The fate of indefinite and low-grade dysplasia in ulcerative colitis and primary sclerosing cholangitis colitis before and after liver transplantation.

BACKGROUND: Patients with primary sclerosing cholangitis (PSC) and ulcerative colitis (UC) are at an increased risk of colorectal neoplasia, but it is unknown if liver transplantation (LT) alters neoplasia progression. AIM: To examine the natural history of indefinite dysplasia (IND) and low-grade dysplasia (LGD) that develop in patients with PSC-UC with and without LT. METHODS: We performed a retrospective review of patients with PSC and UC evaluated at our institution between 1993 and 2011 who were diagnosed with IND or LGD before or after LT for PSC. The primary end point was neoplasia progression or persistent LGD. RESULTS: Ninety-six patients (non-LT n = 63, LT n = 33) were examined. For the IND group, multifocal lesions were significantly associated with time to neoplasia progression [hazard ratio (HR), 3.5; 95% confidence interval (CI), 1.3-9.7], while 5-aminosalicylate (5-ASA) use was protective (HR, 0.2; 95% CI, 0.1-0.6). For patients with LGD, multifocal lesions were significantly associated with the primary end point (HR, 7.1; 95% CI, 1.7-28.3), while LT was protective (HR, 0.3; 95% CI, 0.1-0.9). CONCLUSIONS: In PSC-UC patients with IND, 5-ASA use was associated with a decreased the risk of neoplasia progression, regardless of transplant status. In contrast, multifocal IND and LGD were associated with neoplasia progression or persistent LGD. Patients who developed LGD following LT for PSC were less likely to have progressive neoplasia or persistent LGD, compared with those who had not been transplanted.

Advances towards a Marker-Assisted Selection Breeding Program in Prairie Cordgrass, a Biomass Crop.

Prairie cordgrass (Spartina pectinata Bosc ex Link) is an indigenous, perennial grass of North America that is being developed into a cellulosic biomass crop suitable for biofuel production. Limited research has been performed into the breeding of prairie cordgrass; this research details an initial investigation into the development of a breeding program for this species. Genomic libraries enriched for four simple sequence repeat (SSR) motifs were developed, 25 clones from each library were sequenced, identifying 70 SSR regions, and primers were developed for these regions, 35 of which were amplified under standard PCR conditions. These SSR markers were used to validate the crossing methodology of prairie cordgrass and it was found that crosses between two plants occurred without the need for emasculation. The successful cross between two clones of prairie cordgrass indicates that this species is not self-incompatible. The results from this research will be used to instigate the production of a molecular map of prairie cordgrass which can be used to incorporate marker-assisted selection (MAS) protocols into a breeding program to improve this species for cellulosic biomass production.

Endoscopic ablative therapy for Barrett's esophagus: a potential cause of eosinophilic esophagitis.

Markedly increased esophageal eosinophils are associated with allergy- or reflux-based eosinophilic esophagitis. Other known disorders that cause this entity are unusual. To characterize the clinical, endoscopic, and histological findings of patients who develop marked esophageal eosinophilic infiltration after ablative therapy for Barrett's dysplasia. All patients who underwent endoscopic ablation of Barrett's esophagus between 1991 and 2009 with photodynamic therapy or radio frequency were screened for a pathologic descriptor of 'eosinophils' on biopsy. Patients whose biopsies demonstrated >15 eosinophils per high power (HPF) field in squamous epithelium after ablation were reviewed and included in the study group. Thirteen of 385 (3.4%) patients underwent ablation for Barrett's esophagus and subsequently had large numbers of intraepithelial eosinophils. All patients had long segment Barrett's (mean 8.0 cm) with low- or high-grade dysplasia or adenocarcinoma. All had undergone photodynamic therapy as their form of ablation. No patients had typical symptoms or endoscopic findings of eosinophilic esophagitis. Eleven patients were on proton pump inhibitors. The time between ablation and onset of esophageal eosinophilia ranged from 83 to 692 days. Intraepithelial eosinophil counts ranged from 30 to 150/HPF (mean 90). The majority of cases showed eosinophilic degranulation, spongiosis, increased papillary height, and basal zone thickening. The natural history of esophageal eosinophilia was variable after ablation, persisting consistently or sporadically on biopsy for up to 6 years. Ablation for Barrett's dysplasia can be followed rarely by eosinophil infiltrates with a histological resemblance to allergy-based eosinophilic esophagitis, but lacking dysphagia. The pathophysiology is unknown.

Management of warm-season grass mixtures for biomass production in South Dakota USA.

