Phylogenomic analysis of 2556 single-copy protein-coding genes resolves most evolutionary relationships for the major clades in the most diverse group of lichen-forming fungi

Phylogenomic datasets continue to enhance our understanding of evolutionary relationships in many lineages of organisms. However, genome-scale data have not been widely implemented in reconstructing relationships in lichenized fungi. Here we generate a data set comprised of 2556 single-copy protein-coding genes to reconstruct previously unresolved relationships in the most diverse family of lichen-forming fungi, Parmeliaceae. Our sampling included 51 taxa, mainly from the subfamily Parmelioideae, and represented six of the seven previously identified major clades within the family. Our results provided strong support for the monophyly of each of these major clades and most backbone relationships in the topology were recovered with high nodal support based on concatenated dataset and species tree analyses. The alectorioid clade was strongly supported as sister-group to all remaining clades, which were divided into two major sister-groups. In the first major clade the anzioid and usneoid clades formed a strongly supported sister-group relationship with the cetrarioid?+?hypogymnioid group. The sister-group relationship of Evernia with the cetrarioid clade was also strongly supported, whereas that between the anzioid and usneoid clades needs further investigation. In the second major clade Oropogon and Platismatia were sister to the parmelioid group, while the position of Omphalora was not fully resolved. This study demonstrates the power of genome-scale data sets to resolve long-standing, ambiguous phylogenetic relationships of lichen-forming fungi. Furthermore, the topology inferred in this study will provide a valuable framework for better understanding diversification in the most diverse lineage of lichen-forming fungi, Parmeliaceae.     

Evidence that Singlet Oxygen-induced Human T Helper Cell Apoptosis Is the Basic Mechanism of Ultraviolet-A Radiation Phototherapy

Ultraviolet A (UVA) irradiation is effectively used to treat patients with atopic dermatitis and other T cell mediated, inflammatory skin diseases. In the present study, successful phototherapy of atopic dermatitis was found to result from UVA radiation-induced apoptosis in skin-infiltrating T helper cells, leading to T cell depletion from eczematous skin. In vitro, UVA radiation-induced human T helper cell apoptosis was mediated through the FAS/FAS-ligand system, which was activated in irradiated T cells as a consequence of singlet oxygen generation. These studies demonstrate that singlet oxygen is a potent trigger for the induction of human T cell apoptosis. They also identify singlet oxygen generation as a fundamental mechanism of action operative in phototherapy.     

Bleeding complications associated with glycoprotein IIb/IIIa inhibitors in patients 80 years of age and older undergoing percutaneous coronary intervention

BACKGROUND:

Treatment of symptomatic coronary artery disease with percutaneous intervention requires antithrombotic therapy. Patients with elevated thromboembolic risk benefit from therapy with glycoprotein IIb/IIIa inhibitors. The safety and effectiveness of glycoprotein IIb/IIIa inhibition have been well documented in clinical trials. Drug-induced bleeding complications in elderly patients have not been specifically addressed.

METHODS:

Between 2006 and 2009, a total of 439 unselected patients 80 years of age and older undergoing percutaneous intervention for symptomatic coronary artery disease were included in the present nonrandomized retrospective study. In one-half of the patients, glycoprotein IIb/IIIa inhibitors were administered peri-interventionally. The in-hospital occurrence of bleeding complications (access site, gastrointestinal and cerebral) were analyzed in the groups with and without glycoprotein IIb/IIIa inhibitors.

RESULTS:

The mean age of the patients was 84 years. Nearly all patients (95%) received dual antiplatelet therapy. Patients treated with glycoprotein IIb/IIIa inhibitors had more complex coronary lesions and bypass graft interventions, and a tendency toward more access site bleeding complications than patients without inhibitors, which included femoral hematomas (4.6% versus 2.3%, respectively; P not significant) and femoral pseudoaneurysms (6% versus 3.2%, respectively; P not significant). The rate of blood transfusion was equal in both groups (0.9%). Major hemorrhagic events did not occur. Vessel closure devices were used more often in patients without glycoprotein inhibition.

CONCLUSIONS:

An increase in minor bleedings must be expected when using glycoprotein IIb/IIIa inhibitors in patients 80 years of age and older. However, this issue must not prevent this treatment option from being offered to elderly patients. There appears to be no elevated risk for major bleeding complications. Broadened use of vascular closure devices in this specific patient population may lower the rate of access site complications.     

