Prognostic Significance of the Tumor-Stromal Ratio in Invasive Breast Cancer and a Proposal of a New Ts-TNM Staging System.
Previous studies have demonstrated that the tumor-stromal ratio (TSR) was an independent prognostic factor in several types of carcinomas. This study aimed at exploring the prognostic significance of the TSR in invasive breast cancer using immunohistochemistry (IHC)-stained tissue microarrays (TMAs) and integrating the TSR into the traditional tumor-node-metastasis (TNM) staging system. The prepared 7 TMAs containing 240 patients with 480 invasive BC specimens were stained with cytokeratin (CK) by the IHC staining method. The ratio of tumor cells and stromal cells was visually assessed. TSR > 1 and TSR ≤ 1 were categorized as the high TSR (low stroma) and low TSR (high stroma) groups, respectively, and the prognostic value of the TSR at 5-year disease-free survival (5-DFS) was analyzed. A new Ts-TNM (tumor stroma-tumor-node-metastasis) staging system was established and assessed. IHC staining of CK could specifically label tumor cells with clear contrast, making it easy to manually assess TSR. High TSR (low stroma) and low TSR (high stroma) were observed in 52.5% (n = 126) and 47.5 (n = 114) of the cases, according to the division of value 1. A Kaplan-Meier analysis showed that patients in the low TSR group had a worse 5-DFS compared with patients in the high TSR group (P=0.022). Multivariable analysis indicated that the T stage (P=0.014), N status (P < 0.001), histological grade (P < 0.001), estrogen receptor status (P=0.015), and TSR (P=0.011) were independent prognostic factors of invasive BC patients. The new Ts-TNM staging system combining TSR, tumor staging, lymph node status, and metastasis staging was established. The receiver operating characteristic (ROC) curve analysis demonstrated that the ability of the Ts-TNM staging system to predict recurrence was not lower than that of the TNM staging system. This study confirms that the TSR is a prognostic indicator for invasive breast cancer. The Ts-TNM staging system containing stromal and tumor information may optimize risk stratification for invasive breast cancer.


Effect of Chronic Psychological Stress on Liver Metastasis of Colon Cancer in Mice.
Metastasis to the liver is a main factor in colorectal cancer mortality. Previous studies suggest that chronic psychological stress is important in cancer progression, but its effect on liver metastasis has not been investigated. To address this, we established a liver metastasis model in BALB/c nude mice to investigate the role of chronic stress in liver metastasis. Our data suggest that chronic stress elevates catecholamine levels and promotes liver metastasis. Chronic stress was also associated with increased tumor associated macrophages infiltration into the primary tumor and increased the expression of metastatic genes. Interestingly, β-blocker treatment reversed the effects of chronic stress on liver metastasis. Our results suggest the β-adrenergic signaling pathway is involved in regulating colorectal cancer progression and liver metastasis. Additionally, we submit that adjunctive therapy with a β-blocker may complement existing colorectal cancer therapies.


Review of the earthworm fauna of Iran with emphasis on Kohgiluyeh & Boyer-Ahmad Province.
Earthworms were collected in forests, damp habitats, springs, orchards and agricultural fields of the Kohgiluyeh & Boyer Ahmad Province, Iran, from April 2009 to April 2010. Specimens were collected at 20 established stations by digging and by diluted formalin methods. Ten species belonging to family Lumbricidae were identified based on morphology: Aporrectodea caliginosa (Savigny, 1826), Ap. rosea (Savigny, 1826), Ap. jassyensis (Michaelsen, 1891), Dendrobaena veneta (Rosa, 1886), D. byblica (Rosa, 1893) complex, D. orientalis orientalis Cernosvitov 1940, Eisenia fetida (Savigny, 1826), Eiseniella tetraedra (Savigny, 1826), Octolasion lacteum (Örley, 1881), Perelia kaznakovi (Michaelsen, 1910). Ap. caliginosa was the dominant species in this province and D. orientalis orientalis is a new record for Iran. A checklist of all earthworms species form Iran is presented, containing 19 species. Then, in order to show earthworm geographical affinities, hierarchical analysis were applied to available data on earthworm of Iran.


α-Galactosylceramide-Reactive NKT Cells Increase IgG1 Class Switch against a Clostridioides difficile Polysaccharide Antigen and Enhance Immunity against a Live Pathogen Challenge.
All clinical Clostridioides difficile strains identified to date express a surface capsule-like polysaccharide structure known as polysaccharide II (PSII). The PSII antigen is immunogenic and, when conjugated to a protein carrier, induces a protective antibody response in animal models. Given that CD1d-restricted natural killer T (NKT) cells promote antibody responses, including those against carbohydrates, we tested the hypothesis that immunization with PSII and a CD1d-binding glycolipid adjuvant could lead to enhanced protection against a live C. difficile challenge. We purified PSII from a clinical isolate of C. difficile and immunized B6 mice with PSII alone or PSII plus the CD1d-binding glycolipid α-galactosylceramide (α-GC). PSII-specific IgM and IgG titers were evident in sera from immunized mice. The inclusion of α-GC had a modest influence on isotype switch but increased the IgG1/IgG2c ratio. Enhanced protection against C. difficile disease was achieved by inclusion of the α-GC ligand and was associated with reduced bacterial numbers in fecal pellets. In contrast, NKT-deficient Traj18-/- mice were not protected by the PSII/α-GC immunization modality. Absence of NKT cells similarly had a modest effect on isotype switch, but ratios of IgG1/IgG2c decreased. These results indicate that α-GC-driven NKT cells move the humoral immune response against C. difficile PSII antigen toward Th2-driven IgG1 and may contribute to augmented protection. This study suggests that NKT activation represents a pathway for additional B-cell help that could be used to supplement existing efforts to develop vaccines against polysaccharides derived from C. difficile and other pathogens.


Willingness to Use a Nursing Home: A Study of Korean American Elders.
This study explored predictors of willingness to use a nursing home in Korean American elders. Andersen's behavioral health model was adapted with predisposing factors (age, gender, education, length of residence in the United States), potential health needs (chronic condition, functional disability, self-perceived health), and network-related enabling factors (marital status and living arrangement, family network, having someone close living in a nursing home). Among 427 participants, 45% reported their willingness to use a nursing home. Logistic regression analysis showed that the likelihood of willingness increased when individuals had poorer perceived health and had a close other living in a nursing home. Findings indicate that (a) self-perceived health serves as a proxy for future needs for long-term care services, and (b) indirect exposure to formal care is an important enabler for more acceptance of nursing home use. Implications of the findings and further directions for research are discussed.


Postpartum hemoperitoneum due to avulsion of pelvic uterine adhesion band.
A 31-year-old nulliparous woman presented in labor with preterm rupture of membranes at 35 weeks of gestation. The ensuing intrapartum course was uneventful, and she delivered a healthy infant (birth weight, 2,850 g) vaginally. Four hours after delivery, the patient had a syncopal episode due to hypovolemic shock. At laparotomy, a fibrous band between the right fallopian tube and uterus was found to be avulsed and actively bleeding, confirming preoperative findings obtained with multidetector row computed tomographic angiography.


Between sacred and medical realities: culturally sensitive therapy with Jewish ultra-orthodox patients.
One disconcerting aspect of the role of culture in shaping human suffering is the gap between the explanatory models of therapists and patients in multicultural settings. This gap is particularly noted in working with Jewish ultra-orthodox psychiatric patients whose idioms of distress are often derived from a sacred reality not easily reconcilable with psychomedical reality. To meet the challenge to therapeutic efficacy that this incompatibility may pose, we propose a culturally sensitive therapy based on strategic principles that focus on the patient's mythic world and religious idioms of distress as the kernel of therapeutic interventions. Using one case of post-traumatic stress disorder (PTSD) as illustration, we seek to show how the religious symbols through which the patient's distress was articulated may be manipulated to effect cure. The case highlights the narrative quality of both illness construction and self-reconstruction.


Office-Based Screening for Sexually Transmitted Infections in Adolescents.
Almost 1 in 4 adolescents have a sexually transmitted infection (STI). These infections are preventable through safe sexual practices and routine screening. Pediatricians are the first line of clinical care for adolescents and are well positioned to offer sexual and reproductive health care counseling and services to their patients; yet, there is a paucity of sexual health screening provided at routine health supervision visits. This article addresses the epidemiology of STIs in adolescents, reviews the evidence of current clinical practice, presents recommended STI screening from government and medical agencies, and offers strategies to address barriers to providing care for adolescents and for sexual health screening in primary care.


The management of multiple sclerosis by reference centers in south of Italy: a 2011 survey on health demands and needs in Campania region.
This cross-sectional study has investigated the diagnostic and therapeutic management of patients suffering from multiple sclerosis (MS) in the Campania Region (Italy). A survey involving all the reference centers for MS in Campania Region was conducted from March to August 2011. Centers responded to a web-administered questionnaire on management and clinical characteristics of MS patients. In the study period, 3263 patients (mean age 37 years, 66 % females) accessed the centers. Patients received a first diagnosis of MS in 161 cases (4.9 %). About 37 % of the subjects without a previous diagnosis came to the centers on their own initiative. All patients underwent a complete neurological examination and expanded disability status scale. The other most common investigations were magnetic resonance imaging (44.0 %) and evoked potentials (22.1 %). The number of treated patients was 2797 (87.1 %). The most used drugs were interferon β and glatiramer acetate. The time between diagnosis and initiation of therapy exceeded 6 months in 32 % of cases. Second-line drugs were under-used: 16 % of patients who might benefit from them show high clinical and radiological disease activity despite treatment with immunomodulant drugs. The MS care management of the surveyed centers showed consistent margins for improvement in 2011. Even though these data do not represent the current situation, they can be used to monitor improvements in MS care.


Protective role of angiotensin II type 2 receptor signaling in a mouse model of pancreatic fibrosis.
The renin-angiotensin system contributes to pathological processes in a variety of organs. In the pancreas, blocking the angiotensin II (AII) type 1 receptor (AT1) attenuates pancreatic fibrogenesis in animal models of pancreatitis. Because the role of the AII type 2 receptor (AT2) in modulating pancreatic injury is unknown we investigated the role of AT2 in pancreatic injury and fibrosis. Pancreatic fibrosis was induced by repetitive cerulein administration in C57BL/6 wild-type (WT) or AT2-deficient (AT2-/-) mice and assessed by morphology and gene expression at 10 days. There was no difference between WT and AT2-/- mice in the degree of acute pancreatic injury as assessed by amylase release at 9 and 12 h and by histological examination of the pancreas at 12 h. In contrast, parenchymal atrophy and fibrosis were more pronounced in AT2-/- mice compared with WT mice at 10 days. Fibrosis was accompanied by activation of pancreatic stellate cells (PSC) evaluated by Western blot analysis for alpha-smooth muscle actin and by immunocytochemistry; PSC activation was further increased in AT2-/- mice compared with WT mice. The level of pancreatic transforming growth factor-beta1 mRNA and protein after repetitive cerulein treatment was higher in AT2-/- mice than in WT mice. Our results demonstrate that, in contrast to AT1 receptor signaling, AT2 receptor signaling modulates protective antifibrogenic effects in a mouse model of cerulein-induced pancreatic fibrogenesis. We propose that the effects of AII on injury-induced pancreatic fibrosis may be determined by the balance between AT1 and AT2 receptor signaling.


