantly higher mean skin concentrations of orbifloxacin within 3 hours of administration (Day 0: 7.80 +/- 3.40 mcg/g, Days 4 to 6: 9.47 +/- 6.23 mcg/g) than did dogs with normal skin (Day 0: 3.85 +/- 1.08 mcg/g, Days 4 to 6: 5.43 +/- 1.02 mcg/g). After dosing on Day 0 and after five to seven daily treatments, dogs with pyoderma had significantly higher mean orbifloxacin skin:plasma ratios (1.40 and 1.44, respectively) than did clinically normal dogs (0.81 and 0.96, respectively). The accumulation of orbifloxacin in diseased skin may contribute to the efficacy of this compound for the treatment of bacterial skin infections.

  17. Antimicrobial susceptibility and rRNA gene restriction patterns among Staphylococcus intermedius from healthy dogs and from dogs suffering from pyoderma or otitis externa.

    PubMed

    Pedersen, K; Wegener, H C

    1995-01-01

    A total of 60 Staphylococcus intermedius strains from dogs were investigated by their sensitivity to various antibiotics (50 strains) and by their rRNA gene restriction patterns (ribotyping) (60 strains). Fifteen isolates were from healthy dogs, 9 with otitis externa, and 36 with pyoderma, including 10 strains from a previous study. Sixty per cent of the 50 strains tested for antibiotic susceptibility demonstrated resistance to penicillin, 24% to spiramycin, 20% to tetracycline, 16% to chloramphenicol, and 2% to fucidic acid. All isolates were susceptible to amoxycillin with clavulanic acid, enrofloxacin, and sulphonamides with trimethoprim. There were no significant differences in antimicrobial susceptibility patterns observed among isolates from pyoderma, otitis externa or healthy dogs. Among the 60 strains studied by ribotyping, 10 different ribotypes were identified: 6 different ribotypes among isolates from otitis externa, 8 among isolates from pyoderma, and 5 among isolates from healthy dogs. One ribotype (profile C) was dominant among the isolates from healthy dogs while another ribotype (profile A) was dominant among strains from dogs suffering from pyoderma. This profile was not demonstrated in any of the strains from healthy dogs. From 5 different dogs suffering from pyoderma, 2 different clones were demonstrated based on their plasmid profile and antibiogram. In these dogs 1 of the clones always belonged to ribotype A. The results concerning strains of S. intermedius isolated from furunculosis suggest the existence of distinct subpopulations with different pathogenicity to dogs.

  18. Origin of the Ciomadul Dacite, Carpathian-Pannonian Region, Eastern-Central Europe: Rejuvenation of a Pre-Existing Crystal Mush

    NASA Astrophysics Data System (ADS)

    Kiss, B.; Harangi, S.; Molnar, K.; Jankovics, E. M.; Lukacs, R.; Ntaflos, T.

    2012-12-01

    Dacitic composite volcanoes and calderas worldwide have many common specific characters. Notably, their activities are fairly unpredictable since the repose time between the active phases could be rather long, i.e. even several tens or hundreds ka. This nature might be related to the origin of such magmas. Petrological observations indicate that relatively old, cool, highly crystalline magma body (i.e., a crystal mush) could be present beneath the seemingly inactive dacitic volcanoes before reawakening. Reactivation of such locked magma chambers could occur due to the upwelling and intrusion of mafic magma and recent calculations suggest that this process takes place rather fast. Understanding the nature and time-scale of such remobilization events is crucial to explain the reason of the change in volcanic behaviour from dormant to active phase (i.e., the reawakening of the volcano). In this study, we show the role and the character of a pre-existing near-solidus granodioritic crystal mush to generate the eruptible dacitic magma in the Ciomadul volcano. The Ciomadul dacite is a crystal-rich rock with ubiquitous plagioclases and amphiboles. They form viscous lava domes and pumices generated by sub-plinian explosive eruptions. Combined, mineral-scale textural and geochemical investigations indicate a complex origin of these minerals, formed partly in a low temperature dioritic-granodioritic crystal mush body, partly in higher temperature hybrid magma. In addition, biotite, titanite, apatite, allanite, zircon, K-feldspar and quartz occur in various amounts and are interpreted also as antecrysts derived from the remobilized mushy body. High-Mg olivines and clinopyroxenes represent basaltic magma intruded into the mush. The nature of the crystal mush was closely investigated through the detailed analysis of the crystal clots found often in the Ciomadul dacites. Their texture resembles plutonic rocks, but they contain interstitial vesiculated glasses. The glass could

  19. Evaluation of neutrophilic function (chemotaxis, phagocytosis and microbicidal activity) in healthy dogs and in dogs suffering from recurrent deep pyoderma.

    PubMed

    Chammas, P P; Hagiwara, M K

    1998-07-01

    The modified Boyden's technique of chemotaxis ('leading front' method) and the bacterial killing test with Staphylococcus sp. stained with acridine orange were performed with suspensions of granulocytes from 50 healthy dogs. Lipopolisacharide of Escherichia coli, in normal dog serum was used as the chemotactic factor. The mean value for the chemotactic differential found was 30.41 +/- 12.14 mu. The optimal concentration of bacteria and opsonins (normal dog serum) was 4 and 15%, respectively, and the ideal incubation period was 30 min. The mean values obtained for phagocytosis percentage, number of bacteria per PMN, phagocytosis index and percentage of dead bacteria, were 97.01 +/- 3.22%, 22.20 +/- 4.6, 21.53 +/- 4.50 and 45.30 +/- 9.18%, respectively. Granulocyte functions in 18 dogs with recurrent, chronic, deep pyoderma were assessed by the same methods. No significant difference between the two groups, for any of the evaluated parameters, was found. For elucidation of the pathogenesis of recurrent pyoderma, further studies involving humoral and cellular immunity and the complement system are required. PMID:9661262

  20. The prevalence of the pre-existing hepatitis C viral variants and the evolution of drug resistance in patients treated with the NS3-4a serine protease inhibitor telaprevir

    SciTech Connect

    Rong, Libin; Ribeiro, Ruy M; Perelson, Alan S

    2008-01-01

    Telaprevir (VX-950), a novel hepatitis C virus (HCV) NS3-4A serine protease inhibitor, has demonstrated substantial antiviral activity in patients infected with HCV genotype 1. Some patients experience viral breakthrough, which has been shown to be associated with emergence of telaprevir-resistant HCV variants during treatment. The exact mechanisms underlying the rapid selection of drug resistant viral variants during dosing are not fully understood. In this paper, we develop a two-strain model to study the pre-treatment prevalence of the mutant virus and derive an analytical solution of the mutant frequency after administration of the protease inhibitor. Our analysis suggests that the rapid increase of the mutant frequency during therapy is not due to mutant growth but rather due to the rapid and profound loss of wild-type virus, which uncovers the pre-existing mutant variants. We examine the effects of backward mutation and hepatocyte proliferation on the pre-existence of the mutant virus and the competition between wild-type and drug resistant virus during therapy. We then extend the simple model to a general model with multiple viral strains. Mutations during therapy do not play a significant role in the dynamics of various viral strains, although they are capable of generating low levels of HCV variants that would otherwise be completely suppressed because of fitness disadvantages. Hepatocyte proliferation may not affect the pretreatment frequency of mutant variants, but is able to influence the quasispecies dynamics during therapy. It is the relative fitness of each mutant strain compared with wild-type that determines which strain(s) will dominate the virus population. The study provides a theoretical framework for exploring the prevalence of pre-existing mutant variants and the evolution of drug resistance during treatment with other protease inhibitors or HCV polymerase inhibitors.

  1. The mechanism of Fe(2+)-initiated lipid peroxidation in liposomes: the dual function of ferrous ions, the roles of the pre-existing lipid peroxides and the lipid peroxyl radical.

    PubMed

    Tang, L; Zhang, Y; Qian, Z; Shen, X

    2000-11-15

    The mechanism of Fe(2+)-initiated lipid peroxidation in a liposomal system was studied. It was found that a second addition of ferrous ions within the latent period lengthened the time lag before lipid peroxidation started. The apparent time lag depended on the total dose of Fe(2+) whenever the second dose of Fe(2+) was added, which indicates that Fe(2+) has a dual function: to initiate lipid peroxidation on one hand and suppress the species responsible for the initiation of the peroxidation on the other. When the pre-existing lipid peroxides (LOOH) were removed by incorporating triphenylphosphine into liposomes, Fe(2+) could no longer initiate lipid peroxidation and the acceleration of Fe(2+) oxidation by the liposomes disappeared. However, when extra LOOH were introduced into liposomes, both enhancement of the lipid peroxidation and shortening of the latent period were observed. When the scavenger of lipid peroxyl radicals (LOO(.)), N,N'-diphenyl-p-phenylene-diamine, was incorporated into liposomes, neither initiation of the lipid peroxidation nor acceleration of the Fe(2+) oxidation could be detected. The results may suggest that both the pre-existing LOOH and LOO(.) are necessary for the initiation of lipid peroxidation. The latter comes initially from the decomposition of the pre-existing LOOH by Fe(2+) and can be scavenged by its reaction with Fe(2+). Only when Fe(2+) is oxidized to such a degree that LOO(.) is no longer effectively suppressed does lipid peroxidation start. It seems that by taking the reactions of Fe(2+) with LOOH and LOO(.) into account, the basic chemistry in lipid peroxidation can explain fairly well the controversial phenomena observed in Fe(2+)-initiated lipid peroxidation, such as the existence of a latent period, the critical ratio of Fe(2+) to lipid and the required oxidation of Fe(2+). PMID:11062055

  2. Towards ethical guidelines for dealing with unsolicited patient emails and giving teleadvice in the absence of a pre-existing patient-physician relationship — systematic review and expert survey

    PubMed Central

    2000-01-01

    Background Many health information providers on the Internet and doctors with email accounts are confronted with the phenomenon of receiving unsolicited emails from patients asking for medical advice. Also, a growing number of websites offer "ask-the-doctor" services, where patients can ask questions to health professionals via email or other means of telecommunication. It is unclear whether these types of interactions constitute medical practice, and whether physicians have the ethical obligation to respond to unsolicited patient emails. Objective To improve the quality of online communication between patients and health professionals (physicians, experts) in the absence of a pre-existing patient-physician relationship or face-to-face communication, by preparing a set of guiding ethical principles applicable to this kind of interaction. Methods Systematic review of the literature, professional, and ethical codes; and consultation with experts. Results Two different types of patient-physician encounters have to be distinguished. "Traditional" clinical encounters or telemedicine applications are called "Type B" interactions here (Bona fide relationship). In comparison, online interactions lack many of the characteristics of bona fide interactions; most notably there is no pre-existing relationship and the information available to the physician is limited if, for example, a physician responds to the email of a patient who he has never seen before. I call these "Type A" consultations (Absence of pre-existing patient-physician relationship). While guidelines for Type B interactions on the Internet exist (Kane, 1998), this is not the case for Type A interactions. The following principles are suggested: Physicians responding to patients' requests on the Internet should act within the limitations of telecommunication services and keep the global nature of the Internet in mind; not every aspect of medicine requires face-to-face communication; requests for help, including

  3. A study of community-associated methicillin-resistant Staphylococcus aureus in patients with pyoderma

    PubMed Central

    Venniyil, Prasanth V.; Ganguly, Satyaki; Kuruvila, Sheela; Devi, Sheela

    2016-01-01

    Background: Health care–associated methicillin-resistant Staphylococcus aureus(HA-MRSA) are resistant to multiple antibiotics, therefore infections caused by them are difficult to treat resulting in high morbidity and mortality. While most of the research activities and public health initiatives are focused on HA-MRSA, the newly emerging pathogen, community-associated methicillin-resistant Staphylococcus aureus(CA-MRSA) is gaining in significance in respect to patient morbidity. There is a significant paucity of data regarding CA-MRSA in the developing parts of the world. Aim: To study the proportions of HA-MRSA and CA-MRSA infections among patients with culture-proven S. aureus infection and to find out how many of these patients showed presence of MRSA in nasal cultures of healthy contacts. Materials and Methods: Clinical details of 227 patients were recorded in the study, such as the duration and recurrence of the infection, history of antibiotic intake, and the presence of other medical illnesses. A pus swab was taken from each lesion and sent for culture and sensitivity. If the culture grew S. aureus, they were screened for methicillin resistance. A swab from the anterior nares of the healthy contact of each patient, whenever available, was collected and it was screened for MRSA. Results: Furunculosis was most common among the primary pyodermas (53/134; 39. 5%). Out of 239 pus culture samples obtained from 227 patients, 192 (84.58%) grew S. aureus; of these 150 (78.12%) were methicillin-sensitive S. aureus (MSSA), whereas 42 (21.98%) were MRSA. Out of the 42 MRSA isolated, 33 turned out to be CA-MRSA (78%) and 9 (22%) were HA-MRSA. Nasal swabs of healthy contacts of 34 MRSA patients were cultured. Out of them, two grew MRSA in the culture. Conclusion: The isolation rate of S. aureus was high in our study. Furthermore, our study, although hospital based, clearly indicated the substantial magnitude of the CA-MRSA problem in the local population. PMID:27294048

  4. An Integral Effects Test in a zion-like geometry to investigate the effects of pre-existing hydrogen on direct containment heating in the Surtsey Test Facility. The IET-6 experiment

    SciTech Connect

    Allen, M.D.; Blanchat, T.K.; Pilch, M.; Nichols, R.T.

    1993-01-01

    The sixth experiment of the Integral Effects Test (IET-6) series was conducted to investigate the effects of high pressure melt ejection on direct containment heating. Scale models of the Zion reactor pressure vessel (RPV), cavity, instrument tunnel, and subcompartment structures were constructed in the Surtsey Test Facility at Sandia National Laboratories. The RPV was modeled with a melt generator that consisted of a steel pressure barrier, a cast MgO crucible, and a thin steel inner liner. The melt generator/crucible had a hemispherical bottom head containing a graphite limitor plate with a 4-cm exit hole to simulate the ablated hole in the RPV bottom head that would be formed by ejection of an instrument guide tube in a severe nuclear power plant accident. The cavity contained 3.48 kg of water, which corresponds to condensate levels in the Zion plant, and the containment basement floor was dry. A 43-kg initial charge of iron oxide/aluminum/chromium thermite was used to simulate corium debris on the bottom head of the RPV. Molten thermite was ejected by steam at an initial pressure of 6.3 MPa into the reactor cavity. The Surtsey vessel atmosphere contained pre-existing hydrogen to represent partial oxidation of the zirconium in the Zion core. The initial composition of the vessel atmosphere was 87.1 mol.% N{sub 2}, 9.79 mol.% O{sub 2}, and 2.59 mol.% H{sub 2}, and the initial absolute pressure was 198 kPa. A partial hydrogen burn occurred in the Surtsey vessel. The peak vessel pressure increase was 279 kPa in IET-6, compared to 246 kPa in the IET-3 test. The total debris mass ejected into the Surtsey vessel in IET-6 was 42.5 kg. The gas grab sample analysis indicated that there were 180 g{center_dot} moles of pre-existing hydrogen, and that 308{center_dot}moles of hydrogen were produced by steam/metal reactions. About 335 g{center_dot}moles of hydrogen burned, and 153 g{center_dot}moles remained unreacted.

  5. Cutaneous sporotrichosis presenting as a keratoacanthoma.

    PubMed

    Meffert, J J

    1998-07-01

    Sporothrix schenckii is a ubiquitous dimorphic fungus with a variety of clinical presentations, including imitation of other diseases such as pyoderma, rosacea, and pyoderma gangrenosum. A case in which sporotrichosis appeared as a keratoacanthoma-like nodule on the lower lip of a young woman is presented, with treatment considerations and diagnostic pitfalls. PMID:9675531

  6. 3-D numerical modelling of the influence of reactivated pre-existing faults on the distribution of deformation: example of North-Western Ghana around 2.15-2.00 Ga

    NASA Astrophysics Data System (ADS)

    FENG, Xiaojun; Gerbault, Muriel; Martin, Roland; Ganne, Jérôme; Jessell, Mark

    2015-04-01

    High strain zones appear to play a significant role in feeding the upper crust with fluids and partially molten material from lower crust sources. The Bole-Bulenga terrain (North-Western Ghana) is located in between two subvertical shear zones, and mainly consists of high-grade orthogneisses, paragneisses and metabasites intruded by partially molten lower crustal material with monzogranites and orthogneisses (Eburnean orogeny, around 2.1 Ga). In order to understand the location of these high grade rocks at the edges and in between these two shear zones, a three dimensional numerical model was built to test the influence of different orientations of a system of branched strike-slip faults on visco-plastic deformation, under compressional and simple shear boundary conditions. Our models indicate domains of tensile vs. compressional strain as well as shear zones, and show that not only internal fault zones but also the host rock in between the faults behave relatively softer than external regions. Under both applied compressive and simple shear boundary conditions, these softened domains constitute preferential zones of tensile strain accommodation (dilation) in the upper crust, which may favor infilling by deeper partially molten rocks. Our modeled pre-existing faults zones are assumed to have formed during an early D1 stage of deformation, and they are shown to passively migrate and rotate together with the solid matrix under applied external boundary conditions (corresponding to a post D1 - early D2 phase of deformation). We suggest that in the Bole-Bulenga terrain, fluids or partially molten material stored in deeper crustal domains, preferentially intruded the upper crust within these highly (shear and tensile) strained domains, thanks to this D2 shearing deformation phase. Building relief at the surface is primarily controlled by fault orientations, together with mechanical parameters and external boundary conditions. In particular, greatest magnitudes of relief

  7. A synthetic M protein peptide synergizes with a CXC chemokine protease to induce vaccine-mediated protection against virulent streptococcal pyoderma and bacteremia.

    PubMed

    Pandey, Manisha; Langshaw, Emma; Hartas, Jon; Lam, Alfred; Batzloff, Michael R; Good, Michael F

    2015-06-15

    Infections caused by Streptococcus pyogenes (group A Streptococcus [GAS]) are highly prevalent in the tropics, in developing countries, and in the Indigenous populations of developed countries. These infections and their sequelae are responsible for almost 500,000 lives lost prematurely each year. A synthetic peptide vaccine (J8-DT) from the conserved region of the M protein has shown efficacy against disease that follows i.p. inoculation of bacteria. By developing a murine model for infection that closely mimics human skin infection, we show that the vaccine can protect against pyoderma and subsequent bacteremia caused by multiple GAS strains, including strains endemic in Aboriginal communities in the Northern Territory of Australia. However, the vaccine was ineffective against a hypervirulent cluster of virulence responder/sensor mutant GAS strain; this correlated with the strain's ability to degrade CXC chemokines, thereby preventing neutrophil chemotaxis. By combining J8-DT with an inactive form of the streptococcal CXC protease, S. pyogenes cell envelope proteinase, we developed a combination vaccine that is highly effective in blocking CXC chemokine degradation and permits opsonic Abs to kill the bacteria. Mice receiving the combination vaccine were strongly protected against pyoderma and bacteremia, as evidenced by a 100-1000-fold reduction in bacterial burden following challenge. To our knowledge, a vaccine requiring Abs to target two independent virulence factors of an organism is unique.

  8. Staphylococcus pseudintermedius and Staphylococcus schleiferi Subspecies coagulans from Canine Pyoderma Cases in Grenada, West Indies, and Their Susceptibility to Beta-Lactam Drugs

    PubMed Central

    Gibson, Kathryn; Frankie, Matthew; Matthew, Vanessa; Daniels, Joshua; Martin, Nancy A.; Andrews, Linton; Paterson, Tara; Sharma, Ravindra N.

    2014-01-01

    Over a 2-year period 66 cases of canine pyoderma in Grenada, West Indies, were examined by aerobic culture in order to ascertain the bacteria involved and their antimicrobial resistance patterns. Of the 116 total bacterial isolates obtained, the majority belonged to Gram-positive species, and the most common organism identified through biochemical and molecular methods was Staphylococcus pseudintermedius. Additionally, identification of a Staphylococcus schleiferi subspecies coagulans isolate was confirmed by molecular methods. All isolates of staphylococci were susceptible to beta-lactam drugs: amoxicillin-clavulanic acid, cefovecin, cefoxitin, cefpodoxime, and cephalothin. They were also susceptible to chloramphenicol and enrofloxacin. Resistance was highest to tetracycline. Methicillin resistance was not detected in any isolate of S. pseudintermedius or in S. schleiferi. Among the Gram-negative bacteria, the most common species was Klebsiella pneumoniae, followed by Acinetobacter baumannii/calcoaceticus. The only drug to which all Gram-negative isolates were susceptible was enrofloxacin. This report is the first to confirm the presence of S. pseudintermedius and S. schleiferi subspecies coagulans, in dogs with pyoderma in Grenada, and the susceptibility of staphylococcal isolates to the majority of beta-lactam drugs used in veterinary practice. PMID:24592351

  9. Deep vein thrombosis, ecythyma gangrenosum and heparin-induced thrombocytopenia occurring in a man with a heterozygous Factor V Leiden mutation

    PubMed Central

    Apostolova, Mariya; Weng, Baoying; Pote, Harry H.; Ashcraft, Harold; Goldblatt, Curtis; Woolley, Paul V.

    2012-01-01

    Skin necrosis and limb gangrene are occasional thrombotic manifestations of anticoagulation therapy. We report a man heterozygous for the Factor V Leiden (FVL) mutation, and with a history of recurrent deep venous thrombosis, who initially presented with a necrotic skin lesion of the right flank while on warfarin therapy with a therapeutic international normalized ratio. Warfarin was discontinued and he received intravenous heparin. Thereafter he developed thrombocytopenia and pedal erythema and was diagnosed with heparin-induced thrombocytopenia (HIT). Heparin was replaced with argatroban. He ultimately underwent bilateral below-knee amputations for the thrombotic complications of the HIT. The initial necrotic lesion healed with antibiotics and wound care. Pathologic examination of multiple biopsy specimens revealed two separate lesions. One was necrotic tissue infiltrated with methicillin resistant Staphylococcus aureus having features of ecthyma gangrenosum. The second showed thrombotic changes consistent with HIT. The case illustrates the differential diagnosis of skin necrosis and limb gangrene in patients on warfarin and heparin, and also the clinical complexities that can occur in a FVL heterozygote. PMID:23355938

  10. Evaluation of in vitro activity of two topical products against three organisms isolated from canine referral patients with otitis externa and cutaneous pyoderma.

    PubMed

    Okwumabua, O; Goodman, F; Elfassy, O

    2000-01-01

    Canine otitis externa and cutaneous pyoderma are common problems that are often associated with Staphylococcus intermedius, Pseudomonas aeruginosa, and Malassezia pachydermatis. In vitro activity of two topical products against these organisms isolated from canine referral patients were evaluated. Organisms were grown and diluted to a concentration equivalent to 10(7) colony-forming units (CFU) per mL and exposed to either a 0 or 1/5 dilution of Hexadene Flush with Spherulites (Virbac Animal Health Inc, Fort Worth, TX) or a 1/5 or 1/25 dilution of ResiCHLOR Lotion with Spherulites (Virbac Animal Health Inc, Fort Worth, TX) at time intervals from 1 to 30 minutes. Results showed that all three organisms were killed within 1 minute of contact time at 0 and 1/5 dilution of the flush. The lotion diluted to 1/5 also killed all three organisms. At 1/25 dilution, this lotion killed S. intermedius and P. aeruginosa within 1 minute of contact time, whereas M. pachydermatis was killed after 1 minute. The findings suggest that the two topical products exhibit efficacy against these common skin pathogens in vitro and can be useful in their clinical management.

  11. 75 FR 45013 - Pre-Existing Condition Insurance Plan Program

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-07-30

    ... 2719A (regarding patient protections), published in the Federal Register on June 28, 2010 (75 FR 37188... of rape or incest, or where the life of the woman would be endangered. Exec. Order No. 13,535, 75...

  12. 77 FR 52614 - Pre-Existing Condition Insurance Plan Program

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-30

    ... posted on the Internet exactly as received, and can be retrieved by most Internet search engines. No...: http://www.regulations.gov . Follow the search instructions on that Web site to view public comments... 30, 2010 (75 FR 45014). For the reasons explained below, HHS is now issuing an amendment to...

  13. Treatment of pre-existing cardiomyopathy during pregnancy.

    PubMed

    Gevaert, Sofie; De Pauw, Michel; Tromp, Fiona; Ascoop, An-Kristien; Roelens, Kristien; De Backer, Julie

    2014-04-01

    Heart failure is an established predictor of primary cardiac events during pregnancy. Adequate heart failure treatment in pregnant women is hampered by important foetotoxicity of several conventional drugs. Hydralazine with or without long-acting nitrates has been proposed as an alternative for ACE inhibitors or angiotensin receptor blockers. There are no published data, however, on the use of hydralazine to treat heart failure during pregnancy. We describe the course and outcome of pregnancy in two patients with heart failure. A 31-year-old woman with dilated cardiomyopathy was not treated with hydralazine during pregnancy and developed worsening heart failure. A 36-year-old woman with ischaemic cardiomyopathy was treated with hydralazine early during pregnancy and remained stable throughout and after pregnancy. We assume that early initiation of hydralazine as an alternative for ACE inhibitors or angiotensin receptor blockers during pregnancy in patients with cardiomyopathy could prevent further left ventricular dilatation and worsening heart failure.

  14. 78 FR 30218 - Pre-Existing Condition Insurance Plan Program

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-22

    ...'s out-of-pocket cost for the covered service as calculated by the plan. The PCIP program was... annual claims cost paid per enrollee was $32,108. This cost per enrollee exceeds even that of state high... enrollees are limited to people that were previously considered uninsurable due to high expected claims...

  15. Effects of an ethyl lactate shampoo in conjunction with a systemic antibiotic in the treatment of canine superficial bacterial pyoderma in an open-label, nonplacebo-controlled study.

    PubMed

    de Jaham, Caroline

    2003-01-01

    An open-label, nonplacebo-controlled study was designed to compare systemic cephalexin therapy versus systemic cephalexin and ethyl lactate shampoo therapy in the treatment of canine superficial bacterial pyoderma. Twenty client-owned dogs diagnosed with generalized superficial bacterial pyoderma (SP) were alternately assigned to oral treatment with cephalexin (25 to 30 mg/kg every 12 hours) or treatment with cephalexin (as for Group 1) and twice-weekly shampooing with a 10% ethyl lactate shampoo, which was left in contact with the dog's skin for 10 minutes. On Days 14 and 28, skin lesion severity scores, assessed by the investigators, were significantly (P <.01) lower for the group treated with cephalexin and shampoo than for the group treated with cephalexin only. On Day 14, dog owners gave better scores to dogs treated with cephalexin and shampoo for haircoat appearance and body odor than for dogs treated only with cephalexin. Clinical and cytologic resolution of SP occurred significantly (P <.02) sooner in the cephalexin/shampoo group (29.4 days) than in the cephalexin only group (37.8 days).

  16. Cerebral vascular findings in PAPA syndrome: cerebral arterial vasculopathy or vasculitis and a posterior cerebral artery dissecting aneurysm.

    PubMed

    Khatibi, Kasra; Heit, Jeremy J; Telischak, Nicholas A; Elbers, Jorina M; Do, Huy M

    2015-06-24

    A young patient with PAPA (pyogenic arthritis, pyoderma gangrenosum, and acne) syndrome developed an unusual cerebral arterial vasculopathy/vasculitis (CAV) that resulted in subarachnoid hemorrhage from a ruptured dissecting posterior cerebral artery (PCA) aneurysm. This aneurysm was successfully treated by endovascular coil sacrifice of the affected segment of the PCA. The patient made an excellent recovery with no significant residual neurologic deficit.

  17. New described dermatological disorders.

    PubMed

    Gönül, Müzeyyen; Cevirgen Cemil, Bengu; Keseroglu, Havva Ozge; Kaya Akis, Havva

    2014-01-01

    Many advances in dermatology have been made in recent years. In the present review article, newly described disorders from the last six years are presented in detail. We divided these reports into different sections, including syndromes, autoinflammatory diseases, tumors, and unclassified disease. Syndromes included are "circumferential skin creases Kunze type" and "unusual type of pachyonychia congenita or a new syndrome"; autoinflammatory diseases include "chronic atypical neutrophilic dermatosis with lipodystrophy and elevated temperature (CANDLE) syndrome," "pyoderma gangrenosum, acne, and hidradenitis suppurativa (PASH) syndrome," and "pyogenic arthritis, pyoderma gangrenosum, acne, and hidradenitis suppurativa (PAPASH) syndrome"; tumors include "acquired reactive digital fibroma," "onychocytic matricoma and onychocytic carcinoma," "infundibulocystic nail bed squamous cell carcinoma," and "acral histiocytic nodules"; unclassified disorders include "saurian papulosis," "symmetrical acrokeratoderma," "confetti-like macular atrophy," and "skin spicules," "erythema papulosa semicircularis recidivans." PMID:25243162

  18. Pelvic Arterial Embolisation in a Trauma Patient with a Pre-Existing Aortobifemoral Graft

    SciTech Connect

    Abulaban, Osama; Hopkins, Jonathan; Willis, Andrew P.; Jones, Robert G.

    2011-02-15

    Pelvic fractures secondary to blunt trauma are associated with a significant mortality rate due to uncontrolled bleeding. Interventional radiology (IR) can play an important and central role in the management of such patients, offering definitive minimally invasive therapy and avoiding the need for high-risk surgery. Rapid access to whole-body computed tomography has been shown to improve survival in polytrauma patients and allows rapid diagnosis of vascular injury and assessment of suitability for endovascular therapy. IR can then target and treat the specific area of bleeding. Embolisation of bleeding pelvic arteries has been shown to be highly effective and should be the treatment of choice in this situation. The branches of the internal iliac artery (IIA) are usually involved, and these arteries are accessed by way of IIA catheterisation after abdominal aortography. Occasionally these arteries cannot be accessed by way of this conventional route because of recent IIA ligation carried out surgically in an attempt to stop the bleeding or because (in the rare situation we describe here) these vessels are excluded secondary to previous aortoiliac repair. In this situation, knowledge of pelvic arterial collateral artery pathways is important because these will continue to supply pelvic structures whilst making access to deep pelvic branches challenging. We describe a rare case, which has not been previously reported in the literature, in which successful embolisation of a bleeding pelvic artery was carried out by way of the collateral artery pathways.

  19. Ionization-induced annealing of pre-existing defects in silicon carbide

    SciTech Connect

    Zhang, Yanwen; Sachan, Ritesh; Pakarinen, Olli H.; Chisholm, Matthew F.; Liu, Peng; Xue, Haizhou; Weber, William J.

    2015-08-12

    A long-standing objective in materials research is to find innovative ways to remove preexisting damage and heal fabrication defects or environmentally induced defects in materials. Silicon carbide (SiC) is a fascinating wide-band gap semiconductor for high-temperature, high-power, high-frequency applications. Its high corrosion and radiation resistance makes it a key refractory/structural material with great potential for extremely harsh radiation environments. Here we show that the energy transferred to the electron system of SiC by energetic ions via inelastic ionization processes results in a highly localized thermal spike that can effectively heal preexisting defects and restore the structural order. This work reveals an innovative self-healing process using highly ionizing ions, and it describes a critical aspect to be considered in modeling SiC performance as either a functional or a structural material for device applications or high-radiation environments.

  20. Pre-existent asymmetry in the human cyclooxygenase-2 sequence homodimer.

    PubMed

    Dong, Liang; Sharma, Narayan P; Jurban, Brice J; Smith, William L

    2013-10-01

    Prostaglandin endoperoxide H synthase-2 (PGHS-2), also known as cyclooxygenase-2 (COX-2), is a sequence homodimer. However, the enzyme exhibits half-site heme and inhibitor binding and functions as a conformational heterodimer having a catalytic subunit (Ecat) with heme bound and an allosteric subunit (Eallo) lacking heme. Some recombinant heterodimers composed of a COX-deficient mutant subunit and a native subunit (i.e. Mutant/Native PGHS-2) have COX activities similar to native PGHS-2. This suggests that the presence of heme plus substrate leads to the subunits becoming lodged in a semi-stable Eallo-mutant/Ecat-Native∼heme form during catalysis. We examined this concept using human PGHS-2 dimers composed of combinations of Y385F, R120Q, R120A, and S530A mutant or native subunits. With some heterodimers (e.g. Y385F/Native PGHS-2), heme binds with significantly higher affinity to the native subunit. This correlates with near native COX activity for the heterodimer. With other heterodimers (e.g. S530A/Native PGHS-2), heme binds with similar affinities to both subunits, and the COX activity approximates that expected for an enzyme in which each monomer contributes equally to the net COX activity. With or without heme, aspirin acetylates one-half of the subunits of the native PGHS-2 dimer, the Ecat subunits. Subunits having an S530A mutation are refractory to acetylation. Curiously, aspirin acetylates only one-quarter of the monomers of S530A/Native PGHS-2 with or without heme. This implies that there are comparable amounts of two noninterchangeable species of apoenzymes, Eallo-S530A/Ecat-Native and Eallo-Native/Ecat-S530A. These results suggest that native PGHS-2 assumes a reasonably stable, asymmetric Eallo/Ecat form during its folding and processing. PMID:23955344

  1. Pre-Existing Background Knowledge Influences Socioeconomic Differences in Preschoolers' Word Learning and Comprehension

    ERIC Educational Resources Information Center

    Kaefer, Tanya; Neuman, Susan B.; Pinkham, Ashley M.

