Atypical type of familial Mediterranean fever: An underdiagnosed cause of chronic aseptic meningitis

ArticleNeurology and clinical neuroscience. 6(6): 191-193 (2018)journal articl

Experimental evidence for direct insulator-quantum Hall transition in multi-layer graphene

We have performed magnetotransport measurements on a multi-layer graphene flake. At the crossing magnetic field Bc, an approximately temperature-independent point in the measured longitudinal resistivity, which is ascribed to the direct insulator-quantum Hall (I-QH) transition, is observed. By analyzing the amplitudes of the magnetoresistivity oscillations, we are able to measure the quantum mobility of our device. It is found that at the direct I-QH transition, the product of the quantum mobility and is about 0.37 which is considerably smaller than 1. In contrast, at Bc, the longitudinal resistivity is close to the Hall resistivity, i.e., the product of the classical mobility and the crossing field is about 1. Therefore our results suggest that different mobilities need to be introduced for the direct I-QH transition observed in multi-layered graphene. Combined with existing experimental results obtained in various material systems, our data obtained on graphene suggest that the direct I-QH transition is a universal effect in 2D.Comment: 4 figure

Omentin Prevents Myocardial Ischemic Injury Through AMP-Activated Protein Kinase- and Akt-Dependent Mechanisms

ObjectivesThis study examined the impact of omentin on myocardial injury in a mouse model of ischemia/reperfusion (I/R) and explored its underlying mechanisms.BackgroundObesity is a major risk factor for ischemic heart disease. Omentin is a circulating adipokine that is down-regulated by obesity.MethodsIn patients who underwent successful reperfusion treatment after acute myocardial infarction, cardiac function and perfusion defect were assessed by using scintigraphic images. Mice were subjected to myocardial ischemia followed by reperfusion.ResultsThis study found that high levels of plasma omentin were associated with improvement of heart damage and function after reperfusion therapy in patients with acute myocardial infarction. Systemic administration of human omentin to mice led to a reduction in myocardial infarct size and apoptosis after I/R, which was accompanied by enhanced phosphorylation of AMP-activated protein kinase (AMPK) and Akt in the ischemic heart. Fat-specific overexpression of human omentin also resulted in reduction of infarct size after I/R. Blockade of AMPK or Akt activity reversed omentin-induced inhibition of myocardial ischemic damage and apoptosis in mice. In cultured cardiomyocytes, omentin suppressed hypoxia/reoxygenation-induced apoptosis, which was blocked by inactivation of AMPK or Akt.ConclusionsOur data indicate that omentin functions as an adipokine that ameliorates acute ischemic injury in the heart by suppressing myocyte apoptosis through both AMPK- and Akt-dependent mechanisms

Diagnostic accuracy of 16S ribosomal RNA gene polymerase chain reaction in bacteremia: A prospective observational study

　The standard method for diagnosing bacteremia is blood culture. However, the sensitivity of blood culture is low when the number of bacteria in the blood is low or when antibiotics have already been administered. Furthermore, some bacteria are difficult to detect in blood cultures. 16S ribosomal RNA (rRNA) contains conserved sequences that are targeted for PCR amplification using universal primers. We investigated whether the threshold cycle (Ct) value of 16S rRNA real-time PCR in whole-blood samples can be used for early diagnosis of bacteremia. Ct values of the 16S rRNA real-time PCR in 307 collected specimens showed a bimodal distribution. Ct values of the blood culture-positive group were significantly lower than those of the blood culture-negative group (P < 0.001). The cutoff value of the receiver operating characteristic curve was 38.80, as determined using finite-mixture modeling and expectation-maximization algorithm. Analysis of the diagnostic accuracy at this cutoff value showed a sensitivity of 91.4%, specificity of 33.5%, positive predictive value of 15.0%, and negative predictive value of 96.8%. The Ct value of 16S rRNA real-time PCR shows high negative predictive value, it may be useful for excluding bacteremia when the cutoff value is set appropriately

The diagnostic accuracy of biomarkers for the prediction of bacteremia in patients with suspected infection: a prospective observational study

　Rapid recognition of bacteremia is important for critical care, especially in patients with suspected bloodstream infections. Procalcitonin and presepsin are widely used biomarkers in point-of care medical testing for identifying infectious diseases and sepsis; however, the diagnostic accuracy for the prediction of bacteremia is not well established. Therefore, this study aimed to evaluate the diagnostic accuracy of procalcitonin and presepsin for the prediction of bacteremia in patients with suspected bacteremia. We performed a prospective observational study at our hospital. A total of 210 patients (307 samples) who had been admitted from December 2014 through September 2016 with a suspected infection were included. Presepsin and procalcitonin were tested simultaneously with blood cultures and routine laboratory tests. One hundred and four blood samples were obtained at the emergency room (ER). Others were obtained during hospital admission. Blood cultures were positive in 34 samples; 25 samples were obtained in the ER. Presepsin and procalcitonin levels were significantly higher in patients with positive blood cultures than in those with negative blood cultures (1028.5 pg/mL vs. 485.0 pg/mL, P < 0.001 and 4.53 ng/mL vs. 0.33 ng/mL, P < 0.001, respectively). For predicting bacteremia, receiver operating characteristic curve analysis for presepsin showed an area under the curve (AUC) of 0.718 and negative predictive value (NPV) of 95%. The analysis for procalcitonin showed an AUC of 0.778 and NPV of 94.8%. C-reactive protein tests and the quick Sequential Organ Failure Assessment score in the ER failed to be useful tools for predicting bacteremia. Based on our results, procalcitonin and presepsin showed good diagnostic accuracy and NPV for predicting bacteremia among patients with suspected infection. Therefore, these biomarkers may be useful for ruling out bacteremia in patients with suspected infection

