Two-step mechanism of rotational relaxation in lamellar phases of rods: accelerating effect of the addition of spheres.
By using computer simulation on a model colloidal rod-sphere mixture in its lamellar phase, the mechanism responsible for the rod rotational relaxation has been definitely identified and characterized. It consists of two steps: first, a rod, parallel to the director, has to escape from the layer in which it is located and go into the interlayer region mostly populated by spheres, perpendicular to the director; then, it has to insinuate again into one of the adjacent layers, with 50% of probability of resulting antiparallel to the director. While this mechanism is also operating in a pure smectic phase of rods, the presence of spheres increases notably its efficacy, thus promoting the rotational relaxation and facilitating its observation.


[Hofmannsthal and the gliding out of this world].
In the sphere of language, Hugo von Hofmannsthal was already in his childhood talented by nature. His first poems and essays he wrote when he was 17 years old, his first drama ("The Death of Tizian") in his 18th year. From the beginning he followed the great tradition of the theatre of Vienna. His lyrical creations end already before he turned 30 years. At this time the dramatist begins with the reception of the medieval mystery plays, Calderon and the greek-oriental myths. The phenomena of gliding-out-of-the-world are found before this time, in the period of his very own spiritual conceiving. They show a remarkable inclination to abandon the world of reality (Wirklichkeit, koinos kosmos): gliding into the world of dream and trance, of phantastic tales, of magic and demonia, of depersonalization and dilusion, of dying and of death (idios kosmos). These tendencies vanish when Hofmannsthal turns to more conventional topics.


Antitumor and antimetastatic activity of a novel water-soluble low molecular weight beta-1, 3-D-glucan (branch beta-1,6) isolated from Aureobasidium pullulans 1A1 strain black yeast.
Though it has been reported that beta-glucans or protein-binding hetero-glucans isolated from mushrooms have antitumor activity, the antitumor and antimetastatic actions of purified, structurally defined polysaccharides (such as beta-glucans) have not been proven yet. A new low molecular weight (approximately 100 kDa) beta-glucan was isolated from Aureobasidium pullulans black yeast, and was found to have low viscosity and to be water-soluble. The industrial production of this P-glucan was achieved from the culture media of A. pullulans. The effects of water-soluble low-molecular-weight (LMW) beta-(1-->3) and 50-80% branched beta-(1-->6) glucan isolated from A. pullulans on tumor growth and metastasis to the liver were examined in mice intrasplenically with implanted colon 26 tumor cells. In addition, to clarify the antitumor and antimetastatic actions of LMW beta-(1,3-1,6) glucan, the effects on immune functions in the small intestine were also examined. The intraperitoneal (5 and 15 mg/kg) and oral (50 mg/kg) administration of LMW P-(1.3-1.6) glucan inhibited the tumor growth and liver metastasis in mice intrasplenically implanted with colon 26 cells. The numbers of natural killer (NK)- and interferon (IFN)-gamma-positive cells in the small intestine of colon 26-bearing mice were lower than those in normal mice. The intraperitoneally and orally administered LMW beta-(1,3-1,6) glucan prevented the reduction of the number of NK- and IFN-gamma-positive cells induced by the tumor growth after implantation of colon 26 cells. These findings suggest that the antitumor and antimetastatic actions of LMW beta-(1,3-1,6) glucan may involve the enhancement of intestinal immune functions through increases in NK- and IFN-gamma-positive cell numbers.


Ventilatory capacity and its utilisation during exercise.
Inadequate ventilation is not usually considered an exercise-limiting factor because it is thought that the respiratory system's maximum ventilatory capacity is never reached during exercise. This so-called reserve can be defined as the difference between the ventilated volume, attained during a maximum voluntary ventilation manoeuvre (MVV) and the maximum ventilation V(Emax) achieved during exercise. This study explores the relationship between ventilatory capacity, the MVV manoeuvre, and respiratory function. Twelve healthy adults completed a maximal cycle test and 12-, 30-, and 60-s MVV manoeuvres while seated or standing. The MVV(12) manoeuvre produced the largest ventilation volume (115 +/- 22 vs. (V(Emax)) 102 +/- 23 L min(-1)), signifying a reserve of 13%. With longer MVV (30 and 60 s) manoeuvres, the ventilated volume and (V(Emax)) were the same, signifying no reserve. MVV increased with the forced expiratory volume at one second, FEV(1). The breath rates were approximately 120 vs. 48 +/- 6 breaths min(-1) and tidal volumes were approximately 1 vs. 2.2 +/- 0.5 L during the MVV and exercise, respectively. The longer MVV manoeuvre provides the best estimate of ventilatory capacity and shows that 100% of the reserve is used during maximal exercise. A nomogram relating MVV to FEV(1) is shown.


Solitary fibrous tumour of the liver: a rare imaging diagnosis using MRI and diffusion-weighted imaging.
Solitary fibrous tumour of the liver is an extremely rare neoplasm, the reported imaging features of which are largely non-specific. We present a case in which dynamic contrast-enhanced CT, MRI and diffusion-weighted MRI findings suggested a diagnosis of solitary fibrous tumour of the liver that was subsequently confirmed by immunohistochemical evaluation.


Local anesthetic lidocaine induces apoptosis in human corneal stromal cells in vitro.
To demonstrate the apoptosis-inducing effect of lidocaine on human corneal stromal (HCS) cells in vitro, and provide experimental basis for safety anesthetic usage in clinic of ophthalmology. In vitro cultured HCS cells were treated with lidocaine at different doses and times, and their morphology was monitored successively with inverted phase contrast microscopy. The membrane permeability of them was detected by acridine orange/ethidium bromide (AO/EB) double staining. The DNA fragmentation of them was examined by agarose gel electrophoresis, and their ultrastructure was observed by transmission electron microscopy (TEM), respectively. Exposure to lidocaine at doses from 0.3125g/L to 20g/L induced morphological changes of HCS cells such as cytoplasmic vacuolation, cellular shrinkage, and turning round, and elevated membrane permeability of these cells in AO/EB staining. The change of morphology and membrane permeability was dose- and time-dependent, while lidocaine at dose below 0.15625g/L could not induce these changes. Furthermore, lidocaine induced DNA fragmentation and ultrastructural changes such as cytoplasmic vacuolation, structural disorganization, chromatin condensation, and apoptotic body appearance of the cells. Lidocaine has significant cytotoxicity on human corneal stromal cells in vitro in a dose- and time-dependent manner by inducing apoptosis of these cells. The established experimental model and findings based on this model here help provide new insight into the apoptosis-inducing effect of local anesthetics in eye clinic.


Validation of Calculated Globulin (CG) as a Screening Test for Antibody Deficiency in an Italian University Hospital.
Morbidity and mortality of primary and secondary antibody deficiencies (AD) are frequently associated with diagnostic delays. These could be avoided by a combination of factors including a widespread and effective development in screening tests. Calculated globulin (CG), derived from the difference between serum total protein and albumin levels, reflects immunoglobulin serum levels and has shown to have a predictive value in the early diagnosis of antibody deficiencies. This study investigated the possibility to use low levels of CG to detect antibody deficiency in an Italian University Hospital. First, we conducted an analysis of anonymized adult samples collected at our biochemistry laboratory with a range of calculated globulin levels from 15 to 22 g/l. A CG cut-off of 19 g/l detected subjects with IgG lower than 600 mg/dl with a sensitivity of 70% and a specificity of 75%. To further verify the clinical usefulness of CG, we retrospectively evaluated the relationship between CG values and serum IgG levels in 38 patients diagnosed with CVID at our Institution. Using a CG cut-off of 19 g/l, we detected antibody deficiency in 97.3% (37/38) of the subjects present in our cohort. Finally, we chose a CG value of 19 g/l as the cut-off for a prospective AD screening program. The results of this study show that a screening CG test can be used as a tool to reduce diagnostic delays, improve long-term prognosis and reduce the healthcare costs of antibody deficiency.


Any Cortical Bridging Predicts Healing of Supracondylar Femur Fractures After Treatment With Locked Plating.
To determine the accuracy and reliability of radiographic cortical bridging criteria in predicting the final healing of supracondylar femur fractures after treatment with locked plating. Retrospective review. Two Level 1 trauma centers. Patients who presented with supracondylar femur fractures (OTA/AO 33A, C) and were treated with locking plate fixation between January 1, 2004, and January 1, 2011. The final study population included 82 fractures after excluding patients with open physes (n = 4), nondisplaced fractures (n = 4), early revision for technical failure (n = 4), or inadequate follow-up (n = 42). Distal femur locking plate fixation. Postoperative radiographs until final follow-up were assessed for cortical bridging at each cortex on anterior-posterior and lateral views. Images were analyzed independently by 3 orthopaedic traumatologists to allow for assessment of reliability. Final determination of union required both radiographic and clinical confirmation. Assessment for any cortical bridging was the earliest accurate predictor of final union (95.1% accuracy at 4 months postoperatively), compared with criteria requiring bicortical bridging (93.9% accuracy at 6 months) and tricortical bridging (78% accuracy at 21 months). Any cortical bridging demonstrated a higher interobserver reliability (kappa = 0.73) relative to bicortical (kappa = 0.27) or tricortical bridging (kappa = 0.5). Our results for plate fixation of supracondylar distal femur fractures mirror those previously described for intramedullary nailing of tibia shaft fractures. Any radiographic cortical bridging by 4 months postoperatively is an accurate and reliable predictor of final healing outcome after locking plate fixation of supracondylar femur fractures. Assessment for bicortical or tricortical bridging is less reliable and inaccurate during the first postoperative year. Diagnostic Level III. See Instructions for Authors for a complete description of levels of evidence.


Genetic changes of MLH1 and MSH2 genes could explain constant findings on microsatellite instability in intracranial meningioma.
Postreplicative mismatch repair safeguards the stability of our genome. The defects in its functioning will give rise to microsatellite instability. In this study, 50 meningiomas were investigated for microsatellite instability. Two major mismatch repair genes, MLH1 and MSH2, were analyzed using microsatellite markers D1S1611 and BAT26 amplified by polymerase chain reaction and visualized by gel electrophoresis on high-resolution gels. Furthermore, genes DVL3 (D3S1262), AXIN1 (D16S3399), and CDH1 (D16S752) were also investigated for microsatellite instability. Our study revealed constant presence of microsatellite instability in meningioma patients when compared to their autologous blood DNA. Altogether 38% of meningiomas showed microsatellite instability at one microsatellite locus, 16% on two, and 13.3% on three loci. The percent of detected microsatellite instability for MSH2 gene was 14%, and for MLH1, it was 26%, for DVL3 22.9%, for AXIN1 17.8%, and for CDH1 8.3%. Since markers also allowed for the detection of loss of heterozygosity, gross deletions of MLH1 gene were found in 24% of meningiomas. Genetic changes between MLH1 and MSH2 were significantly positively correlated (p = 0.032). We also noted a positive correlation between genetic changes of MSH2 and DVL3 genes (p = 0.034). No significant associations were observed when MLH1 or MSH2 was tested against specific histopathological meningioma subtype or World Health Organization grade. However, genetic changes in DVL3 were strongly associated with anaplastic histology of meningioma (χ2 = 9.14; p = 0.01). Our study contributes to better understanding of the genetic profile of human intracranial meningiomas and suggests that meningiomas harbor defective cellular DNA mismatch repair mechanisms.


