Phytochemical variations among four distinct varieties of Indian cardamom Elettaria cardamomum (L.) Maton.
Elettaria cardamomum (L.) Maton prestigiously called as Indian cardamom and is mostly cultivated in south India at higher altitudes ranging from 900 to 1400 msl. The chemical composition of dry capsules essential oil of the four distinct varieties was chemo-profiled by gas chromatography-mass spectrometry (GC-MS). Results revealed a higher concentration of major monoterpene 1, 8-Cineole ranging between 28.94% and 34.91% in PV 1 and PV 2 varieties respectively. Other monoterpenes like α-Pinene, Sabinene, Linalool, α-Terpineol and Nerol were present considerable quantities in all of the four cardamom varieties. Two sesquiterpenic constituents namely, ç-Elemene and 1,6,10-dodecatrien-3-ol (Nerolidol) were identified in all varieties. Three ester constituents were also obtained in PV 1 in which α-Terpinyl acetate (26.68%) exhibited as a major ester constituent followed by Ocimenyl acetate (0.80%) and E5-Dodecenyl acetate (0.30%). This is the first published report on the phytochemical concentration of recent varieties of Indian cardamom.[Formula: see text].


The antilipolytic action of insulin in obese subjects with resistance to its glucoregulatory action.
To compare the ability of insulin to regulate lipolysis in lean and obese subjects, free fatty acid (FFA) suppression was compared in groups of six lean [body mass index, 25.7 +/- 1.1 (+/-SEM) kg/m2] and six obese (body mass index, 48.8 +/- 3.1) Pima Indians during euglycemic hyperinsulinemic clamps which increased plasma insulin levels approximately 10, 20, and 100 microU/ml above basal concentrations. Basal FFA concentrations were slightly, but not significantly, elevated in the obese group (445 +/- 35 vs. 406 +/- 40 mu eg/liter). The mean decline in FFA from basal after 60-90 min of insulin infusion in the obese group was somewhat less than that in the lean group at the lower doses [67 +/- 23 vs. 132 +/- 32 (P = NS) during the 10-microU clamp, and 144 +/- 39 vs. 217 +/- 20 (P = NS) during the 20-microU clamp] and was almost identical in the two groups during the 100-microU clamp (226 +/- 29 vs. 229 +/- 51). In contrast, insulin-mediated glucose disposal at all insulin increments was much lower in the obese group (0.33 +/- 0.03, 0.56 +/- 0.04, and 1.39 +/- 0.04 mg/kg X min) than in the lean group (0.78 +/- 0.06, 1.67 +/- 0.12, and 4.96 +/- 0.26; P less than 0.001). The data suggest that although the obese subjects exhibited significant resistance to the glucoregulatory action of insulin, there were only small changes in insulin's antilipolytic effects. Relative maintenance of sensitivity to the antilipolytic action of insulin in the presence of resistance to insulin's glucoregulatory action could maintain fat deposition in obese individuals.


Economic cost of treatment of childhood epilepsy in Enugu, southeast Nigeria.
The aim of this study was to determine the economic costs and the level of catastrophic health expenditure (CHE) due to childhood epilepsy. The study was conducted at the Paediatric Neurology Clinic of the University of Nigeria Teaching Hospital, Enugu. Data were collected using pre-tested questionnaires that were administered to caregivers of the children. The indirect and direct expenditure due to childhood epilepsy were computed. A 40 percent of monthly non-food expenditure was used to estimate CHE. The average annual direct and indirect expenditures were USD 162.6 and USD 82.3, respectively. Most of direct costs were drugs (25.4 percent versus 35.3 percent) and investigations (48.7 percent versus 61.3 percent) for out-patient and in-patient, respectively. CHE was 34.1 percent and 63.6 percent for out-patient and in-patient care, respectively. The total annual costs: (direct and indirect), for childhood epilepsy of USD244.9. Considering the estimated 190,000 epileptic children in Nigeria, it will amount to USD46.53 million annually, approximately 0.018 percent of Nigeria Gross Domestic Product (GDP). All payments were made out-of-pocket with no health insurance for financial risk protection. The cost of treatment of childhood epilepsy is high and catastrophic for many households. There was lack of usage of health financial risk mechanisms. Scale-up use of health financial risk protection mechanisms such as health insurance can reduce the economic burden.


Sclerosing stromal tumour of the ovary.
Sclerosing stromal tumour (SST) of the ovary is a rare entity. It is a benign neoplasm which forms a distinct subgroup separate from the other ovarian stromal tumours, including thecomafibromas, by virtue of its unique histology. One such tumour in a 25-year old female is reported.


Genetic fingerprinting of germplasm accessions as an aid for species conservation: a case study with Borderea chouardii (Dioscoreaceae), one of the most critically endangered Iberian plants.
Molecular markers have changed previous expectations about germplasm collections of endangered plants, as new perspectives aim at holding a significant representation of all the genetic diversity in the studied species to accomplish further conservation initiatives successfully. Borderea chouardii is a critically endangered allotetraploid dioecious member of Dioscoreaceae, known from a single population in the Iberian pre-Pyrenees. This population was reported to be highly structured into two genetically distinct groups of individuals corresponding to their spatial separation along the vertical cliff where it grows. In 1999, the Spanish Government of Aragón launched the first conservation programme for the ex situ preservation of this species, and since then a seed collection has been conserved at the Germplasm Bank of the Universidad Politécnica de Madrid. However, as some seed samples had not been labelled clearly at the time of collection, their origin was uncertain. Genetic variation in germplasm accessions of B. chouardii was investigated using microsatellite (simple sequence repeat; SSR) markers. The 17 primer pairs used detected 62 SSR alleles in the 46 samples analysed from five different germplasm stocks. Eight alleles scored from the wild population were not detected in the germplasm samples analysed. The relatedness of the germplasm samples to the wild subpopulations through neighbour-joining clustering, principal coordinates analysis (PCO) and assignment tests revealed a biased higher representation of the genetic diversity of the lower cliff (43 samples) subpopulation than that of the upper cliff (three samples). The collection of additional samples from the upper cliff is recommended to achieve a better representation of the genetic diversity of this subpopulation. It is also recommended that these stocks should be managed separately according to their distinct microspatial origin in order to preserve the genetic substructuring of the wild population.


[Co-expression and prognostic significance of hnRNP B1 and CD44 in non-small cell lung cancers].
To study the co-expression and prognostic significance of hnRNP B1 and CD44 in non-small cell lung cancers (NSCLC). The co-expressions of CD44 and hnRNP B1 in the tissues from 88 cases of NSCLC were measured by immunohistochemistry. The relationship between the expressions and the prognosis of NSCLC was analysed. The NSCLC had a high expression of hnRNP B1 (68.18%) and CD44 (52.27%). The cells had the longest average life [(59.607 +/- 4.092) months] in the conditions of high expressed hnRNP B1 and low expressed CD44, and shortest average life [(21.357 +/- 3.545) months] in the conditions of low expressed hnRNP B1 and high expressed CD44. Combined detection of hnRNP B1 and CD44 can help forecast the prognosis of NSCLC.


