MOLECULAR DYNAMICS SIMULATION OF WATER BEHAVIOR AS A FUNCTION OF TEMPERATURES AND MONOMER NUMBERS IN NAFION 117

ABSTRACT The proton exchange membrane plays a critical role as an electrolyte for proton transports in the PEMFC. Generally, the membrane, such as Nafion 117, consists of a polytetrafluoroethylene (PTFE) backbone and side-chains terminated with a sulfonate group ( 3 SO − ). Operating the fuel cell, the membrane preferentially becomes hydrated by absorbing water. Then, the hydrogen atom on the 3 SO − part of the side-chain can detach from its own position and hop to the next 3 SO − site. The water management is the key to the efficient operation of the fuel cell, since the water content is the one of decisive factors for membrane's lifetime and efficient operations of fuel cells as well. In this report, we set up the molecular model for hydrated Nafion 117 and simulate the molecular movements for various temperatures and monomer numbers. Here, we obtain the mean square displacements of water molecules and estimate the selfdiffusion coefficients of water in the Nafion 117. Greek Symbol

Lung Metastasis from an Immature Teratoma of the Nasal Cavity Masquerading as Small Cell Carcinoma of the Lung

We report a case of small cell lung cancer that turned out to be a metastatic teratoma from the nasal cavity rather than a new primary cancer. A 54-year-old woman was diagnosed with an immature teratoma of the nasal cavity with a predominant neuroblastomatous component. Small cell lung cancer was detected by bronchoscopic biopsy 21 months later, and it was treated with concurrent radiochemotherapy as if it had been a new primary cancer. Since a recurrent tumor containing fat-like density grew slowly on the serial chest CT scans after achieving complete response, we reached the conclusion that the small undifferentiated cells could be metastatic neuroblastomatous components from the immature teratoma of the nasal cavity

Cost-effectiveness of a medication event monitoring system for tuberculosis management in Morocco

BACKGROUND: Digital health technologies have been used to enhance adherence to TB medication, but the cost-effectiveness remains unclear. METHODS: We used the real data from the study conducted from April 2014 to December 2020 in Morocco using a smart pillbox with a web-based medication monitoring system, called Medication Event Monitoring Systems (MEMS). Cost-effectiveness was evaluated using a decision analysis model including Markov model for Multi-drug resistant (MDR) TB from the health system perspective. The primary outcome was the incremental cost-effectiveness ratio (ICER) per disability adjusted life-year (DALY) averted. Two-way sensitive analysis was done for the treatment success rate between MEMS and standard of care. RESULTS: The average total per-patient health system costs for treating a new TB patient under MEMS versus standard of care were $398.70 and$155.70, respectively. The MEMS strategy would reduce the number of drug-susceptible TB cases by 0.17 and MDR-TB cases by 0.01 per patient over five years. The ICER of MEMS was $434/DALY averted relative to standard of care, and was most susceptible to the TB treatment success rate of both strategies followed by the managing cost of MEMS. CONCLUSION: MEMS is considered cost-effective for managing infectious active TB in Morocco

Pulmonary Metastases of Uterine Endometrial Stromal Sarcoma: Diffuse Micronodular and Ground Glass Opacities: A Case Report

Pulmonary metastases of uterine endometrial stromal sarcoma (ESS) are uncommon. The patterns of uterine ESS metastasis to the lung are multiple pulmonary nodules, single nodule, or cystic lesions. Pulmonary intraalveolar micronodular metastases of uterine ESS are unusual and have not been reported. We experienced a case of metastatic uterine ESS presenting as pulmonary diffuse micronodules with ground glass opacities on chest computed tomography of a 37-yr-old woman who previously underwent hysterectomy due to low grade ESS of the uterus four years ago. The histologic findings of video assisted thoracotomy biopsy showed numerous intraalveolar polypoid micronodules protruding from the alveolar septums. All tumor nodules were composed of short spindle cells arranged in ill-defined whorls, and nuclear feature and sparse cytoplasm were seen in uterine ESS. Immunohistochemically, these cells showed strong nuclear staining for estrogen receptor and progesterone receptor, and diffuse cytoplasmic staining for CD10

