The effect of different pulse durations in the treatment of nail psoriasis with 595-nm pulsed dye laser: a randomized, double-blind, intrapatient left-to-right study

Several studies have proven the efficacy of pulsed dye laser (PDL) in the treatment of plaque type psoriasis. However, only two published studies indicate the effectiveness of PDL on nail psoriasis.

High-dose intravenous corticosteroid pulse therapy in alopecia areata: own experience compared with the literature

BACKGROUND: Seven prospective studies including 193 patients have been published on high-dose intravenous corticosteroid pulse therapy in alopecia areata (AA).We compare these data with a retrospective analysis of our own consecutive patients. PATIENTS AND METHODS: Between 1998 and 2002,25 patients with severe AA were treated at the Department of Dermatology, University of Bern, with infusions of 500 mg methylprednisolone on 3 consecutive days.In addition to the inpatient records, in 2004 all patients were followed up by a questionnaire. RESULTS: Four of 10 patients with multifocal AA and 3 of 9 patients with ophiasis-type AA had full re-growth of hair, whereas all 6 patients with AA totalis/universalis failed to respond. CONCLUSION: Intravenous corticosteroid pulse therapy may be helpful in the treatment of multifocal and ophiasis-type AA. Patients with an initial episode of short duration have better chances for success.

Pulse mTOR inhibitor treatment effectively controls cyst growth but leads to severe parenchymal and glomerular hypertrophy in rat polycystic kidney disease

The efficacy of mammalian target of rapamycin (mTOR) inhibitors is currently tested in patients affected by autosomal dominant polycystic kidney disease. Treatment with mTOR inhibitors has been associated with numerous side effects. However, the renal-specific effect of mTOR inhibitor treatment cessation in polycystic kidney disease is currently unknown. Therefore, we compared pulse and continuous everolimus treatment in Han:SPRD rats. Four-week-old male heterozygous polycystic and wild-type rats were administered everolimus or vehicle by gavage feeding for 5 wk, followed by 7 wk without treatment, or continuously for 12 wk. Cessation of everolimus did not result in the appearance of renal cysts up to 7 wk postwithdrawal despite the reemergence of S6 kinase activity coupled with an overall increase in cell proliferation. Pulse everolimus treatment resulted in striking noncystic renal parenchymal enlargement and glomerular hypertrophy that was not associated with compromised kidney function. Both treatment regimens ameliorated kidney function, preserved the glomerular-tubular connection, and reduced proteinuria. Pulse treatment at an early age delays cyst development but leads to striking glomerular and parenchymal hypertrophy. Our data might have an impact when long-term treatment using mTOR inhibitors in patients with autosomal dominant polycystic kidney disease is being considered.

THE NEW ROLE OF PROPROTEIN CONVERTASE SUBTILISIN/KEXIN TYPE 9: A CONNECTION OF PROPROTEIN CONVERTASE SUBTILISIN/KEXIN TYPE 9, APOLIPOPROTEIN B, and AUTOPHAGY

