Establishment and Stability of the Murine Oral Microbiome.

Commensal microbiomes exert critical functions at barrier sites. In particular, establishment of the commensal microbiome after birth dictates immune functionality and tissue homeostasis at mucosal surfaces. To investigate the establishment and stability of the oral mucosal microbiome in mice, we evaluated oral microbiome communities shortly after birth, through adulthood, and up to 1 y of life in a controlled manner, using sequential oral samples from the same mice over time. We further evaluated transmissibility of oral microbiomes from parents and during cohousing experiments and evaluated susceptibility to oral inflammatory disease in mice harboring distinct microbiomes. Our work reveals basic principles in the establishment and stability of a health-associated oral microbiome after birth and provides insights that may be important for host-microbiome experimentation in animal models.

Correction: Responses of deposition and bioaccumulation in the Great Lakes region to policy and other large-scale drivers of mercury emissions.

Correction for 'Responses of deposition and bioaccumulation in the Great Lakes region to policy and other large-scale drivers of mercury emissions' by J. A. Perlinger et al., Environ. Sci.: Processes Impacts, 2018, 20, 195-209.

Responses of deposition and bioaccumulation in the Great Lakes region to policy and other large-scale drivers of mercury emissions.

Mercury (Hg) emissions pose a global problem that requires global cooperation for a solution. However, neither emissions nor regulations are uniform world-wide, and hence the impacts of regulations are also likely to vary regionally. We report here an approach to model the effectiveness of regulations at different scales (local, regional, global) in reducing Hg deposition and fish Hg concentrations in the Laurentian Great Lakes (GL) region. The potential effects of global change on deposition are also modeled. We focus on one of the most vulnerable communities within the region, an Indigenous tribe in Michigan's Upper Peninsula (UP) with a high fish consumption rate. For the GL region, elements of global change (climate, biomass burning, land use) are projected to have modest impacts (<5% change from the year 2000) on Hg deposition. For this region, our estimate of the effects of elimination of anthropogenic emissions is a 70% decrease in deposition, while our minimal regulation scenario increases emissions by 35%. Existing policies have the potential to reduce deposition by 20% with most of the reduction attributable to U.S. policies. Local policies within the Great Lakes region show little effect, and global policy as embedded in the Minamata Convention is projected to decrease deposition by approximately 2.8%. Even within the GL region, effects of policy are not uniform; areas close to emission sources (Illinois, Indiana, Ohio, Pennsylvania) experience larger decreases in deposition than other areas including Michigan's UP. The UP landscape is highly sensitive to Hg deposition, with nearly 80% of lakes estimated to be impaired. Sensitivity to mercury is caused primarily by the region's abundant wetlands. None of the modeled policy scenarios are projected to reduce fish Hg concentrations to the target that would be safe for the local tribe. Regions like Michigan's UP that are highly sensitive to mercury deposition and that will see little reduction in deposition due to regulations require more aggressive policies to reduce emissions to achieve recovery. We highlight scientific uncertainties that continue to limit our ability to accurately predict fish Hg changes over time.

An exploratory study of the association of adrenergic and serotonergic genotype and gastrointestinal motor functions.

Adrenergic and serotonergic mechanisms alter human gut motor functions. Genotype variation influences phenotype. Our aim was to test the hypothesis that variation in genes that control these functions is associated with gastrointestinal (GI) motor functions in humans with functional GI disorders (FGID). A database of 251 people was assembled by combining genotype data with measurements of gut transit and gastric volumes. Genetic variations evaluated were: alpha(2A) adrenergic (C-1291G), alpha(2C) (Del 332-325), 5-HT transporter (SLC6A4) and GNbeta3 (C825T). We sought associations between motor function or disease groups and genotypes, adjusting for age, gender and body mass index. Among 251 participants, 82 were healthy, 20 with irritable bowel syndrome (IBS) with mixed bowel habit, 49 with constipation-predominant IBS, 67 with diarrhoea-predominant IBS and 33 with functional dyspepsia. For all candidate genes, there was no significant association between motor function and wildtype vs non-wildtype gene status. There were significant interactions between genotype and motility phenotype, specifically GNbeta3 and alpha(2A) and gastric emptying at 4 h. Borderline associations were noted for SCL6A4 and alpha(2A) and postprandial gastric volume, and for alpha(2C) and gastric emptying at 2 h. We conclude that genotype variation may affect gastric motor functions in different FGID phenotypes. However, these candidate genes account for only a limited amount of the variance in gastric function of patients with FGID.

