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Prediction of Functional Outcome in Post-Hospital Brain Injury Rehabilitation

Journal of Behavioral and Brain Science 2019年第12期9卷 406-416页

作者： Frank d. Lewis Gordon J. Horn NeuroRestorative Research Institute Medical College of Georgia at Augusta University Augusta GA USA NeuroRestorative Research Institute College of Medicine Florida State University Tallahassee FL USA

Post-hospital brain injury rehabilitation programs are afforded limited time to reduce chronic disability resulting from acquired brain injury. Therefore, the purpose of this study was to identify deficit areas resulting from acquired brain injury that have the greatest impact on functional outcomes to enable greater efficiency in rehabilitation programming. Study participants were 1717 persons with acquired brain injury treated in residential post-hospital rehabilitation programs. Participants were assessed at admission and discharge on the MPAI-4. Functional status at discharge was evaluated based on T-scores derived from MPAI-4 discharge participation index items: Initiation, self-care and residence. The data base of 1717 was randomly divided into two subsets. Items from admission Abilities Index and select person variables were entered into stepwise multiple regression on subset one and then in a hierarchical multiple regression on subset two. rash analysis demonstrated satisfactory construct validity and internal consistency of admission and discharge MPAI-4 evaluations (Person reliability > 0.90, Item reliability = 0.99). Both regression analyses revealed that Mobility and Novel Problem Solving accounted for 40% of the variance in functional outcome, p d brain injury results in a myriad of cognitive and physical impairments. Of the many possible deficits, the greatest gains in overall functional outcomes may be achieved by allocating additional treatments aimed at reducing disability in mobility and novel problem solving.

关键词： Brain Injury Mayo Portland Adaptability Index Version-4 Rasch Analysis Outcome Post-Hospital Brain Injury Rehabilitation

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MSH1 Is a Plant Organellar dNA Binding and Thylakoid Protein under Precise Spatial Regulation to Alter development

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Molecular Plant 2016年第2期9卷 245-260页

作者： Kamaldeep S. Virdi Yashitola Wamboldt Hardik Kundariya John d. Laurie Ido Keren K.R. Sunil Kumar Anna Block Gilles Basset Steve Luebker Christian Elowsky Philip M. day Johnna L. Roose Terry M. Bricker Thomas Elthon Sally A. Mackenzie School of Biological Sciences department of Agronomy and Horticulture University of Nebraska Lincoln NE 68588 USA Center for Biotechnology University of Nebraska Lincoln NE 68588 USA department of Biological Sciences Louisiana State University Baton Rouge LA 70803 USA These authors contributed equally to this article

As metabolic centers, plant organelles participate in maintenance, defense, and signaling. MSH1 is a plant- specific protein involved in organeUar genome stability in mitochondria and plastids. Plastid depletion of MSH1 causes heritable, non-genetic changes in development and dNA methylation. We investigated the rash I phenotype using hemi-complementation mutants and transgene-null segregants from RNAi suppres- sion lines to sub-compartmentalize MSH1 effects. We show that MSH1 expression is spatially regulated, specifically localizing to plastids within the epidermis and vascular parenchyma. The protein binds dNA and localizes to plastid and mitochondrial nucleoids, but fractionation and protein-protein interactions data indicate that MSH1 also associates with the thylakoid membrane. Plastid MSH1 depletion results in variegation, abiotic stress tolerance, variable growth rate, and delayed maturity. depletion from mitochon- dria results in 7%-10% of plants altered in leaf morphology, heat tolerance, and mitochondrlal genome sta- bility. MSH1 does not localize within the nucleus directly, but plastid depletion produces non-genetic changes in flowering time, maturation, and growth rate that are heritable independent of MSH 1. MSH1 deple- tion alters non-photoactive redox behavior in plastids and a sub-set of mitochondrially altered lines. Ectopic expression produces deleterious effects, underlining its strict expression control. Unraveling the complexity of the MSH1 effect offers insight into triggers of plant-specific, transgenerational adaptation behaviors.

