Crystallization and preliminary X-ray diffraction analysis of three recombinant mutants of Vaccinia virus uracil DNA glycosylase.

Amino-acid residues located at a highly flexible area in the uracil DNA glycosylase of Vaccinia virus were mutated. In the crystal structure of wild-type D4 these residues lie at the dimer interface. Specifically, three mutants were generated: (i) residue Arg167 was replaced with an alanine (R167AD4), (ii) residues Glu171, Ser172 and Pro173 were substituted with three glycine residues (3GD4) and (iii) residues Glu171 and Ser172 were deleted (Δ171-172D4).

Does extensive upper abdomen surgery during primary cytoreduction impact on long-term quality of life?

Objectives: The objective of this study was to evaluate the feasibility in terms of safety and quality of life in a sample of Italian patients affected by advanced ovarian cancer and submitted to either extensive upper abdomen or standard surgery, through validated questionnaires.

Methods: From January 2006 to November 2011, a prospective, observational study was conducted to compare quality of life in patients affected by advanced ovarian cancer and submitted to primary cytoreduction in the Division of Gynecology of the University Campus Bio-Medico of Rome. After surgery patients were stratified into 2 groups (group A: standard surgery or group B: extensive upper abdomen surgery).

The role of novel biomarker HE4 in endometrial cancer: a case control prospective study.

The aim of the study was to explore the clinical value of serum human epididymis secretory protein E4 (HE4) and CA125 in endometrial carcinoma. From January 2010 to April 2012, serum specimens were collected from consecutive cases of endometrial carcinoma and from cases of uterus benign disease (control group). The CA125 normal value is considered less than 35 U/mL.

Using a 16-French resectoscope as an alternative device in the treatment of uterine lesions: a randomized controlled trial.

Objective: To compare a 16-French resectoscope with a 22-French resectoscope and a 15-French hysteroscope for the treatment of uterine cavity lesions.

Methods: This was a prospective, randomized study of women with endometrial polyps or submucous myomas treated with a 16-French resectoscope, a traditional 22-French resectoscope, or a 15-French hysteroscope. The operating time, volume of distension medium delivered, discharge time, and patient discomfort by visual analog scale were recorded.

Identification of consensus-based quality end points for colorectal surgery.

Background: Process and outcome measures for quality assessment of colorectal surgical care are poorly defined.

Objective: The aim of this study was to develop candidate end points for use in surgeon-specific registries designed for case reporting and quality improvement program development.

Design: The study design was based on modified Delphi-based development of consensus quality end points.

Tumorigenic adenovirus 12 cells evade NK cell lysis by reducing the expression of NKG2D ligands.

Activation of natural killer (NK) cells depends on a balance between signals received from activation and inhibitory ligands expressed on the surface of target cells. Tumorigenic human adenovirus 12 (Ad12) transformed cells express low levels of the NK cell inhibitory ligand MHC I, but do not exhibit increased sensitivity to NK cell lysis compared to their non-tumorigenic counterparts. Analysis of the expression of activation ligands that bind to the NKG2D receptor revealed that RAE1β and H60 were reduced on the surface of Ad12 mouse cells as well as at the level of transcription.

Complications after rectal prolapse surgery: does approach matter?

Background: Data comparing surgical outcomes following abdominal and transperineal approaches for rectal prolapse are limited.

Objective: We sought to identify differences in postoperative complications following abdominal vs transperineal approaches to rectal prolapse.

Design: We studied a retrospective cohort in the American College of Surgeon's National Surgical Quality Improvement Program from January 2005 through December 2008.

Transformation by E1A oncoprotein involves ubiquitin-mediated proteolysis of the neuronal and tumor repressor REST in the nucleus.

The adenovirus early region 1A (E1A) protein promotes cell immortalization and transformation by mediating the activities of key cellular regulators. The repressor element 1-silencing transcription factor (REST), which is a major neuronal and tumor suppressor, was previously found mainly in the cytoplasm rather than in the nuclei of adenovirus-transformed rodent cells (22). We now demonstrate that the loss of REST in the nucleus is due to its rapid degradation by the ubiquitin-proteasome system.

