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Infection with the Epstein-Barr virus (EBV) is a common disease and is mainly asymptomatic during childhood, whereas infectious mononucleosis with clinical signs such as fever, pharyngitis, lymphadenopathy and hepatosplenomegaly often occurs in adolescents and adults with primary infection. Acalculous cholecystitis has been reported as a rare complication. We report herein a case of acalculous cholecystitis accompanied by infectious mononucleosis by EBV, which was treated successfully by medical treatment. A 33-year-old woman who had been admitted by fever, pharyngitis and lymphadenopathy developed a right upper quadrant pain, that was diagnosed as acalculous cholecystitis based on an imaging study. Antibiotic treatment did not resolve the symptoms, and surgical intervention was considered. We diagnosed her as having infectious mononucleosis based on a typical physical presentation and seropositivity for the EBV viral capsid antigen, suggesting that the acalculous cholecystatis might have been a complication of the EBV infection. After the administration of glucocorticoid and acyclovir, the patient became afebrile and the abdominal pain disappeared. Though acalculous cholecystitis rarely accompanies infectious mononucleosis caused by EBV, clinicians should be aware of this complication to avoid unnecessary cholecystectomy.

The antibacterial activity of honey produced by the stingless bees Scaptotrigona postica (H6) and Scaptotrigona bipunctata (H7) was evaluated against methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-sensitive S. aureus (MSSA) strains. Fifty-three MRSA strains in the bacterial collection of the hospital of Londrina State University, three standard MRSA strains and two standard MSSA strains were used. Evaluation of the antibacterial activity of honey samples was determined by agar well diffusion assay, calculation of minimum inhibitory concentrations (MICs), and construction of growth and viability curves. The inhibition zones generated by the honey samples ranged from 20 to 27 mm for H6 and 20 to 24 mm for H7, while MIC values ranged from 0.62 to 1.25% for H6 and 1.25 to 2.5% for H7. According to the growth curves, the growth of all MRSA and MSSA strains was completely inhibited. Honey cytotoxicity was evaluated by dimethylthiazol diphenyl tetrazolium bromide (MTT) assay, and the CC50 val...

The following is a report on a congenital vaginal malformation, imperforate vagina, in the common marmoset (Callithrix jacchus). This anomaly was observed for the first time in an adult female in our research colony. There was no uterine and vaginal aplasia or atresia in her grossly normal genital tract. The plasma progesterone concentration suggested that the ovarian cycle had ceased. However, this may not be related to a functional anomaly, but rather to suppressed ovulation resulting from subordination to cagemates considering the various stages of follicular development observed.

A new criterion is proposed for evaluating the multiaxial high-cycle fatigue limit of components with notches and superficial small holes. Two parameters are specified: (1) one governing crack initiation and (2) the other governing initial crack growth. The new criterion is based on the multiaxial fatigue criterion for smooth components previously proposed by the authors. The accuracies of the proposed and conventional criteria are evaluated using experimentally determined fatigue limit data of notches and superficial small holes under combined bending and torsion stresses and combined axial and torsion stresses. The error of the proposed criterion is approximately 10%.

The Brazilian poultry industry generates large amounts of organic waste, such as chicken litter, which is often used in agriculture. Among the bacteria present in organic fertilizer are members of the Enterobacteriaceae family. The objective of this study was to detect the presence of diarrheagenic Escherichia coli (DEC) strains in avian organic fertilizer, and assess the potential damage they can cause in humans due to antimicrobial resistance. The presence of DEC pathotypes and phylogenetic groups were detected by multiplex-PCR. Phenotypic assays, such as tests for adhesion, cytotoxicity activity, biofilm formation and especially antimicrobial susceptibility, were performed. Fifteen DEC strains from 64 E. coli were isolated. Among these, four strains were classified as enteropathogenic (EPEC; 6.2%), three strains as Shiga toxin-producing (STEC; 4.7%), 10 strains as enteroaggregative (EAEC; 12.5%), but two of these harbored the eaeA gene too. The low number of isolated strains was most likely due to the composting process, which reduces the number of microorganisms. These strains were able to adhere to HEp-2 and HeLa cells and produce Shiga-toxins and biofilms; in addition, some of the strains showed antimicrobial resistance, which indicates a risk of the transfer of resistance genes to human E. coli. These results showed that DEC strains isolated from avian organic fertilizers can cause human infections.

