Higher Organ Research Articles

Heteropathogenic virulence and phylogeny reveal phased pathogenic metamorphosis in Escherichia coli O2:H6

Extraintestinal pathogenic and intestinal pathogenic (diarrheagenic) Escherichia coli differ phylogenetically and by virulence profiles. Classic theory teaches simple linear descent in this species, where non-pathogens acquire virulence traits and emerge as pathogens. However, diarrheagenic Shiga toxin-producing E. coli (STEC) O2:H6 not only possess and express virulence factors associated with diarrheagenic and uropathogenic E. coli but also cause diarrhea and urinary tract infections. These organisms are phylogenetically positioned between members of an intestinal pathogenic group (STEC) and extraintestinal pathogenic E. coli. STEC O2:H6 is, therefore, a ‘heteropathogen,’ and the first such hybrid virulent E. coli identified. The phylogeny of these E. coli and the repertoire of virulence traits they possess compel consideration of an alternate view of pathogen emergence, whereby one pathogroup of E. coli undergoes phased metamorphosis into another. By understanding the evolutionary mechanisms of bacterial pathogens, rational strategies for counteracting their detrimental effects on humans can be developed.Subject Categories Microbiology, Virology & Host Pathogen Interaction

In vivo dose verification of 3D conformal treatments with the use of an a-Si EPID

In vivo dose verification of 3D conformal treatments with the use of an a-Si EPID

Patient dose estimation in cardiac computed tomography with a 320 detector row scanner based on Monte Carlo simulation

Patient dose estimation in cardiac computed tomography with a 320 detector row scanner based on Monte Carlo simulation

10.5937/mckg48-6173 = Late-onset systemicus lupus erithematosus

There is an assumption that the late-onset systemic lupus erythematosus (SLE), with the beginning after the age of 50, has a different clinical course, with an insidious start and non-specific first manifestations. The incidence of late-onset SLE is 12-20% of all patients with SLE. Atypical presentation, nonspecific initial clinical manifestations and smaller incidence of SLE in elderly population may contribute to the delayed diagnosis. It could be concluded that despite the less major organ involvement (nephritis, central nervous system), and more benign course of disease, late-onset SLE has poorer prognosis, because of the higher frequency of co-morbid conditions and higher organ damage, due to the aging and longer exposition to typical vascular risk factors. The prognosis depends not only on the disease per se, but on the clinical context in which it occurs. Strategies to reduce the occurrence of cardiovascular disease, osteoporosis, pathological fractures, infections and other forms of damage should be aggressively implemented particularly in the late-onset patients, and they have to be closely followed because they are more susceptible to damage in long-term follow-up.

Biodistribution of Fluorescently Labeled PAMAM Dendrimers in Neonatal Rabbits: Effect of Neuroinflammation

Dendrimers are being explored in many preclinical studies as drug, gene, and imaging agent delivery systems. Understanding their detailed organ, tissue, cellular uptake, and retention can provide valuable insights into their effectiveness as delivery vehicles and the associated toxicity. This work explores a fluorescence-quantification based assay that enables simultaneous quantitative biodistribution and imaging of dendrimers with a single agent. We have labeled an ethylenediamine-core generation-4 hydroxyl-terminated poly(amidoamine) (PAMAM) dendrimer using the fluorescent photostable, near-IR cyanine dye (Cy5) and performed quantitative and qualitative biodistribution of the dendrimer-Cy5 conjugates (D-Cy5) in healthy neonatal rabbits and neonatal rabbits with cerebral palsy (CP). The biodistribution of D-Cy5 and free Cy5 dye was evaluated in newborn rabbits, based on the developed quantification methods using fluorescence spectroscopy, high-performance liquid chromatography (HPLC), and size exclusion chromatography (SEC) and supported by microscopic imaging. The uptake was assessed in the brain, heart, liver, lungs, kidneys, blood serum, and urine. Results obtained based on these three independent methods are in good agreement and indicate the fast renal clearance of D-Cy5 and free Cy5 with relatively higher organs accumulation of the D-Cy5 conjugate. Following systemic administration, the D-Cy5 mainly accumulated in kidneys and bladder at 24 h. The quantitative biodistribution is in good agreement with previous studies based on radiolabeling. These methods for dendrimers quantification are easier and more practical, provide excellent sensitivity (reaching 0.1 ng per gram of tissue), and allow for quantification of dendrimers in different organs over longer time periods without concerns for radioactive decay, while also enabling tissue and cellular imaging in the same animal. In kits with fetal-neuroinflammation induced CP, there was a significantly higher uptake of D-Cy5 in the brain, while biodistribution in other organs was similar to that of healthy kits.

