Typical MR features and interpretation of perianal fistulas in patients with Crohn's disease.

Perianal fistulas in Crohn's disease (CD) are a poor prognostic phenotype requiring a combination of medical and surgical management. Perianal fistulas in CD are characterized by more complex and multi-branched fistulas, association with skin tags, and frequent presence of proctitis. A comprehensive approach with clinical examination, endoscopic and MR assessment is required, and in particular, MR interpretation provides detailed information on the type of fistula with its internal component and activity, secondary tracts and extension, internal, external openings, associated abscess, and presence of proctitis. Structured reporting of these items would be recommended for further discussion and management planning both at initial diagnosis and for disease monitoring during treatment follow-up. Management strategy would be individualized for each patient, and control of luminal disease activity could be an important determinant in the selection of treatment options. In this review, we provide an overview of the MRI evaluation of perianal fistulas in CD with a proposed structured MR report.

Ultrasonography of intrascrotal torsed appendages: size and interval between symptom onset and the ultrasonographic examination according to echogenicity.

PURPOSE: This study investigated the size of torsed appendages and the interval between symptom onset and the ultrasonographic examination according to the echogenicity of the torsed appendages. METHODS: This was a retrospective analysis of 54 cases in 46 patients with torsion of the testicular appendages between December 2008 and July 2021. Eight patients received follow-up ultrasonography 7-48 days after initial ultrasonography. The echogenicity of torsed appendages was classified into three groups: hypoechoic, hyperechoic, or isoechoic. RESULTS: The 54 torsed appendages were hypoechoic (n=40), hyperechoic (n=9), or isoechoic (n=5). The size of the torsed appendages ranged from 4 to 14 mm (8.0±3.1 mm) in hypoechoic torsed appendages and from 2.6 to 5.0 mm (3.7±0.9 mm) in hyperechoic torsed appendages. The interval between symptom onset and the ultrasonographic examination ranged from 0 to 17 days (4.2±4.4 days) in hypoechoic torsed appendages and from 8 to 48 days (29.8±16.0 days) in hyperechoic torsed appendages. The hyperechoic torsed appendages were smaller and had longer intervals between symptom onset and the ultrasonographic examination than the hypoechoic torsed appendages (P<0.05). Three hypoechoic torsed appendages and a single isoechoic torsed appendage on initial ultrasonography became hyperechoic on follow-up ultrasonography. CONCLUSION: The size of the torsed appendages and the interval between symptom onset and the ultrasonographic examination varied according to the echogenicity of the torsed appendages. The hyperechoic torsed appendages were smaller and had longer intervals until the examination than the hypoechoic torsed appendages.

Comparison of the Diagnostic Performance of Deep Learning Algorithms for Reducing the Time Required for COVID-19 RT-PCR Testing.

(1) Background: Rapid and accurate negative discrimination enables efficient management of scarce isolated bed resources and adequate patient accommodation in the majority of areas experiencing an explosion of confirmed cases due to Omicron mutations. Until now, methods for artificial intelligence or deep learning to replace time-consuming RT-PCR have relied on CXR, chest CT, blood test results, or clinical information. (2) Methods: We proposed and compared five different types of deep learning algorithms (RNN, LSTM, Bi-LSTM, GRU, and transformer) for reducing the time required for RT-PCR diagnosis by learning the change in fluorescence value derived over time during the RT-PCR process. (3) Results: Among the five deep learning algorithms capable of training time series data, Bi-LSTM and GRU were shown to be able to decrease the time required for RT-PCR diagnosis by half or by 25% without significantly impairing the diagnostic performance of the COVID-19 RT-PCR test. (4) Conclusions: The diagnostic performance of the model developed in this study when 40 cycles of RT-PCR are used for diagnosis shows the possibility of nearly halving the time required for RT-PCR diagnosis.

Free-Living Amoeba Vermamoeba vermiformis Induces Allergic Airway Inflammation.