Lens implantation in children.
Two objections to lens implantation in children are answered. After the second year of life the size and the strength of the implanted lens does not have to be changed any more. Long-term follow-up (more than ten years) of Binkhorst 2-platinum loop lenses in traumatic cataract gives indication of slight decrease in visual function. In view of this the indication for lens implantation has still to be very strict, although fewer complications are to be expected in the posterior chamber lenses.


Review: recent advances in argatroban-warfarin transition in patients with heparin-induced thrombocytopenia.
Heparin-induced thrombocytopenia is a devastating, life-threatening, immune-mediated complication of therapy with unfractionated heparin, and less frequently, with low molecular weight heparin. Direct thrombin inhibitors are now standard therapy for the prevention of thrombosis in heparin-induced thrombocytopenia. Argatroban, a small synthetic molecule that inhibits thrombin at its active site, is increasingly used as the direct thrombin inhibitors of choice. Transition to longer term oral anticoagulation needs to be instituted after the platelet count has risen, because of the persistent risk of thrombosis. Although guidelines available in the literature outline the management of heparin-induced thrombocytopenia, they are not presented in a concise and comprehensive manner easily followed by physicians. This article reviews current recommendations, relevant studies, and clinical management trials carried out on patients with heparin-induced thrombocytopenia and provides updated, detailed guidelines for treatment of heparin-induced thrombocytopenia with emphasis on a key part of the management, the argatroban-warfarin transition.


[Lymph node micrometastases in gastric cancer].
Lymph node micrometastases in gastric cancer are based on the definition in the 6th version of the TNM classification of malignant tumours edited by the International Union Against Cancer, which is also quoted in the 14th version of the Japanese Classification of Gastric Carcinoma. Histopathologic examination such as immunohistochemistry and molecular biological techniques including RT-PCR and one-step nucleic acid amplification are used for the detection of micrometastases. Because the time required for such detection is shortened to 30 to 40 min, intraoperative detection is feasible. Many papers have reported the correlation between micrometastases and prognosis in gastric cancer, although whether micrometastases are correlated with poor prognosis even when completely resected remains unknown. Intraoperative detection of micrometastases is important to decide the operative procedure in sentinel node navigation surgery.


Exploring the postoperative pain experiences of individuals with opioid use disorder and the nurses providing care in the USA: A qualitative descriptive study protocol.
The goal of this study is to gain firsthand insights from individuals with a history of opioid use disorder (OUD) using medication for OUD on their experiences with postoperative pain care. This study also seeks to describe the experiences of nurses caring for individuals with OUD, and the challenges they may face managing complaints of pain in this population. Research suggests that hospitals can significantly enhance the quality of the care they deliver by investigating an individual's experience in the care setting. These insights will allow for the development of strategies for nurses to deepen their understanding of and, therefore, advocate and improve care for, this vulnerable and often stigmatised population. A qualitative descriptive study will be conducted consisting of a prescreening and demographics questionnaire, and individual semistructured interviews with approximately 10-15 individuals with OUD having recently undergone surgery and 10-15 nurses providing care for this population for a total of 20-30 interviews. This approach involves the collection of separate but complementary data (ie, perceptions of individuals with OUD and nurses) concerning the phenomena of postoperative pain management. Sampling will continue until data saturation is reached. Descriptive statistics and thematic analysis will then be used. Reporting will adhere to the Standards for Reporting Qualitative Research checklist. This study received approval from the Institutional Review Board at Northeastern University. Alongside peer-reviewed journal publications, the findings will be presented at relevant conferences, and a plain language summary will be distributed to the study participants.


Rationale and design of the Registry of Acute Stroke Under Novel Oral Anticoagulants-prime (RASUNOA-prime).
Anticoagulation with vitamin K antagonists and non-vitamin K antagonists oral anticoagulants (NOAC) is effective in stroke prevention in patients with atrial fibrillation. However, anticoagulation also poses a major challenge for emergency treatment of patients suffering ischaemic stroke or intracerebral haemorrhage. The registry RASUNOA-prime is designed to describe current patterns of emergency management, clinical course and outcome of patients with atrial fibrillation experiencing an acute ischaemic stroke or intracerebral haemorrhage under different anticoagulation schemes prior to stroke (NOAC, vitamin K antagonists or no anticoagulation). RASUNOA-prime (ClinicalTrials.gov, NCT02533960) is a prospective, investigator-initiated, multicentre, observational cohort study aiming to recruit 3000 patients with acute ischaemic stroke and atrial fibrillation, and 1000 patients with acute intracerebral haemorrhage and atrial fibrillation with different anticoagulation schemes pre-stroke. It is a non-interventional triple-armed study aiming at a balanced inclusion of ischaemic stroke and intracerebral haemorrhage patients according to the different anticoagulation schemes. Patients will be followed up for clinical course, management and outcome up to three months after the event. Findings in ischaemic stroke and intracerebral haemorrhage patients on NOAC will be compared with patients taking vitamin K antagonists or no anticoagulant pre-stroke. Primary endpoint for ischaemic stroke patients: occurrence of symptomatic intracerebral haemorrhage, for intracerebral haemorrhage patients: occurrence of secondary haematoma expansion. Secondary endpoints include assessment of coagulation, use of thrombolysis and/or mechanical thrombectomy, occurrence of complications, implementation of secondary prevention. Describing the current patterns of early management as well as outcome of stroke patients with atrial fibrillation will help guide physicians to develop recommendations for emergency treatment of stroke patients under different anticoagulation schemes.


Expression, Purification, Characterization of Amphioxus Insulin-like Peptide and Preparation of Polyclonal Antibody to It.
To elucidate the origination and evolution as well as structure-function relationship of insulin and IGF-1, the gene of amphioxus insulin-like peptide (ILP), a common ancestor of insulin and IGF-1, was chemically synthesized and cloned into the expression vector pVT102-U. In the recombinant ILP, the C-terminus of B-domain and the N-terminus of A-domain of amphioxus ILP deduced from cDNA were linked together by a tripeptide, Ala-Ala-Lys, and its B28Arg residue was also replaced by Lys to facilitate its conversion to a double-chain form by Lys-C cleavage. The expression vector was transformed into yeast cells and the recombinant ILP was expressed efficiently. The purified single-chain and double-chain ILP was obtained by fermentation, purification and enzymatic cleavage. Molecular weight measurement and amino acid composition analysis showed that the primary structure of ILP was correct. Circular dichroism analysis showed that the secondary and tertiary structure of double-chain ILP was similar to that of insulin, while double-chain ILP had no measurable insulin activity in insulin receptor binding assay. Additionally, New Zealand Rabbits were immunized with single-chain ILP and high titre polyclonal antibody was obtained. This work was important for further investigating the molecular evolution of insulin and IGF-1 and the distribution and existence of ILP in amphioxus.


Prevalence and comorbidities of autism among children referred to the outpatient clinics for neurodevelopmental disorders.
Autism spectrum disorders (ASD) is a neurodevelopmental disorder that has been rarely diagnosed in Sub-Saharan Africa. Although a proportion of children do present features of ASD in the Democratic Republic of Congo (DRC), little is known about it prevalence. Often, the co-morbidities constitute the upfront symptoms and therefore may it recognition and management difficult, aggravating as such the prognosis. The present study therefore aimed at studying the clinical profile of autism spectrum disorder (ASD) and the associated morbidities among children and adolescents in outpatient clinics in Kinshasa, the Democratic Republic of Congo. We conducted a cross sectional study in the three outpatients centers receiving patients referred for neurodevelopmental disorders in Kinshasa, DRC, from June 2008 to June 2010. A total of 450 subjects aged from 1-18 years old were referred and included in the study. The clinical diagnosis for ASD was made using the DSM-IV-R and the ADIR. Co-morbidities were identified using DSM-IV-R criteria together with an extensive clinical interview and observation. All patients were subject to an intellectual quotient evaluation and an electroencephalogram reporting. Of the 450 subjects referred, 120 (29.3%) received the diagnosis of ASD, with boys outnumbering girls (OR 3:1. The mean age was 7.9 years (SD 3.4) (p< 0.001). Intellectual disability (75.83 %) and epilepsy (72.50%) were the main co-morbidities significantly associated with autism (p< 0.001). It was also found that co-morbidities were most frequent in subjects with an IQ<70 (p=0.05). ASD is frequent among patients referred for neurodevelopmental disorders in the three outpatients' centers for neurodevelopmental disorders in Kinshasa. Males seem to be more affected than female. The main co-morbidities were epilepsy and intellectual disabilities. Our findings suggest that it is important to screen for ASD and co-morbidities among all subjects referred for neurodevelopmental disorders and to undertake survey on ASD in various structures of rejected children from the society in Kinshasa DRC. This will help to identify and manage ASD and associated co-morbidities at an early stage for a better prognosis.


A Picture is Worth 1,000 Words. The Use of Clinical Images in Electronic Medical Records.
To understand how clinicians utilize image uploading tools in a home grown electronic health records (EHR) system. A content analysis of patient notes containing non-radiological images from the EHR was conducted. Images from 4,000 random notes from July 1, 2009 - June 30, 2010 were reviewed and manually coded. Codes were assigned to four properties of the image: (1) image type, (2) role of image uploader (e.g. MD, NP, PA, RN), (3) practice type (e.g. internal medicine, dermatology, ophthalmology), and (4) image subject. 3,815 images from image-containing notes stored in the EHR were reviewed and manually coded. Of those images, 32.8% were clinical and 66.2% were non-clinical. The most common types of the clinical images were photographs (38.0%), diagrams (19.1%), and scanned documents (14.4%). MDs uploaded 67.9% of clinical images, followed by RNs with 10.2%, and genetic counselors with 6.8%. Dermatology (34.9%), ophthalmology (16.1%), and general surgery (10.8%) uploaded the most clinical images. The content of clinical images referencing body parts varied, with 49.8% of those images focusing on the head and neck region, 15.3% focusing on the thorax, and 13.8% focusing on the lower extremities. The diversity of image types, content, and uploaders within a home grown EHR system reflected the versatility and importance of the image uploading tool. Understanding how users utilize image uploading tools in a clinical setting highlights important considerations for designing better EHR tools and the importance of interoperability between EHR systems and other health technology.


