Bimanual crossed-uncrossed difference and asynchrony of normal, anterior- and totally-split-brain individuals

This study investigated interhemispheric transfer in ten normal, four anterior-, and four totally-split-brain individuals, through measures of manual asynchrony and bimanually-recorded crossed-uncrossed difference (CUD). The CUD relied on the difference between crossed and uncrossed responses whereas the asynchrony measure relied on the reaction time difference between the two responding hands. Manipulations of sensory and attentional factors were assessed for both measures. We found a normal CUD (3.8 ms) along with an exacerbated and more variable asynchrony for partial split-brain individuals (40.8 ms) compared to normal individuals (CUD: 0.4 ms, asynchrony: 13.8 ms). In turn, the CUD of total split-brain individuals (20.4 ms) was larger than that of partial split-brain and normal individuals. Also, the asynchrony of total split-brain individuals (57.6 ms) was larger and more variable than that of normal individuals, and more variable than that of partial split-brain individuals. We interpret these results as behavioural evidence of independent mechanisms underlying the CUD and bimanual synchronization, as well as evidence of the joint involvement of both the anterior and the posterior portions of the corpus callosum in bimanual coordination.     

Genome Wide Identification of Recessive Cancer Genes by Combinatorial Mutation Analysis

We devised a novel procedure to identify human cancer genes acting in a recessive manner. Our strategy was to combine the contributions of the different types of genetic alterations to loss of function: amino-acid substitutions, frame-shifts, gene deletions. We studied over 20,000 genes in 3 Gigabases of coding sequences and 700 array comparative genomic hybridizations. Recessive genes were scored according to nucleotide mismatches under positive selective pressure, frame-shifts and genomic deletions in cancer. Four different tests were combined together yielding a cancer recessive p-value for each studied gene. One hundred and fifty four candidate recessive cancer genes (p-value<1.5×10⁻⁷, FDR=0.39) were identified. Strikingly, the prototypical cancer recessive genes TP53, PTEN and CDKN2A all ranked in the top 0.5% genes. The functions significantly affected by cancer mutations are exactly overlapping those of known cancer genes, with the critical exception for the absence of tyrosine kinases, as expected for a recessive gene-set.     

Valve-sparing removal of aortic fibroelastoma through ministernotomy

Cardiac papillary fibroelastoma is a rare benign tumor which involves the heart valves and may cause thromboembolism or mechanical interference with valvular function. The case is presented of an asymptomatic, 22-year-old man in whom a fibroelastoma was localized on the ventricular aspect of the right coronary leaflet of the aortic valve. The tumor was identified during transthoracic echocardiography performed to monitor a mitral valve prolapse that had occurred at the age of 16 years. The patient underwent surgical intervention by means of a minimally invasive thoracotomy. The postoperative course was uneventful, and the patient was discharged on postoperative day 5. Due to the high incidence of embolism, the tumor must be surgically removed immediately a diagnosis is confirmed. A minimal surgical approach appears to be safe and allows good exposure of the lesion.     

NPM1 mutations are more stable than FLT3 mutations during the course of disease in patients with acute myeloid leukemia

NPM1 mutations have been reported to be the most frequent mutations in acute myeloid leukemia (AML). They are associated with a wide spectrum of morphologic subtypes of AML, normal karyotype and FLT3 mutations. The high frequency of NPM1 mutations might provide a suitable marker for monitoring residual disease of AML.     

Computed tomography and magnetic resonance angiography in the evaluation of aberrant origin of the external carotid artery branches

Aim of our study was to evaluate the prevalence of aberrant origin of the branches of the external carotid artery (ECA) in 97 patients by computed tomography (CTA) and magnetic resonance angiography (MRA) and to compare the accuracy of these two techniques in the visualization of the ECA system. All patients underwent CTA and MRA examination of the head and neck. Multiplanar and volumetric reformations were obtained in all cases. For each set of images, the presence of aberrant origin of the branches of the external carotid artery was investigated. MRA and CTA images of each patient were compared to define their information content. Anatomical anomalies were found in 88 heminecks, with a prevalence of 53.3%. In the 61 patients in whom the CTA was performed before the MRA, the latter method showed only 92% of abnormalities detected at the first examination; in the 36 patients in whom MRA was performed first, CTA identified all of the anomalies highlighted by the former, adding 12 new. Knowledge of the anomalies of origin of the ECA branches is essential for the head and neck surgeon; the high prevalence of anomalies found in our series as in the previous studies indicates the opportunity to perform a CTA or a MRA of the head and neck before any surgical or interventional procedure. CTA is the method of choice in the evaluation of anomalies of origin of the branches of the ECA and in the definition of their course.     

Evaluation of nurses' theoretical knowledge in Basic Life Support: a study in a district Greek hospital

ObjectiveNurses are usually the first-responders in cases of in-hospital cardiac arrest. Their competence in Basic Life Support (BLS) is important in improving patient outcome. The purpose of this study was to evaluate the nurses’ BLS knowledge in a small district hospital.MethodsData was collected by an anonymous questionnaire, distributed to all nursing personnel in this hospital.Data/resultsThe failure rate of the BLS theoretical questionnaire was 84%. Regarding self-assessment 10.3% of the participants rated their BLS knowledge as very good, whereas 31.2%, 44.2% and 14.3% of them rated it as good, moderate or not good respectively. This self-assessment did not correlate significantly with the final performance in the written test. No difference regarding the performance in the written test was observed between nurses who had participated in a refresher BLS course after graduation and those who had not. The nurses without any previous personal experience in the BLS had a higher probability to pass the written test.ConclusionsOur results indicate a low level of BLS knowledge among the study participants. Having an occasional refresher BLS course, or prior experience in BLS, does not affect the level of knowledge.     

Human yeast-specific CD8 T lymphocytes show a nonclassical effector molecule profile

Pathogenic yeast and fungi represent a major group of human pathogens. The consequences of infections are diverse and range from local, clinically uncomplicated mycosis of the skin to systemic, life-threatening sepsis. Despite extensive MHC class I-restricted frequencies of yeast-specific CD8 T lymphocytes in healthy individuals and the essential role of the cell-mediated immunity in controlling infections, the characteristics and defense mechanisms of antifungal effector cells are still unclear. Here, we describe the direct analysis of yeast-specific CD8 T lymphocytes in whole blood from healthy individuals. They show a unique, nonclassical phenotype expressing granulysin and granzyme K in lytic granules instead of the major effector molecules perforin and granzyme B. After stimulation in whole blood, yeast-specific CD8 T cells degranulated and, upon cultivation in the presence of IL-2, their granula were refilled with granulysin rather than with perforin and granzyme B. Moreover, yeast-specific stimulation through dendritic cells but not by yeast cells alone led to degranulation of the effector cells. As granulysin is the only effector molecule in lytic granules known to have antifungal properties, our data suggest yeast-specific CD8 T cells to be a nonclassical effector population whose antimicrobial effector machinery seems to be tailor-made for the efficient elimination of fungi as pathogens.