Search

Background Anti-N-methyl- d -aspartate receptor (Anti-NMDAR) encephalitis is a serious autoimmune disease in which antibody production against the NMDA receptor results in profound neurotransmitter dysregulation. Patients may present with a wide variety of symptoms, including psychosis, orofacial dyskinesias, dysautonomia, hallucinations, mental status changes, seizures, and headaches. Case Report A previously healthy 25-year-old woman presented on several occasions to the Emergency Department with a severe pounding headache that initially responded well to treatment. She later developed signs consistent with meningoencephalitis along with altered mental status and neuropsychiatric changes. She was diagnosed with anti-NMDAR encephalitis after hospitalization. Why Should an Emergency Physician Be Aware of This? Anti-NMDAR encephalitis is an under-recognized condition with diverse presentations. Recurrent headaches that improve with treatment may be an early sign of this disorder. Anti-NMDAR encephalitis should be considered in patients with recurrent undifferentiated headaches, and an appropriate work-up should be performed. Early recognition and diagnosis of this condition is critical to optimize favorable patient outcomes, as delays to diagnosis may lead to fatalities and long-term neurologic sequelae.

Using electroencephalography and electromyography recordings from healthy participants during a visual-depended bimanual coordination task, de Vries and colleagues showed that functional synchronization is important in motor coordination. The authors reported that higher coordination correlated positively with intermuscular synchrony, but correlated negatively with corticomuscular synchrony. They proposed that these two diverse motor systems operate differently depending on task demands. Similar experimental paradigms could identify motor mechanisms in patients with neurological disorders to design novel rehabilitation strategies.

Soybean suspension culture cells were subjected to mutagenesis with ethyl methane sulfonate and cells resistant to the ATP synthase inhibitor oligomycin were recovered. Suspension cultures showed high levels of resistance over a period of 17 months after mutagenesis. The level of resistance to oligomycin decreased during prolonged growth in the absence of the selection agent. Although mitochondrial inheritance of the resistance phenotype was not tested, this observation is consistent with segregation of resistant and sensitive mitochondria in progeny cells. Cross resistance to venturicidin was also observed which suggested the possible involvement of the mitochondrial ATP synthase subunit 9 gene, however, sequences of ATP synthase subunit 9 cDNA clones from resistant cells were identical to the wild type sequence. In addition, Southern blot analyses of DNA from wild type and resistant cultures did not identify rearrangements. These results indicated that resistance to oligomycin could not be directly attributed to a mutation in the primary gene sequence, an alteration in the RNA editing pattern of transcripts, or gross rearrangements in the region containing and directly adjacent to the ATP synthase subunit 9 gene in the mitochondrial DNA from resistant cultures.

Id1, a helix-loop-helix (HLH) protein which lacks a DNA binding domain, has been shown to negatively regulate other members of the HLH family by direct protein-protein interactions, both in vitro and in vivo. In this study, we report the results of site-directed mutagenesis experiments aimed at defining the regions of Id1 which are important for its activity. We have found that the HLH domain of Id1 is necessary and nearly sufficient for its activity. In addition, we show that two amino acid residues at the amino terminus of the Id1 loop are critical for its activity, perhaps by specifying the correct dimerization partners. In this regard, replacing the first four amino acids of the loops of the basic HLH proteins E12 and E47 with the corresponding amino acids of Id1 confers Id1 dimerization specificity. These studies point to the loop region as an important structural and functional element of the Id subfamily of HLH proteins.

To make sure big health care facility investments don't end up as big capital mistakes, building projects must be linked to long-term organizational goals.

