Molecular Detection of Plasmid-Mediated Quinolone Resistance Genes (qnrA and aac(6?)-Ib-cr) in Drug Resistant Escherichia coli, Sudan

Background: The quinolone group, a synthetic antimicrobial, is widely used worldwide to treat many diseases, including those caused by Gram-negative bacteria. Escherichia coli and others are among the bacteria that produce quinolone resistance genes (qnr) such as qnrA and aac(6?)-Ib-cr. Objective: The present study aimed to the isolate Escherichia coli from patients attending some Hospitals in Wad Medani city, identification of drug resistance patterns and detection of the frequency of quinolones resistance genes; qnrA and aac(6?)-Ib-cr among isolated strains. Methods: A cross-sectional descriptive, hospital-based study included 119 Escherichia coli strains was conducted. A designed questionnaire used for demographic data collection and the attitude toward antimicrobials usage. Clinical specimens were processed for aerobic bacterial isolation and identification. Antimicrobial sensitivity performed by Kirby Bauer disc diffusion technique according to the CLSI guidelines. Presence of qnrA and aac(6?)-Ib-cr genes was assessed by multiplex PCR. Results: Most strains of Escherichia coli originated from urine 53.8% (64/119) and wounds 42.9% (51/119) specimens. Meropenem had the best effect against tested strains with susceptibility of 85% (101/119). Multiplex PCR assay, using specific primers, demonstrated that 41.2% (49/119) and 37.8% (45/119) of isolated Escherichia coli possessed qnrA and aac(6?)-Ib-cr genes respectively. Conclusion: The high rate of qnrA and aac (6)-Ib-cr genes among Escherichia coli necessitate the usage of molecular tools in detecting the genetic determinants of drug resistance microorganisms in countries such as Sudan.

A3 receptor agonist modulates IL-1ß hippocampus levels in a rat model of neuropathic pain

Introduction: Considering the lack of specific treatments for neuropathic pain, this study aimed to evaluate the effect of a single dose of adenosine A3 receptor IB-MECA on inflammatory and neurotrophic parameters in rats subjected to a neuropathic pain model. Methods: 64 adult male Wistar rats were used. Neuropathic pain was induced by chronic constriction injury (CCI) of the sciatic nerve and the treatment consisted of a 0.5 µmol/kg dose of IB-MECA, a selective A3 adenosine receptor agonist, dissolved in 3% DMSO; vehicle groups received DMSO 3% in saline solution, and morphine groups received 5 mg/kg. Cerebral cortex and hippocampus IL-1ß, BDNF, and NGF levels were determined by Enzyme-Linked Immunosorbent assay. Results: The main outcome was that a single dose of IB-MECA was able to modulate the IL-1ß hippocampal levels in neuropathic pain induced by CCI and the DMSO increased IL-1ß and NGF hippocampal levels in sham-operated rats. However, we did not observe this effect when the DMSO was used as vehicle for IB-MECA, indicating that IB-MECA was able to prevent the effect of DMSO. Conclusions: Considering that the IL-1ß role in neuropathic pain and the contributions of the hippocampus are well explored, our result corroborates the relationship between the A3 receptor and the process of chronic pain maintenance.

Cambios en el perfil protéico de E. coli O157:H7 frente al tratamiento con Ib-M1 e IONP@Ib-M1 / Changes in the protein profile of E. coli O157: H7 against treatment with Ib-M1 and IONP@Ib-M1 / Identificação de alterações no perfil protetor de E. coli O157: H7 contra o tratamento com Ib-M1 e IONP@Ib-M1

Resumen Escherichia coli 0157:H7 es una bacteria patógena reconocida por su capacidad de resistencia a diversos antibióticos; razón por la cual, se generan complicaciones en el tratamiento de infecciones producidas por esta bacteria. El péptido Ib-M1 y el bioconjugado I0NP@Ib-M1 han surgido como una nueva alternativa antimicrobiana contra E. coli 0157:H7. El mecanismo de acción de Ib-Mi e I0NP@Ib-M1 contra esta bacteria aún es desconocido; por lo tanto, el objetivo de esta investigación fue identificar el cambio en el perfil de proteínas de E. coli 0157:H7 luego del tratamiento con Ib-M1 e I0NP@ Ib-M1 como primer paso para determinar su mecanismo de acción. Para esto, se llevó a cabo la obtención de proteínas, posteriormente se realizó una electroforesis bidimensional para finalmente realizar la determinación de la variabilidad de los perfiles proteicos. Una vez obtenidos estos perfiles, se llevó a cabo un análisis de varianza (AN0VA). Se identificaron 72 proteínas expresadas diferencialmente, las cuales pueden relacionarse con el efecto sobre el crecimiento de la bacteria en presencia de Ib-M1 e I0NP@Ib-M. Estas proteínas se encuentran involucradas en procesos de transferencia de grupos acilo (proteína Yhbs), translocación de lipoproteínas (proteína LolA) y transporte de aminoácidos (proteína GpmA), entre otros.

