Magnet displacement: a rare complication following cochlear implantation

The purpose of this paper is to describe cases which reported complication after cochlear implantation in children: displacement of magnet from the receiver pocket, possibly aided by the use of magnetic toys. We observed magnet displacement in two female children from the same family and in one male child. Age at implantation was 23, 51, and 24months, respectively. Magnet displacement occurred at 37, 16, and 32months, respectively after the initial surgery. The magnets were replaced under general anaesthesia and we did not observe recurrent magnet dislodgement. Measurements indicated that forces required to remove the magnet from its pocket were not greater than those exerted by magnetic toys or the magnet used in the external sender coil. Although magnet displacement is not common after cochlear implantation, it is a major complication in children where subsequent general anaesthesia and surgery are necessary to replace the magnet. Therefore, we propose that pockets for removable magnets of cochlear implants used in children should be redesigned to increase forces to remove the magnet or that removable magnets not be used at al

Oncostatin M Mediates STAT3-Dependent Intestinal Epithelial Restitution via Increased Cell Proliferation, Decreased Apoptosis and Upregulation of SERPIN Family Members

Objective: Oncostatin M (OSM) is produced by activated T cells, monocytes, and dendritic cells and signals through two distinct receptor complexes consisting of gp130 and LIFR (I) or OSMR-beta and gp130 (II),respectively. Aim of this study was to analyze the role of OSM in intestinal epithelial cells (IEC) and intestinal inflammation. Methods: OSM expression and OSM receptor distribution was analyzed by PCR and immunohistochemistry experiments, signal transduction by immunoblotting. Gene expression studies were performed by microarray analysis and RT-PCR. Apoptosis was measured by caspases-3/7 activity. IEC migration and proliferation was studied in wounding and water soluble tetrazolium assays. Results: The IEC lines Caco-2, DLD-1, SW480, HCT116 and HT-29 express mRNA for the OSM receptor subunits gp130 and OSMR-b, while only HCT116, HT-29 and DLD-1 cells express LIFR mRNA. OSM binding to its receptor complex activates STAT1, STAT3, ERK-1/2, SAPK/JNK-1/2, and Akt. Microarray analysis revealed 79 genes that were significantly up-regulated (adj.-p <= 0.05) by OSM in IEC. Most up-regulated genes belong to the functional categories "immunity and defense'' (p=2.1x10(-7)),"apoptosis'' (p=3.7x10(-4)) and "JAK/STAT cascade'' (p=3.4x10(-6)). Members of the SERPIN gene family were among the most strongly up-regulated genes. OSM significantly increased STAT3- and MEK1-dependent IEC cell proliferation (p < 0.05) and wound healing (p=3.9x10(-5)). OSM protein expression was increased in colonic biopsies of patients with active inflammatory bowel disease (IBD). Conclusions: OSM promotes STAT3-dependent intestinal epithelial cell proliferation and wound healing in vitro. Considering the increased OSM expression in colonic biopsy specimens of patients with active IBD, OSM upregulation may modulate a barrier-protective host response in intestinal inflammation. Further in vivo studies are warranted to elucidate the exact role of OSM in intestinal inflammation and the potential of OSM as a drug target in IBD

Cryptococcosis mimicking cutaneous cellulitis in a patient suffering from rheumatoid arthritis: a case report

<p>Abstract</p> <p>Background</p> <p><it>Cryptococcus neoformans </it>is an encapsulated yeast and the most frequent cryptococcal species found in humans. Cryptococcosis is considered an opportunistic infection as it affects mainly immunosuppressed individuals. In humans, <it>C. neoformans </it>causes three types of infections: pulmonary cryptococcosis, cryptococcal meningitis and wound or cutaneous cryptococcosis.</p> <p>Case Presentation</p> <p>An 81-year-old woman developed severe necrotizing cellulitis on her left arm without any preceding injury. The patient had been treated with systemic corticosteroids over twenty years for rheumatoid arthritis (RA). Skin biopsies of the wound area were initially interpreted as cutaneous vasculitis of unknown etiology. However, periodic acid Schiff staining and smear analysis later revealed structures consistent with <it>Cryptococcus neoformans</it>, and the infection was subsequently confirmed by culture. After the initiation of therapy with fluconazole 400 mg per day the general condition and the skin ulcers improved rapidly and the patient was discharged to a rehabilitation facility. Subsequently surgical debridement and skin grafting were performed.</p> <p>Conclusions</p> <p>Opportunistic infections such as cryptococcosis can clinically and histologically mimic cutaneous vasculitis and have to be investigated rigorously as a differential diagnosis in immunosuppressed patients.</p

Effective Adoption of Tablets for Psychodiagnostic Assessments in Rural Burundi : Evidence for the Usability and Validity of Mobile Technology in the Example of Differentiating Symptom Profiles in AMISOM Soldiers 1 Year After Deployment

