Exclusion criteria were the following: age younger than 18 years,

Exclusion criteria were the following: age younger than 18 years, pregnancy or breast feeding, duration of severe sepsis selleck screening library for longer than 72 hours, antiviral treatment with ganciclovir, valaciclovir, cidofovir, or foscarnet in the previous 7 days, and manifest immunosuppression because of HIV infection, congenital defects, leukopenia <2,000/��l, radiation or treatment with immunosuppressive substances within the last 6 months including prednisone, rituximab, alemtuzumab, tacrolimus, sirolimus, ciclosporin, mycophenolic acid, azathioprine, anti-lymphocytic or anti-IL6 antibodies.Study protocolThe investigation was approved by the local ethics committee of the Faculty of Medicine, which waived the need for informed consent.

As soon as a patient fulfilled the inclusion criterion of severe sepsis and had no exclusion criterion present the first set of virological examinations including CMV serology was performed within the next three days.Patients having a positive anti-CMV IgG titer were enrolled and further monitored for CMV reactivation once a week until discharge from the University Hospital or death.Clinicians were not aware of the virological results, since they were assessed in a specific internal database applied for scientific purposes only. Ordering examinations to look for CMV disease as well as the initiation of antiviral treatment was left to the decision of the clinician, independently of the study.

The following data were evaluated at enrolment: age, gender, underlying disease requiring ICU treatment, the type of infection and the organ dysfunction constituting severe sepsis, presence of septic shock, the length of stay in the ICU, duration of mechanical ventilation and severity of illness and organ dysfunction as indicated by the Simplified Acute Physiology Score (SAPS) II [20] and the Sequential Organ Failure Assessment (SOFA) scores. Additionally, the records of each patient were reviewed for the presence of malignant disease, the number of surgical procedures, and the number of red blood cell units transfused during the current hospital stay before enrolment. After enrolment it was registered whether a CMV disease was diagnosed by the responsible clinicians. The study nurses collecting clinical data were blinded for virological findings with the exception of CMV serology, which was reported immediately.

The consequences of active CMV infection were longitudinally examined from enrolment until discharge or death by assessing in-hospital mortality, length of stay (LOS) in the ICU and in the hospital as well as time on mechanical ventilator.Virological assaysSamples were processed in the virological laboratory each Monday and Thursday independently from the day severe sepsis Anacetrapib was diagnosed. The personnel performing the virological examinations had no contact with patients and no insight into clinical data. All data were fed into an internal database for scientific purposes to ensure mutual blinding.

Let (UV) be its inverse; that is,(UV)(ST)=(USUTVSVT)=(In/20n/20n/

Let (UV) be its inverse; that is,(UV)(ST)=(USUTVSVT)=(In/20n/20n/2In/2).(11)Then together we carry out the same similarity transformation on P1 and P2 as follows:(UV)P1(ST)=(UP1SUP1TVP1SVP1T)=(0n/2UP1T0n/2VP1T),(UV)P2(ST)=(UP2SUP2TVP2SVP2T)=(UP2S0n/2VP2SIn/2),(12)where P1 and P2 are idempotent implies that VP1T and UP2S are idempotent and r(P1) = r(P2) = n/2 implies that VP1T = In/2 and UP2S = 0n/2. Hence, X is similar to the following matrix:(0n/2��UP1T0n/20n/2)+(0n/20n/2?��VP2S0n/2).(13)That is, X is s2N in Mn(K).When car(K) = 2, X is (��, ��) composite for arbitrary nonzero �� K, we can similarly prove that X is s2N in Mn(K) replacing ?�� with �� in the previous proof.Step 4 �� Suppose car(K) �� 2 and all eigenvalues of X are in K; then by Corollary 5, jk(X, ��) = jk(X, ?��) for every k Z+ and arbitrary nonzero �� K.