Abstract Escherichia coli 0157: H7 is a pathogenic bacterium which is recognized for the ability to resist multiple antibiotics; accordingly, complications occur in the treatment of infections caused by this bacterium. The Ib-M1 peptide and the I0NP @ Ib-M1 bioconjugate have emerged as a new antimicrobial alternatives against E. coli 0157: H7. The mechanism of action of Ib-M1 and I0NP @ Ib-M1 against this bacterium is still unknown; therefore, the goal of this research was to identify the change in the proteins profile of E. coli 0157: H7 after treatment with Ib-M1 and I0NP @ Ib-M1 as a first step to determine its mechanism of action. For this, the proteins were obtained first, and then a two-dimensional electrophoresis was performed to finally determine the variability of the protein profiles. 0nce the protein profiles were obtained, an analysis of variance (AN0VA) was carried out. 72 differentially expressed proteins were identified, which can be connected to the effect on the bacterium's growth in the presence of Ib-M1 and I0NP @ Ib-M. These proteins are involved in acyl groups transfer processes (Yhbs protein), lipoprotein translocation (LolA protein) and amino acid transport (GpmA protein), among others.

Resumo Escherichia coli O157: H7 é uma bactéria patogênica reconhecida por sua capacidade de resistir a vários antibióticos; razão pela qual, complicações são geradas no tratamento de infecções produzidas por essa bactéria. O peptídeo Ib-M1 livre e imobilizado em nanopartículas magnéticas de óxido de ferro (IONP @ Ib-M1) surgiu como uma nova alternativa antimicrobiana contra E. coli O157: H7 e isolados clínicos desta bactéria. O mecanismo de ação de Ib-M1 e IONP @ Ib-M1 contra E. coli O157: H7 ainda é desconhecido; Portanto, o objetivo desta pesquisa foi identificar a alteração no perfil proteico de E. coli O157: H7 após o tratamento com Ib-M1 e IONP @ Ib-M1 como um primeiro passo para determinar seu mecanismo de ação. Para isso, foi realizada a obtenção das proteínas, posteriormente foi realizada uma eletroforese bidimensional para finalmente determinar a variabilidade dos perfis protéicos. Uma vez obtidos os perfis de proteínas, foi realizada uma análise de variância (ANOVA). Os resultados mostram a identificação de proteínas expressas diferencialmente e que estão envolvidas em processos de transferência de grupos acila (proteína Yhbs), translocação de lipoproteínas (proteína LolA) e transporte de aminoácidos (proteína GpmA), entre outros.

Método microespectrofotométrico para la determinación de valores de referencia de la fosfomanosa isomerasa / A Microspectrophotometric Method for the Determination of Reference Values of Phosphomannose Isomerase / Método microespectrofotométrico para determinar valores de referência da fosfomanose isomerase

Resumen: Los desórdenes congénitos de glicosilación son un conjunto de defectos genéticos de tipo multisistémico que afectan la función de la proteína. Se han descrito cerca de 75 enfermedades desde sus primeros estudios. En el presente estudio se desarrolló un método microespectrofotométrico para el diagnóstico de la enzima citosólica fosfomanosa isomerasa EC 5.3.1.8 (PMI), se analizaron 32 muestras de individuos con rango de edad de 0,6 a 27 años y se estableció el intervalo y el valor de referencia de actividad enzimática específica. Este estudio permitirá iniciar el diagnóstico de pacientes deficientes de la PMI de forma temprana y oportuna, lo cual la convierte en una posible enzima candidata para pruebas de tamizaje neonatal, ya que esta patología tiene un tratamiento fácil y de bajo costo, que consiste en la suplementación de manosa en forma oral. El diagnóstico clínico de este desorden metabólico beneficiará al paciente y a su familia al mejorar su calidad de vida, como también al sistema de salud colombiano.

