817 research outputs found

    Bankruptcy

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    The authors analyze developments in bankruptcy, including decisions involving the rights of secured parties and lienors, jurisdiction of the bankruptcy courts, valuation of security, discharge, preferences and newsman\u27s and attorney-client privileges in bankruptcy. The article also reports recent decisions interpreting the Uniform Commercial Code as it pertains to bankruptcy. Included are a number of bankruptcy issues which recently have been adjudicated for the first time

    Bloqueio Atrioventricular Paroxístico como Causa de Síncope em Crianças sem Cardiopatia Congênita

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    Histórico: A síncope causada por bloqueio atrioventricular (AV) paroxístico, definido como bloqueio de segundo ou terceiro grau transitório, raramente é relatada em pacientes pediátricos sem cardiopatias congênitas. Métodos: Realizou-se uma revisao do banco de dados de arritmias da nossa instituiçao, de janeiro de 1988 a janeiro de 2007, para identificar todos os pacientes com menos de 18 anos de idade com anatomia cardíaca normal e episódios de síncope associados a bloqueio AV paroxístico. Informaçoes demográficas e clínicas foram coletadas. Resultados: Foram identificados seis pacientes, cinco do sexo feminino, com idade média de 9,3 ± 4,4 anos, que haviam sofrido episódios de síncope durante 5,6 ± 3,3 anos, em média, antes do diagnóstico (Tabela 1). Todos foram submetidos a exame físico, eletrocardiograma e ecocardiograma. Os resultados dos exames laboratoriais, inclusive para doença de Lyme, foram negativos. Nenhum deles recebia medicaçao capaz de interferir na conduçao AV nodal. Cinco dos seis episódios relatados foram atípicos para síncope vasovagal (com exceçao do paciente 6). Todos os pacientes tiveram bloqueio AV paroxístico documentado em monitor cardíaco ou gravador de Holter de 24 horas, registrado durante a síncope em pacientes internados. Houve manutençao ou aceleraçao do ritmo sinusal durante os episódios de síncope em todos os pacientes (ritmo atrial médio de 107 ± 37 bpm). Os seis pacientes receberam o implante de marcapasso transvenoso permanente, com a resoluçao dos sintomas durante um acompanhamento médio de 5,2 ± 6,3 anos. Conclusao: O bloqueio AV paroxístico é um achado raro em pacientes pediátricos, mas deve ser considerado uma etiologia possível naqueles que apresentam episódios atípicos de síncope vasovagal. A terapia utilizando marcapassos preveniu novas ocorrências em todos os seis pacientes

    Bloqueio Atrioventricular Paroxístico como Causa de Síncope em Crianças sem Cardiopatia Congênita

    Get PDF
    Histórico: A síncope causada por bloqueio atrioventricular (AV) paroxístico, definido como bloqueio de segundo ou terceiro grau transitório, raramente é relatada em pacientes pediátricos sem cardiopatias congênitas. Métodos: Realizou-se uma revisao do banco de dados de arritmias da nossa instituiçao, de janeiro de 1988 a janeiro de 2007, para identificar todos os pacientes com menos de 18 anos de idade com anatomia cardíaca normal e episódios de síncope associados a bloqueio AV paroxístico. Informaçoes demográficas e clínicas foram coletadas. Resultados: Foram identificados seis pacientes, cinco do sexo feminino, com idade média de 9,3 ± 4,4 anos, que haviam sofrido episódios de síncope durante 5,6 ± 3,3 anos, em média, antes do diagnóstico (Tabela 1). Todos foram submetidos a exame físico, eletrocardiograma e ecocardiograma. Os resultados dos exames laboratoriais, inclusive para doença de Lyme, foram negativos. Nenhum deles recebia medicaçao capaz de interferir na conduçao AV nodal. Cinco dos seis episódios relatados foram atípicos para síncope vasovagal (com exceçao do paciente 6). Todos os pacientes tiveram bloqueio AV paroxístico documentado em monitor cardíaco ou gravador de Holter de 24 horas, registrado durante a síncope em pacientes internados. Houve manutençao ou aceleraçao do ritmo sinusal durante os episódios de síncope em todos os pacientes (ritmo atrial médio de 107 ± 37 bpm). Os seis pacientes receberam o implante de marcapasso transvenoso permanente, com a resoluçao dos sintomas durante um acompanhamento médio de 5,2 ± 6,3 anos. Conclusao: O bloqueio AV paroxístico é um achado raro em pacientes pediátricos, mas deve ser considerado uma etiologia possível naqueles que apresentam episódios atípicos de síncope vasovagal. A terapia utilizando marcapassos preveniu novas ocorrências em todos os seis pacientes