Background Current guidelines for cardiopulmonary resuscitation (CPR) emphasise that emergency medical service (EMS) dispatchers should identify sudden cardiac arrest (CA) with abnormal breathing and assist lay rescuers performing CPR. However, lay rescuers description of abnormal breathing may be inconsistent, and it is unclear how EMS dispatchers provide instruction for CPR based on the breathing status of the CA victims described by laypersons. Methods and results To investigate the incidence of abnormal breathing and the association between the EMS dispatcher-assisted CPR instruction and layperson CPR, we retrospectively analysed 283 witnessed CA cases whose information regarding breathing status of CA victims was available from population-based prospective cohort data. In 169 cases (59.7%), laypersons described that the CA victims were breathing in various ways, and that the victims were ‘not breathing’ in 114 cases (40.3%). Victims described as breathing in various ways were provided EMS dispatch-instruction for CPR less frequently than victims described as ‘not breathing’ (27.8% (47/169) vs 84.2% (96/114); p

The poultry industry experiences enormous economic losses due to microbial contamination, leading to searches for natural antimicrobials. Sophorolipid is a glycolipid produced by Starmerella bombicola, that acts as an emulsifier and antimicrobial agent. The aim of this research was to produce, characterize and apply sophorolipid from S. bombicola against the chicken pathogens Clostridium perfringens and Campylobacter jejuni, which are responsible for diseases that cause great damage to the poultry industry. The application of sophorolipid against these microorganisms has not yet been reported and to aggregate value to the product, sophorolipid was associated with lactic acid, a nontoxic molecule already utilized in the food industry. Sophorolipid production reached 69.83 g.L−1 with a productivity of 0.24 g.L−1.h−1 and a yield of 46.41% at 288 h in a bioreactor. The structural characterization analyses confirmed the predominance of the lactonic form. Sophorolipid demonstrated antimicrobial activity against the tested bacteria and the combined treatment of sophorolipid and lactic acid represented an additive interaction. Therefore, this combination could be an alternative to use as a new natural sanitizer in the poultry industry, reducing the microbial contamination of these main pathogens.

Von Willebrand factor (VWF)-cleaving protease (ADAMTS13) cleaves ultralarge VWF (ULVWF) secreted from endothelium and by which is regulating its physiologic function. An imbalance between ULVWF secretion and ADAMTS13 level occurs in sepsis and may cause multiple organ dysfunction. We evaluated the association between the VWF-propeptide (VWF-pp)/ADAMTS13 ratio and disease severity in patients with severe sepsis or septic shock. In 27 patients with severe sepsis or septic shock and platelet count less than 120,000/μL, we measured plasma VWF, VWF-pp, and ADAMTS13 levels on hospital days 1, 3, 5, and 7. The VWF-pp/ADAMTS13 ratio was increased greater than 12-fold in patients with severe sepsis or septic shock on day 1 and remained markedly high on days 3, 5, and 7 compared with normal control subjects. The VWF-pp/ADAMTS13 ratio significantly correlated with Acute Physiology and Chronic Health Evaluation II score on days 1 and 5; Sepsis-related Organ Failure Assessment score on days 1, 3, and 5; maximum Sepsis-related Organ Failure Assessment score and tumor necrosis factor α level on days 1, 3, 5, and 7; and creatinine level on days 1, 5, and 7. Patients with greater than stage 1 acute kidney injury had significantly higher VWF-pp/ADAMTS13 ratio than patients without acute kidney injury. In summary, the VWF-pp/ADAMTS13 ratio was associated with disease severity in patients with severe sepsis or septic shock and may help identify patients at risk for multiple organ dysfunction by detecting severe imbalance between ULVWF secretion and ADAMTS13 level.

A new criterion for multiaxial high-cycle fatigue limit is proposed using two parameters: one governing crack initiation and the other governing initial crack growth. The axial fatigue limit and the true fracture strength are used as the material properties required in estimations. The prediction accuracies using conventional criteria and the proposed criterion were compared using known data about fatigue limits under different loading conditions. The comparison was made for the effects of phase difference, mean stress, and the combination of phase difference and mean stress. The estimation error of the proposed criterion was approximately 10%, which is better than that of the other criteria used for comparison.

Thrombotic thrombocytopenic purpura (TTP), while rare, is a potentially life-threatening disorder. Plasma exchange (PE) is considered the primary treatment for TTP. In Western countries, rituximab, an anti-CD20 antibody, is recommended with PE for the treatment of refractory/relapsed TTP, and as up-front therapy in newly diagnosed TTP with neurological/cardiac pathology. The present open-label, single-arm, multicenter study evaluated the efficacy and safety of rituximab in Japanese patients with refractory/relapsed TTP. Patients received rituximab 375 mg/m2 intravenously, once weekly for a total of four treatments, with PE and steroids. Of six evaluable patients in the full analysis set, two met the primary efficacy endpoint (platelet count >150 × 109/L at week 4), yielding a 33.3 % response rate (95 % confidence interval: 4.3–77.7). While the lower confidence limit of the primary efficacy endpoint failed to reach the pre-specified threshold of 30 %, clinically significant recovery of platelet count with discontinuation of PE, increase of ADAMTS13 activity, disappearance of ADAMTS13 inhibitor, and improvement of TTP-associated clinical manifestations were observed after rituximab therapy in all patients. No safety concerns were identified in this study; therefore, rituximab is considered a useful treatment option in Japanese TTP patients who are refractory to conventional therapy. Trial registration JMA-IIA00160.