Switchgrass (Panicum virgatum L.), big bluestem (Andropogon gerardii Vitman), and indiangrass (Sorghastrum nutans (L.) Nash) are native warm-season grasses commonly used for pasture, hay, and conservation. More recently switchgrass has also been identified as a potential biomass energy crop, but management of mixtures of these species for biomass is not well documented. Therefore, the objectives of our study were to: (1) determine the effects of harvest timing and N rate on yield and biomass characteristics of established warm-season grass stands containing a mixture of switchgrass, big bluestem, and indiangrass, and (2) evaluate the impact of harvest management on species composition. Five N rates (0, 56, 112, and 224 kg ha(-1) applied annually in spring and 224 kg ha(-1) evenly split between spring and fall) and two harvest timings (anthesis and killing frost) were applied to plots at two South Dakota USA locations from 2001 to 2003. Harvesting once a year shortly after a killing frost produced the greatest yields with high concentrations of neutral detergent fiber (NDF), acid detergent fiber (ADF), and acid detergent lignin (ADL) along with lower concentrations of total nitrogen (TN) and ash. This harvest timing also allowed for the greatest percentage of desirable species while maintaining low grass weed percentages. While N rates of 56 and 112 kg ha(-1) tended to increase total biomass without promoting severe invasion of grass and broadleaf weed species, N application did not always result in significant increases in biomass production. Based on these results, mixtures of switchgrass and big bluestem were well suited for sustainable biomass energy production. Furthermore, N requirements of these mixtures were relatively low thus reducing production input costs.

The Second Chance Club: repeat adolescent pregnancy prevention with a school-based intervention.

The Second Chance Club, a high school-based intervention for pregnant and parenting adolescents, was evaluated to determine the repeat birth rate among participants. A retrospective case-controlled cohort study was conducted (participants, n = 50; control subjects, n = 255) over 3 years after enrollment in the intervention. Repeat births occurred in 3/50 (6%) of participants and 95/255 (37%) of controls (p <.05).

Use of the BULIT bulimia screening questionnaire to assess risk and progress in weight management for overweight women who weight cycle. BULImia Test.

A bulimia screening questionnaire was examined for usefulness in assessing risk for bulimia and measuring progress in reducing binge eating in overweight women who weight cycle. In two studies the BULIT test was used to screen for risk for bulimia. Study 1 was a descriptive study of motivations for overeating in normal weight women compared to overweight women who weight cycled. In Study 2, overweight women who weight cycled were examined at baseline, 6, and 12 months for effectiveness of a clinical treatment strategy to reduce binge eating. In Study 1, BULIT scores were statistically significantly higher for overweight compared to normal weight subjects. In Study 2, subjects' BULIT scores were lower after using a long term clinical treatment strategy to gain control of eating. The BULIT test was useful for specifying four categories of eating patterns to assess risk for bulimia and progress in reducing binge eating.

Near death of a woman stung by red imported fire ants: management of anaphylaxis.

Patients with allergic reactions to RIFA should be instructed in avoidance of RIFA and in the administration of epinephrine, given emergency identification information, and referred to an allergist for definitive diagnosis and for desensitization as indicated. RIFA are a growing menace in this country; as their habitat steadily extends north and west, no doubt a growing number of people will be affected by them. Their sting can be acutely life threatening and, as in this one case example, a severe reaction can profoundly affect the life of the victim.

Underrecognition of morbidity from stings of the red imported fire ant in the southeastern United States.

This cross-sectional study was conducted to determine the health-seeking behaviors of a group of patients stung by red imported fire ants (RIFA) and the number of nursing referrals resulting in treatment. The following two research questions were asked: (1) Is there a delay in seeking the care of a board-certified allergist for symptoms of fire ant hypersensitivity? (2) Are nurses referring patients for treatment? The entire population of board-certified allergists in Alabama, Georgia, and South Carolina (n = 98) was sampled. A questionnaire was developed for the office nurses to use to collect information from allergy patients actually receiving fire ant injections (n = 257). Each patient reported on the reaction, when it occurred as well as age, sex, and county of residence. Descriptive statistics revealed that a delay of a month or more in seeking care of an allergist was experienced by 154 (56%) of patients who completed the questionnaire. The average delay was 1.8 years. The main source of referrals was a general practitioner or emergency room personnel. Nursing and other health professionals must recognize the problem and to institute prompt referral for treatment. In areas where RIFA colonies are spreading, they have to be fully informed and trained in effective primary and secondary techniques to prevent serious reaction to the stings of these ants.

Alteration of pulsatile growth hormone secretion by growth-inducing exercise: involvement of endogenous opiates and somatostatin.

Our aim was to examine whether 1) growth-inducing exercise altered the pulsatile pattern of GH release, 2) endogenous opiates mediated these changes, and 3) endogenous somatostatin (SRIF) suppressed pulsatile GH secretion in slowly growing sedentary hamsters. To that end, mature female hamsters were either exposed to 2 weeks of voluntary running or prevented from engaging in running activity. Intracardiac catheters were inserted to allow blood collection every 20 min during 6 h. GH and PRL secretory patterns were determined with homologous RIAs for hamster hormones after administration of saline, naloxone, or anti-SRIF serum. It was found that exercise accelerated somatic growth. GH pulse frequency and amplitude were significantly higher in rapidly growing hamsters. The rate of growth was inversely related to basal trough values of GH and PRL. Opiate receptor blockade reduced GH pulse frequency and amplitude to below sedentary values and did not affect PRL secretion. Anti-SRIF serum increased GH pulse frequency and amplitude in naloxone- as well as in saline-injected animals. Our results are consistent with the conclusions that 1) rapid growth, spontaneous or induced by exercise, is associated with increased GH pulse frequency and amplitude and decreased GH and PRL baseline concentrations in hamsters; 2) endogenous SRIF inhibits pulsatile GH secretion in slowly growing hamsters; and 3) endogenous opiates mediate increases in GH pulse frequency and amplitude in rapidly growing hamsters by antagonizing the endogenous SRIF action.