Small bowel obstruction caused by intramural hemorrhage secondary to anticoagulant therapy

Intramural hemorrhage as a cause for small bowel obstruction is extremely rare. We presented an unusual case report of small bowel obstruction caused by intramural jejunal hemorrhage secondary to anticoagulant therapy. An 85-year-old male patient with atrial fibrillation on long-term warfarin presented with nausea and vomiting for 2 days, accompanied with no bowel movement since the onset. Physical exam was unremarkable except soft abdomen with distension but no tenderness, hyperactive bowel sounds and positive fecal occult blood test. Investigations showed anemia with hemoglobin/ hematocrit of 10 (g/dl) / 30%, prothrombin time with an International Normalized Ratio (INR) of 9.58. Abdominal x-ray showed air fluid levels suggestive of small bowel obstruction. Contrast-enhanced abdominal computerized tomography showed circumferential wall thickening, luminal narrowing and partial small bowel obstruction secondary to intramural jejunal hemorrhage. Patient recovered completely 48 hours after medical treatment (nothing per oral, intravenous fluids, nasal gastric tube, Vitamin K, frozen fresh plasma and packed red blood cell transfusion). Spontaneous intramural small-bowel hematoma is rare and occurs in patients who receive excessive anticoagulation with warfarin or who have some other risk factors for bleeding. Intramural hematoma most commonly involves the jejunum, followed by the ileum and the duodenum. The spectrum of presentation is wide, from abdominal pain, emesis to gastrointestinal tract hemorrhage. Abdominal CT is the key for diagnosis, with characteristics including circumferential wall thickening, intramural hyperdensity, luminal narrowing, and intestinal obstruction. Early diagnosis is crucial because most patients are treated nonoperatively with a good outcome.

Longitudinal double-spin asymmetry for inclusive jet production in p[over -->] + p[over -->] collisions at sqrt[s]=200 GeV

We report a new STAR measurement of the longitudinal double-spin asymmetry A(LL) for inclusive jet production at midrapidity in polarized p + p collisions at a center-of-mass energy of sqrt[s]=200 GeV. The data, which cover jet transverse momenta 5<p(T)<30 GeV/c, are substantially more precise than previous measurements. They provide significant new constraints on the gluon spin contribution to the nucleon spin through the comparison to predictions derived from one global fit to polarized deep-inelastic scattering measurements.

The dielectric properties of Ba(0.6)Sr(0.4)Cr(x)Ti(1-x)O(3) thin films prepared by pulsed laser deposition

Ba(0.6)Sr(0.4)Cr(x)Ti(1-x)O(3) (BSCT) films were prepared by pulsed laser deposition with the value of x varying from 0 mol% to 2.0 mol%. X-ray diffraction analysis detected an increase in the lattice parameters, which could be due to the characteristics of the growth process. Dielectric properties and tunability of the BSCT films were measured. The dissipation factors of the films decreased with increasing Cr-concentration. The highest figure of merit (FOM) value of 33.3 was obtained in 1.0 mol%-doped BSCT film. As a result, the effect of Cr doping is positive.

Effect of V(2)O(5) on the sintering behavior, microstructure, and electrical properties of (Na(0.5)K(0.5))NbO(3) ceramics

Well-sintered (Na(0.5)K(0.5))NbO(3)-x mol% V(2)O(5) ceramics (abbreviated as NKN-V) with fine electrical properties were successfully prepared by conventional solid-state reaction through the careful control of processing conditions. The sintering behavior, phase structure, and electrical properties of the V(2)O(5)-doped NKN ceramics were investigated. Results show that when the V(2)O(5) content is 0.6 mol%, the NKN ceramics attained the maximum density of 4.46 g/cm(3) (about 98.9% of the theoretical density) at 1060 degrees C, and therefore possessed enhanced electrical properties. But when the V(2)O(5) content continued increasing, the density decreased. The secondary phase (Na(2)V (6)O(16)) could be detected by XRD analysis in all samples except x = 0 mol%. The Curie temperature of the NKN-based materials was found to decrease with the increase of V(2)O(5). The dielectric properties of NKN ceramics doped with 0.6 and 0.9 mol% V(2)O(5) were better than that of pure NKN ceramics. In addition, annealing treatment was proved to be an effective technique for improving dielectric properties and reducing the leakage current density.

Platelet-derived growth factor signals play critical roles in differentiation of longitudinal smooth muscle cells in mouse embryonic gut

In the development of mouse gut, longitudinal smooth muscle cells (LMC) and interstitial cells of Cajal (ICC) originate from common precursor cells expressing c-Kit. Recently, some gastrointestinal stromal tumours, which develop from smooth muscle layers of the gut and have gain-of-function mutations of c-kit, have been reported to have gain-of-function mutations of platelet-derived growth factor (PDGF) receptor alpha gene. These data raise the possibility that PDGF signalling might be involved in the development of LMC. Therefore, we examined the expression pattern of the PDGF signal family of embryonic gut by immunohistochemistry and in situ hybridization, and investigated the role of PDGF signals in the development of smooth muscle layers in mouse gut using a new organ culture system. During embryonic development, the circular muscle layer expressed PDGF-A, enteric neurons expressed PDGF-B and common precursor cells of LMC and ICC expressed both PDGF receptor alpha and beta. The selective PDGF receptor inhibitor AG1295 suppressed the differentiation of LMC in gut explants. We conclude that PDGF signals play critical roles in the differentiation of LMC in mouse embryonic gut.

