111 research outputs found

    Hospitalized Pediatric Parainfluenza Virus Infections in a Medical Center

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    Background/PurposeParainfluenza viruses (PIVs) are common pathogens in respiratory tract infections. The aims of this study were to determine the clinical presentation of PIV infections in hospitalized children and to identify particular clinical indications that may effectively distinguish between different PIV serotypes.MethodsA retrospective review of data from children hospitalized with PIV infections at the Mackay Memory Hospital in Taipei between January 2005 and December 2007 was undertaken. Symptoms, signs, laboratory findings and seasonal variations between different types of PIV (serotypes 1, 2 and 3) were compared.ResultsA total of 206 patients [119 (57.8%) boys and 87 (42.2%) girls] were enrolled in the study. Seventy-four (35.9%) patients were infected with PIV serotype 1, 25 (12.1%) with serotype 2 and 107 (51.9%) with serotype 3. The most common clinical presentations were fever (81.1%), cough (66.0%), rhinorrhea (44.2%) and hoarseness (22.3%); 4.9% of the infected children also had skin rashes. No significant differences were found in average white blood cell counts and C-reactive protein levels between the three serotypes. PIV serotype 1 infections were discernible throughout the year; serotype 2 tended to cluster in the late summer and autumn of 2005 and 2007; and serotype 3 was more common in the spring and early summer.ConclusionThe clinical presentation of PIV infection in hospitalized children ranges from upper respiratory tract infection to croup, bronchiolitis and viral bronchopneumonia, with the different types of PIV infections giving rise to similar symptoms. The seasonal distribution of the different serotypes is, nevertheless, quite distinct

    Factors for poor prognosis of neonatal bacterial meningitis in a medical center in Northern Taiwan

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    BackgroundBacterial meningitis has long been a severe infectious disease in neonates, as well as a leading cause of adverse outcomes. We designed this study to know the factors for poor prognosis in neonatal bacterial meningitis.MethodsWe enrolled children aged less than 1 month who were admitted to Mackay Memorial Hospital from 1984 to 2008 and had culture-proven bacterial meningitis. The laboratory data and children’s clinical features were recorded. The patients’ outcomes were divided into four groups: death, having sequelae, complete recovery, and loss to follow-up. Patients with the outcomes of death and having sequelae were regarded as having a poor prognosis. Those who were lost to follow-up were excluded from the analysis of outcome. Multivariate analyses were performed to find the risk factors for poor prognosis.ResultsOne hundred fifty-six neonates fulfilled the inclusion criteria. Among these, 96 were boys (61.5%) and 102 (65.4%) had concomitant bacteremia. Group B streptococci (39.1%) and Escherichia coli (20.1%) were the two leading pathogens. Excluding those who were lost to follow-up (4.5%), 22 of 149 patients (14.8%) died, 36 (24.2%) had sequelae, and 91 (61.1%) recovered completely. Cerebrospinal fluid (CSF) protein more than 500 mg/dL at admission {odds ratio (OR): 171.18 [95% confidence interval (CI): 25.6–1000]}, predisposition to congenital heart disease [OR: 48.96 (95% CI: 6.06–395.64)], hearing impairment found during hospitalization [OR: 23.40 (95% CI: 3.62–151.25)], and seizure at admission or during hospitalization [OR: 10.10 (95% CI: 2.11–48.32)] were the factors predicting poor prognosis.ConclusionIn this 25-year study of newborns with bacterial meningitis, approximately one-seventh of the patients died, while two-fifths had sequelae. Nearly two-thirds of these had concomitant bacteremia. Group B streptococci and E. coli remained the two leading pathogens throughout the study period. Several factors for poor prognosis in newborns with culture-proven bacterial meningitis were found: high CSF protein concentration, congenital heart disease, hearing impairment, and seizure

    Analysis of clinical outcomes in pediatric bacterial meningitis focusing on patients without cerebrospinal fluid pleocytosis

