EBI2 expression is associated with B cell inflammation in human sinuses (120.35)

Epstein-Barr virus-induced G-protein coupled receptor 2 (EBI2) is important for the migration of B cells and induction of extrafollicular plasma cells within secondary lymphoid tissues. Recent studies from our group have demonstrated that many molecules associated with B cell survival and plasma cell differentiation (e.g. BAFF and immunoglobulins) were elevated in nasal polyps from patients with chronic rhinosinusitis (CRS). To investigate whether B cells or EBI2 played a role in CRS pathogenesis, expression of B cell- and EBI2-related genes in nasal tissue from normal controls and CRS patients with (CRSwNP) or without (CRSsNP) nasal polyps was assessed. EBI2 mRNA was quantitated by qRT-PCR, EBI2 protein was measured by western blot, and B cell subsets were characterized by flow cytometry. Expression of EBI2 mRNA was significantly elevated in polyp tissue (p<0.001) and correlated with mRNA expression of CD20 (r=0.71; p<0.0001) and CH25H, an enzyme responsible for production of an EBI2 ligand (r=0.65; p<0.001). EBI2 protein was also elevated in polyps (p<0.01, n=10). In addition, B cells (CD20+) and plasma cells (CD138+) were significantly elevated in polyps compared to nasal tissue from normal controls (p<0.05). Collectively, these data suggest that elevated EBI2 may facilitate B cell migration and differentiation in the nasal mucosa, especially nasal polyps. These findings provide new insights into the pathogenesis of CRS and may indicate potential new therapeutic targets.

Leucocyte subpopulations in the seminal plasma and their effects on fertilisation rates in an IVF cycle

Controversy exists on the role of leucocytospermia on fertilisation rates and IVF outcomes. The aim of our study was to identify the effect of leucocytes and leucocyte subpopulations on fertilisation rates in an IVF cycle. A prospective comparative study of the leucocyte subpopulations of seminal fluid of partners of women attending an IVF cycle was conducted. The samples underwent immunocytochemical staining. The monoclonal antibodies used in this study include CD3, CD4, CD8 (T Cells), CD14 (monocytes/macrophages), CD16 (granulocytes), CD20 (B Cells), CD45 (Pan Leucocytes), CD56 (natural killer cells) and CD69 (activated T and B Cells). Of 21 patients who were recruited into the study, seven were identified as poor fertilisers (<35%) and 14 were identified as good fertilisers (>60%). Data were analysed with SPSS version 14. The total leucocyte counts (CD45) between the poor and good fertilisers were not statistically significant. The macrophages and the monocytes (CD14) were significantly elevated in the good fertilisers group in comparison with the poor fertilisers (P < 0.05). We also found that T cells (CD2, CD4, CD8) and CD14 (macrophages) correlated significantly (r = 0.47, P value < 0.01) with the fertilisation rate. Our study confirms that the presence of leucocytes does not adversely affect the fertilisation rates and the outcome of an IVF cycle. However, macrophages and the monocytes (CD14) were significantly elevated in the good fertilisers group. The increased phagocytic activity in these individuals might increase their fertilising potential by removing spermatozoa with abnormal morphology.

Abnormal radiological features in a multiple myeloma patient: a case report and radiological review of myelomas

Multiple myeloma is the prototype of malignant monoclonal gammopathies. The most common skeletal sites are pelvis, skull, spine, ribs and femoral and humeral shafts. The classic radiographic presentation of multiple myeloma is lytic skeletal lesions. Other types of presentation include sclerotic and porotic changes. Primary sclerotic manifestations are rare and occur in only 3% of cases. Although exceptional, multiple myeloma must be borne in mind in the presence of bone sclerosis. This report presents a patient with multiple myeloma with a sunburst/hair-on-end pattern on the radiograph and sclerotic skeletal lesions.

