A randomized trial of aspirin to prevent colorectal adenomas in patients with previous colorectal cancer.

Abstract: BACKGROUND Experimental studies in animals and observational studies in humans suggest that regular aspirin use may decrease the risk of colorectal adenomas, the precursors to most colorectal cancers.

Abstract: METHODS We conducted a randomized, double-blind trial to determine the effect of aspirin on the incidence of colorectal adenomas.

Abstract: We randomly assigned 635 patients with previous colorectal cancer to receive either 325 mg of aspirin per day or placebo.

Abstract: We determined the proportion of patients with adenomas, the number of recurrent adenomas, and the time to the development of adenoma between randomization and subsequent colonoscopic examinations.

Abstract: Relative risks were adjusted for age, sex, cancer stage, the number of colonoscopic examinations, and the time to a first colonoscopy.

Abstract: The study was terminated early by an independent data and safety monitoring board when statistically significant results were reported during a planned interim analysis.

Abstract: RESULTS A total of 517 randomized patients had at least one colonoscopic examination a median of 12.8 months after randomization.

Abstract: One or more adenomas were found in 17 percent of patients in the aspirin group and 27 percent of patients in the placebo group (P=0.004).

Abstract: The mean (+/-SD) number of adenomas was lower in the aspirin group than the placebo group (0.30+/-0.87 vs. 0.49+/-0.99, P=0.003 by the Wilcoxon test).

Abstract: The adjusted relative risk of any recurrent adenoma in the aspirin group, as compared with the placebo group, was 0.65 (95 percent confidence interval, 0.46 to 0.91).

Abstract: The time to the detection of a first adenoma was longer in the aspirin group than in the placebo group (hazard ratio for the detection of a new polyp, 0.64; 95 percent confidence interval, 0.43 to 0.94; P=0.022).

Abstract: CONCLUSIONS Daily use of aspirin is associated with a significant reduction in the incidence of colorectal adenomas in patients with previous colorectal cancer.


The Wilms tumour suppressor protein WT1 (+KTS isoform) binds alpha-actinin 1 mRNA via its zinc-finger domain.

Abstract: Mutations in WT1 are associated with developmental syndromes that affect the urogenital system and neoplasms, including Wilms tumour, acute myeloid leukemia, and breast and prostate cancers.

Abstract: The WT1 protein belongs to the early growth response family of zinc-finger transcription factors.

Abstract: Uniquely to WT1, an evolutionarily conserved alternative splice event inserts the tripeptide KTS, between zinc fingers 3 and 4.

Abstract: Whereas -KTS isoforms bind DNA and activate or repress transcription, +KTS isoforms bind DNA less efficiently and interact with splice factors and RNA in vitro and in vivo.

Abstract: Although candidate DNA targets have been found, physiological mRNA targets are yet to be defined.

Abstract: We examined the distribution of WT1 in ribonucleoprotein (RNP) complexes in nuclear extract prepared from M15 cells, a mouse mesonephric fetal kidney cell line.

Abstract: WT1 cofractionated with the splice factor PSF in large RNP particles >or=2 MDa.

Abstract: We also found that PSF co-immunoprecipitated with WT1, suggesting a functional interaction between these 2 multifunctional proteins.

Abstract: Using yeast three-hybrid library constructed from the co-immunoprecipitated RNA we found that WT1 (+KTS) binds close to or at the start codon of alpha-actinin 1 (ACTN1) mRNA.

Abstract: A band shift assay confirmed the ability of the WT1 zinc-finger domain (+KTS) to bind this sequence in vitro.

Abstract: ACTN1 is the first likely physiological mRNA target of WT1.


How safe are psychiatric medications after a voluntary overdose?

Abstract: PURPOSE This study assessed psychiatric medications and their potential lethality in a representative sample of suicide attempts.

Abstract: MATERIALS AND METHODS During 1996-98, 563 suicide attempts were studied in a general hospital in Madrid (Spain).

Abstract: Medication overdose was used in 456 suicide attempts (81%).

Abstract: The ratio between dose taken and maximum prescription dose recommended was used to evaluate the medication toxicity.

Abstract: RESULTS Benzodiazepines were the drugs most often used in self-poisoning (65% of overdoses), followed by new antidepressants (11%), tricyclic antidepressants (TCAs) (10%), and antipsychotics (8%).

Abstract: An overdose with any of the three latter psychiatric medications was significantly more frequent in patients prescribed those medications.

Abstract: The overdoses for TCA were potentially lethal in 47% of the cases.

Abstract: However, all patients who overdosed on psychiatric medications recovered well and were discharged without any sequelae.

Abstract: DISCUSSION This study suggests that psychiatric medications, particularly benzodiazepines, new antidepressants and antipsychotics, are relatively safe when they are used for self-poisoning.

Abstract: If patients with mental illnesses are under treated, there is a clear and documented higher risk for suicide.

Abstract: CONCLUSION

Abstract: It is better to prescribe psychiatric medications, particularly the new ones, rather than withhold them due to an exaggerated fear of a lethal overdose


Health benefits, costs, and cost-effectiveness of earlier eligibility for adult antiretroviral therapy and expanded treatment coverage: a combined analysis of 12 mathematical models.

Abstract: BACKGROUND New WHO guidelines recommend ART initiation for HIV-positive persons with CD4 cell counts ≤500 cells/µL, a higher threshold than was previously recommended.

Abstract: Country decision makers must consider whether to further expand ART eligibility accordingly.

Abstract: METHODS We used multiple independent mathematical models in four settings-South Africa, Zambia, India, and Vietnam-to evaluate the potential health impact, costs, and cost-effectiveness of different adult ART eligibility criteria under scenarios of current and expanded treatment coverage, with results projected over 20 years.

Abstract: Analyses considered extending eligibility to include individuals with CD4 ≤500 cells/µL or all HIV-positive adults, compared to the previous recommendation of initiation with CD4 ≤350 cells/µL. We assessed costs from a health system perspective, and calculated the incremental cost per DALY averted ($/DALY) to compare competing strategies.

Abstract: Strategies were considered 'very cost-effective' if the $/DALY was less than the country's per capita gross domestic product (GDP; South Africa: $8040, Zambia: $1425, India: $1489, Vietnam: $1407) and 'cost-effective' if $/DALY was less than three times per capita GDP.

Abstract: FINDINGS In South Africa, the cost per DALY averted of extending ART eligibility to CD4 ≤500 cells/µL ranged from $237 to $1691/DALY compared to 2010 guidelines; in Zambia, expanded eligibility ranged from improving health outcomes while reducing costs (i.e. dominating current guidelines) to $749/DALY.

Abstract: Results were similar in scenarios with substantially expanded treatment access and for expanding eligibility to all HIV-positive adults.

Abstract: Expanding treatment coverage in the general population was therefore found to be cost-effective.

Abstract: In India, eligibility for all HIV-positive persons ranged from $131 to $241/DALY and in Vietnam eligibility for CD4 ≤500 cells/µL cost $290/DALY.

Abstract: In concentrated epidemics, expanded access among key populations was also cost-effective.

Abstract: INTERPRETATION Earlier ART eligibility is estimated to be very cost-effective in low- and middle-income settings, although these questions should be revisited as further information becomes available.

Abstract: Scaling-up ART should be considered among other high-priority health interventions competing for health budgets.

Abstract: FUNDING The Bill and Melinda Gates Foundation and World Health Organization.


Chronic daily headache: long-term prognosis following inpatient treatment with repetitive IV DHE.

Abstract: We retrospectively studied the long-term (2-year) outcome of 50 consecutive patients admitted to our inpatient headache program because of chronic daily headache (CDH) associated with the overuse of analgesics, ergotamine, or both.

Abstract: They had been detoxified, given repetitive intravenous dihydroergotamine (IV DHE) and prophylactic medications as part of the program, and had become headache-free on this regimen.

Abstract: At the time of admission, 37 of the 50 patients had transformed migraine (TM), 12 had new daily persistent headache (NDPH), and 1 had chronic tension-type headache; 29 of the patients with TM, 7 of those with NDPH, and the single patient with chronic tension-type headache had coexistent migraine.

Abstract: Substances abused, alone or in combination, included: caffeine in 39 patients (av.

Abstract: 441 mg/d), acetaminophen in 32 (av.

Abstract: 2187 mg/d), aspirin in 24 (av.

Abstract: 1807 mg/d), ibuprofen in 9 (av.

Abstract: 1156 mg/d), narcotics in 7 (av.

Abstract: 10.1 mg morphine equivalents/d) and ergotamine in 11 (av.

Abstract: 2.3 mg/d).

Abstract: Twenty patients were using preventive medication at the time of admission.

Abstract: Follow-up evaluations were performed at 3, 6, 12, and 24 months after discharge.

Abstract: Forty-three patients were analyzed at 3 months.

Abstract: Of these, 44% had an excellent or good result and 28% a fair result; 3 were overusing analgesics.

Abstract: At 24 months, 39 patients were analyzed: 59% had a good or excellent result and 28% a fair result; 5 were overusing analgesics, 4 of whom were doing poorly.(ABSTRACT TRUNCATED AT 250 WORDS)


Survival in a case of massive paraquat ingestion.

Abstract: Serious exposure to the herbicide paraquat usually results in death, either due to gastrointestinal caustic lesions, shock, and acute respiratory distress syndrome or related to the progressive development of pulmonary fibrosis associated with refractory hypoxemia.

Abstract: We report a case of suicidal paraquat ingestion in a 59-year-old man.

Abstract: Most of the indicators of poor prognosis were encountered in this patient.

Abstract: Treatment consisted of early digestive decontamination and hemodialysis, followed by antioxidant therapy, including the administration of deferoxamine (100 mg/kg in 24 h) and a continuous infusion of acetylcysteine (300 mg/kg/d during 3 weeks).

Abstract: The patient only developed a nonoliguric acute renal failure, a mild alteration of liver tests, and an impairment of CO transfer factor without any respiratory complaint.

Abstract: Renal and hepatic disturbances completely resolved within 1 month, whereas CO transfer factor remained altered 14 months later.

Abstract: This observation suggests that early administration of an antioxidant therapy, including deferoxamine and acetylcysteine could be usefully associated with measures that prevent digestive absorption or enhance elimination to limit systemic toxicity in potentially fatal paraquat poisoning.


Cyclic GMP-AMP synthase is a cytosolic DNA sensor that activates the type I interferon pathway.

Abstract: The presence of DNA in the cytoplasm of mammalian cells is a danger signal that triggers host immune responses such as the production of type I interferons.

Abstract: Cytosolic DNA induces interferons through the production of cyclic guanosine monophosphate-adenosine monophosphate (cyclic GMP-AMP, or cGAMP), which binds to and activates the adaptor protein STING.

Abstract: Through biochemical fractionation and quantitative mass spectrometry, we identified a cGAMP synthase (cGAS), which belongs to the nucleotidyltransferase family.

Abstract: Overexpression of cGAS activated the transcription factor IRF3 and induced interferon-β in a STING-dependent manner.

Abstract: Knockdown of cGAS inhibited IRF3 activation and interferon-β induction by DNA transfection or DNA virus infection.