The high percentage of Vermamoeba was found in tap water in Korea. This study investigated whether Vermamoeba induced allergic airway inflammation in mice. We selected 2 free-living amoebas (FLAs) isolated from tap water, which included Korean FLA 5 (KFA5; Vermamoeba vermiformis) and 21 (an homolog of Acanthamoeba lugdunensis KA/ E2). We axenically cultured KFA5 and KFA21. We applied approximately 1 × 106 to mice's nasal passages 6 times and investigated their pathogenicity. The airway resistance value was significantly increased after KFA5 and KFA21 treatments. The eosinophil recruitment and goblet cell hyperplasia were concomitantly observed in bronchial alveolar lavage (BAL) fluid and lung tissue in mice infected with KFA5 and KFA21. These infections also activated the Th2-related interleukin 25, thymic stromal lymphopoietin, and thymus and activation-regulated chemokines gene expression in mouse lung epithelial cells. The CD4+ interleukin 4+ cell population was increased in the lung, and the secretion of Th2-, Th17-, and Th1-associated cytokines were upregulated during KFA5 and KFA21 infection in the spleen, lung-draining lymph nodes, and BAL fluid. The pathogenicity (allergenicity) of KFA5 and KFA21 might not have drastically changed during the long-term in vitro culture. Our results suggested that Vermamoeba could elicit allergic airway inflammation and may be an airway allergen.

Comparison of Diagnostic Performance of Ultrasonography and Magnetic Resonance Enterography in the Assessment of Active Bowel Lesions in Patients with Crohn's Disease: A Systematic Review and Meta-Analysis.

We aimed to evaluate and compare the diagnostic performances of ultrasonography (US) and magnetic resonance enterography (MRE) in assessing active bowel lesions in patients with Crohn's disease (CD). MATERIALS AND METHODS: We searched PubMed and EMBASE for studies in which US and MRE were used to assess active bowel lesions in CD patients. Bivariate random effect meta-analytic methods were used to estimate pooled sensitivity, specificity, and hierarchical summary receiver operating characteristic (HSROC) curves. We performed a meta-regression analysis to explore the source of study heterogeneity. RESULTS: Eleven studies involving 752 patients were included. US exhibited a pooled sensitivity of 86% (95% confidence interval (CI) 72-94), pooled specificity of 88% (95% CI 78-94), and HSROC of 0.93 in 10 studies. MRE exhibited a pooled sensitivity of 88% (95% CI 76-95), pooled specificity of 87% (95% CI 73-95), and an HSROC of 0.94 in eight studies. In seven studies comparing the diagnostic performances of US and MRE, the summary sensitivity of US and MRE were 86% (95% CI 65-96, I2 = 92.1) and 86% (95% CI 72-93, I2 = 88.1) (p = 0.841), respectively. The summary specificity of US and MRE were 87% (95% CI 78-93, I2 = 79.8%) and 84% (72-90, I2 = 72.5%) (p = 0.431), respectively, which showed no statistical differences. On meta-regression analysis, studies from Europe (p = 0.002), those that used linear US probes (p = 0.012), those on small bowel lesions (p = 0.01), and those with outcomes as combined features (active inflammation) reported higher US sensitivity than those from other regions, those that used both linear and convex US probes, those on small and large bowels, and those with outcome as one feature (bowel wall thickening or ulcer). Studies with pediatric patients (p = 0.001), those with reference standards including US (p = 0.001), and outcomes as combined features (p = 0.01) reported higher MRE specificity than those with adult populations, reference standards other than the US, and outcomes as one feature. CONCLUSIONS: In spite of considerable heterogeneity in the included studies, both US and MRE can diagnose active bowel lesions with comparable diagnostic accuracy in patients with CD. The study region, type of US probe, lesion location, investigated outcome for US sensitivity and study population, reference standards, and investigated outcomes for MRE specificity were potential sources of heterogeneity.

The application of a deep learning system developed to reduce the time for RT-PCR in COVID-19 detection.

Reducing the time to diagnose COVID-19 helps to manage insufficient isolation-bed resources and adequately accommodate critically ill patients. There is currently no alternative method to real-time reverse transcriptase polymerase chain reaction (RT-PCR), which requires 40 cycles to diagnose COVID-19. We propose a deep learning (DL) model to improve the speed of COVID-19 RT-PCR diagnosis. We developed and tested a DL model using the long short-term memory method with a dataset of fluorescence values measured in each cycle of 5810 RT-PCR tests. Among the DL models developed here, the diagnostic performance of the 21st model showed an area under the receiver operating characteristic (AUROC), sensitivity, and specificity of 84.55%, 93.33%, and 75.72%, respectively. The diagnostic performance of the 24th model showed an AUROC, sensitivity, and specificity of 91.27%, 90.00%, and 92.54%, respectively.

