Bleeding pancreatic pseudoaneurysms : management by angioembolization combined with therapeutic endoscopy

Bleeding pancreatic pseudocysts (PPCs) are a rare but lethal complication of pancreatitis. Transcatheter arterial embolization (TAE) is the first-line treatment of acute hemorrhage, but consensus on the definitive management of bleeding PPCs is lacking. The aim of this study was to evaluate the safety and efficacy of the combination of TAE and therapeutic endoscopy in the treatment of bleeding PPCs. Patients with acute or chronic pancreatitis treated for bleeding PPCs in Helsinki University Hospital during 2004-2014 comprised the study group. Inpatients with acute necrotizing pancreatitis were excluded. Patients underwent TAE as the primary treatment to control the bleeding. Therapeutic endoscopy performed on an outpatient visit after TAE allowed the definitive treatment of PPCs. A total of 58 patients underwent TAE. Re-bleeding rate (<30 days) was 15.5 %, necessitating re-embolization on seven and surgical intervention on two patients. Overall, TAE success rate was 96.6 %. Mortality rate (<30 days) was 3.4 %. Of the 58, 47 patients were followed up for their PPCs in our unit. PPCs resolved spontaneously in 13 (27.1 %). The remaining 34 had an endoscopic treatment attempt with endoscopic draining performed on 32 and unsuccessful cannulation on two (5.9 %). Of the 32 patients with initially successful endoscopy, 7 (21.9 %) needed an additional drainage procedure (six non-surgical and one surgical). Overall success rate of non-surgical management was 91.5 %. Post-endoscopy mortality rate (<30 days) was 2.9 %. Our follow-up continued for 15 (1-75) months. By the time of data retrieval, 35 of 58 patients had died with alcohol liver disease being the most common cause of death. Five-year survival estimate was 63 %. Bleeding pancreatic pseudoaneurysms require non-surgical management. We need more data on the optimal timing of therapeutic endoscopy and on the role of empirical embolizations.Peer reviewe

Exchange of functional domains between a bacterial conjugative relaxase and the integrase of the human adeno-associated virus

Endonucleases of the HUH family are specialized in processing single-stranded DNA in a variety of evolutionarily highly conserved biological processes related to mobile genetic elements. They share a structurally defined catalytic domain for site-specific nicking and strand-transfer reactions, which is often linked to the activities of additional functional domains, contributing to their overall versatility. To assess if these HUH domains could be interchanged, we created a chimeric protein from two distantly related HUH endonucleases, containing the N-terminal HUH domain of the bacterial conjugative relaxase TrwC and the C-terminal DNA helicase domain of the human adeno-associated virus (AAV) replicase and site-specific integrase. The purified chimeric protein retained oligomerization properties and DNA helicase activities similar to Rep68, while its DNA binding specificity and cleaving-joining activity at oriT was similar to TrwC. Interestingly, the chimeric protein could catalyse site-specific integration in bacteria with an efficiency comparable to that of TrwC, while the HUH domain of TrwC alone was unable to catalyze this reaction, implying that the Rep68 C-terminal helicase domain is complementing the TrwC HUH domain to achieve site-specific integration into TrwC targets in bacteria. Our results illustrate how HUH domains could have acquired through evolution other domains in order to attain new roles, contributing to the functional flexibility observed in this protein superfamily.This work was supported by the Medical Research Council (MRC) grant MR/N022890/1 to EH and grant 1001764 to RML; National Institutes of Health (NIH) grant RO1-GM09285 to CRE; Spanish Ministry of Economy and competitiveness (MINECO) grant BIO2013-46414-P to ML and AFM is supported by a Doc.Mobility fellowship from the Swiss National Science Foundation. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript

A STUDY OF MISSA ARIRANG BY COOL-JAE HUH: ELEMENTS OF KOREAN TRADITIONAL FOLK MUSIC

This document focuses on a setting of the Ordinary of the Mass, Missa Arirang, composed by Cool-Jae Huh (b. 1965). Huh is one of South Korea's most prolific and innovative composers. He is especially known for his use of Korean folk songs in Western musical settings. In the Missa Arirang, Huh employs six traditional folk songs, called Min-yo from different provinces. The musical idioms of each type of folk song vary considerably. This study explores general information about Korean folk songs and the specific use of elements of Korean folk music, such as modes, rhythmic patterns, and unique ornamentations, which appear in this piece. Arirang, the title of the Mass, is the most famous and celebrated folk song in the history of Korea. It has served as the basis for pieces in almost all musical genres. This document investigates Arirang's significance in understanding Korean culture, and introduces the four versions of Arirang adopted in Huh's work. Missa Arirang is not only a compelling choral composition, containing Korean traditional musical aspects, but also a beneficial resource to introduce traditional Korean music to non-Korean musicians. In addition, the piece delivers the message of "peace" through various musical contents in the composition

Placing the Displaced: Translating the North Korean Characters in Sister Mok-rahn for an American Audience