Abstract: cGAS bound to DNA in the cytoplasm and catalyzed cGAMP synthesis.

Abstract: These results indicate that cGAS is a cytosolic DNA sensor that induces interferons by producing the second messenger cGAMP.


Eating pathology, emotion regulation, and emotional overeating in obese adults with Binge Eating Disorder.

Abstract: OBJECTIVE The purpose of the current study was to examine the relationship among emotional regulation, emotional overeating, and general eating pathology in a treatment seeking sample of adults with Binge Eating Disorder (BED).

Abstract: METHOD The sample was composed of 326 adults (248 women, 78 men) who were obese and met DSM-IV-TR criteria for BED.

Abstract: Prior to treatment, participants completed the Difficulties in Emotion Regulation Scale (DERS), Emotional Overeating Questionnaire (EOQ), Beck Depression Inventory (BDI), and Eating Disorder Examination-Questionnaire (EDE-Q) as part of a larger assessment battery.

Abstract: RESULTS A series of hierarchical regression analyses indicated that difficulties with emotion regulation accounted for unique variance in both emotional overeating and general eating pathology above and beyond sex and negative affect.

Abstract: DISCUSSION Emotion regulation may play a significant role in the maintenance of emotional overeating and eating pathology in obese adults with BED.


Monoallelic expression and methylation of imprinted genes in human and mouse embryonic germ cell lineages.

Abstract: Imprinting is an epigenetic modification leading to monoallelic expression of some genes, and disrupted imprinting is believed to be a barrier to human stem cell transplantation, based on studies that suggest that epigenetic marks are unstable in mouse embryonic germ (EG) and embryonic stem (ES) cells.

Abstract: However, stem cell imprinting has not previously been examined directly in humans.

Abstract: We found that three imprinted genes, TSSC5, H19, and SNRPN, show monoallelic expression in in vitro differentiated human EG-derived cells, and a fourth gene, IGF2, shows partially relaxed imprinting at a ratio from 4:1 to 5:1, comparable to that found in normal somatic cells.

Abstract: In addition, we found normal methylation of an imprinting control region (ICR) that regulates H19 and IGF2 imprinting, suggesting that imprinting may not be a significant epigenetic barrier to human EG cell transplantation.

Abstract: Finally, we were able to construct an in vitro mouse model of genomic imprinting, by generating EG cells from 8.5-day embryos of an interspecific cross, in which undifferentiated cells show biallelic expression and acquire preferential parental allele expression after differentiation.

Abstract: This model should allow experimental manipulation of epigenetic modifications of cultured EG cells that may not be possible in human stem cell studies.


Functional in vivo interactions between JNK1 and JNK2 isoforms in obesity and insulin resistance.

Abstract: The c-Jun N-terminal kinases (JNKs) are key regulators of inflammation and interfere with insulin action in cultured cells and whole animals.

Abstract: Obesity increases total JNK activity, and JNK1, but not JNK2, deficiency results in reduced adiposity and improved insulin sensitivity.

Abstract: Interestingly, a higher-than-normal level of JNK activation is observed in Jnk2(-/-) mice, particularly in the liver, indicating an interaction between the isoforms that might have masked the metabolic activity of JNK2 in isolated mutant mice.

Abstract: To address the role of the JNK2 isoform in metabolic homeostasis, we intercrossed Jnk1(-/-) and Jnk2(-/-) mice and examined body weight and glucose metabolism in the resulting mutant allele combinations.

Abstract: Among all of the viable genotypes examined, we observed only reduced body weight and increased insulin sensitivity in Jnk1(-/-) and Jnk1(+/-)Jnk2(-/-) mice.

Abstract: These two groups of mice also exhibited reduced total JNK activity and cytokine expression in liver tissue compared with all other genotypes examined.

Abstract: These data indicate that the JNK2 isoform is also involved in metabolic regulation, but its function is not obvious when JNK1 is fully expressed because of regulatory crosstalk between the two isoforms.


The immunological synapse of CTL contains a secretory domain and membrane bridges.

Abstract: Cytotoxic T lymphocytes (CTL) rapidly destroy their targets.

Abstract: Here we show that although target cell death occurs within 5 min of CTL-target cell contact, an immunological synapse similar to that seen in CD4 cells rapidly forms in CTL, with a ring of adhesion proteins surrounding an inner signaling molecule domain.

Abstract: Lytic granule secretion occurs in a separate domain within the adhesion ring, maintaining signaling protein organization during exocytosis.

Abstract: Live and fixed cell studies show target cell plasma membrane markers are transferred to the CTL as the cells separate.

Abstract: Electron microscopy reveals continuities forming membrane bridges between the CTL and target cell membranes, suggesting a possible mechanism for this transfer.


Compromised intestinal epithelial barrier induces adaptive immune compensation that protects from colitis.

Abstract: Mice lacking junctional adhesion molecule A (JAM-A, encoded by F11r) exhibit enhanced intestinal epithelial permeability, bacterial translocation, and elevated colonic lymphocyte numbers, yet do not develop colitis.

Abstract: To investigate the contribution of adaptive immune compensation in response to increased intestinal epithelial permeability, we examined the susceptibility of F11r(-/-)Rag1(-/-) mice to acute colitis.

Abstract: Although negligible contributions of adaptive immunity in F11r(+/+)Rag1(-/-) mice were observed, F11r(-/-)Rag1(-/-) mice exhibited increased microflora-dependent colitis.

Abstract: Elimination of T cell subsets and cytokine analyses revealed a protective role for TGF-β-producing CD4(+) T cells in F11r(-/-) mice.

Abstract: Additionally, loss of JAM-A resulted in elevated mucosal and serum IgA that was dependent upon CD4(+) T cells and TGF-β.

Abstract: Absence of IgA in F11r(+/+)Igha(-/-) mice did not affect disease, whereas F11r(-/-)Igha(-/-) mice displayed markedly increased susceptibility to acute injury-induced colitis.

Abstract: These data establish a role for adaptive immune-mediated protection from acute colitis under conditions of intestinal epithelial barrier compromise.


Apoptosis and chemoresistance in transgenic cancer models

Abstract: Multidrug resistance remains an unresolved problem in clinical oncology.

Abstract: Over a decade ago genes encoding cellular efflux pumps were shown to confer resistance to a broad spectrum of biochemically unrelated anticancer drugs even before the compounds reached their intracellular targets.

Abstract: More recently it has become apparent that many drugs induce a common apoptotic program, such that mutations in this program can also produce multidrug resistance.

Abstract: However, a thorough evaluation of the contribution of apoptotic defects to this "postdamage" drug resistant phenotype is technically complicated, and this has led to uncertainty about the overall significance of apoptosis in therapy-induced cell death.

Abstract: For example, correlative analyses using patient specimens are limited by unknown background mutations in the biopsy material, and assays using cancer cell lines can be biased by unphysiological conditions.

Abstract: We sought to circumvent these restrictions by utilizing a tractable transgenic cancer model to examine the impact of apoptosis on treatment outcome.

Abstract: Here we discuss potential caveats of cell culture based assays, highlight features of genetically engineered mice as potential model systems, and describe a tractable transgenic mouse model to study drug responses in a series of primary lymphomas with genetically defined lesions treated at their natural site.


NC-100717: a versatile RGD peptide scaffold for angiogenesis imaging.

Abstract: Targeting the molecular pathways associated with angiogenesis offers great potential in detecting disease pathology using in vivo imaging technologies.

Abstract: Initiation of angiogenesis requires activation and migration of endothelial cells in order for neovascularization to proceed.

Abstract: Endothelial cells associate with the extracellular matrix through specific interactions with a variety of cell adhesion receptors known as integrins.

Abstract: Peptides containing the tripeptide sequence RGD are known to bind with high affinity to the alphavbeta3 and alphavbeta5 integrins associated with angiogenesis.

Abstract: We present herein the synthesis and in vitro binding affinity of the RGD-containing peptide NC-100717 and a range of molecular probes derived from this intermediate.


Dose-dependent effect of statins on the incidence of acute kidney injury after cardiac surgery.

Abstract: BACKGROUND Acute kidney injury (AKI) after cardiac surgery is associated with increased morbidity and mortality.

Abstract: METHODS We assessed whether statin treatment is associated with a lower incidence of postoperative AKI in 2,104 consecutive patients who underwent coronary artery bypass graft or valve surgery at the Minneapolis Veterans Administration Medical Center.

Abstract: Acute kidney injury was defined as absolute increase greater than 0.3 mg/dL or relative increase greater than 50% in serum creatinine from baseline, within 48 hours after surgery or requiring postoperative hemodialysis per AKI network.

Abstract: Propensity scores were utilized to adjust for the differences between the statin and the no-statin treatment groups.

Abstract: All statins were converted to equivalent-dose simvastatin and divided at the median to construct high-dose (≥40 mg) and low-dose (<40 mg) statin groups.

Abstract: RESULTS Of the 2,104 patients, 1,435 (68%) were taking statins (638 high-dose) and 495 (24%) developed AKI (25% high-dose vs 40% low-dose vs 35% no-statin; p = 0.014).

Abstract: Estimated preoperative glomerular filtration rate (p = 0.003), diabetes mellitus (p=0.02), valve surgery with or without coronary artery bypass graft (p = 0.024), cardiopulmonary bypass time (p = 0.001), and intraaortic balloon pump (p = 0.055) were independent predictors of AKI.

Abstract: After propensity adjustment statin treatment was not associated with postoperative AKI (odds ratio 0.79; 95% confidence interval 0.59 to 1.06; p = 0.11 for high-dose v. no-statin).

Abstract: After full adjustment for all independent predictors of AKI, the results did not change.

Abstract: Statins also had no effect on the incidence of postoperative hemodialysis (0.8% high-dose vs 1.9% low-dose vs 1% no-statin; p = 0.15).

Abstract: CONCLUSIONS Statin treatment is not associated with a lower incidence of AKI after cardiac surgery.


Comparison of allogeneic vs autologous bone marrow–derived mesenchymal stem cells delivered by transendocardial injection in patients with ischemic cardiomyopathy: the POSEIDON randomized trial.

Abstract: CONTEXT Mesenchymal stem cells (MSCs) are under evaluation as a therapy for ischemic cardiomyopathy (ICM).

Abstract: Both autologous and allogeneic MSC therapies are possible; however, their safety and efficacy have not been compared.

Abstract: OBJECTIVE To test whether allogeneic MSCs are as safe and effective as autologous MSCs in patients with left ventricular (LV) dysfunction due to ICM.

Abstract: DESIGN, SETTING, AND PATIENTS A phase 1/2 randomized comparison (POSEIDON study) in a US tertiary-care referral hospital of allogeneic and autologous MSCs in 30 patients with LV dysfunction due to ICM between April 2, 2010, and September 14, 2011, with 13-month follow-up.

Abstract: INTERVENTION Twenty million, 100 million, or 200 million cells (5 patients in each cell type per dose level) were delivered by transendocardial stem cell injection into 10 LV sites.

Abstract: MAIN OUTCOME MEASURES Thirty-day postcatheterization incidence of predefined treatment-emergent serious adverse events (SAEs).

