Association of HLA B8 with spontaneous resolution in sarcoidosis

HLA may influence the natural history of some diseases. HLA frequencies have been compared in 164 healthy control subjects, 50 patients with sarcoid lung fibrosis, and 37 patients with sarcoidosis that resolved spontaneously. B8 was increased significantly in the resolved group compared to both healthy control subjects (p less than 0.001) and the fibrotic group (p less than 0.01). The results support the findings of other investigators, and are consistent with the hypothesis that inherited host factors, perhaps related to immune response, influence the clinical expression of sarcoidosis.

An empirical analysis of stressors for gay men and lesbians

This research describes the empirical classification of stressors for gay men and lesbians. Volunteer respondents were recruited through a free local gay and lesbian newspaper, through gay and lesbian student organizations nationwide, through gay and lesbian bookstores nationwide, and at a gay festival in St. Louis. Nine hundred seventy-nine (979) participants completed a 70-item measure with stressors that had been identified in previous qualitative research. Participants were asked to indicate the degree to which they had experienced stress associated with a variety of experiences. Participants also completed a measure of dysphoria (CES-D), responded about their degree of openness regarding sexual orientation, and provided information about their relationship status and involvement with gay groups and activities. Using confirmatory factor analysis, a six-factor model was predicted to account for the data. One-factor, six-factor, and ten-factor models were tested. The ten-factor model yielded the best fit with the data and accounted for 63.5% of the variance. The factor structure remained stable when gay men were compared to lesbians, when those endorsing a predominantly gay versus exclusively gay orientation were compared, and when those in a relationship were compared to those who were not in a relationship. Increased gay stress was associated with more dysphoria. Implications of these findings are discussed and directions for future research are considered.

The value of visual evoked potential as a screening test in neurofibromatosis

Pattern reversal visual evoked potential (VEP) test was performed in 30 asymptomatic patients with neurofibromatosis (NF). All patients had normal visual acuity, visual fields, and ophthalmoscopic examination results. Pattern reversal VEP was abnormal in eight patients (26%). Seven of these patients had computed tomographic scans with reformated orbital views. Orbital computed tomographic scans were abnormal in six patients and in each case showed enlargement of the optic nerve on the side of VEP abnormality. Our data indicate that pattern reversal VEP is a valuable screening test in asymptomatic patients with NF. Because of the high incidence of VEP abnormality in such patients, VEP abnormality must be interpreted cautiously when a patient with NF is suspected of having other diseases or disorders that potentially affect the visual pathways.

TdTomato and EGFP identification in histological sections: insight and alternatives

Tandem dimer Tomato (tdTomato) provides a useful alternative to enhanced green fluorescent protein (eGFP) for performing simultaneous detection of fluorescent protein in histological sections together with fluorescence immunohistochemistry (IHC). eGFP has many properties that make it useful for cell labeling; however, during simultaneous fluorescence IHC, the usefulness of eGFP may be limited. This limitation results from a fixation step required to identify eGFP in histological tissue sections that can mask antibody epitopes and adversely affect staining intensity. An alternative fluorescent protein, tdTomato, may assist concurrent detection of fluorescent protein within tissue sections and fluorescence IHC, because detection of tdTomato does not require tissue fixation. Tissue sections were obtained from various organs of mice ubiquitously expressing eGFP or tdTomato that were either unfixed or fixed with 4% paraformaldehyde. These tissues later were combined with fluorescence IHC. Both eGFP and tdTomato displayed robust signals in fixed frozen sections. Only tdTomato fluorescence, however, was detected in unfixed frozen sections. Simultaneous detection of fluorescence IHC and fluorescent protein in histological sections was observed only in unfixed frozen tdTomato tissue. For this reason, tdTomato is a useful substitute for eGFP for cell labeling when simultaneous fluorescence IHC is required.

Inducible Nitric Oxide Synthase and CD11b+Gr1+ Cells Impair Lymphatic Contraction of Tumor-Draining Lymphatic Vessels

Background: Metastatic tumor cells spread through lymphatic vessels and colonize draining lymph nodes (LNs). It is known that tumors induce lymphangiogenesis to enhance lymphatic metastasis and that metastatic cancer cells are carried by lymph flow to LNs. Methods and Results: Here, we investigated the molecular and cellular regulation of collecting lymphatic vessel contraction in vessels draining a metastatic tumor using intravital microscopy. In tumor-draining collecting lymphatic vessels, we found vessel contraction was suppressed. The infiltration of peritumor tissue by inducible nitric oxide synthase positive and CD11b⁺Gr1⁺ myeloid cells played a critical role in the suppression of lymphatic contraction. Depletion of Gr1⁺ cells with an anti-Gr1 antibody improved contraction of tumor-draining lymphatic vessels. In addition, inducing tumor cell death restored lymphatic contraction in nude mice. Conclusions: These findings indicate that tumors contribute to regulation of lymphatic transport in a reversible manner, warranting further investigation into the role of impaired lymphatic transport in cancer progression.

Chromosomally mediated intrinsic resistance to penicillin of penicillinase producing strains of Neisseria gonorrhoeae isolated in Sydney: guide to treatment with Augmentin

Single dose Augmentin treatment fails to cure an appreciable proportion of patients infected with penicillinase producing Neisseria gonorrhoeae (PPNG) strains in parts of the world where high levels of chromosomally mediated intrinsic resistance are also present in gonococci. The levels of intrinsic resistance to penicillin of 31 PPNG strains isolated in Sydney were assessed by obtaining beta lactamase negative variants of these strains and measuring the minimum inhibitory concentration of penicillin by agar plate dilution techniques. The levels of intrinsic resistance found in these imported PPNG strains were higher than those recorded for local isolates of non-PPNG strains, which indicates that caution should be exercised in the use of single dose Augmentin treatment of infections with PPNG strains in Sydney.