Plasma low-density lipoprotein (LDL) levels are positively correlated with the incidence of coronary artery disease. In the circulation, the plasma LDL clearance is mainly achieved by the uptake via LDL receptor (LDLR). Proprotein convertase subtilisin/kexin type 9 (PCSK9) is a newly discovered gene, playing an important role in LDL metabolism. Gain-of-function mutations of PCSK9 lead to hypercholesterolemia and loss-of-function mutations of PCSK9 are associated with decrease of LDL cholesterol. The effects of PCSK9 on cholesterol levels are the consequence of a strong interaction between the catalytic domain of PCSK9 and epidermal growth factor-like repeat A (EGF-A) domain of LDLR on the cell surface of hepatocytes. This PCSK9/LDLR complex enters the cell via endocytosis, where both PCSK9 and LDLR are removed via the lysosome pathway, resulting in decreased levels of LDLR and accumulation of LDL in the plasma. However, whether this is the exclusive function of PCSK9 on LDL metabolism was challenged by us; we observed PCSK9 interacted with apolipoprotein B (apoB) and increased apoB production, irrespective of the LDLR. ApoB is the primary structure protein of LDL particle and it also serves as the ligand for the LDL receptor. There is ample evidence showing that the levels of apoB are a better indicator for heart disease than either total cholesterol or LDL cholesterol levels. We used a second-generation adenoviral vector to overexpress PCSK9 (Ad-PCSK9) in wild-type C57BL/6 and LDLR deficient mice (Ldlr-/- and Ldlr-/-Apobec1-/-). Our study revealed that overexpression of PCSK9 promoted the production and secretion of apoB in the form of very-low density lipoprotein (VLDL), which is the precursor of LDL, in the 3 mouse models studied (C57BL/6J, Ldlr-/-, and Ldlr-/-Apobec1-/-). The increased apoB production in mice was regulated at post-transcriptional levels, since there was no difference in apoB mRNA levels between mice treated with Ad-PCSK9 and control vector Ad-Null. By using pulse-chase experiment on primary hepatocytes, we showed that overexpression of PCSK9 increased the secretion of apoB, independent of LDLR. In the circulation, we showed that PCSK9 was associated with LDL particles. By using 3 different protein–protein interaction assays of co-immunoprecipitation, mammalian two-hybrid system, and in situ proximity ligation assay, we demonstrated a direct protein–protein interaction between PCSK9 and apoB. The impact of this interaction inhibited the physiological removal process of apoB via autophagosome/lysosome pathway in an LDLR-independent fashion, resulting in increased production and secretion of apoB-containing lipoproteins. The significance of this process was shown in the Pcsk9 knockout mice in the background of Ldlr-/-Apobec1-/- mice (triple knockout mice); in the absence of Pcsk9 (triple knockout mice) the levels of cholesterol, triacylglycerol, and apoB decreased significantly in comparison to that of Ldlr-/-Apobec1-/- mice. Taken together, our study demonstrated a direct intracellular interaction of PCSK9 with apoB, resulting in the inhibition of apoB degradation via the autophagosome/lysosome pathway independent of LDLR. This discovery provides a new concept of the importance of PCSK9 and suggests new approaches for the therapeutic intervention of hyperlipidemia.

EMI filter design of a three-phase buck-type rectifier for aircraft applications

An EMI filter for a three-phase buck-type medium power pulse-width modulation rectifier is designed. This filter considers differential mode noise and complies with MIL-STD- 461E for the frequency range of 10kHz to 10MHz. In industrial applications, the frequency range of the standard starts at 150kHz and the designer typically uses a switching frequency of 28kHz because the fifth harmonic is out of the range. This approach is not valid for aircraft applications. In order to design the switching frequency in aircraft applications, the power losses in the semiconductors and the weight of the reactive components should be considered. The proposed design is based on a harmonic analysis of the rectifier input current and an analytical study of the input filter. The classical industrial design does not consider the inductive effect in the filter design because the grid frequency is 50/60Hz. However, in the aircraft applications, the grid frequency is 400Hz and the inductance cannot be neglected. The proposed design considers the inductance and the capacitance effect of the filter in order to obtain unitary power factor at full power. In the optimization process, several filters are designed for different switching frequencies of the converter. In addition, designs from single to five stages are considered. The power losses of the converter plus the EMI filter are estimated at these switching frequencies. Considering overall losses and minimal filter volume, the optimal switching frequency is selected

New Considerations in the Input Filter Design of a Three-Phase Buck-Type PWM Rectifier for Aircraft Applications

An EMI filter for a three-phase buck-type medium power pulse-width modulation rectifier is designed. This filter considers differential mode noise and complies with MIL-STD-461E for the frequency range of 10kHz to 10MHz. In industrial applications, the frequency range of the standard starts at 150kHz and the designer typically uses a switching frequency of 28kHz because the fifth harmonic is out of the range. This approach is not valid for aircraft applications. In order to design the switching frequency in aircraft applications, the power losses in the semiconductors and the weight of the reactive components should be considered. The proposed design is based on a harmonic analysis of the rectifier input current and an analytical study of the input filter. The classical industrial design does not consider the inductive effect in the filter design because the grid frequency is 50/60Hz. However, in the aircraft applications, the grid frequency is 400Hz and the inductance cannot be neglected. The proposed design considers the inductance and the capacitance effect of the filter in order to obtain unitary power factor at full power. In the optimization process, several filters are designed for different switching frequencies of the converter. In addition, designs from single to five stages are considered. The power losses of the converter plus the EMI filter are estimated at these switching frequencies. Considering overall losses and minimal filter volume, the optimal switching frequency is selected.