The adhesive protein von Willebrand factor (VWF) plays an essential role in physiological hemostasis, mediating platelet adhesion and aggregation under high shear stress conditions.[1][1],[2][2] The VWF-cleaving protease ADAMTS13 precisely down-regulates VWF activity to avoid pathological

A cetose bovina é uma doença metabólica que atinge vacas principalmente após o parto, podendo apresentar-se tanto na forma clínica como subclínica e muitas vezes não é percebido pelo produtor, porém causa perdas econômicas consideráveis, pois há uma diminuição na produção de leite, atraso do próximo parto e desenvolvimento de doenças secundárias. Neste trabalho foi realizado um levantamento em 41 vacas pós-parto (oitavo ao sexagésimo dia de lactação), para análise comparativa de dois métodos de diagnóstico de cetose bovina, por meio da avaliação da presença de corpos cetônicos na urina, utilizando fita reagente em comparação com o beta-hidroxibutirato (BHB) no sangue total, utilizando aparelho portátil. O teste realizado através do exame de urina com fita reagente obteve resultado de 2,4% (1/41) de animais positivos enquanto o realizado através de aparelho automático portátil, apresentou 58,5% (24/41) de positividade para cetose, todas subclínica. Pode-se evidenciar que o teste com aparelho portátil é mais eficiente e é possível realizar um diagnóstico precoce, já que a cetose identificada com o teste da urina precisa estar em altas concentrações para ser positiva. O objetivo deste trabalho foi identificar qual método de diagnóstico de cetose subclínica e clínica é mais eficaz, com maior precisão de dados, maior facilidade em coleta e melhor relação.

Reperfusion after brain ischemia causes thrombus formation and microcirculatory disturbances, which are dependent on the platelet glycoprotein Ib–von Willebrand factor (VWF) axis. Because ADAMTS13 cleaves VWF and limits platelet-dependent thrombus growth, ADAMTS13 may ameliorate ischemic brain damage in acute stroke. We investigated the effects of ADAMTS13 on ischemia-reperfusion injury using a 30-minute middle cerebral artery occlusion model in Adamts13−/− and wild-type mice. After reperfusion for 0.5 hours, the regional cerebral blood flow in the ischemic cortex was decreased markedly in Adamts13−/− mice compared with wild-type mice (P < .05), which also resulted in a larger infarct volume after 24 hours for Adamts13−/− compared with wild-type mice (P < .01). Thus, Adamts13 gene deletion aggravated ischemic brain damage, suggesting that ADAMTS13 may protect the brain from ischemia by regulating VWF-platelet interactions after reperfusion. These results indicate that ADAMTS13 may be a useful therapeutic agent for stroke.

Daily changes in serum concentrations of natriuretic peptides and various cardiopulmonary parameters were measured after the onset of subarachnoid hemorrhage (SAH) to investigate the pathogenesis of the cardiac and pulmonary consequences in 15 patients with acute phase SAH, divided into the control group (n = 5) with consciousness continuously preserved from SAH onset to admission, and the consciousness disturbance group (n = 10). Daily changes in serum A-type and B-type natriuretic peptides (ANP and BNP, respectively) were measured for 10 days, and intrathoracic blood volume index and extravascular lung water index (EVLWI) were measured for 5 days by the single transpulmonary thermodilution method. Natriuretic peptides in the consciousness disturbance group showed significantly higher values during the 10-day period, with ANP 119.2 +/- 12.4 pg/ml (mean +/- standard error of the mean, p = 0.005) on day 2 and BNP 354.1 +/- 80.3 pg/ml (p = 0.009) on day 1. EVLWI showed higher values in the consciousness disturbance group compared to the control group throughout the 5-day period. The increases in natriuretic peptide levels and increase in pulmonary extravascular water content found in SAH patients with consciousness disturbance show that load on the left ventricle or atrium as well as pulmonary capillary pressure are increased immediately after onset, supporting the contention that excessive release of catecholamines occurs at this time.