Intestinal permeability and irritable bowel syndrome.

Based on a systematic PubMed search, this short review addresses why intestinal permeability may be important in the pathobiology of irritable bowel syndrome (IBS), the evidence of abnormal permeability in patients with IBS, and the pros and cons of the different probe molecules available to assess intestinal permeability. While a subgroup of patients with IBS appears to have evidence of increased intestinal permeability, improvements in the methods and validation are key to further research in this field in order to better understand intestinal barrier functions in IBS.

Interpreting transference in the supervision of psychoanalytic psychotherapy.

Supervisors of analytic psychotherapy have long wrestled with the question of whether interpretation has a legitimate role in dealing with supervisee countertransference and the transferences of the supervisory experience, itself. Currently, the majority view relies on didactic methods to deal with these transferences and avoids interpretation as incompatible with, even dangerous to, the supervisory task. This paper takes issue with this view and uses a clinical example to illustrate the impact and irreplaceable value of direct interpretation in supervision. It demonstrates that interpretation of a resistance in the supervisee can fundamentally and beneficially affect the therapeutic relationship, the supervisory process, and can have unanticipated diagnostic significance. It also demonstrates that, when applied with the same appropriateness and tact taken for granted in psychotherapy, concerns that supervisory interpretation will be traumatizing or counterproductive are unwarranted.

Improving the technique of nuclear cystography: the manometric approach.

A simple technique of manometric scintigraphic retrograde cystography was applied prospectively to 125 patients (85 per cent children) with 142 studies. 99mTechnetium sulfur colloid (0.5 to 1 mCi.) was instilled in the bladder followed by increments of normal saline under manometric control. The sensitivity of the test was increased when the filling phase was concluded at 25 cm. water pressure rather than when the patient complained of fullness (usually at 15 cm.). The studies had a voiding phase that was essential for patients in whom pressures greater than 15 cm. could not be achieved. Reflux was not detected on the voiding phase alone in 5 patients and the voiding phase could not be performed in 5 of 34 positive studies. It was not possible to predict volumes of fluid instilled to achieve satisfactory pressures. Monitoring during the entire study was necessary to diagnose reflux, which may occur at low or high pressure, or while voiding only.

Persistence of serum lipid abnormalities in children with idiopathic nephrotic syndrome.

We investigated the severity and duration of hyperlipidemia in 59 nephrotic children during relapse and remission. Serum total cholesterol and triglyceride values were greater than or equal to 95th percentile for age and sex in all patients with minimal change nephrotic syndrome in relapse and in patients with non-MCNS and persistent proteinuria. Most of these patients also had a significant elevation of low- and very-low-density lipoproteins. A significant number of children with MCNS during prolonged remission had elevated serum concentrations of total cholesterol (46%), triglycerides (42%), LDL (29%), and VLDL (40%). Persistence and severity of lipid changes correlated well with duration of disease and frequency of relapses. Significantly decreased HDL and HDL/LDL were found in patients with non-MCNS and persistent proteinuria. Our results suggest that nephrotic children may have prolonged periods of hyperlipidemia even after clinical remission. In addition, some of these children with significantly decreased HDL/LDL may be at increased risk of developing premature atherosclerosis.

Childhood systemic lupus erythematosus. Association with pancreatitis, subcutaneous fat necrosis, and calcinosis cutis.

Pancreatitis developed in a 12-year-old girl with a one-year history of systemic lupus erythematosus. The pancreatitis was first manifested by panniculitis of the lower extremities. Calcinosis cutis subsequently developed, both in areas of panniculitis and in areas free of panniculitis. The patient's medications at the time of onset of pancreatitis included prednisone, hydrochlorothiazide, and azathioprine, all of which have been reported to be causes of pancreatitis. We wish to alert physicians that pancreatitis associated with cutaneous panniculitis and calcinosis cutis may develop in children with systemic lupus erythematosus.

