Mosaic variant in ATP2C1 presenting as relapsing linear acantholytic dermatosis.

Relapsing linear acantholytic dermatosis (RLAD) is a rare disease that manifests as recurring episodes of crusted and vesicular lesions distributed in a Blaschkoid pattern with histology resembling Hailey-Hailey disease. RLAD, in the presence of generalized disease, has been shown to be a type 2 mosaic form of Hailey-Hailey disease. RLAD, without systemic disease, has been hypothesized to be type 1 mosaic Hailey-Hailey disease, but this assertion has lacked genetic conformation. To determine the genetic abnormalities causing RLAD, we performed exome sequencing of affected tissue and blood in one patient. Exome sequencing of a punch biopsy revealed a c.238A>T, p.(Lys80*) variant in ATP2C1 found in 26% of the reads from lesional skin but absent in germline DNA. This somatic variant causes a truncated protein that would likely result in loss of function. Our findings indicate that, in this patient, RLAD is a clinical presentation of type 1 segmental Hailey-Hailey disease. What's already known about this topic? Relapsing linear acantholytic dermatosis (RLAD) is postulated to be a mosaic form of Hailey-Hailey disease. This hypothesis has remained unproven for type 1 disease and the putative gene and driving genetic variants have remained unknown. What does this study add? Exome sequencing, performed on lesional skin and matched blood, found RLAD lesions to be mosaic for variants causing a premature stop codon in ATP2C1. Our findings support the hypothesis that RLAD is a type 1 segmental form of Hailey-Hailey disease caused by postzygotic variants in ATP2C1.

Exercise training comprising of single 20-s cycle sprints does not provide a sufficient stimulus for improving maximal aerobic capacity in sedentary individuals.

PURPOSE: Sprint interval training (SIT) provides a potent stimulus for improving maximal aerobic capacity ([Formula: see text]), which is among the strongest markers for future cardiovascular health and premature mortality. Cycling-based SIT protocols involving six or more 'all-out' 30-s Wingate sprints per training session improve [Formula: see text], but we have recently demonstrated that similar improvements in [Formula: see text] can be achieved with as few as two 20-s sprints. This suggests that the volume of sprint exercise has limited influence on subsequent training adaptations. Therefore, the aim of the present study was to examine whether a single 20-s cycle sprint per training session can provide a sufficient stimulus for improving [Formula: see text]. METHODS: Thirty sedentary or recreationally active participants (10 men/20 women; mean ± SD age: 24 ± 6 years, BMI: 22.6 ± 4.0 kg m(-2), [Formula: see text]: 33 ± 7 mL kg(-1) min(-1)) were randomised to a training group or a no-intervention control group. Training involved three exercise sessions per week for 4 weeks, consisting of a single 20-s Wingate sprint (no warm-up or cool-down). [Formula: see text] was determined prior to training and 3 days following the final training session. RESULTS: Mean [Formula: see text] did not significantly change in the training group (2.15 ± 0.62 vs. 2.22 ± 0.64 L min(-1)) or the control group (2.07 ± 0.69 vs. 2.08 ± 0.68 L min(-1); effect of time: P = 0.17; group × time interaction effect: P = 0.26). CONCLUSION: Although we have previously demonstrated that regularly performing two repeated 20-s 'all-out' cycle sprints provides a sufficient training stimulus for a robust increase in [Formula: see text], our present study suggests that this is not the case when training sessions are limited to a single sprint.

Defensive secretions of the carabid beetle Chlaenius cordicollis: chemical components and their geographic patterns of variation.