Giant Parapharyngeal Space Lipoma Extending to the Pterygoid Region (Anterior Skull Base).
Although lipoma is frequently seen in the head and neck region, but occurrence of the lipoma in the parapharyngeal space is rare. It is extremely rare for a parapharyngeal lipoma to extent to the pterygoid region (ie, anterior skull base). Management of giant parapharyngeal space lipoma with skull base extension and proximity to the vital neurovascular structures poses a challenge to surgeon. The authors report a patient with giant lipoma extending from the upper border of the clavicle to the pterygoid region. Complete excision was done using upper transverse cervical incision and pterygoid region was approached after removal of the ipsilateral submandibular gland. Surgery produced excellent cosmetic results with no functional impairment.


Readiness to change in a clinical sample of problem drinkers: relation to alcohol use, self-efficacy, and treatment outcome.
According to the transtheoretical model of behaviour change, individuals addicted to psychotropic drugs typically cycle through a sequence of five discrete stages (precontemplation, contemplation, preparation, action, and maintenance) before achieving sustained long-term abstinence and moderation, respectively. A number of English-language questionnaires have been developed to assess client motivation in accordance with the stages of change approach. The present study aimed to expand the research on the transtheoretical model by establishing the factor structure of a German-language version of the Stages of Change Readiness and Treatment Eagerness Scale (SOCRATES) in a large sample of alcohol-dependent inpatients (n = 350). Furthermore, the relation of client motivation to alcohol use, self-efficacy and treatment outcome at 3-month follow-up was examined. Exploratory factor analysis revealed three separate dimensions of readiness to change (Taking Steps, Recognition, and Ambivalence). The factorial structure of the German-language SOCRATES corresponded almost exactly to that of the original version. Readiness to change accounted for 9.4% of the variance in treatment outcome. Moreover, readiness to change was positively related to pretreatment self-efficacy.


Chinese medicine users in the United States. Part I: Utilization, satisfaction, medical plurality.
Chinese medicine is growing in popularity and offers an important alternative or complement to biomedical care, but little is known of who uses it or why they purchase it. This article reports the first in-depth, large-scale (n = 575) survey of United States acupuncture users. An anonymous mixed quantitative-qualitative survey questionnaire assessed user demographics, Chinese medicine modalities used, complaints, response to care, other health-care used, and satisfaction with care in six general-service clinics in five states. The user demographic picture was of mid-age, well-educated, employed, mid-income patients. They sought care for a wide variety of conditions; top uses were for relief of musculoskeletal dysfunction, mood care, and wellness care. A large majority reported "disappearance" or "improvement" of symptoms, improved quality of life, and reduced use of selected measures including prescription drugs and surgery. Respondents reported utilizing a wide array of practices in addition to Chinese medicine, while also expressing extremely high satisfaction with Chinese medicine care. The evidence indicates that these respondents behave as astute consumers within a plural health care system. Part II (in press) details reasons given for satisfaction and situates respondent attitudes within a larger sociocultural framework.


Revealing different bonding modes of self-assembled octadecylphosphonic acid monolayers on oxides by time-of-flight secondary ion mass spectrometry: silicon vs aluminum.
Condensed octadecylphosphonic acid (OPA) dimers, i.e., two OPA molecules combined with the loss of a water molecule, were detected by time-of-flight secondary ion mass spectrometry (TOF-SIMS) on OPA self-assembled monolayers (SAMs) that are only weakly bonded on the native oxide layer of a silicon wafer. In contrast, these condensed dimers were absent on OPA SAMs formed on the oxide layer of an aluminum film, where the OPA molecules are chemically bonded on the substrate through a P-O-Al linkage. These observations lead us to conclude that the OPA molecules in their SAMs have to be free from chemical bonding with the substrate in order for the primary ion beam to generate ion fragments of the condensed dimer. We demonstrate that the detection of condensed OPA dimers serves as an analytical criterion for TOF-SIMS to reveal the bonding mode of OPA molecules in their SAMs on different oxides.


Ringer's lactate with or without 3% dextran-60 as volume expanders during abdominal aortic surgery.
To compare a solution of 3% dextran-60 (D60) in Ringer's lactate (RL) with RL alone as maintenance fluids for abdominal aortic surgery. Randomized control trial of 20 consecutive patients undergoing elective aortic reconstructive surgery. A surgical ICU in a university hospital. Consecutive patients, mean age 64 yr. Five patients had abdominal aneurysm, 12 had aortic obstruction disease, and three had aortic renal bypass surgery. These patients were followed for 1 month. Pulmonary artery occlusion pressure of at least 10 mm Hg and a urine output greater than 30 mL/h were used to guide the intraoperative fluid infusion rates, which were 36 and 104 mL/kg of D60 and RL, respectively (ratio 1:2.9). Body weight at 24 hr had increased more with RL (7.8 kg) than with D60 (3.2 kg) infusion (p less than .01), despite intraoperative urine volumes of 151 and 92 mg/kg with RL and D60, respectively. Total intravascular albumin decreased from 0.7 g/kg (1.4 to 0.7 g/kg) in both groups, corresponding to a plasma volume (PV) loss of 13 mg/kg without fluid infusions. A total intravascular dextran of 0.5 g/kg resulted in a PV expansion at 1 hr of 4.4 mL/kg above preoperative level, in sharp contrast to 7.0 mL/kg decrease in PV with RL. Of the intraoperative 3% D60 and RL infused, an estimated 51% D60 and 6% RL remained as PV expansion at 1 hr. A diluted colloid solution in Ringer's lactate is of significant value in maintaining intravascular volumes and hemodynamics during and after major operative procedures.


The prognostic impact of different stages of acute kidney injury in patients with decompensated cirrhosis: a prospective cohort study.
To assess the impact of the different stages of acute kidney injury (AKI) on the prognosis of patients hospitalized with decompensated cirrhosis. This was a prospective cohort study of consecutive patients admitted in two tertiary hospitals in southern Brazil. Participants were considered eligible if they were admitted for acute decompensation of cirrhosis. The main exposure factor was the onset of AKI. AKI stages were defined according the European recommendations. The outcomes evaluated were survival time and death rates at 28 and 90 days from hospital admission. A χ2 test was used to compare mortality between groups. Kaplan-Meier survival analyses were undertaken assessing time to event as days from AKI diagnosis to death or liver transplant. Two hundred and five patients were included in the study, and 121 met the criteria for AKI. Patients with AKI 1b, AKI 2 and AKI 3 had higher 90-day mortality than patients without AKI (P = 0.008, P < 0.001 and P < 0.001, respectively). However, there was no difference in 90-day mortality when patients with AKI 1a were compared with those without AKI (P = 0.742). The mean survival of patients without AKI was higher than that of patients with AKI 1b (591.4 and 305.4 days, respectively, P = 0.015), while there was no significant difference between the mean survival of patients without AKI and that of patients with AKI 1a (591.4 and 373.6 days, respectively, P = 0.198). Only AKI ≥1b seems to substantially impact mortality of patients hospitalized for acute decompensation of cirrhosis.


Biochemical studies of a soxF-encoded monomeric flavoprotein purified from the green sulfur bacterium Chlorobaculum tepidum that stimulates in vitro thiosulfate oxidation.
In the green sulfur bacterium Chlorobaculum tepidum, three sulfur oxidizing enzyme system (Sox) proteins, SoxAXK, SoxYZ, and SoxB (the core TOMES, thiosulfate oxidizing multi-enzyme system) are essential to in vitro thiosulfate oxidation. We purified monomeric flavoprotein SoxF from this bacterium, which had sulfide dehydrogenase activity. SoxF enhanced the thiosulfate oxidation activity of the purified core TOMES with various cytochromes as electron acceptors to different degrees without any change in the affinity for thiosulfate. The apparent reaction rates with 50 microM- C. tepidum cytochrome c-554 were slightly higher than with horse-heart cytochrome c, and the addition of 0.5 microM- SoxF increased the rate by 92%. The rates with 50 microM- horse-heart cytochrome c and 50 muM- horse-heart cytochrome c plus 0.5 muM- cytochrome c-554 were increased by SoxF by 31% and 120% respectively. We conclude that SoxF mediates electron transfer between the components of core TOMES and externally added cytochromes.


The N-terminal Ca2+-independent calmodulin-binding site on the inositol 1,4,5-trisphosphate receptor is responsible for calmodulin inhibition, even though this inhibition requires Ca2+.
Calmodulin (CaM) is a ubiquitous Ca(2+)-sensor protein that plays an important role in regulating a large number of Ca(2+) channels, including the inositol 1,4,5-trisphosphate receptor (IP(3)R). CaM binds to the IP(3)R at Ca(2+)-dependent as well as at Ca(2+)-independent interaction sites. In this study, we have investigated the Ca(2+)-independent CaM-binding site for its role in the regulation of the Ca(2+)-dependent bell-shaped activation curve of the IP(3)R. Suramin, a polysulfonated napthylurea, displaced CaM in both the presence and the absence of Ca(2+). Suramin competed with CaM for binding to different peptides representing the previously identified CaM-binding sites on IP(3)R1. By interacting with the N-terminal Ca(2+)-independent CaM-binding site, suramin mimicked the functional effect of CaM and induced an allosteric but competitive inhibition of IP(3) binding. Therefore, suramin also potently inhibited IP(3)-induced Ca(2+) release (IICR) from permeabilized cells predominantly expressing IP(3)R1 (L15 fibroblasts) or IP(3)R3 (Lvec fibroblasts), even though the IP(3)R3 does not contain Ca(2+)-dependent CaM-binding sites. Furthermore, we have found that CaM(1234), a CaM mutated in its four EF hands, inhibited IICR in a Ca(2+)-dependent way with the same potency as CaM. We conclude that CaM inhibits IICR via the N-terminal binding site. The inhibition requires Ca(2+) but CaM itself is not the Ca(2+) sensor for the inhibition of the IP(3)R.


