Retrograde gastroesophageal intussusception: Initial presenting feature of achalasia in a teenager

A 16-year-old Caucasian male presented with acute vomiting and dysphagia. Imaging studies revealed retrograde gastroesophageal intussusception (RGEI), which reduced prior to diagnostic laparoscopy. No clear etiology for RGEI was identified at that time, so further surgical intervention was deferred. He returned several months later with persistent dysphagia. Imaging, endoscopy, and endoluminal function imaging probe then diagnosed achalasia. He underwent a second laparoscopy for Heller myotomy and Dor fundoplication. This is the first report of RGEI preceding a diagnosis of achalasia

Clonal Selection and Population Dynamics of Vγ2/Vδ2 T Cells in Macaca Fascicularis

HIV infection increases the susceptibility to new M. tuberculosis (Mtb) infections, the risk of reactivating latent infections and the risk of rapid TB progression. γδ T cells, in particular the Vγ2Jγ1.2 subset, are thought to be part of the innate immune response to both HIV and Mtb. Importantly, both HIV and Mtb perturb gd T cells homeostasis, causing a profound and highly specific depletion of the Vγ2Jγ1.2 subset

Accuracy of Physical Self-Description Among Chronic Exercisers and Non-Exercisers

This study addressed the role of chronic exercise to enhance physical self-description as measured by self-estimated percent body fat. Accuracy of physical self-description was determined in normal-weight, regularly exercising and non-exercising males with similar body mass index (BMI)’s and females with similar BMI’s (n=42 males and 45 females of which 23 males and 23 females met criteria to be considered chronic exercisers). Statistical analyses were conducted to determine the degree of agreement between self-estimated percent body fat and actual laboratory measurements (hydrostatic weighing). Three statistical techniques were employed: Pearson correlation coefficients, Bland and Altman plots, and regression analysis. Agreement between measured and self-estimated percent body fat was superior for males and females who exercised chronically, compared to nonexercisers. The clinical implications are as follows. Satisfaction with one’s body can be influenced by several factors, including self-perceived body composition. Dissatisfaction can contribute to maladaptive and destructive weight management behaviors. The present study suggests that regular exercise provides a basis for more positive weight management behaviors by enhancing the accuracy of self-assessed body composition

The electrocardiogram and the position of the heart

The profound effects that rotation of the heart, particularly about the longitudinal axis, have on the mean electrical axis, as seen in limb leads, are emphasized, and some of the experimental and clinical studies that bear on this matter are discussed. The advantages that spatial vectorcardiograms may have in the evaluation of electrocardiographic changes due solely to an unusual position of the heart are pointed out, but, for a number of practical reasons, it is felt that such records will not be very useful in the solution of these or similar problems in the near future.Peculiarities in the form of tracings from the precordium due entirely to an unusual position of the heart are mentioned, but it is considered unwise (except for purposes of investigation) to recommend a change from the conventional sites for multiple precordial leads because of the suspicion that the heart may be placed in an unusual fashion.The suggestion of Kossmann and co-workers that signs suggesting right ventricular enlargement in both standard and precordial leads may arise as a result of marked clockwise rotation of the heart about the long axis is discussed, and some evidence for and against this view is presented. Since concepts basic in the interpretation of precordial leads are involved in this problem, the need for further studies to decide the matter is emphasized. It is pointed out that tangential rather than purely radial spread of the activation wave over the ventricles may explain some of the difficulties encountered in interpretation of precordial leads, particularly when right ventricular enlargement or left bundle branch block is present.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/32545/1/0000656.pd

The proton Nuclear Magnetic Resonance spin-lattice relaxation rate of some hydrated synthetic and natural sands

The proton nuclear magnetic resonance (NMR) spin-lattice relaxation rate (R1) of hydrated sands is often used to determine porosity characteristics of near-surface aquifers using magnetic resonance sounding. Large variations in R1 have been reported in laboratory measurements on hydrated sands. To understand these variations, the R1 values of several fully hydrated sands were studied as a function of grain diameter (d) and magnetic field strength (BB0). We conclude the variations are a consequence of trace paramagnetic metals in the sand grains. R1 values from magnetic resonance sounding data should not be used to predict void size in aquifers unless the exact chemical composition of the grains is known

Highly conserved molecular pathways, including Wnt signaling, promote functional recovery from spinal cord injury in lampreys