Background/purpose Cytokines are inflammatory mediators found in the circulation after surgery. Newborns have less protection against oxidation and are very susceptible to free radical oxidative damage. Melatonin has been reported recently to reduce oxidative stress in neonates with sepsis, asphyxia, and respiratory distress. The aim of this study has been to determine if melatonin would lower interleukin (IL)-6, IL-8, tumor necrosis factor alpha (TNF-α) and nitrite/nitrate (NOx) levels and modify serum inflammation parameters, improving the clinical course of surgical neonates. Methods Ten newborns (group 1), 5 with surgical malformations and respiratory distress (group 1a) and 5 with isolated abdominal surgical malformations (group 1b) received a total of 10 doses of melatonin (10 mg/kg) at defined times interval for 72 hours. The treatment was started within 3 hours after the end of surgery. Ten surgical neonates (group 2), did not receive melatonin. Twenty healthy neonates (group 3) served as control. Blood samples were collected at the end of operation; before treatment with the antioxidant; and 24 hours 72 hours, and 7 days after start of treatment with melatonin or placebo, respectively. Results Postoperative value of cytokines and NOx levels of groups 1 and 2 were significantly higher than group 3. Compared with group 1b, group 2 displayed significantly higher cytokines and NOx levels at 24 hours, 72 hours, and at 7 days. In group 1a the immediate postoperative values of cytokines were significantly higher than group 1b and group 2, but a significant improvement was observed after administration of melatonin with significantly lower levels of IL-6 and IL-8 with respect to group 2. An improvement of clinical outcome was observed by progressive reduction of clinical parameters of inflammation. Conclusions Melatonin reduces cytokines and NOx levels showing potent antioxidant properties with improvement in clinical outcome. Further studies are warranted to define, on larger numbers, the role of melatonin in surgical patients.

The assessment of growth hormone deficiency (GHD) in children with growth retardation is frequently difficult. The diagnostic reliability of standard pharmacological GH provocative tests has been questioned and several investigators have focussed on measurement of spontaneous GH secretion at frequent intervals over periods of 12-24 hours, with mathematical analysis of resulting secretory patterns. The aim of our study was to assess GH secretion in children with growth retardation, either in prepuberal and puberal ages, in order 1) to evaluate the diagnostic relevance of spontaneous GH secretion in comparison to tests, and 2) to gain neuroendocrine interpretations of GH secretion. We investigated 58 short children (height5th centile), 35 males, aged 6.4-15 years, without chronic diseases or dysmorphic syndromes. All subjects were divided into 3 groups, either in prepubertal and pubertal ages: normal (normal growth rate, within -0.80 HVSDS; normal GH peak after standard clonidine test7 ng/ml; 15 prepubertal, 8 pubertal); slow-growing (growth rate lower than -0.80 SDS; normal GH peak to test; 13 prepubertal, 13 pubertal); GH deficit (growth rate lower than -0.80 SDS; GH peak to test7 ng/ml; 6 prepubertal, 3 pubertal). In all children spontaneous GH secretion was evaluated for 24-hrs, 12-hrs daily and 12-hrs overnight, sampling every 30 minutes. The results were analyzed by the PULSAR computer program to determine number, height, area and amplitude of pulses and the baseline and GH secretory areas under and over baseline.(ABSTRACT TRUNCATED AT 250 WORDS)

It is generally believed that tumours originate from adult tissues, in which most cells are quiescent, and that the proliferative advantage of tumour cells arises from their ability to bypass senescence. Once this is obtained, cells can accumulate further genetic alterations that drive progressive transformation into highly malignant derivatives. How normal cells evade the senescence program remains an unresolved issue. Recent findings suggest the alternative possibility that stem/progenitor cells are the targets of transformation. Many tumours contain only a small subset of cells endowed with the property of uncontrolled growth (cancer stem cells). Although the program of senescence in stem cells is suppressed, their lifespan is restrained by signalling pathways (p19-p53; p16-Rb) that are activated by DNA damage (telomere dysfunction, environmental stresses). It is proposed that inactivation of these pathways in stem cells might contribute to tumour formation. We set out to cultivate in vitro breast stem cells from the mouse mammary gland (BSC) based on their ability to survive in suspension as 'mammospheres' and to differentiate into myoepithelial and epithelial cells. Murine mammospheres do not result from passive cell aggregation and have clonal origin, as assessed by labelling cell membranes with different epifluorescent dyes. To prove the 'staminality' of these cellular populations we performed in vivo reconstitution experiments, by inoculating single cell suspensions of mammospheres in the mouse cleared fat pad. Using the same experimental approach, we were also able to generate mammospheres from MMTV-ErbB2(cNeu) transgenic mice. These mice develop polyclonal mammary adenocarcinomas arising synchronously. The mammospheres arising from MMTV-ErbB2 mice show a dramatically prolonged lifespan upon serial passages and are bigger than their normal counterparts (more than 1000 cells/sphere vs 200–400 cells in the w.t. mice). To prove that cancer mammospheres are enriched in cancer BSC, we are performing transplantation experiments in which single cell suspensions of these mammospheres are inoculated in the normal gland of singenic mice.

