Risks of transmissible diseases in relation to embryo transfer.
Realizing the potential of Embryo transfer (ET) for rapid, cheap and widespread dissemination of genetic material, the risk of transmission disease through the embryos must be considered. The aim of this paper is to evaluate theses risks at each step of production, storage and transfer. The pathogen agent may potentially originate from the donor male (semen) or the donor female (oocytes, embryos) and finally from the environmental conditions. As the differences between in vivo and in vitro derived embryos have been well described, evaluation of the potential risks should be assessed separately for in vivo and in vitro produced embryos. Even if this paper insist on the diseases or diseases agents that are more questionable, it clearly appears that ET remains the more safety way to transfer gene, provided prevention measures are properly handled (use of donor that are specific pathogen free, washing of embryos, additional treatment...) and furthermore it can be easily seen as the best way to prevent some disease transmissions (TSEs, leukosis, foot-and-mouth disease...).


Liver transplantation in patients with Caroli's disease and recurrent cholangitis.
Caroli's disease is an uncommon congenital disorder of the intrahepatic biliary tree. It is characterized by multiple and segmental dilatations of the bile ducts. The clinical course of Caroli's disease is often complicated by recurrent episodes of bacterial cholangitis that seriously impair the patient's quality of life. Despite wide spectrum antimicrobial agents, medical treatment of cholangitis is frequently unsuccessful in patients with Caroli's disease due to the persistence of bacteria in dilatated bile ducts. Other therapies, including internal or external biliary drainages and various surgical or endoscopic procedures, have been used in the treatment of Caroli's disease, with poor results. There are no previous reports in the literature of liver transplantation for recurrent cholangitis in patients with Caroli's disease. We present two such cases, in which cholangitis is resolved.


Methanol Intoxication Victims are Suitable Donors for Corneal Transplantation.
Purpose. To evaluate the outcome of corneal transplantation and the feasibility of tissue donation from donors with methanol intoxication.Methods. Four corneas from two methanol intoxication victims were procured and transplanted in four patients at our medical center. The outcome and graft survival were evaluated.Results. The recipients were between 12 and 49 years of age. Indications for transplantation were keratoconus (two patients), post-traumatic corneal perforation (one patient) and alkaline burn (one patient). The follow-up period ranged between 12 and 60 months. All grafts remained clear, and the postoperative visual acuity was 20/30 in keratoconus patients and 20/60 in others.Conclusions. The methanol intoxication victims appear to be suitable donors for corneal transplantation. To the best of our knowledge, this is the first study to report successful corneal transplantation from donors with methanol intoxication.


Phenomenal Holism and Cognitive Phenomenology.
The cognitive phenomenology debate centers on two questions. (1) What is an apt characterization of the phenomenology of conscious thought? And (2), what role does this phenomenology play? I argue that the answers to the former question bear significantly on the answers to the latter question. In particular, I show that conservatism about cognitive phenomenology is not compatible with the view that phenomenology explains the constitution of conscious thought. I proceed as follows: To begin with, I analyze the phenomenology of our sensory experiences and argue for a weak phenomenal holism (WPH) about sensory phenomenology. Next, I explore how WPH can be integrated into the competing accounts of cognitive phenomenology. I argue that, given WPH, conservatism turns out to reduce phenomenal character to a merely concomitant phenomenon that has no explanatory power when it comes to the constitution of conscious thoughts. In contrast, liberalism is explanatorily more powerful in this respect. Finally, I propose a new version of liberalism that explains how phenomenology constitutes conscious thoughts and fits best with WPH.


Transient reduction in venous susceptibility during posterior reversible encephalopathy syndrome.
We report a case of posterior reversible encephalopathy syndrome (PRES) in which followed-up MRI demonstrated a transient reduction in venous signal on initial SWAN images. The progressive normalization of venous signal on D10 and D40 imaging paralleled the progressive decrease of hyperperfusion on CBF images. Decreased venous susceptibility has never been reported in PRES; it relates most likely to a transient BOLD effect induced by brain hyperperfusion.


Screen time and physical activity in children and adolescents aged 10-15 years.
Previous research studies have demonstrated a relationship between low levels of physical activity and high amounts of screen time in children and adolescents. However, this is usually based on self-reported data. Therefore, the aim of this cross-sectional study was to investigate the association between objectively measured smartphone screen time and physical activity among children and adolescents aged 10-15 years. During seven consecutive days, we objectively assessed smartphone screen time, using the SCRIIN smartphone application, and physical activity, using the SCRIIN activity tracker, in children and adolescents recruited from two schools in Stockholm County, Sweden. Moreover, the children/adolescents and their parents responded to a questionnaire, obtaining among other things: self-reported screen time, physical activity, sleep and health-related quality of life. A total of 121 children and adolescents (mean age: 12.1 ± 1.5) were included in the study. Objectively measured smartphone screen time was 161.2 ± 81.1 min/day. Mean physical activity, measured with the SCRIIN activity tracker, was 32.6 ± 16.5 active min/day. Minutes of screen time and physical activity did not differ between the children and adolescents from the two schools, despite located in different socioeconomic areas. Further, we found no association between smartphone screen time and physical activity. However, girls aged 14-15 years, had more smartphone screen time (p<0.01) and were significantly more physically active (p<0.01) than girls aged 10-12 years. In addition, boys reported more than five times more time spent on computer and video games than girls did. Smartphone screen time was not associated with physical activity level among children and adolescents aged 10-15 years.


Discrimination, Sexual Violence, Depression, Post-traumatic Stress Disorder, and Social Support among Black Women.
Black Americans face significant discrimination associated with mental health disorder, which may be exacerbated among sexually victimized people. Social support may buffer that relationship. Cross-sectional data from a retrospective cohort study were analyzed to examine if discrimination and sexual victimization overlap to exacerbate symptoms of depression and post-traumatic stress disorder (PTSD) and to determine the extent to which social support moderated that association among Black women living in Baltimore, Maryland [138 non-abused (no physical/sexual victimization) and 98 abused (sexually victimized) since age 18]. Symptoms of depression and PTSD were independently associated with discrimination. Multilinear regression showed social support from friends moderated the association between discrimination and depressive symptoms among sexually abused participants only. Discrimination may exacerbate symptoms of depression and PTSD more for sexually victimized Black women, but sources of informal social support may attenuate adverse effects of discrimination on depressive symptoms among members of that group.


"I HEAR MY VOICE, BUT WHO IS TALKING?": UNDERSTANDING DEPERSONALIZATION.
Depersonalization is the frightening experience of being a shut-inside, ghostlike, "true" self that observes another part of the self interacting in the outside world. The "true" self hides safely within, while the "participating" self holds all affects and impulses. This split in the ego is created via internal projective identification in the face of overwhelming affect, unavailability of adequate identifications, and insufficient support for psychic cohesion. As the transference develops, the powerful entrapping cocoon of depersonalization can be projected onto the now-entrapping analyst, where it can be addressed. A clinical vignette illustrates these points.


The rigidity of human fingernails: a biophysical investigation on influencing physical parameters.
(A) The property of withstanding bending and buckling in a composite material such as the nail is best described by such terms as rigidity or stiffness. (B) The physical property of rigidity can be understood from the macromolecular orientation of the keratin filaments and the cellular architecture of the dorsal and ventral nail plates. (C) The rigidity is influenced by factors such as the water content of the nail material. Specimens investigated must therefore be well equilibrated prior to the measurements. (D) Detergents, organic solvents, oils etc. are factors which are likely to influence nail rigidity.


Desmopressin for treating nocturia in patients with multiple sclerosis: A systematic review: A report from the Neuro-Urology Promotion Committee of the International Continence Society (ICS).
To systematically assess all available evidence on efficacy and safety of desmopressin for treating nocturia in patients with multiple sclerosis (MS). This systematic review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Studies were identified by electronic search of Cochrane register, Embase, Medline, Scopus (last search March 3, 2018) and by screening of reference lists and reviews. After screening of 7015 abstracts, 8 prospective, and 1 retrospective studies were included enrolling a total of 178 patients. The mean patient age ranged between 43 and 51 years. A significant decrease in the number of micturitions per night was reported in 5 studies. An increase in the maximum hours of uninterrupted sleep was only found in two studies. A significant reduction of the volume of nocturnal incontinence was described in one study. The patient satisfaction rates ranged from 56% to 82%. The rate of adverse events was between 0% and 57.9%. The rate of hyponatremia ranged from 0% to 23.5% and other commonly reported adverse events were headache, nausea, fluid retention, rhinitis/epistaxis, malaise, and swollen ankles. Risk of bias and confounding was relevant in all studies. Preliminary data suggest that desmopressin might be effective for treating nocturia in patients with MS. However, adverse events are relatively common, the overall quality of evidence is low and the number of studied patients is very limited. Further studies with newer formulations of desmopressin are highly warranted.


Cognitive dysfunction 1 year after COVID-19: evidence from eye tracking.
Increasing evidence suggests persistent cognitive dysfunction after COVID-19. In this cross-sectional study, frontal lobe function was assessed 12 months after the acute phase of the disease, using tailored eye tracking assessments. Individuals who recovered from COVID-19 made significantly more errors in all eye tracking tasks compared to age/sex-matched healthy controls. Furthermore, patients who were treated as inpatients performed worse compared to outpatients and controls. Our results show impaired inhibitory cortical control in individuals who recovered from COVID-19. The association between disease severity and its sequelae may contribute to a better understanding of post-COVID-19 cognitive function.


Endoscope versus microscope in the diagnosis of esophageal non-erosive reflux disease: a study of 71 cases.
Non-erosive reflux disease (NERD) is a type of gastroesophageal reflux disease (GERD) defined as symptomatic GERD without mucosal breaks on endoscopy. There is no gold standard for diagnosis of NERD till date. Biopsy from the distal esophagus in patients of GERD is said to reveal characteristic, although non-specific injury patterns such as squamous cell hyperplasia and intraepithelial inflammatory cell infiltration, collectively known as microscopic esophagitis. Recently, dilated intercellular spaces (DIS) are also shown to be associated with NERD. The present study was undertaken to evaluate the role of biopsy in NERD cases. Two mucosal biopsies were taken at 3 cm above the squamocolumnar junction (SCJ) from 71 cases of NERD having symptom scores of more than 10. Biopsies were evaluated for features of microscopic esophagitis and DIS, and the results were analyzed. Fifty out of 71 (70.4%) patients with symptomatic NERD had features of microscopic esophagitis. DIS was noted in 46/71 (64.8%) of cases, and correlated significantly with microscopic esophagitis (p<0.0001). Basal cell hyperplasia, papillary elongation, intraepithelial neutrophils, and intraepithelial eosinophils were seen in 83.1%, 76.1%, 40.8%, and 12.7% of NERD cases respectively. In symptomatic patients of GERD, when endoscopy does not show mucosal breaks (so called NERD), histopathological evaluation of distal esophageal mucosa may have a diagnostic value. The present study also reinforces the diagnostic utility of DIS in symptomatic NERD.