Conventional and ultrasound-assisted extraction of anthocyanins from blackberry and sweet cherry cultivars.
Blackberry and sweet cherry are important plant foods rich in anthocyanins well-known for their pharmacological and antioxidant effects. The aim of the present paper was to comparatively investigate conventional and ultrasound-assisted extraction procedures in order to isolate an enriched crude anthocyanin extract from blackberry (Thornfree cultivar) and sweet cherry (Black Gold cultivar). Hydroethanolic solution and acidified ethanol were used to conventionally extract anthocyanins by a discontinuous process at 4 degreeC for 2/ 24 hours. Added hydrochloric acid in ethanol of different concentrations proved to be more efficient in both type of samples. In the ultrasound-assisted extraction, the highest recovered anthocyanin content in blackberry (107.81 mg 100 g(-1) FM) was obtained with a 10/1 solvent/solid ratio (v/w) at 30 degreeC for 5 minutes, while a 15/1 solvent/solid ratio (v/w) at 30 degreeC for 20 minutes lead to an increased antioxidant capacity as determined by ferric reducing antioxidant power in the extract using 0.1% HCI in 80% ethanol. The optimum conditions obtained for ultrasound-assisted extraction from sweet cherry in 0.1% HCI in 60% ethanol at 30 degree C include a 15/1 solid/solvent ratio (w/v) and 5 minutes for the maximum yield (36.05 mg 100(-1) FM). The final crude anthocyanin extracts may find useful application as dietary supplements, or may be further purified for application as food ingredients.


Stable variants of sperm aneuploidy among healthy men show associations between germinal and somatic aneuploidy.
Repeated semen specimens from healthy men were analyzed by sperm fluorescence in situ hybridization (FISH), to identify men who consistently produced elevated frequencies of aneuploid sperm and to determine whether men who were identified as stable variants of sperm aneuploidy also exhibited higher frequencies of aneuploidy in their peripheral blood lymphocytes. Seven semen specimens were provided by each of 15 men over a 2-year period and were evaluated by the X-Y-8 multicolor sperm FISH method (i.e., approximately 1,050,000 sperm were analyzed from 105 specimens). Three men were identified as stable aneuploidy variants producing significantly higher frequencies of XY, disomy X, disomy Y, disomy 8, and/or diploid sperm over time. In addition, one man and three men were identified as sperm-morphology and sperm-motility variants, respectively. Strong correlations were found between the frequencies of sperm with autosomal and sex-chromosome aneuploidies and between the two types of meiosis II diploidy; but not between sperm aneuploidy and semen quality. A significant association was found between the frequencies of sex-chromosome aneuploidies in sperm and lymphocytes in a subset of 10 men (r2=0.67, P=.004), especially between XY sperm and sex-chromosome aneuploidy in lymphocytes (r2=0.70, P=.003). These findings suggest that certain apparently healthy men can produce significantly higher frequencies of both aneuploid sperm and lymphocytes. Serious long-term somatic and reproductive health consequences may include increased risks of aneuploidy-related somatic diseases and of having children with paternally transmitted aneuploidies, such as Klinefelter, Turner, triple-X, and XYY syndromes.


Distortion-product otoacoustic emissions: a useful test for monitoring ototoxicity induced by pegylated interferon and ribavirin treatment in patients with chronic hepatitis C.
Pegylated-interferon (peg-IFN) and ribavirin combination therapy for the treatment of hepatitis C virus (HCV) infection is well known to be associated with significant adverse effects. Several studies have investigated a possible auditory pathway involvement during IFN therapy, but a method to monitor the potential auditory involvement during treatment has not yet been described. The aim of this study is to evaluate possible modifications of the outer hair cell (OHC) function in HCV patients receiving peg-IFN and ribavirin combination therapy. Thirteen adult HCV patients (8 F/5 M, mean age 52∓12 years) treated with peg-IFN and ribavirin combination therapy underwent Pure Tone Audiogram and Distortion Product Otoacoustic Emission (DPOAE) tests. We compared mean auditory thresholds (PTA) and mean DPOAE amplitude before, at month 3 during, and at the end of treatment (T0, T3, and Tend, respectively), and 3 months after treatment discontinuation (Tfu). No significant differences were found in hearing levels at the different time points analyzed. During treatment, three patients developed tinnitus, which in 2 cases resolved spontaneously after the end of therapy. Compared to T0 (19.5±0.83), a statistically significant DPOAE increase at T3 (30±1,26) and Tend (28.6±2.16) was found (p<0.05 at both time points), while DPOAEs returned to pre-treatment levels at Tfu (19.3±1.3). In our group, none of the patients reported a permanent auditory impairment, excluding one patient with persistent tinnitus. Peg-IFN could produce an increase of motility of the OHCs by means of intracellular pathways. DPOAE test could be considered a new method for monitoring ototoxicity induced by IFN. On the basis of recent literature and our audiological results, physicians should be aware of the possible ototoxic effects of peg-IFN, requiring appropriate surveillance, and the patient should be informed of the potential side effects of IFN therapy on the auditory pathway.


Lithium conductivity in glasses of the Li2O-Al2O3-SiO2 system.
To improve the understanding of Li-dynamics in oxide glasses, i.e. the effect of [AlO4](-) tetrahedra and non-bridging oxygens on the potential landscape, electrical conductivity of seven fully polymerized and partly depolymerized lithium aluminosilicate glasses was investigated using impedance spectroscopy (IS). Lithium is the only mobile particle in these materials. Data derived from IS, i.e. activation energies, pre-exponential factors and diffusivities for lithium, are interpreted in light of Raman spectroscopic analyses of local structures in order to identify building units, which are crucial for lithium dynamics and migration. In polymerized glasses (compositional join LiAlSiO4-LiAlSi4O10) the direct current (DC) electrical conductivity continuously increases with increasing lithium content while lithium diffusivity is not affected by the Al/Si ratio in the glasses. Hence, the increase in electrical conductivity can be solely assigned to lithium concentration in the glasses. An excess of Li with respect to Al, i.e. the introduction of non-bridging oxygen into the network, causes a decrease in lithium mobility in the glasses. Activation energies in polymerized glasses (66 to 70 kJ mol(-1)) are significantly lower than those in depolymerized networks (76 to 78 kJ mol(-1)) while pre-exponential factors are nearly constant across all compositions. Comparison of the data with results for lithium silicates from the literature indicates a minimum in lithium diffusivity for glasses containing both aluminium tetrahedra and non-bridging oxygens. The findings allow a prediction of DC conductivity for a large variety of lithium aluminosilicate glass compositions.


Evidence for nucleosome depletion at active regulatory regions genome-wide.
The identification of nuclease-hypersensitive sites in an active globin gene and in the 5' regions of fruit fly heat shock genes first suggested that chromatin changes accompany gene regulation in vivo. Here we present evidence that the basic repeating units of eukaryotic chromatin, nucleosomes, are depleted from active regulatory elements throughout the Saccharomyces cerevisiae genome in vivo. We found that during rapid mitotic growth, the level of nucleosome occupancy is inversely proportional to the transcriptional initiation rate at the promoter. We also observed a partial loss of histone H3 and H4 tetramers from the coding regions of the most heavily transcribed genes. Alterations in the global transcriptional program caused by heat shock or a change in carbon source resulted in an increased nucleosome occupancy at repressed promoters, and a decreased nucleosome occupancy at promoters that became active. Nuclease-hypersensitive sites occur in species from yeast to humans and result from chromatin perturbation. Given the conservation of sequence and function among components of both chromatin and the transcriptional machinery, nucleosome depletion at promoters may be a fundamental feature of eukaryotic transcriptional regulation.


alpha-1,4-Glucan lyase performs a trans-elimination via a nucleophilic displacement followed by a syn-elimination.
alpha-Glucan lyase (EC 126.96.36.199, GLase) cleaves alpha-1,4-glucosidic bonds via an elimination reaction to produce 1,5-d-anhydrofructose. GLase was inactivated by the mechanism based alpha-glucosidase inactivator, 5-fluoro-beta-l-idosyl fluoride. The trapped glycosyl-enzyme intermediate was isolated and the nucleophilic amino acid residue (Asp 553) identified is equivalent to the residue so identified in sequence-related alpha-glucosidases. This intermediate undergoes a syn-elimination reaction to release the product. Further evidence against a direct trans-elimination mechanism was provided by the absence of a primary kinetic isotope effect on the substrate substituted with deuterium at the C2 position.


A benign teratoma presenting as an obstruction of the nasal cavity: a case report.
Teratoma refers to a neoplasm that recapitulates all three germ layers. Teratomas may be histologically mature and oncologically benign. Teratomas may also be histologically immature while being oncologically benign, or they may harbor malignant components and have the potential to exhibit an aggressive biological behavior. Teratomas of the head and neck are extremely rare and usually present in the neonatal period. As a general rule, pediatric teratomas of the head and neck tend to be oncologically benign, whereas adult teratomas tend to be histologically and oncologically malignant. Most of these teratomas are found in the cervical region and nasopharynx. Calcification within the mass is often evident. A 27-year-old Caucasian man complaining of a nasal obstruction was admitted to our clinic in January 2006. A transnasal endoscopic examination revealed a mass arising from the nasal septum which was completely removed using an endoscopic approach. Histologically, it was determined to be a benign teratoma. Herein, we present a rare case, along with a review of the related literature, in order to emphasize that a benign teratoma of the nasal septum should not be ignored.


Viral bronchiolitis during early life induces increased numbers of bronchiolar mast cells and airway hyperresponsiveness.
The objectives of this study were to determine the kinetics of Sendai virus-induced increases in bronchiolar mast cells and to determine whether virus-induced increases in bronchiolar mast cells were associated with increased airway responsiveness to methacholine and with altered allergic inflammatory responses to antigen stimulation. Mast cell density in intrapulmonary airways was measured in outbred CD (Crl:CDBR) rats by use of morphometric techniques at 7, 15, 30, 60, and 90 days after viral or sham inoculation. Density of bronchiolar mast cells was higher in virus-inoculated rats than in control rats at 30, 60, and 90 days after inoculation (P less than 0.01), but not at 7 or 15 days after inoculation. Total pulmonary mast cell numbers were increased in virus-inoculated rats at 30 days after inoculation. Rats at 42 days after viral inoculation had over a threefold increase in sensitivity to the concentration of nebulized metbacholine that would stimulate a 50% increase in respiratory resistance. Virus-inoculated rats sensitized to ovalbumin had over a 10-fold increase (P less than 0.02) in pulmonary neutrophils that were recovered by bronchoalveolar lavage at 4 hours after ovalbumin aerosol challenge. Virus-inoculated rats at this time also had higher densities of neutrophils in bronchiolar walls than allergen-exposed control rats. The results indicate that Sendai virus induces increases in numbers of bronchiolar mast cells at times from 30 to 90 days after inoculation, and that mast cell increases are associated with airway hyperresponsiveness to methacholine and heightened allergic airway inflammatory reactions.