Abstract: Efficacy assessments included 6-minute walk test, exercise peak VO2, Minnesota Living with Heart Failure Questionnaire (MLHFQ), New York Heart Association class, LV volumes, ejection fraction (EF), early enhancement defect (EED; infarct size), and sphericity index.

Abstract: RESULTS Within 30 days, 1 patient in each group (treatment-emergent SAE rate, 6.7%) was hospitalized for heart failure, less than the prespecified stopping event rate of 25%.

Abstract: The 1-year incidence of SAEs was 33.3% (n = 5) in the allogeneic group and 53.3% (n = 8) in the autologous group (P = .46).

Abstract: At 1 year, there were no ventricular arrhythmia SAEs observed among allogeneic recipients compared with 4 patients (26.7%) in the autologous group (P = .10).

Abstract: Relative to baseline, autologous but not allogeneic MSC therapy was associated with an improvement in the 6-minute walk test and the MLHFQ score, but neither improved exercise VO2 max.

Abstract: Allogeneic and autologous MSCs reduced mean EED by −33.21% (95% CI, −43.61% to −22.81%; P < .001) and sphericity index but did not increase EF.

Abstract: Allogeneic MSCs reduced LV end-diastolic volumes.

Abstract: Low-dose concentration MSCs (20 million cells) produced greatest reductions in LV volumes and increased EF.

Abstract: Allogeneic MSCs did not stimulate significant donor-specific alloimmune reactions.

Abstract: CONCLUSIONS In this early-stage study of patients with ICM, transendocardial injection of allogeneic and autologous MSCs without a placebo control were both associated with low rates of treatment-emergent SAEs, including immunologic reactions.

Abstract: In aggregate, MSC injection favorably affected patient functional capacity, quality of life, and ventricular remodeling.

Abstract: TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT01087996.


Periosteal bone formation--a neglected determinant of bone strength.

Abstract: Life forms that have low body mass can hunt for food on the undersurface of branches or along shear cliff faces quite unperturbed by gravity.

Abstract: For larger animals, the hunt for dinner and the struggle to avoid becoming someone else's meal require rapid movement against gravity.

Abstract: This need is met by the lever function of long bones, three-dimensional masterpieces of biomechanical engineering that, by their material composition and structural design, achieve the contradictory properties of stiffness and flexibility, strength and lightness.1 Material stiffness results from the encrusting of the triple-helical structure of collagen type I with hydroxyapatite crystals, which confers . . .


Triglyceride depletion of brown adipose tissue enables analysis of mitochondrial respiratory function in permeabilized biopsies.

Abstract: The research on mitochondrial functions in adipocytes has increasingly evidenced that mitochondria plays an important role in the onset and/or progression of obesity and related pathologies.

Abstract: Mitochondrial function in brown adipose tissue (BAT) has been classically assessed by measuring either the levels/activity of mitochondrial enzymes, or the respiration in isolated mitochondria.

Abstract: Isolation of mitochondria is not advantageous because it demands significant time and amount of tissue and, as tissue homogenates, disrupts biochemical and physical connections of mitochondria within the cell.

Abstract: Here, we described a new and efficient protocol to analyze the mitochondrial respiratory states in BAT biopsies that relies on intracellular triglyceride depletion followed by tissue permeabilization.

Abstract: In addition to minimizing tissue requirements to ∼17 mg wet weight, the proposed protocol enabled analysis of all mitochondrial respiratory states, including phosphorylation (OXPHOS), no-phosphorylation (LEAK), and uncoupled (ETS) states, as well as the use of substrates for complex I, complex II, and cytochrome c; together, these features demonstrated mitochondrial integrity and validated the preparation efficacy.

Abstract: Therefore, the protocol described here increases the possibilities of answering physiological questions related to small BAT regions of human and animal models, which shall help to unravel the mechanisms that regulate mitochondrial function in health and disease.


HES-1 preserves purified hematopoietic stem cells ex vivo and accumulates side population cells in vivo.

Abstract: Mouse long-term hematopoietic reconstituting cells exist in the c-Kit+Sca-1+Lin- (KSL) cell population; among them, CD34(low/-) cells represent the most highly purified population of hematopoietic stem cells in the adult bone marrow.

Abstract: Here, we demonstrate that retrovirus-mediated transduction of CD34(low/-)c-Kit+Sca-1+Lin- (34-KSL) cells with the HES-1 gene, which encodes a basic helix-loop-helix transcription factor functioning downstream of the Notch receptor, and is a key molecule for the growth phase of neural stem cells in the embryo, preserves the long-term reconstituting activity of these cells in vitro.

Abstract: We also show that cells derived from the HES-1-transduced 34-KSL population produce progenies characterized by negative Hoechst dye staining, which defines the side population, and by CD34(low/-) profile in the bone marrow KSL population in each recipient mouse at ratios 3.5- and 7.8-fold those produced by nontransduced 34-KSL-derived competitor cells.

Abstract: We conclude that HES-1 preserves the long-term reconstituting hematopoietic activity of 34-KSL stem cells ex vivo.

Abstract: Up-regulation of HES-1 protein in the 34-KSL population before unnecessary cell division, that is, without retrovirus transduction, may represent a potent approach to absolute expansion of hematopoietic stem cells.


Measuring Absolute RNA Copy Numbers at High Temporal Resolution Reveals Transcriptome Kinetics in Development.

Abstract: Transcript regulation is essential for cell function, and misregulation can lead to disease.

Abstract: Despite technologies to survey the transcriptome, we lack a comprehensive understanding of transcript kinetics, which limits quantitative biology.

Abstract: This is an acute challenge in embryonic development, where rapid changes in gene expression dictate cell fate decisions.

Abstract: By ultra-high-frequency sampling of Xenopus embryos and absolute normalization of sequence reads, we present smooth gene expression trajectories in absolute transcript numbers.

Abstract: During a developmental period approximating the first 8 weeks of human gestation, transcript kinetics vary by eight orders of magnitude.

Abstract: Ordering genes by expression dynamics, we find that "temporal synexpression" predicts common gene function.

Abstract: Remarkably, a single parameter, the characteristic timescale, can classify transcript kinetics globally and distinguish genes regulating development from those involved in cellular metabolism.

Abstract: Overall, our analysis provides unprecedented insight into the reorganization of maternal and embryonic transcripts and redefines our ability to perform quantitative biology.


Inflammasome activation by adenylate cyclase toxin directs Th17 responses and protection against Bordetella pertussis.

Abstract: Inflammasome-mediated IL-1beta production is central to the innate immune defects that give rise to certain autoinflammatory diseases and may also be associated with the generation of IL-17-producing CD4(+) T (Th17) cells that mediate autoimmunity.

Abstract: However, the role of the inflammasome in driving adaptive immunity to infection has not been addressed.

Abstract: In this article, we demonstrate that inflammasome-mediated IL-1beta plays a critical role in promoting Ag-specific Th17 cells and in generating protective immunity against Bordetella pertussis infection.

Abstract: Using a murine respiratory challenge model, we demonstrated that the course of B. pertussis infection was significantly exacerbated in IL-1R type I-defective (IL-1RI(-/-)) mice.

Abstract: We found that adenylate cyclase toxin (CyaA), a key virulence factor secreted by B. pertussis, induced robust IL-1beta production by dendritic cells through activation of caspase-1 and the NALP3-containing inflammasome complex.

Abstract: Using mutant toxins, we demonstrate that CyaA-mediated activation of caspase-1 was not dependent on adenylate cyclase enzyme activity but was dependent on the pore-forming capacity of CyaA. In addition, CyaA promoted the induction of Ag-specific Th17 cells in wild-type but not IL-1RI(-/-) mice.

Abstract: Furthermore, the bacterial load was enhanced in IL-17-defective mice.

Abstract: Our findings demonstrate that CyaA, a virulence factor from B. pertussis, promotes innate IL-1beta production via activation of the NALP3 inflammasome and, thereby, polarizes T cell responses toward the Th17 subtype.

Abstract: In addition to its known role in subverting host immunity, our findings suggest that CyaA can promote IL-1beta-mediated Th17 cells, which promote clearance of the bacteria from the respiratory tract.


Infection and apoptosis as a combined inflammatory trigger.

Abstract: While inflammatory phagocytosis of microbial pathogens and non-inflammatory phagocytosis of apoptotic cells have each been studied extensively, the consequences of innate immune recognition of host cells undergoing apoptosis as a direct result of infection are unclear.

Abstract: In this situation, the innate immune system is confronted with mixed signals, those from apoptotic cells and those from the infecting pathogen.

Abstract: Nuclear receptor activation has been implicated downstream of apoptotic cell recognition while Toll-like receptors are the prototypical inflammatory receptors engaged during infection.

Abstract: When the two signals combine, a new set of events takes place beginning with transrepression of a subset of inflammatory-response genes and ending with the induction of a T helper-17 adaptive immune response.

Abstract: This response is best suited for clearing the infecting pathogen and repairing the damage that occurred to the host tissue during infection.


Chronic lymphocytic leukemia with t(14;19)(q32;q13) is characterized by atypical morphologic and immunophenotypic features and distinctive genetic features.

Abstract: The t(14;19)(q32;q13) involving the IGH@ and BCL3 loci is an infrequent cytogenetic abnormality detected in B-cell malignancies.

Abstract: We describe the clinicopathologic, cytogenetic, and molecular genetic characteristics of 14 cases of chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL) with t(14;19)(q32;q13).

Abstract: All patients (10 men and 4 women) had lymphocytosis; 10 had lymphadenopathy.

Abstract: Blood and bone marrow lymphocytes were predominantly small, but cytologically and immunophenotypically atypical.

Abstract: In all cases, t(14;19) was found in the neoplastic stem line; it was the sole abnormality in 4.

Abstract: Ten cases showed additional cytogenetic abnormalities, including trisomy 12 in 9 and complex karyotypes in 7.

Abstract: Fluorescence in situ hybridization demonstrated IGH@/BCL3 fusion gene in all cases.

Abstract: In all cases, the IGHV genes were unmutated, but only 7 expressed ZAP70.

Abstract: Seven cases preferentially used IGHV4-39.

Abstract: Our results indicate that t(14;19)(q32;q13) identifies a subset of CLL/SLL with distinctive clinicopathologic and genetic features.

Abstract: Furthermore, t(14;19) may represent an early, possibly primary, genetic event.


Risk factors for the development of gallstone recurrence following medical dissolution. The British-Italian Gallstone Study Group.

Abstract: OBJECTIVE To assess risk factors for gallstone recurrence following non-surgical treatment.

Abstract: DESIGN A prospective follow-up of a multicentre cohort of post-dissolution gallstone patients.

Abstract: SETTING Six gastroenterology units in the UK and Italy.

Abstract: PARTICIPANTS One hundred and sixty-three patients with confirmed gallstone dissolution following non-surgical therapy (bile acids or lithotripsy plus bile acids), followed up by ultrasound scan and clinical assessment at 6-monthly intervals for up to 6 years (median, 25 months; range, 6-70 months).

