Elevated anti-alpha-enolase antibody levels in Kawasaki disease

OBJECTIVE

By functioning as a heat-shock protein (HSP), alpha-enolase has an important role in the pathophysiology of multivariant vasculitis. Kawasaki disease (KD) is a type of vasculitis occurring primarily in children. The role of alpha-enolase in KD was assessed by measuring anti-alpha-enolase antibody (Ab) titres in patients with KD and the usefulness of anti-alpha-enolase Ab as a diagnostic tool in atypical KD patients was evaluated.

METHODS

Anti-alpha-enolase Ab titres were measured by using an enzyme-linked immunosorbent assay (ELISA) in seven normal control patients, nine febrile control patients and 14 KD patients (10 typical KD, four atypical KD). A standard deviation (SD) of 3 above the mean of the normal control group was considered to be positive reactivity. Western blotting using recombinant human alpha-enolase was performed in four KD patients and three normal controls.

RESULTS

With the positive reactivity limited to +3 SD over the mean (>0.6), 10 out of 14 patients (71%) were positive at the acute onset and 12 out of 14 patients (85.7%) were positive before discharge. In total, 12 out of 14 patients (85.7%) were positive either at acute onset or before discharge. All four atypical KD patients showed positive reactivity. Specific positive bands against recombinant human alpha-enolase were detected by western blotting in all four KD patients, but no reactivity was seen in three patients with normal controls.

CONCLUSION

This is the first study to demonstrate that autoantibodies against the alpha-enolase are present in the sera of KD patients. We suggest that anti-alpha-enolase Ab should be a good candidate for a diagnostic tool in atypical KD.

Incidence of tuberculosis among health care workers at a private university hospital in South Korea

SETTING

A private university hospital in South Korea.

OBJECTIVE

To investigate the incidence of tuberculosis (TB) among health care workers (HCWs) employed at a university hospital in South Korea.

DESIGN

The occurrence of TB cases among HCWs over a 6-year period (2001-2006) was reviewed. The prevalence of TB was compared with that of the general population using a prevalence ratio (PR) adjusted by age and sex.

RESULTS

The study involved 8433 people. TB developed in 61 HCWs (0.72%). The prevalence ratio among all HCWs was 1.05 (95%CI 0.80-1.35). In occupational subgroups, the PRs for doctors, nurses and employees in other departments were respectively 0.58 (95%CI 0.30-1.01), 1.81 (95%CI 1.21-2.59) and 0.95 (95% CI 0.58-1.46). For nurses working in TB-related departments, the relative risk of developing TB was 3.4 times higher (95%CI 1.52-8.25) than for employees in other departments (P=0.005). The PR for nurses working in TB-related department was 5.1 (95%CI 3.23-8.42).

CONCLUSION

Among HCWs, nurses working in TB-related departments were at increased risk of developing TB. This suggests that some TB develops via in-hospital infection.

Structural diversity and extreme stability of unimolecular Oxytricha nova telomeric G-quadruplex

Oxytricha nova telomeric DNA contains guanine-rich short-tandem repeat sequences (GGGGTTTT) n and terminates as a single strand at the 3'-end. This single-stranded overhang forms a novel DNA structure, namely, G-quadruplex, comprising four quartets. In this study, we investigated the structures and dynamics of unimolecular Oxytricha nova ( O. nova) telomeric G-quadruplexes by performing single molecule fluorescence resonance energy transfer (FRET) spectroscopy and bulk circular dichroism (CD) measurements. We observed that unimolecular O. nova G-quadruplexes exhibit structural polymorphism according to monovalent cations. In the presence of Na (+), only antiparallel conformation is detected, which was demonstrated in previous studies; however, in the presence of K (+), they fold into two different conformations, a parallel conformation and an antiparallel one different from that induced by Na (+). Furthermore, these G-quadruplexes show extremely high stability in their dynamics when compared with human G-quadruplexes. While human telomeric G-quadruplexes that possess three quartets display fast dynamic behavior (<100 s) at low K (+) concentrations or high temperatures, O. nova G-quadruplexes maintain their conformational state for a long time (>1000 s), even at the lowest K (+) concentration and the highest temperature investigated. This high stability is primarily due to an extra quartet that results in additional cation coordination. In addition to cation coordination, we propose that other factors such as base stacking and the size of the thymine loop may contribute to the stability of O. nova G-quadruplexes; this is based on the fact that the O. nova G-quadruplexes were observed to be more stable than the human ones in the presence of Li (+), which is known to greatly destabilize G-quadruplexes because of imprecise coordination. This extreme stability of four-quartet G-quadruplexes enables telomere protection even in the absence of protective proteins or in the case of abrupt environmental changes, although only a single G-quadruplex structure can be derived from the short single-stranded overhang.

