Development and validation of a simple and practical method for differentiating MS from other neuroinflammatory disorders based on lesion distribution on brain MRI.

There is an unmet need to develop practical methods for differentiating multiple sclerosis (MS) from other neuroinflammatory disorders using standard brain MRI. To develop a practical approach for differentiating MS from neuromyelitis optica spectrum disorder (NMOSD) and MOG antibody-associated disorder (MOGAD) with brain MRI, we first identified lesion locations in the brain that are suggestive of MS-associated demyelination ("MS Lesion Checklist") and compared frequencies of brain lesions in the "MS Lesion Checklist" locations in a development sample of patients (n = 82) with clinically definite MS, NMOSD, and MOGAD. Patients with MS were more likely than patients with non-MS to have lesions in 3 locations only: anterior temporal horn (p < 0.0001), periventricular ("Dawson's finger") (p < 0.0001), and cerebellar hemisphere (p = 0.02). These three lesion locations were used as predictor variables in a multivariable regression model for discriminating MS from non-MS. The model had area under the curve (AUC) of 0.853 (95% confidence interval: 0.76-0.945), sensitivity of 87.1%, and specificity of 72.5%. We then used an independent validation sample with equal representation of MS and NMOSD/MOGAD cases (n = 97) to validate our prediction model. In the validation sample, the model was 76.3% accurate in discriminating MS from non-MS. Our simple method for predicting MS versus NMOSD/MOGAD only requires a neuroradiologist or clinician to ascertain the presence of lesions in three locations on conventional MRI sequences. It can therefore be readily applied in the real-world setting for training and clinical practice.

Cloning of the structural genes of three H8 antigens and of protein III of Neisseria gonorrhoeae.

A bank of gonococcal DNA was constructed in the lambda gt11 expression vector. immunological screening of the bank resulted in the isolation of a clone that contains the structural gene of protein III. In addition, several clones reactive with mAbs specific for the H8 antigen were isolated. DNA hybridization studies revealed that these H8-reactive clones were derived from three different gonococcal genes. When the products produced by these clones were used to absorb antibodies from a rabbit antiserum, and the eluted antibodies were used in immunological studies, it could be shown that the parent gonococcus expressed the product of two of these H8 genes, and in strain R10, these had Mr of approximately 19,700 21,200 respectively. The larger form has not been recognized hitherto because the epitope reactive with the H8 mAb may be masked in this product.

Brain Imaging Use and Findings in COVID-19: A Single Academic Center Experience in the Epicenter of Disease in the United States.

Coronavirus disease 2019 (COVID-19) is a serious public health crisis and can have neurologic manifestations. This is a retrospective observational case series performed March 1-31, 2020, at New York University Langone Medical Center campuses. Clinical and imaging data were extracted, reviewed, and analyzed. Two hundred forty-two patients with COVID-19 underwent CT or MRI of the brain within 2 weeks after the positive result of viral testing (mean age, 68.7 ± 16.5 years; 150 men/92 women [62.0%/38.0%]). The 3 most common indications for imaging were altered mental status (42.1%), syncope/fall (32.6%), and focal neurologic deficit (12.4%). The most common imaging findings were nonspecific white matter microangiopathy (134/55.4%), chronic infarct (47/19.4%), acute or subacute ischemic infarct (13/5.4%), and acute hemorrhage (11/4.5%). No patients imaged for altered mental status demonstrated acute ischemic infarct or acute hemorrhage. White matter microangiopathy was associated with higher 2-week mortality (P < .001). Our data suggest that in the absence of a focal neurologic deficit, brain imaging in patients with early COVID-19 with altered mental status may not be revealing.

Mutations that allow disulfide bond formation in the cytoplasm of Escherichia coli.

Disulfide bonds are rarely found in cytoplasmic proteins. Mutations were selected for in Escherichia coli that allow disulfide bond formation in the cytoplasm. In the presence of these mutations, export-defective versions of alkaline phosphatase and mouse urokinase were able to fold into their enzymatically active conformations in the cytoplasm because their disulfide bonds were formed. The mutations were mapped to the gene for thioredoxin reductase and diminish or eliminate the activity of this enzyme. Thioredoxin itself was found to be unnecessary for this disulfide bond formation. Thioredoxin reductase, but not thioredoxin, is thus implicated in keeping cysteines reduced in cytoplasmic proteins.

