Long-term follow-up of a bilateral acute posterior multifocal placoid pigment epitheliopathy following COVID-19 infection: a case report

BACKGROUND

Acute posterior multifocal placoid pigment epitheliopathy (APMPPE) is a rare inflammatory eye disorder that is characterized by the presence of multiple placoid lesions in the posterior pole of the eye. Relentless placoid chorioretinitis (RPC) is an inflammatory chorioretinopathy that combines clinical features of APMPPE and serpiginous chorioretinitis, which is a progressive condition with a high risk of visual disability. Patients with COVID-19 can develop various ocular manifestations, however, there have been limited reports of APMPPE and RPC associated with the infection. We report a case of a patient who developed APMPPE after a COVID-19 infection and subsequently progressed into RPC.

CASE PRESENTATION

A 17-year-old male presented with a one-week history of painless gradual visual loss in both eyes. Two months prior to the visual symptoms, the patient had a SARS CoV-2 infection, confirmed by polymerase chain reaction test. Clinical findings with fundoscopy, optical coherence tomography and fluorescein angiography were consistent with APMPPE. Due to the severely affected vision in both eyes, the patient was started on 50 mg oral prednisolone daily, after which vision began to improve rapidly. Two months after symptom onset during steroid taper, the impression of continued inflammatory activity and new lesions in the retinal periphery of both eyes suggested RPC. Adalimumab 40 mg every other week was initiated with 12.5 mg prednisolone daily followed by slow tapering. Vision improved and five months after the start of the adalimumab treatment, the steroid was discontinued and there were no signs of active inflammation. The patient has been followed for a total of 21 months since presentation, had full visual recovery and good tolerance of the immunosuppressive treatment.

CONCLUSION

COVID-19 might cause long-lasting activity of APMPPE. The scarcity of reports compared with the number of confirmed COVID-19 infections worldwide suggests a rare entity. The association of APMPPE with a variety of infections may suggest a common immunological aberrant response that might be triggered by various factors. Further examinations and case reports are needed to understand the role of biological therapy in the treatment of such cases.

A Study on Chloride Corrosion Resistance of Reactive Powder Concrete (RPC) with Copper Slag Replacing Quartz Sand under Freeze-Thaw Conditions

In order to study the influence of freeze-thaw cycles on chloride ion corrosion resistance of RPC with copper slag (CS) instead of quartz sand (QS), the 28d uniaxial compressive strength (UCS) of CSRPC with a different CS substitution rate was investigated by unconfined compression tests. The electric flux test method was used to study the chloride ion diffusion resistance of CSRPC after freeze-thaw cycles, and the pore size distribution was obtained through the nuclear magnetic resonance (NMR) method. Then, a mathematical relationship between the chloride ion diffusion coefficient and the pore fractal characteristic parameter T was established to study the effect of freeze-thaw cycles on chloride ion diffusion. Finally, SEM/EDS, XRD, and DTG methods were combined to study the influence of the distribution of Friedel's salts generated after freeze-thaw cycles on chloride ion diffusion in CSRPC. The results indicate that CS has a micro aggregate effect and pozzolanic activity, which can effectively improve the chloride ion diffusion resistance of CSRPC after freeze-thaw cycles. In addition, the electric flux of CSRPC decreases with the increase in freeze-thaw cycles, and the chloride diffusion coefficient is closely related to the pore fractal dimension.

Mechanical Properties and Water Permeability of Textile-Reinforced Reactive Powder Concrete with Lightweight Aggregate