Moreover, X is similar to X1 Xs, where both the characteristic polynomial and the minimal polynomial of Xi are [(x ? ��i)(x + ��i)]ri = (x2 ? ��i2)ri with 2��i=1sri = n and ��i K0 is one of eigenvalues of X for every i [s]. Without loss of generality, we just need to prove Xi is s2N.Since Xi is similar to C((x2 ? ��i2)ri) as follows:(00??0a010??00010?0a2?????????10a2ri?20??010),(14)where (x2 ? ��i2)ri = x2ri ? a2ri?2x2ri?2 ? ?a2x2 ? a0. We have C((x2 ? ��i2)ri) = E2,1 + +E2ri,2ri?1 + a0E1,2ri + a2E3,2ri + +a2ri?2E2ri?1,2ri = (E2,1 + E4,3 + +E2ri,2ri?1)+(E3,2 + +E2ri?1,2ri?2 + a0E1,2ri + a2E3,2ri + +a2ri?2E2ri?1,2ri) = N1 + N2. Obviously, both N1 and N2 are square nilpotent matrices; that is, Xi is s2N. Hence, X is s2N in Mn(K).

When car(K) = 2, all blocks in the Jordan reduction of X with respect to �� K0 have an even size by Corollary 6; that is, both the characteristic polynomial and minimal polynomial of every block with respect to �� are (x + ��)si = ((x + ��)2)si/2 = (x2 + ��2)si/2, where si is even. Similarly, we can also prove that X is s2N in Mn(K).
The triple-band bandstop filter (TBBSF) has evolved rapidly and has led to a dramatic demand for a lower-cost product with a compact size and strong communication capabilities. In a microwave communication system, the bandstop filter (BSF) is an important component that is typically adopted in the transmitter and receiver system. Triple-band antennas, baluns, and filters are required to accommodate triple-band wireless systems [1�C3].

Triple-band BSFs are the key components for suppressing the specific bands of frequencies among these devices. Compared to single-band and dual-band filters, these filters are more popular due to their miniature size.Recently, an increasing number of researchers have paid attention to triple-band bandstop filters as a key component for evolving WiMAX applications Entinostat of the future. The conventional topology of filters design fails to meet the requirement of compact size [2�C5]. Thus, this paper focuses on a design that expands the frequency band to reduce the size with a rectangular meandered-line stepped impedance technology.

5) Finally, we did not find any association related to the under

5). Finally, we did not find any association related to the underlying disease process.Figure 4Bland-Altman analysis of agreement showing the differences between protein content (g/L) measurements plotted against the average between methods. Squares selleck chem Axitinib correspond to patients. The middle horizontal line indicates the average difference between the …Figure 5Bland-Altman analysis of agreement showing the differences between measurements of percentage of neutrophils plotted against the average between methods. Squares correspond to patients. The middle horizontal line indicates the average difference between …DiscussionThe sampling of alveolar fluid from patients with acute respiratory failure allows the study of lung inflammatory response to various injuries.

As demonstrated by Matthay and co-workers [4,5,10], direct sampling of undiluted lung oedema fluid may provide fundamental insights into the onset and evolution of acute inflammatory changes in permeability lung oedema as well as help to determine whether the pulmonary oedema is primarily from a hydrostatic or increased permeability mechanism. bBAL is generally well tolerated even in severely hypoxaemic patients with ALI/ARDS [15]. Yet, the sampling collections with this gold standard technique may sometimes be restricted by persistent severe hypoxaemia or cardiovascular instability, the presence of small endotracheal tubes or the unavailability of a bronchoscopist.

Mini-BAL has been successfully evaluated in comparison with bBAL for the diagnosis of ventilator-associated pneumonia [8], but it showed disappointing results in a recent study where both techniques were compared for assessing alveolar permeability and inflammation in patients at risk for ARDS or with ARDS [9]. However, considering that the s-Cath sampling might not perform adequately after 24 hours because the ability to obtain oedema fluid may decline over the course of ALI/ARDS, we decided to use the mini-BAL as a comparison methodology, because it is easily performed at the bedside and may be completed without a bronchoscopist.Mini-BAL was generally a safe procedure. However, when performed with a 16-Fr 5 mm outer diameter catheter, the mini-BAL procedure on rare occasions induced significant gas exchange abnormalities lasting up to 30 minutes after the end of collection, as shown by SpO2 and PaO2/FiO2abnormalities.

Hypoxaemia was probably induced by the lavage itself and by reduced tidal volumes delivered while the catheter was in place [7,16]. We measured the Ppeak on the ventilator (back pressure) before, during and after the procedure. This pressure significantly increased during mini-BAL sampling, representing an indirect sign of unstable tidal volumes during the ventilatory cycle [7,17]. Moreover, mini-BAL caused minor bronchial GSK-3 haemorrhage in five patients, leading us to stop the investigation prematurely.