关键词： Thylakoid protein Organellar dNA binding MSH1 Epigenetic variation

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用抗雌激素药物改善皮肌炎皮疹

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世界核心医学期刊文摘（皮肤病学分册） 2006年第3期2卷 31-32页

作者： Sereda d. Werth V.P. 刘艳 2 Rhoads Pavilion Department of Dermatology 36th and Spruce Streets Philadelphia PA19104United States Dr

Background: dermatomyositis (dM) is an autoimmune disorder that occurs more often inwomen than men and causes highly symptomatic and inflammatory cutaneous and proximal muscle disease. Corticosteroids have been the treatment of choice for myositis in dM, and antimalarial agents for the skin disease of dM, with methotrexate sodium, azathioprine, mycophenolate mofetil, cyclosporine, and intravenous immunoglobulin used as steroid-sparing agents. Recently, reports supporting a role for anti-tumor necrosis factorα (TNF-α ) therapy in the treatment of dM have emerged. Observations: We describe 2 women who experienced an improvement in their dM-associated skin eruptions while taking antiestrogen medication. The first patient was taking tamoxifen, a selective estrogen receptor modulator that has been found to have anti-TNF-α properties. The second was taking anastrozole, an aromatase inhibitor. When tamoxifen therapy was discontinued after 4 years of use in the first patient, her dM rash worsened and remained difficult to control with conventional immunosuppressant medication. Conclusions: With the limited number of therapies available to manage dM skin eruptions, the discovery of novel agents effective in treating this disease is vital. Using antiestrogen medication in women with dM may result in a significant improvement in their rash, possibly via the inhibition of TNF-α production by immune or other cells. Further investigation into the use of antiestrogen therapy in dM is merited to evaluate longterm risks and benefits.

关键词：抗雌激素药物皮肌炎肿瘤坏死因子-α(TNF-α) 选择性雌激素受体调节剂静脉注射免疫球蛋白自身免疫性疾病皮疹女性患者抗TNF-α 皮肤损害

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Two Approaches to the Study of a Controversial Relationship: Cutaneous Photosensitivity and Anti-Ro/SS-A Autoantibodies

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Open Journal of Rheumatology and Autoimmune diseases 2014年第1期4卷 1-12页

作者： Mariela L. Paz Eliana M. Cela Alejandro Ferrari Adrián d. Friedrich Juliana Leoni daniel H. González Maglio Immunology department Pharmacy and Biochemistry School University of Buenos Aires Buenos Aires Argentina.

Background: Autoantibodies (Aabs) are the hallmark of numerous systemic autoimmune pathologies (SAPs), for instance anti-Ro/SS-A Aabs are usually found in Systemic Lupus Erythematosus (SLE) and Sjogren’s Syndrome. Cutaneous photosensitivity (CP) is found in most forms and subsets of LE and consists of a skin rash as a result of unusual reaction to sunlight. There are many theories which relate specifically the presence of circulating anti-Ro/SS-A Aabs with the CP phenomenon, though there are several studies which are in disagreement. Results: In this study we analyzed the relationship between CP and anti-Ro Aabs by means of two approaches. The first one included an in vitro model where we evaluated by flow cytometry the binding capacity of affinity-purified Aabs to autoantigens relocalized on apoptotic keratinocyte’s surface. We found that there was no relationship between the binding capacity of serum from 10 selected patients or their corresponding purified anti-Ro52 and anti-Ro60 Aabs, and the presence or absence of CP, neither with the SAPs. The in vivo model consisted of Hairless SKH:1 mice which were induced to produce anti-murine Ro52 and/or Ro60 Aabs and were subsequently irradiated with UVB light. We evaluated the skin histology and also the epidermal production of TNF-α. We found no differences between the groups in neither of the parameters evaluated. Conclusions: These results agree with some studies on the role of the Aabs in CP, considering anti-Ro Aabs not as the only responsible for the manifestation;and disagree with many other authors, who believe in the strong association between these two events.

