Fast CT for pulmonary embolus

Recent technical advances in CT have led to the ability to scan a volume in a shorter period with optimal contrast opacification of blood vessels, including the pulmonary arteries. Initially, there were isolated instances of an accidental detection of a filling defect because of pulmonary embolus in the pulmonary arteries. Gradually, directed examinations were introduced to diagnose or exclude pulmonary embolus. These examinations were successful. Radiologists and clinicans now are turning to fast CT for this purpose for a variety of reasons, including the proven accuracy and reliability of the method and the relative deficiencies of traditional noninvasive methods. Accurate interpretation of CT scans for possible pulmonary embolus depends on the ability to conduct a high-quality examination and to recognize the spectrum of findings for both acute and chronic emboli. This article reviews the history of fast CT pulmonary angiography, and it presents both technical and diagnostic information germaine to the performance of this technique.     

Ein Beitrag zur Funktionsbeurteilung und Funktionsverbesserung von Daumenmißbildungen

Ohne ZusammenfassungHerrn Professor Dr. med. Dr. med. h. c. G. Hohmann zum 85. Geburtstag gewidmet.     

Economic antecedents of temporal variation in the incidence of ocular trauma

PURPOSE: To test the reciprocal risk hypothesis that the monthly number of unemployed persons in Alabama predicts: 1) the odds that a worker will suffer an ocular injury; and 2) the incidence of ocular injuries at home. METHODS: Data from the United States Eye Injury Registry and from the Bureau of Labor Statistics are analyzed with time series methods to test the hypotheses. RESULTS: As implied by the reciprocal risk hypothesis, the monthly odds of a worker reporting a job-related ocular injury decrease as the number of unemployed persons increases. The incidence of ocular injuries in the home, however, increases when the number of unemployed persons increases. CONCLUSIONS: Consistent with theory and earlier research, the incidence of ocular injuries appears related to the performance of the economy. Unlike earlier research, however, we find a reciprocal risk between injuries at work and home. The findings suggest that public health efforts to prevent injuries could be made more effective by strategically shifting the focus from home to work and vice versa depending on changes in the local economy.     

HLA tetramer-based artificial antigen-presenting cells for stimulation of CD4+ T cells

Current evidence suggests that immunotherapy for cancer or infectious diseases will require the activation of CD4(+) T cells in addition to the activation of cytotoxic CD8(+) T cells. To complement and overcome some of the limitations of dendritic-cell-based vaccines and ex vivo expansion of human T cells, we sought to engineer artificial antigen-presenting cells (aAPCs) for the stimulation of antigen-specific human CD4(+) T cells. We have designed a variety of aAPCs using magnetic beads as a scaffold on which to coat HLA-peptide tetrameric complexes along with costimulatory molecules such as anti-CD28. Here, we tested various forms of conjugation of the tetramers onto beads, characterized the relative concentration of antigen available on the surface of the beads, and evaluated the ability of different types of beads to promote activation of antigen-specific CD4(+) T cells. We find that an indirect coating of HLA-peptide tetramers on beads via an anti-Class II antibody provides specific stimulation of antigen-specific CD4(+) T cells.     

Synthesis and Evaluation of [67Ga]-AMD3100: A Novel Imaging Agent for Targeting the Chemokine Receptor CXCR4

In order to develop a possible C-X-C chemokine receptor type 4 (CXCR4) imaging agent for oncological scintigraphy, [⁶⁷Ga]-labeled 1,1′-[1,4-Phenylene-bis(methylene)]bis(1,4,8,11-tetraazacyclotetradecane) ([⁶⁷Ga]-AMD3100) was prepared by using [⁶⁷Ga]GaCl₃ and AMD-3100 for 2 h at 50 °C (radiochemical purity: >95% ITLC, >99% HPLC, specific activity: 1800–2000 TBq/mmol) in acetate buffer. The stability of the complex was checked in the presence of human serum (37 °C) and in the final formulation for four days. The biodistribution of the labeled compound in the vital organs of wild type Sprague-Dawley rats was determined and compared with that of the free Ga³⁺ cation up to 48 h. Considering the spleen as the target organ, the best target:non target ratios were obtained 48 h post-injection (spleen:blood ratio; 14.5 and spleen:muscle ratio; 88.4). Initial SPECT images and biodistribution results in the wild type rats matched each other and demonstrated rapid washout of the tracer from the urinary tract. SPECT images in human breast carcinoma-bearing mice demonstrated a detectable tumor uptake in 48 h post-injection.     

Botulinum toxin therapy

Botulinum toxin therapy has emerged as a treatment modality for a variety of spastic- or contracture-related muscle diseases. Its safety has been proven for long-term use in the treatment of benign essential blepharospasm, hemifacial spasm, and certain types of strabismus. Recent approval from the Federal Drug Administration should make botulinum toxin available for use in a greater number of patients.     

Intraspecies Transfer of the Chromosomal Acinetobacter baumannii blaNDM-1 Carbapenemase Gene

The species Acinetobacter baumannii is one of the most important multidrug-resistant human pathogens. To determine its virulence and antibiotic resistance determinants, the genome of the nosocomial bla_NDM-1-positive A. baumannii strain R2090 originating from Egypt was completely sequenced. Genome analysis revealed that strain R2090 is highly related to the community-acquired Australian A. baumannii strain D1279779. The two strains belong to sequence type 267 (ST267). Isolate R2090 harbored the chromosomally integrated transposon Tn125 carrying the carbapenemase gene bla_NDM-1 that is not present in the D1279779 genome. To test the transferability of the metallo-β-lactamase (MBL) gene region, the clinical isolate R2090 was mated with the susceptible A. baumannii recipient CIP 70.10, and the carbapenem-resistant derivative R2091 was obtained. Genome sequencing of the R2091 derivative revealed that it had received an approximately 66-kb region comprising the transposon Tn125 embedding the bla_NDM-1 gene. This region had integrated into the chromosome of the recipient strain CIP 70.10. From the four known mechanisms for horizontal gene transfer (conjugation, outer membrane vesicle-mediated transfer, transformation, and transduction), conjugation could be ruled out, since strain R2090 lacks any plasmid, and a type IV secretion system is not encoded in its chromosome. However, strain R2090 possesses three putative prophages, two of which were predicted to be complete and therefore functional. Accordingly, it was supposed that the transfer of the resistance gene region from the clinical isolate R2090 to the recipient occurred by general transduction facilitated by one of the prophages present in the R2090 genome. Hence, phage-mediated transduction has to be taken into account for the dissemination of antibiotic resistance genes within the species A. baumannii.