This paper focuses on the development of thin-walled panels with specific properties for applications such as water-tight structures. The authors propose the use of textile-reinforced concrete (TRC) as a composite material and highlight its advantages, which include high tensile strength, improved crack resistance, and design flexibility. The study presents a novel approach which combines TRC with reactive powder concrete (RPC) as a matrix and a lightweight aggregate. RPC, known for its brittle behaviour, is reinforced with glass fibres and a textile fabric to increase its flexural strength. The research includes a comprehensive analysis of the physical and mechanical properties of both the unreinforced RPC matrix and the TRC composite. In particular, the lightweight aggregate RPC matrix has a porosity of 41%, and its mechanical properties, such as flexural and compressive strength, are discussed. The TRC composites, produced in thicknesses ranging from 1 mm to 4 mm, are subjected to flexural tests to evaluate their behaviour under load. The thicker elements show typical damage phases, while the thinner elements show greater flexibility and elasticity. SEM observations confirm good adhesion between the glass fibres and the RPC matrix. Water permeability tests show that the TRC composite, despite its highly porous structure, achieves a water permeability two orders of magnitude higher than that of a reference material, highlighting the roles of both the porous aggregate and the matrix hydration. The paper concludes with a proof of concept-a canoe called the PKanoe, which is constructed from the developed TRC composite. The design of the canoe is supported by numerical analysis to ensure its optimal shape and structural integrity under load. The research contributes to the exploration of innovative materials for sustainable civil engineering applications and addresses both structural and environmental considerations.

Enhancing Metabolism and Milk Production Performance in Periparturient Dairy Cattle through Rumen-Protected Methionine and Choline Supplementation

For dairy cattle to perform well throughout and following lactations, precise dietary control during the periparturient phase is crucial. The primary issues experienced by periparturient dairy cows include issues like decreased dry matter intake (DMI), a negative energy balance, higher levels of non-esterified fatty acids (NEFA), and the ensuing inferior milk output. Dairy cattle have always been fed a diet high in crude protein (CP) to produce the most milk possible. Despite the vital function that dairy cows play in the conversion of dietary CP into milk, a sizeable percentage of nitrogen is inevitably expelled, which raises serious environmental concerns. To reduce nitrogen emissions and their production, lactating dairy cows must receive less CP supplementation. Supplementing dairy cattle with rumen-protected methionine (RPM) and choline (RPC) has proven to be a successful method for improving their ability to use nitrogen, regulate their metabolism, and produce milk. The detrimental effects of low dietary protein consumption on the milk yield, protein yield, and dry matter intake may be mitigated by these nutritional treatments. In metabolic activities like the synthesis of sulfur-containing amino acids and methylation reactions, RPM and RPC are crucial players. Methionine, a limiting amino acid, affects the production of milk protein and the success of lactation in general. According to the existing data in the literature, methionine supplementation has a favorable impact on the pathways that produce milk. Similarly, choline is essential for DNA methylation, cell membrane stability, and lipid metabolism. Furthermore, RPC supplementation during the transition phase improves dry matter intake, postpartum milk yield, and fat-corrected milk (FCM) production. This review provides comprehensive insights into the roles of RPM and RPC in optimizing nitrogen utilization, metabolism, and enhancing milk production performance in periparturient dairy cattle, offering valuable strategies for sustainable dairy farming practices.

Multi-Criteria Optimization of Cost-Effective and Environmentally Friendly Reactive Powder Concrete Incorporating Waste Glass and Micro Calcium Carbonate

In pursuit of developing an eco-friendly and cost-effective reactive powder concrete (RPC), we utilized a multi-objective optimization technique. This approach pivoted on the incorporation of byproducts, with a spotlight on ground glass powder (GP) as a pivotal supplementary cementitious material (SCM). Our goal was twofold: engineering cost-efficient concrete while maintaining environmental integrity. The derived RPC showcased robust mechanical strength and impressive workability. Rigorous evaluations, containing attributes like compressive strength, resistance to chloride ion penetration, ultrasonic pulse speed, and drying shrinkage, highlighted its merits. Notably, the optimized RPC, despite an insignificant decrease in compressive strength at 90 days compared to its traditional counterpart, maintained steady strength augmentation over time. The refinement process culminated in a notable 29% reduction in ordinary Portland cement (OPC) usage and a significant 64% decrease in silica fume (SF), with the optimized mix composition being 590 for cement, 100 for SF, 335 for GP, and 257 kg/m3 for calcium carbonate. Additionally, the optimized RPC stood out due to the enhanced rheological behavior, influenced by the lubricative properties of calcium carbonate and the water conservation features of the glass powder. The reactive properties of SF, combined with GP, brought distinct performance variations, most evident at 28 days. Yet, both mixtures exhibited superior resistance to chloride, deeming them ideal for rigorous settings like coastal regions. Significantly, the RPC iteration, enriched with selective mineral admixtures, displayed a reduced tendency for drying-induced shrinkage, mitigating potential crack emergence.