The Pleckstrin homology domain of CK2 interacting protein-1 is required for interactions and recruitment of protein kinase CK2 to the plasma membrane.
CKIP-1 is a recently identified interaction partner of protein kinase CK2 with a number of protein-protein interaction motifs, including an N-terminal pleckstrin homology domain. To test the hypothesis that CKIP-1 has a role in targeting CK2 to specific locations, we examined the effects of CKIP-1 on the localization of CK2. These studies demonstrated that CKIP-1 can recruit CK2 to the plasma membrane. Furthermore, the pleckstrin homology domain of CKIP-1 was found to be required for interactions with CK2 and for the recruitment of CK2 to the plasma membrane. In this regard, point mutations in this domain abolish membrane localization and compromise interactions with CK2. In addition, replacement of the pleckstrin homology domain with a myristoylation signal was insufficient to elicit any interaction with CK2. An investigation of the lipid binding of CKIP-1 reveals that it has broad specificity. A comparison with other pleckstrin homology domains revealed that the pleckstrin homology domain of CKIP-1 is distinct from other defined classes of pleckstrin homology domains. Finally, examination of CK2alpha for a region that mediates interactions with CKIP-1 revealed a putative HIKE domain, a complex motif found exclusively in proteins that bind pleckstrin homology domains. However, mutations within this motif were not able to abolish CKIP-1-CK2 interactions suggesting that this motif by itself may not be sufficient to mediate interactions. Overall, these results provide novel insights into how CK2, a predominantly nuclear enzyme, is targeted to the plasma membrane, and perhaps more importantly how it may be regulated.


Restriction fragment length polymorphism of the L-myc gene and susceptibility to metastasis in genitourinary cancers.
We examined Southern blot analysis of genomic DNAs from 70 patients with sporadic renal cell carcinoma, using the human L-myc oncogene fragment as a hybridization probe. Our purpose was to study the relationship between the restriction fragment length polymorphism (RFLP) of the L-myc and the frequencies of metastasis. The patients were classified into 3 genotypes according to the polymorphic patterns defined by two alleles (L-L:17, L-S:31, S-S:22). The relative ratios of the 3 genotypes in the renal cancer patients were similar to those seen in healthy Japanese. However, of 20 patients who exhibited distant metastases at diagnosis, only 2 belonged to the L-L type. The incidence of distant metastasis in L-L type patients was significantly lower than that in L-S and S-S patients (p = 0.068, by Fisher's exact probability test). These results basically correspond to the previous findings in the lung cancer patients [Kawashima et al.: Proc. natn. Acad. Sci. USA 85: 2353-2356, 1988]. On the other hand, L-myc RFLP analysis in 50 prostatic cancer patients revealed that the incidence of metastasis at diagnosis did not correlate with L-myc genotypes. L-myc RFLP seems to be less promising in prostatic cancer than in lung or kidney cancer.


Concentrations of sulfadoxine and trimethoprim in plasma, lymph fluids and some tissues 24 h after intramuscular administration to Angora goats.
This study was carried out to determine the concentrations of sulfadoxine and trimethoprim in plasma, lymph, and some tissues in goats after administration of a single recommended therapeutic dose. Five healthy, adult Angora goats were used. The drug combination, containing 200 mg sulfadoxine and 40 mg trimethoprim per millilitre, was given as a single IM injection at the recommended dose level, 15 mg/kg body weight for sulfadoxine and 3 mg/kg body weight for trimethoprim. The goats were slaughtered 24 hours after drug administration and samples were taken from liver, bone marrow, pelvic limb muscles, hepatic, thoracic duct, and the pelvic limb lymph fluids for analysis of drug concentrations by HPLC. The concentrations of trimethoprim in bone marrow, liver, pelvic limb muscles, hepatic lymph, the pelvic limb lymph, and thoracic duct lymph were found to be 6, 5, 4, 2, 5 and 15 times higher than those of plasma, respectively. Although the sulfadoxine concentrations in bone marrow, pelvic limb muscles, and liver were 2, 3 and 2 times higher than the plasma concentrations, respectively, the sulfadoxine concentrations in hepatic lymph, the pelvic limb lymph, and thoracic duct lymph were lower than those of plasma. The results show that the trimethoprim concentrations in lymph fluids were quite similar to those in tissues. However, the sulfadoxine concentrations in lymph fluids were different in each tissue.


Preoperative magnetic resonance imaging is associated with baseline neurological status and can predict postoperative recovery in patients with cervical spondylotic myelopathy.
A blinded observational study of consecutive patients, prospectively enrolled and followed up to 1 year postoperatively. To assess whether quantitative assessment of preoperative magnetic resonance imaging (MRI) predicts baseline patient status and postoperative neurological recovery. Factors that can predict neurological recovery in patients with cervical spondylotic myelopathy (CSM) postoperatively are of great interest. Currently, the literature regarding the significance of MRI signal changes in relation to prognosis is inconsistent and conflicting. A total of 57 consecutive patients with CSM were studied preoperatively and 1 year postoperatively. Modified Japanese Orthopaedic Association (mJOA), Nurick Grade, SF-36, neck disability index, 30-meter walk cadence (Wc) and time (Wt), grip strength, and Berg Balance Scale were administered at baseline and 1 year after surgery. Preoperative status and postoperative recovery were assessed in relation to quantitative MRI measurements pre- and postoperatively using univariate and multivariate analysis. Low T1 signal change preoperatively was associated with a lower mJOA (P = 0.0030), higher Nurick Grade (P = 0.0298), decreased grip (P = 0.0152), impaired Wt, Wc (P≤ 0.0001) and poor Berg Balance Scale (P = 0.0005) at baseline. Focal high T2 signal was associated with lower mJOA scores and higher Nurick Grade compared with diffuse T2 (P = 0.0035 P = 0.0079) or no T2 signal (P = 0.0680 P = 0.0122). Preoperative segmentation of T2 signal, showed a significant increase in Wt, Wc, and Berg Balance Scale (P = 0.0266; P = 0.0167; P = 0.0042). Preoperative T1 signal was associated with lower postoperative grip (P = 0.0260), greater Wt, Wc (P = 0.0360, P = 0.0090). Preoperative focal T2 signal had a significant association with poorer postoperative Wt, Wc (P = 0.0220) and Nurick Grade (P = 0.0230). Preoperative maximal cord compromise was negatively correlated with postoperative SF-36 mental score (P = 0.0130). MRI signal changes are predictive of baseline neurological status and postoperative recovery. MRI indicators of poorer outcome include the presence of low T1 signal, focal increased T2 signal and segmentation of T2 signal changes. 2.


[The care of the senior citizen from a social-hygienic viewpoint].
From the point of view of social hygiene is shown, in what way social conditions are given and sued in the GDR to take influence on the state of health up to old age. As main factors of work dwelling and social or cultural care are considered. Resuming his treatise the author confirms that not yet all sources are used to solve the problems regarded. References to law-materials and other principles are given to support physicians in treating and guiding older people and to enable authorities not belonging to health service to fulfill the adequate tasks.


HIV/AIDS and sexual minorities in Mexico: a globalized struggle for the protection of human rights.
The fight against HIV/AIDS is an example of a global struggle for the promotion of sexual health and the protection of human rights for all, including sexual minorities. It represents a challenge for the understanding of its impact on political, social, and economic processes. My central goal in this piece is twofold. First, I underline the importance of a political and human rights perspective to the analysis of the global response to the pandemic, and I introduce the concept of policy networks for a better understanding of these dynamics. Second, I argue that, in the case of Mexico, the constitution of HIV/AIDS policy networks, which incorporate civil society and state actors, such as sexual minority activists and public officials, and their actions—both domestic and international—have resulted in a more inclusive HIV/AIDS policy-making process. However, serious human rights violations of HIV/AIDS patients and sexual minorities still remain.


Antibodies to proliferating cell nuclear antigen as S-phase probes in flow cytometric cell cycle analysis.
The usefulness of different anti-proliferating cell nuclear antigen monoclonal antibodies as S-phase probes in flow cytometric analysis was evaluated after various fixation procedures on human cell lines. With a newly developed detergent extraction/fixation method the monoclonal antibody PC10 acted as a selective S-phase marker. A total of 27 human hematopoietic tumors were analyzed using PC10, and all exhibited the characteristic S-phase recognition pattern. The percentage of PC10-positive cells was easily calculated and showed strong correlation to the fraction of S-phase cells determined from DNA histograms. Using alternative fixation procedures PC10, on the other hand, could recognize all actively cycling cells, a feature also observed for the monoclonal antibodies, 19A2 and TOB7.


Kinetic Monte Carlo simulations for heterogeneous catalysis: Fundamentals, current status, and challenges.
Kinetic Monte Carlo (KMC) simulations in combination with first-principles (1p)-based calculations are rapidly becoming the gold-standard computational framework for bridging the gap between the wide range of length scales and time scales over which heterogeneous catalysis unfolds. 1p-KMC simulations provide accurate insights into reactions over surfaces, a vital step toward the rational design of novel catalysts. In this Perspective, we briefly outline basic principles, computational challenges, successful applications, as well as future directions and opportunities of this promising and ever more popular kinetic modeling approach.


Impact of subtypes and comorbidities on breast cancer relapse and survival in population-based studies.
To study the impact of subtypes and comorbidities on breast cancer (BC) relapse and survival in the heterogeneous patients of the real world. We identified patients diagnosed with BC between January 2003 and December 2005 from six population-based Swiss cancer registries. Clinicopathologic data was completed with information on locoregional and distant relapse and date and cause of death for over 10-years. We approximated BC subtypes using grade and the immunohistochemical panel for oestrogen, progesterone and human epidermal growth factor 2 (HER2) receptor status. We studied factors affecting relapse and survival. Luminal A-like subtype represented 46% of all newly diagnosed BC (N = 1831), followed by luminal B-like (N = 1504, 38%), triple negative (N = 436, 11%) and HER2 enriched (N = 204, 5%). We observed regional disparities in subtype prevalence that contribute to explain regional differences in survival formerly described. Disease relapse and BC specific mortality differed by subtype and were lower for luminal A like tumours than for other subtypes for any stage at diagnosis. After a median follow-up of 10.9 years, 1311 (33%) had died, half of them 647 (16%) due to another disease, showing the importance of comorbidities. Omission of systemic therapies in selected patients was not associated with poorer BC specific survival, BC subtype and life expectancy playing a role. Information on tumour subtype is necessary for an adequate interpretation of population-based BC studies. Measures of comorbidity or frailty help in the evaluation of quality of care in the highly heterogeneous patients of the real world.