Abstract: Congenital glycosylation disorders are a set of multi-systemic genetic defects affecting protein function. About 75 diseases have been described since early studies. This study developed a microspectrophotometric method for the diagnosis of the cytosolic enzyme phosphomannose isomerase (PMI) (EC 5.3.1.8), analyzed 32 samples of individuals ranging between 0.6 and 27 years old, and established the interval and reference value of specific enzyme activity. This study will allow early and timely diagnosis of PMI deficient patients, which makes this enzyme a potential candidate for neonatal screening tests since this pathology has an easy, low-cost treatment (oral administration of mannose supplements). Clinical diagnosis of this metabolic disorder will benefit the patient and his family by improving his quality of life, as well as the Colombian healthcare system.

Resumo: Os defeitos congénitos de glicosilação são um conjunto de defeitos genéticos de tipo mul-tissistêmico que afetam a função da proteína. Foram descritas 75 doenças desde seus primeiros estudos. Neste estudo, foi desenvolvido um método microespectrofotométrico para diagnosticar a enzima citosólica fosfomanose isomerase EC 5.3.1.8 (PMI); foram analisadas 32 amostras de indivíduos entre 0,6 e 27 anos e estabelecidos o intervalo e o valor de referência de atividade enzimática específica. Este estudo permitirá iniciar o diagnóstico de pacientes deficientes da PMI de forma precoce e oportuna, o que a converte em uma possível enzima candidata para testes genéticos de rastreio pré-natal, já que essa patologia tem um tratamento fácil e de baixo custo, que consiste na suplementação de manose por via oral. O diagnóstico clínico desse defeito metabólico beneficiará o paciente e sua família ao melhorar a qualidade de vida e o sistema de saúde colombiano.

Application of Multi-stage Countercurrent Extraction Technology in the Extraction Process of Aesculi / 世界科学技术-中医药现代化

This study was aimed to optimize the extraction process of Aesculi. The extraction process of Aesculi wasoptimized through orthogonal experiment while the transfer rate of escin Ia and escin Ib. And the yield of dry extract. wasadopted as marks. And ratio of solid to liquid, the ethanol concentration, extraction time and extraction temperature werestudies. The results showed that optimized extraction conditions of Aesculi were determined as follows. The ratio of solidto liquid was 1: 10, the ethanol concentration was 70％, extracted for 20 minutes ever stage and the extractiontemperature was 60℃. It was concluded that the extraction process is efficacious for general flavone and icariinextraction. The method is suitable for the standardized production technology of Aesculi.

Trombocitopenia inducida por fármacos / Drug-induced thrombocytopenia

La trombocitopenia puede tener varias causas, como la utilización de determinados fármacos. Los mecanismos causantes de la trombocitopenia inducida por fármacos incluyen disminución en la producción (supresión medular) o incremento en la destrucción (por mecanismos inmunes). Adicionalmente, la seudotrombocitopenia es un efecto in vitro, que se distingue de una real trombocitopenia inducida por medicamentos. Los estudios epidemiológicos son pocos, difieren en la metodología utilizada y describen una incidencia de 10 casos por millón de habitantes por año. El mecanismo fundamental de la trombocitopenia inducida por fármacos no está completamente esclarecido, pero al menos se plantean seis posibles mecanismos: anticuerpos inducidos por haptenos, anticuerpos dependientes del fármaco, inhibidores del complejo GP IIb-IIIa, autoanticuerpos inducidos por la droga, complejos inmunes y trombocitopenia inducida por heparina. La diana para los anticuerpos dependientes del fármaco son las glucoproteínas de la membrana plaquetaria, como las glucoproteínas Ib/IX y GPIIb/IIIa. El diagnóstico de trombocitopenia inducida por fármacos puede consistir en la identificación de síntomas clínicos (hematomas, petequias, sangramientos), la cuidadosa evaluación de la relación causal con el fármaco sospechoso, las investigaciones generales de laboratorio (conteos en sangre total, extendidos de sangre periférica, para descartar seudotrombocitopenia) y las pruebas serológicas para plaquetas. La trombocitopenia inducida por fármacos es una reacción adversa a medicamentos relativamente raros cuyas sus consecuencias pueden ser graves.

