An unusual case of abdominal pain: psychogenic vomiting complicated by spontaneous pneumomediastinum

BACKGROUND

Spontaneous pneumomediastinum (SPM) was defined by the appearance of free air in the mediastinum that was not preceded by trauma, surgery, or other medical procedures. Among the numerous manifestations of SPM, abdominal pain had seldom been described.

CASE PRESENTATION

A 25-year-old man presented to the emergency department with nausea, vomiting, and abdominal pain for 7 days. The presenting clinical features and the radiological results were suggestive of psychogenic vomiting with spontaneous pneumomediastinum in a patient who suffered from abdominal pain.

CONCLUSIONS

The special feature of this case was the elucidation of a rare cause of abdominal pain, which should be differentiated in patients with vomiting combined with abdominal pain. The importance of this case was that its recognition may prevent unnecessary procedures to rule out or treat other causes of abdominal pain.

Clinical significance of serum levels of 14-3-3β protein in patients with stable chronic obstructive pulmonary disease

Nowadays, the diagnosis and treatment of COPD are often based on the results of lung function tests. Certain individuals, however, are not candidates for lung function testing due to pulmonary bullae, cardiac failure, low lung function, and other factors. Therefore, we evaluated whether serum tyrosine3-monooxygenase/tryptophan5-monooxygenase activation protein β (14-3-3β) could be a biomarker for the diagnosis of stable COPD patients. The expression of serum 14-3-3β protein was evaluated by an enzyme-linked immunosorbent assay. The association between its concentrations and clinical parameters of stable COPD patients were analyzed by correlation analysis and ROC curve. The results before propensity score matching (PSM) showed that serum 14-3-3β protein concentrations (ng/ml) in stable COPD patients were significantly higher than in healthy controls (P < 0.001). Furthermore, serum 14-3-3β protein concentrations were higher in GOLD 3&4 COPD patients compared with healthy participants, GOLD 1 and GOLD 2 COPD patients (P < 0.05), which shows that the concentration of 14-3-3β protein correlates with disease severity in stable COPD patients. After 1:1 PSM, there was also a statistically significant rise in 14-3-3 protein levels in stable COPD patients compared to healthy controls (P < 0.01). Serum 14-3-3β protein levels were positively correlated with blood neutrophil levels (P < 0.05), and negatively related to lung function parameters in stable COPD patients (P < 0.01). When the cutoff value was set at 29.53 ng/ml, the ROC curve yielded a sensitivity of 84.9% and a specificity of 68.3% for diagnosing stable COPD. The 14-3-3β protein may be a potential serum biomarker for the diagnosis of stable COPD patients, which is associated with disease severity, systemic inflammation, and small airway obstruction.

Risk prediction of second primary malignancies in primary colorectal neuroendocrine neoplasms patients: a population-based study

PURPOSE

In this study, we aimed to identify risk factors for developing second primary malignancies (SPMs) in colorectal neuroendocrine neoplasms (NENs) patients and develop a competing-risk nomogram to predict SPMs' probabilities quantitatively.

METHODS

Patients with colorectal NENs were retrospectively collected from the Surveillance, Epidemiology, and End Results (SEER) database during 2000-2013. Potential risk factors for SPMs' occurrence in colorectal NENs' patients were identified by the Fine and Gray's proportional sub-distribution hazards model. Then, a competing-risk nomogram was constructed to quantify SPMs' probabilities. The discriminative abilities and calibrations of this competing-risk nomogram were assessed by the area under the receiver-operating characteristic (ROC) curves (AUC) and calibration curves.

RESULTS

We identified 11,017 colorectal NENs' patients, and randomly divided them into training (n = 7711 patients) and validation (n = 3306 patients) cohorts. In the whole cohort, 12.4% patients (n = 1369) had developed SPMs during the maximum follow-up of approximately 19 years (median 8.9 years). Sex, age, race, primary tumor location, and chemotherapy were identified as risk factors for SPMs' occurrence in colorectal NENs' patients. Such factors were selected to develop a competing-risk nomogram and showed excellent predictive ability for SPMs' occurrence (the 3-, 5-, and 10-year AUC values were 0.631, 0.632, and 0.629 in the training cohort and 0.665, 0.639, 0.624 in the validation cohort, respectively).

CONCLUSIONS

This research identified risk factors for SPMs' occurrence in colorectal NENs' patients. Competing-risk nomogram was constructed and proved to have good performance.

Can tibio-femoral kinematic and kinetic parameters reveal poor functionality and underlying deficits after total knee replacement? A systematic review

BACKGROUND

Extensive efforts have been made to understand joint kinematics and kinetics in total knee arthroplasty (TKA) in subjects with satisfactory outcomes during daily functional activities and clinical tests, but it remains unclear whether such movement characteristics hold the potential to indicate the underlying aetiology of unsatisfactory or bad TKA outcomes.

PURPOSE

To investigate which kinematic and kinetic parameters assessed during passive clinical tests and functional activities of daily living are associated with poor functionality and underlying deficits after total knee replacement.

METHODS

We focused on studies characterizing the kinematic or kinetic parameters of the knee joint that are associated with poor clinical outcome after TKA. Seventeen articles were included for the review, and kinematic and kinetic data from 719 patients with minimal follow up of 6 months were extracted and analyzed.

RESULTS

Passive posterior translation at 90°flexionexhibited good potential for differentiating stable and unstable TKAs. Anterior-posterior (A-P) translation of the medial condyle at 0-30° and 30-60° flexion, A-P translation of the lateral condyle at 60-90°during closed chain exercises, as well asknee extension moment during stair ascent and descent, knee abduction moment during stair descent, knee internal rotation moment and plantar flexion moment during walking, 2ndpeak ground reaction force during stair ascent and walkingshowed the greatest promise as functional biomarkers for a dissatisfied/poor outcome knee after TKA.

CONCLUSION

In this study, we systematically reviewed the state-of-the-art knowledge of kinematics and kinetics associated with functional deficits, and found 11 biomechanical parameters that showed promise for supportingdecision making in TKA.

