Practices and perspectives on advanced diagnostic and interventional bronchoscopy among pediatric pulmonologists in the United States.

INTRODUCTION: Advanced diagnostic bronchoscopy includes endobronchial ultrasound (EBUS) guided transbronchial lung and lymph node biopsies, CT navigation and robotic bronchoscopy. Interventional bronchoscopy refers to procedures performed for therapeutic purposes such as balloon dilation of the airway, tissue debulking, cryotherapy, removal of foreign bodies and insertion of endobronchial valves [1]. For adult patients, these procedures are standard of care [2, 3]. Despite a lack of formalized training, there are numerous case reports and case series describing the use of advanced diagnostic and interventional bronchoscopy techniques in children. The safety and feasibility of EBUS-TBNA, cryotherapy techniques, endobronchial valves among other techniques have been demonstrated in these publications [1, 4-9]. METHODS: We sought to better understand the current practices and perspectives on interventional and advanced bronchoscopy among pediatric pulmonologists through surveys sent to pediatric teaching hospitals across the United States. RESULTS: We received 43 responses representing 28 programs from 25 states. The highest bronchoscopy procedure volume occurred in the 0-5 years age group. Among our respondents, 31% self-identified as a pediatric interventional/advanced bronchoscopist. 79% believe that advanced and interventional training is feasible in pediatric pulmonology and 77% believe it should be offered to pediatric pulmonary fellows. DISCUSSION: This is the first study to characterize current practices and perspectives regarding advanced diagnostic and interventional bronchoscopy procedures among pediatric pulmonologists in the United States. Pediatric interventional pulmonology (IP) is in its infancy and its beginnings echo those of the adult IP where only certain centers were performing these procedures.

Improved reverse Monte Carlo analysis of optical property of Fe and Ni from reflection electron energy loss spectroscopy spectra.

The energy loss functions (ELFs) of Fe and Ni have been derived from measured reflection electron energy loss spectroscopy (REELS) spectra by a reverse Monte Carlo analysis in our previous work. In this work, we present further improvements of ELFs for these metals. For Fe, we have updated ELFs at primary electron energies of 2 keV and 3 keV in a wider photon energy region (0-180 eV) with a better accuracy, which is verified by sum rules. Regarding to Ni, we supplement the ELF at primary energy of 5 keV and we also improve the data accuracy at 3 keV. Applying these new and more accurate ELFs we present the optical constants and dielectric functions for the two metals. The improvements were highlighted by comparing our present results with the previous data.

Reaction extent or advancement of reaction: A definition for complex chemical reactions.

The concept of reaction extent (the progress of a reaction, advancement of the reaction, conversion, etc.) was introduced around 100 years ago. Most of the literature provides a definition for the exceptional case of a single reaction step or gives an implicit definition that cannot be made explicit. There are views that the reaction extent somehow has to tend to 1 when the reaction goes to completion as time tends to infinity. However, there is no agreement on which function should tend to 1. Starting from the standard definition by IUPAC and following the classical works by De Donder, Aris, and Croce, we extend the definition of the reaction extent for an arbitrary number of species and reaction steps. The new general, explicit definition is also valid for non-mass action kinetics. We also studied the mathematical properties (evolution equation, continuity, monotony, differentiability, etc.) of the defined quantity, connecting them to the formalism of modern reaction kinetics. Our approach tries to adhere to the customs of chemists and be mathematically correct simultaneously. To make the exposition easy to understand, we use simple chemical examples and many figures, throughout. We also show how to apply this concept to exotic reactions: reactions with more than one stationary state, oscillatory reactions, and reactions showing chaotic behavior. The main advantage of the new definition of reaction extent is that by knowing the kinetic model of a reacting system one can now calculate not only the time evolution of the concentration of each reacting species but also the number of occurrences of the individual reaction events.

Highly selective MXene/V2O5/CuWO4-based ultra-sensitive room temperature ammonia sensor.