Forefoot varus predicts subtalar hyperpronation in young people.
Subtalar joint hyperpronation is a foot misalignment that has been associated with several musculoskeletal injuries. Forefoot varus is thought to result in subtalar hyperpronation during weightbearing circumstances. However, few studies have aimed to verify whether there is a significant relationship between forefoot alignment and subtalar hyperpronation. Moreover, no study has attempted to verify whether forefoot varus can predict subtalar hyperpronation in young individuals. Therefore, the purpose of this study was to verify whether forefoot varus can predict subtalar hyperpronation, measured using the rearfoot eversion angle test, the navicular drop test, and the Foot Posture Index (FPI), in young people. Fifty-four healthy adolescents volunteered for this study (28 boys and 26 girls). A single examiner evaluated the forefoot angle, rearfoot angle, navicular drop, and FPI of each participant. Statistical analysis included the Pearson correlation test and a linear regression analysis to establish the relationship between the variables. These results showed a high positive correlation between forefoot varus and rearfoot angle (r = 0.86; P < .001), navicular drop (r = 0.76; P < .001), and FPI (r = 0.82; P < .001). Moreover, the forefoot varus variable was able to predict 74% of the variability in the rearfoot angle, 58% in the navicular drop, and 67% in the FPI (P < .001). These findings support previous assumptions that individuals with forefoot varus present subtalar hyperpronation. Clinicians should not overlook forefoot alignment when prescribing foot orthoses for treating patients with foot misalignments.


Switching from Twice-Daily Basal Insulin Injections to Once-Daily Insulin Degludec Injection for Basal-Bolus Insulin Regimen in Japanese Patients with Type 1 Diabetes: A Pilot Study.
The aim of this study was to investigate the efficacy of insulin degludec used for basal-bolus insulin regimen after switching from twice-daily basal insulin in Japanese patients with type 1 diabetes mellitus. The subjects were 22 type 1 diabetes patients treated with basal-bolus insulin regimen with twice-daily basal insulin. Basal insulin was switched to once-daily injection of insulin degludec with 10% dose reduction. HbA1c and fasting plasma glucose (FPG) were measured before and 12 weeks after switching. The frequency of hypoglycemic episodes, standard deviation (SD) of blood glucose, and mean of daily difference (MODD) were evaluated by continuous glucose monitoring (CGM) before and 4 weeks after switching. HbA1c and FPG before and 12 weeks after switching were comparable (HbA1c 8.5 ± 1.4 versus 8.7 ± 1.6%, P = 0.28; FPG 203.2 ± 81.2 versus 206.5 ± 122.4 mg/dL, P = 0.91). The frequency of hypoglycemia during nighttime was not significantly different at 4 weeks after switching (14.4 ± 17.0 versus 11.1 ± 15.0%, P = 0.45). In addition, SD and MODD before and 4 weeks after switching were also comparable. In conclusion, glycemic control under once-daily insulin degludec injection was almost comparable to that under twice-daily basal insulin injections in Japanese type 1 diabetes patients. This study was registered with ID: UMIN000010474.


New method for deciphering free energy landscape of three-state proteins.
We have developed a new simulation method to estimate the distance between the native state and the first transition state and the distance between the intermediate state and the second transition state of a protein which mechanically unfolds via intermediates. Assuming that the end-to-end extension DeltaR is a good reaction coordinate to describe the free energy landscape of proteins subjected to an external force, we define the midpoint extension DeltaR(*) between two transition states from either constant force or constant loading rate pulling simulations. In the former case, DeltaR(*) is defined as a middle point between two plateaus in the time-dependent curve of DeltaR, while, in the latter one, it is a middle point between two peaks in the force-extension curve. Having determined DeltaR(*), one can compute times needed to cross two transition state barriers starting from the native state. With the help of the Bell and microscopic kinetic theory, force dependencies of these unfolding times can be used to locate the intermediate state and to extract unfolding barriers. We have applied our method to the titin domain I27 and the fourth domain of Dictyostelium discoideum filamin (DDFLN4) and obtained reasonable agreement with experiments, using the C(alpha)-Go model.


Interrelationship between insulin resistance and portal haemodynamic abnormality in cirrhosis.
Background: There are only limited data regarding the effect of impaired portal circulation on the glucose metabolism. The study prospectively examined the interrelationship between insulin resistance (IR) and portal haemodynamic abnormality in cirrhosis. Methods: There were 53 cirrhosis patients (61.6 ± 13.0 years) all presenting gastroesophageal varices. Portal haemodynamics by both hepatic venous catheterisation and Doppler ultrasound were examined with respect to the homeostasis model assessment (HOMA)-IR and HOMA2-IR. The IR was defined by HOMA-IR > 3.0 or HOMA2-IR > 2.0. Results: Forty-two patients (79.2%) had collateral vessels, 38 with left gastric vein, 12 with short/posterior gastric vein, 9 with splenorenal shunt, and 3 with inferior mesenteric vein. Multivariate analysis provided significant factors; wedged hepatic venous pressure (HR1.183, 95% CI 1.012-1.383, p=0.035) for HOMA-IR > 3.0, body mass index for HOMA2-IR > 2.0 (HR1.490, 95% CI 1.176-1.888, p=0.001), and collateral flow volume for both HOMA-IR > 3.0 (HR1.007, 95% CI 1.001-1.014, p=0.015) and HOMA2-IR > 2.0 (HR 1.007, 95% CI 1.002-1.013, p=0.009). The best cut-off value of collateral flow volume was 165 ml/min for detecting the HOMA-IR > 3.0 showing area under the receiver operating characteristic curve (AUROC) 0.688 (Odds ratio, 5.33) with sensitivity 70% and specificity 69.6%, and was 165 ml/min for detecting median value of HOMA2-IR > 2.0 showing AUROC 0.698 (odds ratio, 5.7) with sensitivity 75% and specificity 65.5%. Conclusion: There is a close linkage between the IR and impaired portal haemodynamics presented by the collateral development, suggesting the underlying pathogenesis of portal hypertension in cirrhosis patients.


Field-induced dielectric response saturation in o-TaS3.
We investigated dependence of the dielectric properties on temperature and electric field below 50 K along the chain direction of o-TaS3. With external electric field increase, two threshold features could be identified. For electric fields somewhat larger than the lower threshold [Formula: see text], the dielectric constant starts to decrease whereas the conductivity increases due to the tunnelling of solitons. For higher external electric field we observe a saturation of dielectric response and analyze that the possible reasons may be related to the polarization behavior of charged solitons. With a decrease in temperature, the effect of external field on the dielectric response of the system weakens gradually and at 13 K it diminishes due to soliton freezing.


Increasing the uptake of cervical screening programmes.
Successful cervical screening programmes depend on the degree of coverage and the rate of attendance. There are many demographic reasons why some women fail to attend for cervical screening, including lack of knowledge and education and socioeconomic status. Moreover, a woman's ethnicity and her age also play a role in screening uptake. Community and practice nurses are ideally positioned to identify women's information needs and provide appropriate information to overcome barriers to screening attendance. This article discusses the main predictors of participation in cervical screening programmes and interventions that can be used to increase cervical screening uptake.


Smoking, telomere length and lung function decline: a longitudinal population-based study.
Telomere shortening is associated with COPD and impaired lung function in cross-sectional studies, but there is no longitudinal study. We used data from 448 participants recruited as part of the French follow-up of the European Community Respiratory Health Survey. We found no relationship between telomere length at baseline and FEV1 decline after 11 years of follow-up. However, heavy smoking was associated with an accelerated FEV1 decline in individuals with short telomeres, but not in subjects with longer telomeres (p for interaction p=0.08). Our findings suggest that short telomere length in peripheral leucocytes might be a marker for increased susceptibility to the effect of smoking.


The effect of opium addiction on thyroid function tests.
A number of abnormalities has been identified among drug addicted users especially heroin addicts. However, there are a few studies to assess the opium effects on thyroid hormones. the aim of the present study is to investigate the effect of opium on the thyroid function tests. In this case-control, 50 male addicts, aged 20-50 years, with history of addiction to opium lasting more than two years, and 50 male non-addicts as control group were randomly selected. 10 cc blood sample was taken for measurements of TSH, total T4 and T3, free T4 and T3, and T3 resin uptake (T3RU) and 50 cc urine sample for opium testing. The univariate analysis revealed that there was not a significant association between opium and serum levels of T4 and TSH, but compared with control group, a slight increase in total T3 and a decrease in T3RU were observed among addicts (P < 0.05). In multivariate analysis, opium was also found to exert a lowering effect on serum free T4 level after adjusting of age and cigarette smoking (P < 0.05). The findings of the present study demonstrated that opium can influence on thyroid function by increasing total T3 and decreasing T3RU and free T4 levels.


Evaluation of imperfections in silica and chalcogenide glass microspheres using focussed ion beam milling and imaging.
Microspheres made from optical glasses such as silica and chalcogenide are used as both passive and active optical elements in micro-optics systems and devices. The homogeneity of the microspheres is crucial to their optical quality and performance in such devices and so it is essential, in optimizing such systems, that techniques with nanometer scale resolution are developed to measure the internal structure and homogeneity of such spheres. In this work an analytical protocol based on focussed ion beam milling, combined with secondary ion and secondary electron imaging, has been developed to study the internal homogeneity of glass microspheres. The results have shown that silica microspheres with diameters of three to five microns, fabricated by a sol-gel method, have internal inhomogeneities and voids that will lead to non-uniform optical properties. The FIB milling and imaging technique developed has been found to be a very useful method of studying such inhomogeneities, which have been proposed, but never previously observed, in glass microspheres. The FIB based technique has also been used on larger chalcogenide glass (Ga(2)S(3):La(2)S(3)) microspheres (diameter of order 70 microns) but no inhomogeneities have been observed at the spatial resolution of a few microns so far achieved for these larger microspheres. This study suggests that the FIB based milling and imaging technique may have potential for quantitative use in the measurement of morphological variations in such systems as well as in the study of aging processes in micron-sized glass spheres.