Ileal and cecal microbiota response to Salmonella Typhimurium challenge in conventional and slow-growing broilers.
Despite the negative impacts of Salmonella intestinal colonization on human health, Salmonella is a natural colonizer of the gastrointestinal tract and is not overtly pathogenic to the avian host. It is of interest to understand the impacts and colonization rates of Salmonella across selected genetic lines such as slow-growing (SG) and conventional (CONV) broilers. The objective of this study was to characterize the relationship between Salmonella enterica serovar Typhimurium challenge and selected broiler genetic lines on the ileal and cecal microbiome. Male chicks of two broiler breeds (n = 156/breed) were cohoused in an open floor pen until day 7. On day 13, the chicks were then separated into 12 isolators per breed (4 rooms, 6 isolators/room, 11 chicks/isolator). On day 14, chicks in the 12 treatment isolators (6 isolators/breed, 108 total) were challenged with Salmonella Typhimurium (ST) (1 × 10 8 CFU/ml) via oral gavage while the remaining chicks (n = 108) were given an oral gavage of sterile tryptic soy broth control (C). Ileal and cecal contents were collected on day 7 from 24 chicks of each breed, and on days 13, 17, 21, and 24 from two chicks per isolator. Samples underwent DNA extraction and PCR amplification to obtain 16S rRNA amplicons that were sequenced with Illumina MiSeq. Salmonella Typhimurium colonization in the cecum was not different in the two broiler breeds. The main effect of breed had the greatest impact on the ileum microbiota of broilers 7 days of age where SG broilers had significantly lower diversity and richness compared to CONV broilers (p < 0.05). Salmonella Typhimurium challenge consistently caused a change in beta diversity. Regardless of day or intestinal location, challenged broilers had many amplicon sequence variants (ASVs) with decreased abundance of likely beneficial bacteria such as Mollicutes RF39, Shuttleworthia, Flavonifractor, and Oscillibacter compared to broilers that were unchallenged with Salmonella Typhimurium (p < 0.05). Additionally, there was a difference in the timing of when the microbiota alpha and beta diversity of each breed responded to Salmonella Typhimurium challenge. Thus, both broiler breed and Salmonella Typhimurium can impact the intestinal microbiota.


Differential effects of alprazolam and imipramine in generalized anxiety disorder: somatic versus psychic symptoms.
Some researchers have recently suggested that antidepressants may be superior to benzodiazepines in the alleviation of generalized anxiety. In a 6-week, double-blind, parallel-design study with flexible dosage scheduling, the authors compared the effects of alprazolam with those of imipramine in 60 patients who had generalized anxiety disorder. On rating scales that contained both psychic and somatic symptoms, patients in both treatment groups improved to a similar degree after 2 weeks. However, alprazolam was more effective in attenuating somatic symptoms, and imipramine was more effective in attenuating psychic symptoms such as dysphoria and negative anticipatory thinking. The authors' results suggest that, in generalized anxiety, somatic symptoms and hyperarousal selectively respond to drugs acting on the gamma-aminobutyric acid system, whereas psychic symptoms respond to treatments affecting the noradrenergic or serotonergic systems.


Integration of heterogeneous molecular networks to unravel gene-regulation in Mycobacterium tuberculosis.
Different methods have been developed to infer regulatory networks from heterogeneous omics datasets and to construct co-expression networks. Each algorithm produces different networks and efforts have been devoted to automatically integrate them into consensus sets. However each separate set has an intrinsic value that is diluted and partly lost when building a consensus network. Here we present a methodology to generate co-expression networks and, instead of a consensus network, we propose an integration framework where the different networks are kept and analysed with additional tools to efficiently combine the information extracted from each network. We developed a workflow to efficiently analyse information generated by different inference and prediction methods. Our methodology relies on providing the user the means to simultaneously visualise and analyse the coexisting networks generated by different algorithms, heterogeneous datasets, and a suite of analysis tools. As a show case, we have analysed the gene co-expression networks of Mycobacterium tuberculosis generated using over 600 expression experiments. Regarding DNA damage repair, we identified SigC as a key control element, 12 new targets for LexA, an updated LexA binding motif, and a potential mismatch repair system. We expanded the DevR regulon with 27 genes while identifying 9 targets wrongly assigned to this regulon. We discovered 10 new genes linked to zinc uptake and a new regulatory mechanism for ZuR. The use of co-expression networks to perform system level analysis allows the development of custom made methodologies. As show cases we implemented a pipeline to integrate ChIP-seq data and another method to uncover multiple regulatory layers. Our workflow is based on representing the multiple types of information as network representations and presenting these networks in a synchronous framework that allows their simultaneous visualization while keeping specific associations from the different networks. By simultaneously exploring these networks and metadata, we gained insights into regulatory mechanisms in M. tuberculosis that could not be obtained through the separate analysis of each data type.


Analysis of the Isotopic Purity of D2O with the Characteristic NIR-II Phosphorescence of Singlet Oxygen from a Photostable Polythiophene Photosensitizer.
D2O plays important roles in a variety of fields (such as the nuclear industry and bioorganic analysis), and thus its isotopic purity (H2O contents) is highly concerned. Due to its highly similar physical properties to H2O and large excess amounts of H2O over D2O, it is challenging to distinguish D2O from H2O. On the basis of the characteristic NIR-II phosphorescence of singlet oxygen (1O2), and the fact that H2O is a more efficient quencher for 1O2 than D2O, here, we proposed to simply use the 1275 nm emission of 1O2 for the analysis of the isotopic purity of D2O. In normal cases (a xenon lamp for excitation), such steady-state emission is extremely weak for valid analytical applications, we thus employed laser excitation for intensification. To this goal, a series of photosensitizers were screened, and eventually polythiophene PT10 was selected with high singlet oxygen quantum yield (ΦΔ = 0.51), high H2O/D2O contrast, and excellent photostability. Upon excitation with a 445 nm laser, a limit of detection (LOD, 3σ) of 0.1% for H2O in D2O was achieved. The accuracy of the proposed method was verified by the analysis of the isotopic purity of several D2O samples (with randomly added H2O). More interestingly, the hygroscopicity of D2O was sensitively monitored with the proposed probe in a real-time manner; the results of which are important for strengthening the care of D2O storage and the importance of humidity control during related investigations. Besides D2O isotopic purity evaluation, this work also indicated the potential usefulness of the NIR-II emission of singlet oxygen in future analytical detection.


Diabetes mellitus: pathophysiology and current trends in management.
Diabetes mellitus is a group of disorders that have in common abnormal insulin function resulting in disordered carbohydrate, protein and fat metabolism, the cardinal feature being elevated blood glucose levels. Acute complications include diabetic ketoacidosis, hyperosmolar non-ketotic "coma" and hypoglycemia. Long-term complications develop over several years and cause more morbidity and mortality than the acute complications. Although the pathogenesis of long-term complications is still unknown, it is likely that it relates to the abnormal metabolic state that occurs in diabetes. Current techniques of monitoring diabetes include blood glucose self-monitoring and the measurement of glycosylated hemoglobin. Management focuses on dietary adjustments (caloric amount, timing and composition), exercise and medications. Patients are encouraged to participate in comprehensive diabetes education programs to learn about new aspects of treatment and prevention of complications.


Factors in recruitment and employment of allied health students: preliminary findings.
The efforts of a group of participants in the Coalition for Allied Health Leadership program to assess how and why allied health students became interested in their professions and students' plans for future employment are described. Results of a survey administered to 29 physical therapist assistant (PTA) and 54 communication disorders (CD) students revealed that most of the students first learned about their professions through personal experience. Almost half of the PTA students decided to pursue their career after working in another career, and most of the CD students made the decision during high school or in college. The most important factors in students' decisions to enter the professions were a desire to help others and the nature of the work. CD students preferred private practice, whereas the most desired employment setting for PTA students was an outpatient clinical facility. For both groups, the three most important factors influencing where they wish to live and work were job availability, access to medical care, and proximity to family and loved ones. Although half of the CD students hailed from small towns and rural areas, less than one third intended to work in these areas. Implications of survey findings are discussed.


Attitudes and preventive dental health behaviour in children with congenital cardiac disease.
A study of 114 children with congenital cardiac disease (C.C.D.) and healthy control children was carried out at the Royal Children's Hospital--Melbourne and at the Department of Conservative Dentistry--Melbourne. The C.C.D. group was divied into Cyanotic and Acyanotic subgroups to assess the influence of the severity of chronic illness on the issues under study. Questionnaires were designed to assess knowledge, attitude and behaviour relating to dental health for eight to ten year old children and their mothers. Detailed clinical examinations were carried out. Findings are summarized in this article.


Use of a projection reconstruction method to decrease motion sensitivity in diffusion-weighted MRI.
Diffusion-weighted MRI is a clinically useful technique, but its utility is compromised by high sensitivity to patient motion. Use of radial-scan data acquisition and projection reconstruction, rather than the conventional Fourier imaging method, can substantially reduce the sensitivity to global translational motion of the object. The basis of this concept and a demonstration of the technique in an animal imaging experiment are presented.


Investigation of the mechanism of phosphinothricin inactivation of Escherichia coli glutamine synthetase using rapid quench kinetic technique.
A number of slow tight-binding inhibitors are known for glutamine synthetase that resemble the geometry of the tetrahedral intermediate formed during the enzyme-catalyzed condensation of gamma-glutamyl phosphate and ammonia. One of these inhibitors, phosphinothricin [L-2-amino-4-(hydroxymethyl-phosphinyl)butanoic acid], has been investigated by rapid kinetic methods. Phosphinothricin not only exhibits the kinetic properties of a slow tight-binding inhibitor but also undergoes phosphorylation during the course of the ATP-dependent inactivation. The acid lability of phosphinothricin phosphate enabled investigation of the kinetics of glutamine synthetase inactivation using rapid quench kinetic techniques. The rate-limiting step in the inhibition reaction is the binding of inhibitor (0.004-0.014 microM-1 s-1) and/or a conformational change associated with binding, which is several orders of magnitude slower than the binding of ATP. The association rate of phosphinothricin depends on which metal ion is bound to the enzyme (Mn2+ or Mg2+). With Mn2+ bound to glutamine synthetase the rate of association and the phosphorylation rate are faster than when Mg2+ is bound. The data are interpreted with use of a model in which the binding of a substrate analogue with a tetrahedral moiety enhances the phosphorylation rate of the reaction intermediate; however, the initial binding interaction is retarded because the enzyme has to bind a molecule that has a "transition-state" geometry rather than a ground-state substrate structure. During the course of the inactivation, progressively slower rates for binding and phosphoryl transfer were observed, indicating communication between active sites.