Abstract: OUTCOME MEASURES Subject-related variables (sex, age, height, weight, body mass index), gallstone-related variables (number, diameter, presence of symptoms, months to complete stone clearance), treatment modalities (bile acid therapy, extracorporeal shock wave lithotripsy) and follow-up related variables (weight change, use of non-steroidal anti-inflammatory agents, statins, pregnancies and/or use of oestrogens) were assessed by univariate and multivariate analysis as putative risk factors for gallstone recurrence.

Abstract: RESULTS Forty-five gallstone recurrences were observed during the follow-up period.

Abstract: Multiple primary gallstones and length of time to achieve gallstone dissolution were the only variables associated with a significant increase in the recurrence rate.

Abstract: Appearance of biliary sludge during follow-up was also significantly related to development of gallstone recurrence.

Abstract: Use of statins or non-steroidal anti-inflammatory agents did not confer protection against recurrence.

Abstract: CONCLUSIONS Patients with primary single stones are the best candidates for non-surgical treatment of gallstones, because of a low risk of gallstone recurrence.

Abstract: The positive association of recurrence with biliary sludge formation and time to dissolution of primary stones may provide indirect confirmation for the role of impaired gallbladder motility in the pathogenesis of this condition.


Deletion of the developmentally essential gene ATR in adult mice leads to age-related phenotypes and stem cell loss.

Abstract: Developmental abnormalities, cancer, and premature aging each have been linked to defects in the DNA damage response (DDR).

Abstract: Mutations in the ATR checkpoint regulator cause developmental defects in mice (pregastrulation lethality) and humans (Seckel syndrome).

Abstract: Here we show that eliminating ATR in adult mice leads to defects in tissue homeostasis and the rapid appearance of age-related phenotypes, such as hair graying, alopecia, kyphosis, osteoporosis, thymic involution, fibrosis, and other abnormalities.

Abstract: Histological and genetic analyses indicate that ATR deletion causes acute cellular loss in tissues in which continuous cell proliferation is required for maintenance.

Abstract: Importantly, thymic involution, alopecia, and hair graying in ATR knockout mice were associated with dramatic reductions in tissue-specific stem and progenitor cells and exhaustion of tissue renewal and homeostatic capacity.

Abstract: In aggregate, these studies suggest that reduced regenerative capacity in adults via deletion of a developmentally essential DDR gene is sufficient to cause the premature appearance of age-related phenotypes.


Conventional and monocyte-derived CD11b(+) dendritic cells initiate and maintain T helper 2 cell-mediated immunity to house dust mite allergen.

Abstract: Dendritic cells (DCs) are crucial for mounting allergic airway inflammation, but it is unclear which subset of DCs performs this task.

Abstract: By using CD64 and MAR-1 staining, we reliably separated CD11b(+) monocyte-derived DCs (moDCs) from conventional DCs (cDCs) and studied antigen uptake, migration, and presentation assays of lung and lymph node (LN) DCs in response to inhaled house dust mite (HDM).

Abstract: Mainly CD11b(+) cDCs but not CD103(+) cDCs induced T helper 2 (Th2) cell immunity in HDM-specific T cells in vitro and asthma in vivo.

Abstract: Studies in Flt3l(-/-) mice, lacking all cDCs, revealed that moDCs were also sufficient to induce Th2 cell-mediated immunity but only when high-dose HDM was given.

Abstract: The main function of moDCs was the production of proinflammatory chemokines and allergen presentation in the lung during challenge.

Abstract: Thus, we have identified migratory CD11b(+) cDCs as the principal subset inducing Th2 cell-mediated immunity in the LN, whereas moDCs orchestrate allergic inflammation in the lung.


Interplay between the dividing cell and its neighbors regulates adherens junction formation during cytokinesis in epithelial tissue.

Abstract: How adherens junctions (AJs) are formed upon cell division is largely unexplored.

Abstract: Here, we found that AJ formation is coordinated with cytokinesis and relies on an interplay between the dividing cell and its neighbors.

Abstract: During contraction of the cytokinetic ring, the neighboring cells locally accumulate Myosin II and produce the cortical tension necessary to set the initial geometry of the daughter cell interface.

Abstract: However, the neighboring cell membranes impede AJ formation.

Abstract: Upon midbody formation and concomitantly to neighboring cell withdrawal, Arp2/3-dependent actin polymerization oriented by the midbody maintains AJ geometry and regulates AJ final length and the epithelial cell arrangement upon division.

Abstract: We propose that cytokinesis in epithelia is a multicellular process, whereby the cooperative actions of the dividing cell and its neighbors define a two-tiered mechanism that spatially and temporally controls AJ formation while maintaining tissue cohesiveness.


Cancer stem cells in solid tumours: accumulating evidence and unresolved questions

Abstract: Solid tumours are an enormous cancer burden and a major therapeutic challenge.

Abstract: The cancer stem cell (CSC) hypothesis provides an attractive cellular mechanism to account for the therapeutic refractoriness and dormant behaviour exhibited by many of these tumours.

Abstract: There is increasing evidence that diverse solid tumours are hierarchically organized and sustained by a distinct subpopulation of CSCs.

Abstract: Direct evidence for the CSC hypothesis has recently emerged from mouse models of epithelial tumorigenesis, although alternative models of heterogeneity also seem to apply.

Abstract: The clinical relevance of CSCs remains a fundamental issue but preliminary findings indicate that specific targeting may be possible.


The structure of the follistatin:activin complex reveals antagonism of both type I and type II receptor binding.

Abstract: TGF-beta ligands stimulate diverse cellular differentiation and growth responses by signaling through type I and II receptors.

Abstract: Ligand antagonists, such as follistatin, block signaling and are essential regulators of physiological responses.

Abstract: Here we report the structure of activin A, a TGF-beta ligand, bound to the high-affinity antagonist follistatin.

Abstract: Two follistatin molecules encircle activin, neutralizing the ligand by burying one-third of its residues and its receptor binding sites.

Abstract: Previous studies have suggested that type I receptor binding would not be blocked by follistatin, but the crystal structure reveals that the follistatin N-terminal domain has an unexpected fold that mimics a universal type I receptor motif and occupies this receptor binding site.

Abstract: The formation of follistatin:BMP:type I receptor complexes can be explained by the stoichiometric and geometric arrangement of the activin:follistatin complex.

Abstract: The mode of ligand binding by follistatin has important implications for its ability to neutralize homo- and heterodimeric ligands of this growth factor family.


The activity of siRNA in mammalian cells is related to structural target accessibility: a comparison with antisense oligonucleotides.

Abstract: The biological activity of siRNA seems to be influenced by local characteristics of the target RNA, including local RNA folding.

Abstract: Here, we investigated quantitatively the relationship between local target accessibility and the extent of inhibition of the target gene by siRNA.

Abstract: Target accessibility was assessed by a computational approach that had been shown earlier to be consistent with experimental probing of target RNA.

Abstract: Two sites of ICAM-1 mRNA predicted to serve as accessible motifs and one site predicted to adopt an inaccessible structure were chosen to test siRNA constructs for suppression of ICAM-1 gene expression in ECV304 cells.

Abstract: The local target-dependent effectiveness of siRNA was compared with antisense oligonucleotides (asON).

Abstract: The concentration dependency of siRNA-mediated suppression indicates a >1000-fold difference between active siRNAs (IC50 approximately 0.2-0.5 nM) versus an inactive siRNA (IC50 > or = 1 microM) which is consistent with the activity pattern of asON when relating target suppression to predicted local target accessibility.

Abstract: The extremely high activity of the siRNA si2B (IC50 = 0.24 nM) indicates that not all siRNAs shown to be active at the usual concentrations of >10-100 nM belong to this highly active species.

Abstract: The observations described here suggest an option to assess target accessibility for siRNA and, thus, support the design of active siRNA constructs.

Abstract: This approach can be automated, work at high throughput and is open to include additional parameters relevant to the biological activity of siRNA.


Rapid accumulation of mutations during seed-to-seed propagation of mismatch-repair-defective Arabidopsis.

Abstract: During the many cell divisions that precede formation of plant gametes, their apical-meristem and floral antecedents are continually exposed to endogenous and environmental mutagenic threats.

Abstract: Although some deleterious recessive mutations may be eliminated during growth of haploid gametophytes and functionally haploid early embryos ("haplosufficiency quality-checking"), the multiplicity of plant genome-maintenance systems suggests aggressive quality control during prior diploid growth.

Abstract: To test in Arabidopsis a hypothesis that prior mismatch repair (MMR) is paramount in defense of plant genetic fidelity, we propagated in parallel 36 MMR-defective (Atmsh2-1) and 36 wild-type lines.

Abstract: The Atmsh2-1 lines rapidly accumulated a wide variety of mutations: fifth-generation (G5) plants showed abnormalities in morphology and development, fertility, germination efficiency, seed/silique development, and seed set.

Abstract: Only two Atmsh2-1, but all 36 wild-type lines, appeared normal at G5.

Abstract: Analyses of insertion/deletion mutation at six repeat-sequence (microsatellite) loci showed each Atmsh2-1 line to have evolved its own "fingerprint," the results of as many as 10 microsatellite mutations in a single line.

Abstract: Thus, MMR during diploid growth is essential for plant genomic integrity.


Archaeal chromatin and transcription.

Abstract: Archaea contain a variety of sequence-independent DNA binding proteins consistent with the evolution of several different, sometimes overlapping and exchangeable solutions to the problem of genome compaction.

Abstract: Some of these proteins undergo residue-specific post-translational lysine acetylation or methylation, hinting at analogues of the histone modifications that regulate eukaryotic chromatin structure and transcription.

Abstract: Archaeal transcription initiation most closely resembles the eukaryotic RNA polymerase II (RNAPII) system, but Archaea do not appear to have homologues of the multisubunit complexes that remodel eukaryotic chromatin and activate RNAPII initiation.

Abstract: In contrast, they have sequence-specific regulators that repress and perhaps activate archaeal transcription by mechanisms superficially similar to the bacterial paradigm of regulating promoter binding by RNAP.

Abstract: Repressors compete with archaeal TATA-box binding protein (TBP) and TFB for the TATA-box and TFB-recognition elements (BRE) of the archaeal promoter, or with archaeal RNAP for the site of transcription initiation.

Abstract: Transcript-specific regulation by repressors binding to sites of transcript initiation is consistent with such sites having very little sequence conservation.

Abstract: However, most Archaea have only one TBP and/or TFB that presumably must therefore bind to similar TATA-box and BRE sequences upstream of most genes.

Abstract: Repressors that function by competing with TBP and/or TFB binding must therefore also make additional contacts with transcript-specific regulatory sites adjacent or remote from the TATA-box/BRE region.

Abstract: The fate of the archaeal TBP and TFB following transcription initiation remains to be determined.

Abstract: Based on functional homology with their eukaryotic RNAPII-system counterparts, archaeal TBP and possibly also TFB should remain bound to the TATA-box/BRE region after transcription initiation.

Abstract: However, this seems unlikely as it might limit repressor competition at this site to only the first round of transcription initiation.


Temporal segregation of 4-1BB versus CD28-mediated costimulation: 4-1BB ligand influences T cell numbers late in the primary response and regulates the size of the T cell memory response following influenza infection.