Thrombocytopenia can have several causes, including the use of certain drugs. The mechanism behind drug-induced thrombocytopenia is either a decrease in platelet production (bone marrow suppression) or an increased destruction (immune-mediated thrombocytopenia). In addition, pseudothrombocytopenia, an in vitro effect, has to be distinguished from true drug-induced thrombocytopenia. A small number of epidemiological studies, differing largely in the methodology used, describe incidences in the magnitude of 10 cases per 1 000 000 inhabitants per year. The underlying mechanism of drug-induced immune thrombocytopenia is not completely clarified, but at least six different types of antibodies appear to play a role; hapten-induced antibody, drug-dependent antibody ("compound" or "conformational-dependent" antibody), GPIIb-IIIa inhibitors, drug-induced autoantibody, immune complex and heparin-induced thrombocytopenia. Targets for drug-dependent antibodies are glycoproteins on the cell membrane of the platelets, such as glycoprotein (GP) Ib/IX and GPIIb/IIIa. Diagnosis of drug-induced immune thrombocytopenia may consist of identifying clinical symptoms (bruising, petechiae, bleeding), a careful evaluation of the causal relationship of the suspected causative drug, general laboratory investigation, such as total blood count and peripheral blood smear (to rule out pseudothrombocytopenia), and platelet serology tests. Although drug-induced thrombocytopenia is a relatively rare adverse drug reaction, its consequences may be severe.

Effect of Adjuvant Chemotherapy after Complete Resection for Pathologic Stage IB Lung Adenocarcinoma in High-Risk Patients as Defined by a New Recurrence Risk Scoring Model / Journal of the Korean Cancer Association, 대한암학회지

PURPOSE: We conducted a retrospective analysis to determine if adjuvant chemotherapy prolongs overall survival in patients with pathologic stage IB lung adenocarcinoma who had undergone complete resection and were defined as high-risk by a newly developed recurrence risk scoring model. MATERIALS AND METHODS: Patients who underwent curative resection for stage IB lung adenocarcinoma were analyzed with a newly developed recurrence risk scoring model and divided into a low-risk group and a high-risk group. The patients in the high-risk group were retrospectively divided into two groups based on whether they underwent adjuvant chemotherapy or observation. Recurrence-free survival and overall survival were compared between these two groups. RESULTS: A total of 328 patients who underwent curative resection between 2000 and 2009 were included in this study, of whom 110 (34%) received adjuvant chemotherapy and 218 (67%) underwent observation without additional treatment. According to our risk model, 167 patients (51%) were high-risk and 161 (49%) were low-risk. The 5-year recurrence-free survival rates and overall survival were 84.4% and 91.5% in low-risk patients and 53.9% and 74.7% in high-risk patients (p < 0.001). In high-risk patients, the 5-year overall survival rates were 77% among patients who underwent observation and 87% among those who underwent adjuvant chemotherapy (p=0.019). CONCLUSION: Adjuvant chemotherapy prolonged overall survival among high-risk patients who had undergone complete resection for stage IB lung adenocarcinoma.

Novel SLC37A4 Mutations in Korean Patients With Glycogen Storage Disease Ib

BACKGROUND: Molecular techniques are fundamental for establishing an accurate diagnosis and therapeutic approach of glycogen storage diseases (GSDs). We aimed to evaluate SLC37A4 mutation spectrum in Korean GSD Ib patients. METHODS: Nine Korean patients from eight unrelated families with GSD Ib were included. SLC37A4 mutations were detected in all patients with direct sequencing using a PCR method and/or whole-exome sequencing. A comprehensive review of previously reported SLC37A4 mutations was also conducted. RESULTS: Nine different pathogenic SLC37A4 mutations were identified in the nine patients with GSD Ib. Among them, four novel mutations were identified: c.148G>A (pGly50Arg), c.320G>A (p.Trp107*), c.412T>C (p.Trp138Arg), and c.818G>A (p.Gly273Asp). The most common mutation type was missense mutations (66.7%, 6/9), followed by nonsense mutations (22.2%, 2/9) and small deletion mutations (11.1%, 1/9). The most common mutation identified in the Korean population was c.443C>T (p.Ala148Val), which comprised 39.9% (7/18) of all tested alleles. This mutation has not been reported in GSD Ib patients in other ethnic populations. CONCLUSIONS: This study expands knowledge of the SLC37A4 mutation spectrum in Korean patients with GSD Ib.

