Epidemiology of Musculoskeletal Tuberculosis in an Area with High Disease Prevalence

Michael F. G. Held,Sven Hoppe,Maritz Laubscher,Stewart Mears,Stewart Dix-Peek,Heather J. Zar,Robert N. Dunn 대한척추외과학회 2017 Asian Spine Journal Vol.11 No.3

Study Design: Retrospective observational study. Purpose: The aim of this study was to assess the distribution of age and site of infection in patients with musculoskeletal tuberculosis (TB) and determine the number of TB/human immunodeficiency virus (HIV) coinfections as well as the incidence of multidrugresistant (MDR) TB. Overview of Literature: Of all TB cases, 1%–3% show skeletal system involvement and 30% are HIV coinfected. Although the reported distribution of skeletal TB is majorly in the spine, followed by the hip, knee, and foot/ankle, the epidemiology of extrapulmonary TB and especially musculoskeletal TB remains largely unknown, particularly in areas with a high prevalence of the disease. Methods: This is a retrospective study of a consecutive series of patients admitted to a tertiary care facility in an area with the highest prevalence of TB worldwide. TB was confirmed on tissue biopsy with polymerase chain reaction testing (Xpert for Mycobacterium tuberculosis and rifampicin resistance), culturing, or histological analysis. Data were analyzed regarding demographic information, location of the disease, HIV coinfections, and drug resistance. Results: In all, 125 patients (44 children; 35%) with a mean age of 27 years (range, 1–78 years) were included. Age peaks were observed at 5, 25, and 65 years. Spinal disease was evident in 98 patients (78%). There were 66 HIV-negative (53%) and 29 (23%) HIVpositive patients, and in 30 (24%), the HIV status was unknown. Five patients (4%) showed MDR TB. Conclusions: The age distribution was trimodal, spinal disease was predominant, MDR TB rate in our cohort was high, and a large portion of TB patients in our hospital were HIV coinfected. Hence, spinal services with sufficient access to operating facilities are required for tertiary care facilities in areas with a high TB prevalence.

Towards a Comprehensive Catalog of Zebrafish Behavior 1.0 and Beyond

Kalueff, Allan V.,Gebhardt, Michael,Stewart, Adam Michael,Cachat, Jonathan M.,Brimmer, Mallorie,Chawla, Jonathan S.,Craddock, Cassandra,Kyzar, Evan J.,Roth, Andrew,Landsman, Samuel,Gaikwad, Siddharth Mary Ann Liebert 2013 Zebrafish Vol.10 No.1

On the influence of vector design on antibody phage display

Soltes, Glenn,Hust, Michael,Ng, Kitty K.Y.,Bansal, Aasthaa,Field, Johnathan,Stewart, Donald I.H.,Dü,bel, Stefan,Cha, Sanghoon,Wiersma, Erik J. Elsevier 2007 Journal of biotechnology Vol.127 No.4

<P><B>Abstract</B></P><P>Phage display technology is an established technology particularly useful for the generation of monoclonal antibodies (mAbs). The isolation of phagemid-encoded mAb fragments depends on several features of a phage preparation. The aims of this study were to optimize phage display vectors, and to ascertain if different virion features can be optimized independently of each other.</P><P>Comparisons were made between phagemid virions assembled by g3p-deficient helper phage, Hyperphage, Ex-phage or Phaberge, or corresponding g3p-sufficient helper phage, M13K07. All g3p-deficient helper phage provided a similar level of antibody display, significantly higher than that of M13K07. Hyperphage packaged virions at least 100-fold more efficiently than did Ex-phage or Phaberge. Phaberge's packaging efficiency improved by using a SupE strain.</P><P>Different phagemids were also compared. Removal of a 56 base pair fragment from the promoter region resulted in increased display level and increased virion production. This critical fragment encodes a lacZ′-like peptide and is also present in other commonly used phagemids.</P><P>Increasing display level did not show statistical correlation with phage production, phage infectivity or bacterial growth rate. However, phage production was positively correlated to phage infectivity.</P><P>In summary, this study demonstrates simultaneously optimization of multiple and independent features of importance for phage selection.</P>

Lymph node yield in node-negative patients predicts cancer specific survival following radical cystectomy for transitional cell carcinoma

Jack Crozier,Nathan Papa,Marlon Perera,Michael Stewart,Jeremy Goad,Shomik Sengupta,Damien Bolton,Nathan Lawrentschuk 대한비뇨의학회 2017 Investigative and Clinical Urology Vol.58 No.6