A Schottky junction based on Ti3C2Tx MXene sheet integrated with marigold flower-like V2O5/CuWO4 heterojunction was designed and fabricated for robust ammonia sensing by monitoring the electrical resistance changes in air and ammonia. The electron transport behavior of the sensor was investigated by electrochemical analysis, ultraviolet photoelectron spectroscopy and reflection electron energy loss spectroscopy. Besides, negative zeta potential obtained for sensor components was in consistent with surface functional groups (e.g. OH and F) observed by XPS analysis helping better understanding of the ammonia sensing mechanism. The results desirably confirmed high sensitivity, selectivity, linear range (1-160 ppm), the limit of quantification, repeatability, long-term stability, very short response time (few seconds) and low working temperature (25 °C) of the sensor. The measurements on the resistance changes of the MXene/V2O5/CuWO4-based sensor under the exposure to various types of analytes (Ammonia, Acetone, Benzene, Chloroform, DMF, Ethanol, humidity (80%), Methanol and Toluene as well as NO, NO2, H2S, SO2, CO and CH4) at different concentrations revealed that the fabricated sensor is excellently selective to ammonia with ultra-high sensitivity. Intra-day stability (7 runs a day) and long-term stability (every 10 days over 70 days) as important sensor characteristics were investigated at 51 ppm and ambient temperature, which showed very good repeatability and recoverability in both short and long periods for sensing the ammonia. Overall, MXene/V2O5/CuWO4 was shown to be cost-effective, easy to handle and suitably applicable for simple, ultrafast and extremely efficient trace ammonia detection, which could be of high interest for future exhaled breath analysis and the development of a novel noninvasive diagnostic strategy to monitor chronic kidney disease to stop a large measure of unnecessary invasive testing.

A fully automated system with an optical immersion probe (OIP) for high-precision spectrophotometric measurements.

A new and fully automated system with the interconnection of an Optical Immersion Probe (OIP) - pH meter - peristaltic pump was used to study the spectral and protolytic properties of carbocyanine the dyes 1,1',3,3,3',3'-hexamethylindocarbocyanine chloride (HIC); 1,1',3,3,3',3'-hexamethylindodicarbocyanine iodide (HIDC); and 3,3'-diethyloxadicarbocyanine iodide (DODC). This system can measure a large number of experimental points in a short time period. The effect of 32 various organic solvents on the UV-ViS spectra of the dyes was studied. The solvatochromic behaviour of studied dyes was characterized by positive solvatochromism for HIDC and negative solvatochromism for HIC and DODC. Through the application of a large number of experimental points, the protonation and hydrolysis constants of dyes were determined with high precision, where the confidence interval of the рK values is ±(0.001-0.005), compared with a confidence interval of ±(0.04-0.10) for standard procedures. The fully automated system presented is accurate, fast, environmentally friendly and promising for multiple analytical applications.

Fecal expression of Escherichia coli lysine decarboxylase (LdcC) is downregulated in E-cadherin negative lobular breast carcinoma.

Breast cancer is characterized by oncobiosis, the abnormal composition of the microbiome in neoplastic diseases. The biosynthetic capacity of the oncobiotic flora in breast cancer is suppressed, as suggested by metagenomic studies. The microbiome synthesizes a set of cytostatic and antimetastatic metabolites that are downregulated in breast cancer, including cadaverine, a microbiome metabolite with cytostatic properties. We set out to assess how the protein expression of constitutive lysine decarboxylase (LdcC), a key enzyme for cadaverine production, changes in the feces of human breast cancer patients (n = 35). We found that the fecal expression of Escherichia coli LdcC is downregulated in lobular cases as compared to invasive carcinoma of no special type (NST) cases. Lobular breast carcinoma is characterized by low or absent expression of E-cadherin. Fecal E. coli LdcC protein expression is downregulated in E-cadherin negative breast cancer cases as compared to positive ones. Receiver operating characteristic (ROC) analysis of LdcC expression in lobular and NST cases revealed that fecal E. coli LdcC protein expression might have predictive values. These data suggest that the oncobiotic transformation of the microbiome indeed leads to the downregulation of the production of cytostatic and antimetastatic metabolites. In E-cadherin negative lobular carcinoma that has a higher potential for metastasis formation, the protein levels of enzymes producing antimetastatic metabolites are downregulated. This finding represents a new route that renders lobular cases permissive for metastasis formation. Furthermore, our findings underline the role of oncobiosis in regulating metastasis formation in breast cancer.

