Paradoxical effects of interleukin-10 on the maturation of murine myeloid dendritic cells

The immunoregulatory cytokine, interleukin-10 (IL-10), has been shown to inhibit the maturation of human myeloid dendritic cells (DC). In the present study, we demonstrate that IL-10 has paradoxical effects on the maturation of murine myeloid bone marrow-derived DC. On the one hand, IL-10 inhibits the maturation of murine myeloid DC. The addition of IL-10 to granulocyte-macrophage colony-stimulating factor (GM-CSF)-supported murine BM-derived DC cultures reduced the frequency of major histocompatibility complex (MHC) class IIbright cells. These IL-10-pretreated DC have a reduced capacity to stimulate T cells in an allogeneic mixed leucocyte reaction. On the other hand, however, and in contrast to the effects of IL-10 on human DC, we found that the addition of IL-10 from the initiation of the culture onwards induced an up-regulation of the expression of the costimulatory molecules CD40, CD80 and CD86 on murine myeloid DC, as compared to DC generated with GM-CSF only. Moreover, a subpopulation of IL-10-pretreated MHC class IIdim DC lacked the capacity to take up dextran-fluorescein isothiocyanate (FITC), a feature of DC maturation. Taken together, our data demonstrate that the generation of murine myeloid DC in the presence of IL-10 results in a population of incompletely matured MHC class IIdim CD80+ CD86+ DC. These DC lack T-cell stimulatory capacity, suggesting a role for IL-10 in conferring tolerogenic properties on murine myeloid DC.     

HRAS-related epidermal nevus syndromes: Expansion of the spectrum with first branchial arch defects

Epidermal nevus syndrome (ENS) comprises a heterogeneous group of neurocutaneous syndromes associated with the presence of epidermal nevi and variable extracutaneous manifestations. Postzygotic activating HRAS pathogenic variants were previously identified in nevus sebaceous (NS), keratinocytic epidermal nevus (KEN), and different ENS, including Schimmelpenning–Feuerstein–Mims and cutaneous-skeletal-hypophosphatasia syndrome (CSHS). Skeletal involvement in HRAS-related ENS ranges from localized bone dysplasia in association with KEN to fractures and limb deformities in CSHS. We describe the first association of HRAS-related ENS and auricular atresia, thereby expanding the disease spectrum with first branchial arch defects if affected by the mosaic variant. In addition, this report illustrates the first concurrent presence of verrucous EN, NS, and nevus comedonicus (NC), indicating the possibility of mosaic HRAS variation as an underlying cause of NC. Overall, this report extends the pleiotropy of conditions associated with mosaic pathogenic variants in HRAS affecting ectodermal and mesodermal progenitor cells.     

Two-year outcomes for children with autism after the cessation of early intensive behavioral intervention

Evidence from recent meta-analytic and narrative review suggests that early intensive behavioral intervention (EIBI) may improve life chances of preschool children with autism. Unfortunately, there are few data indicating whether early gains are maintained after intervention ceases. The purpose of the present study was to establish the 2-year follow-up outcome for children with autism (N = 41) who had participated in an earlier 2-year controlled comparison of EIBI. Twenty-three children in the intervention group (100% of original sample) and 18 in the treatment-as-usual comparison group (86% of original sample) were located and retested. Group differences favoring intervention substantially diluted in this period but varied significantly between subgroups who had received university-supervised and parent-commissioned interventions, favoring the latter. These groups differed in terms of their baseline characteristics and intensity of intervention. Results strongly suggest a need for better characterization of those children who would benefit from more active maintenance programs.     

A prospective randomized study of combined visual laser ablation and transurethral resection of the prostate versus transurethral prostatectomy alone