On the Composition of the Deputies in the National People's Congress of China

The composition of the deputies in the National People’s Congress of China shows reliance on the principle of formal proportionality based on the national census and substantial representation based on the inclusion of rural areas, minorities and other groups which are a statistically smaller portion of the population. However the quota system based on these principles of representation cannot mitigate against the overrepresentation of government officials and the increasing elitism of the deputies. Yet these issues are nominal compared to the forging of closer political bonds between the representatives and the represented. The author believes that the correlation between the representatives and the represented may be strengthened by moving towards the direct election of the deputies of the National People’s Congress, thereby placing the constitutionality of the National People’s Congress as the highest organ of state sovereignty on a firmer foundation.

It's up to you: a multi‐message, phased driver facility campaign to increase organ donation registration rates in Illinois

The present project applied successful strategies employed in previous driver facility campaigns occurring during the inception of a registry to examine whether these approaches are effective in growing a mature registry, a registry where the majority of individuals have had the opportunity to register as an organ donor. Driver facilities (N = 40) in Illinois with high (n = 20) and low (n = 20) organ donation registration percentages were selected and served as either intervention or control sites for the campaign. Among facilities with historically high and low registration percentages, support for the campaign was found with the intervention facilities experiencing higher organ donation registration rates compared with control facilities. In addition, the results provide partial support for the effectiveness of employing a multi-message, phased driver facility intervention in states with a mature registry. The practical implications of utilizing driver facility campaigns in states with an established first-person consent registry also are discussed.

Application of Ferrate for the Treatment of Organic Matters in Wastewater

Fe (VI) was evaluated to treat municipal secondary effluents derived from wastewater treatment plants. Organic matter and reactive phosphate compounds in wastewater was oxidized by Fe (VI) l, and the formation of adsorbable organic haloids (AOX) as by-products in this study. Additionally, the most probable number (MPN) of cultivable heterotrophic bacteria was also determined. In every case for 100% bacterial inactivation a low Fe (VI) concentration (5 mg L.1) was enough and by this concentration 40% chemical oxygen demand (COD) and 20% total organic carbon (TOC) removal could be obtained on average. Higher Fe (VI) concentration (715 mg L.1) resulted in an even higher organics reduction (depending on the water matrix up to 79% COD and 45% TOC removal). Monitoring AOX concentration during Fe (VI)-treatment, it could be stated that AOX formation was in linear relationship with the applied Fe (VI) concentration, but at higher than about 10 mg L-1 Fe (VI) concentration this increase became much less than at lower Fe (VI) concentration.

The Effect of Rutin on Antioxidant and Anti-inflammation in Streptozotocin-induced Diabetic Rats

The study examined the antioxidant activities and anti-inflammatory effects of rutin from the streptozotocin (STZ)-induced diabetic rats. Results revealed that the levels of plasma glucose and serum glucose were remarkably higher in the STZ-treated group compared to other groups and were significantly reduced in the STZ+rutin treated group compared to the STZ-treated group. In terms of weight, it significantly increased in all experimental groups during the experiment period except for STZ-induced diabetic group. The weight of the STZ-treated group was remarkably reduced compared to other groups. Regarding the weight of each body organ, the STZ-treated group showed higher organ weight compared to the other groups while STZ+rutin-treated group showed significantly reduced kidney and liver weights compared to those of STZ-treated group. In the pancreas tissue of the STZ-treated group, -cell destruction and vacuolization were observed. Inflammation in the heart, liver, kidney, and retina tissues were also vividly recorded. In the STZ+rutin administered group, the heart and retina tissues were shown to be preserved normally while the liver and kidney tissues showed reduced histopathology in general compared to the STZ-treated group. Conclusionally, the rutin has the effect on the antioxidant activities and anti-inflammation in the STZ-induced diabetic rats.