Research on the use of mobile technology in health sciences has identified several advantages of so-called mHealth (mobile health) applications. Tablet-supported clinical assessments are becoming more and more prominent in clinical applications, even in low-income countries. The present study used tablet computers for assessments of clinical symptom profiles in a sample of Burundian AMISOM soldiers (i.e., African Union Mission to Somalia; a mission approved by the UN). The study aimed to demonstrate the feasibility of mHealth-supported assessments in field research in Burundi. The study was conducted in a resource-poor setting, in which tablet computers are predestined to gather data in an efficient and reliable manner. The overall goal was to prove the validity of the obtained data as well as the feasibility of the chosen study setting. Four hundred sixty-three soldiers of the AMISOM forces were investigated after return from a 1-year military mission in Somalia. Symptoms of posttraumatic stress disorder (PTSD) and depression were assessed. The used data-driven approach based on a latent profile analysis revealed the following four distinct groups, which are based on the soldiers' PTSD and depression symptom profiles: Class 1: moderate PTSD, Class 2: moderate depression, Class 3: low overall symptoms, and Class 4: high overall symptoms. Overall, the four identified classes of soldiers differed significantly in their PTSD and depression scores. The study clearly demonstrates that tablet-supported assessments can provide a useful application of mobile technology in large-scale studies, especially in resource-poor settings. Based on the data collected for the study at hand, it was possible to differentiate different sub-groups of soldiers with distinct symptom profiles, proving the statistical validity of the gathered data. Finally, advantages and challenges for the application of mobile technology in a resource-poor setting are outlined and discussed.publishe

Chromosomal translocations t(4;14), t(11;14) and proliferation rate stratify patients with mature plasma cell myelomas into groups with different survival probabilities: a molecular epidemiologic study on tissue microarrays

Plasma cell myelomas (PMs) exhibit clinical and molecular heterogeneity. To date, morphology and immunohistochemistry on bone marrow trephines are of limited value to stratify patients into different prognostic categories. However, some chromosomal translocations are of prognostic and/or of predictive importance in PMs. In this study, the prognostic significance of morphology, CyclinD1 expression, proliferation index (Mib1) and presence of the translocations FGFR3/IgH [t(4;14)] and CCND1/IgH [t(11;14)] are compared in 119 patients with PM. Immunohistochemistry and fluorescence in situ hybridization analysis were carried out on a tissue microarray containing bone marrow trephines. Hundred and one PMs showed a mature morphology whereas 10 were immature. All but one PM carrying a translocation showed a mature morphology. Patients with a t(4;14) (12%) had a statistically significant shorter 1-year survival (P=0.004), whereas those with a t(11;14) (21%) had a trend towards a better clinical outcome. CyclinD1 protein expression was not significantly associated with survival. Besides the t(4;14), an immature morphology (P<0.001) and a proliferation index (Mib1) of more than 10% (P=0.002) were associated with a significantly worse outcome. A high occurrence of strong CyclinD1 protein expression in the tumor cells was predictive of either a t(11;14) or of a low level amplification of the CCND1 gene, suggesting that different molecular mechanisms may have lead to an over-expression of the CyclinD1 protein in PMs. These findings demonstrate that a high proliferation rate and translocations involving the IgH locus can stratify mature PMs into groups with distinct survival probabilities

OSM is up-regulated in colonic biopsies of patients with active inflammatory bowel disease.

<p>OSM expression in colonic biopsies was higher in inflamed colonic biopsy samples in both active CD and UC patients than in non-inflamed colonic lesions of patients in remission. OSM in inflamed lesions is highly expressed in epithelial cells but also in sub-epithelial laminar propria mononuclear cells. Overall, biopsy specimens of 4 CD and 4 UC patients with active disease and in remission were analyzed. Representative images (20× and 40× magnification) of CD patients in remission and active disease (A) and UC patients in remission and active disease (B) and isotype controls are shown. (C) OSM mRNA levels in inflamed mucosal lesions of 23 patients with CD were significant higher than in non-inflamed lesions (*p = 0.001). (D) OSM mRNA levels were not significant different in inflamed lesions compared to non-inflamed lesions of 10 patients with UC (p = 0.11).</p

Apoptosis of HCT116 cells is downregulated after OSM stimulation.

<p>Treatment with OSM (10 ng/mL and 100 ng/mL) for 6 hours significantly reduced caspase-3/7 activity (* p = 0.03; **p = 0.02, respectively) compared to unstimulated HCT116 cells. TNF-α (50 ng/mL) served as positive control (^# p = 0.007 vs. unstimulated HCT116 cells).</p

OSM-mediated wound healing in HCT116 cells is MEK-1- and STAT3-dependent.

<p>Wounding assays were performed to analyze cell migration. Presented are representative images of unstimulated HCT116 cells at baseline (left panel) and after 16 hours (right panel) (A) and OSM-stimulated cells at baseline (left panel) and after 16 hours (right panel) (B). (C) OSM (100 ng/mL) induced a significant increase of cell migration (* p = 3.9×10⁻⁵ vs. unstimulated controls). Preincubation with the MEK-1 inhibitor PD98059 (10 µM) and STAT3 siRNA (5 µM) reduced OSM-induced cell migration in the wounding assay (** p = 1.7×10⁻⁵ and ^# p = 0.01 vs. OSM-stimulated cells). In all experiments, relative cell overgrowth in unstimulated control cells was arbitrarily set to 1.0.</p