    2015-01-01

    The goal of the current study is to explore the influence of knowledge on socioeconomic discrepancies in word learning and comprehension. After establishing socioeconomic differences in background knowledge (Study 1), the authors presented children with a storybook that incorporates this knowledge (Study 2). Results indicated that middle-income…

  2. Condensational uptake of semivolatile organic compounds in gasoline engine exhaust onto pre-existing inorganic particles

    NASA Astrophysics Data System (ADS)

    Li, S.-M.; Liggio, J.; Graham, L.; Lu, G.; Brook, J.; Stroud, C.; Zhang, J.; Makar, P.; Moran, M. D.

    2011-10-01

    This paper presents the results of laboratory studies on the condensational uptake of gaseous organic compounds in the exhaust of a light-duty gasoline engine onto preexisting sulfate and nitrate seed particles. Significant condensation of the gaseous organic compounds in the exhaust occurs onto these inorganic particles on a time scale of 2-5 min. The amount of condensed organic mass (COM) is proportional to the seed particle mass, suggesting that the uptake is due to dissolution determined by the equilibrium partitioning between gas phase and particles, not adsorption. The amount of dissolution in unit seed mass, S, decreases as a power function with increased dilution of the exhaust, ranging from 0.23 g g-1 at a dilution ratio of 81, to 0.025 g g-1 at a dilution ratio of 2230. It increases nonlinearly with increasing concentration of the total hydrocarbons in the gas phase (THC), rising from 0.12 g g-1 to 0.26 g g-1 for a CTHC increase of 1 to 18 μg m-3, suggesting that more organics are partitioned into the particles at higher gas phase concentrations. In terms of gas-particle partitioning, the condensational uptake of THC gases in gasoline engine exhaust can account for up to 30% of the total gas + particle THC. The organic mass spectrum of COM has the largest fragment at m/z 44, with mass ratios of mass fragments 43/44 and 57/44 at 0.59 and 2.91, much lower than those reported for gasoline engine primary organic aerosols. The mass fragment 44/total organic mass ratio of 0.097 indicates that COM contains large oxygenated components. By incorporating the present findings, regional air quality modelling results suggest that the condensational uptake of THC onto sulfate particles alone can be comparable to the primary particle mass under moderately polluted ambient conditions. These findings are important for modelling and regulating the air quality impacts of gasoline vehicular emissions.

  3. Pre-existing structural abnormalities of the limbic system in transient global amnesia.

    PubMed

    Park, Kang Min; Han, Yong Hee; Kim, Tae Hyung; Mun, Chi Woong; Shin, Kyong Jin; Ha, Sam Yeol; Park, JinSe; Kim, Sung Eun

    2015-05-01

    This study aimed to investigate the clinical and radiological findings in patients with transient global amnesia and to evaluate structural abnormalities using voxel-based morphometry. The subjects were diagnosed with transient global amnesia. For the voxel-based morphometry analyses, Statistical Parametric Mapping, running on the MATLAB platform (MathWorks, Natick, MA, USA), was employed to analyze the structural differences between patients with transient global amnesia and control subjects. Eighty patients met the inclusion criteria. Twenty-three patients (29%) were men, and 57 patients (71%) were women. There were significantly more women among the transient global amnesia patients compared with the general Korean population. MRI revealed hippocampal cavities in 41 patients (51%), and the incidence of such cavities was significantly different from that of the control subjects (24%). There were no differences in the clinical factors between the patients with and without hippocampal cavities. Diffusion-weighted imaging was performed in 54 patients, and 13 patients (24%) exhibited high signal intensity in the hippocampus. There were also no differences in the clinical factors between the patients with and without high signal intensities in the hippocampus on diffusion-weighted imaging. Twenty-six patients underwent three-dimensional volumetric T1-weighted imaging that produced results suitable for voxel-based morphometry, and these patients presented with gray matter volume reductions in the hippocampus, cingulum, and cerebellum. There were significant structural differences in the limbic structures between patients with transient global amnesia and the control subjects that might have contributed to vulnerability of the memory pathways of the patients with transient global amnesia.

  4. Mechanical and microstructural development of Carrara marble with pre-existing strain variation

    NASA Astrophysics Data System (ADS)

    Bruijn, Rolf H. C.; Kunze, Karsten; Mainprice, David; Burlini, Luigi

    2011-04-01

    A series of two-stage torsion experiments on Carrara marble were conducted to constrain the influence of known prior deformation on rheological response and microstructural evolution. Comparison with previous experimental data on Carrara marble flow and fabric evolution during single-stage torsion deformation experiments provided direct insights into the significance of initial deformation at various conditions. Our experiments were conducted at 727 °C temperature and 300 MPa confining pressure, while maintaining a constant strain rate of 3 × 10 - 4 s - 1 on the periphery of the cylindrical samples. Under these conditions, the marble is known to deform in power-law ( n = 6-10) ductile flow. All torsion experiments were performed with a Paterson type gas-medium testing machine equipped with a torsion actuator module. Prior (D1) and subsequent (D2) deformation are accomplished by two torsion experiments in sequence on same sample segments. The effect of D1 strain history is investigated during D2 by applying counter-clockwise torsion to a sandwich sample consisting of three segments with different D1 rotation sense. D2 samples experienced continued, first and reversed shearing deformation in top, centre and bottom segments, respectively. D2 bulk strain was chosen equal to D1 strain in top and bottom segments. D1 experiments followed the typical single-stage deformation behaviour of Carrara marble under the applied experimental conditions. Yielding was followed by strain hardening until a peak stress was reached at a shear strain around 1, after which work softening occurred. Weakening gradually evolved into a constant stress regime. During hardening, a shear microstructure and crystallographic preferred orientation (CPO) developed. Afterwards the volume fraction of smaller dynamic recrystallised grains increased continuously, resulting in a recrystallisation microstructure and CPO at shear strains of 5 and higher. The new D2 experiments displayed a strain variation between homogeneously deformed sample segments that increased with increasing D1 strain. The stress-strain behaviour of the D2 bulk sandwich samples showed less pronounced work-hardening and -softening when compared with single-stage deformation experiments. Furthermore, constant flow stress was attained at increasingly lower strain with increasing D1 strain. In most D2 segments, fabric development is equivalent to single-stage experiments at corresponding absolute strain. The fabrics differed markedly from those in single-stage experiments in the case of reversed two-stage deformation at moderate strain (D1 shear strain 1 and 2.6). Experiments show that grain shape by shearing of relict grains is defined by finite strain and thus affected by strain reversal. Recrystallisation is controlled by absolute strain and not influenced by strain reversal.

  5. Developing a Community Profile: A Handbook for Using Pre-existing Data in Prevention Planning.

    ERIC Educational Resources Information Center

    Gabriel, Roy M.; Brinkerhoff, Charles

    Abuse of alcohol and other drugs causes a variety of problems in a community. Accordingly, this is a manual for use by groups of citizens working to build a broadly based community alcohol and drug abuse prevention program. It includes both a systematic framework which a coalition can apply to its community, and a detailed case study of one…

  6. Serum uric acid and subsequent cognitive performance in patients with pre-existing cardiovascular disease.

    PubMed

    Molshatzki, Noa; Weinstein, Galit; Streifler, Jonathan Y; Goldbourt, Uri; Tanne, David

    2015-01-01

    High serum uric acid (UA) levels are associated with numerous vascular risk factors, and vascular disease, that predispose patients to cognitive impairment, yet UA is also a major natural antioxidant and higher levels have been linked to slower progression of several neurodegenerative disease. In-order to test the association between UA and subsequent cognitive performance among patients that carry a high vascular burden, UA levels were determined by calorimetric enzymatic tests in a sub-cohort of patients with chronic cardiovascular disease who previously participating in a secondary prevention trial. After an average of 9.8±1.7 years, we assessed cognitive performance (Neurotrax Computerized Cognitive Battery) as well as cerebrovascular reactivity (CVR) and common carotid intima-media thickness (IMT). Among 446 men (mean age 62.3±6.4 yrs) mean UA levels were 5.8±1.1 mg/dL. Adjusted linear regression models revealed that low UA levels (bottom quintile) were associated with poorer cognitive performance. Adjusted differences between the bottom quintile and grouped top UA quintiles were (B coefficient±SE) -4.23±1.28 for global cognitive scores (p = 0.001), -4.69±1.81 for memory scores (p = 0.010), -3.32±1.43 for executive scores (p = 0.020) and -3.43±1.97 for visual spatial scores (p = 0.082). Significant difference was also found for attention scores (p = 0.015). Additional adjustment for impaired CVR and high common carotid IMT slightly attenuated the relationship. Stronger UA effect on cognitive performance was found for older (age>65) patients with significant age interaction for global cognitive score (p = 0.016) and for executive (p = 0.018) and attention domains (p<0.001). In conclusion, we demonstrate that low UA levels in patients with preexisting cardiovascular disease are associated with poorer cognitive function a decade later. These findings lend support to the hypothesis that oxidative stress may be involved in the pathogenesis of age-associated cognitive impairment. PMID:25794156

  7. Ionization-induced annealing of pre-existing defects in silicon carbide

    DOE PAGESBeta

    Zhang, Yanwen; Sachan, Ritesh; Pakarinen, Olli H.; Chisholm, Matthew F.; Liu, Peng; Xue, Haizhou; Weber, William J.

    2015-08-12

    A long-standing objective in materials research is to find innovative ways to remove preexisting damage and heal fabrication defects or environmentally induced defects in materials. Silicon carbide (SiC) is a fascinating wide-band gap semiconductor for high-temperature, high-power, high-frequency applications. Its high corrosion and radiation resistance makes it a key refractory/structural material with great potential for extremely harsh radiation environments. Here we show that the energy transferred to the electron system of SiC by energetic ions via inelastic ionization processes results in a highly localized thermal spike that can effectively heal preexisting defects and restore the structural order. This work revealsmore » an innovative self-healing process using highly ionizing ions, and it describes a critical aspect to be considered in modeling SiC performance as either a functional or a structural material for device applications or high-radiation environments.« less

  8. Nonspecific genital ulcers.

    PubMed

    Sehgal, Virendra N; Pandhi, Deepika; Khurana, Ananta

    2014-01-01

    Recent intervention of nonspecific genital ulcers has added refreshing dimensions to genital ulcer disease. It was considered pertinent to dwell on diverse clinical presentation and diagnostic strategies. It seems to possess spectrum. It includes infective causes, Epstein Bar Virus, tuberculosis, Leishmaniasis, HIV/AIDS related ulcers and amoebiasis. Noninfective causes are immunobullous disorders, aphthosis, Behcet's disease (BD), inflammatory bowel disease, lichen planus and lichen sclerosis et atrophicus, drug reactions, premalignant and malignant conditions, pyoderma gangrenosum, and hidradenitis suppurativa. The diagnostic features and treatment option of each disorder are succinctly outlined for ready reference.

  9. Noninfectious genital ulcers.

    PubMed

    Kirshen, Carly; Edwards, Libby

    2015-12-01

    Noninfectious genital ulcers are much more common than ulcers arising from infections. Still, it is important to take a thorough history of sexual activity and a sexual abuse screen. A physical exam should include skin, oral mucosa, nails, hair, vulva, and vaginal mucosa if needed. The differential diagnosis of noninfectious genital ulcers includes: lipschütz ulcers, complex aphthosis, Behçet's syndrome, vulvar metastatic Crohn's disease, hidradenitis suppurativa, pyoderma gangrenosum, pressure ulcers, and malignancies. It is important to come to the correct diagnosis to avoid undue testing, stress, and anxiety in patients experiencing genital ulcerations.

  10. Observational Study of the Genetic Architecture of Neutrophil-Mediated Inflammatory Skin Diseases

    ClinicalTrials.gov

    2016-09-26

    Other Specified Inflammatory Disorders of Skin or Subcutaneous Tissue; Pyoderma Gangrenosum; Erosive Pustular Dermatosis of the Scalp; Sweet's Syndrome; Behcet's Disease; Bowel-associated Dermatosis-arthritis Syndrome; Pustular Psoriasis; Acute Generalized Exanthematous Pustulosis; Keratoderma Blenorrhagicum; Sneddon-Wilkinson Disease; IgA Pemphigus; Amicrobial Pustulosis of the Folds; Infantile Acropustulosis; Transient Neonatal Pustulosis; Neutrophilic Eccrine Hidradenitis; Rheumatoid Neutrophilic Dermatitis; Neutrophilic Urticaria; Still's Disease; Erythema Marginatum; Unclassified Periodic Fever Syndromes / Autoinflammatory Syndromes; Dermatitis Herpetiformis; Linear IgA Bullous Dermatosis; Bullous Systemic Lupus Erythematosus; Inflammatory Epidermolysis Bullosa Aquisita; Neutrophilic Dermatosis of the Dorsal Hands (Pustular Vasculitis); Small Vessel Vasculitis Including Urticarial Vasculitis; Erythema Elevatum Diutinum; Medium Vessel Vasculitis

  11. DNase I and proteinase K impair Listeria monocytogenes biofilm formation and induce dispersal of pre-existing biofilms.

    PubMed

    Nguyen, Uyen T; Burrows, Lori L

    2014-09-18

    Current sanitation methods in the food industry are not always sufficient for prevention or dispersal of Listeria monocytogenes biofilms. Here, we determined if prevention of adherence or dispersal of existing biofilms could occur if biofilm matrix components were disrupted enzymatically. Addition of DNase during biofilm formation reduced attachment (<50% of control) to polystyrene. Treatment of established 72h biofilms with 100μg/ml of DNase for 24h induced incomplete biofilm dispersal, with <25% biofilm remaining compared to control. In contrast, addition of proteinase K completely inhibited biofilm formation, and 72h biofilms-including those grown under stimulatory conditions-were completely dispersed with 100μg/ml proteinase K. Generally-regarded-as-safe proteases bromelain and papain were less effective dispersants than proteinase K. In a time course assay, complete dispersal of L. monocytogenes biofilms from both polystyrene and type 304H food-grade stainless steel occurred within 5min at proteinase K concentrations above 25μg/ml. These data confirm that both DNA and proteins are required for L. monocytogenes biofilm development and maintenance, and that these components of the biofilm matrix can be targeted for effective prevention and removal of biofilms.

  12. 45 CFR 155.345 - Coordination with Medicaid, CHIP, the Basic Health Program, and the Pre-existing Condition...

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... specified in § 155.320(c)(3). (g) Determination of eligibility for individuals submitting applications... initially received an application. (h) Standards for sharing information between the Exchange and the... affordability programs has been determined eligible for Medicaid, CHIP, or the BHP, as specified in §...

  13. 45 CFR 155.345 - Coordination with Medicaid, CHIP, the Basic Health Program, and the Pre-existing Condition...

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... individuals potentially eligible for Medicaid based on other information or through other coverage groups. For... filer's household income, as defined in 26 CFR 1.36B-1(e), is less than 100 percent of the FPL for the benefit year for which coverage is requested, determines that the tax filer is not eligible for...

  14. 45 CFR 155.345 - Coordination with Medicaid, CHIP, the Basic Health Program, and the Pre-existing Condition...

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... individuals potentially eligible for Medicaid based on other information or through other coverage groups. For... filer's household income, as defined in 26 CFR 1.36B-1(e), is less than 100 percent of the FPL for the benefit year for which coverage is requested, determines that the tax filer is not eligible for...

  15. Pre-existing Arterial Micro-Calcification Predicts Primary Unassisted Arteriovenous Fistula Failure in Incident Hemodialysis Patients.

    PubMed

    Choi, Su Jin; Yoon, Hye Eun; Kim, Young Soo; Yoon, Sun Ae; Yang, Chul Woo; Kim, Yong-Soo; Park, Sun Cheol; Kim, Young Ok

    2015-01-01

    Vascular access micro-calcification is a risk factor for cardiovascular morbidity and mortality in hemodialysis (HD) patients but its influence on vascular access patency is still undetermined. Our study aimed to determine the impact of arterial micro-calcification (AMiC) on the patency of vascular access in HD patients. One-hundred fourteen HD patients receiving arteriovenous fistula (AVF) operation were included in this study. During the operation, we obtained partial arterial specimen and performed pathological examination by von Kossa stain to identify AMiC. We compared primary unassisted AVF failure within 1 year between positive and negative AMiC groups, and performed Cox regression analysis for evaluating risk factor of AVF failure. The incidence of AMiC was 37.7% and AVF failure occurred in 45 patients (39.5%). The AVF failure rate within 1 year was greater in the positive AMiC group than those in the negative AMiC group (53.5% vs. 31.0%, p = 0.02). Kaplan-Meier analysis showed that the positive AMiC group had a lower AVF patency rate than the negative AMiC group (p = 0.02). The presence of AMiC was an independent risk factor for AVF failure. In conclusion, preexisting AMiC of the vascular access is associated with primary unassisted AVF failure in incident HD patients.

  16. Developing a Community Profile: A Handbook for Using Pre-Existing Data in Prevention Planning. Second Edition.

    ERIC Educational Resources Information Center

    Gabriel, Roy M.; And Others

    This manual is for citizens working to develop drug prevention programs for their communities using preexisting data and consists of three sections. Part 1 asserts the need to assemble a community profile. The purpose for the data gathering activity must be clearly articulated. In part 2 the steps in assembling a package of community indicators…

  17. Combined direct regeneration protocols in tissue culture of different cumin genotypes based on pre-existing meristems.

    PubMed

    Ebrahimie, Esmaeil; Hosseinzadeh, Abdolhadi; Nagavi, Mohammad Reza; Ghannadha, Mohammad Reza; Mohammadie-Dehcheshmeh, Manijeh

    2007-05-01

    Rapid and genotype-independent protocols for two direct in vitro morphogenesis pathways including direct shoot organogenesis from embryo and direct shoot proliferation from node have been developed in cumin (Cuminum cyminum L.). Direct regenerations occurring without passing callus phase are important since fewer somaclonal variation and genotype-dependency are likely to arise from these methods in comparison with regenerations trough callus. After embryo culture, shoots with single-cellular origin were regenerated from the meristematic zone of embryo without any intermediate callus phase. In contrast, proliferated shoots with multi-cellular origin were directly regenerated from the axillary buds (meristems) of node explants. Effects of different concentrations of 6-Benzylaminopurine (BAP), alpha-Naphthaleneacetic Acid (NAA) and Indole-3-kcetic Acid (IAA) on B5 medium of embryo and node cultures as well as subculture were studied in detail. In direct organogenesis pathway from embryo explant, 0.1 mg L(-1) NAA + 1 mg L(-1) IAA resulted the highest shoot regeneration response (89.5 shoots per regenerated explant), whereas 0.1 mg L(-1) BAP + 1 mg L(-1) NAA was the most effective combination in direct shoot proliferation from node explant (42 shoots per regenerated explant). BAP (cytokinin) revealed the inhibitory effect on induction of direct shoot organogenesis pathway from embryo explant, while low concentration of BAP (0.1 mg L(-1)) had positive effect on direct shoot proliferation pathway from node explant. Subculturing was not necessary for shoot multiplication and elongation in embryo culture, whereas multiplication and elongation of shoots in node culture were associated to subculture on growth regulator-free medium. In other part of study, the behavior of different cumin genotypes in direct regeneration pathways was studied. Both direct organogenesis and direct proliferation pathways were applicable to different cumin genotypes and regenerated plants were phenotypically normal. This study supports the feasibility of combined direct regenerations protocols from embryo and node of cumin in germplasm conservation by in vitro cloning and genetic improvement programs.

  18. Trimeric forms of the photosystem I reaction center complex pre-exist in the membranes of the cyanobacterium Spirulina platensis.

    PubMed

    Shubin, V V; Tsuprun, V L; Bezsmertnaya, I N; Karapetyan, N V

    1993-11-01

    Oligomeric and monomeric forms of chlorophyll-protein complexes of photosystem I (PSI) have been isolated from the mesophilic cyanobacterium Spirulina [(1992) FEBS Lett. 309, 340-342]. Electron microscopic analysis of the complexes showed that the oligomeric form is a trimer of the shape and dimensions similar to those of the trimer from thermophilic cyanobacteria. The chlorophyl ratio in the isolated trimer and monomer was found to be 7:3. The trimeric form of PSI complex in contrast to the monomeric one contains the chlorophyll emitting at 760 nm (77K), which is also found in Spirulina membranes and therefore could be used as an intrinsic probe for the trimeric complex. The 77K circular dichroism spectrum of the trimeric form is much more similar to that of Spirulina membranes than the spectrum of the monomer. Thus, the trimeric PSI complexes exist and dominate in the Spirulina membranes. PMID:8224233

  19. Individual Differences in Reading Comprehension Gains from Assisted Reading Practice: Pre Existing Conditions, Vocabulary Acquisition, and Amounts of Practice

    ERIC Educational Resources Information Center

    Shany, Michal; Biemiller, Andrew

    2010-01-01

    We conducted a study of the effects of assisted reading practice (Shany & Biemiller, 1995). In this paper we examined the original data to find factors affecting gains in reading comprehension. We contrasted 14 children who had below median gains in reading comprehension and 15 who had above median gains. There were no significant correlations…

  20. Effects of a pre-existing food allergy on the oral introduction of food proteins: findings from a murine model.

    PubMed

    Kulis, M; Burks, A W

    2015-01-01

    Cashew-allergic mice develop elevated walnut-specific IgE upon oral feeding of walnut proteins. Ingestion of tree nuts in the presence of a known nut allergy could lead to additional sensitizations and anaphylaxis following subsequent exposure. PMID:25155558

  1. The Architecture of Support: The Activation of Pre-existing Ties and Formation of New Ties for Tailored Support

    PubMed Central

    LaValley, Susan; Panagakis, Christina; Shelton, Rachel C.

    2015-01-01

    This study examines differences in the resources, information, and support parents coping with pediatric cancer accessed from different types of network contacts. Using interviews with parents of childhood cancer patients (N = 80 parents), we examine (1) if parents rely on different types of network ties to access tailored information, resources or support; (2) differences in the nature or utility of information, resources, and support offered by different types of network contacts; and (3) the role of health-related professionals in brokering new network ties. Findings show that after a child’s cancer diagnosis, parents received support from a broad portfolio of network members, which included preexisting network ties to friends and families as well as the formation of new ties to other cancer families and health-related professionals. Family, friends, and neighbors offered logistical support that aided balancing preexisting work and household responsibilities with new obligations. Parents formed new ties to other families coping with cancer for tailored health-related emotional and informational support. Health-related professionals served as network brokers, who fostered the development of new network ties and connected parents with supportive resources. PMID:25888807

  2. THE IMPACT OF PRE-EXISTING TAXES ON THE BENEFITS OF REGULATIONS AFFECTING HEALTH OR PRODUCTIVITY. (R825313)

    EPA Science Inventory

    The perspectives, information and conclusions conveyed in research project abstracts, progress reports, final reports, journal abstracts and journal publications convey the viewpoints of the principal investigator and may not represent the views and policies of ORD and EPA. Concl...

  3. 40 CFR Appendix B to Part 434 - Baseline Determination and Compliance Monitoring for Pre-existing Discharges at Remining Operations

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... Discharges at Remining Operations I. General Procedure Requirements a. This appendix presents the procedures... specify that pollutant loadings of total iron, total manganese, total suspended solids, and net acidity in.... Each loading value is calculated as the product of a flow measurement and pollutant concentration...

  4. Surgical Stress Abrogates Pre-Existing Protective T Cell Mediated Anti-Tumor Immunity Leading to Postoperative Cancer Recurrence.

    PubMed

    Ananth, Abhirami A; Tai, Lee-Hwa; Lansdell, Casey; Alkayyal, Almohanad A; Baxter, Katherine E; Angka, Leonard; Zhang, Jiqing; Tanese de Souza, Christiano; Stephenson, Kyle B; Parato, Kelley; Bramson, Jonathan L; Bell, John C; Lichty, Brian D; Auer, Rebecca C

    2016-01-01

    Anti-tumor CD8+ T cells are a key determinant for overall survival in patients following surgical resection for solid malignancies. Using a mouse model of cancer vaccination (adenovirus expressing melanoma tumor-associated antigen (TAA)-dopachrome tautomerase (AdDCT) and resection resulting in major surgical stress (abdominal nephrectomy), we demonstrate that surgical stress results in a reduction in the number of CD8+ T cell that produce cytokines (IFNγ, TNFα, Granzyme B) in response to TAA. This effect is secondary to both reduced proliferation and impaired T cell function following antigen binding. In a prophylactic model, surgical stress completely abrogates tumor protection conferred by vaccination in the immediate postoperative period. In a clinically relevant surgical resection model, vaccinated mice undergoing a positive margin resection with surgical stress had decreased survival compared to mice with positive margin resection alone. Preoperative immunotherapy with IFNα significantly extends survival in surgically stressed mice. Importantly, myeloid derived suppressor cell (MDSC) population numbers and functional impairment of TAA-specific CD8+ T cell were altered in surgically stressed mice. Our observations suggest that cancer progression may result from surgery-induced suppression of tumor-specific CD8+ T cells. Preoperative immunotherapies aimed at targeting the prometastatic effects of cancer surgery will reduce recurrence and improve survival in cancer surgery patients. PMID:27196057

  5. Pre-existing cognitive impairment and post-operative cognitive dysfunction: should we be talking the same language?

    PubMed

    Evered, Lisbeth; Silbert, Brendan; Scott, David A

    2016-07-01

    Changes in cognition are known to follow anesthesia and surgery in older individuals (Evered et al., 2011). Although survival per se was the prime outcome in the 19th and early 20th centuries for invasive procedures, a link was none-the-less observed with adverse cognitive outcomes as far back as 1887 (Savage, 1887). Historical reports of "insanity" or "weak mindedness" after anesthesia appeared within 40 years of the first anesthetic having been administered and anecdotal and retrospective reports have implicated anesthesia ever since. However, it was not until the 1970s that these observations received any sound scientific evaluation, when clinicians became aware of cognitive changes following cardiac surgery. It was assumed that the cardiopulmonary bypass (heart lung machine) must have been the main culprit because it was this factor which so greatly distinguished cardiac surgery from non-cardiac surgery (Shaw et al., 1987). This long held belief entered surgical folklore and was the basis for many publications endeavoring to identify particular aspects of the heart lung machine responsible for this cognitive decline.

  6. Evaluating a parainfluenza virus 5-based vaccine in a host with pre-existing immunity against parainfluenza virus 5.

    PubMed

    Chen, Zhenhai; Xu, Pei; Salyards, Gregory W; Harvey, Stephen B; Rada, Balazs; Fu, Zhen F; He, Biao

    2012-01-01

    Parainfluenza virus 5 (PIV5), formerly known as simian virus 5 (SV5), is a paramyxovirus often referred to as canine parainfluenza virus (CPI) in the veterinary field. PIV5 is thought to be a contributing factor to kennel cough. Kennel cough vaccines containing live PIV5 have been used in dogs for many decades. PIV5 is not known to cause any diseases in humans or other animals. PIV5 has been used as a vector for vaccine development for humans and animals. One critical question concerning the use of PIV5 as a vector is whether prior exposure to PIV5 would prevent the use of PIV5-based vaccines. In this work, we have examined immunogenicity of a recombinant PIV5 expressing hemagglutinin (HA) of influenza A virus subtype 3 (rPIV5-H3) in dogs that were immunized against PIV5. We found that vaccination of the dogs containing neutralizing antibodies against PIV5 with rPIV5-H3 generated immunity against influenza A virus, indicting that PIV5-based vaccine is immunogenic in dogs with prior exposure. Furthermore, we have examined exposure of PIV5 in human populations. We have detected neutralizing antibody (nAb) against PIV5 in 13 out of 45 human serum samples (about 29 percent). The nAb titers in humans were lower than that in vaccinated dogs, suggesting that nAb in humans is unlikely to prevent PIV5 from being an efficacious vector in humans. PMID:23185558

  7. Interaction between an emerging flux region and a pre-existing fan-spine dome observed by IRIS and SDO

    NASA Astrophysics Data System (ADS)

    Jiang, Fayu; Zhang, Jun; Yang, Shuhong

    2016-04-01

    We present multi-wavelength observations of a fan-spine dome in the active region NOAA 11996 with the Interface Region Imaging Spectrograph (IRIS) and the Atmospheric Imaging Assembly on board the Solar Dynamics Observatory (SDO) on March 9, 2014. The destruction of the fan-spine topology owing to the interaction between its magnetic fields and an nearby emerging flux region (EFR) is firstly observed. The line-of-sight magnetograms from the Helioseismic and Magnetic Imager on board the SDO reveal that the dome is located on the mixed magnetic fields, with its rim rooted in the redundant positive polarity surrounding the minority parasitic negative fields. The fan surface of the dome consists of a filament system and recurring jets are observed along its spine. The jet occurring around 13:54 UT is accompanied with a quasi-circular ribbon that brightens in the clockwise direction along the bottom rim of the dome, which may indicate an occurrence of slipping reconnection in the fan-spine topology. The EFR emerges continuously and meets with the magnetic fields of the dome. Magnetic cancellations take place between the emerging negative polarity and the outer positive polarity of the dome's fields, which lead to the rise of the loop connecting the EFR and brightenings related to the dome. A single Gaussian fit to the profiles of the IRIS SI IV 1394 Å line is used in the analysis. It appears that there are two rising components along the slit, except for the rise in the line-of-sight direction. The cancellation process repeats again and again. Eventually the fan-spine dome is destroyed and a new connectivity is formed. We suggest that magnetic reconnection between the EFR and the magnetic fields of the fan-spine dome in the process is responsible for the destruction of the dome.

  8. Asymmetrical effects of adaptation to left- and right-shifting prisms depends on pre-existing attentional biases.

    PubMed

    Goedert, Kelly M; Leblanc, Andrew; Tsai, Sen-Wei; Barrett, Anna M

    2010-09-01

    Proposals that adaptation with left-shifting prisms induces neglect-like symptoms in normal individuals rely on a dissociation between the postadaptation performance of individuals trained with left- versus right-shifting prisms (e.g., Colent, Pisella, & Rossetti, 2000). A potential problem with this evidence is that normal young adults have an a priori leftward bias (e.g., Jewell & McCourt, 2000). In Experiment 1, we compared the line bisection performance of young adults to that of aged adults, who as a group may lack a leftward bias in line bisection. Participants trained with both left- and right-shifting prisms. Consistent with our hypothesis, while young adults demonstrated aftereffects for left, but not right prisms, aged adults demonstrated reliable aftereffects for both prisms. In Experiment 2, we recruited a larger sample of young adults, some of whom were right-biased at baseline. We observed an interaction between baseline bias and prism-shift, consistent with the results of Experiment 1: Left-biased individuals showed a reduced aftereffect when training with right-shifting prisms and right-biased individuals showed a reduced aftereffect when training with left-shifting prisms. These results suggest that previous failures to find generalizable aftereffects with right-shifting prisms may be driven by participants' baseline biases rather than specific effects of the prism itself.

  9. REVENUE-RAISING VS. OTHER APPROACHES TO ENVIRONMENTAL PROTECTION: THE CRITICAL SIGNIFICANCE OF PRE- EXISTING TAX DISTORTIONS. (R825313)

    EPA Science Inventory

    The perspectives, information and conclusions conveyed in research project abstracts, progress reports, final reports, journal abstracts and journal publications convey the viewpoints of the principal investigator and may not represent the views and policies of ORD and EPA. Concl...

  10. The effect of the pre-existing surface crack morphologies on the thermal fracture of ceramic coatings

    NASA Astrophysics Data System (ADS)

    Zhou, Bin

    The fracture or delamination of ceramic thermal barrier coatings (TBCs) at the ceramic-bondcoat interface can be induced by the vertical surface cracks due to the high heat flux loading. Previous studies, on the other hand, indicated that a population of preexisting through-thickness surface cracks can increase the tensile in-plane compliance of the TBC layer, therefore reduce the energy driving the interface fracture and enhance the durability of the TBCs. However, in these studies, the effects of the length of the surface pre-cracks and the thickness of the coating were not considered. Therefore, the influences of the complete coating configurations including the pre-crack length, pre-crack density and the coating thickness, on the TBC surface and interface fracture, are not yet well understood. In this work, the finite element method was used to investigate the effects of surface pre-crack morphology (crack density and length), coating thickness and high heat flux loading on the delamination cracking at the TBC interface. Laser thermal shock experiments on real TBC specimens were also performed to verify the results from the analyses. The analytical model was able to predict the surface crack growth and the resulted interface crack driving force as a function of the pre-crack morphology. The results agreed with the laser tests and indicated that optimum pre-crack morphology can minimize the crack driving force at the interface, and thicker coatings also have the potential to be more resistant to the interface fracture. Based on this model, the methodology for designing the TBC pre-crack morphology to increase the coating fracture resistance was introduced. Finally, the thermal loading parameters other than the maximum surface temperature were studied. It was found that, the temperature difference through the coating thickness, the duration of the heating and the cooling schemes after the thermal loading all greatly affect the TBC thermal fracture behaviors.