Surface Study of Fe3O4 Nanoparticles Functionalized With Biocompatible Adsorbed Molecules.

Surfaces of iron oxide of ferrimagnetic magnetite (Fe3O4) nanoparticles (MNPs) prepared by Massart's method and their functionalized form (f-MNPs) with succinic acid, L-arginine, oxalic acid, citric acid, and glutamic acid were studied by dynamic light scattering (DLS), Fourier transform infrared spectroscopy (FTIR-S), UV-vis, thermogravimetric analysis (TGA)/differential scanning calorimetry (DSC), X-ray photoelectron spectroscopy (XPS), and reflection electron energy loss spectroscopy (REELS). The XPS analysis of elements and their chemical states at the surface of MNPs and f-MNPs revealed differences in chemical bonding of atoms, content of carbon-oxygen groups, iron oxide forms, iron oxide magnetic properties, adsorbed molecules, surface coverage, and overlayer thickness, whereas the Auger parameters (derived from XPS and Auger spectra) and elastic and inelastic scattering probabilities of electrons on atoms and valence band electrons (derived from REELS spectra) indicated modification of surface charge redistribution, electronic, and optical properties. These modified properties of f-MNPs influenced their biological properties. The surfaces biocompatible for L929 cells showed various cytotoxicity for HeLa cells (10.8-5.3% of cell death), the highest for MNPs functionalized with oxalic acid. The samples exhibiting the largest efficiency possessed smaller surface coverage and thickness of adsorbed molecules layers, the highest content of oxygen and carbon-oxygen functionalizing groups, the highest ratio of lattice O2- and OH- to C sp2 hybridizations on MNP surface, the highest ratio of adsorbed O- and OH- to C sp2 hybridizations on adsorbed molecule layers, the closest electronic and optical properties to Fe3O4, and the lowest degree of admolecule polymerization. This high cytotoxicity was attributed to interaction of cells with a surface, where increased content of oxygen groups, adsorbed O-, and OH- may play the role of additional adsorption and catalytic sites and a large content of adsorbed molecule layers of carboxylic groups facilitating Fenton reaction kinetics leading to cell damage.

Dosing interval and diagnosis predict infliximab levels in patients with inflammatory bowel disease on maintenance treatment.

OBJECTIVE: The aim of the study was to identify factors influencing infliximab (IFX) trough levels (TL) in patients with inflammatory bowel disease (IBD). METHODS: This was a multicentre cross-sectional study performed at 5 large IBD centres in Slovakia. The cohort consisted of IBD patients, treated either with original IFX or CT-P13 biosimilar, who were examined for the IFX TL and antidrug antibodies (ADA) in a central laboratory. RESULTS: The patient cohort consisted of 116 consecutive IBD patients, 68 with Crohn's disease (CD) and 48 with ulcerative colitis (UC). CD patients had significantly lower IFX TL compared to UC, 2.41 (0.998-5.56) mg/L vs. 4.49 (1.76-8.41) mg/L, p = 0.017. During maintenance treatment, significantly higher mean IFX TL were observed in patients with a 4 week dosing interval than in patients with a 6 or 8 (7.44±3.6 µg/mL vs. 4.19±4.2 vs. 3.30±3.1 µg/mL, p = 0.011 and p< 0.0001, respectively). There was no difference in median TL IFX between original IFX and biosimilar CT-P13 (3.25 (1.24-6.52) mg/L vs. 3.03 (1.30-7.10)). IFX TL correlated with ADA (p=0.005). Multiple regression analysis revealed two independent factors for IFX TL: dosing interval (p<0.0001) and diagnosis (p=0.02). CONCLUSION: In the present study we observed that IBD patients assigned to an intensified dosing interval during maintenance therapy have significantly higher IFX TL than patients receiving conventional 8 week interval. Patients with UC had significantly higher IFX TL.

Relapse rates of inflammatory bowel disease patients in deep and clinical remission after discontinuing anti-tumor necrosis factor alpha therapy.