These can be used either to predict a patient likely to respond t

These can be used either to predict a patient likely to respond to a volume challenge or to carefully monitor the response to a fluid bolus. This therefore provides a sophisticated and sensitive mechanism for titrating intravenous fluids to complex patients. Benefit has been demonstrated with fluid loading alone to maximize stroke volume, using these Crenolanib AML technologies [48,50]. Targeting of the pulse pressure variation in mechanically ventilated patients to a value of less than 10% with fluid challenges has been demonstrated to improve post-operative outcome and reduce length of hospital stay [51].Fluid therapy as guided by the oesophageal Doppler (Deltex Medical Ltd, Chichester, UK) reduces mortality and hospital stay [31,52,53]. The oesophageal Doppler is well tolerated and can be used throughout the entire peri-operative period.

It has little bias and high clinical agreement when compared with the PAC for monitoring changes in cardiac output [54]. FTc is inversely proportional to systemic vascular resistance and is sensitive to changes in left ventricular preload [55]. It may also be a more sensitive indicator of cardiac filling than pulmonary artery occlusion pressure [56]. Improved outcome as demonstrated by faster return of gastrointestinal function, a reduction in post-operative complications and shortened hospital stay was demonstrated when using the oesophageal Doppler for goal-directed fluid administration (that is, targeting stroke volume and FTc to maximize CI) during major surgery [48].

A meta-analysis of five RCTs of 420 patients undergoing major abdominal surgery showed fewer complications, less requirement for inotropes, faster return of gastro-intestinal function, fewer ICU admissions and shorter hospital stay in patients who received oesophageal Doppler-guided haemodynamic management [50].The LiDCOplus system (LiDCO Ltd, Cambridge, UK) is also well validated [57]. In 2005 Pearse and colleagues [38] conducted a RCT of post-operative GDT in high-risk general surgical patients using colloid and dopexamine to achieve a 2 or conventional management DO2I of 600 ml/minute/m using the LiDCOplus to measure CO. There were fewer complications in the control group (44% versus 68%), less complications per patient and a shorter hospital stay, although there was no difference in 28- or 60-day mortality.

Several studies have shown that the PiCCO system (PULSION Medical Systems, Munich, Germany) is also a reliable method of assessing cardiac preload and may actually be more sensitive than the PAC [58-60]. Goepfert and colleagues [61] devised a GDT algorithm based on targeting global end-diastolic volume index, an indicator of cardiac preload as measured GSK-3 by PiCCO to achieve a goal of >640 ml/m2 and CI >2.5 l/minute/m2 in patients undergoing elective coronary artery bypass grafting surgery.

It is well recognized that the first ICU in mainland China was se

It is well recognized that the first ICU in mainland China was set up in the Peking Union Medical College Hospital in 1982, in the form of a surgical ICU with only one bed [4,5]. Two years later, it became the first Department of Critical Care Medicine in mainland China, with a seven-bed general mostly ICU in the Peking Union Medical College Hospital, chaired by Dr Dechang Chen, the well-recognized founding father of critical care medicine in mainland China.In November 1989, the Ministry of Health issued the Regulation of Hospital Accreditation and Management, which required the establishment of an ICU as a prerequisite for accreditation as a tertiary hospital [4,5]. Many ICUs were set up in hospitals all over China following the release of this document.

Many physicians (including general surgeons, internists, emergency physicians, and anesthesiologists) were sent to other hospitals for critical care training, either abroad or domestically, before returning to practice as intensivists [4,5].Development of critical care medicine as a specialty in mainland ChinaIn mainland China, physicians of other relevant specialties were the first to be assigned to work in ICUs because of their familiarity with the necessary techniques (anesthesiologists), disease entities (surgeons and internists), and required urgency of treatment (emergency physicians). However, after years of hard work, the important role of intensivists, as a coordinator during patient evaluation and treatment, has gradually been recognized and respected by other specialties.

Junior physicians interested in critical care training can choose to be intensivists after they finish 3 or 4 years of fellowship training in surgery or internal medicine. However, the traditional specialties often still assume responsibility for or ‘ownership’ of patients, as well as have a desire to treat critically ill patients, as reflected by the fact that the proposal for setting up a critical care society under the Chinese Medical Association (CMA) was rejected in 1996.Public healthcare crises in China since 2003 have provided intensivists with an opportunity to demonstrate their knowledge and skills. Epidemics of severe acute respiratory syndrome (SARS) in 2003, of Streptococcus suis in 2005, and of avian influenza, as well as the Wenchuan Earthquake in 2008, caused extreme anxiety in the public due to the vulnerability of the general population, the high communicability of the diseases, and the high case fatality rate.