  11. DNase I and proteinase K impair Listeria monocytogenes biofilm formation and induce dispersal of pre-existing biofilms.

    PubMed

    Nguyen, Uyen T; Burrows, Lori L

    2014-09-18

    Current sanitation methods in the food industry are not always sufficient for prevention or dispersal of Listeria monocytogenes biofilms. Here, we determined if prevention of adherence or dispersal of existing biofilms could occur if biofilm matrix components were disrupted enzymatically. Addition of DNase during biofilm formation reduced attachment (<50% of control) to polystyrene. Treatment of established 72h biofilms with 100μg/ml of DNase for 24h induced incomplete biofilm dispersal, with <25% biofilm remaining compared to control. In contrast, addition of proteinase K completely inhibited biofilm formation, and 72h biofilms-including those grown under stimulatory conditions-were completely dispersed with 100μg/ml proteinase K. Generally-regarded-as-safe proteases bromelain and papain were less effective dispersants than proteinase K. In a time course assay, complete dispersal of L. monocytogenes biofilms from both polystyrene and type 304H food-grade stainless steel occurred within 5min at proteinase K concentrations above 25μg/ml. These data confirm that both DNA and proteins are required for L. monocytogenes biofilm development and maintenance, and that these components of the biofilm matrix can be targeted for effective prevention and removal of biofilms. PMID:25043896

  12. Undue delay in the diagnosis of lung cancer due to the clinician's preoccupation with pre-existing tuberculosis.

    PubMed

    Revannasiddaiah, Swaroop; Madabhavi, Irappa; Thakur, Priyanka; Seam, Rajeev Kumar

    2011-01-01

    The authors report the case of a seminomadic older patient who had already received a course of antitubercular treatment and within a few weeks of completion suffered resurgence of symptoms. His treating physician assumed it to be relapse of tuberculosis and hence re-started the patient on antitubercular treatment. Though the mass lesion on CT scan procured by the primary care physician suggested the possibility of a neoplasm, areas of necrosis within the mass led to a 'cavitary appearance', which unfortunately happens to be a feature of tuberculosis. Once the patient presented to the authors, they performed cytological investigations which established that the patient had lung cancer co-existing with tuberculosis, which indeed was the reason for his progressive symptoms in spite of antitubercular treatment. PMID:22674956

  13. ACAT inhibition reduces the progression of pre-existing, advanced atherosclerotic mouse lesions without plaque or systemic toxicity

    PubMed Central

    Rong, James X.; Blachford, Courtney; Feig, Jonathan E.; Bander, Ilda; Mayne, Jeffrey; Kusunoki, Jun; Miller, Christine; Davis, Matthew; Wilson, Martha; Dehn, Shirley; Thorp, Edward; Tabas, Ira; Taubman, Mark B.; Rudel, Lawrence L.; Fisher, Edward A.

    2013-01-01

    Objective Acyl-CoA:cholesterol acyltransferase (ACAT) converts cholesterol to cholesteryl esters in plaque foam cells. Complete deficiency of macrophage ACAT has been shown to increase atherosclerosis in hypercholesterolemic mice due to cytotoxicity from free cholesterol accumulation, while we previously showed that partial ACAT inhibition by Fujirebio compound F1394 decreased early atherosclerosis development. In this report, we tested F1394 effects on pre-established, advanced lesions of apoE-/- mice. Methods & Results ApoE-/- mice on Western diet for 14 weeks developed advanced plaques, and were either sacrificed (“Baseline”), or continued on Western diet without or with F1394 and sacrificed after 14 more weeks. F1394 was not associated with systemic toxicity. Compared to the baseline group, lesion size progressed in both groups; however, F1394 significantly retarded plaque progression, and reduced plaque macrophage, free and esterified cholesterol, and tissue factor contents compared to the untreated group. Apoptosis of plaque cells was not increased, consistent with the decrease in lesional free cholesterol, plaque necrosis was not increased, and efferocytosis (phagocytic clearance of apoptotic cells) was not impaired. The effects of F1394 were independent of changes in plasma cholesterol levels. Conclusions Partial ACAT inhibition by F1394 lowered plaque cholesterol content and had other antiatherogenic effects in advanced lesions in apoE-/- mice without overt systemic or plaque toxicity, suggesting the continued potential of ACAT inhibition for the clinical treatment of atherosclerosis in spite of recent trial data. PMID:23139293

  14. Idiotypes of pre-existing human anti-carcinoma anti-T and anti-Tn antibodies.

    PubMed

    Zanetti, M; Lenert, G; Springer, G F

    1993-02-01

    All humans normally possess antibodies, predominantly IgM, that react specifically with the Thomsen-Friedenreich (T) and the Tn antigens which are present in immunoreactive form on > 85% of all human carcinomas, but not in healthy and otherwise diseased tissues. We report here a serological study of idiotype expression and antigen reactivity of the anti-T and anti-Tn antibodies. Idiotypy was analyzed with rabbit antibodies raised against, and made specific for, affinity-purified polyclonal anti-T and anti-Tn antibodies from blood group A1B healthy adult donors. Anti-T and anti-Tn antibodies cross-reacted idiotypically in spite of their distinct epitope specificities. By adsorbing anti-T antibodies on insolubilized synthetic T carbohydrate we could firmly link idiotype expression with antigen reactivity. The relation of idiotype expression to the antigen-binding site of plant seed lectins was also studied; one originated from Arachis hypogaea [peanut agglutinin (PNA)], the other from Artocarpus integrifolia (Jacalin). PNA inhibited only anti-T antibodies. Jacalin inhibited both anti-T and anti-Tn antibodies in a dose-dependent manner. Neither idiotypic nor anti-idiotypic antibodies diminished the binding of lectins to T and Tn epitopes. The shared idiotypes on natural anti-T and anti-Tn antibodies permit consideration of application of their anti-idiotypes in treatment and/or prevention of human carcinoma.

  15. Pre-Existing Carbon Structure and Its Effect on Site-Specific Carbon Isotopes in Small Organic Molecules

    NASA Astrophysics Data System (ADS)

    Piasecki, A.; Eiler, J. M.

    2014-12-01

    The ability to measure site-specific isotopes in organic molecules allows for better understanding of the mechanisms of their biosynthetic and/or catagenic formation and destruction. Here we examine for site-specific isotopic composition of propane from natural and synthetic sources using novel instruments and techniques gas source mass spectrometry 1, and discuss the possible relationship of our findings to recent independent evidence from NMR measurements for the isotopic structures of long-chain alkanes2. A recent NMR study2 demonstrates that n-alkanes can be divided into three groups according to their site-specific carbon isotope structure: long (C16+) even carbon number, long (C17+) odd carbon number , and short (C11-C15). We modeled the isotopic site-specific composition of propane derived from these three distinct groups. If propane is cleaved from such long-chain hydrocarbons without fractionation, the long odd-numbered and the shorter alkanes would produce propane with an average terminal position 6-7‰ lighter than the center position, while the long even-numbered chain compounds would produce propane with a terminal position averaging around 7‰ heavier than the center. If, instead the fractionation associated with cleaving propane from such parent molecules is ~10‰ (as seems likely), then these average terminal — center differences should be decreased by ~5 ‰ (i.e., to -11-12 and +1-2 ‰, respectively). We will compare these predictions with our previous demonstrations of the changes in bulk and site specific compositions in propane due to isotope exchange equilibria, diffusion and conventional models of kerogen 'cracking', and will use these models as a framework for interpreting the observed site-specific isotopic compositions of propane from diverse natural gas deposits. 1. Piasecki, A. et al. Site-Specific Carbon Isotope Measurement of Organics by Gas Source Mass Spectrometry. Mineralogical Magazine 77, (2013). 2. Gilbert, A., Yamada, K. & Yoshida, N. Organic Geochemistry. Organic Geochemistry 62, 56-61 (2013).

  16. Pre-existing cognitive impairment and post-operative cognitive dysfunction: should we be talking the same language?

    PubMed

    Evered, Lisbeth; Silbert, Brendan; Scott, David A

    2016-07-01

    Changes in cognition are known to follow anesthesia and surgery in older individuals (Evered et al., 2011). Although survival per se was the prime outcome in the 19th and early 20th centuries for invasive procedures, a link was none-the-less observed with adverse cognitive outcomes as far back as 1887 (Savage, 1887). Historical reports of "insanity" or "weak mindedness" after anesthesia appeared within 40 years of the first anesthetic having been administered and anecdotal and retrospective reports have implicated anesthesia ever since. However, it was not until the 1970s that these observations received any sound scientific evaluation, when clinicians became aware of cognitive changes following cardiac surgery. It was assumed that the cardiopulmonary bypass (heart lung machine) must have been the main culprit because it was this factor which so greatly distinguished cardiac surgery from non-cardiac surgery (Shaw et al., 1987). This long held belief entered surgical folklore and was the basis for many publications endeavoring to identify particular aspects of the heart lung machine responsible for this cognitive decline. PMID:27145889

  17. PARTICLE GROWTH BY ACID-CATALYZED HETEROGENEOUS REACTIONS OF ORGANIC CARBONYLS ON PRE-EXISTING AEROSOLS. (R828176)

    EPA Science Inventory

    The perspectives, information and conclusions conveyed in research project abstracts, progress reports, final reports, journal abstracts and journal publications convey the viewpoints of the principal investigator and may not represent the views and policies of ORD and EPA. Concl...

  18. Surgical Stress Abrogates Pre-Existing Protective T Cell Mediated Anti-Tumor Immunity Leading to Postoperative Cancer Recurrence

    PubMed Central

    Lansdell, Casey; Alkayyal, Almohanad A.; Baxter, Katherine E.; Angka, Leonard; Zhang, Jiqing; Tanese de Souza, Christiano; Stephenson, Kyle B.; Parato, Kelley; Bramson, Jonathan L.; Bell, John C.; Lichty, Brian D.; Auer, Rebecca C.

    2016-01-01

    Anti-tumor CD8+ T cells are a key determinant for overall survival in patients following surgical resection for solid malignancies. Using a mouse model of cancer vaccination (adenovirus expressing melanoma tumor-associated antigen (TAA)—dopachrome tautomerase (AdDCT) and resection resulting in major surgical stress (abdominal nephrectomy), we demonstrate that surgical stress results in a reduction in the number of CD8+ T cell that produce cytokines (IFNγ, TNFα, Granzyme B) in response to TAA. This effect is secondary to both reduced proliferation and impaired T cell function following antigen binding. In a prophylactic model, surgical stress completely abrogates tumor protection conferred by vaccination in the immediate postoperative period. In a clinically relevant surgical resection model, vaccinated mice undergoing a positive margin resection with surgical stress had decreased survival compared to mice with positive margin resection alone. Preoperative immunotherapy with IFNα significantly extends survival in surgically stressed mice. Importantly, myeloid derived suppressor cell (MDSC) population numbers and functional impairment of TAA-specific CD8+ T cell were altered in surgically stressed mice. Our observations suggest that cancer progression may result from surgery-induced suppression of tumor-specific CD8+ T cells. Preoperative immunotherapies aimed at targeting the prometastatic effects of cancer surgery will reduce recurrence and improve survival in cancer surgery patients. PMID:27196057

  19. [Effect of indications and pre-existing conditions on the result of McDonald's cervix-closure surgery].

    PubMed

    Avar, Z; Tóth, B; Zacher, P

    1979-01-01

    Authors have performed the McDonald cerclage operation on 172 gravidae because of cervical incompetence. From these pregnancies 80.2 per cent of the infants have survived over the sixth day. While with operations performed on the basis of extended indications for surgery an effect of 56.5 per cent was achieved, it was in cases of classical ones 92.8 per cent. Two complicated cases are reported caused by blastospores or bacteria respectively, isolated also in the vaginal secretion which have ascended into the uterine cavity. Both cases resulted in fetal death and in a septic condition of the mother. It is emphasized that the normal vaginal bioflora is essential condition for the cervical suture. PMID:375620

  20. Ecthyma gangrenosum in a patient with acute leukemia.

    PubMed

    Kryeziu, Emrush; Kryeziu, K; Bajraktari, Gjani; Abazi, M; Zylfiu, B; Rudhani, I; Sadiku, Sh; Ukimeri, A; Brovina, A; Dreshaj, Sh; Telaku, S

    2010-01-01

    Ecthymagangrenosum (EG)is a rare condition with characteristic clinical appearance of red maculae that progresses to a central area of necrosis surrounded by an erythematous halo. The most frequently it is caused by Pseudomonas bacteriaemia in neutropenic patient. The authors presents a patient with acute myloblastic leukemia M4 type in whom in relapse EG caused by Pseudomonas aeruginosa was found. The patient was treated with antibiotics and surgical debridement. The author wants to point out on clinical significance this condition with high mortality rate.

  1. New Described Dermatological Disorders

    PubMed Central

    Cevirgen Cemil, Bengu; Keseroglu, Havva Ozge; Kaya Akis, Havva

    2014-01-01

    Many advances in dermatology have been made in recent years. In the present review article, newly described disorders from the last six years are presented in detail. We divided these reports into different sections, including syndromes, autoinflammatory diseases, tumors, and unclassified disease. Syndromes included are “circumferential skin creases Kunze type” and “unusual type of pachyonychia congenita or a new syndrome”; autoinflammatory diseases include “chronic atypical neutrophilic dermatosis with lipodystrophy and elevated temperature (CANDLE) syndrome,” “pyoderma gangrenosum, acne, and hidradenitis suppurativa (PASH) syndrome,” and “pyogenic arthritis, pyoderma gangrenosum, acne, and hidradenitis suppurativa (PAPASH) syndrome”; tumors include “acquired reactive digital fibroma,” “onychocytic matricoma and onychocytic carcinoma,” “infundibulocystic nail bed squamous cell carcinoma,” and “acral histiocytic nodules”; unclassified disorders include “saurian papulosis,” “symmetrical acrokeratoderma,” “confetti-like macular atrophy,” and “skin spicules,” “erythema papulosa semicircularis recidivans.” PMID:25243162

  2. A case of neutrophilic dermatosis who develop palpable purpura during the use of montelukast

    PubMed Central

    Çetin, Gözde Yıldırım; Sayarlıoğlu, Hayriye; Erhan, Çiğdem; Kahraman, Hasan; Cıralık, Harun; Sayarlıoğlu, Mehmet

    2014-01-01

    In this case report, we present a female patient with neutrophilic dermatosis (ND) occurring as palpable purpura after using montelukast. Neutrophilic dermatoses (NDs) are characterized by skin lesions in which mature neutrophils are predominantly located in the epidermis and dermis in the absence of any infective pathology. Classification of the NDs is based upon the recognition of clinical and pathologic features, as well as the identification of associated diseases, like Sweet’s syndrome, pyoderma gangrenosum, generalized pustular psoriasis, and Behçet’s disease. Cutaneous findings in NDs are variable and can include vesiculopustules, plaques, nodules, or ulcerations. Drug-induced NDs are not uncommon, but ND with palpable purpura is uncommon. The current patient appeared with a rare presentation as palpable purpura without vasculitis regarding ND. It is important that this is the first case report. PMID:27708908

  3. [Dermato-mucosal manifestations of Behçet's disease].

    PubMed

    Francès, C

    1999-11-01

    Oral and genital aphthae are the main clinical dermatologic manifestations of Behçet's disease. They look like those that occur in other aphthosis. Cutaneous lesions include pseudofolliculitis, folliculitis, erythema nodosum-like lesions, Sweet's-like lesions and pyoderma gangrenosum-like lesions. Histologically, these lesions are frequently perivascular with proeminent infiltrates of neutrophils and/or lymphocytes. Hypersensibility to needle pricks is explored by the pathergy test which sensibility is highly variable depending on the countries. When there is no systemic lesions requiring oral corticosteroids or immunosuppressive therapy, colchicine, aspirine, or dapsone may be prescribed. Thalidomide is sometimes required if aphthosis is refractory to other treatments despite its neurotixic and teratogenic effects. PMID:10637669

  4. Thalidomide: dermatological indications, mechanisms of action and side-effects.

    PubMed

    Wu, J J; Huang, D B; Pang, K R; Hsu, S; Tyring, S K

    2005-08-01

    Thalidomide was first introduced in the 1950s as a sedative but was quickly removed from the market after it was linked to cases of severe birth defects. However, it has since made a remarkable comeback for the U.S. Food and Drug Administration-approved use in the treatment of erythema nodosum leprosum. Further, it has shown its effectiveness in unresponsive dermatological conditions such as actinic prurigo, adult Langerhans cell histiocytosis, aphthous stomatitis, Behçet's syndrome, graft-versus-host disease, cutaneous sarcoidosis, erythema multiforme, Jessner-Kanof lymphocytic infiltration of the skin, Kaposi sarcoma, lichen planus, lupus erythematosus, melanoma, prurigo nodularis, pyoderma gangrenosum and uraemic pruritus. This article reviews the history, pharmacology, mechanism of action, clinical uses and adverse effects of thalidomide.

  5. Important cutaneous manifestations of inflammatory bowel disease

    PubMed Central

    Trost, L; McDonnell, J

    2005-01-01

    Inflammatory bowel disease (IBD) has many extraintestinal manifestations. Cutaneous manifestations are usually related to the activity of the bowel disease but may have an independent course. Anyone presenting with IBD should be examined for cutaneous manifestations. Pyoderma gangrenosum is a severe painful ulcerating disease that requires moist wound management and, in the absence of secondary infection, systemic corticosteroids, cyclosporine, or both. Infliximab may also be used. Erythema nodosum is a common cause of tender red nodules of the shins. Management includes leg elevation, NSAIDs, and potassium iodide. Oral manifestations of IBD include aphthous stomatitis, mucosal nodularity (cobblestoning), and pyostomatitis vegetans. Treatment should be directed both at the cutaneous lesions and at the underlying systemic condition. PMID:16143688

  6. Management of cutaneous disorders related to inflammatory bowel disease

    PubMed Central

    Pellicer, Zaira; Santiago, Jesus Manuel; Rodriguez, Alejandro; Alonso, Vicent; Antón, Rosario; Bosca, Marta Maia

    2012-01-01

    Almost one-third of patients with inflammatory bowel disease (IBD) develop skin lesions. Cutaneous disorders associated with IBD may be divided into 5 groups based on the nature of the association: specific manifestations (orofacial and metastatic IBD), reactive disorders (erythema nodosum, pyoderma gangrenosum, pyodermatitis-pyostomatitis vegetans, Sweet’s syndrome and cutaneous polyarteritis nodosa), miscellaneous (epidermolysis bullosa acquisita, bullous pemphigoid, linear IgA bullous disease, squamous cell carcinoma-Bowen’s disease, hidradenitis suppurativa, secondary amyloidosis and psoriasis), manifestations secondary to malnutrition and malabsorption (zinc, vitamins and iron deficiency), and manifestations secondary to drug therapy (salicylates, immunosupressors, biological agents, antibiotics and steroids). Treatment should be individualized and directed to treating the underlying IBD as well as the specific dermatologic condition. The aim of this review includes the description of clinical manifestations, course, work-up and, most importantly, management of these disorders, providing an assessment of the literature on the topic. PMID:24713996

  7. [Martorell Hypertensive Ischaemic Leg Ulcer].

    PubMed

    Nobbe, S; Hafner, J

    2015-10-01

    Martorell hypertensive ischaemic leg ulcer (HYTILU) represents an important differential diagnosis of painful leg ulcerations. Stenotic subcutaneous arteriolosclerosis in patients with long-standing arterial hypertension finally leads to skin infarction. The typical histological changes are very similar in Martorell HYTILU and calciphylaxis. This raises the hypothesis that the two entities may have a common pathogenesis. Martorell HYTILU presents as an extremely painful ulcer that is regularly located at the laterodorsal lower leg or at the Achilles tendon. Because of its inflammatory and violaceous wound edges and its tendency to progression, clinicians unaware of the diagnosis Martorell HYTILU might misdiagnose pyoderma gangrenosum or necrotising cutaneous vasculitis start an immunosuppressive treatment and avoid surgical diagnostic and therapeutic procedures. Instead, necrosectomy and split skin grafting are the treatment of choice for Martorell HYTILU.

  8. Helicobacter spp. other than H. pylori.

    PubMed

    Rossi, Mirko; Hänninen, Marja-Liisa

    2012-09-01

    Significant advances have been made over the last 12 months in the understanding of the biology of non-H. pylori Helicobacter species (NHPH). Several studies have investigated the association between NHPH and human disease, including Crohn's disease, lithiasis, liver disease, coronary disease, gastritis, and pyoderma gangrenosum-like ulcers. Novel Helicobacter taxa were identified in new vertebrate hosts, and new methodologies in the fields of identification of Helicobacter spp. and evaluation of antibiotic resistance were described. The genome of the first human-derived gastric NHPH strain (Helicobacter bizzozeronii CIII-1) was sequenced, and several studies elucidated functions of different genes in NHPH. A number of important investigations regarding pathogenesis and immunopathobiology of NHPH infections have been published including the description of a new urease in Helicobacter mustelae. Finally, the effects of the gut microbiota and probiotics on NHPH infections were investigated.

  9. The skin as a target organ in multisystemic diseases II.

    PubMed

    Tsankov, Nikolai; Kazandjieva, Jana; Darlenski, Razvigor

    2015-01-01

    Progress in medical science has given a new reading to the claim that the skin could be a mirror of the pathological changes found in the internal organs. The concept that we previously promoted is furthered in this issue; namely that the greatest part of skin diseases are systemic ones. In this issue we focus on another group of diseases with systemic involvement and skin manifestations. We review such inflammatory conditions as lichen planus, autoinflammatory syndromes, and pyoderma gangrenosum focusing on their systemic involvement. We have not missed such classic examples of systemic involvement as scleroderma. In this issue we have included two infectious diseases with multi-organ involvement: Lyme disease and Herpes simplex. In contrast to our previous work, we have also addressed neoplastic diseases - namely mycosis fungoides. PMID:26321395

  10. HCV Drug Resistance Challenges in Japan: The Role of Pre-Existing Variants and Emerging Resistant Strains in Direct Acting Antiviral Therapy

    PubMed Central

    Chayama, Kazuaki; Hayes, C. Nelson

    2015-01-01

    Sustained virological response (SVR) rates have increased dramatically following the approval of direct acting antiviral (DAA) therapies. While individual DAAs have a low barrier to resistance, most patients can be successfully treated using DAA combination therapy. However, DAAs are vulnerable to drug resistance, and resistance-associated variants (RAVs) may occur naturally prior to DAA therapy or may emerge following drug exposure. While most RAVs are quickly lost in the absence of DAAs, compensatory mutations may reinforce fitness. However, the presence of RAVs does not necessarily preclude successful treatment. Although developments in hepatitis C virus (HCV) therapy in Asia have largely paralleled those in the United States, Japan’s July 2014 approval of asunaprevir plus daclatasvir combination therapy as the first all-oral interferon-free therapy was not repeated in the United States. Instead, two different combination therapies were approved: sofosbuvir/ledipasvir and paritaprevir/ritonavir/ombitasvir/dasabuvir. This divergence in treatment approaches may lead to differences in resistance challenges faced by Japan and the US. However, the recent approval of sofosbuvir plus ledipasvir in Japan and the recent submissions of petitions for approval of paritaprevir/ritonavir plus ombitasvir suggest a trend towards a new consensus on emerging DAA regimens. PMID:26473914

  11. Disease Interactions in a Shared Host Plant: Effects of Pre-Existing Viral Infection on Cucurbit Plant Defense Responses and Resistance to Bacterial Wilt Disease

    PubMed Central

    Mauck, Kerry E.; Pulido, Hannier; De Moraes, Consuelo M.; Stephenson, Andrew G.; Mescher, Mark C.

    2013-01-01

    Both biotic and abiotic stressors can elicit broad-spectrum plant resistance against subsequent pathogen challenges. However, we currently have little understanding of how such effects influence broader aspects of disease ecology and epidemiology in natural environments where plants interact with multiple antagonists simultaneously. In previous work, we have shown that healthy wild gourd plants (Cucurbita pepo ssp. texana) contract a fatal bacterial wilt infection (caused by Erwinia tracheiphila) at significantly higher rates than plants infected with Zucchini yellow mosaic virus (ZYMV). We recently reported evidence that this pattern is explained, at least in part, by reduced visitation of ZYMV-infected plants by the cucumber beetle vectors of E. tracheiphila. Here we examine whether ZYMV-infection may also directly elicit plant resistance to subsequent E. tracheiphila infection. In laboratory studies, we assayed the induction of key phytohormones (SA and JA) in single and mixed infections of these pathogens, as well as in response to the feeding of A. vittatum cucumber beetles on healthy and infected plants. We also tracked the incidence and progression of wilt disease symptoms in plants with prior ZYMV infections. Our results indicate that ZYMV-infection slightly delays the progression of wilt symptoms, but does not significantly reduce E. tracheiphila infection success. This observation supports the hypothesis that reduced rates of wilt disease in ZYMV-infected plants reflect reduced visitation by beetle vectors. We also documented consistently strong SA responses to ZYMV infection, but limited responses to E. tracheiphila in the absence of ZYMV, suggesting that the latter pathogen may effectively evade or suppress plant defenses, although we observed no evidence of antagonistic cross-talk between SA and JA signaling pathways. We did, however, document effects of E. tracheiphila on induced responses to herbivory that may influence host-plant quality for (and hence pathogen acquisition by) cucumber beetles. PMID:24155951

  12. HCV Drug Resistance Challenges in Japan: The Role of Pre-Existing Variants and Emerging Resistant Strains in Direct Acting Antiviral Therapy.

    PubMed

    Chayama, Kazuaki; Hayes, C Nelson

    2015-10-01

    Sustained virological response (SVR) rates have increased dramatically following the approval of direct acting antiviral (DAA) therapies. While individual DAAs have a low barrier to resistance, most patients can be successfully treated using DAA combination therapy. However, DAAs are vulnerable to drug resistance, and resistance-associated variants (RAVs) may occur naturally prior to DAA therapy or may emerge following drug exposure. While most RAVs are quickly lost in the absence of DAAs, compensatory mutations may reinforce fitness. However, the presence of RAVs does not necessarily preclude successful treatment. Although developments in hepatitis C virus (HCV) therapy in Asia have largely paralleled those in the United States, Japan's July 2014 approval of asunaprevir plus daclatasvir combination therapy as the first all-oral interferon-free therapy was not repeated in the United States. Instead, two different combination therapies were approved: sofosbuvir/ledipasvir and paritaprevir/ritonavir/ombitasvir/dasabuvir. This divergence in treatment approaches may lead to differences in resistance challenges faced by Japan and the US. However, the recent approval of sofosbuvir plus ledipasvir in Japan and the recent submissions of petitions for approval of paritaprevir/ritonavir plus ombitasvir suggest a trend towards a new consensus on emerging DAA regimens. PMID:26473914

  13. [Determining the parameters for receptor-ligand interaction by serial dilution method for the case when the ligand and receptor are in a pre-existing mixture].

    PubMed

    Bobrovnik, S A

    2005-01-01

    New methods of determining the binding parameters for ligand-receptor interaction are considered. The considered approaches are based on the earlier suggested method of serial dilution and application of so-called coordinates of dilution. It was shown that the suggested methods allow to evaluate affinity constant and ligand concentration even for the case, when the receptor and corresponding ligand of unknown concentration are in a mixture and their separation from each other is impossible. In this connection the suggested methods are especially useful for studying the ligand-receptor interaction if the receptor is very liable and its purification from the ligand would cause drastic changes of its binding properties.

  14. The immunological basis of endotoxin-induced tumor regression. Requirement for a pre-existing state of concomitant anti-tumor immunity

    PubMed Central

    1978-01-01

    It was shown that of four syngeneic, murine tumors investigated, only those that evoked the generation of a state of concomitant anti-tumor immunity were susceptible to endotoxin-induced regression. Moreover, the temporal relationship between the generation of concomitant immunity and the onset of susceptibility to endotoxin-induced regression points to the likely possibility that tumor regression depends on the preceding acquisition of the specifically-sensitized, effector T cells that express concomitant immunity. It is suggested that endotoxin-induced hemorrhagic necrosis which invariably precedes tumor regression serves to create conditions inside the tumor that are conducive to the entry and the functioning of effector T cells. It is also suggested that tumor necrosis factor causes hemorrhagic necrosis rather than tumor regression. PMID:309922

  15. BRCA1 loss pre-existing in small subpopulations of prostate cancer is associated with advanced disease and metastatic spread to lymph nodes and peripheral blood

    SciTech Connect

    Bednarz, Natalia; Eltze, Elke; Semjonow, Axel; Rink, Michael; Andreas, Antje; Mulder, Lennart; Hannemann, Juliane; Fisch, Margit; Pantel, Klaus; Weier, Heinz-Ulrich G.; Bielawski, Krzysztof P.; Brandt, Burkhard

    2010-03-19

    A recent study concluded that serum prostate specific antigen (PSA)-based screening is beneficial for reducing the lethality of PCa, but was also associated with a high risk of 'overdiagnosis'. Nevertheless, also PCa patients who suffered from organ confined tumors and had negative bone scans succumb to distant metastases after complete tumor resection. It is reasonable to assume that those tumors spread to other organs long before the overt manifestation of metastases. Our current results confirm that prostate tumors are highly heterogeneous. Even a small subpopulation of cells bearing BRCA1 losses can initiate PCa cell regional and distant dissemination indicating those patients which might be at high risk of metastasis. A preliminary study performed on a small cohort of multifocal prostate cancer (PCa) detected BRCA1 allelic imbalances (AI) among circulating tumor cells (CTCs). The present analysis was aimed to elucidate the biological and clinical role of BRCA1 losses on metastatic spread and tumor progression in prostate cancer patients. Experimental Design: To map molecular progression in PCa outgrowth we used FISH analysis of tissue microarrays (TMA), lymph node sections and CTC from peripheral blood. We found that 14% of 133 tested patients carried monoallelic BRCA1 loss in at least one tumor focus. Extended molecular analysis of chr17q revealed that this aberration was often a part of larger cytogenetic rearrangement involving chr17q21 accompanied by AI of the tumor suppressor gene PTEN and lack of the BRCA1 promoter methylation. The BRCA1 losses correlated with advanced T stage (p < 0.05), invasion to pelvic lymph nodes (LN, p < 0.05) as well as BR (p < 0.01). Their prevalence was twice as high within 62 LN metastases (LNMs) as in primary tumors (27%, p < 0.01). The analysis of 11 matched primary PCa-LNM pairs confirmed the suspected transmission of genetic abnormalities between those two sites. In 4 of 7 patients with metastatic disease, BRCA1 losses appeared in a minute fraction of cytokeratin- and vimentin-positive CTCs. Small subpopulations of PCa cells bearing BRCA1 losses might be one confounding factor initiating tumor dissemination and might provide an early indicator of shortened disease-free survival.

  16. Effects of Pre-Existing Ice Crystals on Cirrus Clouds and Comparison between Different Ice Nucleation Parameterizations with the Community Atmosphere Model (CAM5)

    SciTech Connect

    Shi, Xiangjun; Liu, Xiaohong; Zhang, Kai

    2015-01-01

    In order to improve the treatment of ice nucleation in a more realistic manner in the Community Atmospheric Model version 5.3 (CAM5.3), the effects of preexisting ice crystals on ice nucleation in cirrus clouds are considered. In addition, by considering the in-cloud variability in ice saturation ratio, homogeneous nucleation takes place spatially only in a portion of cirrus cloud rather than in the whole area of cirrus cloud. With these improvements, the two unphysical limiters used in the representation of ice nucleation are removed. Compared to observations, the ice number concentrations and the probability distributions of ice number concentration are both improved with the updated treatment. The preexisting ice crystals significantly reduce ice number concentrations in cirrus clouds, especially at mid- to high latitudes in the upper troposphere (by a factor of ~10). Furthermore, the contribution of heterogeneous ice nucleation to cirrus ice crystal number increases considerably.Besides the default ice nucleation parameterization of Liu and Penner (2005, hereafter LP) in CAM5.3, two other ice nucleation parameterizations of Barahona and Nenes (2009, hereafter BN) and Kärcher et al. (2006, hereafter KL) are implemented in CAM5.3 for the comparison. In-cloud ice crystal number concentration, percentage contribution from heterogeneous ice nucleation to total ice crystal number, and preexisting ice effects simulated by the three ice nucleation parameterizations have similar patterns in the simulations with present-day aerosol emissions. However, the change (present-day minus pre-industrial times) in global annual mean column ice number concentration from the KL parameterization (3.24×106 m-2) is obviously less than that from the LP (8.46×106 m-2) and BN (5.62×106 m-2) parameterizations. As a result, experiment using the KL parameterization predicts a much smaller anthropogenic aerosol longwave indirect forcing (0.24 W m-2) than that using the LP (0.46 W m-2) and BN (0.39 W m-2) parameterizations.