SU-C-144-04: Whole Body and Relative Organ Dose Values From Neutron and Gamma Irradiation of the Liver and Breast in a Voxelized Anthropomorphic Phantom Using Monte Carlo Methods

Purpose: Using Monte Carlo, we estimated the 3-dimensional organ-dose distribution for neutron and gamma irradiation of the male liver, female liver, and female breasts for neutron-and gamma-stimulated imaging. Understanding the dose distribution from these diagnostic scans is essential for assessing radiation risk. Methods: Monte Carlo was performed using the GEANT4 GATE application and a voxelized XCAT human phantom. Male and female XCAT phantoms were voxelized into 256×256×600 voxels (3.125×3.125×3.125mm^3). A monoenergetic rectangular beam of neutrons or gammas with 1.6×10^7 particles was irradiated onto a 2cm thick slice at eight different angles from 0–180°. For the liver, the beam rotated about the axis of the torso. For the breast, the beam rotated around the pendulous breasts. The neutron irradiation utilized a 5MeV neutron beam and the gamma irradiation utilized a 7MeV gamma beam. Dose volume histograms were computed to analyze the absolute and relative doses in each organ. Results: The neutron irradiation of the liver for both the male/female phantoms imparted the highest organ dose to the liver. All other organ doses were below ∼15% of the liver dose, except for the stomach-wall which registered ∼80% and ∼70% respectively for the male and female. The highest dose for gamma irradiation of the liver occurred in the stomach-wall, with a relative liver dose of ∼70% in the male and ∼75% in the female. Most other organ doses were below ∼10% of the stomach dose. For the breast scans, both the neutron and gamma irradiation registered maximum organ doses in the breasts, with all other relative organ doses being well below 2% of the breast dose. Conclusion: Neutron and gamma irradiation of target organs such as the liver and breasts imparts the maximum dose to the primary target organ and a considerably lower dose to proximal organs outside of the beam plane.

SAT0565 Medical Costs and their Predictors in Korean Patients with Systemic Lupus Erythematosus

BackgroundSystemic lupus erythematosus (SLE) has very high economic burdens on society and healthcare system.ObjectivesThe aim of this study was to estimate the annual direct costs and predictors of cost in...

THU0470 Association of Relapsing Polychondritis with Other Autoimmune Conditions: Experience of a Romanian Center

BackgroundRelapsing polychondritis(RP) is a rare inflammatory disease affecting cartilaginous structures. About one third of the patients with RP have a concurrent or preceding autoimmune disease thus making diagnosis difficult.ObjectivesTo assess...

The Aggressive Phenotype Revisited: Utilization of Higher-Risk Liver Allografts

Organ shortage has led to increased utilization of higher risk liver allografts. In kidneys, aggressive center-level use of one type of higher risk graft clustered with aggressive use of other types. In this study, we explored center-level behavior in liver utilization. We aggregated national liver transplant recipient data between 2005 and 2009 to the center-level, assigning each center an aggressiveness score based on relative utilization of higher risk livers. Aggressive centers had significantly more patients reaching high MELDs (RR 2.19, 2.33 and 2.28 for number of patients reaching MELD>20, MELD>25 and MELD>30, p<0.001), a higher organ shortage ratio (RR 1.51, 1.60 and 1.51 for number of patients reaching MELD>20, MELD>25 and MELD>30 divided by number of organs recovered at the OPO, p<0.04), and were clustered within various geographic regions, particularly regions 2, 3 and 9. Median MELD at transplant was similar between aggressive and nonaggressive centers, but average annual transplant volume was significantly higher at aggressive centers (RR 2.27, 95% CI 1.47-3.51, p<0.001). In cluster analysis, there were no obvious phenotypic patterns among centers with intermediate levels of aggressiveness. In conclusion, highwaitlist disease severity, geographic differences in organ availability, and transplant volume are the main factors associated with the aggressive utilization of higher risk livers.

