Dirbtinės odos Integra™ naudojimas gydant didelius melanocitinius apgamus

Melanocytic nevi are congenital, benign, pigmented proliferations. They have high risk of malignancy, most frequently transform to malignant skin melanoma and 70% it occurs in the first life decade. The risk of malignant transformation increases proportionately to their size. The best way to avoid those risks is early and radical excision. In 1996 on the market appeared the Integra™ artificial skin, has made it possible to improve the methods for the elimination of large congenital nevi and significantly reduce the risk of malignant melanoma, at an early age. 2011–2019, in Children’s Hospital, Affiliate of Vilnius University Hospital Santaros Clinics, the Integra™ was used to treat congenital melanocytic nevi in four children. Implantation of the skin substitute Integra™ has been successful for all the patients, the prognosis was good. The treatment of congenital melanocytic nevi is a necessity to avoid the risk of developing malignant melanoma. The rarity of this condition has led to the fact that so far there is no universal approach for all the cases. Integra™ artificial skin is an excellent choice for the treatment of congenital melanocytic nevi, especially for paediatric patients.Melanocitiniai apgamai – įgimti gerybiniai pigmentiniai dariniai, turintys didelę piktybinio naviko išsivystymo riziką. Šie dariniai dažniausiai transformuojasi į piktybinę odos melanomą. 70 proc. atvejų tai įvyksta per pirmąjį gyvenimo dešimtmetį. Apgamų piktybiškumo rizika didėja proporcingai jų dydžiui. Norint transformacijos išvengti, būtinas ankstyvas ir radikalus šių darinių pašalinimas. 1996 m. rinkoje pasirodžiusi dirbtinė oda Integra™ suteikė galimybę patobulinti didelių įgimtų apgamų pašalinimo metodus ir jau ankstyvoje vaikystėje smarkiai sumažinti piktybinės melanomos riziką. 2011–2019 m. Vaikų ligoninėje, Vilniaus universiteto ligoninės Santaros klinikos filiale, Integra™ panaudota gydant įgimtus melanocitinius apgamus keturiems vaikams. Odos pakaitalo Integra™ implantacija visiems pacientams buvo sėkminga, prognozė gera. Įgimtų melanocitinių apgamų gydymas reikšmingai sumažina piktybinės melanomos išsivystymo riziką. Būklė gana reta, todėl iki šiol nėra nė vieno visiems tinkamo metodo. Integra™ dirbtinė oda yra puikus pasirinkimas gydant įgimtus melanocitinius apgamus, ypač pediatriniams pacientams

The Second Transmembrane Domain of P2X7 Contributes to Dilated Pore Formation

Activation of the purinergic receptor P2X7 leads to the cellular permeability of low molecular weight cations. To determine which domains of P2X7 are necessary for this permeability, we exchanged either the C-terminus or portions of the second transmembrane domain (TM2) with those in P2X1 or P2X4. Replacement of the C-terminus of P2X7 with either P2X1 or P2X4 prevented surface expression of the chimeric receptor. Similarly, chimeric P2X7 containing TM2 from P2X1 or P2X4 had reduced surface expression and no permeability to cationic dyes. Exchanging the N-terminal 10 residues or C-terminal 14 residues of the P2X7 TM2 with the corresponding region of P2X1 TM2 partially restored surface expression and limited pore permeability. To further probe TM2 structure, we replaced single residues in P2X7 TM2 with those in P2X1 or P2X4. We identified multiple substitutions that drastically changed pore permeability without altering surface expression. Three substitutions (Q332P, Y336T, and Y343L) individually reduced pore formation as indicated by decreased dye uptake and also reduced membrane blebbing in response to ATP exposure. Three others substitutions, V335T, S342G, and S342A each enhanced dye uptake, membrane blebbing and cell death. Our results demonstrate a critical role for the TM2 domain of P2X7 in receptor function, and provide a structural basis for differences between purinergic receptors. © 2013 Sun et al

The impact of quality management systems on construction performance in the North West of England

