Temporal differences of onset between primary skin lesions and regional lymph node lesions for tularemia in Japan: a clinicopathologic and immunohistochemical study of 19 skin cases and 54 lymph node cases

For tularemia, a zoonosis caused by the gram-negative coccobacillus Francisella tularensis, research of the relation between skin lesions and lymph node lesions has not been reported in the literature. This report describes skin lesions and lymph node lesions and their mutual relation over time for tularemia in Japan. Around the second day after infection (DAI), a subcutaneous abscess was observed (abscess form). Hand and finger skin ulcers formed during the second to the fourth week. Subcutaneous and dermal granulomas were observed with adjacent monocytoid B lymphocytes (MBLs) (abscess–granulomatous form). From the sixth week, large granulomas with central homogeneous lesions emerged diffusely (granulomatous form). On 2–14 DAI, F. tularensis antigen in skin lesions was detected in abscesses. During 7–12 DAI, abscesses with adjacent MBLs appeared without epithelioid granuloma (abscess form) in regional lymph nodes. During the second to fifth week, granulomas appeared with necrosis (abscess–granulomatous form). After the sixth week, large granulomas with a central homogeneous lesion (granulomatous form) appeared. F. tularensis antigen in lymph node lesions was observed in the abscess on 7–92 DAI. Apparently, F. tularensis penetrates the finger skin immediately after contact with infected hares. Subsequently, the primary lesion gradually transfers from skin to regional lymph nodes. The regional lymph node lesions induced by skin lesion are designated as dermatopathic lymphadenopathy. This study revealed temporal differences of onset among the skin and lymph node lesions

Number of teeth and myocardial infarction and stroke among elderly never smokers

<p>Abstract</p> <p>Background</p> <p>In most previous studies the association between number of teeth and cardiovascular diseases has been found to be stronger among younger age groups than in older age groups, which indicates that age may modify the association between number of teeth and cardiovascular diseases.</p> <p>We investigated the association between tooth loss and atherosclerotic vascular diseases such as myocardial infarction and stroke in a homogeneous elderly population.</p> <p>The study population was comprised of a subpopulation of 392 community-living elderly people who participated in the population-based Kuopio 75+ study. The data were collected through an interview, a structured clinical health examination and from patient records. The main outcome measures were a history of diagnosed myocardial infarction and diagnosed ischemic stroke. Prevalence proportion ratios (PPR) were estimated using generalised linear models.</p> <p>Results</p> <p>Edentate subjects had a weakly, statistically non-significantly increased likelihood of a history of myocardial infarction and ischemic stroke compared with dentate subjects. Those with a large number of teeth had a slightly, but not statistically significantly increased likelihood of a history of myocardial infarction and ischemic stroke compared with those with a small number of teeth.</p> <p>Conclusion</p> <p>These data did not show evidence that total or partial tooth loss would be associated with atherosclerotic vascular diseases such as myocardial infarction and ischemic stroke among an elderly population aged 75 years or older.</p

An Agent-Based Model of a Hepatic Inflammatory Response to Salmonella: A Computational Study under a Large Set of Experimental Data

Citation: Shi, Z. Z., Chapes, S. K., Ben-Arieh, D., & Wu, C. H. (2016). An Agent-Based Model of a Hepatic Inflammatory Response to Salmonella: A Computational Study under a Large Set of Experimental Data. Plos One, 11(8), 39. doi:10.1371/journal.pone.0161131We present an agent-based model (ABM) to simulate a hepatic inflammatory response (HIR) in a mouse infected by Salmonella that sometimes progressed to problematic proportions, known as "sepsis". Based on over 200 published studies, this ABM describes interactions among 21 cells or cytokines and incorporates 226 experimental data sets and/or data estimates from those reports to simulate a mouse HIR in silico. Our simulated results reproduced dynamic patterns of HIR reported in the literature. As shown in vivo, our model also demonstrated that sepsis was highly related to the initial Salmonella dose and the presence of components of the adaptive immune system. We determined that high mobility group box-1, C-reactive protein, and the interleukin-10: tumor necrosis factor-a ratio, and CD4+ T cell: CD8+ T cell ratio, all recognized as biomarkers during HIR, significantly correlated with outcomes of HIR. During therapy-directed silico simulations, our results demonstrated that anti-agent intervention impacted the survival rates of septic individuals in a time-dependent manner. By specifying the infected species, source of infection, and site of infection, this ABM enabled us to reproduce the kinetics of several essential indicators during a HIR, observe distinct dynamic patterns that are manifested during HIR, and allowed us to test proposed therapy-directed treatments. Although limitation still exists, this ABM is a step forward because it links underlying biological processes to computational simulation and was validated through a series of comparisons between the simulated results and experimental studies

Tilintarkastuksen laatu yritysjohdon näkökulmasta

Tilintarkastuksen laatua on alettu arvioida entistä tarkemmin 2000-luvun alun kirjanpitoskandaalien ja niistä seuranneiden konkurssien jälkeen. Tilintarkastusyhtiöt tarjoavat yleensä samanlaisia tuotteita, jolloin kilpailijoista voidaan erottua laatutekijöillä. Vaikka tilintarkastuksen laatua on selitetty tutkimuksissa useiden eri tekijöiden avulla, tutkimukset eivät ole ottaneet kuitenkaan kantaa latuun tilintarkastusasiakkaan näkökulmasta. Sitä selvitetään tässä tutkimuksessa yrittäjien näkemysten ja kokemusten pohjalta. Tutkimukseni rajoittuu käsittelemään pienten ja keskisuurten yrittäjien näkökulmaa. Olen kiinnostunut yrittäjien omista näkemyksistä, jolloin lähestymistavaksi soveltuu luontevasti laadullinen teemahaastatteluun perustuva tutkimus. Opinnäytetyössä selvitettiin yrittäjien kokemuksia ja näkemyksiä tilintarkastuksen laadusta. Haastattelin neljää kokenutta pk-yrittäjää, jotka edustivat eri toimialoja. Aineisto analysoitiin laadullisen sisällönanalyysin avulla, jossa keskeisimmäksi teemaksi muodostui tilintarkastajan ammattitaito. Muut teemat olivat: näkemys tilintarkastuksesta, tilintarkastusyhteisön koko ja maine, tilintarkastusprosessi ja tilintarkastuksen lisäarvo. Tulosten perusteella voidaan päätellä yritysjohdon kokevan tilintarkastuksen laadun kokonaisuutena hyväksi. Yrittäjien mielestä tilintarkastuksen tärkein tehtävä on antaa varmistus sille, että yrityksessä asiat on tehty rehellisesti ja lainmukaisesti. Osallistujien mielestä tilintarkastajan ammattitaidolla on merkittävä vaikutus tilintarkastuksen lopputulokseen. Tilintarkastajan ammattitaito korostui kaikissa tilintarkastusprosessin vaiheissa, mutta etenkin niissä tilanteissa, joissa tilintarkastajalta kaivataan konkreettisia vihjeitä yritystoimintaan. Tutkimustulosten mukaan myös tilintarkastajien ammattikunnan olisi syytä miettiä omia toimintaperiaatteitaan pystyäkseen paremmin ottamaan pk-yritysten erityspiirteet huomioon. Yrittäjien näkemykset ovat samansuuntaisia tilintarkastuksen laadusta kuin on aikaisemmin havaittu muissa tilintarkastuksen laatua käsitelleissä tutkimuksissa