Cloning, expression, and sequence analysis of the ORF4 gene of the porcine reproductive and respiratory syndrome virus MN-1b.
Porcine reproductive and respiratory syndrome virus (PRRSV) MN-1b strain open reading frame 4 (ORF4) has been cloned, sequenced, and expressed in Escherichia coli. The homologies of nucleotide and amino acid sequences between MN-1b (US isolate) and LV (European isolate) are 69% and 64%, respectively. The data also showed that ORF4 of MN-1b is 36 bases shorter than that of LV. Western blot analysis of expressed recombinant ORF4 protein reacted with 65% (26/40) of PRRSV-infected pig sera tested. These results demonstrated that ORF4 of PRRSV may not be a well-conserved region.


Aberrant Bcl6 protein expression in mantle cell lymphoma.
Mantle cell lymphoma is routinely considered as a Bcl6-negative B-cell lymphoma carrying the translocation t(11;14). Here we describe a series of five Bcl6-positive mantle cell lymphoma cases, including three classic and two blastoid variants. The proliferative index of these cases, measured with the Ki-67 antibody, was slightly higher than in Bcl6-negative mantle cell lymphoma cases (32.2 vs. 23.7%) Bcl6 expression was associated with translocations involving 3q27 in four of the five cases and an extra copy of the BCL6 gene in the fifth. A mutational study of the major mutational cluster in the BCL6 gene revealed no increased mutation rate, except in one case. One of the three cases displayed a high mutational index in the IgVH gene, suggesting exposure to a germinal center microenvironment. Chromosomal alterations involving 3q27 seem to be responsible for this increased Bcl6 expression, which needs to be considered when Bcl6 is used in lymphoma diagnosis.


Whose Moral Community? Religiosity, Secularity, and Self-rated Health across Communal Religious Contexts.
Scholars have long theorized that religious contexts provide health-promoting social integration and regulation. A growing body of literature has documented associations between individual religiosity and health as well as macro-micro linkages between religious contexts, religious participation, and individual health. Using unique data on individuals and county contexts in the United States, this study offers new insight by using multilevel analysis to examine meso-micro relationships between religion and health. We assess whether and how the relationship between individual religiosity and health depends on communal religious contexts. In highly religious contexts, religious individuals are less likely to have poor health, while nonreligious individuals are markedly more likely to have poor health. In less religious contexts, religious and nonreligious individuals report similar levels of health. Consequently, the health gap between religious and nonreligious individuals is largest in religiously devout contexts, primarily due to the negative effects on nonreligious individuals' health in religious contexts.


Determinants of birth asphyxia among newborns in Debre Berhan referral hospital, Debre Berhan, Ethiopia: a case-control study.
Birth asphyxia is the major public health problem in the world. It is estimated that around 23% of all newborn deaths are caused by birth asphyxia worldwide. Birth asphyxia is the top three causes of newborn deaths in sub-Saharan Africa and more than one-third of deaths in Ethiopia. Therefore, the aim of this study was to identify determinants of birth asphyxia which can play a crucial role to decrease the death of newborns. Unmatched case-control study design was implemented among 276 (92 cases and 184 controls) newborns from January 1st to March 30th, 2020. A systematic sampling technique was used to select the study participants. Data were collected by using a semi-structured interviewer-administered questionnaire and document review by trained nurses and midwives who work at the delivery ward of the hospitals. Bivariate logistic regression analysis was done to identify determinants of birth asphyxia. Adjusted odds ratios with 95% confidence intervals and p-value less than and equal to 0.05 were used to assess the level of significance. In this study, maternal education of being can't read & write [AOR = 4.7, 95% CI: (1.2, 11.9)], ante-partum hemorrhage [AOR = 7.7, 95% CI: (1.5, 18.5)], prolonged labor [AOR =13.5, 95% CI: (2.0, 19.4)], meconium stained amniotic fluid [AOR = 11.3, 95% CI: (2.7, 39.5)], breech fetal presentation [AOR = 4.5, 95% CI: (2.0, 8.4)] and preterm birth [AOR: 4.1, 95% CI: (1.8, 9.2)] were factors which showed significantly associated with birth asphyxia among newborns. In this study, maternal education can't read & write, antepartum hemorrhage, prolonged labor, stained amniotic fluid, breech fetal presentation, preterm birth were significantly associated with birth asphyxia. So, educating mothers to enhance health-seeking behaviors and close monitoring of the labor and fetus presentation were recommended to reduce birth asphyxia.


Diffuse axonal injury associated with multiple traumatic aneurysms of the distal anterior cerebral artery--case report.
A rare case of multiple traumatic aneurysms, arising from the distal anterior cerebral artery (ACA), associated with a diffuse axonal injury is presented. An 18-year-old male sustained a frontal impact injury in a traffic accident on February 19, 1988. He immediately lost consciousness and was transported to a local hospital where his Glasgow Coma Scale score was 6. A computed tomographic scan showed a traumatic subarachnoid hemorrhage extending from the corpus callosum to the left parietal lobe. With conservative treatment, he gradually regained consciousness and was referred to our hospital 12 days later. Skull x-rays revealed no fracture. A right common carotid angiogram revealed multiple aneurysmal dilatations on the right distal ACA. A left frontoparietal craniotomy was then performed to determine the nature of the aneurysmal dilatation, and to evacuate the intracerebral hematoma because his right hemiparesis persisted. Two aneurysmal dilatations on the distal ACA were tightly surrounded by clots and a hematoma extended from the corpus callosum to the parietal lobe. The ACA was trapped proximal and distal to the aneurysmal dilatations. The postoperative course was uneventful.


Vitamin B12 supplementation improves rates of sustained viral response in patients chronically infected with hepatitis C virus.
In vitro, vitamin B12 acts as a natural inhibitor of hepatitis C virus (HCV) replication. To assess the effect of vitamin B12 on virological response in patients with chronic HCV hepatitis naïve to antiviral therapy. Ninety-four patients with chronic HCV hepatitis were randomly assigned to receive pegylated interferon α plus ribavirin (standard-of-care; SOC) or SOC plus vitamin B12 (SOC+B12). Viral response-namely, undetectable serum HCV-RNA, was evaluated 4 weeks after starting treatment (rapid viral response), 12 weeks after starting treatment (complete early viral response) and 24 or 48 weeks after starting treatment (end-of-treatment viral response) and 24 weeks after completing treatment (sustained viral response (SVR)). Genotyping for the interleukin (IL)-28B polymorphism was performed a posteriori in a subset (42/64) of HCV genotype 1 carriers. Overall, rapid viral response did not differ between the two groups, whereas the rates of complete early viral response (p=0.03), end-of-treatment viral response (p=0.03) and SVR (p=0.001) were significantly higher in SOC+B12 patients than in SOC patients. In SOC+B12 patients, the SVR rate was also significantly higher in carriers of a difficult-to-treat genotype (p=0.002) and in patients with a high baseline viral load (p=0.002). Distribution of genotype IL-28B did not differ between the two groups. At multivariate analysis, only easy-to-treat HCV genotypes (OR=9.00; 95% CI 2.5 to 37.5; p=0.001) and vitamin B12 supplementation (OR=6.9; 95% CI 2.0 to 23.6; p=0.002) were independently associated with SVR. Vitamin B12 supplementation significantly improves SVR rates in HCV-infected patients naïve to antiviral therapy.


A Comparison of Relative-Efficacy Estimate(S) Derived From Both Matching-Adjusted Indirect Comparisons and Standard Anchored Indirect Treatment Comparisons: A Review of Matching-Adjusted Indirect Comparisons.
We present an empirical comparison of relative-efficacy estimate(s) from matching-adjusted indirect comparisons (MAICs) with estimates from corresponding standard anchored indirect treatment comparisons. A total of 80 comparisons were identified from 17 publications through a systematic rapid review. A standardized metric that used reported relative treatment efficacy estimates and their associated uncertainty was used to compare the methods across different treatment indications and outcome measures. On aggregate, MAICs presented for connected networks tended to report a more favorable relative-efficacy estimate for the treatment for which individual-level patient data were available relative to the reported indirect treatment comparison estimate. Although we recognize the importance of MAIC and other population adjustment methods in certain situations, we recommend that results from these analyses are interpreted with caution. Researchers and analysts should carefully consider if MAICs are appropriate where presented and whether MAICs would have added value where omitted.


Control of tumourigenesis by the Scribble/Dlg/Lgl polarity module.
The neoplastic tumour suppressors, Scribble, Dlg and Lgl, originally discovered in the vinegar fly Drosophila melanogaster, are currently being actively studied for their potential role in mammalian tumourigenesis. In Drosophila, these tumour suppressors function in a common genetic pathway to regulate apicobasal cell polarity and also play important roles in the control of cell proliferation, survival, differentiation and in cell migration/invasion. The precise mechanism by which Scribble, Dlg and Lgl function is not clear; however, they have been implicated in the regulation of signalling pathways, vesicle trafficking and in the Myosin II-actin cytoskeleton. We review the evidence for the involvement of Scribble, Dlg, and Lgl in cancer, and how the various functions ascribed to these tumour suppressors in Drosophila and mammalian systems may impact on the process of tumourigenesis.


Morphology and ultrastructure of pink cusk-eel (Genypterus blacodes, Schneider 1801) spermatozoa by scanning and transmission electron microscopy.
In this study, the morphology and ultrastructure of Genypterus blacodes spermatozoa were characterized through scanning and transmission electron microscopy. Findings revealed that the G. blacodes spermatozoa can be differentiated into three major parts: a spherical head without an acrosome (typical for externally fertilizing fish), a short mid-piece, and a long flagellum. The mean length of the spermatozoa was 57.6 ± 6.08 μm, with flagella accounting for 56.2 ± 7.2 μm. The head was 1.47 ± 0.2 μm long, and 0.89 ± 0.06 μm wide. The mid-piece had a total dimension of 0.72 ± 0.16 μm, and was 0.31 ± 0.02 μm in length and 0.6 ± 0.05 μm in width. It was located lateral to the nucleus and contained 4 or 5 spherical mitochondria. The mitochondria were separated from the axoneme by a cytoplasmic canal. The main piece of the flagellum had short irregular side-fins, and the axoneme was composed of the typical 9 + 2 microtubular doublet structure enclosed by a cell membrane. The present study reveals that G. blacodes sperm can be categorized as a primitive type. This study is the first to provide comprehensive details on the morphology and ultrastructure of spermatozoa in G. blacodes.


