Splenic Infarction in Acute Cytomegalovirus and Human Parvovirus Concomitant Infection

We present a case report of a 35-year-old woman who had splenic infarction. She had persistent high fever, systemic joint pain, and abnormal liver function. She was diagnosed with cytomegalovirus and human parvovirus B19 concomitant infection. Her coagulopathy test revealed no abnormal results. She was treated with intravenous ganciclovir for 13 days; consequently, her splenic infarction improved after 7 weeks. As per our knowledge, this is the first case of cytomegalovirus and parvovirus B19 coinfection complicated by splenic infarction. Cytomegalovirus and parvovirus B19 may induce a hypercoagulation state during the acute phase

Effect of Cetuximab and EGFR Small Interfering RNA Combination Treatment in NSCLC Cell Lines with Wild Type EGFR and Use of KRAS as a Possible Biomarker for Treatment Responsiveness

[Background] The epidermal growth factor receptor (EGFR) is a therapeutic target for patients with non-small cell lung cancer (NSCLC). Cetuximab is an anti-EGFR monoclonal antibody that inhibits EGFR signaling and proliferation of colorectal cancer and head and neck cancers. Since only few NSCLC patients benefit from cetuximab therapy, we evaluated a novel combination treatment using cetuximab and EGFR small interfering RNA (siRNA) to strongly suppress EGFR signaling and searched for a biomarker in NSCLC cell lines harboring wild-type EGFR. [Methods] Alterations in EGFR and its downstream genes in five NSCLC cell lines (A549, Lu99, 86-2, Sq19 and Ma10) were assessed through sequencing. The protein expression levels of these molecules were assessed through western blotting. The effect of combination treatment was determined through cell proliferation assay, caspase-3/7 assay, invasion assay, and migration assay. [Results] All cell lines were harboring wild-type EGFR, whereas KRAS, PTEN, TP53 and TP53 were mutated in A549 and Lu99; Lu99 and Sq19; Lu99, 86-2, Sq19 and Ma10; and A549, 86-2, and Sq19 cell lines, respectively. PTEN was not expressed in Sq19, and LKB1 was not expressed in both A549 and Sq19. TP53 was not expressed in both A549 and Lu99. The combination of cetuximab and EGFR siRNA significantly suppressed cell proliferation in 86-2, Sq19 and Ma10, which express wild-type KRAS. It induced apoptosis in A549, 86-2 and Ma10 cells, which express wild type PTEN. The combination treatment had no effect either on cell invasion nor migration in all cell lines. [Conclusion] EGFR targeted therapy using the combination of cetuximab and EGFR siRNA is effective in NSCLC cell lines harboring wild-type EGFR. Wild-type KRAS may act as a potential biomarker for response to combination treatment by the induction of apoptosis in cells with wild-type PTEN

Leukocytapheresis for the treatment of acute exacerbation of idiopathic interstitial pneumonias : a pilot study

Objective : Idiopathic interstitial pneumonias (IIPs) are a group of heterogeneous diffuse parenchymal lung disorders of unknown etiology. An acute exacerbation (AE) is an acute respiratory deterioration that occurs in IIPs. The prognosis of AE of IIPs (AE-IIPs) is extremely severe ; however, no established therapies exist. We aimed to evaluate the efficacy of leukocytapheresis (LCAP) to treat patients with AE-IIPs. Patients and Methods : Six chronic IIPs patients who developed AE were enrolled in this study. We performed LCAP on days 2, 3, 9 and 10 in all six patients. All patients were also treated with high-dose corticosteroids and a continuous administration of low-molecular-weight heparin. We observed 30-day survival after the diagnosis of AE to evaluate the efficacy of LCAP. We also assessed oxygenation, high-resolution computed tomography (HRCT) findings, and certain chemical mediators in the peripheral blood. Results : Five of six patients survived more than 30 days. One patient died of progressive respiratory failure. Oxygenation and HRCT findings tended to improve in all survivors. The serum levels of lactate dehydrogenase, high mobility group box-1, and interleukin-18 were significantly decreased statistically post-LCAP. No severe adverse events occurred. Conclusion :We suggest that LCAP is a safe and effective therapy for treating patients with AE-IIPs

Evaluation of antigen-positive toxin-negative enzyme immunoassay results for the diagnosis of toxigenic Clostridium difficile infection