关键词： Cutaneous Photosensitivity Purified Anti-Ro/SS-A Autoantibodies SKH-1 Hairless Mice UVB Irradiation TNF-α

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原发性人疱疹病毒6型感染的群体调查研究

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世界核心医学期刊文摘（儿科学分册） 2005年第7期1卷 2-3页

作者： Zerr d.M. Meier A.S. Selke S.S. 李开 Children's Hospital 4800 Sand Point Way NE Seattle WA 98105 United States Dr.

BACKGROUNd: Serologic studies indicate that human herpesvirus 6 (HHV-6) infects 90 percent of children by two years of *** is known about the acquisition, virologic course, and clinical manifestations of HHV-6 ***: We prospectively studied a cohort of 277 children from birth through the first two years of life to define the pattern of acquisition of *** children’s saliva was tested weekly for HHV-6 dNA with the use of the polymerase chain *** maintained a daily log of signs and symptoms of illness in their ***: Primary HHV-6 infection occurred in 130 children, with cumulative percentages of 40 percent by the age of 12 months and 77 percent by the age of 24 *** peak age of acquisition was between 9 and 21 *** acquisition of HHV-6 was associated with female sex (adjusted hazard ratio, 1.7; 95 percent confidence interval, 1.2 to 2.4) and having older siblings (adjusted hazard ratio, 2.1; 95 percent confidence interval, 1.4 to 2.9).Among 81 children with a well-defined time of acquisition of HHV-6, 93 percent had symptoms, and 38 percent were seen by a *** had *** compared with children who had other illnesses, those with primary HHV-6 infection were more likely to have fever (P=0.003), fussiness (P=0.02), diarrhea (P=0.03), rash (P=0.003), and roseola (P=0.002) and were more likely to visit a physician (P=0.003).CONCLUSIONS: The acquisition of HHV-6 in infancy is usually symptomatic and often results in medical *** occurs in a minority of patients, and febrile seizures are infrequently associated with primary HHV-6 *** siblings appear to serve as a source of HHV-6 transmission.

关键词：疱疹病毒群体调查高峰年龄感染方式病毒感染过程多聚酶链式反应前瞻性队列研究热性惊厥易激惹血清学

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肝移植后急性移植物抗宿主病的早期指征:皮疹和全血细胞减少

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世界核心医学期刊文摘(皮肤病学分册) 2005年第9期 61-62页

作者： Whalen J.G. Jukic d.M. English III J.C. 焦婷 department of dermatology University of Pittsburgh 145 Lothrop Hall 190 Lothrop St Pittsburgh PA 15213 United States Dr.

Acute graft-versus-host disease is mainly a complication of allogeneic bone-marrow transplantation, and rarely seen after transplantation of solid organs. We describe a 68-year-old man who developed a maculopapular eruption and fever approximately 15 days after orthotopic liver transplantation for cryptogenic cirrhosis. At day 19, the patient developed abrupt neutropenia and diarrhea. Skin biopsy was performed and the specimen revealed basal cell layer vacuolization, necrotic keratinocytes, and satellite cell necrosis. Bone-marrow aspiration performed after the patient became pancytopenic revealed aplastic marrow with scattered lymphocytes and rare megakaryocytes. A diagnosis of acute graft-versus-host disease was made and an immunosuppressive drug regimen was initiated. Unfortunately, the patient died after support was withdrawn because of total ablation of his bone marrow and multiorgan failure. This report describes the rare presentation of acute graft-versus-host disease after solid organ transplantation, and that skin manifestations may be an early presenting sign.

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先天性的系统性毛细血管漏综合征:皮肤受累被误诊

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世界核心医学期刊文摘（皮肤病学分册） 2005年第4期1卷 28-29页

作者： Fardet L. Kerob d. Rybojad M. C. Lebbé 田中伟 Serv. dermatol. Professeur P. Morel Ctr. Hosp. Universitaire Saint-Louis 1 avenue Claude-Vellefaux FR-75010 Paris France Dr.