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    BackgroundCerebrospinal fluid (CSF) cell count and biochemical examinations and cultures form the basis for the diagnosis of bacterial meningitis. However, some patients do not have typical findings and are at a higher risk of being missed or having delayed treatment. To better understand the correlation between CSF results and outcomes, we evaluated CSF data focusing on the patients with atypical findings.MethodsThis study enrolled CSF culture-proven bacterial meningitis patients aged from 1 month to 18 years in a medical center. The patients were divided into “normal” and “abnormal” groups for each laboratory result and in combination. The correlations between the laboratory results and the outcomes were analyzed.ResultsA total of 175 children with confirmed bacterial meningitis were enrolled. In CSF examinations, 16.2% of patients had normal white blood cell counts, 29.5% had normal glucose levels, 24.5% had normal protein levels, 10.2% had normal results in two items, and 8.6% had normal results in all three items. In logistic regression analysis, a normal CSF leukocyte count and increased CSF protein level were related to poor outcomes. Patients with meningitis caused by Streptococcus pneumoniae and hyponatremia were at a higher risk of mortality and the development of sequelae.ConclusionsIn children with bacterial meningitis, nontypical CSF findings and, in particular, normal CSF leukocyte count and increased protein level may indicate a worse prognosis

    Громадянське виховання підлітків у контексті педагогічної спадщини А. Б. Рєзніка

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    У статті висвітлено основні положення педагогічної спадщини видатного педагога Кіровоградщини А. Б. Рєзніка в царині громадянського виховання. Доведено, що теоретичні положення, педагогічні висновки, методичні поради, які він розробив, набувають особливої актуальності у наш час і їх застосування у виховній практиці, сприятиме вибору активної життєвої позиції та свідомому формуванню громадянського світогляду молоді

    Real-Time CARS Imaging Reveals a Calpain-Dependent Pathway for Paranodal Myelin Retraction during High-Frequency Stimulation

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    High-frequency electrical stimulation is becoming a promising therapy for neurological disorders, however the response of the central nervous system to stimulation remains poorly understood. The current work investigates the response of myelin to electrical stimulation by laser-scanning coherent anti-Stokes Raman scattering (CARS) imaging of myelin in live spinal tissues in real time. Paranodal myelin retraction at the nodes of Ranvier was observed during 200 Hz electrical stimulation. Retraction was seen to begin minutes after the onset of stimulation and continue for up to 10 min after stimulation was ceased, but was found to reverse after a 2 h recovery period. The myelin retraction resulted in exposure of Kv 1.2 potassium channels visualized by immunofluorescence. Accordingly, treating the stimulated tissue with a potassium channel blocker, 4-aminopyridine, led to the appearance of a shoulder peak in the compound action potential curve. Label-free CARS imaging of myelin coupled with multiphoton fluorescence imaging of immuno-labeled proteins at the nodes of Ranvier revealed that high-frequency stimulation induced paranodal myelin retraction via pathologic calcium influx into axons, calpain activation, and cytoskeleton degradation through spectrin break-down

    Association analysis of ACE and ACTN3 in Elite Caucasian and East Asian Swimmers

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    PURPOSE: Polymorphic variation in the angiotensin-converting enzyme (ACE) and alpha-actinin-3 (ACTN3) genes has been reported to be associated with endurance and/or power-related human performance. Our aim was to investigate whether polymorphisms in ACE and ACTN3 are associated with elite swimmer status in Caucasian and East Asian populations. METHODS: ACE I/D and ACTN3 R577X genotyping was carried out for 200 elite Caucasian swimmers from European, Commonwealth, Russian and American cohorts (short and middle distance, SMD ≤ 400 m, n = 130; long distance, LD greater than 400 m, n = 70) and 326 elite Japanese and Taiwanese swimmers (short distance, SD ≤ 100 m, n = 166; middle distance, MD: 200 - 400 m, n = 160). Genetic associations were evaluated by logistic regression and other tests accommodating multiple testing adjustment. RESULTS: ACE I/D was associated with swimmer status in Caucasians, with the D-allele being overrepresented in SMD swimmers under both additive and I-allele dominant models (permutation test p = 0.003 and p = 0.0005, respectively). ACE I/D was also associated with swimmer status in East Asians. In this group, however, the I-allele was overrepresented in the SD swimmer group (permutation test p = 0.041 and p = 0.0098 under the additive and the D-allele-dominant models, respectively). ACTN3 R577X was not significantly associated with swimmer status in either Caucasians or East Asians. CONCLUSIONS: ACE I/D associations were observed in these elite swimmer cohorts, with different risk alleles responsible for the associations in swimmers of different ethnicities. The functional ACTN3 R577X polymorphism did not show any significant association with elite swimmer status, despite numerous previous reports of associations with 'power/sprint' performance in other sports.Additional co-authors: Jason Gulbin, Viktor A. Rogozkin, Ildus I. Ahmetov, Nan Yang, Kathryn N. North, Saraslanidis Ploutarhos, Hugh E. Montgomery, Mark E.S. Bailey, and Yannis P. Pitsiladi

