Raalin, a transcript enriched in the honey bee brain, is a remnant of genomic rearrangement in Hymenoptera

We identified a predicted compact cysteine-rich sequence in the honey bee genome that we called 'Raalin'. Raalin transcripts are enriched in the brain of adult honey bee workers and drones, with only minimum expression in other tissues or in pre-adult stages. Open-reading frame (ORF) homologues of Raalin were identified in the transcriptomes of fruit flies, mosquitoes and moths. The Raalin-like gene from Drosophila melanogaster encodes for a short secreted protein that is maximally expressed in the adult brain with negligible expression in other tissues or pre-imaginal stages. Raalin-like sequences have also been found in the recently sequenced genomes of six ant species, but not in the jewel wasp Nasonia vitripennis. As in the honey bee, the Raalin-like sequences of ants do not have an ORF. A comparison of the genome region containing Raalin in the genomes of bees, ants and the wasp provides evolutionary support for an extensive genome rearrangement in this sequence. Our analyses identify a new family of ancient cysteine-rich short sequences in insects in which insertions and genome rearrangements may have disrupted this locus in the branch leading to the Hymenoptera. The regulated expression of this transcript suggests that it has a brain-specific function.

Association among vitamin D, oral candidiasis, and calprotectinemia in HIV

Vitamin D deficiency is associated with negative health outcomes, including infections. Vitamin D modulates inflammation and down-regulates the expression of calprotectin, a molecule which influences neutrophil functions and which has been linked to oral candidiasis (OC), the most prevalent oral lesion in human immunodeficiency virus (HIV). We hypothesized a positive association between vitamin D deficiency and OC, and that this effect was partially modulated by calprotectinemia. Plasma calprotectin and serum 25 (OH) vitamin D levels were measured in stored samples from 84 HIV-seropositive Chicago women enrolled in the Oral Substudy of the Women's Interagency HIV Study (WIHS). OC and vitamin D deficiency were diagnosed in, respectively, 14 (16.7%) and 46 (54.8%) of those studied. Vitamin D deficiency was positively associated with OC (p = 0.011) and with higher calprotectinemia (p = 0.019) in univariate analysis. After adjustment for CD4, HIV viral load, HIV treatment, and tobacco and heroin/methadone use, vitamin D deficiency remained a significant predictor of OC (OR 5.66; 95% confidence interval 1.01-31.71). This association weakened after adjustment for calprotectinemia, supporting a role for calprotectinemia as a moderator of this effect. These findings support studies to examine the effect of vitamin D status on calprotectinemia, neutrophil functions, and opportunistic mucosal infections in HIV.

US imaging in operated tendons

Ultrasound (US) plays an essential role in the follow-up of operated tendons. The US operator must keep in mind three main elements: healing of traumatic injuries of the tendons seems to follow the biological model of histologic healing, surgical repair of a tendon rupture improves the structural parameters of the operated tendon, but it does not grant restitutio ad integrum, and US findings therefore seem poorly correlated with the functional evolution.Before examination, the US operator should be familiar with the nature of the tendon injury that has led to surgery including location, severity, time elapsed between tendon injury and surgical repair, surgical technique, postoperative course and possible complications. US findings in operated as well as non-operated tendons depend on several factors: morphology, structure, vascularization of the tendon, mobility of the tendon and mobility of the peritendinous tissues. Particular features are therefore considered according to the location: shoulder, elbow, wrist, hand, knee, ankle and foot. Interpretation of the US image requires knowledge of the surgical technique and "normal" postoperative appearance of the operated tendon in order to detect pathological findings such as thinning, persistent fluid collections within or around the tendon, persistent hypervascularization, intratendinous calcifications and adhesions.

[Neurological adverse events under anti-TNF alpha therapy]

INTRODUCTION

Anti-TNF alpha treatments are increasingly prescribed in various rheumatological or gastroenterological inflammatory diseases. Several adverse events, including neurological episodes have been reported in the literature. Relation to treatment is a major concern and guidelines for management of those patients are not available. The aim of our study is to collect and analyze neurological adverse events occurring during anti-TNF alpha therapy, and to propose guidelines for diagnosis of demyelinating-induced diseases.

METHODS

All patients treated with anti-TNF alpha drug, who were addressed in our department following a neurological event, were collected. We gathered clinical data including previous neurological history and immunosuppressive treatments. Paraclinical data included brain and spinal MRI, CSF study and outcome after anti-TNF therapy was collected.