Mucopolysaccharidoses type IV A (Morquio syndrome): a case series of three siblings

Mucopolysaccharidoses (MPS) are a family of inherited metabolic diseases that results from the deficiency of lysosomal enzymes involved in the degradation of the glycosaminoglycans (mucopolysaccharides). Despite the well-documented oral and dental findings of MPS type IV, there is not much literature documented about the incidence of this disorder among siblings in the same family. This report outlines the clinical and radiographic findings found in three siblings with Morquio syndrome.

Midlife vascular risk factor exposure accelerates structural brain aging and cognitive decline

OBJECTIVE

Our aim was to test the association of vascular risk factor exposure in midlife with progression of MRI markers of brain aging and measures of cognitive decline.

METHODS

A total of 1,352 participants without dementia from the prospective Framingham Offspring Cohort Study were examined. Multivariable linear and logistic regressions were implemented to study the association of midlife vascular risk factor exposure with longitudinal change in white matter hyperintensity volume (WMHV), total brain volume (TBV), temporal horn volume, logical memory delayed recall, visual reproductions delayed-recall (VR-d), and Trail-Making Test B-A (TrB-A) performance a decade later.

RESULTS

Hypertension in midlife was associated with accelerated WMHV progression (p < 0.001) and worsening executive function (TrB-A score; p = 0.012). Midlife diabetes and smoking were associated with a more rapid increase in temporal horn volume, a surrogate marker of accelerated hippocampal atrophy (p = 0.017 and p = 0.008, respectively). Midlife smoking also predicted a more marked decrease in total brain volume (p = 0.025) and increased risk of extensive change in WMHV (odds ratio = 1.58 [95%confidence interval 1.07-2.33], p = 0.021). Obesity in midlife was associated with an increased risk of being in the top quartile of change in executive function (1.39 [1.02-1.88], p = 0.035) and increasing waist-to-hip ratio was associated with marked decline in TBV (10.81 [1.44-81.01], p = 0.021). Longitudinal changes in brain structure were significantly correlated with decline in memory and executive function.

CONCLUSIONS

Midlife hypertension, diabetes, smoking, and obesity were associated with an increased rate of progression of vascular brain injury, global and hippocampal atrophy, and decline in executive function a decade later.

Detection of subpopulations of leucocytes in different subgroups of semen sample qualities

The role of leucocytospermia in male subfertility is a much debated topic despite being a frequent finding. This study aimed to identify the role of leucocytes, leucocyte subpopulations and natural killer cells in male subfertility. Seventy-sex subfertile men attending a regional andrology unit were recruited into this prospective study and subdivided into groups based on their semen analysis. The different leucocyte subpopulations were identified using immunocytochemical staining. Significant levels of CD3 helper T lymphocytes (P < 0.001) were present in the oligospermic, asthenospermic, oligoasthenospermic and obstructive azoospermic group compared to the normospermic group. Significant levels of B cells (P < 0.05) were present in the asthenospermic, oligoasthenospermic and obstructive azoospermic group. The natural killer cells (CD56) were significantly raised in the oligoasthenospermic and obstructive azoospermic group (P < 0.05). Our study suggests that leucocytospermia impairs sperm function through enhanced T helper cell modulation, increased B cell population which leads to increased levels of antisperm antibody and natural killer cells mediated sperm damage. The site of seminal leucocyte production is not necessarily confined to the vas or the epididymis.

Critical Materials, Device Design, Performance and Reliability Issues in 4H-SiC Power Umosfet Structures

The long-term reliability of gate insulator under high field stress of either polarity presents a constraint on the highest electric field that can be tolerated in a 4H-SiC UMOSFET under on or off condition. A realistic performance projection of 41H-SiC UMOSFET structures based on electric field in the gate insulator (1.5 MV/cm under on-condition and 3 MV/cm under offcondition) consistent with long-term reliability of insulator is provided for the breakdown voltage in the range of 600 to 1500 V. The use of P+ polysilicon gate allows us to use a higher field of 3 MV/cm in the insulator under off-condition and leads to a higher breakdown voltage as the Fowler Nordheim (FN) injection from the gate electrode is reduced. FN injection data is presented for p type 4H-SiC MOS capacitor under inversion at room temperature and at 325°C. It is concluded that the insulator reliability, and not the SiC, is the limiting factor and therefore the high temperature operation of these devices may not be practical.