The defensive secretion of the ground beetle Chlaenius cordicollis is predominantly 3-methylphenol. Adult C. cordicollis were collected in Pennsylvania and Manitoba and induced to discharge defensive secretion in a vial. The headspace was sampled by solid phase microextraction, and samples were analyzed by gas chromatography-mass spectrometry. Five alkylphenolic compounds were detected: all beetles secreted 3-methlyphenol, 2,5-dimethylphenol, and 3-ethylphenol, and most beetles from each locality secreted detectable amounts of 2,3-dimethlyphenol and 3,4-dimethylphenol. In about 80% of beetles, we detected small amounts of the alkoxyphenolic compounds 2-methoxy-4-methylphenol and 2-methoxy-5-methylphenol. Multivariate compositional analysis of relative peak areas of alkylphenolic compounds revealed geographic variation and sexual dimorphism in defensive secretions. Compared with samples from Manitoba, relative peak areas of samples from Pennsylvania were lower for 2,3-dimethylphenol and higher for 3-methylphenol. Sexual dimorphism was detected only in Manitoba where, compared with samples from males, relative peak areas for samples from females were higher for 2,5-dimethylphenol and lower for 3-ethylphenol. This is the first report of geographic variation in defensive secretions of carabid beetles, and it demonstrates the need for knowledge of patterns of variation before characterizing the defensive secretions of a species as a whole.

Methicillin-resistant Staphylococcus aureus in a cystic fibrosis unit.

Methicillin-resistant Staphylococcus aureus (MRSA) infection in a cystic fibrosis (CF) unit was investigated. Two typing methods, phage-typing and restriction fragment length polymorphism (RFLP) by pulsed-field gel electrophoresis (PFGE) and phylogenetic analysis, showed that nonsocomial transmission of MRSA from the general hospital population had occurred. One instance of possible transmission between two patients was identified. However, transmission between two family members did not occur indicating a minimal risk of MRSA acquisition from social contact compared with hospital admission. This study supports policies for limiting CF-patient admission to hospital but transmission of MRSA does not appear to be a reason for limiting social contact with other CF patients.

Sexual reproduction in the soybean sudden death syndrome pathogen Fusarium tucumaniae.

We investigated the sexual reproductive mode of the two most important etiological agents of soybean sudden death syndrome, Fusarium tucumaniae and Fusarium virguliforme. F. tucumaniae sexual crosses often were highly fertile, making it possible to assign mating type and assess female fertility in 24 South American isolates. These crosses produced red perithecia and oblong-elliptical ascospores, as is typical for sexual members of the F. solani species complex. Genotyping of progeny from three F. tucumaniae crosses confirmed that sexual recombination had occurred. In contrast, pairings among 17 U.S. F. virguliforme isolates never produced perithecia. Inter-species crosses between F. tucumaniae and F. virguliforme, in which infertile perithecia were induced only in one of the two F. tucumaniae mating types, suggest that all U.S. F. virguliforme isolates are of a single mating type. We conclude that the F. tucumaniae life cycle in S. America includes a sexual reproductive mode, and thus this species has greater potential for rapid evolution than the F. virguliforme population in the U.S., which may be exclusively asexual.

Nursing homes infection control audit.

OBJECTIVES: To carry out a telephone audit looking at the number of nursing homes adhering to the recommendations that nursing homes should-. have a trained infection control link nurse have appropriate reference material respond appropriately to enteric outbreaks record residents with previously identified MRSA and C. diff. be aware of clients with possible infections offer influenza vaccination to all residents. DESIGN: An initial telephone survey of all 23 nursing homes within Forth Valley Health Board area in February 2000 was followed by offering a training programme and repeating the survey in December 2000 to find out if improvements had been made. RESULTS: In February 2000 there were 17(74%) nursing homes with link nurses. In December 2000 this was 19(83%). The numbers who had attended a PHICN induction course were low (11% vs 16%). The lack of availability of reference material in a number of homes gave cause for concern. About one third of nursing homes had residents with diarrhoea and vomiting in the last three months and had called the GP. In February none and in December one of the respondents said that Public Health had been informed. The number of homes which took specimens was 33% in February vs 88% in December and with carriers of MRSA was 75% vs 83%. Those flagging notes increased from 73% to 100%. The number with residents with C.diff was extremely small (1vs2) and all notes were reported to be flagged. CONCLUSION: Staff retention and training were highlighted as areas to be addressed. Improvements in availability of reference material in nursing homes, standardisation of "flagging" or marking of notes and increased notification of possible outbreaks to the Communicable Disease Team are required.