The Effect of Supplementation of Rumen-Protected Choline on Reproductive and Productive Performances of Dairy Cows

We aimed to evaluate the effects of organic herbal preparations containing rumen-protected choline (RPC) in dairy cow milk’s BHB and progesterone (P4) concentration changes, reproduction, and production performances. Cows were divided into the following two groups: The CHOL (n = 60) cow diet was supplemented with 10 g/day RPC from 20 days pre-calving to 20 days post-calving, and CONT (n = 60) were fed a conventional diet. BHB and P4 concentrations were measured at 5−64 DIM and 21−64 DIM, respectively, with DelPro 4.2. BHB was lower in the CHOL group at 5−64 DIM than CONT p > 0.05. The first post-calving P4 peak, p < 0.001, was determined earlier in the CHOL group, and the P4 profile during 21−64 DIM was similar, p > 0.05. The insemination rate was lower, and the interval between calvings was shorter. The first insemination time was earlier in the CHOL group, p < 0.05. Milk yield was higher in the CHOL group at 21−64 DIM, p > 0.05. The CHOL group had more fat in their milk at 31−60 DIM, p < 0.05. There were no significant differences in protein and SCC between the groups, p > 0.05. Based on our results, we concluded that the supplementation of RPC pre- and post-calving had statistically significant effects on the first peak of P4, and benefited the reproduction performances, milk yield, and milk fat during the early postpartum period.

The Influence of Rumen-Protected Choline and α-tocopherol Supplementation on Early Lactating Dairy Cows Metabolism

It is well documented that choline is known as one of the essential ingredients of phospholipids. Choline acts as a determinative element for appropriate cell membrane functions. On the other hand α-tocopherol (Vit E) is a fat-soluble vitamin. This vitamin acts as a strong antioxidant in the living body's defense system against oxidative stress. Lipid peroxidation in peripartum and early lactating cows is significantly increased while the level of serum Vit E is decreases dramatically. These concomitant physiological changes demonstrate a higher level of oxidative stress subsequently leads to serious health issues in dairy cows. Therefore, the present research was designed to investigate the following items in dairy cattle: 1) evaluation of the possible changes in serum protein fractions, and 2) comparing the oxidative status of orally RPC and vitamin E supplementation in dairy cows in early lactation period. In the current study 30 early lactating primiparous and multiparous Holstein cows (body condition score (BCS)=2.51 ± 0.10) were used beginning five weeks postpartum. All the animals were randomly divided in to three groups (n=10) (number of lactation=2.61). The animals were randomly assigned to receive one of the following treatments. Group 1 served as control group were not received any supplement. The second group was supplemented with 90 g/d of RPC (Reashre Choline, Balchem, USA). The third group was administrated 4400 IU/d vitamin E (Roche, Vitamins Ltd; Switzerland). In the current study, serum protein electrophoresis showed four main fractions as follows: albumin, α-globulin, β-globulin, and γ-globulin. The recorded data showed that the percentages of albumin and γ-globulin fractions were higher in treated groups compared to the control group. In the animals supplementing with RPC and vitamin E the percentages of serum albumin increased to the value of 37. 70±1.63 and 38.21±1.28 respectively compare to the control group (34.69±1.21), which were significant (P<0.05).

Potent Blockchain-Enabled Socket RPC Internet of Healthcare Things (IoHT) Framework for Medical Enterprises

Present-day intelligent healthcare applications offer digital healthcare services to users in a distributed manner. The Internet of Healthcare Things (IoHT) is the mechanism of the Internet of Things (IoT) found in different healthcare applications, with devices that are attached to external fog cloud networks. Using different mobile applications connecting to cloud computing, the applications of the IoHT are remote healthcare monitoring systems, high blood pressure monitoring, online medical counseling, and others. These applications are designed based on a client-server architecture based on various standards such as the common object request broker (CORBA), a service-oriented architecture (SOA), remote method invocation (RMI), and others. However, these applications do not directly support the many healthcare nodes and blockchain technology in the current standard. Thus, this study devises a potent blockchain-enabled socket RPC IoHT framework for medical enterprises (e.g., healthcare applications). The goal is to minimize service costs, blockchain security costs, and data storage costs in distributed mobile cloud networks. Simulation results show that the proposed blockchain-enabled socket RPC minimized the service cost by 40%, the blockchain cost by 49%, and the storage cost by 23% for healthcare applications.