Serum 14-3-3β protein: a new biomarker in asthmatic patients with acute exacerbation in an observational study

Background

The determination of systemic inflammatory markers is one of the important directions to study the pathogenesis of asthma and improve the diagnosis of asthma. Current studies have found that the 14-3-3 protein family subtypes interact with target proteins to participate in the pathogenesis of a variety of immune inflammatory diseases. However, studies on serum tyrosine3-monooxygenase/tryptophan5-monooxygenase activation protein β (14-3-3β) in asthma are scarce. This study aimed to assess the clinical significance of 14-3-3β in asthmatic patients.

Methods

We recruited 54 asthmatic patients with acute exacerbation and 50 asthmatic patients with chronic persistent. The normal control group included 54 healthy individuals. Clinical characteristics, clinical indicators [fractional expiratory nitric oxide (FeNO), eosinophil count, forced vital capacity (FVC), percent of predicted FVC (FVC% predicted), forced expiratory volume in one second (FEV1), percent of predicted FEV1 (FEV1% predicted), the ratio of forced expiratory volume in one second to forced vital capacity (FEV1/FVC) and serum 14-3-3β levels were measured to compare among each group. Spearman’s rank correlation coefficient was used to evaluate the correlation between 14-3-3β and clinical indicators. Finally, Receiver-operating characteristic (ROC) curves analysis was used to determine the sensitivity and specificity of 14-3-3β.

Results

Our results showed that median (interquartile range) of serum 14-3-3β concentration (ng/mL) in acute exacerbation group of asthma (41.18 [33.06–51.76]) was much higher than that in normal control group (24.99 [17.43–29.91]; P < 0.001) and chronic persistent group of asthma (25.88 [21.03–34.55]; P < 0.001). Spearman’s correlation coefficient shows that the serum 14-3-3β level was positively correlated with FeNO (r = − 0.292, P = 0.032) and peripheral blood eosinophil count (r = 0.328, P = 0.016), and was negatively related to FEV1/FVC (r = − 0.293, P = 0.031) in the acute exacerbation group of asthma. At the same time, the serum 14-3-3β level was also negatively associated with FEV1 (r = − 0.297, P = 0.036) in the chronic persistent group of asthma. ROC curve analysis comparing acute exacerbation group of asthma with normal control group demonstrated a significant (P < 0.001) AUC of 0.90 (95% CI 0.85–0.96).

Conclusion

The serum 14-3-3β protein may become a potential biomarker in asthmatic patients with acute exacerbation.

Supplementary Information

The online version contains supplementary material available at 10.1186/s13223-021-00608-4.

Accurate prediction and genome-wide association analysis of digital intramuscular fat content in longissimus muscle of pigs

Intramuscular fat (IMF) content is a critical indicator of pork quality that affects directly the purchasing desire of consumers. However, to measure IMF content is both laborious and costly, preventing our understanding of its genetic determinants and improvement. In the present study, we constructed an accurate and fast image acquisition and analysis system, to extract and calculate the digital IMF content, the proportion of fat areas in the image (PFAI) of the longissimus muscle of 1709 animals from multiple pig populations. PFAI was highly significantly correlated with marbling scores (MS; 0.95, r²  = 0.90), and also with IMF contents chemically defined for 80 samples (0.79, r²  = 0.63; more accurate than direct analysis between IMF contents and MS). The processing time for one image is only 2.31 s. Genome-wide association analysis on PFAI for all 1709 animals identified 14 suggestive significant SNPs and 1 genome-wide significant SNP. On MS, we identified nine suggestive significant SNPs, and seven of them were also identified in PFAI. Furthermore, the significance (-log P) values of the seven common SNPs are higher in PFAI than in MS. Novel candidate genes of biological importance for IMF content were also discovered. Our imaging systems developed for prediction of digital IMF content is closer to IMF measured by Soxhlet extraction and slightly more accurate than MS. It can achieve fast and high-throughput IMF phenotype, which can be used in improvement of pork quality.

Osthole Attenuates Macrophage Activation in Experimental Asthma by Inhibitingthe NF-ĸB/MIF Signaling Pathway

Inhibition of activated macrophages is an alternative therapeutic strategy for asthma. We investigated whether a coumarin compound, osthole, isolated from Cnidium monnieri (L.) Cuss, alleviated macrophage activation in vivo and in vitro. Osthole could reduce expression of a marker of activated macrophages, cluster of differentiation (CD)206, in an ovalbumin-challenge model of asthma in mice. Osthole could also inhibit infiltration of inflammatory cells, collagen deposition and production of proinflammatory cytokines [interleukin (IL)-1β, tumor necrosis factor-ɑ, macrophage migration inhibitory factor (MIF)] in asthmatic mice. In vitro, expression of phosphorylated-IĸBɑ, MIF and M2 cytokines (Ym-1, Fizz-1, arginase-1) in IL-4-induced macrophages decreased upon exposure to the NF-ĸB inhibitor MG-132. In our short hairpin (sh)RNA-MIF-knockdown model, reduced expression of M2 cytokines was detected in the IL-4 + shRNA-MIF group. Osthole could attenuate the proliferation and migration of an IL-4-induced rat alveolar macrophages line (NR8383). Osthole could reduce IL-4-induced translocation of nuclear factor-kappa B (NF-ĸB) in NR8383 cells. Collectively, our results suggest that osthole ameliorates macrophage activation in asthma by suppressing the NF-ĸB/MIF signaling pathway, and might be a potential agent for treating asthma.

The Role of Macrophage Migration Inhibitory Factor (MIF) in Asthmatic Airway Remodeling

Purpose

Recent studies have demonstrated that macrophage migration inhibitory factor (MIF) is of importance in asthmatic inflammation. The role of MIF in modulating airway remodeling has not yet been thoroughly elucidated to date. In the present study, we hypothesized that MIF promoted airway remodeling by intensifying airway smooth muscle cell (ASMC) autophagy and explored the specific mechanisms.