Funcion renal en el feto y en el recien nacido. / Kidney function in the fetus and in the newborn infant

Se presenta una revision de los diversos estados de desarrollo morfologico, fisiologico, metabolico y endocrinologico del rinon. Durante el desarrollo del embrion y en el periodo fetal temprano, las funciones excretoras, asi como de homeostasis hidrica y electrolitica, son manejadas principalmente por las membranas placentarias, actuando el amnios como reservorio de los productos de desecho. Despues que se establece la circulacion fetal se inician, tanto el flujo sanguineo renal, como la filtracion glomerular, los cuales se incrementan a medida que avanza el embarazo; los glomerulos que se desarrollan en primer termino son los de la zona yuxtamedular. El desarrollo de la funcion tubular es mas tardio que la glomerular. Este desequilibrio glomerulotubular persiste hasta el periodo de neonatal temprano. La capacidad limitada del neonato para concentrar, pero adecuada para diluir la orina, se correlaciona bastante bien con la composicion organica del neonato: expansion del volumen extracelular y relativa hipotonicidad intracelular. Se concluye que en el individuo normal, las necesidades homeostaticas del organismo se correlacionan adecuadamente con la funcion renal presente en las diversas etapas del desarrollo

Chronic renal failure in children: analysis of main causes and deterioration rate in 81 children.

Cause of chronic renal failure (CRF), age at clinical onset, and deterioration rate were studied in 81 unselected children 2 months to 18 years old who were referred to UM-JMH during a six-year period. Obstructive uropathies caused 42%, glomerulopathies 27%, renal hypoplasias 15%, and hereditary and vascular nephropathies 8%. Age at clinical onset of CRF was significantly lower in patients with obstructive uropathies (2.8 years) and renal hypoplasias (2.4 years) than in glomerulopathies (10.7 years). Deterioration rate correlated with cause of CRF; it was more rapid in primary glomerulopathies (4.1 years) and renal hypoplasias (4.2 years) than in obstructive uropathies (6.7 years). Within the six-year period, half the patients studied reached end-stage renal disease (ESRD). Final outcome did not seem to be modified significantly by corrective procedures. These findings suggest that major efforts should be directed toward identification of the etiopathogenesis of congenital nephropathies to prevent occurrence of CRF.

Prolonged nitroprusside and intermittent hemodialysis as therapy for intractable hypertension.

Nitroprusside was used with intermittent hemodialysis over a 26-day period in a 6-year-old boy with intractable hypertension. Hemodialysis effectively removed thiocyanate from the blood, thus preventing its accumulation and subsequent toxic manifestations. Prolonged nitroprusside infusion maintained arterial blood pressure at acceptable levels until the patient became responsive to other antihypertensive therapy.

Bone-methyl methacrylate interfacial shear strength: an experimental study of dogs.

Bone-methyl methacrylate interfacial shear strength at failure in chronically implanted hip prostheses was studied. Gorman total hip prostheses fixed with methyl methacrylate bone cement were implanted in 6 large dogs. Interface shear strength studies were performed at 8, 16, and 24 weeks. Mechanical testing determined that the mean interfacial shear strength was 15.2 +/- 13.0 kg/cm2. Variability of the data was too great to allow conclusions to be drawn from statistical analysis, but trends in the data were observed. It was concluded that the interfacial bond had sufficient strength to withstand axial loads 3 to 6 times greater than those applied under normal physiologic conditions.

Ventricular function following acute carbon monoxide exposure.

Cardiac output function curves were used to investigate the effects of carbon monoxide on the heart in the conscious dog. Each dog was briefly exposed to 1,500 ppm carbon monoxide through a permanent tracheostomy. Immediately upon attaining either 10%, 20%, or 30% HbCO a rapid infusion of Ringer's lactate was given to test cardiac capabilities. The combined effects of carbon monoxide and infusion produced significant increases in cardiac output, heart rate, mean left ventricular pressure, dP/dt and (dP/dt)/IP. Cardiac output was sufficient to prevent peripheral hypoxia at all HbCO levels; however, there was evidence of impending cardiac depression beginning at 20% HbCO.