  17. The absence of attenuating effect of red light exposure on pre-existing melanopsin-driven post-illumination pupil response.

    PubMed

    Lei, Shaobo; Goltz, Herbert C; Sklar, Jaime C; Wong, Agnes M F

    2016-07-01

    It has been proposed that after activation by blue light, activated melanopsin is converted back to its resting state by long wavelength red light exposure, a putative mechanism of melanopsin chromophore recovery in vivo. We tested this hypothesis by investigating whether red light attenuates the ongoing post-illumination pupil response (PIPR) induced by melanopsin-activating blue light. Pupillary light responses were tested using "Blue+Red" double flashes and "Blue Only" single flash stimuli in 10 visually normal subjects. For "Blue+Red" conditions, PIPR was induced with an intense blue flash, followed by experimental red light exposure of variable intensity and duration (Experiment 1) immediately or 9s after the offset of the blue flash (Experiment 2). For "Blue Only" conditions, only the PIPR-inducing blue stimuli were presented (reference condition). PIPR was defined as the mean pupil size from 10 to 30s (Experiment 1) and from 25 to 60s (Experiment 2) after the offset of blue light stimuli. The results showed that PIPR from "Blue+Red" conditions did not differ significantly from those of "Blue Only" conditions (p=0.55) in Experiment 1. The two stimulation conditions also did not differ in Experiment 2 (p=0.38). We therefore conclude that red light exposure does not alter the time course of PIPR induced by blue light. This finding does not support the hypothesis that long wavelength red light reverses activated melanopsin; rather it lends support to the hypothesis that the wavelengths of stimuli driving both the forward and backward reactions of melanopsin may be similar.

  18. [Relations of the duration of pre-existing angina pectoris, collateral circulation and left ventricular function after isolated coronary occlusion with or without myocardial infarction].

    PubMed

    Juillière, Y; Danchin, N; Grentzinger, A; Suty-Selton, C; Perrin, O; Guenoun, P; Pernot, C; Cherrier, F

    1990-10-01

    The aim of this retrospective study was to determine the relationship between the duration of preceding angina pectoris, collateral circulation and left ventricular function after isolated coronary occlusion with or without myocardial infarction. Coronary angiography of 138 consecutive patients showed isolated and complete occlusions of the left anterior descending (58 patients) or right coronary artery (80 patients). One hundred and four patients had myocardial infarction with (Group A, n = 21) or without (Group B, n = 83) preceding angina pectoris and 34 had angina without myocardial infarction (Group C). The left ventricular ejection fraction was measured by ventriculography in the 30 degrees right anterior oblique projection. The collateral circulation was assessed by coronary angiography and evaluated as follows: no flow or flow limited to collateral branches (subgroup 1) and partial or complete filling of the epicardial arterial segment (subgroup 2). In the global population the left ventricular ejection fraction was higher and the duration of preceding angina pectoris was longer in the subgroups with a well developed collateral circulation. There was no difference in ejection fraction between Groups A and B (presence of myocardial infarction), on the other hand, within each of the groups, a good collateral circulation (subgroup 2) was associated with a significantly higher ejection fraction. Group C (without infarction) patients had better ejection fractions than Groups A or B, especially when the collateral circulation was poorly developed. Within Group C, the quality of the collateral circulation did not seem to affect the ejection fraction. The left ventricular ejection fraction is lower in patients with isolated coronary occlusion and myocardial infarction.(ABSTRACT TRUNCATED AT 250 WORDS)

  19. The significance of pre-existing, deeply weathered crystalline rock in interpreting the effects of glaciation in the Minnesota River valley, U.S.A.

    USGS Publications Warehouse

    Patterson, C.J.; Boerboom, Terrence

    1999-01-01

    Minnesota is largely underlain by Precambrian crystalline bedrock that was weathered to an average depth of 30 m prior to Late Cretaceous time. The fresh-rock-weathered-rock interface is irregular, with as much as 45 m of relief. Weathering exploited joints, locally isolating meter-sized volumes of rock known as corestones. Variable amounts of residuum were removed through glaciation to leave (1) saprolite overlain by an in-situ Late Cretaceous soil profile; (2) partially eroded saprolite; and (3) undulating fresh rock surfaces (commonly mantled by rounded boulders) that display striae and glacial or fluvial polish. Significant subglacial erosion of fresh bedrock is not required to form smoothly undulating bedrock surfaces with closed depressions; they may also form through removal of weathered bedrock and exposure of the weathering front. Large rounded boulders are not always shaped during transport; they may represent chemically rounded corestones resting at or near the bedrock source. Unambiguous evidence for glacial erosion includes striae and streamlining of bedrock parallel to striae. Polish on rock can be created fluvially, and smoothed grooves and ridges in the rock may be chemically produced. Many rounded boulders found in glacial till and strewn on bedrock surfaces probably originated as corestones.

  20. Temperature-mediated hyperinduction of fatty acid desaturation in pre-existing and newly formed fatty acids synthesized endogenously in Bacillus megaterium.

    PubMed

    Lombardi, F J; Fulco, A J

    1980-05-28

    3H-labedeled fatty acids synthesized endogenously by Bacillus megaterium ATCC 14581 growing at 35 degrees C in the presence of L-[G-3H]valine exhibited the same time-course of hyperinduced desaturation following a temperature decrease to 20 degrees C as was observed previously with exogenously supplied 14C-labeled fatty acids. Radioactive fatty acids synthesized in the presence of [U-14C]glucose during hyperinduction at 20 degrees C following a shift-down from 35 degrees C were desaturated at the same relative rate as 14C-labeled fatty acids synthesized previously at 35 degrees C, suggesting that the newly synthesized fatty acids equilibrate with a large portion of the preexisting moieties before becoming susceptible to desaturation. PMID:6769497

  1. The absence of attenuating effect of red light exposure on pre-existing melanopsin-driven post-illumination pupil response.

    PubMed

    Lei, Shaobo; Goltz, Herbert C; Sklar, Jaime C; Wong, Agnes M F

    2016-07-01

    It has been proposed that after activation by blue light, activated melanopsin is converted back to its resting state by long wavelength red light exposure, a putative mechanism of melanopsin chromophore recovery in vivo. We tested this hypothesis by investigating whether red light attenuates the ongoing post-illumination pupil response (PIPR) induced by melanopsin-activating blue light. Pupillary light responses were tested using "Blue+Red" double flashes and "Blue Only" single flash stimuli in 10 visually normal subjects. For "Blue+Red" conditions, PIPR was induced with an intense blue flash, followed by experimental red light exposure of variable intensity and duration (Experiment 1) immediately or 9s after the offset of the blue flash (Experiment 2). For "Blue Only" conditions, only the PIPR-inducing blue stimuli were presented (reference condition). PIPR was defined as the mean pupil size from 10 to 30s (Experiment 1) and from 25 to 60s (Experiment 2) after the offset of blue light stimuli. The results showed that PIPR from "Blue+Red" conditions did not differ significantly from those of "Blue Only" conditions (p=0.55) in Experiment 1. The two stimulation conditions also did not differ in Experiment 2 (p=0.38). We therefore conclude that red light exposure does not alter the time course of PIPR induced by blue light. This finding does not support the hypothesis that long wavelength red light reverses activated melanopsin; rather it lends support to the hypothesis that the wavelengths of stimuli driving both the forward and backward reactions of melanopsin may be similar. PMID:27371765

  2. Maturation of Human Embryonic Stem Cell–Derived Pancreatic Progenitors Into Functional Islets Capable of Treating Pre-existing Diabetes in Mice

    PubMed Central

    Rezania, Alireza; Bruin, Jennifer E.; Riedel, Michael J.; Mojibian, Majid; Asadi, Ali; Xu, Jean; Gauvin, Rebecca; Narayan, Kavitha; Karanu, Francis; O’Neil, John J.; Ao, Ziliang; Warnock, Garth L.

    2012-01-01

    Diabetes is a chronic debilitating disease that results from insufficient production of insulin from pancreatic β-cells. Islet cell replacement can effectively treat diabetes but is currently severely limited by the reliance upon cadaveric donor tissue. We have developed a protocol to efficiently differentiate commercially available human embryonic stem cells (hESCs) in vitro into a highly enriched PDX1+ pancreatic progenitor cell population that further develops in vivo to mature pancreatic endocrine cells. Immature pancreatic precursor cells were transplanted into immunodeficient mice with streptozotocin-induced diabetes, and glycemia was initially controlled with exogenous insulin. As graft-derived insulin levels increased over time, diabetic mice were weaned from exogenous insulin and human C-peptide secretion was eventually regulated by meal and glucose challenges. Similar differentiation of pancreatic precursor cells was observed after transplant in immunodeficient rats. Throughout the in vivo maturation period hESC-derived endocrine cells exhibited gene and protein expression profiles that were remarkably similar to the developing human fetal pancreas. Our findings support the feasibility of using differentiated hESCs as an alternative to cadaveric islets for treating patients with diabetes. PMID:22740171

  3. SHORT-TERM INHALATION OF PARTICULATE TRANSITION METALS HAS LITTLE EFFECT ON THE ELECTROCARDIOGRAMS OF DOGS HAVING PRE-EXISTING CARDIAC ABNORMALITIES. (R826442)

    EPA Science Inventory

    The perspectives, information and conclusions conveyed in research project abstracts, progress reports, final reports, journal abstracts and journal publications convey the viewpoints of the principal investigator and may not represent the views and policies of ORD and EPA. Concl...

  4. Magnetism as a distortion of a pre-existent primordial energy field and the possibility of extraction of electrical energy directly from space

    NASA Astrophysics Data System (ADS)

    Depalma, Bruce

    The spatial distortion induced into the homogeneous primordial energy field (PEF) by the anisotropy of the magnet is what is called magnetism. It is the thesis here that the distortion of the PEF occasioned by the magnet is the operative principle in the class of machinery known as induction machines. The PEF is also distorted as a consequence of the spatial reaction to the centripetal force field existing within the rotating magnetized conductor. Based on an effect first discovered by Michael Faraday in 1831, the N machine/space power generator is an electrical machine which has the possibility of producing electrical energy with significantly less mechanical power input than the presently used induction machines.

  5. A dual vaccine against influenza & Alzheimer's disease failed to enhance anti-β-amyloid antibody responses in mice with pre-existing virus specific memory.

    PubMed

    Davtyan, Hayk; Ghochikyan, Anahit; Hovakimyan, Armine; Davtyan, Arpine; Cadagan, Richard; Marleau, Annette M; Albrecht, Randy A; García-Sastre, Adolfo; Agadjanyan, Michael G

    2014-12-15

    Novel dual vaccine, WSN-Aβ(1-10), based on the recombinant influenza virus, expressing immunodominant B-cell epitope of β-amyloid, simultaneously induced therapeutically potent anti-Aβ and anti-influenza antibodies. In this study we showed that boosting of WSN-WT primed mice with WSN-Aβ(1-10) enhances anti-viral, but fails to induce anti-Aβ antibody responses. This inhibition is associated with expression of Aβ(1-10) within the context of an inactivated influenza virus vaccine. These results demonstrate that the use of an inactivated influenza virus as a carrier for AD vaccine may not be applicable due to the possible inhibition of anti-Aβ antibody response in individuals previously vaccinated or infected with influenza.

  6. Six new examples of the bipartite trapezoid bone: morphology, significant population variation, and an examination of pre-existing criteria to identify bipartition of individual carpal bones.

    PubMed

    Burnett, Scott E; Stojanowski, Christopher M; Mahakkanukrauh, Pasuk

    2015-03-01

    Carpal bone bipartition is a developmental variant resulting in the division of a normally singular carpal into two distinct segments. Cases involving the scaphoid are best known, though many other carpals can be affected, including the trapezoid. Six new examples of bipartite trapezoids, identified in African and Asian anatomical and archeological samples, are reported here and compared with the eight previously known. While the site of bipartition is consistent, the resulting segments exhibit variability in their articulations with neighboring carpals. Five of the six affected trapezoids were identified in African or African-derived samples, yielding a significantly higher frequency (0.323%) of bipartite trapezoid than seen in anatomical or archeological series of European origin. Bilateral bipartite trapezoids in archeological remains from the Mid Holocene site of Gobero (Niger) are potentially the oldest bipartite carpals yet identified in humans. Their discovery may indicate that trapezoid bipartition is a condition that has been present in African populations since prehistoric times, though more data are needed. Because bipartite carpals may be symptomatic and can occur as part of syndromes, the significant population variation in frequency identified here has potential utility in both anatomical and clinical contexts. However, a comparison of the morphological appearance of bipartite trapezoids with the suggested criteria for bipartite scaphoid diagnosis indicates that these criteria are not equally applicable to other carpals. Fortunately, due to the rarity of fracture, identification of the bipartite trapezoid and separating it from pathological conditions is considerably easier than diagnosing a bipartite scaphoid.

  7. Disease interactions in a shared host plant: effects of pre-existing viral infection on cucurbit plant defense responses and resistance to bacterial wilt disease.

    PubMed

    Shapiro, Lori R; Salvaudon, Lucie; Mauck, Kerry E; Pulido, Hannier; De Moraes, Consuelo M; Stephenson, Andrew G; Mescher, Mark C

    2013-01-01

    Both biotic and abiotic stressors can elicit broad-spectrum plant resistance against subsequent pathogen challenges. However, we currently have little understanding of how such effects influence broader aspects of disease ecology and epidemiology in natural environments where plants interact with multiple antagonists simultaneously. In previous work, we have shown that healthy wild gourd plants (Cucurbita pepo ssp. texana) contract a fatal bacterial wilt infection (caused by Erwinia tracheiphila) at significantly higher rates than plants infected with Zucchini yellow mosaic virus (ZYMV). We recently reported evidence that this pattern is explained, at least in part, by reduced visitation of ZYMV-infected plants by the cucumber beetle vectors of E. tracheiphila. Here we examine whether ZYMV-infection may also directly elicit plant resistance to subsequent E. tracheiphila infection. In laboratory studies, we assayed the induction of key phytohormones (SA and JA) in single and mixed infections of these pathogens, as well as in response to the feeding of A. vittatum cucumber beetles on healthy and infected plants. We also tracked the incidence and progression of wilt disease symptoms in plants with prior ZYMV infections. Our results indicate that ZYMV-infection slightly delays the progression of wilt symptoms, but does not significantly reduce E. tracheiphila infection success. This observation supports the hypothesis that reduced rates of wilt disease in ZYMV-infected plants reflect reduced visitation by beetle vectors. We also documented consistently strong SA responses to ZYMV infection, but limited responses to E. tracheiphila in the absence of ZYMV, suggesting that the latter pathogen may effectively evade or suppress plant defenses, although we observed no evidence of antagonistic cross-talk between SA and JA signaling pathways. We did, however, document effects of E. tracheiphila on induced responses to herbivory that may influence host-plant quality for (and hence pathogen acquisition by) cucumber beetles.

  8. A dual vaccine against influenza & Alzheimer’s disease failed to enhance anti-β-amyloid antibody responses in mice with pre-existing virus specific memory

    PubMed Central

    Davtyan, Hayk; Ghochikyan, Anahit; Hovakimyan, Armine; Davtyan, Arpine; Cadagan, Richard; Marleau, Annette M.; Albrecht, Randy A.; García-Sastre, Adolfo; Agadjanyan, Michael G.

    2014-01-01

    Novel dual vaccine, WSN-Aβ1–10, based on the recombinant influenza virus, expressing immunodominant B-cell epitope of β-amyloid, simultaneously induced therapeutically potent anti-Aβ and anti-influenza antibodies. In this study we showed that boosting of WSN-WT primed mice with WSN-Aβ1–10 enhances anti-viral, but fails to induce anti-Aβ antibody responses. This inhibition is associated to expression of Aβ1–10 within the context of an inactivated influenza virus vaccine. These results demonstrate that the use of an inactivated influenza virus as a carrier for AD vaccine may not be applicable due to the possible inhibition of anti-Aβ antibody response in individuals previously vaccinated or infected with influenza. PMID:25455094

  9. Diseases associated with hidranitis suppurativa: part 2 of a series on hidradenitis.

    PubMed

    Scheinfeld, Noah

    2013-06-01

    Hidradenitis suppurativa (HS), a pathologic follicular disease, impacts patients' lives profoundly and usually occurs in isolation. The diseases with the strongest association are obesity, depression, and pain. HS is associated with many diseases including acne conglobata (AC), dissecting cellulitis, pilonidal cysts, and obesity. Pyoderma fistulans sinifica (fox den disease) appears to be the same entity as Hurley Stage 2 of 3 HS. The rate of acne vulgaris in HS patients mirrors unaffected controls. The most common, albeit still uncommon, association is with seronegative, haplotype unlinked arthritis (most importantly B27), in particular spondolyarthritis. Crohn disease and HS occur together at a rate that varies from 0.6% to 38% in retrospective cases series. Ulcerative colitis occurred with HS in 14% of patients in one series. The next most common association is with pyoderma gangrenosum, but this association is likely under-reported. Synovitis-Acne-Pustulosis Hyperostosis-Osteitis (SAPHO) syndrome, which is rare, has more than 10 reports linking it to HS. Nine case reports have linked Dowling-Degos disease (DDD) to HS and two reports related HS to Fox-Fordyce disease (FF), but because both occur in the axilla this might be a mere coincidence. HS is rarely associated with ophthalmic pathology. Specifically, more than 5 reports link it to Keratitis-Ichthyosis-Deafness syndrome (KID); greater than10 cases link it to interstitial keratitis and 2 cases are linked to Behçet's disease. The presence of proteinuria and acute nephritis link HS to the kidney, especially since and reports have documented resolution of HS after renal transplant. Florid steatocystoma multiplex, Sjogren Syndrome, and HS have been linked and their reports likely underestimate their coincidence because all these entities involve occlusion (albeit by different mechanisms). Three reports link HS and amyloid, but both share some common genetic underpinnings and thus the coincidence of these

  10. Phenotypic and genotypic characterization of canine pyoderma isolates of Staphylococcus pseudintermedius for biofilm formation.

    PubMed

    Casagrande Proietti, Patrizia; Stefanetti, Valentina; Hyatt, Doreene Rose; Marenzoni, Maria Luisa; Capomaccio, Stefano; Coletti, Mauro; Bietta, Annalisa; Franciosini, Maria Pia; Passamonti, Fabrizio

    2015-08-01

    Biofilm-forming ability is increasingly being recognized as an important virulence factor in several Staphylococcus species. This study evaluated the biofilm-forming ability of sixty canine derived clinical isolates of S. pseudintermedius, using three phenotypic methods, microtiter plate test (MtP), Congo red agar method (CRA) and tube adherence test, and the presence and impact of biofilm-associated genes (icaA and icaD). The results showed that icaA and icaD genes were detected concomitantly in 55 (91.7%) of 60 isolates. A majority (88.3%) of the strains screened had matching results by the tube adherence test, MtP and PCR analysis. Better agreement (95%) was found between the PCR-based analysis and the CRA. Results of the icaA and icaD gene PCRs showed good agreement with CRA results, with a kappa of 0.7. Comparing the phenotypic methods, the statistical analysis showed that the agreement among the phenotypical tests using categorical data was generally good. Considering two classes (biofilm producer and biofilm non-producer), the percentage of matching results between the CRA method and the tube adherence test and between the CRA method and the MtP was 93.3%. A concordance of 100% was revealed between the MtP and the tube adherence test. The results indicate a high prevalence of the ica genes within S. pseudintermedius isolates, and their presence is associated with in vitro formation of a biofilm. A combination of phenotypic and genotypic tests is recommended for investigating biofilm formation in S. pseudintermedius.

  11. The effect of pre-existing mental health comorbidities on the stage at diagnosis and timeliness of care of solid tumor malignances in a Veterans Affairs (VA) medical center.

    PubMed

    Wadia, Roxanne J; Yao, Xiaopan; Deng, Yanhong; Li, Jia; Maron, Steven; Connery, Donna; Gunduz-Bruce, Handan; Rose, Michal G

    2015-09-01

    There are limited data on the impact of mental health comorbidities (MHC) on stage at diagnosis and timeliness of cancer care. Axis I MHC affect approximately 30% of Veterans receiving care within the Veterans Affairs (VA) system. The purpose of this study was to compare stage at diagnosis and timeliness of care of solid tumor malignancies among Veterans with and without MHC. We performed a retrospective analysis of 408 charts of Veterans with colorectal, urothelial, and head/neck cancer diagnosed and treated at VA Connecticut Health Care System (VACHS) between 2008 and 2011. We collected demographic data, stage at diagnosis, medical and mental health co-morbidities, treatments received, key time intervals, and number of appointments missed. The study was powered to assess for stage migration of 15-20% from Stage I/II to Stage III/IV. There was no significant change in stage distribution for patients with and without MHC in the entire study group (p = 0.9442) and in each individual tumor type. There were no significant differences in the time intervals from onset of symptoms to initiation of treatment between patients with and without MHC (p = 0.1135, 0.2042 and 0.2352, respectively). We conclude that at VACHS, stage at diagnosis for patients with colorectal, urothelial and head and neck cancers did not differ significantly between patients with and without MHC. Patients with MHC did not experience significant delays in care. Our study indicates that in a medical system in which mental health is integrated into routine care, patients with Axis I MHC do not experience delays in cancer care.

  12. Joint modelling of serological and hospitalization data reveals that high levels of pre-existing immunity and school holidays shaped the influenza A pandemic of 2009 in the Netherlands.

    PubMed

    Te Beest, Dennis E; Birrell, Paul J; Wallinga, Jacco; De Angelis, Daniela; van Boven, Michiel

    2015-02-01

    Obtaining a quantitative understanding of the transmission dynamics of influenza A is important for predicting healthcare demand and assessing the likely impact of intervention measures. The pandemic of 2009 provides an ideal platform for developing integrative analyses as it has been studied intensively, and a wealth of data sources is available. Here, we analyse two complementary datasets in a disease transmission framework: cross-sectional serological surveys providing data on infection attack rates, and hospitalization data that convey information on the timing and duration of the pandemic. We estimate key epidemic determinants such as infection and hospitalization rates, and the impact of a school holiday. In contrast to previous approaches, our novel modelling of serological data with mixture distributions provides a probabilistic classification of individual samples (susceptible, immune and infected), propagating classification uncertainties to the transmission model and enabling serological classifications to be informed by hospitalization data. The analyses show that high levels of immunity among persons 20 years and older provide a consistent explanation of the skewed attack rates observed during the pandemic and yield precise estimates of the probability of hospitalization per infection (1-4 years: 0.00096 (95%CrI: 0.00078-0.0012); 5-19 years: 0.00036 (0.00031-0.0044); 20-64 years: 0.0015 (0.00091-0.0020); 65+ years: 0.0084 (0.0028-0.016)). The analyses suggest that in The Netherlands, the school holiday period reduced the number of infectious contacts between 5- and 9-year-old children substantially (estimated reduction: 54%; 95%CrI: 29-82%), thereby delaying the unfolding of the pandemic in The Netherlands by approximately a week.

  13. The Impact of the Birth of a Child with Intellectual Disabilities on Pre-Existing Parental Christian Faith from the Perspective of Parents Who Have Parented Their Child to Adulthood

    ERIC Educational Resources Information Center

    Baines, Susannah; Hatton, Chris

    2015-01-01

    Background: Faith in the lives of UK families with an adult with intellectual disabilities is an under-researched area with little existing literature. Research in the United States with Christian parents suggests that they draw on their faith for coping (Rogers-Dulan 1998) and for understanding (Skinner et al. 1999). Methods: In this study,…

  14. Cysts in angiomyolipoma with epithelial cysts may be consisted of entrapped and dilated renal tubules: report of a case with additional immunohistochemical evidence to the pre-existing literature.

    PubMed

    Tajima, Shogo; Yamada, Yukio

    2015-01-01

    Angiomyolipoma with epithelial cysts (AMLEC) is a distinctive variant of angiomyolipoma characterized by grossly apparent epithelial cysts and a cellular, müllerian-like subepithelial stroma. Some authors suspect that the epithelial cysts mainly represent dilated entrapped native renal collecting duct epithelium, while other authors think that they represented true epithelial differentiation of the AML. Recently, it has been reported that obvious immunolabeling of melanocytic markers such as Melan A and HMB45, which are often immunolabeled in classical angiomyolipoma, are present in epithelial cysts in cases of AMLEC. Here, we report the case of a 43-year-old Japanese woman with AMLEC, and attempt to elucidate the significance of melanocytic marker immunolabeling in the cyst's epithelium. In the present case, Melan A was labeled in the cyst's epithelium, and was thought to reflect its labeling in renal tubules existing in the renal parenchyma outside the tumor. This finding may indicate that the cyst epithelium is derived from entrapped renal tubules inside the AML. Non-immunolabeling of the estrogen and progesterone receptors in the cyst epithelium may also suggest that the cyst epithelium is not neoplastic, in contrast to their labeling in neoplastic cells existing in cyst wall. Further examination, such as molecular analysis, is needed to determine whether these epithelial cysts is neoplastic or non-neoplastic.

  15. Pre-existing cardiovascular conditions and high altitude travel. Consensus statement of the Medical Commission of the Union Internationale des Associations d'Alpinisme (UIAA MedCom) Travel Medicine and Infectious Disease.

    PubMed

    Donegani, Enrico; Hillebrandt, David; Windsor, Jeremy; Gieseler, Ulf; Rodway, George; Schöffl, Volker; Küpper, Thomas

    2014-01-01

    The number of persons visiting high altitude regions for various purposes (recreation, business etc.), and the age of people who do so, increases. Therefore there are more and more patients who need specific and individual advice to prevent emergency situations at altitude and to deal with emergencies if the safety strategy should fail. Since literature concerning cardiocirculatory diseases at altitude is scarce and studies with a controlled setting and high evidence level are missing, UIAA MedCom has checked all available literature for specific information to enable physicians who are active in travel or high altitude medicine to advise the patients at the highest possible level of evidence. It must be pointed out that there are several other medical fields where such information is mandatory, e.g. in occupational medicine, when employees depart to high altitude destinations for business purposes. The recommendations are based on a detailed literature research (databases, handbooks and the respective references). For easier use the paper has been structured as follows: general information, cardiocirculatory system and ECG at altitude, several cardiocirculatory diseases and their specific recommendations. The commission concludes, that a general "don't go!" is no state-of-the-art advice for the patients. With the information presented here a safe trip to altitude should be possible for many patients.

  16. Analysis of phthalates in wine using liquid chromatography tandem mass spectrometry combined with a hold-back column: Chromatographic strategy to avoid the influence of pre-existing phthalate contamination in a liquid chromatography system.

    PubMed

    Hayasaka, Y

    2014-11-01

    This paper describes the development and application of a novel method for the analysis of phthalates in wine using HPLC-MS/MS combined with a hold-back column. Phthalates are ubiquitous contaminants in the environment and can be widely found in laboratory materials and equipment. A HPLC system is no exception and can be the source of contamination affecting the accuracy and precision of analytical results. The new method successfully separates phthalates from the different sources, a wine sample and HPLC system by a simple technique using an additional HPLC column (a hold-back column) placed upstream of the injection valve. The hold-back column effectively retains the HPLC-derived contaminants during column equilibrium time and delays their elution times from an analytical column. Consequently, a phthalate from a wine sample can be baseline separated as it elutes sufficiently earlier than the same phthalate from the HPLC system. HPLC-MS/MS analysis combined with the hold-back column demonstrated virtually no influence of the HPLC contaminants on the quantification of phthalates present in wine. Together with a simple and rapid sample preparation and the use of labeled internal standards, the method was confirmed to be robust and reliable to determine concentrations of phthalates in wine. Quantification limits were within the range of 1.6-9.8μgL(-1) for dimethyl, diethyl, dibutyl, benzylbutyl, bis(2-ethylhexyl) and dioctyl phthalates, and 7.5-26.6μgL(-1) for multiple isomeric phthalates, di-iso-nonyl and di-iso-dodecyl phthalates.

  17. Cysts in angiomyolipoma with epithelial cysts may be consisted of entrapped and dilated renal tubules: report of a case with additional immunohistochemical evidence to the pre-existing literature

    PubMed Central

    Tajima, Shogo; Yamada, Yukio

    2015-01-01

    Angiomyolipoma with epithelial cysts (AMLEC) is a distinctive variant of angiomyolipoma characterized by grossly apparent epithelial cysts and a cellular, müllerian-like subepithelial stroma. Some authors suspect that the epithelial cysts mainly represent dilated entrapped native renal collecting duct epithelium, while other authors think that they represented true epithelial differentiation of the AML. Recently, it has been reported that obvious immunolabeling of melanocytic markers such as Melan A and HMB45, which are often immunolabeled in classical angiomyolipoma, are present in epithelial cysts in cases of AMLEC. Here, we report the case of a 43-year-old Japanese woman with AMLEC, and attempt to elucidate the significance of melanocytic marker immunolabeling in the cyst’s epithelium. In the present case, Melan A was labeled in the cyst’s epithelium, and was thought to reflect its labeling in renal tubules existing in the renal parenchyma outside the tumor. This finding may indicate that the cyst epithelium is derived from entrapped renal tubules inside the AML. Non-immunolabeling of the estrogen and progesterone receptors in the cyst epithelium may also suggest that the cyst epithelium is not neoplastic, in contrast to their labeling in neoplastic cells existing in cyst wall. Further examination, such as molecular analysis, is needed to determine whether these epithelial cysts is neoplastic or non-neoplastic. PMID:26617918

  18. Increased IgG4 responses to multiple food and animal antigens indicate a polyclonal expansion and differentiation of pre-existing B cells in IgG4-related disease

    PubMed Central

    Culver, Emma L; Vermeulen, Ellen; Makuch, Mateusz; van Leeuwen, Astrid; Sadler, Ross; Cargill, Tamsin; Klenerman, Paul; Aalberse, Rob C; van Ham, S Marieke; Barnes, Eleanor; Rispens, Theo

    2015-01-01

    Background IgG4-related disease (IgG4-RD) is a systemic fibroinflammatory condition, characterised by an elevated serum IgG4 concentration and abundant IgG4-positive plasma cells in the involved organs. An important question is whether the elevated IgG4 response is causal or a reflection of immune-regulatory mechanisms of the disease. Objectives To investigate if the IgG4 response in IgG4-RD represents a generalised polyclonal amplification by examining the response to common environmental antigens. Methods Serum from 24 patients with IgG4-RD (14 treatment-naive, 10 treatment-experienced), 9 patients with primary sclerosing cholangitis and an elevated serum IgG4 (PSC-high IgG4), and 18 healthy controls were tested against egg white and yolk, milk, banana, cat, peanut, rice and wheat antigens by radioimmunoassay. Results We demonstrated an elevated polyclonal IgG4 response to multiple antigens in patients with IgG4-RD and in PSC-high IgG4, compared with healthy controls. There was a strong correlation between serum IgG4 and antigen-specific responses. Responses to antigens were higher in treatment-naive compared with treatment-experienced patients with IgG4-RD. Serum electrophoresis and immunofixation demonstrated polyclonality. Conclusions This is the first study to show enhanced levels of polyclonal IgG4 to multiple antigens in IgG4-RD. This supports that elevated IgG4 levels reflect an aberrant immunological regulation of the overall IgG4 response, but does not exclude that causality of disease could be antigen-driven. PMID:25646372

  19. Extradigestive manifestations of IBD in pediatrics.

    PubMed

    Aloi, M; Cucchiara, S

    2009-03-01

    Inflammatory bowel diseases (IBD) are often associated with extraintestinal manifestations (EIMs), which occur in approximately one third of patients. There is only few published data on the occurrence of these manifestations in children and adolescents, so most of the data are taken by studies in adult patients. The organs most commonly affected are joints, skin, eyes and biliary tract, although nearly every organ may be involved. Some of the EIMs are clearly related to intestinal disease activity (i.e., erythema nodosum, peripheral arthritis, orofacial lesions), whereas others occur independently (i.e., pyoderma gangrenosum, anterior uveitis/iritis, ankylosing spondylitis, primary sclerosing cholangitis). Many extraintestinal disorders may be direct inflammatory and metabolic complications of the intestinal inflammation (i.e., osteoporosis, growth retardation, nephrolithiasis, ureteral obstruction, thromboembolic disease). In this review we provide an overview on the prevalence and clinical aspects of the more commonly reported EIMs of Crohn's disease and ulcerative colitis in pediatric patients, focusing on specific issues of children affected by IBD (growth failure and metabolic osteopathy). PMID:19530508

  20. Aetiology, comorbidities and cofactors of chronic leg ulcers: retrospective evaluation of 1 000 patients from 10 specialised dermatological wound care centers in Germany.