The emerging role of pituitary tumour transforming gene (PTTG) in endocrine tumourigenesis

It is now 10 years since PTTG was first cloned and isolated. Perhaps the major story of the intervening decade of work performed by numerous groups around the world is the sheer multifunctionality ascribed to this gene. PTTG has been implicated in mechanisms of gene transactivation, cell transformation, angiogenesis, metabolism, apoptosis, DNA repair, genetic instability and mitotic control, both in endocrine and non-endocrine settings. In the current review, we cast a critical eye over a decade of PTTG research within the field of endocrine neoplasia.

Vector field mapping of local polarization using gold nanoparticle functionalized tips: independence of the tip shape

We have measured local electric field vectors of local polarizaton on the nanoscale using gold nanoparticle functionalized tips as local field scatterers. In our experiments, the local field induces a dipole-moment in the gold nanoparticle functionalized tip, which then radiates into the far-field, transferring the full information about the local electric field from the near into the far field. The polarization characteristics of the scattered fields are analyzed using a conventional ellipsometry method. The tip dependent scattering function- the polarizability tensor- is fully determined by far field scattering measurements. Once the polarizability tensor for each tip is correctly accounted for in the data analysis, our results show that the finally determined local field polarization vectors are essentially independent of the tip shape.

Separase, securin and Rad21 in neural cell growth

The key mitotic regulator securin is expressed at low levels in fetal brain compared with adult, and modulates the proliferation of human embryonic neuronal N-Tera2 (NT2) cells. We now examine the function and expression of securin's interacting partner separase, along with Rad21, the functional component of cohesin, which is cleaved by separase following interaction with securin. In contrast to securin, the cleaved forms of separase and Rad21 were highly expressed in human fetal cerebral cortex compared with adult. In a murine model of absent securin expression - the PTTG knock-out mouse - separase and Rad21 were over-expressed in multiple brain regions. In addition, cDNA array analysis of other key mitotic regulators additionally identified cyclin C and sestrin 2 to be induced in the brains of securin-null mice compared with wild type. Further, Rad21 mRNA expression was highly correlated with that of securin, separase, cyclin C and sestrin 2 in fetal brains. In embryonic neuronal NT2 cells, siRNA repression of separase failed to significantly alter cell turnover, whereas repression of securin expression resulted in increased levels of the activated forms of Rad21 and separase, and promoted cell proliferation. Our data suggest that the co-ordinated expression of separase, securin and Rad21 is fundamental for the developing brain.

Thyroid cancer: are molecular studies making any difference?

'Translational research' encompasses all activities that apply basic scientific research findings to clinical practice. Although it has taken almost 20 years since the first scientific discoveries, the approval of new 'drugs' such as Herceptin and Avastin represents a successful example. There has also been successful translation of science into the clinic in the field of otolaryngology. In the last decade, we have seen major developments in molecular biology and genetics. Two notable achievements have been the completion of the human genome project and the parallel advances in high-throughput molecular genomic and proteomic technologies. Linked with these events has been the enormous accumulation of new data which offers the promise of important future clinical applications. This review aims to discuss these major scientific developments, to demonstrate successes in thyroid translational research, and to summarise more recent research findings in thyroid disease which provide hope for the development of future clinical tools.

Terahertz electromagnetic wave transmission through random arrays of single rectangular holes and slits in thin metallic sheets

We report on the observation of terahertz transparency in random arrays of the single rectangular holes and slits with the areal coverage of only 12%. The terahertz transparency occurs at the fundamental shape resonance of the rectangular holes and confirms the theoretical predictions of earlier works of García-Vidal et al. [Phys. Rev. Lett. 95, 103901 (2005)] on single rectangular holes and of Ruan and Qiu [Phys. Rev. Lett. 96, 233901 (2006)] on random arrays of holes.

Fourier-transform terahertz near-field imaging of one-dimensional slit arrays: mapping of electric-field-, magnetic-field-, and Poynting vectors

We present 2D measurements of the full THz electric field behind a sample consisting of multiple slits in a metal foil. Our measurements, which have a sub-wavelength spatial, and a sub-period temporal resolution, reveal electric field lines, electric field vortices and saddle points. From our measurements we are able to reconstruct the magnetic field and, finally, the position and time-dependent Poynting vector which shows the flow of energy behind the sample. Our results show that it is possible to study the flow of light near sub-wavelength plasmonic structures such as slit-arrays and, by implication, other metamaterial samples.