A mutation affecting the regulation of a secA-lacZ fusion defines a new sec gene.

It was shown previously that the secA gene of Escherichia coli is derepressed in cells that have a defect in protein export. Here it is demonstrated that the beta-galactosidase produced by a secA-lacZ gene fusion strain is regulated in the same way. Studies on the fusion strain reveal that the promoter or a site involved in regulation of the secA gene is located considerably upstream from the structural gene. The properties of the fusion strain provide a new selection for mutants that are defective in protein export. Selection for increased lac expression of a secA-lacZ fusion strain yields mutations in three of the known sec genes, secA, secD and prlA/secY. In addition, mutations in several genes not previously known to affect secA expression were obtained. A mutation in one of these genes causes a pleiotropic defect in protein export and a cold-sensitive growth defect; this gene, which maps at approximately 90 min on the bacterial chromosome, has been named secE.

Pancreatitis of pancreas divisum.

Pancreas divisum is a frequently encountered congenital anatomic variant of the pancreatic ductal system. Its presence alone rarely causes pancreatitis on the basis of "functional obstruction" at the minor papilla. Endoscopic and surgical interventions, to relieve hypothetical obstruction at the minor papilla, may not be necessary at all.

[Role of various methods of examination in the detection and functional evaluation of chronic bronchitis]. / Rol' razlichnykh metodov issledovaniia v vyiavlenii i funktsional'noi otsenke khronicheskogo bronkhita.

An analysis of data obtained in the course of screening of 2173 persons made it possible to outline aims and objectives of the employed methods. Pneumotachography with air flow interruption under the above conditions helped to reveal persons at risk of developing chronic bronchopulmonary diseases including chronic bronchitis. Radionuclide scintigraphy of the lungs with 133Xe was indicated for a more through examination of patients with diagnosed chronic bronchitis to detect the initial signs of the development of its obstructive form.

[Individual active surgical tactics in acute gastroduodenal hemorrhage caused by peptic ulcer]. / Individua'lno-aktivnaia khirurgicheskaia taktika pri ostrykh gastroduodena'lnykh krovotecheniiakh iazvennogo geneza.

The current possibilities for identifying the sources and volumes of bleeding as well as the methods of local and general hemostatic therapy allow individual-active surgical tactics to be employed in acute hemorrhage from an ulcer. It is based on consideration for the severity, volume, rate, and duration of bleeding, the localization and visual appraisal of the ulcerous substrate and the vessel undergoing erosion, the patient's age, the concomitant pathological conditions, and the degree of the operative risk. Operations in such cases should be distributed into 3 groups: emergency, postponed, and early planned. Individual choice with due account for the indications for each group of operations, which was determined in 1,789 operative interventions, made it possible to reduce the total postoperative mortality to 2.9%.

[Determination of the degree of surgical risk in treating peptic gastrointestinal hemorrhages]. / Opredelenie stepeni riska pri lechenii iazvennykh zheludochno-kishechnykh krovotechenii.

Based on a complex analysis of case histories of 817 patients operated upon for ulcerous gastro-intestinal bleedings the authors have developed a system of the assessment of a degree of operative risk. High risk degree of the forthcoming surgery necessitates its shorter duration and less traumatic character as well as careful management of the patients in the nearest postoperative period.

[Total gastrectomy in the surgery of malignant stomach neoplasms]. / Total'naia gastréktomiia v khirurgii zlokachestvennykh novoobrazovanii zheludka.

An analysis of surgical treatment of 100 patients with malignant tumors of the stomach with using total gastrectomy has shown that postoperative lethality made up 90%, unfavorable results of using total gastrectomy being associated with insufficient sutures of the esophageal-intestinal anastomosis. The modified method used allows to elevate reliability of the esophageal intestinal anastomosis, to shorten the time of operative procedure. Total gastrectomy followed by chemotherapy in the postoperative period prolongs the patient's life, but does not secure against recurrences of the disease in later terms.