PU.1 acts as tumor suppressor for myeloma cells through direct transcriptional repression of IRF4.
We previously reported that PU.1 is downregulated in the majority of myeloma cell lines and primary myeloma cells of certain myeloma patients, and conditional expression of PU.1 in such myeloma cell lines induced cell cycle arrest and apoptosis. We found downregulation of IRF4 protein in the U266 myeloma cell line following induction of PU.1. Previous studies reported that knockdown of IRF4 in myeloma cell lines induces apoptosis, prompting us to further investigate the role of IRF4 downregulation in PU.1-induced cell cycle arrest and apoptosis in myeloma cells. PU.1 induced downregulation of IRF4 at the protein level, cell cycle arrest and apoptosis in six myeloma cell lines. Chromatin immunoprecipitation (ChIP) revealed that PU.1 directly binds to the IRF4 promoter, whereas a reporter assay showed that PU.1 may suppress IRF4 promoter activity. Stable expression of IRF4 in myeloma cells expressing PU.1 partially rescued the cells from apoptosis induced by PU.1. As it was reported that IRF4 directly binds to the IRF7 promoter and downregulates its expression in activated B cell-like subtype of diffuse large B cell lymphoma cells, we performed ChIP assays and found that IRF4 directly binds the IRF7 promoter in myeloma cells. It is known that IRF7 positively upregulates interferon-β (IFNβ) and induces apoptosis in many cell types. Binding of IRF4 to the IRF7 promoter decreased following PU.1 induction, accompanied by downregulation of IRF4 protein expression. Knockdown of IRF7 protected PU.1-expressing myeloma cells from apoptosis. Furthermore, IFNβ, which is a downstream target of IRF7, was upregulated in myeloma cells along with IRF7 after PU.1 induction. Finally, we evaluated the mRNA expression levels of PU.1, IRF4 and IRF7 in primary myeloma cells from patients and found that PU.1 and IRF7 were strongly downregulated in contrast to the high expression levels of IRF4. These data strongly suggest that PU.1-induced apoptosis in myeloma cells is associated with IRF4 downregulation and subsequent IRF7 upregulation.


[Rehabilitation program for patients after the anterior cruciate ligament of the knee plasty].
Arthroscopic anterior cruciate ligament (ACL) plasty is currently a standard operation that makes it possible for patients to return to an active lifestyle. Despite its high prevalence, specific programs for postoperative patient rehabilitation have not yet been developed. Traditional approaches to rehabilitation are inferior and are unable to provide a complete recovery process. The developed program is structured, easy to use and includes the use of proprietary techniques and devices that accelerate the patient recovery process. Of this study was to evaluate the effectiveness of the developed author's program for the rehabilitation of patients after ACL plasty. A total of 74 patients were examined after arthroscopic plasty of ACL. The primary group included 34 patients whose rehabilitation was carried out using the developed author's program. The comparison group included 40 patients who underwent traditional unstructured rehabilitation after such an operation. Reconstructive treatment was carried out in the 1st week after surgery within the hospital, then on an outpatient basis. The control was carried out through electronic communication and patients visiting the rehabilitologist 1, 2, and 8 months after the operation. Evaluation criteria were the patient complaints, pain assessment on a visual analogue scale (VAS) and goniometry. The final result was evaluated in 70 observations. Among the patients of the comparison group, 12 (33.3%) had pain from 2 to 6 VAS points by the end of the 1st month after surgery, and contractures were recorded in 8 (22.2%). In the primary group, only 4 (11.8%) patients during this period had pain of 3 and 4 points according to VAS, there were no restrictions on mobility. 1 month after surgery, 26 (76.5%) patients in the primary group were able to fully return to an active lifestyle and household tasks, in the comparison group 20 (55.5%) patients experienced difficulties in doing housework and returned to full activity only 3-5 months later. The developed rehabilitation program has shown its effectiveness compared to the standard one. It is convenient to use and may be recommended for patients after ACL plastic surgery both at the inpatient and outpatient stages of rehabilitation.


[Is cholecystokinin a biological support in panic attacks?].
Cholecystokinin (CCK) is a peptide found high density in the cerebral cortex, the amygdala and the hippocampus of the mammalian brain. Molecular forms of varying amino acid lengths of CCK have been isolated. The sulphated octapeptide (CCK-8S) is the most abundant form and shorter molecular forms are also present in the brain. CCK-8S has been shown to coexist with neurotensin and dopamine in neurons projecting from the ventral tegmental area to the nucleus accumbens, and to a lesser extent in neurons of the substantia nigra projecting to periventricular regions of the caudate. Evidence suggests that CCK acts as a neurotransmitter in the NCS it is synthesized and stored in nerve terminals and cell bodies; it is released by depolarization; it has specific binding sites; it can affect the firing rate of CNS neurons; and its effects can be interfered with by analogues. Studies have found microiontophoretic application of CCK-8S and CCK-4 on cortical and hippocampal neurons to elicit a strong excitatory action. CCK receptors are widely distributed throughout the central nervous system with high densities in the striatum and nucleus accumbens. Considerable effort has been devoted to characterizing the specificity of brain CCK receptors. So far, two types of CCK receptors have been described: CCK-A receptors which have a higher affinity for sulphated CCK-8 than for de-sulphated CCK-8 (CCK-8US), CCK 4 or gastrin, and CCK-B receptors have a high affinity for all of these compounds.(ABSTRACT TRUNCATED AT 250 WORDS)


Empirical approaches for the investigation of toxicant-induced loss of tolerance.
It has been hypothesized that sensitivity to low-level chemical exposures develops in two steps: initiation by an acute or chronic chemical exposure, followed by triggering of symptoms by low levels of previously tolerated chemical inhalants, foods, or drugs. The Working Group on Toxicant-induced Loss of Tolerance has formulated a series of research questions to test this hypothesis: Do some individuals experience sensitivity to chemicals at levels of exposure unexplained by classical toxicological thresholds and dose-response relationships, and outside normally expected variation in the population? Do chemically sensitive subjects exhibit masking that may interfere with the reproducibility of their responses to chemical challenges? Does chemical sensitivity develop because of acute, intermittent, or continuous exposure to certain substances? If so, what substances are most likely to initiate this process? An experimental approach for testing directly the relationship between patients' reported symptoms and specific exposures was outlined in response to the first question, which was felt to be a key question. Double-blind, placebo-controlled challenges performed in an environmentally controlled hospital facility (environmental medical unit) coupled with rigorous documentation of both objective and subjective responses are necessary to answer this question and to help elucidate the nature and origins of chemical sensitivity.


Excited-state singlet manifold and oscillatory features of a nonatetraeniminium retinal chromophore model.
In this paper we use ab initio multireference Møller-Plesset second-order perturbation theory computations to map the first five singlet states (S(0), S(1), S(2), S(3), and S(4)) along the initial part of the photoisomerization coordinate for the isolated rhodopsin chromophore model 4-cis-gamma-methylnona-2,4,6,8-tetraeniminium cation. We show that this information not only provides an explanation for the spectral features associated to the chromophore in solution but also, subject to a tentative hypothesis on the effect of the protein cavity, may be employed to explain/assign the ultrafast near-IR excited-state absorption, stimulated emission, and transient excited-state absorption bands observed in rhodopsin proteins (e.g. rhodopsin and bacteriorhodopsin). We also show that the results of vibrational frequency computations reveal a general structure for the first (S(1)) excited-state energy surface of PSBs that is consistent with the existence of the coherent oscillatory motions observed both in solution and in bacteriorhodopsin.


The Role of Exercise in Reducing Hyperlipidemia-Induced Neuronal Damage in Apolipoprotein E-Deficient Mice.
Hyperlipidemia causes nervous system-related diseases. Exercise training has developed into an established evidence-based treatment strategy that is beneficial for neuronal injury. This study investigated the effect of exercise on hyperlipidemia-induced neuronal injury in apolipoprotein E-deficient (ApoE-/-) mice. Male ApoE-/- mice (age: 8 weeks) were randomly divided into four groups as follows: mice fed a normal diet (ND), normal diet+swimming training (ND+S), high-fat diet (HD), and high-fat diet+swimming (HD+S). Exercise training consisted of swimming for 40 min/day, 5 days/week for 12 weeks. After 12 weeks, we measured serum levels of total cholesterol (TC), triglyceride (TG), and low-density lipoprotein cholesterol (LDL-c). We also evaluated glial fibrillary acidic protein (GFAP) expression levels using immunohistochemistry, real-time PCR, and immunoblotting. In addition, NLR family pyrin domain-containing 3 (NLRP3), interleukin- (IL-) 18, caspase-1, Bax, Bcl-2, and phosphorylated extracellular signal-regulated kinase (p-ERK) expression levels were measured using immunoblotting. Serum levels of TG, TC, and LDL-c were lower in ApoE-/- HD+S mice than in ApoE-/- HD mice. Immunohistochemistry, real-time PCR, and immunoblotting showed increased levels of GFAP in the ApoE-/- HD group. Immunoblotting revealed increased levels of NLRP3, IL-18, caspase-1, Bax, Bcl-2, and p-ERK in the ApoE-/- HD group; however, they were significantly suppressed in the ApoE-/- HD+S group. Therefore, exercise has protective effects against neuronal injury caused by hyperlipidemia.


The pathogenesis of iodide mumps: A case report.
Iodide mumps is an uncommon condition, induced by iodide-containing contrast, and is characterized by a rapid, painless enlargement of the bilateral or unilateral salivary gland. At present, the pathogenesis of iodide mumps is not yet clear. It may be related to an idiosyncratic reaction, a toxic accumulation of iodine in the gland duct, or renal function damage leading to an iodine excretion disorder. This paper reports the clinical manifestations and magnetic resonance imaging results of one case of iodide mumps, which occurred after digital subtraction angiography. A 66-year-old Chinese man presented to our department with a 1-month speech barrier and 1 day of vomiting. He had the history of high blood sugar, the history of high blood pressure and the history of Vitiligo. He had no history of allergies and had never previously received iodide-containing contrast. His renal function and other laboratory examinations were normal. During the digital subtraction angiography (DSA), the patient received approximately 130 mL of nonionic contrast agent (iodixanol). Five hours postsurgery, the patient experienced bilateral parotid enlargement with no other discomfort, such as pain, fever, skin redness, itching, hives, nausea, vomiting, or respiratory abnormalities. We thought the diagnosis was iodide mumps. Intravenous dexamethasone (5 mg) was administered. 20 hours post-DSA, after which the bilateral parotid shrunk. By 4 days postsurgery, the patient's bilateral parotid had recovered completely. We found no obvious abnormal sequence signal in diffusion magnetic resonance imaging or the corresponding apparent diffusion coefficient. Our findings suggest that vasogenic edema may play an important role in the pathogenesis of iodide mumps.


Ca(2+)-induced alterations in the activity of membrane (Ca(2+)-Mg2+)-ATPase of human and rat erythrocytes.
Effect of intraerythrocyte Ca2+ elevation on human and rat erythrocyte membrane (Ca(2+)-Mg2+)-ATPase along with that of incubation of the erythrocyte ghosts in their own hemolysates enriched with Ca2+ has been studied. While the membrane (Ca(2+)-Mg2+)-ATPase levels of Ca(2+)-loaded human erythrocytes showed an initial increase and subsequent decline, membranes incubated in their own hemolysate showed a consistent decrease in the enzyme activity. Calmodulin sensitivity was retained by the preparations in contrast to the earlier observations made with washed erythrocyte membranes. Similar changes in (Ca(2+)-Mg2+)-ATPase activity but of greater magnitude were observed in response to Ca2+ in the calpain-rich rat erythrocytes. Considerable crosslinking and proteolysis was observed in case of human and rat erythrocytes exposed to high Ca2+ concentrations. The Ca(2+)-activable transglutaminase, however, did not play any role in the activation of the (Ca(2+)-Mg2+)-ATPase.