Seven novel mammalian SNARE proteins localize to distinct membrane compartments.
Soluble N-ethylmaleimide-sensitive factor-attachment protein receptor (SNARE) proteins of the vesicle-associated membrane protein (VAMP) and syntaxin families play a central role in vesicular trafficking through the formation of complexes between proteins present on vesicle and target membranes. Formation of these complexes is proposed to mediate aspects of the specificity of vesicle trafficking and to promote fusion of the lipid bilayers. In order to further understand the molecular mechanisms that organize membrane compartments, we have characterized seven new mammalian proteins of the VAMP and syntaxin families. The proteins are broadly expressed; however, syntaxin 13 is enriched in brain and VAMP 8 in kidney. The seven novel SNAREs localize in distinct patterns overlapping with Golgi, endosomal, or lysosomal markers. Our studies support the hypothesis that evolutionary radiation of these two gene families gave rise to sets of proteins whose differential expression and combinatorial associations define and organize the membrane compartments of cells.


Osteonecrosis of the jaw associated with bisphosphonate use: Presentation of seven cases and literature review.
Bisphosphonates, pyrophosphate analogs, are strong osteoclast inhibitors that are used for osteoporosis and in the treatment of solid tumors with bony metastasis. There are growing reports of osteonecrosis associated with the nitrogen containing bisphosphonates, Pamindronate and Zolendronic acid therapy. Theses cases have been most commonly seen and treated by oral surgeons. An untreated maxillary osteonecrosis can lead to pansinusitis, involving the otolaryngologist in these patients' care. To the authors' knowledge, this is the first case series reported in the otolaryngology literature. A retrospective chart review was conducted on patients presenting to the Mount Sinai Hospital Center and at Elmhurst General Hospital between October 2003 and November 2004 with a history of refractory osteomyelitis of the jaws and chronic bisphosphonate therapy. Seven patients were identified with both of these conditions. These patients presented with nonhealing ulcers of the mandible or maxilla. Four of the patients were on bisphosphonate therapy, and the other three had been treated with bisphosphonates. Three of the patients required extensive operations to remove the involved bone. One patient required endoscopic sinus surgery. Increasing reports of bisphosphonate associated osteomyelitis and the difficulty in treating these patients requires further investigation to identify the subset of patients who are at increased risk for this process. The optimal and safe duration of treatment with bisphosphonates needs to be determined.


Amyloid deposits in the trachea and esophagus ultrastructural confirmation.
The clinical details of two patients suffering from amyloid infiltration of the trachea and esophagus respectively are presented. The "amyloid tumor" in the trachea presented with dysphonia and a swelling in the lower subglottic region. Attempts at complete surgical excision of it were unsuccessful. The patient with esophageal amyloid presented acutely with dysphagia and features of dehydration and malnutrition. Systematized amyloidosis was discovered at autopsy, but no primary initiating cause for it was found. In both cases it was possible to confirm the diagnosis by electron microscopy. The current views on the composition, structure, causation and treatment of amyloid disease are reviewed.


Hepatotoxicity of herbal remedies: an emerging dilemma.
The surge in consumption of herbal remedies has been stimulated by several factors, including the notion that all herbal products are safe and effective, consumers becoming more proactive in self-treating, and lack of regulation by the Food and Drug Administration. Although herbal remedies are generally perceived as harmless, reports of hepatotoxicity associated with herbal use are accumulating, suggesting they are not completely innocuous. On the basis of various case reports, the liver injury from herbal remedies has ranged from mild elevations of liver enzymes to fulminant liver failure requiring liver transplantation. Although regulation by the Food and Drug Administration may be part of the solution, increasing public awareness and educating healthcare professionals about the potential dangers of herbal preparations will need to be implemented. This article reviews the hepatotoxicity of herbal remedies as reported in the literature and discusses issues related to regulation of herbal preparations.


Inhibitory effect of nitric oxide on the metabolism of halogenated volatile anesthetics by cytochrome P-450.
This study was undertaken to examine the effect of nitric oxide (NO) on the metabolism of halogenated volatile anesthetics (HVA) by cytochrome P-450 (CYP) under both aerobic and anaerobic conditions using rat hepatic microsomes. A microsomal fraction was prepared by centrifugation from normal and phenobarbital-treated male SD rats. The anaerobic metabolism of HVA by CYP was followed by measuring the formation of a halothane CYP complex spectrophotometrically. Aerobic CYP activity was determined using either the defluorination of sevoflurane or the demethylation of aminopyrine. The formation of the halothane-CYP complex was dose-dependently inhibited by NO. NO also decreased CYP defluorination of halothane in a dose-dependent manner. In phenobarbital-induced microsomes, the inhibition rates of both complex formation and the defluorination of halothane were the same as those seen in normal microsomes. Although the defluorination of sevoflurane and the demethylation of aminopyrine were inhibited by NO aerobically, the inhibition was much less than that of the metabolism of halothane under anaerobic conditions. These results suggest that NO binds the heme of CYP and inhibits the metabolism of HVA, with the effect lasting for a prolonged period of time. Furthermore, the balance between NO and O(2) is important for NO to inhibit CYP.


'My relationships have changed because I've changed': biographical disruption, personal relationships and the formation of an early menopausal subjectivity.
Early menopause (EM) or premature ovarian insufficiency (POI) can disrupt gendered and age-related expectations associated with perceived 'normative' biographies for young adult women, with implications for subjectivity and relationships. While previous qualitative research has concentrated on the impacts of EM/POI on biography and sense of self, in this article, we examine the enmeshment of personal relationships with the formation of early menopausal subjectivities. Drawing on research exploring concepts of 'biographical disruption' and personal relationships, and theoretical work on social norms and subject formation, we present findings from a narrative thematic analysis of 25 interviews with women diagnosed with spontaneous or medically induced EM/POI. We identify three main narrative 'types' of subjective and relational experience in response to the 'disruption' of EM/POI: interlude and continuity; disruption and adaptation; and disruption and ambivalence. Women's accounts of their experience of EM/POI indicate that the formation of early menopausal selves is mediated by the extent to which women and those around them identify with gendered norms related to reproduction and age. Consistent with theoretical perspectives that consider the self as relationally produced, we argue that the subjective and relational dimensions of EM/POI are intertwined and must be understood in tandem.