No two languages are more different from each other than American English and Korean spoken in the Democratic People’s Republic of Korea (North Korea). It goes the same for their speakers. Average theatergoers in New York in 2017 share little with the average North Koreans or North Korean refugees scattered around the world. So how should a translator present North Korean characters for an American audience? This paper discusses dramaturgical issues surrounding translating the North Korean characters in "Sister Mok-rahn" for an American audience

Oral History Interview: Fred Vinson and Ruby Vinson

The interview begins with Mrs. Vinson covering her childhood chores and teaching experiences. Mr. Vinson then joins in relating his own experiences as a teacher. He and Mrs. Vinson then relate their life in the country to their work. Teachers pay, community dances, gun fighting, church and socials are among the topics discussed.https://mds.marshall.edu/oral_history/1148/thumbnail.jp

Telling it like it is: an interpretative phenomenological analysis of multiple family group intervention for young people at risk of reoffending

Interventions aimed at reducing youth offending have tended to focus on either parents/carers or young people. In recent years, literature has highlighted the impact ofthe family on the emergence of offending behaviour in adolescence (Loeber & Stouthamer-Loeber, 1987). Evidence suggests that family interventions can be more effective but harder to implement successfully (Fadden, 1997). Research has indicated that working with both young people and their parents within a multiple family group (MFG) setting may be more effective for 'hard to reach' groups (McKay, etal., 1995).In the present study, a qualitative methodology was used to explore the experiences of five families and two facilitators who had attended a multiple family group (MFG) for young people at risk ofreoffending. Semi-stuctured interviews were analysed using Interpretative Phenomenological Analysis (IPA). The aim was to provide an in-depth account of the way in which these individuals made sense ofthe group process and the impact they perceived it to have on their wider lives.Six super-ordinate themes were identified. The first related to the struggles families were experiencing prior to the MFG and the way in which this impacted on their ability to access services. The second related to participants' negative expectations of MFG intervention, largely based on previous experience ofprofessional input. The third concerned participants' overall positive perceptions oftheir involvement in the MFG. The fourth theme related to significant characteristics ofthe MFG that were thought to facilitate engagement. These were characterised in terms of a group 'ethos'. The fifth theme encompassed the overall impact that participants felt the MFG had on their own lives. The final theme related to the limitations ofthe MFG interventionOverall, families responded well to MFG intervention and found it to have a positive impact in terms of their relationships with one another. This study has highlighted some of the critical factors that result in these families being labelled as 'hard to reach' and has identified some elements within service provision that may encourage them to engage. The need to offer a follow-up service was also identified

Evolving clinical profile of IL-1β, IL-10 and CTLA-4 gene in rheumatoid factor positive Caucasian population

Rheumatoid arthritis (RA), a systemic autoimmune condition, causes joint damage and sometimes extra-articular lesions (cutaneous vasculitis, neuropathy, Felty’s syndrome, pericarditis, intersticial lung disease) that may be life threatening. The reason why extra-articular features will develop in rare RA patients is unknown. Our study was aimed to find any disease correlation with respect to a few genetic loci implicated in rheumatoid arthritis. In our study no significant association was observed for Il-1β and IL-10. However CTLA-4 showed polymorphism in RA and controls. In our earlier article we reported polymorphism of HLA-DRB1 in Caucasian population. The study was conducted on 60 patients, where 30 were control and 30 were diseased. All the patients selected for the study were Rf (rheumatoid factor) positive. Therefore the studies need to be conducted on larger group of patients, so that the association can be verified in Caucasian population (Indian scenario)

Cationic poly(amidoamine) promotes cytosolic delivery of bovine RNase A in melanoma cells, while maintaining its cellular toxicity

Ribonucleases are known to cleave ribonucleic acids, inducing cell death. RNase A, a member of the ribonuclease family, generally displayed poor in vitro activity. This has been attributed to factors such as low intracellular delivery. Poly(amidoamine)s have been used to promote the translocation of non-permeant proteins to the cytosol. Our objective was to demonstrate that poly(amidoamine)s could potentially promote the delivery of RNase A to selected cell line. Interactions of three cationic poly(amidoamine)s (P1, P2 and ISA1) with wild-type bovine RNase A were investigated using gel retardation assays, DLS and microcalorimetry. Although the polymers and the protein are essentially cationic at physiological pH, complexation between the PAAs and RNase A was observed. The high sensitivity differential scanning calorimetry (HSDSC) thermograms demonstrated that the thermal stability of the protein was reduced when complexed with ISA1 (Tmax decreased by 6.5 °C) but was not affected by P1 and P2. All the polymers displayed low cytotoxicity towards non-cancerous cells (IC50 > 3.5 mg mL?1). While RNase A alone was not toxic to mouse melanoma cells (B16F1), P1 was able to promote cytosolic delivery of biologically active RNase A, increasing cell death (IC50 = 0.09 mg mL?1)