Delay in childhood vaccinations during the COVID-19 pandemic.

OBJECTIVES: In many jurisdictions, routine medical care was reduced in response to the COVID-19 pandemic. The objective of this study was to determine whether the frequency of on-time routine childhood vaccinations among children age 0-2 years was lower following the COVID-19 declaration of emergency in Ontario, Canada, on March 17, 2020, compared to prior to the pandemic. METHODS: We conducted a longitudinal cohort study of healthy children aged 0-2 years participating in the TARGet Kids! primary care research network in Toronto, Canada. A logistic mixed effects regression model was used to determine odds ratios (ORs) for delayed vaccination (> 30 days vs. ≤ 30 days from the recommended date) before and after the COVID-19 declaration of emergency, adjusted for confounding variables. A Cox proportional hazards model was used to explore the relationship between the declaration of emergency and time to vaccination. RESULTS: Among 1277 children, the proportion of on-time vaccinations was 81.8% prior to the COVID-19 declaration of emergency and 62.1% after (p < 0.001). The odds of delayed vaccination increased (odds ratio = 3.77, 95% CI: 2.86-4.96), and the hazard of administration of recommended vaccinations decreased after the declaration of emergency (hazard ratio = 0.75, 95% CI: 0.60-0.92). The median vaccination delay time was 5 days (95% CI: 4-5 days) prior to the declaration of emergency and 17 days (95% CI: 12-22 days) after. CONCLUSION: The frequency of on-time routine childhood vaccinations was lower during the first wave of the COVID-19 pandemic. Sustained delays in routine vaccinations may lead to an increase in rates of vaccine-preventable diseases.

RéSUMé: OBJECTIFS: Dans plusieurs juridictions, les soins médicaux systématiques étaient réduits à cause de la pandémie de COVID-19. L'objectif de cette étude était de déterminer si la fréquence de donner les vaccinations systématiques aux enfants de l'âge de 0 à 2 ans était réduite en conséquence de la déclaration d'urgence de COVID-19 en Ontario, Canada dès le 17 mars 2020, comparer avec la fréquence avant la pandémie. MéTHODES: Nous avons mené une étude de cohorte longitudinale des enfants en bonne santé âgés de 0 à 2 ans qui participent dans le réseau de recherche en soins primaires TARGet Kids! à Toronto, Canada. Un modèle de régression logistique à effets mixtes était utilisé pour déterminer le rapport de cotes (RC) pour les vaccinations retardées (> 30 jours c. ≤ 30 jours de la date recommandée) et était équilibré pour les variables confondantes. Le modèle à risques proportionnels de Cox était utilisé pour examiner le lien entre la déclaration d'urgence et le temps jusqu'à la vaccination. RéSULTATS: Parmi 1 277 enfants, la proportion de vaccination à l'heure était 81,8 % avant la déclaration d'urgence de COVID-19 et 62,1 % après (p < 0,001). La possibilité de vaccination retardée était augmentée (RC = 3,77; IC95% : 2,86­4,96), et le taux d'administration recommandé pour les vaccinations était réduit après la déclaration d'urgence (ratio de hasard = 0,75; IC95% : 0,60­0,92). Le médian temps de retard pour les vaccinations était 5 jours (IC95% : 4­5 jours) avant la déclaration d'urgence et 17 jours (IC95% : 12­22 jours) après. CONCLUSION: La fréquence de vaccinations systématiques aux enfants à l'heure était inférieure pendant la première vague de la pandémie COVID-19. Des retards soutenus pour recevoir les vaccinations systématiques peuvent entrainer une augmentation des taux de maladies évitables par la vaccination.

The Relationship between Social Norms, Avoidance, Future Orientation, and Willingness to Engage in Climate Change Advocacy Communications.