BACKGROUND AND AIMS: Relapse rates after discontinuing anti-tumor necrosis factor-α (TNFα) therapy of inflammatory bowel disease (IBD) patients in deep remission are poorly understood. This prospective single-center open-label study evaluated the relapse rates of IBD patients after stopping anti-TNFα therapy. METHODS: All IBD patients who were in clinical remission and stopped anti-TNFα therapy in 2011-2013 and were followed up for at least 12 months were enrolled. The "Ultradeep" patients were in calprotectin-negative (<50 ng/g) deep remission for at least six months and ceased anti-TNFα therapy on physician recommendations. The "clinical" patients were in clinical but not deep remission and ceased anti-TNFα therapy for other reasons. Relapse rates were assessed and relapse risk factors identified. RESULTS: One year after stopping, 27 % and 27 % of the Ultradeep (n = 11) and Clinical (n = 11) patients relapsed, respectively. Two years after stopping, 57 % and 62 % relapsed, respectively (p = 0.89). All relapsed patients who underwent retreatment with anti-TNFα therapy re-entered remission. Male sex was a significant risk factor for relapse (p = 0.03). CONCLUSION: Our study showed that even highly selected IBD patients who lack clinical, endoscopic or laboratory signs of disease activity have a relatively high relapse rate in the follow-up period after ceasing anti-TNFα therapy (Tab. 2, Fig. 3, Ref. 24).

Tocopherol inhibits the relaxing effect of terbutaline in the respiratory and reproductive tracts of the rat: the role of the oxidative stress index.

AIMS: Reactive oxygen species play a role in the signal transduction of beta-adrenergic receptors. We investigated whether an antioxidant (tocopherol) can reduce the effect of terbutaline in beta-2-adrenergic receptor (ß2-AR)-regulated smooth muscles. MAIN METHODS: Contractility of the tissues from nonpregnant (trachea) and 22-day-pregnant (myometrium and cervix) rats was investigated in an isolated organ bath. The tracheal and uterine ß2-AR expressions were increased by 17-beta-estradiol valerate (E2) and progesterone (P4), respectively. The accumulation of cyclic-AMP (cAMP), and the total oxidant (TOS) and total antioxidant status (TAS) were also measured. The oxidative stress index (OSI) was defined as the ratio of TOS and TAS. KEY FINDINGS: Terbutaline (10(-10)-10(-5)M) decreased the contractions in the nontreated and the P4-pretreated myometria, but tocopherol (10(-7)M) did not alter these actions. Terbutaline (10(-6)M) increased the cervical resistance both in the nontreated and in the P4-treated samples, while tocopherol reduced this action only in the P4-treated cervices. Terbutaline (10(-9)-10(-4)M) reduced the tracheal tones both in the nontreated and in the E2-treated tissues, while tocopherol reduced these effects. The changes in the intracellular cAMP levels of the tissues were in harmony with the isolated organ results. The OSI was highest in the trachea and lowest in the pregnant myometrium. SIGNIFICANCE: A higher OSI is linked to a higher tocopherol sensitivity of beta-mimetic-induced relaxation. Our results suggest that the antiasthmatic effect of beta-mimetics may worsen, while their tocolytic effect may remain unchanged during parallel tocopherol administration.

Androgenic effect of honeybee drone milk in castrated rats: roles of methyl palmitate and methyl oleate.

ETHNOPHARMACOLOGICAL RELEVANCE: Numerous honeybee (Apis mellifera) products have been used in traditional medicine to treat infertility and to increase vitality in both men and women. Drone milk (DM) is a relatively little-known honeybee product with a putative sexual hormone effect. The oestrogenic effect of a fraction of DM has recently been reported in rats. However, no information is available on the androgenic effects of DM. The purpose of the present study was to determine the androgen-like effect of DM in male rats and to identify effective compounds. MATERIALS AND METHODS: A modified Hershberger assay was used to investigate the androgenic effect of crude DM, and the plasma level of testosterone was measured. The prostatic mRNA and protein expression of Spot14-like androgen-inducible protein (SLAP) were also examined with real-time PCR and Western blot techniques. GC-MS and NMR spectroscopic investigations were performed to identify the active components gained by bioactivity-guided fractionation. RESULTS: The crude DM increased the relative weights of the androgen-dependent organs and the plasma testosterone level in castrated rats and these actions were flutamide-sensitive. DM increased the tissue mRNA and protein level of SLAP, providing further evidence of its androgen-like character. After bioactivity-guided fractionation, two fatty acid esters, methyl palmitate (MP) and methyl oleate (MO), were identified as active compounds. MP alone showed an androgenic effect, whereas MO increased the weight of androgen-sensitive tissues and the plasma testosterone level only in combination. CONCLUSION: The experimental data of DM and its active compounds (MO and MP) show androgenic activity confirming the traditional usage of DM. DM or MP or/and MO treatments may project a natural mode for the therapy of male infertility.