Dental otalgia

BACKGROUND

Secondary or referred otalgia can represent a diagnostic challenge to the otolaryngologist. Collectively, dental disorders are the most common causes of secondary otalgia presenting to the ENT clinic, and may account for up to 50 per cent of referred otalgia. Temporomandibular joint dysfunction syndrome represents the most common dental cause of referred otalgia. Decay and pulpal inflammation of posterior teeth can also frequently present as otalgia. The common embryological developmental origin of both oral and dental structures and the ear is responsible for their overlapping sensory nerve supplies, and this explains referred otalgia secondary to dental and temporomandibular joint disorders. These disorders can be easily overlooked, resulting in unnecessary and costly investigations.

AIMS

This review aims to give a succinct overview of common dental causes of otalgia, and to provide ENT clinicians with guidelines for performing a rapid and simple dental and temporomandibular joint examination, which will reliably diagnose or exclude dental otalgia.

Increased serum levels of macrophage migration inhibitory factor in patients with Kawasaki disease

OBJECTIVE

To determine whether serum levels of macrophage migration inhibitory factor (MIF) increase in patients with Kawasaki disease (KD) and also correlate with other inflammatory indices.

METHODS

Serum samples from 10 patients with KD, 15 normal healthy subjects, and seven febrile control subjects were assayed for MIF by enzyme-linked immunosorbent assay (ELISA).

RESULTS

There was a significant increase in the serum levels of MIF in the acute stage of KD [113.06 (range 20.6-157.36) ng/mL] compared with those in the subacute stage [28.11 (8.57-143.48) ng/mL, p<0.01], normal controls [12.95 (8.40-18.67) ng/mL, p<0.001], and febrile controls [36.58 (21.31-59.67) ng/mL, p = 0.01]. The increase in MIF correlated with an increase in interleukin-6 (IL-6) (r = 0.52, p = 0.047).

CONCLUSION

MIF may be a useful marker in the acute stage of KD and may provide important clues to the pathogenesis of this disease.

Pad - a new self-collection device for human papillomavirus

This study was designed to determine the accuracy and agreement of a self-collection method using pad for human papillomavirus (HPV) DNA. One hundred and thirty-four patients at university hospitals voluntarily participated in the accuracy study, and 314 volunteers participated in the agreement study at local clinics. DNA was extracted and amplified using HPV L1 consensus primers designed for the direct sequencing. In the accuracy study, all samples were probed via histological examinations. With regard to the detection of squamous intraepithelial lesion (SIL), self-collection pad sampling displays sensitivity, of 76.9%, and specificity, of 93.3%. Three hundred and fourteen self-collection pad samples and the concurrent physicians' samples showed a 97.8% agreement, with a Kappa value of 0.9200. A new self-collection pad for the detection of HPV DNA appears to constitute an easy, rapid, and convenient alternative method for the cervical cancer screening of many women with the virtue of being incredible readily accessible.

Effective medium description of plasmonic metamaterials

We demonstrate that the electromagnetic properties of a plasmonic metamaterial, composed of a perfectly conducting metal film perforated with an array of holes, can be effectively described by a structureless, three layer film. The enhanced transmission, first observed by Ebbessen, is identified with resonant tunneling in the equivalent three layer system and perfect transmission is shown to be possible below the critical thickness of a metamaterial. The nature of modes mediating perfect transmission is clarified.

Impact of short-term exposure to fluoroquinolones on ofloxacin resistance in HIV-negative patients with tuberculosis

SETTING

Seoul, Korea, a country with an intermediate tuberculosis (TB) burden and low prevalence of human immunodeficiency virus (HIV) infection.

OBJECTIVES

To determine the frequency of ofloxacin (OFX) resistance in Mycobacterium tuberculosis, and to assess whether short-term use of fluoroquinolones (FQNs) induces ofloxacin-resistant M. tuberculosis.

DESIGN

The subject cohort consisted of 2788 patients with culture-confirmed TB with drug susceptibility testing data; only four were HIV-positive. The patients were divided into two groups: those who were or were not recently exposed to FQNs.

RESULTS

Of the 2788 isolates, the rates of OFX resistance were 1.1% and 8.5% in initially treated and retreated patients, respectively (P < 0.05). Of the 94 OFX-resistant isolates, 83 (88.3%) were multidrug-resistant (MDR). There was no difference in rates of OFX resistance throughout the study period, or between the FQN-exposed (1/39, 2.6%) and control groups (93/2749, 3.4%). The median duration of FQN treatment was 7 days (range 1-47 days). One OFX-resistant isolate in the FQN-exposed group was MDR.

