Tracking antigen-specific T-cells during clinical tolerance induction in humans.

Allergen immunotherapy presents an opportunity to define mechanisms of induction of clinical tolerance in humans. Significant progress has been made in our understanding of changes in T cell responses during immunotherapy, but existing work has largely been based on functional T cell assays. HLA-peptide-tetrameric complexes allow the tracking of antigen-specific T-cell populations based on the presence of specific T-cell receptors and when combined with functional assays allow a closer assessment of the potential roles of T-cell anergy and clonotype evolution.

Histone H3 serine 57 and lysine 56 interplay in transcription elongation and recovery from S-phase stress.

Background: Acetylation of lysine 56 of histone H3 plays an important role in the DNA damage response and it has been postulated to play an as yet undefined role in transcription, both in yeast and in higher eukaryotes. Because phosphorylated human histone H3 serine 57 peptides have been detected by mass spectrometry we examined whether H3-S57 phosphorylation interplays with H3-K56 acetylation in vivo.

Methodology/principal Findings: To explore the physiological role of H3-S57, H3-K56 was mutated to mimic constitutively (un)acetylated forms of H3-K56 and these were combined with constitutively (un)phosphorylated mimics of H3-S57, in yeast.

Filaggrin null mutations associate with increased frequencies of allergen-specific CD4+ T-helper 2 cells in patients with atopic eczema.

Background: Filaggrin null mutations associate with atopic eczema and also with asthma when present with eczema. However, while epidermal dysfunction is an important factor in disease pathogenesis, it is unclear how such dysfunction interacts with immune responses to contribute to cutaneous and other inflammatory atopic disease.

Objectives: To gain a better understanding of the mechanisms underlying such predisposition in order to understand different disease phenotypes and possibly identify potential treatment targets.

Does the use of photography help to prioritise patients when referring to the oral medicine department?

OBJECTIVE To determine whether the use of referral letters with and without photography will make a difference to prioritising patients to the oral medicine department. DESIGN Retrospective analysis. SETTING Oral medicine department of Birmingham Dental Hospital.

Has the anterolateral thigh flap replaced the latissimus dorsi flap as the workhorse for lower limb reconstructions?

Objective: To compare the applicability and reliability of free Anterolateral thigh flap (ALTF) with Latissimus Dorsi free flap (LD) in different reconstructive scenarios of lower limb. To compare flap elevation time, vessel diameters, pedicle lengths, total operative time, peri-operative blood requirement, number of secondary procedures and complications between the two types of flaps.

Methods: Patients of all age groups with lower limb soft tissue defects requiring free tissue transfer, reporting to Department of Plastic Surgery, Combined Military Hospital, Rawalpindi, from November 2005 to November 2008, were included in the study.

Frequencies of circulating allergen-specific T cells temporally associate with longitudinal changes in severity of cutaneous atopic disease.

Increased levels of allergen-specific T-cells have been documented in the peripheral blood of patients with atopic dermatitis (AD) compared with nonatopic controls. However, little is known about how these relate to disease severity. This study sought to examine if frequencies of circulating allergen-specific T cells correlate with changes in clinical disease severity in a cohort of seven adults with AD who were positive for human leucocyte antigen DRB1*1501.

Immature teratoma of the vulva with an inguinal lymph node metastasis: report of a case and review of literature.

Neoplasms of the vulva are rare and most commonly reported amongst them are epithelial tumors. Teratomas have been reported in many extragonadal sites. We report the only case of an immature teratoma of the vulva with inguinal lymph node metastasis.

Quality of care in nutritional rehabilitation in HIV-endemic Malawi: caregiver perspectives.

In Malawi, HIV and malnutrition are two of the most common causes of childhood morbidity and mortality. This qualitative study based in Nutrition Rehabilitation Units (NRU) in HIV-endemic Malawi explores caregiver's (staff and family) perspectives on quality of care for severely malnourished children. Three carer focus groups and 30 carer and staff in-depth interviews were conducted in two NRUs.

Overcoming barriers to diabetes care: Perceived communication issues of healthcare professionals attending a pilot Diabetes UK training programme.

As part of our evaluation of the Diabetes UK Careline workshop "Overcoming barriers to diabetes care", we received feedback from 18 healthcare professionals. Generally, they felt competent in identifying patients' psychosocial issues but less knowledgeable/skilled in handling them. Lack of time, privacy and support were barriers to addressing patients' psychosocial concerns.

Rotation-transposition correction of nasal deformity in Tessier number 1 and 2 clefts.

Objective: To formulate a standardized procedure for repair of the nasal component of Tessier number 1 and 2 clefts.