Purpose: To determine the oncological implications of increased nodal dissection in node-negative bladder cancer during radical cystectomy in a contemporary Australian series. Materials and Methods: We performed a multicenter retrospective study, including more than 40 surgeons across 5 sites over a 10-year period. We identified 353 patients with primary bladder cancer undergoing radical cystectomy. Extent of lymphadenectomy was defined as follows; limited pelvic lymph node dissection (PLND) (perivesical, pelvic, and obturator), standard PLND (internal and external iliac) and extended PLND (common iliac). Multivariable cox proportional hazards and logistic regression models were used to determine LNY effect on cancer-specific survival. Results: Over the study period, the extent of dissection and lymph node yield increased considerably. In node-negative patients, lymph node yield (LNY) conferred a significantly improved cancer-specific survival. Compared to cases where LNY of 1 to 5 nodes were taken, the hazard ratio (HR) for 6 to 15 nodes harvested was 0.78 (95% confidence interval [CI], 0.43–1.39) and for greater than 15 nodes the HR was 0.31 (95% CI, 0.17–0.57), adjusted for age, sex, T stage, margin status, and year of surgery. The predicted probability of cancer-specific death within 2 years of cystectomy was 16% (95% CI, 13%–19%) with 10 nodes harvested, falling to 5.5% (95% CI, 0%–12%) with 30 nodes taken. Increasing harvest in all PLND templates conferred a survival benefit. Conclusions: The findings of the current study highlight the improved oncological outcomes with increased LNY, irrespective of the dissection template. Further prospective research is needed to aid LND data interpretation.

Fourteen Weeks of Treatment with Viscofiber Increased Fasting Levels of Glucagon-Like Peptide-1 and Peptide-YY

Frank Greenway,Carol E. O'Neil,Laura Stewart,Jennifer Rood,Michael Keenan,Roy Martin 한국식품영양과학회 2007 Journal of medicinal food Vol.10 No.4

Fermentable dietary fiber has been shown to cause fat loss and to increase peptide-YY (PYY) and glucagon-like peptide 1 (GLP-1) levels in rodents. In single meal tests, humans have an increase in PYY and GLP-1 to dietary fiber,but the response of these hormones to longer-term treatment is not known. Viscofiber?? (Cevena Bioproducts Inc., Edmonton,AB, Canada) is a high-viscosity fermentable dietary fiber made by a proprietary process from oats and barley. Seven healthyoverweight and obese subjects were treated with a calorie-restricted diet, a lifestyle change program, and 4 g of Viscofiber/dayfor 16 weeks. Hunger, satiety, PYY, and GLP-1 were measured before and 1 hour after a standard meal test before and atweek 14 of the study. Hunger and satiety were measured by Visual Analog Scales. PYY and GLP-1 were measured by ra-dioimmunoassay and enzyme-linked immunosorbent assay, respectively. Weight was reduced 3.07. 3.13 kg (P. .05) overthe 16 weeks. Fasting PYY increased 8.67. 6.62 pg/mL (P. .05) and fasting GLP-1 increased 2.67. 0.84 pmol/L (P..01) at 14 weeks compared to baseline. Satiety increased 1.78. 1.43 cm (P. .01) at the 1-hour post-meal time point onweek 14 compared to the study baseline. We conclude that 14 weeks of treatment with Viscofiber at 4 g/day along with alifestyle change program and diet causes weight loss and increases fasting PYY, fasting GLP-1, and satiety at 1 hour fol-lowing a standard meal, which extends the single meal test observations in humans.

Materials for Step and Flash Imprint Lithography

C. Grant Willson,Jianjun Hao,Michael Stewart,Yukio Nishimura,Frank Palmieri,Wei-Lun Jen,Michael Dickey,Andrew Chan,Kai Wu,John Ekerdt,Jordan Owens,Jeffery T. Wetzel 한국고분자학회 2006 한국고분자학회 학술대회 연구논문 초록집 Vol.2006 No.10

Tolerance of dormant and active cells in Pseudomonas aeruginosa PA01 biofilm to antimicrobial agents.

Kim, Jaeeun,Hahn, Ji-Sook,Franklin, Michael J,Stewart, Philip S,Yoon, Jeyong Academic Press ; Oxford University Press 2009 The Journal of antimicrobial chemotherapy Vol.63 No.1

<P>OBJECTIVES: The aim of the study was to determine the susceptibility of active and dormant cell populations from Pseudomonas aeruginosa biofilms to non-antibiotic antimicrobial agents such as chlorine, hydrogen peroxide and silver ions in comparison with antibiotics. METHODS: Active cells in colony biofilm were differentially labelled by induction of a green fluorescent protein (GFP). Active and dormant cells were sorted in phosphate buffered solution by flow cytometry. Reductions in viability were determined with plate counts. RESULTS: The spatial pattern of metabolic activity in colony biofilm was verified, and the active and dormant cells were successfully sorted according to the GFP intensity. Active cells had bigger cell size and higher intracellular density than dormant cells. While dormant cells were more tolerant to tobramycin and silver ions, active cells were more tolerant to chlorine. Metabolically active cells contain denser intracellular components that can react with highly reactive oxidants such as chlorine, thereby reducing the available concentrations of chlorine. In contrast, the concentrations of silver ions and hydrogen peroxide were constant during treatment. Aerobically grown stationary cells were significantly more tolerant to chlorine unlike other antimicrobial agents. CONCLUSIONS: Chlorine was more effective in inactivation of metabolically inactive dormant cells and also more effective under anaerobic conditions. The high oxidative reactivity and rapid decay of chlorine might influence the different antimicrobial actions of chlorine compared with antibiotics. This study contributes to understanding the effects of dormancy and the presence of oxygen on the susceptibility of P. aeruginosa biofilm to a wide range of antimicrobial agents.</P>