Diagnosis of Local Recurrence of Malignant Soft Tissue Tumors after Reconstructive Surgery on MRI.
Magnetic resonance imaging (MRI) is useful in the diagnosis of local recurrence, but few studies have explored recurrence in MRI in patients after reconstructive surgery. The purpose of this study was to analyze MRI findings of locoregional recurrence following reconstructive surgery after malignant soft tissue tumor resection. Fifty-three postoperative MRIs from 37 patients who underwent reconstructive surgery after malignant soft tissue tumor resection were retrospectively reviewed. A total of 76 enhancing lesions, including 40 locoregional recurrences and 36 postoperative changes, were analyzed regarding morphology (location on the transplanted tissue, border, and shape) and the signals on T1- and T2-weighted imaging (T1WI, T2WI), fat-suppressed (FS) T2WI, and contrast-enhanced FS T1WI. Diffusion-weighted imaging with an apparent diffusion coefficient was assessed. A chi-squared test and Fisher's exact test were used for statistical analysis. The most common site of recurrent tumors and postoperative changes was the peripheral margin on transplanted tissue (63% and 61%, respectively p = 0.907). Recurrent tumors commonly appeared with well-defined borders (75%) as well as nodular appearance (98%), hyperintensity on T2WI (85%) and FS-T2WI (95%), isointensity on T1WI (65%), impeded water diffusion (55%), and intense (50%) or moderate (45%) enhancement. Postoperative changes showed ill-defined borders (75%), nodular appearance (56%), facilitated water diffusion (69%), and moderate (86%) enhancement, which were significantly different from those of recurrent tumors (p ≤ 0.020). Common and partitioning MRI features of locoregional recurrence were well-defined borders, nodular shape, impeded water diffusion, and intense enhancement. Peripheral margins on transplanted tissue were common sites in both recurrent tumors and postoperative changes.


[Specific IgM and IgA antibodies in Chlamydia trachomatis infections in adults].
The authors have compared the prevalence of Chlamydia trachomatis specific serum IgM and IgA antibodies in two populations with Chlamydia positive total antibodies. The first population, P1 had a positive direct diagnosis, and the second had a negative one. IgM antibodies were found in 13.5 p. cent of P1 only. IgA were found in 51.9 p. cent of P1 versus 15.7 p. cent of P2. The interest of IgA detection is discussed, particularly towards deep infections where they could be an argument of an active infection.


Can cytomorphology differentiate between benign nodules and tumors arising in Graves' disease?
Fine-needle aspiration (FNA) specimens from thyroid nodules arising in Graves' disease (GD) can pose diagnostic difficulties because the cytomorphologic changes in GD may mimic nuclear features of papillary thyroid carcinoma (PTC). In addition, treatment of GD patients with radioactive iodine (RAI) may cause significant cytologic atypia, further increasing the diagnostic difficulty. From March 1999 to April 2002, a total of 14 hypofunctioning nodules in 9 patients with GD underwent FNA; 3 patients had received RAI treatment. Three cases were diagnosed as suspicious for PTC and 11 as benign. Three patients with the diagnosis of suspicious for PTC on FNA underwent surgery and were found to have papillary carcinoma. We assessed all cases to find key cytologic features that can differentiate between nodules with reactive/reparative nuclear atypia from PTC arising in GD. The cytologic features assessed included cellularity, amount of colloid, monotony of the cell population, oncocytic features, cell crowding, lymphocytic infiltration, nuclear elongation, nuclear grooves, pale powdery chromatin, presence of small eccentric nucleoli, and random nuclear atypia. Each feature was semiquantitatively graded on a sliding scale of 0 to 4, with 0 representing absence and 4 representing a predominance of the feature. The mean value of each feature was calculated and the benign and malignant lesions were compared using the unpaired t-test. Four features were found to be statistically significant in the diagnosis of PTC as compared to the benign nodules in GD. The nuclei of PTC in GD show prominent nuclear elongation, pale powdery chromatin, intranuclear grooves, and small eccentric nucleoli. All other features studied were not found to be statistically significant. There does exist an overlap between the cytologic features of benign nodules and PTC arising in GD. However, adherence to strict diagnostic criteria (nuclear elongation, pale powdery chromatin, intranuclear grooves, and small eccentric nucleoli) can enable the diagnosis of PTC arising in GD.


Cyclical Cushing's: how best to catch the ups and downs.
A 68-year-old man with a background of hypertension and type 2 diabetes presented with fluctuating symptoms of muscle aches and pains and tiredness. His initial work-up for the possibility of hypercortisolaemia showed a completely variable pattern, with 24-hour cortisol excretion and serum cortisol post 1 mg dexamethasone suppression test ranging from normal to significantly elevated. A series of salivary cortisol with symptom diary confirmed the cyclical nature of hypercortisolaemia, and his concomitant adrenocorticotropic hormone (ACTH) levels were elevated. An inferior petrosal sinus sampling, performed during hypercortisolaemic phase of his cycle,suggested a central source of ACTH secretion. He had unsuccessful exploration of his pituitary and was eventually treated with bilateral adrenalectomy followed by lifelong steroid replacement. His symptoms improved immediately, and he came off his oral hypoglycaemic and antihypertensive agents within 6 months following his surgery.


Characterization of monoclonal antibodies to chicken gizzard talin.
Eleven monoclonal antibodies against chicken gizzard talin, a major focal adhesion protein, have been produced. In order to determine the degree of homology between talin molecules from different sources, these antibodies were used to immunolocalize talin in five different vertebrate species. Three representative talin antibodies are described in this report.


Effect of body mass index on clinical outcome and all-cause mortality in patients undergoing transcatheter aortic valve implantation.
To assess the effect of body mass index (BMI) on outcome among patients with severe aortic stenosis (AS) admitted for transcatheter aortic valve implantation (TAVI). Being overweight or obese is associated with improved outcome following certain medical treatments, suggesting the existence of a BMI paradox. However, the relationship between BMI and mortality after TAVI remains controversial. Patients were classified according to World Health Organisation criteria such as normal weight, overweight, or obesity according to their BMI (18.5 to 24.9 kg/m2, 25.0 to 29.9 kg/m2, and ≥30.0 kg/m2, respectively). A total of 549 consecutive patients (age: 80.2 ± 7.5 years; logistic European system for cardiac operative risk evaluation [EuroSCORE]: 17.3 ± 9.9%) who underwent TAVI for AS were included. Of these patients, 43% (n = 237) had normal weight, 36% (n = 200) were overweight, and 20% (n = 112) were obese. There were no differences in peri-operative bleeding or vascular complication rates between the groups. All-cause mortality after 30 days, and 1 year, were higher in normal weight patients compared with overweight and obese patients (7% vs. 5 and 4%, p = 0.383, and 19% vs. 9 and 10%, p = 0.006, respectively). After adjustment for several confounding factors, overweight was associated with a decreased 30-day and 1‑year all-cause mortality outcome (hazard ratio [HR] 0.69; 95% confidence interval [CI] 0.47-0.99, and HR 0.65; 95% CI 0.45-0.94, respectively). Despite the well-documented adverse effects of increased body weight on health, being overweight is associated with improved survival following TAVI when compared with normal weight.


[Clinical study of bladder injury].
Since bladder injury has no specific clinical symptoms, accurate diagnosis at first consultation is relatively difficult. To elucidate the clinical characters type of injury, clinical symptoms, laboratory findings, methods of therapy and diagnosis, we reviewed 15 patients with bladder injury over a 9-year-period 1990-1998 (10 were traumatic injuries and 5 spontaneous injuries). We found no specific clinical symptom of bladder injury. Bladder injury may occur anywhere in the bladder wall, but most commonly occurred at the dome of the bladder (60.0%). Gross hematuria was not seen in 40.0% of the cases. The accuracy of diagnosis at first consultation was relatively low (46.7%) and the tendency to make a misdiagnosis as acute abdomen on digestive organs was found. Of the traumatic injuries 60% were afflicted in the drunken state, so alcohol intoxication was considered as an important enviromental factor of bladder injury. Surgical repair of injury sites was employed in 11 cases (73.3%: 7 were intraperitoneal injuries, 4 were extraperitoneal injuries), 4 cases were managed with indwelling urethral catheter. With appropriate treatment, the prognosis is excellent.


Monocyte/macrophage Fc gamma RIII, unlike Fc gamma RIII on neutrophils, is not a phosphatidylinositol-linked protein.
The low affinity IgG Fc receptor, Fc gamma RIII, expressed on circulating neutrophils, natural killer (NK) cells, and tissue macrophages, is involved in effector functions such as cytotoxicity and immune complex clearance by these cells. While Fc gamma RIII is reported to be a phosphatidylinositol (PI)-linked, rather than peptide-linked, protein on neutrophils and NK cells, its membrane linkage in macrophages has not been studied. We examined the sensitivity of Fc gamma RIII to cleavage by PI-specific phospholipase C (PI-PLC) in cultured monocytes and alveolar tissue macrophages and report that this receptor is not PI-linked on these cells. We also observed normal levels of Fc gamma RIII on cultured monocytes of a patient with paroxysmal nocturnal hemoglobinuria, a disease in which PI-linked proteins are deficient. The results suggest that Fc gamma RIII occurs solely in a transmembrane form in cells of the monocyte/macrophage lineage. In addition, we studied Fc gamma RIII on a cloned NK cell line and found it to be resistant to the effects of PI-PLC under conditions that cleaved Fc gamma RIII on neutrophils. Taken together, our results provide evidence for a distinct form of Fc gamma RIII that differs from the neutrophil receptor in its structure and, possibly, in its function.


[Primary mesenchymal chondrosarcoma of the mediastinum].
Cartilaginous lesions of the mediastinum are quite rare and primary cartilage forming tumors arising within the mediastinum are even more exceptional. Radiologic findings are unspecific. However, certain characteristics can orient the diagnosis. They are presented one mediastinal chondrosarcoma case in adult patient of patho-anatomical diagnosis. The findings described entail chest radiography, computed tomography and magnetic resonance.


Decoherence as decay of the Loschmidt echo in a Lorentz gas.
Classical chaotic dynamics is characterized by exponential sensitivity to initial conditions. Quantum mechanics, however, does not show this feature. We consider instead the sensitivity of quantum evolution to perturbations in the Hamiltonian. This is observed as an attenuation of the Loschmidt echo M(t), i.e., the amount of the original state (wave packet of width sigma) which is recovered after a time reversed evolution, in the presence of a classically weak perturbation. By considering a Lorentz gas of size L, which for large L is a model for an unbounded classically chaotic system, we find numerical evidence that, if the perturbation is within a certain range, M(t) decays exponentially with a rate 1/tau(phi) determined by the Lyapunov exponent lambda of the corresponding classical dynamics. This exponential decay extends much beyond the Eherenfest time t(E) and saturates at a time t(s) approximately equal to lambda(-1)ln[N], where N approximately (L/sigma)(2) is the effective dimensionality of the Hilbert space. Since tau(phi) quantifies the increasing uncontrollability of the quantum phase (decoherence) its characterization and control has fundamental interest.