Abstract: In this report, we demonstrate that CD28(-/-) mice are severely impaired in the initial expansion of D(b)/NP366-374-specific CD8 T cells in response to influenza virus infection, whereas 4-1BB ligand (4-1BBL)(-/-) mice show no defect in primary T cell expansion to influenza virus.

Abstract: In contrast, 4-1BBL(-/-) mice show a decrease in D(b)/NP366-374-specific T cells late in the primary response.

Abstract: Upon secondary challenge with influenza virus, 4-1BBL(-/-) mice show a decrease in the number of D(b)/NP366-374-specific T cells compared to wild-type mice such that the level of the CD8 T cell expansion during the in vivo secondary response is reduced to the level of a primary response, with concomitant reduction of CTL effector function.

Abstract: In contrast, Ab responses, as well as secondary CD4 T cell responses, to influenza are unaffected by 4-1BBL deficiency.

Abstract: Thus, CD28 is critical for initial T cell expansion, whereas 4-1BB/4-1BBL signaling affects T cell numbers much later in the response and is essential for the survival and/or responsiveness of the memory CD8 T cell pool.


Functional role of high-affinity anandamide transport, as revealed by selective inhibition.

Abstract: Anandamide, an endogenous ligand for central cannabinoid receptors, is released from neurons on depolarization and rapidly inactivated.

Abstract: Anandamide inactivation is not completely understood, but it may occur by transport into cells or by enzymatic hydrolysis.

Abstract: The compound N-(4-hydroxyphenyl)arachidonylamide (AM404) was shown to inhibit high-affinity anandamide accumulation in rat neurons and astrocytes in vitro, an indication that this accumulation resulted from carrier-mediated transport.

Abstract: Although AM404 did not activate cannabinoid receptors or inhibit anandamide hydrolysis, it enhanced receptor-mediated anandamide responses in vitro and in vivo.

Abstract: The data indicate that carrier-mediated transport may be essential for termination of the biological effects of anandamide, and may represent a potential drug target.


Silibinin inhibits the invasion of IL-6-stimulated colon cancer cells via selective JNK/AP-1/MMP-2 modulation in vitro.

Abstract: Silibinin is a flavonoid with antihepatotoxic properties and pleiotropic anticancer capabilities.

Abstract: This study investigated silibinin inhibition of cell invasion by down-regulating matrix metalloproteinase-2 (MMP-2) expression, via attenuation of activator protein-1 (AP-1) in IL-6-stimulated LoVo colon cancer cells.

Abstract: Western blot data showed that the expression of MMP-2 protein was reduced 1.6- or 1.7-fold over the control by treatment with silibinin or JNK inhibitor in the models.

Abstract: Similar results were revealed in zymography and confocal microscopy.

Abstract: Pretreatment with silibinin also abolished the binding activity of AP-1 and MMP-2 promoter activity via AP-1 binding, as observed by EMSA and luciferase assay.

Abstract: Finally, a [(3)H]-thymidine incorporation proliferation assay and cell migration assay demonstrated that silibinin inhibited IL-6-stimulated LoVo cell proliferation and invasion.

Abstract: Taken together, these data indicated that silibinin inhibits LoVo cell invasion with the reduction of MMP-2 presentation by attenuating AP-1 binding activity, suggesting a novel antimetastatic application for silibinin in colon cancer chemoprevention.


Immigration cohorts and residential overcrowding in southern California

Abstract: To what degree do immigrants reduce their high rates of residential overcrowding with increasing length of residence in the United States?

Abstract: This question is addressed through the application of a “double cohort” method that nests birth cohorts within immigration cohorts.

Abstract: This method enables duration of immigration effects to be separated from aging effects as cohorts pass through life course phases, when family sizes may be growing or shrinking.

Abstract: The analysis finds that cohort trends differ sharply from the cross-sectional pattern observed at a single point in time.

Abstract: Cohorts’ growth in income is found to contribute substantially to the decline in overcrowding over time.

Abstract: Cohort trends among Hispanic immigrants, however, diverge from those among others, indicating much less decrease in overcrowding and even increases over certain age spans.


Expression of green fluorescent protein in the ureteric bud of transgenic mice: a new tool for the analysis of ureteric bud morphogenesis.

Abstract: The growth and branching of the ureteric bud is a complex process that is ultimately responsible for the organization of the collecting duct system as well as the number of nephrons in the metanephric kidney.

Abstract: While the genes involved in the regulation of this process have begun to be elucidated, our understanding of the cellular and molecular basis of ureteric bud morphogenesis remains rudimentary.

Abstract: Furthermore, the timing and sequence of branching and elongation that gives rise to the collecting system of the kidney can only be inferred from retrospective staining or microdissection of fixed preparations.

Abstract: To aid in the investigation of these issues, we developed strains of transgenic mice in which a green fluorescent protein (GFP) is expressed in the ureteric bud under the control of the Hoxb7 promoter.

Abstract: In these mice, GFP is expressed in every branch of the ureteric bud throughout renal development, and in its derivative epithelia in the adult kidney.

Abstract: As GFP fluorescence can be easily visualized in living tissue, this allows the dynamic pattern of ureteric bud growth and branching to be followed over several days when the kidneys are cultured in vitro.

Abstract: Using confocal microscopy, branching of the ureteric bud in all three dimensions can be analyzed.

Abstract: These mice represent an extremely powerful tool to characterize the normal patterns of ureteric bud morphogenesis and to investigate the response of the bud to growth factors, matrix elements, and other agents that regulate its growth and branching.


Biological properties of herpes simplex virus 2 replication-defective mutant strains in a murine nasal infection model.

Abstract: We used a mouse nasal model of herpes simplex virus 2 (HSV-2) infection to examine the biological properties of HSV-2 wild-type (wt), TK-negative, and replication-defective strains in vivo.

Abstract: Nasal septa tissue is the major site of wt viral replication post intranasal (i.n.) inoculation.

Abstract: The HSV-2 strain 186 syn(+)-1 wt virus caused lethal encephalitis at doses of 10(4) PFU and above per nostril, and at lower doses no neurons in the trigeminal ganglia were positive for the latency-associated transcript, indicating a lack of latent infection.

Abstract: The 186DeltaKpn TK-negative mutant virus replicated in nasal septa tissue but showed low-level replication in trigeminal ganglia at only one timepoint.

Abstract: In situ hybridization of trigeminal ganglia showed that the number of LAT-positive neurons was proportional to the inoculum dose from 10(3) to 10(6) PFU per nare.

Abstract: The replication-defective mutant virus 5BlacZ showed no replication in nasal septa tissue and no persistence of viral DNA at the inoculation site or the trigeminal ganglia.

Abstract: Nevertheless, inoculation of 5BlacZ or the double-mutant dl5-29 at distal sites reduced acute replication and latent infection of 186DeltaKpn following intranasal challenge.

Abstract: This infection model provides a biological system to test the properties of HSV-2 strains and shows that replication-defective mutant strains do not persist at sites of inoculation or in sensory ganglia but can induce immune protection that reduces the latent viral load of a challenge virus.


The sphingosine-1-phosphate receptor agonist FTY720 modulates dendritic cell trafficking in vivo.

Abstract: The pro-drug FTY720 is undergoing phase III clinical trials for prevention of allograft rejection.

Abstract: After phosphorylation, FTY720 targets the G protein-coupled-sphingosine-1-phosphate receptor 1 (S1PR1) on lymphocytes, thereby inhibiting their egress from lymphoid organs and their recirculation to inflammatory sites.

Abstract: Potential effects on dendritic cell (DC) trafficking have not been evaluated.

Abstract: Here, we demonstrate the expression of all five S1PR subtypes (S1PR1-5) by murine DCs.

Abstract: Administration of FTY720 to C57BL/10 mice markedly reduced circulating T and B lymphocytes within 24 h, but not blood-borne DCs, which were enhanced significantly for up to 96 h, while DCs in lymph nodes and spleen were reduced.

Abstract: Numbers of adoptively transferred, fluorochrome-labeled syngeneic or allogeneic DCs in blood were increased significantly in FTY720-treated animals, while donor-derived DCs and allostimulatory activity for host naïve T cells within the spleen were reduced.

Abstract: Administration of the selective S1PR1 agonist SEW2871 significantly enhanced circulating DC numbers.

Abstract: Flow analysis revealed that CD11b, CD31/PECAM-1, CD54/ICAM-1 and CCR7 expression on blood-borne DCs was downregulated following FTY720 administration.

Abstract: Transendothelial migration of FTY720-P-treated immature DCs to the CCR7 ligand CCL19 was reduced.

Abstract: These novel data suggest that modulation of DC trafficking by FTY720 may contribute to its immunosuppressive effects.


Sustained survivin expression from OX40 costimulatory signals drives T cell clonal expansion.

Abstract: Sustained signaling from the T cell receptor (TCR) and costimulatory molecules is thought necessary for generating high numbers of effector T cells.

Abstract: Here, we show that Survivin is controlled in peripheral T cells by OX40 cosignaling via sustained PI3k and PKB activation.

Abstract: Survivin is induced by OX40 independent of mitotic progression in late G1, and blocking Survivin suppresses S-phase transition and division of T cells and leads to apoptosis.

Abstract: Moreover, Survivin expression alone is sufficient to restore proliferation and to antagonize apoptosis in costimulation-deficient T cells and can rescue T cell expansion in vivo.

Abstract: Survivin allows effector T cells to accumulate in large numbers, but Bcl-2 family proteins are required for T cell survival after the phase of active division.

Abstract: Thus, sustained Survivin expression from costimulatory signaling maintains T cell division over time and regulates the extent of clonal expansion.


The Combination of Exercise and Respiratory Training Improves Respiratory Muscle Function in Pulmonary Hypertension

Abstract: Increased dyspnea and reduced exercise capacity in pulmonary arterial hypertension (PAH) can be partly attributed to impaired respiratory muscle function.

Abstract: This prospective study was designed to assess the impact of exercise and respiratory training on respiratory muscle strength and 6-min walking distance (6MWD) in PAH patients.

Abstract: Patients with invasively confirmed PAH underwent 3 weeks of in-hospital exercise and respiratory training, which was continued at home for another 12 weeks.

Abstract: Medication remained constant during the study period.

Abstract: Blinded observers assessed efficacy parameters at baseline (I) and after 3 (II) and 15 weeks (III).

Abstract: Respiratory muscle function was assessed by twitch mouth pressure (TwPmo) during nonvolitional supramaximal magnetic phrenic nerve stimulation.

Abstract: Seven PAH patients (4 women; mean pulmonary artery pressure 45 ± 11 mmHg, median WHO functional class 3.1 ± 0.4, idiopathic/associated PAH n = 5/2) were included.

Abstract: The training program was feasible and well tolerated by all patients with excellent compliance.

Abstract: TwPmo was I: 0.86 ± 0.37 kPa, II: 1.04 ± 0.29 kPa, and III: 1.27 ± 0.44 kPa, respectively.

Abstract: 6MWD was I: 417 ± 51 m, II: 509 ± 39 m, and III: 498 ± 39 m, respectively.

