Quorum sensing (QS) is known to regulate different functions viz. pathogenesis, biofilm formation, and host colonization, along with other functions by regulating bacterial virulence determinants. Therefore, QS is deemed to be an interesting target to modulate pathogenesis. Also, there have been global reports of continuous emergence of antibiotic-resistant microbes; hence, an alternative treatment that compliments antibiotic activity is highly desirable. One such approach is to look for QS inhibitors, which can quench the virulence phenotypes exerted by pathogenic bacteria and compliment antibiotic treatment. In the present study, Pseudomonas aeruginosa strain was used as the model organism which produces three pigments viz. pyocyanin, pyoverdin and pyorubin. Pyocyanin synthesis is reported to be QS dependent and is one of the virulence factors of P. aeruginosa. Hence, we envisage inhibition of pyocyanin pigment would indicate QS inhibition (QSI). Auto-inducers like N-(3-oxododecanoyl)-L-homoserine lactone (OdDHL/3-oxo-C12-HSL) and N-butyryl-L- homoserine lactone (BHL/C4-HSL) were used to enhance the pyocyanin pigment production by the model strain at different doses and time points. BHL, at 25 microM was found to be a better inducer of pyocyanin. Tannic acid (TA) was tested to suppress this pigment synthesis and it was found to be effective when assessed at different time points. About 5.12 mg/mL TA was found to be the optimum concentration at which pyocyanin was inhibited by 77.3%. Thus, we confirm that TA can be used as a QSI, either in its purest form or in the crude form found in various plant species, and could be considered for development to compliment antibiotic therapy.

Mus musculus is the only known species from which embryonic stem cells (ESC) can be isolated under conditions requiring only leukemia inhibitory factor (LIF). Other species are non-permissive in LIF media, and form developmentally primed epiblast stem cells (EpiSC) similar to cells derived from post-implantation, egg cylinders. To evaluate whether non-permissiveness extends to induced pluripotent stem cells (iPSC), we derived iPSC from the eight founder strains of the mouse Collaborative Cross. Two strains, NOD/ShiLtJ and the WSB/EiJ, were non-permissive, consistent with the previous classification of NOD/ShiLtJ as non-permissive to ESC derivation. We determined non-permissiveness is recessive, and that non-permissive genomes do not compliment. We overcame iPSC non-permissiveness by using GSK3B and MEK inhibitors with serum, a technique we termed 2iS reprogramming. Although used for ESC derivation, GSK3B and MEK inhibitors have not been used during iPSC reprogramming because they inhibit survival of progenitor differentiated cells. iPSC derived in 2iS are more transcriptionally similar to ESC than EpiSC, indicating that 2iS reprogramming acts to overcome genetic background constraints. Finally, of species tested for ESC or iPSC derivation, only some M. musculus strains are permissive under LIF culture conditions suggesting that this is an evolutionarily derived characteristic in the M. musculus lineage.

BACKGROUND

Hepatitis B virus (HBV) causes chronic liver-associated diseases and its early detection is of high public health importance. Its diagnosis is mainly based on immunological assays among which Enzyme-Linked Immunosorbent Assay (ELISA) and rapid tests are the most common and widespread methods. However, a major challenge is the discordance of results of any two laboratory assays which cannot be easily resolved. Therefore, this study was designed to evaluate the validity and reliability of commercially available five rapid test kits in comparison with two Enzyme Immunoassays (EIAs) in Nigeria using hepatitis B surface antigen as a reference marker.

METHODS

A total of 100 sera of previously diagnosed consenting HBV-positive patients from private diagnostic laboratories in Ibadan between March and August, 2011 were tested using two EIA and five rapid commercially available HBV test kits in Nigeria. Data were analyzed by SPSS version 15, while bivariate and multivariate analyses were carried out to identify associations at P < 0.05 considered significant.