As the total construction output in the North West of England (NWE) is forecast to rise by an average of 2.5% over the next five years. It is imperative for organizations in the region to improve their overall construction performance, particularly if they are to hit the targets presented by UK Government in the construction 2025 report. Despite the known benefits of quality management systems (QMS) its implementation in relation to construction performance is very limited, particularly in the UK. Therefore, the purpose of this paper is to examine whether QMS can affect construction performance in the NWE. A pragmatic mixed method approach of sequential explanatory strategy was adopted to conduct this research. This initially involved a quantitative approach of questionnaire surveys to gain opinions and views of a representative sample of industry professionals based in the NWE. The quantitative results were analyzed to discover relationships in the data and further formulate the questions for the qualitative interviews. Three interviews with leading industry professionals were then conducted and the data was analyzed using a thematic approach. The themes identified in the interviews were then cross-referenced with the data discovered in the questionnaire survey and literature review. The findings provide a clear indication that the implementation of a QMS has a positive effect on construction performance in the NWE. Immediate improvements in efficiency of a construction organization when implementing a QMS were discovered, including greater managerial control and the recording and reduction in defects. Long term effects of changing company attitude by setting out company requirements and responsibilities through highlighting the significance of quality, and furthermore encouraging a culture of co-operation and teamwork, were also proven to increase construction performance as time progresses. To further enhance this research the focus could be on the whole of the UK. However, a greater amount of time would be required to gain the required representative sample. Furthermore, although the questionnaire survey was distributed equally within the selected sample, a greater number of respondents working for contractors responded. Therefore, the respondents of the questionnaire survey were not equal in terms of organization (client, contractor, sub-contractor, project manager). According to the best knowledge of the authors and through searching many sources, there are no specific studies examining QMS and their effect on construction performance in the UK and particularly in the NWE. Therefore, it is believed the study is the first of its kind. The study discovered many findings that can be considered as a contribution to practice and theory. Moreover, it can be considered as a fundamental base for future studies in this research area. © 2019, © 2019 Informa UK Limited, trading as Taylor & Francis Group

Pore-opening mechanism in trimeric P2X receptor channels

The opening of ion channels in response to ligand binding, voltage or membrane stretch underlies electrical and chemical signalling throughout biology. Two structural classes of pore-opening mechanisms have been established, including bending of pore-lining helices in the case of tetrameric cation channels, or tilting of such helices in mechanosensitive channels. In this paper, we explore how the structure of the pore changes during opening in P2X receptors by measuring the modification of introduced cysteine residues in transmembrane helices by thiol-reactive reagents, and by engineering metal bridges. Our results are consistent with the X-ray structure of the closed state, and demonstrate that expansion of the gate region in the external pore is accompanied by a significant narrowing of the inner pore, indicating that pore-forming helices straighten on ATP binding to open the channel. This unique pore-opening mechanism has fundamental implications for the role of subunit interfaces in the gating mechanism of P2X receptors and points to a role of the internal pore in ion permeation

Activation kinetics of single P2X receptors

After the primary structure of P2X receptors had been identified, their function had to be characterized on the molecular level. Since these ligand-gated ion channels become activated very quickly after binding of ATP, methods with adequate time resolution have to be applied to investigate the early events induced by the agonist. Single-channel recordings were performed to describe conformational changes on P2X2, P2X4, and P2X7 receptors induced by ATP and also by allosteric receptor modifiers. The main results of these studies and the models of P2X receptor kinetics derived from these observations are reviewed here. The investigation of purinoceptors by means of the patch clamp technique following site-directed mutagenesis will probably reveal more details of P2X receptor function at the molecular level

The effectiveness of ω-3 polyunsaturated fatty acid interventions during pregnancy on obesity measures in the offspring: an up-to-date systematic review and meta-analysis.