The use of novel hemostatic sealant (Tisseel) in laparoscopic myomectomy: a case-control study.

Background: This is the first case-control study on the use of a fibrin sealant (Tisseel) on uterine suture during laparoscopic myomectomy (LM), with the primary endpoint to evaluate the intraoperative bleeding and postoperative blood loss. In addition, we evaluated the time required to achieve hemostasis using Tisseel and how much it can influence operative time.

Methods: From December 2009 to January 2011, consecutive patients older than 18 years with symptomatic isolate intramural myoma with maximal diameter B6 cm and ≥ 4 cm and with a sonographically diagnosed free myometrium margin ≥ 0.

PTPN22 and myasthenia gravis: replication in an Italian population and meta-analysis of literature data.

Polymorphisms in PTPN22 are associated with many autoimmune diseases; while rs2476601 is supposed to play a major role, other experimental data suggest that rs2488457 may be even more important. Results in myasthenia gravis are controversial. In 356 Italian myasthenic patients and 439 controls genotyped for both polymorphisms, we found that rs2476601 was not associated with myasthenia, presence of autoantibodies, thymus pathology, sex or onset age unlike previous studies on other European populations (confirmed by the present meta-analysis).

Do admissions and discharges to long-term care facilities influence hospital burden of Clostridium difficile infection?

Background: Substantial geographical clustering of Clostridium difficile infection (CDI) outbreaks in hospitals in the USA have previously been demonstrated.

Aim: To test the hypothesis that hospital burden of CDI is associated with admission from and discharge to long-term care facilities (LTCFs).

Methods: Hospital discharge data from 19 states in the USA were used to identify all patients discharged with a diagnosis of CDI from 1 January 2002 to 31 December 2004.

How often do patients return to the operating room after colorectal resections?

Aim: We sought to identify the rate of re-operation after an index colorectal surgical procedure and potential contributing risk factors.

Method: This is a retrospective cohort study from the American College of Surgeons National Surgical Quality Improvement Program. We identified all patients who either returned or did not return to the operating room after any colorectal resection from January 2005 to December 2008.

Urinary tract infection after colon and rectal resections: more common than predicted by risk-adjustment models.

Background: Urinary tract infections (UTIs) are the most common hospital-acquired infections in the United States. We hypothesized that the risk of UTI after colorectal surgery exceeds the risk after other gastrointestinal operations.

Study Design: We used National Surgical Quality Improvement Program (NSQIP) data from 2005 to 2008 to compute rates of UTI after colorectal resections and other gastrointestinal and general surgery.

Who performs proctectomy for rectal cancer in the United States?

Background: There is wide variation in surgical care for rectal cancer in the United States.

Objective: This study aimed to assess the differences in individual surgeon procedural profiles that might explain variations in the rates of restorative vs nonrestorative proctectomy for rectal cancer.

Design: This study was a retrospective examination of a cohort derived from trackable state hospital discharge data from 11 states.

Identification of protein-protein interaction inhibitors targeting vaccinia virus processivity factor for development of antiviral agents.

Poxvirus uracil DNA glycosylase D4 in association with A20 and the catalytic subunit of DNA polymerase forms the processive polymerase complex. The binding of D4 and A20 is essential for processive polymerase activity. Using an AlphaScreen assay, we identified compounds that inhibit protein-protein interactions between D4 and A20.

Employee use and perceived benefit of a complementary and alternative medicine wellness clinic at a major military hospital: evaluation of a pilot program.

Objectives: The objectives of this study were to examine the feasibility of a weekly on-site complementary and alternative medicine (CAM) wellness clinic for staff at a military hospital, and to describe employees' perceptions of program effectiveness.

Setting: The study setting was the Restore & Renew(®) Wellness Clinic at a United States Department of Defense hospital.