    Natural killer cells attenuate cytomegalovirus-induced hearing loss in mice

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    <div><p>Congenital cytomegalovirus (CMV) infection is the most common non-hereditary cause of sensorineural hearing loss (SNHL) yet the mechanisms of hearing loss remain obscure. Natural Killer (NK) cells play a critical role in regulating murine CMV infection via NK cell recognition of the Ly49H cell surface receptor of the viral-encoded m157 ligand expressed at the infected cell surface. This Ly49H NK receptor/m157 ligand interaction has been found to mediate host resistance to CMV in the spleen, and lung, but is much less effective in the liver, so it is not known if this interaction is important in the context of SNHL. Using a murine model for CMV-induced labyrinthitis, we have demonstrated that the Ly49H/m157 interaction mediates host resistance in the temporal bone. BALB/c mice, which lack functional Ly49H, inoculated with mCMV at post-natal day 3 developed profound hearing loss and significant outer hair cell loss by 28 days of life. In contrast, C57BL/6 mice, competent for the Ly49H/m157 interaction, had minimal hearing loss and attenuated outer hair cell loss with the same mCMV dose. Administration of Ly49H blocking antibody or inoculation with a mCMV viral strain deleted for the m157 gene rendered the previously resistant C57BL/6 mouse strain susceptible to hearing loss to a similar extent as the BALB/c mouse strain indicating a direct role of the Ly49H/m157 interaction in mCMV-dependent hearing loss. Additionally, NK cell recruitment to sites of infection was evident in the temporal bone of inoculated susceptible mouse strains. These results demonstrate participation of NK cells in protection from CMV-induced labyrinthitis and SNHL in mice.</p></div

    Giant coronary artery aneurysms in juvenile polyarteritis nodosa: a case report

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    Juvenile polyarteritis nodosa (PAN) is a rare, necrotizing vasculitis, primarily affecting small to medium-sized muscular arteries. Cardiac involvement amongst patients with PAN is uncommon and reports of coronary artery aneurysms in juvenile PAN are exceedingly rare. We describe a 16 year old girl who presented with fever, arthritis and two giant coronary artery aneurysms, initially diagnosed as atypical Kawasaki disease and treated with IVIG and methylprednisolone. Her persistent fevers, arthritis, myalgias were refractory to treatment, and onset of a vasculitic rash suggested an alternative diagnosis. Based on angiographic abnormalities, polymyalgia, hypertension and skin involvement, this patient met criteria for juvenile PAN. She was treated with six months of intravenous cyclophosphamide and high dose corticosteroids for presumed PAN related coronary vasculitis. Maintenance therapy was continued with azathioprine and the patient currently remains without evidence of active vasculitis. She remains on anticoagulation for persistence of the aneurysms. This case illustrates a rare and unusual presentation of giant coronary artery aneurysms in the setting of juvenile PAN

    A Novel and Lethal De Novo LQT-3 Mutation in a Newborn with Distinct Molecular Pharmacology and Therapeutic Response