Late-onset systemic lupus erythematosus: clinical features, course, and prognosis

There are contradictory opinions if late-onset systemic lupus erythematosus (SLE) is associated with a different, more benign disease course and better prognosis than early-onset SLE. The objective of this study was to evaluate the clinical manifestations, course, treatment, and prognosis of late-onset SLE. Patients who developed SLE after/or at the age of 50 years were considered late-onset SLE and compared to a group of randomly selected patients aged younger than 50 years at the diagnosis, matched for disease duration. Lower frequency of cutaneous manifestations (p = 0.01) and higher frequency of cytopenias (p = 0.02) were registrated at the SLE onset in the late-onset group. Atypical clinical presentation of SLE contributed to a longer delay of diagnosis in late-onset SLE patients (p = 0.005), who fullfiled less American College of Rheumatology criteria at the diagnosis (p = 0.022). Cumulative incidence of clinical manifestations showed lower frequency of cutaneous (p = 0.017), neuropsychiatric manifestations (p = 0.021), lupus nephritis (p = 0.006), and higher frequency of Sjogren's syndrome (p = 0.025) in the late-onset group. Late-onset SLE patients received lower doses of corticosteroid (p = 0.006) and cyclophosphamide (p = 0.001) and had more cyclophosphamide-induced complications (p = 0.005). Higher prevalence of comorbid conditions in the late-onset group (p = 0.025), and higher Systemic Lupus International Collaborating Clinics/American College of Rheumatology damage index was noticed (p = 0.018). Despite the less major organ involvement and more benign course of disease, late-onset SLE has poorer prognosis, because of the higher frequency of comorbid conditions and higher organ damage, due to the aging and longer exposition to a classical vascular risk factors.

Calculated organ doses using Monte Carlo simulations in a reference male phantom undergoing HDR brachytherapy applied to localized prostate carcinoma

The aim of this study was to obtain equivalent doses in radiosensitive organs (aside from the bladder and rectum) when applying high-dose-rate (HDR) brachytherapy to a localized prostate carcinoma using (60)Co or (192)Ir sources. These data are compared with results in a water phantom and with expected values in an infinite water medium. A comparison with reported values from proton therapy and intensity-modulated radiation therapy (IMRT) is also provided. Monte Carlo simulations in Geant4 were performed using a voxelized phantom described in International Commission on Radiological Protection (ICRP) Publication 110, which reproduces masses and shapes from an adult reference man defined in ICRP Publication 89. Point sources of (60)Co or (192)Ir with photon energy spectra corresponding to those exiting their capsules were placed in the center of the prostate, and equivalent doses per clinical absorbed dose in this target organ were obtained in several radiosensitive organs. Values were corrected to account for clinical circumstances with the source located at various positions with differing dwell times throughout the prostate. This was repeated for a homogeneous water phantom. For the nearest organs considered (bladder, rectum, testes, small intestine, and colon), equivalent doses given by (60)Co source were smaller (8%-19%) than from (192)Ir. However, as the distance increases, the more penetrating gamma rays produced by (60)Co deliver higher organ equivalent doses. The overall result is that effective dose per clinical absorbed dose from a (60)Co source (11.1 mSv/Gy) is lower than from a (192)Ir source (13.2 mSv/Gy). On the other hand, equivalent doses were the same in the tissue and the homogeneous water phantom for those soft tissues closer to the prostate than about 30 cm. As the distance increased, the differences of photoelectric effect in water and soft tissue, and appearance of other materials such as air, bone, or lungs, produced variations between both phantoms which were at most 35% in the considered organ equivalent doses. Finally, effective doses per clinical absorbed dose from IMRT and proton therapy were comparable to those from both brachytherapy sources, with brachytherapy being advantageous over external beam radiation therapy for the furthest organs. A database of organ equivalent doses when applying HDR brachytherapy to the prostate with either (60)Co or (192)Ir is provided. According to physical considerations, (192)Ir is dosimetrically advantageous over (60)Co sources at large distances, but not in the closest organs. Damage to distant healthy organs per clinical absorbed dose is lower with brachytherapy than with IMRT or protons, although the overall effective dose per Gy given to the prostate seems very similar. Given that there are several possible fractionation schemes, which result in different total amounts of therapeutic absorbed dose, advantage of a radiation treatment (according to equivalent dose to healthy organs) is treatment and facility dependent.