RESULTS

Nine patients were included in this study. Sex ratio was eight and mean age was 49±9 years. One patient had previous history of subarachnoïdian hemorrage. All the patients previously received immunosuppressive drugs, including methotrexate (nine) and leflunomide (four). Three patients had a brain MRI before initiation of anti-TNF treatment, which was normal. Clinical episode was stroke-like in three cases, clinically isolated syndrome (CIS) in five cases, and peripheral neuropathy in one case. MRI showed lesions suggestive of demyelinating T2 hyperintensities in four cases, vascular infarcts in two cases, and non-specific T2 hyperintensities in three cases. Barkhof and Tintore criteria were fulfilled in one of the four CIS cases. CSF study was available for six patients. It was normal (four cases), showed oligoclonal bands (one case) and lymphocytic meningitis (one case). Anti-TNF alpha discontinuation was decided in five cases. Outcome was favorable for eight patients. One patient, whom MRI fulfilled Barkhof and Tintore criteria, and CSF showed oligoclonal bands, further developed relapsing remitting multiple sclerosis.

CONCLUSION

Our study is compatible with data found in the literature. Barkhof and Tintore criteria and CSF study are useful in clinical practice to diagnose a first demyelinating event. Standardized paraclinical neurological explorations should be proposed to physicians who are in charge of anti-TNF treated patients.

Behavioral deficits and cellular damage following developmental ethanol exposure in rats are attenuated by CP-101,606, an NMDAR antagonist with unique NR2B specificity

NMDAR-mediated excitotoxicity has been implicated in some of the impairments following fetal ethanol exposure. Previous studies suggest that both neuronal cell death and some of the behavioral deficits can be reduced by NMDAR antagonism during withdrawal, including antagonism of a subpopulation of receptors containing NR2B subunits. To further investigate NR2B involvement, we selected a compound, CP-101,606 (CP) which binds selectively to NR2B/2B stoichiometries, for both in vitro and in vivo analyses. For the in vitro study, hippocampal explants were exposed to ethanol for 10 days and then 24 h following removal of ethanol, cellular damage was quantified via propidium iodide fluorescence. In vitro ethanol withdrawal-associated neurotoxicity was prevented by CP (10 and 25 nM). In vivo ethanol exposure was administered on PNDs 1-7 with CP administered 21 h following cessation. Activity (PNDs 20-21), motor skills (PNDs 31-33), and maze navigation (PNDs 43-44) were all susceptible to ethanol insult; treatment with CP (15 mg/kg) rescued these deficits. Our findings show that CP-101,606, a drug that blocks the NR2B/2B receptor, can reduce some of the damaging effects of "3rd trimester" alcohol exposure in our rodent model. Further work is clearly warranted on the neuroprotective potential of this drug in the developing brain.

3D vector control during alveolar ridge augmentation using distraction osteogenesis and temporary anchorage devices: a new technique

This report describes a combined orthodontic surgical technique involving vertical alveolar distraction using temporary anchorage devices (TADs) in cases of massive alveolar ridge bone and teeth loss. A combined surgical orthodontic protocol included presurgical orthodontic preparation and a preimplantation surgical augmentation stage for insertion of a vertical distractor. During the active vertical alveolar distraction process TADs were inserted. Intraoral orthodontic elastics were attached to the main orthodontic archwire exerting multidirectional forces to control the vertical distraction vector. After 3 months of vector controlling and active bone moulding, the TADs were removed. Anterior alveolar ridge augmentation using distraction osteogenesis was achieved. The application of TADs for better anterior segment curvature enabled dental implant insertion, better positioning and restoration. A combined surgical orthodontic management protocol involving vertical alveolar distraction osteogenesis for augmentation purposes is an efficient treatment method to improve alveolar ridge volume for the preimplantation stage.

Cutaneous Side-effects of Immunomodulators in MS

Local skin reactions to subcutaneous injections of interferon beta (IFNB) or glatiramer acetate (GA) in multiple sclerosis (MS) are frequent, while severe cutaneous toxicity is rare. Both IFNB and GA are immunomodulatory drugs that have excellent safety profiles and are currently used for treatment of MS. They are administered by SC injection every other day for IFNB-1b, three times a week for IFNB-1a or daily for 20 mg for GA. The most common adverse effects, which occur in approximately 20-60% of patients, include pain, inflammation and induration at the injection sites. Another adverse effect is frank panniculitis followed by localized lipoatrophy at the injection sites, which has been described in half of the patients receiving GA injections but is also described with Subcutaneous IFNB-1b. No guidelines have yet been established for the treatment of skin reactions, which is a frequent point for discussion between neurologists and dermatologists. In addition, no treatment has been found for established lipoatrophy. The prevention and management of cutaneous side-effects include patient education, regular examination and manual palpation of all injection sites. Non-steroid antiinflammatory gels, local corticosteroids or endermology can help patients to resolve side-effects and to continue immunomodulatory treatment.