Dosage Effect of Wet-Process Tuff Silt Powder as an Alternative Material of Sand on the Performance of Reactive Powder Concrete

A large amount of stone powder is produced during the production of machine-made sand. This research aims to study the effect of wet-process tuff silt powder (WTSP) dosages (as an alternative sand material to utilize waste stone powder and reduce environmental hazards) on reactive powder concrete’s (RPC) mechanical performance. The physical and chemical properties of WTSP were analyzed as per relevant standards. This study prepared RPC samples with various WTSP content (0%, 6%, 12%, and 18%) to replace quartz sand at the same water–binder ratio (0.14) and allowed the samples to cure for 3 days, 7 days and 28 days prior to unconfined compression testing and flexural testing. Scanning electron microscopy (SEM) and Mercury Intrusion Porosimetry (MIP) testing were also carried out to observe the evolution of macroscopic properties in response to replacing part of quartz sand with the same amount of WTSP. The results show that the developed flexural and unconfined compressive strength (UCS) decreases slowly with a greater dosage of WTSP. However, when the WTSP content is 12% or less, the RPC made with WTSP satisfies the industrial application threshold regarding mechanical properties. For RPC samples containing more than 12% WTSP, the UCS and flexural strength showed a dramatic drop. Thus 12% of WTSP content was deemed the maximum and the corresponding UCS of 104.6 MPa and flexural strength of 12 MPa for 28 days of curing were the optimums. The microscopic characteristics indicate that the addition of WTSP can effectively fill the large pores in the RPC micro-structure, hence reducing the porosity of RPC. Furthermore, the WTSP can react with the cementitious material to form calcium aluminate during the hydration process, further strengthening the interface. The alkaline calcium carbonate in WTSP could improve the interfacial adhesion and make the structure stronger.

Microstructure and Mechanical Property Evaluation of Dune Sand Reactive Powder Concrete Subjected to Hot Air Curing

The use of different sustainable materials in the manufacture of ultra-high-performance concrete (UHPC) is becoming increasingly common due to the unabating concerns over climate change and sustainability in the construction sector. Reactive powder concrete (RPC) is an UHPC in which traditional coarse aggregates are replaced by fine aggregates. The main purpose of this research is to produce RPC using dune sand and to study its microstructure and mechanical properties under different curing conditions of water curing and hot air curing. The effects of these factors are studied over a long-term period of 90 days. Quartz sand is completely replaced by a blend of crushed and dune sand, and cement is partially replaced by using binary blends of ground granulated blast furnace slag (GGBS) and fly ash (FA), which are used alongside silica fume (SF) to make a ternary supplementary binder system. Microstructural analysis is conducted using scanning electron microscopy (SEM), and engineering properties like compressive strength and flexural strength are studied to evaluate the performance of dune sand RPC. Overall, the results affirm that the production of UHPC is possible with the use of dune sand. The compressive strength of all mixes exceeded 120 MPa after 12 h only of hot air curing (HAC). The SEM results revealed the dense microstructure of RPC. However, goethite-like structures (corrosion products) were spotted at 90 days for all HAC specimens. Additionally, the use of FA accelerated the formation of such products as compared to GGBS. The effect of these products was insignificant from a mechanical point of view. However, additional research is required to determine their effect on the durability of RPC.

Clinical patterns and the evolution of relapsing polychondritis based on organ involvement: a Chinese retrospective cohort study

Background

Relapsing polychondritis (RPC) is a rare autoimmune disease and its early diagnosis remains challenging. Defining the clinical patterns and disease course may help early recognition of RPC.