BACKGROUND: The potential role of ω-3 long chain polyunsaturated fatty acid (LCPUFA) supplementation during pregnancy on subsequent risk of obesity outcomes in the offspring is not clear and there is a need to synthesise this evidence. OBJECTIVE: A systematic review and meta-analysis of randomised controlled trials (RCTs), including the most recent studies, was conducted to assess the effectiveness of ω-3 LCPUFA interventions during pregnancy on obesity measures, e.g. BMI, body weight, fat mass in offspring. METHODS: Included RCTs had a minimum of 1-month follow-up post-partum. The search included CENTRAL, MEDLINE, SCOPUS, WHO's International Clinical Trials Reg., E-theses and Web of Science databases. Study quality was evaluated using the Cochrane Collaboration's risk of bias tool. RESULTS: Eleven RCTs, from ten unique trials, (3644 children) examined the effectiveness of ω-3 LCPUFA maternal supplementation during pregnancy on the development of obesity outcomes in offspring. There were heterogeneities between the trials in terms of their sample, type and duration of intervention and follow-up. Pooled estimates did not show an association between prenatal intake of fatty acids and obesity measures in offspring. CONCLUSION: These results indicate that maternal supplementation with ω-3 LCPUFA during pregnancy does not have a beneficial effect on obesity risk. Due to the high heterogeneity between studies along with small sample sizes and high rates of attrition, the effects of ω-3 LCPUFA supplementation during pregnancy for prevention of childhood obesity in the long-term remains unclear. Large high-quality RCTs are needed that are designed specifically to examine the effect of prenatal intake of fatty acids for prevention of childhood obesity. There is also a need to determine specific sub-groups in the population that might get a greater benefit and whether different ω-3 LCPUFA, i.e. eicosapentaenoic (EPA) vs. docosahexanoic (DHA) acids might potentially have different effects

The five-item Brief-Symptom Rating Scale as a suicide ideation screening instrument for psychiatric inpatients and community residents

<p>Abstract</p> <p>Background</p> <p>An efficient screening instrument which can be used in diverse settings to predict suicide in different populations is vital. The aim of this study was to use the five-item Brief Symptom Rating Scale (BSRS-5) as a screening instrument for the prediction of suicide ideation in psychiatric, community and general medical settings.</p> <p>Methods</p> <p>Five hundred and one psychiatric, 1,040 community and 969 general medical participants were recruited. The community participants completed a structured telephone interview, and the other two groups completed the self-report BSRS-5 questionnaire.</p> <p>Results</p> <p>The logistic regression analysis showed that the predictors of suicide ideation for the psychiatric group were depression, hostility and inferiority (<it>p </it>< 0.001, <it>p </it>= 0.016, <it>p </it>= 0.011), for the community group, inferiority, hostility and insomnia (<it>p </it>< 0.001, <it>p </it>< 0.001, <it>p </it>= 0.003), and for the general medical group, inferiority, hostility, depression and insomnia (<it>p </it>< 0.001, <it>p </it>= 0.001, <it>p </it>= 0.020, <it>p </it>= 0.008). The structural equation model showed the same symptom domains that predicted suicide ideation for all three groups. The receiver operating characteristic curve using the significant symptom domains from logistic regression showed that for the psychiatric group, the optimal cut-off point was 4/5 for the total of the significant dimensions (positive predictive value [PPV] = 78.01%, negative predictive value [NPV] = 79.05%), for the community group, 7/8 (PPV = 68.75%, NPV = 96.09%), and for the general medical group, 12/13 (PPV = 92.86%, NPV = 88.48%).</p> <p>Conclusion</p> <p>The BSRS-5 is an efficient tool for the screening of suicide ideation-prone psychiatric inpatients, general medical patients, and community residents. Understanding the discriminative symptom domains for different groups and the relationship between them can help health care professionals in their preventative programs and clinical treatment.</p

Targeting the EGFR in ovarian cancer with the tyrosine kinase inhibitor ZD1839 (“Iressa”).