Use of pericranial flaps in the management of cranial base trauma

Pericranial flaps based on the musuloaponeurotic or myofacial layers of the scalp have great utility in the management of acquired and congenital craniofacial deformities. Their use in traumatic deformities is indicated in the presence of craniopharyngeal communications and significant anterior cranial fossa dead space created from frontal sinus obliteration. The indications and operative techniques and the results of the use of these flaps in 10 consecutive patient with extensive cranial base trauma are presented.

Severity of hyperacusis predicts individual differences in speech perception in Williams Syndrome

BACKGROUND

Williams Syndrome (WS) is a neurodevelopmental disorder of genetic origin, characterised by relative proficiency in language in the face of serious impairment in several other domains. Individuals with WS display an unusual sensitivity to noise, known as hyperacusis.

METHODS

In this study, we examined the extent to which hyperacusis interferes with the perception of speech in children and adults with WS. Participants were required to discriminate words which differed in one consonant of a cluster when these contrasts were embedded in a background of noise.

RESULTS

Although the introduction of noise interfered with performance on a consonant cluster discrimination task equally in the WS and control groups, the severity of hyperacusis significantly predicted individual variability in speech perception within the WS group.

CONCLUSIONS

These results suggest that alterations in sensitivity to input mediate atypical pathways for language development in WS, where hyperacusis exerts an important influence together with other non-auditory factors.

[Periarticular diseases of the hip in young adults]

Multiple periarticular structures are present around the hip joint: tendons, bursae, muscles and entheses, fascias, nerves and vessels. Periarticular diseases of the hip in young adults include, in decreasing order of functional impairment: posttraumatic lesions of muscles and tendons that should not be overlooked because of the risk of functional sequelae, enthesopathy detected on plain films and ultrasound, snapping hip syndrome frequent in athletes and tunnel syndromes (such as compression of the lateral femoral cutaneous nerve where ultrasound is valuable). The main pitfalls to avoid are the stress fracture, trauma to a pelvic muscle and calcium deposition.

Chronic ataluren (PTC124) treatment of nonsense mutation cystic fibrosis

In a subset of patients with cystic fibrosis (CF), nonsense mutations (premature stop codons) disrupt production of full-length, functional CF transmembrane conductance regulator (CFTR). Ataluren (PTC124) allows ribosomal readthrough of premature stop codons in mRNA. We evaluated drug activity and safety in patients with nonsense mutation CF who took ataluren three times daily (morning, midday and evening) for 12 weeks at either a lower dose (4, 4 and 8 mg·kg(-1)) or higher dose (10, 10 and 20 mg·kg(-1)). The study enrolled 19 patients (10 males and nine females aged 19-57 yrs; dose: lower 12, higher seven) with a classic CF phenotype, at least one CFTR nonsense mutation allele, and an abnormal nasal total chloride transport. Both ataluren doses were similarly active, improving total chloride transport with a combined mean change of -5.4 mV (p<0.001), and on-treatment responses (at least -5 mV improvement) and hyperpolarisations (values more electrically negative than -5 mV) in 61% (p<0.001) and 56% (p = 0.002) of patients. CFTR function was greater with time and was accompanied by trends toward improvements in pulmonary function and CF-related coughing. Adverse clinical and laboratory findings were uncommon and usually mild. Chronic ataluren administration produced time-dependent improvements in CFTR activity and clinical parameters with generally good tolerability.

A viewer-centric editor for 3D movies

A proposed mathematical framework is the basis for a viewer-centric digital editor for 3D movies that's driven by the audience's perception of the scene. The editing tool allows both shot planning and after-the-fact digital manipulation of the perceived scene shape.

