Emergence of surfactant-​free micelles from ternary solutions

Curious effects ranging from enzyme activity to anomalies in evapn. rates that have been known for over fifty years suggest the existence and thermodn. stability of surfactant-free micelles. Only recently, joint X-ray, light and neutron scattering expts. have demonstrated that aggregates and bulk pseudo-phases coexist in presumably normal solns., in which a water insol. component is solubilized in a certain domain of concn. of a hydrotrope component like ethanol. Nevertheless, nothing is known about the mol.-level shape and structure of such aggregates. In this work we characterize mixts. of octanol, ethanol, and water by mol. dynamics simulations. For compns. in the "pre-ouzo" region (close to the single phase stability limit) we observe micelle-like aggregates that are clearly distinct from simple crit. d. fluctuations. We define an ethanol partition in the pseudo-phase from an integral of the van der Waals dispersion energy term. From this partition, octanol-rich aggregates swollen with ethanol appear with an emerging interface. Ethanol is present in the water pseudo-phase with an exponential decay similar to the one predicted by Marcelja and Radic forty years ago

Genes and environment in Graves' hyperthyroidism. A prospective cohort study

De concentratie van bepaalde antistoffen in het bloed (TBII) is een maat voor de ernst van een te snel werkende schildklier. Dit is een van de conclusies uit het onderzoek van Xander Vos. Vos deed een studie naar de invloed van bepaalde genen en omgevingsfactoren op de ernst en het klinisch beloop van Graves’ hyperthyreoïdie (GH). GH is een auto-immuunziekte waarbij de schildklier aangezet wordt tot overmatige productie van schildklierhormonen. Vos toont aan dat Graves-patiënten die uit families komen waar veel auto-immuunziekten van de schildklier voorkomen met een hoge familiaire belasting voor auto-immuun schildklierziekten, de ziekte op eerdere leeftijd ontwikkelen. De invloed van genetische factoren lijkt groter te zijn bij mannen dan bij vrouwen. Hierbij is de invloed van omgevingsfactoren kleiner bij patiënten met een grotere genetische vatbaarheid voor GH. Vos ontwikkelde ook een model dat de kans op terugkeer van de ziekte voor het begin van de behandeling berekent. Dit model kan relevant zijn voor de behandeling van nieuwe patiënten met GH

Variation in phenotypic appearance of Graves' disease: effect of genetic anticipation and duration of complaints

Objective: Both genetic and environmental factors contribute to susceptibility of Graves' disease. In this study. we evaluated whether the duration of symptoms or a positive family history of autoimmune thyroid disease (AITD) are related to specific phenotypes in patients with a first episode of Graves' hyperthyroidism (GH). Design: Cross-sectional multicentre observational study. Patients: Two hundred and sixty-three consecutive Untreated patients (mean age (+/- S.D.) 42.6 +/- 12.4 years: range 16-79 years) with a first episode of GH were included. Biochemical and clinical severity of GH was evaluated. Participants were asked to complete questionnaires about environmental factors (smoking behavior, use of estrogens, stress etc.), the duration of symptoms (interval between start of symptoms and date of referral) and family history For AITD. We ascertained the autoimmune nature of thyroid disease in affected relatives. Family history scores (FHS: high score indicating it close genetic relationship and/or a large number of affected relatives) were calculated for patients with a positive family history for AITD. Results: The peak incidence for the diagnosis of GH was 2-3 months after onset of symptoms (32%, of patients). Duration of symptoms was negatively associated with age (P for trend=0.04). A positive family history for AITD was present in 42.6% of patients. Patients with the highest FHS were more often male (P=0.01) while age at onset was lower (P=0.02) compared to patients with a lower FHS. Among patient groups Mill different HIS. no differences were found in exposure to environmental factors. nor in clinical or biochemical severity of hyperthyroidism. Conclusion: Our study does not Support the hypothesis that a short duration of thyrotoxic symptoms Until diagnosis is related to more severe hyperthyroidism in Graves' disease. WC have Found Supporting evidence for the existence of genetic anticipation in Graves' disease by means of a lower age of onset in the group with the highest FH

Frequency and characteristics of TBII-seronegative patients in a population with untreated Graves' hyperthyroidism: a prospective study

Objective It is claimed that second generation thyrotropin-binding inhibitory immunoglobulin (TBII) assays have a very high sensitivity for the diagnosis of Graves' hyperthyroidism (GH). However, studies evaluating the accuracy of TBII have been retrospective in nature and/or GH had not been diagnosed independently of TBII. The aim of the present study, therefore, was to prospectively evaluate the frequency and characteristics of TBII-seronegative patients in a population of untreated GH diagnosed independent of serum TBII. Design Prospective multicentre observational study. Patients A total of 259 consecutive untreated patients with a first episode of GH, diagnosed independent of serum TBII. TBII levels were measured by second generation assay and correlated to thyroid function, clinical characteristics and exposure to environmental factors. Results Serum TBII was positive in 245 (94.6%) patients and negative ( <2 IU/l) in 14 (5.4%) patients. TBII-seronegative patients had lower fT4 (median 42.5 vs. 53.9 pmol/l, P = 0.02), T3 (median 3.55 vs. 4.90 nmol/l, P <0.01) and fT3-index (median 4.30 vs. 6.27, P <0.01) compared to TBII-seropositive patients. None of the TBII-seronegative patients had TSH-receptor activating mutations, Graves' orbitopathy or pretibial myxedema. Serum TBII was positively correlated to free T3 (fT3)-index and free T4 (fT4)-index (P <0.01), goitre size (P <0.01) and the prevalence of Graves' orbitopathy (P <0.01). There were no significant differences between TBII-seropositive and TBII-seronegative patients in environmental factors. Conclusion The prevalence of TBII-seronegativity in untreated patients with GH is 5.4% using a second generation assay. TBII-seronegative patients have biochemically less severe thyrotoxicosis and no Graves' orbitopathy. TBII-seronegative and TBII-seropositive patients apparently belong to the same population of GH, albeit the severity of the autoimmune attack is less in TBII-seronegative patient

Predicting the Risk of Recurrence Before the Start of Antithyroid Drug Therapy in Patients With Graves' Hyperthyroidism

Genotyping increases the accuracy of a clinical score (based on pretreatment age, goiter size, FT4, TBII) for predicting recurrence of Graves' hyperthyroidism after a course of antithyroid drugs: a prospective stud

Pathology image exchange : The Dutch digital pathology platform for exchange of whole-slide images for efficient teleconsultation, telerevision, and virtual expert panels

Among the many uses of digital pathology, remote consultation, remote revision, and virtual slide panels may be the most important ones. This requires basic slide scanner infrastructure in participating laboratories to produce whole-slide images. More importantly, a software platform is needed for exchange of these images and functionality to support the processes around discussing and reporting on these images without breaching patient privacy. This poses high demands on the setup of such a platform, given the inherent complexity of the handling of digital pathology images. In this article, we describe the setup and validation of the Pathology Image Exchange project, which aimed to create a vendor-independent platform for exchange of whole-slide images between Dutch pathology laboratories to facilitate efficient teleconsultation, telerevision, and virtual slide panels. Pathology Image Exchange was released in April 2018 after technical validation, and a first successful validation in real life has been performed for hematopathology cases