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    SCN5A encodes the alpha-subunit (Na(v)1.5) of the principle Na(+) channel in the human heart. Genetic lesions in SCN5A can cause congenital long QT syndrome (LQTS) variant 3 (LQT-3) in adults by disrupting inactivation of the Na(v)1.5 channel. Pharmacological targeting of mutation-altered Na(+) channels has proven promising in developing a gene-specific therapeutic strategy to manage specifically this LQTS variant. SCN5A mutations that cause similar channel dysfunction may also contribute to sudden infant death syndrome (SIDS) and other arrhythmias in newborns, but the prevalence, impact, and therapeutic management of SCN5A mutations may be distinct in infants compared with adults.Here, in a multidisciplinary approach, we report a de novo SCN5A mutation (F1473C) discovered in a newborn presenting with extreme QT prolongation and differential responses to the Na(+) channel blockers flecainide and mexiletine. Our goal was to determine the Na(+) channel phenotype caused by this severe mutation and to determine whether distinct effects of different Na(+) channel blockers on mutant channel activity provide a mechanistic understanding of the distinct therapeutic responsiveness of the mutation carrier. Sequence analysis of the proband revealed the novel missense SCN5A mutation (F1473C) and a common variant in KCNH2 (K897T). Patch clamp analysis of HEK 293 cells transiently transfected with wild-type or mutant Na(+) channels revealed significant changes in channel biophysics, all contributing to the proband's phenotype as predicted by in silico modeling. Furthermore, subtle differences in drug action were detected in correcting mutant channel activity that, together with both the known genetic background and age of the patient, contribute to the distinct therapeutic responses observed clinically.The results of our study provide further evidence of the grave vulnerability of newborns to Na(+) channel defects and suggest that both genetic background and age are particularly important in developing a mutation-specific therapeutic personalized approach to manage disorders in the young

    A glimpse into the differential topology and geometry of optimal transport

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    This note exposes the differential topology and geometry underlying some of the basic phenomena of optimal transportation. It surveys basic questions concerning Monge maps and Kantorovich measures: existence and regularity of the former, uniqueness of the latter, and estimates for the dimension of its support, as well as the associated linear programming duality. It shows the answers to these questions concern the differential geometry and topology of the chosen transportation cost. It also establishes new connections --- some heuristic and others rigorous --- based on the properties of the cross-difference of this cost, and its Taylor expansion at the diagonal.Comment: 27 page

    Polymorphisms in Toll-like receptor genes influence antibody responses to cytomegalovirus glycoprotein B vaccine

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    <p>Abstract</p> <p>Background</p> <p>Congenital Cytomegalovirus (CMV) infection is an important medical problem that has yet no current solution. A clinical trial of CMV glycoprotein B (gB) vaccine in young women showed promising efficacy. Improved understanding of the basis for prevention of CMV infection is essential for developing improved vaccines.</p> <p>Results</p> <p>We genotyped 142 women previously vaccinated with three doses of CMV gB for single nucleotide polymorphisms (SNPs) in TLR 1-4, 6, 7, 9, and 10, and their associated intracellular signaling genes. SNPs in the platelet-derived growth factor receptor (PDGFRA) and integrins were also selected based on their role in binding gB. Specific SNPs in TLR7 and IKBKE (inhibitor of nuclear factor kappa-B kinase subunit epsilon) were associated with antibody responses to gB vaccine. Homozygous carriers of the minor allele at four SNPs in TLR7 showed higher vaccination-induced antibody responses to gB compared to heterozygotes or homozygotes for the common allele. SNP rs1953090 in IKBKE was associated with changes in antibody level from second to third dose of vaccine; homozygotes for the minor allele exhibited lower antibody responses while homozygotes for the major allele showed increased responses over time.</p> <p>Conclusions</p> <p>These data contribute to our understanding of the immunogenetic mechanisms underlying variations in the immune response to CMV vaccine.</p

    Pan-Cancer Analysis of lncRNA Regulation Supports Their Targeting of Cancer Genes in Each Tumor Context

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    Long noncoding RNAs (lncRNAs) are commonly dys-regulated in tumors, but only a handful are known toplay pathophysiological roles in cancer. We inferredlncRNAs that dysregulate cancer pathways, onco-genes, and tumor suppressors (cancer genes) bymodeling their effects on the activity of transcriptionfactors, RNA-binding proteins, and microRNAs in5,185 TCGA tumors and 1,019 ENCODE assays.Our predictions included hundreds of candidateonco- and tumor-suppressor lncRNAs (cancerlncRNAs) whose somatic alterations account for thedysregulation of dozens of cancer genes and path-ways in each of 14 tumor contexts. To demonstrateproof of concept, we showed that perturbations tar-geting OIP5-AS1 (an inferred tumor suppressor) andTUG1 and WT1-AS (inferred onco-lncRNAs) dysre-gulated cancer genes and altered proliferation ofbreast and gynecologic cancer cells. Our analysis in-dicates that, although most lncRNAs are dysregu-lated in a tumor-specific manner, some, includingOIP5-AS1, TUG1, NEAT1, MEG3, and TSIX, synergis-tically dysregulate cancer pathways in multiple tumorcontexts
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