Application observation of neoadjuvant chemotherapy in radical resection of cervical cancer of stage IB2-ⅡB / 中国综合临床

Objective To investigate the efficacy of neoadjuvant chemotherapy combined with radical resection of cervical cancer in the treatment of stage IB2-ⅡB cervical cancer.Methods According to the treatment plan from October 2012 to October 2016 in the People′s Hospital of Luohu District of Shenzhen in 80 cases of stage IB2-II B cervical cancer patients were divided into observation group(n=43) and control group(n=37),the observation group was treated with neoadjuvant chemotherapy combined with radical surgery for cervical cancer,patients in the control group directly treated for radical resection of cervical cancer.Chemotherapy effect,operation time,intraoperative blood loss,postoperative pathological risk factor differences of two groups of patients were compared.Results (1)Evaluated the curative effect of neoadjuvant chemotherapy,squamous cell carcinoma group complete remission(CR) 4 cases,partial remission(PR) 22 cases,stable disease(SD),6 cases of disease progression(PD) in 0 cases,in adenocarcinoma group CR 1 cases,PR 3 cases,SD 5 cases,PD 2 cases of squamous cell carcinoma group adjuvant chemotherapy was significantly better than that of adenocarcinoma group,the difference was statistically significant(z=2.4968,P=0.0063).(2)The operation time((215±57) min) and intraoperative blood loss((682±145) ml) in the observation group were significantly lower than those in the control group(((259±62) min,(758±193) ml)),the difference was statistically significant(t=3.8780,2.2528,P=0.0002,0.0263).(3)The two groups of patients with ureteral fistula(P=0.5039),vesicovaginal fistula(P=0.3639),wound healing(P=0.5182),lower extremity deep venous thrombosis(P=0.4818) complications had no significant difference.(4)The positive rate of the observation group of lymph nodes(χ2=8.2005,P=0.0000),parametrial infiltration rate(χ2=8.1553,P=0.0000) was significantly lower than the control group,the difference was statistically significant.Two groups of patients with deep myometrial invasion rate(χ2=0.0991,P=0.7516),the incidence of cancer embolus(χ2=0.0130,P=0.9176) compared to no statistical significance.Conclusion The effect of neoadjuvant chemotherapy on cervical squamous cell carcinoma is better than that of adenocarcinoma.Compared with the direct for radical resection of cervical cancer,neoadjuvant chemotherapy combined with radical resection of cervical cancer patients for the treatment of stage IB2-ⅡB cervical cancer,operation time and blood loss are lower,node positive and parametrial invasion and postoperative pathologic risk factors in lymph node also can get better effect.

Full Sibling Identification by IBS Scoring Method and Establishment of the Query Table of Its Critical Value / 法医学杂志

Objective T o establish a query table of IB S critical value and identification pow er for the detection system s w ith different num bers of ST R loci under different false judgm ent standards. Methods Sam ples of 267 pairs of full siblings and 360 pairs of unrelated individuals w ere collected and 19 auto-som al ST R loci w ere genotyped by G oldeneyeTM 20A system . T he full siblings w ere determ ined using IB S scoring m ethod according to the 'R egulation for biological full sibling testing'. T he critical values and identification pow er for the detection system s w ith different num bers of ST R loci under different false judgm ent standards w ere calculated by theoretical m ethods. Results A ccording to the form al IB S scoring criteria, the identification pow er of full siblings and unrelated individuals w as 0.7640 and the rate of false judgm ent w as 0. T he results of theoretical calculation w ere consistent w ith that of sam ple observation. T he query table of IB S critical value for identification of full sibling detection system s w ith different num bers of ST R loci w as successfully established. Conclusion T he IB S scoring m ethod defined by the regulation has high detection efficiency and low false judgm ent rate, w hich provides a relatively conservative result. T he query table of IB S critical value for identification of full sibling detection sys-tem s w ith different num bers of ST R loci provides an im portant reference data for the result judgm ent of full sibling testing and ow ns a considerable practical value.

Topoisomerase IB of Deinococcus radiodurans resolves guanine quadruplex DNA structures in vitro.