Epstein-Barr Virus Antibodies in Kawasaki Disease

The prevalent ages at onset for Kawasaki Disease (KD) and Epstein-Barr virus (EBV) infection are known to be similar in Korea and Japan. We evaluated the correlation between EBV infection and KD. The antibodies to EBV such as anti-viral capsid antigen (VCA) IgG and IgM, anti-diffuse and restricted early antigen IgG (anti-EADR IgG), and the anti-EBV determined nuclear antigen IgG (anti-EBNA IgG) were examined in 29 KD patients at five separate times sequentially during a period of one year, and also in 14 other children with a past history of KD. The results of each group were compared with those of age-matched controls. The positive rates of anti-VCA IgG and IgM at presentation in the KD patients were 41.4% (12/29) and 0% (0/29), respectively. Only one patient was found to be anti-VCA IgM-positive within two months. There were no cases of anti-VCA IgG except one, anti-EADR IgG and anti-EBNA IgG positive to negative seroconversion during the year. The children with a past history of KD showed higher anti-EBNA IgG-positive rates than the controls (p = 0.04). There was no difference in the seropositive rates of the antibodies to EBV, cytomegalovirus, herpes simplex virus and herpes zoster virus. In conclusion, children with KD were noted to have normal immune responses to EBV infection. Children with a past history of KD seemed to be infected with EBV at a later age than children with no history of KD

Genome Wide Association Studies Using Multiple-lactation Breeding Value in Holsteins

A genome wide association study was conducted using estimated breeding value (EBV) for milk production traits from 1st to 4th lactation. Significant single nucleotide polymorphism (SNP) markers were selected for each trait and the differences were compared by lactation. DNA samples were taken from 456 animals with EBV which are Holstein proven bulls whose semen is being sold or the daughters of old proven bulls whose semen is no longer being sold in Korea. High density genome wide SNP genotype was investigated and the significance of markers associated with traits was tested using the breeding value estimated by a multiple lactation model as a dependent variant. As the result of significance comparisons by lactations, several differences were found between the first lactation and subsequent lactations (from second to 4th lactation). A similar trend was noted in mean deviation and correlation of the estimated effects by lactation. Since there was a difference in the genes associated with EBV for each trait between first and subsequent lactations, a multi-lactation model in which lactation is considered as a different trait is genetically useful. Also, significant markers in all lactations and common markers for different traits were detected, which can be used as markers for quantitative trait loci exploration and marker assisted selection in milk production traits

Detection of ureaplasmas by the polymerase chain reaction in the amniotic fluid of patients with cervical insufficiency