Effects of the sol-concentration on the structural and dielectric properties of Pb(0.3)Sr(0.7)TiO(3) thin films derived by the sol-gel method

Pb(0.3)Sr(0.7)TiO(3)(PST) thin films were deposited on Pt coated Si(100) substrates by sol-gel techniques using different sol-concentrations. The structural and dielectric characteristics of lead strontium titanate (PST) thin films as a function of the sol concentration were investigated. PST thin films reveal a columnar texture through the thickness when the sol-concentration is lower than 0.30 M. PST thin films derived from 0.35 M sol show better dielectric characteristics with the dielectric constant, dielectric loss, tunability, and field of motion (FOM) (tunability/ dissipation) of 200, 0.01, 47% and 47, respectively. The temperature dependence of the dielectric constant, dielectric loss and tunability of PST thin films were investigated in the temperature range of -140 to 120 degrees C exhibiting a dielectric peak of about -45 degrees C.

A randomized, placebo-controlled trial of repeated IV antibiotic therapy for Lyme encephalopathy

BACKGROUND

Optimal treatment remains uncertain for patients with cognitive impairment that persists or returns after standard IV antibiotic therapy for Lyme disease.

METHODS

Patients had well-documented Lyme disease, with at least 3 weeks of prior IV antibiotics, current positive IgG Western blot, and objective memory impairment. Healthy individuals served as controls for practice effects. Patients were randomly assigned to 10 weeks of double-masked treatment with IV ceftriaxone or IV placebo and then no antibiotic therapy. The primary outcome was neurocognitive performance at week 12-specifically, memory. Durability of benefit was evaluated at week 24. Group differences were estimated according to longitudinal mixed-effects models.

RESULTS

After screening 3368 patients and 305 volunteers, 37 patients and 20 healthy individuals enrolled. Enrolled patients had mild to moderate cognitive impairment and marked levels of fatigue, pain, and impaired physical functioning. Across six cognitive domains, a significant treatment-by-time interaction favored the antibiotic-treated group at week 12. The improvement was generalized (not specific to domain) and moderate in magnitude, but it was not sustained to week 24. On secondary outcome, patients with more severe fatigue, pain, and impaired physical functioning who received antibiotics were improved at week 12, and this was sustained to week 24 for pain and physical functioning. Adverse events from either the study medication or the PICC line were noted among 6 of 23 (26.1%) patients given IV ceftriaxone and among 1 of 14 (7.1%) patients given IV placebo; these resolved without permanent injury.

CONCLUSION

IV ceftriaxone therapy results in short-term cognitive improvement for patients with posttreatment Lyme encephalopathy, but relapse in cognition occurs after the antibiotic is discontinued. Treatment strategies that result in sustained cognitive improvement are needed.

Measurement of transverse single-spin asymmetries for Dijet production in proton-proton collisions at sqrt[s]=200 GeV

We report the first measurement of the opening angle distribution between pairs of jets produced in high-energy collisions of transversely polarized protons. The measurement probes (Sivers) correlations between the transverse spin orientation of a proton and the transverse momentum directions of its partons. With both beams polarized, the wide pseudorapidity (-1< or = eta < or = +2) coverage for jets permits separation of Sivers functions for the valence and sea regions. The resulting asymmetries are all consistent with zero and considerably smaller than Sivers effects observed in semi-inclusive deep inelastic scattering. We discuss theoretical attempts to reconcile the new results with the sizable transverse spin effects seen in semi-inclusive deep inelastic scattering and forward hadron production in pp collisions.

Coherent atom-trimer conversion in a repulsive Bose-Einstein condensate

We show that the use of a generalized atom-molecule dark state permits the enhanced coherent creation of triatomic molecules in a repulsive atomic Bose-Einstein condensate, with further enhancement being possible in the case of heteronuclear trimers via the constructive interference between two chemical reaction channels.

Partonic Flow and phi-Meson production in Au+Au collisions at sqrt radical sNN = 200 GeV

We present first measurements of the phi-meson elliptic flow (v2(pT)) and high-statistics pT distributions for different centralities from radical sNN=200 GeV Au+Au collisions at RHIC. In minimum bias collisions the v2 of the phi meson is consistent with the trend observed for mesons. The ratio of the yields of the Omega to those of the phi as a function of transverse momentum is consistent with a model based on the recombination of thermal s quarks up to pT approximately 4 GeV/c, but disagrees at higher momenta. The nuclear modification factor (R CP) of phi follows the trend observed in the K S 0 mesons rather than in Lambda baryons, supporting baryon-meson scaling. These data are consistent with phi mesons in central Au+Au collisions being created via coalescence of thermalized s quarks and the formation of a hot and dense matter with partonic collectivity at RHIC.