INTRODUCTION: Visual laser ablation of the prostate (VLAP) has a clinical failure rate of up to 18% which is 3 times higher than transurethral resection of the prostate (TURP) alone. Prolonged spontaneous passage of necrotic debris is the major shortcoming of this method. Therefore combined visual laser-assisted and transurethral prostatectomy was compared to TURP alone. MATERIALS AND METHODS: 105 patients were evaluated in a prospective randomized study comparing TURP alone and VLAP combined with TURP. The patients were evaluated 1, 3 and 12 months after surgery. First VLAP was performed using a neodymium:yttrium-aluminum-garnet laser with the prolase fiber followed by standard resection of the necrotic and remaining prostatic tissue. Treatment efficacy was assessed by the American Urological Association (AUA) symptom score, measurements of peak urinary flow, residual urine volume, intraoperative bleeding, and by the occurrence of intra- and postoperative complications. RESULTS: The use of VLAP and consecutive TURP improved the AUA symptom score, urinary flow and residual volume and was comparable in all patients treated. Intraoperative bleeding was significantly reduced from 522 +/- 45 ml by TURP to 214 +/- 33 ml by VLAP+TURP (p < 0.05). There was a significant improvement in the postoperative values of the parameters observed in both groups. CONCLUSIONS: It appears that the combined method for treatment of benign prostatic hyperplasia reduced the specific intraoperative morbidity of TURP while achieving the same clinical effect as TURP alone.     

Simultaneous B1 + homogenization and specific absorption rate hotspot suppression using a magnetic resonance phased array transmit coil.

In high-field MRI severe problems with respect to B(1) (+) uniformity and specific absorption rate (SAR) deposition pose a great challenge to whole-body imaging. In this study the potential of a phased array transmit coil is investigated to simultaneously reduce B(1) (+) nonuniformity and SAR deposition. This was tested by performing electromagnetic simulations of a phased array TEM coil operating at 128 MHz loaded with two different homogeneous elliptical phantoms and four dielectric patient models. It was shown that the wave interference of a circularly polarized RF field with an ellipse and a pelvis produces largely identical B(1) (+) and electric field patterns. Especially for obese patients, this results in large B(1) (+) nonuniformity and global areas with elevated SAR deposition. It is demonstrated that a phased array transmit coil can reduce these phenomena. The technique was especially successful in suppressing SAR hotspots with a decrease up to 50%. The application of optimized settings for an ellipse to the patient models leads to comparable results as obtained with the patient-specific optimizations. This suggests that generic phase/amplitude port settings are possible, requiring no preinformation about patient-specific RF fields. Such a scheme would, due to its simultaneous B(1) (+) homogenization and extra SAR margin, have many benefits for whole-body imaging at 3 T.     

Comparison of radiologists and technologists in the performance of air-contrast barium enemas

OBJECTIVE: The purpose of this study was to determine whether the rate of polyp detection and the quality of air-contrast barium enema (ACBE) procedures performed by technologists differ from those performed by radiologists. CONCLUSION: Our results showed that well-trained certified technologists can perform ACBE similar in overall quality and accuracy to ACBE performed by attending physicians and residents. Training technologists to perform ACBE may help to alleviate the radiology staffing shortage in the United States.     

右美托咪定的实验研究和临床应用(英文)

右美托咪定(DEX)是高选择性α2肾上腺素受体激动药,起效快,作用时间短、兼具有镇静、镇痛作用、且无呼吸抑制,近来在临床上越来越受到重视。研究证明,右美托咪定在达到并维持足够的镇静水平的同时,具有独特的易于唤醒的特点,同时可减少其他镇静药物的用量。右美托咪定诱导的镇静类似于非快速动眼睡眠,故可提高睡眠质量,有利于免疫系统恢复。右美托咪定的镇痛作用呈剂量依赖性,且有封顶效应。右美托咪定和阿片类药物联合应用,不仅增强阿片类药物的镇痛作用,还可以减少阿片类药物的用量,有效预防阿片类药物过量所致的不良反应。右美托咪定有血流动力学稳定作用,但也可以引起心动过缓和低血压;右美托咪定还可降低术后躁动、恶心、呕吐的发生率。右美托咪定用于长期使用阿片类药物的患者,未出现明显的撤药反应,同时可以治疗阿片类药物引起的痛觉过敏。右美托咪定和布比卡因混合液用于骶管阻滞,提供足够的镇痛作用同时,显著延长骶管阻滞时间。对于神经外科手术患者,右美托咪定不抑制体感诱发电位,不影响术中神经系统功能评估。由于右美托咪定独特的无呼吸抑制的显著特点,在众多需要保持患者自主呼吸的临床麻醉应用中是一种较理想的药物。总之,右美托咪定这些特性将使得其在未来的...