RESULTS

Overall, the sensitivity rates of the two EIA kits were 100% and 99.9% (95% confidence interval [CI] = 98.9-99.7) with specificity of 100% and 99.9% (95% CI = 98.9-99.7), respectively. The sensitivity of the five rapid test kits ranged from 97.5% (95% CI = 96.4-97.6) to 98.9% (95% CI = 97.9-99.9) with specificity of 80% (95% CI = 79.3-80.9) to 90% (95% CI = 89.2-91.0). Also, the positive predictive value ranged from 88% (95% CI = 88.2-89.9) to 89% (95% CI = 88.2-89.9), while the negative predictive value ranged from 80% (95% CI = 79.3-80.9) to 90% (95% CI = 89.2-91.0) for the five rapid kits. However, that of the two EIAs ranged from 99.9% (98.9-99.7) to 100%. Further analysis showed significant (P = 0.033) variations in the sensitivity and specificity of the EIAs and rapid test kits.

CONCLUSIONS

The results from this study have clearly revealed the challenges of diagnosis of HBV infections in Nigeria. This study has also demonstrated that the sensitivity of most of the rapid test kits may not be adequate when compared with EIA for early detection of HBV infections. The implications of possible misdiagnosis on the various intervention strategies that rely predominantly on correct HBV status of an individual are enormous. Therefore, there is the need to further compliment the use of rapid test kits with EIAs for HBV control in Nigeria.

Peroxidasin (PXDN) facilitates peroxidative reactions via utilisation of hydrogen peroxide (H2O2) and has been shown to crosslink collagen IV through sulfilimine bond formation in the presence of hypohalous acids. Aberrant PXDN expression has been associated with kidney fibrosis, cancer, congenital eye defects and various cardiovascular disorders. Since PXDN expression is modified by H2O2, we hypothesized that a major antioxidant response transcription factor, nuclear factor erythroid 2-related factor 2 (Nrf2), may regulate PXDN expression. PXDN expression in response to H2O2 and the Nrf2-specific inducers, tert-butylhydroquinone (tBHQ) and sulforaphane (SFN), was determined by western blotting and immunofluorescence microscopy, in HeLa and HEK293 cells. Chromatin immunoprecipitation and luciferase reporter assays were used to investigate the regulation of PXDN by Nrf2. We observed elevated Nrf2 nuclear translocation and increased PXDN protein expression in response to H2O2, tBHQ and SFN, in both cell lines. We found that Nrf2 binds to and increases luciferase reporter gene expression from the PXDN promoter via a putative Nrf2-binding site. In summary, we show that PXDN is a novel target of the redox sensitive transcription factor Nrf2. This finding further highlights the role of PXDN in redox-related processes and compliments the currently understood pathophysiological functions of PXDN.

Ultrasound is an integral part of prenatal interventions. Doppler studies and 3-dimensional ultrasound (3DUS) are frequently used to determine whether fetal surgery is required. The operator's experience remains crucial for reducing procedure-related morbidity. Real-time 3DUS (or 4DUS) can simultaneously display the needle tip in three orthogonal planes, providing reassurance that no fetal parts are in the path. In experienced hands, 4DUS guidance may not be more effective than B-mode, but its value for less-experienced operators remains to be determined. Recent developments in needle, shunt, and video endoscopic technologies may compliment the use of image-guided in utero procedures. Future developments of higher-dimensional transducers and image software may improve the utility of ultrasound for invasive obstetric interventions.

BACKGROUND

Respiratory tract infections have an enormous social economic impact, with high incidence of hospitalization and high costs. Adequate specimen collection is the first crucial step for the correct diagnosis of viral respiratory infections.

OBJECTIVE

The present retrospective study aimed: i) to verify the cell yield obtained from sampling the nasal respiratory tract using mid-turbinate flocked swabs; ii) to evaluate the normalization of viral load, based on cell number; and iii) to compare the kinetics of viral infection obtained with normalized vs non-normalized viral load.

METHODS

The number of cells were quantified by real-time PCR in residual extract of nasal swabs tested for respiratory viruses detection and stored at -80 °C in a universal transport medium (UTM™).