Mesophilic anaerobic co-digestion of pulp and paper sludge and food waste for methane production in a fed-batch basis

Co-digestion of pulp and paper sludge (PPS) and food waste (FW) in a batch-fed digestion system was conducted on a laboratory scale. Three reactors named A1, A2, and A3 were tested. PPS and FW mixed at different mass ratios of 1:3, 1:1, and 3:1, respectively, were loaded in the reactors. Bioconversion at high efficiency was obtained in the system. The accumulative methane yield of each reactor was 144 mL g−1VSfed (A1), 256 mL g−1VSfed (A2), and 123 mL g−1VSfed (A3). The soluble chemical oxygen demand (COD) removal efficiencies reached 73.2% (A1), 93.9% (A2), and 79.6% (A3). A pH in the range 5.8–8.4 was obtained in the three reactors without adjustment due to the high buffer capacity of the mixing feedstock. No toxicity inhibitions of volatile fatty acids and NH3-N occurred in reactor A2. This study showed that it was good for co-digestion of PPS and FW in a mass ratio of 1:1 for methane production, which resulted in higher methane yield, a greater buffer capacity, a higher organics removal efficiency, and a more stable process.

Prognostic factors in critically ill patients with hematologic malignancies admitted to the intensive care unit

ObjectiveDespite an improvement in the prognosis of patients with hematologic malignancies, the mortality of such patients transferred to the intensive care unit (ICU) is high. This study determined the predictors of mortality in a cohort of critically ill patients with hematologic malignancies admitted to the ICU. MethodsWe studied 227 critically ill patients with hematologic malignancies who were admitted to the ICU between April 2009 and December 2011. A cohort of consecutive patients with hematologic malignancies was reviewed retrospectively to identify clinically useful prognostic factors. ResultsThe ICU mortality rate was 84.1%, and the in-hospital mortality rate was 89.9%. The ICU mortality was significantly higher in patients with acute leukemia than in those with other malignancies. A significant difference between survivors and nonsurvivors was found in neutropenia and its recovery during the ICU stay, presence of cardiac dysfunction, the need for an invasive mechanical ventilator, use of inotropic/vasopressor agents, platelet count, aspartate transaminase level, pH, and Acute Physiology And Chronic Health Evaluation II score. In the multivariate analysis, acute leukemia, need for invasive mechanical ventilator, use of inotropic/vasopressor agents, and Acute Physiology And Chronic Health Evaluation II scores were independently associated with a worse outcome in patients with hematologic malignancies admitted to the ICU. ConclusionHigher mortality in patients with hematologic malignancies admitted to the ICU is associated with more severe illness, as reflected by higher organ failure scores or respiratory or hemodynamic instability. Mortality is higher in patients with acute leukemia as compared with other hematologic malignancies.