Generation of a unique fibroblast-activating factor by human monocytes.
Purified human monocytes incubated with phytohemagglutinin (PHA), bacterial lipopolysaccharide (LPS), or serum-opsonized zymosan particles (OZ) generate human dermal fibroblast-activating activity, as assessed by increased fibroblast incorporation of [3H]-thymidine. A maximum concentration of fibroblast-activating activity was attained within 4 hr with OZ, whereas similar maximum levels required 12 hr with LPS and PHA. Sonicates of unstimulated monocytes had only minimal activity and the protein synthesis inhibitor cycloheximide suppressed significantly the appearance of fibroblast-activating activity, suggesting that the factors are generated prior to release. Filtration of supernates from OZ-stimulated monocytes on Sephadex G-75 yielded polydisperse fibroblast-activating activities, of which the major factors exhibited a mol. wt. of approximately 60,000 and 10,000. The supernates from PHA-stimulated monocytes had one predominant factor, termed fibroblast-activating factor of monocytes (FAF-M), with an apparent mol. wt. of 38,000 and a minor activity with a mol. wt. of 10,000. FAF-M was composed of two principles with isoelectric points of 5.1-5.2 and 4.0-4.2 and was free of interleukin-1, as determined by the absence of thymocyte-activating activity. FAF-M and other fibroblast-activating factors may contribute to wound healing and fibrosis in lesions characterized by mononuclear phagocyte infiltrates.


Endodontic hand instruments: cutting efficiency, instrumentation of curved canals, bending and torsional properties.
In an assessment of the usefulness of different root canal instruments, two aspects are of particular interest for the endodontist: the cutting efficiency of the instruments and their ability to enlarge curved canals without undesirable changes of the canal shape such as the formation of zips and elbows. This review paper is based on own investigations on the cutting efficiency and instrumentation of curved canals. Additionally, two parameters which are described in ISO 3630-1, resistance to bending and resistance to fracture, are discussed. With regard to cutting efficiency in rotary motion, flexible stainless steel reamers and K-files clearly display the best results and are superior to conventional stainless steel as well as titanium-based reamers and K-files. Regarding cutting efficiency in linear motion, stainless steel Hedström files made by certain manufacturers are significantly superior to stainless steel and titanium-based Hedström files of other brands. Flexible stainless steel instruments with modified noncutting tips clearly produce the best canal shape in curved canals. With only rare exceptions, all the instruments tested fulfilled the requirements of the ISO standard concerning resistance to fracture and resistance to bending.


An alternative route towards the fabrication of 2D blue phosphorene.
Blue phosphorene (BlueP) is a novel two-dimensional material that shares properties with black phosphorene and is potentially even more interesting for opto-electronic applications because of its layer dependent wide band gap of ≈ 2 to 3 eV and superior charge carrier mobility. It was first fabricated on Au(111), where, however, a network consisting of BlueP subunits and Au-linker atoms is formed. The physical properties of such an arrangement strongly differ from a freestanding BlueP monolayer. Here, we report on the growth of epitaxial BlueP on the Au(100) surface, which is an interesting alternative when aiming at quasi-freestanding BlueP domains. We find two different phosphorus phases by means of scanning tunneling microscopy and distortion-corrected low-energy electron diffraction. In the low coverage regime, we observe a commensurate (2 × 2) phase, whereas for higher coverage, a nearly hexagonal structure is formed. For the latter, the lattice parameters measured via atomically resolved scanning tunneling hydrogen microscopy closely resemble those of freestanding BlueP, and the typical height modulation of the phosphorus atoms is verified in our layers by means of x-ray photoelectron diffraction. We further analyze the chemical and electronic properties of these films by means of x-ray and (angle resolved) ultraviolet photoelectron spectroscopy.


Contribution of renal angiotensin converting enzyme (ACE) to blood pressure regulation: possible role of brush border ACE.
The role of renal angiotensin converting enzyme (ACE) in blood pressure regulation is not well understood. In our studies, both acute and chronic treatment of hypertensive rats SHR and SHRSP with ACE inhibitors Enalapril and SA446 had a blood pressure lowering effect that coincided with an inhibition of renal cortical and aortic ACE, but not plasma ACE. Further, ACE activities in the renal cortex and aorta were found to increase with aging of the SHRSP, therefore concomitantly with hypertension development. In the kidney, brush border membranes (BBM) contained abundant ACE. We found that the activities of ACE in the renal cortex closely correlated to the activities in isolated BBM, in Wistar Kyoto rats and in the SHRSP. Thus, renal cortical ACE activity and blood pressure correlated in cases of ACE inhibition and hypertension development. Since the ACE activity in the renal cortex appeared to reflect the enzyme activity in BBM, the brush border ACE may have to be taken into account, in view of the relationship between renal ACE and blood pressure.


Symptoms and hospitalization decisions.
On the basis of semistructured evaluations of all new patients presenting for care during a 1-year period at a comprehensive psychiatric facility, the authors systematically assessed the relationship between various aspects of the patients' symptoms and hospitalization decisions. The individual symptoms correlating the highest with hospitalization were self-neglect, disorganized thought process, and impulsivity. Even greater correlations, in increasing order, were obtained for the total number of symptoms present, for delusional psychosis (one of the broad factors underlying the patient's symptoms), and for a linear combination composed of self-neglect, impulsivity, suspiciousness, and suicidal indicators.


ING4 induces G2/M cell cycle arrest and enhances the chemosensitivity to DNA-damage agents in HepG2 cells.
The known members of inhibitor of growth (ING) gene family are considered as candidate tumor suppressor genes. ING4, a novel member of ING family, is recently reported to interact with tumor suppressor p53, p300 (a major component of histone acetyl transferase complexes), and p65(RelA) subunit of NF-kappaB. In this study, we investigated the cellular behaviors of HepG2 cells with exogenous ING4. Interestingly, the overexpression of ING4 negatively regulated the cell growth with significant G2/M arrest of cell cycle, and moreover, enhanced the cell apoptosis triggered by serum starvation in HepG2 cells. Furthermore, the exogenous ING4 could upregulate endogenous p21 and Bax in HepG2 cells, not in p53-deficient Saos-2 cells, suggesting that G2/M arrest induced by ING4 could be mediated by the increased p21 expression in a p53-dependent manner, although there is no significant increase of p53 expression in HepG2 cells. Moreover, HepG2 cells with exogenous ING4 could significantly increase cell death, as exposed to some DNA-damage agents, such as etoposide and doxorubicin, implying that ING4 could enhance chemosensitivity to certain DNA-damage agents in HepG2 cells.