RESULTS

A total of 513 virus-positive and 226 virus-negative samples were analyzed. Overall, a median of 4.42 log10 β2-microgolubin DNA copy number/ml of UTM™ (range 1.17-7.26) was detected. A significantly higher number of cells was observed in virus-positive as compared to virus-negative samples (4.75 vs 3.76; p < 0.001). Viral loads expressed as log10 RNA copies/ml of UTM™ and log10 RNA copies/median number of cells were compared in virus-positive samples and a strict correlation (r = 0.89, p < 0.001) and agreement (R2 = 0.82) were observed. In addition, infection kinetics were compared using the two methods with a follow-up series of eight episodes of viral infection and the mean difference was -0.57 log10 (range -1.99 to 0.40).

CONCLUSIONS

The normalization of viral load using cellular load compliments the validation of real-time PCR results in the diagnosis of respiratory viruses but is not strictly needed.

The appearance of ipsilateral terminal degeneration in the thalamic visual centers is studied with the aid of the Fink-Heimer II technique in Xenopus larvae and postmetamorphic toadlets following unilateral eye removal. The youngest age at which degeneration can reliably be shown in the lateral geniculate complex (nucleus of Bellonci and corpus geniculatum thalami) was at stage 62, that is, 10-12 days before metamorphic climax. The whole compliment of the ipsilateral retinothalamic projection develops only in postmetamorphic toadlets, and it is much more abundant in Xenopus than in Rana species. The first appearance of the ipsilateral degeneration in the lateral geniculate complex coincides in time with the first ipsilateral visuotectal responses described by others. The possibility that the two phenomena may have a closer relationship than the mere time coincidence, is discussed.

Diabetes mellitus is often attended by complications such as neuropathy. A standardized examination method can presumably facilitate identification of patients with peripheral neuropathy. A study was carried out for the purpose of evaluating monofilament examination as a compliment to vibration testing in the workup of peripheral sensibility. 236 adult patients, mainly with type-2 diabetes, were examined by diabetes nurses. These examinations entailed analysis of potential variations in correlation between neuropathy, age and duration of diabetes. The results showed a difference between the two test methods, with vibration testing showing greater sensitivity. There was a clear association between neuropathy on the one hand, and both increased age and longer duration of diabetes on the other. Even if the monofilament instrument did not show as great a sensitivity as tuning-fork/Biothesiometer in this study it should nonetheless be used as a complement in the neuropathy workup of the diabetic patient.

BACKGROUND

Immunosensor for illicit drugs have gained immense interest and have found several applications for drug abuse monitoring. This technology has offered a low cost detection of narcotics; thereby, providing a confirmatory platform to compliment the existing analytical methods.

METHODS

In this minireview, we define the basic concept of transducer for immunosensor development that utilizes antibodies and low molecular mass hapten (opiate) molecules.

RESULTS

This article emphasizes on recent advances in immunoanalytical techniques for monitoring of opiate drugs. Our results demonstrate that high quality antibodies can be used for immunosensor development against target analyte with greater sensitivity, specificity and precision than other available analytical methods.

CONCLUSIONS

In this review we highlight the fundamentals of different transducer technologies and its applications for immunosensor development currently being developed in our laboratory using rapid screening via immunochromatographic kit, label free optical detection via enzyme, fluorescence, gold nanoparticles and carbon nanotubes based immunosensing for sensitive and specific monitoring of opiates.

OBJECTIVE

To investigate temporal changes in global gene expression and pathways involved in the response to irradiation during phases of growth inhibition, recovery and repopulation in a human head and neck squamous cell cancer (HNSCC) xenograft.

METHODS

Low passage head and neck squamous cancer cells (UT-14-SCC) were injected into the flanks of female nu/nu mice to generate xenografts. After tumors reached a size of 500 mm3, they were treated with either sham RT or 15Gy in one fraction. At different time points, days 0, 3, and 10 for controls and days 4, 7, 12, and 21 after irradiation, the tumors were harvested for global gene expression analysis and pathway analysis.

