Circumscribed scalp hair loss following multiple hair-cutter ant invasion

A 32-year-old woman presented with an abrupt, localized loss of scalp hair that occurred on the previous day. Her nails, skin, and mucosae were normal. On the vertex of the scalp, there was a circular patch of alopecia; the hairs were broken at approximately equal lengths above the skin surface. Several erythematous macules were seen in the affected area, but scale, twisted hair, and exclamation-mark hairs were not present. Further examination revealed the presence of ants on the scalp. This patient is one of several referred to our department presenting with hair loss associated with hair-cutter ant invasion.     

Low Helicobacter pylori eradication rates with 4- and 7-day regimens in an Iranian population

BACKGROUND: In Iran, there is insufficient information on the efficacy of Helicobacter pylori eradication regimens shorter than 10 days. This study aims at assessing the efficacy of 4- and 7-day H. pylori eradication regimens in a high-incidence area of gastric cancer in Iran. METHODS: Subjects with an endoscopic diagnosis of gastritis, positive urease test, and a histological diagnosis of chronic gastritis were enrolled. Patients were randomly assigned to one of three groups: AOC7 (1000 mg amoxicillin, 20 mg omeprazole, and 500 mg clarithromycin twice daily for 7 days), FOT4 (200 mg furazolidone, 20 mg omeprazole, and 500 mg tetracycline twice daily for 4 days) and FOT7 (the same treatment as the FOT4 group but for 7 days). Sensitivity to these antibiotics was determined in all isolates recovered from culture. The efficacy of eradication was assessed 8 weeks after the end-of-treatment by the 14C-urea breath test. RESULTS: One hundred and twenty-eight patients were enrolled in the study. Culture was positive for 84 patients and none of these were resistant to amoxicillin, tetracycline or furazolidone, 1.2% were resistant to clarithromycin and 32.1% to metronidazole. Forty-five, 41 and 42 patients were randomly allocated to the AOC7, FOT4, and FOT7 groups, respectively. The intention-to-treat eradication rates were 35.5, 17.1, and 23.8% for the AOC7, FOT4, and FOT7 groups, respectively. CONCLUSION: Treatment regimens of 4 or 7 days are unacceptable for H. pylori infection in Iran, even in the presence of a favorable sensitivity profile.     

Anterior transposition of the inferior oblique muscle for treatment of superior oblique palsy

PURPOSE: Weakening of the inferior oblique muscle is the procedure of primary importance in patients with superior oblique palsy, Knapp's Classes I and III. In this study, the effectiveness of anterior transposition of the inferior oblique muscle in treatment of these patients was evaluated. METHODS: Sixteen patients with superior oblique palsy, Knapp's Classes I and III, underwent anterior transposition of the inferior oblique muscle. The tip of the disinserted muscle was sutured to the sclera, parallel, and adjacent to the lateral border of the inferior rectus muscle insertion. The prism and alternate cover test measurements were made in all cardinal positions of gaze before and 6 months after surgery. RESULTS: The mean reduction of hyperdeviation was 15 prism diopters (PD) in the primary position, 23.4 PD in adduction, 26.65 PD in elevation and adduction, and 18.63 PD in depression and adduction. There was no hypotropia in the primary position. Mild limitation of upgaze has occurred in 3 of these patients, and mild fullness of the lower lid was developed by 25%. Postoperative hyperdeviation in the primary position was 5 PD or less in 15 out of 16 patients. CONCLUSIONS: The anterior transposition of the inferior oblique muscle is very effective in eliminating hyperdeviation in patients with superior oblique palsy, Knapp's Classes I and III. Up to 25 PD reduction of hyperdeviation in the primary position can be achieved. If this type of anterior transposition is used, primary position hypotropia or marked limitation of upgaze possibly will not occur.     

Selective abrogation of the proinvasive activity of the trefoil peptides pS2 and spasmolytic polypeptide by disruption of the EGF receptor signaling pathways in kidney and colonic cancer cells

Trefoil peptides (TFFs) are now considered as scatter factors, proinvasive and angiogenic agents acting through cyclooxygenase-2 (COX-2)- and thromboxane A2 receptor (TXA2-R)-dependent signaling pathways. As expression and activation levels of the epidermal growth factor receptor (EGFR) predict the metastatic potential of human colorectal cancers, the purpose of this study was to establish whether the EGF receptor tyrosine kinase (EGFR-TK) contributes to cellular invasion induced by TFFs in kidney and colonic cancer cells. Both the dominant negative form of the EGFR (HER-CD533) and the EGFR-TK inhibitor ZD1839 (Iressa) abrogated cellular invasion induced by pS2, spasmolytic polypeptide (SP) and the src oncogene, but not by ITF and the TXA2-R. Similarly, EGFR-TK inhibition by ZD1839 reversed the invasive phenotype promoted by the constitutively activated form of the EGFR (EGFRvIII) and the EGFR agonists transforming growth factor alpha (TGFalpha), amphiregulin and EGF. We also provide evidence that TFFs, EGFRvIII, and TGFalpha trigger common proinvasive pathways using the PI3'-kinase and Rho/Rho- kinase cascades. These findings identify the EGFR-TK as a key signaling element for pS2- and SP-mediated cellular invasion. It is concluded that although pS2, SP and ITF belong to the same family of inflammation- and cancer-associated regulatory peptides, they do not control identical signaling networks.     