This study examined factors associated with willingness to engage in communication behaviors related to climate change advocacy. Data were collected as part of an online, longitudinal US study beginning in March 2020. Outcomes included willingness to post materials online, contact state legislators, and talk with peers about climate change. Covariates included climate change-related social norms, avoidance of climate change information, and perceptions of the future impact of climate change. A minority of the 586 respondents (23%) reported regular conversations about climate change, while approximately half of the respondents reported willingness to discuss climate change with peers (58%), post materials online (47%), and contact state legislators (46%). Strong predictors of willingness to engage in each climate change communications behaviors included climate change social norms, not avoiding climate change information, and believing that climate change will have a negative impact on the future. Findings indicate the importance of designing programs to foster increased climate change communications in order to promote community-level climate change advocacy norms.

Ultrasonography of the distal common bile duct: An easy-to-perform technique for better visualization.

BACKGROUND AND STUDY AIMS: No standard ultrasonography (US) method exists for visualizing the distal common bile duct (CBD). The supine HD view is usually adopted for CBD evaluation, but duodenal or colonic gas shadowing can affect this view. PATIENTS AND METHODS: We developed and evaluated an easy-to-perform technique, the supine distal CBD view, applying the US protocol for the distal CBD evaluation. Five reviewers checked the visibility of the distal CBD and cystic duct, as well as each view's image quality and influencing factors. RESULTS: The visibility of the distal CBD was enhanced on the supine distal CBD view (86.0%-94.6%) versus the supine hepatoduodenal view (40.8%-82.1%), with less variability among the reviewers. The image quality of the supine distal CBD view was superior to that of the supine HD view (2.52 ± 0.67 vs. 1.93 ± 0.86, respectively; p < 0.01). The depth of the distal CBD from the surface was significantly larger in the patients with nonvisible distal CBDs. CONCLUSION: We present a user-friendly, easy-to-perform US view for locating and visualizing the distal CBD. With this technique, the distal CBD can be evaluated without changing a patient's position or increasing the duration of the procedure.

Correlates of Levels of Willingness to Engage in Climate Change Actions in the United States.

While the majority of the American public believe climate change is occurring and are worried, few are engaged in climate change action. In this study, we assessed factors associated with the level of willingness to engage in climate change actions using an online, longitudinal US study of adults. Climate change action outcomes included the level of willingness to post materials online, take political actions, talk with peers about climate change, and donate to or help an organization. Predictors included climate change attitudes, environmental attitudes, political ideology, political party affiliation, and demographic variables. Most (72%) of the 644 respondents only talked about climate change with peers a few times a year or less, though 65% were very or extremely worried about climate change. Many respondents indicated a willingness to do somewhat or a lot more, from 38% willing to talk to peers to 25% for willing to take political actions. In multinomial regression models, the Climate Change Concern scale was strongly and consistently associated with willingness to engage in climate change action. These findings indicate a need to both identify those who are willing to act and finding activities that fit with their interests and availability.

Extracellular vesicles of Echinococcus granulosus have therapeutic effects in allergic airway inflammation.

BACKGROUND: Previous studies have shown that Echinococcus granulosus cystic fluid can alleviate Th2 allergic airway inflammatory responses by increasing the number of CD4+ CD25+ Foxp3+ T (regulatory T; Treg) cells. Parasite-derived extracellular vesicles (EV) are known to not only promote parasite infection by communicating between parasites but also regulate the inflammatory response by acting as an immunomodulatory agent in the host. METHODS: To evaluate the effect of EV extracted from the cystic fluid of E. granulosus on allergic airway inflammation, gene expression was investigated after administering EV to mouse lung epithelial cells (MLE-12) following 2 h of pretreatment with Aspergillus proteins. An allergic airway inflammation animal model was used to investigate the regulation of the inflammatory response by EV and induced with ovalbumin. RESULTS: EV treatment significantly reduced airway resistance and the number of eosinophils and other immune cells in the bronchoalveolar lavage fluid and Th2- and Th17-related cytokine levels. EV pretreatment decreased the number of IL-4+ CD4+ T cells and increased the number of Treg cells in the lung-draining lymph nodes and spleen. CONCLUSIONS: Echinococcus granulosus cystic fluid derived EV ameliorated Th2 allergic airway inflammatory through Treg cells, similar to whole cystic fluid treatment. Thus, EV may be important immunomodulatory molecules in cystic fluid.