Aims: The purpose of this study was to determine the clinical significance of detecting microbial footprints of ureaplasmas in amniotic fluid (AF) using specific primers for the polymerase chain reaction (PCR) in patients presenting with cervical insufficiency. Methods: Amniocentesis was performed in 58 patients with acute cervical insufficiency (cervical dilatation, >= 1.5 cm) and intact membranes, and without regular contractions (gestational age, 16-29 weeks). AF was cultured for aerobic and anaerobic bacteria as well as genital mycoplasmas. Ureaplasmas (Ureaplasma urealyticum and Ureaplasma parvum) were detected by PCR using specific primers. Patients were divided into three groups according to the results of AF culture and PCR for ureaplasmas: those with a negative AF culture and a negative PCR (n = 44), those with a negative AF culture and a positive PCR (n = 10), and those with a positive AF culture regardless of PCR result (n = 4). Results: 1) Ureaplasmas were detected by PCR in 19.0% (11/58) of patients, by culture in 5.2% (3/58), and by culture and/or PCR in 22.4% (13/58); 2) Among the 11 patients with a positive PCR for ureaplasmas, the AF culture was negative in 91% (10/11); 3) Patients with a negative AF culture and a positive PCR for ureaplasmas had a significantly higher median AF matrix metalloproteinase-8 (MMP-8) concentration and white blood cell (WBC) count than those with a negative AF culture and a negative PCR (P < 0.001 and P < 0.05, respectively); 4) Patients with a positive PCR for ureaplasmas but a negative AF culture had a higher rate of spontaneous preterm birth within two weeks of amniocentesis than those with a negative AF culture and a negative PCR (P < 0.05 after adjusting for gestational age at amniocentesis); 5) Of the patients who delivered within two weeks of amniocentesis, those with a positive PCR for ureaplasmas and a negative AF culture had higher rates of histologic amnionitis and funisitis than those with a negative AF culture and a negative PCR (P < 0.05 after adjusting for gestational age at amniocentesis, for each); 6) However, no significant differences in the intensity of the intra-amniotic inflammatory response and perinatal outcome were found between patients with a positive AF culture and those with a negative AF culture and a positive PCR. Conclusions: 1) Cultivation techniques for ureaplasmas did not detect most cases of intra-amniotic infection caused by these microorganisms (91% of cases with cervical insufficiency and microbial footprints for ureaplasmas in the amniotic cavity had a negative AF culture); 2) Patients with a negative AF culture and a positive PCR assay were at risk for intra-amniotic and fetal inflammation as well as spontaneous preterm birth.Park CW, 2009, PLACENTA, V30, P56, DOI 10.1016/j.placenta.2008.09.017KIEFER DG, 2009, AM J OBSTET GYNECOL, V200Mazaki-Tovi S, 2008, J PERINAT MED, V36, P485, DOI 10.1515/JPM.2008.084Park CW, 2008, J PERINAT MED, V36, P497, DOI 10.1515/JPM.2008.079Viscardi RM, 2008, J PERINATOL, V28, P759, DOI 10.1038/jp.2008.98Lee SE, 2008, J PERINAT MED, V36, P316, DOI 10.1515/JPM.2008.067Gotsch F, 2008, J MATERN-FETAL NEO M, V21, P529, DOI 10.1080/14767050802127349Hamill N, 2008, J PERINAT MED, V36, P217, DOI 10.1515/JPM.2008.034Gotsch F, 2008, J MATERN-FETAL NEO M, V21, P605, DOI 10.1080/14767050802212109Nhan-Chang CL, 2008, J MATERN-FETAL NEO M, V21, P763, DOI 10.1080/14767050802244946Kusanovic JP, 2008, J MATERN-FETAL NEO M, V21, P902, DOI 10.1080/14767050802320357BUJOLD E, 2008, J OBSTET GYNAECOL CA, V30, P882ONDERDONK AB, 2008, AM J OBSTET GYNECOL, V199, pNI114Erez O, 2008, J PERINAT MED, V36, P377, DOI 10.1515/JPM.2008.082LEE SE, 2008, AM J OBSTET GYNECOL, V198Holst RM, 2007, J MATERN-FETAL NEO M, V20, P885, DOI 10.1080/14767050701752601Aaltonen R, 2007, BJOG-INT J OBSTET GY, V114, P1432, DOI 10.1111/j.1471-0528.2007.01410.xFriel LA, 2007, J PERINAT MED, V35, P385, DOI 10.1515/JPM.2007.101LEE SE, 2007, AM J OBSTET GYNECOL, V197Hassan S, 2006, J PERINAT MED, V34, P13, DOI 10.1515/JPM.2006.002Waites KB, 2005, CLIN MICROBIOL REV, V18, P757, DOI 10.1128/CMR.18.4.757-789.2005Biggio JR, 2005, AM J OBSTET GYNECOL, V192, P109, DOI 10.1016/j.ajog.2004.06.103Shim SS, 2004, AM J OBSTET GYNECOL, V191, P1339, DOI 10.1016/j.ajog.2004.06.085Perni SC, 2004, AM J OBSTET GYNECOL, V191, P1382, DOI 10.1016/j.ajog.2004.05.070Yoon BH, 2003, AM J OBSTET GYNECOL, V189, P919, DOI 10.1067/S0002-9378(03)00839-1Jacobsson B, 2003, ACTA OBSTET GYN SCAN, V82, P423Gerber S, 2003, J INFECT DIS, V187, P518Fortunato SJ, 2002, J ASSIST REPROD GEN, V19, P483Viscardi RM, 2002, PEDIATR DEVEL PATHOL, V5, P141, DOI 10.1007/s10021-001-0134-yYoon BH, 2001, AM J OBSTET GYNECOL, V185, P1130Park JS, 2001, AM J OBSTET GYNECOL, V185, P1156Yoon BH, 2000, AM J OBSTET GYNECOL, V183, P1130, DOI 10.1067/mob.2000.109036Maymon E, 2000, AM J OBSTET GYNECOL, V183, P94, DOI 10.1067/mob.2000.105344Li YH, 2000, PEDIATR RES, V48, P114Mays JK, 2000, OBSTET GYNECOL, V95, P652Yoon BH, 2000, AM J OBSTET GYNECOL, V182, P675BASHIRI N, 1999, PRIMARY CARE UPDATE, V6, P82Luki N, 1998, EUR J CLIN MICROBIOL, V17, P255Yoon BH, 1997, AM J OBSTET GYNECOL, V177, P19Cunliffe NA, 1996, J MED MICROBIOL, V45, P27AbeleHorn M, 1996, EUR J CLIN MICROBIOL, V15, P595YOON BH, 1995, AM J OBSTET GYNECOL, V172, P960TENG K, 1994, J CLIN MICROBIOL, V32, P2232BLANCHARD A, 1993, CLIN INFECT DIS S1, V17, P148ROMERO R, 1992, AM J OBSTET GYNECOL, V167, P1086GRAY DJ, 1992, PRENATAL DIAG, V12, P111TREADWELL MC, 1991, AM J OBSTET GYNECOL, V165, P555ROMERO R, 1989, AM J OBSTET GYNECOL, V161, P817CHARLES D, 1981, AM J OBSTET GYNECOL, V141, P1065