Effect of replacing soybean protein with protein from ensiled stylo (Stylosanthes guianensis (Aubl.) Sw. var. guianensis) on growth performance, carcass traits and organ weights of exotic (Landrace × Yorkshire) and native (Moo Lath) Lao pigs

The present study examined the impact of replacing crude protein (CP) from soybean with CP from ensiled stylo (ES) on growth performance, carcass traits and organ weights in Landrace × Yorkshire (LY) and Moo Lath (ML) native Lao pigs. Twenty-four castrated male pigs, 12 of each breed, were allocated to the diet treatments according to a completely randomised 3 × 2 factorial (three ES levels × two breeds) arrangement, with four pigs per diet treatment. Pigs were kept in individual pens and fed at 4% dry matter of body weight for 98days. The control diet was formulated with soybean meal as the main CP source, and in the other two experimental diets, CP from soybean was replaced at 25% (ES25) and 50% (ES50) by CP from ES. Calculated metabolisable energy intake decreased with ES50 diet, while dry matter intake (DMI) and CP intake (CPI) were the highest in ES25 diet (P < 0.001). Overall, average daily gain (ADG) and feed conversion ratio (FCR) were unaffected by diet treatments. Carcass weight, backfat thickness and dressing percentage were unaffected by soybean CP replacement, while the weights of lung, large intestine and stomach were higher (P < 0.001) when 25% of soybean CP was replaced by CP from ES. LY pigs had higher (P < 0.001) DMI, CPI and ADG and poorer (P < 0.001) FCR than ML pigs. LY pigs had higher carcass weight (P < 0.001), lower backfat thickness (P < 0.001) and higher organ weight (P < 0.001) than ML pigs, except for small intestine weight, where there was no difference between the LY and ML pigs (P > 0.05). In conclusion, ES can replace up to 50% of soybean CP in the diet of growing Lao LY and ML pigs without negative effects on performance and carcass traits.

The “Tell Us Now” Campaign for Organ Donation: Using Message Immediacy to Increase Donor Registration Rates

There is a substantial gap between those people in the United States who identify as being favorable toward organ donation (~90%) and those registered as donors (~30%). A growing body of evidence suggests Department of Motor Vehicles (DMV) offices are effective sites for facilitating higher organ donor registration rates on a national scale. The goal of the current study was to determine the utility and sustainability of a message immediacy approach, which draws from theoretical concepts such as priming and cues to action. Message immediacy requires individuals be: (a) exposed to a message that prompts an action, (b) in an environment where a prescribed action or behavior can be enacted, and (c) favorable toward the promoted behavior or action. Thirty-four Michigan counties, divided into three implementation groups, received campaigns in October (Group 1), November (Group 2), and December (Group 3) of 2009. Registration rates for three to six months after campaign implementation indicate that the on-site message prompts almost doubled registration rates in DMV offices. Additionally, preliminary cost-effectiveness evidence suggests message immediacy offers a relatively inexpensive campaign strategy.

Higher organ donation consent rates by relatives of potential uncontrolled donors versus potential controlled donors after death

Refusal to consent to organ donation is an important cause of the persisting gap between the number of potential organ donors and effectuated donors. In the Netherlands, organ donors include both uncontrolled donors: donors who die unexpectedly after cardiac death (DCD), after failed resuscitation and donors in whom death can be expected and donors after brain death, and controlled DCD donors: those who die after the withdrawal of treatment. Different donor type implies a different setting in which relatives are requested to consent to organ donation. It is unknown whether the setting influences the eventual decision for donation or not. Therefore, we compared the consent rate in potential donors who died unexpectedly (UD group) and in whom death was expected. A total of 523 potential organ donors between 2003 and 2011 in the 715-bed Maastricht University Medical Centre, the Netherlands were included. Both the patients' registration in the national donor register (DR) and the relatives' refusal rate in the two groups were retrospectively assessed using data from the donation application database. There were 109 unexpected and 414 expected potential donors The potential donors in the UD group were younger (mean age 52 versus 55 years, P = 0.032) and more often male (68 versus 52%, P = 0.003). There were no significant differences in registration in the DR between the groups. The relatives' consent rate in non-registered potential donors, or those who mandated the relatives for that decision, was higher in the UD group (53 versus 29%, P < 0.001). Less than 50% of the potential donors were registered in the national DR. Therefore, the relatives have an important role in the choice for organ donation. The relatives of potential donors who died unexpectedly consented more often to donation than those in whom death was expected.