RESULTS

The tumors showed growth inhibition through days 4-7 and began the transition to regrowth around the day 12 time point. When comparing the pooled controls to each day of treatment, there were 22, 119, 125, and 25 differentially expressed genes on days 4, 7, 12, and 21 respectively using a p⩽0.01 and a 2-fold cut-off. Gene Ontology (GO), gene set enrichment analysis (GSEA) and sub-network enrichment analysis (SNEA) identified different biological processes, cell process pathways and expression targets to be active on each time point after irradiation. An important observation was that the molecular events on day 12 which represented the transition from growth inhibition to regrowth identified interferon and cytokine related genes and signaling pathways as the most prominent.

CONCLUSIONS

The findings in this study compliment research which has identified components of interferon-related signaling pathways to be involved in radioresistance. Further work will be required to understand the significance of these genes in both radioresistance and treatment response leading to new therapeutic strategies and prognostic tools.

Oncolytic virus therapy (OVT) is a promising treatment modality for cancer that uses tumor-specific defects to target cancer cells selectively. An increasing number of replicating viruses has been demonstrated to cure cancer in a diverse set of animal models. Accordingly, many such viruses have entered the clinic, with several phase III clinical trials having recently been approved or initiated. As with most modalities that target cancer, which is a disease characterized by pronounced cellular heterogeneity and genetic instability, it is anticipated that the efficacy of OVT will benefit from combination therapy. During the past 5 years, significant efforts have been invested in evaluating the combination of OVT and existing chemotherapies, as well as rationally designing chemical-OVT combinations. This review provides an update on these two approaches to augmenting OVT, and suggests that unbiased, high-throughput genetic and chemical screening technologies may both compliment and offer several advantages when combined with these approaches in the pursuit of effective chemical-OVT combinations for the treatment of cancer.

This paper explores the benefits and drawbacks of new team-based approaches to error management in medicine through a case study of teamwork, double witnessing and incident reporting in assisted conception clinics in the UK. This is based upon the analysis of a series of semi-structured interviews with people working in assisted conception clinics and two periods of ethnography in clinics, conducted between 2004 and 2007, as part of an ESRC-funded study on the ethics of assisted conception and embryo research. In common with other studies of practitioners' management of error, I identify a series of tensions around individual and collective autonomy in identifying and preventing error, for the assisted conception team as a whole, and for particular groups within it, notably consultants and embryologists. I found that team-based approaches could create the conditions for error to occur when it undermined independent thinking, responsibility or concentration. There was also a danger that teamwork could come to be associated with particular 'technical' practices or occupational groups, diminishing its relevance and value in clinical settings. I, therefore, conclude that team-based approaches and professional autonomy have their 'dark' as well as their 'light' sides (Vaughan, D. (1999). The dark side of organisations: mistake, misconduct, and disaster. Annual Review of Sociology, 25, 271-305). Errors cannot be prevented in their entirety, but they can be well managed when teamwork and autonomy are complementary. Drawing on Reason (Reason, J. (2004). Beyond the organisational accident: the need for "error wisdom" on the frontline. Quality Safety in Health Care, 12, ii28-ii33), I argue that informed vigilance and intelligent wariness in a necessary compliment to systems-based approaches to error management in assisted conception in particular, and medicine in general.

Complete surgical resection of stage III non-small cell lung cancer (NSCLC) is at times impossible. Adjuvant radiation therapy is required to sterilize the residual tumor. This study is to investigate the safety, reproducibility, and effectiveness of intraoperative I-125 or Pd-103 Gelfoam plaque implant technique as an adjuvant treatment for resected stage III NSCLC with positive surgical margin. Between 1989 and 1993, 12 patients with stage III NSCLC received intraoperative lung implant with radioactive I-125 or Pd-103 pellets. All 12 patients underwent tumor resection, but either gross or microscopic positive margin was found during operation. Radioactive I-125 or Pd-103 seeds were embedded in the Gelfoam plaque. After surgical resection was completed, the radioactive Gelfoam plaque was secured onto the tumor bed either by clips or suture. Either preoperative or postoperative external beam radiation of 45-60 Gy was given to all of the 12 patients. Four patients received chemotherapy. No patient has developed any early or late complications attributable to implant procedure or radiation. The local control rate at last follow-up is 82%. The 2-year overall and cause-specific survival rates are 45% and 56%, respectively. The intraoperative Gelfoam I-125 or Pd-103 planar implant technique is a safe, reproducible, and effective technique of treatment for stage III NSCLC with a positive surgical margin. Encouraging local control and survival are achieved in patients treated with this technique. This technique will compliment standard adjuvant treatments to further improve local control in resected state III lung cancer.