Abstract: Both TwPmo (+0.41 ± 0.34 kPa, +56 ± 39 %) and 6MWD (+81 ± 30 m, +20 ± 9 %) increased significantly in the period between baseline and the final assessment (pairwise comparison: p = 0.012/<0.001; RM-ANOVA considering I, II, III: p = 0.037/<0.001).

Abstract: Exercise and respiratory training as an adjunct to medical therapy may be effective in patients with PAH to improve respiratory muscle strength and exercise capacity.

Abstract: Future, randomized, controlled trials should be carried out to further investigate these findings.


Dual role of the IL-12/IFN-gamma axis in the development of autoimmune myocarditis: induction by IL-12 and protection by IFN-gamma.

Abstract: IL-12 and IFN-gamma positively regulate each other and type 1 inflammatory responses, which are believed to cause tissue damage in autoimmune diseases.

Abstract: We investigated the role of the IL-12/IFN-gamma (Th1) axis in the development of autoimmune myocarditis.

Abstract: IL-12p40-deficient mice on a susceptible background resisted myocarditis.

Abstract: In the absence of IL-12, autospecific CD4(+) T cells proliferated poorly and showed increased Th2 cytokine responses.

Abstract: However, IFN-gamma-deficient mice developed fatal autoimmune disease, and blockade of IL-4R signaling did not confer susceptibility to myocarditis in IL-12p40-deficient mice, demonstrating that IL-12 triggers autoimmunity by a mechanism independent of the effector cytokines IFN-gamma and IL-4.

Abstract: In conclusion, our results suggest that the IL-12/IFN-gamma axis is a double-edged sword for the development of autoimmune myocarditis.

Abstract: Although IL-12 mediates disease by induction/expansion of Th1-type cells, IFN-gamma production from these cells limits disease progression.


Somatic and Germline Diversification of a Putative Immunoreceptor within One Phylum: Dscam in Arthropods.

Abstract: Arthropod Dscam, the homologue of the human Down Syndrome cell adhesion molecule, is a receptor used by the nervous and immune systems.

Abstract: Unlike in vertebrates, evolutionary pressure has selected and maintained a vast Dscam diversity of isoforms, known to specifying neuronal identity during the nervous system differentiation.

Abstract: This chapter examines the different modes of Dscam diversification in the context of arthropods' evolution and that of their immune system, where its role is controversial.

Abstract: In the single Dscam gene of insects and crustaceans, mutually exclusive alternative splicing affects three clusters of duplicated exons encoding the variable parts of the receptor.

Abstract: The Dscam gene produces over 10,000 isoforms.

Abstract: In the more basal arthropods such as centipedes, Dscam diversity results from a combination of many germline genes (over 80) with, in about half of those, the possibility of alternative splicing affecting only one exon cluster.

Abstract: In the even more basal arthropods, such as chelicerates, no splicing possibility is detected, but there exist dozens of germline Dscam genes.

Abstract: Compared to controlling the expression of multiple germline genes, the somatic mutually alternative splicing within a single gene may offer a simplified way of expressing a large Dscam repertoire.

Abstract: Expressed by hemocytes, Dscam is considered a phagocytic receptor but is also encountered in solution.

Abstract: More information is necessary about its binding to pathogens, its role in phagocytosis, its possible role in specifying hemocyte identity, its kinetics of expression, and the regulation of its RNA splicing to understand how its diversity is linked to immunity.


Epidemiology, health-related quality of life and economic burden of binge eating disorder: a systematic literature review

Abstract: PURPOSE To perform a systematic review on the epidemiology, the health-related quality of life (HRQoL) and economic burden of binge eating disorder (BED).

Abstract: METHODS A systematic literature search of English-language articles was conducted using Medline, Embase, PsycINFO, PsycARTICLES, Academic Search Complete, CINAHL Plus, Business Source Premier and Cochrane Library.

Abstract: Literature search on epidemiology was limited to studies published between 2009 and 2013.

Abstract: Cost data were inflated and converted to 2012 US$ purchasing power parities.

Abstract: All of the included studies were assessed for quality.

Abstract: RESULTS Forty-nine articles were included.

Abstract: Data on epidemiology were reported in 31, HRQoL burden in 16, and economic burden in 7 studies.

Abstract: Diagnosis of BED was made using 4th Edition of The Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) criteria in 46 studies.

Abstract: Lifetime prevalence of BED was 1.1-1.9% in the general population (DSM-IV).

Abstract: BED was associated with significant impairment in aspects of HRQoL relating to both physical and mental health; the Short Form 36 Physical and Mental Component Summary mean scores varied between 31.1 to 47.3 and 32.0 to 49.8, respectively.

Abstract: Compared to individuals without eating disorder, BED was related to increased healthcare utilization and costs.

Abstract: Annual direct healthcare costs per BED patient ranged between $2,372 and $3,731.

Abstract: CONCLUSIONS BED is a serious eating disorder that impairs HRQoL and is related to increased healthcare utilization and healthcare costs.

Abstract: The limited literature warrants further research, especially to better understand the long-term HRQoL and economic burden of BED.


Subcellular steroid/nuclear receptor dynamics.

Abstract: Steroid hormones, thyroid hormones, retinoic acids, and vitamin D bind to their receptors, which are now called steroid/nuclear receptors, and liganded receptors translocate either intracellularly or intranuclearly and form large protein complexes with cofactors to induce or repress gene transcription.

Abstract: Therefore, steroid/nuclear receptors are ligand-dependent transcription factors.

Abstract: With the advent of green fluorescent protein (GFP) and its color variants, the subcellular distribution of many steroid/nuclear receptors has been found to be much more dynamic than previously thought, with some of the receptors shuttling between the cytoplasm and nucleus.

Abstract: Steroid/nuclear receptors can be divided into three categories based on their unliganded distribution: those that are primarily in the nucleus, those in the cytoplasm, and those with mixed cytoplasmic and nuclear distributions.

Abstract: However, in all cases, the addition of a ligand leads to almost complete nuclear translocation of the receptors.

Abstract: Hormonal stimulation induces intranuclear receptor distribution from a homogeneous pattern to a heterogeneous dot-like image.

Abstract: Ligand binding to steroid/nuclear receptors leads to the recruitment of many proteins including cofactors to provoke the redistribution of receptor complexes in the nucleus.

Abstract: This focal organization could involve more complex events than simple DNA binding sites for transcription.

Abstract: Protein activities and interactions of steroid/nuclear receptors can be imaged and localized in a single cell.


EMT, the cytoskeleton, and cancer cell invasion

Abstract: The metastatic process, i.e. the dissemination of cancer cells throughout the body to seed secondary tumors at distant sites, requires cancer cells to leave the primary tumor and to acquire migratory and invasive capabilities.

Abstract: In a process of epithelial-mesenchymal transition (EMT), besides changing their adhesive repertoire, cancer cells employ developmental processes to gain migratory and invasive properties that involve a dramatic reorganization of the actin cytoskeleton and the concomitant formation of membrane protrusions required for invasive growth.

Abstract: The molecular processes underlying such cellular changes are still only poorly understood, and the various migratory organelles, including lamellipodia, filopodia, invadopodia and podosomes, still require a better functional and molecular characterization.

Abstract: Notably, direct experimental evidence linking the formation of migratory membrane protrusions and the process of EMT and tumor metastasis is still lacking.

Abstract: In this review, we have summarized recent novel insights into the molecular processes and players underlying EMT on one side and the formation of invasive membrane protrusions on the other side.


Different response of human glioma tumor-initiating cells to epidermal growth factor receptor kinase inhibitors.

Abstract: Because a subpopulation of cancer stem cells (tumor-initiating cells, TICs) is believed to be responsible for the development, progression, and recurrence of many tumors, we evaluated the in vitro sensitivity of human glioma TICs to epidermal growth factor receptor (EGFR) kinase inhibitors (erlotinib and gefitinib) and possible molecular determinants for their effects.

Abstract: Cells isolated from seven glioblastomas (GBM 1-7) and grown using neural stem cell permissive conditions were characterized for in vivo tumorigenicity, expression of tumor stem cell markers (CD133, nestin), and multilineage differentiation properties, confirming that these cultures are enriched in TICs.

Abstract: TIC cultures were challenged with increasing concentrations of erlotinib and gefitinib, and their survival was evaluated after 1-4 days.

Abstract: In most cases, a time- and concentration-dependent cell death was observed, although GBM 2 was completely insensitive to both drugs, and GBM 7 was responsive only to the highest concentrations tested.

Abstract: Using a radioligand binding assay, we show that all GBM TICs express EGFR.

Abstract: Erlotinib and gefitinib inhibited EGFR and ERK1/2 phosphorylation/activation in all GBMs, irrespective of the antiproliferative response observed.

Abstract: However, under basal conditions GBM 2 showed a high Akt phosphorylation that was completely insensitive to both drugs, whereas GBM 7 was completely insensitive to gefitinib, and Akt inactivation occurred only for the highest erlotinib concentration tested, showing a precise relationship with the antiproliferative effects of the drug.

Abstract: Interestingly, in GBM 2, phosphatase and tensin homolog expression was significantly down-regulated, possibly accounting for the insensitivity to the drugs.

Abstract: In conclusion, glioma TICs are responsive to anti-EGFR drugs, but phosphatase and tensin homolog expression and Akt inhibition seem to be necessary for such effect.


Structural features of the interaction of the 3'-untranslated region of mRNA containing exosomal RNA-specific motifs with YB-1, a potential mediator of mRNA sorting.

Abstract: We have previously shown that YB-1 is the only protein of the HEK293 cell cytoplasmic (S100) extract that specifically interacts with RNA hairpins each containing one of the motifs ACCAGCCU (1), CAGUGAGC (2) and UAAUCCCA (3), which had been identified as often found in exosomal RNA and proposed as potential cis-acting elements targeting RNAs into exosomes.

Abstract: Here we explored the interactions of YB-1 with a fragment of the 3'-untranslated region (UTR) of septin 14 mRNA (SEPT14 RNA), which contains all three motifs.

Abstract: We demonstrated the occurrence of YB-1 among proteins pulled down from the HEK293 S100 extract using biotinylated SEPT14 RNA.

Abstract: With recombinant YB-1, it was found that SEPT14 RNA can bind up to 5 moles of protein per mole of RNA in a cooperative manner, which was shown to be mainly facilitated by the presence of the above motifs.

Abstract: RNA hairpins with motifs 1 and 2 competed with SEPT14 RNA for binding to the protein, whereas that with motif 3 was less competitive, in accordance with the affinity of YB-1 for these RNA hairpins.

Abstract: With YB-1-bound RNA, nucleotides protected from attack by hydroxyl radicals were revealed in all three motifs, although hairpins with motif 2 and especially with motif 1 contained many protected nucleotides outside the motifs, suggesting that the specific environments of these motifs contribute significantly to the YB-1 binding.

Abstract: An analysis of the environments of motifs 1-3 in the HEK293 cell mRNA 3' UTRs gained from RNA-seq data led us to conclude that the primary binding sites of YB-1 in the 3' UTRs are hairpins containing some part of the motif along with its specific surroundings; the consensus sequences of these hairpins were derived.

Abstract: Thus, our findings provide a new understanding of the structural basis of the interactions between YB-1 and mRNAs carrying the aforementioned motifs.


