Normal expression of IFN-gammaR in four patients with uncommon mycobacterial infection phenotypes

Several primary immunodeficiency diseases affecting the interleukin 12/interferon gamma (IFN-gamma) pathway have been identified, most of them characterized by recurrent and protracted infections produced by intracellular microorganisms, particularly by several species of mycobacteria. In the present study we analyzed the expression of IFN-gamma receptor (IFN-gammaR) and signal transducer and activator of transcription 1 (STAT-1) in 4 children with Mycobacterium tuberculosis infection of uncommon clinical presentation. These molecules were evaluated by flow cytometry and Western blotting in B cells transformed with Epstein-Barr virus and mutations were scanned by single-strand conformational polymorphisms and DNA sequencing. The expression of IFN-gammaR1 was normal in all 4 patients. The genetic analysis of IFN-gammaR1 and IFN-gammaR2 coding sequences did not reveal any mutation. The expression of the STAT-1 molecule was similar in patients and healthy controls; however, when the phosphorylation of this transcription factor in response to IFN-gamma activation was evaluated by Western blot, a significant lower signal was evident in one patient. These data indicate that there are no alterations in the expression or function of the IFN-gammaR chains in these patients. However, the low level of STAT-1 phosphorylation found in one of these patients might be explained by a defect in one of the molecules involved in the signal transduction pathway after IFN-gamma interacts with its receptor. In the other three patients the inability to eliminate the mycobacteria may be due to a defect in another effector mechanism of the mononuclear phagocytes.

Blood flow measurements in rats using four color microspheres during blockade of different vasopressor systems

The use of colored microspheres to adequately evaluate blood flow changes under different circumstances in the same rat has been validated with a maximum of three different colors due to methodological limitations. The aim of the present study was to validate the use of four different colors measuring four repeated blood flow changes in the same rat to assess the role of vasopressor systems in controlling arterial pressure (AP). Red (150,000), white (200,000), yellow (150,000), and blue (200,000) colored microspheres were infused into the left ventricle of 6 male Wistar rats 1) at rest and 2) after vasopressin (aAVP, 10 µg/kg, iv), 3) renin-angiotensin (losartan, 10 mg/kg, iv), and 4) sympathetic system blockade (hexamethonium, 20 mg/kg, iv) to determine blood flow changes. AP was recorded and processed with a data acquisition system (1-kHz sampling frequency). Blood flow changes were quantified by spectrophotometry absorption peaks for colored microsphere components in the tissues evaluated. Administration of aAVP and losartan slightly reduced the AP (-5.7 ± 0.5 and -7.8 ± 1.2 mmHg, respectively), while hexamethonium induced a 52 ± 3 mmHg fall in AP. The aAVP injection increased blood flow in lungs (78%), liver (117%) and skeletal muscle (>150%), while losartan administration enhanced blood flow in heart (126%), lungs (100%), kidneys (80%), and gastrocnemius (75%) and soleus (94%) muscles. Hexamethonium administration reduced only kidney blood flow (50%). In conclusion, four types of colored microspheres can be used to perform four repeated blood flow measurements in the same rat detecting small alterations such as changes in tissues with low blood flow.

Twenty-four-hour esophageal pH monitoring in children and adolescents with chronic and/or recurrent rhinosinusitis

Gastroesophageal reflux (GER) disorder was studied in children and adolescents with chronic and/or recurrent rhinosinusitis not associated with bronchial asthma. Ten children with a clinical and radiological diagnosis of chronic and/or recurrent rhinosinusitis, consecutively attended at the Pediatric Otolaryngology Outpatient Clinic, Federal University of São Paulo, were evaluated. Prolonged esophageal pH monitoring was used to investigate GER disorder. The mean age of the ten patients evaluated (eight males) was 7.4 ± 2.4 years. Two patients presented vomiting as a clinical manifestation and one patient presented retrosternal pain with a burning sensation. Twenty-four-hour esophageal pH monitoring was performed using the Sandhill apparatus. An antimony probe electrode was placed in the lower third of the esophagus, confirmed by fluoroscopy and later by a chest X-ray. The parameters analyzed by esophageal pH monitoring included: total percent time of the presence of acid esophageal pH, i.e., pH below 4 (<4.2%); total number of acid episodes (<50 episodes); number of reflux episodes longer than 5 min (3 or less), and duration of the longest reflux episode (<9.2 min). One patient (1/10, 10%) presented a 24-h esophageal pH profile compatible with GER disorder. This data suggest that an association between chronic rhinosinusitis not associated with bronchial asthma and GER disorder may exist in children and adolescents, especially in those with compatible GER disorder symptoms. In these cases, 24-h esophageal pH monitoring should be performed before indicating surgery, since the present data suggest that 10% of chronic rhinosinusitis surgeries can be eliminated.