Therapists' emotional reactions to anxious inpatients during integrated behavioral-psychodynamic treatment: a psychometric evaluation of a feeling word checklist.
The purpose of this study was to examine the factor structure of a feeling checklist purported to measure therapists' emotional reactions to their patients, and to evaluate psychometrically the factor-based scales. Therapists completed the checklist after both a behavioral and a psychodynamic phase of a treatment program for inpatients with panic disorder, agoraphobia, and other phobic disorders. The results of factor analysis revealed three distinct dimensions: interest-boredom, insecurity-security, and anger. The corresponding three subscales proved to have a satisfactory internal consistency, and they correlated strongly with their respective factors. The criterion-oriented validity of the insecurity and anger subscales was supported by their ability to differentiate between completers and noncompleters of the program. The three subscales correlated poorly with DSM-III-R personality disorder indices. More subjectively experienced interest and less subjectively experienced anger on the part of the therapists toward patients were related to a stronger reduction in the patients' avoidance behavior in the one-year follow-up period.


Design of an ultrasonic physiotherapy system with pulse wave feedback control.
Due to different physical and biological mechanisms behind ultrasound hyperthermia and phonophoresis, the requirement for ultrasound power, frequency and control modes varies. This paper introduces an adaptive ultrasonic physiotherapy system based on real-time surveillance over physiological characteristics of the patients, which in turn assists the individual treatment and dose limitation in auxiliary rehabilitation. The method essentially takes advantage of distinctive characteristics of two different phases (systole and diastole) of the human cardiac cycle as a medium for modulation. The abundance of blood flow during systole enables energy exchange for hyperthermia while blood flow insufficiency caused by diastole assists in drug penetration. Said method could improve the adjuvant therapy as it provides partial drug penetration and therapeutic dosage control. By adjusting time window and intensity of multi-frequency ultrasound, it is possible to reduce the irradiation dosage to around 22% of that during continuous irradiation at 1 MHz. The method shows high potential in clinical practice. Frequency-tuning ultrasound therapy would be more efficient regarding drug penetration and improve the therapeutic efficacy of hyperthermia.


Munchausen syndrome as dermatitis simulata.
Psychiatric comorbidity is associated with many dermatological disorders. It may be the cause for skin problem or may be the effect of a skin problem as skin being a visual organ. A 28-year-old female presented with multiple red lesions on the skin with unusual morphology and was diagnosed as dermatitis simulata. She gave history of multiple episodes of similar illnesses with admissions in various hospitals and being evaluated and dropping off in between treatments. After detailed psychological evaluation, patient was diagnosed as case of Munchausen syndrome.


Diabetes and periodontitis: How well are the patients aware about an established relation?
The study aimed to assess the levels of awareness about the mutual relationship between diabetes and periodontitis among high-risk age group of the general population and to assess the attitude of general physicians in suggesting diabetic patients to visit a dentist. A structured, closed-ended questionnaire either in English or in local language (Telugu) was distributed and collected from 203 patients who were willing to participate in the study attending the Department of Periodontics, Narayana Dental College & Hospital, Nellore, AP. Data were statistically analyzed and represented in percentages and number. Only 49.8% of the sample population knew about the mutual relationship between diabetes and periodontitis and only 46% of the diabetic study population was suggested to visit a dentist by the physician. There is an insufficient knowledge among the diabetic population regarding the mutual relationship. Only few physicians have suggested their diabetic patients to visit a dentist. As diabetic patients tend to visit a physician earlier than a dentist, it is their responsibility to educate and motivate their patients to seek dental treatment.


Digestible phosphorus needs of terminal-cross growing-finishing pigs.
Growth and digestion experiments were conducted to estimate the digestible P needs of terminal-cross growing-finishing pigs fed sorghum-soybean meal-based diets from 25 to 118 kg. Dietary available P levels approximated the levels recommended by the NRC (1988) or were approximately 25% above or below those levels. Up to 80 kg, dietary treatment did not affect performance; from 80 to 118 kg, the lowest P level (no inorganic P) reduced (P = .03) feed efficiency. Carcass leanness, subjective quality scores for the loin, chemical content of lean, and sensory evaluation of cooked lean were not adversely affected by decreasing P. As dietary P decreased, connective tissue amount in the lean decreased (P = .06). Ash content (P < .01) and peak load (P < .05) of metacarpals and metatarsals decreased as dietary P decreased, but structural soundness scores in the live pig were unaffected by treatment. Apparent digestibility of P decreased (P = .08 to P < .01) as dietary P decreased in the diets. Estimated P excretions per pig decreased with decreasing dietary P up to 80 kg; during the 80-to-118-kg interval, P excretions were similar for pigs fed the two lowest P diets due to reduced feed efficiency of pigs fed the lowest P diet. Dietary digestible P contents maximizing performance and carcass merit were .21, .19, and .16% for pigs fed from 25 to 50, 50 to 80, and 80 to 118 kg, respectively. The results suggest that P excretions of terminal-cross pigs can be reduced by feeding less than current NRC recommendations for P without reducing performance, carcass merit, or structural soundness of live pigs.


Hyperhomocysteinemia in rheumatoid arthritis: influence of methotrexate treatment and folic acid supplementation.
To examine the effect of methotrexate (MTX) and folic acid supplementation on the homocysteine level in patients with rheumatoid arthritis (RA). A cross sectional study was performed in 81 patients with RA, comprising a standardized clinical interview, an examination, and a blood specimen test. P-homocysteine tended to be lower in 41 patients receiving MTX, compared with 40 patients not receiving MTX. Of the MTX treated patients, 76% received folic acid supplementation. Multivariate analysis revealed a statistically significant association between P-homocysteine and P-creatinine (p < 0.001), and disease activity/progression measured by the Health Assessment Questionnaire score (p < 0.001). There was a tendency to negative association between P-homocys-teine and folic acid supplementation. P-homocysteine in patients with RA receiving MTX and folic acid supplementation did not differ significantly from P-homocysteine in RA patients receiving other types of treatment.


Coping style.
The fit of patient coping style and psychotherapy focus has been suggested as improving treatment outcome. This article reviews the definitions, measures, and previous research surrounding this hypothesis. An original meta-analysis of 12 carefully selected studies (N = 1,291 patients) resulted in a weighted, mean effect size (d) of .55 in favor of a fit between externalizing patients and symptom-focused treatment or, alternatively, internalizing patients and insight-focused treatment. This medium-size effect indicates that nondiagnostic patient factors, like coping style, are important considerations in the selection of effective therapies. Clinical examples and clinical recommendations are provided.


Comparative Proteomic Analysis of Different Isolates of Fusarium oxysporum f.sp. lycopersici to Exploit the Differentially Expressed Proteins Responsible for Virulence on Tomato Plants.
The vascular wilt of tomato caused by Fusarium oxysporum f.sp. lycopersici is an important soil borne pathogen causes severe yield loss. The molecular characterization and their interaction with its host is necessary to develop a protection strategy. 20 isolates of F. oxysporum f.sp. lycopersici (FOL) were isolated from wilt infected tomato plants across Tamil Nadu. They were subjected to cultural, morphological, molecular and virulence studies. The results revealed that all the isolates produced both micro and macro conidia with different size, number of cells. The colors of the culture and growth pattern were also varied. In addition, chlamydospores were observed terminally and intercalary. The PCR analysis with F. oxysporum species-specific primer significantly amplified an amplicon of 600 bp fragment in all the isolates. Based on the above characters and pathogenicity, isolate FOL-8 was considered as virulent and FOL-20 was considered as least virulent. Proteomics strategy was adopted to determine the virulence factors between the isolates of FOL-8 and FOL-20. The 2D analyses have showed the differential expression of 17 different proteins. Among them, three proteins were down regulated and 14 proteins were significantly up regulated in FOL-8 than FOL-20 isolate. Among the 17 proteins, 10 distinct spots were analyzed by MALDI-TOF. The functions of the analyzed proteins, suggested that they were involved in pathogenicity, symptom expression and disease development, sporulation, growth, and higher penetration rate on tomato root tissue. Overall, these experiments proves the role of proteome in pathogenicity of F. oxysporum f.sp. lycopersici in tomato and unravels the mechanism behinds the virulence of the pathogen in causing wilt disease.


Aged amylase: a valuable test for detecting and tracking pancreatic pseudocysts.
Amylase-rich fluid that incubates ("ages") within a pancreatic pseudocyst undergoes a change that can be detected by isoenzyme analysis of amylase from the serum. This aging is a result of deamination of the asparagine and glutamine residues on the amylase molecule. Eighteen of 20 patients with surgically proved pseudocysts had greater than 15% aged (deaminated) amylase in their serum. Levels of aged amylase returned to normal following treatment of their pseudocysts. Twenty of 23 patients with acute pancreatitis had levels of aged amylase below 15% (P less than .05). A criterion of 15% aged amylase resulted in 87% specificity, and 91% sensitivity for the diagnosis of pseudocysts. Because this test is noninvasive and easy to perform, it should become the ideal screen for patients at risk of development of pseudocysts, Endoscopic retrograde pancreatography, ultrasonography, and abdominal computed tomographic scanning should be reserved for confirmation of the diagnosis when the result of isoenzyme analysis is positive.


Colonic adenocarcinoma metastatic to the thyroid: report of a case.
We report herein the case of a 67-year-old man who was admitted to our hospital with a 3-month history of hoarseness, a cervical mass, and weak muscles of the extremities 6 years after undergoing a right colectomy for carcinoma. Physical and imaging examinations disclosed a nodule in the thyroid with swollen cervical lymph nodes, multiple pulmonary lesions with pleural effusion, and a cerebral mass. Fine-needle aspiration cytology of the thyroid nodule and brush cytology of the lung mass revealed adenocarcinoma, which was consistent with a diagnosis of metastases from the primary colon adenocarcinoma to the thyroid, brain, and lung. The patient eventually died from the malignancy, although he survived for 4 months after the disclosure of the metastases. The rarity, diagnosis, and prognosis of thyroid metastasis from colon carcinoma are discussed.


Reliéva, a Mahonia aquifolium extract for the treatment of adult patients with atopic dermatitis.
This clinical study was conducted to determine the efficacy and safety of Reliéva cream in adult patients with atopic dermatitis (eczema). This was an open-label trial in 42 patients with atopic dermatitis treated for 12 weeks with Reliéva cream (a homeopathic product containing Psorberine, a proprietary Mahonia aquifolium extract). Efficacy and safety was assessed using Eczema Area and Severity Index scores and a Subject Reported Evaluation of Treatment. The results showed significant (P < 0.05) improvements with respect to Eczema Area and Severity Index scores by comparison to subjects' baseline scores. In addition, subjects responding to a posttreatment evaluation questionnaire indicated a substantial benefit when rating effectiveness, itching, and appearance as a result of using the study preparation. Reliéva cream appears to be a safe and effective treatment for adult patients with atopic dermatitis (eczema).


