Epinephrine is often used for the treatment of patients with heart failure, low cardiac output and cardiac arrest. It can acutely improve hemodynamic parameters; however, it does not seem to improve longer term clinic...Epinephrine is often used for the treatment of patients with heart failure, low cardiac output and cardiac arrest. It can acutely improve hemodynamic parameters; however, it does not seem to improve longer term clinical outcomes. Therefore, we hypothesized that epinephrine may induce unfavorable changes in gene expression of cardiomyocyte. Thus, we investigated effects of epinephrine exposure on the mediation or modulation of gene expression of cultured cardiomyocytes at a genome-wide scale. Our investigation revealed that exposure of cardiomyocytes to epinephrine in an in vitro environment can up-regulate the expression ofangiopoietin-2 gene （~ 2.1 times）, and down-regulate the gene expression of neuregulin 1 （-3.7 times）, plasminogen activator inhibitor-1 （-2.4 times） and SPARC-related modular calcium-binding protein-2 （-4.5 times）. These changes suggest that epinephrine exposure may induce inhibition of angiogenesis-related gene expressions in cultured rat cardiomyocytes. The precise clinical significance of these changes in gene expression, which was induced by epinephrine exposure, warrants further experimental and clinical investigations.展开更多
In an attempt to improve upon the end results obtained in treating colorectal cancer it was apparent that the earlier the diagnosis that could be obtained, the better the chance for obtaining desired results. In the c...In an attempt to improve upon the end results obtained in treating colorectal cancer it was apparent that the earlier the diagnosis that could be obtained, the better the chance for obtaining desired results. In the case of more advanced tumors typified by later stage colorectal cancer, surgical debulking is an important part of the treatment strategy. Here the use of additional therapeu-tic modalities including chemotherapy and present day immunotherapy has failed to accomplish the desired im-provements that have been sought after. Adjuvant ther-apy, has offered little to the overall survival. The concept of early detection is now recognized as the initial step in reaching proper end results and can readily be demon-strated from colorectal cancer studies. Here survival has been found to be a reflection of the stage at which the tumor is first identified and treated. When specific mono-clonals targeting colorectal cancer are employed diagnos-tically, we have been able to demonstrate detection of colorectal cancer at its inception as a premalignant lesion, such that genotypic features can be identified before the phenotypic appearance of cancer can be noted.展开更多
Background and study aims:The usefulness of a new quick test for endoscopic diagnosis of adult-type hypolactasia was tested in duodenal biopsies.In this test,an endoscopic biopsy from the postbulbar duodenum is incuba...Background and study aims:The usefulness of a new quick test for endoscopic diagnosis of adult-type hypolactasia was tested in duodenal biopsies.In this test,an endoscopic biopsy from the postbulbar duodenum is incubated with lactose on a test plate,and a color reaction develops within 20 min as a result of hydrolyzed lactose(a positive result) in patients with normolactasia,whereas no reaction(a negative result) develops in patients with severe hypolactasia.Patients and methods:Two postbulbar duodenal biopsies were taken from 80 prospectively enrolled adult outpatients with dyspepsia.The biopsies were used for the Quick Lactase Test(Biohit PLC,Helsinki,Finland) and in biochemical disaccharidase(lactase,sucrase,and maltase) assays.In addition,the C/T-13910 genotype was determined from DNA extracted from gastric antral biopsies using polymerase chain reaction sequencing in genomic analysis of adult-type hypolactasia.Results:Twenty-one of 22 patients(95% ;95% CI,87-100%) with biochemical lactase activity < 10 U/g protein,but none of the 58 patients with lactase activity of 10 U/g protein or more had a negative result in the Quick Lactase Test.Seven of the 80 patients(9% ;95% CI,3-15%) had a Quick Lactase Test result that indicated mild hypolactasia(a mild color reaction) .All patients with celiac disease(n = 6) had a negative Quick Lactase Test result.Nine of 74 patients(six patients with celiac disease were excluded) had a CC-13910 genotype in genomic testing,indicating adult-type hypolactasia.All of them had negative test results with the Quick Lactase Test.Twenty-six patients had a TT genotype,indicating normolactasia,and none of these patients had a negative test result in the Quick Lactase Test.Six of 39 patients(15% ;95% CI,4-27%) with a CT genotype had a negative result in the Quick Lactase Test.Conclusions:The Quick Lactase Test effectively identifies patients with severe duodenal hypolactasia.In comparison with CC(adult-type hypolactasia) and TT individuals(normolactasia) ,the sensitivity and specificity of the Quick Lactase Test result was 100%.In comparison with biochemical lactase assays,the sensitivity and specificity of a negative Quick Lactase Test for indicating hypolactasia(lactase activity < 10 U/g protein) were 95%(95% CI,87-100%) and 100%,respectively.展开更多