Mass fraction profiling based on x-ray tomography and its application to characterizing porous silica boules.

Mass fraction profiling is a specialized tomographic technique designed to allow one to measure the concentration profiles of the component species of a synthetic composite material. While developed for the express purpose of determining the dopant, density, and porosity profiles of unsintered soot boules, the method hould also be useful in analyzing other types of ceramic such as dried gels. Mass fraction profiling amounts to a three-step process consisting of scanning the object of interest with well-collimated beams of x rays, reconstructing the attenuation coefficient profiles for several x-ray energies, and generating the density and concentration or mass fraction profiles. The method for determining these profiles is outlined, and some measurement results obtained for soot boules are presented.

Evolution of an endemic methicillin-resistant Staphylococcus aureus population in an Australian hospital from 1967 to 1996.

The evolution over 30 years of a population of methicillin-resistant Staphylococcus aureus (MRSA) from a tertiary referral hospital was studied by phylogenetic analysis of SmaI-generated restriction fragment length polymorphisms (RFLPs). The results suggest that a new clone of MRSA appeared at the hospital in the early 1980s, which, although usually retaining its ancestral phage-type, developed four different RFLP pulsotypes in the next 16 years. This finding indicates that multiple RFLP patterns in MRSA do not necessarily represent multiple clones deriving from different mec gene transfer events. Such variation within a clone may be significant in the interpretation of RFLP patterns during outbreaks and emphasizes the need to use two typing methods in studies of such populations. Since the appearance of new clones of MRSA is a relatively rare event, cross-infection control is paramount in the prevention of MRSA dissemination.

A monoclonal antibody to the surface membrane of human platelets which inhibits ristocetin- and collagen-induced platelet aggregation reacts with H1 histones of cell nuclei.

A murine monoclonal antibody HuPIA3, produced by immunization with human platelet membranes, reacted by radioimmunoassay with platelets, and inhibited ristocetin- and collagen-induced platelet aggregation and release of 14C-serotonin. The antibody also inhibited ristocetin-induced aggregation of washed, formaldehyde-fixed platelets by von Willebrand factor. On cultures of human and rodent fibroblasts, and on frozen sections of rabbit liver and rat kidney, the antibody gave a diffuse, homogenous immunofluorescence staining of cell nuclei which could be abolished by treatment with 0.1 M HC1 or 2 M NaCl and restored by reconstitution with histones, suggesting a reaction with nuclear histones. Absorption of the antibody with histones abolished nuclear staining and abrogated the inhibitory effect of the antibody on ristocetin- and collagen-induced platelet aggregation and 14C-serotonin release. Conversely, absorption with platelets removed antibody reactivity for platelets and for cell nuclei. In addition, the antibody reacted with H1 histones by radioimmunoassay, and immunoblotting studies showed that the antibody reacted with a protein of 199,000 daltons on platelets and with H1 histones (31,000 dalton and 32,000 dalton). These observations suggest that the antibody recognizes epitopes found on surface molecules of platelets as well as on H1 histones of cell nuclei.

Clinical and economic consequences of wound sepsis after appendicectomy and their modification by metronidazole or povidone iodine.

The effects of intrarectal metronidazole and intraincisional povidone iodine on sepsis after emergency appendicectomy were compared in a double-blind randomised controlled trial in 496 patients. Wound sepsis occurred in 12.3% of metronidazole-treated patients compared with 24% in the povidone-iodine group and 23.5% in an untreated control group. The metronidazole-treated patients left hospital approximately 2 days earlier than patients in the other two groups. They returned to work sooner and receiver fewer visits from the district nursing service. A short six-dose course of metronidazole significantly reduces the wound-infection rate in patients over the age of 12 undergoing emergency appendicectomy. If the clinical and economic benefits of metronidazole shown by this study are confirmed, the drug should be considered for routine use in emergency appendicectomy.