Perforated corneal hydrops treated with sulfur hexafluoride (SF6) gas and tissue adhesive

Purpose: To report a case of a perforated acute hydrops in a mentally retarded patient that was successfully managed with intracameral sulfur hexafluoride gas and cyanoacrylate tissue adhesive. Methods: Interventional case report. Results: A 14-year-old mentally retarded male patient with keratoconus presented with a perforated acute hydrops. A bandage contact lens was applied. However, following a large emesis 2 days later, the aqueous leak worsened with shallowing of the anterior chamber. Under general anesthesia, sulfur hexafluoride was injected to reform the anterior chamber and cyanoacrylate tissue adhesive was applied to the perforated site and covered by a bandage contact lens and temporary tarsorrhaphy. A follow-up examination at 1 month showed a formed anterior chamber with tissue adhesive in situ and no aqueous leak. Conclusions: The successful use of intracameral sulfur hexafluoride and tissue adhesive in the management of perforated acute hydrops may avoid emergency tectonic penetrating keratoplasty and reduce potential complications in the poorly cooperative patient.

Zebrafish KLF4 is essential for anterior mesendoderm/pre-polster differentiation and hatching

Gene knockout studies of Kruppel-like factors (KLFs) in mice have shown essential roles in organogenesis. A screen for KLF family members in zebrafish identified many KLFs. One of these, zebrafish KLF4 (zKLF4) is the homologue of neptune, a Xenopus laevis KLF. zKLF4 is expressed from approximately 80% epiboly a patch of dorsal/anterior mesendodermal cells called the pre-polster and, subsequently, in the polster and hatching gland. Here we investigate the function of zKLF4 using morpholino-based antisense oligonucleotides. Knockdown of zKLF4 resulted in complete absence of hatching gland formation and subsequent hatching in zebrafish. In addition, there was early knockdown of expression of the pre-polster/anterior mesendoderm markers CatL, cap1, and BMP4. These results indicate zKLF4 is expressed within the pre-polster, an early mesendodermal site, and that it plays a critical role in the differentiation of these cells into hatching gland cells.

Does chemotherapy improve survival in high-risk Stage I and II Merkel cell carcinoma of the skin?

Purpose: The effectiveness of synchronous carboplatin, etoposide, and radiation therapy in improving survival was evaluated by comparison of a matched set of historic control subjects with patients treated in a prospective Phase II study that used synchronous chemotherapy and radiation and adjuvant chemotherapy. Patients and Methods: Patients were included in the analysis if they had disease localized to the primary site and nodes, and they were required to have at least one of the following high-risk features: recurrence after initial therapy, involved nodes, primary size greater than 1 cm, or gross residual disease after surgery. All patients who received chemotherapy were treated in a standardized fashion as part of a Phase II study (Trans-Tasman Radiation Oncology Group TROG 96:07) from 1997 to 2001. Radiation was delivered to the primary site and nodes to a dose of 50 Gy in 25 fractions over 5 weeks, and synchronous carboplatin (AUC 4.5) and etoposide, 80 mg/m(2) i.v. on Days 1 to 3, were given in Weeks 1, 4, 7, and 10. The historic group represents a single institution's experience from 1988 to 1996 and was treated with surgery and radiation alone, and patients were included if they fulfilled the eligibility criteria of TROG 96:07. Patients with occult cutaneous disease were not included for the purpose of this analysis. Because of imbalances in the prognostic variables between the two treatment groups, comparisons were made by application of Cox's proportional hazard modeling. Overall survival, disease-specific survival, locoregional control, and distant control were used as endpoints for the study. Results: Of the 102 patients who had high-risk Stage I and II disease, 40 were treated with chemotherapy (TROG 96:07) and 62 were treated without chemotherapy (historic control subjects). When Cox's proportional hazards modeling was applied, the only significant factors for overall survival were recurrent disease, age, and the presence of residual disease. For disease-specific survival, recurrent disease was the only significant factor. Primary site on the lower limb had an adverse effect on locoregional control. For distant control, the only significant factor was residual disease. Conclusions: The multivariate analysis suggests chemotherapy has no effect on survival, but because of the wide confidence limits, a chemotherapy effect cannot be excluded. A study of this size is inadequately powered to detect small improvements in survival, and a larger randomized study remains the only way to truly confirm whether chemotherapy improves the results in high-risk MCC. (c) 2006 Elsevier Inc.