Prediction of nonresponsiveness to medium-dose intravenous immunoglobulin (1 g/kg) treatment: an effective and safe schedule of acute treatment for Kawasaki disease

PurposeMedium-dose (1 g/kg) intravenous immunoglobulin (IVIG) is effective in the majority of patients with Kawasaki disease (KD) but some patients who do not respond to medium-dose IVIG are at high risk for the development of coronary artery lesions (CALs). The purpose of this study was to identify the clinical predictors associated with unresponsiveness to medium-dose IVIG and the development of CALs.MethodsA retrospective study was performed in 91 children with KD who were treated with medium-dose IVIG at our institution from January 2004 to December 2013. We classified the patients into responders (group 1; n=68) and nonresponders (group 2; n=23). We compared demographic, laboratory, and echocardiographic data between the 2 groups.ResultsMultivariate logistic regression analysis identified 6 variables as predictors for resistance to medium-dose IVIG. We generated a predictive scoring system assigning 1 point each for percentage of neutrophils ≥65%, C-reactive protein≥100 mg/L, aspartate aminotransferase≥100 IU/L, and alanine aminotransferase≥100 IU/L, as well as 2 points for less than 5 days of illness, and serum sodium level≤136 mmol/L. Using a cutoff point of ≥4 with this scoring system, we could predict nonresponsiveness to medium-dose IVIG with 74% sensitivity and 71% specificity.ConclusionIf a patient has a low-risk score in this system, medium-dose IVIG can be recommended as the initial treatment. Through this process, we can minimize the adverse effects of high-dose IVIG and incidence of CALs

Early detection of cardiac involvement in Miyoshi myopathy: 2D strain echocardiography and late gadolinium enhancement cardiovascular magnetic resonance

<p>Abstract</p> <p>Background</p> <p>Miyoshi myopathy (MM) is an autosomal recessive distal myopathy characterized by early adult onset. Cardiomyopathy is a major clinical manifestation in other muscular dystrophies and an important prognostic factor. Although dysferlin is highly expressed in cardiac muscle, the effect of dysferlin deficiency in cardiac muscle has not been studied. We hypothesized that early myocardial dysfunction could be detected by 2D strain echocardiography and late gadolinium enhancement (LGE) cardiovascular magnetic resonance (CMR).</p> <p>Method</p> <p>Five consecutive MM patients (3 male) in whom we detected the DYSF gene mutation and age-matched healthy control subjects were included. None of the patients had history of cardiac disease or signs and symptoms of overt heart failure. Patients were studied using 2D strain echocardiography and CMR, with 2D strain being obtained using the Automated Function Imaging technique.</p> <p>Results</p> <p>All patients had preserved left ventricular systolic function. However, segmental Peak Systolic Longitudinal Strain (PSLS) was decreased in 3 patients. Global PSLS was significantly lower in patients with MM than in control subjects (p = 0.005). Basal anterior septum, basal inferior septum, mid anterior, and mid inferior septum PSLS were significantly lower in patients with MM than in control subjects (P < 0.0001, < 0.0001, 0.038 and 0.003, respectively). Four patients showed fibrosis by LGE. The reduced PSLS lesion detected by 2D strain tended to be in the same area as that which showed fibrosis by LGE.</p> <p>Conclusions</p> <p>Patients with MM showed subclinical involvement of the heart. 2D strain and LGE are sensitive methods for detecting myocardial dysfunction prior to the development of cardiovascular symptoms. The prognostic significance of these findings warrants further longitudinal follow-up.</p