Trichinella spiralis infection ameliorated diet-induced obesity model in mice.

Obesity is an increasingly prevalent disease worldwide, and genetic and environmental factors are known to regulate the development of obesity and associated metabolic diseases. Emerging studies indicate that innate and adaptive immune cell responses in adipose tissue play critical roles in the regulation of metabolic homeostasis. Parasitic helminths are the strongest natural inducers of type 2 inflammatory responses, and several studies have revealed that helminth infections inversely correlate with metabolic syndrome. Hence, this study investigated whether helminth infections could have preventative effects on high fat diet-induced obesity. Female C57BL/6 mice were maintained on either a low fat diet (LFD, 10% fat) or a high fat diet (HFD, 60% fat) for 6 weeks after Trichinella spiralis infection. The mice were randomly divided into four groups and were fed a normal diet, LFD, LFD after T. spiralis infection (Inf + LFD), a high fat diet (HFD), or HFD after T. spiralis infection (HFD + inf). All groups were assayed for body weight, food efficiency ratio (FER), total body weight gain (g)/total food intake amount (g) fat weight, and blood biochemical parameters. Our data indicate that the HFD + inf group significantly reduced body weight gain, fat mass, total cholesterol, and FER. Analysis of immune cell composition by flow cytometry revealed that T. spiralis promoted strong decreases in proinflammatory adipose macrophages (F4/80+CD11c+) and T cells. The alterations in microbiota from fecal samples of mice were analyzed, which showed that T. spiralis infection decreased the ratio of Firmicutes to Bacteriodetes, thereby restoring the previously increased ratio of Firmicutes to Bacteriodetes in HFD-fed mice. Moreover, elimination of T. spiralis retained the protective effects in the HFD-fed obese mice whereas flubendazole (FLBZ) treatment increased levels of the families Lachnospiraceae and Ruminococcaceae. In summary, we provided novel data suggesting that helminth infection protects against obesity and the protection was closely related to M2 macrophage proliferation, an inhibiting proinflammatory response. In addition, it alters the microbiota in the gut.

Differences in nurses' perceptions of self-reported pain and the administered morphine dose according to the patient's facial expression in Korea

PURPOSE: This study aimed to compare nurses' perceptions of self-reported pain, the recorded pain score, and pain treatment according to the patient's facial expression. METHODS: In this descriptive cross-sectional survey, the participants were 472 nurses working at a tertiary hospital in Seoul, Korea. A self-report questionnaire presented nurses with a smiling patient complaining of acute post-surgical pain and a grimacing patient with cancer pain, both of whom reported a pain level of 8 out of 10, and asked nurses to indicate their perception of the pain intensity, the pain score that they would record, and the medication that they would provide for each patient. RESULTS: The pain intensity perceived by nurses for the grimacing patient was significantly higher than that for the smiling patient (P<0.001). The recorded pain score was likewise significantly higher for the grimacing patient than for the smiling patient (P<0.001). There was a significant difference in the amount of morphine chosen by the nurses for pain interventions between the smiling and grimacing patients (P=0.040). Higher perceived pain intensity and score were associated with higher administered doses of morphine. CONCLUSION: These findings suggest that nurses might be affected by patients' facial expressions when treating pain. A pain management program should be developed that trains nurses to accurately recognize pain hidden in patients' faces and provides them with the knowledge of how to appropriately assess and manage patients' pain.

Effects of lifelong spontaneous exercise on the M1/M2 macrophage polarization ratio and gene expression in adipose tissue of super-aged mice.