Evaluation of five rapid diagnostic tests for detection of antibodies to hepatitis C virus (HCV): A step towards scale-up of HCV screening efforts in India.
Hepatitis C virus (HCV) infection is a major contributor to morbidity and mortality worldwide. Early detection and curative treatment of HCV can reduce the risk of liver-related mortality and serve to prevent transmission of new infections. India is estimated to have about six million HCV infected individuals, most of whom are unaware of their infection status. Rapid diagnostic test kits (RDTs) could help identify HCV infected persons more expeditiously and thus availability of high performing, quality-assured RDTs is essential to scale-up HCV screening efforts. The present study was thus undertaken to evaluate the performance characteristics of five anti-HCV RDTs. Five anti-HCV RDTs (Alere Truline, Flaviscreen, Advanced Quality, SD Bioline and OraQuick) were evaluated using two panels of known anti-HCV positive and negative samples; one characterized from Indian patient samples (n = 360) and other obtained from the US Centers for Disease Control and Prevention (CDC), Atlanta (n = 100). Sensitivity, specificity, inter-observer agreement, test validity and operational characteristics of RDTs were assessed. The combined sensitivities across both panels for Alere Truline, Flaviscreen, Advanced Quality, SD Bioline and OraQuick RDTs were 99.4% (95%CI-96.6%-99.9%), 86.2% (95%CI-79.8%-91.1%), 96.2% (95%CI-91.9%-98.6%), 99.4% (95%CI-96.6%-99.9%) and 99.4% (95%CI-96.6%-99.9%) respectively. The overall specificities across both panels for all RDTs were 99.7%. The inter-observer agreement was 100% for Alere Truline, SD Bioline and OraQuick, while it was 99.5% and 98.6% with Advanced Quality and Flavicheck respectively. Discordant results were significantly associated with human immunodeficiency virus (HIV) positivity for both Advanced Quality and Flavicheck (p<0.001). The present evaluation demonstrated that Alere Truline, SD Bioline and OraQuick RDTs had sensitivity and specificity in accordance with the acceptance criteria of the Drug Controller General, India, the national regulatory authority, had excellent inter-observer agreement and superior operational characteristics. Our findings suggest that certain HCV RDTs perform well and can be a useful tool in screening of HCV infections expeditiously.


Use of dried plasma spots in the determination of pharmacokinetics in clinical studies: validation of a quantitative bioanalytical method.
A novel approach has been developed for the quantitative determination of circulating drug concentrations in clinical studies using dried plasma spots (DPS) on paper substrates, rather than conventional plasma samples. A quantitative bioanalytical high-pressure liquid chromatography-tandem mass spectrometry (HPLC-MS/MS) assay has been validated using paroxetine as a tool compound (range 0.2-200 ng/mL human plasma). The assay employed simple solvent extraction of a punched disk taken from the DPS sample, followed by reversed phase HPLC separation, combined with multiple reaction monitoring mass spectrometric detection. In addition to performing routine experiments to establish the validity of the assay to internationally accepted criteria (precision, accuracy, linearity, sensitivity, selectivity), experiments are included to assess the effect of the volume of plasma spotted and the use of an indicating paper. The validated DPS approach was successfully applied to a clinical study utilizing pooled samples and a direct comparison of DPS and plasma was made (single oral dose of 37.5 mg of paroxetine).


Pathophysiology, assessment and treatment of coronary heart disease in women.
Despite improvements in mortality rates, coronary heart disease (CHD) continues to be a leading cause of death in the UK. It has a long-standing reputation as a 'male disease', and although there has been an increased interest in and awareness of the disease, CHD in women remains understudied, under-diagnosed and undertreated. This article discusses the apparent disparity in pathophysiology, symptom presentation, risk factor profile, assessment, management and outcomes between men and women in relation to CHD and acute coronary syndrome, which is an acute manifestation of CHD.


Modification of binuclear Pt-Tl bonded complexes by attaching bipyridine ligands to the thallium site.
Complex formation of monomeric thallium(III) species with 2,2'-bipyridine (bipy) in dimethyl sulfoxide (dmso) and acetonitrile solutions was studied by means of multinuclear ((1)H, (13)C, and (205)Tl) NMR spectroscopy. For the first time, NMR signals of the individual species [Tl(bipy)(m)(solv)](3+) (m = 1-3) were observed despite intensive ligand and solvent exchange processes. The tris(bipy) complex was crystallized as [Tl(bipy)(3)(dmso)](ClO(4))(3)(dmso)(2) (1), and its crystal structure determined. In this compound, thallium is seven-coordinated; it is bonded to six nitrogen atoms of the three bipy molecules and to an oxygen atom of dmso. Metal-metal bonded binuclear complexes [(NC)(5)Pt-Tl(CN)(n)(solv)](n)(-) (n = 0-3) have been modified by attaching bipy molecules to the thallium atom. A reaction between [(NC)(5)Pt-Tl(dmso)(4)](s) and 2,2'-bipyridine in dimethyl sulfoxide solution results in the formation of a new complex, [(NC)(5)Pt-Tl(bipy)(solv)]. The presence of a direct Pt-Tl bond in the complex is convincingly confirmed by a very strong one-bond (195)Pt-(205)Tl spin-spin coupling ((1)J((195)Pt-(205)Tl) = 64.9 kHz) detected in both (195)Pt and (205)Tl NMR spectra. In solutions containing free cyanide, coordination of CN(-) to the thallium atom occurs, and the complex [(NC)(5)Pt-Tl(bipy)(CN)(solv)](-) ((1)J((195)Pt-(205)Tl) = 50.1 kHz) is formed as well. Two metal-metal bonded compounds containing bipy as a ligand were crystallized and their structures determined by X-ray diffractometry: [(NC)(5)Pt-Tl(bipy)(dmso)(3)] (2) and [(NC)(5)Pt-Tl(bipy)(2)] (3). The Pt-Tl bonding distances in the compounds, 2.6187(7) and 2.6117(5) A, respectively, are among the shortest reported separations between these two metals. The corresponding force constants in the molecules, 1.38 and 1.68 N/cm, respectively, were calculated using Raman stretching frequencies of the Pt-Tl vibrations and are characteristic for a single metal-metal bond. Electronic absorption spectra were recorded for the [(NC)(5)Pt-Tl(bipy)(m)(solv)] compounds, and the optical transition was attributed to the metal-metal bond assigned.


Automated review of patient position in DIBH breast hybrid IMRT with EPID images.
Deep Inspiration Breath Hold (DIBH) is a respiratory-gating technique adopted in radiation therapy to lower cardiac irradiation. When performing DIBH treatments, it is important to have a monitoring system to ensure the patient's breath hold level is stable and reproducible at each fraction. In this retrospective study, we developed a system capable of monitoring DIBH breast treatments by utilizing cine EPID images taken during treatment. Setup error and intrafraction motion were measured for all fractions of 20 left-sided breast patients. All patients were treated with a hybrid static-IMRT technique, with EPID images from the static fields analyzed. Ten patients had open static fields and the other ten patients had static fields partially blocked with the multileaf collimator (MLC). Three image-processing algorithms were evaluated on their ability to accurately measure the chest wall position (CWP) in EPID images. CWP measurements were recorded along a 61-pixel region of interest centered along the midline of the image. The median and standard deviation of the CWP were recorded for each image. The algorithm showing the highest agreement with manual measurements was then used to calculate intrafraction motion and setup error. To measure intrafraction motion, the median CWP of the first EPID frame was compared with that of the subsequent EPID images of the treatment. The maximum difference was recorded as the intrafraction motion. The setup error was calculated as the difference in median CWP between the MV DRR and the first EPID image of the lateral tangential field. The results showed that the most accurate image-processing algorithm can identify the chest wall within 1.2 mm on both EPID and MV DRR images, and measures intrafraction motion and setup errors within 1.4 mm.