Adjective correlates for women on the CPI scales: a replication

In a replication of a ten-year-old study by Gough, peer-rated adjectives from the Adjective Check List were correlated with scores on the 18 standard scales of the California Psychological Inventroy (CPI) for 95 college sorority members. For each scale, the ten most positively and negatively correlated adjectives were selected for comparison with Gough's results. The absolute magnitude of the correlations, the qualitative content of the adjectives, and the degree of correspondence with Gough's findings were used to assess the extent to which each CPI scale achieved its stated objective.

Induction of cytotoxic lymphocytes directed against public alloantigens

The response of H-2k lymphocytes to in vitro stimulation by H-2b and HI2d spleen cells has been monitored for the production of cytotoxic lymphocytes (CL). Using cells from H-2b strains CL which were capable of lysing both H-2b and H-2d target cells (TC) were generated. These results, together with competitive inhibitor studies of the cytotoxic activity against H-2d TC, demonstrated that T lymphocytes can respond to both public and private alloantigens of the H-2 complex. When H-2d cells were used for stimulation two of the three strains tested induced CL with cytotoxic activity towards both H-2d and H-2b TC. These observations indicate that the T cell response to alloantigen, leading to the production of cytotoxic lymphocytes, can be multicomponent like the established B cell response and can be expected to be subject to as much phenotypic variation. The full complexity may only be revealed by examing a number of combinations of stimulating strains, methods of stimulation and different kinds of target cells.

A novel method for rapid isolation of plasmid DNA

A new disposable chromatographic column, pZ523, has been developed for separating plasmid DNA from bacterial chromosomal DNA. Use of pZ523 spun columns eliminates the need for ethidium bromide-cesium chloride density gradients which require long centrifugation times. pZ523 purified plasmids have been shown to be of purity suitable for restriction analysis, ligation, transfection of mammalian cells and transformation of bacteria. Unlike the traditional ultracentrifugation method, pZ523 offers an extremely rapid alternative method for purifying large amounts of plasmid DNA (2.5 mg to 4.5 mg) from cleared bacterial lysates in only 25 minutes.

Pre- and posthemodialysis measures of serum albumin levels

OBJECTIVE

To determine whether there was a difference between pre- and posthemodialysis serum albumin levels and, if so, whether that difference correlated with the amount of fluid removed during treatment.

DESIGN

This descriptive study used a comparative data analysis strategy.

SAMPLE/SETTING

287 paired measurements of pre- and post-hemodialysis serum albumin levels were collected from 46 patients in a midwestern hemodialysis center.

METHODS

Pre- and posthemodialysis serum albumin levels were obtained using the bromcresol green method.

RESULTS

The pretreatment mean for serum albumin levels was 3.875 gm/dL (SD .4) and the posttreatment mean was 4.273 gm/dL (SD .599), significant at p < 0.0001. The amount of fluid removed during treatment was strongly correlated with the difference between pre- and posttreatment albumin levels (R = .6149; p < 0.0001). When data were sub-divided into three groups according to the amount of fluid removed during treatment, the mean differences between pre- and post hemodialysis albumin were significant at p < 0.0001.

CONCLUSION

The strong correlation with fluid removed during hemodialysis suggests that fluid overload may be responsible for the significantly higher posttreatment albumin values in most patients.

INTRA VITAM BONE MARROW PUNCTURE IN PERNICIOUS ANEMIA

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Early Pre-clinical Exposure Enhances Medical Student Knowledge and Readiness in Caring for Patients with Disabilities

Physicians receive little dedicated training in caring for patients with disabilities. This study evaluated whether integrating disability-focused content into pre-clinical curricula improved medical student knowledge, readiness, and attitudes in caring for patients with disabilities. Readings, clinical reasoning cases, and patient panels were added to the existing pre-clinical curricula. Students self-reported increased knowledge and readiness in caring for patients with disabilities following implementation. No changes were reported in student attitudes toward patients with disabilities. Integrating disability-related training into the curricula was effective in improving students' self-reported knowledge and readiness to care for patients with disabilities.

Supplementary Information

The online version contains supplementary material available at 10.1007/s40670-024-02061-5.

Pharmacokinetics and pharmacodynamics of Hedgehog pathway inhibitors used in the treatment of advanced or treatment-refractory basal cell carcinoma

INTRODUCTION

Sonidegib and vismodegib are currently the only US Food and Drug Administration and European Medicines Agency-approved small-molecule Hedgehog pathway inhibitors (HHIs)for treating adults with advanced or refractory basal cell carcinoma (BCC) that is not amenable to conventional surgery or radiotherapy. At this time, there are no head-to-head clinical trials comparing these two HHIs for efficacy and safety to assist clinicians with determining which HHI may be best suited for their patients.

AREAS COVERED

This review briefly describes the pathogenesis of BCC, provides a detailed overview of the key pharmacokinetic profile differences between sonidegib and vismodegib, explains their pharmacodynamics, and highlights the therapeutic considerations when either HHI is used to treat special patient populations.

EXPERT OPINION

Although both HHIs act at the same molecular target in the Hedgehog pathway, there are significant differences in their pharmacokinetic profiles that may play a potential role in their efficacy and safety. Evidence-based recommendations serve to inform clinicians until direct comparative clinical trials of sonidegib versus vismodegib are conducted to determine the clinical relevance of the reported differences in their pharmacokinetic properties.