Preferred bonding motif for indium aminoethanethiolate complexes: structural characterization of (Me2NCH2CH2S)2InX/SR (X = Cl, I; R = 4-MeC6H4, 4-MeOC6H4).
The metathesis reaction of InCl3 with Me2NCH2CH2SNa or the redox reaction of indium metal with elemental iodine and the disulfide (Me2NCH2CH2S)2 yield the indium bis(thiolate) complexes (Me2NCH2CH2S)2InX [X = Cl (3) and I (4)], respectively. Compounds 3 and 4 may be further reacted with the appropriate sodium thiolate salts to afford the heteroleptic tris(thiolate) complexes (Me2NCH2CH2S)2InSR [R = 4-MeC6H4 (5), 4-MeOC6H4 (6), and Pr (7)]. Reaction of 2,6-Me2C6H3SNa with 4 affords (Me2NCH2CH2S)2InS(2,6-Me2C6H3) (8), while no reaction is observed with 3, suggesting a greater reactivity for 4. All isolated compounds were characterized by elemental analysis, melting point, and Fourier transform IR and 1H and 13C{1H} NMR spectroscopies. X-ray crystallographic analyses of 3-6 show a bicyclic arrangement and a distorted trigonal-bipyramidal geometry for In in all cases. The two sulfur and one halogen (3 and 4) or three sulfur (5 and 6) atoms occupy equatorial positions, while the nitrogen atoms of the chelating (dimethylamino)ethanethiolate ligands occupy the axial positions. The metric parameters of the (Me2NCH2CH2S)2In framework were found to change minimally upon variation of the X/SR ligand, while the solubility of the corresponding compounds in organic solvents varied greatly. 1H NMR studies in D2O showed that 6 and 7 react slowly with an excess of the tripeptide l-glutathione and that the rate of reaction is affected by the pendant thiolate ligand -SR.


Extraction Behaviors of Heavy Rare Earths with Organophosphoric Extractants: The Contribution of Extractant Dimer Dissociation, Acid Ionization, and Complexation. A Quantum Chemistry Study.
Heavy rare earths (HREs), namely Ho3+, Er3+, Tm3+, Yb3+ and Lu3+, are rarer and more exceptional than light rare earths, due to the stronger extraction capacity for 100 000 extractions. Therefore, their incomplete stripping and high acidity of stripping become problems for HRE separation by organophosphoric extractants. However, the theories of extractant structure-performance relationship and molecular design method of novel HRE extractants are still not perfect. Beyond the coordination chemistry of the HRE-extracted complex, the extractant dimer dissociation, acid ionization, and complexation behaviors can be crucial to HRE extraction and reactivity of ionic species for understanding and further improving the extraction performance. To address the above issues, three primary fundamental processes, including extractant dimer dissociation, acid ionization, and HRE complexation, were identified and investigated systematically. The intrinsic extraction performances of HRE cations with four acidic organophosphoric extractants (P507, P204, P227 and Cyanex 272) were studied by using relativistic energy-consistent 4f core pseudopotentials, combined with density functional theory and a solvation model. Four acidic organophosphoric extractants have been qualified quantitatively from microscopic structures to chemical properties. It has been found that the Gibbs free energy changes of the overall extraction process (sequence: P204 > P227 > P507 > Cyanex 272) and their differences as a function of HREs (sequence: Ho/Er > Er/Tm > Tm/Yb > Yb/Lu) are in good agreement with the experimental maximum extraction capacities and separation factors. These results could provide an important approach to evaluate HRE extractants by the comprehensive consideration of dimer dissociation, acid ionization, and complexation processes. This paper also demonstrates the importance of the P-O bond, the P-C bond, isomer substituent, and solvation effects on the structure-performance relationship that can be used to guide molecular designs of HRE extraction in future.


High-efficiency simplification method of irregular FOV for accelerating the imaging process in the Risley-Prism system.
The Risley-Prism system, which has advantages in large FOV (field of view), high resolution and flexible imaging, faces limitations in image processing speed due to the non-convex characteristics of the FOV. Here, we proposed a simplified FOV model using inscribed rectangle and its property in area size, equivalent resolution and dynamic characteristics are studied, shows high consistency with original FOV. The simulation and experimental results show that the simplified FOV can reduce the calculation time of the total area of multi sub-FOVs from 3500 ms to 7.4 ms, and the image distortion correction time can also be reduced by 88.9%∼96.9%.


Cosmic rays and random magnetic traps.
The spatial distribution of cosmic ray (CR) particles in the interstellar medium (ISM) is of major importance in radio astronomy, where its knowledge is essential for the interpretation of observations, and in theoretical astrophysics, where CRs contribute to the structure and dynamics of the ISM. Local inhomogeneities in interstellar magnetic field strength and structure can affect the local diffusivity and ensemble dynamics of the CR particles. Magnetic traps (regions between magnetic mirrors located on the same magnetic line) can lead to especially strong and persistent features in the CR spatial distribution. Using test particle simulations, we study the spatial distribution of an ensemble of CR particles (both protons and electrons) in various magnetic field configurations, from an idealized axisymmetric trap to those that emerge in intermittent (dynamo-generated) random magnetic fields. We demonstrate that both the inhomogeneity in the CR sources and the energy losses by the CR particles can lead to persistent local inhomogeneities in the CR distribution and that the protons and electrons have different spatial distributions. Our results can have profound implications for the interpretation of the synchrotron emission from astronomical objects, and in particular its random fluctuations.


The Drosophila TIS11 homologue encodes a developmentally controlled gene.
We previously identified a murine primary response gene family containing three members; TIS11, TIS11B and TIS11D. Using degenerate oligonucleotides derived from conserved regions of the mouse TIS11 family cDNAs as primers and Drosophila genomic DNA as template for polymerase chain reaction amplification, we have identified a fly TIS11 homologue called DTIS11. The DTIS11 protein shares 90% sequence identity with the murine TIS11B and TIS11D proteins, over a 74 amino acid region that contains two CX8CX5CX3H repeated motifs separated by 18 amino acids. DTIS11 maps to region 11B(14-16) on the X-chromosome. Northern blot and in situ hybridization show that a maternal 3 kb message is present in embryos of early developmental stages. A 6 kb DTIS11 mRNA subsequently appears. In KC embryonal cells, both a strong 3 kb message and a less intense 6 kb message are present. The larger (6 kb) message is modestly induced in KC cells by both forskolin and tetradecanoyl phorbol acetate, and is stabilized by cycloheximide.


Greater prefrontal activation during sitting toe tapping predicts severer freezing of gait in Parkinson's disease: an fNIRS study.
Previous studies have revealed that, compared with Parkinson's disease (PD) patients without freezing of gait (FoG), the ones with FoG showed greater prefrontal activation while doing lower-limb movements involving standing, walking and turning, which require both locomotor and balance control. However, the relation between FoG and pure locomotor control as well as its underlying mechanism remain unclear. A total of 56 PD subjects were recruited and allocated to PD-FoG and PD-noFoG subgroups, and 34 age-matched heathy adults were included as heathy control (HC). Functional near-infrared spectroscopy was used to measure their prefrontal activation in a sitting lower-limb movement task, wherein subjects were asked to sit and tap their right toes as big and as fast as possible. Result of one-way ANOVA (Group: PD-FoG vs. PD-noFoG vs. HC) revealed greater activation in the right prefrontal cortex in the PD-FoG group than in the other 2 groups. Linear mixed-effects model showed consistent result. Furthermore, the right prefrontal activation positively correlated with the severity of FoG symptoms in PD-FoG patients. These findings suggested that PD patients with FoG require additional cognitive resources to compensate their damaged automaticity in locomotor control, which is more pronounced in severe FoG patients than milder ones.


Radiation-Induced Morphea of the Breast Treated With Wide Local Excision and Abdominal Free Flap Breast Reconstruction.
Radiation-induced morphea (RIM) associated with breast cancer treatment is a rare and underdiagnosed skin complication of radiotherapy that can lead to severe and painful contractures, resulting in disfigurement, failure of reconstruction, and poor quality of life in patients. The condition may present on a spectrum of local or more generalized forms involving skin over the breast and anterior chest wall. This diagnosis must be differentiated from post-radiation fibrosis, infection, cancer recurrence, inflammatory breast cancer, and other inflammatory conditions as the clinical course and treatment approaches differ. Various noninvasive and topical agents have been used; however, many cases are refractory to treatment. Surgery has been less commonly described in the management of generalized RIM. This report describes a case of RIM in a patient with breast cancer who experienced simultaneous resolution of symptoms as well as successful breast reconstruction using autologous free-tissue transfer.


Prevalence and characteristics of colorectal polyps in symptomatic and asymptomatic Iranian patients undergoing colonoscopy from 2009-2013.
Colorectal cancer is the third most common type of cancer in males and the second in females in Iran. Males are more likely to develop CRC than women and age is considered as a main risk factor for colorectal cancer. Prevalence of colorectal cancer has been increasing in Asian countries. The object of this study was to determine the clinical and pathology characteristics of colorectal polyps in Iranian patients and to investigate the variation between our populations with other populations. A total of 167 patients with colorectal polyps were included in our study. All underwent colonoscopy during 2009-2013 and specimens were taken through polypectomy and transferred to pathology. All data in patient files including pathology reports were collected and analyzed by SPSS 16 software. A two-tailed test was used and a P-value of <0.05 was considered significant. Mean age of participants was 57±15. Some 84 were females (50.3%) and 83 males (49.7%). Total of 225 polyps were detected which 119 (52.9%) were in males and 106 (47.1%) were in females. Solitary polyps were observed in 124 patients (74%), 26 (15.6%) had two polyps and 17 (10.1%) with more than two polyps (three to five). Rectosigmoid was the site of most of the polyps (63.1%), followed by 19.6% in the descending colon, 7.6% in the transverse, 5.8% in the ascending, and 3.1% in the cecum, data being missing in two cases. Recto sigmoid was site of most of the polyps. The most prevalent type of lesion was adenomatous polyps detected in 78 (34.7%). Mixed hyperplastic adenomatous type observed in 70 (31.1%). This high prevalence of adenomatous polyps in Iranian patients implies the urgent need for screening plans to prevent further healthcare problems with colorectal cancer in the Iranian population.