Methods

MIF knockdown in the lung tissues of C57BL/6 mice was conducted by instilling intratracheally adeno-associated virus (AAV) vectors (MIF-mutant AAV9) into mouse lung tissues. Mice genetically deficient in the autophagy marker ATG5 (ATG5^+/−) was used to detect the role of autophagy in ovalbumin (OVA)-asthmatic murine models. Moreover, to block the expression of MIF and CD74 in vitro models, inhibitors, antibodies and lentivirus transfection techniques were employed.

Results

First, MIF knockdown in the lung tissues of mice showed markedly reduced airway remodeling in OVA murine mice models. Secondly, ASMC autophagy was increased in the OVA-challenged models. Mice genetically deficient in the autophagy marker ATG5 (ATG5^+/−) that were primed and challenged with OVA showed lower airway remodeling than genetically wild-type asthmatic mice. Thirdly, MIF can induce ASMC autophagy in vitro. Moreover, the cellular source of MIF which promoted ASMC autophagy was macrophages. Finally, MIF promoted ASMC autophagy in a CD74-dependent manner.

Conclusions

MIF can increase asthmatic airway remodeling by enhancing ASMC autophagy. Macrophage-derived MIF can promote ASMC autophagy by targeting CD74.

Diagnostic accuracy of 14-3-3 η protein in rheumatoid arthritis: A meta-analysis

AIM

To evaluate the overall diagnostic performance of 14-3-3 η protein in patients with rheumatoid arthritis (RA).

METHODS

PubMed, EMBASE, and Web of Science were searched to acquire eligible studies. Articles published in English before 20 February 2020 were included. Quality Assessment of Diagnostic Accuracy Studies 2 was used to evaluate the risk of bias and application concern of the included articles. Pooled analysis of diagnostic indicators of 14-3-3 η protein for RA was conducted by using a random effects model. Subgroup analysis was used to explore the sources of heterogeneity. Deeks' funnel plot asymmetry test was used to evaluate for the presence of publication bias.

RESULTS

A total of 13 studies (1554 positive and 1934 negative participants) were included. The pooled sensitivity and specificity were 0.73 (95% CI 0.71-0.75) and 0.88 (95% CI 0.87-0.90), respectively. The pooled positive/negative likelihood were 5.98 (95% CI 4.39-8.14) and 0.28 (95% CI 0.21-0.37), respectively. In addition, the pooled diagnostic odds ratio was 23.48 (95% CI 13.76-40.08) and the area under curve was 0.9245. The results of subgroup analysis indicated that ethnicity and control group might be the source of heterogeneity. The results of sensitivity analysis were stable. No significant publication bias was found.

CONCLUSIONS

The current evidence indicated that 14-3-3 η protein has moderate accuracy for the diagnosis of RA.

Blockade of JAK2 protects mice against hypoxia-induced pulmonary arterial hypertension by repressing pulmonary arterial smooth muscle cell proliferation

Objectives

Hypoxia is an important risk factor for pulmonary arterial remodelling in pulmonary arterial hypertension (PAH), and the Janus kinase 2 (JAK2) is believed to be involved in this process. In the present report, we aimed to investigate the role of JAK2 in vascular smooth muscle cells during the course of PAH.

Methods

Smooth muscle cell (SMC)‐specific Jak2 deficient mice and their littermate controls were subjected to normobaric normoxic or hypoxic (10% O₂) challenges for 28 days to monitor the development of PAH, respectively. To further elucidate the potential mechanisms whereby JAK2 influences pulmonary vascular remodelling, a selective JAK2 inhibitor was applied to pre‐treat human pulmonary arterial smooth muscle cells (HPASMCs) for 1 hour followed by 24‐hour hypoxic exposure.

Results

Mice with hypoxia‐induced PAH were characterized by the altered JAK2/STAT3 activity in pulmonary artery smooth muscle cells. Therefore, induction of Jak2 deficiency in SMCs protected mice from hypoxia‐induced increase of right ventricular systolic pressure (RVSP), right ventricular hypertrophy and pulmonary vascular remodelling. Particularly, loss of Jak2 significantly attenuated chronic hypoxia‐induced PASMC proliferation in the lungs. Similarly, blockade of JAK2 by its inhibitor, TG‐101348, suppressed hypoxia‐induced human PASMC proliferation. Upon hypoxia‐induced activation, JAK2 phosphorylated signal transducer and activator of transcription 3 (STAT3), which then bound to the CCNA2 promoter to transcribe cyclin A2 expression, thereby promoting PASMC proliferation.

Conclusions

Our studies support that JAK2 could be a culprit contributing to the pulmonary vascular remodelling, and therefore, it could be a viable target for prevention and treatment of PAH in clinical settings.

Transcriptional control of K5, K6, K14, and K17 keratin genes by AP-1 and NF-kappaB family members

The expression of keratins K5 and K14 is restricted to the basal layers of the healthy epidermis, whereas the expression of K6 and K17 is induced in response to proliferative and inflammatory signals, respectively. The control of keratin expression occurs primarily at the transcriptional level. We studied the effects of transcription factors of the AP-1 and NF-kappaB families on the expression of those four keratin genes. We chose AP-1 and NF-kappaB proteins because they are activated by many extracellular signals, including those in hyperproliferative and inflammatory processes. DNA constructs expressing the transcription factors were, in various combinations, cotransfected with constructs containing keratin gene promoters and the CAT reporter gene into HeLa cells or keratinocytes. We found that the K5 and K14 promoters, which are coexpressed in vivo, are regulated in parallel by the cotransfected genes. Both were activated by the c-Fos and c-Jun components of AP-1, but not by Fra1. On the other hand, the NF-kappaB proteins, especially p65, suppressed these two promoters. The K17 promoter was specifically activated by c-Jun, whereas the other transcription factors tested had no significant effect. In contrast, the K6 promoter was very strongly activated by all AP-1 proteins, especially by the c-Fos + c-Jun and Fra1 + c-Jun combinations. It was also strongly activated by the p65 NF-kappaB protein. AP-1 and NF-kappaB acted synergistically in activating the K6 promoter, although the AP-1 and the NF-kappaB responsive sites could be separated physically. These results suggest that the interplay of AP-1 and NF-kappaB proteins regulates epidermal gene expression and that the activation of these transcription factors by extracellular signaling molecules brings about the differential expression of keratin genes in epidermal differentiation, cutaneous diseases, and wound healing.