Therefore, intensivists were often convened by the government Carfilzomib to be involved in crisis management very early [6]. Their ability to coordinate, cooperate, and communicate with regard to both patient management and policy-making was well demonstrated during daily work, and recognised by the general public and healthcare authorities.

She was discharged home well on the second postoperative day and

She was discharged home well on the second postoperative day and was able to continue her chemotherapy two weeks later. Case 6 �� A 22 year old man (BMI 20.2kg/m2) from the Middle East who presented with a three month history of recurrent www.selleckchem.com/products/CHIR-258.html abdominal pain and weight loss with night sweats having being diagnosed with pulmonary tuberculosis six months prior to presentation. CT and terminal ileoscopy revealed an inflammatory stricture of the terminal ileum. Due to the degree of local symptoms, he went single port laparoscopic resection of the ileal loop with primary stapled extracorporeal anastomosis. Histological examination demonstrated ileocaecal tuberculosis and he was commenced on appropriate therapy. Cases 7, 8, 9 and 10. All females (37 years (BMI 20.8kg/m2), 34 years (BMI kg/m2), 27 years (BMI kg/m2), 24 years (BMI 20.

5kg/m2) with known Crohn’s disease presented with increasingly frequent episodes of intermittent, crampy right iliac fossa pain with occasional postprandial vomiting despite maximal medical therapy. One patient had a palpable mass evident on palpation in her right iliac fossa. CT abdomen revealed distal ileal disease in all cases. Single port laparoscopy allowed the performance of a limited ileo-caecal resection with extracorporeal anastomosis in each case. All made uncomplicated postoperative recoveries and were discharged home on between postoperative day 4 (n = 3) and 6. Subsequent pathological examination confirmed the diagnosis of Crohn’s disease. 4. Discussion SALS provides the benefits of conventional laparoscopy while reducing the tissue trauma due to the reduction in size and number of ports used.

The potential benefits of SALS include reduced postoperative pain, a shorter recovery period, lower morbidity, reduced cost, and superior cosmesis [1]. It also obviates trocar-related intra-abdominal injury and port site incisional hernia formation, and thus may ultimately prove superior. This approach is particularly compelling in cases where a 3cm incision is required anyway for the purposes of specimen extraction or stoma formation and so this wound can be made at the commencement of the surgery and used as the sole site of transabdominal incision before being closed securely under direct vision at procedure end.

The ability to focus local anaesthetic regimens towards one single wound is also intuitively advantageous over the Carfilzomib more variable responses associated with broader regional techniques such as transversus abdominus preperitoneal plane (TAPPS) blocks. To date, however, the published experience is limited with regard to followup beyond hospital discharge and lack of long-term clinical outcome data demonstrating superiority. Furthermore, many laparoscopic surgeons still raise concerns overthe ergonomics of the technique.

The day-case rate of 60 per cent achieved in the present study co

The day-case rate of 60 per cent achieved in the present study could therefore equate to annual savings of at least ��74,700 based on a hospital performing 500 cases per year. Higher day-case rates are therefore desirable, although in the context of randomised controlled trials, with patients selected on the basis of operative fitness Nutlin-3a and proximity to hospital, a day-case rate of only 80 per cent is reported [3, 4, 8�C10]. This relates predominantly to uncontrolled pain, nausea, and vomiting, which are known to affect both hospital stay and patient discharge [3, 4]. The use of intraoperative local anaesthetic, postoperative paracetamol, and nonsteroidal anti-inflammatories, with an avoidance of opiates, have all been suggested as techniques to minimise these problems [1].

Since October 2009 our own institution has therefore introduced a standardised anaesthetic and postoperative analgesia protocol for day-case laparoscopic cholecystectomy, which it is hoped will further increase day-case rates. Additional cost savings are also achievable by using an integrated patient pathway, such as that shown in Figure 2, which can minimise the need for repeat ultrasound studies (��49), blood tests (��10), and outpatient appointments (��88) [7]. The use of nondisposable surgical instruments and limiting the use of intraoperative antibiotics is also important. The gallbladder pathway used in this study adheres to the principles outlined in the ��Focus on Cholecystectomy�� document [1]. Reducing the number of patient visits by providing preassessment at the initial clinic visit and preventing routine outpatient followup resulted in less disruption to patients.