Deinococcus radiodurans genome contains a large number of guanine repeats interrupted by a few non-guanine bases, termed G motifs. Some of these G motifs were shown forming guanine quadruplex (G4) DNA structure in vitro. How is the formation and relaxation of G4 DNA regulated in the genome of D. radiodurans is not known and is worth investigating. Here, we showed that the topoisomerase Ib of D. radiodurans (DraTopoIB) could change the electrophoretic mobility of fast migrating intramolecular recF-G4 DNA into the slow migrating species. DraTopoIB also reduced the positive ellipticity in circular diachroism (CD) spectra of intramolecular recF-G4 DNA structures stabilized by K+. On the contrary, when DraTopoIB is incubated with G-motifs annealed without K+, it showed neither any change in electrophoretic mobility nor was ellipticity of the CD spectra affected. DNA synthesis by Taq DNA polymerase through G4 DNA structure was attenuated in the presence of G4 DNA binding drugs, which was abrogated by DraTopoIB. This implies that DraTopoIB could destabilize the G4 DNA structure, which is required for G4 drugs binding and stabilization. Camptothecin treatment inhibited DraTopoIB activity on intramolecular G4 DNA structures. These results suggested that DraTopoIB can relax intramolecular G4 DNA structure in vitro and it may be one such protein that could resolve G4 DNA under normal growth conditions in D. radiodurans.

Amelioration of Cerebral Ischemic Injury by a Synthetic Seco-nucleoside LMT497

Recently, we reported that the A3 adenosine receptor (A3AR) agonist LJ529 (2-chloro-N6-(3-iodobnzyl)-5'-N-methylcarbamoyl-4'-thioadenosine) reduces cerebral ischemic injury via inhibition of recruitment of peripheral inflammatory cells into ischemic brain lesion. A3AR agonists, however, are known to possess anti-platelet activity, which may deter the combination therapy with tissue plasminogen activator for the therapy of cerebral ischemic stroke. Thus, the present study investigates the neuroprotective/anti-ischemic effect of a synthetic seco-nucleoside, LMT497 ((S)-2-((R)-1-(2-chloro-6-(3-iodobenzylamino)-9H-purin-9-yl)-2-hydroxyethoxy)-3-hydroxy-N-methylpropanamide) with little anti-platelet activity. LMT497 neither showed A3AR binding activity nor anti-platelet activity. In our present study LMT497 significantly attenuated the injury/death of cortical neurons exposed to oxygen-glucose deprivation (OGD) followed by re-oxygenation (R). LMT497 significantly reduced the ascending cellular level of reactive oxygen species under ischemic conditions by increasing the superoxide dismutase (SOD) levels. LMT497 also inhibited the migration of microglia which mediates inflammatory responses in ischemia. In rats subjected to middle cerebral artery occlusion (MCAO, 1.5 h) followed by reperfusion, LMT497 largely reduced brain infarction volume, and edema, and improved neurological score. Therapeutic efficacy of LMT497 was obtained by twice treatments even at 10 h and 18 h after the onset of ischemia. Collectively, LMT497 could be a therapeutic drug candidate with a wide therapeutic time window for the treatment of cerebral ischemic stroke.

Investigation of plasmid-mediated quinolone resistance in Pseudomonas aeruginosa clinical isolates.

Aims: To investigate plasmid‑mediated quinolone resistance in clinical isolates of Pseudomonas aeruginosa with the polymerase chain reaction (PCR). The plasmid‑mediated quinolone resistance genes have been identified in many bacteria within the Enterobactericeae family, they have not been detected in P. aeruginosa isolates. Subjects and Methods: Identification of the isolates and testing of antibiotic susceptibility was performed in Vitek2 Compact (Biomeriux, France) and Phoinex (BD, USA) automated systems. Screening for the qnrA, qnrB, qnrS, qnrC, aac (6′)‑Ib‑cr and qepA genes was carried out by PCR amplification and aac (6′)‑Ib‑cr DNA sequencing. Results: The qnr and the qepA genes were not detected in any of P. aeruginosa isolates. The aac (6’)‑Ib gene was detected in six of the isolates and positive isolates for aac (6’)‑Ib were sequenced for detection of the aac (6’)‑Ib‑cr variant but aac (6’)‑Ib‑cr was not detected in any isolates. Conclusions: Plasmid‑mediated quinolone resistance genes have so far not been identified in P. aeruginosa isolates. However, qnrB have detected in P. florescens and P. putida isolates. This is the first study conducted on the qnrA, qnrB, qnrS and qnrC genes as well as the qepA and aac (6’)‑Ib‑cr genes in P. aeruginosa clinical isolates.