Reversible parasympathetic dysautonomia following stinging attributed to the box jelly fish (Chironex fleckeri).
Following a box jelly fish sting, a 52 year old Chinese fisherman developed acute abdominal distension, inability to pass urine and failure of erection. Examination revealed gaseous abdominal distension and a distended urinary bladder. Absence of lachrimation and absence of changes in the R-R interval in the ECG during breathing and carotid sinus massage gave further evidence of parasympathetic dysautonomia. The patient made a complete recovery. The case highlights the occurrence of reversible parasympathetic dysautonomia following box jelly fish sting.


Hypoglycemic brain damage.
Hypoglycemia was long considered to kill neurons by depriving them of glucose. We now know that hypoglycemia kills neurons actively rather than by starvation from within. Hypoglycemia only causes neuronal death when the EEG becomes flat. This usually occurs after glucose levels have fallen below 1 mM (18 mg/dL) for some period. At that time abrupt energy failure occurs, the excitatory amino acid aspartate is massively released into the limited brain extracellular space and floods the excitatory amino acid receptors located on neuronal dendrites. Calcium fluxes occur and membrane breaks in the cell lead rapidly to neuronal necrosis. Significant neuronal necrosis occurs after 30 min of electrocerebral silence. Other neurochemical changes include energy depletion to roughly 25% of control, phospholipase and other enzyme activation, tissue alkalosis, and a tendency for all cellular redox systems to shift towards oxidation. Hypoglycemia often differs from ischemia in its neuropathologic distribution, in that necrosis of the dentate gyrus of the hippocampus can occur and a predilection for the superficial layers of the cortex is sometimes seen. Cerebellum and brainstem are universally spared in hypoglycaemic brain damage. Hypoglycemia constitutes a unique metabolic brain insult.


Reducing All-cause 30-day Hospital Readmissions for Patients Presenting with Acute Heart Failure Exacerbations: A Quality Improvement Initiative.
Background Congestive heart failure (CHF) is the most common cause of hospitalization in the US for people older than 65 years of age. It has the highest 30-day re-hospitalization rate among medical and surgical conditions, accounting for up to 26.9% of the total readmission rates. We conducted a quality improvement project at our hospital with the objective to reduce the 30-day all-cause readmissions of patients with CHF by improving the transition of care and setting up scheduled follow-up appointments within two weeks of patient discharge. Method Retrospective data were collected to understand the pattern of admission for CHF during November 2017. Data on 30-day readmission post-discharge was also collected to understand readmission rates. Similarly, all patients who were admitted with acute CHF exacerbation to our hospital during the month of November 2018 were included in our intervention cohort. The 30-day readmission rates of these patients post-intervention were calculated and compared to the initial cohort. Results As part of our study, we ensured that 58% of the enrolled patients had a follow-up appointment scheduled within two weeks of discharge compared to only 30% in 2017. Also, 56% of the enrolled patients kept their follow-up appointments compared to 37% in 2017. The 30-day readmission rate of CHF patients was reduced in half after the implementation of our project, with a 14% readmission rate for our study patients compared to 28% in 2017. Conclusion Patient education and measures to augment post-discharge follow-up appointments can lead to substantial reductions in the readmission rates of heart failure (HF) patients.


Occupation and meaning in the lives of women with chronic pain.
The aim of this study was to examine how women experience occupations as they live with chronic pain and more specifically to gain detailed knowledge regarding the meaning of important occupations in their life. The article is based on an analysis of 17 narratives based on an Occupational Performance History Interview. Participants were interviewed as part of their occupational therapy assessment at Orton Rehabilitation. The narratives were analysed in order to identify the experiences of doing occupations in everyday life. When interpreting their problems in and solution for doing occupations women in this study used four basic metaphors: (1) moving forward, (2) slowing down, (3) fighting and (4) standing still. The tone of the narratives varied from hopeful to hopeless and from fearful to frustrated. Each of these four types of narratives differed in: (a) the tone of the narrative, (b) the meaning ascribed to occupation, (c) how others are viewed in relation to one's doing, and (d) how the future is envisioned. The experience of occupation in the lives of women with chronic pain is heterogeneous and depends on the underlying meaning of the narrative used to experience and interpret occupational life.


An objective method for evaluating electronic portal imaging devices.
A statistical technique is described for analyzing the image of a contrast-detail phantom acquired by a radiotherapy electronic portal imaging device. By using Student's t test, the image analysis algorithm computes which holes in the contrast-detail phantom can be objectively resolved from the background signal. The specific pattern of the resolved holes and the total number of the resolved holes characterize the performance of the electronic portal imaging device. Image processing techniques are used to align the holes automatically. Because the use of this algorithm is completely automated, the procedure removes operator subjectivity from the evaluation.


Effect of intravenous immunoglobulin on cerebellar ataxia and neuropathic pain associated with celiac disease.
Cerebellar syndrome and small fiber neuropathy may complicate celiac disease (CD) and may be resistant to a strict gluten-free diet. Case series. We report three patients with biopsy-proven CD who developed cerebellar ataxia and neuropathic pain despite strict adherence to a gluten-free diet. A small fiber neuropathy was suggested by skin biopsy findings in two patients. All patients' symptoms, including small fiber neuropathy symptoms, responded to treatment with intravenous immunoglobulin (IVIG). Discontinuation of IVIG in two patients resulted in worsened ataxia that reversed after resumption of IVIG. Intravenous immunoglobulin may be effective in treating cerebellar ataxia and small fiber neuropathy associated with CD, suggesting an immune pathogenesis. Further prospective, controlled studies are necessary to determine the long-term response to IVIG or other immunomodulation therapy.


[Changes in transitory evoked otoacoustic emissions and acoustic distortion products in disorders of eustachian tube ventilation].
Middle ear impedance plays an important role in the retrograde middle ear transfer and interpretation of otoacoustic emissions (OAE). Changes of emission spectra and reproducibility or absence of sound emissions can be caused by middle ear dysfunction. To avoid misinterpretation, especially in infant screening, we combined measurements of transiently-evoked otoacoustic emissions (TEOAE), distortion products (DPOAE) and middle ear pressure. With a single acoustic probe ear canal baro-pressure was adjusted individually to the middle ear pressure, allowing OAE to be measured at maximum compliance of the middle ear. Fifty children (ages, 3-8 years) were examined with hypoventilation of the middle ear. Twenty-five normally hearing adults were also studied. Positive and negative middle ear pressures significantly attenuated the amplitude of low-frequency OAE (< 2 kHz), whereas high-frequency emissions were stable. Individual adaptations of static ear canal pressure eliminated these alterations of TEOAE and DPOAE.


