Mycobacterial Disease Overlooked in a Frail Diabetic Male Treated for Pneumonia

Mycobacterial disease has been characterized to cause human illness since the 1950’s but practitioners whom address pulmonary disease can overlook its insidious presentation. This case report documents the presentation of a mycobacterial illness treated as a severe pneumonia. This is the case of a critically ill 43-year-old male, with poorly treated diabetes who presented with severe, long-standing respiratory distress in DKA. He had a history of weight loss, night sweats, decreased oral intake, and weakness for about a month. He was treated for euglycemia and his pulmonary disease was characterized as a bacterial pneumonia. Common pathogens were ruled out in an RIDP and he was treated with broad-spectrum antibiotics and discharged. On hospital follow up, careful examination of imaging report and history taking consisted with a timely screening for TB. A quantiferon gold test was positive and our patient was admitted to isolation on our inpatient service for evaluation. His AFB smear being positive, he was started on RIPE therapy. He was discharged with three negative sputum smears on the same therapy with cultures pending final characterization. This report documents a common treatment algorithm, based on a differential focused on typical culprits for pulmonary infection. Latent mycobacterial infections in our community are on the rise, especially in individuals whom are immunocompromised such as HIV+ or diabetics. First, these individuals must be identified using a screening tool such as a questionnaire. Second, obtaining screening labwork, even in non-compliant individuals are easily obtainable. Quantiferon gold assays could be administered to those identified as high risk even with no previous testing or prior negative test results. As these tests result, evaluation with a chest X-ray will stratify our groups to either further evaluation for latent mycobacterial infections or for treatment based on a positive chest X-ray. There needs to be a focus on identifying patients at risk for exposure to TB and providing diagnosis and treatment for latent infection or active disease. This will decrease the spread of tuberculosis

Design of Soft, Modular Appendages for a Bio-inspired Multi-Legged Terrestrial Robot

Soft robots have the ability to adapt to their environment, which makes them suitable for use in disaster areas and agricultural fields, where their mobility is constrained by complex terrain. One of the main challenges in developing soft terrestrial robots is that the robot must be soft enough to adapt to its environment, but also rigid enough to exert the required force on the ground to locomote. In this paper, we report a pneumatically driven, soft modular appendage made of silicone for a terrestrial robot capable of generating specific mechanical movement to locomote and transport loads in the desired direction. This two-segmented soft appendage uses actuation in between the joint and the lower segment of the appendage to ensure adequate rigidity to exert the required force to locomote. A prototype of a soft-rigid-bodied tethered physical robot was developed and two sets of experiments were carried out in both air and underwater environments to assess its performance. The experimental results address the effectiveness of the soft appendage to generate adequate force to navigate through various environments and our design method offers a simple, low-cost, and efficient way to develop terradynamically capable soft appendages that can be used in a variety of locomotion applications

Confusion after spine injury: cerebral fat embolism after traumatic rupture of a Tarlov cyst: Case report

<p>Abstract</p> <p>Background</p> <p>Acute low back pain is a very common symptom and reason for many medical consultations. In some unusual circumstances it could be linked to a rare aetiology.</p> <p>Case presentation</p> <p>We report a 70-year-old man with an 8-month history of left posterior thigh and leg pain who had sudden confusion after a fall from standing. It was due to cerebral fat embolism suspected by computed tomography scan, later confirmed by brain magnetic resonance imaging (MRI). A spinal MRI scan was then performed and revealed a sacral fracture which drained into an unknown perineurial cyst (Tarlov cyst). Under medical observation the patient fully recovered within three weeks.</p> <p>Conclusions</p> <p>Sacral perineurial cysts are rare, however they remain a potential cause of lumbosacral radiculopathy.</p

Structural Analysis of the Essential Resuscitation Promoting Factor YeaZ Suggests a Mechanism of Nucleotide Regulation through Dimer Reorganization

Extent: 8p.Background: The yeaZ gene product forms part of the conserved network YjeE/YeaZ/YgjD essential for the survival of many Gram-negative eubacteria. Among other as yet unidentified roles, YeaZ functions as a resuscitation promoting factor required for survival and resuscitation of cells in a viable but non-culturable (VBNC) state. Methodology/Principal Findings: In order to investigate in detail the structure/function relationship of this family of proteins we have performed X-ray crystallographic studies of Vibrio parahaemolyticus YeaZ. The YeaZ structure showed that it has a classic actin-like nucleotide-binding fold. Comparisons of this crystal structure to that of available homologues from E. coli, T. maritima and S. typhimurium revealed two distinctly different modes of dimer formation. In one form, prevalent in the absence of nucleotide, the putative nucleotide-binding site is incomplete, lacking a binding pocket for a nucleotide base. In the second form, residues from the second subunit complete the nucleotide-binding site. This suggests that the two dimer architectures observed in the crystal structures correspond to a free and a nucleotide-bound form of YeaZ. A multiple sequence alignment of YeaZ proteins from different bacteria allowed us to identify a large conserved hydrophobic patch on the protein surface that becomes exposed upon nucleotide-driven dimer re-arrangement. We hypothesize that the transition between two dimer architectures represents the transition between the ‘on’ and ‘off’ states of YeaZ. The effect of this transition is to alternately expose and bury a docking site for the partner protein YgjD. Conclusions/Significance: This paper provides the first structural insight into the putative mechanism of nucleotide regulation of YeaZ through dimer reorganization. Our analysis suggests that nucleotide binding to YeaZ may act as a regulator or switch that changes YeaZ shape, allowing it to switch partners between YjeE and YgjD.Inci Aydin, Yumiko Saijo-Hamano, Keiichi Namba, Connor Thomas and Anna Roujeinikov