In the adipose tissue (AT), an increase in the M1 macrophage (M1Ø)/M2 macrophage (M2Ø) polarization ratio can be a risk factor enhancing the inflammatory response during aging, as well as increasing the risk of chronic disease, thereby reducing lifespan, or at least reducing "healthy" lifespan. The purpose of this study was to analyze and compare the AT M1Ø/M2Ø polarization ratio at the final lifespan stage in aged and control animals performing lifelong spontaneous wheel running. Based on flow cytometric analysis, the AT ratio of macrophages revealed M2Ø polarization following lifelong spontaneous exercise (LSE) regardless of age. However, for Icam1 and Tnf, the qPCR analysis showed no difference in gene expressions in young mice; Arg1 expression was higher in Young-EXE (exercising) than in Young-CON (control) mice (p < .0001). In Old-EXE, Icam1 (p < .0001) and Tnf (p < .0001) expression were lower than in Old-CON; for Arg1, gene expression in Old-EXE was higher than in Old-CON (p < .0001). LSE prevents deterioration of physical fitness owing to aging, maintaining high M2Ø polarization levels in the AT. Additionally, LSE does not downregulate Icam1 and Tnf in the AT but appears to suppress the increased M1Ø polarization ratio attributed to aging by upregulating Arg1.

Identification of Free-Living Amoebas in Tap Water of Buildings with Storage Tanks in Korea.

Free-living amoebas (FLAs) can cause severe disease in humans and animals when they become infected. However, there are no accurate survey reports on the prevalence of FLAs in Korea. In this study, we collected 163 tap water samples from buildings, apartments, and restrooms of highway service areas in 7 Korean provinces with high population density. All these buildings and facilities have water storage tanks in common. The survey was separated into categories of buildings, apartments, and highway service areas. Five hundred milliliters of tap water from each building was collected and filtered with 0.2 µm pore filter paper. The filters were incubated in agar plates with heated E. coli at 25°C. After axenization, genomic DNA was collected from each FLA, and species classification was performed using partial 18S-rDNA PCR-sequencing analysis. We found that 12.9% of tap water from buildings with storage tanks in Korea was contaminated with FLAs. The highway service areas had the highest contamination rate at 33.3%. All of the FLAs, except one, were genetically similar to Vermamoeba vermiformis (Hartmannella vermiformis). The remaining FLA (KFA21) was very similar to Acanthamoeba lugdunensis (KA/E26). Although cases of human infection by V. vermiformis are very rare, we must pay attention to the fact that one-third of tap water supplies in highway service areas have been contaminated.

Differences in macrophage polarization in the adipose tissue of obese mice under various levels of exercise intensity.

Animal studies have demonstrated that the ratio of M1 (M1Φ) to M2 (M2Φ) macrophage-specific gene expression in adipose tissue (AT) may be altered by chronic exercise; however, whether macrophage polarization is induced under these conditions has not yet been reported. Therefore, this study aimed to investigate the effect of chronic exercise on M1Φ/M2Φ polarization in the AT of high-fat diet (HFD)-induced obese mice. Exercise-induced differences in M1Φ/M2Φ polarization were verified via an exercise intensity study (EIS) in which different levels of exercise intensity were evaluated. Obesity was induced in male C57BL/6 J mice by feeding them with an HFD for 6 weeks. The study consisted of four groups: control group (CON), HFD-fed group (HFD), HFD-fed with exercise group (HFD + EXE), dietary conversion from HFD to normal diet (ND) group (DC), and dietary conversion from HFD to ND group (DC + EXE). For EIS, the HFD + EXE group was divided into three subgroups: low- (LI), mid- (MI), and high- (HI) intensity exercise. The total intervention period was 8 weeks. M1Φ/M2Φ polarization was confirmed by flow cytometry. M2Φ polarization in the AT of obese mice was significantly higher in HFD + EXE mice than in HFD mice, despite the HFD intake. In the EIS, M2Φ polarization was most pronounced in HFD + EXE-HI mice than in HFD mice. It can be proposed that the enhanced insulin resistance and inflammation by obesity can be improved by the increase of M2Φ polarization which is achieved by relatively high-intensity exercise.

Experience and Satisfaction of Cancer Patients With a Central Venous Catheter at a Tertiary Hospital in South Korea.