Cost-utility analysis of treatments for stage IB cervical cancer / 부인종양

OBJECTIVE: To analyze the cost-utility of two common clinical practices for stage IB cervical cancer patients from provider and societal viewpoints. METHODS: A decision tree model was conducted to examine value for expenditure between the following: (1) radical hysterectomy with pelvic lymph node dissection (RHPLND) with or without postoperative adjuvant therapy according to the risk of recurrence and (2) concurrent chemoradiotherapy (CCRT). The relevant studies were identified to extract the probability data, and meta-analysis was performed. Direct medical costs were estimated from hospital database and medical records review. Direct non-medical costs and utility parameters were obtained through interviews with patients to estimate quality-adjusted life years (QALYs) outcome. The time horizon was according to the life expectancy of Thai women. RESULTS: From provider viewpoint, RHPLND and CCRT resulted in approximate costs of US $5,281 and US $5,218, respectively. The corresponding costs from societal viewpoint were US $6,533 and US $6,335, respectively. QALYs were 16.40 years for RHPLND and 15.94 years for CCRT. The estimated incremental cost effectiveness ratio of RHPLND in comparison to CCRT from provider and societal viewpoints were US $100/QALY and US $430/QALY, respectively. RHPLND had more cost-effectiveness than CCRT if patients did not need adjuvant therapy. The most effective parameter in model was a direct medical cost of CCRT. At the current ceiling ratio in Thailand, RHPLND provides better value for money than CCRT, with a probability of 75%. CONCLUSION: RHPLND is an efficient treatment for stage IB cervical cancer. This advantage is only for patients who require no adjuvant treatment.

Bernard Soulier Syndrome associated with acute myeloid leukemia.

Bernard Soulier Syndrome is a very rare congenital bleeding disorder characterized by deficiency in glycoprotein Ib (Gp Ib) which is vital for clot formation. We present a case of 21-year-old girl with onset of menorrhagia since 4 months. She was investigated and diagnosed to be a case of AML-M4 with associated Gp Ib deficiency.

Successful Endovascular Treatment of Delayed Type Ib Endoleak with Aortic Rupture after Endovascular Repair of Abdominal Aortic Aneurysm / 대한혈관외과학회지

Endovascular aneurysm repair (EVAR) has progressively become the preferred method for abdominal aortic aneurysm repair. Controlled studies have indicated that EVAR is related to decreased perioperative morbidity and mortality compared with open repair. However, long-term complications are more common. The most common complication following EVAR is an endoleak. Few studies on delayed type Ib endoleak with aortic rupture have been found in the literature. We report a case of a 92-year-old man with a delayed type Ib endoleak with aortic rupture that developed 7 years after EVAR. Lifelong surveillance after EVAR is mandatory.

The Concept of Zero Energy Intelligent Buildings (ZEIB): A Review of Sustainable Development for Future Cities.

It is noticed that intelligent buildings are aimed to consider social, environmental and economic values beside a substantial focus to the automated technological attributes. Due to many promising green building initiatives, the accelerated level of interests towards the applications of information technology and advanced control techniques in architecture design has been observed. With a viewpoint to the sustainable development of future cities, attributing the eventual impacts of climate change, various interrelated green building design approaches have been implemented. This study aims to elucidate the significant advancements of intelligent building design as a key constituent of eco-city development for creating greener and effective built environments. Current effort in this study is also geared toward considerable and practical implementations that were carried out in order to create buildings with zero energy consumption. Emphasis is placed upon reviewing the recent theories, attempts, implementations, and challenges towards the development of zero energy intelligent buildings (ZEIB). The findings inferred from the theoretical analysis confirm that the significant contribution of ZEIB concept will end up for the sustainable development of future eco-cities.

The first report of the qnrB19, qnrS1 and aac(6´)-Ib-cr genes in urinary isolates of ciprofloxacin-resistant Escherichia coli in Brazil

In this study, we investigated the presence of plasmid-mediated quinolone resistance (PMQR) genes among 101 ciprofloxacin-resistant urinary Escherichia coli isolates and searched for mutations in the quinolone-resistance-determining regions (QRDRs) of the DNA gyrase and topoisomerase IV genes in PMQR-carrying isolates. Eight isolates harboured the qnr and aac(6')-Ib-cr genes (3 qnrS1, 1 qnrB19 and 4 aac(6')-Ib-cr). A mutational analysis of the QRDRs in qnr and aac(6')-Ib-cr-positive isolates revealed mutations in gyrA, parC and parE that might be associated with high levels of resistance to quinolones. No mutation was detected in gyrB. Rare gyrA, parC and parE mutations were detected outside of the QRDRs. This is the first report of qnrB19, qnrS1 and aac(6')-Ib-cr -carrying E. coli isolates in Brazil.