Inhibition of cyclooxygenase activity by standardized hydroalcoholic extracts of four Asteraceae species from the Argentine Puna

We determined the anti-inflammatory activity of standardized extracts of four medicinal plant species (Baccharis incarum, B. boliviensis, Chuquiraga atacamensis, Parastrephia lucida) that grow in the Argentine Puna (3800 m above sea level) and that are used to reduce oxidative stress and alleviate gout and arthritic pain. The extracts of plant aerial parts were standardized in terms of total phenolic compounds and flavone/flavanone content and free radical scavenging activity. All extracts showed high phenolic compound concentration (0.5-1.6 mg/mL), mainly flavones and flavonols (0.1-0.8 mg/mL). The extracts showed hydrogen donating ability (DPPH and ABTS) and reactive oxygen species scavenging activity (O2●-, OH-, H2O2). The ability of the extracts to inhibit cyclooxygenase enzymes (COX-1 and COX-2) was determined by calculating percent inhibition of PGE2 production measured by enzyme immunoassay. All extracts inhibited both enzymes with IC50 values of 2.0 to 16.7 µg/mL. The anti-inflammatory activity of B. incarum and C. atacamensis extracts was higher than that of B. boliviensis and P. lucida. The IC50 values obtained for indomethacin were 0.11 and 0.78 µM for COX-1 and COX-2, respectively. The present results are consistent with the anecdotal use of these species in phytotherapic preparations.

Clinical and pathological challenges in the diagnosis of late-onset biliary atresia: four case studies

Biliary atresia (BA) is classically described at the neonatal age. However, rare cases of BA in older infants have also been reported. We report four cases of late-onset BA in infants older than 4 weeks (3 males, 1 female), and describe the diagnostic and management difficulties. One of the cases had a late-onset (29 weeks) presentation with a successful surgical procedure. We highlight the importance of this unusual differential diagnosis in infants with cholestatic syndrome, who may benefit from Kasai surgery, regardless of age.

IFRS 9 – standardiuudistus Big Four -tilintarkastusyhteisöjen näkökulmasta – kommenttikirjeiden empiirinen analyysi

Since 2008, One of the International Accounting Standards Board’s (IASB) objective has been to replace the old IAS 39 – Financial Instruments standard. IASB achieved this objective in July 2014 when they published the new IFRS 9 – Financial Instruments after many phases. In this study, the main purpose was to find out how the Big Four – audit entities have welcomed the different reforms which IFRS 9 brings to the treatment of financial instruments in the financial statements. Alongside with this, the study presents a short overview to the common attitude towards the new standard. The study proceeds so that the most siginificant reforms have been divided into three main categories and inside of these more precisely to single reforms. This study is based on the qualitative research method. The empirical data of the study consists of comment letters by the Big Four – entities, which have been sent to the IASB regarding Exposure Drafts (ED) of IFRS 9. In total IASB received 757 comment letters regarding to the specific EDs. In this study the population were restricted to 16 comment letters sent by the Big Four – entities. The data is available at IFRS Foundation’s website. According to the research results Big Four – entities think that the reforms which IFRS 9 brings are mainly welcome. In its entirety Big Four – entities consider IFRS 9 better than its predecessor IAS 39. There were differnces in opinions towards IFRS 9 and specific reforms among the Big Four - entities. According to the findings the best reforms were related to the efficiency demands of hedge accounting and to impairments and the valuation of credit losses. The least popular reforms were the reforms regarding the measurement of financial assets and liabilities; more specifically fair value option and the reforms concerning equity instruments were viewed as most challenging.