    PubMed

    Jockenhöfer, Finja; Gollnick, Harald; Herberger, Katharina; Isbary, Georg; Renner, Regina; Stücker, Markus; Valesky, Eva; Wollina, Uwe; Weichenthal, Michael; Karrer, Sigrid; Kuepper, Bernhard; Roesch, Alexander; Dissemond, Joachim

    2016-10-01

    Numerous comorbidities and cofactors have been known to influence wound healing processes. In this multicentre study, clinical data of 1 000 patients with chronic leg ulcers from ten specialised dermatological wound care centers were analysed. The patient cohort comprised 567 females and 433 males with an average age of 69·9 years. The wounds persisted on average for 40·8 months and had a mean size of 43·7 cm(2) . Venous leg ulcers represented the most common entity accounting for 51·3% of all chronic wounds, followed by mixed-type ulcers in 12·9% and arterial ulcerations in 11·0% of the patients. Vasculitis was diagnosed in 4·5%, trauma in 3·2%, pyoderma gangrenosum in 2·8%, lymphoedema in 1·7%, neoplasia in 1·0% and delayed post-surgical wound healing in 0·6% of the included patients. In total, 70·5% of patients suffered from arterial hypertension, 45·2% were obese, 27·2% had non-insulin dependent diabetes, and 24·4% dyslipidaemia. Altogether 18·4% suffered from metabolic syndrome. Cofactors and comorbidities of patients with chronic leg ulcers have previously been studied but not in detail. Here, we were able to demonstrate the existence of several potentially relevant cofactors, comorbidities of their associations and geographical distributions, which should be routinely examined in patients with chronic leg ulcers and - if possible - treated.

  1. Hidradenitis suppurrativa (acne inversa) as a systemic disease.

    PubMed

    Dessinioti, Clio; Katsambas, Andreas; Antoniou, Christina

    2014-01-01

    Hidradenitis suppurativa (HS), also known as acne inversa, is a chronic follicular occlusive skin disorder characterized by recurrent abscesses, draining sinuses, and scarring, with a multifactorial pathogenesis. The answer to the question whether HS may be considered a systemic disease relies on the presence of accompanying systemic manifestations, on the proof of association with other diseases or conditions, and on the occurrence of systemic implications. We address these questions based on a systemic review of the existing literature. There are several reports in the literature of the coexistence of HS with other diseases, including pyoderma gangrenosum, PASH syndrome, Adamantiades-Behcet's disease, spondylarthropathy, Crohn's disease, SAPHO, pachyonychia congenita, Dowling-Degos disease, and the keratitis-ichthyosis-deafness (KID) syndrome. Case series exist only for Crohn's disease, while most other reports are anecdotal, thus, not providing high-quality scientific evidence. Based on well-designed studies, HS has been associated with the metabolic syndrome and with excess body weight or obesity. The link between HS and systemic associations may be attributed to common genetic or environmental factors or shared inflammatory pathways. PMID:24767187

  2. Guidelines for treatment with infliximab for Crohn's disease.

    PubMed

    Hommes, D W; Oldenburg, B; van Bodegraven, A A; van Hogezand, R A; de Jong, D J; Romberg-Camps, M J L; van der Woude, J; Dijkstra, G

    2006-01-01

    Infliximab is an accepted induction and maintenance treatment for patients with Crohn's disease. The effectiveness of infliximab has been demonstrated for both active luminal disease and for enterocutaneous fistulisation. In addition, infliximab can be administered for extraintestinal symptoms of Crohn's disease, such as pyoderma gangrenosum, uveitis and arthropathy. Maintenance treatment with infliximab is effective and is regarded as safe as long as the necessary safety measures are heeded. Infusion reactions occur in 3 to 17% of the patients and are associated with the formation of antibodies to infliximab. A reduction in infusion reactions is possible by the concurrent administration of steroids and the use of immunosuppressants (azathioprine, 6-mercaptopurine, methotrexate). Furthermore, immunosuppressants increase the duration of the response to infliximab. For these reasons, the concomitant use of immunosuppressants with infliximab is recommended. Infections and most specifically tuberculosis need to be ruled out before infliximab is administered. Up to now, there are no indications for a connection between an increased risk for malignancies and treatment with infliximab. PMID:16929083

  3. Monogenic Autoinflammatory Diseases: Concept And Clinical Manifestations

    PubMed Central

    De Jesus, Adriana Almeida; Goldbach-Mansky, Raphaela

    2013-01-01

    The objectives of this review are to describe the clinical manifestations of the growing spectrum of monogenic autoinflammatory diseases including recently described syndromes. The autoinflammatory diseases can be grouped based on clinical findings: 1. the three classic hereditary “periodic fever syndromes”, familial Mediterranean Fever (FMF); TNF receptor associated periodic syndrome (TRAPS); and mevalonate kinase deficiency/hyperimmunoglobulinemia D and periodic fever syndrome (HIDS); 2. the cryopyrin associated periodic syndromes (CAPS), comprising familial cold autoinflammatory syndrome (FCAS), Muckle-Wells syndrome (MWS) and neonatal-onset multisystem inflammatory disease (NOMID) or CINCA, and; 3. pediatric granulomatous arthritis (PGA); 4. disorders presenting with skin pustules, including deficiency of interleukin 1 receptor antagonist (DIRA); Majeed syndrome; pyogenic arthritis, pyoderma gangrenosum and acne (PAPA) syndrome; deficiency of interleukin 36 receptor antagonist (DITRA); CARD14 mediated psoriasis (CAMPS), and early-onset inflammatory bowel diseases (EO-IBD); 5. inflammatory disorders caused by mutations in proteasome components, the proteasome associated autoinflammatory syndromes (PRAAS) 6. very rare conditions presenting with autoinflammation and immunodeficiency. PMID:23711932

  4. Neutrophilic Skin Lesions in Autoimmune Connective Tissue Diseases

    PubMed Central

    Hau, Estelle; Vignon Pennamen, Marie-Dominique; Battistella, Maxime; Saussine, Anne; Bergis, Maud; Cavelier-Balloy, Benedicte; Janier, Michel; Cordoliani, Florence; Bagot, Martine; Rybojad, Michel; Bouaziz, Jean-David

    2014-01-01

    Abstract The pathophysiology of neutrophilic dermatoses (NDs) and autoimmune connective tissue diseases (AICTDs) is incompletely understood. The association between NDs and AICTDs is rare; recently, however, a distinctive subset of cutaneous lupus erythematosus (LE, the prototypical AICTD) with neutrophilic histological features has been proposed to be included in the spectrum of lupus. The aim of our study was to test the validity of such a classification. We conducted a monocentric retrospective study of 7028 AICTDs patients. Among these 7028 patients, a skin biopsy was performed in 932 cases with mainly neutrophilic infiltrate on histology in 9 cases. Combining our 9 cases and an exhaustive literature review, pyoderma gangrenosum, Sweet syndrome (n = 49), Sweet-like ND (n = 13), neutrophilic urticarial dermatosis (n = 6), palisaded neutrophilic granulomatous dermatitis (n = 12), and histiocytoid neutrophilic dermatitis (n = 2) were likely to occur both in AICTDs and autoinflammatory diseases. Other NDs were specifically encountered in AICTDs: bullous LE (n = 71), amicrobial pustulosis of the folds (n = 28), autoimmunity-related ND (n = 24), ND resembling erythema gyratum repens (n = 1), and neutrophilic annular erythema (n = 1). The improvement of AICTDS neutrophilic lesions under neutrophil targeting therapy suggests possible common physiopathological pathways between NDs and AICTDs. PMID:25546688

  5. [Current therapeutic indications of thalidomide and lenalidomide].

    PubMed

    Ordi-Ros, Josep; Cosiglio, Francisco Javier

    2014-04-22

    Thalidomide is a synthetic glutamic acid derivative first introduced in 1956 in Germany as an over the counter medications. It was thought to be one of the safest sedatives ever produced as it was effective in small doses, was not addictive, and did not have acute side-effects such as motor impairment, but was quickly removed from market after it was linked to cases of severe birth defects. The Food and Drug Administration approved use in the treatment of erythema nodosum leprosum. Further, it was shown its effectiveness in unresponsive dermatological conditions such as actinic prurigo, adult Langerhans cell hystiocytosis, aphthous stomatitis, Behçet syndrome, graft-versus-host disease, cutaneous sarcoidosis, erythema multiforme, Jessner-Kanof lymphocytic infiltration of the skin, Kaposi sarcoma, lichen planus, lupus erythematosus, melanoma, prurigo nodularis, pyoderma gangrenosum and others. In May 2006, it was approved for the treating multiple myeloma. New thalidomide analogues have been developed but lack clinical experience. This paper is a review of the history, pharmacology, mechanism of action, clinical applications and side effects of thalidomide and its analogues.

  6. Off-label use of TNF-alpha inhibitors in a dermatological university department: retrospective evaluation of 118 patients.

    PubMed

    Sand, Freja Lærke; Thomsen, Simon Francis

    2015-01-01

    Tumor necrosis factor-alpha (TNF)-alpha inhibitors are licensed for patients with severe refractory psoriasis and psoriatic arthritis. However, TNF-alpha inhibitors have also been used off-label for various recalcitrant mucocutaneous diseases. This study aimed to evaluate the efficacy and safety of TNF-alpha inhibitors used for off-label dermatological indications. We retrospectively evaluated patient records of 118 patients treated off-label with TNF-alpha inhibitors in a dermatological university department. Patients presented with severe aphthous stomatitis/genital aphthous lesions (26), chronic urticaria (25), hidradenitis suppurativa (29), acne conglobata (11), dissecting cellulitis of the scalp (two), orofacial granulomatosis (four), sarcoidosis (four), granuloma annulare (two), granulomatous rosacea (one), granuloma faciale (one), subcorneal pustulosis (one), pyoderma gangrenosum (four), Sweet's syndrome (four), Well's syndrome (one), benign familial pemphigus (one), lichen planus (one), and folliculitis decalvans (one). A significant number of these patients went into remission during therapy with TNF-alpha inhibitors. A total of 11 patients (9%) experienced severe adverse effects during therapy. Off-label therapy with TNF-alpha inhibitors may be considered for selected patients with severe recalcitrant mucocutaneous diseases. The risk of severe adverse effects signals that a thorough benefit-risk assessment should be performed before initiating off-label treatment with TNF-alpha inhibitors for these conditions. PMID:25731720

  7. AUTOINFLAMMATORY PUSTULAR NEUTROPHILIC DISEASES

    PubMed Central

    Naik, Haley B.; Cowen, Edward W.

    2013-01-01

    SYNOPSIS The inflammatory pustular dermatoses constitute a spectrum of non-infectious conditions ranging from localized involvement to generalized disease with associated acute systemic inflammation and multi-organ involvement. Despite the variability in extent and severity of cutaneous presentation, each of these diseases is characterized by non-infectious neutrophilic intra-epidermal microabscesses. Many share systemic findings including fever, elevated inflammatory markers, inflammatory bowel disease and/or osteoarticular involvement, suggesting potential common pathogenic links (Figure 1). The recent discoveries of several genes responsible for heritable pustular diseases have revealed a distinct link between pustular skin disease and regulation of innate immunity. These genetic advances have led to a deeper exploration of common pathways in pustular skin disease and offer the potential for a new era of biologic therapy which targets these shared pathways. This chapter provides a new categorization of inflammatory pustular dermatoses in the context of recent genetic and biologic insights. We will discuss recently-described monogenic diseases with pustular phenotypes, including deficiency of IL-1 receptor antagonist (DIRA), deficiency of the IL-36 receptor antagonist (DITRA), CARD14-associated pustular psoriasis (CAMPS), and pyogenic arthritis, pyoderma gangrenosum, acne (PAPA). We will then discuss how these new genetic advancements may inform how we view previously described pustular diseases, including pustular psoriasis and its clinical variants, with a focus on historical classification by clinical phenotype. PMID:23827244

  8. Multiple skin ulcers due to Serratia marcescens in a immunocompetent patient.

    PubMed

    Carlesimo, M; Pennica, A; Muscianese, M; Bottoni, U; Abruzzese, C; Giubettini, M; Pranteda, G; Pranteda, G

    2014-06-01

    Serratia marcescens is a species of gram negative bacillus, classified as a member of the Enterobacteriaceae, mainly involved in opportunistic infections, particulary in the hospital environment. Cutaneous infections have rarely reported in literature and are predominantly observed in elderly or in immunocompromised patients. The clinical manifestations of skin infections include granulomatous lesions, necrotizing fasciitis, nodules, cellulitis, ulcers, dermal abscesses. Infections caused by S. marcescens may be difficult to treat because of resistance to a variety of antibiotics, including ampicillin and first and second generation cephalosporins. Aminoglycosides have good activity against S. marcescens, but resistant strains have also been described. We report a very intriguing case of S. marcescens infection, in an immunocompetent 18-year-old man, causing multiple rounded ulcers of varying sizes, along with few pustular lesions that both clinically and histopathologically mimic a pyoderma gangrenosum (PG). This is a non infectious neutrophilic skin disorder, characterized by painful and rapidly progressing skin ulceration. According to our experience, we would strongly recommend to perform cultures of multiple skin ulcers resembling PG, even in young healthy patients, to ensure correct diagnosis and treatment, since resistant to conventional antibiotics bacteria such as S. marcescens may be the cause of these lesions, like in the case here reported.

  9. An atlas of the morphological manifestations of hidradenitis suppurativa.

    PubMed

    Scheinfeld, Noah

    2014-04-16

    This article is dermatological atlas of the morphologic presentations of Hidradenitis Suppurativa (HS). It includes: superficial abscesses (boils, furnucles, carbuncles), abscesses that are subcutaneous and suprafascial, pyogenic granulomas, cysts, painful erythematous papules and plaques, folliculitis, open ulcerations, chronic sinuses, fistulas, sinus tracts, scrotal and genital lyphedema, dermal contractures, keloids (some that are still pitted with follicular ostia), scarring, skin tags, fibrosis, anal fissures, fistulas (i.e. circinate, linear, arcuate), scarring folliculitis of the buttocks (from mild to cigarette-like scarring), condyloma like lesions in intertrigous areas, fishmouth scars, acne inversa, honey-comb scarring, cribiform scarring, tombstone comedones, and morphia-like plaques. HS can co-exist with other follicular diseases such as pilonidal cysts, dissecting cellulitis, acne conglobata, pyoderma gangrenosum, and acanthosis nigricans. In sum, the variety of presentations of HS as shown by these images supports the supposition that HS is a reaction pattern.HS is a follicular based diseased and its manifestations involve a multitude of follicular pathologies [1,2]. It is also known as acne inversa (AI) because of one manifestation that involves the formation of open comedones on areas besides the face. It is as yet unclear why HS is so protean in its manifestations. HS severity is assessed using the Hurley Staging System (Table 1). It also remains unclear why hidradentitis may remain limited to Hurley Stage 1, evolve to the more confluent (Hurley Stage 2), or progress even further to the fully confluent (Hurley Stage 3).In addition, HS can be associated with other follicular based diseases such as pilonidal cysts (PCs) of the sacrum and buttocks, dissecting cellulitis (DC), and acne conglobata (AC), which usually involves the face, chest, When HS occurs with PCs, DC, and/or AC it is referred to as the follicular occlusion triad or tetrad [2]. HS

  10. An atlas of the morphological manifestations of hidradenitis suppurativa.

    PubMed

    Scheinfeld, Noah

    2014-01-01

    This article is dermatological atlas of the morphologic presentations of Hidradenitis Suppurativa (HS). It includes: superficial abscesses (boils, furnucles, carbuncles), abscesses that are subcutaneous and suprafascial, pyogenic granulomas, cysts, painful erythematous papules and plaques, folliculitis, open ulcerations, chronic sinuses, fistulas, sinus tracts, scrotal and genital lyphedema, dermal contractures, keloids (some that are still pitted with follicular ostia), scarring, skin tags, fibrosis, anal fissures, fistulas (i.e. circinate, linear, arcuate), scarring folliculitis of the buttocks (from mild to cigarette-like scarring), condyloma like lesions in intertrigous areas, fishmouth scars, acne inversa, honey-comb scarring, cribiform scarring, tombstone comedones, and morphia-like plaques. HS can co-exist with other follicular diseases such as pilonidal cysts, dissecting cellulitis, acne conglobata, pyoderma gangrenosum, and acanthosis nigricans. In sum, the variety of presentations of HS as shown by these images supports the supposition that HS is a reaction pattern.HS is a follicular based diseased and its manifestations involve a multitude of follicular pathologies [1,2]. It is also known as acne inversa (AI) because of one manifestation that involves the formation of open comedones on areas besides the face. It is as yet unclear why HS is so protean in its manifestations. HS severity is assessed using the Hurley Staging System (Table 1). It also remains unclear why hidradentitis may remain limited to Hurley Stage 1, evolve to the more confluent (Hurley Stage 2), or progress even further to the fully confluent (Hurley Stage 3).In addition, HS can be associated with other follicular based diseases such as pilonidal cysts (PCs) of the sacrum and buttocks, dissecting cellulitis (DC), and acne conglobata (AC), which usually involves the face, chest, When HS occurs with PCs, DC, and/or AC it is referred to as the follicular occlusion triad or tetrad [2]. HS

  11. Certain Autoimmune Manifestations Are Associated With Distinctive Karyotypes and Outcomes in Patients With Myelodysplastic Syndrome

    PubMed Central

    Lee, Sang Jin; Park, Jin Kyun; Lee, Eun Young; Joo, Sang Hyun; Jung, Kyeong Cheon; Lee, Eun Bong; Song, Yeong Wook; Yoon, Sung-Soo

    2016-01-01

    Abstract Autoimmune manifestations (AIMs) are common in patients with myelodysplastic syndrome (MDS). This study aimed to investigate whether AIMs are associated with a specific cytogenetic abnormalities and worse survival in patients with MDS. A total of 67 MDS patients with AIMs and 134 age- and sex-matched MDS patients without AIMs, all of whom received medical care at Seoul National University Hospital from January 2000 through July 2014, were enrolled. The clinical features, chromosomal abnormalities, and outcomes were examined. The effect of AIMs on mortality was estimated after adjusting for age, sex, and the International Prognostic Scoring System. The mean age (±SD) at the time of MDS diagnosis was 54.5 ± 17.1 years, and 44.8% of patients were male. Neutrophilic dermatosis (ND; Sweet syndrome and pyoderma gangrenosum) was the most prevalent AIM (n = 24 36%]), followed by Behcet disease (10 [15%]), rheumatoid arthritis (9 [13%]), vasculitis (8 [12%]), myositis (3 [4%]), spondyloarthropathy (3 [4%]), and systemic lupus erythematous (2 [3%]). ND and vasculitis occurred at the time of MDS diagnosis, whereas other AIMs occurred years after MDS diagnosis. Deletion of 5q was associated with ND (P = 0.001), whereas trisomy 8 was associated with Behcet disease (P = 0.015). Strikingly, ND was associated with a 1.8-fold increase in mortality (95% CI 1.033–3.093; P = 0.038). Certain AIMs in MDS patients are associated with distinctive karyotypes and worse survival. A larger study is needed to confirm whether the presence of AIMs influences disease outcome in MDS. PMID:27043672

  12. [A Case of Peristomal Cutaneous Ulcer Following Amebic Colitis Caused by Entamoeba histolytica].

    PubMed

    Sasaki, Yu; Yoshida, Tetsuya; Suzuki, Jun; Kobayashi, Seiki; Sato, Tomotaka

    2016-01-01

    A 66-year-old Japanese male with a history of a rectal ulcer and rectovesical fistula following brachytherapy and radiotherapy for prostate cancer, who had undergone colostomy and vesicotomy presented with a painful peristomal ulcer of approximately 5 x 2.5cm adjacent to the direction of 6 o'clock of the stoma in his left lower abdomen. Although he was admitted to be treated with intravenous antibiotics and topical debridement, the ulcer was rapidly increasing. In the laboratory findings, WBC was 12,400/μL, CRP was 16.9 mg/dL, ESR was 105mm in the first hour. Contrast enhanced CT images showed a wide high density area of skin and subcutaneous tissue around the stoma and dillitation of the transverse and descending colon. Colonoscopy showed furred profound ulcers in the rectum. A biopsy from the ulcer floor submitted to histopathology showed necrotic tissue with a mixed inflammatory infiltrates mainly composed of neutrophils and lymphocytes in the dermis. We suspected pyoderma gangrenosum with an inflammatory bowel disease in the beginning. Although he was started on oral prednisolone 60 mg daily, the ulcer did not respond to treatment. Additional methylprednisolone pulse therapy, intravenous cyclosporine and granulocytapheresis were also ineffective. A biopsy specimen from the skin ulcer margin showed erythrophagocytosis by trophozoites of amebae which were identified on PAS stained slides. The PCR method and stool examination showed positive for Entamoeba histolytica (E. histolytica), but serum antibodies were negative. Within two weeks of treatment with oral metronidazole 2,250 mg/day and topical metronidazole ointment, resolution of the ulcer was observed, then the prednisolone dosage was tapered. A split-thickness skin graft was used to cover the ulcer with a successful result. Even though we originally misdiagnosed this case, we finally reached a diagnosis of amebiasis. It is important to take account of amebiasis in the differential diagnosis of intractable

  13. [A Case of Peristomal Cutaneous Ulcer Following Amebic Colitis Caused by Entamoeba histolytica].

    PubMed

    Sasaki, Yu; Yoshida, Tetsuya; Suzuki, Jun; Kobayashi, Seiki; Sato, Tomotaka

    2016-01-01

    A 66-year-old Japanese male with a history of a rectal ulcer and rectovesical fistula following brachytherapy and radiotherapy for prostate cancer, who had undergone colostomy and vesicotomy presented with a painful peristomal ulcer of approximately 5 x 2.5cm adjacent to the direction of 6 o'clock of the stoma in his left lower abdomen. Although he was admitted to be treated with intravenous antibiotics and topical debridement, the ulcer was rapidly increasing. In the laboratory findings, WBC was 12,400/μL, CRP was 16.9 mg/dL, ESR was 105mm in the first hour. Contrast enhanced CT images showed a wide high density area of skin and subcutaneous tissue around the stoma and dillitation of the transverse and descending colon. Colonoscopy showed furred profound ulcers in the rectum. A biopsy from the ulcer floor submitted to histopathology showed necrotic tissue with a mixed inflammatory infiltrates mainly composed of neutrophils and lymphocytes in the dermis. We suspected pyoderma gangrenosum with an inflammatory bowel disease in the beginning. Although he was started on oral prednisolone 60 mg daily, the ulcer did not respond to treatment. Additional methylprednisolone pulse therapy, intravenous cyclosporine and granulocytapheresis were also ineffective. A biopsy specimen from the skin ulcer margin showed erythrophagocytosis by trophozoites of amebae which were identified on PAS stained slides. The PCR method and stool examination showed positive for Entamoeba histolytica (E. histolytica), but serum antibodies were negative. Within two weeks of treatment with oral metronidazole 2,250 mg/day and topical metronidazole ointment, resolution of the ulcer was observed, then the prednisolone dosage was tapered. A split-thickness skin graft was used to cover the ulcer with a successful result. Even though we originally misdiagnosed this case, we finally reached a diagnosis of amebiasis. It is important to take account of amebiasis in the differential diagnosis of intractable

  14. Neutrophilic Dermatoses in Antineutrophil Cytoplasmic Antibody-Associated Vasculitis: A French Multicenter Study of 17 Cases and Literature Review.

    PubMed

    de Boysson, Hubert; Martin Silva, Nicolas; de Moreuil, Claire; Néel, Antoine; de Menthon, Mathilde; Meyer, Olivier; Launay, David; Pagnoux, Christian; Guillevin, Loïc; Puéchal, Xavier; Bienvenu, Boris; Aouba, Achille

    2016-03-01

    A few reports suggest combination of ANCA-associated vasculitis (AAV) and neutrophilic dermatoses (ND). We aimed to describe the main characteristics of patients presenting with both AAV and ND in a French cohort and through a systematic literature review, and to discuss the possible common pathogenic process involved. We conducted a retrospective study of patients with both conditions. Patients were selected via the French Internal Medicine Society (SNFMI) and the French Vasculitis Study Group (FVSG). A literature review focusing on a combination of both conditions, concentrated only on publications with well-established diagnoses and individual detailed data. Seventeen patients diagnosed with AAV and ND were identified in this cohort. Twelve patients had granulomatosis with polyangiitis (GPA), 4 had microscopic polyangiitis (MPA) and one had eosinophilic GPA (EGPA). Eight patients, all with GPA, displayed pyoderma gangrenosum (PG). Sweet's syndrome was observed in 6 patients (4 with MPA, one with GPA and one with EGPA) and erythema elevatum diutinum in the other three (2 with GPA and 1 with MPA). The literature review identified 33 additional patients with both conditions, including 26 with GPA. Altogether, of the 50 patients (17 from our study and 33 from the literature review), 33 (66%) patients presented with PG associated with GPA in 29 cases (89%). Corticosteroids were the first-line treatment in conjunction with an immunosuppressive agent in most cases. Outcomes were good and a total of 15 patients experienced a relapse. Patients who relapsed were more likely to have ear, nose and throat manifestation than patients who did not [12/15 (80%) relapsing patients vs. 15/35 (43%) non-relapsing patients; p = 0.03)]. In our stud, the most frequent association concerned GPA and PG. ND should be considered and specifically researched within the spectrum of cutaneous manifestations observed in AAV.

  15. [Minocycline].

    PubMed

    Bernier, C; Dréno, B

    2001-05-01

    Minocycline belongs to the second generation class of cyclines. It was synthesized in 1967 and marketed in 1972. Minocycline has an antiinfectious activity with a spectrum similar to that of other cyclines, notably against Chlamydias, Treonema and Proprionibacterium acenes. The antiinflammatory activity is associated with this antiinfectious action is greater than that of first generation cyclines with specifically a modulator effect on epidermal cytokines. The pharmokinetics of minocycline is characterized by an excellent absorption, a long half-life and an important lipophilic property inducing good tissue distribution. Clinical trials of minocycline have mainly been performed in sexually transmissible diseases and in acne, a field where randomized studies are the most frequent. These trials show that the effect of minocycline is not stronger than first generation cyclines or doxycycline, but that the action is quicker than that of tetracycline at the dose of 500 mg a day. Minocycline is also efficient in nocardiasis, mycobacteriosis, leprosy, Lyme disease, pyoderma gangrenosum, autoimmune bullous dermatitis, Carteaud disease, and prurigo. However, the effect of minocycline in these different conditions has always been evaluated in open trials with a small number of patients. The usual side effects of cyclines, i.e. digestive problems, fungal infections, are less frequent than with first generation cyclines. No photosensitivity has been demonstrated although pigmentations have been described. Dizziness is a specific side effect of minocycline. Furthermore, rare but severe side effects have been reported, including hypersensitivity syndrome, autoimmune hepatitis, and lupus. Regular indications for minocycline in dermatology are acne and three sexually transmissible diseases (mycoplasm, chlamydia, treponema). Proposed dosage is 100 mg per day in sexually transmissible disease with a reduction to 50 mg per day after 15 days in acne.

  16. The presenting manifestations of subcutaneous panniculitis-like T-cell lymphoma and T-cell lymphoma and cutaneous γδ T-cell lymphoma may mimic those of rheumatic diseases: a report of 11 cases.

    PubMed

    Yi, Lin; Qun, Shi; Wenjie, Zheng; Wen, Zhang; Jian, Li; Yan, Zhao; Fengchun, Zhang

    2013-08-01

    This study aims to investigate the association between subcutaneous panniculitis-like T-cell lymphoma (SPTCL) or cutaneous gamma/delta T-cell lymphoma (CGDTCL) and a variety of manifestations that mimic autoimmune disorders. A retrospective chart review was made for 11 patients who were initially diagnosed as autoimmune diseases but finally turned out to be SPTCL or CGDTCL. Eleven patients were initially diagnosed with erythema nodosum, nodular panniculitis, lupus erythematosus profundus, systemic vasculitis, dermatomyositis, or pyoderma gangrenosum. The interval between presenting symptoms and the diagnosis of lymphoma was 17.5 (range, 3-84)  months on average. Nearly all cases had multiple subcutaneous nodules or plaques that were most commonly distributed on the extremities and trunk. Fever was the primary accompanying sign (9/10), followed by lymphadenopathy (6/11), splenomegaly (5/11), and hepatomegaly (3/11). Two patients developed hemophagocytic syndrome. A total of 26 biopsies involving multiple anatomic locations were performed. Antirheumatic therapy including steroids and immunosuppressive agents administered before the identification of T-cell lymphoma revealed unsustainable therapeutic effect. In contrast, seven cases gained partial response after chemotherapy, while the remaining four cases died with disease progression and disease-associated severe infections. SPTCL and CGDTCL are rare and heterogeneous which may resemble those rheumatologic diseases that are characterized by inflammation involving the skin or subcutaneous fat tissue. The diagnosis relies on the constellation of disease-specific pathologic, immunophenotypic, and T-cell receptor gene rearrangement tests. In the context of an ambiguous clinical picture demonstrating inconsistency with the initial diagnosis of benign autoimmune diseases, repeated excisional biopsies of the subcutaneous lesions may be required to uncover the underlying lymphoma. PMID:23588884

  17. JAK3 as an Emerging Target for Topical Treatment of Inflammatory Skin Diseases

    PubMed Central

    Alves de Medeiros, Ana Karina; Speeckaert, Reinhart; Desmet, Eline; Van Gele, Mireille; De Schepper, Sofie; Lambert, Jo

    2016-01-01

    The recent interest and elucidation of the JAK/STAT signaling pathway created new targets for the treatment of inflammatory skin diseases (ISDs). JAK inhibitors in oral and topical formulations have shown beneficial results in psoriasis and alopecia areata. Patients suffering from other ISDs might also benefit from JAK inhibition. Given the development of specific JAK inhibitors, the expression patterns of JAKs in different ISDs needs to be clarified. We aimed to analyze the expression of JAK/STAT family members in a set of prevalent ISDs: psoriasis, lichen planus (LP), cutaneous lupus erythematosus (CLE), atopic dermatitis (AD), pyoderma gangrenosum (PG) and alopecia areata (AA) versus healthy controls for (p)JAK1, (p)JAK2, (p)JAK3, (p)TYK2, pSTAT1, pSTAT2 and pSTAT3. The epidermis carried in all ISDs, except for CLE, a strong JAK3 signature. The dermal infiltrate showed a more diverse expression pattern. JAK1, JAK2 and JAK3 were significantly overexpressed in PG and AD suggesting the need for pan-JAK inhibitors. In contrast, psoriasis and LP showed only JAK1 and JAK3 upregulation, while AA and CLE were characterized by a single dermal JAK signal (pJAK3 and pJAK1, respectively). This indicates that the latter diseases may benefit from more targeted JAK inhibitors. Our in vitro keratinocyte psoriasis model displayed reversal of the psoriatic JAK profile following tofacitinib treatment. This direct interaction with keratinocytes may decrease the need for deep skin penetration of topical JAK inhibitors in order to exert its effects on dermal immune cells. In conclusion, these results point to the important contribution of the JAK/STAT pathway in several ISDs. Considering the epidermal JAK3 expression levels, great interest should go to the investigation of topical JAK3 inhibitors as therapeutic option of ISDs. PMID:27711196

  18. Certain Autoimmune Manifestations Are Associated With Distinctive Karyotypes and Outcomes in Patients With Myelodysplastic Syndrome: A Retrospective Cohort Study.