E4BP4 facilitates glucocorticoid sensitivity of human bronchial epithelial cells via down-regulation of glucocorticoid receptor-beta

It has recently been recognized that a subset of asthma patients suffer from glucocorticoid (GC) insensitivity, and glucocorticoid receptor-β (GR-β) is associated with corticosteroid resistance, but the underlying mechanisms remain unknown. Here we demonstrated that Interleukin-17A induced glucocorticoid sensitivity in human bronchial epithelial cells (16HBE) is enhanced, which is depend on E4 promoter-binding protein 4 (E4BP4) mediated GR-β expression. Our data show that the expression of E4BP4 is significantly up-regulated in 16HBE cells, and the depletion of E4BP4 dramatically decreased glucocorticoid sensitivity in IL-17A induced 16HBE cells. Mechanistic studies revealed that E4BP4 plays a crucial role in Interleukin-17A induced glucocorticoid sensitivity in 16HBE cells via down-regulating GR-β, which is probably mediated by PI3K/Akt activation. Collectively, we can draw the conclusion that E4BP4 contribute to enhance the GCs sensitivity, which may offer a new strategy for therapeutic intervention for GC-insensitive asthma.

Interactions of vanadium(iv) with amidoxime ligands: redox reactivity

The use of amidoxime-functionalized polymer fibers as a sorbent for uranium has attracted recent interest for the extraction of uranium from seawater. Vanadium is one of the main competing ions for uranium sorption as V(v) species, however, vanadium is also present as V(iv) in seawater. In the present study, the interactions of V(iv) with amidoxime and similar ligands were explored. Attempts were made to synthesize V(iv) complexes of glutaroimide-dioxime, a molecular analogue of polymer sorbents. However, V(iv) was found to react irreversibly with glutaroimide-dioxime and other oxime groups, oxidizing to the V(v) oxidation state. We have explored the reactions and propose mechanisms, as well as characterized the redox behavior of the vanadium-glutaroimide-dioxime complex.

An overview and recent progress in the chemistry of uranium extraction from seawater

This review provides a brief background on the extraction of uranium from seawater as well as recent work by the United States Department of Energy on this project. The world's oceans contain uranium at 3 parts per billion, and despite this low concentration, there has been historical interest in harvesting it, mainly in Japan in the 1980s and the United States in this decade. Improvements in materials, chemistry, and deployment methods have all been made, with the ultimate goal of lower cost. This has been partially realized, dropping from approximately $2000 per kg U₃O₈ extracted in 1984 to $500 per kg today, although this is not yet competitive with terrestrial uranium. This technology may become cost-competitive if the cost of land-based uranium rises, especially if seawater extraction technology is improved further. The coordination chemistry aspects of the project are described in more detail, exploring the functional groups that are present on typical polymer sorbents as well as small-molecule analogues of these ligands. Selectivity for uranium over other metals, particularly vanadium, remains problematic, and techniques to both quantify binding strength and selectivity in order to overcome this issue are essential for future cost improvements.

Total alkaloids of Corydalis saxicola bunting inhibits migration of A549 cells by suppressing Cdc42 or Vav1

Cell division cycle 42 (Cdc42) is a critical regulator, which functions in cancer metastasis. Numerous previous studies have demonstrated that vav guanine nucleotide exchange factor 1 (Vav1) is ectopically expressed in numerous types of human malignancies and have suggested that Vav1 may efficiently promote the formation of invadopodia and matrix degradation by regulating the activation of Cdc42. Total alkaloids of Corydalis saxicola bunting (TAOCSB), a type of alkaloid compound extracted from the root of C. saxicola bunting, has been revealed to have anticancer properties. However, there is no available information to address the effects of TAOCSB on the metastasis of human lung cancer. In the present study, the anticancer effect on A549 non-small cell lung cancer cells induced by TAOCSB was investigated, as well as its underlying mechanisms. The results demonstrated that a low dose of TAOCSB exhibited anti-metastatic potential in suppressing the invasion and migration of A549 cells, and this action may be involved in TAOCSB-mediated inhibition of Cdc42 expression at the level of mRNA and protein in parallel with TAOCSB-mediated inhibition of matrix metalloproteinase (MMP)-2 and MMP-9 protein expression levels. Although the present study did not reveal the expression level of Vav1 protein in A549 cells, the expression level of Vav1 mRNA was investigated. The effect of Vav1 expression in A549 cells requires further study. Overall, the results of the present study revealed that TAOCSB may provide more information regarding lung cancer treatment.

Acid-Catalyzed Protocol for the Synthesis of Novel 6-Substituted Tetrahydroquinolines by Highly Regioselective C6-Functionalization of Tetrahydroquinolines with Chromene Hemiacetals or β-Nitrostyrenes

A simple and novel method has been developed for the C6-functionalization of unprotected tetrahydroquinoline with chromenes or β-nitrostyrenes in aqueous medium to afford novel 6-substituted tetrahydroquinolines. This method is simple and convenient, and has low costs and mild reaction conditions. Regioselectively C6-alkylated products were obtained exclusively from tetrahydroquinoline, without the formation of C5-, C7-, C8-, or N-alkylated products.