The metalloprotease ADAMTS13 is assumed to regulate the functional levels of von Willebrand factor (VWF) appropriate for normal hemostasis in vivo by reducing VWF multimer size, which directly represents the thrombogenic activity of this factor. Using an in vitro perfusion chamber system, we studied the mechanisms of ADAMTS13 action during platelet thrombus formation on a collagen surface under whole blood flow conditions. Inhibition studies with a function-blocking anti-ADAMTS13 antibody, combined with immunostaining of thrombi with an anti-VWF monoclonal antibody that specifically reflects the VWF-cleaving activity of ADAMTS13, provided visual evidence for a shear rate–dependent action of ADAMTS13 that limits thrombus growth directly at the site of the ongoing thrombus generation process. Our results identify an exquisitely specific regulatory mechanism that prevents arterial occlusion under high shear rate conditions during mural thrombogenesis.

Sepsis is a systemic inflammatory response syndrome caused by severe microbial infection. Uncontrollable activation of both inflammatory and coagulation pathways may result in multiple organ failure, a leading cause of death in intensive care units even in developed countries. An adhesive protein

Background: We modified the dispatch protocol for cardiopulmonary resuscitation (CPR) using results of a retrospective analysis that identified descriptions by laypersons of possible patterns of agonal respiration. The purpose of this study was to assess the effectiveness of this modified protocol by comparing the frequency of dispatch instructions for CPR and bystander CPR before and after protocol implementation. We also identified descriptions of abnormal breathing patterns among 'Not in cardiac arrest (CA)' unresponsive cases. Methods: This study was conducted prospectively using the population-based registry of out-of-hospital cardiac arrests (OHCAs). For 8 months we implemented this modified protocol in cooperation with 4 fire departments that cover regions with a total population of 840, 000. Results: There were 478 and 427 OHCAs before and after implementation, respectively. Among them, 69 and 71 layperson-witnessed OHCAs for pre- and post-implementation, respectively, were analyzed. Dispatchers provided CPR instructions more frequently after protocol implementation than before (55/71 [77.5 %] vs. 41/69 [59.4 %], p < 0.05). Based on breathing patterns described by emergency callers, dispatchers assessed 143 'Not in CA' unresponsive cases and provided CPR instruction for 45 cases. Sensitivity and specificity of this protocol was 93 % and 50 %, respectively. Conclusions: This modified protocol based on abnormal breathing described by laypersons significantly increased CPR instructions. Considering high sensitivity and low specificity for abnormal breathing to identify CA and the low risk of chest compression for 'Not in CA' cases, our study suggested that dispatchers can provide CPR instruction assertively and safely for those unresponsive individuals with various abnormal breathing patterns.

A apiterapia é uma forma de medicina popular e preventiva para tratamento de doenças. Apesar de diversos estudos comprovarem a atividade antimicrobiana dos méis, a ação é variável dependendo do tipo e origem do mel, além disso ainda não houveram relatos sobre o efeito da combinação entre méis. Neste estudo, a atividade antibacteriana dos méis e em combinação entre eles, produzidos por abelhas sem ferrão Scaptotrigona bipunctata e Scaptotrigona postica, foi avaliada contra cepas bacterianas Gram-positivas (Enterococcus spp., Staphylococcus spp. e Streptococcus spp.) e Gram-negativas (Escherichia spp., Klebsiella spp., Pseudomonas spp. e Salmonella spp.). Os ensaios para a determinação da ação foram realizados através de técnicas de poço difusão em ágar, microdiluição em caldo (tratado e não com catalase), curva de crescimento e morte, citotoxicidade e microscopia eletrônica de varredura (MEV). Os resultados mostram atividade de ambos os méis contra todas as cepas testadas, com os valores de concentração inibitória mínima (CIM) variando de 0,62 a 5% (Gram-positvas), 2,5 a 10% (Gram-negativas) e quando combinadas apresentam efeito sinérgico. Através das imagens de MEV pode-se observar diferentes formas de ação dos méis sobre as bactérias. Este estudo demonstrou que o mel possui atividade bactericida in vitro contra cepas Gram-positivas e Gram-negativas, incluindo cepas multirresistentes. A combinação dos méis de S. bipunctata e S. postica pode levar a um novo antimicrobiano de amplo-espectro, que poderia vir a ser utilizado como medicamento ou cosmético, com potencial de prevenir a emergência de cepas bacterianas resistentes. Apitherapy has become the attention as a form of folk and preventive medicine for treating diseases. Although several studies prove the antibacterial activity of honeys, the action is variable depending of type and origin of honey, furthermore there is no relate about the effect of honey combination. In this study, the antibacterial activity of honey isolated and in combination, produced by stingless bee Scaptotrigona bipunctata and Scaptotrigona postica, was evaluated against Gram-positive (Enterococcus spp., Staphylococcus spp. e Streptococcus spp.) and Gram-negative (Escherichia spp., Klebsiella spp., Pseudomonas spp. e Salmonella spp.) bacterial strains. The assays for determining the action were made through agar well difusion assay, broth microdilution (treated and not with catalase), time-kill curve, cytotoxicity and scanning electron miscroscopy (SEM). Results showed activity of both honey against all strains tested, the minimal inhibitory concentrations (MICs) values ranged from 0.62 to 5% (Gram-positive), 2.5 to 10% (Gram-negative) and when used in combination showed synergistic effect. Through SEM images could be observed different forms of action of honey on bacteria. This study demonstrated that honey has bactericidal activity in vitro against Gram-positive and Gram-negative strains, including multidrug-resistant strains. The combination of honey from S. bipunctata and S. postica could lead to a new broad-spectrum antimicrobials, which could be used as medicines or cosmetic, that have the potential to prevent the emergence of resistant bacterial strains.