Impact of coal mining on soil characteristics around Ib river coalfield, Orissa, India.

The present article deals with soil analysis around five opencast coal projects of Ib river coalfield during pre-monsoon (March), monsoon (July) and post monsoon (November) periods of successive three years (i.e., 2006, 2007 and 2008). Sampling of soil has been done from the vertical surface of the overburden at successive depths of 0-5 ft, 5-10 ft and at 10-15 ft. The different physical (soil texture, soil moisture, particle density, bulk density and porosity) and chemical (pH, organic carbon, nitrogen, phosphorus and potassium) parameters have been analysed. The soil textures of the study area are found to be loamy sand to loam, loam to silty loam and clay loam to silty clay loam in the depth of 0-5 ft, 5-10 ft and at 10-15 ft, respectively. The moisture content (7.297 at 0-5ft, 5.25 at 5-10 ft and 4.134% at 10-15 ft) and porosity (43.994 at 0-5ft, 40.682 at 5-10 ft and 35.85% at 10-15 ft) of the soil in the study area decreased gradually from the surface to greater depth. However, the particle density (2.639 at 0-5ft, 3.11 at 5-10 ft and 3.523 g cc-1 at 10-15 ft) and the bulk density (1.478 at 0-5ft, 1.839 at 5-10 ft and 2.269 g cc-1 at 10-15 ft) in this region increased from surface to the deeper region of the soil. The organic carbon (1.367 at 0-5ft, 0.9 at 5-10 ft and 0.396 kg ha-1 at 10-15 ft), nitrogen (2.845 at 0-5ft, 1.059 at 5-10 ft and 0.48 kg ha-1 at 10-15 ft) and phosphorus level (1.11 at 0-5ft, 0.715 at 5-10 ft and 0.679 kg ha-1 at 10-15 ft) of the soil decreased with increasing depth of the soil. However, the content of potassium (2.636 at 0-5ft, 4.374 at 5-10 ft and 5.82 kg ha-1 at 10-15 ft) increased gradually from the surface to the greater depth. Analysis of variance is computed to infer the variation in the concentration of parameters in different opencast coal projects and in various depths of the study area.

Comparison of outcomes between radical hysterectomy followed by tailored adjuvant therapy versus primary chemoradiation therapy in IB2 and IIA2 cervical cancer / 부인종양

OBJECTIVE: To compare survival outcomes and treatment-related morbidities between radical hysterectomy (RH) and primary chemoradiation therapy (CRT) in patients with bulky early-stage cervical cancer. METHODS: We selected 215 patients with stage IB2 and IIA2 cervical cancer (tumor diameter > 4 cm on magnetic resonance imaging) who underwent RH followed by tailored adjuvant therapy (n=147) or primary CRT (n=68) at two tertiary referral centers between 2001 and 2010. RESULTS: About twenty nine percent of patients were cured by RH alone and these patients experienced the best survival outcomes with the lowest morbidity rates. After the median follow-up times of 40 months, 27 RH (18.4%) and 20 CRT (29.4%) patients had recurrence (p=0.068) and 23 (15.6%) and 17 (25%) patients died of disease (p=0.101). The 5-year progression-free survival were 77% and 66% (p=0.047), and the 5-year overall survival were 78% and 67% (p=0.048) after RH and primary CRT, respectively. In multivariate analysis, patients who received primary CRT was at higher risk for tumor recurrence (odds ratio [OR], 2.26; 95% confidence interval [CI], 1.24 to 4.14; p=0.008) and death (OR, 3.02; 95% CI, 1.53 to 5.98; p=0.001) than those who received RH. Grade 3-4, early (17% vs. 30.9%, p=0.021) and late (1.4% vs. 8.8%, p=0.007) complications were significantly less frequent after RH than primary CRT. CONCLUSION: Thirty percent of patients were cured by RH alone. A treatment outcome was better in this retrospective study in terms of morbidity and survival. Randomized trials are needed to confirm this result.