Association between microRNA polymorphisms and coronary heart disease : A meta-analysis

The association between microRNA polymorphisms (miR polymorphisms) and coronary heart disease (CHD) risk has been studied intensively, but the results have been conflicting. Therefore, we conducted the present meta-analysis to obtain a more conclusive answer. We searched for eligible articles in PubMed, MEDLINE, EMBASE, Scopus, and CNKI. Odds ratios (ORs) and 95% confidence intervals (CIs) were used to identify any potential associations. Ten case-control studies including 5,292 CHD patients and 5,446 control subjects were analyzed. The overall meta-analysis results showed that the miR-146a rs2910164 polymorphism, the miR-196a2 rs11614913 polymorphism, and the miR-499 rs3746444 polymorphism were all significantly associated with CHD risk in certain genetic models. Besides, the C allele of the miR-146a rs2910164 and miR-499 rs3746444 polymorphisms conferred increased susceptibility to CHD (C versus G, p < 0.0001, OR = 1.14, 95% CI = 1.07-1.21; p = 0.003, OR = 1.14, 95% CI = 1.05-1.25). Overall, our findings suggest that the miR-146a rs2910164, miR-196a2 rs11614913, and miR-499 rs3746444 polymorphisms may be correlated with the risk of CHD.

Hydrolysis of thorium(iv) at variable temperatures

Hydrolysis of Th(iv) was studied in tetraethylammonium perchlorate (0.10 mol kg(-1)) at variable temperatures (283-358 K) by potentiometry and microcalorimetry. Three hydrolysis reactions, mTh(4+) + nH2O = Thm(OH)n((4m-n)+) + nH(+), in which (n,m) = (2,2), (8,4), and (15,6), were invoked to describe the potentiometric and calorimetric data for solutions with the [hydroxide]/[Th(iv)] ratio ≤ 2. At higher ratios, the formation of (16,5) cannot be excluded. The hydrolysis constants, *β2,2, *β8,4, and *β15,6, increased by 3, 7, and 11 orders of magnitude, respectively, as the temperature was increased from 283 to 358 K. The enhancement is mainly due to the significant increase of the degree of ionization of water as the temperature rises. All three hydrolysis reactions are endothermic at 298 K, with enthalpies of (118 ± 4) kJ mol(-1), (236 ± 7) kJ mol(-1), and (554 ± 4) kJ mol(-1) for ΔH2,2, ΔH8,4, and ΔH15,6 respectively. The hydrolysis constants at infinite dilution have been obtained with the specific ion interaction approach. The applicability of three approaches for estimating the equilibrium constants at different temperatures, including the constant enthalpy approach, the constant heat capacity approach and the DQUANT equation was evaluated with the data from this work.

Bacillus spore wet heat resistance and evidence for the role of an expanded osmoregulatory spore cortex

Previous work reported that decoated Bacillus cereus spores incubated in 4 mol l(-1) CaCl2 are killed at lower temperatures than spores in water. This wet heat sensitization was suggested to support a role for an osmoregulatory peptidoglycan cortex in spore cores' low water content, and their wet heat resistance. Current work has replicated this finding with spores of B. cereus, Bacillus megaterium and Bacillus subtilis. However, this work found that decoated spores apparently killed at 80°C in 4 mol l(-1) CaCl2 : (i) were recovered on plates containing lysozyme; (ii) lost no dipicolinic acid (DPA) and their inner membrane remained impermeable; (iii) released no DPA upon stimulation with nutrient germinants and could not complete germination; and (iv) released DPA relatively normally upon stimulation with dodecylamine. These results indicate that decoated spores treated with 80°C- 4 mol l(-1) CaCl2 are not dead, but some protein(s) essential for spore germination, most likely germinant receptors, are inactivated by this treatment. Thus, the original finding does not support a role for an osmoregulatory cortex in spore wet heat resistance.

SIGNIFICANCE AND IMPACT OF THE STUDY

Bacillus spores' low core water content is a major factor in their wet heat resistance. One suggested mechanism for achieving low spore core water content is osmoregulated expansion of spores' peptidoglycan cortex. Evidence for this mechanism includes a report that decoated Bacillus cereus spores incubated in 4 mol l(-1) CaCl2 exhibit drastically reduced heat resistance. The current work shows that this heat sensitization of decoated spores of three Bacillus species is most likely due to inactivation of some crucial spore germination protein(s), since while treated spores appear dead, their apparent low viability is rescued by triggering spore germination with lysozyme.

Abstract P5-12-02: Effect of 5 vs 2.5 mg/day letrozole on residual estrogen levels in post-menopausal women with high BMI - A prospective crossover study

Background: Some studies have suggested that women with high BMI have less benefit from aromatase inhibitors (AI) vs. tamoxifen as adjuvant treatment for early breast cancer. One possible mechanism for this observation is that complete suppression of estrogen is not achieved in these women with the standard flat dose of AI. We evaluated whether a doubling of letrozole to 5 mg/day for 4 weeks affected residual estrogen levels in this population.

Methods: Post-menopausal women with early breast cancer and BMI&gt;25 already taking adjuvant letrozole for at least 3 months were recruited from medical oncology clinics at 4 sites in Toronto, Canada. Fasting blood samples were collected 24 hours following the last dose at baseline (routine use of own letrozole), after 28 days of monitored adherence to a provided supply of letrozole (Femara) 2.5 mg/day (Part A), and after an additional 28 days of letrozole (Femara) 5 mg/day (Part B). Symptom/quality of life questionnaires were completed at the same timepoints. Estradiol and estrone were measured using a high sensitivity liquid chromatography-tandem mass spectrometry assay. One interim analysis for futility and efficacy was planned after 31 eligible patients had completed the study, using estradiol and O'Brien-Fleming boundaries with an inner wedge.