Deficiency of adenosine deaminase (ADA) results in severe combined immunodeficiency. Clinical cure has been observed in several ADA-severe combined immunodeficiency patients after bone marrow transplantation in which only donor T cells were engrafted, suggesting that T-cell correction alone is sufficient for full immune reconstitution. Children without an HLA-matched donor have been treated with polyethylene glycol-ADA as enzyme replacement therapy, resulting in varying degrees of immunologic and clinical improvement. In September 1990, we began treating a 4-y-old girl with periodic infusions of autologous culture-expanded T cells genetically corrected by insertion of a normal ADA gene using retroviral-mediated gene transfer with the LASN vector. After 2 y of polyethylene glycol-ADA treatment and before gene therapy, she continued to experience recurrent infections, was anergic and lymphopenic, and was deficient in isohemagglutinins. After seven infusions totaling 7 x 10(10) T cells, she has demonstrated a substantial increase in the number of circulating T cells (571/microL pre-gene therapy versus a mean of 1995/microL with gene therapy infusions every 6-8 wk) and the ADA activity in her peripheral blood T cells has increased > 10-fold. The increase in T-cell numbers and ADA activity has been associated with the development of positive delayed-type hypersensitivity skin tests, a significant increase in the level of isohemagglutinins, the regrowth of tonsils, and a decreased number of infectious illnesses. This improvement has persisted during suspension of treatment for more than 6 mo. A second patient treated since February 1991 has shown similar improvement in immune status.(ABSTRACT TRUNCATED AT 250 WORDS)

Growth hormone (GH) pituitary reserve and magnetic resonance imaging (MRI) findings were studied in 22 short prepubertal slow growing children (aged 6-11 yrs; males 14). We assessed GH responses to a combined administration of arginine (0.5g/kg) plus GH-releasing hormone (GHRH, 1μg/kg) (Arg+GHRH test) and mean spontaneous nocturnal GH secretion (MGHC, normal = >3 ng/ml). Subjects were divided into 3 groups, comparable in ages, heights and growth rates: group I, 5 GH deficient children, with reduced GH pituitary reserve (Arg+GHRH GH peaks: 20 ng/ml; 58.3±7.9 ng/ml) and low MGHC (1.9±0.3 ng/ml); group III, 8 slow growing children, with normal GH pituitary reserve (Arg+GHRH peak: 51.1±13.2 ng/ml) and normal MGHC (5.4±0.8 ng/ml). MRI examination was performed to measure height, width, lenght and volumes of the pituitary gland. Results. All children showed a normal pituitary anatomy without stalk interruption; mean gland measurements were not significantly different between the 3 groups (height: 2.7±0.5, 3.5±0.3, 3.1±0.3 mm in groups I, II, III, respectively; volumes: 111.6 ± 32, 124.5 ± 15 and 126.3 ± 20 mm3, respectively). These data show that in subjects with normal pituitary anatomy and intact stalk the GH pituitary reserve is not correlated with magnetic resonance imaging findings.

The antiemetic effects of domperidone in patients undergoing post-surgical cytostatic treatment for stomach and colorectal carcinoma have been evaluated. The study has been performed on 3 groups of patients treated with domperidone, metoclopramide and placebo respectively. The antiemetic activity of domperidone proved to be better than that of metoclopramide. No side effects were observed in patients treated with domperidone.

Aztreonam is a monobactam antibiotic active against aerobic gram-negative bacteria. The susceptibility of 127 urinary tract isolates to aztreonam, cefotaxime, cefonicid and ceftazidime was determined. Aztreonam showed good antibacterial activity even against Pseudomonas spp. Only 7 bacterial strains were resistant to aztreonam. The clinical efficacy and pharmacokinetics of aztreonam were assessed in two patients treated for urinary tract infections. The concentrations of aztreonam in serum and urine are reported. Aztreonam safety was evaluated on 20 patients given aztreonam immediately prior to an elective abdominal, urinary or gynecological operation. The results provide support for the use of aztreonam for prophylaxis.

This article, the third in a series, begins to explain the detailed process of estimating space for various materials management functions. The first installment looked at planning overall concepts and provided a framework for articles to follow. The second concentrated on defining the physical components and their intra- and interdepartmental functional relationships.

Law 194 of the Italian law code, promulgated on May 22, 1978, legalizes abortion on request if performed within the first trimester, and abortion for therapeutic reasons if performed after the first trimester. This law follows law 405 of July 29, 19 75, which promulgated the institution of family planning centers all over the country. Unfortunately these centers, usually located inside a hospital, are not yet satisfactorily equipped to provide even for distribution of free contraception, let alone for performing abortions. Moreover the law states that qualified physicians only should be in charge of the operative procedures, unless they declare themselves contrary to abortion, in which case they are excused for "conscientious objection" reasons. The law is very unclear on this point, since, at the same time, it provides penalties for doctors who refuse to perform abortions. Personnel trained to assist during abortions are scarce and badly trained, and appropriate facilities for patients are totally inadequate.

