Transcatheter Arterial Embolization of Spontaneous Soft Tissue Hematomas: A Systematic Review

CardioVascular and Interventional Radiology - Severe spontaneous soft tissue hematomas (SSTH) are usually treated with transcatheter arterial embolization (TAE) although only limited retrospective...     

Pneumonia due to Bordetella bronchiseptica in a cystic fibrosis patient: 16S rRNA sequencing for diagnosis confirmation

Bordetella bronchiseptica was identified as an unusual etiologic agent of pulmonary recurrent exacerbations and pneumonia in a cystic fibrosis (CF) patient by utilizing a 16S rRNA molecular kit in our hospital's clinical laboratory. This method appears to be a useful approach for identifying new emerging CF pathogens when discrepancies exist between phenotypical tests.     

The RhoA- and CDC42-specific exchange factor Dbs promotes expansion of immature thymocytes and deletion of double-positive and single-positive thymocytes

Specific members of the Rho family of GTPases exert unique influences on thymocyte proliferation, differentiation and deletion. Dbs is a guanine nucleotide exchange factor which is expressed throughout thymocyte development and is able to activate the Rho family GTPases CDC42, RhoA and RhoG. Transgenic mice expressing an activated form of Dbs had increased numbers of double-negative thymocytes. The Dbs transgene promoted expansion of double-negative thymocytes in the absence of pre-TCR, but had no effect on pre-TCR-dependent differentiation of double-negative thymocytes into double-positive thymocytes. Transgenic double-positive thymocytes were proliferative in vivo, but were also susceptible to apoptosis in vivo and in vitro. The transgenic single-positive thymocytes had attenuated proliferative responses following TCR ligation, and were depleted rather than expanded during culture in the presence of anti-CD3. When expressing a positively selectable TCR, transgenic double-positive thymocytes were increased in number and activated, but the output of single-positive thymocytes was reduced. Transgenic double-positive thymocytes were acutely sensitive to deletion by TCR ligation in vivo. These results indicate that activation of Dbs has the potential to promote proliferation throughout thymocyte development, but also sensitizes double-positive and single-positive thymocytes to deletion.     

Expression of a G-protein {beta} subunit-related gene during lymphocyte activation

Using a subtractlve strategy, we have cloned an activation-relatedgene from a human B cell cDNA library. Sequence analysis revealedthat this gene was identical to H12.3, a gene belonging to anexpanding family of guanlne nucleotlde-blndlng protein ßsubunlts. The expression of H12.3 was induclble in the latephase of mltogen-stlmulated T and B cells. In T cells, IL-2and IL-4 by themselves had no direct effect on the expressionof H12.3, but they could augment the level of steady-state H12.3mRNA stimulated by phytohemagglutlnln. On the other hand, IFN-and IL-6 had no obvious effect on the expression in B cellswith or without Staphytococcus aureus Cowan l-stlmulatlon. CyclosporinA, a strong immunosuppressant, Inhibited the mltogen-stlmulatedexpression of H12.3, but rapamycin, another such agent, didnot. In synchronized Jurkat cells, the expression of H12.3 hadno cell cycle-dependent decrease in S and G₂/M phase, whilecyclin E, which controls the progression of the cell cycle unlate G₁ phase, did show a periodic expression pattern. The resultssuggest that H12.3 might be involved in regulation of lymphocyteactivation.     

A Subset of Type I Conventional Dendritic Cells Controls Cutaneous Bacterial Infections through VEGFα-Mediated Recruitment of Neutrophils

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EUFOREA consensus on biologics for CRSwNP with or without asthma

Novel therapies such as type 2 targeting biologics are emerging treatment options for patients with chronic inflammatory respiratory diseases, fulfilling the needs of severely uncontrolled patients. The majority of patients with chronic rhinosinusitis with nasal polyps (CRSwNP) and over half of patients with asthma show a type 2 inflammatory signature in sinonasal mucosa and/or lungs. Importantly, both chronic respiratory diseases are frequent comorbidities, ensuring alleviation of both upper and lower airway pathology by systemic biological therapy. Type 2‐targeting biologics such as anti‐IgE, anti‐IL4Rα, anti‐IL5, and anti‐IL5Rα have entered the market for selected pheno/endotypes of asthma patients and may soon also become available for CRSwNP patients. Given the high prevalence of chronic respiratory diseases and the high cost associated with biologics, patient selection is crucial in order to implement such therapies into chronic respiratory disease care pathways. The European Forum for Research and Education in Allergy and Airway Diseases (EUFOREA) organized a multidisciplinary Expert Board Meeting to discuss the positioning of biologics into the care pathways for CRSwNP patients with and without comorbid asthma.     