    Functioning Nanomachines Seen in Real-Time in Living Bacteria Using Single-Molecule and Super-Resolution Fluorescence Imaging

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    Molecular machines are examples of “pre-established” nanotechnology, driving the basic biochemistry of living cells. They encompass an enormous range of function, including fuel generation for chemical processes, transport of molecular components within the cell, cellular mobility, signal transduction and the replication of the genetic code, amongst many others. Much of our understanding of such nanometer length scale machines has come from in vitro studies performed in isolated, artificial conditions. Researchers are now tackling the challenges of studying nanomachines in their native environments. In this review, we outline recent in vivo investigations on nanomachines in model bacterial systems using state-of-the-art genetics technology combined with cutting-edge single-molecule and super-resolution fluorescence microscopy. We conclude that single-molecule and super-resolution fluorescence imaging provide powerful tools for the biochemical, structural and functional characterization of biological nanomachines. The integrative spatial, temporal, and single-molecule data obtained simultaneously from fluorescence imaging open an avenue for systems-level single-molecule cellular biophysics and in vivo biochemistry

    Mycobacterial trehalose dimycolate reprograms macrophage global gene expression and activates matrix metalloproteinases.

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    Trehalose 6,6′-dimycolate (TDM) is a cell wall glycolipid and an important virulence factor of mycobacteria. In order to study the role of TDM in the innate immune response to Mycobacterium tuberculosis, microarray analysis was used to examine gene regulation in murine bone marrow-derived macrophages in response to 90-μm-diameter polystyrene microspheres coated with TDM. A large number of genes, particularly those involved in the immune response and macrophage function, were up- or downregulated in response to these TDM-coated beads compared to control beads. Genes involved in the immune response were specifically upregulated in a myeloid differentiation primary response gene 88 (MyD88)-dependent manner. The complexity of the transcriptional response also increased greatly between 2 and 24 h. Matrix metalloproteinases (MMPs) were significantly upregulated at both time points, and this was confirmed by quantitative real-time reverse transcription-PCR (RT-PCR). Using an in vivo Matrigel granuloma model, the presence and activity of MMP-9 were examined by immunohistochemistry and in situ zymography (ISZ), respectively. We found that TDM-coated beads induced MMP-9 expression and activity in Matrigel granulomas. Macrophages were primarily responsible for MMP-9 expression, as granulomas from neutrophil-depleted mice showed staining patterns similar to that for wild-type mice. The relevance of these observations to human disease is supported by the similar induction of MMP-9 in human caseous tuberculosis (TB) granulomas. Given that MMPs likely play an important role in both the construction and breakdown of tuberculous granulomas, our results suggest that TDM may drive MMP expression during TB pathogenesis

    Identification of Novel Susceptibility Loci for Kawasaki Disease in a Han Chinese Population by a Genome-Wide Association Study

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    Kawasaki disease (KD) is an acute systemic vasculitis syndrome that primarily affects infants and young children. Its etiology is unknown; however, epidemiological findings suggest that genetic predisposition underlies disease susceptibility. Taiwan has the third-highest incidence of KD in the world, after Japan and Korea. To investigate novel mechanisms that might predispose individuals to KD, we conducted a genome-wide association study (GWAS) in 250 KD patients and 446 controls in a Han Chinese population residing in Taiwan, and further validated our findings in an independent Han Chinese cohort of 208 cases and 366 controls. The most strongly associated single-nucleotide polymorphisms (SNPs) detected in the joint analysis corresponded to three novel loci. Among these KD-associated SNPs three were close to the COPB2 (coatomer protein complex beta-2 subunit) gene: rs1873668 (p = 9.52×10−5), rs4243399 (p = 9.93×10−5), and rs16849083 (p = 9.93×10−5). We also identified a SNP in the intronic region of the ERAP1 (endoplasmic reticulum amino peptidase 1) gene (rs149481, pbest = 4.61×10−5). Six SNPs (rs17113284, rs8005468, rs10129255, rs2007467, rs10150241, and rs12590667) clustered in an area containing immunoglobulin heavy chain variable regions genes, with pbest-values between 2.08×10−5 and 8.93×10−6, were also identified. This is the first KD GWAS performed in a Han Chinese population. The novel KD candidates we identified have been implicated in T cell receptor signaling, regulation of proinflammatory cytokines, as well as antibody-mediated immune responses. These findings may lead to a better understanding of the underlying molecular pathogenesis of KD
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