4H-SiC Power Devices: Comparative Overview of UMOS, DMOS, and GTO Device Structures

Silicon Carbide (SiC) is an emerging semiconductor material which has been widely predicted to be superior to both Si and GaAs in the area of power electronic switching devices [1]. This paper presents an overview of SiC power devices and concludes that MOS Turn-Off Thyristor (MTOTM) is one of the most promising near term SiC switching device given its high power potential, ease of turn-off, 500°C operation and resulting reduction in cooling requirements. It is further concluded that in order to take advantage of SiC power devices, high temperature packages and components with double sided attachment need to be developed along with the SiC power devices.

The pitfalls of protocols - a case of postpartum splenic artery aneurysm rupture

The authors present a case of splenic artery aneurysm rupture, which neatly illustrates some of the problems of modern medical practice and the potential detriment of blind adherence to protocol driven care, without adequate reflection on the whole clinical picture and possible alternative diagnoses.

Depressive symptoms and risk of dementia: the Framingham Heart Study

OBJECTIVES

Depression may be associated with an increased risk for dementia, although results from population-based samples have been inconsistent. We examined the association between depressive symptoms and incident dementia over a 17-year follow-up period.

METHODS

In 949 Framingham original cohort participants (63.6% women, mean age = 79), depressive symptoms were assessed at baseline (1990-1994) using the 60-point Center for Epidemiologic Studies Depression Scale (CES-D). A cutpoint of > or = 16 was used to define depression, which was present in 13.2% of the sample. Cox proportional hazards models adjusting for age, sex, education, homocysteine, and APOE epsilon4 examined the association between baseline depressive symptoms and the risk of dementia and Alzheimer disease (AD).

RESULTS

During the 17-year follow-up period, 164 participants developed dementia; 136 of these cases were AD. A total of 21.6% of participants who were depressed at baseline developed dementia compared with 16.6% of those who were not depressed. Depressed participants (CES-D >/=16) had more than a 50% increased risk for dementia (hazard ratio [HR] 1.72, 95% confidence interval [CI] 1.04-2.84, p = 0.035) and AD (HR 1.76, 95% CI 1.03-3.01, p = 0.039). Results were similar when we included subjects taking antidepressant medications as depressed. For each 10-point increase on the CES-D, there was significant increase in the risk of dementia (HR 1.46, 95% CI 1.18-1.79, p < 0.001) and AD (HR 1.39, 95% CI 1.11-1.75, p = 0.005). Results were similar when we excluded persons with possible mild cognitive impairment.

CONCLUSIONS

Depression is associated with an increased risk of dementia and AD in older men and women over 17 years of follow-up.

Evidence for altered activity of the IL-6 pathway in chronic rhinosinusitis with nasal polyps

BACKGROUND

IL-6 activates T(H)17 cells and regulates the response of B lymphocytes and regulatory T cells. The IL-6 receptor and the membrane protein, glycoprotein 130 (gp130), form an active signaling complex that signals through signal transducer and activator of transcription 3 (STAT3) and other signaling molecules. Both the IL-6 receptor (IL-6R) and gp130 can be found in soluble forms that regulate the pathway.

OBJECTIVE

We measured IL-6 signaling components and IL-17 in chronic rhinosinusitis (CRS) with nasal polyps (CRSwNP), CRS without nasal polyps (CRSsNP), and controls to assess the IL-6 pathway in CRS.

METHODS

IL-6, soluble IL-6R, soluble gp130 (sgp130), and IL-17 were measured in sinus tissue extracts and in nasal lavage fluid by either cytokine bead array or ELISA. phosphoSTAT3 (p-STAT3) was determined by Western blot and by immunohistochemistry.