[The cost of surgical and endovascular treatment of abdominal aortic aneurysm - a retrospective comparative study]. / Náklady na chirurgickú a endovaskulárnu liecbu aneuryzmy brusnej aorty - retrospektívna komparatívna stúdia.

INTRODUCTION: A comparison of the costs of a surgery and an endovascular treatment of abdominal aortic aneurysms (AAA) for the General Health Insurance Company (VsZP) in 2009-2010. MATERIAL AND METHODS: Between 2009 and 2010, VsZP paid for treatment of 211 patients with AAA with an average age of 69 years (range: 41-91 years). Out of these, 174 patients underwent surgical treatment and 37 patients were treated by endovascular means. In both groups, we observed a total cost of treatment, payment for hospitalization (UH) and separately charged material (ZM), the cost of blood and reimbursement for CT (computer tomography) examinations and the patient age. For statistical comparison, we used the nonparametric Mann-Whitney U test, the limit of statistical significance was <0.01. The data were processed and compared by means of contingency tables in MS Excel and then statistically processed in the program StatSoft, Inc.. (2011). STATISTICA (data analysis software system), version 10th www.statsoft.com. RESULTS: The total two-year costs of VsZP for the treatment of AAA were € 1 212 188 - out of which 37% were represented by the OR costs (open repair) and 63% for EVAR (endovascular aneurysm repair) (p <0.01). In terms of the ZM use (p <0.01), and the use of CT examinations (p <0.01), EVAR is cost demanding. OR is cost demanding in terms of the blood consumption levels (p <0.01). The average total cost per admission was € 21,038 for EVAR and € 2,493 for OR, representing only 12% of the total EVAR costs. The age of patients has no impact on the costs (p> 0.01). The decisive impact on the total costs is represented by ZM, which presents 90 % of costs of EVAR method and 44% of OR method. CONCLUSION: OR and EVAR are effective modalities for the treatment of AAA. EVAR is a minimally invasive method, but the treatment costs are more than 8 times higher than the costs of surgical treatment. In terms of the VsZP cost control for the treatment of AAA, there must be clearly defined explicit indication criteria for EVAR. In terms of the costs for the treatment of AAA with "good risk" patients and those cases where there are no local obstacles for the surgical treatment (eg, colostoma, hostile abdomen, ren arcuatus and other), the surgical therapy is a "gold" standard. The health insurance company is a crucial regulator of the system of payment for provided medical care. The development of medical technology and the financial burden, on one hand, and the limited and scarce resources, on the other hand, are a source of "tension" between the health care providers and the regulators (insurance, Ministry of Health). One way to slow the "opening of the scissors" is to establish clear rules for the entry of new technologies into clinical practice, clearly defined costs (COI - cost of illness), and the usefulness and cost-effectiveness (CEA - cost-effectiveness analysis, ICER - incremental cost-effectiveness ratio, QALY - quality-adjusted life year). Despite the fact that it has beenmore than 20 years after the "velvet revolution", implementing the principles of health economics and health technology into practice has been managed in a rather weak way. The comparison of the costs of treatment is applicable in many areas of clinical medicine, and in the case of well-defined data it can be a source for the determination of ICER, CEA and QALYs. Key words: abdominal aortic aneurysms - surgery and endovascular treatment - costs.

[Basal cell carcinoma of the periocular region]. / Basalzellkarzinome des periokulären Bereichs.

Basal cell carcinoma is the most common malignant tumor of the periocular region with local aggressive growth and extensive destruction. The histological subtypes of periocular basalioma, the recurrence rates and resection border relationships were analyzed and the results were compared with basaliomas from other body regions. The results of gender and age distribution, histological subtypes, recurrence rates and resection border relationships were evaluated using the χ(2)-test. The results showed a significantly higher recurrence rate (p < 0.01) for the periocular region compared to other body regions and the incidence of periocular basalioma was higher in women (p < 0.05). In addition the rarer histological subtypes were more commonly found in this region compared to other body regions (p < 0.01).