Determinants of birth asphyxia among newborns delivered in public hospitals of West Shoa Zone, Central Ethiopia: A case-control study.
Birth asphyxia is one of the leading causes of death in low and middle-income countries and the prominent cause of neonatal mortality in Ethiopia. Early detection and managing its determinants would change the burden of birth asphyxia. Thus, this study identified determinants of birth asphyxia among newborns delivered in public hospitals of West Shoa Zone, central Ethiopia. A hospital-based unmatched case-control study was conducted from May to July 2020. Cases were newborns with APGAR (appearance, pulse, grimaces, activity, and respiration) score of <7 at first and fifth minute of birth and controls were newborns with APGAR score of ≥ 7 at first and fifth minute of birth. All newborns with birth asphyxia during the study period were included in the study while; two comparable controls were selected consecutively after each birth asphyxia case. A pre-tested and structured questionnaire was used to collect maternal socio-demographic and antepartum characteristics. The pre-tested checklist was used to retrieve intrapartum and fetal related factors from both cases and controls. The collected data were entered using Epi-Info and analyzed by SPSS. Bi-variable logistic regression analysis was done to identify the association between each independent variable with the outcome variable. Adjusted odds ratio (AOR) with a 95% CI and a p-value of <0.05 was used to identify determinants of birth asphyxia. In this study, prolonged labor (AOR = 4.15, 95% CI: 1.55, 11.06), breech presentation (AOR = 5.13, 95% CI: 1.99, 13.21), caesarean section delivery (AOR = 3.67, 95% CI: 1.31, 10.23), vaginal assisted delivery (AOR = 5.69, 95% CI: 2.17, 14.91), not use partograph (AOR = 3.36, 95% CI: 1.45, 7.84), and low birth weight (AOR = 3.74, 95% CI:1.49, 9.38) had higher odds of birth asphyxia. Prolonged labor, breech presentation, caesarean and vaginal assisted delivery, fails to use partograph and low birth weights were the determinants of birth asphyxia. Thus, health care providers should follow the progress of labor with partograph to early identify prolonged labor, breech presentation and determine the mode of delivery that would lower the burden of birth asphyxia.


'STEMI-like' acute pulmonary embolism, an unusual presentation.
We present the case of a 65-year-old man with an atypical presentation of pulmonary embolism (PE) as ST elevation myocardial infarction (STEMI) with high troponin. He presented with acute exertional dyspnoea without chest pain. Since the initial ECG showed ST elevation anteroseptal (V1-V4) with concomitant deep Q waves, a delayed STEMI with probable left ventricular aneurysm was the working diagnosis and was treated accordingly. Nevertheless, his coronary angiography was normal and it was then that PE was suspected. D-dimer was found to be elevated and CT pulmonary angiography confirmed bilateral PE with a large thrombus within the right main pulmonary artery. The patient made good clinical recovery and his ST elevation resolved with anticoagulation. The source was found to be a deep vein thrombosis in his right leg. The treatment was not compromised by the delayed diagnosis as he received timely anticoagulation as part of STEMI management.


Use of Resuscitative Endovascular Balloon Occlusion of the Aorta in a Multidisciplinary Approach.
The usage of resuscitative endovascular balloon occlusion of the aorta, also known as aortic balloon occlusion, is an emerging method for bleeding control as a bridge to definitive treatment in trauma management. We describe a trauma case where resuscitative endovascular balloon occlusion of the aorta was used as part of the EndoVascular hybrid Trauma and bleeding Management concept to facilitate transient hemorrhage control and thereby to permit damage control surgery. The case is an illustration of the adoption of a multidisciplinary approach.


Biophysical behavior of lung surfactant: implications for respiratory physiology and pathophysiology.
The major emphasis of this article has been the complex, multicomponent system of surfactants that are required for proper pulmonary mechanics and function in the mammalian lung. Although LS was discovered over 30 years ago, and soon after was linked directly with neonatal RDS, it has taken a significant time for researchers to develop a fundamental understanding of the pulmonary surfactant system, and its actions and roles in respiratory physiology. Nonetheless, knowledge about LS has increased greatly over the past decade, and it is now clear that exogenous surfactant replacement therapy for infants with RDS provides a substantial clinical advantage for these patients. Indeed, the therapy is life-saving in many very small premature infants, and as experience accrues, and therapy is optimized, this advance is clearly a major step forward in neonatology. Perhaps the most prominent theme that has been presented throughout the discussion here is that pulmonary surfactant research must take advantage of interdisciplinary descriptions and cross-correlations for accurate and rapid progress. One positive feature of prior work on lung surfactant replacement and RDS is that its difficulty has forced investigators toward a level of understanding that is sound enough to extend LS research into related fields, such as lung injury and ARDS. These areas have their own complications, including a much more diverse pathology and injury progressions than found with neonatal RDS. In fact, if defining the role of lung surfactant in ARDS (and developing replacement therapy for it) had been the goal of investigators before considering neonatal RDS, it is difficult to imagine a positive outcome. The situation now, however, is one where it is realistic to think of recognizing when and how LS effects will occur in different ARDS lung injuries, so that surfactant replacement will have the best opportunity to help mitigate their progressive pathology. In dealing with ARDS, it is well to remember that there are a variety of complicating factors, since lung injuries vary with animal age and species, and according to the level and duration of exposure. For example, in the hyperoxic injury described in the previous section there was clearly significant LS involvement. However, had animals been subjected to a lower level of oxygen (eg, 60%), even for a comparatively long time (eg, 21 days), the entire pathologic pattern would have been altered, as demonstrated, for example, by Holm et al.(ABSTRACT TRUNCATED AT 400 WORDS)


Potential energy surface and rovibrational states of the ground Ar-HI complex.
A potential energy surface for the ground electronic state of the Ar-HI van der Waals complex is calculated at the coupled-cluster with single and double excitations and a noniterative perturbation treatment of triple excitations [CCSD(T)] level of theory. Calculations are performed using for the iodine atom a correlation consistent triple-zeta valence basis set in conjunction with large-core Stuttgart-Dresden-Bonn relativistic pseudopotential, whereas specific augmented correlation consistent basis sets are employed for the H and Ar atoms supplemented with an additional set of bond functions. In agreement with previous studies, the equilibrium structure is found to be linear Ar-I-H, with a well depth of 205.38 cm(-1). Another two secondary minima are also predicted at a linear and bent Ar-H-I configurations with well depths of 153.57 and 151.57 cm(-1), respectively. The parametrized CCSD(T) potential is used to calculate rovibrational bound states of Ar-HI/Ar-DI complexes, and the vibrationally averaged structures of the different isomers are determined. Spectroscopic constants are also computed from the CCSD(T) surface and their comparison with available experimental data demonstrates the quality of the present surface in the corresponding configuration regions.


Electromechanical and robot-assisted arm training for improving generic activities of daily living, arm function, and arm muscle strength after stroke.
Electromechanical and robot-assisted arm training devices are used in rehabilitation, and might help to improve arm function after stroke. To assess the effectiveness of electromechanical and robot-assisted arm training for improving generic activities of daily living, arm function, and arm muscle strength in patients after stroke. We will also assess the acceptability and safety of the therapy. We searched the Cochrane Stroke Group's Trials Register (last searched July 2011), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2011, Issue 7), MEDLINE (1950 to July 2011), EMBASE (1980 to July 2011), CINAHL (1982 to July 2011), AMED (1985 to July 2011), SPORTDiscus (1949 to July 2011), PEDro (searched August 2011), COMPENDEX (1972 to July 2011), and INSPEC (1969 to July 2011). We also handsearched relevant conference proceedings, searched trials and research registers, checked reference lists, and contacted trialists, experts and researchers in our field, as well as manufacturers of commercial devices. Randomised controlled trials (RCTs) comparing electromechanical and robot-assisted arm training for recovery of arm function with other rehabilitation or placebo interventions, or no treatment, for patients after stroke. Two review authors independently selected trials for inclusion, assessed trial quality, and extracted data. We contacted trialists for additional information. We analysed the results as standardised mean differences (SMDs) for continuous variables and risk differences (RDs) for dichotomous variables. We included 19 trials (involving 666 participants) in this update of our review. Electromechanical and robot-assisted arm training did improve activities of daily living (SMD 0.43, 95% confidence interval (CI) 0.11 to 0.75, P = 0.009, I(2) = 67%) as well as arm function (SMD 0.45, 95% CI 0.20 to 0.69, P = 0.0004, I(2) = 45%), but arm muscle strength did not improve (SMD 0.48, 95% CI -0.06 to 1.03, P = 0.08, I(2) = 79%). Electromechanical and robot-assisted arm training did not increase the risk of patients to drop out (RD 0.00, 95% CI -0.04 to 0.04, P = 0.82, I(2) = 0.0%), and adverse events were rare. Patients who receive electromechanical and robot-assisted arm training after stroke are more likely to improve their generic activities of daily living. Paretic arm function may also improve, but not arm muscle strength. However, the results must be interpreted with caution because there were variations between the trials in the duration and amount of training, type of treatment, and in the patient characteristics.


Hereditary vitamin D-resistant rickets in Lebanese patients: the p.R391S and p.H397P variants have different phenotypes.
Hereditary vitamin D-resistant rickets (HVDRR) is an autosomal recessive disorder caused by mutations in the vitamin D receptor (VDR) gene. Variable phenotypes have been associated with these mutations, and some of these were linked to the effects they have on the interacting partners of VDR, mainly the retinoic X receptor (RXR). We examined four patients with HVDRR from three unrelated Lebanese families. All parents were consanguineous with normal phenotype. We used Sanger sequencing to identify mutations in the coding exons of VDR. Two homozygous mutations (p.R391S and p.H397P), both in exon 9 of the VDR gene, were identified. Phenotype/genotype association was not possible even for the same mutation. Alopecia was seen only with the p.R391S mutation. Despite a comparable rachitic bone disease, the patients showed different responsiveness to large doses of alfacalcidol (1-α-hydroxy vitamin D3) supplementation. This is the first report of VDR mutations in Lebanon with promising clinical outcomes despite the severity of the phenotypes.