This is particularly important due to the wide geographical distribution of our patients, although these limitations in access to transport may have also led to some patients not being suitable for day-case surgery. Providing patients with a choice of dates for surgery led to fewer cancellations on the day of surgery. Staggered admission times, whilst preventing long periods of waiting or starvation, were not used during this study. These were limited by the need for an anaesthetist or surgeon to see the patient preoperatively, particularly as operating lists were increasingly pooled to meet waiting list targets.

Clerical error, particularly with respect to patients being listed on afternoon operating lists, resulted in a number of patients suitable for day-case surgery requiring an overnight stay. This issue has Cilengitide been previously identified in randomised trials of laparoscopic day-case cholecystectomy versus overnight stay [9]. Following the interim audit in 2008, patients suitable for day-case were predominantly scheduled on a morning list or first on the afternoon list, which resulted in a substantial increase in day-case rates from 30 to over 60 per cent.

A previous study of pediatric patients with neoplastic diseases i

A previous study of pediatric patients with neoplastic diseases in Germany by Simon et al. [10] found a rate of NIs of 5.2 cases per 100 admittances and of 10.8 cases per 1000 days of hospitalization, which is similar to the results obtained by our study. A study of Urrea et al. [11] among pediatric patients with neoplastic diseases in Spain found an NI rate of 1.77 cases per 100 selleck inhibitor days of hospitalization. The incidence of NIs in our study was relatively low in comparison to the study of Urrea et al. This may be because our study excluded patients with fever of unknown origin and those who had viral infections. In addition, in our study patients appeared to have lower rates of central venous catheterizations than patients in previous studies [5, 10, 11].

Patients with ALL who represented 59% of the sample population had the highest NI rate (41.3%) in our study. Since the percentage of ALL patients in our study was higher than that reported in other studies [10, 11], it could represent a skewed population. In regards to sites of NIs, most infections in our study occurred in the blood stream (30.5%), as in other studies by Simon et al. [10] (52.5%) and Urrea et al. [11] (55.5%). Regarding causal organisms of NIs, studies from Eastern countries found that gram-negative bacteria were most common, like in our study. Our study found 47.1% gram-negative bacteria and 29.4% gram-positive bacteria while the study by Frank et al. [12] in Israel from 1992 to 2001, which focused particularly on bacteremia in pediatric wards, found 54.3% gram-negative bacteria and 36.6% gram-positive bacteria.

However, our study focused on children with neoplastic diseases while Frank’s et al. study included the general pediatric population, including intensive care units. Therefore this comparison might not be completely valid. In contrast, studies from European countries were more likely to report gram-positive bacteria to be more common. For example, the study by Simon et al. [10] found up to 83.3% gram-positive and 11.1% gram-negative bacteria, and the study by Urrea et al. [11] reported up to 78.6% gram-positive bacteria. The higher rate of gram-positive bacteria as causal organisms for NIs in European countries could be due to the fact that in European countries central venous catheterization is more common than in Eastern countries, such as in Thailand.

In addition, in our study we found 3 cases of Salmonella enteritidis infections. Salmonella enteritidis is unlikely to be a causal organism of NIs since it is normally found in community settings. We think that these patients may have been colonized with this organism outside the hospital and then developed symptoms when their immunity level Dacomitinib was low after chemotherapy. Furthermore, our study found that fungal infections accounted for 14.7% of infections, while in the previous two studies by Simon et al. [10] and Urrea et al.

The use of CABG, as compared with both percutaneous coronary inte

The use of CABG, as compared with both percutaneous coronary intervention (PCI) and medical therapy, Romidepsin FK228 is superior with regard to long-term symptom relief, major adverse cardiac or cerebrovascular events and survival benefit [1�C4]. However, because of the use of cardiopulmonary bypass and median sternotomy, CABG is associated with significant surgical trauma leading to a long rehabilitation period and delayed postoperative improvement of quality of life [5]. An alternative ��hybrid�� approach to multivessel coronary artery disease combines surgical left internal thoracic artery (LITA) to left anterior descending coronary artery (LAD) bypass grafting and percutaneous coronary intervention of the remaining lesions [3, 6�C8].