Clostridium difficile (C. difficile)-associated diarrhea (CDAD) is a challenging nosocomial infectious disease. C. DIFF Quik Chek Complete assay is widely used to detect glutamate dehydrogenase (GDH) antigen and toxin A/B of C. difficile simultaneously. However, the interpretation of GDH positive/toxin negative results is problematic.We performed a retrospective study of patients with GDH positive/toxin negative results to determine the probability of detecting toxigenic C. difficile and its risk factors. Between April 2012 and March 2017, we investigated cultures of fecal specimens followed by toxin detection tests. The clinical histories of patients with and without toxigenic C. difficile were compared using univariate- and multivariate-analyses. In total, 2675 patients were examined using C. Diff Quik Chek Complete assay. Among 356 GDH positive/toxin negative patients, cultures were performed in 220 cases and toxigenic C. difficile was recovered from 139 (63.2%) specimens. Patients with toxigenic C. difficile had significantly lower body mass index than those without. Over half the GDH positive/toxin negative patients were infected with toxigenic C. difficile. Lower BMI was a CDAD risk factor in this patient population. These data can be utilized to initiate isolation and clinical interventions before confirmatory test results are available

Modeling and Optimization of Crop Production and Energy Generation for Economic Profit in an Organic Photovoltaics Integrated Greenhouse

This study aimed to achieve the following two goals; first, developing an inclusive model which simulates solar irradiance to a tilted surface, electric energy generated by organic photovoltaic (OPV) modules on tilted greenhouse roof, light transmittance through multi-span greenhouse roof, solar irradiance available at the crop canopy level in the greenhouse, the crop (lettuce in this study) growth and yield, the energy consumed by greenhouse system for cooling and heating, cost and sales of electric energy and the crop. Finally, the model also determined the total economic profit achieved by the optimization program which computed the coverage ratio of OPV module, the period of shading curtain deployment for crop cultivation before and after summer period during which no crop cultivation occurred. The developed model also enables these analyses by adjusting the property of modeled PV modules, thus making it possible to study both organic (typically semi-transparent and flexible) and inorganic (opaque and solid) PV modules. To optimize the economic profit under the assumed environmental and economic conditions, MIDACO solver (http://www.midaco-solver.com/) was adopted. It can solve mixed integer non-linear programming (MINLP) problem by combining an extended evolutionary Ant Colony Optimization (ACO) algorithm with the Oracle Penalty Method for constrained handling (MIDACO-SOLVER, 2018, http://www.midaco-solver.com/index.php/download). All the simulation and optimization source code were written in Python 2.7. The optimization algorithm was licensed by MIDACO solver. The simulator can serve as a building block for further research about Agrivoltaics with new materials including OPV, and can be further enhanced with additional sub-simulation algorithms by other programmers and researchers interested in this field. The optimization results showed that, in Tucson, a semi-arid climate condition, the overall profitability could be increased by extending the cultivation of the lettuce into the summer, using both the shading curtain and OPV modules while decreasing high solar irradiance transmitted into the greenhouse and air temperature inside. The optimized OPV module coverage ratio was 58.0% when assuming its depreciation was completed, cell efficiency was 4.3%, visible light transmittance was 30%, the overall temperature coefficient was 0.02%, and the selling price of generated electricity was same as the purchase price, which was around 0.11 to 0.12 USD/kWh in Arizona. This indicated that the profit of lettuce cultivated in summer exceeded the cultivation cost in summer (labor cost and cooling cost) with a combination of PV module and shading curtain with a simple strategy that changes its deployment time each month according to the monthly average DLI: Thus, high-tech equipment for curtain control may not be required. At the optimal 58.0% OPV deployment rate, the amount of electricity generated per unit area basis was 47.7 kWh/m2 (satisfying 45.7% of the electricity consumption by greenhouse cooling, which was assumed to be the only factor consuming electricity) and the lettuce crop yield was 57.9 kg/m2, with an economic profit generated at 460.5 USD/m2. The simulation code developed also allows user or grower to evaluate alternative OPV coverage ratios and shade curtain deployments providing results on potential electricity generation, crop yields and economic profits. Although the profit made by electricity production with the current OPV film was much less than that of lettuce production, and further analyses should be conducted replacing various assumed values with available real data. The simulation result suggested some shading curtain and lettuce cultivation strategies in arid and semi-arid regions which had a potential to improve the profitability when OPVs integrated with a greenhouse system