Background: Systemic capillary leak syndrome (SCLS) is a severe disorder characterized by unexplained rapid transferof considerable volumes of plasma from the intravascular to the extravascular compartment. For some cases of SCLS, no aetiology is evident and these cases are reported as idiopathic (ISCLS). Objectives: To describe the cutaneous findings in 3 patients with ISCLS. Results: Cutaneous involvement consisted in sclerosis, livedo, purpura and photodistributed maculopapular erythematous rash. dermal mucinosis was proven by biopsy in 1 patient. No underlying disease was diagnosed during follow-up. Conclusion: The above-mentioned cutaneous findings can be present during acute attacks of *** seem specifically related to the ISCLS and not indicative of an underlying disease.

关键词：急性发作期斑丘疹潜在疾病青斑外腔黏蛋白活组织检查病因学

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成人细菌性脑膜炎的临床特点和预后因素

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世界核心医学期刊文摘（神经病学分册） 2005年第3期1卷 8-9页

作者： Van de Beek d. de Gans J. Spanjaard L. 黄卫东 Academic Medical Center University of Amsterdam Departm ent of Neurology H2 P.O. Box 22660 1100 DD Amsterdam Netherlands Dr.

BACKGROUNd: We conducted a nationwide study in the Netherlands to determine cl inical features and prognostic factors in adults with community acquired acute bacterial meningitis. METHOdS: From October 1998 to April 2002, all dutch patien ts with community acquired acute bacterial meningitis, confirmed by cerebrospin al fluid cultures, were prospectively evaluated. All patients underwent a neurol ogic examination on admission and at discharge, and outcomes were classified as unfavorable (defined by a Glasgow Outcome Scale score of 1 to 4 points at discha rge) or favorable (a score of 5). Predictors of an unfavorable outcome were iden tified through logis tic regression analysis. RESULTS: We evaluated 696 episod es of community acquired acute bacterial meningitis. The most common pathogens were Streptococcus pneumoniae (51 percent of pisodes) and Neisseria meningitidis (37 percent). The classic triad of fever, neck stiffness, and a change in menta l status was present in only 44 percent of episodes; however, 95 percent had at least two of the four symptoms of headache, fever, neck stiffness, and altered m ental status. On admission, 14 percent of patients were comatose and 33 percent had focal neurologic abnormalities. The overall mortality rate was 21 percent. T he mortality rate was higher among patients with pneumococcal meningitis than am ong those with meningococcal meningitis (30 percent vs. 7 percent, Pdes. Risk factors for an unfavor able outcome were advanced age, presence of otitis or sinusitis, absence of rash, a low score on the Glasgow Coma Scale on admission , tachycardia, a positive blood culture, an elevated erythrocyte sedimentation r ate, thrombocytopenia, and a low cerebrospinal fluid white cell count. In adult s presenting with community acquired acute bacterial meningitis, the sensitivit y of the classic triad of fever, neck stiffness, and altered mental status is lo w, but almost all p

关键词：细菌性脑膜炎链球菌性脑膜炎脑脊液白细胞颈强直血培养阳性常见病原体脑脊液培养全身性损害神经病学淋球菌

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6-巯基嘌呤治疗炎症性肠病的单中心10年治疗经验

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世界核心医学期刊文摘（胃肠病学分册） 2005年第7期1卷 40-41页

作者： Glazier K.d. Palance A.L. Griffel L.H. das K.M. 樊菁 UMdNJ- Robert Wood Johnson Med. Sch. 1 Robert Wood Johnson Place New Brunswick NJ 08903 United States Dr.

