Obamacare's (3) Day(s) in Court

Before the oral arguments in late March, the vast majority of legal scholars felt confident that the Supreme Court of the United States would uphold the individual mandate against the constitutional challenge that 26 states have levied against it. Since the oral arguments, that confidence has been severely shaken. This article asks why legal scholars were so confident before the argument and what has made us so concerned since the argument. The article posits that certain fundamental characteristics of health insurance, particularly its unusual role in steering health-care consumption decisions, which distinguishes health insurance from standard kinds of indemnity insurance, should make the constitutional question easy, but the Obama Administration's legal team was understandably hesitant to highlight those unique characteristics in its arguments. Because the Supreme Court justices seemed not to understand the uniqueness of health insurance without the government's help and because the justices seemed unusually willing to adopt a new constitutional constraint in this case, the individual mandate appears to be in far greater jeopardy than we legal scholars anticipated.     

Compound heterozygosity of Hb D(Iran) (beta(22) Glu-->Gln) and beta(0)-thalassemia (619 bp-deletion) in India

The present report describes the hematologic and molecular study of the second case of Hb D(Iran) associated with beta(0)-thalassemia (619 bp-deletion) found in India and the first case in which the mutations have been identified at molecular level. The patient showed hypochromic, microcytic red cell picture with reduced red cell indices. The characterization of the hemoglobinopathy was made by electrophoretic and chromatographic techniques and confirmed by sequencing of the beta-globin gene. Both the propositus and her father were found to be carriers of the gene for beta(0)-thalassemia owing to the 619 bp-deletion mutation as seen by the polymerase chain reaction (PCR). Single base substitution GAA > CAA (indicative of Hb D(Iran)) in the heterozygous form was seen in the propositus as well as the mother by sequencing.     

Antiphospholipid antibodies (APLA) in immune thrombocytopenic purpura (ITP) and antiphospholipid syndrome (APS)

Antiphospholipid antibodies (APLA) are associated with anti-phospholipid syndrome (APS), a thrombotic disorder, but they are also frequently detected in immune thrombocytopenic purpura (ITP), a bleeding disorder. To investigate possible differences of APLA between these two disorders, we assayed IgG and IgM APLA by ELISA in 21 patients with ITP and 33 with APS. The APLA reacting against two protein target antigens, beta(2)-glycoprotein 1 (beta2GP1) and FVII/VIIa, and four phospholipids [cardiolipin (CL), phosphatidylcholine (PC), phosphatidylserine (PS), and phosphatidylethanolamine (PE)] as well as lupus anticoagulant (LA) were analyzed. We made the following observations: (i) IgG and IgM antibodies to beta2GP1 and IgM antibodies to FVII/VIIa were more common in APS than ITP, P < 0.05, while IgG antibodies against the phospholipids (aCL, aPC, aPS, aPE) were more common in ITP than APS, P < 0.05; (ii) multiple APLA > or =3 antigens) were more frequent in APS than ITP, P < 0.05; (iii) LA was frequently associated with APS but was absent in ITP; (iv) APLA is quite common in ITP: two-thirds were positive for at least one APLA. In summary, APLA are prevalent in ITP but their profile differs from APS. In APS, antibodies were predominantly against beta2GP1 and 80% had positive LA, while in ITP the APLA reacted most often with the phospholipids without LA. The difference in APLA may result in opposite clinical manifestations in two disorders.     