Polyploidy in large-headed sperm: FISH study of three cases.
Macrocephalic or large headed sperm with multiflagella is a rare abnormality often associated with infertility. Sperm chromosomal abnormalities could be associated with this specific morphological abnormality. The cytogenetic content of large-headed sperm was assessed by dual and three-colour fluorescence in-situ hybridization in three patients carrying this specific morphological abnormality. In all patients nearly all sperm contained at least one copy of each sex chromosome, and in more than half of them at least two copies of either chromosome 1 or 18 were identified. In some sperm a tetraploidy was found. These observations suggested that both meiotic I and II divisions were affected by incomplete partition of homologous chromosomes during meiosis I and of sister chromatids during meiosis II associated with a failure of nuclear cleavage. Furthermore, they provide evidence for a clear relationship between a specific morphological abnormality of the sperm and their abnormal cytogenetic content. The treatment of infertility using ICSI would probably be unsuccessful and have a high genetic risk in these cases.


Research on the Evaluation Method of Enterprises' Independent Innovation Ability Based on Improved BP Neural Network and DQN Algorithm.
The development of enterprises has a very important influence on promoting national economic growth and improving comprehensive economic strength. This work evaluates the independent innovation ability of enterprises, analyzes the characteristics and difficulties of technological innovation of enterprises, and proposes corresponding solutions to promote independent technological innovation of enterprises. Firstly, the characteristics of the research object are clarified, and on the basis of relevant research, the theory of technological innovation and evaluation at home and abroad is expounded. At the same time, the basic theory of the improved BP neural network and DQN algorithm is introduced, which provides a theoretical basis for the research of the thesis. Secondly, according to the characteristics of enterprise technological innovation, an index system for evaluating the technological innovation capability of enterprises is constructed. Then, according to the related theory of the improved BP neural network and DQN algorithm, a neural network model for evaluating the technological innovation capability of enterprises is designed, and the validity of the model is verified through empirical research. Finally, this paper applies the evaluation model to the surveyed enterprises, comprehensively analyzes the characteristics and existing problems of independent technological innovation of enterprises, and proposes practical and feasible countermeasures to improve technological innovation capabilities from the perspective of enterprises themselves. The research results of this paper can be used as an effective supplement to the research on independent technological innovation of enterprises, and at the same time promote the continuous improvement of independent technological innovation capabilities of enterprises.


Survival benefits of pulmonary cellular activation in AIDS patients with Pneumocystis infection.
Pneumocystis carinii pneumonia (PCP) is the most common life-threatening, opportunistic infection in patients with acquired immunodeficiency syndrome. Between 1984 and 1987, patients infected with human immunodeficiency virus (HIV) received bronchoalveolar lavages to confirm PCP diagnosis. Unstained slides containing bronchoalveolar cells from 20 of these patients were stored. Eight years after the last diagnostic bronchoalveolar lavage, blinded investigators immunohistochemically analyzed the unstained bronchoalveolar cells for the presence of proliferating cells and pneumocystic cysts. A significant association was found between the percentage of activated macrophages and patient survival after diagnostic bronchoalveolar lavage. On chart review, patients with higher CD4/CD8 ratios had significantly greater alveolar macrophage activation. The correlation of life span and pulmonary cellular activation in these cases (most predating retroviral therapy) suggests the importance of pulmonary cellular function to immunity and survival in patients infected with HIV.


Prognostic value of mean velocity at the pulmonary artery estimated by cardiovascular magnetic resonance as a prognostic predictor in a cohort of patients with new-onset heart failure with reduced ejection fraction.
Pulmonary hypertension (PH) conveys a worse prognosis in heart failure (HF), in particular when right ventricular (RV) dysfunction ensues. Cardiovascular magnetic resonance (CMR) non-invasively estimates pulmonary vascular resistance (PVR), which has shown prognostic value in HF. Importantly, RV to pulmonary artery (PA) coupling is altered early in HF, before significant rise in PV resistance occurs. The aim of this study was to assess the prognostic value of mean velocity at the pulmonary artery (mvPA), a novel non-invasive parameter determined by CMR, in HF with reduced ejection fraction (HFrEF) with and without associated PH. Prospective inclusion of 238 patients admitted for new-onset HFrEF. MvPA was measured with CMR during index admission. The primary endpoint was defined as a composite of HF readmissions and all-cause mortality. During a median follow-up of 25 months, 91 patients presented with the primary endpoint. Optimal cut-off value of mvPA calculated by the receiver operator curve for the prediction of the primary endpoint was 9 cm/s. The primary endpoint occurred more frequently in patients with mvPA≤9 cm/s, as indicated by Kaplan-Meier survival curves; Log Rank 16.0, p < 0.001. Importantly, mvPA maintained its prognostic value regardless of RV function and also when considering mortality and HF readmissions separately. On Cox proportional hazard analysis, reduced mvPA≤9 cm/s emerged as an independent prognostic marker, together with NYHA III-IV/IV class, stage 3-4 renal failure and ischemic cardiomyopathy. In our HFrEF cohort, mvPA emerged as an independent prognostic indicator independent of RV function, allowing identification of a higher-risk population before structural damage onset. Moreover, mvPA emerged as a surrogate marker of the RV-PA unit coupling status.


Solution Synthesis of Semiconducting Two-Dimensional Polymer via Trimerization of Carbonitrile.
The synthesis of crystalline two-dimensional polymers (2DPs) with proper bandgaps and well-defined repeating units presents a great challenge to synthetic chemists. Here we report the first solution synthesis of a single-layer/few-layer triazine-based 2DP via trimerization of carbonitrile at the interface of dichloromethane and trifluoromethanesulfonic acid. The processable triazine-based 2DP can be assembled into mechanically strong layered free-standing films with a high specific surface area via filtration. Moreover, the highly crystalline triazine-based 2DP can function as the active semiconducting layer in a field-effect transistor via drop coating and exhibits slightly bipolar behavior with a high on/off ratio of 103 and a remarkable mobility of 0.15 cm2 V-1 s-1.


[Clinical, biological, therapeutic and evolving profile of patients with HIV infection hospitalized at Infectious and tropical diseases unit in Abidjan (Ivory Coast)].
The objective of this study is to describe the clinical, biological, therapeutic and evolving current profile of hospitalized patients with HIV infection in the cohort of the Infectious and Tropical Diseases Unit (ITDU) in the aim to improve their care management. This is a retrospective study, conducted on medical data of hospitalized cases of patients with HIV infection in the ITDU at the teaching hospital of Treichville (Abidjan) from 2006 to 2007. During the two years, 447 patients were included in the study. Their average age was 39 years [18 years-86 years] and sex ratio was 0.69. Of the 447 patients, 35% were unemployed and 67% were new patients who had never undergone antiretroviral therapy (ART). The duration of drug exposure was less than 6 months in 59% of treated patients. The average time to initiate ART was seven weeks. Among naive patients 41.9% were lost to follow up, 35.9% were waiting for treatment and 22.1% waiting for baseline biological test to initiate ART. At the initiation of ART, 79.6% of patients had a CD4 count less than 200/mm(3). The reasons of hospitalization defining AIDS were dominated by tuberculosis (34.2%), cerebral toxoplasmosis (17.9%) and neuromeningeal cryptococcosis (8%). The main reasons of hospitalization in classifying non-AIDS were pyelonephritis (6.5%), bacterial pneumonia (5.4%) and undetermined infectious encephalitis (4.9%). Hospital mortality was 24.4%. The leading causes of death were tuberculosis (22.9%), cerebral toxoplasmosis (20.2%), undetermined infectious encephalitis (18.3%) and cryptococcal meningitis (13.7%). The profile of PLHIV in hospital is characterized by profound immunosuppression due to late diagnosis and high mortality associated with severe opportunistic infections and late initiation of ART.


[Prevalence of celiac disease in patients with chronic diarrhea].
The objective of this research was to study the frequency of celiac disease in patients with chronic diarrhea. The biopsy materials of the small intestine and levels of antibodies to alpha-gliadin of class A immunoglobulins (IgA) and tissue transglutaminase were studied in 206 patients with chronic diarrhea. Morphologic celiac-specific symptoms were discovered in 35 (16.9%) patients. Symptoms of the total atrophy were discovered in 28 patients (13.5%); those of subtotal one were found in 7 (3.4%) patients. The increase of antibody levels to IgA alpha-gliadin and tissue transglutaminase was discovered in all 35 patients. Their average level made up 123.7 21.2 units per milliliter and 48.7 11.3 units per milliliter, respectively. It was possible to observe the typical celiac form only in 4 (11.4%) patients; the latent form was found in 30 (85.7%) patients, and the torpid (refractory) form was discovered in 1 (2.8%) patient. The frequency of celiac disease in patients with chronic diarrhea is equal to 16.9%. Patients with the latent form of the disease prevail among patients with celiac disease. Immunological screenings with the subsequent morphologic study of the mucous coat of the small intestine should be prescribed to all patients with the chronic diarrhea syndrome to enable the early diagnostics of celiac disease.


Transforming 3D CAU-10-H into 2D Materials with High Base Stability for Membrane Separation.
Two-dimensional (2D) nanomaterials have received a significant research attention owing to their unique chemical and physical properties. These materials not only provide the chemically active sites and exposed surface atoms, but also display the porous nature suitable for their use as membranes for gas separation. In this study, 3D CAU-10-H has been transformed into a novel alkali stabilized 2D CACl-10 (180). Though CACl-10 (180) is similar to AlOOH, it is a novel 2D nanomaterial synthesized by using 4-chloroisophthalic acid and aluminum nitrate nonahydrate, with thermal decomposition at 300 °C. Further, CACl-10 (180) is noted to retain its framework structure in strong alkali solutions, attributed to the alkali-resistant aluminum hydroxide. At the same time, it has been demonstrated that 3D CAU-10-H can also transform into 3D CACl-10 (140) and 3D CACl-10 (130), and the halogen atoms of the ligands (-Cl) affect the alkali stability of the materials. Subsequently, the PVAm-CACl-10 (180)/MPSf mixed matrix membranes were prepared and applied for CH4 /N2 separation. The developed membrane exhibits the CH4 permeance of 1647.99 GPU with a CH4 /N2 selectivity of 3.1. As a result, 2D CACl-10 (180), with a strong alkali stability and an acceptable CH4 /N2 membrane separation performance, represents a high potential of application in the membrane separation process.