A Drug-Based Intervention Study on the Importance of Buffaloes for Human Schistosoma Japonicum Infection around Poyang Lake, People’s Republic of China

Schistosomiasis japonica is a zoonosis of major public health importance in southern China. We undertook a drug intervention to test the hypothesis that buffalo are major reservoirs for human infection in the marshlands/lake areas, where one million people are infected. We compared human and buffalo infection rates and intensity in an intervention village (Jishan), where humans and buffalo were treated with praziquantel, and a control village (Hexi), where only humans were treated, in the Poyang Lake region. Over the four-year study, human incidence in Jishan decreased but increased in Hexi. Adjustment of incidence by age, sex, water exposure, year, and village further confirmed the decreased human infection in Jishan. Chemotherapy for buffaloes resulted in a decrease in buffalo infection rates in Jishan, which coincided with the reduction in human infection rates there in the last two years of the study. Mathematical modeling predicted that buffalo are responsible for 75% of human transmission in Jishan. Copyright © 2006 by The American Society of Tropical Medicine and Hygiene.

Genome-wide analysis of mammalian promoter architecture and evolution

Mammalian promoters can be separated into two classes, conserved TATA box-enriched promoters, which initiate at a welldefined site, and more plastic, broad and evolvable CpG-rich promoters. We have sequenced tags corresponding to several hundred thousand transcription start sites (TSSs) in the mouse and human genomes, allowing precise analysis of the sequence architecture and evolution of distinct promoter classes. Different tissues and families of genes differentially use distinct types of promoters. Our tagging methods allow quantitative analysis of promoter usage in different tissues and show that differentially regulated alternative TSSs are a common feature in protein-coding genes and commonly generate alternative N termini. Among the TSSs, we identified new start sites associated with the majority of exons and with 3' UTRs. These data permit genome-scale identification of tissue-specific promoters and analysis of the cis-acting elements associated with them.

Patterns of painting in satin bowerbirds Ptilonorhynchus violaceus and males' responses to changes in their paint

Satin bowerbirds Ptilonorhynchus violaceus have an elaborate multi-component sexual display, some components of which have been extensively studied. We describe a relatively unstudied component of this display, bower painting, and birds' responses to manipulations of their paint. Males of this species focus their display around a stick bower constructed on the forest floor which they decorate with a variety of objects and paint. Painting involves a male masticating plant material and wiping the plant-saliva mixture onto the inside walls of the bower; during courtship visits to bowers, females nibble at this paint. We found that 93% of 53 males painted their bowers at our study site and the time males spent painting their bowers accounted for 24% of their time at the bower. We experimentally removed and added paint to bowers to test whether males respond to these changes in their paint. Males gave more advertisement calls and spent less time manipulating sticks at the bower when we added fresh wet paint to their bowers compared to older dried paint or a control treatment. They did not respond to the removal of paint from their bowers, perhaps because it was primarily older dried paint that was removed. We also found that males painted more frequently when there was measurable wind in their bowers, which could have degraded the quality of the signal. Our findings indicate that fresh wet paint is more important to males than older dried paint and, together with previous work at this site, suggest that paint may act as a signal to females. Given that females nibble bower sticks during courtship, we suggest that bower paint may function as a chemical sexual signal rather than a visual signal.

Toxinology in Australia's colonial era: A chronology and perspective of human envenomation in 19th century Australia

The medical management of those envenomed by snakes, spiders and poisonous fish in Australia featured extensively in the writings 19th century doctors, expeditioners and anthropologists. Against the background of this introduced medical doctrine there already existed an extensive tradition of Aboriginal medical lore; techniques of heat treatment, suction, incision and the application of plant-derived pharmacological substances featured extensively in the management of envenomed victims. The application of a hair-string or grass-string ligature, suctioning of the bite-site and incision were practised in a variety of combinations. Such evolved independently of and pre-dated such practices, which were promoted extensively by immigrant European doctors in the late 19th century. Pacific scientific toxinology began in the 17th century with Don Diego de Prado y Tovar's 1606 account of ciguatera. By the end of the 19th century more than 30 papers and books had defined the natural history of Australian elapid poisoning. The medical management of snakebite in Australia was the focus of great controversy from 1860 to 1900. Dogmatic claims of the supposed antidote efficacy of intravenous ammonia by Professor G.B. Halford, and that of strychnine by Dr. Augustus Mueller, claimed mainstream medical attention. This era of potential iatrogenic disaster and dogma was brought to a conclusion by the objective experiments of Joseph Lauterer and Thomas Lane Bancroft in 1890 in Brisbane; and by those of C.J. Martin (from 1893) and Frank Tidswell (from 1898), both of Sydney. The modern era of Australian toxinology developed as a direct consequence of Calmette's discovery, in Paris in 1894, of immune serum, which was protective against snakebite. We review the key contributors and discoveries of toxinology in colonial Australia.