The modulating effects of the orally active epidermal growth factor receptor-specific tyrosine kinase inhibitor ZD 1839 (‘Iressa’) on cell growth and signalling were evaluated in four ovarian cancer cell lines (PE01, PE04, SKOV-3, OVCAR-5) that express the epidermal growth factor receptor, and in A2780, which is epidermal growth factor receptor-negative. Transforming growth factor-α stimulated growth was completely inhibited by concentrations of ZD 1839 ⩾0.3 μM in the epidermal growth factor receptor-expressing cell lines, as were transforming growth factor-α stimulated phosphorylation of the epidermal growth factor receptor and downstream components of the MAP kinase and PI-3 kinase signalling cascades. Growth inhibition in the absence of added transforming growth factor-α was also observed which could be consistent with suppression of action of autocrine epidermal growth factor receptor-activating ligands by ZD 1839. In support of this, transforming growth factor-α, EGF and amphiregulin mRNAs were detected by RT–PCR in the epidermal growth factor receptor-expressing cell lines. ZD 1839 inhibited growth of the PE04 ovarian cancer xenograft at 200 mg kg(−1) day(−1). These data lend further support to the view that targeting the epidermal growth factor receptor in ovarian cancer could have therapeutic benefit. British Journal of Cancer (2002) 86, 456–462. DOI: 10.1038/sj/bjc/6600058 www.bjcancer.com © 2002 The Cancer Research Campaig

The Sound of Interconnectivity; The European Vasculitis Society 2022 Report

The first European Vasculitis Society (EUVAS) meeting report was published in 2017. Herein, we report on developments in the past 5 years which were greatly influenced by the pandemic. The adaptability to engage virtually, at this critical time in society, embodies the importance of networks and underscores the role of global collaborations. We outline state-of-the-art webinar topics, updates on developments in the last 5 years, and proposals for agendas going forward. A host of newly reported clinical trials is shaping practice on steroid minimization, maintenance strategies, and the role of newer therapies. To guide longer -term strategies, a longitudinal 10-year study investigating relapse, comorbidity, malignancy, and survival rates is at an advanced stage. Disease assessment studies are refining classification criteria to differentiate forms of vasculitis more fully. A large international validation study on the histologic classification of anti-neutrophil cytoplasmic antibody (ANCA) glomerulonephritis, recruiting new multicenter sites and comparing results with the Kidney Risk Score, has been conducted. Eosinophilic granulomatosis with polyangiitis (EGPA) genomics offers potential pathogenic subset and therapeutic insights. Among bio-markers, ANCA testing is favoring immunoassay as the preferred method for diagnostic evaluation. Consolidated development of European registries is progressing with an integrated framework to analyze large clinical data sets on an unprecedented scale

Heidegger’s Underdeveloped Conception of the Undistinguishedness (Indifferenz) of Everyday Human Existence

This chapter provides an interpretation of the early Heidegger’s underdeveloped conception of the undistinguishedness of everyday human existence in Being and Time. After explaining why certain translation choices of some key terms in this text are interpretively and philosophically important, I first provide a concise argument for why the social constitution interpretation of the relation between ownedness and unownedness makes better overall sense of Heidegger’s ambivalent attitude toward the social constitution of the human being than the standard existentialist interpretation of this relation. I then proceed to the heart of this chapter, which develops his inchoate conception of the undistinguishedness of everydayness by arguing that it specifies the third distinctive mode of concrete human existence in addition to ownedness and unownedness. Accordingly, I show how unownedness is actually a generic phenomenon with two distinct species, namely, undistinguishedness and disownedness, which are at once closely related to, but also differ in significant respects from, each other. Consequently, instead of taking for granted a one-dimensional and mutually exclusive opposition between ‘authenticity’ and ‘inauthenticity’, I argue that we should adopt a two-dimensional and more nuanced understanding of the relations among undistinguishedness, disownedness, and ownedness that intersects with Heidegger’s underappreciated distinction between genuineness and ungenuineness. After raising and replying to some objections to this interpretation of undistinguishedness, I conclude this chapter by briefly sketching three of its philosophical consequences and pointing out its potential as an important resource for contemporary social theories