Background: Determining the best biopsy technique for a suspected lentigo maligna can be challenging. Because complete excisional biopsy is rarely practical, the physician is left to choose an appropriate area to biop...Background: Determining the best biopsy technique for a suspected lentigo maligna can be challenging. Because complete excisional biopsy is rarely practical, the physician is left to choose an appropriate area to biopsy. Sampling error can have devastating consequences,especially if the biopsy demonstrates a pigmented lesion that was considered in the clinical differential diagnosis. The presence of a solar lentigo, pigmented actinic keratosis, or reticulated seborrheic keratosis could mislead the pathologist and clinician to the erroneous conclusion that the incisional specimen is representative of the whole, and that no lentigo maligna is present. Objective: We have often observed the presence of a contiguous pigmented lesion adjacent to lentigo maligna. The current study was designed to determine how frequently this phenomenon occurs. Methods: We studied Mohs debulking specimens of lentigo maligna, and broad shave biopsy specimens of pigmented lesions on heavily sun-damaged areas of the skin proven to be lentigo maligna. Results: Contiguous pigmented lesions were present in 48%of the specimens. The most common lesion was a benign solar lentigo (30%), followed by pigmented actinic keratosis (24%). Conclusion: Recognition of this phenomenon may prevent misdiagnosis of lentigo maligna related to sampling error.展开更多
1.Introduction Healthcare facilities that include laboratories provide services to patients and help in safeguarding public health.They also generate a large amount of waste,which can create serious health problems fo...1.Introduction Healthcare facilities that include laboratories provide services to patients and help in safeguarding public health.They also generate a large amount of waste,which can create serious health problems for the public if it is not treated and disposed of as per institutional/local and international guidelines.Healthcare facilities produce diverse wastes,which include hazardous infectious waste.展开更多
Background:Rhino-enteroviruses,particularly enterovirus strain D68(EV-D68),have been associated with severe respiratory distress in children.The goal of this study was to compare the long-term outcomes of children wit...Background:Rhino-enteroviruses,particularly enterovirus strain D68(EV-D68),have been associated with severe respiratory distress in children.The goal of this study was to compare the long-term outcomes of children with EV-D68 infection to that of children with other enterovirus/rhinovirus.Methods:Nasopharyngeal swabs from 174 children presenting with respiratory distress were tested by PCR for respiratory viruses.The primary outcome was diagnosis of a chronic respiratory condition within the followup period.Admission to intensive care,and length of stay were recorded.Odds ratios were determined using multinomial logistic regression.Results:During 5 years of follow-up,the crude odds of diagnosis with a chronic respiratory condition were significantly more likely in EV-D68 cases(OR:1.95,95%CI:1.02,3.82),but failed to remain significant after adjusting for a past history of asthma.Upon admission for a primary concern of asthma,length of stay both in hospital and intensive care were significantly longer in EV-D68 cases(OR:2.10[95%CI:1.56,2.82,p<0.001])and(OR:5.18[95%CI:1.90,6.28,p<0.001]),respectively.After adjustment for a history of asthma,EV-D68 cases had significantly longer length of stay in hospital,admitted for 1.94 days for each day that controls were admitted(95%CI:1.40,2.68).In admissions to intensive care,EV-D68 cases spent 2.74 days for each day of admission in controls(95%CI:1.62,4.97,p<0.001).Conclusions:Ours is first study to assess prognostic respiratory outcomes of patients infected with EV-D68 in childhood.Our study finds that EV-D68 cases were significantly more likely be hospitalized for longer than other enterovirus/rhinovirus controls in subsequent admissions for respiratory distress.Need for intensive care was significantly longer in EV-D68 infections.Our next steps will be validation in a larger sample size.展开更多