Swash-aquifer interaction in the vicinity of the water table exit point on a sandy beach

The coupling of sandy beach aquifers with the swash zone in the vicinity of the water table exit point is investigated through simultaneous measurements of the instantaneous shoreline (swash front) location, pore pressures and the water table exit point. The field observations reveal new insights into swash-aquifer coupling not previously gleaned from measurements of pore pressure only. In particular, for the case where the exit point is seaward of the observation point, the pore pressure response is correlated with the distance between the exit point and the shoreline in that when the distance is large the rate of pressure drop is fast and when the distance is small the rate decreases. The observations expose limitations in a simple model describing exit point dynamics which is based only on the force balance on a particle of water at the sand surface and neglects subsurface pressures. A new modified form of the model is shown to significantly improve the model-data comparison through a parameterization of the effects of capillarity into the aquifer storage coefficient. The model enables sufficiently accurate predictions of the exit point to determine when the swash uprush propagates over a saturated or a partially saturated sand surface, potentially an important factor in the morphological evolution of the beach face. Observations of the shoreward propagation of the swash-induced pore pressure waves ahead of the runup limit shows that the magnitude of the pressure fluctuation decays exponentially and that there is a linear increase in time lags, behavior similar to that of tidally induced water table waves. The location of the exit point and the intermittency of wave runup events is also shown to be significant in terms of the shore-normal energy distribution. Seaward of the mean exit point location, peak energies are small because of the saturated sand surface within the seepage face acting as a "rigid lid'' and limiting pressure fluctuations. Landward of the mean exit point the peak energies grow before decreasing landward of the maximum shoreline position.

Hematozoa of teleosts from Lizard Island, Australia with some comments on their possible mode of transmission and the description of a new hemogregarine species

Little is known of the blood parasites of coral reef fishes and nothing of how they are transmitted. We examined 497 fishes from 22 families, 47 genera, and 78 species captured at Lizard Island, Australia, between May 1997 and April 2003 for hematozoa and ectoparasites. We also investigated whether gnathiid isopods might serve as potential vectors of fish hemogregarines. Fifty-eight of 124 fishes caught in March 2002 had larval gnathiid isopods, up to 80 per host fish, and these were identified experimentally to be of 2 types, Gnathia sp. A and Gnathia sp. B. Caligid copepods were also recorded but no leeches. Hematozoa, found in 68 teleosts, were broadly hemogregarines of 4 types and an infection resembling Haemohormidium. Mixed infections (hemogregarine with Haemohormidium) were also observed, but no trypanosomes were detected in blood films. The hemogregarines were identified as Haemogregarina balistapi n. sp., Haemogregarina tetraodontis, possibly Haemogregarina bigemina, and an intraleukocytic hemogregarine of uncertain status. Laboratory-reared Gnathia sp. A larvae, fed experimentally on bruslitail tangs, the latter heavily infected with the H. bigemina-like hemogregarine, contained hemogregarine gamonts and possibly young oocysts up to 3 days postfeeding, but no firm evidence that gnathiids transmit hemogregarines at Lizard Island was obtained.

Perspective on the host response to human metapneumovirus infection: what can we learn from respiratory syncytial virus infections?

Human metapneumovirus (HMPV) is a recently discovered pathogen first identified in respiratory specimens from young children suffering from clinical respiratory syndromes ranging from mild to severe lower respiratory tract illness. HMPV has worldwide prevalence, and is a leading cause of respiratory tract infection in the first years of life, with a spectrum of disease similar to respiratory syncytial virus (RSV). The disease burden associated with HMPV infection has not been fully elucidated; however, studies indicate that HMPV may cause upper or lower respiratory tract illness in patients between ages 2 months and 87 years, may co-circulate with RSV, and HMPV infection may be associated with asthma exacerbation. The mechanisms and effector pathways contributing to immunity or disease pathogenesis following infection are not fully understood; however, given the clinical significance of HMPV, there is a need for a fundamental understanding of the immune and pathophysiological processes that occur following infection to provide the foundation necessary for the development of effective vaccine or therapeutic intervention strategies. This review provides a current perspective on the processes associated with HMPV infection, immunity, and disease pathogenesis. (c) 2005 Elsevier SAS. All rights reserved.