Differential Expressed Genes Identified Between African American and European American Keloid Fibroblasts

Keloids are benign fibroproliferative tumors due to dysregulation of collagen remodeling and abnormal wound healing. Although worldwide, there is a higher incidence of keloid disease (KD) in skin of color, little is known about this predisposition. In this study, we used one tissue micro array slide comprised of six AA and 6 EA punch biopsies of primary untreated keloid tissue from the head and neck area was created, following the NanoString® DSP Technology Access Program protocol. The GeoMx Human Whole Transcriptome Atlas Assay was performed, using morphology marker FAP. Polygonal region of interests selection strategy for Fibroblast Activation Protein (FAP) positive cells was conducted. Univariate analysis was performed, using linear regression models to identify differentially expressed genes (DEG) at a false discovery rate (FDR) of 0.05. Ingenuity pathway analysis (IPA) software was used to determine DEG pathway enrichment. 1,450 DEG were identified (p-va

Coincident Port-site and Functional End-to-end Anastomotic Recurrences after Laparoscopic Surgery for Colon Cancer : A case report and literature review

Herein, we report coincident recurrences at the port site and functional end-to-end anastomosis after laparoscopic right hemicolectomy for cancer of the ascending colon. The patient was an 83-year-old man who had undergone the aforementioned procedure (Stage IIA) in the referral hospital. At the 10-month follow-up, computed tomography showed two tumours around 3 cm in diameter : one on the right-flank abdominal wall-the surgical port-site-and the other at the functional end-to-end anastomosis. Likewise, a positron emission tomography scan was positive for two tumours. Endoscopic examination showed an ulcerated tumour with a clear margin, and a biopsy confirmed moderately differentiated tubular adenocarcinoma. The patient was diagnosed with coincident recurrences at the port site and functional end-to-end anastomosis after laparoscopic right hemicolectomy for cancer of the ascending colon. We re-operated inMarch 2016. The tumours at the functional end-to-end anastomosisand functional end-to-end anastomosiswere resected. After 7 months, no recurrence was detected

Peritoneal cecal cancer metastasis to a mesh-plug prosthesis : A case report

We report the case of a 77-year-old man who presented to our hospital with cecal cancer, lung metastasis, and liver metastasis in January 2013. After four courses of modified infusional intravenous fluorouracil and levofolinate with oxaliplatin (mFOLFOX 6) + bevacizumab, there was no new metastatic lesion and lung metastasis reduction was observed. Ileocecal resection was performed in May, left lower lung lobectomy in August, and extended right posterior segmentectomy + S8 partial liver resection was performed in December. The tumor marker declined initially ; thereafter, it gradually increased. Computed tomography (CT) performed in April 2014 revealed right inguinal mass around the mesh-plug prosthesis. A positron emission tomography-CT (PET-CT) also revealed a high 2-fluoro-2-deoxy-D-glucose (FDG) uptake at the same site. Right inguinal tumor resection was performed in July. Cancer tissues were confirmed by performing intraoperative rapid pathological diagnosis, and R0 resection could be achieved. Previous studies have reported malignant tumor metastases to the mesh-plug prosthesis, and this was believed to one of the sites that cancer cells can easily engraft. In particular, in patients with a history of advanced malignant tumors, if mass formation around the artifact insertion site is observed, the possibility of peritoneal metastasis should be considered

Combined resection of re-recurrent lateral lymph nodes and external iliac vein : Case Report and Literature

Herein, we describe the operative procedure for combined resection of re-recurrent lateral lymph nodes and the external iliac vein. There is no consensus on the clinical implications of resection of locally re-recurrent colorectal tumors, as the operative procedure is extremely difficult. We present the case of a 52- year-old woman who underwent abdominoperineal resection. About one year later, we excised a recurrent lymph node in the left lateral obturator area through an extraperitoneal approach. About 18 months later, lymph node re-recurrence in the left external iliac area was observed. Re-recurrent lymph nodes directly invade the left external iliac vein.We removed the re-recurrent lymph node with combined, radical segmental resection of the left external iliac vein, left obturator artery and vein, and left obturator nerve