As cancer chemotherapy transitions from inpatient care to outpatient care, the number of patients who receive a central venous catheter (CVC) and the interest in CVCs as a safe intravenous administration route have increased recently in South Korea. The purpose of this study was to investigate the discomforts and satisfaction that cancer patients with a CVC may experience in daily activities as an outpatient and to provide rationale for nursing interventions. Data collection was conducted between April 11, 2011, and August 31, 2011. Forty-three questionnaires were collected, and a total of 41 questionnaires were used for the final analysis. The mean age of patients was 45.1 years (SD = 11.1 years; range, 18-64 years). The average score of experience of the CVC insertion procedure, daily life experiences of patients with a CVC, the satisfaction and fear of using a CVC, and the acceptance of CVCs were 2.48 ± 0.56, 2.18 ± 0.50, 2.56 ± 0.49, and 2.35 ± 0.39, respectively. The results showed that more detailed information on CVCs, as well as sufficient emotional support, should be provided to the patient to minimize discomfort during CVC insertion. Patient-centered education helps empower patients to master CVC self-management, as well as an understanding of the cultural aspect of South Korean patients who practice the traditional Confucian ethics of "unaltering one's body" and are therefore reluctant to have CVCs inserted into their bodies.

Adoptive transfer of Trichinella spiralis-activated macrophages can ameliorate both Th1- and Th2-activated inflammation in murine models.

Trichinella spiralis is a zoonotic nematode and food borne parasite and infection with T. spiralis leads to suppression of the host immune response and other immunopathologies. Alternative activated macrophages (M2) as well as Treg cells, a target for immunomodulation by the helminth parasite, play a critical role in initiating and modulating the host immune response to parasite. The precise mechanism by which helminths modulate host immune response is not fully understood. To determine the functions of parasite-induced M2 macrophages, we compared the effects of M1 and M2 macrophages obtained from Trichinella spiralis-infected mice with those of T. spiralis excretory/secretory (ES) protein-treated macrophages on experimental intestinal inflammation and allergic airway inflammation. T. spiralis infection induced M2 macrophage polarization by increasing the expression of CD206, ARG1, and Fizz2. In a single application, we introduced macrophages obtained from T. spiralis-infected mice and T. spiralis ES protein-treated macrophages into mice tail veins before the induction of dextran sulfate sodium (DSS)-induced colitis, ovalbumin (OVA)-alum sensitization, and OVA challenge. Colitis severity was assessed by determining the severity of colitis symptoms, colon length, histopathologic parameters, and Th1-related inflammatory cytokine levels. Compared with the DSS-colitis group, T. spiralis-infected mice and T. spiralis ES protein-treated macrophages showed significantly lower disease activity index (DAI) at sacrifice and smaller reductions of body weight and proinflammatory cytokine level. The severity of allergic airway inflammation was assessed by determining the severity of symptoms of inflammation, airway hyperresponsiveness (AHR), differential cell counts, histopathologic parameters, and levels of Th2-related inflammatory cytokines. Severe allergic airway inflammation was induced after OVA-alum sensitization and OVA challenge, which significantly increased Th2-related cytokine levels, eosinophil infiltration, and goblet cell hyperplasia in the lung. However, these severe allergic symptoms were significantly decreased in T. spiralis-infected mice and T. spiralis ES protein-treated macrophages. Helminth infection and helminth ES proteins induce M2 macrophages. Adoptive transfer of macrophages obtained from helminth-infected mice and helminth ES protein-activated macrophages is an effective treatment for preventing and treating airway allergy in mice and is promising as a therapeutic for treating inflammatory diseases.

[Perception on Parental Coping on Unintentional Injury of Their Early Infants and Toddlers: Q Methodological Approach].

PURPOSE: The purpose of this study was to identify parental coping strategies in the face of early infant and toddler injury, and to provide basic data for a parental education program and the most desirable directions it should take. METHODS: A Q-methodology to analyze the subjectivity of each item was used. Thirty-four Q-statements were derived from a literature review and interviews. Forty-seven parents were classified into a shape of normal distribution using a 9-point scale. Collected data were analyzed by the pc-QUANL program. RESULTS: Five types of parental coping in early infant and toddler injury were identified. Type I was "hospital treatment focused", type II was "Improving the safety of the child's environment", type III was "expression of negative emotion", type IV was "taking the lead in problem solving", and type V was "Interrogating the person in charge of the situation in which the injury occurred". CONCLUSION: The results of this study indicate that different approaches to educational programs can be used for parents in early childhood injury.