基金supported by internal funding from the Department of Anesthesiology and Perioperative Medicine
文摘Epinephrine is often used for the treatment of patients with heart failure, low cardiac output and cardiac arrest. It can acutely improve hemodynamic parameters; however, it does not seem to improve longer term clinical outcomes. Therefore, we hypothesized that epinephrine may induce unfavorable changes in gene expression of cardiomyocyte. Thus, we investigated effects of epinephrine exposure on the mediation or modulation of gene expression of cultured cardiomyocytes at a genome-wide scale. Our investigation revealed that exposure of cardiomyocytes to epinephrine in an in vitro environment can up-regulate the expression ofangiopoietin-2 gene （~ 2.1 times）, and down-regulate the gene expression of neuregulin 1 （-3.7 times）, plasminogen activator inhibitor-1 （-2.4 times） and SPARC-related modular calcium-binding protein-2 （-4.5 times）. These changes suggest that epinephrine exposure may induce inhibition of angiogenesis-related gene expressions in cultured rat cardiomyocytes. The precise clinical significance of these changes in gene expression, which was induced by epinephrine exposure, warrants further experimental and clinical investigations.
文摘In an attempt to improve upon the end results obtained in treating colorectal cancer it was apparent that the earlier the diagnosis that could be obtained, the better the chance for obtaining desired results. In the case of more advanced tumors typified by later stage colorectal cancer, surgical debulking is an important part of the treatment strategy. Here the use of additional therapeu-tic modalities including chemotherapy and present day immunotherapy has failed to accomplish the desired im-provements that have been sought after. Adjuvant ther-apy, has offered little to the overall survival. The concept of early detection is now recognized as the initial step in reaching proper end results and can readily be demon-strated from colorectal cancer studies. Here survival has been found to be a reflection of the stage at which the tumor is first identified and treated. When specific mono-clonals targeting colorectal cancer are employed diagnos-tically, we have been able to demonstrate detection of colorectal cancer at its inception as a premalignant lesion, such that genotypic features can be identified before the phenotypic appearance of cancer can be noted.
文摘Background and study aims:The usefulness of a new quick test for endoscopic diagnosis of adult-type hypolactasia was tested in duodenal biopsies.In this test,an endoscopic biopsy from the postbulbar duodenum is incubated with lactose on a test plate,and a color reaction develops within 20 min as a result of hydrolyzed lactose(a positive result) in patients with normolactasia,whereas no reaction(a negative result) develops in patients with severe hypolactasia.Patients and methods:Two postbulbar duodenal biopsies were taken from 80 prospectively enrolled adult outpatients with dyspepsia.The biopsies were used for the Quick Lactase Test(Biohit PLC,Helsinki,Finland) and in biochemical disaccharidase(lactase,sucrase,and maltase) assays.In addition,the C/T-13910 genotype was determined from DNA extracted from gastric antral biopsies using polymerase chain reaction sequencing in genomic analysis of adult-type hypolactasia.Results:Twenty-one of 22 patients(95% ;95% CI,87-100%) with biochemical lactase activity < 10 U/g protein,but none of the 58 patients with lactase activity of 10 U/g protein or more had a negative result in the Quick Lactase Test.Seven of the 80 patients(9% ;95% CI,3-15%) had a Quick Lactase Test result that indicated mild hypolactasia(a mild color reaction) .All patients with celiac disease(n = 6) had a negative Quick Lactase Test result.Nine of 74 patients(six patients with celiac disease were excluded) had a CC-13910 genotype in genomic testing,indicating adult-type hypolactasia.All of them had negative test results with the Quick Lactase Test.Twenty-six patients had a TT genotype,indicating normolactasia,and none of these patients had a negative test result in the Quick Lactase Test.Six of 39 patients(15% ;95% CI,4-27%) with a CT genotype had a negative result in the Quick Lactase Test.Conclusions:The Quick Lactase Test effectively identifies patients with severe duodenal hypolactasia.In comparison with CC(adult-type hypolactasia) and TT individuals(normolactasia) ,the sensitivity and specificity of the Quick Lactase Test result was 100%.In comparison with biochemical lactase assays,the sensitivity and specificity of a negative Quick Lactase Test for indicating hypolactasia(lactase activity < 10 U/g protein) were 95%(95% CI,87-100%) and 100%,respectively.