Substrate-modification using electroanatomical mapping in sinus rhythm to treat ventricular tachycardia in patients with ischemic cardiomyopathy

The treatment especially of frequent ischemic VT remains a challenge for medical and catheter ablation procedures. We evaluated the efficacy of a substrate-based procedure to eliminate clinical VTs in this patient collective.

Methods  

In 25 consecutive patients (ejection fraction 37±12%) with frequent symptomatic medically refractory ischemic VT (with recurrent ICD-shocks), left ventricular anatomic scar mapping (Biosense Webster CARTO™) was performed in order to modify the underlying myocardial substrate. Scar tissue was identified as having bipolar voltages <0.5 mv.=" prior=" to=" the=" procedure=" an=" electrophysiological=" study=" (eps)=" to=" determine=" number=" and=" morphology=" of=" inducible=" vts=" was=" performed.=" linear=" ablation=" procedures=" (8=" mm=" tip,=" 70=" watts,=" 70=" °c)=" were=" based=" on=" the=" findings=" of=" scar=" areas=" and=" proximity=" to=" anatomic=" obstacles.=" correct=" location=" of=" ablation=" was=" documented=" by=" similarity=" of=" the=" morphology=" during=" pace-mapping.=" follow-up=" included=" clinical=" evaluation,=" icd=" holter=" interrogation=" plus=" holter=" ecg=">     

The emergence of the unmarked: a new perspective on the language-specific function of Broca's area

A number of neuroimaging studies have implicated an involvement of Broca's area, particularly of the pars opercularis of the left inferior frontal gyrus (IFG), in the processing of complex (permuted) sentences. However, functional interpretations of this region's role range from very general (e.g., in terms of working memory) to highly specific (e.g., as supporting particular types of syntactic operations). A dissociation of these competing accounts is often impossible because in most cases, the language internal complexity of permuted sentence structures is accompanied invariably by increasing costs of a more general cognitive nature (e.g., working memory, task difficulty, and acceptability). We used functional magnetic resonance imaging to explore the precise nature of the pars opercularis activation in the processing of permuted sentences by examining the permutation of pronouns in German. Although clearly involving a permutation operation, sentences with an initial object pronoun behave like simple, subject-initial sentences (e.g., in terms of acceptability) because of a rule stating that pronouns should generally precede non-pro-nominal arguments. The results of the experiment show that in contrast to non-pro-nominal permutations, sentences with a permuted pronoun do not engender enhanced pars opercularis activation. Our findings therefore speak against both language-related working memory and transformation-based accounts of this region's role in sentence comprehension. Rather, we argue that the pars opercularis of the left IFG supports the language-specific linearization of hierarchical linguistic dependencies.     

Intolerance reactions due to the selective cyclooxygenase type II inhibitors rofecoxib and celecoxib. Results of oral provocation tests in patients with NSAID hypersensitivity

Intolerance reactions due to the ingestion of non-steroidal anti-inflammatory drugs (NSAIDs) are frequent emergencies. It is thought that inhibition of the isoenzyme cyclooxygenase type I (COX-1) is responsible for the common NSAID-associated adverse effects, whereas inhibition of COX-2 is mainly responsible for the therapeutic effects. The goal of our study was to estimate the frequency of intolerance reactions due to ingestion of the two newly approved selective COX-2 inhibitors, rofecoxib or celecoxib. In a sample of 13 patients who had previously documented NSAID hypersensitivity reactions to non-selective COX inhibitors, 2 patients (15.3%) showed intolerance reactions (2 of 9 patients with rofecoxib, 1 of 5 patients with celecoxib). These drugs cannot therefore be administered uncritically to patients with known NSAID hypersensitivity. Selective COX-2 inhibitors can only be used as alternative drugs in these patients after assessing their specific tolerability in a properly performed provocation test.     

Heart-lung transplantation for patients under 10 with cystic fibrosis

The outcome of patients with cystic fibrosis aged under 10 years referred for heart-lung transplantation assessment (n = 58) was determined and compared with older children (n = 109). Similar proportions were placed on to the active waiting list (64% v 71%) and received transplants (35% v 31%). Three year post-transplantation survival figures were also similar (41% v 46%), as were the figures for overall survival for those placed on to the active list (27% v 29%). Paediatricians should not be deterred from referring younger patients for transplantation.     