Heated fiber optic distributed temperature sensing for measuring soil volumetric heat capacity and water content: A dual probe heat-pulse approach

The first feasibility study of using dual-probe heated fiber optics with distributed temperature sensing to measure soil volumetric heat capacity and soil water content is presented. Although results using different combinations of cables demonstrate feasibility, further work is needed to gain accuracy, including a model to account for the finite dimension and the thermal influence of the probes. Implementation of the dual-probe heat-pulse (DPHP) approach for measurement of volumetric heat capacity (C) and water content (θ) with distributed temperature sensing heated fiber optic (FO) systems presents an unprecedented opportunity for environmental monitoring (e.g., simultaneous measurement at thousands of points). We applied uniform heat pulses along a FO cable and monitored the thermal response at adjacent cables. We tested the DPHP method in the laboratory using multiple FO cables at a range of spacings. The amplitude and phase shift in the heat signal with distance was found to be a function of the soil volumetric heat capacity. Estimations of C at a range of moisture contents (θ = 0.09– 0.34 m3 m−3) suggest the feasibility of measurement via responsiveness to the changes in θ, although we observed error with decreasing soil water contents (up to 26% at θ = 0.09 m3 m−3). Optimization will require further models to account for the finite radius and thermal influence of the FO cables. Although the results indicate that the method shows great promise, further study is needed to quantify the effects of soil type, cable spacing, and jacket configurations on accuracy.

γ-Aminobutyric acid type A receptors modulate cAMP-mediated long-term potentiation and long-term depression at monosynaptic CA3–CA1 synapses

cAMP induces a protein-synthesis-dependent late phase of long-term potentiation (LTP) at CA3–CA1 synapses in acute hippocampal slices. Herein we report cAMP-mediated LTP and long-term depression (LTD) at monosynaptic CA3–CA1 cell pairs in organotypic hippocampal slice cultures. After bath application of the membrane-permeable cAMP analog adenosine 3′,5′-cyclic monophosphorothioate, Sp isomer (Sp-cAMPS), synaptic transmission was enhanced for at least 2 h. Consistent with previous findings, the late phase of LTP requires activation of cAMP-dependent protein kinase A and protein synthesis. There is also an early phase of LTP induced by cAMP; the early phase depends on protein kinase A but, in contrast to the later phase, does not require protein synthesis. In addition, the cAMP-induced LTP is associated with a reduction of paired-pulse facilitation, suggesting that presynaptic modification may be involved. Furthermore, we found that Sp-cAMPS induced LTD in slices pretreated with picrotoxin, a γ-aminobutyric acid type A (GABAA) receptor antagonist. This form of LTD depends on protein synthesis and protein phosphatase(s) and is accompanied by an increased ratio of failed synaptic transmission. These results suggest that GABAA receptors can modulate the effect of cAMP on synaptic transmission and thus determine the direction of synaptic plasticity.

Response of B-type natriuretic pepticle to exercise in hypertensive patients with suspected diastolic heart failure: Correlation with cardiac function, hemodynamics, and workload

