The spatial organization of DNA within the bacterial nucleoid remains unclear. To investigate chromosome organization in Escherichia coli, we examined the relative positions of the ribosomal RNA ...(rRNA) operons in space. The seven rRNA operons are nearly identical and separated from each other by as much as 180° on the circular genetic map, a distance of ≥2 million base pairs. By inserting binding sites for fluorescent proteins adjacent to the rRNA operons and then examining their positions pairwise in live cells by epifluorescence microscopy, we found that all but rrnC are in close proximity. Colocalization of the rRNA operons required the rrn P1 promoter region but not the rrn P2 promoter or the rRNA structural genes and occurred with and without active transcription. Non-rRNA operon pairs did not colocalize, and the magnitude of their physical separation generally correlated with that of their genetic separation. Our results show that E. coli bacterial chromosome folding in three dimensions is not dictated entirely by genetic position but rather includes functionally related, genetically distant loci that come into close proximity, with rRNA operons forming a structure reminiscent of the eukaryotic nucleolus.
Abstract Background Bariatric surgery is an effective weight loss and comorbidity treatment among severely obese patients. However, there are limited data describing its impact on patient-reported ...quality of life (QoL). We examined patient-reported QoL after bariatric surgery and analyzed variables associated with higher postoperative QoL. Methods Patient demographics, comorbidities, and weight loss data were obtained from our institutional database for patients who underwent bariatric surgery from January 2010 to December 2012. QoL scores were obtained during preoperative and postoperative visits (2, 6, 12, 24, 52, and 104 wk) from the Moorehead-Ardelt Quality of Life Questionnaire II. Multivariable logistic regression was performed to generate odds ratios for variables hypothesized a priori to be associated with higher postoperative QoL. Results A total of 209 patients were included in the study. Patients lost an average of 59.1% (±19.0) of excess body weight 1 y after surgery. One-year postoperative QoL scores were available for 42% of patients. Mean QoL scores improved from 0.82 preoperatively to 1.66 1 y postoperatively ( P = 0.004). Patients scored higher in all individual areas of Moorehead-Ardelt Quality of Life Questionnaire II: self-esteem (0.22 versus 0.36), physical activity (0.11 versus 0.31), social life (0.28 versus 0.36), work ability (0.07 versus 0.22), sexual functioning (0.04 versus 0.16), and approach to food (0.11 versus 0.26; all P values <0.05). On multivariable analysis, higher QoL was associated with private insurance/self-pay versus Medicare (odds ratio 4.20 95% confidence interval 1.39-12.68). Conclusions Bariatric surgery patients experienced significant improvement in QoL 1 y after surgery. Identifying modifiable predictors of high QoL after bariatric surgery requires additional investigation.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK, ZRSKP
Lymphoma of the central nervous system (CNS) forms a rare type of lymphoma with a poor prognosis. Chemo-immunotherapy containing a methotrexate backbone remains the treatment of choice in the first ...line setting. When responses are achieved, this treatment needs to be followed, whenever possible, by treatment intensification followed by autologous stem cell transplantation (ASCT). There is no consensus on the optimal conditioning regimen for ASCT. Most studied regimens contain thiotepa, an agent that can cross the blood brain barrier, which confer excellent survival outcomes. However, this drug is not widely accessible in the United States for multiple reasons. An alternative to thiotepa-based regimens is the combination of busulfan, cyclophosphamide, and etoposide (BuCyE), which has resulted in conflicting outcomes. Here we report our experience with 3 cases of CNS lymphoma, treated with BuCyE, with a protocol using dosages different from what was previously reported, specifically with busulfan 3.2 mg/kg at days -8 to -5 (with pharmacokinetics adapted dosing at days -6 and -5), etoposide 30 mg/kg on day -4, and cyclophosphamide 60 mg/kg on day -3. Treatment resulted in excellent long-term outcomes with all 3 patients being alive at least 4 years following ASCT with no evidence of relapse. The side effect profile was acceptable, with the exception of a case of pulmonary toxicity. This cohort is limited by its small size, and further work comparing it to other treatments is being done at our institution.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
“Accelerated” chronic lymphocytic leukemia/small lymphocytic lymphoma (A-CLL) is a rare histological variant of CLL/SLL, which tends to exhibit an aggressive clinical behavior compared to CLL. Due to ...the rarity of A-CLL (<1% of all cases), the optimal management remains ill-defined. We report two cases of A-CLL from our institution, in which both relapsed following initial chemoimmunotherapy regimens. Both patients were treated with single agent ibrutinib, a Bruton's tyrosine kinase inhibitor (BTKi), and achieved rapid, deep and durable responses. With the absence of clear guidance on A-CLL treatment, BTKi agents should be considered in the frontline treatment of A-CLL.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
The rate of cesarean delivery has increased over the last 2 decades. Obesity is a risk factor for complications during pregnancy and cesarean procedures. The objective of this study was to evaluate ...cesarean delivery outcomes in patients with vs without obesity, and determine the impact of obesity on complications.
The medical records of patients who underwent a cesarean delivery from 2010 to 2014 were reviewed. Patients were grouped by body mass index (BMI) into obese (≥30kg/m²) and non-obese (<30kg/m²) cohorts for comparison.
Nine hundred seventy-one patients were included; 432 whom had obesity, and 539 did not have obesity. The rate of gestational diabetes was increased among patients with vs without obesity (15.3% vs 5.8%; P<0.001). Obesity was associated with an increased incidence of surgical site infections (8.1% vs 2.4%; P<0.001), yeast infection (2.8% vs 0.2%; P<0.001), and seroma (2.8% vs 0.4%; P=0.002). Obesity was an independent risk factor for surgical site infections, regardless of wound closure technique (adjusted odds ratio=3.24, 95% CI, 1.66-6.32; P<0.001).
Obesity is a risk factor for wound infections after a cesarean delivery. As obesity rates increase, it is important to be aware of these risks after performing a cesarean delivery.
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