Involvement of Phospholipase A(2) in H(2)O(2)-dependent Platelet Activation

Hydrogen peroxide (H(2)O(2)) triggers activation of platelets 'primed' by low concentrations of arachidonic acid (< 20 μM) or collagen (< 0.2 μg/ml), but has no effect on platelets exposed to low concentrations of thrombin, ADP or A23187. Platelets are not affected (they do not aggregate or produce thromboxane A(2) or release serotonin) by H(2)O(2) alone or by the low concentrations of arachidonic acid or collagen. The H(2)O(2) concentration used (0.15-7.5 μM) induces aggregation, TA(2) production and dense granule content release (monitored by radiolabeled serotonin) by 'primed' platelets. Using arachidonic acid as the 'priming' stimulus, K(app) of 687 nM and 560 nM are calculated for platelet aggregation and TA(2) formation respectively. With collagen as the 'priming' stimulus, K(app) of 841 nM and 946 nM are obtained for platelet aggregation and TA(2) production, respectively. The effect of H(2)O(2) is dependent on arachidonic acid metabolism because aspirin prevents H(2)O(2)-mediated platelet activation. Furthermore this activation seems to be dependent on arachidonic acid mobilization from platelet phospholipids by phospholipase A(2) since mepacrine is able to block H(2)O(2)-mediated platelet activation.     

Forcipomyia (Lasiohelea) sibirica (Diptera, Ceratopogonidae) in Poland]

A single male of Forcipomyia (Lasiohelea) sibirica (Bujanova, 1962) was collected in the Pieniny Mts. This is the first record of the species from Poland. F. sibirica is an Eastern Palaearctic bloodsucker causing a severe annoyance to humans in the vicinities of Krasnoyarsk (East Siberia). It seems that in Central Europe the species lives only in mountains which probably are its relic refuges since the Pleistocene. F. sibirica is very similar to F. nipponica. The only difference is found in the relation between X and XI male flagellomeres. In F. nipponica flagellomere X is shorter than the next one, while in F. sibirica they are inversely related.     

Mites (Acari) occurring on Geotrupes vernalis (L., 1758) (Insecta, Scarabaeidae) in Poland

5078 mites belonging to ca. 13 species were collected from 165 specimens of G. vernalis. The most common are: Caloglyphus geotruporum, Neopodocinum meridionalis and Macrocheles glaber. Pelethiphis equestris is a new one for Polish fauna. A lot of new localities for rare or known as rare species (N. meridionalis, Parasitus coleoptratorum, P. copridis) was given.     

妊娠糖尿病患者血清高敏C反应蛋白的变化及临床意义

在口服糖耐量试验(OGTT)诊断的86例妊娠糖尿病的患者中，高敏C反应蛋白(sC—RP)正常61例，升高25例。sC-RP升高组的体质指数、OGTT30和60min的胰岛素水平，30和120min的血糖，甘油三酯和心率等，均明显高于sC—RP正常组。     

Rare Earth impurities in yb(6) and zrb(12)

We present data on the depression of the superconducting transition temperatures of YB₆ and ZrB₁₂ by rare earth impurities. These data show unusual features. Ce in YB₆ is in some ways analogous to Yb in ZrB₁₂, and this analogy also appears to hold between Ce in CeB₆ and YB in YbB₁₂.     

C-reactive protein (CRP) levels in systemic lupus erythematosus (SLE)

Summary CRP levels in 194 serum samples from 43 SLE patients were measured. Patients with inactive disease have levels below 10 g/ml; patients with active SLE have higher levels, but never over 50 g/ml. In the presence of infection or inflammatory processes, regardless of the activity of SLE, the levels are significantly higher (p<0.05), and well over 50 g/ml. Both active SLE patients and inactive SLE patients with local infections have levels between 10 g/ml and 50 g/ml. In this situation, the presence of anti-DNA antibodies strongly suggests disease activity (82% versus 9%, p<0.05). The clinical and physiopathological meaning of these findings is discussed.     

Leydig cell tumor of the ovary (biologic (in vivo and in vitro) and ultrastructural study) (author's transl)

The authors present the case of a young hirsute woman of 28 years old. Urinary 17 KS were very increased without DHA, but with androsterone, etiocholanolone and 11 oxy 17 Ketosteroids. Androstenedione and testosterone plasmatic levels were very high and per operative selective ovarian vein catheterization showed a direct production of these potent androgens. In vitro study of the tumor allowed to obtain same results. Light and electron microscopic study showed a Leydig cell tumor of left ovary.