The onset and effectiveness of Adult Plant Resistance (APR) in Tallon barley

Field observations of net blotch epidemics indicated that Tallon barley was quite resistant to infection during later stages of growth despite being susceptible as a seedling. A glasshouse experiment was conducted to determine the effectiveness of this resistance and when it became operative. Three cultivars – Gilbert (very susceptible), Patty (resistant) and Tallon – were inoculated at various stages of growth with conidia of Pyrenophora teres f. teres and the infection response and leaf area diseased, recorded 13 days later. The response of Tallon clearly changed from susceptible to moderately susceptible at growth stage 33. Plants sown two weeks earlier were susceptible and plants sown two weeks later were moderately resistant. The response of the other two cultivars at similar growth stages paralleled their seedling responses. The resistance of Tallon appeared to increase with maturity so that, at its most resistant growth stage, the leaf area diseased was just 10% that of the susceptible, Gilbert. While this resistance appears pathotype specific, this experiment demonstrated very effective APR to net blotch. As most losses to this disease occur during the later stages of plant development, APR offers a valuable source of resistance.

Design and synthesis of potential antimicrobial agents

Chorismate mutase is one of the essential enzymes in the shikimate pathway and is key to the survival of the organism Mycobacterium tuberculosis. The x-ray crystal structure of this enzyme from Mycobacterium tuberculosis was manipulated to prepare an initial set of in silico protein models of the active site. Known inhibitors of the enzyme were docked into the active site using the flexible ligand / flexible active site side chains approach implemented in CAChe Worksystem (Fujitsu Ltd). The resulting complexes were refined by molecular dynamics studies in explicit water using Amber 9. This yielded a further set of protein models that were used for additional rounds of ligand docking. A binding hypothesis was established for the enzyme and this was used to screen a database of commercially available drug-like compounds. From these results new potential ligands were designed that fitted appropriately into the active site and matched the functional groups and binding motifs founds therein. Some of these compounds and close analogues were then synthesized and submitted for biological evaluation. As a separate part of this thesis, analogues of very active anti-tuberculosis pyridylcarboxamidrazone were also prepared. This was carried out by the addition and the deletion of the substitutions from the lead compound thereby preparing heteroaryl carboxamidrazone derivatives and related compounds. All these compounds were initially evaluated for biological activity against various gram positive organisms and then sent to the TAACF (USA) for screening against Mycobacterium tuberculosis. Some of the new compounds proved to be at least as potent as the original lead compound but less toxic.

Sequence analysis and distribution in Salmonella enterica serovars of IS3-like elements

The genome of Salmonella enterica serovar Enteritidis was shown to possess three IS3-like insertion elements, designated IS1230A, B and C, and each was cloned and their respective deoxynucleotide sequences determined. Mutations in elements IS1230A and B resulted in frameshifts in the open reading frames that encoded a putative transposase to be inactive. IS1230C was truncated at nucleotide 774 relative to IS1230B and therefore did not possess the 3' terminal inverted repeat. The three IS1230 derivatives were closely related to each other based on nucleotide sequence similarity. IS1230A was located adjacent to the sef operon encoding SEF14 fimbriae located at minute 97 of the genome of S. Enteritidis. IS1230B was located adjacent to the umuDC operon at minute 42.5 on the genome, itself located near to one terminus of an 815-kb genome inversion of S. Enteritidis relative to S. Typhimurium. IS1230C was located next to attB, the bacteriophage P22 attachment site, and proB, encoding gamma-glutamyl phosphate reductase. A truncated 3' remnant of IS1230, designated IS1230T, was identified in a clinical isolate of S. Typhimurium DT193 strain 2391. This element was located next to attB adjacent to which were bacteriophage P22-like sequences. Southern hybridisation of total genomic DNA from eighteen phage types of S. Enteritidis and eighteen definitive types of S. Typhimurium showed similar, if not identical, restriction fragment profiles in the respective serovars when probed with IS1230A.

Liposomes:Formulation and characterisation as contrast agents and as vaccine delivery systems

