Insight into highly conserved H1 subtype-specific epitopes in influenza virus hemagglutinin

Influenza viruses continuously undergo antigenic changes with gradual accumulation of mutations in hemagglutinin (HA) that is a major determinant in subtype specificity. The identification of conserved epitopes within specific HA subtypes gives an important clue for developing new vaccines and diagnostics. We produced and characterized nine monoclonal antibodies that showed significant neutralizing activities against H1 subtype influenza viruses, and determined the complex structure of HA derived from a 2009 pandemic virus A/Korea/01/2009 (KR01) and the Fab fragment from H1-specific monoclonal antibody GC0587. The overall structure of the complex was essentially identical to the previously determined KR01 HA-Fab0757 complex structure. Both Fab0587 and Fab0757 recognize readily accessible head regions of HA, revealing broadly shared and conserved antigenic determinants among H1 subtypes. The beta-strands constituted by Ser110-Glu115 and Lys169-Lys170 form H1 epitopes with distinct conformations from those of H1 and H3 HA sites. In particular, Glu112, Glu115, Lys169, and Lys171 that are highly conserved among H1 subtype HAs have close contacts with HCDR3 and LCDR3. The differences between Fab0587 and Fab0757 complexes reside mainly in HCDR3 and LCDR3, providing distinct antigenic determinants specific for 1918 pdm influenza strain. Our results demonstrate a potential key neutralizing epitope important for H1 subtype specificity in influenza virus

Initial serum sodium concentration determines the decrease in sodium level after terlipressin administration in patients with liver cirrhosis

BACKGROUND: Terlipressin, as a prodrug of vasopressin, has agonistic effects on the V1 receptor and partial agonistic effects on renal vasopressin V2 receptors. However, its effects on serum sodium concentration are controversial. METHODS: This study retrospectively investigated 127 patients with liver cirrhosis to examine the incidence and risk factors for the decrease in serum sodium level following terlipressin administration. RESULTS: Terlipressin was prescribed for bleeding control (99) and management of hepatorenal syndrome (28). Serum sodium level decreased from 134.0 ± 6.5 mmol/L to 130.4 ± 6.2 mmol/L during or after terlipressin treatment (P < 0.001) in all patients. In 45 patients (35.4%), the serum sodium concentration decreased by > 5 mmol/L, in 29 patients (22.8%); by 5–10 mmol/L; and in 16 patients (12.6%), by > 10 mmol/L. Five patients in the latter group showed neurological manifestations. In the univariate analysis, several factors including age, purpose of use, serum creatinine, and Model for End-Stage Liver Disease score, representing liver function, were significantly associated with the decrease in serum sodium after terlipressin administration. However, a multivariate analysis revealed that only initial sodium level was the most powerful predictor of terlipressin-induced reduction in serum sodium. CONCLUSION: An acute reduction in serum sodium concentration was not uncommon during terlipressin treatment, and the baseline serum sodium level was closely related to the reduction in serum sodium concentration

Nanomorphology dependence of the environmental stability of organic solar cells

Previous studies have reported contradictory effects of small-molecule acceptors on the environmental stability of polymer:small-molecule blends, with one showing that a small-molecule acceptor stabilizes and another showing that it destabilizes the polymer donor. In this work, to investigate the origin of these contradictory results, the effects of the nanomorphologies of small-molecule acceptors on the environmental stability of polymer:small-molecule blends are demonstrated. Investigations on the environmental stabilities of polymer:fullerene blends of poly[[4, 8-bis[(2-ethylhexyl)oxy]benzo[1, 2-b:4, 5-b′]dithiophene-2, 6-diyl][3-fluoro-2-[(2-ethylhexyl)carbonyl]thieno[3, 4-b]thiophenediyl]] (PTB7):phenyl-C₆₁-butyric acid methyl ester (PCBM) with contrasting nanomorphologies of PCBM reveal that dispersed PCBM in a mixed phase is the critical factor that causes triplet-mediated singlet oxygen generation and, hence, the severe photooxidation of PTB7, whereas an aggregated PCBM phase stabilizes PTB7 by reducing the formation of PTB7 triplet excitons. In addition, the photooxidation of PTB7 substantially degrades hole transport in the PTB7:PCBM blends by destroying the crystalline PTB7 phases within the films; this effect is strongly correlated with the efficiency losses of the PTB7:PCBM organic solar cells. These conclusions are also extended to polymer:nonfullerene blends of PTB7:ITIC and PTB7:Y6, thereby confirming the generality of this phenomenon for polymer:small-molecule organic solar cells