Introduction: Extraintestinal pathogenic Escherichia coli (ExPEC) is associated with various diseases such as urinary tract infections, neonatal meningitis and septicemia. There are many virulence factors (VF) encoded by genes in ExPEC, including papC, papG, ecpA, iroN, fyuA, iutA, ompTp, tsh, hlyF, hlyA and iss. These virulence genes may be present in pathogenicity islands (PAI) or plasmids. Methodology: In this study, we analyzed the presence of VF encoding genes, PAI sequences and phylogenetic groups of 96 ExPEC strains isolated from the urine and blood of patients at the University Hospital of Londrina, and we compared them with 50 faecal commensal strains from healthy individuals. Results: The VF fyuA (65.60%) was detected in pathogenic strains and commensal strains (46%). A comparison of the distribution of ExPEC and commensal strains in the phylogenetic groups showed that more ExPEC strains belonged to group B2 whereas more of the commensal isolates belonged to group A. The distribution of the seven PAI sequences between commensal strains and ExPEC strains showed that PAI IV536 was common in both ExPEC and commensal isolates. Conclusions: These results showed that the ExPEC strains that belonged to group B2 had more PAI sequences compared to those of the other groups, especially group B1, which had virulence genes but the lowest percentage of PAI sequences, which leads us to conclude that the virulence of ExPEC strains characterized as B2 is likely attributed to PAI encoded genes, whereas the virulence of ExPEC strains belonging to phylogenetic group B1 is likely due to plasmid encoded virulence genes.

Several studies have tested antimicrobial activity of combinations of honey and various substances. In this study, we tested a combination of two stingless bee honeys against various bacterial strains. In particular: the antibacterial activity of honeys produced by Scaptotrigona bipunctata (SB) and Scaptotrigona postica (SP) was evaluated against Gram-positive and Gram-negative bacterial strains by agar well diffusion assays, minimum inhibitory concentration (MIC) assessment, construction of growth and viability curves and scanning electron microscopy (SEM). The interaction of the two honeys was also evaluated by the checkerboard assay. Inhibition zones ranged from 8 to 22 mm. The MIC values of the individual honeys ranged from 0.62 to 10% (v v−1) and decreased to 1/4 to 1/32 when the honeys were combined. SEM images showed division inhibition and cell wall disruption for the SB and SP honeys, respectively, and these alterations were observed in same field when the SB and SP honeys were combined. This study demonstrated that the natural honeys possess in vitro antimicrobial activity against Gram-positive and Gram-negative bacteria, including multidrug-resistant strains. Combination of the SB and SP honeys could lead to the development of new broad-spectrum antimicrobials that have the potential to prevent the emergence of resistant bacterial strains.

von Willebrand factor (vWF) is a multimeric plasma glycoprotein with three tandem A domains. Domains A1 and A3 bind to platelet glycoprotein Ibalpha (GPIbalpha) and collagen, respectively. Domain A2 contains the Tyr-1605-Met-1606 bond that is cleaved by the metalloprotease ADAMTS13, and this reaction inhibits platelet thrombus growth. Fluid shear stress increases the rate of cleavage, suggesting that productive interaction with ADAMTS13 requires conformational changes within or near domain A2. The influence of the adjacent A1 and A3 domains was assessed by mutagenesis of a recombinant substrate consisting of domains A1A2A3. Deletion of domain A3 did not affect cleavage by ADAMTS13, whereas deletion of domain A1 increased the rate of cleavage approximately 10-fold. Similar effects were observed with plasma ADAMTS13 and recombinant ADAMTS13 truncated after the spacer domain. Digestion of A1A2A3 by plasma ADAMTS13 was enhanced to a similar extent by a recombinant mutant fragment of platelet GPIbalpha that binds with high affinity to domain A1 or by heparin. Heparin also increased the digestion of purified plasma vWF. Neither GPIbalpha nor heparin increased the cleavage of substrate A2A3 that lacks domain A1. The results suggest that vWF domain A1 inhibits the cleavage of domain A2, and that inhibition can be relieved by interaction of domain A1 with platelet GPIbalpha or certain glycosaminoglycans. Thus, binding of vWF to its major physiological ligands may promote the feedback inhibition of platelet adhesion by stimulating the cleavage of domain A2 by ADAMTS13 independent of fluid shear stress.