Calcimimetics: a new tool for management of hyperparathyroidism and renal osteodystrophy in patients with chronic kidney disease. Epidemiologic, clinical, and basic scientific studies led to an explosion in our understanding of disorders of mineral metabolism in the chronic kidney disease (CKD) patient. These advances are not always translated into improved care of renal osteodystrophy in CKD-5 patients. The introduction of a new class of drugs, calcimimetics, allows improved control of abnormal calcium/phosphorus metabolism. The calcimimetics compliment, rather than replace, current treatment options for secondary hyperparathyroidism in the chronic disease patient.

The ongoing evolution of feline immunodeficiency virus (FIV) has resulted in the existence of a diverse continuum of viruses. FIV isolates differ with regards to their mutation and replication rates, plasma viral loads, cell tropism and the ability to induce apoptosis. Clinical disease in FIV-infected cats is also inconsistent. Genomic sequence variation of FIV is likely to be responsible for some of the variation in viral behaviour. The specific genetic sequences that influence these key viral properties remain to be determined. With knowledge of the specific key determinants of pathogenicity, there is the potential for veterinarians in the future to apply this information for prognostic purposes. Genomic sequence variation of FIV also presents an obstacle to effective vaccine development. Most challenge studies demonstrate acceptable efficacy of a dual-subtype FIV vaccine (Fel-O-Vax FIV) against FIV infection under experimental settings; however, vaccine efficacy in the field still remains to be proven. It is important that we discover the key determinants of immunity induced by this vaccine; such data would compliment vaccine field efficacy studies and provide the basis to make informed recommendations on its use.

Transradial cardiac procedures have many advantages over the femoral approach, but forgotten is a similarly eloquent approach to venous access. Central venous access can actually be easily obtained using the forearm veins without risking the femoral or neck approaches. Whether it is needed for right heart hemodynamic monitoring or diagnosis with a cardiac catheter, as a site for temporary pacing during periods of iatrogenic bradycardia from interventional techniques, or as a sit for a transvencus interventional procedure, forearm venous access can provide a reliable and safe entry site to compliment or complete the transradial procedure. Venous access from the forearm can be accomplished efficiently and without compromise by avoiding an otherwise riskier anatomical approach. Understanding venous techniques and recognizing this important adjunct to transradial interventions completes the operator's radial skills and further enhance the potential of transradial interventions.

The purpose of this study was to evaluate the safety and efficiency of a specific ambulance while providers delivered basic and advanced life support. Forty-eight, Emergency Medical Service (EMS) teams were observed delivering care to a simulated patient during an anaphylaxis scenario in a moving ambulance that contained a complete compliment of medical supplies and equipment. A detailed coding system was developed and applied to the audio and video behavioural data. Patterns of interaction among EMS personnel, the patient, equipment and the ambulance interior during the patient simulation scenario were analyzed. The results revealed a number of issues associated with the patient compartment including: potentially unsafe seated and standing positions; hazardous barriers to movement around the patient; difficulties accessing equipment and supplies; and the adequacy of work surfaces and waste disposal. A number of design recommendations are made to guide provider and patient comfort, efficiency and safety.

This brief commentary illustrates how laboratory research compliments populational research. The finding that susceptibility to autoimmune thyroid disease in animals is due to the additive effects of a number of unrelated genes led to a field study of a genetically predisposed population. In humans, as in animals, the major histocompatibility complex plays a preeminent role. Unlike many other autoimmune diseases, however, different HLA haplotypes predominate in different families, just as different H-2 haplotypes determine susceptibility in different strains of mice. Like the predisposed chicken, humans have a number of other genes that act independently to influence autoimmune susceptibility. Insight into the nature and action of the additional genes depends upon renewed studies of the animal models. Thus, we see a symbiotic relation between basic science as practiced in the laboratory and population-based research in the field.