HIV-1 reverse transcriptase: structure predictions for the polymerase domain.
Reverse transcriptase (RT) plays an essential role in the life cycle of the human immunodeficiency viruses (HIV). A better understanding of this enzyme, and its two catalytic functions, the DNA polymerase and the RNase H, could lead to the development of new drugs that would specifically block HIV replication. The available genetic, sequence, biochemical, and immunological data on the reverse transcriptase of HIV-1 constrain the possible structure of the DNA polymerase domain. The purpose of this review is to correlate the data and to discuss, in light of that data, a model for the structure of the polymerase domain. In this model, the polymerase domain is approximately 50 to 60 A in diameter with a 20 A opening to accommodate the nucleic acid duplex. The most evolutionarily conserved region of RT (amino acids 20-190 of HIV-1 RT) is proposed to form the inner surface of the 20 A opening to which the nucleic acid hemiduplex is bound.


Experimental evaluation of PCXMC and prepare codes used in conventional radiology.
The objective of this study is to evaluate the precision of dose-calculation computer codes used in our laboratory (PCXMC and PREPARE) for organ dose evaluation. Measurements of entrance and organ dose were performed using ionisation chamber and thermoluminescence dosimetry. To obtain a mean dose of organ, we have used the Rando-Alderson phantom. The results showed that computed and measured doses correlate well (within 28%) in 60% of the samples. The percentage shows that the computed doses correlate with the experimental doses rather well for PCXMC software than PREPARE. Although the two programs are based on the Monte-Carlo method, their calculations differ. PCXMC carries out a simulation of the trajectory of the photon, whereas PREPARE provides interpolated values. Our experimental results are close to the values given by the PCXMC, a program which takes into account the weight, the height of the patient and field dimensions.


Electronic, Optical, and Lattice Dynamical Properties of Tetracalcium Trialuminate (Ca₄Al₆O13).
The electronic, optical, and lattice dynamical properties of tetracalcium trialuminate (Ca₄Al₆O13) with a special sodalite cage structure were calculated based on the density functional theory. Theoretical results show that Ca₄Al₆O13 is ductile and weakly anisotropic. The calculated Young's modulus and Poisson ratio are 34.18 GPa and 0.32, respectively. Ca₄Al₆O13 is an indirect-gap semiconductor with a band gap of 5.41 eV. The top of the valence band derives from O 2p states, and the bottom of conduction band consists of Ca 3d states. Transitions from O 2p, 2s states to empty Ca 4s, 3d and Al 3s, 3p states constitute the major peaks of the imaginary part of the dielectric function. Ca₄Al₆O13 is a good UV absorber for photoelectric devices due to the high absorption coefficient and low reflectivity. The lattice vibration analysis reveals that O atoms contribute to the high-frequency portions of the phonon spectra, while Ca and Al atoms make important contributions to the middle- and low-frequency portions. At the center of the first Brillouin zone, lattice vibrations include the Raman active modes (E, A₁), infrared active mode (T₂), and silentmodes (T₁, A₂). Typical atomic displacement patterns were also investigated to understand the vibration modes more intuitively.


Regulation of alternative pre-mRNA splicing.
The first wave of bioinformatic studies that followed genome and complementary DNA sequencing projects revealed that alternative splicing of messenger RNA precursors (pre-mRNAs) contributes substantially to transcriptome complexity in higher eukaryotes. Together with the realisation of the impact of the process on cell differentiation, development and disease, these studies portray alternative splicing as a fundamental component of gene regulation. Both detailed mechanistic studies and genome-wide analyses will be necessary to unravel the molecular basis for cell type-specific splice site selection. This paper will highlight some recent progress and future challenges for functional genomics and bioinformatics in this rapidly developing area.


Effect and safety of sertraline for treat posttraumatic stress disorder: a multicenter randomised controlled study.
Although several previous studies have examined the efficacy of sertraline in the treatment of posttraumatic stress disorder (PTSD), none involved Chinese PTSD patients. This study aimed to evaluate sertraline efficacy and adverse events in Chinese patients with PTSD over 12 weeks. In total, 72 PTSD patients were randomly assigned to receive sertraline (135 mg daily) or a placebo for 12 weeks. Impact of Event Scale-Revised subscores constituted the primary outcome, with Clinical Global Impression Scale-Severity scores and adverse events as secondary outcomes. Sixty-five subjects completed the study, and their data were included in the final analysis. Sertraline showed greater efficacy in enhancing Impact of Event Scale-Revised and Clinical Global Impression Scale-Severity scores at 6 and 12 weeks relative to that of the placebo. The most common adverse event was nausea, which occurred in 12 (33.3%) and 8 (22.2%) patients in the sertraline and placebo groups, respectively. No sertraline-related deaths were recorded. In summary, we demonstrated that 12 weeks of sertraline was efficacious and well-tolerated in Chinese patients with PTSD.


Unilateral congenital corneal keloid with anterior segment mesenchymal dysgenesis and subluxated lens: case report and review of literature.
To report the unusual association of unilateral congenital corneal keloid with anterior-segment mesenchymal dysgenesis and bilateral subluxated lens. A 20-year old man presented with a mass lesion involving the left cornea. The corneal lesion had been present since birth. On biomicroscopic examination, a well-defined vascularized, grayish-white mass occupying the whole of the left cornea was seen. The right eye showed multiple peripheral corneal opacities with iridocorneal adhesions, a poorly defined supranasal limbus, and a subluxated lens. Excision biopsy of the mass was done for histopathologic examination. Histopathologic examination of the excised corneal mass showed features consistent with that of a corneal keloid: thickened keratinized epithelium, absent Bowman membrane layer, and fibrovascular hyperplasia composed of hyalinized collagen fibers with irregular orientation of the collagen lamellae. During penetrating keratoplasty of the left eye, an anomalous iris pattern with poorly defined angle and a supranasal subluxated lens was also observed. Extraction of the subluxated lens was also done. The graft failed subsequent to a nonhealing persistent epithelial defect. Our case report highlights the rare association of a unilateral congenital corneal keloid with anterior-segment mesenchymal dysgenesis and bilateral subluxated lens.


Why base-catalyzed isomerization of N-propargyl amides yields mostly allenamides rather than ynamides.
The base-catalyzed isomerization of N-propargylamides or carbamates may furnish N-allenyl compounds (allenamides/allencarbamates) or further evolve to N-alkynyl compounds (ynamides or yncarbamates). The particular fate of this reaction varies from experiment to experiment and there is no clear rule for predicting the reaction outcome for a particular structure. With the support of ab initio and DFT computations, this work shows that observed results can be explained by assuming an exchange equilibrium between energetically close N-propargyl, allenyl and N-alkynyl forms and that the reaction outcome correlates to a particular equilibrium mixture. Due to the very small energy gap between the N-allenyl and N-alkynyl forms, small structural changes may easily alter the equilibrium position, explaining the variety of observed experimental results. Based on CBS-QB3 computations, the ωB97 functional provided reasonably accurate isomerization energies and could successfully predict the experimentally observed behavior for several examples from the literature.


Hemodynamic responses to alpha-adrenergic blockade during hypoxemia in the fetal lamb.
The mechanisms responsible for the increase in umbilical venous and hepatic vascular resistance during hypoxemia are poorly understood. To assess the relative importance of alpha-adrenergic receptors, we produced an acute, severe hypoxemia in chronically instrumented fetal sheep. While fetal arterial oxygen saturation was maintained at the same level, we then injected phentolamine, a selective alpha-adrenoreceptor blocker. We found that the hypoxemia-induced vasoconstriction of the umbilical veins and hepatic vasculature was reversed by alpha blockade. Thus, alpha-adrenergic stimulation is necessary to maintain vasoconstriction of the umbilical veins and hepatic vasculature during acute fetal hypoxemia. Furthermore, alpha-adrenergic stimulation is responsible for the hypoxemia-induced vasoconstriction of the gut, spleen, and lower carcass. Thus, the alpha-adrenergic system mediates important fetal hemodynamic adaptations to acute hypoxemia. However, the alpha-adrenergic system is not responsible for the hypoxemia-induced constriction of the renal vasculature.


Duodenal duplication cyst and pancreas divisum causing acute pancreatitis in an adult male.
Duodenal duplication cysts are rare congenital abnormalities which are more commonly diagnosed in infancy and childhood. However, in rare cases, these lesions can remain asymptomatic until adulthood. The combination of duplication cyst and pancreas divisum is extremely rare and both conditions have been linked with acute recurrent pancreatitis. We present the case of a 37 years-old patient who presented with repeated episodes of acute pancreatitis. By means of magnetic resonance imaging and endoscopic ultrasonography we discovered a duplication cyst whose cavity received drainage from the dorsal pancreas. After opening the cyst cavity to the duodenal lumen with a needle knife the patient presented no further episodes in the clinical follow-up. Comparable literature findings and therapeutic options for these abnormalities are discussed with regard to the presented case.


Evaluation of the uncertainty budget for 226Ra analysis in water samples.
An alpha spectrometric method for the rapid determination of 226Ra isotope in water samples is presented. The method is based on the co-precipitation of (Ba)(Ra)SO4 for source preparation. The parameters contributing to the uncertainty budget are investigated. Geometry factor (solid angle / 4pi) was used instead of 226Ra standard disc for the determination of detector efficiency. The analytical method has been successfully applied to the determination of 226Ra for water samples in proficiency tests organized by International Atomic Energy Agency (IAEA) and National Physical Laboratory (NPL). The proposed method also showed high reproducibility.


The kreisler mouse: a hindbrain segmentation mutant that lacks two rhombomeres.
kreisler is a recessive mutation resulting in gross malformation of the inner ear of homozygous mice. The defects in the inner ear are related to abnormalities in the hindbrain of the embryo, adjacent to the ear rudiments. At E9.5, the neural tube posterior to the boundary between the third and fourth rhombomeres, r3 and r4, appears unsegmented, and the region that would normally correspond to r4 is unusually thick-walled and contains many dying cells. The absence of morphological segmentation in the posterior hindbrain corresponds to an altered pattern of gene expression in that region, with major abnormalities posterior to the r4/5 boundary and minor abnormalities anterior to it. From the expression patterns at E9.5 of Krox-20, Hoxb-1 (Hox 2.9), Hoxb-2 (Hox 2.8), Hoxa-3 (Hox 1.5), Hoxd-4 (Hox 4.2) and cellular retinoic-acid binding protein I (CRABP I), it appears that the fundamental defect is a loss of r5 and r6. Correspondingly, the glossopharyngeal ganglion and nerve, associated with r6 are missing and the abducens nerve, which originates from r5 and r6, is also absent. Examination of Krox-20 expression at stages as early as E8.5 indicates that Krox-20 fails ever to be expressed in its r5 domain in the homozygous kreisler mutant. The abnormal amount of cell death is seen only later. An interpretation is that the cells that would normally become specified at an early stage as r5 and r6 adopt an r4 character instead, producing an excess of r4 cells that is disposed of subsequently by cell death.