文摘Background: Determining the best biopsy technique for a suspected lentigo maligna can be challenging. Because complete excisional biopsy is rarely practical, the physician is left to choose an appropriate area to biopsy. Sampling error can have devastating consequences,especially if the biopsy demonstrates a pigmented lesion that was considered in the clinical differential diagnosis. The presence of a solar lentigo, pigmented actinic keratosis, or reticulated seborrheic keratosis could mislead the pathologist and clinician to the erroneous conclusion that the incisional specimen is representative of the whole, and that no lentigo maligna is present. Objective: We have often observed the presence of a contiguous pigmented lesion adjacent to lentigo maligna. The current study was designed to determine how frequently this phenomenon occurs. Methods: We studied Mohs debulking specimens of lentigo maligna, and broad shave biopsy specimens of pigmented lesions on heavily sun-damaged areas of the skin proven to be lentigo maligna. Results: Contiguous pigmented lesions were present in 48%of the specimens. The most common lesion was a benign solar lentigo (30%), followed by pigmented actinic keratosis (24%). Conclusion: Recognition of this phenomenon may prevent misdiagnosis of lentigo maligna related to sampling error.
文摘1.Introduction Healthcare facilities that include laboratories provide services to patients and help in safeguarding public health.They also generate a large amount of waste,which can create serious health problems for the public if it is not treated and disposed of as per institutional/local and international guidelines.Healthcare facilities produce diverse wastes,which include hazardous infectious waste.
基金supported by the Research Institute of St.Joe’s Healthcare Hamilton.
文摘Background:Rhino-enteroviruses,particularly enterovirus strain D68(EV-D68),have been associated with severe respiratory distress in children.The goal of this study was to compare the long-term outcomes of children with EV-D68 infection to that of children with other enterovirus/rhinovirus.Methods:Nasopharyngeal swabs from 174 children presenting with respiratory distress were tested by PCR for respiratory viruses.The primary outcome was diagnosis of a chronic respiratory condition within the followup period.Admission to intensive care,and length of stay were recorded.Odds ratios were determined using multinomial logistic regression.Results:During 5 years of follow-up,the crude odds of diagnosis with a chronic respiratory condition were significantly more likely in EV-D68 cases(OR:1.95,95%CI:1.02,3.82),but failed to remain significant after adjusting for a past history of asthma.Upon admission for a primary concern of asthma,length of stay both in hospital and intensive care were significantly longer in EV-D68 cases(OR:2.10[95%CI:1.56,2.82,p<0.001])and(OR:5.18[95%CI:1.90,6.28,p<0.001]),respectively.After adjustment for a history of asthma,EV-D68 cases had significantly longer length of stay in hospital,admitted for 1.94 days for each day that controls were admitted(95%CI:1.40,2.68).In admissions to intensive care,EV-D68 cases spent 2.74 days for each day of admission in controls(95%CI:1.62,4.97,p<0.001).Conclusions:Ours is first study to assess prognostic respiratory outcomes of patients infected with EV-D68 in childhood.Our study finds that EV-D68 cases were significantly more likely be hospitalized for longer than other enterovirus/rhinovirus controls in subsequent admissions for respiratory distress.Need for intensive care was significantly longer in EV-D68 infections.Our next steps will be validation in a larger sample size.
