Inhibition of ERN1 affects the expression of TGIF1 and other homeobox gene expressions in U87MG glioblastoma cells.

Background: The ERN1 (endoplasmic reticulum to nucleus signaling 1) pathway plays an important role in the regulation of gene expression in glioblastoma, but molecular mechanism has not yet been fully elucidated. The aim of this study was to evaluate the relative relevance of ERN1 activity as a kinase in comparison to its endoribonuclease activity in the regulation of homeobox gene expression.

Methods: Two sublines of U87MG glioblastoma cells with different ways of ERN1 inhibition were used: dnERN1 (overexpressed transgene without protein kinase and endoribonuclease) and dnrERN1 (overexpressed transgene with mutation in endoribonuclease).

Insulin receptor substrate 1 gene expression is strongly up-regulated by HSPB8 silencing in U87 glioma cells.

The aim of the present investigation was to study the expression of genes encoding IRS1 (insulin receptor substrate 1) and some other functionally active proteins in U87 glioma cells under silencing of polyfunctional chaperone HSPB8 for evaluation of the possible significance of this protein in intergenic interactions. Silencing of HSPB8 mRNA was introduced by HSPB8 specific siRNA. The expression level of , , , , , , , , , , and genes was studied in U87 glioma cells by quantitative polymerase chain reaction.

Single-walled carbon nanotubes affect the expression of genes associated with immune response in normal human astrocytes.

The effect of single-walled carbon nanotubes (SWCNTs) on the expression of a subset of immune response, apoptosis and cell proliferation -associated genes was studied in normal human astrocytes (line NHA/TS). In the cells treated with SWCNTs (2, 10 and 50 ng/ml of medium for 24 h) we observed a strong dose-dependent down-regulation of the expression of a cell surface glycoproteins HLA-DRA (major histocompatibility complex, class II, DR alpha) and HLA-DRB1. At the same time, the expression of HLA-F (major histocompatibility complex, class I, F), LMNB1 (lamin B1), and HTRA1 (high temperature requirement A1) genes as well as the level of miR-190b and miR-7 was up-regulated in NHA/TS subjected to different concentrations of SWCNTs.

Large serpiginous thrombus straddling the patent foramen ovale and traversing through mitral and tricuspid valves into both ventricles: a therapeutic dilemma of impending paradoxical embolism and recurrent pulmonary embolism.

A 51-year-old male with history of resected renal cell carcinoma and prior pulmonary embolism presented with tachypnea, tachycardia and progressive dyspnea on exertion. Chest computed tomography revealed bilateral acute pulmonary embolism. Transthoracic echocardiogram showed severe pulmonary hypertension with severe cor-pulmonale and presence of a large worm-like thrombus extending across the foramen ovale, entering both ventricles through the mitral and tricuspid valves.

NHANES III equations enhance early detection and mortality prediction of bronchiolitis obliterans syndrome after hematopoietic SCT.

Bronchiolitis obliterans syndrome (BOS) is a serious complication of chronic GVHD (cGVHD) following HSCT (hematopoietic SCT). The clinical diagnosis of BOS is based on pulmonary function test (PFT) abnormalities including: FEV1<75% predicted and obstructive FEV1/VC ratio, calculated using reference equations. We sought to determine if the frequency of clinical diagnoses and severity of BOS would be altered by using the recommended NHANES III vs older equations (Morris/Goldman/Bates, MGB) in 166 cGVHD patients, median age 48 (range: 12-67).

Puzzling dyspnea caused by respiratory muscle weakness.

Dyspnea is common in advanced stages of neuromuscular disorders, but it is infrequently the presenting symptom. However, dyspnea is a frequent complaint in a primary care setting but is rarely caused by a respiratory muscle weakness. Consequently, the diagnosis of respiratory muscle weakness often is delayed.

What is the role of PFTs in monitoring adverse effects of surgery, drug treatments, radiation therapy, and during hospitalization?

Measurement of various aspects of pulmonary function is a relatively easy, noninvasive, and inexpensive way to gauge the status of the respiratory system. Interest in using these tests to determine risk from medical and surgical interventions stems from their presumed ability to be more sensitive than history or physical examination in detecting underlying lung disease. When coupled with the assumption that early detection of pulmonary abnormalities will lead to alterations in patient management, the ultimate goal of improved patient outcomes becomes very attractive.

Racial discordance in spirometry comparing four commonly used reference equations to the National Health and Nutrition Examination Study III.

Diagnosing lung function abnormalities requires application of the appropriate reference equation for a given patient population. Current guidelines recommend the National Health and Examination Study III data set for evaluating patients in the United States. In Caucasian patients, relying on older reference equations, as opposed to those derived from the NHANES III data set, will often result in a different interpretation of a patient's spirometry.

Discordance in spirometric interpretations using three commonly used reference equations vs national health and nutrition examination study III.