Outcomes of auto-SCT for lymphoma in subjects aged 70 years and over

The safety and efficacy of auto-SCT for lymphoma in older patients is not well established, particularly in those ≥70 years old. We performed a retrospective analysis comparing 17 auto-SCT recipients ≥70 years old with 39 recipients aged 65-69 years. Hematopoietic cell transplantation comorbidity index (HCT-CI) scores were similar in both groups. Nonrelapse mortality (NRM) was increased in patients aged 70 years and older (hazard ratio (HR) 6.04, P=0.0029), and OS was decreased (HR 1.98, P=0.082). 1-year NRM was 35% in patients aged ≥70 years vs 8% in those aged 65-69 years (P=0.017). The incidence of in-hospital falls was higher in those aged ≥70 years (29 vs 8%, P=0.047). In a secondary exploratory analysis, we found that the occurrence of in-hospital falls was strongly associated with inferior OS (HR 3.36, P=0.0023) and NRM (HR 4.60, P=0.009) among all patients of aged 65 years and older. We conclude that auto-SCT is feasible in older patients but that mortality rates appear increased in those over age of 70 years. In-hospital falls were correlated with higher mortality, and prevention of falls may improve outcomes. Susceptibility to falls may indicate underlying frailty and should be explored prospectively as a means of selecting older patients for auto-SCT.

Effects of breastfeeding in children of women taking antiepileptic drugs

BACKGROUND

Breastfeeding is known to have beneficial effects, but there is concern that breastfeeding during antiepileptic drug (AED) therapy may be harmful to cognitive development. Animal and human studies have demonstrated that some AEDs can adversely affect the immature brain. However, no investigation has examined effects of breastfeeding during AED therapy on subsequent cognitive abilities in children.

METHODS

The Neurodevelopmental Effects of Antiepileptic Drugs Study is an ongoing prospective multicenter observational investigation of long-term effects of in utero AED exposure on cognition. Between 1999 and 2004, we enrolled pregnant women with epilepsy who were taking a single AED (carbamazepine, lamotrigine, phenytoin, or valproate). We recently reported on differential AED effects on age 3 year cognitive outcomes. In this report, we focus on the effects of breastfeeding during AED therapy on age 3 cognitive outcomes in 199 children.

RESULTS

A total of 42% of children were breastfed. IQs for breastfed children did not differ from nonbreastfed children for all AEDs combined and for each of the 4 individual AED groups. Mean adjusted IQ scores (95% confidence intervals) across all AEDs were breastfed = 99 (96-103) and nonbreastfed = 98 (95-101). Power was 95% to detect a half SD IQ effect in the combined AED analysis, but was inadequate within groups.

CONCLUSIONS

This preliminary analysis fails to demonstrate deleterious effects of breastfeeding during AED therapy on cognitive outcomes in children previously exposed in utero. However, caution is advised due to study limitations. Additional research is needed to confirm this observation and extend investigations to other AEDs and polytherapy.

Psychological correlates of adherence to self-care, disease activity and functioning in persons with systemic lupus erythematosus

The aim of the study was to assess the effects of Sense of Coherence (SOC), emotional distress and treatment adherence on disease activity and functioning level of persons with systemic lupus erythematosus (SLE). One hundred persons with SLE, aged 18–60, participated in the study. They responded to the SOC scale, hospital anxiety and depression scale (emotional distress) and to questionnaires about adherence to treatment, level of functioning and disease activity. The results show a moderate level of disease activity and everyday functioning, as well as moderate levels of emotional distress. Income, emotional distress and adherence significantly predicted the levels of functioning ( p < 0.001), while income and emotional distress significantly predicted the levels of disease activity only ( p < 0.001). SOC was significantly associated with higher level of functioning ( p < 0.001) and lower disease activity ( p < 0.01), while emotional distress, but not treatment adherence, highly mediated these relationships. The results emphasize the associations of emotional distress and SOC with severity of the symptoms and level of functioning, and the associations between SOC and adherence to treatment. Further confirmation of the results with larger samples and longitudinal designs are warranted.

[Longitudinal study of health related quality of life in multiple sclerosis: correlation with MRI parameters]

INTRODUCTION

Health related quality of life (HRQOL) is often affected in multiple sclerosis (MS). Nevertheless, to our knowledge, there is no longitudinal study in the literature about the correlation between MRI parameters and HRQOL in MS patients.

METHODS

We included 28 patients with clinically definite relapsing remitting MS. All patients initiated subcutaneous interferon beta-1a therapy. To assess HRQOL, we used the SEP-59 scale, the French validated translation of MSQOL-54, and the MusiQoL scale. Conventional MRI was performed every year. Lesion load (LL) and brain atrophy were automatically measured using SepINRIA, a free software developed by INRIA in Sophia Antipolis.