Power spectral frequency and coherence abnormalities in patients with intractable epilepsy and their usefulness in long-term remediation of seizures using neurofeedback.
Medically intractable seizures appear to be highly correlated with focal slow activity (delta or theta). They also correlate highly with decreases in the coherence of theta. Normalization of focal slowing and of decreased theta coherence will probably be the neurofeedback approaches most likely to decrease or eliminate seizures in future cases. Neurofeedback has been used for over 35 years to reduce the incidence and severity of seizures. With power training to decrease theta and increase the sensorimotor rhythm (12-15 Hz), an average of 82% of patients experienced a significant reduction in seizure frequency, and occasional remissions were seen. Recent improvements using QEEG to guide neurofeedback training have made it possible to eliminate seizures in most patients, even those with intractable seizures. Following our previous study in 2005, we report an additional 25 patients so treated. We also report an analysis of the frequency of QEEG abnormalities in this patient group. All of the intractable epileptic patients had one or more slow foci (excessive theta or delta compared with the normal database). One third had a relative deficiency of beta power. One fourth had a deficiency of absolute delta. Eighteen percent had excessive absolute alpha power, 18% had deficient absolute alpha power, 18% percent had excessive absolute beta power, and 18% percent had deficient absolute beta power. Hypocoherence of theta was found in 75%, and decreases in alpha coherence were noted in 42%. Hypocoherence of beta was found in 50%, and hypocoherence of delta was found in 25%. Increases in alpha coherence were noted in 33%. Seventeen percent had no coherence abnormalities. When most of the power and coherence abnormalities were normalized with neurofeedback training, all the patients became seizure-free; 76% no longer required an anticonvulsant for seizure control.


Stem cells: An eventual treatment option for heart diseases.
Stem cells are of global excitement for various diseases including heart diseases. It is worth to understand the mechanism or role of stem cells in the treatment of heart failure. Bone marrow derived stem cells are commonly practiced with an aim to improve the function of the heart. The majority of studies have been conducted with acute myocardial infarction and a few has been investigated with the use of stem cells for treating chronic or dilated cardiomyopathy. Heterogeneity in the treated group using stem cells has greatly emerged. Ever increasing demand for any alternative made is of at most priority for cardiomyopathy. Stem cells are of top priority with the current impact that has generated among physicians. However, meticulous selection of proper source is required since redundancy is clearly evident with the present survey. This review focuses on the methods adopted using stem cells for heart diseases and outcomes that are generated so far with an idea to determine the best therapeutic possibility in order to fulfill the present demand.


[Distribution of periodontal pathogens in dental plaque samples from 7 to 12-years-old children of Changchun Ziqiang primary school].
To detect the presence of Porphyromonas gingivalis (Pg) and Actinobacillus actinomycetemcomitans (Aa) using polymerase chain reaction (PCR) in the oral plaque samples from children and investigate the relationship between bacteria and clinical parameters. A total of 151 children aged 7 to 12 years were selected from Changchun Ziqiang primary school. The supragingival plaque sample was collected from the mesiobuccal and labial surfaces of the right maxillary central incisor and the right maxillary first molar. Extracted DNA from plaque samples was used for PCR analysis. Intraoral examination, probing depth (PD) and bleeding on probing (BOP) were performed and recorded. The detection rate for Pg was 27.6% and Aa 54.3% in supragingival plaque. The detection rates for Pg in molars were much higher than those in incisors (P < 0.01). The detection rate of Pg was positively related to BOP+ and PD. The detection rate for Pg increased gradually with aging, and the detection rate for Aa was highest in the group aged 11 to 12 and the detection rates for Pg and Aa were higher in the gingiva with BOP+ than that with BOP- (P < 0.05). The detection rates for Pg increased remarkably with BOP+ and especially when PD was greater than 4 mm. Detection rates of putative periodontal pathogens from healthy children of 7 to 12 years of age were high. The detection rates for Pg in molars were much higher than those in incisors,and the presence of Pg and Aa in supragingival plaque was related to periodontal parameters.


The Accuracy of the Broselow™ Pediatric Emergency Tape for Weight Estimation in an Omani Paediatric Population.
This study aimed to evaluate the accuracy of the Broselow™ Pediatric Emergency Tape (BT) for estimating weight in an Omani paediatric population at a tertiary care hospital. This retrospective cross-sectional study was conducted during July 2015. The electronic medical records of Omani outpatients <14 years old attending the Sultan Qaboos University Hospital, Muscat, Oman, between July 2009 and June 2013 were reviewed for recorded height and weight data. The BT Version 2002A was used to predict weight based on actual height measurements. Predicted weight measurements were then compared with actual weight to determine the accuracy of the estimation. A total of 3,339 children were included in the study, of which 43.5% were female and 56.5% were male. The mean age was 6.4 ± 3.1 years and the mean height was 93.2 ± 23.5 cm. The mean actual weight was 13.9 ± 6.7 kg while the mean BT-predicted weight was 14.4 ± 6.9 kg. The BT-predicted weight estimations correlated significantly with actual weight measurements (intraclass correlation coefficient: 0.97; P <0.001). A Bland-Altman analysis indicated that the BT performed well when estimating weight among Omani children, with an overestimation of only 0.5 kg for the entire cohort. The BT was found to be an effective tool for estimating weight according to body length in an Omani paediatric population. It should therefore be considered for use in emergency situations when actual weight cannot be determined.


Conversion of MT-sulfone to a trifluoromethyl group by IF5: the application of an MT-sulfone anion as a trifluoromethyl anion equivalent.
An MT-sulfone group was converted to a trifluoromethyl group by treatment with IF(5) after an alkylation reaction. Therefore, an MT-sulfone anion can be used as a trifluoromethyl anion equivalent. The formal asymmetric Michael-addition of a trifluoromethyl anion to crotonaldehyde was also performed.


Syndrome of inappropriate antidiuretic hormone secretion in a dog with a histiocytic sarcoma.
A 7-year-old female neutered Bernese mountain dog was presented in a semi-comatose state. Based on serum hypo-osmolality with inappropriate urine hyper-osmolality and urine sodium excretion, the dog was diagnosed with a syndrome of inappropriate antidiuretic hormone secretion secondary to a histiocytic sarcoma. This report describes the first case of this syndrome in a dog with histiocytic sarcoma.


Neuroprotection of retinal ganglion cells in DBA/2J mice with GDNF-loaded biodegradable microspheres.
This study aims to promote long-term retinal ganglion cell (RGC) survival in a spontaneous glaucoma model by injecting slow-release Poly(DL-lactide-co-glycolide) (PLGA) microspheres containing glial cell line-derived neurotrophic factor (GDNF) into the vitreous. Microspheres (1 microL) suspended in PBS were injected in ipsilateral eyes while contralateral eyes served as untreated controls. Mice were injected at 2 months intervals (1-4 injections) depending on the protocol. ELISA assay indicated a cumulative GDNF release of 35.4 ng/mg over 71 days. The release was nonlinear with an initial burst of over 50%. Mice displayed a 30% drop in RGC density by 8 months (p = 0.013) and 80% drop by 10 months (p < 0.01). GDNF delivery increased RGC survival in all groups. Mice receiving early treatment showed up to 3.5 times greater RGC density than untreated mice at 15 months survival (p < 0.05). No significant effect was found in sham or lens injury groups. Microsphere-delivered GDNF significantly increases long-term RGC survival in a spontaneous glaucoma model, although the nonlinear release kinetics suggest that burst release may play a role in this rescue. Neuroprotection with slow-release polymers with improved release kinetics should be further studied as a potential therapy for glaucoma and other diseases involving the loss of central nervous system neurons.


Condom effectiveness in reducing heterosexual HIV transmission: a systematic review and meta-analysis of studies on HIV serodiscordant couples.
This systematic review and meta-analysis aimed to reassess the effectiveness of condoms in reducing heterosexual transmission of HIV. Medline, Scopus, and the ISI Web of Science databases were searched up to June 2014. Eligible studies were synthesized using random-effects models. Twenty-five studies with 10,676 HIV serodiscordant heterosexual couples were analyzed. The risk of HIV transmission was considerably lower among couples that were always using condoms compared to never-users (RR: 0.29, 95% CI: 0.20-0.43) or inconsistent users (RR: 0.23, 0.13-0.40). The protective effect was slightly higher when the male rather than the female partner was infected (RR: 0.31, 0.20-0.48; vs. RR: 0.44, 0.24-0.80), and very high in Asian settings (RR: 0.06, 0.01-0.46). Though imperfect, condoms reduce HIV transmission by more than 70% when used consistently by HIV serodiscordant heterosexual couples. Social, cultural and biological differences need to be studied further to inform projection modelers and policy makers.


A pharmacoeconomic analysis of pegaspargase versus native Escherichia coli L-asparaginase for the treatment of children with standard-risk, acute lymphoblastic leukemia: the Children's Cancer Group study (CCG-1962).
The purpose of this pharmacoeconomic analysis was to compare pegaspargase. a newer chemotherapeutic agent used for treating acute lymphoblastic leukemia, with native Escherichia coli L-asparaginase in induction, delayed intensification 1 and delayed intensification 2. A subset of patients with newly diagnosed, standard-risk, acute lymphoblastic leukemia enrolled in the Children's Cancer Group (CCG) study CCG-1962 at seven participating institutions gave consent and was enrolled in our pharmacoeconomic analysis study. Societal (transportation, lodging, missed workdays, food, babysitter) and payer (frequency of encounters) cost data were collected from diaries (n = 27). Additional payer costs, such as drug costs, cost per clinic visit, and cost per inpatient day stay were collected from patients in CCG-1962 and participating institutions. We considered costs of therapy, including higher pegaspargase costs when comparing regimens of pegaspargase versus native E. coli L-asparaginase in induction, delayed intensification 1, and delayed intensification 2. Our results showed that the costs of the two therapies were similar from the payer perspective, with pegaspargase costing 1.8% more than E. coli L-asparaginase. The difference between groups also was small (<1%) from the societal perspective. Inpatient stay accounted for 88% of pegaspargase payer costs and 91% of the native E. coli L-asparaginase costs. We recommend that pegaspargase not be withheld from treatment protocols solely because of its higher pharmacy costs.


MicroRNAs/LncRNAs Modulate MDSCs in Tumor Microenvironment.
Myeloid-derived suppressor cells (MDSCs) are a heterogeneous group of immature cells derived from bone marrow that play critical immunosuppressive functions in the tumor microenvironment (TME), promoting cancer progression. According to base length, Non-coding RNAs (ncRNAs) are mainly divided into: microRNAs (miRNAs), lncRNAs, snRNAs and CircRNAs. Both miRNA and lncRNA are transcribed by RNA polymerase II, and they play an important role in gene expression under both physiological and pathological conditions. The increasing data have shown that MiRNAs/LncRNAs regulate MDSCs within TME, becoming one of potential breakthrough points at the investigation and treatment of cancer. Therefore, we summarize how miRNAs/lncRNAs mediate the differentiation, expansion and immunosuppressive function of tumor MDSCs in TME. We will then focus on the regulatory mechanisms of exosomal MicroRNAs/LncRNAs on tumor MDSCs. Finally, we will discuss how the interaction of miRNAs/lncRNAs modulates tumor MDSCs.