Goals: To report the 10- year experience of a single center in treating pati ents with refractory inflammatory bowel disease (IBd) with relatively lower dose of 6- mercaptopurine (6- MP). Study: The charts of 285 patients with IBd (Cro hn’ s disease 160 and ulcerative colitis 125) receiving 6- MP were reviewed. C linical response, subsequent breakthrough while taking 6- MP, and relapse rates when 6- MP was discontinued and side effects were assessed. Results: Ninety- three percent of the patients were taking 50 to 75 mg/day of 6- MP. Complete re mission was achieved in 62% , partial remission in 14.5% , and failure to achi eve remission in 23.5% of the patients. Of complete responders, 27.5% had br eakthrough while continuing 6- MP. Nine percent of those that achieved a comple te remission experienced a relapse after 6- MP was discontinued. Side effects i ncluded leukopenia (11.2% ), abnormal liver function tests (3.8% ), various in fections, including pneumonia (3.1% ), pancreatitis (2.5% ), nausea (2.1% ), headache (2.8% ), fever (1.4% ), hair loss (1% ), and rash (0.7% ). Two canc ers occurred while taking 6- MP: melanoma on the finger and a fatal colonic lym phoma. Four patients continued 6- MP throughout pregnancies and had normal outc omes. Conclusions: In our experience 6- MP is relatively safe and appears to be as effective at a lower dosage (0.84 mg/kg per day) compared with the recommend ed higher dosage (1- 1.5 mg/kg per day), when leukopenia was more frequent. Ser ious side effects, although rare, need to be monitored.

关键词：炎症性肠病单中心克罗恩病溃疡性结肠炎结肠淋巴瘤临床反应复发率黑色素瘤白细胞减少正常分娩

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融合性网状乳头瘤病(Gougerot-Carteaud综合征):发病机制中无酵母菌感染证据的美满霉素反应性皮肤病,对39例患者的研究并提出新的诊断标准

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世界核心医学期刊文摘（皮肤病学分册） 2006年第6期2卷 25-26页

作者： davis M.d.P. Weenig R.H. Camilleri M.J. 吴佳纹 department of dermatology Mayo Clinic 200 First Street SW Rochester MN 55905 United States

Background: Confluent and reticulate papillomatosis (CRP) (Gougerot-Carteaud syndrome) is a disorder that has been characterized in only small cohorts of patients. Objectives: Better to characterize the clinical and pathological findings of the disorder. Methods: We retrospectively reviewed the clinical presentation, response to treatment and histological findings of patients presenting to Mayo Clinic (Rochester, MN, U.S.A.) with CRP. Results: The disorder was diagnosed in 39 patients between 1972 and 2003. Mean age at onset of the skin eruption was 15 years (range 8-32); 21 patients (54%) were male; most were white; most (33) presented for reasons of cosmesis; and eight described the rash as mildly pruritic. At presentation, the skin eruption had been present for a mean of 3.1 years (range 3 months-20 years) and had been recalcitrant to treatment, including antifungal treatment. Typical objective findings were scaling brown macules and patches and velvety papules and plaques, reticulated and papillomatous at least in part, involving the upper trunk, axillae and neck. The most frequent initial diagnostic impressions were tinea versicolor, acanthosis nigricans and CRP. Scales in 32 cases were examined with potassium hydroxide: eight (25%) showed hyphae, and 24 (75%) did not. Skin biopsy specimens from 21 patients showed variable degrees of hyperkeratosis, acanthosis and papillomatosis. Minocycline was prescribed for 22 patients, of whom 14 of 18 (78%) had complete clearing of the skin eruption and four (22%) a partial response. The skin eruptions recurred after stopping treatment in six patients. Conclusions: CRP occurs predominantly in young adults and teenagers, with cosmetically displeasing brown scaling patches and plaques affecting the neck, upper trunk and axillae. Frequently, the diagnosis is delayed and the disorder not recognized by physicians, including dermatologists. Clinically, the eruption is most often confused with tinea versicolor. Potassium hydroxid

关键词：融合性网状乳头瘤病 RP患者初步诊断发病机制反应性综合征酵母菌感染美满霉素标准皮肤病

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