Patients And Methods: The procedure was performed from 1998 to 2007 in 13 patients with congenital nasal clefts of different degrees of expression corresponding to Tessier 1 and 2. The patients' ages ranged from 3 months to 28 years.

Clinico-pathological profile and outcome of inhalational burns.

Objective: To determine clinico-pathological profile and outcome of inhalational burns in a specialized burns treatment unit.

Study Design: Case-series.

Place And Duration Of Study: The Department of Plastic Surgery and Burns Centre Unit, Combined Military Hospital, Kharian Cantonment in March 2005.

Initial presentation of pheochromocytoma with Takotsubo cardiomyopathy: a brief review of literature.

Takotsubo cardiomyopathy, or transient left ventricular apical ballooning or broken heart syndrome, is characterized by excessive sympathetic stimulation induced acute coronary vasospasm. A 46-year-old female presented with polyuria and polydypsia and was diagnosed with new-onset diabetes mellitus, treated with insulin and intravenous fluids. During the hospital stay, she complained of an episode of left-sided chest pain and had mildly elevated cardiac enzymes.

Attraction problems following magnet ingestion.

Ingestion of magnetic toys is associated with serious complications that can result in pressure necrosis and bowel perforation. We report three cases of multiple (more than two) magnet ingestion. In two patients, the symptoms did not resolve and complications of perforation and jejunocolic fistula occurred.

Atropine-induced polymorphic ventricular tachycardia: a rare and bygone occurrence revisited.

Atropine is commonly a used pre anesthetic medication. A 22-year-old female with history of unexplained recurrent syncope during electrophysiology developed inducible ventricular arrhythmias when 0.5 mg of atropine was injected intravenously to improve this Wenckebach.

Sinus node dysfunction in association with chronic lithium therapy: a case report and review of literature.

Lithium is derived from the Greek word "lithia" which means "stone." Since its discovery by the Swedish chemist Arfedsson in the year 1817, it has been used for treatment of gout, hypertension, uremia, and rheumatism. Currently, lithium is the treatment of choice for the long-term control of mania and to prevent relapse in bipolar disorder.

Pain management for unilateral orchidopexy in children: an effective regimen.

Background: The reported high incidence of 30-60% postoperative pain after an elective day surgical orchidopexy is undesirable. We evaluated the efficacy of our analgesic regimen for unilateral orchidopexy in preschool children performed as a day surgical procedure.

Methods: Between January 2004 and December 2006, 247 children (mean age: 3.

Early experience of pediatric thoracoscopic lobectomy in the UK.

Purpose: The aim of this study was to report on the early experience of pediatric thoracoscopic lobectomy in two UK centers (Royal Hospital for Sick Children, Edinburgh, and Addenbrookes Hospital, Cambridge).

Methods: Twelve patients between February 2000 and November 2005 were treated with a lobectomy for pulmonary disease.

Results: Diagnoses included 7 congenital cystic adenomatous malformations, 4 patients with bronchiectasis, and 1 thoracic mature teratoma.

Cardiac troponin I in sickle cell crisis.

Gross and microscopic findings consistent with acute and healed myocardial injury without coronary artery disease have been described in autopsy studies of patients with sickle cell crisis. The present study was designed to determine whether serum levels of cardiac troponin I are elevated in sickle cell crisis. Cardiac troponin I levels were measured in 32 patients age>18 years with the admission diagnosis of sickle cell crisis.

Proteases from Schistosoma mansoni cercariae cleave IgE at solvent exposed interdomain regions.

Parasitic infections, including schistosomiasis, are associated with high titres of specific and non-specific IgE antibody, and many reports show an in vitro role for IgE in parasite killing. Despite an active immune response, schistosomes survive for long periods in the human bloodstream, implying that the parasite is able to overcome or evade the IgE response mounted against it. One such mechanism is through cleavage of IgE into non-functional fragments by potent parasite derived enzymes.

Bifunctional nanotube scaffolds for diverse ligands are purified simply from Escherichia coli strains coexpressing two functionalized flagellar genes.

We functionalized Escherichia coli FliC flagellin proteins to form tailored nanotubes binding single types or pairs of ligands, including divalent cations, fluorescent antibodies, or biotin-avidin-linked moieties such as ferritins. The ratio of each tag in bifunctionalized flagella could be toggled extending their sophistication as nanoscaffolds. Tobacco Etch Virus (TEV) protease site-containing FliCs were cleaved by the cognate protease without filament disintegration, potentiating their use as removable nanolithography masks to deposit attached ligands by protease cleavage.

Prosthetic heart valves: types and echocardiographic evaluation.

In the last five decades multiple different models of prosthetic valves have been developed. The purpose of this article is to provide a comprehensive source of information for the types and the echocardiographic evaluation of the prosthetic heart valves.