[Effect of salinity on immobilized microorganisms in biological aerated filter (BAF)].
Based on the satisfactory treatment effect of synthesized oil field wastewater with salinity of 0 - 3%, the salinity effect on the immobilized microorganism in the biological aerated filter (BAF) was further investigated. It was shown that the quantity of live microorganisms could rise to 1.3 x 10(7) per cm3 as the influent salinity was less than 1%, whereas it would decline to 1.1 x 10(6) per cm3 as the salinity increased to 2%, accompanied with the small and cracked cells running out in effluent in the domesticated system. Dehydrogenase activity (DHA) was the highest of 14.4 microg/(mg h) at salinity of 0.5%, which means the greatest degradation capability. And the extra cellular polysaccharide (ECP,) excreted by microorganisms to immobilize themselves on the carriers was the most of 209.9 microg/mg at the salinity of 2%. Although extra cellular polymers (ECP(s)) and microorganisms weight accumulated during the react system operation, the macro-pore diameter of patented FPUFS was from 0.3 to 0.7 mm, which could avoid the clog caused by the microorganisms and their ECP(s), and retained agreeable air and water condition for microorganisms under high salinity.


Paraneoplastic polyarthritis in association with metastatic neuroendocrince tumour of the adrenal gland.
Paraneoplastic polyarthritis is a rare manifestation described in association with various solid tumours. We describe the clinical presentation, diagnostic evaluation, differential diagnosis, and management of a 28-year-old woman who presented with fever, weight loss, and symmetrical polyarthritis, subsequently diagnosed to have a metastatic neuroendocrine tumour of the adrenal gland with paraneoplastic polyarthritis. Paraneoplastic polyarthritis must be considered in polyarthritis unexplained by common aetiologies. The unusual presentation of this case, alerts us about the atypical presentation of these tumours. To the best of our knowledge, this is the first case study of a neuroendocrine tumour presenting as paraneoplastic polyarthritis.


Response Prediction after Neoadjuvant Chemotherapy for Colon Cancer Using CT Tumor Regression Grade: A Preliminary Study.
To investigate whether CT-based tumor regression grade (ctTRG) can be used to predict the response to neoadjuvant chemotherapy (NAC) in colon cancer. A total of 53 patients were enrolled. Two radiologists independently assessed the ctTRG using the length, thickness, layer pattern, and luminal and extraluminal appearance of the tumor. Changes in tumor volume were also analyzed using the 3D Slicer software. We evaluated the association between pathologic TRG (pTRG) and ctTRG. Patients with Rödel's TRG of 2, 3, or 4 were classified as responders. In terms of predicting responder and pathologic complete remission (pCR), receiver operating characteristic was compared between ctTRG and tumor volume change. There was a moderate correlation between ctTRG and pTRG (ρ = -0.540, p < 0.001), and the interobserver agreement was substantial (weighted κ = 0.672). In the prediction of responder, there was no significant difference between ctTRG and volumetry (Az = 0.749, criterion: ctTRG ≤ 3 for ctTRG, Az = 0.794, criterion: ≤ -27.1% for volume, p = 0.53). Moreover, there was no significant difference between the two methods in predicting pCR (p = 0.447). ctTRG might predict the response to NAC in colon cancer. The diagnostic performance of ctTRG was comparable to that of CT volumetry.


Genetic transmission of fibrodysplasia ossificans progressiva. Report of a family.
Fibrodysplasia ossificans progressiva is a rare connective-tissue disorder characterized by congenital malformation of the great toes and by progressive heterotopic ossification of the tendons, ligaments, fasciae, and skeletal muscles. We document the genetic transmission of fibrodysplasia ossificans progressiva from a sporadically affected father to each of his three children: two daughters and a son. Previous consideration of a genetic etiology was based on the fact that the disease has been reported in several sets of monozygotic twins, that an increased paternal age has been associated with sporadic occurrences of the disorder, and that there have been several reports of genetic transmission in the remote past. Although an autosomal-dominant genetic transmission has long been suspected, the findings in the family reported on here provide confirmation for such inheritance and a basis for the diagnosis and counseling of patients who have this disease.


Silk Fibroin Improves the Release of Nerve Growth Factor from Hydroxyapatite Particles Maintaining its Bioactivity.
Hydroxyapatite (HA) was emerging as the most promising biomaterial owing to its excellent bioactivity, biocompatibility, and high compressive strength for segmental bone defects. However, due to the lack of synergistic signals of osteogenic cells or growth factors, attempts concerning HA have not achieved an ideal therapeutical effect. This work was intended to combine HA particles with nerve growth factor (NGF) to coaccelerate the bone repair. To deal with the strong absorption on HA particles and short half-life of exogenous NGF, bovine serum albumin (BSA) and silk fibroin (SF) were introduced. Protected with SF, maximum release rate was 49.8% at 48 h for 2 mg/ml SF used group while the release rate was less than 5% without SF. PC-12 cells cultured in the NGF release fluid quit proliferation and differentiated to neural phenotype, and approximately 9.5% of NGF loading released from the particles within 48 h. Protected with BSA, in vitro release showed no obvious effect on strong absorption for the surface of HA particles, however, the drug loading of model protein decreased. Fortunately, SF demonstrated the capacity of adjusting the release profile of protein by varying the amount of SF embedded with no influence on drug loading and maintaining the bioactivity of NGF absorbed on HA particles.


Magnitude and Allele Frequency of Cry1F Resistance in Field Populations of the Fall Armyworm (Lepidoptera: Noctuidae) in Brazil.
Bacillus thuringiensis (Bt) corn producing the Cry1F protein was the first highly efficacious Bt corn deployed against the fall armyworm Spodoptera frugiperda (J.E. Smith) (Lepidoptera: Noctuidae) in Brazil, but reduced efficacy of this technology against the fall armyworm has been reported in some regions of the country. Here, we surveyed Cry1F resistance allele frequency and susceptibility of eight S. frugiperda populations collected in 2013 from non-Bt fields in different regions of Brazil. In F1 screen experiments, the overall frequency of the Cry1F resistance alleles in Brazilian populations was estimated at 0.24, with 95% credibility interval between 0.18 and 0.25. In concentration-response bioassays, five of the eight populations surveyed exhibited significant resistance levels, which were over 32 times higher than that of the standard susceptible laboratory strain. The estimates of Cry1F resistance allele frequency were positively correlated with those of median effective or lethal concentrations (i.e., EC50 or LC50). These results show that the allelic frequency and the magnitude of Cry1F resistance are high in field populations of S. frugiperda in Brazil, indicating a challenging situation for resistance management.


Autologous stem cell transplantation following induction therapy with an anthracycline-based regimen including interferon-alpha for low-grade non-Hodgkin's lymphoma.
The role of upfront autologous stem cell transplantation (ASCT) in low-grade non-Hodgkin's lymphoma (LGNHL) continues to be an area of investigation. After undergoing this novel anthracycline-based induction regimen including interferon (IFN)-alpha, a group of LGNHL patients received high-dose chemotherapy followed by ASCT. The induction regimen was based on the concept of regrowth resistance in which patients received nonmyelotoxic agents mid-cycle to slow tumor proliferation between courses of cytotoxic therapy. In addition, IFN-alpha was given at the end of the cycle because studies have shown that it has a 50% response rate in treating LGNHL. We treated 44 consecutive patients between August 1993 and February 1999 with an induction regimen containing cyclophosphamide, mitoxantrone, and teniposide intravenously on day 1 with oral prednisone given on days 1-5. On day 15, patients received vincristine and bleomycin IV. IFN-alpha-2b subcutaneously was administered on days 22-26. In this phase II single-institution study, there were 2 main patient groups. Nineteen patients received the chemotherapy induction regimen and 17 patients received chemotherapy followed by upfront ASCT. For the chemotherapy group, 58% had follicular histology and 84% had stage IV disease. For the ASCT group, 76% had follicular histology, and 71% had stage IV disease. Of the patients treated with chemotherapy, the overall response rate was 95% with 58% complete responses and 37% partial responses. Of the patients treated with chemotherapy and later ASCT, the overall response rate was 100% with 82% complete responses and 18% partial responses. In analyzing progression-free curves for these 2 groups of patients, there was evidence that the upfront autologous group fared better, log-rank test X(2)=4.6028, P < .0319.


Antioxidant Activity of Coconut (Cocos nucifera L.) Protein Fractions.
Coconut cake is an abundant and good potential edible protein source. However, until now it has not been extensively used in the food industry. To promote its usage, the characterization, nutrition value and antioxidant activity of coconut cake protein fractions (albumin, globulin, prolamine, glutelin-1 and glutelin-2) were studied. Results revealed that all the albumin, globulin, glutelin-1 and glutelin-2 fractions showed a high nutrition value. The prolamine, glutelin-1 and glutelin-2 all exhibited good radical scavenging activity and reducing power, and the globulin and prolamine showed high ion chelating ability (89.14-80.38%). Moreover, all the fractions except glutelin-2 could effectively protect DNA against oxidative damage. Several peptides containing five to eight amino acids with antioxidant activity were also identified by LC-MS/MS from the globulin and glutelin-2 fractions. The results demonstrated that the coconut cake protein fractions have potential usages in functional foods.


Trade-offs of the opto-electrical properties of a-Si:H solar cells based on MOCVD BZO films.
Boron-doped zinc oxide (BZO) films, deposited by metal-organic chemical vapor deposition (MOCVD), have been widely used as front electrodes in thin-film solar cells due to their native pyramidal surface structure, which results in efficient light trapping. This light trapping effect can enhance the short-circuit current density (Jsc) of solar cells. However, nanocracks or voids in the silicon active layer may form when the surface morphology of the BZO is too sharp; this usually leads to degraded electrical properties of the cells, such as open-circuit voltage (Voc) and the fill factor (FF), which in turn decreases efficiency (Eff) [Bailat et al., Photovoltaic Energy Conversion, Conference Record of the 2006 IEEE 4th World Conference on. IEEE, 2006, vol. 2, pp. 1533-1536]. In this paper, an etching and coating method was proposed to modify the sharp "pyramids" on the surface of the BZO films. As a result, an evident enhancement was achieved for these modified, BZO-based cells' Voc, FF, and Eff, although the Jsc exhibited a small decrease. In order to increase the Jsc and maintain the improved electrical properties (Voc, FF) of the cell, a thin BZO coating, deposited by MOCVD, was introduced to coat the sputtering-treated BZO film. Finally, we optimized the trade-off among the Voc, FF, and Jsc, that is, we identified a regime with an increase of the Jsc as well as a further improvement of the other electrical properties.