Liposome systems are well reported for their activity as vaccine adjuvants; however novel lipid-based microbubbles have also been reported to enhance the targeting of antigens into dendritic cells (DCs) in cancer immunotherapy (Suzuki et al 2009). This research initially focused on the formulation of gas-filled lipid coated microbubbles and their potential activation of macrophages using in vitro models. Further studies in the thesis concentrated on aqueous-filled liposomes as vaccine delivery systems. Initial work involved formulating and characterising four different methods of producing lipid-coated microbubbles (sometimes referred to as gas-filled liposomes), by homogenisation, sonication, a gas-releasing chemical reaction and agitation/pressurisation in terms of stability and physico-chemical characteristics. Two of the preparations were tested as pressure probes in MRI studies. The first preparation composed of a standard phospholipid (DSPC) filled with air or nitrogen (N2), whilst in the second method the microbubbles were composed of a fluorinated phospholipid (F-GPC) filled with a fluorocarbon saturated gas. The studies showed that whilst maintaining high sensitivity, a novel contrast agent which allows stable MRI measurements of fluid pressure over time, could be produced using lipid-coated microbubbles. The F-GPC microbubbles were found to withstand pressures up to 2.6 bar with minimal damage as opposed to the DSPC microbubbles, which were damaged at above 1.3 bar. However, it was also found that DSPC-filled with N2 microbubbles were also extremely robust to pressure and their performance was similar to that of F-GPC based microbubbles. Following on from the MRI studies, the DSPC-air and N2 filled lipid-based microbubbles were assessed for their potential activation of macrophages using in vitro models and compared to equivalent aqueous-filled liposomes. The microbubble formulations did not stimulate macrophage uptake, so studies thereafter focused on aqueous-filled liposomes. Further studies concentrated on formulating and characterising, both physico-chemically and immunologically, cationic liposomes based on the potent adjuvant dimethyldioctadecylammonium (DDA) and immunomodulatory trehalose dibehenate (TDB) with the addition of polyethylene glycol (PEG). One of the proposed hypotheses for the mechanism behind the immunostimulatory effect obtained with DDA:TDB is the ‘depot effect’ in which the liposomal carrier helps to retain the antigen at the injection site thereby increasing the time of vaccine exposure to the immune cells. The depot effect has been suggested to be primarily due to their cationic nature. Results reported within this thesis demonstrate that higher levels of PEG i.e. 25 % were able to significantly inhibit the formation of a liposome depot at the injection site and also severely limit the retention of antigen at the site. This therefore resulted in a faster drainage of the liposomes from the site of injection. The versatility of cationic liposomes based on DDA:TDB in combination with different immunostimulatory ligands including, polyinosinic-polycytidylic acid (poly (I:C), TLR 3 ligand), and CpG (TLR 9 ligand) either entrapped within the vesicles or adsorbed onto the liposome surface was investigated for immunogenic capacity as vaccine adjuvants. Small unilamellar (SUV) DDA:TDB vesicles (20-100 nm native size) with protein antigen adsorbed to the vesicle surface were the most potent in inducing both T cell (7-fold increase) and antibody (up to 2 log increase) antigen specific responses. The addition of TLR agonists poly(I:C) and CpG to SUV liposomes had small or no effect on their adjuvanticity. Finally, threitol ceramide (ThrCer), a new mmunostimulatory agent, was incorporated into the bilayers of liposomes composed of DDA or DSPC to investigate the uptake of ThrCer, by dendritic cells (DCs), and presentation on CD1d molecules to invariant natural killer T cells. These systems were prepared both as multilamellar vesicles (MLV) and Small unilamellar (SUV). It was demonstrated that the IFN-g secretion was higher for DDA SUV liposome formulation (p<0.05), suggesting that ThrCer encapsulation in this liposome formulation resulted in a higher uptake by DCs.

Plant ecology of lowland Alnus Glutinosa woodlands:The management implications of species composition, requirements and distribution

Wet woodlands have been recognised as a priority habitat and have featured in the UK BAP since 1994. Although this has been acknowledged in a number of UK policies and guidelines, there is little information relating to their detailed ecology and management. This research, focusing on lowland Alnus glutinosa woodlands, aimed to address this data paucity through the analysis of species requirements and to develop a methodology to guide appropriate management for this habitat for the benefit of wildlife. To achieve these aims data were collected from 64 lowland Alnus glutinosa woodlands and a review of the literature was undertaken to identify species associated with the target habitat. The groundflora species found to be associated with lowland Alnus glutinosa woodland were assessed in relation to their optimal environmental conditions (Ellenberg indicator values) and survival strategies (Grime CSR-Strategy) to determine the characteristics (Characters of a Habitat; CoaHs) and range of intra-site conditions (Niches of a Habitat; NoaH). The methodologies, using CSR and Ellenberg indicator values in combination, were developed to determine NoaHs and were tested both quantitatively and qualitatively at different lowland Alnus glutinosa sites. The existence of CoaHs and NoaHs in actual sites was verified by detailed quadrat data gathered at three Alnus glutinosa woodlands at Stonebridge Meadows, Warwickshire, UK and analysed using TWINSPAN and DCA ordination. The CoaHs and NoaHs and their component species were confirmed to have the potential to occur in a particular woodland. Following a literature search relating to the management of small wet woodlands within the UK, in conjunction with the current research, broad principles and strategies were identified for the management of lowland Alnus glutinosa woodland. Using the groundflora composition, an innovative procedure is developed and described for identifying the potential variation within a particular site and determining its appropriate management. Case studies were undertaken on distinct woodlands and the methodology proved effective.