    PubMed

    Lee, Sang Jin; Park, Jin Kyun; Lee, Eun Young; Joo, Sang Hyun; Jung, Kyeong Cheon; Lee, Eun Bong; Song, Yeong Wook; Yoon, Sung-Soo

    2016-03-01

    Autoimmune manifestations (AIMs) are common in patients with myelodysplastic syndrome (MDS). This study aimed to investigate whether AIMs are associated with a specific cytogenetic abnormalities and worse survival in patients with MDS. A total of 67 MDS patients with AIMs and 134 age- and sex-matched MDS patients without AIMs, all of whom received medical care at Seoul National University Hospital from January 2000 through July 2014, were enrolled. The clinical features, chromosomal abnormalities, and outcomes were examined. The effect of AIMs on mortality was estimated after adjusting for age, sex, and the International Prognostic Scoring System. The mean age (±SD) at the time of MDS diagnosis was 54.5 ± 17.1 years, and 44.8% of patients were male. Neutrophilic dermatosis (ND; Sweet syndrome and pyoderma gangrenosum) was the most prevalent AIM (n = 24 36%]), followed by Behcet disease (10 [15%]), rheumatoid arthritis (9 [13%]), vasculitis (8 [12%]), myositis (3 [4%]), spondyloarthropathy (3 [4%]), and systemic lupus erythematous (2 [3%]). ND and vasculitis occurred at the time of MDS diagnosis, whereas other AIMs occurred years after MDS diagnosis. Deletion of 5q was associated with ND (P = 0.001), whereas trisomy 8 was associated with Behcet disease (P = 0.015). Strikingly, ND was associated with a 1.8-fold increase in mortality (95% CI 1.033-3.093; P = 0.038). Certain AIMs in MDS patients are associated with distinctive karyotypes and worse survival. A larger study is needed to confirm whether the presence of AIMs influences disease outcome in MDS. PMID:27043672

  19. Medical Complications of Tattoos: A Comprehensive Review.

    PubMed

    Islam, Parvez S; Chang, Christopher; Selmi, Carlo; Generali, Elena; Huntley, Arthur; Teuber, Suzanne S; Gershwin, M Eric

    2016-04-01

    Tattoos are defined as the introduction of exogenous pigments into the dermis in order to produce a permanent design. This process may occur unintentional or may be deliberately administered for cosmetic or medical reasons. Tattoos have been around for over 5000 years and over time have evolved to represent a common cosmetic practice worldwide. Currently, adverse reactions are relatively rare and generally unpredictable and predominantly include immune-mediated reactions and skin infections. Along with better healthcare standards and more stringent public health mandates such as the provision of disposable needles, major infectious complications related to hepatitis and human retroviral infections have decreased significantly. When they do occur, skin infections are most frequently associated with Staphylococcus aureus or Streptococcus pyogenes. The aim of this study is to review the types and rates of medical complications of permanent tattoos. PubMed search and search dates were open ended. Acute local inflammation is the most common complication, but infections, allergic contact dermatitis, and other inflammatory or immune responses that are not well-characterized may occur. As many patients with immune reactions to tattoos do not react on skin or patch testing, it is postulated that the antigens contained in dyes or pigments are such small molecules that they need to be haptenized in order to become immunogenic. Red ink is associated more frequently with long-term reactions, including granulomatous and pseudolymphomatous phenomena or morphea-like lesions and vasculitis. Exacerbation of preexisting psoriasis, atopic dermatitis, and pyoderma gangrenosum may occur after tattooing. There is no well-defined association between cancer and tattoos. The treatment of tattoo-related complications may include local destructive measures (cryotherapy, electro-surgery, dermabrasion, chemical destruction, ablative laser destruction), surgical excision, and thermolysis of the

  20. Neutrophilic Dermatoses in Antineutrophil Cytoplasmic Antibody-Associated Vasculitis

    PubMed Central

    de Boysson, Hubert; Martin Silva, Nicolas; de Moreuil, Claire; Néel, Antoine; de Menthon, Mathilde; Meyer, Olivier; Launay, David; Pagnoux, Christian; Guillevin, Loïc; Puéchal, Xavier; Bienvenu, Boris; Aouba, Achille

    2016-01-01

    Abstract A few reports suggest combination of ANCA-associated vasculitis (AAV) and neutrophilic dermatoses (ND). We aimed to describe the main characteristics of patients presenting with both AAV and ND in a French cohort and through a systematic literature review, and to discuss the possible common pathogenic process involved. We conducted a retrospective study of patients with both conditions. Patients were selected via the French Internal Medicine Society (SNFMI) and the French Vasculitis Study Group (FVSG). A literature review focusing on a combination of both conditions, concentrated only on publications with well-established diagnoses and individual detailed data. Seventeen patients diagnosed with AAV and ND were identified in this cohort. Twelve patients had granulomatosis with polyangiitis (GPA), 4 had microscopic polyangiitis (MPA) and one had eosinophilic GPA (EGPA). Eight patients, all with GPA, displayed pyoderma gangrenosum (PG). Sweet's syndrome was observed in 6 patients (4 with MPA, one with GPA and one with EGPA) and erythema elevatum diutinum in the other three (2 with GPA and 1 with MPA). The literature review identified 33 additional patients with both conditions, including 26 with GPA. Altogether, of the 50 patients (17 from our study and 33 from the literature review), 33 (66%) patients presented with PG associated with GPA in 29 cases (89%). Corticosteroids were the first-line treatment in conjunction with an immunosuppressive agent in most cases. Outcomes were good and a total of 15 patients experienced a relapse. Patients who relapsed were more likely to have ear, nose and throat manifestation than patients who did not [12/15 (80%) relapsing patients vs. 15/35 (43%) non-relapsing patients; p = 0.03)]. In our stud, the most frequent association concerned GPA and PG. ND should be considered and specifically researched within the spectrum of cutaneous manifestations observed in AAV. PMID:26986103

  1. The skin pathergy test: innately useful?

    PubMed

    Varol, Alexandra; Seifert, Oliver; Anderson, Chris D

    2010-04-01

    Pathergy is the term used to describe hyper-reactivity of the skin that occurs in response to minimal trauma. A positive skin pathergy test (SPT), characterised by erythematous induration at the site of the needle stick with a small pustule containing sterile pus at its centre, is among the criteria required for a diagnosis of Behçet's disease (BD) and in certain population has been shown to be highly specific for this condition. Problems with standardising the induction manoeuvre for the SPT as well as the method of assessment of the response have limited the usefulness of the SPT in the clinical setting. Extensive investigation into histopathological and immunological aspects of pathergy has led to a number of hypotheses relating to the aetiology of the skin pathergy reaction and the disease itself, but the cause is considered to be unknown. Pathergy lesions, the development of new skin lesions or the aggravation of existing ones following trivial trauma, are also reported in pyoderma gangrenosum and has been noted in other neutrophilic dermatoses such as Sweet's syndrome. The response of such patient groups to the systematic application of the SPT has not been described. We propose that a new way of considering the pathergy reaction is to see it as an aberration of the skin's innate reactivity from a homeostatic reactive mode closely coupled to tissue healing to an abnormal destructive/inflammatory mode. Our understanding of BD and other similar conditions would profit by more detailed mechanistic knowledge of skin homeostasis to minimal trauma in both health and disease through a more structured and systematic use of the SPT. PMID:20012749

  2. Medical Complications of Tattoos: A Comprehensive Review.

    PubMed

    Islam, Parvez S; Chang, Christopher; Selmi, Carlo; Generali, Elena; Huntley, Arthur; Teuber, Suzanne S; Gershwin, M Eric

    2016-04-01

    Tattoos are defined as the introduction of exogenous pigments into the dermis in order to produce a permanent design. This process may occur unintentional or may be deliberately administered for cosmetic or medical reasons. Tattoos have been around for over 5000 years and over time have evolved to represent a common cosmetic practice worldwide. Currently, adverse reactions are relatively rare and generally unpredictable and predominantly include immune-mediated reactions and skin infections. Along with better healthcare standards and more stringent public health mandates such as the provision of disposable needles, major infectious complications related to hepatitis and human retroviral infections have decreased significantly. When they do occur, skin infections are most frequently associated with Staphylococcus aureus or Streptococcus pyogenes. The aim of this study is to review the types and rates of medical complications of permanent tattoos. PubMed search and search dates were open ended. Acute local inflammation is the most common complication, but infections, allergic contact dermatitis, and other inflammatory or immune responses that are not well-characterized may occur. As many patients with immune reactions to tattoos do not react on skin or patch testing, it is postulated that the antigens contained in dyes or pigments are such small molecules that they need to be haptenized in order to become immunogenic. Red ink is associated more frequently with long-term reactions, including granulomatous and pseudolymphomatous phenomena or morphea-like lesions and vasculitis. Exacerbation of preexisting psoriasis, atopic dermatitis, and pyoderma gangrenosum may occur after tattooing. There is no well-defined association between cancer and tattoos. The treatment of tattoo-related complications may include local destructive measures (cryotherapy, electro-surgery, dermabrasion, chemical destruction, ablative laser destruction), surgical excision, and thermolysis of the

  3. T-cell prolymphocytic leukemia in a 63-year-old female with a pre-existing T-cell large granular lymphocytic leukemia: metachronous T-cell leukemias with discordant subset restrictions (CD4 versus CD8) and distinct clonal identities.

    PubMed

    Wei, Qiang; Papavassiliou, Paulie; Rehder, Catherine; Sebastian, Siby; Wang, Endi

    2014-12-01

    A 55-year-old female with T-cell large granular lymphocytic leukemia (T-LGL) (CD8+) was initially treated with anti-thymocyte globulin and then cyclosporine due to anemia/neutropenia. While the severity of cytopenia varied with the therapy, the T-LGL persisted. Eight years after the initial diagnosis, she developed lymphadenopathy and hepatosplenomegaly. A complete blood cell count revealed leukocytosis, anemia and thrombocytopenia with ∼ 80% lymphocytes. In contrast to the LGL cells, the blood lymphocytes at this time were medium-large in size and had oval/irregular nuclei, condensed chromatin, indistinct nucleoli and a moderate amount of basophilic cytoplasm, many with elongated vacuoles, and some with cytoplasmic projections. The abnormal lymphocytes comprised ∼ 30% of the bone marrow cellularity with interstitial infiltrates/aggregates. Immunophenotypic analyses demonstrated a T-cell neoplasm with features suggestive of T-cell prolymphocytic leukemia (T-PLL) (CD4+). Cytogenetic analysis revealed a novel clone with complex abnormalities. PCR-based TRG gene rearrangement studies detected a clonal amplicon distinct from that of the preexisting T-LGL. Because of the chronological sequence of the two T-cell neoplasms, this case was initially considered an aggressive transformation of T-LGL. However, this was ultimately excluded by a discordant CD4-subset restriction and the presence of a distinct clonal identity. While these two T-cell neoplasms may have intrinsic connections, the underlying pathogenesis remains to be investigated.

  4. Dissecting cellulitis (Perifolliculitis Capitis Abscedens et Suffodiens): a comprehensive review focusing on new treatments and findings of the last decade with commentary comparing the therapies and causes of dissecting cellulitis to hidradenitis suppurativa.

    PubMed

    Scheinfeld, Noah

    2014-05-01

    Dissecting cellulitis (DC) also referred to as to as perifolliculitis capitis abscedens et suffodiens (Hoffman) manifests with perifollicular pustules, nodules, abscesses and sinuses that evolve into scarring alopecia. In the U.S., it predominantly occurs in African American men between 20-40 years of age. DC also occurs in other races and women more rarely. DC has been reported worldwide. Older therapies reported effective include: low dose oral zinc, isotretinoin, minocycline, sulfa drugs, tetracycline, prednisone, intralesional triamcinolone, incision and drainage, dapsone, antiandrogens (in women), topical clindamycin, topical isotretinoin, X-ray epilation and ablation, ablative C02 lasers, hair removal lasers (800nm and 694nm), and surgical excision. Newer treatments reported include tumor necrosis factor blockers (TNFB), quinolones, macrolide antibiotics, rifampin, alitretinoin, metronidazole, and high dose zinc sulphate (135-220 mg TID). Isotretinoin seems to provide the best chance at remission, but the number of reports is small, dosing schedules variable, and the long term follow up beyond a year is negligible; treatment failures have been reported. TNFB can succeed when isotretinoin fails, either as monotherapy, or as a bridge to aggressive surgical treatment, but long term data is lacking. Non-medical therapies noted in the last decade include: the 1064 nm laser, ALA-PDT, and modern external beam radiation therapy. Studies that span more than 1 year are lacking. Newer pathologic hair findings include: pigmented casts, black dots, and "3D" yellow dots. Newer associations include: keratitis-ichthyosis-deafness syndrome, Crohn disease and pyoderma gangrenosum. Older associations include arthritis and keratitis. DC is likely a reaction pattern, as is shown by its varied therapeutic successes and failures. The etiology of DC remains enigmatic and DC is distinct from hidradenitis suppurativa, which is shown by their varied responses to therapies and their

  5. The Relationship between NALP3 and Autoinflammatory Syndromes

    PubMed Central

    Campbell, Lorna; Raheem, Irfan; Malemud, Charles J.; Askari, Ali D.

    2016-01-01

    The nucleotide-binding domain, leucine-rich repeat/pyrin domain-containing-3 (NALP3) inflammasome, which is required for synthesis of interleukin-1β, has been implicated in the pathogenesis of several autoinflammatory syndromes. This review of the literature summarizes the interconnectedness of NALP3 inflammasome with some of these disorders. Familial Mediterranean fever results from a mutation in the Mediterranean fever (MEFV) gene, which encodes the pyrin protein. Previous study results suggest that pyrin suppresses caspase-1 activation, perhaps by competing for the adaptor protein, termed, pyrin domain of apoptosis/speck-like protein containing a caspase-recruitment domain (ACS) which therefore interferes with NALP3 inflammasome activation. The nucleotide-binding domain, leucine-rich repeat/pyrin domain-containing-3 (NALP3) inflammasome is constitutively activated in cryopyrin-associated periodic syndromes due to gain-of-function mutations resulting from point mutations within the neuronal apoptosis inhibitor protein/class 2 transcription factor/heterokaryon incompatibility/telomerase-associated protein-1 (NACHT) domain of the NALP3 protein. Pyogenic arthritis, pyoderma gangrenosum and acne (PAPA) syndrome is caused by mutations in the genes encoding proline-serine-threonine phosphatase interacting protein 1 (PSTPIP1). These PSTPIP1 mutants are thought to bind to pyrin causing an increase in the pyrin domain of apoptosis/speck-like protein containing a caspase-recruitment domain (ASC) pyroptosome assembly leading to procaspase-1 recruitment and therefore its activation. Hyperimmunoglublinemia D syndrome is caused by mevalonate kinase (MVK) deficiency, which may be affected by protein accumulation that leads to NALP3 inflammasome activation. Tumor necrosis factor receptor–associated periodic syndrome is associated with mutations in the tumor necrosis factor receptor superfamily, member 1A (TNFRSF1A) gene which decreases the level of soluble tumor necrosis

  6. Disseminated sporotrichosis mimicking sarcoidosis.

    PubMed

    Yang, Deborah J; Krishnan, Ravi S; Guillen, David R; Schmiege, Lorenz M; Leis, Paula F; Hsu, Sylvia

    2006-04-01

    . In addition to the nonhealing ulcer on his left forearm, which he had acquired several months earlier, he had also developed a 3.0 cm ulcer on his right arm and a 3.0 cm ulcer on his central back. The patient refused biopsies at this visit. Given the patient's previous diagnosis of pulmonary sarcoidosis, it was thought that the skin lesions might represent ulcerative cutaneous sarcoidosis. Pyoderma gangrenosum was also considered to be a likely diagnosis. Therefore, the patient was started on a course of oral prednisone, an effective therapy for both sarcoidosis and pyoderma gangrenosum. Despite 1 month of treatment with 60 mg/day of prednisone, the ulcers increased, and the patient was subsequently referred to our clinic. Physical examination at the time of presentation revealed steroid acne on the trunk and upper extremities and three non-tender ulcers with erythematous, undermined borders (Figs 1-3). On the left arm, there was an adjacent nodule which the patient attributed to a scar from a previously healed ulcer. Histologic examination of biopsy specimens from all three sites showed similar findings. The lesion contained diffuse, suppurative, granulomatous, inflammatory infiltrates with extensive central necrosis. The infiltrates were composed of histiocytes, multinucleated foreign-body-type giant cells, plasma cells, lymphocytes, neutrophils, and neutrophil fragments. No organisms were seen in the initial, routinely stained sections. However, periodic acid-Schiff (PAS) staining demonstrated small fungal spores (Fig. 4) morphologically consistent with sporotrichosis, within the cytoplasm of multinucleated histiocytic giant cells (Fig. 5). Additional stains for bacteria and acid-fast organisms were negative. Cultures of the biopsy specimens from all three sites grew Sporothrix schenckii. Further questioning of the patient failed to reveal an obvious source of the infection. The patient denied any history of traumatic skin inoculation and did not engage in

  7. Targeted localized use of therapeutic antibodies: a review of non-systemic, topical and oral applications.

    PubMed

    Jones, Russell G A; Martino, Angela

    2016-01-01

    Therapeutic antibodies provide important tools in the "medicine chest" of today's clinician for the treatment of a range of disorders. Typically monoclonal or polyclonal antibodies are administered in large doses, either directly or indirectly into the circulation, via a systemic route which is well suited for disseminated ailments. Diseases confined within a specific localized tissue, however, may be treated more effectively and at reduced cost by a delivery system which targets directly the affected area. To explore the advantages of the local administration of antibodies, we reviewed current alternative, non-systemic delivery approaches which are in clinical use, being trialed or developed. These less conventional approaches comprise: (a) local injections, (b) topical and (c) peroral administration routes. Local delivery includes intra-ocular injections into the vitreal humor (i.e. Ranibizumab for age-related macular degeneration), subconjunctival injections (e.g. Bevacizumab for corneal neovascularization), intra-articular joint injections (i.e. anti-TNF alpha antibody for persistent inflammatory monoarthritis) and intratumoral or peritumoral injections (e.g. Ipilimumab for cancer). A range of other strategies, such as the local use of antibacterial antibodies, are also presented. Local injections of antibodies utilize doses which range from 1/10th to 1/100th of the required systemic dose therefore reducing both side-effects and treatment costs. In addition, any therapeutic antibody escaping from the local site of disease into the systemic circulation is immediately diluted within the large blood volume, further lowering the potential for unwanted effects. Needle-free topical application routes become an option when the condition is restricted locally to an external surface. The topical route may potentially be utilized in the form of eye drops for infections or corneal neovascularization or be applied to diseased skin for psoriasis, dermatitis, pyoderma

  8. A Real World, Observational Registry of Chronic Wounds and Ulcers

    ClinicalTrials.gov

    2016-05-18

    Diabetic Foot; Varicose Ulcer; Pressure Ulcer; Surgical Wound Dehiscence; Vasculitis; Skin Ulcer; Leg Ulcer; Wounds and Injuries; Pyoderma; Peripheral Arterial Disease; Diabetic Neuropathies; Lymphedema; Venous Insufficiency; Diabetes Complications; Amputation Stump

  9. 21 CFR 520.88g - Amoxicillin trihydrate and clavulanate potassium film-coated tablets.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... pyoderma due to susceptible strains of beta-lactamase (penicillinase) Staphylococcus aureus, nonbeta-lactamase S. aureus, Staphylococcus spp., Streptococcus spp., and Escherichia coli. Treatment of periodontal... (penicillinase) producing S. aureus, nonbeta-lactamase producing S. aureus, Staphylococcus spp.,...

  10. 21 CFR 520.88g - Amoxicillin trihydrate and clavulanate potassium film-coated tablets.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... pyoderma due to susceptible strains of beta-lactamase (penicillinase) Staphylococcus aureus, nonbeta-lactamase S. aureus, Staphylococcus spp., Streptococcus spp., and Escherichia coli. Treatment of periodontal... (penicillinase) producing S. aureus, nonbeta-lactamase producing S. aureus, Staphylococcus spp.,...

  11. 21 CFR 524.1465 - Mupirocin.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... infections of the skin, including superficial pyoderma, caused by susceptible strains of Staphylococcus aureus and S. intermedius. (3) Limitations. Federal law restricts this drug to use by or on the order...

  12. 21 CFR 520.88g - Amoxicillin trihydrate and clavulanate potassium film-coated tablets.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... pyoderma due to susceptible strains of beta-lactamase (penicillinase) Staphylococcus aureus, nonbeta-lactamase S. aureus, Staphylococcus spp., Streptococcus spp., and Escherichia coli. Treatment of periodontal... (penicillinase) producing S. aureus, nonbeta-lactamase producing S. aureus, Staphylococcus spp.,...

  13. 21 CFR 520.88g - Amoxicillin trihydrate and clavulanate potassium film-coated tablets.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... pyoderma due to susceptible strains of beta-lactamase (penicillinase) Staphylococcus aureus, nonbeta-lactamase S. aureus, Staphylococcus spp., Streptococcus spp., and Escherichia coli. Treatment of periodontal... (penicillinase) producing S. aureus, nonbeta-lactamase producing S. aureus, Staphylococcus spp.,...

  14. Macroscopic, cytological and bacteriological evaluation of anal sac content in normal dogs and in dogs with selected dermatological diseases.

    PubMed

    Pappalardo, Ersilia; Martino, Piera Anna; Noli, Chiara

    2002-12-01

    Macroscopic and cytological aspects of anal sac content were evaluated in 40 normal dogs and 10 dogs each with pyoderma, Malassezia dermatitis associated with atopic dermatitis and uncomplicated atopic dermatitis. Bacteria isolated from anal sacs were compared with those from abdominal skin and hair in 20 normal dogs and 10 dogs with pyoderma. There was no difference between the groups in anal sac dimension, or in the colour, consistency or presence of granules in their content. Extracellular bacteria were found in higher numbers in diseased animals, whereas intracellular bacteria were observed in 40% of dogs with pyoderma and in only 2.5% of normal dogs. Malassezia spp. were present in 15.7% of dogs, with no difference between groups. Neutrophils were observed in 12.5% of normal dogs, 30% of dogs with Malassezia dermatitis with underlying atopic dermatitis and in 70 and 80% of dogs with pyoderma and uncomplicated atopic dermatitis, respectively. Seven bacterial species were isolated from anal sacs, with no difference between normal dogs and dogs with pyoderma. In five normal animals and in four dogs with pyoderma the same bacterial strains were isolated from anal sacs and from abdominal skin and hair. PMID:12464064

  15. 17 CFR 248.121 - Affiliate marketing opt out and exceptions.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... you have a pre-existing business relationship; (2) To facilitate communications to an individual for... investment adviser does not have a pre-existing business relationship with the consumer and none of the other...) By an affiliate that has or has previously had a pre-existing business relationship with the...

  16. 16 CFR 680.21 - Affiliate marketing opt-out and exceptions.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    .... The creditor does not have a pre-existing business relationship with the consumer and none of the... affiliate that has or has previously had a pre-existing business relationship with the consumer; or (ii) As... least one of the affiliates on the joint notice has or has previously had a pre-existing...

  17. 12 CFR 571.21 - Affiliate marketing opt-out and exceptions.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... institution does not have a pre-existing business relationship with the consumer and none of the other... affiliate that has or has previously had a pre-existing business relationship with the consumer; or (ii) As... least one of the affiliates on the joint notice has or has previously had a pre-existing...

  18. Benefits of swimming pools in two remote Aboriginal communities in Western Australia: intervention study

    PubMed Central

    Lehmann, Deborah; Tennant, Mary T; Silva, Desiree T; McAullay, Daniel; Lannigan, Francis; Coates, Harvey; Stanley, Fiona J

    2003-01-01

    Objective To determine the health impact of swimming pools built with the aim of improving quality of life and reducing high rates of pyoderma and otitis media. Design Intervention study assessing prevalence of ear disease and skin infections before and at six monthly intervals after opening of swimming pools. Setting Two remote Aboriginal communities in Western Australia. Participants 84 boys and 78 girls aged < 17 years. Main outcome measures Changes in prevalence and severity of pyoderma and perforation of tympanic membranes with or without otorrhoea over 18 months after opening of pools. Results In community A, 61 children were seen before the pool was opened, and 41, 46, and 33 children were seen at the second, third, and fourth surveys. Equivalent figures for community B were 60, 35, 39, and 45. Prevalence of pyoderma declined significantly from 62% to 18% in community A and from 70% to 20% in community B during the 18 months after the pools opened. Over the same period, prevalence of severe pyoderma fell from 30% to 15% in community A and from 48% to 0% in community B. Prevalence of perforations of the tympanic membrane fell from 32% in both communities to 13% in community A and 18% in community B. School attendance improved in community A. Conclusion Swimming pools in remote communities were associated with reduction in prevalence of pyoderma and tympanic membrane perforations, which could result in long term benefits through reduction in chronic disease burden and improved educational and social outcomes. PMID:12933727

  19. Pseudomonas sepsis with Noma: an association?

    PubMed

    Vaidyanathan, S; Tullu, M S; Lahiri, K R; Deshmukh, C T

    2005-08-01

    We report here a 2.5-year-old male child with community-acquired Pseudomonal sepsis showing the characteristic lesions of ecthyma gangrenosum. The child had development of gangrenous changes of the nose and face - the 'cancrum oris' or 'Noma'. We highlight the possible association of Pseudomonas sepsis and Noma, with malnutrition playing a central role in causing both the diseases.

  20. Serum detection of IgG antibodies against Demodex canis by western blot in healthy dogs and dogs with juvenile generalized demodicosis.

    PubMed

    Ravera, Ivan; Ferreira, Diana; Gallego, Laia Solano; Bardagí, Mar; Ferrer, Lluís

    2015-08-01

    The aim of this study was to investigate the presence of canine immunoglobulins (Ig) G against Demodex proteins in the sera of healthy dogs and of dogs with juvenile generalized demodicosis (CanJGD) with or without secondary pyoderma. Demodex mites were collected from dogs with CanJGD. Protein concentration was measured and a western blot technique was performed. Pooled sera from healthy dogs reacted mainly with antigen bands ranging from 55 to 72 kDa. Pooled sera from dogs with CanJGD without secondary pyoderma reacted either with 10 kDa antigen band or 55 to 72 kDa bands. Pooled sera from dogs with CanJGD with secondary pyoderma reacted only with a 10 kDa antigen band. The results of this study suggest that both healthy dogs and dogs with CanJGD develop a humoral response against different proteins of Demodex canis. PMID:26267107

  1. Serum detection of IgG antibodies against Demodex canis by western blot in healthy dogs and dogs with juvenile generalized demodicosis.

    PubMed

    Ravera, Ivan; Ferreira, Diana; Gallego, Laia Solano; Bardagí, Mar; Ferrer, Lluís

    2015-08-01

    The aim of this study was to investigate the presence of canine immunoglobulins (Ig) G against Demodex proteins in the sera of healthy dogs and of dogs with juvenile generalized demodicosis (CanJGD) with or without secondary pyoderma. Demodex mites were collected from dogs with CanJGD. Protein concentration was measured and a western blot technique was performed. Pooled sera from healthy dogs reacted mainly with antigen bands ranging from 55 to 72 kDa. Pooled sera from dogs with CanJGD without secondary pyoderma reacted either with 10 kDa antigen band or 55 to 72 kDa bands. Pooled sera from dogs with CanJGD with secondary pyoderma reacted only with a 10 kDa antigen band. The results of this study suggest that both healthy dogs and dogs with CanJGD develop a humoral response against different proteins of Demodex canis.

  2. M-Protein Analysis of Streptococcus pyogenes Isolates Associated with Acute Rheumatic Fever in New Zealand.

    PubMed

    Williamson, Deborah A; Smeesters, Pierre R; Steer, Andrew C; Steemson, John D; Ng, Adrian C H; Proft, Thomas; Fraser, John D; Baker, Michael G; Morgan, Julie; Carter, Philip E; Moreland, Nicole J

    2015-11-01

    We applied an emm cluster typing system to group A Streptococcus strains in New Zealand, including those associated with acute rheumatic fever (ARF). We observed few so-called rheumatogenic emm types but found a high proportion of emm types previously associated with pyoderma, further suggesting a role for skin infection in ARF.

  3. Sudden Appearance of Indurated Erythematous Plaques on a Man's Face

    PubMed Central

    Carter, A.; Shulman, K.

    2016-01-01

    Rosacea fulminans (RF), previously known as pyoderma faciale, is a rare presentation of rosacea mostly seen in young women. RF is seen very rarely in men. We present below a case of a fifty-year-old male who presented with RF and was successfully treated with a combination of corticosteroids and isotretinoin. PMID:27703816

  4. Predictive modeling of synergistic effects in nanoscale ion track formation

    DOE PAGESBeta

    Zarkadoula, Eva; Pakarinen, Olli H.; Xue, Haizhou; Zhang, Yanwen; Weber, William J.

    2015-08-05

    Molecular dynamics techniques and the inelastic thermal spike model are used to study the coupled effects of inelastic energy loss due to 21 MeV Ni ion irradiation and pre-existing defects in SrTiO3. We determine the dependence on pre-existing defect concentration of nanoscale track formation occurring from the synergy between the inelastic energy loss and the pre-existing atomic defects. We show that the nanoscale ion tracks’ size can be controlled by the concentration of pre-existing disorder. This work identifies a major gap in fundamental understanding concerning the role played by defects in electronic energy dissipation and electron–lattice coupling.

  5. THE COST-EFFECTIVENESS OF ALTERNATIVE INSTRUMENTS FOR ENVIRONMENTAL PROTECTION IN A SECOND-BEST SETTING. (R825313)

    EPA Science Inventory

    Abstract

    This paper employs analytical and numerical general equilibrium models to examine the significance of pre-existing factor taxes for the costs of pollution reduction under a wide range of environmental policy instruments. Pre-existing taxes imply significantly ...

  6. 12 CFR 41.21 - Affiliate marketing opt-out and exceptions.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... relationship; (2) To facilitate communications to an individual for whose benefit the bank provides employee... institution does not have a pre-existing business relationship with the consumer and none of the other... affiliate that has or has previously had a pre-existing business relationship with the consumer; or (ii)...

  7. 12 CFR 334.21 - Affiliate marketing opt-out and exceptions.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ...) To facilitate communications to an individual for whose benefit you provide employee benefit or other... depository institution does not have a pre-existing business relationship with the consumer and none of the...) By an affiliate that has or has previously had a pre-existing business relationship with the...

  8. 29 CFR 1904.5 - Determination of work-relatedness.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... contributed to the resulting condition or significantly aggravated a pre-existing injury or illness. Work... employee eating, drinking, or preparing food or drink for personal consumption (whether bought on the... condition or significantly aggravated a pre-existing condition. (4) How do I know if an event or exposure...

  9. 12 CFR 717.21 - Affiliate marketing opt-out and exceptions.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... federal credit union does not have a pre-existing business relationship with the consumer and none of the... provided: (i) By an affiliate that has or has previously had a pre-existing business relationship with the... business relationship with the consumer. (b) Making solicitations. (1) In general. For purposes of...

  10. 45 CFR 152.2 - Definitions.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... authorization; (iii) Aliens who have been granted employment authorization under 8 CFR 274a.12(c)(9), (10), (16... CFR 144.103. Pre-Existing Condition Insurance Plan (PCIP) means the temporary high risk health... DEPARTMENT OF HEALTH AND HUMAN SERVICES REQUIREMENTS RELATING TO HEALTH CARE ACCESS PRE-EXISTING...

  11. 45 CFR 152.2 - Definitions.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... authorization; (iii) Aliens who have been granted employment authorization under 8 CFR 274a.12(c)(9), (10), (16... CFR 144.103. Pre-Existing Condition Insurance Plan (PCIP) means the temporary high risk health... Department of Health and Human Services REQUIREMENTS RELATING TO HEALTH CARE ACCESS PRE-EXISTING...

  12. 45 CFR 152.2 - Definitions.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... authorization; (iii) Aliens who have been granted employment authorization under 8 CFR 274a.12(c)(9), (10), (16... CFR 144.103. Pre-Existing Condition Insurance Plan (PCIP) means the temporary high risk health... DEPARTMENT OF HEALTH AND HUMAN SERVICES REQUIREMENTS RELATING TO HEALTH CARE ACCESS PRE-EXISTING...

  13. Settling No Conflict in the Public Place: Truth in Education, and in Rancierean Scholarship

    ERIC Educational Resources Information Center

    Bingham, Charles

    2010-01-01

    This essay offers an educational understanding of truth deriving from the work of Jacques Ranciere. Unlike other educational accounts--the traditional, progressive, and critical accounts--of truth that take education as a way of approaching pre-existing truths (or lack of pre-existing truths), this essay establishes an account of truth that is…

  14. Eradication of scabies with a single treatment schedule.

    PubMed

    Taplin, D; Arrue, C; Walker, J G; Roth, W I; Rivera, A

    1983-10-01

    A single application (16 to 20 hours) of 1% gamma benzene hexachloride (GBH) lotion, when applied to a total island population of 178 persons in which seventy-four clinically had scabies, resulted in a cure rate of over 98%. Re-examination of the population at 10 and 21 weeks revealed only one remaining individual still having scabies. On a neighboring island, only those with clinical evidence of scabies were treated (140 persons). Applications of 1% GBH lotion were applied with the same methods used on the first island. When the population was re-examined at 10 weeks, the prevalence of scabies was reduced by only 50%. Successful eradication of scabies from a population should include treatment of all contacts, whether clinically infected or not. Treatment of the entire population at risk at one time is preferable. Coexistent pyoderma should be treated, and a second treatment for scabies may be needed when the pyoderma has cleared.