Tumor vasculature address book: identification of stage-specific tumor vessel zip codes by phage display

Using in vivo phage display technology with murine tumorigenesis models, two reports have identified peptide motifs that selectively home to distinct molecular vascular targets in a tumor type- and stage-specific manner (Hoffman et al., 2003 and Joyce et al., 2003 [this issue of Cancer Cell]). By probing the surface-protein repertoire of these unique vascular beds, a pioneering draft of a molecular roadmap to decipher the heterogeneity of the vascular system in the context of carcinogenic progression has been plotted. Analysis of these phage peptides that differentially home to dysplastic or invasive tumor vasculature will lay the foundation for identifying unique functional tumor vascular-specific motifs that could potentially be applied to targeted therapeutic and imaging modalities.     

Cooperation of fuzzy segmentation operators for correction aliasing phenomenon in 3D color Doppler imaging

The study described in this paper concerns natural object modeling in the context of uncertain, imprecise and inconsistent representation. We propose a fuzzy system which offers a global modeling of object properties such as color, shape, velocity, etc. This modeling makes a transition from a low level reasoning (pixel level), which implies a local precise but uncertain representation, to a high level reasoning (region level), inducing a certain assignment. So, we use fuzzy structured partitions characterizing these properties. At this level. each property will have its own global modeling. Then, these different models are merged for decision making. Our approach was tested with several applications. In particular, we show here its performance in the area of blood flow analysis from 3D color Doppler images in order to quantify and study the development of this flow. We present methods that detect and correct aliasing phenomenon, i.e. inconsistent information. At first, the flow space is partitioned into fuzzy sectors where each sector is defined by a center, an angle and a direction. In parallel, the velocity information carried by the pixels is classified into fuzzy classes. Then, by combining these two partitions, we obtain the velocity distribution into sectors. Moreover, for each found path (from the first sector to the last one), we locate and correct inconsistent velocities by applying global rules. After extracting some meaningful sector features, the fuzzy modeling, applied to the aliasing correction, makes it possible to simplify and synthesize the blood flow direction.     

Efficacy of Magnetic Sphincter Augmentation Across the Spectrum of GERD Disease Severity

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病重特护患者压疮的发生率、预防和治疗

研究背景压疮普遍发生于急性和慢性患者.然而危重疾病患者通常是压疮发生的高风险因素.目标这个研究的主导是评估重症护理患者的压疮发生率,个体进入到病重护理状态下时,影响压疮发生率的因素和压疮过程.设计纵向设计.     

Generation of a functional and durable vascular niche by the adenoviral E4ORF1 gene

Vascular cells contribute to organogenesis and tumorigenesis by producing unknown factors. Primary endothelial cells (PECs) provide an instructive platform for identifying factors that support stem cell and tumor homeostasis. However, long-term maintenance of PECs requires stimulation with cytokines and serum, resulting in loss of their angiogenic properties. To circumvent this hurdle, we have discovered that the adenoviral E4ORF1 gene product maintains long-term survival and facilitates organ-specific purification of PECs, while preserving their vascular repertoire for months, in serum/cytokine-free cultures. Lentiviral introduction of E4ORF1 into human PECs (E4ORF1⁺ ECs) increased the long-term survival of these cells in serum/cytokine-free conditions, while preserving their in vivo angiogenic potential for tubulogenesis and sprouting. Although E4ORF1, in the absence of mitogenic signals, does not induce proliferation of ECs, stimulation with VEGF-A and/or FGF-2 induced expansion of E4ORF1⁺ ECs in a contact-inhibited manner. Indeed, VEGF-A-induced phospho MAPK activation of E4ORF1⁺ ECs is comparable with that of naive PECs, suggesting that the VEGF receptors remain functional upon E4ORF1 introduction. E4ORF1⁺ ECs inoculated in implanted Matrigel plugs formed functional, patent, humanized microvessels that connected to the murine circulation. E4ORF1⁺ ECs also incorporated into neo-vessels of human tumor xenotransplants and supported serum/cytokine-free expansion of leukemic and embryonal carcinoma cells. E4ORF1 augments survival of PECs in part by maintaining FGF-2/FGF-R1 signaling and through tonic Ser-473 phosphorylation of Akt, thereby activating the mTOR and NF-κB pathways. Therefore, E4ORF1⁺ ECs establish an Akt-dependent durable vascular niche not only for expanding stem and tumor cells but also for interrogating the roles of vascular cells in regulating organ-specific vascularization and tumor neo-angiogenesis.