Bitiscetin, a platelet adhesion inducer isolated from venom of the snake Bitis arietans, activates the binding of the von Willebrand factor (VWF) A1 domain to glycoprotein Ib (GPIb) in vitro. This activation requires the formation of a bitiscetin-VWF A1 complex, suggesting an allosteric mechanism of action. Here, we report the crystal structure of bitiscetin-VWF A1 domain complex solved at 2.85 A. In the complex structure, helix α5 of VWF A1 domain lies on a concave depression on bitiscetin, and binding sites are located at both ends of the depression. The binding sites correspond well with those proposed previously based on alanine-scanning mutagenesis (Matsui, T., Hamako, J., Matsushita, T., Nakayama, T., Fujimura, Y., and Titani, K. (2002) Biochemistry 41, 7939–7946). Against our expectations, the structure of the VWF A1 domain bound to bitiscetin does not differ significantly from the structure of the free A1 domain. These results are similar to the case of botrocetin, another snake-derived inducer of platelet aggregation, although the binding modes of botrocetin and bitiscetin are different. The modeled structure of the ternary bitiscetin-VWF A1-GPIb complex suggests that an electropositive surface of bitiscetin may interact with a favorably positioned anionic region of GPIb. These results suggest that snake venom proteins induce VWF A1-GPIbα binding by interacting with both proteins, and not by causing conformational changes in VWF A1.

The following is a report on a congenital vaginal malformation, imperforate vagina, in the common marmoset (Callithrix jacchus). This anomaly was observed for the first time in an adult female in our research colony. There was no uterine and vaginal aplasia or atresia in her grossly normal genital tract. The plasma progesterone concentration suggested that the ovarian cycle had ceased. However, this may not be related to a functional anomaly, but rather to suppressed ovulation resulting from subordination to cagemates considering the various stages of follicular development observed.

Sara Goncalves Paschoal, Erick Kenji Nishio, Gerson Nakazato, Renata Katsuko Takayama Kobayashi, Joao Carlos Palazzo de Mello, Ieda Spacino Scarminio, Audrey Alesandra Stinghen Garcia Lonni. Avaliacao da Acao Antibacteriana de Extrato de Trichilia catigua Contra as Bacterias Patogenicas de Origem Alimentar. In: Anais do 12o Congresso Latinoamericano de Microbiologia e Higiene de Alimentos MICROAL 2014 [= Blucher Food Science Proceedings, num.1, vol.1]. Sao Paulo: Editora Blucher, 2014. DOI 10.5151/foodsci-microal-315 Avaliacao da Acao Antibacteriana de Extrato de Trichilia catigua Contra as Bacterias Patogenicas de Origem Alimentar

Erick Kenji Nishio, Jhonatan Macedo Ribeiro, Renata Katsuko Takayama Kobayashi, Admilton Golcalves de Oliveira Junior, Edson Aparecido Proni, Gerson Nakazato. Avaliacao do Efeito do Mel de Scaptotrigona Bipunctata (Lepeletier, 1836) Sobre Staphylococcus Aureus Meticilina-Resistente Atraves de Microscopia Eletronica de Varredura.. In: Anais do 12o Congresso Latinoamericano de Microbiologia e Higiene de Alimentos MICROAL 2014 [= Blucher Food Science Proceedings, num.1, vol.1]. Sao Paulo: Editora Blucher, 2014. DOI 10.5151/foodsci-microal-280 Avaliacao do Efeito do Mel de Scaptotrigona Bipunctata (Lepeletier, 1836) Sobre Staphylococcus Aureus Meticilina-Resistente Atraves de Microscopia Eletronica de Varredura.

Giovana Carolina Bodnar, Erick Kenji Nishio, Mariane Trizotti Krupiniski, Renata Katsuko Takayama Kobayashi, Gerson Nakazato. Acao Antimicrobiana do Oleo de Cravo Contra Bacterias Gram Positivas e Gram Negativas. In: Anais do 12o Congresso Latinoamericano de Microbiologia e Higiene de Alimentos MICROAL 2014 [= Blucher Food Science Proceedings, num.1, vol.1]. Sao Paulo: Editora Blucher, 2014. DOI 10.5151/foodsci-microal-326 Acao Antimicrobiana do Oleo de Cravo Contra Bacterias Gram Positivas e Gram Negativas