Comparison between aroma compounds in wines from four Vitis vinifera grape varieties grown in different shoot positions

The aroma characteristics of wines from four Vitis vinifera grape varieties (‘Cabernet sauvignon’, ‘Merlot’, ‘Chardonnay’, and ‘Italian Riesling’) grown in three shoot positions were evaluated by HS-SPME-GC/MS. In this study, the numerous significant differences found in most of the aromatic compounds influence of different shoot positions on the quality of wine. The results showed that the middle shoot position increased significantly the aroma concentration in the majority of wines investigated. The volatile components showing the greatest differences in the wines of different cultivars were aldehydes and terpenes. 8 and 11 compounds were found and quantified (OAVs>1) in the two red wines and white wines at concentrations higher than their corresponding odor thresholds, respectively; and therefore they significantly contributed to the wine aromas. According to their OAVs, fruity, floral, cheese and fatty aroma strongly influenced the characteristics of the four monovarietal wines, while the two white wines showed the green and fresh aroma characteristics. These results are related to the different microclimate of the canopies of the different shoot positions and varieties. They suggest that proper elevating the fruiting zones could improve the accumulation of aroma compounds in wines from the different varieties. On the other hand, grapevines trained to systems with uniform fruiting zones could improve the quality of wine.

Report of four cases of Bardet-Biedl syndrome

Bardet-Biedl syndrome is rare. Although its diagnosis depends on cardinal clinical manifestations which appear in childhood, we report four cases of Bardet-Biedl syndrome lately diagnosed in a dialysis center. Three cases were diagnosed in end-stage renal disease patients when they started maintenance hemodialysis, and one case was diagnosed through screening among hemodialysis patients' relatives. Although pediatricians have more opportunity to diagnose the syndrome, nephrologists are important during the treatment, since renal failure is the main cause of death among Bardet-Biedl syndrome patients. Moreover, late diagnosis of the syndrome among patients with end-stage renal disease can help to detect new cases through the screening among hemodialysis patients' relatives.

1978 - 79 Men's Coxed Four

From left to right. Top: Pierre Nadeau, Dave Blanchard, Tony Biernacki (Coach), Kevin McLaughlin, Mike McDonald. Bottom: Andy Ness.

Changing roles of nurse educators employed in acute and chronic care settings : the impact of professional and statutory mandates in Ontario at four sites of one hospital corporation /

The role of the hospital-employed nurse educator is evolving. Factors influencing this change include the introduction of standards for nurse educators by the College of Nurses of Ontario (CNO), a change in the way nurses are educated, the emergence of nursing as a profession, and hospital restructuring as a result of budgetary constraints. Two of these influencing factors: the introduction of the updated Standards of Practice for Registered Nurses and Registered Practical Nurses (1996) and hospital restructuring occurred over the last 7 years at several hospitals in southern Ontario. Current literature as well as the Standards of Practice (1996) were utilized to examine the current roles and responsibilities of nurse educators and subsequently develop a questionnaire to study the impact of these influencing factors on the role of the nurse educator. This questionnaire was piloted and revised before its distribution at 4 hospitals in southern Ontario. Twenty-five of the 41 surveys (61%) distributed were returned for analysis. The data reflected that the Standards of Practice had a positive influence on the role of the nurse educator, while hospital restructuring had a negative impact. In addition, many of the roles and responsibilities identified in the literature were indeed part of the current role of nurse educators, as well as several responsibilities not captured in the literature. The predictions for the future of this role in its current state were not positive given the financial status of the health care system as well as the lack of clarity for the role and the current level ofjob satisfaction among practicing nurse educators. However, a list of recommendations were generated which, if implemented, could add clarity to the role and improve job satisfaction. This could enhance the retention of current nurse educators and the possibility of recruiting competent nurse educators to the role in the future.

Exploring female graduate students' multifaceted and intersecting roles and identities in a complex educational milieu /

This qualitative phenomenological investigation explored six female Master of Education students' critical understandings of their identity and role negotiations, and their perceptions of environmental conditions that facilitated or impeded their identity explorations and negotiations within the institution. The interweaving of Feminist and Women's Development theories enabled the data to be examined under different, yet complementary, lenses. The data collection strategies included: four to five in-depth semistructured interviews, three take-home activities (involving identity mapping, object and metaphor identification, and strategy development), and the compilation of extensive interview notes as well as researcher reflections. The combination of a constant comparative method and a voice-centered method were used in tandem to analyze the data. Together they uncovered five emergent themes: (a) intricate understandings of key terms; (b) life-long learning and transformative pathways; (c) gender issues; (d) challenges, tensions, and possibilities; as well as (e) personal, professional, and educational implications. The findings underscored the possibility for both a singular static identity and dynamic multifaceted identities to exist in tandem, and the emergence of natural or logical identity intersections, as well as disjointed or colliding identity intersections. Ultimately, it is the continuous negotiation of internal and external spheres that contributes to the complexity and multidimensionality of graduate students' identities.

Four days at Niagara Falls, in North America /

Inscription in ink, t.p. verso: James Ainsworth Esq With the respectful com'ts of the author.