The prevalence and risk factors for osteoporosis in patients with inflammatory bowel disease.

AIM: Osteoporosis is a known chronic complication of inflammatory bowel diseases (IBD). The aim of our study was to describe the prevalence of reduced bone mineral density (BMD) in IBD patients and to identify crucial risk factors for osteoporosis. METHODS: The cohort consisted of 76 IBD patients, 40 with Crohn's disease (CD) and 36 with ulcerative colitis (UC). Clinical characteristics of every patient were recorded, i.e. age, sex, duration of the disease, clinical behavior, location of disease according to Montreal classification, surgeries, steroid medication, sIBDQ, and smoking habits. We examined the serum 25-hydroxyl vitamin D3 (25-OHD3) in each patient. The BMD was determined by dual-energy X-ray absorptiometry (DXA) at the lumbar spine and femoral neck. RESULTS: Osteoporosis was documented in 10 IBD patients (13.2 %), while osteopenia in 35 of them (46.1 %). Patients with CD have significantly lower femoral Z score than patients with UC. Femoral Z score was strongly associated with disease duration, and in CD patients suffering from stricturing form, with ileic or ileocolic location and history of proctocolectomy or total colectomy. Patients with osteoporosis had a significantly lower level of 25-OHD3 than patients with normal BMD. CONCLUSION: Patients with long disease duration and those suffering from stricturing form of CD with ileic/ileocolic location and history of proctocolectomy/total colectomy are at higher risk of developing osteoporosis than other IBD patients. The high proportion of osteopenia/osteoporosis in our study underlines the importance of BMD measurement in all IBD patients as a base for initiating the appropriate treatment (Tab. 1, Fig. 3, Ref. 63).

Short communication: Survey of animal-borne pathogens in the farm environment of 13 dairy operations.

A survey was conducted on 13 dairies to determine the occurrence of 5 animal-borne pathogens (Salmonella enterica, Escherichia coli O157:H7, Campylobacter jejuni, Mycobacterium avium ssp. paratuberculosis, and Cryptosporidium parvum) and their distributions across farm elements (feces, bedding, milk filters, stored manure, field soil, and stream water). Presence of C. parvum was measured only in feces and stored manure. All but one farm were positive for at least one pathogen species, and 5 farms were positive for 3 species. Escherichia coli O157:H7 was detected on 6 farms and in all farm elements, including milk filters. Mycobacterium avium ssp. paratuberculosis was detected on 10 of 13 farms and in all farm elements except for milk filters. Salmonella enterica and C. jejuni were detected at lower frequencies and were not identified in soil, stream water, or milk filters on any of the 13 farms. Cryptosporidium parvum was detected in feces but not in stored manure. Stored manure had the highest occurrence of pathogens (73%), followed by feces (50%), milk filters, bedding, soil, and water (range from 23 to 31%). Association of pathogen presence with farm management factors was examined by t-test; however, the small number of study farms and samples may limit the scope of inference of the associations. Pathogens had a higher prevalence in maternity pen bedding than in calf bedding, but total pathogen occurrence did not differ in calf compared with lactating cow feces or in soils with or without manure incorporation. Herd size and animal density did not appear to have a consistent effect on pathogen occurrence. The extent of pathogen prevalence and distribution on the farms indicates considerable public health risks associated with not only milk and meat consumption and direct animal contact, but also potential dissemination of the pathogens into the agroecosystem.

The impact of thiopurine-S-methyltransferase genotype on the adverse drug reactions to azathioprine in patients with inflammatory bowel diseases.