In order to evaluate the quality of the measles vaccine, it was carried out a study in three states of Mexico (Durango, San Luis Potosi and Yucatan) during the intensive vaccination campaign in 1986. Edmonston-Zagreb measles vaccine vials were obtained from the different administrative-sanitary levels of the Ministry of Health in Mexico. Interviews were performed to the vaccine responsibles. Questionnaires had the following aspects of the cold chain: storage, preservation, control and transport of measles vaccine. Answers were evaluated through a system, where 100% indicated the necessary and sufficient level to get a good operating of the cold chain. The vaccine potency did not have variations under the minimum titre recommended for the World Health Organization (W.H.O.). The three states had the following compliment of the cold chain norms: 1) Central state level: 83% in storage, 80% in preservation, 100% in control and 100% in transport norms; 2) Regional level (jurisdiction): 87% in storage, 51% in preservation, 93% in control and 100% in transport norms; 3) Local level: 83% in storage, 64% in preservation, 83% in control and 33% in transport norms.

This study examined fluency enhancement in people who stutter via the concomitant presentation of silently mouthed visual speech. Ten adults who stutter recited memorized text while watching another speaker silently mouth linguistically equivalent and linguistically different material. Relative to a control condition, in which no concomitant stimulus was provided, stuttering was reduced by 71% in the linguistically equivalent condition versus only 35% in the linguistically different condition. Despite being an 'incomplete' second speech signal, visual speech possesses the capacity to immediately and substantially enhance fluency when it is linguistically equivalent to the intended utterance. It is suggested that fluency enhancement via concomitantly presented external speech is achieved through the extraction of relevant speech gestures from the external speech signal that compliment the intended production, thereby compensating for possible internal inconsistencies in the matching of speech codes in people who stutter. As visual speech perception relies on fewer redundant cues to demarcate the intended gestures, when used as an external stuttering inhibitor, higher degrees of linguistic equivalence seem to be necessary for optimal stuttering inhibition.

BACKGROUND

Non-linear approaches to assessment of postural control can provide insight that compliment linear approaches. Control entropy (CE) is a recently developed statistical tool from non-linear dynamical systems used to assess the complexity of non-stationary signals. We have previously used CE of high resolution accelerometry in running to show decreased complexity with exhaustive exercise. The purpose of this study was to determine if complexity of postural control decreases following fatiguing exercise using CE.

METHODS

Ten subjects (5 M/5 F; 25 ± 3 yr; 169.4 ± 11.7 cm; 79.0 ± 16.9 kg) consented to participation approved by Western Oregon University IRB and completed two trials separated by 2-7 days. Trials consisted of two single-legged balance tests separated by two Wingate anaerobic tests (WAnT; PreFat/PostFat), or rest period (PreRest/PostRest). Balance tests consisted of a series of five single-legged stances, separated by 30 s rest, performed while standing on the dominant leg for 15-s with the participant crossing the arms over the chest and flexing the non-dominant knee to 90 degrees. High resolution accelerometers (HRA) were fixed superficial to L3/L4 at the approximate center of mass (COM). Triaxial signals from the HRA were streamed in real time at 625 Hz. COM accelerations were recorded in g's for vertical (VT), medial/lateral (ML), and anterior/posterior (AP) axes. A newly developed statistic (R-test) was applied to group response shapes generated by Karhunen Loeve (KL) transform modes resulting from Control Entropy (CE) analysis.

RESULTS

R-tests showed a significant mean vector difference (p < .05) within conditions, between axes in all cases, except PostFat, indicating the shape of the complexity response was different in these cases. R-test between conditions, within axis, differences were only present in PostFat for AP vs. PreFat (p < .05). T-tests showed a significantly higher overall CE PostFat in VT and ML compared to PreFat and PostRest (p < .0001). PostFat CE was also higher than PostRest in AP (p < .0001).