Results

Sixty-six males and 60 females were included in this study. The average age at onset were 47.1 ± 13.8 years and the median follow-up period was 18 months. Correlation analysis revealed a strong negative correlation between airway involvement and auricular chondritis (r = − 0.75, P < 0.001). Four distinct clinical patterns were identified: Ear pattern (50.8%), Airway pattern (38.9%), Overlap pattern (4.8%) and Airway-Ear negative pattern (5.6%), and patients with Ear pattern and Airway pattern were further divided into limited and systemic form of RPC (27.8% with limited form of Ear pattern and 24.6% with limited form of Airway pattern initially). During follow-up, a minority of patients with Ear pattern and Airway pattern progressed into Overlap pattern, and some Airway-Ear negative pattern patients progressed into Ear pattern. While a large majority of limited RPC patients remained limited form during follow-up, a minority of limited RPC patients progressed into systemic form. Patients with Ear pattern had the highest survival rate and relatively lower inflammatory status.

Conclusions

RPC patients can be categorized as 4 different clinical patterns and 2 distinct presenting forms (limited and systemic) based on organ involvement. The clinical patterns and presenting forms may evolve during follow-up. Our findings may facilitate early recognition of this rare disease.

Investigation into reversed-phase chromatography peptide separation systems Part IV: Characterisation of mobile phase selectivity differences

The differentiation of mobile phase compositions between sub-classes which exhibit distinct chromatographic selectivity (i.e. termed characterisation) towards a range of peptide probes with diverse functionality and hence the possibility for multi-modal retention mechanisms has been undertaken. Due to the complexity of peptide retention mechanisms in given mobile phase conditions, no attempt has been made to explain these, instead mobile phases have simply been classified into distinct groups with an aim of identifying those yielding differing selectivities for use in strategic method development roadmaps for the analysis of peptide mixtures. The selectivity differences between nine synthetic peptides (fragments of [Ile27]-Bovine GLP-2) were used to assess how fifty-one RPC mobile phase compositions of differing pH (range 1.8 - 7.8), salt types, ionic strengths, ion-pair reagents and chaotropic / kosmotropic additives affected chromatographic selectivity on a new generation C18 stationary phase (Ascentis Express C18). The mobile phase compositions consisted of commonly used and novel UV or MS compatible additives. The chemometric tool of Principal Component Analysis (PCA) was used to visualise the differences in selectivity generated between the various mobile phases evaluated. The results highlight the importance of screening numerous mobile phases of differing pH, ion-pair reagents and ionic strength in order to maximise the probability of achieving separation of all the peptides of interest within a complex mixture. PCA permitted a ranking of the relative importance of the various mobile phase parameters evaluated. The concept of using this approach was proven in the analysis of a sample of Bovine GLP-2 (1-15) containing synthesis related impurities. Mobile phases with high ionic strength were demonstrated to be crucial for the generation of symmetrical peaks. The observations made on the C18 phase were compared on three additional stationary phases (i.e. alkyl amide, fluorophenyl and biphenyl), which had previously been shown to possess large selectivity differences towards these peptides, on a limited sub-set of mobile phases. With the exception of the ion-pair reagent, similar trends were obtained for the C18, fluorophenyl and biphenyl phases intimating the applicability of these findings to the vast majority of RPC columns (i.e. neutral or weakly polar in character) which are suitable for the analysis of peptides. The conclusions were not relevant for columns with a more disparate nature (i.e. containing a high degree of positive charge).

Ginkgo Biloba affects microvascular morphology: a prospective optical coherence tomography angiography pilot study

PURPOSE

To analyze the vascular morphology changes after consumption of Ginkgo biloba in healthy volunteers by optical coherence tomography angiography (OCTA).

METHODS

Sixty healthy volunteers without systemic and ocular disease were included in this prospective pilot study. After receiving the informed consent of the volunteers, Ginkgo biloba extract (120 mg oral capsule) was administered to sixty volunteers for 4 weeks, once a day in the morning. The main outcome measures were the difference between before and after four-week of consumption in best-corrected visual acuity (BCVA), retinal nerve fiber layer (RNFL) and subfoveal choroidal thickness (sfCT) with optical coherence tomography; whole, foveal, parafoveal and perifoveal regions' superior and deep macular vascular plexus vessel density, foveal avascular zone area (FAZ), FAZ perimeter (PERIM), vessel density in a 300 µm wide region around FAZ (FD-300), choroidal and outer retinal flow area, radial peripapillary capillary (RPC) vascular density of whole, inside the disc, peripapillary and four quadrants with OCTA.