BACKGROUND AND AIMS: The thiopurine drugs, azathioprine (AZA) and 6-mercaptopurine, are established in the treatment of inflammatory bowel diseases (IBD). Polymorphisms in thiopurine S-methyltransferase (TPMT) gene have been associated with adverse drug reactions (ADRs) to AZA. METHODS: The aim of this study was to evaluate TPMT polymorphisms and AZA-related toxicity in a Slovak cohort of 220 IBD patients treated with AZA. In every patient, the dose and duration of AZA therapy, concomitant 5-aminosalicylate (5-ASA) medication, frequency, type, time to onset, dose of ADR and concomitant 5-ASA at the onset of ADR were recorded. Each patient was also genotyped for the presence of variant TPMT alleles (*2,*3A,*3B,*3C). Frequency, type and circumstances of ADRs were compared according to TPMT status. RESULTS: Of the 220 patients, 205 (93.2 %) were wild-type (TPMT*1/*1), one (0.5%) carried a TPMT*1/*3C allele, 13 (5.9 %) carried TPMT *1/*3A allele and one was homozygous for TMPT *3A allele. No TPMT *2 mutation was found. The incidence of adverse drug reactions was 62/205 (30.2 %) in the wild-type group as compared to 13/15 (86.7 %) in the TPMT mutation group, p=2.10-5. Leukopenia (WBC< 3.0*10^9/L) occurred in 21/205 (10.2 %) patients with wild type TPMT versus 11/15 (73.3 %) patients with TPMT mutations, p=0.000001. There was no significant difference between TMPT groups in gastrointestinal or other ADRs. No impact of 5-ASA on the incidence and severity of AZA adverse drug reactions was observed. CONCLUSION: The incidence of leukopenia in TPMT mutant patients was significantly higher and more severe as compared to TPMT wild type patients. We observed no impact of concomitant 5-ASA therapy on AZA induced toxicity (Tab. 4, Fig. 2, Ref. 37).

Light scattering from liquid crystal director fluctuations in steady magnetic fields up to 25 tesla.

We report on homodyne dynamic light scattering measurements of orientational fluctuation modes in both calamitic and bent-core nematic liquid crystals, carried out in the new split-helix resistive magnet at the National High Magnetic Field Laboratory. The relaxation rate and inverse scattered intensity of director fluctuations exhibit a linear dependence on field-squared up to 25 tesla, which is consistent with strictly lowest order coupling of the tensor order parameter Q to field (Q(αß)B(α)B(ß)) in the nematic free energy. However, we also observe evidence of field dependence of certain nematic material parameters, an effect which may be expected from the mean field scaling of these quantities with the magnitude of Q and the predicted variation of Q with field.

Ancient schwannoma of the orbit.

Schwannoma, also referred to as neurilemmoma or peripheral neurinoma, is an unusual orbital benign tumour that may pose diagnostic challenges. Awareness of the clinical features that may be associated with the tumour and prompt surgical excision with histopathologic examination enable correct diagnosis. The authors describe a progressively increasing inferolateral orbital mass in a 32-year-old patient that was demonstrated to be an orbital ancient schwannoma.

Survival characteristics of Salmonella enterica serovar Newport in the dairy farm environment.

Multi-drug resistant (MDR) Salmonella enterica serovar Newport (S. Newport) has established a reservoir in dairy cattle. Infected herds suffer significant mortality in both adult and young animals, posing a considerable economic loss to producers. Land application of manure from infected animals may further spread the pathogen into the agroecosystem, causing public health concerns. Previous work by our group demonstrated that the organism persisted in manure and manured soil for 6 to 10 mo under laboratory conditions. In the present study, we determined the survival characteristics of MDR S. Newport in a dairy lagoon, compost pile, and soil of a grass field under natural conditions using environmental sentinel chambers with an initial concentration of S. Newport around 7 log(10) per gram. In the static compost pile at 64 °C, S. Newport was eliminated within 18 h. In the dairy effluent lagoon, the pathogen survived for >137 d, whereas in the field soil, the organisms persisted for over 276 d. The survival of MDR S. Newport in both the lagoon and field soil followed a pattern of (1) an increase or plateau for a few days, (2) log-linear decline for 6 to 13 wk, and (3) a long tailing phase at low and variable concentration for 4 to 9 mo. Log reduction times (days required for 90% decrease in concentration) based on the log-linear decline phase were 7 d in the lagoon and 14 to 20 d in the soil. Conditions leading to faster inactivation during the initial phase do not necessarily translate into a quicker elimination of the pathogen. Regression models of the log-linear phase may be inaccurate for estimating complete pathogen elimination.