Surgical Treatment of Adult Degenerative Scoliosis

The rapid increase of elderly population has resulted in increased prevalence of adult scoliosis. Adult scoliosis is divided into adult idiopathic scoliosis and adult degenerative scoliosis. These two types of scoliosis vary in patient age, curve pattern and clinical symptoms, which necessitate different surgical indications and options. Back pain and deformity are major indications for surgery in adult idiopathic scoliosis, whereas radiating pain to the legs due to foraminal stenosis is what often requires surgery in adult degenerative scoliosis. When selecting a surgical method, major symptoms and underlying medical diseases should be carefully evaluated, not only to relieve symptoms but also to minimize postoperative complications. Surgical options for adult degenerative scoliosis include: decompression alone; decompression and limited short fusion; and decompression coupled with long fusion and correction of deformity. Decompression and limited short fusion can be applied to patients with a small Cobb's angle and normal sagittal imbalance. For those with a large Cobb's angle and positive sagittal imbalance, long fusion with correction of deformity is required. When long fusion is applied, a careful decision regarding the extent of fusion level should be made when selecting L5 or S1 as the distal fusion level and T10 or the thoracolumbar junction as the proximal fusion level. For the fusion extending to the sacrum, restoration of sagittal balance and rigid fixation with additional iliac screws should be considered. Any surgical procedures for adult degenerative scoliosis are known to have relatively high occurrences of complications; therefore, risks and benefits should be meticulously considered before selecting a surgical procedure

Nest entry shape change may cause nest abandonment in urban cavity-nesting species: a case study of the Tree Sparrow Passer montanus

The threat of predation is the main cause of bird nest abandonment, with such behaviour imposing considerable energetic costs on breeding birds. However, for several species, nest abandonment can be a less costly alternative to complete brood failure. In this study, we examined nest abandonment among Eurasian Tree Sparrows (Passer montanus) by surveying 71 Tree Sparrow nests with various types of entry holes and conducted artificially manipulating some of the entrance shapes. We found that nest abandonment was caused by changes to the nest entry shape in seven cases and by human interference in two cases. Nest abandonments occurred throughout the breeding season, and breeding pairs attempted to breed again immediately after nest abandonment. The results of the artificial nest entry shape manipulation experiment showed that nine of twelve nests (75.0%) were abandoned where the nest entrance holes were widened, and six of eleven nests (54.5%) were abandoned where the nest entrance holes were narrowed. However, none of the nests were abandoned where the entry shape was unchanged. Thus, nest abandonment by Tree Sparrows is correlated with nest entry shape manipulation and is more likely to occur when the energy cost of breeding again is less than that of abandoning the nest

Vascular Injury Associated with Blunt Trauma without Dislocation of the Knee

Failure to recognize popliteal artery injury and restore vessel continuity of flow after blunt trauma is a major cause of lower extremity amputation and morbidity. A high index of suspicion and early recognition of the injury are paramount for limb salvage. We experienced a rare case of poplitial artery occlusion with the presence of arterial pulses due to collateral circulation after blunt trauma. Expeditious revascularization was achieved by using posterior approach, allowing two surgical teams to work simultaneously. This case illustrates that, even in the absence of knee dislocation, surgeons must always consider the possibility of a popliteal artery damage whenever a blunt trauma near the knee

A Surgically Treated Case of Chronic Necrotizing Aspergillosis with Pleural Invasion

Aspergillus is a ubiquitous fungus and can cause many levels of disease severity. Chronic necrotizing aspergillosis is a rare disease and few cases have been reported in Korea. We experienced a case of pleural aspergillosis that was treated successfully with medical and surgical interventions. The 52-year-old man who was diagnosed with chronic necrotizing pulmonary aspergillosis underwent surgical treatment including a lobectomy, decortication, and myoplasty. The patient was also medically treated with amphotericin B followed by voriconazole. Pleural irrigation with amphotericin B was also performed. A multi-dimensional approach should be considered for treating chronic necrotizing pulmonary aspergillosis