Background: Spirometry plays an essential role in the diagnosis and management of pulmonary diseases. The accurate interpretation of spirometric data depends on comparison to a reference population to identify abnormalities in ventilatory function. National guidelines recommended the use of the National Health and Nutrition Examination Study (NHANES) III data set as the preferred reference population for those persons 8 to 80 years of age in the United States.

Impending paradoxical embolism presenting as a pulmonary embolism, transient ischemic attack, and myocardial infarction.

A 25-year-old man presented with complaints of nonpleuritic, substernal chest pain, dyspnea, and decreasing exercise tolerance. His vital signs were normal, with the exception of an oxygen saturation level of 93% while breathing room air. During his assessment, he developed transient left facial droop, left arm and leg weakness, and an ataxic gait, which lasted 15 min then resolved spontaneously.

Do specialists differ on do-not-resuscitate decisions?

Study Objective: Opinions regarding do-not-resuscitate (DNR) decisions differ between individual physicians. We attempted to determine whether the strength of DNR recommendations varies with medical specialty and experience.

Design: Written survey.

Spirometry in surgery for anterior mediastinal masses.

Study Objectives: To identify the impact of upright and supine spirometry (USS) on the choice of anesthesia and outcomes in patients undergoing surgery for anterior mediastinal masses (AMMs).

Design: Retrospective cohort study.

Setting: A referral, tertiary-care, military medical center.

Endobronchial involvement and airway hyperreactivity in patients with sarcoidosis.

Study Objective: To determine the relationship between airway hyperreactivity (AHR) and endobronchial involvement in patients with sarcoidosis.

Design: Prospective series of consecutive patients.

Setting: Pulmonary clinic of a military, tertiary-care teaching hospital.

Endobronchial biopsy for sarcoidosis: a prospective study.

Study Objectives: To determine the yield of endobronchial biopsy (EBB) for suspected sarcoidosis, and to evaluate if EBB increases the diagnostic value of fiberoptic bronchoscopy (FOB) when added to transbronchial biopsy (TBB).

Design: Prospective study of consecutive patients.

Setting: Pulmonary clinic of a tertiary-care, academic medical center.

Circulating D dimer in patients with sarcoidosis.

Study Objectives: To determine the relationship between D dimer (DD) status and markers of disease activity in patients with sarcoidosis.

Design: Prospective, observational analysis.

Setting: Pulmonary clinic of a tertiary care, university-affiliated hospital.

Diagnosing and monitoring the clinical course of chronic obstructive pulmonary disease.

COPD is an extremely common, chronic disorder characterized by a reduction in airflow after the administration of an inhaled bronchodilator as measured by the FEV1. The diagnosis is suspected in patients with a history of several decades of cigarette smoking who present with nonspecific respiratory symptoms. The diagnosis is established by simple forced expiratory spirometry.

Delivery of high concentrations of inspired oxygen via Tusk mask.

Objectives: Nonrebreather face masks (NRM) are frequently used in patients with respiratory distress and profound hypoxemia. A simpler modification to the partial rebreather face mask, using only two pieces of respiratory tubing or "tusks," has also been shown to increase FiO2 compared with the NRM in five normal subjects. Clinically, we have observed this modification to further increase PaO2 in critically ill patients already using the NRM in the intensive care unit.

Necessity of routine chest roentgenography after thoracentesis.

Objective: To determine the necessity of posteroanterior chest roentgenography for the identification of pneumothorax and other complications after thoracentesis.

Design: Prospective cohort study.

Setting: Tertiary care teaching hospital.

Evaluation of internists' spirometric interpretations.

Background: Correct interpretation of screening spirometry results is essential in making accurate clinical diagnoses and directing subsequent pulmonary evaluation. The general internist is largely responsible for interpreting screening spirometric tests at community hospitals. However, reports of new guidelines for screening spirometry are infrequently published in the general internal medicine literature.

Adherence to established guidelines for preoperative pulmonary function testing.

Guidelines for ordering preoperative spirometry have been proposed by GM Tisi (1979) and more recently by the American College of Physicians (ACP). Requests for preoperative spirometries represent a significant portion of all requests for screening spirometry at our institution and utilize significant man-hours of technician time. We determined the percentage of these requests that did not meet the ACP guidelines and characterized why these requests were being generated.

Noninvasive monitoring.

Noninvasive monitors are finding increased use in the intensive care unit both as labor-saving tools and as a means to reduce complications associated with invasive techniques. The current technology allows for the replacement of a number of invasive devices with a noninvasive counterpart capable of providing similar information. The potential reduction in morbidity and mortality realized with a greater reliance on noninvasive monitors should result in widespread application of these modalities.

Maximum voluntary ventilation. Spirometric determinants in chronic obstructive pulmonary disease patients and normal subjects.

The 12-s maximum voluntary ventilation (MVV) provides an estimate of the ventilatory reserves available to meet the physiologic demands of exercise. Earlier studies established a general relationship between MVV and FEV1. We hypothesized that the resting maximum inspiratory flow rate (MIFR) also serves as a clinically useful predictor of the MVV.