Ideally, the LITA to LAD bypass graft is performed in a minimally invasive fashion through minimally invasive direct coronary artery bypass grafting (MIDCAB) [9]. This hybrid approach takes advantage of the survival benefit of the LITA to LAD bypass, while minimizing invasiveness and lowering morbidity by avoiding median sternotomy, rib retraction, aortic manipulation, and cardiopulmonary bypass [3, 8, 10�C14]. The purpose of the hybrid approach is to achieve complete coronary revascularization with outcomes equivalent to conventional coronary artery bypass grafting, while ensuring faster patient recovery, shorter hospital stays, and earlier return to work due to lower morbidity and mortality rates. Angelini and colleagues reported the first hybrid coronary revascularization (HCR) procedure in 1996, and several patient series using hybrid coronary revascularization have been published since then [3].

These series support the above-mentioned presumptions and indicate that the hybrid approach is a feasible option for the treatment of selected patients with multivessel coronary artery disease involving the left main. Moreover, the introduction of drug-eluting stents (DESs) with lower rates of restenosis and better clinical outcomes may make hybrid coronary revascularization a more sustainable and feasible option than previously reported [9, 15]. Nevertheless, this hybrid approach has not been widely adopted because practical and logistical concerns have been expressed. These concerns implicate the need for close cooperation between surgeon and interventional cardiologist, logistical issues regarding sequencing and timing of the procedures, and the use of aggressive anticoagulant therapy for percutaneous coronary intervention that may worsen bleeding in the surgical patient [7, 14, 16]. This review aims to clarify Batimastat the place of hybrid coronary revascularization in the current therapeutic armamentarium against multivessel coronary artery disease. First, the patient selection for the HCR procedure is clarified.

Plzf is a transcriptional regulator that can both repress and act

Plzf is a transcriptional regulator that can both repress and activate gene expression. The function of Plzf may depend on its interaction partners in cells. In the study of David et al. Plzf represses transcription by recruiting a histone deacetylase selleck chemicals Gemcitabine through the SMRT mSin3 HDAC co repressor complex. In contrast, Plzf is found to activate GATA4 transcription by binding to angiotensin II activated AT2 receptor. Plzf contains an N terminal BTB POZ domain and nine kruppel like C2H2 aurora kinase C promoter activity by Plzf are not different in the presence of Znf179 or not. We speculate that, first, the protein level of ectopic Plzf expression in the Plzf transfected only cells may be enough for the maximal sup pression. Second, Znf179 indeed affects the ability of Plzf to regulate aurora kinase C promoter activity.

However, the effect of Znf179 on Plzf repression activity is compen sated by the increase of Plzf protein. However, it is still possible that Znf179 may affect the ability of Plzf to regu late specific downstream target genes. Plzf is subject to several different post translational modifications, including phosphorylation, acetylation and conjugation to ubiquitin and SUMO 1. Btbd6a was found to promote the relocation of Plzf from nucleus to cytoplasm and targets Plzf for ubiquitination and deg radation. In contrast, the deubiquitinating enzyme USP37 interacts with Plzf which increases Plzf protein sta bility. In addition, Plzf is found to be phosphorylated by CDK2 on Ser197 and Thr282 and this phosphorylation results in a decrease in protein stability.

In our study, we have found that Znf179 interacts with Plzf and in creases the ectopic expression of Plzf at posttranscrip tional level. It is possible that interaction of Plzf with Znf179 may affect its interaction with other protein and or alters its post translational modification, which results in an increase of the Plzf protein. The expression of the Znf179 gene is restricted to the brain and is regulated during brain development. However, the Plzf is widely expressed in neural progenitors and functions to inhibit neurogenesis. The interaction and reciprocal regulation between Znf179 and Plzf during the neurogenesis is an important issue. Znf179 is a RING finger protein with a characteristic C3HC4 motif located in the N terminus.

It is known that many RING finger proteins act as E3 ubiquitin ligases and are AV-951 associated with the ubiquitin proteasome pathway. In human genome, more than 600 RING finger proteins were annotated as E3s. Whether Znf179 functions as an E3 ubiquitin lig ase needs to be further investigated. Our results reveal that Znf179 interacts with Plzf and increased Plzf expression at posttranscriptional level. In other words, if Znf179 func tions as an E3 ubiquitin ligase, Plzf may not be its sub strate. Plzf is found to be an adaptor of E3 ligase cullin 3. In the study of Mathew et al.