CONCLUSION

The rate of OFX-resistant M. tuberculosis was low and stationary throughout the study period in Korea. Most OFX resistance was accompanied by MDR, and the frequency of OFX-resistant M. tuberculosis was low in subjects taking short-term FQNs.

Suitable whole blood levels 2 hours after neoral in liver transplant patients: experiences at a single center

Whole blood levels 2 hours after Neoral (C2) administration were observed to correlate better with area under the curve (AUC(0-4)) than trough levels (C0), suggesting that C2 may be the best single time point predictor of Neoral absorption. Owing to concerns about drug toxicity due to excessive immunosuppression, C2 adjustments to target blood levels may represent an advance. The present study measured C2 and levels to determine which correlated more closely with AUC(0-4).

METHODS

Between August 2003 and July 2004, 40 adult liver transplantations were performed in our center. All patients received Neoral twice daily. They were maintained at a C0 level of about 200 ng/mL. C0 levels were measured daily. C2 levels were estimated on postoperative days 3, 5, 7, 14, and 28. AUC(0-4) performed on postoperative days 3, 7, and 28 was calculated using the trapezoidal rule.

RESULTS

The mean AUC(0-4), C0, C1, C2, C3, and C4 were 1100.3 +/- 484.8 ng/mL, 197.1 +/- 84.7 ng/mL, 240.7 +/- 166.2 ng/mL, 307.8 +/- 162.6 ng/mL, 302.8 +/- 138.9 ng/mL, and 300.3 +/- 142.8 ng/mL, respectively. C2 correlated with AUC(0-4) (R2 = 0.868: P < .05) better than C0 (R2 = 0.245: P < .05), C1 (R2 = 0.604: P < .05), or C4 (R2 = 0.583: P < .05).

CONCLUSIONS

Neoral dose monitoring according to a mean C2 range of 307.8 +/- 162.6 ng/mL correlated better with AUC(0-4). Further studies are required to determine suitable C2 levels in liver transplant patients.

Vagus nerve stimulation in pediatric intractable epilepsy: a Korean bicentric study

OBJECTIVE

To present our experience with vagus nerve stimulation (VNS) and to evaluate the long-term efficacy and safety of the procedure in pediatric intractable epilepsy.

METHODS

This study included sixteen patients, who were implanted with a vagus nerve stimulator and could be followed up for at least more than 12 months in two epilepsy centers. Data including seizure frequency, EEG, quality of life measures and adverse events were prospectively filed over a 5-year period.

RESULTS

VNS resulted in a > 50% reduction in seizure frequency in 50.0% (8/16) of children with 31.3% (5/16) of patients achieving a > 90% reduction. Additionally, enhancements in quality of life were as follows: memory in 50.0% (8/16), mood in 62.5% (10/16), behavior in 68.8% (11/16), alertness in 68.8% (11/16), achievement in 37.5% (6/16), and verbal skills in 43.8% (7/16) of the patients. Adverse events included hoarseness in two patients, dyspnea during sleep in two patients, and sialorrhea in one patient. However, these events were tolerable or could be controlled by the adjustment of output currents. In one patient, wound revision was required.

CONCLUSION

Our data supports the role of VNS as an alternative therapy for pediatric intractable epilepsy.

Terahertz transparency at Fabry-Perot resonances of periodic slit arrays in a metal plate: experiment and theory

We report on a perfect transmission in one-dimensional metallic structure using time-domain terahertz spectroscopy. Fabry-Perot resonance appearing in spectral region below first Rayleigh minimum strongly enhances transmission up to over ninety-nine percent. Theoretical calculations reveal that under the perfect transmission condition, a symmetric eigenmode inside the slits is excited and a funneling of all incident energy onto the slits occurs, resulting in large energy concentration equivalent to the inverse sample coverage and high near-field enhancement of electric and magnetic field intensities. Our work opens way toward near-field terahertz amplification, applicable to high-field terahertz spectroscopy.

Influence of NICE guidelines on removal of third molars in a region of the UK

We investigated compliance in the West Midlands, UK with the guidelines issued by the National Institute of Clinical Excellence (NICE) on the indications for the removal of third molars. We audited the practice at three departments of maxillofacial surgery that take referrals from three districts of the West Midlands. Of a total of 300 referral letters 217 (72%) specified a NICE-compliant diagnosis. A total of 267 patients (89%) were advised to have third molars removed and all three units achieved 100% compliance with NICE guidelines. There was a concordance of diagnosis of 69% between referring general dental practitioners and attending oral surgeons (concordance was 79% if only those referral letters that carried a specific indication were considered). Disease-free wisdom teeth made up a mean of only 6% of all referrals.

