Bacteriophage therapy against pathological Klebsiella pneumoniae ameliorates the course of primary sclerosing cholangitis

Primary sclerosing cholangitis (PSC) is characterized by progressive biliary inflammation and fibrosis. Although gut commensals are associated with PSC, their causative roles and therapeutic strategies remain elusive. Here we detect abundant Klebsiella pneumoniae (Kp) and Enterococcus gallinarum in fecal samples from 45 PSC patients, regardless of intestinal complications. Carriers of both pathogens exhibit high disease activity and poor clinical outcomes. Colonization of PSC-derived Kp in specific pathogen-free (SPF) hepatobiliary injury-prone mice enhances hepatic Th17 cell responses and exacerbates liver injury through bacterial translocation to mesenteric lymph nodes. We developed a lytic phage cocktail that targets PSC-derived Kp with a sustained suppressive effect in vitro. Oral administration of the phage cocktail lowers Kp levels in Kp-colonized germ-free mice and SPF mice, without off-target dysbiosis. Furthermore, we demonstrate that oral and intravenous phage administration successfully suppresses Kp levels and attenuates liver inflammation and disease severity in hepatobiliary injury-prone SPF mice. These results collectively suggest that using a lytic phage cocktail shows promise for targeting Kp in PSC.

An old model with new insights: endogenous retroviruses drive the evolvement toward ASD susceptibility and hijack transcription machinery during development

The BTBR T+Itpr3tf/J (BTBR/J) strain is one of the most valid models of idiopathic autism, serving as a potent forward genetics tool to dissect the complexity of autism. We found that a sister strain with an intact corpus callosum, BTBR TF/ArtRbrc (BTBR/R), showed more prominent autism core symptoms but moderate ultrasonic communication/normal hippocampus-dependent memory, which may mimic autism in the high functioning spectrum. Intriguingly, disturbed epigenetic silencing mechanism leads to hyperactive endogenous retrovirus (ERV), a mobile genetic element of ancient retroviral infection, which increases de novo copy number variation (CNV) formation in the two BTBR strains. This feature makes the BTBR strain a still evolving multiple-loci model toward higher ASD susceptibility. Furthermore, active ERV, analogous to virus infection, evades the integrated stress response (ISR) of host defense and hijacks the transcriptional machinery during embryonic development in the BTBR strains. These results suggest dual roles of ERV in the pathogenesis of ASD, driving host genome evolution at a long-term scale and managing cellular pathways in response to viral infection, which has immediate effects on embryonic development. The wild-type Draxin expression in BTBR/R also makes this substrain a more precise model to investigate the core etiology of autism without the interference of impaired forebrain bundles as in BTBR/J.

Validation and standardization of DNA extraction and library construction methods for metagenomics-based human fecal microbiome measurements

BACKGROUND

Validation and standardization of methodologies for microbial community measurements by high-throughput sequencing are needed to support human microbiome research and its industrialization. This study set out to establish standards-based solutions to improve the accuracy and reproducibility of metagenomics-based microbiome profiling of human fecal samples.

RESULTS

In the first phase, we performed a head-to-head comparison of a wide range of protocols for DNA extraction and sequencing library construction using defined mock communities, to identify performant protocols and pinpoint sources of inaccuracy in quantification. In the second phase, we validated performant protocols with respect to their variability of measurement results within a single laboratory (that is, intermediate precision) as well as interlaboratory transferability and reproducibility through an industry-based collaborative study. We further ascertained the performance of our recommended protocols in the context of a community-wide interlaboratory study (that is, the MOSAIC Standards Challenge). Finally, we defined performance metrics to provide best practice guidance for improving measurement consistency across methods and laboratories.

CONCLUSIONS

The validated protocols and methodological guidance for DNA extraction and library construction provided in this study expand current best practices for metagenomic analyses of human fecal microbiota. Uptake of our protocols and guidelines will improve the accuracy and comparability of metagenomics-based studies of the human microbiome, thereby facilitating development and commercialization of human microbiome-based products. Video Abstract.

Effects of monthly feedback of VFA measured by dual BIA method in Japanese patients with obesity: a randomized controlled study

Objective

To investigate the effects of monthly feedback of changes in visceral fat area (VFA) as measured by dual bioelectrical impedance analysis method and the importance of VFA in individuals with obesity.

Methods

Thirty‐eight Japanese patients with obesity underwent VFA measurements. The feedback group was given feedback on VFA measurements each month for 4 months. The control group underwent VFA measurements at the beginning and end of the study but was not informed of the results. All the study participants completed eating behaviour and weight efficacy lifestyle questionnaires.