Erick Kenji Nishio, Mariane Trizotti Krupiniski, Renata Katsuko Takayama Kobayashi, Edson Aparecido Proni, Gerson Nakazato. Avaliacao da Atividade Antibacteriana de Dois Meis de Abelhas Indigenas Sem Ferrao Contra Bacterias de Importância Alimentar. In: Anais do 12o Congresso Latinoamericano de Microbiologia e Higiene de Alimentos MICROAL 2014 [= Blucher Food Science Proceedings, num.1, vol.1]. Sao Paulo: Editora Blucher, 2014. DOI 10.5151/foodsci-microal-279 Avaliacao da Atividade Antibacteriana de Dois Meis de Abelhas Indigenas Sem Ferrao Contra Bacterias de Importância Alimentar

To the Editor: Cerebral vasospasm leading to delayed brain ischemia is a major cause of death in patients who initially survive subarachnoid hemorrhage (SAH).1 2 Because of this, the prediction and treatment of vasospasm are critical in the management of SAH patients. Recent studies published in Stroke have reported that several factors, including age

Background and Purpose: Very few reports are available on changes in the human hippocampus after cardiac arrest. The objective of this study was to investigate if specific hippocampal volume losses can be demonstrated in the human brain following reperfusion after cardiac arrest. Methods: We assessed the volumes of the hippocampal formation (HF) and temporal lobe excluding HF (TL) as the contrast using magnetic resonance (MR)-imaging-based volumetry in 11 vegetative patients after cardiac arrest and in 22 healthy controls of similar age, sex and body size distribution. The measured volumes were normalized for differences in the head size among subjects by dividing by the total intracranial volume (TICV). The MR images of the 11 patients were obtained between days 8 and 21 after cardiac arrest. Results: The observed volumes of HFs and TLs of both patient and control groups were as follows: right HF volume (HFV): 2.67 ± 0.19 (mean ± SD, cm3) in patients versus 3.89 ± 0.44 in controls; left HFV: 2.72 ± 0.17 versus 3.74 ± 0.35; right TL volume (TLV): 73.37 ± 6.54 versus 80.08 ± 7.62, and left TLV: 72.45 ± 6.77 versus 78.59 ± 6.68. The normalized indices (HFV/TICV and TLV/TICV) were as follows: right HF: 0.0021 ± 0.0002 (mean ± SD) in patients versus 0.0031 ± 0.0001 in controls, p < 0.0001, left HF: 0.0022 ± 0.0002 versus 0.0030 ± 0.0001, p < 0.0001, right TL: 0.058 ± 0.002 versus 0.064 ± 0.004, p = 0.0007, and left TL: 0.058 ± 0.002 versus 0.062 ± 0.004, p = 0.0014. The HFV-TLV ratios (HFV/TICV divided by TLV/TICV) of both groups were: right HFV-TLV ratio: 0.037 ± 0.004 in patients versus 0.049 ± 0.004 in controls, p < 0.0001, left HFV-TLV ratio: 0.038 ± 0.004 versus 0.048 ± 0.004, p < 0.0001. Conclusions: The patient group had HFs that were 26.8–30.6% smaller than those of the control group, but in the patient group, the TLs slightly decreased in size by only 7.8–8.2% of the volume of those in the control group within 21 days after cardiac arrest. The volume reductions in the bilateral HFs of patients after cardiac arrest were significantly larger than those in the bilateral TLs. We speculate that this specific rapid hippocampal shrinkage reflects its greater vulnerability to global brain ischemia.

We report a case of stunned myocardium induced by coronary vasospasm which was associated with spontaneous pneumothorax. A 72-year-old woman with a sudden onset of chest pain was transferred to our hospital by an ambulance. Electrocardiography on admission suggested evidence of myocardial ischemia, and chest radiography disclosed a right pneumothorax. After right chest drainage was carried out, the findings of myocardial ischemia on electrocardiography persisted. Therefore, emergency coronary angiography was performed, which demonstrated coronary vasospasm on an acetylcholine loading test. Left ventriculography revealed akinesis in a portion of the anterior wall that normalized on echocardiography two days later. We made a diagnosis of stunned myocardium associated with pneumothorax. The severe chest pain and respiratory alkalosis were conseqences of the coronary vasospasm. It is known that the electrocardiographic characteristics of pneumothorax are similar to those of myocardial ischemia. In patients with pneumothorax and ST-T changes on electrocardiography, coronary vasospasm should be considered.