RESULTS

The study group consisted of sixty eyes of 32 women and 28 men with a mean age of 20.57 ± 1.16 years. In post-consumption measurements, peripapillary and superior, inferior, temporal quadrant RPC vascular density (%) was statistically significantly higher than pre-consumption measurements (p 0.020, p 0.021, p 0.008 and p 0.014, respectively). No significant difference was observed for BCVA, sfCT, other macular or RPC vascular density and flow area OCTA parameters between measurements.

CONCLUSION

Four-week consumption of Ginkgo biloba leads to vascular morphological changes in RPC. Further clinical studies are needed to demonstrate its use and effects/benefits in glaucoma, optic neuropathy and other diseases affecting the optic nerve.

Investigation into reversed phase chromatography peptide separation systems part I: Development of a protocol for column characterisation

A protocol was defined which utilised peptides as probes for the characterisation of reversed phase chromatography peptide separation systems. These peptide probes successfully distinguished between differing stationary phases through the probe's hydrophobic, electrostatic, hydrogen bonding and aromatic interactions with the stationary phase, in addition, to more subtle interactions such as the phase's ability to separate racemic or isomeric probes. The dominating forces responsible for the chromatographic selectivity of peptides appear to be hydrophobic as well as electrostatic and polar in nature. This highlights the need for other types of stationary phase ligands with possibly mixed mode functionalities / electrostatic / polar interactions for peptide separations rather than the hydrophobic ligands which dominate small molecule separations. Selectivity differences are observed between phases, but it appears that it is the accessibility differences between these phases which play a crucial role in peptide separations i.e. accessibility to silanols, the hydrophobic acetonitrile / ligand layer or a thin adsorbed water layer on the silica surface.

Block Adjustment without GCPs for Chinese Spaceborne SAR GF-3 Imagery

The Gaofen-3 (GF-3) satellite is the first C-band multi-polarization synthetic aperture radar (SAR) with the ability of high-accuracy mapping in China. However, the Ground Control Points (GCPs) are essential to ensure the accuracy of mapping for GF-3 SAR imagery at present. In this paper, we analyze the error sources that affect the geometric processing and propose a new block adjustment method without GCPs for GF-3 SAR imagery. Firstly, the geometric calibration of GF-3 image is carried out. Secondly, the rational polynomial coefficient (RPC) model is directly generated after the geometric calibration parameters compensation of each image. Finally, we solve the orientation parameters of the GF-3 images through DEM assisted planar block adjustment and conduct ortho-rectification. With two different imaging modes of GF-3 satellite, which include the QPSI and FS2, we carry out the block adjustment without GCPs. Experimental results of testing areas including Wuhan city and Hubei province in China show that the geometric mosaic accuracy and the absolute positioning accuracy of the orthophoto are better than one pixel, which has laid a good foundation for the application of GF-3 image in global high-accuracy mapping.

The Retinal Pigment Epithelium Is a Notch Signaling Niche in the Mouse Retina

Notch signaling in neural progenitor cell is triggered by ligands expressed in adjacent cells. To identify the sources of active Notch ligands in the mouse retina, we negatively regulated Notch ligand activity in various neighbors of retinal progenitor cells (RPCs) by eliminating mindbomb E3 ubiquitin protein ligase 1 (Mib1). Mib1-deficient retinal cells failed to induce Notch activation in intra-lineage RPCs, which prematurely differentiated into neurons; however, Mib1 in post-mitotic retinal ganglion cells was not important. Interestingly, Mib1 in the retinal pigment epithelium (RPE) also contributed to Notch activation in adjacent RPCs by supporting the localization of active Notch ligands at RPE-RPC contacts. Combining this RPE-driven Notch signaling and intra-retinal Notch signaling, we propose a model in which one RPC daughter receives extra Notch signals from the RPE to become an RPC, whereas its sister cell receives only a subthreshold level of intra-retinal Notch signal and differentiates into a neuron.