Results

Mean age was 53.9 (14.3) years; mean body mass index was 30.6 (4.3) kg m⁻². At the 4‐month follow‐up, there was no significant difference in VFA reduction between the control and feedback groups (−4.4% vs. −3.0%; 95% CI, −3.8 to 5.5). In post‐hoc analysis using the overall group irrespective of allocation, changes of eating style were significantly associated with a reduction in VFA at 4 months (p = 0.034).

Conclusions

Monthly feedback on changes in VFA does not reduce VFA. More frequent feedback may be required. In post‐hoc analysis, changes of eating style were associated with a reduction in VFA.

Effects of deep sedation under mechanical ventilation on cognitive outcome in patients undergoing surgery for oral and maxillofacial cancer and microvascular reconstruction

OBJECTIVE

Cognitive impairment after intensive care unit (ICU) admission is becoming increasingly recognized. High-dose deep sedation has been suggested to play an important role in the development of cognitive impairment. However, the impact of heavy sedation as a single cause in the development of cognitive impairment in ICU patients remains unclear. In this study we investigated whether a three-day deep sedation protocol could reduce cognitive function in mechanically ventilated non-critical patients.

DESIGN

A prospective observational study was carried out.

PATIENTS

A total of 17 surgical patients were studied.

INTERVENTION

None.

VARIABLES OF INTEREST

Cognitive function before and after ICU admission.

RESULTS

Thirty-one patients requiring three days of sedation after microvascular reconstruction were initially enrolled in the study. Sedation in the ICU was maintained with propofol and dexmedetomidine combined with fentanyl. Cognitive function was assessed using a battery of 6 neuropsychological tests two days before surgery and three weeks after surgery. Finally, a total of 17 patients were included in the analysis. Cognitive impairment (defined as a decline of >20% from the pre-admission cognitive evaluation scores in at least two of 6 tests) was observed in 5 of the 17 patients (29%). However, there were no significant differences between the pre- and post-admission cognitive evaluations in 6 tests.

CONCLUSIONS

Middle-term cognitive function can be impaired in some patients subjected to deep sedation during several days following maxillary-mandibular oral surgery with microvascular reconstruction.

Structure and Thermal Behaviour of a Thermotropic Liquid Crystalline Polyimide (PI-LC)

Anomalous solid structures formed by a thermotropic liquid crystalline polyimide (PI-LC) were investigated by thermal analysis, polarized light microscopy and x-ray analysis. It was revealed that PI-LC should undergo a phase transition from the crystalline to the isotropic phase through the smectic or nematic phase in the temperature range 277–300 °C. The PI-LC filament extruded at 280 °C, at which temperature the polymer was in liquid crystalline phase, was formed to have a structure similar to the smectic C phase, while that extruded and melt-drawn at 310 °C, at which temperature the polymer was in the isotropic phase, had a structure similar to the smectic A phase.

Miscibility, Morphology and Tensile Properties of the Melt Blends of Liquid Crystalline Polyimide (PI-LC) with Two Different Thermoplastic Polyimides: Semicrystalline Polyimide (N-TPI) and Amorphous Poly(Ether-Imide) (PEI)

A liquid crystalline polyimide (poly[1, 3-bis[4-(4-aminophenoxy)-α, α-dimethylbenzyl]benzene pyromellitimide]: PI-LC) was blended with two kinds of thermoplastic polyimide: poly[3, 3′-(4, 4′-dioxybiphenyl)diphenylene pyromellitimide] (N-TPI) which is a semicrystalline polyimide having a melting point of 388 °C and poly[2, 2′-bis(3, 4-dicarboxyphenoxy)phenylpropane-2-phenylene bisimide] (PEI) which is an amorphous poly(etherimide) having a glass transition temperature at 220 °C. The miscibility of N-TPI and PI-LC was evaluated by DSC using enthalpy relaxation, and the phase diagram of their blend was drawn above the melting point of N-TPI. The result indicated that the PI-LC-rich blend was miscible in a wide range of compositions. However, the extruded samples of their blend, which had been prepared under a flow of high shear, showed a phase separation structure. In the other combination of PEI and PI-LC, the blend was immiscible, but at low composition of PI-LC their blend fibre showed higher tensile properties than the original PEI fibre.

Comparison of some risk factors for diabetes across different social groups: a cross-sectional study

Background:

In fast, developing economies such as India, the population is undergoing rapid social transition, which can increase the risk profile for diabetes. Market forces promoting lifestyles such as sedentary habits, alcohol and tobacco use, which earlier were more prevalent among affluent urban populations are now trickling into the urban poor and rural populations.