Background Diastolic heart failure (DHF) is characterized by dyspnea due to increased left ventricular (LV) filling pressures during stress. We sought the relationship of exercise-induced increases in B-type natriuretic peptide (BNP) to LV filling pressures and parameters of cardiovascular performance in suspected DHF. Methods Twenty-six treated hypertensive patients with suspected DHF (exertional dyspnea, LV ejection fraction >50%, and diastolic dysfunction) underwent maximal exercise echocardiography using the Bruce protocol. BNP, transmitral Doppler, and tissue Doppler for systolic (So) and early (Ea) and late (Aa) diastolic mitral annular velocities were obtained at rest and peak stress. LV filling pressures were estimated with E/Ea ratios. Results Resting BNP correlated with resting pulse pressure (r=0.45, P=0.02). Maximal exercise performance (4.6 +/- 2.5min) was limited by dyspnea. Blood pressure increased with exercise (from 143 +/- 19/88 +/- 8 to 191 +/- 22/90 +/- 10 mm Hg); 13 patients (50%) had a hypertensive response. Peak exercise BNP correlated with peak transmitral E velocity (r = 0.41, P <.05) and peak heart rate (r = -0.40, P <.05). BNP increased with exercise (from 48 57 to 74 97 pg/mL, P =.007), and the increment of BNP with exercise was associated with maximal workload and peak exercise So, Ea, and Aa (P <.01 for all). Filling pressures, approximated by lateral E/Ea ratio, increased with exercise (7.7 +/- 2.0 to 10.0 +/- 4.8, P <.01). BNP was higher in patients with possibly elevated filling pressures at peak exercise (E/Ea >10) compared to those with normal pressures (123 +/- 124 vs 45 +/- 71 pg/mL, P =.027). Conclusions Augmentation of BNP with exercise in hypertensive patients with suspected DHF is associated with better exercise capacity, LV systolic and diastolic function, and left atrial function. Peak exercise BNP levels may identify exercise-induced elevation of filling pressures in DHF.

Differentiating responses to obstructive sleep apnoea using pulse transit time

Conventional overnight polysomnography (PSG) used to determine the respiratory behaviour during sleep can be a complex and expensive procedure. Pulse transit time analysis (PTT) has shown potential to detect obstructive apnoeic and hypopnoeic events in adults. This study was undertaken to determine the potential of PTT to differentiate responses to upper airway obstruction. 103 obstructive respiratory events occurred in PSG studies performed on 11 children (10 male and 1 female, mean age 7.5years). PTT measurements were evaluated against the corresponding PSG results pre-scored by 2 blinded observers. Broadly, there were 2 types of responses. They can be either short period of rapid PTT decreases (Type 1) or prolonged but gradual PTT decreases (Type 2). Type 1 obstructive events showed a mean change of 51.77% (p

The steady state performance of converter type reactive power compensators

As a source or sink of reactive power, compensators can be made from a voltage sourced inverter circuit with the a.c. terminals of the inverter connected to the system through an inductive link and with a capacitor connected across the d.c. terminals. Theoretical calculations on linearised models of the compensators have shown that the parameters characterising the performance are the reduced firing angle and the resonance ratio. The resonance ratio is the ratio of the natural frequency of oscillation of the energy storage components in the circuit to the system frequency. The reduced firing angle of the inverter divided by the damping coefficient, β, where β is half the R to X ratio of the link between the inverter and the system. The theoretical results have been verified by computer simulation and experiment. There is a narrow range of values for the resonance ratio below which there is no appreciable improvement in performance, despite an increase in the cost of the energy storage components, and above which the performance of the equipment is poor with the current being dominated by harmonics. The harmonic performance of the equipment is improved by using multiple inverters and phase shifting transformers to increase the pulse number. The optimum value of the resonance ratio increases pulse number, indicating a reduction in the energy storage components needed at high pulse numbers. The reactive power output from the compensator varies linearly with the reduced firing angle while the losses vary as the square of it.

Pulse shaping in mode-locked ring-cavity fibre lasers

By means of extensive numerical modelling we have demonstrated the possibility of nonlinear pulse shaping in a mode-locked fibre laser using control of the intra-cavity propagation dynamics by adjustment of the normal net dispersion and integrated gain. Beside self-similar mode-locking, the existence of a novel type of pulse shaping regime that produces pulses with a triangular temporal intensity profile and a linear frequency chirp has been observed.

Pulse shaping in mode-locked ring-cavity fibre lasers

By means of extensive numerical modelling we have demonstrated the possibility of nonlinear pulse shaping in a mode-locked fibre laser using control of the intra-cavity propagation dynamics by adjustment of the normal net dispersion and integrated gain. Beside self-similar mode-locking, the existence of a novel type of pulse shaping regime that produces pulses with a triangular temporal intensity profile and a linear frequency chirp has been observed.