Expression of rac1 protein in the crypt-villus axis of rat small intestine: in reference to insulin action.
The expression of rho family along the crypt-villus axis of rat small intestine was investigated. The immunoblot analysis showed that the content of rac1 protein gradually increased from tip-villus to crypt-villus enterocytes without changes in the contents of rhoA and rac2 proteins. Furthermore, the contents of rac1 protein in the entire enterocytes were markedly decreased in streptozotocin-induced diabetic rats and restored by short-term treatment with insulin. These results suggest that differentiation and proliferation in the enterocytes of rat small intestine are possibly related to the expression of rac1 protein through insulin action.


Valuing neurosurgery services: part I. The historical development and interrelationships of current procedural terminology and the medicare fee schedule.
Current Procedural Terminology (CPT) standardizes medical procedure coding for billing and reimbursement. Since adoption of CPT coding as the basis for the Medicare Fee Schedule (MFS) in 1992, CPT coding policies and policy changes have been influenced not only by medical necessity and customary practice, but also increasingly by Medicare payment policies. The MFS created regulatory price control in the United States medical market based on widespread adoption of modified MFS by private payers and benchmark MFS fees governed by federal budget limitations and set annually by government agency (Centers for Medicare and Medicaid Services).


DNAzyme-based magneto-controlled electronic switch for picomolar detection of lead (II) coupling with DNA-based hybridization chain reaction.
A novel magneto-controlled electrochemical DNA biosensor is designed for the ultrasensitive detection of lead coupling a lead-specific DNAzyme with DNA-based hybridization chain reaction (HCR). To construct such a magnetic lead sensor, DNAzyme-based molecular beacons, selective to cleavage in the presence of Pb(2+), are initially immobilized onto magnetic beads, which were used as the recognition elements. Upon addition of target lead, catalytic cleavage of substrate DNA segments in the double-stranded DNAzymes results in the capture of the initiator strands via the conjugated catalytic strands on magnetic beads. The captured DNA initiator strands trigger the hybridization chain reaction between two alternating hairpin DNA structures labeled with ferrocene to form a nicked double-helix on the magnetic beads. Numerous ferrocene molecules are formed on the neighboring probes, each of which produces an electrochemical signal within the applied potential. Under optimal conditions, the electrochemical signal of the magnetic lead sensor increases with the increasing lead level in the sample, and exhibits a linear response over a Pb(2+) concentration range of 0.1-75 nM with a detection limit of 37 pM. Quantitative measurement of Pb(2+) in the complex sample demonstrates the selectivity of the sensor scheme and points favorably to the application of such technologies to the analysis of environmental samples. The unique combination of a DNAzyme with hybridization chain reaction makes it possible to change the DNAzyme to select for other compounds of interest. This work represents the initial steps toward the creation of a robust field sensor for lead in groundwater or drinking water.


The toppler mouse: a novel mutant exhibiting loss of Purkinje cells.
We describe the genetic and neurological features of toppler, a spontaneous autosomal mutation that appeared in a colony of FVB/N mice and that manifests as severe ataxia appearing at around 12 days of age, worsening with age. The lifespan of affected mice is 8-12 months, with occasional mice living longer. Both homozygous males and females are fertile, and females are able to nurture litters. Histological examination of brain revealed no striking abnormalities other than the loss of cerebellar Purkinje cells. The toppler mutation was mapped to mouse chromosome 8, and to assess whether it was novel or a recurrence of a previously described chromosome 8 mouse mutant, toppler mice were crossed with the nervous and tottering mouse mutants. These studies demonstrate that toppler is a unique mouse mutation. Purkinje cell abnormalities in toppler mice were obvious around postnatal day (P) 14, i.e., toppler Purkinje cells already exhibited abnormal morphology. Staining for calbindin, a calcium binding protein enriched in Purkinje cells, showed altered dendritic morphology. Between P14 and P30, dramatic Purkinje cell loss occurred, although there were differences in the degree of Purkinje cell loss in each lobule. At P30, the surviving Purkinje cells expressed zebrin II. From P30 through 6 months, many of the remaining Purkinje cells gradually degenerated. Purkinje cell loss was analyzed by terminal deoxynucleotidyl transferase-mediated biotinylated UTP nick end labeling (TUNEL), and Purkinje cells were TUNEL-positive most abundantly at P21. In addition, Bergmann glia were TUNEL positive at P21, and they expressed activated caspase-3 at earlier time points. Interestingly, despite the apparent death of some Bergmann glia, there was up-regulation of glial fibrillary acidic protein, expressed in astrocytes as well as Bergmann glia. Given the changes in both Purkinje cells and glia in toppler cerebellum, this may be a very useful model in which to investigate the developmental interaction of Purkinje cells and Bergmann glia.


Polymorphisms in the Chlamydia trachomatis cytotoxin locus associated with ocular and genital isolates.
Chlamydia trachomatis is a strict human pathogen producing infections that cause medically important chronic inflammatory diseases, such as blinding trachoma and tubal factor infertility. Isolates exist as serotypes that fall into distinct biologic and pathological groups corresponding to differences in infection tissue tropism and invasion properties. Paradoxically, genome sequencing of several diverse strains has revealed a remarkable level of genomic synteny, suggesting that minor genetic differences determine the pathogen host- and tissue-specific infection characteristics. To better understand the genetic basis of chlamydial pathobiologic diversity, we performed comparative DNA-DNA microarray genomic hybridizations with all 15 C. trachomatis serovariants. We found there are few major genetic differences among the 15 serovars. An exception was the cytotoxin locus located in the plasticity zone, a region that exhibited significant polymorphisms among serovars. We therefore sequenced this region from all 15 serovars. The cytotoxin gene was interrupted by extensive mutations and deletions among the different serovars; however, three basic open reading frame motifs were discovered that correlated with noninvasive oculotropic, urogenitotropic, and invasive serovars. Of interest, only noninvasive genitotropic serovars possessed an intact N-terminal portion of the putative toxin gene. This region contains the UDP-glucose binding domain and the glycosyltransferase domain required for enzymatic activity of the clostridial toxin homologs, suggesting a role in urogenital infection or pathogenesis.


Computation of transcranial magnetic stimulation electric fields using self-supervised deep learning.
Electric fields (E-fields) induced by transcranial magnetic stimulation (TMS) can be modeled using partial differential equations (PDEs). Using state-of-the-art finite-element methods (FEM), it often takes tens of seconds to solve the PDEs for computing a high-resolution E-field, hampering the wide application of the E-field modeling in practice and research. To improve the E-field modeling's computational efficiency, we developed a self-supervised deep learning (DL) method to compute precise TMS E-fields. Given a head model and the primary E-field generated by TMS coils, a DL model was built to generate a E-field by minimizing a loss function that measures how well the generated E-field fits the governing PDE. The DL model was trained in a self-supervised manner, which does not require any external supervision. We evaluated the DL model using both a simulated sphere head model and realistic head models of 125 individuals and compared the accuracy and computational speed of the DL model with a state-of-the-art FEM. In realistic head models, the DL model obtained accurate E-fields that were significantly correlated with the FEM solutions. The DL model could obtain precise E-fields within seconds for whole head models at a high spatial resolution, faster than the FEM. The DL model built for the simulated sphere head model also obtained an accurate E-field whose average difference from the analytical E-fields was 0.0054, comparable to the FEM solution. These results demonstrated that the self-supervised DL method could obtain precise E-fields comparable to the FEM solutions with improved computational speed.


Scaling-up of carbon dots hydrothermal synthesis from sugars in a continuous flow microreactor system for biomedical application as in vitro antimicrobial drug nanocarrier.
Carbon dots (CDs) are a new class of nanomaterials exhibiting high biocompatibility, water solubility, functionality, and tunable fluorescence (FL) property. Due to the limitations of batch hydrothermal synthesis in terms of low CDs yield and long synthesis duration, this work aimed to increase its production capacity through a continuous flow reactor system. The influence of temperature and time was first studied in a batch reactor for glucose, xylose, sucrose and table sugar precursors. CDs synthesized from sucrose precursor exhibited the highest quantum yield (QY) (175.48%) and the average diameter less than 10 nm (~6.8 ± 1.1 nm) when synthesized at 220°C for 9 h. For a flow reactor system, the best condition for CDs production from sucrose was 1 mL min-1 flow rate at 280°C, and 0.2 MPa pressure yielding 53.03% QY and ~ 6.5 ± 0.6 nm average diameter (6.6 mg min-1 of CDs productivity). CDs were successfully used as ciprofloxacin (CP) nanocarrier for antimicrobial activity study. The cytotoxicity study showed that no effect of CDs on viability of L-929 fibroblast cells was detected until 1000 µg mL-1 CDs concentration. This finding demonstrates that CDs synthesized via a flow reactor system have a high zeta potential and suitable surface properties for nano-theranostic applications.


Associations between changes in precerebral blood flow and cerebral oximetry in the lower body negative pressure model of hypovolemia in healthy volunteers.
Reductions in cerebral oxygen saturation (ScO2) measured by near infra-red spectroscopy have been found during compensated hypovolemia in the lower body negative pressure (LBNP)-model, which may reflect reduced cerebral blood flow. However, ScO2 may also be contaminated from extracranial (scalp) tissues, mainly supplied by the external carotid artery (ECA), and it is possible that a ScO2 reduction during hypovolemia is caused by reduced scalp, and not cerebral, blood flow. The aim of the present study was to explore the associations between blood flow in precerebral arteries and ScO2 during LBNP-induced hypovolemia. Twenty healthy volunteers were exposed to LBNP 20, 40, 60 and 80 mmHg. Blood flow in the internal carotid artery (ICA), ECA and vertebral artery (VA) was measured by Doppler ultrasound. Stroke volume for calculating cardiac output was measured by suprasternal Doppler. Associations of changes within subjects were examined using linear mixed-effects regression models. LBNP reduced cardiac output, ScO2 and ICA and ECA blood flow. Changes in flow in both ICA and ECA were associated with changes in ScO2 and cardiac output. Flow in the VA did not change during LBNP and changes in VA flow were not associated with changes in ScO2 or cardiac output. During experimental compensated hypovolemia in healthy, conscious subjects, a reduced ScO2 may thus reflect a reduction in both cerebral and extracranial blood flow.