Core Needle Biopsy Accuracy for Androgen Receptor Expression in Invasive Breast Cancer.
Breast cancer (BC) biomarkers, such as hormone receptors expression, are crucial to guide therapy in BC patients. Antiandrogens have been studied in BC; however, limited data are available on androgen receptor (AR) expression test methodology. We aim to report the core needle biopsy (CNB) accuracy for AR expression in BC. Patients diagnosed with stage I-III invasive BC from a single institution were included. Androgen receptor expression was evaluated by immunohistochemistry (IHC) using 1 and 10% cutoff and the AR expression in surgical specimens (SS) was the gold standard. Kappa coefficients were used to evaluate the intraprocedural agreement. A total of 72 patients were included, with a mean age of 61 years old and 84% were Luminal A or B tumors. The prevalence of AR expression in all BC samples was 87.5% using a cutoff ≥ 10% in SS. With a cutoff value ≥ 1%, CNB had an accuracy of 95.8% (Kappa value = 0.645; 95% confidence interval [CI]: 0.272-1.000; p < 0.001) and 86.1% (Kappa value = 0.365; 95% CI: 0.052-0.679; p < 0.001) when ≥ 10% cutoff was used for AR positivity. Androgen receptor expression in CNB (cutoff ≥ 1%) had a sensitivity of 98.5%, specificity of 60%, positive predictive value of 97.0%, and a negative predictive value of 76.9% in the detection of AR expression in SS. Core needle biopsy has good accuracy in evaluating AR expression in BC. The accuracy of CNB decreases with higher cutoff values for AR positivity.


Leydig cell function in mice lacking connexin43.
Connexin43 (Cx43) is the most abundantly expressed member of the connexin (gap junction protein) family and the only one so far identified in mouse Leydig cell gap junctions. Mice lacking Cx43 were used to investigate its role in testicular androgen production and regulation. Testes from term fetuses were grafted under the kidney capsules of castrated adult males. After 3 weeks, serum from host mice was analyzed for androgens. In order to test their response to stimulation, the grafted testes were incubated in vitro with varying concentrations of LH and their androgen end products analyzed. Incubation with radiolabeled progesterone was followed by high performance liquid chromatography to quantify the androgen-intermediate metabolites. Radiolabeled testosterone in the presence of NADPH was used to determine the activity of testosterone-metabolizing enzymes 17beta-hydroxysteroid dehydrogenase (17betaHSD), 5alpha-reductase (5alphaR), and 3alpha-hydroxysteroid dehydrogenase (3alpha HSD). Serum androgen levels did not differ between hosts carrying wild-type versus null mutant grafts although Cx43-deficient testes had more 17betaHSD and 5alphaR activity than wild-type controls. Furthermore, the genotype of grafted testes did not influence LH-stimulated androgen production in vitro. These results indicate that the steroidogenic function of Leydig cells is not compromised by the absence of Cx43, perhaps because other gap junction proteins are present. Dye transfer experiments demonstrated that Cx43-deficient Leydig cells retain intercellular coupling, indicating that Cx43 is not the only protein contributing to their gap junctions. Thus, despite their prominence in Leydig cells, Cx43 gap junctions are not essential for androgen production.


[Hepatic fibrosis: role of matrix metalloproteases and TGFbeta].
Liver fibrosis and cirrhosis involve multiple cellular and molecular events that lead to deposition of an excess of extracellular matrix proteins and increase the distortion of normal liver architecture. Etiologies include chronic viral hepatitis, alcohol abuse and drug toxicity. Degradation of these matrix proteins occurs predominantly as a result of a family of enzymes called metalloproteases (MMPs) that specifically degrade collagenous and non-collagenous substrates. Matrix degradation in the liver is due to the action of at least four of these enzymes: MMP-1, MMP-2, MMP-3 and MMP-9. In the fibrinolytic system, MMPs can be activated through proteolytic cleavage by the action of urokinase plasminogen activator; a second mechanism includes the same metalloproteases. This activity is regulated at many levels in the fibrinolytic system. The main regulator is the PAI-1. This molecule blocks the conversion of plasminogen into plasmin, and the MMP cannot be activated. At a second level, the inhibition is possible by binding to inhibitors called TIMP that can inhibit the proteolitic activity even when the MMPs had been previously activated by plasmin. During abnormal conditions, overexpression of these inhibitors is directed by the transforming growth factor-beta that in a fibrotic disease acts as an extremely important adverse factor.


Immunomodulation by tramadol combined with acetaminophen or dexketoprofen: In vivo animal study.
Among other functions, macrophages remove foreign particles, including medications, from the circulation, making them an important target for immunomodulatory molecules. Currently, growing evidence suggests that analgesics affect the activity of immune cells not directly related to pain, and thus may induce unwanted immunosuppression in patients at risk. However, the immunomodulatory effects resulting from macrophage targeting by these drugs are understudied. Therefore, the current study investigated the immune effects induced in healthy mice by repeated administration of tramadol alone or in combination with acetaminophen or dexketoprofen. We observed that drug administration decreased the percentage of infiltrating macrophages in favor of resident macrophages in peritoneal exudates. While all drugs reduced the number of infiltrating macrophages that phagocytosed sheep red blood cells (SRBC), their administration increased the effectiveness of phagocytosis, and treatment with acetaminophen with or without tramadol elevated the expression of MHC class II by Mac3+ macrophages. Interestingly, SRBC-pulsed macrophages from mice treated with tramadol combined with acetaminophen potently activated SRBC-specific B cells in humoral response, and administration of these drugs to recipients of contact hypersensitivity effector cells augmented the resulting cellular immune response. In addition, tramadol administered alone or with dexketoprofen enhanced the spontaneous release of pro-inflammatory cytokines by macrophages. Our current research findings demonstrate that tramadol therapy in combination with acetaminophen or dexketoprofen has a relatively low risk of causing immunosuppressive side effect because the drugs slightly reduce the inflammatory reaction of macrophages but do not impair their ability to activate the adaptive immune responses.


Multimodality Treatment of Pulmonary Sarcomatoid Carcinoma: A Review of Current State of Art.
Pulmonary sarcomatoid carcinoma (PSC) is an unconventional non-small-cell lung cancer (NSCLC) that is currently managed under guidelines used for conventional NSCLC and has poor survival. Surgery is the optimal choice for resectable PSC, and the prevalence of mutations in this type of tumor laid the foundation for novel systemic therapies such as targeted therapy and immunotherapy. PSC is resistant to chemotherapy and radiotherapy, and the effects of the 2 therapies are controversial. Targeted therapies have been reported to confer survival benefits, and savolitinib, an oral selective MET tyrosine-kinase inhibitor, has been approved in metastatic patients with MET exon 14 skipping mutations. Expression and positive rate of programmed death ligand 1 in PSC are high; our previous research has also revealed a high mutational burden and a T-cell-inflamed microenvironment of PSC. Correspondingly, immune checkpoint inhibitors have shown preliminary antitumor effects (overall response rates of 40.5% (15/37) and 31.6% (6/19) in two retrospective studies, respectively) in PSC patients. In summary, patients should receive operations at an early stage and multimodality treatments are needed to maximize the benefits of patients with advanced disease.