In-cavity pulse shaping and dissipative parametric instability mode-locking in fibre lasers

At the level of fundamental research, fibre lasers provide convenient and reproducible experimental settings for the study of a variety of nonlinear dynamical processes, while at the applied research level, pulses with different and optimised features – e.g., in terms of pulse duration, temporal and/or spectral shape, energy, repetition rate and emission bandwidth – are sought with the general constraint of developing efficient cavity architectures. In this work, we review our recent progress on the realisation of pulse shaping in passively- mode-locked fibre lasers by inclusion of an amplitude and phase spectral filter into the laser cavity. We present a fibre laser design in which pulse shaping occurs through filtering of a spectrally nonlinearly broadened pulse in the cavity. This strategy of pulse shaping is illustrated through the numerical demonstration of the laser operation in different pulse-generation regimes, including parabolic, flattop and triangular waveform generations, depending on the amplitude profile of the in-cavity spectral filter [1]. As an application of this general approach, we show that the use of an in-cavity flat-top spectral filter makes it possible to directly generate sinc-shaped Nyquist pulses of high quality and of a widely tunable bandwidth from the laser [2]. We also report on a recently-developed versatile erbium-doped fibre laser, in which conventional soliton, dispersion-managed soliton (stretched-pulse) and dissipative soliton mode-locking regimes can be selectively and reliably targeted by programming different group-velocity dispersion profiles and bandwidths on an in-cavity programmable filter [3]. Further, we report on our recent results on the passive mode locking of a Raman fibre laser by a recently predicted new type of parametric instability – the dissipative Faraday instability [4], where spatially periodic zig-zag modulation of spectrally dependent losses can lead to pattern formation in the temporal domain. High-order harmonic mode locking is achieved in a very simple experimental configuration, with the laser cavity including an optical fibre and two chirped fibre Bragg gratings, and no additional mode-locking elements. The results not only open up new possibilities for the design of mode-locked lasers, but extend beyond fibre optics to other fields of physics and engineering. References [1] S. Boscolo, C. Finot, H. Karakuzu, P. Petropoulos, “Pulse shaping in mode-locked fiber laser by in-cavity spectral filter,” Opt. Lett., vol. 39, pp. 438–441, 2014. [2] S. Boscolo, C. Finot, S. K. Turitsyn, “Bandwidth programmable optical Nyquist pulse generation in passively mode-locked fiber laser,” IEEE Photon. J., vol. 7, 7802008(8), 2015. [3] J. Peng, S. Boscolo, “Filter-based dispersion-managed versatile ultrafast fibre laser,” Sci. Rep., 2016, In press. [4] A. M. Perego, N. Tarasov, D. V. Churkin, S. K. Turitsyn, K. Staliunas, “Pattern generation by dissipative parametric instability,” Phys. Rev. Lett., vol. 116, 028701, 2016.

Mucopolysaccharidosis Type Ii: Identification Of 30 Novel Mutations Among Latin American Patients.

In this study, 103 unrelated South-American patients with mucopolysaccharidosis type II (MPS II) were investigated aiming at the identification of iduronate-2-sulfatase (IDS) disease causing mutations and the possibility of some insights on the genotype-phenotype correlation The strategy used for genotyping involved the identification of the previously reported inversion/disruption of the IDS gene by PCR and screening for other mutations by PCR/SSCP. The exons with altered mobility on SSCP were sequenced, as well as all the exons of patients with no SSCP alteration. By using this strategy, we were able to find the pathogenic mutation in all patients. Alterations such as inversion/disruption and partial/total deletions of the IDS gene were found in 20/103 (19%) patients. Small insertions/deletions/indels (<22 bp) and point mutations were identified in 83/103 (88%) patients, including 30 novel mutations; except for a higher frequency of small duplications in relation to small deletions, the frequencies of major and minor alterations found in our sample are in accordance with those described in the literature.