Exogenous sphingomyelinase causes impaired intestinal epithelial barrier function.
To test the hypothesis that hydrolysis of sphingomyelin to ceramide changes the composition of tight junctions (TJs) with increasing permeability of the intestinal epithelium. Monolayers of Caco-2 cells were used as an in vitro model for the intestinal barrier. Permeability was determined by quantification of transepithelial flux and transepithelial resistance. Sphingolipid-rich membrane microdomains were isolated by a discontinuous sucrose gradient and characterized by Western-blot. Lipid content of microdomains was analysed by tandem mass spectrometry. Ceramide was subcellularly localized by immunofluorescent staining. Exogenous sphingomyelinase increased transepithelial permeability and decreased transepithelial resistance at concentrations as low as 0.01 U/mL. Lipid analysis showed rapid accumulation of ceramide in the membrane fractions containing occludin and claudin-4, representing TJs. In these fractions we observed a concomitant decrease of sphingomyelin and cholesterol with increasing concentrations of ceramide. Immunofluorescent staining confirmed clustering of ceramide at the sites of cell-cell contacts. Neutralization of surface ceramide prevented the permeability-increase induced by platelet activating factor. Our findings indicate that changes in lipid composition of TJs impair epithelial barrier functions. Generation of ceramide by sphingomyelinases might contribute to disturbed barrier function seen in diseases such as inflammatory, infectious, toxic or radiogenic bowel disease.


LXR stimulates a metabolic switch and reveals cholesterol homeostasis as a statin target in Tasmanian devil facial tumor disease.
Devil facial tumor disease (DFTD) and its lack of available therapies are propelling the Tasmanian devil population toward extinction. This study demonstrates that cholesterol homeostasis and carbohydrate energy metabolism sustain the proliferation of DFTD cells in a cell-type-dependent manner. In addition, we show that the liver-X nuclear receptor-β (LXRβ), a major cholesterol cellular sensor, and its natural ligand 24S-hydroxycholesterol promote the proliferation of DFTD cells via a metabolic switch toward aerobic glycolysis. As a proof of concept of the role of cholesterol homeostasis on DFTD proliferation, we show that atorvastatin, an FDA-approved statin-drug subtype used against human cardiovascular diseases that inhibits cholesterol synthesis, shuts down DFTD energy metabolism and prevents tumor growth in an in vivo DFTD-xenograft model. In conclusion, we show that intervention against cholesterol homeostasis and carbohydrate-dependent energy metabolism by atorvastatin constitutes a feasible biochemical treatment against DFTD, which may assist in the conservation of the Tasmanian devil.


Early life sensory ability-ventilatory responses of thornback ray embryos (Raja clavata) to predator-type electric fields.
Predator avoidance is fundamental for survival and it can be particularly challenging for prey animals if physical movement away from a predatory threat is restricted. Many sharks and rays begin life within an egg capsule that is attached to the sea bed. The vulnerability of this sedentary life stage is exacerbated in skates (Rajidae) as the compulsory ventilatory activity of embryos makes them conspicuous to potential predators. Embryos can reduce this risk by mediating ventilatory activity if they detect the presence of a predator using an acute electrosense. To determine how early in embryonic life predator elicited behavioral responses can occur, the reactions of three different age groups (1/3 developed, 2/3 developed, and near hatching) of embryonic thornback rays Raja clavata were tested using predator-type electric field stimuli. Egg capsules were exposed to continuous or intermittent stimuli in order to assess varying predator-type encounter scenarios on the ventilatory behavior of different developmental stages. All embryos reacted with a "freeze response" following initial electric field (E-field) exposure, ceasing ventilatory behavior in response to predator presence, demonstrating electroreceptive functionality for the first time at the earliest possible stage in ontogeny. This ability coincided with the onset of egg ventilatory behavior and may represent an effective means to enhance survival. A continuous application of stimuli over time revealed that embryos can adapt their behavior and resume normal activity, whereas when presented intermittently, the E-field resulted in a significant reduction in overall ventilatory activity across all ages. Recovery from stimuli was significantly quicker in older embryos, potentially indicative of the trade-off between avoiding predation and adequate respiration. © 2015 Wiley Periodicals, Inc. Develop Neurobiol 76: 721-729, 2016.


Developing a Typology for Peer Education and Peer Support Delivered by Prisoners.
Peer interventions delivered for prisoners by prisoners offer a means to improve health and reduce risk factors for this population. The variety of peer programs poses challenges for synthesizing evidence. This article presents a typology developed as part of a systematic review of peer interventions in prison settings. Peer interventions are grouped into four modes: peer education, peer support, peer mentoring, and bridging roles, with the addition of a number of specific interventions identified through the review process. The article discusses the different modes of peer delivery with reference to a wider health promotion literature on the value of social influence and support. In conclusion, the typology offers a framework for developing the evidence base across a diverse field of practice in correctional health care.


[Radical prostatectomy in patients with incident prostate cancer].
The problem of detecting localized prostate cancer following transurethral resection of the prostate (TURP) for benign prostatic hyperplasia is fairly common. Historically, radical prostatectomy (RP) after previously performed TURP was associated with poor surgical and functional outcomes. It is believed that the periprostatic fibrosis, scar tissue and inflammation after previous TURP may interfere with the optimal RP results. The present retrospective study evaluates intraoperative characteristics, postoperative oncological and functional outcomes of RP in patients with a history of TURP.


Protein tyrosine nitration in higher plants grown under natural and stress conditions.
Protein tyrosine nitration is a post-translational modification (PTM) mediated by reactive nitrogen species (RNS) that is linked to nitro-oxidative damages in plant cells. During the last decade, the identification of proteins undergoing this PTM under adverse environmental conditions has increased. However, there is also a basal endogenous nitration which seems to have a regulatory function. The technological advances in proteome analysis have allowed identifying these modified proteins and have shown that the number and identity of the nitrated proteins change among plant species, analysed organs and growing/culture conditions. In this work, the current knowledge of protein tyrosine nitration in higher plants under different situations is reviewed.


Diabetic retinopathy is a poor predictor of type of nephropathy in proteinuric type 2 diabetic patients.
Both diabetic nephropathy (DN) and nondiabetic nephropathy (NDN) are reported to occur in patients with type 2 diabetes mellitus (DM). The precise diagnosis of the type of nephropathy has obvious clinical and prognostic implication. The aim of the study was to evaluate the histologic spectrum of nephropathy in proteinuric type 2 diabetic patients and to find the correlation between type of nephropathy and diabetic retinopathy (DR). Twenty eight proteinuric type 2 diabetic patients were included in the study. Five patients (ADPKD 3 and chronic pyelonephritis 2) were excluded from biopsy. Percutaneous renal biopsy was carried in remaining 23 patients. There was a preponderance of male (75%) and majority of the patients were in the age group of 30-78 years. Duration of diabetes ranged between 4 months to 25 years with mean +/- SD of 10.53 +/- 7.62 years. The presenting features were nephrotic syndrome 14 (60.9%), non-nephrotic proteinuria 9 (39.1%) and impaired renal function in 19 (82.6%) patients. Renal biopsy in 23 cases revealed; isolated diabetic nephropathy 13 (56.2%), NDN7 (13.43%) and 3 (13%) patients had NDN superimposed on diabetic nephropathy. Membranous nephropathy (2), focal segmental glomerulosclerosis (2), mesangiocapillary glomerulonephritis (1) were the nondiabetic glomerular disease in our type 2 diabetic patients. Chronic pyelonephritis and ischemic interstial nephropathy was the predominant tubulointerstial lesion in this study. Diabetic retinopathy (DR) observed in 12 (75%) patients with biopsy proven DN and absent in 4 (25%) patients with DN. The distribution of renal lesions in patients with DR (n = 15) showed DN in 9 (60%), NDN 3 (20%) and remaining 3 patients had combined lesions. Renal biopsy in 8 patients without DR showed typical DN in 4 (50%) and NDN in 4 (50%) patients. This study demonstrates presence of both glomerular and tubulointerstitial lesions unrelated to diabetes (NDN) in proteinuric type 2 diabetic patients. Further presence or absence of DR was a poor predictor of diabetic nephropathy because DN was noted in 50% of patients without DR and 40% of patients with DR had non-diabetic nephropathy either alone or in combination with DN.


Chronic HIV infection impairs nonopsonic phagocytosis of malaria parasites.
Malaria-specific immune responses are altered in HIV/malaria-coinfected individuals and are associated with higher parasite burdens and more severe clinical disease. Monocyte/macrophage phagocytosis is a major mechanism of malaria parasite clearance. We hypothesized that phagocytosis of malaria-parasitized erythrocytes is impaired in coinfected individuals and could contribute to the increased parasite burdens observed. We show that nonopsonic phagocytosis of Plasmodium falciparum parasitized erythrocytes is impaired in monocytes isolated from HIV-infected individuals. The observed defects in phagocytic capacity were rescued after 6 months of antiretroviral therapy, demonstrating the importance of HIV treatment and immune reconstitution in the context of coinfection.


Aconitum Alkaloid Poisoning Because of Contamination of Herbs by Aconite Roots.
Aconitum alkaloid poisoning can occur after drinking decoction and soup made from non-toxic herbs contaminated by aconite roots. In the present review, the main objective is to describe the clinical features, investigations and possible sources of contamination. A combination of neurological, gastrointestinal and cardiovascular signs and symptoms was seen. Ventricular tachyarrhythmias could occur in 18% of subjects. Yunaconitine and crassicauline A, mainly found in certain aconite roots from Southwest China, are most commonly involved. Herbal residues and unused herbs should first be inspected for gross contamination. On-site inspection at the retailer should exclude accidental mix-up or cross-contamination when handling aconite roots. Samples of prescribed herbs are examined for gross contamination and analysed for the presence of Aconitum alkaloids. Samples of the implicated herb are also collected from the wholesaler for investigation. If post-import contamination is unlikely, the regulatory authorities of the exporting countries should be notified for follow-up actions. It is a challenging task to work out how non-toxic herbs become contaminated by aconite roots. The source control with good agricultural and collection practices and quality assurance must be enhanced.


Extraneural Metastases of Glioblastoma without Simultaneous Central Nervous System Recurrence.
Glioblastoma multiforme (GBM) is well known as the most common malignant primary brain tumor. It could easily spread into the adjacent or distant brain tissue by infiltration, direct extension and cerebro-spinal fluid dissemination. The extranueural metastatic spread of GBM is relatively rare but it could have more progressive disease course. We report a 39-year-old man who had multiple bone metastases and malignant pleural effusion of the GBM without primary site recurrence.