  15. Antimicrobial susceptibility of Staphylococcus intermedius and Staphylococcus schleiferi isolated from dogs.

    PubMed

    Vanni, M; Tognetti, R; Pretti, C; Crema, F; Soldani, G; Meucci, V; Intorre, L

    2009-10-01

    The susceptibility to 23 antimicrobial agents was determined in 114 isolates of Staphylococcus intermedius and eight isolates of Staphylococcus schleiferi of canine origin. Overall, 73% of S. intermedius isolates and 37.5% of S. schleiferi isolates were susceptible to all the 23 antimicrobials tested. The large majority of S. intermedius strains retained susceptibility to antimicrobials currently employed in treatment of pyoderma (cephalosporins, cotrimoxazole and association amoxicillin-clavulanic acid) as well as to those effective against staphylococci (fusidic acid, rifampicin and fluoroquinolones). Resistance in S. intermedius was observed mainly against macrolides, chloramphenicol and lincosamides, while S. schleiferi isolates retained susceptibility to all antimicrobials except three of six fluoroquinolones. Although, our results confirm susceptibility to antimicrobials currently employed in pyoderma treatment, the several different resistance patterns observed for S. intermedius emphasize the importance of antimicrobial susceptibility testing of canine staphylococci to choose the most appropriate treatment of infections and to allow the prudent use of antimicrobial drugs in companion animals.

  16. In vitro antimicrobial activity of orbifloxacin against Staphylococcus intermedius isolates from canine skin and ear infections.

    PubMed

    Ganière, Jean-Pierre; Médaille, Christine; Etoré, Florence

    2004-08-01

    The objective of the study was to evaluate the in vitro activity of orbifloxacin against Staphylococcus intermedius strains isolated in France from canine skin and ear infections. The minimum inhibitory concentrations (MICs) of orbifloxacin against 240 field S. intermedius isolates (69 skin and 171 ear isolates) ranged from 0.016 to 8 mg l(-1), with MIC50 and MIC90 equal to 0.5 and 1 mg l(-1), respectively. Only one strain, a pyoderma isolate was resistant (MIC=8 mg l(-1)). Orbifloxacin was tested at different concentrations for killing rate against five isolates obtained from pyoderma cases and against a reference strain (Staphylococcus aureus ATCC 29213). Orbifloxacin expressed a concentration-dependent bactericidal activity against the S. aureus reference strain, but a time-dependent bactericidal activity against S. intermedius. Orbifloxacin induced bactericidal effect against the S. intermedius strains tested with concentrations equal to or two times MIC.

  17. The epidemiology of dermatologic and venereologic disease in a deployed operational setting.

    PubMed

    Vidmar, D A; Harford, R R; Beasley, W J; Revels, J; Thornton, S A; Kao, T C

    1996-07-01

    We studied the epidemiology, morbidity, and etiology of dermatologic and non-human immunodeficiency virus venereologic disease (Derm/STD) aboard a deployed aircraft carrier to revise Derm/STD training objectives for shipboard primary care providers. Onboard supplies for treatment of Derm/STD were also evaluated. Over 3 months, 929 Derm/STD patients were treated for 1,320 diagnoses generating 2,011 visits. Derm/STD caused 22% of the total morbidity. Pyoderma alone accounted for nearly one-half of that morbidity and involved many work-center groups. Air wing, aircraft maintenance, and engineering work-center groups had lower burdens of pyoderma. Bacterial cultures were performed on 248 exudative dermatoses. Staphylococcus aureus was the dominant pathogen and was overwhelmingly sensitive in vitro to common, inexpensive antibiotics. Strategies to encourage prevention, earlier diagnosis, and rapid treatment of Derm/STD by deployed primary care providers are discussed.

  18. Failure strength of icy lithospheres

    NASA Technical Reports Server (NTRS)

    Golombek, M. P.; Banerdt, W. B.

    1987-01-01

    Lithospheric strengths derived from friction on pre-existing fractures and ductile flow laws show that the tensile strength of intact ice under applicable conditions is actually an order of magnitude stronger than widely assumed. It is demonstrated that this strength is everywhere greater than that required to initiate frictional sliding on pre-existing fractures and faults. Because the tensile strength of intact ice increases markedly with confining pressure, it actually exceeds the frictional strength at all depths. Thus, icy lithospheres will fail by frictional slip along pre-existing fractures at yeild stresses greater than previously assumed rather than opening tensile cracks in intact ice.

  19. THE ROLE OF OXIDATIVE STRESS AND MITOCHONDRIA IN PARTICULATE MATTER (PM)-INDUCED CARDIOPULMONARY INJURY IN STROKE PRONE SPONTANEOUSLY HYPERTENSIVE (SHRSP) AND WISTAR KYOTO (WKY) RATS

    EPA Science Inventory

    Epidemiological studies have associated PM exposure with cardiovascular mortality and morbidity, and this effect seems to be enhanced in populations with pre-existing cardiovascular disease. One hypothesis for this exacerbation is that the higher underlying level of oxidative st...

  20. Acrolein-Induced Increases in Blood Pressure and Heart Rate Are Coupled with Decreased Blood Oxygen Levels During Exposure in Hypertensive Rats

    EPA Science Inventory

    Exposure to air pollution increases the risk of cardiovascular morbidity and mortality, especially in individuals with pre-existing cardiovascular disease. Recent studies link exposure to air pollution with reduced blood oxygen saturation suggesting that hypoxia is a potential me...

  1. The effects of ambient particulate matter on human alveolar machrophage oxidative and inflammatory responses

    EPA Science Inventory

    Epidemiologic and occupational studies demonstrate that ambient PM and DEP have deleterious effects on human cardiopulmonary health including exacerbation of pre-existing lung disease and development of respiratory infections. The effects of ambient PM on lung cell responsivenes...

  2. PARTICULATE MATTER, OXIDATIVE STRESS AND NEUROTOXICITY

    EPA Science Inventory

    Particulate matter (PM), a component of air pollution has been epidemiologically associated with sudden deaths, cardiovascular and respiratory illnesses. The effects are more pronounced in patients with pre-existing conditions such as asthma, diabetes or obstructive pulmonary dis...

  3. Integrating Nonchemicals in Cumulative Risk Assessment (CRA):A Case Study of Particulate Matter (PM) and Heart Rate Variability (HRV)

    EPA Science Inventory

    Cumulative risk assessments (CRAs) quantitatively or qualitatively evaluate the risks of combined exposures to chemical and nonchemical stressors. CRAs also examine vulnerabilities (e.g., pre-existing health condition, genetic predisposition, poverty) as these may lead to variabi...

  4. Particulate matter, oxidative stress and neurotoxicity.

    EPA Science Inventory

    Particulate matter (PM), a component of air pollution has been epidemiologically associated with sudden deaths, cardiovascular and respiratory illnesses. The effects are more pronounced in patients with pre-existing conditions such as asthma, diabetes or obstructive pulmonary dis...

  5. Airways Hyperresponsiveness Following a Single Inhalation Exposure to Doxorubicin-Induced Heart Failure Prevents Airways Transition Metal-Rich Particulate Matter in Hypertensive Rats

    EPA Science Inventory

    Exposure to particulate matter (PM) air pollution results in airways hyperresponsiveness (AHR), however it also results in adverse cardiovascular effects, particularly in individuals with underlying cardiovascular disease. The impact of pre-existing cardiac deficit on PM-induced ...

  6. Fine Ambient Air Particulate Matter Exposure Induces Molecular Alterations Indicative of Cardiovascular Disease Progression in Atherosclerotic Susceptible Mice -- B

    EPA Science Inventory

    Background: Epidemiology studies have reported associations between increased mortality and morbidity with exposure to particulate air pollution, particularly within individuals with pre-existing cardiovascular disease (CVD). Clinical and toxicological studies have provided evide...

  7. Predictive modeling of synergistic effects in nanoscale ion track formation

    SciTech Connect

    Zarkadoula, Eva; Pakarinen, Olli H.; Xue, Haizhou; Zhang, Yanwen; Weber, William J.

    2015-08-05

    Molecular dynamics techniques and the inelastic thermal spike model are used to study the coupled effects of inelastic energy loss due to 21 MeV Ni ion irradiation and pre-existing defects in SrTiO3. We determine the dependence on pre-existing defect concentration of nanoscale track formation occurring from the synergy between the inelastic energy loss and the pre-existing atomic defects. We show that the nanoscale ion tracks’ size can be controlled by the concentration of pre-existing disorder. This work identifies a major gap in fundamental understanding concerning the role played by defects in electronic energy dissipation and electron–lattice coupling.

  8. 26 CFR 1.401(a)(5)-1 - Special rules relating to nondiscrimination requirements.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... section 401(a)(5) by section 1111(b) of the Tax Reform Act of 1986 (TRA '86) apply, a plan must be... account pre-existing guidance and the amendments made by TRA '86 to related provisions of the...

  9. 26 CFR 1.401(a)(5)-1 - Special rules relating to nondiscrimination requirements.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... section 401(a)(5) by section 1111(b) of the Tax Reform Act of 1986 (TRA '86) apply, a plan must be... account pre-existing guidance and the amendments made by TRA '86 to related provisions of the...

  10. 26 CFR 1.401(a)(5)-1 - Special rules relating to nondiscrimination requirements.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... section 401(a)(5) by section 1111(b) of the Tax Reform Act of 1986 (TRA '86) apply, a plan must be... account pre-existing guidance and the amendments made by TRA '86 to related provisions of the...

  11. 26 CFR 1.401(a)(5)-1 - Special rules relating to nondiscrimination requirements.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... section 401(a)(5) by section 1111(b) of the Tax Reform Act of 1986 (TRA '86) apply, a plan must be... account pre-existing guidance and the amendments made by TRA '86 to related provisions of the...

  12. Vaccines: Engineering immune evasion

    NASA Astrophysics Data System (ADS)

    Mascola, John R.

    2006-05-01

    One obstacle to realizing the promise of viral vectors for vaccine delivery is pre-existing immunity to such vectors. An adroit application of structure-based design points to a way around that problem.

  13. DIFFERENCES IN CARDIOVASCULAR RESPONSE TO PM EXPOSURE BETWEEN SPONTANEOUSLY HYPERTENSIVE STROKE-PRONE (SHSP) AND WISTAR-KYOTO (WKY) RATS.

    EPA Science Inventory

    ABSTRACT BODY: Epidemiological studies have shown that cardiovascular morbidity and mortality are associated with exposure to elevated levels of ambient particulate matter (PM), notably in people with pre-existing cardiopulmonary disease. To better understand the mechanisms of PM...

  14. Energy Corner: Heat Reclamation Rescues Wasted Heat.

    ERIC Educational Resources Information Center

    Daugherty, Thomas

    1982-01-01

    Heat reclamation systems added to pre-existing central heating systems provide maximum savings at minimum cost. The benefits of a particular appliance marketed under the brand name "Energizer" are discussed. (Author/MLF)

  15. DIFFERENTIAL CARDIAC ARRHYTHMIA PROFILES IN HYPERTENSIVE AND NORMAL RATS AFTER EMISSION SOURCE PARTICULATE EXPOSURE

    EPA Science Inventory

    Exposure to combustion-derived fine particulate air pollution is associated with increased cardiovascular morbidity and mortality. These effects are especially conspicuous in individuals with pre-existing cardiovascular diseases including hypertension and coronary heart disease...

  16. Amifostine Pre-treatment Attenuates Lung Injury, But Not Inflammation, in Rats Intracheally Instilled with Particulate Matter Rich in Transition Metals

    EPA Science Inventory

    Exposure to particulate matter (PM) is associated with increased cardiovascular disease morbidity and mortality. These correlations are strengthened in individuals with pre-existing cardiovascular disease, including hypertension. Extensive evidence supports a significant role for...

  17. Effects of carbon taxes in an economy with prior tax distortions: An intertemporal general equilibrium analysis

    SciTech Connect

    Goulder, L.H. |

    1995-11-01

    This paper analyzes the costs of carbon taxes in a model that recognizes interactions between this tax and pre-existing taxes. First we examine the extent to which costs of a U.S. carbon tax are reduced when its revenues finance cuts in income taxes. Such use of revenues significantly reduces, but does not eliminate, the overall policy costs. The positive overall costs reflect the carbon tax`s focus on intermediate inputs and its relatively narrow base in comparison with income taxes. We also examine the sensitivity of the carbon tax`s costs to the level of pre-existing taxes. For any given use of revenues, welfare costs rise significantly with pre-existing tax rates, indicating that models disregarding pre-existing taxes may substantially understate the costs of new environmental tax initiatives. 47 refs., 4 figs., 4 tabs.

  18. Perioperative management of cardiac disease.

    PubMed

    Aresti, N A; Malik, A A; Ihsan, K M; Aftab, S M E; Khan, W S

    2014-01-01

    Pre-existing cardiac disease contributes significantly to morbidity and mortality amongst patients undergoing non cardiac surgery. Patients with pre-existing cardiac disease or with risk factors for it, have as much as a 3.9% risk of suffering a major perioperative cardiac event (Lee et al 1999, Devereaux 2005). Furthermore, the incidence of perioperative myocardial infarction (MI) is increased 10 to 50 fold in patients with previous coronary events (Jassal 2008).

  19. Genomic and Surface Proteomic Analysis of the Canine Pathogen Staphylococcus pseudintermedius Reveals Proteins That Mediate Adherence to the Extracellular Matrix ▿

    PubMed Central

    Bannoehr, Jeanette; Ben Zakour, Nouri L.; Reglinski, Mark; Inglis, Neil F.; Prabhakaran, Sabitha; Fossum, Even; Smith, David G.; Wilson, Gillian J.; Cartwright, Robyn A.; Haas, Juergen; Hook, Magnus; van den Broek, Adri H. M.; Thoday, Keith L.; Fitzgerald, J. Ross

    2011-01-01

    Cell wall-associated (CWA) proteins made by Gram-positive pathogens play a fundamental role in pathogenesis. Staphylococcus pseudintermedius is a major animal pathogen responsible for the canine skin disease bacterial pyoderma. Here, we describe the bioinformatic analysis of the family of 18 predicted CWA proteins encoded in the genome of S. pseudintermedius strain ED99 and determine their distribution among a phylogenetically diverse panel of S. pseudintermedius clinical isolates and closely related species of the Staphylococcus intermedius group. In parallel, we employed a proteomic approach to identify proteins presented on the surface of strain ED99 in vitro, revealing a total of 60 surface-localized proteins in one or more phases of growth, including 6 of the 18 genome-predicted CWA proteins. Based on these analyses, we selected two CWA proteins (SpsD and SpsL) encoded by all strains examined and investigated their capacity to mediate adherence to extracellular matrix proteins. We discovered that SpsD and SpsL mediated binding of a heterologous host, Lactococcus lactis, to fibrinogen and fibronectin and that SpsD mediated binding to cytokeratin 10, a major constituent of mammalian skin. Of note, the interaction with fibrinogen was host-species dependent, suggestive of a role for SpsD and SpsL in the host tropism of S. pseudintermedius. Finally, we identified IgG specific for SpsD and SpsL in sera from dogs with bacterial pyoderma, implying that both proteins are expressed during infection. The combined genomic and proteomic approach employed in the current study has revealed novel host-pathogen interactions which represent candidate therapeutic targets for the control of bacterial pyoderma. PMID:21576333

  20. Antimicrobial resistance in Staphylococcus spp., Escherichia coli and Enterococcus spp. in dogs given antibiotics for chronic dermatological disorders, compared with non-treated control dogs.

    PubMed

    Rantala, M; Lahti, E; Kuhalampil, J; Pesonen, S; Järvinen, A K; Saijonmaa-Koulumies; Honkanen-Buzalski, T

    2004-01-01

    The aim of this study was to evaluate antimicrobial resistance in canine staphylococci, Escherichia coli and enterococci, which were isolated from 22 dogs with pyoderma and a history of previous antibiotic treatment, compared to bacterial isolates from 56 non-treated control dogs. Two isolates of each bacterial species per dog were investigated, if detected. Staphylococcal isolates from dogs with pyoderma (35 isolates) were more resistant to sulphatrimethoprim than the isolates from controls (56 isolates) (57% vs. 25%, p < 0.004). Multiresistance in staphylococci was also more common in dogs with pyoderma (29% vs. 9%, p = 0.02). A similar trend among isolates of E. coli was detected (24 and 74 isolates from treated and control dogs, respectively), but the differences were not significant. Resistance for macrolide-lincosamides was approximately 20% among staphylococci in both groups. Resistance to ampicillin among enterococci was 4%-7%. The age of the dogs might have an impact on resistance: multiresistance among staphylococcal isolates from younger dogs (< or = 5 years) was more common than in older dogs (26 years) (24%, vs. 0%, 63 and 27 isolates, respectively, p = 0.02). Staphylococci in younger dogs were more resistant to tetracycline (48% vs. 11%, p < 0.001) and sulphatrimethoprim (48% vs. 15%, p < 0.01) than those in older dogs. In contrast, the isolates of E. coli from older dogs tended to be more resistant, although a significant difference was detected only in resistance to tetracycline (13% vs. 2% of 40 and 50 isolates respecthely, p = 0.04)). The results of this small study indicate that resistance in canine staphylococci in the capital area of Finland is comparable with many other countries in Europe. Resistance in indicator bacteria, E. coli and enterococci, was low. PMID:15535085

  1. Malassezia dermatitis and otitis.

    PubMed

    Morris, D O

    1999-11-01

    The incidence of dermatitis and otitis resulting from overgrowth of M. pachydermatis is great enough that cytological sampling techniques should be considered a routine part of the dermatological examination. Because most cases of MD and Malassezia otitis cannot be grossly distinguished from bacterial pyoderma and otitis, respectively, efficiency in performing cytology testing of skin and ear canal exudate is essential to the successful diagnosis and management of pruritic skin diseases and otitis. Although Malassezia infections are rarely primary, therapy can be instituted to remove the yeast as a confounding factor while a differential diagnosis is pursued in evaluating the underlying disease process. PMID:10563001

  2. [Skin diseases in returning travelers: etiologies according to clinical presentation].

    PubMed

    Monsel, G; Caumes, E

    2010-05-12

    Dermatoses are one of the three most common causes of health problem in returning travelers. These dermatoses include infections, environmental diseases (sunburns, arthropod-related reactions) and superficial injuries. Skin infections are the most common cause of consultation after return. They include bacterial infections of cosmopolitan origin (pyoderma, abcess, cellulites) and tropical diseases (hookworm-related cutaneous cutaneous larva migrans, localized cutaneous leishmaniasis, tungiasis, myiasis...). Travelers abroad must be appropriately vaccinated against tetanus and specifically instructed to avoid arthropods bites and sun overexposure. Travel first aid kits should include antibiotics effective against bacterial skin infection, oral antihistamines and corticosteroid ointments. PMID:20545260

  3. [Management of skin lesions in returning travelers].

    PubMed

    Monsel, Gentiane; Caumes, Éric

    2015-04-01

    Dermatoses in returning travellers are common. These dermatoses are mainly infectious, the most common being bacterial infections of cosmopolitan origin (cellulitis, pyoderma and abcess). Others dermatoses are environmental diseases such as sunburns, arthropod-related reactions and superficial injuries. The most common tropical skin disease is hookworm-related cutaneous larva migrans but treating physicians may also face patients with localized cutaneous leishmaniasis, tungiasis, or myiasis. Also some systemic infections can be associated with skin manifestations. The most useful treatments in this setting are oral antihistamines, topical steroids, antibiotics effective against bacterial skin infection, booster for tetanus immunization, and rabies vaccination in case of animal exposure. PMID:26058193

  4. [Fructosuria in pyodermitis].

    PubMed

    Tsyganok, S S; Kriuchkova, G Ia; Anton'yev, A A

    1989-01-01

    Oscillopolarographic studies of fructosuria in 112 patients with pyodermatitis have helped assess their carbohydrate metabolism and, specifically, the enzymic function of the liver. 89.3% of patients have developed increased fructose and fructose diphosphate excretion, vs. the reference group. High levels of both fructose and fructose diphosphate in the urine are not specific for pyoderma and may occur in other infections; concomitant diseases are conducive to an increase of fructosuria. Administration of hemodez as part of combined therapy for pyodermatitis reduces fructose and fructose diphosphate excretion.

  5. Kerion mimicking bacterial infection in an elderly patient

    PubMed Central

    Ahmad, Sheikh Manzoor; Wani, GH Mohiuddin; Khursheed, Bilques

    2014-01-01

    Tinea capitis is generally thought to be a common disease in children but not in adults. When infection does occur in adults, it may have an atypical appearance. We report an elderly female with inflammatory tinea capitis caused by Trichophyton rubrum. She had numerous pustular lesions throughout the scalp with alopecia, initially treated for bacterial infection. We concluded that tinea capitis should remain in the differential diagnosis of elderly patients with alopecia and pyoderma like presentations and culture test should be routinely done in such patients to avoid complications. PMID:25396139

  6. Chronic granulomatous disease.

    PubMed

    Nair, Pradeep S; Moorthy, Prasanna K; Suprakasan, S; Jayapalan, Sabeena; Preethi, K

    2005-01-01

    A 2(1/2)-year-old child presented with multiple discrete granulomatous lesions on the face and flexural regions since the age of 2 months along with lymphadenopathy. The patient also had recurrent bouts of pyodermas and respiratory tract infections. Biopsy of the lesion showed necrosis of tissue with suppuration and histiocytes but no evidence of tuberculosis, fungal infections or atypical mycobacteria. Lymph node biopsy also showed necrosis with suppuration but no infective organism. Nitroblue tetrazolium test was negative indicating that the neutrophils failed to oxidize the dye. We are reporting here a rare case of chronic granulomatous disease. PMID:16394414

  7. Immune response to vaccination against Argentine hemorrhagic Fever in an area where different arenaviruses coexist.

    PubMed

    Ambrosio, Ana M; Riera, Laura M; Saavedra, María Del Carmen; Sabattini, Marta S

    2006-01-01

    Neutralizing antibody (NT Ab) titers to Candid #1 (C#1) vaccine against Argentine hemorrhagic fever were studied for 2 years post-vaccination in 330 volunteers, to assess whether the kinetics and/or magnitude of this immune response is modified by previous infection with the arena viruses Junin (JUN) and lymphocytic choriomeningitis (LCM). A total of 160 volunteers received C#1, distributed as follows: without detectable pre-infection with arenaviruses (n = 54); with pre-existing antibodies to JUN (n = 55); with pre-existing antibodies to LCM (n = 51). The remaining 170 individuals received placebo. Levels of anti-JUN NT Ab displayed a trend in which titers increased with the virulence of the infecting strain, from C#1 (X = 49), through subclinical JUN infection (X = 229), vaccination following subclinical infection (X = 367) to JUN clinical infection (X =773). It was also found that the mean titer of NT Ab to C#1 did not vary significantly during 2 years of study and was: a) significantly lower than that elicited by wild strains of JUN, both clinical and subclinical infections (p < 0.01); b) significantly increased the titers of pre-existing anti-JUN Ab (p < 0.01); and c) was not modified by pre-existing anti-LCM Ab (p > 0.05). These data indicate that the immune response to C#1 boosts pre-existing immunity to JUN virus and is not changed by previous experience with LCM virus.

  8. Prevalence of genes for enterotoxins, toxic shock syndrome toxin 1 and exfoliative toxin among clinical isolates of Staphylococcus pseudintermedius from canine origin.

    PubMed

    Yoon, Jang W; Lee, Gi-Jong; Lee, So-Young; Park, Chul; Yoo, Jong-Hyun; Park, Hee-Myung

    2010-10-01

    A total of 74 Staphylococcus pseudintermedius strains were isolated from the 99 clinical cases of canine pyoderma or chronic otitis in our veterinary teaching hospital during May 2006-February 2008. In this study, we examined the genetic distribution of staphylococcal pyogenic toxins such as staphylococcal enterotoxins A (sea), B (seb), C (sec), D (sed), E (see), and toxic shock syndrome toxin 1 (tst) as well as the previously characterized S. intermedius exfoliative toxin (siet) among those isolates. The polymerase chain reaction analyses with the toxin gene-specific primers revealed that 18 (24.3%) of 74 S. pseudintermedius isolates carried the sec genes, but none of the sea, seb, sed, see and tst genes. Further DNA sequencing analysis of the amplified sec genes revealed that they all belonged to the canine type C staphylococcal enterotoxin (SEC(canine) ) whose superantigenic activity has been demonstrated. In addition to the sec(canine) genes, our polymerase chain reaction results showed that all the 74 isolates carried the siet gene. Since both SEC(canine) and SIET toxins are known to be biologically active, it would be interesting to investigate how those toxins are involved in the pathogenesis of the canine diseases by S. pseudintermedius such as pyoderma or chronic otitis.

  9. Acute rheumatic fever: a chink in the chain that links the heart to the throat?

    PubMed

    McDonald, Malcolm; Currie, Bart J; Carapetis, Jonathan R

    2004-04-01

    Acute rheumatic fever (ARF) remains a major problem in tropical regions, resource-poor countries, and minority indigenous communities. It has long been thought that group A streptococcal (GAS) pharyngitis alone was responsible for acute rheumatic fever; this belief has been supported by laboratory and epidemiological evidence gathered over more than 60 years, mainly in temperate climates where GAS skin infection is uncommon. GAS strains have been characterised as either rheumatogenic or nephritogenic based on phenotypic and genotypic properties. Primary prevention strategies and vaccine development have long been based on these concepts. The epidemiology of ARF in Aboriginal communities of central and northern Australia challenges this view with reported rates of ARF and rheumatic heart disease (RHD) that are among the highest in the world. GAS throat colonisation is uncommon, however, and symptomatic GAS pharyngitis is rare; pyoderma is the major manifestation of GAS infection. Typical rheumatogenic strains do not occur. Moreover, group C and G streptococci have been shown to exchange key virulence determinants with GAS and are more commonly isolated from the throats of Aboriginal children. We suggest that GAS pyoderma and/or non-GAS infections are driving forces behind ARF in these communities and other high-incidence settings. The question needs to be resolved as a matter of urgency because current approaches to controlling ARF/RHD in Aboriginal communities have clearly been ineffective. New understanding of the pathogenesis of ARF would have an immediate effect on primary prevention strategies and vaccine development. PMID:15050943

  10. Acute rheumatic fever: a chink in the chain that links the heart to the throat?

    PubMed

    McDonald, Malcolm; Currie, Bart J; Carapetis, Jonathan R

    2004-04-01

    Acute rheumatic fever (ARF) remains a major problem in tropical regions, resource-poor countries, and minority indigenous communities. It has long been thought that group A streptococcal (GAS) pharyngitis alone was responsible for acute rheumatic fever; this belief has been supported by laboratory and epidemiological evidence gathered over more than 60 years, mainly in temperate climates where GAS skin infection is uncommon. GAS strains have been characterised as either rheumatogenic or nephritogenic based on phenotypic and genotypic properties. Primary prevention strategies and vaccine development have long been based on these concepts. The epidemiology of ARF in Aboriginal communities of central and northern Australia challenges this view with reported rates of ARF and rheumatic heart disease (RHD) that are among the highest in the world. GAS throat colonisation is uncommon, however, and symptomatic GAS pharyngitis is rare; pyoderma is the major manifestation of GAS infection. Typical rheumatogenic strains do not occur. Moreover, group C and G streptococci have been shown to exchange key virulence determinants with GAS and are more commonly isolated from the throats of Aboriginal children. We suggest that GAS pyoderma and/or non-GAS infections are driving forces behind ARF in these communities and other high-incidence settings. The question needs to be resolved as a matter of urgency because current approaches to controlling ARF/RHD in Aboriginal communities have clearly been ineffective. New understanding of the pathogenesis of ARF would have an immediate effect on primary prevention strategies and vaccine development.

  11. Identification of first exfoliative toxin in Staphylococcus pseudintermedius.

    PubMed

    Futagawa-Saito, Keiko; Makino, Shinichiroh; Sunaga, Fujiko; Kato, Yukio; Sakurai-Komada, Naomi; Ba-Thein, William; Fukuyasu, Tsuguaki

    2009-12-01

    Staphylococcus aureus, Staphylococcus hyicus, and Staphylococcus chromogenes are known to cause skin infections in human or animals by producing exfoliative toxins (ETs). Staphylococcus pseudintermedius can also cause canine pyoderma, but no exfoliative toxins or similar toxins have been reported. PCR with degenerate primers targeted to the conserved regions in ETA, ETB, and ETD from S. aureus and SHETB from S. hyicus, and subsequent chromosome walking identified a novel gene, designated as exi (exfoliative toxin of pseudintermedius) in S. pseudintermedius. EXI had significant homologies with the exfoliative toxins (43-68% identity), particularly with ETB (67.1%), ETD (67.9%), and SHETB (65.1%). Phylogenetic analysis showed close relation between EXI and ETB with a bootstrap value of 80%. Neonatal mice injected with the crude proteins from the culture supernatant or recombinant EXI showed gross blisters and/or characteristic skin exfoliation. The prevalence of exi assessed by dot-blot hybridization was 23.3% (10/43) in S. pseudintermedius isolates from canine pyoderma. The EXI reported herein is the first exfoliative toxin identified in S. pseudintermedius. PMID:19891731

  12. Modeling the interactions between noise exposure and other variables.

    PubMed

    Humes, L E; Jesteadt, W

    1991-07-01

    The interaction of noise exposure with other variables is reviewed. For the case of the interaction of noise with other variables that produce behavioral threshold shifts, the application of a newly developed model is described and demonstrated. This model, referred to as the modified power-law model, provides an accurate prediction of the combined effects of two threshold-elevating factors. The model accounts for the interaction of post-exposure a pre-existing pre-existing permanent loss or a pre-existing temporary loss. The model's application is demonstrated for multiple exposures to steady-state noise in which each exposure lasts as short as 12 min or as long as 6 h. Finally, implications of the model's application to the interaction long as 6 h. Finally, implications of the model's application to the interaction of noise with other ototraumatic agents are reviewed.

  13. Active Region Emergence and Remote Flares

    NASA Astrophysics Data System (ADS)

    Fu, Yixing; Welsch, Brian T.

    2016-02-01

    We study the effect of new emerging solar active regions on the large-scale magnetic environment of existing regions. We first present a theoretical approach to quantify the "interaction energy" between new and pre-existing regions as the difference between i) the summed magnetic energies of their individual potential fields and ii) the energy of their superposed potential fields. We expect that this interaction energy can, depending upon the relative arrangements of newly emerged and pre-existing magnetic flux, indicate the existence of "topological" free magnetic energy in the global coronal field that is independent of any "internal" free magnetic energy due to coronal electric currents flowing within the newly emerged and pre-existing flux systems. We then examine the interaction energy in two well-studied cases of flux emergence, but find that the predicted energetic perturbation is relatively small compared to energies released in large solar flares. Next, we present an observational study of the influence of the emergence of new active regions on flare statistics in pre-existing active regions, using NOAA's Solar Region Summary and GOES flare databases. As part of an effort to precisely determine the emergence time of active regions in a large event sample, we find that emergence in about half of these regions exhibits a two-stage behavior, with an initial gradual phase followed by a more rapid phase. Regarding flaring, we find that the emergence of new regions is associated with a significant increase in the occurrence rate of X- and M-class flares in pre-existing regions. This effect tends to be more significant when pre-existing and new emerging active regions are closer. Given the relative weakness of the interaction energy, this effect suggests that perturbations in the large-scale magnetic field, such as topology changes invoked in the "breakout" model of coronal mass ejections, might play a significant role in the occurrence of some flares.

  14. Deep homology and the origins of evolutionary novelty.

    PubMed

    Shubin, Neil; Tabin, Cliff; Carroll, Sean

    2009-02-12

    Do new anatomical structures arise de novo, or do they evolve from pre-existing structures? Advances in developmental genetics, palaeontology and evolutionary developmental biology have recently shed light on the origins of some of the structures that most intrigued Charles Darwin, including animal eyes, tetrapod limbs and giant beetle horns. In each case, structures arose by the modification of pre-existing genetic regulatory circuits established in early metazoans. The deep homology of generative processes and cell-type specification mechanisms in animal development has provided the foundation for the independent evolution of a great variety of structures.

  15. Cryptic magnetic fabric of tectonic origin revealed by heating of sedimentary samples from the Corbières, France

    NASA Astrophysics Data System (ADS)

    Souque, Christine; Robion, Philippe; Frizon de Lamotte, Dominique

    It is largely recognized that heating enhances magnetic signal and that this is probably due to crystallization in a pre-existing petrofabric. This paper presents an example where heating not only enhances the magnetic fabric, but reveals a primary tectonic fabric overprinted by a late crystallization. We focus on a site of red Paleocene silts from the Lagrasse area (Aude, France), which exhibits, in two superimposed beds, primary (due to layer parallel shortening) and secondary (due to late crystallization) fabrics. Partial anisotropy of anhysteretic remanent magnetization and magnetic mineralogy investigations led us to consider that heating allows the growth of oxides, enhancing a cryptic pre-existing fabric.