RESULTS

The mean EDSS score was 1.7 and disease duration was 2.5 years. Our results revealed that HRQOL was significantly correlated to T1 and T2-LL with both SEP-59 and MusiQoL scales. T1-LL was better correlated with physical dimensions and T2-LL was better correlated with mental components. At 1-year follow-up, patients whose MRI showed either an increase of T1 LL or at least one gadolinium enhancing lesion had a worse HRQOL at the end of the study. Initial brain parenchymal fraction (BPF) measure was also correlated with the long-term follow-up HRQOL. EDSS scored at the end of the study had not significantly changed (1.3; P>0.05).

CONCLUSION

Our study revealed pertinent clinicoradiological correlations between HRQOL and MRI parameters in our cohort.

Possibilistic risk management and counterfactual probabilities

Possibility theory is applied to assessing the relative risk associated with very rare, high-consequence hazards. The probability of rare negative events has to be estimated from a few past occurrences that are spread over long exposure periods, with countermeasures added in response to each event to attempt to guard against recurrence. Traditional risk assessments based on conditional probability and statistical expected value are very sensitive to the uncertainty associated with rare events. A new measure of possibility for events whose probability is not well measurably different from zero is proposed and illustrated in the context of possible release of hazardous material from a high containment research laboratory and in the context of large insurance company failures. Strategies for managing and reducing risk that do not depend on well-measured probabilities are discussed.

BACTERIOLOGICAL AND CLINICAL STUDIES OF AN EPIDEMIC OF KOCH-WEEKS BACILLUS CONJUNCTIVITIS ASSOCIATED WITH CELL INCLUSION CONJUNCTIVITIS

1. There are cases in which epithelial cell inclusions may alone be present in the conjunctival smears. In such cases no other pathogenic organisms, such as the Koch-Weeks bacillus or the pneurnococcus, can be demonstrated in smears or cultures. 2. The conjunctiva can become simultaneously infected with the inclusion bodies and Koch-Weeks bacilli or other organisms. 3. In cases of acute or subacute conjunctival inflammations due to mixed infections the clinical features of each infection may be present. The course of the inflammation is, however, more prolonged. 4. Within recent years, the Koch-Weeks bacillus has only seldom been found in our routine examinations. 5. The epidemic studied was of a severe type. 6. Clinically it is practically impossible to distinguish pneurnococcal conjunctivitis from the Koch-Weeks conjunctivitis. Bacteriological examination of smears and cultures is the only means by which the etiological diagnosis can be definitely established. 7. Conjunctivæ of certain species of monkeys are susceptible to the von Prowazek inclusion bodies, but not to the hemoglobinophilic bacilli isolated from cases of epidemic conjunctivitis. 8. The injection of conjunctival scrapings containing the von Prowazek cell inclusions into the testicles of rabbits produces no cell inclusions in the latter, while the injection of a pure culture of the hemoglofcinophilic bacilli causes an acute inflammation accompanied by numerous clumps of the organisms, simulating the von Prowazek bodies at certain stages of their evolution. 9. There exists an apparent morphological similarity between the degenerated forms of this variety of the hemoglobinophilic bacilli and the cell inclusions, both in cultures and in experimental orchitis in the rabbit. But, as a rule, the elementary bodies of the latter are much smaller and more sharply defined than the smallest granules of the former, while the initial bodies are bigger, more intensely stainable, and less definite in their contour than the hemoglobinophilic bacilli found in the infected conjunctivæ.

EXPERIMENTS ON THE CULTIVATION OF SO CALLED TRACHOMA BODIES

1. An organism was isolated and studied in pure cultures from cases of conjunctivitis accompanied by the so called trachoma body inclusions, as well as from a case of old trachoma without inclusions. 2. This organism was not found in the cultures made from other forms of conjunctivitis in which the inclusions were absent. 3. The organism presents the morphological features characteristic of so called trachoma bodies. It undergoes an early transformation, during which the forms known as initial bodies appear, and a later change, during which forms resembling elementary granules arise, while certain intermediate forms between these occur simultaneously. 4. No definite cell inclusions could be produced in monkeys by inoculating pure cultures of the organism. 5. The cultivation of this organism from a case of trachoma without the cell inclusions, together with the previously ascertained fact that the inclusions can be produced in suitable animals by inoculating such material directly from a human case, suggests the possibility of the organism being still present in such cases of trachoma, although not in the form of cell inclusions. 6. The facts presented justify the statement that by a suitable method an organism resembling the various important stages of the trachoma bodies and totally distinct from the gonococcus has been obtained in a living condition, capable of indefinite cultivation from cases of human trachoma and inclusion conjunctivitis. Whether the organism and trachoma bodies are identical cannot be positively stated at present. But the way is now opened to determine this point, as well as the specificity of the trachoma bodies.