Results: 36 patients were enrolled and started on study, and 31 eligible patients completed Parts A and B. The 5 non-completers withdrew because of adverse events (n=4, unlikely related to drug) or withdrawal of consent (n=1). Median age was 62 (range 48 to 77) and BMI 28.3 kg/m2 (Range 25.2 to 42.2 kg/m2). One patient had non-postmenopausal estrogen levels at Day 29 and Day 57 and one patient's blood assay was unsuccessful; both were excluded from further analyses. The predetermined stopping rule for futility was met. Estradiol levels (mean±standard deviation) changed from 2.68±0.40 pg/mL at baseline to 2.67±0.59 pg/mL at Day 29 to 2.70±0.53 pg/mL at Day 57. Mean change from Day 29 to Day 57 was 0.03±0.48 pg/mL (95% confidence interval -0.15 to 0.21 pg/mL). Four patients reported new or increased arthralgias (to NCI CTCAE Grade 2 or 3) while taking letrozole 5 mg/day in Part B. There was no association between changes in estradiol levels and either study non-completion or the development of arthralgias. Estrone results were similar.

Conclusion: Increasing letrozole from 2.5 to 5 mg/day did not further suppress estrogen levels in women with BMI&gt;25. It is unlikely that letrozole dosing tailored to body size would improve clinical outcomes. The letrozole 5 mg/day intervention was terminated based on the results of the interim analysis for futility.

Citation Format: Cescon DW, Ennis M, Pritchard KI, Townsley C, Warr D, Elser C, Rao L, Stambolic V, Sridhar S, Goodwin PJ. Effect of 5 vs 2.5 mg/day letrozole on residual estrogen levels in post-menopausal women with high BMI - A prospective crossover study. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P5-12-02.

Structural and spectroscopic studies of a rare non-oxido V(v) complex crystallized from aqueous solution

A non-oxido V(v) complex with glutaroimide-dioxime (H₃L), a ligand for recovering uranium from seawater, was synthesized from aqueous solution as Na[V(L)₂]·2H₂O, and the structure determined by X-ray diffraction.

A non-oxido V(v) complex with glutaroimide-dioxime (H₃L), a ligand for recovering uranium from seawater, was synthesized from aqueous solution as Na[V(L)₂]·2H₂O, and the structure determined by X-ray diffraction. It is the first non-oxido V(v) complex that has been directly synthesized in and crystallized from aqueous solution. The distorted octahedral structure contains two fully deprotonated ligands (L^3–) coordinating to V⁵⁺, each in a tridentate mode via the imide N (R_V–N = 1.96 Å) and oxime O atoms (R_V–O = 1.87–1.90 Å). Using ¹⁷O-labelled vanadate as the starting material, concurrent ¹⁷O/⁵¹V/¹H/¹³C NMR, in conjunction with ESI-MS, unprecedentedly demonstrated the stepwise displacement of the oxido V Created by potrace 1.16, written by Peter Selinger 2001-2019 ]]> O bonds by glutaroimide-dioxime and verified the existence of the “bare” V⁵⁺/glutaroimide-dioxime complex, [V(L)₂]^–, in aqueous solution. In addition, the crystal structure of an intermediate 1 : 1 V(v)/glutaroimide-dioxime complex, [VO₂(HL)]^–, in which the oxido bonds of vanadate are only partially displaced, corroborates the observations by NMR and ESI-MS. Results from this work provide important insights into the strong sorption of vanadium on poly(amidoxime) sorbents in the recovery of uranium from seawater. Also, because vanadium plays important roles in biological systems, the syntheses of the oxido and non-oxido V⁵⁺ complexes and the unprecedented demonstration of the displacement of the oxido V Created by potrace 1.16, written by Peter Selinger 2001-2019 ]]> O bonds help with the on-going efforts to develop new vanadium compounds that could be of importance in biological applications.

Preconditioning donor livers with cromolyn or compound 48/80 prolongs recipient survival in a rat orthotopic liver transplantation model

BACKGROUND

Acute rejection (AR) remains a challenge in organ transplantation. Preconditioning donor organs can reduce AR and prolong survival. Whether preconditioning with cromolyn (CRM), a mast cell (MC) stabilizer, or compound 48/80 (CMP 48/80), a MC degranulator, can alleviate AR and prolong survival has not been studied.

METHODS

We used the male-DA-to-female-Lewis-rat orthotopic liver transplantation (OLT) model. Donors were preconditioned with CRM in a MC stabilizing way (CRM group) or CMP 48/80 in a MC depleting way (CMP 48/80 group). Rats preconditioned with phosphate-buffered saline were used as controls (PBS group). After preconditioning, OLT surgeries were carried out. OLT male-Lewis-to-female-Lewis-rats were used as the syngeneic group (syngeneic group).

RESULTS

Rats in the PBS group developed AR rapidly and died at 7.40 ± 1.14 days. Rats in the CRM and CMP 48/80 groups had significantly slower rejections and died at day 17.40 ± 1.67 or 14.20 ± 2.28, respectively (P < .05). Rats in the syngeneic group survived more than 60 days. Rejection activity indexes (RAIs) and liver functions were all alleviated through CRM or CMP 48/80 preconditioning. Interferon-γ messenger RNA (mRNA) expressions were reduced and interleukin-10 mRNA levels were higher in allografts in the CRM and CMP 48/80 groups, compared with the PBS group. These were confirmed by testing serum interferon-γ and interlerkin-10.

CONCLUSION

Preconditioning donor livers with CRM or CMP 48/80 can reduce AR and prolong survival of recipients after OLT.

Synergistic sporicidal effect of ethanol on a combination of orthophthalaldehyde and didecyldimethylammonium chloride

The objective of this study was to evaluate the potential synergistic effect of ethanol on a combination of orthophthalaldehyde (OPA) and didecyldimethylammonium chloride (DDAC) against the spores of Bacillus subtilis var. Niger. The quantitative carrier test for sporicidal testing of high-level disinfectants according to the guideline of China (Technical Standard for Disinfection 2002) was used as method. Considerable synergistic effect was observed after a 30-min treatment at 20°C. There was an augment in mean log reduction as the concentration of DDAC was increased ranging from 0·2 to 3 g l(-1) in combination with 6 g l(-1) OPA. Ten and 20% ethanol in combination with 6 g l(-1) OPA and 2 g l(-1) DDAC caused more than a 3-log reduction while either 6 g l(-1) OPA, 2 g l(-1) DDAC and 20% ethanol alone or a combination of two of the three agents produced less than a 1-log reduction. Further, 40-min exposure time of combination of OPA, DDAC and 20% ethanol led to greater than a 5-log reduction in spores, and no spore growth was observed following 60- and 90-min exposures.

