Management issues of congenital adrenal hyperplasia during the transition from pediatric to adult care

Steroid 21-hydroxylase deficiency is the most prevalent form of congenital adrenal hyperplasia (CAH), accounting for approximately 95% of cases. With the advent of newborn screening and hormone replacement therapy, most children with CAH survive into adulthood. Adolescents and adults with CAH experience a number of complications, including short stature, obesity, infertility, tumor, osteoporosis, and reduced quality of life. Transition from pediatric to adult care and management of long-term complications are challenging for both patients and health-care providers. Psychosocial issues frequently affect adherence to glucocorticoid treatment. Therefore, the safe transition of adolescents to adult care requires regular follow-up of patients by a multidisciplinary team including pediatric and adult endocrinologists. The major goals for management of adults with 21-hydroxylase deficiency are to minimize the long-term complications of glucocorticoid therapy, reduce hyperandrogenism, prevent adrenal or testicular adrenal rest tumors, maintain fertility, and improve quality of life. Optimized medical or surgical treatment strategies should be developed through coordinated care, both during transition periods and throughout patients' lifetimes. This review will summarize current knowledge on the management of adults with CAH, and suggested appropriate approaches to the transition from pediatric to adult care

An efficient method for visualization and growth of fluorescent Xanthomonas oryzae pv. oryzae in planta

<p>Abstract</p> <p>Background</p> <p><it>Xanthomonas oryzae </it>pv. <it>oryzae</it>, the causal agent of bacterial blight disease, is a serious pathogen of rice. Here we describe a fluorescent marker system to study virulence and pathogenicity of <it>X. oryzae </it>pv. <it>oryzae</it>.</p> <p>Results</p> <p>A fluorescent <it>X. oryzae </it>pv. <it>oryzae </it>Philippine race 6 strain expressing green fluorescent protein (GFP) (PXO99_GFP) was generated using the <it>gfp </it>gene under the control of the neomycin promoter in the vector, pP<it>neo</it>-<it>gfp</it>. The PXO99_GFPstrain displayed identical virulence and avirulence properties as the wild type control strain, PXO99. Using fluorescent microscopy, bacterial multiplication and colonization were directly observed in rice xylem vessels. Accurate and rapid determination of bacterial growth was assessed using fluoremetry and an Enzyme-Linked ImmunoSorbant Assay (ELISA).</p> <p>Conclusion</p> <p>Our results indicate that the fluorescent marker system is useful for assessing bacterial infection and monitoring bacterial multiplication <it>in planta</it>.</p

Ethanol Extract of the Flower Chrysanthemum morifolium Augments Pentobarbital-Induced Sleep Behaviors: Involvement of Cl− Channel Activation

Dried Chrysanthemum morifolium flowers have traditionally been used in Korea for the treatment of insomnia. This study was performed to investigate whether the ethanol extract of Chrysanthemum morifolium flowers (EFC) enhances pentobarbital-induced sleep behaviors. EFC prolonged sleep time induced by pentobarbital similar to muscimol, a GABAA receptors agonist. EFC also increased sleep rate and sleep time when administrated with pentobarbital at a subhypnotic dosage. Both EFC and pentobarbital increased chloride (Cl−) influx in primary cultured cerebellar granule cells. EFC increased glutamic acid decarboxylase (GAD) expression levels, but had no effect on the expression of α1-, β2-, and γ2-subunits of the GABAA receptor in the hippocampus of a mouse brain. This is in contrast to treatment with pentobarbital, which showed decreased α1-subunit expression and no change in GAD expression. In conclusion, EFC augments pentobarbital-induced sleep behaviors; these effects may result from Cl− channel activation

Theory of magnetic field-induced metaelectric critical end point in BiMn2_2O5_5

A recent experiment on the multiferroic BiMn$_2$O$_5$ compound under a strong applied magnetic field revealed a rich phase diagram driven by the coupling of magnetic and charge (dipolar) degrees of freedom. Based on the exchange-striction mechanism, we propose here a theoretical model with the intent to capture the interplay of the spin and dipolar moments in the presence of a magnetic field in BiMn$_2$O$_5$. Experimentally observed behavior of the dielectric constants, magnetic susceptibility, and the polarization is, for the most part, reproduced by our model. The critical behavior observed near the polarization reversal $(P=0)$ point in the phase diagram is interpreted as arising from the proximity to the critical end point.Comment: Theory; relevant experiment uploaded as arXiv:0810.190

Two distinct red giant branch populations in the globular cluster NGC 2419 as tracers of a merger event in the Milky Way

Recent spectroscopic observations of the outer halo globular cluster (GC) NGC 2419 show that it is unique among GCs, in terms of chemical abundance patterns, and some suggest that it was originated in the nucleus of a dwarf galaxy. Here we show, from the Subaru narrow-band photometry employing a calcium filter, that the red giant-branch (RGB) of this GC is split into two distinct subpopulations. Comparison with spectroscopy has confirmed that the redder RGB stars in the $hk$[=(Ca$-b)-(b-y)$] index are enhanced in [Ca/H] by $\sim$0.2 dex compared to the bluer RGB stars. Our population model further indicates that the calcium-rich second generation stars are also enhanced in helium abundance by a large amount ($\Delta$Y = 0.19). Our photometry, together with the results for other massive GCs (e.g., $\omega$ Cen, M22, and NGC 1851), suggests that the discrete distribution of RGB stars in the $hk$ index might be a universal characteristic of this growing group of peculiar GCs. The planned narrow-band calcium photometry for the Local Group dwarf galaxies would help to establish an empirical connection between these GCs and the primordial building blocks in the hierarchical merging paradigm of galaxy formation.Comment: 4 pages, 4 figures, 1 table, accepted for the publication in ApJ

2D perovskite stabilized phase-pure formamidinium perovskite solar cells.

Compositional engineering has been used to overcome difficulties in fabricating high-quality phase-pure formamidinium perovskite films together with its ambient instability. However, this comes alongside an undesirable increase in bandgap that sacrifices the device photocurrent. Here we report the fabrication of phase-pure formamidinium-lead tri-iodide perovskite films with excellent optoelectronic quality and stability. Incorporation of 1.67 mol% of 2D phenylethylammonium lead iodide into the precursor solution enables the formation of phase-pure formamidinium perovskite with an order of magnitude enhanced photoluminescence lifetime. The 2D perovskite spontaneously forms at grain boundaries to protect the formamidinium perovskite from moisture and suppress ion migration. A stabilized power conversion efficiency (PCE) of 20.64% (certified stabilized PCE of 19.77%) is achieved with a short-circuit current density exceeding 24 mA cm-2 and an open-circuit voltage of 1.130 V, corresponding to a loss-in-potential of 0.35 V, and significantly enhanced operational stability