In vitro and in vivo degradation of poly(D,L lactide/glycolide) type microspheres made by solvent evaporation method

Microspheres of different poly(alpha-hydroxy acids) were prepared by solvent evaporation to study the effects of gamma-sterilization on stability and to establish the degradation process in vitro and in vivo. gamma-Irradiation dramatically decreases polymer molecular weight and this degradation continues on storage. gamma-Irradiation modifies the controlled release pattern of cisplatin-loaded microspheres. After embolization of rat livers by microspheres, a histological study of the inflammatory response was made, along with gel permeation chromatography analysis of degrading polymers. The degradation rate of the polymers increased with the glycolic unit content in the lactic chains. Scanning electron microscopy of microsphere degradation in vitro correlated with the former observations.     

Combined external and endoscopic frontal sinusotomy with stent placement: a retrospective review

OBJECTIVES: To examine the long-term results of combined external and endoscopic frontal sinusotomy using frontal sinus stents and to compare our results with those reported for the endoscopic Lothrop procedure. STUDY DESIGN: We performed a retrospective review of 40 patients with chronic frontal sinusitis refractory to medical management who underwent a total of 62 combined external and endoscopic frontal sinusotomies with stent placement. All procedures were performed by the senior author at Vanderbilt University Medical Center. MAIN OUTCOME MEASURES: Postoperative nasofrontal duct patency and subjective patient improvement based on the last clinical examination. RESULTS: The overall patency rate of the nasofrontal duct was 79% (95% confidence interval [CI] of +/-10%.) The overall subjective patient improvement rate was 78% (95% CI of +/-14%.). The average length of stent placement was 5 weeks. The mean patient follow-up time was 12 months. There were no surgical complications. The nasofrontal duct patency rate and patient improvement rate from our study did not differ statistically from results reported by other authors using the endoscopic Lothrop procedure. CONCLUSION: We have found endoscopic frontal sinusotomy, in conjunction with external frontal sinusotomy and placement of frontal sinus stents, to be as effective in obtaining frontal sinus patency rates and overall patient improvement rates as the endoscopic Lothrop procedure.     

Cardiac troponin I: its contribution to the diagnosis of perioperative myocardial infarction and various complications of cardiac surgery

OBJECTIVE: To study the value of assaying cardiac troponin I (cTnI) for the early diagnosis of perioperative myocardial infarction (PMI) and various complications of cardiac surgery. DESIGN: A prospective observational clinical study. SETTING: Biochemical laboratory, anesthesia, and cardiac surgery department of H?pital Broussais. PATIENTS: Two hundred and sixty consecutive patients undergoing cardiac surgery. INTERVENTIONS: All patients underwent coronary artery bypass grafting and/or valvular surgery under extracorporeal circulation. Per-operative and postoperative follow-up consisted of electrocardiogram, echocardiography (mainly by the transesophageal approach), and serial determinations of biochemical markers such as creatinine kinase-MB isoenzyme (CK-MB) and cTnI. PMI, new ST segment changes, and ventricular arrhythmias were considered postoperative adverse cardiac outcome. MEASUREMENTS AND MAIN RESULTS: CTnI was measured before cardiopulmonary bypass (T0) and 12 and 24 hrs after (T12, T24). CK-MB was measured on arrival in the intensive care unit and on the first postoperative day (D1). Patients were divided into three groups according to the type of surgery: coronary artery bypass graft (CABG), valvular surgery (VS), or both procedures. The plasma CK-MB and cTnI concentrations were high in all patients after extracorporeal circulation because of aortic clamping or cardioplegia. The CK-MB and cTnI values were higher in the VS group than in the CABG group. Values peaked at T12 and fell by T24, except when PMI occurred. Eight patients developed a PMI. Patients with PMI had significantly higher cTnI levels at T12 and T24, and higher CK-MB values at D1 than patients without PMI. Cutoff values of cTnI for diagnosing PMI were >19 microg/L at T12 with 100% sensitivity and 73% specificity, and >36 microg/L at T24, with 100% sensitivity and 93% specificity. Lower cTnI values were highly suggestive of the absence of PMI after CABG and/or VS. Other complications such as ST segment changes, ventricular arrhythmias and cardiac failure were indicated by high cTnI levels at T12 and T24. Myocardial protective measures were associated with a nonsignificant increase in cTnI values. CONCLUSIONS: CTnI is more sensitive and specific than CK-MB for diagnosing PMI and other forms of heart failure after cardiac surgery.