Aim:

The aim of the present research was to compare the prevalence of risk factors for diabetes among three distinct social groups-the urban affluent, the urban poor and the rural poor.

Subjects and Methods:

A total of 775 adult population over 18 years and belonging to both genders were surveyed for prevalence of some of the risk factors for diabetes such as physical inactivity, obesity, alcohol, and tobacco use. The sample comprised of three distinct social groups as follows; 125 medical students representing the affluent, 400 subjects from urban slums, and 250 subjects from rural areas. Obesity was measured by body mass index (BMI) while central obesity was ascertained by waist hip ratio (WHR). Alcohol and tobacco use were elicited by interview.

Results:

The overall response rate was 88.52% (686/775). Medical students were more sedentary with mean hours spent each day sitting or reclining at 10.47 (3.25) h, compared to corresponding figures of 6.34 (3.1) h and 7.49 (3.74) h for the rural and urban slum residents respectively (P < 0.001). However, all types of leisure time physical activities were significantly more among the medical students compared to the other groups (P < 0.001). BMI was significantly highest among the rural population with mean of 24.22 (4.17) kg/m² when compared to the other groups, (P < 0.001). Villagers also had higher WHR and had a higher proportion of persons above the WHR cut-off for gender (P < 0.001). Experimentation with alcohol was more prevalent among the medical students while the urban slum residents were more frequent and heavy drinkers. Smoking was most prevalent among the medical students, while smokeless tobacco use was more among the other groups.

Conclusions:

Physical inactivity, obesity, including central obesity, alcohol and tobacco use were found in various degrees in the study samples. An important finding was that both obesity and central obesity ascertained by BMI and WHR respectively were highest among the rural population implying the impact of social change on diabetic risk factors.

Molecular comparison of waxy null alleles in common wheat and identification of a unique null allele

PCR selection markers for the identification of null waxy alleles were used to screen for waxy mutations in 168 common wheat cultivars. In all cultivars where the Wx-B1 protein was absent, the Wx-B1 allele was identical to the previously identified mutation carried by Kanto 107. Although most cultivars missing the Wx-A1 protein also carried the same Wx-A1 mutation as found in Kanto 107, all of the Turkey Wx-A1 mutants produced a different PCR fragment, implying the presence of a different mutation. Sequencing of this fragment indicated the mutation, which consisted of a 173-bp insertion in an exon, was in a different location than the previously identified Wx-A1 mutation. An 8-bp duplication of the Wx-A1 sequence flanked each end of the insertion, and an element with reverse complementary sequences was present at both ends of the insertion. These structures correspond with the features of class II transposable elements. Hence, the Turkey null Wx-A1 mutation was likely caused by the movement of a transposon, and this spontaneous mutation appears to be present in a limited geographical area.

Rapid classification of partial waxy wheats using PCR-based markers

Mutations in the three homeologous waxy loci Wx-A1, Wx-B1, and Wx-D1 of a waxy wheat line have previously been characterized at the molecular level. Using combinations of these mutations, six types of partial waxy wheat plus wild type and waxy wheat (types 1-8) can be produced. Here, we describe primer sets for all three loci that can be used under a single set of conditions, allowing 32 lines to be characterized as types 1-8 in a single PCR run using a 96-well plate. Using multiplex PCR, mutations at the Wx-B1 and Wx-D1 loci can be identified in a single PCR, reducing the number of reactions necessary to identify and select the desired partial waxy wheat line. A single multiplex PCR can be used to detect all three mutations when products are analyzed using capillary electrophoresis on a microchip device. The PCR conditions and primers are effective with a number of cultivars from other countries, indicating that the mutations found at the Wx-A1 and Wx-B1 loci of these cultivars likely have the same origins as the mutations in the corresponding loci of the waxy wheat line used in this study. The PCR selection method described here is an easy and effective alternative to the commonly used SDS-PAGE methods for identification of null alleles.

Synthesis biological evaluation of alkyl, alkoxy, alkylthio, or amino-substituted 2,3-dihydro-1,5-benzothiazepin-4(5H)-ones

2,3-Dihydro-1,5-benzothiazepin-4(5H)-ones substituted with an alkyl, alkoxy, alkylthio, hydroxy, or amino group on the fused benzene ring of the 1,5-benzothiazepine skeleton were synthesized and their vasodilating, antihypertensive, and platelet aggregation-inhibitory activities were investigated. (-)-cis-3-Acetoxy-5-[2-(di-methylamino) ethyl]-2,3-dihydro-8-methyl-2-(4-methylphenyl)-1,5-benzothiazepin- 4(5H)-one ((-)-13e) was selected for further studies as a potent inhibitor of platelet aggregation.