Simultaneous exposure to Escherichia coli heat-labile and heat-stable enterotoxins increases fluid secretion and alters cyclic nucleotide and cytokine production by intestinal epithelial cells.
Enterotoxigenic Escherichia coli (ETEC) is a significant cause of diarrheal disease and death, especially in children in developing countries. ETEC causes disease by colonizing the small intestine and producing heat-labile toxin (LT), heat-stable toxin (ST), or both LT and ST (LT+ST). The majority of ETEC strains produce both ST and LT. Despite the prevalence of LT+ST-producing organisms, few studies have examined the physiologic or immunologic consequences of simultaneous exposure to these two potent enterotoxins. In the current report, we demonstrate that when LT and ST are both present, they increase water movement into the intestinal lumen over and above the levels observed with either toxin alone. As expected, cultured intestinal epithelial cells increased their expression of intracellular cyclic GMP (cGMP) when treated with ST and their expression of intracellular cyclic AMP (cAMP) when treated with LT. When both toxins were present, cGMP levels but not cAMP levels were synergistically elevated compared with the levels of expression caused by the corresponding single-toxin treatment. Our data also demonstrate that the levels of inflammatory cytokines produced by intestinal epithelial cells in response to LT are significantly reduced in animals exposed to both enterotoxins. These findings suggest that there may be complex differences between the epithelial cell intoxication and, potentially, secretory outcomes induced by ETEC strains expressing LT+ST compared with strains that express LT or ST only. Our results also reveal a novel mechanism wherein ST production may reduce the hosts' ability to mount an effective innate or adaptive immune response to infecting organisms.


Attenuated adenomatous polyposis of the large bowel: Present and future.
Attenuated adenomatous polyposis (AAP) is a poorly understood syndrome, that can be defined as the presence of 10-99 synchronous adenomas in the large bowel, and it is considered a phenotypic variant of familial adenomatous polyposis (FAP). This definition has the advantage of simplicity, but it may include sporadic multiple adenomas of the large bowel at an extreme, or FAP cases on the other side. AAP shows a milder phenotype than FAP, with an older age of onset of adenomas and cancer, and less frequent extracolonic manifestations. AAP may be diagnosed as a single case in a family or, less frequently, it may be present in other family members, and it shows distinct pattern of inheritance. In less than 50% of cases, it may be caused by adenomatous polyposis coli (APC) or MUTYH mutations, referred to as APC-associated polyposis, inherited as an autosomal dominant trait, or MUTYH-associated polyposis, which shows an autosomal recessive mechanism of inheritance, respectively. Surveillance should rely on colonoscopy at regular intervals, with removal of adenomas and careful histological examination. When removal of polyps is not possible or advanced lesions are observed, the surgical approach is mandatory, being subtotal colectomy with ileo-rectal anastomosis the treatment of choice. Studies on this syndrome are lacking, and controversies are still present on many issues, thus, other clinical and genetic studies are requested.


[Eye paralysis and confusion].
Two patients, women of 85 and 76 years, presented with horizontal ocular paresis. The first patient had a palliative ileocecal resection for adenocarcinoma with metastases and developed the ocular paresis only after intravenous glucose infusion. The second had chronic haemolytic anaemia and weight loss due to malnutrition. The two women were also confused. In both patients acute Wernicke's encephalopathy was diagnosed, caused by thiamine deficiency. The disorder could easily have been missed because of confounding clinical problems. Early treatment of Wernicke's encephalopathy (thiamine 100 mg/day intramuscularly for 3 days) is of major importance in preventing permanent neurological damage or even death.


The painful shoulder: diagnosis and treatment.
The shoulder is one of the most complex joints in the body requiring coordinated, functioning muscles and joints to have a fluid, rhythmic motion. The shoulder consists of the glenohumeral (GH) joint, the acromioclavicular (AC) joint, the scapulothoracic (ST) joint, and the sternoclavicular (SC) joint. This article will examine the shoulder anatomy, clinical syndromes, and treatment for common shoulder disorders.


[Pediatric supracondylar fractures of the humerus].
Supracondylar fractures are on the of the most common injuries in paediatric patients. Therapeutic consequences depend on the one hand on the degree of the osseous displacement according to the Gartland classification. On the other hand, the diagnosis of concomitant neuro-vascular injuries is crucial to prevent long term impairment. Never the less, clinical diagnosis can be challenging. In-depth knowledge of pediatric supracondylar humerus fractures is a prerequisite to achieve a functionally and cosmetically satisfactory long-term outcome.


Correlates of Salvia divinorum use in a national sample: findings from the 2009 National Survey on Drug Use and Health.
Salvia, a hallucinogenic plant legally available in most of the United States, has become a widely discussed drug in the media. The extant research on Salvia use relies on non-probability samples and studies of college students. There is a clear need for research that identifies the correlates of Salvia use using data from a large sample that is nationally representative. The current study fills this important gap in the literature by using data from the 2009 National Survey on Drug Use and Health. This survey includes data from nearly 70,000 respondents ages 12 and older living in all 50 U.S. states and the District of Columbia. Due to survey design, separate analyses are conducted among adolescents and adults. Findings indicate that 1.66% of adolescents (respondents ages 12 to 17) and 5.08% of adults (respondents ages 18-34) report the use of Salvia at some point in their lifetime. Correlates of use among adolescents include age, gender, income, peer and parent attitudes toward substance use, and other forms of drug use. Correlates of use among adults include age, gender, race, religiosity, marital status, criminal involvement, and other forms of substance use. Implications of the findings and limitations of the current study are discussed.


[Effect of vitamin E on biochemical processes in erythrocytes].
Effect of therapeutic doses of alpha-tocopherol (50 mg) exceeding 10-12-fold the daily consumption of the vitamin, on glycolysis was studied in erythrocytes of rats maintained on a usual diet. After loading of the animals with tocopherol utilization of glucose was increased 2.4-fold, with simultaneous activation of aldolase and phosphohexoisomerase by 34% and 48%, respectively; content of lactate was increased by 40%.


[Expressions of neurotrophic factors and their receptors in prostate cancer].
To investigate the expressions of neurotrophic factors (NTFs) and their receptors in prostate cancer. We detected the expressions of the nerve growth factor (NGF), brain-derived neurotrophic factor (BDNF), and their receptors TrkA, TrkB and p75 in 35 specimens of prostate cancer by Western blotting, and included 10 specimens of normal prostate tissue from young males that died accidentally. Compared with the control group, the expressions of NGF and p75 were significantly decreased (P < 0.01), while those of BDNF, TrkA and TrkB significantly increased in prostate cancer (P < 0.05). The changes in the expressions of NTFs and their receptors were related with the pathogenesis and progression of prostate cancer, which may be considered as reference indexes for the diagnosis of the disease.


Conformational aspects critical to the immunospecificity of the type III group B streptococcal polysaccharide.
Immunization of rabbits with group B type III streptococcus organisms induces two distinct populations of antibodies with a specificity for determinants on the native capsular polysaccharide antigen of these organisms. Some of the structural and conformational features of the two determinants responsible for the formation of these antibodies were elucidated by (13)C NMR and serological studies on the native type III polysaccharide and some of its structurally modified analogues. The specificity of the determinant corresponding to the major population of antibodies is dependent of the presence of sialic acid residues on the native type III antigen, and although these residues are not an integral part of the determinant, they exert conformational control over it. The carboxylate groups of the sialic acid residues are an important factor in this control mechanism which could possibly involve intramolecular hydrogen bonding. The terminal sialic acid residues control the orientation of the penultimate beta-d-galactopyranose residues with respect to the backbone of the native antigen. The orientation of these residues is critical to the determinant because the determinant is probably small and is located precisely at the junction of the same beta-d-galactopyranose residues with the backbone of the native type III antigen. The determinant corresponding to the other population of antibodies is not sialic acid dependent. This determinant is located on the backbone of the native antigen in the vicinity of the other determinant but on the opposite side to the oligosaccharide branches. In this position, its conformation is unaffected even by the removal of the oligosaccharide branches from the native antigen.


Patient-Centeredness: A Best Practice for HBCU Health Professional Education Programs.
This study examined the influence of physicians' and nurses' patient-centeredness on the satisfaction of African American female Medicaid patients. A multigroup structural equation modeling design was used to test the hypothesized model and its stability across national random test (Nt=98) and cross-validation (Ncv=296) samples. The model fit well. Physician and nurse patient-centeredness significantly and consistently influenced patient satisfaction, explaining 73% of its variance. One standardized deviation increase in physician patient-centeredness increased patient satisfaction, likelihood to recommend, and ratings of care by .698, .665, and .644 deviations. The corresponding effects for nursing were .643, .613, and .594. These effects were consistent across national random samples. The study offers an evidenced-based model that sheds light on provider patient-centered-ness' influence on African American female Medicaid patient satisfaction.


Ginsenoside Re reduces insulin resistance through inhibition of c-Jun NH2-terminal kinase and nuclear factor-kappaB.
Ginsenoside Re (Re), a compound derived from Panax ginseng, shows an antidiabetic effect. However, the molecular basis of its action remains unknown. We investigated insulin signaling and the antiinflammatory effect by Re in 3T3-L1 adipocytes and in high-fat diet (HFD) rats to dissect its anti-hyperglycemic mechanism. Glucose uptake was measured in 3T3-L1 cells and glucose infusion rate determined by clamp in HFD rats. The insulin signaling cascade, including insulin receptor (IR) beta-subunit, IR substrate-1, phosphatidylinositol 3-kinase, Akt and Akt substrate of 160 kDa, and glucose transporter-4 translocation are examined. Furthermore, c-Jun NH(2)-terminal kinase (JNK), MAPK, and nuclear factor (NF)-kappaB signaling cascades were also assessed. The results show Re increases glucose uptake in 3T3-L1 cells and glucose infusion rate in HFD rats. The activation of insulin signaling by Re is initiated at IR substrate-1 and further passes on through phosphatidylinositol 3-kinase and downstream signaling cascades. Moreover, Re demonstrates an impressive suppression of JNK and NF-kappaB activation and inhibitor of NF-kappaBalpha degradation. In conclusion, Re reduces insulin resistance in 3T3-L1 adipocytes and HFD rats through inhibition of JNK and NF-kappaB activation.