We measured the plasma levels of adrenomedullin (AM), a novel vasodilating peptide, in 89 patients with various forms of systemic inflammatory response syndrome (SIRS) and 13 healthy volunteers serving as controls. Plasma levels of AM in SIRS (burns: 20.5 +/- 3. 2 fmol/ml [mean +/- SEM]; pancreatitis: 13.8 +/- 3.8 fmol/ml; trauma: 14.9 +/- 2.5 fmol/ml; traumatic shock: 41.1 +/- 7.8 fmol/ml; severe sepsis: 59.9 +/- 11.2 fmol/ml; septic shock: 193.5 +/- 30.1 fmol/ml) were significantly increased over those of controls (5.1 +/- 0.2 fmol/ml). The patients with traumatic shock or septic shock especially had higher levels of plasma AM than those with trauma or severe sepsis, respectively. These data showed that in patients with SIRS, plasma AM levels increased in proportion to the severity of illness. Subsequently, we measured the plasma levels of mediators such as tumor necrosis factor (TNF)-alpha, interleukin (IL)-6, IL-8, plasminogen activator inhibitor (PAI)-1, and thrombomodulin (TM) in patients with traumatic shock and septic shock. A significant correlation was observed between plasma AM and TNF-alpha levels in patients with septic shock, suggesting an important role for AM as well as of TNF-alpha in the pathophysiology of inflammation. Plasma AM and IL-8 levels correlated positively with Acute Physiology and Chronic Health Evaluation (APACHE) II score, peak multiple organ failure (MOF) score during the first month and prognosis in patients with septic shock, as did plasma IL-6 levels in patients with traumatic shock. The plasma AM level might serve as a useful marker for evaluating the severity of disease and as an early predictor of subsequent organ failure and outcome in septic shock.

Introduction of a common tariff system not only makes new demand by fare reduction in transfer but also shortens the traveling time forpresent passengers by providing various options of routes. This paper describes the construction of a dynamic transport network model which displays the condition of mass transit service and route choice behavior of passengers, for calculating the amount of shortening in the traveling time. The result of analysis in the urban network of Kyoto makes sure of shortening the traveling time by introduction of common tariff system, and displays its cause.

A disintegrin-like and metalloprotease with thrombospondin type 1-motif 13 (ADAMTS-13) cleaves the A2 domain of von Willebrand factor (VWF), converting the ultralarge (UL) and hyperactive VWF multimers freshly released from endothelial cells to smaller and less active forms found in plasma. Recombinant ADAMTS-13 lacking the C-terminal region is active under static conditions, but its functions under flow conditions have not been determined. Here, we show that VWF-cleaving activity measured under flow was preserved in an ADAMTS-13 mutant lacking the second to eighth thrombospondin-1 motifs and the complement components C1r/C1s, Uegf sea urchin fibropellins, and bone morphogenic protein 1 (CUB) domains, but was severely deficient in a mutant that was further truncated to remove the spacer domain. We also show that the mutant lacking the TSP-1 and CUB domains was hyperactive under flow, suggesting that the C-terminal region may negatively regulate ADAMTS-13 activity. The wild type and the mutant without the spacer were more active in the presence of plasma, raising the possibility of ADAMTS-13 cofactors in plasma.

Emphysematous cystitis is a rare form of infection. Well known symptoms are: dysuria, urinary frequency and lower abdominal pain. We experienced a case of emphysematous cystitis presented with atypical peritoneal sign and computed tomography findings of massive intra-peritoneal fluid collection and abnormal gas appearance in pelvic space. Due to its presentation as acute abdomen, patient underwent exploratory laparotomy and the diagnosis of emphysematous cystitis was established. As far as we know, our case is the first report of emphysematous cystitis with intra-peritoneal fluid collection.

To know the role and initiation mechanism of the interaction of glycoprotein (GP) Ib with surface-immobilized von Willebrand factor (vWF), we examined the effect of shear stress levels on platelet binding to vWF-coated plates using a cone-and-plate type viscometer capable of loading various levels of shear stress. The extent of platelet binding to immobilized vWF reached a plateau at the shortest period tested (20 seconds) under high shear stress (90 dyne/cm2), whereas 9 to 12 minutes was necessary for saturable platelet binding under static conditions. This shear effect, which was found to be dependent on the vWF-GP Ib interaction, was observed even under the lowest shear stress (1.5 dyne/cm2) examined. In contrast with the high shear effect previously reported to initiate the interaction of GP Ib with soluble vWF, these results indicate that relatively low levels of shear stress can promote the interaction of GP Ib with surface- immobilized vWF. This effect of shear stress was observed regardless of the manner in which vWF was immobilized, suggesting that immobilization itself and not, as previously hypothesized, a conformational change in vWF induced by direct adsorption to the surface is responsible for the enhanced GPIb binding. Thus, the present findings suggest that the vWF- GP Ib interaction contributes optimally to rapid platelet cohesion on a thrombogenic surface when vWF is in a static state and when platelets are moved by an appropriate rheological force such as low shear stress.