Initial experience of restorative proctocolectomy for ulcerative colitis by transanal total mesorectal rectal excision and single-incision abdominal laparoscopic surgery

AIM

Laparoscopic surgery is well established for colon cancer, with defined benefits. Use of laparoscopy for the performance of restorative proctocolectomy (RPC) with ileoanal anastomosis is more controversial. Technical aspects include difficult dissection of the distal rectum and a potentially increased risk of anastomotic leakage through multiple firings of the stapler. In an attempt to overcome these difficulties we have used the technique of transanal rectal excision to perform the proctectomy. This paper describes the technique, which is combined with an abdominal approach using a single-incision platform (SIP).

METHOD

Data were collected prospectively for consecutive operations between May 2013 and October 2015, including all cases of restorative proctocolectomy with ileoanal pouch anastomosis performed laparoscopically. Only patients having a transanal total mesorectal excision (TaTME) assisted by SIP were included. The indication for RPC was ulcerative colitis (UC) refractory to medical treatment.

RESULTS

The procedure was performed on 16 patients with a median age of 46 (26-70) years. The male:female ratio was 5:3 and the median hospital stay was 6 (3-20) days. The median operation time was 247 (185-470) min and the overall conversion rate to open surgery was 18.7%. The 30-day surgical complication rate was 37.5% (Clavien-Dindo 1 in four patients, 2 in one patient and 3 in one patient). One patient developed anastomotic leakage 2 weeks postoperatively.

CONCLUSION

This initial study has demonstrated the feasibility and safety of TaTME combined with SIP when performing RPC with ileal pouch-anal anastomosis for UC.

Separation of Quadruplex Polymorphism in DNA Sequences by Reversed-Phase Chromatography

This unit describes a method for the separation of a mixture of quadruplex conformations formed from the same parent sequence via reversed-phase chromatography (RPC). Polymorphism is inherent to quadruplex formation and even relatively simple quadruplex-forming sequences can fold into a cornucopia of possible conformations and topologies. Isolation of a specific conformation for study can be problematic. This is especially true for conformations of the human telomere sequence d(GGG(TTAGGG)3). High performance liquid chromatography (HPLC), especially reversed-phase chromatography, has been a mainstay of nucleic acid research and purification for many decades. We have successfully applied this method to the problem of separating individual quadruplex species in the ensemble from the same parent sequence.

Differential responsiveness of distinct retinal domains to Atoh7

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Differential responsiveness to early panocular atoh7 expression.

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Early panocular atoh7 only mildly affects dorsal retina (reduced Müller glia cells).

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Early panocular atoh7 severely affects ventral retina (predominant RGC fate).

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Early panocular atoh7 expression results in coloboma.

During vertebrate eye development retinal progenitor cells (RPCs) differentiate into all neural cell types of the retina. Retinal ganglion cells (RGCs) represent the first cell type to be generated. For their development, Atoh7, a basic Helix Loop Helix (bHLH) transcription factor is crucial. Atoh7 loss of function results in a massive reduction or even a total loss of RGCs. However, inconsistent results have been obtained in atoh7 gain of function experiments with respect to ganglion cell genesis, implying that the effect of Atoh7 is likely to be dependent on the competence state of the RPC.

In this study we addressed the differential susceptibilities of early RPCs to Atoh7 in vivo, using medaka. Unexpectedly, we observed a largely normal development of the dorsal retina, although atoh7 was precociously expressed. However, the development of the retina close to the optic nerve head (part of the ventral retina) was disturbed severely. Photoreceptors were largely absent and the Müller glia cell number was reduced significantly. The majority of cells in this domain were ganglion cells and the abnormal development of this area affected the closure of the optic fissure resulting in coloboma.

Gardner’s syndrome: A case report and review of the literature

Gardner’s syndrome is an autosomal dominant disease characterized by the presence of colonic polyposis, osteomas and a multitude of soft tissue tumors. The syndrome may present at any age from 2 mo to 70 years with a variety of symptoms, either colonic or extracolonic. We present a case of a 11-year-old female patient with Gardner’s syndrome who presented with a lumbar area desmoid tumor and treated with resection of the desmoid, restorative proctocolectomy and ileal pouch anal anastomosis, A review of the current literature has been performed.