CONCLUSIONS

These data indicate that fatiguing exercise eliminates the differential complexity response between axes, but increases complexity in all axes compared to the non-fatigued condition. This has implications with regard to the effects of fatigue on strategies of the control system to maintain postural control.

In summary, the two major facts that have emerged from a year and a half of experience with 405 regulations are shown in Table VI. The increased staffing with the monies made available has greatly enhanced patient care and decreased the resident workload. I want to again compliment Dr. Axelrod for the foresight to make these funds available despite adverse criticism. He clearly understood that the changes needed were quite expensive because the problems are primarily economic in origin. What type of paramedical personnel are needed is yet uncertain. I mentioned briefly earlier that the "data manager" combines an excellent administrative secretary and a nurse. The simple institution of electronic data processing can, surprisingly enough, worsen the problem rather than help. For example, institution of a beeper system, making it possible for anyone to "beep" a house officer at any time, resulted in an astonishing increase in "beeper frequency," a house officer receiving seven or eight such messages per hour, 24 hours a day, rather than communicating by other methods. Such "instant" communication can become a serious hazard rather than a help. Second, as repeatedly mentioned, the on-call time concept is crucial, permitting flexibility that avoids fatigue and yet maintains continuity of care. Otherwise there is a real danger with a rigid time-on/time-off schedule.

We report an autopsy case of elderly-onset anticentromere antibody-positive pulmonary-renal syndrome. An 84-year-old woman was admitted to our hospital with complaints of leg edema and general malaise. Neither skin rush nor arthritis was seen. Because of hematuria, proteinuria with various casts, renal dysfunction and anemia, a clinically diagnosis of rapidly progressive glomerulonephritis was made. Slight pulmonary hypertension was observed in ultrasonic cardiography. Hypocomplementemia was not seen. Tests for MPO- and PR 3-anti-neutrophil cytoplasmic antibodies and anti-glomerular basement membrane antibody were negative, but a high titer of antinuclear antibody with a discrete speckled pattern on immunofluorescent staining was disclosed. Results for anticentromere antibody and anti-Ki antibody were positive, but for anti-Sm antibody and anti-double stranded DNA antibody were both negative. She did not present any clinical features of systemic sclerosis or CREST syndrome. Subsequently, prednisolone was administered, but pulmonary alveolar hemorrhage occurred and the patient died of acute respiratory failure caused by massive pulmonary hemorrhage. Autopsy revealed crescentic glomerulonephritis including glomerular capillaritis and pulmonary capillaritis with positive granular deposits of immunoglobulins and compliment on the glomerular and pulmonary capillary walls. Immunologically mediated crescentic glomerulonephritis and pulmonary capillaritis was then diagnosed histopathologically. The main pathological feature of the case was small-vessel vasculitis with immune-complex deposition. Although this case did not fulfill the clinical criteria for systemic lupus erythematosus (SLE), its histological features resembled those of lupus nephritis and acute lupus pneumonitis. We speculated that anticentromere antibody-positive pulmonary-renal syndrome without any other symptoms or signs of connective tissue disease, such as our case, is a clinical entity distinct from typical SLE or CREST syndrome.

The BP MC252 well failure in the Gulf of Mexico, April 2010 caused concern for crude oil and polycyclic aromatic hydrocarbon (PAHs) exposure along the sandy beaches of the Florida Panhandle. We began collections of Coquina clams (Donax spp.) from the surf zone of Florida Panhandle beaches to monitor PAH contamination to compliment analysis of surf zone sand samples. These clams had higher levels of PAHs relative to ambient sand, and this allowed us to continue to monitor PAH levels after sand concentrations fell below limits of detection. PAH levels in the Coquina tissues were highly variable, perhaps indicative of the heterogeneous distribution of oil and tar on the beaches and exposure to tar particles. Overall, PAH levels decreased continuously in both sand and Coquina tissues, reaching limits of detection within one and two years respectively after oil landed on Florida Panhandle beaches. Our work suggests these surf zone molluscs may be used to monitor pollutant exposure along high energy sandy beach shorelines.