SIGNIFICANCE AND IMPACT OF THE STUDY

Orthophthalaldehyde (OPA) is very effective at concentrations far lower than its recommended in-use concentration of 0·5% (w/v) and is equally effective against both the gram-negative and gram-positive bacteria. However, it shows lower activity against spores. The synergistic sporicidal effect exhibited by ethanol on a combination of OPA and DDAC can be considered to enhance sporicidal activity for using in situations of sterilization, to reduce in-use concentration of OPA used alone, which may minimize its side effect. OPA may be a more satisfactory and the first-choice agent to replace glutaraldehyde (GTA) as a high-level disinfectant for medical devices.

Genetic association of IL-21 polymorphisms with dilated cardiomyopathy in a Han Chinese population

BACKGROUND

Autoimmune abnormalities appear to be major predisposing factors for dilated cardiomyopathy (DCM). Interleukin-21 (IL-21) gene polymorphisms have been previously found to be associated with autoimmune diseases. This study aimed to assess the role of IL-21 in DCM in a Han Chinese population.

PATIENTS AND METHODS

A total of 364 independent DCM patients and 384 unrelated healthy controls were recruited for this case-control association study. rs2055979 and rs12508721 were genotyped by PCR-RFLP. IL-21 plasma levels in samples from DCM and control individuals were evaluated by ELISA. The association between the SNPs and overall survival (OS) was evaluated by Kaplan-Meier analysis. Hazard ratios and 95 % confidence intervals (CIs) were assessed in a Cox regression analysis with adjustment for sex and age.

RESULTS

The T allele frequencies of both SNPs were higher in DCM patients than in controls (p < 0.001). The genotypic frequencies of rs2055979 G > T and rs12508721 C > T were associated with DCM in the codominant, dominant, and recessive models (p < 0.05). IL-21 plasma levels in patients were higher than those of the control subjects (p = 0.009). The TT genotypes of both SNPs were associated with significantly higher plasma levels (prs2055979 = 0.03, prs12508721 < 0.001). Kaplan-Meier analysis showed that the genotypic frequencies of both SNPs were associated with OS in the dominant and the recessive models (p < 0.001). The TT genotypes of both SNPs were associated with the worst OS (p < 0.001).

CONCLUSION

Our findings suggest that theIL-21 gene plays an important role in susceptibility to DCM as well as in the clinical outcome of this ailment in the Han Chinese population.

Transcriptome analysis of glioma cells for the dynamic response to γ-irradiation and dual regulation of apoptosis genes: a new insight into radiotherapy for glioblastomas

Ionizing radiation (IR) is of clinical importance for glioblastoma therapy; however, the recurrence of glioma characterized by radiation resistance remains a therapeutic challenge. Research on irradiation-induced transcription in glioblastomas can contribute to the understanding of radioresistance mechanisms. In this study, by using the total mRNA sequencing (RNA-seq) analysis, we assayed the global gene expression in a human glioma cell line U251 MG at various time points after exposure to a growth arrest dose of γ-rays. We identified 1656 genes with obvious changes at the transcriptional level in response to irradiation, and these genes were dynamically enriched in various biological processes or pathways, including cell cycle arrest, DNA replication, DNA repair and apoptosis. Interestingly, the results showed that cell death was not induced even many proapoptotic molecules, including death receptor 5 (DR5) and caspases were activated after radiation. The RNA-seq data analysis further revealed that both proapoptosis and antiapoptosis genes were affected by irradiation. Namely, most proapoptosis genes were early continually responsive, whereas antiapoptosis genes were responsive at later stages. Moreover, HMGB1, HMGB2 and TOP2A involved in the positive regulation of DNA fragmentation during apoptosis showed early continual downregulation due to irradiation. Furthermore, targeting of the TRAIL/DR5 pathway after irradiation led to significant apoptotic cell death, accompanied by the recovered gene expression of HMGB1, HMGB2 and TOP2A. Taken together, these results revealed that inactivation of proapoptotic signaling molecules in the nucleus and late activation of antiapoptotic genes may contribute to the radioresistance of gliomas. Overall, this study provided novel insights into not only the underlying mechanisms of radioresistance in glioblastomas but also the screening of multiple targets for radiotherapy.

Colorectal neoplasia in long-standing ulcerative colitis - a prospective study from a low-prevalence area

AIM

Despite increasing recognition of ulcerative colitis (UC) in Asia in recent decades, reports on the occurrence of colorectal neoplasia (CRN) in UC are scarce and surveillance for this complication is not routinely practised in this region. We aimed to assess the outcome of a newly initiated pilot screening programme for screening CRN among UC patients in India.

METHOD

In this prospective study from an academic hospital setting, patients with UC at high risk of CRN were offered screening by magnifying chromocolonoscopy and the frequency of neoplastic lesions was assessed.

RESULTS

Twenty-nine (70.7%) of 41 eligible patients [a median age of 46 (interquartile range 36-54.5) years; 17 (58.6%) men] enrolled for surveillance; 41 colonoscopies were undertaken over 42 months. The median disease duration was 10 (interquartile range 7.5-14.5) years. Sixteen (55.1%) had extensive colitis. On initial screening, low-grade dysplasia (LGD) was seen in five (17.2%) and high-grade dysplasia (HGD) in three (10.3%). Of these three, one accepted proctocolectomy immediately, one underwent surgery for adenocarcinoma and one refused surgery. Twelve follow-up colonoscopies in nine patients revealed three new LGD.

CONCLUSIONS

High-grade dysplasia and subsequent adenocarcinoma can be detected with careful follow-up in Indian patients with long-standing UC but acceptance of surveillance and subsequent therapy are suboptimal. We found evidence that screening and surveillance programmes are useful for detecting neoplasias in UC, and need to be customized for this region.