A Therapy System for Post-Traumatic Stress Disorder Using a Virtual Agent and Virtual Storytelling to Reconstruct Traumatic Memories.
Although post-traumatic stress disorder (PTSD) is well treatable, many people do not get the desired treatment due to barriers to care (such as stigma and cost). This paper presents a system that bridges this gap by enabling patients to follow therapy at home. A therapist is only involved remotely, to monitor progress and serve as a safety net. With this system, patients can recollect their memories in a digital diary and recreate them in a 3D WorldBuilder. Throughout the therapy, a virtual agent is present to inform and guide patients through the sessions, employing an ontology-based question module for recollecting traumatic memories to further elicit a detailed memory recollection. In a usability study with former PTSD patients (n = 4), these questions were found useful for memory recollection. Moreover, the usability of the whole system was rated positively. This system has the potential to be a valuable addition to the spectrum of PTSD treatments, offering a novel type of home therapy assisted by a virtual agent.


Liver Transplantation for Primary Sclerosing Cholangitis (PSC) With or Without Inflammatory Bowel Disease (IBD)-A European Society of Organ Transplantation (ESOT) Consensus Statement.
Primary sclerosing cholangitis (PSC) is the classical hepatobiliary manifestation of inflammatory bowel disease (IBD) and a lead indication for liver transplantation (LT) in the western world. In this article, we present a Consensus Statement on LT practice, developed by a dedicated Guidelines' Taskforce of the European Society of Organ Transplantation (ESOT). The overarching goal is to provide practical guidance on commonly debated topics, including indications and timing of LT, management of bile duct stenosis in patients on the transplant waiting list, technical aspects of transplantation, immunosuppressive strategies post-transplant, timing and extension of intestinal resection and futility criteria for re-transplantation.


[Rigid ureteroscopy. Apropos of 88 cases].
Rigid ureteroscopy has become a common tool for the diagnosis and management of several diseases of the upper urinary tract. Between April 1990 and April 1996, 92 ureteroscopy procedures were performed in 88 patients in the B Urology Department of Avicennes hospital for diagnostic or therapeutic purposes. The commonest therapeutic procedure was stone manipulation (72 cases). The overall success rate was 90.8% (Distal ureter: 89.6%, mid ureter: 80%, lumbar ureter: 100%) and the complication rate was 4%. Therapeutic ureteroscopy was also used to dry ureterovaginal fistula (4 cases) and ureteral fistula with retroperitoneal urinoma (2 cases), and to remove a double J stent which had migrated into the pelvic ureter (3 cases). Diagnostic ureteroscopy was performed for 7 ureteral strictures including 3 extrinsic compressions and 4 ureteral strictures all treated with dilatations after biopsy. One false passage was observed among diagnostic ureteroscopy procedures. Rigid ureteroscopy is a minimally invasive and reliable technique for the management of ureteric calculi and for the diagnosis and treatment of other ureteric lesions.


Advances in Discovery of PDE10A Inhibitors for CNS-Related Disorders. Part 1: Overview of the Chemical and Biological Research.
Phosphodiesterase 10A (PDE10A) is a double substrate enzyme that hydrolyzes second messenger molecules such as cyclic-3',5'-adenosine monophosphate (cAMP) and cyclic-3',5'-guanosine monophosphate (cGMP). Through this process, PDE10A controls intracellular signaling pathways in the mammalian brain and peripheral tissues. Pharmacological, biochemical, and anatomical data suggest that disorders in the second messenger system mediated by PDE10A may contribute to impairments in the central nervous system (CNS) function, including cognitive deficits as well as disturbances of behavior, emotion processing, and movement. This review provides a detailed description of PDE10A and the recent advances in the design of selective PDE10A inhibitors. The results of preclinical studies regarding the potential utility of PDE10A inhibitors for the treatment of CNS-related disorders, such as schizophrenia as well as Huntington's and Parkinson's diseases are also summarized.


Optimum fiber spacing in a hollow fiber bioreactor.
A high surface area hollow fiber reactor was developed for mammalian cell culture. The reactor employs an interfiber gel matrix of agar or collagen for cell support. A model was developed to predict cell density as a function of fiber spacing. Optimum spacings are calculated for two sizes of Celgard hollow fibers. Ehrlich Ascites Tumor (EAT) cells were grown to an estimated density of 1.1 x 10(8) viable cells/mL in the extracapillary space-corresponding to an overall reactor density of 7 x 10(7) cells/mL. On the basis of available kinetic and diffusivity data, the model predicts that lactate accumulation may limit cell growth in the early stage of medium utilization, while oxygen delivery becomes limiting at later stages.


Endurance Exercise in Hypoxia, Hyperoxia and Normoxia: Mitochondrial and Global Adaptations.
We hypothesized short-term endurance exercise (EN) in hypoxia (HY) to exert decreased mitochondrial adaptation, peak oxygen consumption (VO2peak) and peak power output (PPO) compared to EN in normoxia (NOR) and hyperoxia (PER). 11 male subjects performed repeated unipedal cycling EN in HY, PER, and NOR over 4 weeks in a cross-over design. VO2peak, PPO, rate of perceived exertion (RPE) and blood lactate (Bla) were determined pre- and post-intervention to assess physiological demands and adaptation. Skeletal muscle biopsies were collected to determine molecular mitochondrial signaling and adaptation. Despite reduced exercise intensity (P<0.05), increased Bla and RPE levels in HY revealed higher metabolic load compared to PER (P<0.05) and NOR (n.s.). PPO increased in all groups (P<0.05) while VO2peak and mitochondrial signaling were unchanged (P>0.05). Electron transport chain complexes tended to increase in all groups with the highest increase in HY (n.s.). EN-induced mitochondrial adaptability and exercise capacity neither decreased significantly in HY nor increased in PER compared to NOR. Despite decreased exercise intensity, short term EN under HY may not necessarily impair mitochondrial adaptation and exercise capacity while PER does not augment adaptation. HY might strengthen adaptive responses under circumstances when absolute training intensity has to be reduced.


Unfinished feticide: a legal commentary.
Jansen expresses concern as to the legal implications of both selective reduction of pregnancy and unsuccessful attempts at termination of pregnancy using mifepristone. This commentary examines the legality of both procedures and concludes that Jansen is over-optimistic in his belief that neither procedure is likely to fall foul of the criminal laws on induced abortion. By contrast his anxieties about civil liability arising from the subsequent live birth of a damaged infant are, it is suggested, unnecessarily pessimistic. Such an action is most unlikely to succeed if brought by the infant herself and any claim on the part of the mother will normally be dependent on proof of negligence. The commentary focusses on the law in England with relevant references to other common law jurisdictions.


Intraoperative initiation of a modified ARDSNet protocol increases survival of septic patients with severe acute respiratory distress syndrome.
To assess the intraoperative initiation and feasibility of a modified NIH-NHLBI ARDS Network Mechanical Ventilation Protocol (mARDSNet protocol) in septic patients with severe ARDS. This prospective observational study included consecutive adult septic patients with severe ARDS who underwent emergency abdominal surgery prior to intensive care unit (ICU) admission. The primary outcome was survival to hospital discharge and at 90 days. Secondary outcomes were intraoperative adverse events and ICU length of stay. Seven patients were included. A statistically significant difference in lung compliance [ε=0.150, F(1.053, 3.158)=31.098, p=0.010] and driving pressure [ε=0.263, F(1.844, 5.532)=7.042, p=0.031] was observed with time, while plateau pressure did not changed significantly during surgery [ε=0.322, F(2.256, 6.769)=1.920, p=0.219]. Also, PEEP values were constantly increased during surgery [ε=0.252, F(1.766, 5.297)=9.994, p=0.017], with the highest values being observed towards to the end of the procedure. No intraoperative adverse events were observed. Mean (±SD) ICU length of stay was 10.43 (±2.64) days, while all patients survived to hospital discharge and at 90 days. The intraoperative implementation of our mARDSNet protocol is feasible and may increase the survival of septic patients with severe ARDS if initiated prior to ICU admission.


An NMR strategy for obtaining multiple conformational constraints for 15N-13C spin-pair labelled organic solids.
This work demonstrates a solid-state NMR strategy for extracting multiple interatomic distance and angle constraints from moderately complex solid organic compounds containing a single (13)C label and a single (15)N label. It is shown that the constraints obtained for the compound cimetidine, with the labels placed at positions directed by the standard synthetic route, are sufficient to provide reliable estimates of 5 of the 8 torsional degrees of freedom in the molecule and are consistent with a molecular conformation close to that determined by crystallography. This strategy will be useful for determining the conformations of sparsely-labelled small molecules in motionally restrained environments, such as within the binding sites of membrane-embedded receptors.


[Prevalence of undernutrition in 143 patients before liver transplantation. The Lausanne experience between 1997 and 2005].
The prevalence of undernutrition was prospectively studied in 143 patients before liver transplantation between 1997 and 2005. Nutritional assessment is a particularly tricky problem in cirrhosis and mid-arm muscle circumference is considered as the best reliable anthropometric tool. In this prospective study, prevalence rate is very high (61%) and undernutrition is more frequent in alcoholic cirrhotic patients. In conclusion, these patients should benefit from an early dietician intervention before liver transplantation.


Correlations of IL-17 and NF-κB gene polymorphisms with susceptibility and prognosis in acute respiratory distress syndrome in a chinese population.
The present study was performed to investigate the association between interleukin-17 (IL-17) and nuclear factor κB (NF-κB) gene polymorphisms and the risk and prognosis of acute respiratory distress syndrome (ARDS) in a Chinese population. A total of 210 Chinese patients with ARDS were selected as the study group, 210 individuals who were identified as at-risk patients but did not meet criteria for ARDS were recruited as the control group. Three single nucleotide polymorphisms (SNPs) of IL-17, including rs763780 (A>G), rs2275913 (G>A), rs8193036 (C>T) and NF-κB1 gene rs3774934 (G>A) loci were examined by Sanger sequencing technique in the peripheral blood of all subjects. Patients were followed for 30-day survival. The IL-17 rs763780 and NF-κB1 rs3774934 SNPs had no impact on ARDS risk and prognosis of ARDS (P>0.05). Compared with individuals carrying the wild-type GG genotype of rs2275913 at IL-17, the AA-homozygous and GA- heterozygous individuals were protected from the development of ARDS. Consistently, a decreased 30-day mortality risk was found among A-allele carriers of rs2275913 at IL-17 (p<0.05). For IL-17 rs8193036 SNP, the homozygote TT genotype and heterozygote CT genotypes were associated with increased ARDS susceptibility and 30-day mortality risk (P<0.05). Besides, decreased IL-17 levels were found in A-allele carriers of IL-17 rs2275913, whereas individuals carrying T-allele of IL-17 rs8193036 were found to have significantly increased levels of IL-17 (P<0.05). Our results suggested that two functional polymorphisms of IL-17, rs2275913 and rs8193036 were associated with ARDS risk and prognosis, indicating that the two genetic variants might act as possible markers for the prediction of ARDS risk and development.