The sartorius myocutaneous island flap

Summary The vascular supply to the distal part of sartorius m. was studied in 37 limbs by dissection under magnification and after black ink and latex injections. The muscle or myocutaneous island flap pedicled on the saphenous artery (SA) is supplied by a retrograde circulation through anastomoses of the SA with the perforating branches of the posterior tibial artery and the medial inferior genicular artery. Three different vascular patterns were defined. Retrograde injection also showed good perfusion of the SA. The flap is useful for covering around the knee, the proximal and middle thirds of the lower leg, and the end of the amputation stump. Raising of the flap has not resulted in any functional or cosmetic defect. Eighteen operations have so far been performed, six using the muscle island flap and twelve using the myocutaneous island flap, and all survived completely.

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Le lambeaux en îlot myo-cutané du muscle sartorius

Résumé L'apport artériel pour la partie distale du m. sartorius a été étudié sur 37 membres par dissection sous grossissement et après injection d'encre de Chine et de latex. Le lambeau en îlot, musculaire ou myo-cutané, pédiculé sur l'artère saphène (SA), est vascularisé par une circulation rétrograde à travers les anastomoses de la SA avec les branches perforantes de l'artère tibiale postérieure et l'artère inféro-médiale du genou. Trois schémas vasculaires différents ont été définis. L'injection rétrograde montrait aussi une bonne perfusion de la SA. Le lambeau est utile pour la couverture des régions proches du genou, des tiers proximal et moyen de la jambe et de l'extrémité des moignons d'amputation. La réalisation du lambeau n'a entraîné aucun dommage fonctionnel ou cosmétique. Dix-huit interventions ont été réalisées jusqu'ici, six utilisant le lambeau en îlot musculaire et douze utilisant le lambeau en îlot myocutané, sans aucune complication locale.

     

有自杀行为的单、双相抑郁症患者父母育龄及胎次效应比较

目的:比较有自杀行为的单、双相抑郁症患者间父母育龄及胎次效应的差异。方法:于1983-07/2003-06选择无锡市精神卫生中心门诊和住院符合中国精神疾病分类方案与诊断标准第3版及美国精神障碍诊断和统计手册第4版心境障碍中抑郁发作标准的、无严重躯体疾病或脑器质性疾病的抑郁患者。有自杀行为的单相抑郁症患者家系59例,双相抑郁症患者家系31例。采用自行编制的精神病家系调查表(内容主要包括患者及一级亲属所有成员社会人口学资料、疾病发作特点及次数、自杀情况),由两名主治医师或以上的研究人员对每一家系进行调查,然后再由两名研究人员在互不知情的情况下对每一患者进行再诊断。对所有先症者及一级亲属中有自杀行为者进行面检(面检率>95%);对无自杀行为的一级亲属则进行信函调查(53%)及面检(47%)。已死亡及不能进行面检者的资料由一两名一级亲属提供有关情况填写调查表。用Haldance和Smith法观察有自杀行为的单相抑郁症患者及双相抑郁症患者父母育龄及胎次的效应。结果:符合入组诊断标准者共151例,完成家系调查的共122例,其中纳入分析的单相抑郁症家系59例,双相抑郁症家系31例。①单相抑郁症患者胎次为1的13例,胎次为2的15例,胎次为3的13例,胎次为4的8例,胎次为5的8例,胎次为7的2例;双相抑郁症患者胎次为1的10例,胎次为2的11例,胎次为3的7例,胎次为4的1例,胎次为5的2例,胎次为7的0例。②有自杀行为单相抑郁症患者与父母育龄及胎次的关系非常显著(C=2.4>2,P<0.01,6A>X6A);有自杀行为双相抑郁症患者与父母育龄及胎次无显著关系(C=0.74<2,P>0.05)。结论:单相抑郁症患者父母育龄越大和胎次越高者易发生自杀行为,双相抑郁症患者父母育龄和胎次自杀行为的发生无明显关系。提示适龄婚育对防止单相抑郁症自杀行为的发生具有重要意义。