© The Author(s), 2018. This article is distributed under the terms of the Creative Commons Attribution License. The definitive version was published in Scientific Reports 8 (2018): 742, doi:10.1038/s41598-017-18757-1.In mammals, spinal cord injury (SCI) leads to dramatic losses in neurons and synaptic connections, and consequently function. Unlike mammals, lampreys are vertebrates that undergo spontaneous regeneration and achieve functional recovery after SCI. Therefore our goal was to determine the complete transcriptional responses that occur after SCI in lampreys and to identify deeply conserved pathways that promote regeneration. We performed RNA-Seq on lamprey spinal cord and brain throughout the course of functional recovery. We describe complex transcriptional responses in the injured spinal cord, and somewhat surprisingly, also in the brain. Transcriptional responses to SCI in lampreys included transcription factor networks that promote peripheral nerve regeneration in mammals such as Atf3 and Jun. Furthermore, a number of highly conserved axon guidance, extracellular matrix, and proliferation genes were also differentially expressed after SCI in lampreys. Strikingly, ~3% of differentially expressed transcripts belonged to the Wnt pathways. These included members of the Wnt and Frizzled gene families, and genes involved in downstream signaling. Pharmacological inhibition of Wnt signaling inhibited functional recovery, confirming a critical role for this pathway. These data indicate that molecular signals present in mammals are also involved in regeneration in lampreys, supporting translational relevance of the model.We gratefully acknowledge support from the National Institutes of Health (R03NS078519 to OB; R01GM104123 to JJS; R01NS078165 to JRM), The Feinstein Institute for Medical Research and The Marine Biological Laboratory, including the Charles Evans Foundation Research Award, the Albert and Ellen Grass Foundation Faculty Research Award, and The Eugene and Millicent Bell Fellowship Fund in Tissue Engineering

The refined biomimetic NeuroDigm GEL™ model of neuropathic pain in a mature rat [version 2; referees: 1 approved, 2 approved with reservations]

Background: Many humans suffering with chronic neuropathic pain have no objective evidence of an etiological lesion or disease. Frequently their persistent pain occurs after the healing of a soft tissue injury. Based on clinical observations over time, our hypothesis was that after an injury in mammals the process of tissue repair could cause chronic neural pain. Our objectives were to create the delayed onset of neuropathic pain in rats with minimal nerve trauma using a physiologic hydrogel, and characterize the rats’ responses to known analgesics and a targeted biologic.   Methods: In mature male Sprague Dawley rats (age 9.5 months) a percutaneous implant of tissue-derived hydrogel was placed in the musculofascial tunnel of the distal tibial nerve. Subcutaneous morphine (3 mg/kg), celecoxib (10 mg/kg), gabapentin (25 mg/kg) and duloxetine (10 mg/kg) were each screened in the model three times each over 5 months after pain behaviors developed. Sham and control groups were used in all screenings. A pilot study followed in which recombinant human erythropoietin (200 units) was injected by the GEL™ neural procedure site.   Results: The GEL group gradually developed mechanical hypersensitivity lasting months. Morphine, initially effective, had less analgesia over time. Celecoxib produced no analgesia, while gabapentin and duloxetine at low doses demonstrated profound analgesia at all times tested. The injected erythropoietin markedly decreased bilateral pain behavior that had been present for over 4 months, p ≤ 0.001. Histology of the GEL group tibial nerve revealed a site of focal neural remodeling, with neural regeneration, as found in nerve biopsies of patients with neuropathic pain.   Conclusion: The refined NeuroDigm GEL™ model induces a neural response resulting in robust neuropathic pain behavior. The analgesic responses in this model reflect known responses of humans with neuropathic pain. The targeted recombinant human erythropoietin at the ectopic neural lesion appears to alleviate the persistent pain behavior in the GEL™ model rodents

The Induction of Autoimmune Arthritis and Sex differences in Mice Impact the Lung Inflammatory Response to Repetitive Inhalant Organic Dust Extract Exposures

Asthma, chronic bronchitis and COPD are common adverse respiratory health effects among persons exposed to agriculture organic dust work environments. Occupational inhalant exposures have been increasingly associated with the risk of rheumatoid arthritis (RA) disease development, particularly among males. Agriculture workers have increased risk of RA and generalized bone disease. Chronic lung disease is associated with production of characteristic autoantibodies associated with RA (e.g.anti-citrullinated antibodies), even in absence of RA disease. The mechanistic link between pulmonary inflammation and arthritis (and vice versa) remains poorly understood. Animal models are lacking.https://digitalcommons.unmc.edu/emet_posters/1004/thumbnail.jp