Nutritional well-being of young children in Duncan Village, East London, South Africa: accessibility of primary health care clinics.
The aim was to contribute to the nutritional well-being of young children living in Duncan Village by investigating factors that influence clinic attendance of mothers and to formulate recommendations for optimisation of accessibility of primary health care (PHC) clinics in the area. PHC clinic accessibility was evaluated by assessing the experiences of mothers who attended clinics in the area as well as the experiences of health care workers (HCWs) in these clinics of service delivery and its recipients (mothers/children), using the focus group technique. The ATLAS/ti program was used to analyse the data in the following steps: preparation and importing of the data, getting to know and coding the data, retrieval and examination of codes and quotations, creation of families and creation of networks. Duncan Village, a low socio-economic urban settlement in East London, South Africa. Focus group discussions (four to seven participants per group) were conducted with four groups of mothers who do not attend PHC clinics, six with mothers who do attend the clinics (including pregnant women) and four groups of HCWs. Four networks that provide a summary of all the major trends in the data were created. The results clearly indicate that mothers in Duncan Village perceive and/or experience serious problems that make it difficult for them to attend clinic and even prevent them from doing so. These problems include both the way they are treated at the clinics (especially the problem of verbal abuse) as well as the actual services delivered (no medicines, no help, disorganised, long waiting periods, being turned away). The main problem experienced by the HCWs with service delivery seems to be a heavy workload, as well as the fact that many mothers do not come for follow-up visits. Efforts to increase the accessibility of PHC clinics in Duncan Village should focus on improving the relationship between mothers and HCWs and the heavy workload experienced by these workers.


Acromioclavicular joint disorders.
The acromioclavicular joint is commonly involved in athletic injuries. Most commonly, a sprain to the joint occurs with variability in the amount of ligamentous damage and displacement that occurs. In all but the most severe dislocations, treatment consists of initial sling immobilization and early functional rehabilitation. The outcome is usually excellent with full return of function following these injuries. The rarer types (IV, V, and VI) require operative reduction and fixation. Distal clavicle fractures are related injuries, which many times disrupt the stabilizing ligaments of the acromioclavicular joint. Many can be treated nonoperatively, but there are several subtypes that should be considered for early fixation to reduce complications of pain and shoulder dysfunction. An atraumatic, overuse condition, which is becoming more prevalent and seems related to weight training, is osteolysis of the distal clavicle. There is insidious onset of shoulder pain with symptoms and signs consistent with acromioclavicular pathology. Activity modification is the best method of controlling symptoms. Failure of the conservative approach necessitates operative excision of the distal clavicle.


[Large granular T-cell lymphocytic leukemia disclosed by bilateral uveitis: association with celiac disease].
A 70-year-old woman presented with bilateral anterior uveitis. She was on a gluten-free diet because of a celiac disease which had been diagnosed 3 months before. An anterior chamber aspirate contained a majority of large granular lymphocytes (LGL). The investigation of a chronic neutropenia led to the diagnosis of an otherwise typical T-LGL leukemia. This seems to be the first report of a CD3+ CD4- CD8+ T-LGL leukemia causing anterior uveitis through infiltration of leukemic cells, and the second report of an intriguing association of celiac disease with T-LGL leukemia.


Mechanical Properties of Full-Scale UHPC-Filled Steel Tube Composite Columns under Axial Load.
In the realm of civil engineering, ultra-high-performance concrete-filled steel tube composite columns (UCFSTCs) constitute a new type of building material and structure, exhibiting high compressive strength and commendable durability. Given their promising characteristics, the prospects of their application are highly promising and are worthy of further exploration. However, current research has primarily focused on scaled-down specimens, thereby limiting a broader understanding of UCFSTCs' full-scale mechanical properties in real-world scenarios. This study aimed to investigate the mechanical properties of full-scale UHPC-filled steel tube composite columns (FUCFSTCs) in practical engineering applications. With the steel tube strength, steel tube thickness, concrete strength, aspect ratio, and steel tube diameter used as design parameters and the finite element software ABAQUS as the analytical tool, a total of 21 FUCFSTCs were designed and analyzed. Through a comparison with experimental curves, the rationality of both the material constitutive model and finite element model was verified, and the maximum error was 6.54%. Furthermore, this study analyzed the influence of different design parameters on FUCFSTCs' ultimate bearing capacity, ductility coefficient, and the stress-strain relationship of their concrete. The ductility coefficient remained around 1.3, and the cross-sectional size had the greatest impact on the bearing capacity of the composite column, with a maximum increase of 145.90%. Additionally, this paper provides an in-depth analysis of FUCFSTCs' mechanical behavior, failure mode, and stress process under an axial load. In conclusion, this research proposes an axial compression limit bearing capacity formula for FUCFSTCs via statistical regression, with a maximum error of 3.04%, meeting engineering accuracy requirements. Consequently, this study lays a strong foundation for the future application of FUCFSTCs in practical engineering.


Vinblastine induces acute, cell cycle phase-independent apoptosis in some leukemias and lymphomas and can induce acute apoptosis in others when Mcl-1 is suppressed.
Chemotherapeutic agents modify intracellular signaling that culminates in the inhibition of Bcl-2 family members and initiates apoptosis. Inhibition of the extracellular signal-regulated kinase by PD98059 dramatically accelerates vinblastine-mediated apoptosis in ML-1 leukemia with cells dying in 4 hours from all phases of the cell cycle. Inhibition of protein synthesis by cycloheximide also markedly accelerated vinblastine-induced apoptosis, showing that the proteins required for this acute apoptosis are constitutively expressed. Vinblastine induced the rapid induction of Mcl-1 that was inhibited by PD98059 and cycloheximide. No change in Bcl-2 or Bcl-X was observed. We hypothesize that ML-1 cells use Mcl-1 for protection from the rapid vinblastine-induced apoptosis. This was confirmed by targeting Mcl-1 with short hairpin RNA. We also investigated the response of 13 other leukemia and lymphoma cell lines and cells from seven chronic lymphocytic leukemia patients. Four cell lines and all chronic lymphocytic leukemia cells were killed in 6 hours by vinblastine alone. Two additional cell lines were sensitized to vinblastine by PD98059, which suppressed Mcl-1. This acute apoptosis either alone or in combination with PD98059 required vinblastine-mediated activation of c-Jun-NH(2)-terminal kinase. PD98059 did not suppress Mcl-1 in other cell lines whereas sorafenib did, but this did not sensitize the cells to vinblastine, suggesting that the acute apoptosis varies depending on which Bcl-2 protein mediates protection. Most of the cell lines were sensitized to vinblastine by cycloheximide, suggesting that inhibition of a short-lived protein in addition to Mcl-1 can acutely sensitize cells. These results suggest several clinical strategies that might provide an effective therapy for selected patients. Mol Cancer Ther; 9(4); 791-802. (c)2010 AACR.


Hepatic hemangiomatosis. Successful management by hepatic artery ligation.
Successful management of severe congestive heart failure secondary to a hepatic hemangioma was accomplished by ligation of the hepatic artery in a 2-month-old infant. In the two years since the operation, follow-up observations including liver biopsy and hepatic angiography have indicated complete regression of the tumor. This report provides reassurance that this procedure is effective in the prompt control of severe heart failure, as well as in safely providing time for the spontaneous regression of the vascular tumor.


A new marine-derived sulfoglycolipid triggers dendritic cell activation and immune adjuvant response.
Dendritic Cells (DCs) recognize infectious non-self molecules and engage the adaptive immune system thereby initiating long lasting, antigen-specific responses. As such, the ability to activate DCs is considered a key tool to enhance the efficacy and quality of vaccination. Here we report a novel immunomodulatory sulfolipid named β-SQDG18 that prototypes a class of natural-derived glycolipids able to prime human DCs by a TLR2/TLR4-independent mechanism and trigger an efficient immune response in vivo. β-SQDG18 induces maturation of DC with the upregulation of MHC II molecules and co-stimulatory proteins (CD83, CD86), as well as pro-inflammatory cytokines (IL-12 and INF-γ). Mice immunized with OVA associated to β-SQDG18 (1:500) produced a titer of anti-OVA Ig comparable to traditional adjuvants. In an experimental model of melanoma, vaccination of C57BL/6 mice with β-SQDG18-adjuvanted hgp10 peptide elicited a protective response with a reduction in tumour growth and increase in survival.


Dissection from the Spanish anatomist's perspective: aims, attitudes, and related aspects.
We present the results of a study conducted on participants of the 21st Congress of the Spanish Society of Anatomy, in which anatomists were asked their opinions about a range of issues related to anatomical dissection: its relative roles as the exclusive source of anatomy teaching, as a source for medical research, or to assist the future professional to acquire emotional control; the attitudes and behaviors they expect the student to have in the dissecting room; whether the student-cadaver relationship can convey knowledge and attitudes affecting the future doctor-patient relationship; and the anatomists' attitudes toward donation. Anatomists considered dissection to be mainly an instrument for professional training and to help develop professional skills. They gave little importance to the role it could play in helping students to control their emotions. However, this aspect was considered to be more important by anatomists who also valued a close doctor-patient relationship. On the other hand, a majority of anatomists felt that the student's attitude and behavior during dissection could be to some extent reflected in future relationships with patients. However, they did not feel that dissection-related attitudes would distinguish between future good or bad doctors. Finally, anatomy teachers are generally in favor of donation (86.5%), especially of organs alone (52.7%), and this aspect was not affected by their religious beliefs.


Teratoid Cyst of the Postauricular Region: The First Ever Case Report.
Rudolf Virchow is considered to be the first scientist to have used the word sebaceous cyst. It was thought that these lesions occurred due to retention of sebaceous secretion consequent to obstruction of sebaceous ducts of sebaceous glands, although that was found not to be the case. In all these cysts, the cavity is filled with keratin. There are six types of keratin-filled cysts, namely, epidermoid, dermoid, teratoid, keratinous, trichilemmal, and teratoma cyst, which have one common name "dermoid cyst." Of the six, teratoid cyst is the least common. In contrast to other dermoid cysts, teratoid cysts contain tissue elements derived from all the three germ layers, namely, ectoderm, mesoderm, and endoderm. Teratomas can be differentiated from teratoid cysts by the fact that recognizable organ structures may be found in the former; examples include teeth and skin. Teratoid cysts can develop anywhere in the body but rarely arise in the head and neck region. They have never been reported in the postauricular region. In this case report, we present a case of teratoid cyst in the postauricular region in a 21-year-old female. The significance of this case lies in its rarity.