RESULTS

IL-6 protein was significantly (P < .001) increased in CRSwNP compared with CRSsNP and controls. Soluble IL-6R was also increased in nasal polyp compared with control tissue (P < .01). Despite elevated IL-6 and sIL-6R, IL-17A, E, and F were undetectable in the sinus tissue from most of the patients with CRS and controls. p-STAT3 levels were reduced in the polyp tissue, possibly indicating reduced activity of IL-6 in the tissue. sgp130 was elevated in CRSwNP compared with CRSsNP and controls.

CONCLUSION

p-STAT3 levels are decreased in CRSwNP despite increased levels of IL-6 and sIL-6R and are associated with the absence of an IL-17 response. This may be a response to elevated levels of sgp130, a known inhibitor of IL-6 signaling. These results indicate that IL-6 and its signaling pathway may be altered in CRSwNP.

Vibrational spectroscopy investigation using ab initio and density functional theory on 3'-chloropropiophenone and 3'-nitropropiophenone

The FTIR and FT Raman spectra of 3'-chloropropiophenone and 3'-nitropropiophenone have been recorded in the regions 4000-400 and 3500-100 cm(-1) respectively. The optimized geometry, frequency and intensity of the vibrational bands of 3'-chloropropiophenone and 3'-nitropropiophenone were obtained by ab initio and DFT levels of theory with complete relaxation in the potential energy surface using 6-31G (d,p) basis set. A complete vibrational assignment aided by the theoretical harmonic frequency analysis has been proposed. The harmonic vibrational frequencies calculated have been compared with experimental FTIR and FT Raman spectra. The observed and the calculated frequencies are found to be in good agreement. The experimental spectra also coincide satisfactorily with those of theoretically constructed simulated spectrograms.

Association of parental dementia with cognitive and brain MRI measures in middle-aged adults

OBJECTIVES

Studies of autosomal dominant Alzheimer disease (AD) have shown structural and cognitive changes in mutation carriers decades prior to clinical disease. Whether such changes are detectable in offspring of persons with sporadic dementia remains unknown. We related prospectively verified parental dementia to brain MRI and cognitive testing in the offspring, within a 2-generational community-based cohort.

METHODS

A total of 717 Framingham offspring (mean age: 59 +/- 8 years) were studied. In multivariate analyses, we compared offspring with and without verified parental dementia (and AD) for 1) performance on tests of memory, abstract reasoning, and cognitive flexibility, and 2) volumetric brain MRI measures of total cerebral brain volume (TCBV), hippocampal volume (HV), and white matter hyperintensity volume (WMHV), assessed cross-sectionally and longitudinally.

RESULTS

When testing the association of parental dementia and AD with baseline cognitive performance, we observed an interaction of parental dementia and AD with APOE epsilon4 status (p < 0.002). In APOE epsilon4 carriers only (n = 165), parental dementia was associated with poorer scores on tests of verbal memory (beta = -1.81 +/- 0.53, p < 0.001) and visuospatial memory (beta = -1.73 +/- 0.47, p < 0.001). These associations were stronger for parental AD (beta = -1.97 +/- 0.52, p < 0.001, beta = -1.95 +/- 0.48, p < 0.001), equivalent to 14-16 years of brain aging. Among APOE epsilon4 carriers, offspring of participants with dementia were also more likely to show an annual decline in TCBV in the top quartile (odds ratio = 4.67 [1.26-17.30], p = 0.02). Regardless of APOE epsilon4 status, participants with parental dementia were more likely to be in the highest quartile of decline in executive function test scores (odds ratio = 1.61 [1.02-2.53], p = 0.04).

CONCLUSIONS

Among middle-aged carriers of the APOE epsilon4 allele, parental dementia and Alzheimer disease were associated with poorer verbal and visuospatial memory and a higher rate of global brain atrophy.