Polyamine stimulation of eEF1A synthesis based on the unusual position of a complementary sequence to 18S rRNA in eEF1A mRNA.
It is thought that Shine-Dalgarno-like sequences, which exhibit complementarity to the nucleotide sequences at the 3'-end of 18S rRNA, are not present in eukaryotic mRNAs. However, complementary sequences consisting of more than 5 nucleotides to the 3'-end of 18S rRNA, i.e., a CR sequence, are present at -17 to -32 upstream from the initiation codon AUG in 18 mRNAs involved in protein synthesis except eEF1A mRNA. Thus, effects of the CR sequence in mRNAs and polyamines on protein synthesis were examined using control and polyamine-reduced FM3A and NIH3T3 cells. Polyamines did not stimulate protein synthesis encoded by 18 mRNAs possessing a normal CR sequence. When the CR sequence was deleted, protein synthetic activities decreased to less than 70% of intact mRNAs. In eEF1A mRNA, the CR sequence was located at -33 to -39 upstream from the initiation codon AUG, and polyamines stimulated eEF1A synthesis about threefold. When the CR sequence was shifted to -22 to -28 upstream from the AUG, eEF1A synthesis increased in polyamine-reduced cells and the degree of polyamine stimulation decreased greatly. The results indicate that the CR sequence exists in many eukaryotic mRNAs, and the location of a CR sequence in mRNAs influences polyamine stimulation of protein synthesis.


Longitudinal Assessment of the Doppler-Estimated Maximum Gradient in Patients With Congenital Valvar Aortic Stenosis Pre- and Post-Balloon Valvuloplasty.
Aortic stenosis has been reported to manifest a slow rate of progression in mild disease, with a greater likelihood of progression in patients with moderate-severe disease. The natural history of the Doppler-estimated maximum gradient (DEMG) in patients after balloon aortic valvuloplasty (BAVP) has not previously been studied on a large scale. A retrospective review was performed of 360 patients from 1984 to 2012 with aortic stenosis, providing a total of 2059 echocardiograms both before and after BAVP. Patients were excluded if they had an intervention within the first 30 days of life. The relationships between the aortic stenosis DEMG and several predictors (age at initial study, body surface area, valve morphology, and initial DEMG) were explored using linear mixed effect models. Patients with a unicommissural aortic valve had a significantly higher rate of progression compared with those with a bicommissural aortic valve (0.81 and 0.45 mm Hg/year; P<0.001). The median rate of progression in the post-BAVP group was significantly lower than the median pre-BAVP rate of progression (n=34; pre-BAVP 3.97 [1.69-8.7] mm Hg/year; post-BAVP 0.40 [-1.80 to 3.88] mm Hg/year; P<0.008). When adjusted for body surface area, there was no significant increase in the DEMG (-0.03 mm Hg/m2 per year; P<0.001). There is a statistically significant increase in the DEMG over time in patients with aortic stenosis. After balloon dilation, the DEMG rate of change is reduced compared with that pre-dilation. Given the effect of body surface area on DEMG progression, more frequent observation should be made during periods of rapid somatic growth.


Complex correspondence principle.
Quantum mechanics and classical mechanics are distinctly different theories, but the correspondence principle states that quantum particles behave classically in the limit of high quantum number. In recent years much research has been done on extending both quantum and classical mechanics into the complex domain. These complex extensions continue to exhibit a correspondence, and this correspondence becomes more pronounced in the complex domain. The association between complex quantum mechanics and complex classical mechanics is subtle and demonstrating this relationship requires the use of asymptotics beyond all orders.


Modifications in drug adherence after switch to fixed-dose combination of perindopril/amlodipine in clinical practice. Results of a large-scale Italian experience. The amlodipine-perindopril in real settings (AMPERES) study.
The purpose of this study was to assess the changes in adherence to treatment, in patients who switched from perindopril and/or amlodipine as a monotherapy (single-pill therapy, SPT) or two-pill combinations to fixed-dose combination (FDC) therapy. A large retrospective cohort study, in three Italian Local Health Units, was performed. All adult subjects who received at least one prescription of anti-hypertensive drugs between January 1, 2010 and December 31, 2014 were selected. The date of the first anti-hypertensive prescription was defined as the index-date (ID). For each patient, we evaluated the anti-hypertensive therapy and the adherence to treatment during the two 12-month periods preceding and following the ID. Changes in the level of adherence have been compared in patients who switched to the FDC of perindopril/amlodipine after the ID, as well as in patients who did not. A total of 24,020 subjects were initially included in the study. Subjects treated with the free dose combination switched more frequently to FDC of perindopril/amlodipine than subjects treated with SPT (p < .001). Adherence to treatment was found to be higher in the 3,597 subjects who switched to the perindopril/amlodipine FDC therapy, than in the 20,423 subjects who did not. A significant decrease in the number of concomitant anti-hypertensive drugs has been observed in patients treated with the same FDC. The results show that perindopril/amlodipine FDC increases the rate of stay-on-therapy and reduces the number of concomitant anti-hypertensive drugs in subjects previously treated with the same drugs as a two-pill combination or as SPT.


Effects of BMP-9 and BMP-2 on the PI3K/Akt Pathway in MC3T3-E1 Preosteoblasts.
The bone morphogenetic proteins (BMPs), which are involved in bone formation and repair, play an important role in tissue engineering. For example, BMP-9 and BMP-2, which are members of different BMP subfamilies, are osteoinductive factors. However, several studies have recently shown that BMP-9 is more osteogenic than BMP-2. We have previously shown that fetal bovine serum (FBS) strongly enhances the osteoblast differentiation of murine preosteoblasts (MC3T3-E1) to BMP-9 but not to BMP-2. This effect is mimicked by IGF-2, which primarily activates the PI3K/Akt pathway, but how Akt phosphorylation sites are implicated in such differentiation is unclear. The effects of BMP-9 and BMP-2 with or without FBS or IGF-2 on Akt phosphorylation sites and subsequent osteoblastic differentiation were determined, respectively, by western blot analysis and alkaline phosphatase activity measurements. The involvement of phosphorylated Akt at Thr308 and/or Ser473 on BMP-mediated osteoblast differentiation was further studied using specific inhibitors. In MC3T3-E1 incubated with or without FBS, BMP-9 and BMP-2 activate Akt on Ser473 and Thr308 very differently in a time and dose-dependent manner. Using inhibitors specific to each Akt phosphorylation site, we showed that both Ser473 and Thr308 must be phosphorylated for BMP-9 and/or IGF-2-induced osteoblast differentiation, whereas BMP-2 requires phosphorylation of only Ser473. Furthermore, cells stimulated with BMP-2 in the presence of FBS require the phosphorylation of Akt at Ser473 and the dephosphorylation of Akt at Thr308 to increase the osteoblast differentiation with alkaline phosphatase activity similar to that of BMP-9 plus FBS. These results provide a better understanding into how BMP-9 induces osteoblast differentiation and its synergy with IGF-2 at the signaling level. This knowledge is essential for preparing the serum-free osteogenic media required for bone tissue engineering or developing growth factor delivery systems to improve bone formation.