Periodic screening for breast cancer: the HIP Randomized Controlled Trial. Health Insurance Plan.

Abstract: This paper summarizes the findings of the first breast cancer screening trial, which was initiated in December 1963 to explore the efficacy of screening.

Abstract: Women aged 40-64 years were selected from enrollees in the Health Insurance Plan (HIP) of Greater New York and were randomly assigned to study and control groups.

Abstract: Study group women were invited for screening, an initial examination, and three annual reexaminations.

Abstract: Screening consisted of film mammography (cephalocaudal and lateral views of each breast) and clinical examination of breasts.

Abstract: Breast cancer and mortality from breast cancer were examined by treatment group (study vs. control) and by entry-age subgroup.

Abstract: By the end of 18 years from entry, the study group had about a 25% lower breast cancer mortality among women aged 40-49 and 50-59 at time of entry than did the control group.

Abstract: However, to a large extent the difference among the 40-49-year-olds occurred in the subgroup with breast cancer diagnosed after these women had passed their 50th birthday, and utility of screening women in their forties is questionable.


Staphylococcus aureus infections.

Abstract: Micrococcus, which, when limited in its extent and activity, causes acute suppurative inflammation (phlegmon), produces, when more extensive and intense in its action on the human system, the most virulent forms of septicaemia and pyaemia.1 In an elegant series of clinical observations and laboratory studies published in 1880 and 1882, Ogston described staphylococcal disease and its role in sepsis and abscess formation.1,2 More than 100 years later, Staphylococcus aureus remains a versatile and dangerous pathogen in humans.

Abstract: The frequencies of both community-acquired and hospital-acquired staphylococcal infections have increased steadily, with little change in overall mortality.

Abstract: Treatment of these infections . . .


Structural overview of the nuclear receptor superfamily: insights into physiology and therapeutics.

Abstract: As ligand-regulated transcription factors, the nuclear hormone receptors are nearly ideal drug targets, with internal pockets that bind to hydrophobic, drug-like molecules and well-characterized ligand-induced conformational changes that recruit transcriptional coregulators to promoter elements.

Abstract: Yet, due to the multitude of genes under the control of a single receptor, the major challenge has been the identification of ligands with gene-selective actions, impacting disease outcomes through a narrow subset of target genes and not across their entire gene-regulatory repertoire.

Abstract: Here, we summarize the concepts and work to date underlying the development of steroidal and nonsteroidal receptor ligands, including the use of crystal structures, high-throughput screens, and rational design approaches for finding useful therapeutic molecules.

Abstract: Difficulties in finding selective receptor modulators require a more complete understanding of receptor interdomain communications, posttranslational modifications, and receptor-protein interactions that could be exploited for target gene selectivity.


Differential assembly of inwardly rectifying K+ channel subunits, Kir4.1 and Kir5.1, in brain astrocytes.

Abstract: The inwardly rectifying K+ channel subunit Kir5.1 is expressed abundantly in the brain, but its precise distribution and function are still largely unknown.

Abstract: Because Kir5.1 is co-expressed with Kir4.1 in retinal glial Muller cells, we have compared the biochemical and immunological properties of Kir5.1 and Kir4.1 in the mouse brain.

Abstract: Immunoprecipitation experiments suggested that brain expressed at least two subsets of Kir channels, heteromeric Kir4.1/5.1 and homomeric Kir4.1.

Abstract: Immunolabeling using specific antibodies showed that channels comprising Kir4.1 and Kir5.1 subunits were assembled in a region-specific fashion.

Abstract: Heteromeric Kir4.1/5.1 was identified in the neocortex and in the glomeruli of the olfactory bulb.

Abstract: Homomeric Kir4.1 was confined to the hippocampus and the thalamus.

Abstract: Homomeric Kir5.1 was not identified.

Abstract: Kir4.1/5.1 and Kir4.1 expression appeared to occur only in astrocytes, specifically in the membrane domains facing the pia mater and blood vessels or in the processes surrounding synapses.

Abstract: Both Kir4.1/5.1 and Kir4.1 could be associated with PDZ domain-containing syntrophins, which might be involved in the subcellular targeting of these astrocyte Kir channels.

Abstract: Because heteromeric Kir4.1/5.1 and homomeric Kir4.1 have distinct ion channel properties (Tanemoto, M., Kittaka, N., Inanobe, A., and Kurachi, Y. (2000) J. Physiol.

Abstract: (Lond.) 525, 587-592 and Tucker, S. J., Imbrici, P., Salvatore, L., D'Adamo, M. C., and Pessia, M. (2000) J. Biol.

Abstract: Chem.

Abstract: 275, 16404-16407), it is plausible that these channels play differential physiological roles in the K+ -buffering action of brain astrocytes in a region-specific manner.


Low-grade serous ovarian cancer: a unique disease.

Abstract: Low-grade serous carcinomas represent approximately 10% of all serous ovarian carcinomas.

Abstract: A growing body of research has demonstrated several important differences between the clinical and molecular characteristics of these tumors and those of high-grade serous ovarian carcinomas.

Abstract: Patients with low-grade serous ovarian tumors are diagnosed at a younger age, have a longer overall survival, and have lower response rates to conventional chemotherapy.

Abstract: In addition, low-grade serous ovarian carcinomas have pathologic and molecular characteristics distinct from high-grade serous carcinomas, yet similar to serous tumors of low malignant potential.

Abstract: This suggests a common pathogenesis and a continuum of disease from serous tumors of low malignant potential to low-grade serous carcinomas.

Abstract: Further study, focusing specifically on low-grade serous carcinomas, is needed to determine the role of other chemotherapeutic agents, hormonal therapy, or targeted biologic agents in the treatment of this disease.


Renal outcomes with different fixed-dose combination therapies in patients with hypertension at high risk for cardiovascular events (ACCOMPLISH): a prespecified secondary analysis of a randomised controlled trial.

Abstract: BACKGROUND The Avoiding Cardiovascular Events through Combination Therapy in Patients Living with Systolic Hypertension (ACCOMPLISH) trial showed that initial antihypertensive therapy with benazepril plus amlodipine was superior to benazepril plus hydrochlorothiazide in reducing cardiovascular morbidity and mortality.

Abstract: We assessed the effects of these drug combinations on progression of chronic kidney disease.

Abstract: METHODS ACCOMPLISH was a double-blind, randomised trial undertaken in five countries (USA, Sweden, Norway, Denmark, and Finland).

Abstract: 11 506 patients with hypertension who were at high risk for cardiovascular events were randomly assigned via a central, telephone-based interactive voice response system in a 1:1 ratio to receive benazepril (20 mg) plus amlodipine (5 mg; n=5744) or benazepril (20 mg) plus hydrochlorothiazide (12.5 mg; n=5762), orally once daily.

Abstract: Drug doses were force-titrated for patients to attain recommended blood pressure goals.

Abstract: Progression of chronic kidney disease, a prespecified endpoint, was defined as doubling of serum creatinine concentration or end-stage renal disease (estimated glomerular filtration rate <15 mL/min/1.73 m(2) or need for dialysis).

Abstract: Analysis was by intention to treat (ITT).

Abstract: This trial is registered with ClinicalTrials.gov, number NCT00170950.

Abstract: FINDINGS The trial was terminated early (mean follow-up 2.9 years [SD 0.4]) because of superior efficacy of benazepril plus amlodipine compared with benazepril plus hydrochlorothiazide.

Abstract: At trial completion, vital status was not known for 143 (1%) patients who were lost to follow-up (benazepril plus amlodipine, n=70; benazepril plus hydrochlorothiazide, n=73).

Abstract: All randomised patients were included in the ITT analysis.

Abstract: There were 113 (2.0%) events of chronic kidney disease progression in the benazepril plus amlodipine group compared with 215 (3.7%) in the benazepril plus hydrochlorothiazide group (HR 0.52, 0.41-0.65, p<0.0001).

Abstract: The most frequent adverse event in patients with chronic kidney disease was peripheral oedema (benazepril plus amlodipine, 189 of 561, 33.7%; benazepril plus hydrochlorothiazide, 85 of 532, 16.0%).

Abstract: In patients with chronic kidney disease, angio-oedema was more frequent in the benazepril plus amlodipine group than in the benazepril plus hydrochlorothiazide group.

Abstract: In patients without chronic kidney disease, dizziness, hypokalaemia, and hypotension were more frequent in the benazepril plus hydrochlorothiazide group than in the benazepril plus amlodipine group.

Abstract: INTERPRETATION Initial antihypertensive treatment with benazepril plus amlodipine should be considered in preference to benazepril plus hydrochlorothiazide since it slows progression of nephropathy to a greater extent.

Abstract: FUNDING Novartis.


Effects of exercise training on health status in patients with chronic heart failure: HF-ACTION randomized controlled trial.

Abstract: CONTEXT Findings from previous studies of the effects of exercise training on patient-reported health status have been inconsistent.

Abstract: OBJECTIVE To test the effects of exercise training on health status among patients with heart failure.

Abstract: DESIGN, SETTING, AND PATIENTS Multicenter, randomized controlled trial among 2331 medically stable outpatients with heart failure with left ventricular ejection fraction of 35% or less.

Abstract: Patients were randomized from April 2003 through February 2007.

Abstract: INTERVENTIONS Usual care plus aerobic exercise training (n = 1172), consisting of 36 supervised sessions followed by home-based training, vs usual care alone (n = 1159).

Abstract: Randomization was stratified by heart failure etiology, which was a covariate in all models.

Abstract: MAIN OUTCOME MEASURES Kansas City Cardiomyopathy Questionnaire (KCCQ) overall summary scale and key subscales at baseline, every 3 months for 12 months, and annually thereafter for up to 4 years.

Abstract: The KCCQ is scored from 0 to 100 with higher scores corresponding to better health status.

Abstract: Treatment group effects were estimated using linear mixed models according to the intention-to-treat principle.

Abstract: RESULTS Median follow-up was 2.5 years.

Abstract: At 3 months, usual care plus exercise training led to greater improvement in the KCCQ overall summary score (mean, 5.21; 95% confidence interval, 4.42 to 6.00) compared with usual care alone (3.28; 95% confidence interval, 2.48 to 4.09).

Abstract: The additional 1.93-point increase (95% confidence interval, 0.84 to 3.01) in the exercise training group was statistically significant (P < .001).

Abstract: After 3 months, there were no further significant changes in KCCQ score for either group (P = .85 for the difference between slopes), resulting in a sustained, greater improvement overall for the exercise group (P < .001).

Abstract: Results were similar on the KCCQ subscales, and no subgroup interactions were detected.

Abstract: CONCLUSIONS Exercise training conferred modest but statistically significant improvements in self-reported health status compared with usual care without training.

Abstract: Improvements occurred early and persisted over time.

Abstract: TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT00047437.


Acute respiratory failure in patients with severe community-acquired pneumonia: a prospective randomized evaluation of noninvasive ventilation.

Abstract: In uncontrolled studies, noninvasive positive pressure ventilation (NPPV) was found useful in avoiding endotracheal intubation in patients with acute respiratory failure (ARF) caused by severe community-acquired pneumonia (CAP).