Pituitary tumor transforming gene (PTTG) stimulates thyroid cell proliferation via a vascular endothelial growth factor/kinase insert domain receptor/inhibitor of DNA binding-3 autocrine pathway

CONTEXT

Vascular endothelial growth factor (VEGF) exerts its biological effects by binding to the tyrosine kinase receptors VEGF receptor type 1 (VEGFR1/Flt-1) and VEGFR2 (Flk-1/KDR). Kinase insert domain receptor (KDR) is the critical receptor controlling proliferation and migration of endothelial cells and has been shown to be expressed in some nonendothelial cells. We recently reported that the proangiogenic pituitary tumor transforming gene (PTTG) stimulates VEGF and up-regulates inhibitor of DNA binding-3 (ID3), an important gene in VEGF-dependent angiogenesis.

OBJECTIVE

Our objective was to test whether VEGF, ID3, and KDR confer a PTTG-mediated effect on thyroid cell growth.

DESIGN

Gene expression, MAPK stimulation, and cell proliferation were assessed in follicular thyroid cancer FTC133 cells. Gene expression and clinical associations were determined in 21 normal and 38 tumorous thyroid specimens (nine follicular and 29 papillary).

RESULTS

ID3 correlated with VEGF mRNA expression in our series of thyroid cancers, which also showed up-regulated KDR mRNA. Stimulation of FTC133 cells with exogenous VEGF enhanced ID3 expression, which could be abrogated by the KDR-specific inhibitor ZM323881, suggesting that VEGF regulation of ID3 is KDR dependent. PTTG significantly correlated with KDR mRNA expression in our thyroid cancer cohort and up-regulated KDR and VEGF expression in FTC133 cells. Finally, cells transfected with PTTG demonstrated increased cell proliferation and phosphorylation of MAPK, which was abrogated by ZM323881.

CONCLUSIONS

We report the presence of a VEGF/KDR/ID3-dependent autocrine pathway in FTC133 thyroid cells. By up-regulating both VEGF and KDR expression, we propose a novel PTTG-mediated proliferative pathway that may be critical to thyroid cancer growth and progression.

Securin induces genetic instability in colorectal cancer by inhibiting double-stranded DNA repair activity

Genetic instability (GI) is a hallmark feature of tumor development. Securin, also known as pituitary tumor transforming gene (PTTG), is a mitotic checkpoint protein which is highly expressed in numerous cancers, is associated with tumor invasiveness, and induces GI in thyroid cells. We used fluorescence inter-simple sequence repeat PCR to assess GI caused primarily by DNA breakage events in 19 colorectal tumors. GI values ranged significantly, with Dukes' stage C&D colorectal tumors exhibiting greater GI and higher securin expression than Dukes' stage A&B tumors. Consistent with these findings, we observed a dose-dependent increase in GI in HCT116 cells in response to securin overexpression, as well as in non-transformed human fibroblasts. As securin has been implicated in a novel DNA repair pathway in fission yeast, we investigated its potential role in chemotoxic DNA damage response pathways in mammalian cells, using host cell reactivation assays. Securin overexpression in HCT116 cells inhibited etoposide-induced double-stranded DNA damage repair activity, and repressed Ku heterodimer function. Additionally, we observed that securin and Ku70 showed a reciprocal cytosol-nuclear translocation in response to etoposide-induced dsDNA damage. Our data suggest that, by repressing Ku70 activity and inhibiting the non-homologous end-joining dsDNA repair pathway, securin may be a critical gene in the development of GI in colorectal cancer.

The metallic composition of aerosols at three monitoring sites in Korea during winter 2002

In the present study, the distribution patterns of various metals were analyzed and compared using PM samples collected concurrently from three monitoring sites located in Korea (Seoul, Busan, and Jeju island) in December 2002. As these sites can represent metal pollution with different degrees of anthropogenic activities, their concentration levels were distinguished in a systematic manner in the order of Jeju, Busan, and Seoul. By comparing the present data sets with those measured previously from other locations in Korea and around the world, we attempted to diagnose the general status of elemental pollution on the Korean peninsula. Through an application of different statistical approaches, the major processes controlling elemental levels were assessed for each of the three study sites. The results indicated the importance of both crustal and anthropogenic sources in all sites with their relative roles varying significantly from each other. The results of the metal analysis data, when examined in relation to back trajectory analysis, confirmed that their concentration changes are affected quite sensitively with air mass movement patterns. The overall results of this study consistently indicated the contribution of a strong anthropogenic source area (e.g., China) to the observed metal concentration levels in the study area, but the strengths of such signals vary considerably across the Korean peninsula.