Il saggio ricostruisce le vicende recenti e le trasformazioni del fumetto americano, dall'underground al "graphic novel", utilizzando Art Spiegelman -- nella doppia veste di autore ed editore -- come figura di riferimento che ben si addice, con la sua carriera, a epitomizzare tali percorsi.

A semiotic analysis of Swift’s Gulliver’s Travels helps us answer three questions: 1. how is size difference between socially interacting bodies transformed into a set of inequalities? 2. how do those inequalities determine the social relationships between Gulliver and the societies he is unwillingly visiting? 3. Can Swift’s fictional metaphor be used to better understand the meaning of measures and quantities in contemporary dressing behaviour?

This paper discusses the case of the Van Der Memes, internet memes based on close-ups of actor James Van Der Beek (hereafter, JVDB) emoting feelings which, born as user-generated content, end up working as marketing tools for a rebranding campaign of the actor. The case study is used as a prism for understanding the dynamics of transformation of media objects in contemporary media culture, where an idea can evolve and take different forms according to technological, cultural, institutional and economic contingencies, ultimately blurring the boundaries between binaries like past and present, ephemerality and permanence, replication and creation of meaning, bottom/up practices and top/down strategies. What I therefore propose here is an examination that, in trying to untangle a wave of heterogenous cross-platforms and cross-spaces practices, ultimately accounts for the transformations of meaning and values, across time and contexts, of the media objects, texts and presonalities involved. Finally, I will argue that, given certain conditions, a past cultural phenomenon could turn into a contingent memory of itself, shaped by and retrofitted to a new cultural context in order to make it valuable and (hopefully) profitable again.

This article addresses the problem of thermal stresses for isotropic microstretch elastic cylinders subjected to a temperature distribution that is linear in the axial coordinate. A direct method is used to reduce the problem to solving plane strain problems. The results are used to study the deformation of circular cylinders.

Il saggio è dedicato agli studi di Franco La Polla sulla serialità televisiva americana. La Polla era un appassionato cultore della produzione seriale, soprattutto serie come Star Trek, a cui dedicò più volume, ma anche Buffy The Vampire Slayer. Proprio negli scritti dedicati a quest'ultimo prodotto appare evidente la peculiare commistione di fandom e discorso critico-ermeneutico che in La Polla anticipa un approccio diventato poi popolare nell'accademia americana.

Franco La Polla, critico e storico sia di letteratura sia di cinema e televisione, si è a lungo occupato del fenomeno molto tempo fa descritto da Philip K. Dick come profonda mutazione riguardante i nostri tempi: una tendenza alla reificazione e, al contempo, la compenetrazione reciproca di ciò che è animato e ciò che è meccanico. La problematica integrità del soggetto è al centro della narrativa e della rappresentazione contemporanea e porta al cuore della attività intellettuale di questo studioso. Che è profondamente umanistica, concernente le strutture e il significato dell’individuo nella storia e nella società (soprattutto americana, di cui egli amava occuparsi) Il presente articolo analizza alcuni significativi esempi di questa prospettiva di studio interrogando la responsabilità intellettuale del critico nel ricollocare l’individuo, la psiche, il corpo al centro dei macrofenomeni, delle tensioni di potere e dei sistemi filosofici

Sull'importanza del lavoro di Franco La Polla nel definire differenze e influenze fra il concetto di cinema popolare così come declinato nel contesto statunitense e come il medesimo concetto è interpretato nel contesto europeo e italiano in particolare.

Analisi dei contributi critici di Franco La Polla sul cinema francese

Saggio sull'opera di Franco La Polla, storico e critico della letteratura americana, del cinema hollywoodiano e della cultura popolare statunitense. Si evidenzia il contributo originale dello studioso nell'ambito degli studi culturali e postmoderni e si sottolinea la particolarità del suo metodo critico, sottolineando in particolare la idmensione "americanistica" dello studioso, in linea con la tradizione degli studi sulla letteratura americana inaugurata in Italia da Cesare Pavese, e proseguita poi a Bologna dalla scuola promossa da Carlo Izzo e portata poi avanti, tra gli altri, da La Polla.