A Case of Crohn's Disease with Improvement after Azathioprine-Induced Pancytopenia

The immunosuppressant azathioprine (AZA) is widely used in the treatment of inflammatory bowel disease (IBD) for both inducing and maintaining remission. However, the adverse effects of AZA can often necessitate a dose reduction or discontinuation. Bone marrow suppression is one of the most serious complications with AZA treatment. On the other hand, some reports have suggested that neutropenia during AZA therapy reduced the relapse rates of IBD patients, and there have been some cases where eradication of the sensitized leukocytes by leukapheresis or bone marrow transplantation improved the IBD, which may explain the relevant role of neutropenia in controlling disease activity. This report describes the case of a 22-year-old male patient who had Crohn's colitis and complicated perianal fistulas that required immunosuppression; he achieved endoscopically determined remission and showed accelerated mucosal healing as well as clinical remission following the AZA-induced pancytopenia

Regulation of antibiotic production in Actinobacteria: new perspectives from the post-genomic era

The antimicrobial activity of many of their natural products has brought prominence to the Streptomycetaceae, a family of Gram-positive bacteria that inhabit both soil and aquatic sediments. In the natural environment, antimicrobial compounds are likely to limit the growth of competitors, thereby offering a selective advantage to the producer, in particular when nutrients become limited and the developmental programme leading to spores commences. The study of the control of this secondary metabolism continues to offer insights into its integration with a complex lifecycle that takes multiple cues from the environment and primary metabolism. Such information can then be harnessed to devise laboratory screening conditions to discover compounds with new or improved clinical value. Here we provide an update of the review we published in NPR in 2011. Besides providing the essential background, we focus on recent developments in our understanding of the underlying regulatory networks, ecological triggers of natural product biosynthesis, contributions from comparative genomics and approaches to awaken the biosynthesis of otherwise silent or cryptic natural products. In addition, we highlight recent discoveries on the control of antibiotic production in other Actinobacteria, which have gained considerable attention since the start of the genomics revolution. New technologies that have the potential to produce a step change in our understanding of the regulation of secondary metabolism are also described

A comparison of eleven static heuristics for mapping a class of independent tasks onto heterogeneous distributed computing systems

The article of record as published may be located at http://dx.doi.org/10.1006 jpdc.2000.1714Journal of Parallel and Distributed Computing 61, 810 837 (2001)This research was supported in part by the DARPA ITO Quorum Program project called MSHN (management system for heterogeneous networks). MSHN was a collaborative research effort among the Naval Postgraduate School, NOEMIX, Purdue University, and the University of Southern California. One objective of MSHN was to design and evaluate mapping heuristics for different types of HC environments.This research was supported in part by the DARPA ITO Quorum Program under NPS Subcontracts N62271-98-M-0217 and N62271-98-M-0448, and under the GSA Subcontract GS09K99BH0250. Some of the equipment used was donated by Intel and Microsoft

Sequence comparison by sequence harmony identifies subtype-specific functional sites

identifies subtype-specific functional site

Four Lessons Learned from Complications in Head and Neck Microvascular Reconstructions and Prevention Strategies

Background: Free flap reconstruction in the head and neck region is a complex field in which patient comorbidities, radiation therapy, tumor recurrence, and variability of clinical scenarios make some cases particularly challenging and prone to devastating complications. Despite low free flap failure rates, the impact of flap failure has enormous consequences for the patients. Methods: Acknowledging and predicting high risk intra- and postoperative situations and having planned strategies on how to deal with them can decrease their rate and improve the patient's reconstructive journey. Results: Herein, the authors present 4 examples of significant complications in complex microvascular head and neck cancer reconstruction, encountered for the last 10 years: compression and kinking of the vascular pedicle, lack of planning of external skin coverage in osteoradionecrosis, management of the vessel-depleted neck, and vascular donor site morbidity after fibula harvest. Conclusion: The authors reflect on the causes and propose preventative strategies in each peri-operative stage