Synthesis of halogen-substituted 1,5-benzothiazepine derivatives and their vasodilating and hypotensive activities

In an attempt to improve the effectiveness and duration of the action of diltiazem (1), a 1,5-benzothiazepine calcium channel blocker, its derivatives (2) with halogen substituents on the fused benzene ring were synthesized. These compounds were evaluated for their effects on vertebral and coronary blood flows and antihypertensive activity. The structure-activity relationships are discussed. The 8-chloro derivative ((+)-2b), the most potent compound in this series, was selected for clinical evaluation as a cerebral vasodilating and antihypertensive agent.

[A study of cisterna magna on brain computerized tomography in children]

Although many publications on cranial computerized tomography have been reported in recent years, very little attention has been directed to the cisterna magna (CM) and its variations. The size of the cisterna magna is still debatable and the criterion of the mega cisterna magna is obscure. We studied age distribution, clinical manifestations, and other CT findings in the children with enlarged cisterna magna. A consecutive series of 367 computerized tomographic scans were reviewed. We classified four classes according to the degree of enlargement of the cisterna magna: CM is undetectable; CM (-), CM is detectable at the level of sella turcica and the fourth ventricle; CM(+), CM extends upward at the level of suprasellar cistern and colliculus inferior; CM (+ +), and CM extends extensively at the level of the third ventricle and colliculus superior; CM (+ + +). We judged 55 CT scans (15%) to belong to CM (+ + +) class and 100 scans (27%) to CM (+ +) class. The greater part of children with CM (+ + +) were younger in contrast with CM (+ +), which distributed uniformly in every ages. Also we differentiated the patients into three groups from clinical manifestations as follows: patients with developmental delayed; group D, patients with organic neurological diseases; group N, patients with other diseases; group O. The ratio of group D is significantly higher in CM (+ + +) than that of other groups. No children had posterior fossa symptoms of mass effect and required treatment.(ABSTRACT TRUNCATED AT 250 WORDS)

[Longitudinal study of epileptic foci in childhood]

We performed the longitudinal study in patients with focal spikes about characteristic changes in epileptic foci for periods of between one year and 5 years 9 months. The 116 epileptic children were evaluated, ranging in onset age from 10 month to 12 year 9 month old (mean age: 6 year 11 month). They were subdivided into four groups according to their region of foci: group 1, 41 patients with the centro-temporal spikes (Rolandic discharges); group 2, 14 patients with the occipital spikes; group 3, 6 patients with frontal pole spikes; group 4, 55 patients with the other focal spikes. EEG examinations were followed 6 months interval in each patients, and total 412 EEG trancing were investigated. Migration of epileptic foci was recognized in thirty eight patients (32.8%): 17 (41%) in Rolandic discharges, 7 (50%) in occipital spikes, 4 (67%) in frontal pole spikes and 10 (18%) in other spikes. The mean time to the migration of next foci was 45.6 months in Rolandic discharges, 18.4 months in occipital spikes, 17.6 months in frontal pole spike and 61.4 months in other spikes. As to the regions of migrated foci, Rolandic discharges tended to move to the near and horizontal areas such as from central to temporal. Whereas, occipital spikes and frontal pole spikes tended to move to the distant and vertical areas such as from occipital to frontal pole and from frontal pole to occipital. But other spikes showed no tendency.(ABSTRACT TRUNCATED AT 250 WORDS)

Chlorambucil central nervous toxicity: a significant side effect of chlorambucil therapy in childhood nephrotic syndrome

Chlorambucil (CHL) was used in combination with prednisolone in the treatment of nine children with frequently relapsing nephrotic syndrome. Serial electroencephalograms were obtained to evaluate CHL central nervous toxicity, before, during and after treatment with this agent. EEG abnormalities were observed in two of the nine children during chlorambucil therapy. EEG changes were diffuse spike and wave complexes and disappeared after discontinuation of therapy. There were no other neurological abnormalities and more particularly, no seizures or myocloni were observed. According to the literature, chlorambucil central nervous toxicity is found almost exclusively in childhood nephrotic syndrome. Strict neurological supervision of patients treated with chlorambucil is recommended.

Hydrogenated benzo[f]quinolines and benz[e]indoles as analgetics. 1

A series of octahydrobenzo[f]quinolines(IIIa) and hexahydro-1H-benz[e]indoles(IIIb), rigid structures related to 3-phenylpiperidine and pyrrolidine analgetics, has been synthesized. Structure-activity relationships were investigated by varying the structural parameters including a change in the stereochemistry of the ring junction. Several of the resulting compounds had analgetic activity on the order of meperidine.