Subjects: The subjects were hospital nurses, physicians, clinicians, support staff, and administrators.

Change in myasthenia gravis epidemiology in Trento, Italy, after twenty years.

Background: The recent literature suggests that the incidence and prevalence of myasthenia gravis (MG) are changing. We performed a population-based study of MG in the province of Trentino (524,826 inhabitants) and compared the results with those collected 20 years ago.

Methods: Multiple sources of information (discharge diagnosis, antibody tests and anticholinesterase drugs) were analyzed.

Has the use of anti-adhesion barriers affected the national rate of bowel obstruction?

In this study, we analyzed temporal trends in anti-adhesion barrier application and admission rates for small bowel obstruction. We used data from the Nationwide Inpatient Sample and identified patients with ICD-9 codes for "application or administration of anti-adhesion barrier substances" from October 2002 through December 2007. Next, we identified cases of bowel obstruction coded from January 1997 through December 2007.

Mortality rate after nonelective hospital admission.

Objective: We hypothesized that the mortality rate after nonelective hospital admission is higher during weekends than weekdays.

Design: Retrospective cohort analysis.

Setting: Patients admitted to hospitals in the Nationwide Inpatient Sample, a 20% sample of US community hospitals.

Identification of inhibitors that block vaccinia virus infection by targeting the DNA synthesis processivity factor D4.

Smallpox was globally eradicated 30 years ago by vaccination. The recent threat of bioterrorism demands the development of improved vaccines and novel therapeutics to effectively preclude a reemergence of smallpox. One new therapeutic target is the vaccinia poxvirus processivity complex, comprising D4 and A20 proteins that enable the viral E9 DNA polymerase to synthesize extended strands.

Cyclical increase in diverticulitis during the summer months.

Objective: We hypothesized that the rate of nonelective hospital admissions for diverticulitis conforms to seasonal variation.

Design: Retrospective cohort analysis.

Setting: Patients admitted to hospitals in the Nationwide Inpatient Sample, a 20% sample of US community hospitals.

Risk of anal cancer in a cohort with human papillomavirus-related gynecologic neoplasm.

Objective: To assess the development of anal cancer in women diagnosed with a human papillomavirus-related cervical, vulvar, or vaginal neoplasm.

Methods: Using data from National Cancer Institute's Surveillance, Epidemiology and End Results program from 1973 through 2007, 189,206 cases with either in situ or invasive cervical, vulvar, or vaginal neoplasm were followed for 138,553,519 person-years for the development of subsequent primary anal cancer. Standardized incidence ratios were calculated from the observed number of subsequent anal cancers compared with those expected based on age-, race-, and calendar year-specific rates in the nonaffected population.

Long-term follow-up after an initial episode of diverticulitis: what are the predictors of recurrence?

Purpose: The purpose of our study was to determine the clinical and CT predictors of recurrent disease after a first episode of diverticulitis that was successfully managed nonoperatively.

Methods: We retrospectively analyzed 954 consecutive patients who presented to our institution with diverticulitis from 2002 to 2008. Patients were identified with International Classification of Diseases, 9th Revision/Current Procedural Terminology codes.

Presence of specialty surgeons reduces the likelihood of colostomy after proctectomy for rectal cancer.

Purpose: Geographic variability in the use of restorative proctectomy for rectal cancer has been described throughout the United States. We examined factors associated with high rates of colostomy formation after proctectomy for rectal cancer across US counties.

Methods: We used state hospital discharge data from 21 states to determine county rates of restorative proctectomy vs nonrestorative proctectomy (ie, colostomy) for rectal cancer.

Screening options and recommendations for colorectal cancer.

Screening reduces the burden of disease from colorectal cancer through early detection of cancerous lesions and removal of precancerous polyps. The ideal colorectal cancer screening modality should be cost-effective, increase life-years gained, permit long intervals between tests with high patient compliance and low risk to the patient. Although no single colorectal cancer screening method is perfect, several options exist.