  16. Pediatric novice nurses: examining compassion fatigue as a mediator between stress exposure and compassion satisfaction, burnout, and job satisfaction.

    PubMed

    Meyer, Rika M L; Li, Angela; Klaristenfeld, Jessica; Gold, Jeffrey I

    2015-01-01

    We investigated whether compassion fatigue mediated associations between nurse stress exposure and job satisfaction, compassion satisfaction, and burnout, controlling for pre-existing stress. The Life Events Checklist was administered to 251 novice pediatric nurses at the start of the nurse residency program (baseline) and 3 months after to assess pre-existing and current stress exposure. Compassion satisfaction, compassion fatigue, and burnout were assessed 3 months after baseline and job satisfaction 6 months after. Stress exposure significantly predicted lower compassion satisfaction and more burnout. Compassion fatigue partially mediated these associations. Results demonstrate a need for hospitals to prevent compassion fatigue in healthcare providers.

  17. Synergy of inelastic and elastic energy loss. Temperature effects and electronic stopping power dependence

    SciTech Connect

    Zarkadoula, Eva; Xue, Haizhou; Zhang, Yanwen; Weber, William J.

    2015-06-16

    A combination of an inelastic thermal spike model suitable for insulators and molecular dynamics simulations is used to study the effects of temperature and electronic energy loss on ion track formation, size and morphology in SrTiO3 systems with pre-existing disorder. We find temperature dependence of the ion track size. In addition, we find a threshold in the electronic energy loss for a given pre-existing defect concentration, which indicates a threshold in the synergy between the inelastic and elastic energy loss.

  18. Synergy of inelastic and elastic energy loss. Temperature effects and electronic stopping power dependence

    DOE PAGESBeta

    Zarkadoula, Eva; Xue, Haizhou; Zhang, Yanwen; Weber, William J.

    2015-06-16

    A combination of an inelastic thermal spike model suitable for insulators and molecular dynamics simulations is used to study the effects of temperature and electronic energy loss on ion track formation, size and morphology in SrTiO3 systems with pre-existing disorder. We find temperature dependence of the ion track size. In addition, we find a threshold in the electronic energy loss for a given pre-existing defect concentration, which indicates a threshold in the synergy between the inelastic and elastic energy loss.

  19. The experience of hepatitis C treatment for people with a history of mental health problems: An interpretative phenomenological analysis.

    PubMed

    Ware, K; Davies, J; Rowse, G; Whittaker, S

    2015-07-01

    This qualitative study explores the experience of hepatitis C virus treatment for people with pre-existing mental health problems within a large city hospital. Four men and four women with pre-existing mental health problems who had received hepatitis C virus treatment took part in semi-structured interviews which were analysed using interpretative phenomenological analysis. A central theme of 'Self, stigma and change' was identified which interlinked with three other main themes of 'Coping and responding to treatment', 'Connectedness to others' and 'The impact of information'. These themes and their sub-themes are discussed in relation to existing literature and clinical practice guidelines.

  20. Acute Bilateral Internal Carotid Occlusion from Embolization of Left Atrial Thrombus During Transesophageal Echocardiography: Case Report

    PubMed Central

    Mahmood, Syed Saad; Manjila, Sunil; Singh, Gagandeep; Xavier, Andrew R

    2016-01-01

    Background and purpose: Transesophageal echocardiography (TEE) is a relatively safe imaging modality used to visualize intracardiac thrombus. Summary of case: We report on a unique, fatal complication during TEE of embolization of a pre-existing “smoking” left atrial thrombus causing acute bilateral internal carotid occlusion, confirmed on angiogram. Conclusions: Patients with history of lung pathology, such as COPD, who experience retching and cough during transesophageal echocardiography may be more susceptible to embolization of pre-existing thrombi. A need exists to risk stratify such patients. PMID:27403219

  1. Shock wave interaction with turbulence: Pseudospectral simulations

    SciTech Connect

    Buckingham, A.C.

    1986-12-30

    Shock waves amplify pre-existing turbulence. Shock tube and shock wave boundary layer interaction experiments provide qualitative confirmation. However, shock pressure, temperature, and rapid transit complicate direct measurement. Computational simulations supplement the experimental data base and help isolate the mechanisms responsible. Simulations and experiments, particularly under reflected shock wave conditions, significantly influence material mixing. In these pseudospectral Navier-Stokes simulations the shock wave is treated as either a moving (tracked or fitted) domain boundary. The simulations assist development of code mix models. Shock Mach number and pre-existing turbulence intensity initially emerge as key parameters. 20 refs., 8 figs.

  2. [Hematogenous metastases of benign pleomorphic adenomas of the salivary glands (author's transl)].

    PubMed

    Heckmayr, M; Seifert, G

    1977-01-01

    Hematogenous metastases of benign pleomorphic adenomas are exceptionally rare. In three secure reports of the world literature metastases occurred in lung, liver or bone after operation of a benign pleomorphic adenoma with the greatest interval of twenty-two years between operation and metastases. This will be interpreted as implantation-metastases. All other observations represented secondary carcinomas in pre-existing pleomorphic adenomas. The morphological criterias of an accurate classification are explained. A number of reports of the literature about metastases of benign pleomorphic adenomas deals with misinterpretations of secondary adenomas in pre-existing pleomorphic adenomas.

  3. Haemolytic uraemic syndrome associated with Pseudomonas aeruginosa sepsis.

    PubMed

    Narayanan, Parameswaran; Rustagi, Rashi S; Sivaprakasam, Prabha; Subramanian, Mahadevan; Parameswaran, Sreejith; Mandal, Jharna; Kaplan, B S

    2013-11-01

    Haemolytic uraemic syndrome (HUS) is a recognized complication of infection with Shiga toxin-producing Escherichia coli (STEC) and Shigella dysenteriae type 1. Infections with other micro-organisms, especially Streptococcus pneumoniae, have been cited as causes of HUS. In addition, influenza virus and other viruses may rarely be associated with this syndrome. A 2-year-old girl presented with severe Pseudomonas aeruginosa sepsis with renal failure and ecthyma gangrenosum. Further investigations revealed features of HUS. She was managed with antibiotics and other supportive measures including peritoneal dialysis, and subsequently made a full recovery. A possible role of neuraminidase in the pathogenesis of P. aeruginosa-associated HUS was proposed. This is the first reported case of P. aeruginosa sepsis leading to HUS.

  4. 40 CFR 434.74 - Effluent limitations attainable by application of the best conventional pollutant control...

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... technology (BCT). Except as provided in 40 CFR 125.30 through 125.32 and 434.72(b)(2), a pre-existing... application of the best conventional pollutant control technology (BCT). 434.74 Section 434.74 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS (CONTINUED)...

  5. Parallels between Adolescents' Conception of Gases and the History of Chemistry.

    ERIC Educational Resources Information Center

    Mas, Carlos J. Furio; And Others

    1987-01-01

    Discusses the need to consider students' pre-existing conceptual schemes when teaching chemistry. Reports on a study done in Spain which indicates that the existence of adolescents preconceptions about gases is important to consider when teaching the principles of conservation of substance, mass, and weight. (TW)

  6. Cellular differentiation: the violin strikes up another tune.

    PubMed

    Cook, Michael A; Tyers, Mike

    2004-01-01

    A switch in cellular identity in budding yeast requires the ubiquitin-dependent elimination of pre-existing master regulators encoded by the MAT locus. Failure to disassemble the prior state not only impairs the cell type transition but imparts a hybrid cellular fate. This theme will undoubtedly arise in many developmental and disease contexts. PMID:14711426

  7. The Thurgood Marshall School of Law Empirical Findings: A Report of the Statistical Analysis of the July 2010 TMSL Texas Bar Results

    ERIC Educational Resources Information Center

    Kadhi, Tau; Holley, D.

    2010-01-01

    The following report gives the statistical findings of the July 2010 TMSL Bar results. Procedures: Data is pre-existing and was given to the Evaluator by email from the Registrar and Dean. Statistical analyses were run using SPSS 17 to address the following research questions: 1. What are the statistical descriptors of the July 2010 overall TMSL…

  8. The Thurgood Marshall School of Law Empirical Findings: A Report of the Statistical Analysis of the February 2010 TMSL Texas Bar Results

    ERIC Educational Resources Information Center

    Kadhi, T.; Holley, D.; Rudley, D.; Garrison, P.; Green, T.

    2010-01-01

    The following report gives the statistical findings of the 2010 Thurgood Marshall School of Law (TMSL) Texas Bar results. This data was pre-existing and was given to the Evaluator by email from the Dean. Then, in-depth statistical analyses were run using the SPSS 17 to address the following questions: 1. What are the statistical descriptors of the…

  9. The Thurgood Marshall School of Law Empirical Findings: A Report of the Relationship between Graduate GPAs and First-Time Texas Bar Scores of February 2010 and July 2009

    ERIC Educational Resources Information Center

    Kadhi, T.; Holley, D.; Palasota, A.

    2010-01-01

    The following report gives descriptive and correlational statistical findings of the Grade Point Averages (GPAs) of the February 2010 and July 2009 TMSL First Time Texas Bar Test Takers to their TMSL Final GPA. Data was pre-existing and was given to the Evaluator by email from the Dean and Registrar. Statistical analyses were run using SPSS 17 to…

  10. Febrile Seizures and Behavioural and Cognitive Outcomes in Preschool Children: An Old Issue Revisited

    ERIC Educational Resources Information Center

    Deonna, Thierry

    2012-01-01

    The possible deleterious role of febrile seizures on development is an old issue. It took a long time to realize that impaired development or occurrence of chronic epilepsy affected a very small minority of children with febrile seizures. These children either had pre-existing brain damage, specific genetic epileptic conditions, or seizure-induced…

  11. Parents and Instruction. The Clipboard Connection. Chapter I Resource Center Curriculum and Instruction.

    ERIC Educational Resources Information Center

    Advanced Technology, Inc., Indianapolis, IN.

    The "Clipboard Connection" is a methodology to facilitate the rapid circulation of relevant pre-existing materials from Chapter 1 Technical Assistance Centers (TACs) to their clients, teachers of educationally disadvantaged children in resource centers. Each "Clipboard Connection" consists of a lead sheet summarizing the contents of the materials…

  12. 48 CFR 5231.205-90 - Shipbuilding capability preservation agreements.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... determining whether such a modification is appropriate, the Navy will consider factors such as the impact of... Navy, the impact of pre-existing private sector work on the cost benefit that would be received by the... authority. The contractor should also provide an informational copy of any such request to the...

  13. Damaged Goods: Exploring Predictors of Distress in Prison Inmates

    ERIC Educational Resources Information Center

    Hochstetler, Andy; Murphy, Daniel S.; Simons, Ronald L.

    2004-01-01

    Victimization is a significant part of the incarceration experience. In this study, we assessed the effects of victimization while incarcerated and pre-existing conditions on prisoners' distress. Data are drawn from surveys administered to 208 men recently released from prison. Using path analysis, we examined the direct effects of victimization…

  14. 76 FR 17801 - Approval and Promulgation of Implementation Plans; New York Reasonable Further Progress Plans...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-31

    ... individuals with a pre-existing respiratory disease, such as asthma. On April 30, 2004 (69 FR 23951), EPA... Poughkeepsie nonattainment area is composed of Dutchess, Orange and Putnam counties. On March 25, 2008 (73 FR... implementation rule, published on April 30, 2004 (69 FR 23951) and referred to as the Phase 1 Rule,...

  15. Fatal diphenhydramine poisoning in a dog

    PubMed Central

    Buchweitz, John P.; Raverty, Stephen A.; Johnson, Margaret B.; Lehner, Andreas F.

    2014-01-01

    We report a fatal diphenhydramine poisoning of a 10-year-old, male poodle-cross dog with pre-existing conditions and suspected co-ingestion of ethanol. This case illustrates that diphenhydramine overdose can be fatal in certain circumstances and that analytical toxicology may play an important role in animal death investigations. PMID:25392554

  16. The Vienna Frailty Questionnaire for Persons with Intellectual Disabilities--Revised

    ERIC Educational Resources Information Center

    Brehmer-Rinderer, Barbara; Zeilinger, Elisabeth Lucia; Radaljevic, Ana; Weber, Germain

    2013-01-01

    Frailty is a theoretical concept used to track individual age-related declines. Persons with intellectual disabilities (ID) often present with pre-existing deficits that would be considered frailty markers in the general population. The previously developed Vienna Frailty Questionnaire for Persons with ID (VFQ-ID) was aimed at assessing frailty in…

  17. Counseling Centers as the Sole Agency for Student Mental Health Services: Issues and Implementation

    ERIC Educational Resources Information Center

    Crego, Clyde A.; Wendland, Marilyn M.

    1974-01-01

    Changing models for providing broad-based mental health coverage emanating from consolidating pre-existing services are discussed in relation to service, staff change, and organizational issues. These include issues internal to the counseling center itself and issues related to its external relations with other university components. (Author)

  18. 78 FR 21302 - Approval and Promulgation of Implementation Plans; New York State Ozone Implementation Plan Revision

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-10

    ... outdoors, and individuals with a pre-existing respiratory disease, such as asthma. On April 30, 2004 (69 FR... a requirement to submit a demonstration of attainment. EPA notes that on December 7, 2009 (74 FR..., 2008 (73 FR 15672) EPA determined that Jefferson County attained the 8-hour ozone standard. On June...

  19. Investigations of severe/tornadic thunderstorm development and evolution based on satellite and AVE/SESAME/VAS data

    NASA Technical Reports Server (NTRS)

    Vonderhaar, T. H.; Purdom, J. F. W.

    1984-01-01

    The use of rapid scan satellite imagery to investigate the local environment of severe thunderstorms is discussed. Mesoscale cloud tracking and vertical wind shear as it affects thunderstorm relative flow are mentioned. The role of pre-existing low level cloud cover in the outbreak of tornadoes was investigated. Applying visible atmospheric sounding imagery to mesoscale phenomena is also addressed.

  20. An Exploration of Transformational Learning in Adults as a Result of Adventure Travel Experiences

    ERIC Educational Resources Information Center

    Bennett, Michael

    2013-01-01

    The purpose of this exploratory qualitative research study was to identify the elements of adventure travel experiences that contribute to the process of transformational learning in adults. A qualitative research design was employed for this study. The sources of data were twelve pre-existing and de-identified interview transcriptions. A textual…

  1. Placement Year Academic Benefit Revisited: Effects of Demographics, Prior Achievement and Degree Programme

    ERIC Educational Resources Information Center

    Reddy, Peter; Moores, Elisabeth

    2012-01-01

    Investigations of whether students taking undergraduate work placements show greater academic improvement than those who do not have shown inconsistent results. In most studies, sample sizes have been relatively small and few studies have taken into account pre-existing student differences. Here data from over 6000 students at one university over…

  2. Atrial Fibrillation in Acute St-Elevation Myocardial Infarction: Clinical and Prognostic Features

    PubMed Central

    Gorenek, Bulent; Kudaiberdieva, Gulmira

    2012-01-01

    Atrial fibrillation (AF) is a common arrhythmia in the setting of acute coronary syndrome and acute ST-elevation myocardial infarction (STEMI). This review summarizes recent evidence on the clinical and prognostic significance of pre-existent and new-onset AF in acute STEMI patients and highlights new emerging predictors of AF development in the era of contemporary treatment. PMID:22920476

  3. 78 FR 37676 - Federal Acquisition Regulation; System for Award Management Name Change, Phase 1 Implementation

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-21

    ... (ORCA), and Excluded Parties List System (EPLS) databases into the System for Award Management (SAM) database. DATES: Effective Date: July 22, 2013. FOR FURTHER INFORMATION CONTACT: Mr. Curtis E. Glover, Sr... database. Upon implementation, the pre- existing applications were retired, and all requirements for...

  4. 40 CFR 434.73 - Effluent limitations attainable by application of the best available technology economically...

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... achievable (BAT). Except as provided in 40 CFR 125.30 through 125.32 and 434.72(b)(2), a pre-existing... application of the best available technology economically achievable (BAT). 434.73 Section 434.73 Protection... MINING POINT SOURCE CATEGORY BPT, BAT, BCT LIMITATIONS AND NEW SOURCE PERFORMANCE STANDARDS Coal...

  5. 40 CFR 434.73 - Effluent limitations attainable by application of the best available technology economically...

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... achievable (BAT). Except as provided in 40 CFR 125.30 through 125.32 and 434.72(b)(2), a pre-existing... application of the best available technology economically achievable (BAT). 434.73 Section 434.73 Protection... MINING POINT SOURCE CATEGORY BPT, BAT, BCT LIMITATIONS AND NEW SOURCE PERFORMANCE STANDARDS Coal...

  6. 40 CFR 434.74 - Effluent limitations attainable by application of the best conventional pollutant control...

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Effluent limitations attainable by application of the best conventional pollutant control technology (BCT). Except as provided in 40 CFR 125.30 through 125.32 and 434.72(b)(2), a pre-existing discharge must comply... application of the best conventional pollutant control technology (BCT). 434.74 Section 434.74 Protection...

  7. On the origins of near-surface stresses in silicon around Cu-filled and CNT-filled through silicon vias

    NASA Astrophysics Data System (ADS)

    Zhu, Ye; Ghosh, Kaushik; Li, Hong Yu; Lin, Yiheng; Tan, Chuan Seng; (Maggie Xia, Guangrui

    2016-05-01

    Micro-Raman spectroscopy was employed to study the near-surface stress distributions and origins in Si around through silicon vias (TSVs) at both room temperature and elevated temperatures for Cu-filled and carbon nanotube (CNT)-filled TSV samples. From observations, we proved that the stresses near TSVs are mainly from two sources: (1) pre-existing stress before via filling, and (2) coefficients of thermal expansion (CTE) mismatch-induced stress. CTE-mismatch-induced stress is shown to dominate the compressive regime of the near-surface stress distribution around the two types of Cu-filled TSV structures in this work and in previous work, while pre-existing stress dominates the full range of the stress distribution in the CNT-filled TSV structures studied. These results show the importance of the pre-existing stress and support the use of a liner technology with lower stress introduction such as deposited oxide instead of thermal oxide. It is specifically important for CNT-filled TSVs, where the pre-existing stress is much larger than the CTE-mismatch-induced stress as observed in this work.

  8. DIFFERENTIAL CARDIAC SUSCEPTIBILITY OF WISTAR KYOTO (WKY) AND SPONTANEOUSLY HYPERTENSIVE RATS (SHR) TO DIESEL EXHAUST EXPOSURE

    EPA Science Inventory

    Exposure to diesel exhaust particles (DEP) is linked to increases in cardiovascular effects. This is enhanced in individuals with pre-existing disease. Animal models of cardiovascular disease are used to study this susceptibility. The heart is rich in mitochondria, which produce ...

  9. Math Notes. The Clipboard Connection. Chapter I Resource Center Curriculum and Instruction.

    ERIC Educational Resources Information Center

    Advanced Technology, Inc., Indianapolis, IN.

    The "Clipboard Connection" is a methodology to facilitate the rapid circulation of relevant pre-existing materials from Chapter 1 Technical Assistance Centers of relevant materials from Chapter 1 Technical Assistance Centers (TACs) to their clients, teachers of educationally disadvantaged children in resource centers. Each "Clipboard Connection"…

  10. Products Available. The Clipboard Connection. Chapter I Resource Center Curriculum and Instruction.

    ERIC Educational Resources Information Center

    Advanced Technology, Inc., Indianapolis, IN.

    The "Clipboard Connection" is a methodology to facilitate the rapid circulation of relevant pre-existing materials from Chapter 1 Technical Assistance Centers (TACs) to their clients, teachers of educationally disadvantaged children in resource centers. Each "Clipboard Connection" consists of a lead sheet summarizing the contents of the materials…

  11. The Reading Writing Connection. The Clipboard Connection. Chapter I Resource Center Curriculum and Instruction.

    ERIC Educational Resources Information Center

    Advanced Technology, Inc., Indianapolis, IN.

    The "Clipboard Connection" is a methodology to facilitate the rapid circulation of relevant pre-existing materials from Chapter 1 Technical Assistance Centers (TACs) to their clients, teachers of educationally disadvantaged children in resource centers. Each "Clipboard Connection" consists of a lead sheet summarizing the contents of the materials…

  12. Evaluation of an S.D.I. System Based on "Nuclear Science Abstracts" and the Performance of Matching by Words in Titles Compared With Indexing Terms.

    ERIC Educational Resources Information Center

    Olive, G.; And Others

    A selective dissemination of information service based on computer scanning of Nuclear Science Abstracts tapes has operated at the Atomic Energy Research Establishment, Harwell, England since October, 1968. The performance of the mechanized SDI service has been compared with that of the pre-existing current awareness service which is based on…

  13. [Diabetes mellitus, coronary artery disease and heart disease].

    PubMed

    Clodi, Martin; Säly, Christoph; Hoppichler, Friedrich; Resl, Michael; Steinwender, Clemens; Eber, Bernd

    2016-04-01

    Diabetes mellitus, cardiovascular disease and heart failure are interacting dynamically. Patients being diagnosed with cardiovascular disease should be screened for diabetes mellitus. Enhanced cardiovascular risk stratification based on biomarkers, symptoms and classical risk factors should be performed in patients with pre-existing diabetes mellitus. PMID:27052249

  14. Ode to Sparklepony: Gamification in Action

    ERIC Educational Resources Information Center

    Sierra, Wendi; Stedman, Kyle D.

    2012-01-01

    Games are becoming increasingly prevalent in education, both in traditional school settings and beyond. In this Disputatio webtext, we look specifically at one application of games for pedagogical use: gamification. Rather than introducing a pre-existing game into the learning spaces, gamification adds elements of games into educational (or other)…

  15. Psychological Adjustment and Levels of Self Esteem in Children with Visual-Motor Integration Difficulties Influences the Results of a Randomized Intervention Trial

    ERIC Educational Resources Information Center

    Lahav, Orit; Apter, Alan; Ratzon, Navah Z.

    2013-01-01

    This study evaluates how much the effects of intervention programs are influenced by pre-existing psychological adjustment and self-esteem levels in kindergarten and first grade children with poor visual-motor integration skills, from low socioeconomic backgrounds. One hundred and sixteen mainstream kindergarten and first-grade children, from low…

  16. Fatal diphenhydramine poisoning in a dog.

    PubMed

    Buchweitz, John P; Raverty, Stephen A; Johnson, Margaret B; Lehner, Andreas F

    2014-11-01

    We report a fatal diphenhydramine poisoning of a 10-year-old, male poodle-cross dog with pre-existing conditions and suspected co-ingestion of ethanol. This case illustrates that diphenhydramine overdose can be fatal in certain circumstances and that analytical toxicology may play an important role in animal death investigations.

  17. 77 FR 56775 - Approval and Promulgation of Implementation Plans; California; Determinations of Attainment for...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-09-14

    ... outdoors, and individuals with a pre-existing respiratory disease, such as asthma. On March 27, 2008 (73 FR 16436), EPA promulgated a revised 8-hour ozone NAAQS of 0.075 ppm. On April 30, 2012 (77 FR 30088 and 77 FR 30160), EPA issued final rules addressing air quality designations and implementation of the...

  18. 76 FR 77178 - Approval and Promulgation of Implementation Plans; New York State Ozone Implementation Plan Revision

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-12

    ... individuals with a pre-existing respiratory disease, such as asthma. On April 30, 2004 (69 FR 23858), EPA... Poughkeepsie nonattainment area is composed of Dutchess, Orange and Putnam counties. On December 7, 2009 (74 FR 63993), EPA determined that the Poughkeepsie area attained the 8-hour ozone standard and on March...

  19. 77 FR 35163 - Systems for Telephonic Notification of Unsafe Conditions at Highway-Rail and Pathway Grade Crossings

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-12

    ... (NPRM) published March 4, 2011 (76 FR 11992). To a certain extent, this rule also builds on pre-existing... an earlier awareness of potential track obstructions, crossing signal malfunctions, and other safety... or pathway grade crossing.'' 76 FR 11992, 12009 (March 4, 2011). The CPUC recommended that all...

  20. The Capacity for Music: What Is It, and What's Special about It?

    ERIC Educational Resources Information Center

    Jackendoff, Ray; Lerdahl, Fred

    2006-01-01

    We explore the capacity for music in terms of five questions: (1) What cognitive structures are invoked by music? (2) What are the principles that create these structures? (3) How do listeners acquire these principles? (4) What pre-existing resources make such acquisition possible? (5) Which aspects of these resources are specific to music, and…

  1. 45 CFR 152.32 - Use of funds.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES REQUIREMENTS RELATING TO HEALTH CARE ACCESS PRE-EXISTING CONDITION INSURANCE PLAN PROGRAM Funding § 152.32 Use of funds. (a) Limitation on use of funding. All funds awarded... administrative costs incurred in the development and operation of the PCIP that are in excess of the amounts...

  2. 26 CFR 1.7704-2 - Transition provisions.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... processing activities, require different types of operating assets, are not commonly conducted at the same... two types of activities generally require different operating assets and earn income from different... of the pre-existing business. (iii) The activity is of a type that is normally conducted in the...

  3. 26 CFR 1.7704-2 - Transition provisions.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... processing activities, require different types of operating assets, are not commonly conducted at the same... two types of activities generally require different operating assets and earn income from different... of the pre-existing business. (iii) The activity is of a type that is normally conducted in the...

  4. From Representation to Emergence: Complexity's Challenge to the Epistemology of Schooling

    ERIC Educational Resources Information Center

    Osberg, Deborah; Biesta, Gert; Cilliers, Paul

    2008-01-01

    In modern, Western societies the purpose of schooling is to ensure that school-goers acquire knowledge of pre-existing practices, events, entities and so on. The knowledge that is learned is then tested to see if the learner has acquired a correct or adequate understanding of it. For this reason, it can be argued that schooling is organised around…

  5. Foundation: Transforming data bases into knowledge bases

    NASA Technical Reports Server (NTRS)

    Purves, R. B.; Carnes, James R.; Cutts, Dannie E.

    1987-01-01

    One approach to transforming information stored in relational data bases into knowledge based representations and back again is described. This system, called Foundation, allows knowledge bases to take advantage of vast amounts of pre-existing data. A benefit of this approach is inspection, and even population, of data bases through an intelligent knowledge-based front-end.

  6. Understanding Narratives of Nationhood: Film-Makers and Culloden

    ERIC Educational Resources Information Center

    Gold, John R.; Gold, Margaret M.

    2002-01-01

    Film audiences have long been invited to view Scotland and Scottish life through a historic lens. Influenced by the pre-existing literary traditions of tartanry and kailyard, film-makers have focused nostalgically on the myths and legends of the Highland and pre-industrial Scotland, with the implications that this approach has for representations…

  7. 12 CFR 222.21 - Affiliate marketing opt-out and exceptions.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... solicitation for marketing purposes to a consumer with whom you have a pre-existing business relationship; (2... 12 Banks and Banking 3 2010-01-01 2010-01-01 false Affiliate marketing opt-out and exceptions. 222... FEDERAL RESERVE SYSTEM FAIR CREDIT REPORTING (REGULATION V) Affiliate Marketing § 222.21...

  8. 45 CFR 152.2 - Definitions.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... Public Health Service Act as of March 23, 2010 and 45 CFR 146.113(a)(1). Enrollee means an individual... authorization; (iii) Aliens who have been granted employment authorization under 8 CFR 274a.12(c)(9), (10), (16... CFR 144.103. Pre-Existing Condition Insurance Plan (PCIP) means the temporary high risk...

  9. 3 CFR 8929 - Proclamation 8929 of January 31, 2013. American Heart Month, 2013

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... pressure, diabetes, poor diet, obesity, tobacco use, and physical inactivity. Any one of them can lead to... blood pressure screening and obesity screening at no out-of-pocket cost to the patient. In 2014, a new..., and children—including those with pre-existing conditions. We are also working to prevent...

  10. Teaching Ideas. The Clipboard Connection. Chapter I Resource Center Curriculum and Instruction.

    ERIC Educational Resources Information Center

    Advanced Technology, Inc., Indianapolis, IN.

    The "Clipboard Connection" is a methodology to facilitate the rapid circulation of relevant pre-existing materials from Chapter 1 Technical Assistance Centers (TACs) to their clients, teachers of educationally disadvantaged children in resource centers. Each "Clipboard Connection" consists of a lead sheet summarizing the contents of the materials…

  11. Common Sense Computing (Episode 4): Debugging

    ERIC Educational Resources Information Center

    Simon, Beth; Bouvier, Dennis; Chen, Tzu-Yi; Lewandowski, Gary; McCartney, Robert; Sanders, Kate

    2008-01-01

    We report on responses to a series of four questions designed to identify pre-existing abilities related to debugging and troubleshooting experiences of novice students before they begin programming instruction. The focus of these questions include general troubleshooting, bug location, exploring unfamiliar environments, and describing students'…

  12. Creating Significant Learning Experiences: A Case Study in the College Religion Classroom

    ERIC Educational Resources Information Center

    Jones, Jennifer L.; St. Hilaire, Robert

    2012-01-01

    In a domain historically dominated by student passivity, instruction that entices students to integrate and assimilate new content into their pre-existing cognitive schema is a new but necessary shift from the traditional teaching paradigm. No longer is college teaching primarily focused on quantity of information, but rather the quality of…

  13. Locating Differential Effectiveness of a STEM Initiative through Exploration of Moderators

    ERIC Educational Resources Information Center

    Newman, Denis; Ma, Boya; Jaciw, Andrew

    2012-01-01

    In randomized control trials, such as the one the authors conducted in Alabama, moderators are potentially an important source of variation in treatment effects. Whether moderators used in the RCT's analysis are pre-existing characteristics of students, their teachers, or the school or other organizational context, they can point toward…

  14. An Empirical Study of Presage Variables in the Teaching-Learning of Statistics, in the Light of Research on Competencies

    ERIC Educational Resources Information Center

    Rodriguez, Clemente; Gutierrez-Perez, Jose; Pozo, Teresa

    2010-01-01

    Introduction: This research seeks to determine the influence exercised by a set of presage and process variables (students' pre-existing opinion towards statistics, their dedication to mastery of statistics content, assessment of the teaching materials, and the teacher's effort in the teaching of statistics) in students' resolution of activities…

  15. Predictors of Funded Scholarly Activity at 4-Year, Non-Doctoral Colleges and Universities

    ERIC Educational Resources Information Center

    Edwards, Maria Montoro

    2010-01-01

    This study seeks to develop a model of institutional supports necessary for faculty to succeed as funded scholars at 4-year non-doctoral colleges and universities. Research was conducted using secondary data analysis on a pre-existing, cross-sectional database from the 2004 National Study of Postsecondary Faculty. Expectancy theory was used as the…

  16. Pre-Gas Drilling Drinking Water Testing--An Educational Opportunity for Extension

    ERIC Educational Resources Information Center

    Swistock, Brian; Clark, James

    2015-01-01

    The increase in shale gas drilling in Pennsylvania has resulted in thousands of landowners receiving predrilling testing of their drinking water. Landowners often have difficulty understanding test reports resulting in low awareness of pre-existing problems. Extension and several partners developed a program to improve understanding of…

  17. 76 FR 57691 - Approval and Promulgation of Implementation Plans; New Jersey; Motor Vehicle Enhanced Inspection...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-16

    ... individuals with a pre-existing respiratory disease, such as asthma. On April 30, 2004 (69 FR 23951), EPA... Maintenance Program Requirements Incorporating the On-Board Diagnostics Check'' (66 FR 18156). The revised I/M... do'' (66 FR 18159). EPA's final rule identifies factors that may serve as a possible...

  18. The use of home-based therapy with ready-to-use therapeutic food to treat malnutrition in a rural area during a food crisis

    Technology Transfer Automated Retrieval System (TEKTRAN)

    When the international community declared a famine in Malawi in January 2006, emergency food aid reached only populations with pre-existing health care services. To treat the widespread childhood malnutrition in Machinga district, a rural area lacking health care facilities, in February 2006 five ou...

  19. The Effect of the Student Success Skills Small Group Counseling Intervention on Factors Associated with Dropout Potential in High School

    ERIC Educational Resources Information Center

    Weinstein, Jodie

    2013-01-01

    The focus of this study is to add to the outcome research on effective school counseling interventions and to specifically evaluate the effectiveness of the Student Success Skills (SSS) small group intervention with students identified as having drop out potential in the 9th grade. This study analyzed two years of pre-existing, non-identifiable…

  20. Simple Things Matter! How Reassurance and Pain Management Strategies Can Improve Outcomes in Physiotherapy: A Case Report

    ERIC Educational Resources Information Center

    Leonard, Guillaume; Tousignant-Laflamme, Yannick; Mercier, Catherine

    2013-01-01

    Psychological barriers to rehabilitation are generally viewed as pre-existing patient traits that clinicians are asked to evaluate and modify. In the present case report, we provide evidence that these barriers can also be involuntarily created or perpetuated by the clinician himself when too much attention is placed on physical abnormalities.…