High-resolution MRI of the intraparotid facial nerve based on a microsurface coil and a 3D reversed fast imaging with steady-state precession DWI sequence at 3T

BACKGROUND AND PURPOSE

3D high-resolution MR imaging can provide reliable information for defining the exact relationships between the intraparotid facial nerve and adjacent structures. The purpose of this study was to explore the clinical value of using a surface coil combined with a 3D-PSIF-DWI sequence in intraparotid facial nerve imaging.

MATERIALS AND METHODS

Twenty-one healthy volunteers underwent intraparotid facial nerve scanning at 3T by using the 3D-PSIF-DWI sequence with both the surface coil and the head coil. Source images were processed with MIP and MPR to better delineate the intraparotid facial nerve and its branches. In addition, the SIR of the facial nerve and parotid gland was calculated. The number of facial nerve branches displayed by these 2 methods was calculated and compared.

RESULTS

The display rates of the main trunk, divisions (cervicofacial, temporofacial), and secondary branches of the intraparotid facial nerve were 100%, 97.6%, and 51.4% by head coil and 100%, 100%, and 83.8% by surface coil, respectively. The display rate of secondary branches of the intraparotid facial nerve by these 2 methods was significantly different (P < .05). The SIRs of the intraparotid facial nerve/parotid gland in these 2 methods were significantly different (P < .05) at 1.37 ± 1.06 and 1.89 ± 0.87, respectively.

CONCLUSIONS

The 3D-PSIF-DWI sequence combined with a surface coil can better delineate the intraparotid facial nerve and its divisions than when it is combined with a head coil, providing better image contrast and resolution. The proposed protocol offers a potentially useful noninvasive imaging sequence for intraparotid facial nerve imaging at 3T.

Schwannoma of the nose and paranasal sinuses

Sckhwannoma is a benign tumor arising from the Schwann cells of nerve sheath.Through they arise more commonly in the head and neck than other regions, a through search in the liturature including medline revealed only about 47 reported cases of schwannoma in the paranasal sinuses of which the maxillary sinus involvement is more common. We report three cases of schwannoma arising from unusual sites in the paranasal sinuses with different modes of presttation each requiring a specific approach for surgical excision Transnasal endoscopic approach in combination with vonventional approaches is of immense value in the surgical management of these benign lessions of the paranasal sinuses.

Rhinofacial zygomycosis caused by conidiobolus coronatus

Fungal infections are common in a tropical country like India. Among the Zygomycosis infections, those caused by Mucorales are more prevalent. However, there exists another order of zygomycetes, the Entomophthorales, which rarely cause clinical disease. We report a rare cause of fungal infection of the maxillo-facial region and the oropharynx in a previously healthly male adult caused by Conidiobolus coronata of the order Entomophthorales to highlight the clinical presentation and treatment of this rare, chronic, indolent form of fungal infection.

Quantitative assessment of chronic lung disease of infancy using computed tomography

The aims of this study were to determine whether infants and toddlers with chronic lung disease of infancy (CLDI) have smaller airways and lower lung density compared with full-term healthy controls. Multi-slice computed tomography (CT) chest scans were obtained at elevated lung volumes during a brief respiratory pause in sedated infants and toddlers; 38 CLDI were compared with 39 full-term controls. For CLDI subjects, gestational age at birth ranged from 25 to 29 weeks. Airway size was measured for the trachea and the next three to four generations into the right lower lobe; lung volumes and tissue density were also measured. The relationship between airway size and airway generation differed between the CLDI and full-term groups; the sizes of the first and second airway generations were larger in the shorter CLDI than in the shorter full-term subjects. The increased size in the airways in the CLDI subjects was associated with increasing mechanical ventilation time in the neonatal period. CLDI subjects had a greater heterogeneity of lung density compared with full-term subjects. Our results indicate that quantitative analysis of multi-slice CT scans at elevated volumes provides important insights into the pulmonary pathology of infants and toddlers with CLDI.

Isolated renal nocardiosis in a patient with AIDS: Unusual presentation

Disseminated or systemic infection with nocardiosis is an opportunistic infection that is seen in immunocompromised individuals and can involve any organ. The primary infection in systemic nocardiosis usually occurs in the lungs and subsequently hematogenous dissemination occurs in other organs of the body. Nocardia infection of the kidney usually manifests as multiple pyelonephritic abscesses. We report a case of isolated renal nocardiosis, without involvement of the lungs or other organs in a patient with AIDS who presented with symptoms of renal failure. The nephrectomy specimen showed multiple calculi in the calyceal system and a tumorous mass with necrotic areas, which histologically showed features of nocardiosis. The case is being presented as this is an unusual manifestation of renal nocardiosis.

Computed tomography score and pulmonary function in infants with chronic lung disease of infancy

Chronic lung disease of infancy (CLDI) remains a common outcome among infants born extremely prematurely. In older children and adults with lung disease, pulmonary function and computed tomography (CT) scores are used to follow up respiratory disease and assess disease severity. For infants and toddlers, however, these outcomes have been used very infrequently and most often, a dichotomous respiratory outcome (presence or absence of CLDI) is employed. We evaluated the performance of CT score and pulmonary function to differentiate infants and toddlers with CLDI from a control group. CT scans, forced expiratory flows and pulmonary diffusing capacity were obtained in 39 CLDI patients and 41 controls (aged 4-33 months). CT scans were quantified using a scoring system, while pulmonary function was expressed as Z-scores. CT score outperformed pulmonary function in identifying those with CLDI. There were no significant correlations between CT score and pulmonary function. CT score had a better performance than pulmonary function in differentiating individuals with CLDI; however, these outcomes may reflect differing components of the pulmonary pathophysiology of CLDI. This new information on pulmonary outcomes can assist in designing studies with these parameters. Future studies will be required to evaluate which of the outcomes can better detect improvement with therapeutic intervention and/or lung growth.