Abstract: We conducted a prospective, randomized study comparing standard treatment plus NPPV delivered through a face mask to standard treatment alone in patients with severe CAP and ARF.

Abstract: Patients fitting the American Thoracic Society criteria for severe CAP were included in presence of ARF (refractory hypoxemia and/or hypercapnia with acidosis).

Abstract: Exclusion criteria were: severe hemodynamic instability, requirement for emergent cardiopulmonary resuscitation, home mechanical ventilation or oxygen long-term supplementation, concomitant severe disease with a low expectation of life, inability to expectorate or contraindications to the use of the mask.

Abstract: Fifty-six consecutive patients (28 in each arm) were enrolled, and the two groups were similar at study entry.

Abstract: The use of NPPV was well tolerated, safe, and associated with a significant reduction in respiratory rate, need for endotracheal intubation (21% versus 50%; p = 0.03), and duration of intensive care unit (ICU) stay (1.8 ± 0.7 d versus 6 ± 1.8 d; p = 0.04).

Abstract: The two groups had a similar intensity of nursing care workload, time interval from study entry to endotracheal intubation, duration of hospitalization, and hospital mortality.

Abstract: Among patients with chronic obstructive pulmonary disease (COPD), those randomized to NPPV had a lower intensity of nursing care workload (p = 0.04) and improved 2-mo survival (88.9% versus 37.5%; p = 0.05).

Abstract: We conclude that in selected patients with ARF caused by severe CAP, NPPV was associated with a significant reduction in the rate of endotracheal intubation and duration of ICU stay.

Abstract: A 2-mo survival advantage was seen in patients with COPD.


Smallest angiosperm genomes found in lentibulariaceae, with chromosomes of bacterial size.

Abstract: Nuclear holoploid genome sizes (C-values) have been estimated to vary about 800-fold in angiosperms, with the smallest established 1C-value of 157 Mbp recorded in Arabidopsis thaliana.

Abstract: In the highly specialized carnivorous family Lentibulariaceae now three taxa have been found that exhibit significantly lower values: Genlisea margaretae with 63 Mbp, G. aurea with 64 Mbp, and Utricularia gibba with 88 Mbp.

Abstract: The smallest mitotic anaphase chromatids in G. aurea have 2.1 Mbp and are thus of bacterial size (NB: E. coli has ca.

Abstract: 4 Mbp).

Abstract: Several Utricularia species range somewhat lower than A. thaliana or are similar in genome size.

Abstract: The highest 1C-value known from species of Lentibulariaceae was found in Genlisea hispidula with 1510 Mbp, and results in about 24-fold variation for Genlisea and the Lentibulariaceae.

Abstract: Taking into account these new measurements, genome size variation in angiosperms is now almost 2000-fold.

Abstract: Genlisea and Utricularia are plants with terminal positions in the phylogeny of the eudicots, so that the findings are relevant for the understanding of genome miniaturization.

Abstract: Moreover, the Genlisea-Utricularia clade exhibits one of the highest mutational rates in several genomic regions in angiosperms, what may be linked to specialized patterns of genome evolution.

Abstract: Ultrasmall genomes have not been found in Pinguicula, which is the sister group of the Genlisea-Utricularia clade, and which does not show accelerated mutational rates.

Abstract: C-values in Pinguicula varied only 1.7-fold from 487 to 829 Mbp.


Parasite multiplication potential and the severity of Falciparum malaria.

Abstract: The multiplication rates and invasiveness of Plasmodium falciparum parasites isolated from adult Thai patients hospitalized with uncomplicated malaria (n=34) were compared with those from persons with severe malaria (n=42).

Abstract: To simulate severe malaria and control for host effects, the in vitro cultures were adjusted to 1% parasitemia and used the same red blood cell donor.

Abstract: P. falciparum isolates from persons with severe malaria had initial cycle multiplication rates in vitro that were 3-fold higher than those from uncomplicated malaria (median [95% confidence interval], 8.3 [7. 1-10.5] vs. 2.8 [1.7-3.9]; P=.001).

Abstract: Parasites causing severe malaria exhibited unrestricted red blood cell invasion, whereas those from uncomplicated malaria were restricted to a geometric mean of 40 (31%-53%) of red blood cells.

Abstract: P. falciparum parasites causing severe malaria were less selective and multiplied more at high parasitemias than those causing uncomplicated malaria.


PHD3-dependent hydroxylation of HCLK2 promotes the DNA damage response.

Abstract: The DNA damage response (DDR) is a complex regulatory network that is critical for maintaining genome integrity.

Abstract: Posttranslational modifications are widely used to ensure strict spatiotemporal control of signal flow, but how the DDR responds to environmental cues, such as changes in ambient oxygen tension, remains poorly understood.

Abstract: We found that an essential component of the ATR/CHK1 signaling pathway, the human homolog of the Caenorhabditis elegans biological clock protein CLK-2 (HCLK2), associated with and was hydroxylated by prolyl hydroxylase domain protein 3 (PHD3).

Abstract: HCLK2 hydroxylation was necessary for its interaction with ATR and the subsequent activation of ATR/CHK1/p53.

Abstract: Inhibiting PHD3, either with the pan-hydroxylase inhibitor dimethyloxaloylglycine (DMOG) or through hypoxia, prevented activation of the ATR/CHK1/p53 pathway and decreased apoptosis induced by DNA damage.

Abstract: Consistent with these observations, we found that mice lacking PHD3 were resistant to the effects of ionizing radiation and had decreased thymic apoptosis, a biomarker of genomic integrity.

Abstract: Our identification of HCLK2 as a substrate of PHD3 reveals the mechanism through which hypoxia inhibits the DDR, suggesting hydroxylation of HCLK2 is a potential therapeutic target for regulating the ATR/CHK1/p53 pathway.


Economic implications of nighttime attending intensivist coverage in a medical intensive care unit.

Abstract: OBJECTIVE Our objective was to assess the cost implications of changing the intensive care unit staffing model from on-demand presence to mandatory 24-hr in-house critical care specialist presence.

Abstract: DESIGN A pre-post comparison was undertaken among the prospectively assessed cohorts of patients admitted to our medical intensive care unit 1 yr before and 1 yr after the change.

Abstract: Our data were stratified by Acute Physiology and Chronic Health Evaluation III quartile and whether a patient was admitted during the day or at night.

Abstract: Costs were modeled using a generalized linear model with log-link and γ-distributed errors.

Abstract: SETTING A large academic center in the Midwest.

Abstract: PATIENTS All patients admitted to the adult medical intensive care unit on or after January 1, 2005 and discharged on or before December 31, 2006.

Abstract: Patients receiving care under both staffing models were excluded.

Abstract: INTERVENTION Changing the intensive care unit staffing model from on-demand presence to mandatory 24-hr in-house critical care specialist presence.

Abstract: MEASUREMENTS AND MAIN RESULTS Total cost estimates of hospitalization were calculated for each patient starting from the day of intensive care unit admission to the day of hospital discharge.

Abstract: Adjusted mean total cost estimates were 61% lower in the post period relative to the pre period for patients admitted during night hours (7 pm to 7 am) who were in the highest Acute Physiology and Chronic Health Evaluation III quartile.

Abstract: No significant differences were seen at other severity levels.

Abstract: The unadjusted intensive care unit length of stay fell in the post period relative to the pre period (3.5 vs. 4.8) with no change in non-intensive care unit length of stay.

Abstract: CONCLUSIONS We find that 24-hr intensive care unit intensivist staffing reduces lengths of stay and cost estimates for the sickest patients admitted at night.

Abstract: The costs of introducing such a staffing model need to be weighed against the potential total savings generated for such patients in smaller intensive care units, especially ones that predominantly care for lower-acuity patients.


GENOTYPING OF THALASSEMIA IN MICROCYTIC HYPOCHROMIC ANEMIA PATIENTS FROM SOUTHWEST REGION OF IRAN

Abstract: Objective: To evaluate the frequency of α -gene, s-gene, and hemoglobin variant numbers in subjects with Microcytic hypochromic anemia.

Abstract: Methodology: In total out of 850, 340 subjects with microcytic hypochromic anemia [MCV<80fl; MCH<27pg] from Southwest part of Iran, were studied in Research Center of Thalassemia and Hemoglobinopathies (RCTH) which is the only center working on hematology and oncology in Southwest (Khuzestan) region of Iran.

Abstract: These include 325 individuals: 171 with Beta-thalassemia trait, 88 with Alpha-thalassemia trait, 13 with thalassemia major, 11 with hemoglobin variants (HbS, HbC, and HbD Punjab ) and 42 with iron-deficiency anemia.

Abstract: The rest 15 patients diagnosed with no definite etiology.

Abstract: Results: Genotyping for -α 3.7 , -α 4.2 , – α PA , - α 5NT and - - MED was done with gap-PCR.

Abstract: The overall frequency of - α 3.7 deletion in 325 individuals is 20%.

Abstract: Genotyping for 23 most known s-gene mutations was done with direct mutation analysis by Amplification Refractory Mutation System (ARMS).

Abstract: The most frequent mutations were CD 36/37, IVS II-I, and IVS I-110 with 9.7%, 11.7%, and 3.5% respected frequencies in 340 patients.

Abstract: There was statistically significant difference between Beta-thalassemia trait and Beta-thalassemia Major in case of MCV (p- value = 0.25) and MCH (P–value =0.23) indices, and also MCH index between Beta-thalassemia trait and Hb Variants (P-value = 0.04).

Abstract: Conclusion: The α -gene and s-gene mutation is quite common in the Southwest part of Iran.

Abstract: Molecular genotyping of α -thalassemia and s-thalassemia help to diagnose unexplained microcytosis, and thus prevent unnecessary iron supplementation.


Systemic biomarkers in exacerbations of COPD: the evolving clinical challenge.

Abstract: BACKGROUND Exacerbations of COPD (ECOPD) remain a major cause of mortality and morbidity.

Abstract: Despite advances in the understanding of their pathophysiology, their assessment relies primarily on clinical presentation, which can be variable and difficult to predict.

Abstract: A large number of biomarkers already have been assessed in this context, and some appear to be promising.

Abstract: METHODS An online search for articles published until December 2010 was conducted using three terms for ECOPD, five terms for biomarkers, and five terms for the sampling method.

Abstract: Biomarkers were evaluated for their potential role in the establishment and confirmation of the diagnosis of ECOPD, the evaluation of etiology and severity, the prediction of prognosis, and the guidance of treatment decisions.

Abstract: RESULTS Several systemic biomarkers have been measured in the context of ECOPD, and most have been found to increase at ECOPD onset and to subside during the course of exacerbations.

Abstract: Correlations have been reported among these biomarkers, but direct associations with clinical variables have been more difficult to establish.

Abstract: Although there are several limitations yet to be addressed, some of the biomarkers, most notably C-reactive protein for the identification of an ECOPD and procalcitonin for antibiotic guidance, may provide clinically relevant information.

Abstract: CONCLUSIONS So far

Abstract: , no single biomarker has been able to gain wide acceptance, but some provide clinically useful information.

Abstract: The evaluation of such biomarkers in large decision-making studies is expected to become an area of intense investigation in the near future.