A novel DFNA5 mutation, IVS8+4 A>G, in the splice donor site of intron 8 causes late-onset non-syndromic hearing loss in a Chinese family

We report here the clinical, genetic, and molecular characteristics of a large Chinese family exhibiting non-syndromic, late-onset autosomal dominant sensorineural hearing loss. Clinical evaluation revealed variable phenotypes of hearing loss in terms of severity and age-at-onset of disease in these subjects. Genome-wide linkage analysis mapped the disease gene to the DFNA5 locus with a maximum two-point log odds score of 5.39 at [theta] = 0 for marker D7S2457. DNA sequencing of DFNA5 revealed a novel heterozygous IVS8+4 A>G substitution in the splice donor site of intron 8. Reverse transcriptase-polymerase chain reaction (RT-PCR) showed skipping of exon 8 in the mutant transcript. This mutation faithfully cosegregated with hearing loss in the family. In addition, the mutation was absent in 100 unrelated control DNA samples of Chinese origin. The IVS8+4 A>G mutation is predicted to create a shift in the reading frame and introduce a stop codon at position 372, thereby resulting in a prematurely truncated DFNA5 protein. Up to date, a total of four mutations in DFNA5 have been reported to lead to hearing impairment, all of them result in skipping of exon 8 at the mRNA level. Our findings provide further support for the hypothesis that DFNA5-associated hearing loss is caused by a very specific gain-of-function mutation.

Avian influenza A (H5N1) infection in a patient in China, 2006

BACKGROUND

Highly pathogenic avian influenza H5N1 virus has caused increasing human infection in Eurasia since 2004. So far, H5N1 human infection has been associated with over 50% mortality that is partly because of delay of diagnosis and treatment.

OBJECTIVES AND METHODS

Here, we report that an H5N1 influenza virus infected a 31-year-old patient in Shenzhen in June 2006. To identify the possible source of the infection, the human isolate and other H5N1 influenza viruses obtained from poultry and wild birds in southern China during the same period of time were characterized.

RESULTS

Genetic and antigenic analyses revealed that the human H5N1 influenza virus, Shenzhen/406H/06, is of purely avian origin and is most closely related to viruses detected in poultry and wild birds in Hong Kong in early 2006.

CONCLUSIONS

The findings of the present study suggest that the continued endemicity of H5N1 influenza virus in the poultry in southern China increases the chance for introduction of the virus to humans. This highlights the importance of continued surveillance of poultry and wild birds for determining the source for human H5N1 infection.

Global Inorganic Source of Atmospheric Bromine

A few bromine molecules per trillion (ppt) causes the complete destruction of ozone in the lower troposphere during polar spring and about half of the losses associated with the "ozone hole" in the stratosphere. Recent field and aerial measurements of the proxy BrO in the free troposphere suggest an even more pervasive global role for bromine. Models, which quantify ozone trends by assuming atmospheric inorganic bromine (Bry) stems exclusively from long-lived bromoalkane gases, significantly underpredict BrO measurements. This discrepancy effectively implies a ubiquitous tropospheric background level of approximately 4 ppt Bry of unknown origin. Here, we report that I- efficiently catalyzes the oxidation of Br- and Cl- in aqueous nanodroplets exposed to ozone, the everpresent atmospheric oxidizer, under conditions resembling those encountered in marine aerosols. Br- and Cl-, which are rather unreactive toward O3 and were previously deemed unlikely direct precursors of atmospheric halogens, are readily converted into IBr2- and ICl2- en route to Br2(g) and Cl2(g) in the presence of I-. Fine sea salt aerosol particles, which are predictably and demonstrably enriched in I- and Br-, are thus expected to globally release photoactive halogen compounds into the atmosphere, even in the absence of sunlight.

The expression of P-gp, Bcl-2 and VEGF in epithelial ovarian carcinoma and their significance

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Background: To investigate the expression of P - gp,Bcl-2 and VEGF in epithelial ovarian carcinoma as well as their significance. Methods: Expression of P- gp,Bcl-2 and VEGF were examined in 72 epithelial ovarian carcinoma by immunohistochemisty (method of S - P) . Results: The positive expressions of P - gp,Bcl-2 and VEGF in patients with ovarian carcinoma were 51.4%,54.2%,56.9% respectively .Compared with those in ovarian benign tumors and normal controls, such expression level were significantly higher ( P < 0.05). The expression of P - gp was positively correlated with the expression of VEGF( P <0. 05) while the expression of VEGF was positively correlated with the expression of Bcl-2 ( P <0. 05). Univariate analysis showed worse disease-free survival in the patients with positive expression of P-gp or VEGF than in those with negative expression of P -gp or VEGF( P < 0. 05). Multivariate analysis of clinical and pathological data by Cox-regression method showed that the expression of P - gp or VEGF and co- expression of these three indexes were correlated with poor prognosis. Conclusions: Over-expression of P - gp,Bcl-2 and VEGF is correlated with drug resistance of clinical chemotherapy and survival rate in ovarian cancer . To examine these 3 indexes in ovarian cancer is helpful to evaluate response to clinical chemotherapy as well as to predict the prognosis.

No significant financial relationships to disclose.