Prospective single-arm study of 72 Gy hyperfractionated radiation therapy and combination chemotherapy for anaplastic astrocytomas

<p>Abstract</p> <p>Background</p> <p>Despite intensive multimodal treatment, outcome of patients with malignant glioma remains poor, and a standard dose of radiotherapy for anaplastic astrocytoma has not been defined. In the past RTOG study (83-02), the arm of 72 Gy hyperfractionated radiotherapy (HFRT) for malignant gliomas showed better outcome than the arms of higher doses (76.8 – 81.6 Gy) and the arms of lower doses (48 – 54.4 Gy). The purpose of this study is to verify the efficacy of this protocol.</p> <p>Methods</p> <p>From July 1995, 44 consecutive eligible patients with histologically proven anaplastic astrocytoma were enrolled in this study (HFRT group). The standard regimen in this protocol was post-operative radiotherapy of 72 Gy in 60 fractions (1.2 Gy/fraction, 2 fractions/day) with concurrent chemotherapy (weekly ACNU). The primary endpoint was local control rate (LCR), and the secondary endpoints were overall survival (OS), progression-free survival (PFS) and late toxicity.</p> <p>Results</p> <p>Three-year OS of the HFRT group was 64.8% (95% confidence interval; 48.4–81.3%). Three-year PFS rate and LCR were 64.4% (95%CI: 48.4–80.3%) and 81.6% (95%CI: 69.2–94.8%), respectively.</p> <p>The number of failures at 5 years in the HFRT group were 14 (32%). The number of failures inside the irradiation field was only about half (50%) of all failures. One (2%) of the patients clinically diagnosed as brain necrosis due to radiation therapy.</p> <p>Conclusion</p> <p>The results of this study suggested that 72 Gy HFRT seemed to show favorable outcome for patients with anaplastic astrocytoma with tolerable toxicity.</p

The effect of gamma irradiation on the structural properties of olivine

Gamma irradiation studies of (Mg0.905Fe0.095)2SiO4 olivine were performed using X-ray fluorescence method, X-ray diffraction, Raman and Mössbauer spectroscopy. The absorbed doses were 300, 600 and 1000 Gy. Small irradiation doses cause an increase of lattice vibrations and small deformation of both M1 and M2 octahedron. The observed effect is similar to the results expose to high temperature. However, the small deformation takes place only in unit cell of Olivine’s structure

Nuclear translocation of haeme oxygenase-1 is associated to prostate cancer

The role of oxidative stress in prostate cancer has been increasingly recognised. Acute and chronic inflammations generate reactive oxygen species that result in damage to cellular structures. Haeme oxygenase-1 (HO-1) has cytoprotective effects against oxidative damage. We hypothesise that modulation of HO-1 expression may be involved in the process of prostate carcinogenesis and prostate cancer progression. We thus studied HO-1 expression and localisation in 85 samples of organ-confined primary prostate cancer obtained via radical prostatectomy (Gleason grades 4–9) and in 39 specimens of benign prostatic hyperplasia (BPH). We assessed HO-1 expression by immunohistochemical staining. No significant difference was observed in the cytoplasmic positive reactivity among tumours (84%), non-neoplastic surrounding parenchyma (89%), or BPH samples (87%) (P=0.53). Haeme oxygenase-1 immunostaining was detected in the nuclei of prostate cancer cells in 55 of 85 (65%) patients but less often in non-neoplastic surrounding parenchyma (30 of 85, 35%) or in BPH (9 of 39, 23%) (P<0.0001). Immunocytochemical and western blot analysis showed HO-1 only in the cytoplasmic compartment of PC3 and LNCaP prostate cancer cell lines. Treatment with hemin, a well-known specific inducer of HO-1, led to clear nuclear localisation of HO-1 in both cell lines and highly induced HO-1 expression in both cellular compartments. These findings have demonstrated, for the first time, that HO-1 expression and nuclear localisation can define a new subgroup of prostate cancer primary tumours and that the modulation of HO-1 expression and its nuclear translocation could represent new avenues for therapy

Effects of retinoic acid on compensatory lung growth

<p>Abstract</p> <p>Background</p> <p>We investigated the effect of Retinoic acid in the growth of contralateral lung after pneumonectomy.</p> <p>Methods</p> <p>Twentyone adult male Wistar albino rats from the same colony were used. They were divided into three groups (Group A, B and C). Group A undergone only left posterolateral thoracotomy. In Group B and C, the rats were subjected to left posterolateral thoracotomy and left pneumonectomy. In Group C, rats were given intraperitoneal Retinoic acid during the operation and continued to be given everyday postoperatively. Rats were sacrificed on the 10^thday and their total body, right lung weights and right lung volumes were measured.</p> <p>Results</p> <p>The volume and weight indices of the lung were found to be higher in Group C. In histopathological examination, there was a reduction in the mean number of alveoli in Group B and C. A significant rise in the mean dimension and average wall thickness of the alveolar structure were determined in Group C.</p> <p>Conclusion</p> <p>Retinoic acid contributes to the compensatory growth of the residual lung tissue.</p