Developmental potential of hematopoietic and neural stem cells: unique or all the same?
Like many other animals, mammals develop from fertilized oocytes - the ultimate stem cells. As embryogenesis proceeds, most cells lose developmental potential and eventually become restricted to a specific cell lineage. The result is the formation of a complete and structured mature organism with complex organs composed of a great variety of mature, mostly mitotically quiescent effector cells. However, along the way, some exceptional cells, known as somatic stem cells (SSCs) are set aside and maintain a high proliferation and tissue-specific differentiation potential. SSCs, in contrast to embryonic stem (ES) cells, which are able to give rise to all cell types of the body, have been regarded as being more limited in their differentiation potential in the sense that they were thought to be committed exclusively to their tissue of origin. However, recent studies have demonstrated that somatic stem cells from a given tissue can also contribute to heterologous tissues and thus show a broad nontissue restricted differentiation potential. The question arises: how plastic are somatic stem cells? To provide a tentative answer, we describe and review here recent investigations into the developmental potentials of two somatic stem cell types, namely hematopoietic and neural stem cells.


Exercise Performance Is a Prognostic Indicator in Elderly Patients With Chronic Heart Failure--Application of Metabolic Exercise Cardiac Kidney Indexes Score.
In patients with chronic heart failure (HF) the Metabolic Exercise Cardiac Kidney Indexes (MECKI) score, is a predictor of cardiovascular death and urgent heart transplantation. We investigated the relationship between age, exercise tolerance and the prognostic value of the MECKI score. We analyzed data from 3,794 patients with chronic systolic HF. The primary endpoint was a composite of cardiovascular death and urgent heart transplantation. Older patients had higher prevalence of comorbidities and lower exercise performance compared with younger subjects (peak V̇O2, 925 vs. 1,351 L/min; P<0.0001; V̇E/V̇CO2slope, 33.2 vs. 28.3; P>0.0001). The rate of the primary endpoint was 19% in the highest age quartile and 14% in the lowest quartile. At multivariable analysis, the independent predictors of the primary endpoint were left ventricular ejection fraction (LVEF), eGFR, peak V̇O2, serum Na(+)and the use of β-blockers in patients aged ≥70 years, and LVEF, eGFR and peak V̇O2in younger subjects. The MECKI risk score increased across age subgroups, but on receiver operating characteristic curve analysis its prognostic power was similar in both patients aged ≥70 and <70 years. Older patients with HF are a high-risk population with lower exercise performance. The MECKI score increased according to age and maintained its prognostic value also in older patients.


[Current diagnosis of venous diseases of the lower limbs].
The haemodynamic of venous circulation of lower limbs seems to be not yet fully understood and different methods are available to study clinical patterns of venous insufficiency, deep venous incompetence or venous occlusion. Simple and common methods as venography, venous doppler and plethysmography are frequently used but other method as impedance plethysmography, ambulatory venous pressure, photoplethysmography, isotopes and thermography can be used for research or clinical investigation. The techniques and the indications of these tests are reviewed and critically analyzed to evaluate the best approach to the patients with venous pathology.


Calculating Retinal Contrast from Scene Content: A Program.
This paper describes a computer program for calculating the contrast image on the human retina from an array of scene luminances. We used achromatic transparency targets and measured test target's luminances with meters. We used the CIE standard Glare Spread Function (GSF) to calculate the array of retinal contrast. This paper describes the CIE standard, the calculation and the analysis techniques comparing the calculated retinal image with observer data. The paper also describes in detail the techniques of accurate measurements of HDR scenes, conversion of measurements to input data arrays, calculation of the retinal image, including open source MATLAB code, pseudocolor visualization of HDR images that exceed the range of standard displays, and comparison of observed sensations with retinal stimuli.


Effects of physical activity on preterm birth.
The authors conducted a cohort study of low income women to determine the effect of physical activity on the risk of preterm birth. Women were sampled prenatally from four clinic sites and were scheduled for delivery at the University of Maryland Medical Systems (UMMS). Women who delivered infants at UMMS but who had received no prenatal care were also eligible. Preterm delivery was defined as a delivery prior to 37 completed weeks gestation. After adjusting for confounders, the odds of preterm delivery were increased for women who climbed stairs > or = 10 times per day (odds ratio (OR) = 1.60, 95% confidence interval 1.05-2.46) and for women who engaged in purposive walking > or = 4 days per week (OR = 2.10, 95% CI 1.38-3.20). Leisure-time exercise (> or = 60 days in the first and second trimesters combined) had a protective effect on preterm delivery (OR = 0.51, 95% CI 0.27-0.95). Television viewing had a U-shaped relation with preterm delivery (ORs (95% CI): < 15 hours, 2.09 (1.21-3.61); 29-42 hours, 1.50 (0.84-2.67); > 42 hours, 3.05 (1.75-5.40)). While the results support current recommendations regarding leisure-time activities, activities of daily living appear to increase risk of preterm delivery among low income women. These findings and those for television watching warrant further investigation.


Compound purification and comparison of adenovirus hexons.
Hexon antigens were separated from the cell-free supernatant of type 1 and type 8 adenovirus-infected cells by ammonium sulfate precipitation and purified by anion exchange chromatography, immune absorption, and exclusion chromatography. The antigens were compared with purified soluble hexons extracted from cells infected with the same adenovirus types. The procedure was found to be suitable for the preparation of pure, homogeneous type 1 hexons from the supernatant, but not for that of adenovirus type 8 hexons. Comparative studies showed no physico-chemical, immunological or electron microscopic differences between soluble hexons of extracellular and intracellular origin.


The effect of sildenafil on segmental oesophageal motility and gastro-oesophageal reflux.
Sildenafil is an inhibitor of type 5 phosphodiesterase. It relaxes or inhibits contraction of smooth muscle by increasing cellular concentrations of cyclic guanosine monophosphate. Multichannel intraluminal impedance manometry/pH allow the precise evaluation of oesophageal bolus transit and acid/non-acid reflux. To investigate the effect of sildenafil on segmental oesophageal motor function and gastro-oesophageal reflux. Eight healthy volunteers underwent multichannel intraluminal impedance manometry baseline, and 15, 30 and 45 min before and after a 50-mg dose of sildenafil successively. The subjects underwent 2-h multichannel intraluminal impedance/pH studies on two separate days after either water or sildenafil ingestion. Sildenafil decreased the resting lower oesophageal sphincter pressure and prolonged the duration of lower oesophageal sphincter relaxation for the 45 min following its ingestion. At 15 min, distal onset velocity, total bolus transit time, bolus presence time and segmental transit time were delayed in the mid to distal oesophagus. At 30 min, distal onset velocity was restored but bolus presence time and bolus presence time were still delayed in distal smooth muscle segment. At 45 min, total bolus transit time and distal onset velocity were restored but bolus presence time and segmental transit time were delayed more in the transition zone. Sildenafil did not alter the reflux. Sildenafil alters lower oesophageal sphincter function and oesophageal bolus transit, but not induce gastro-oesophageal reflux.


Effect of Basicity on the Hydrolysis of the Bi(III) Aqua Ion in Solution: An Ab Initio Molecular Dynamics Study.
Hydrolysis of the Bi(III) aqua ion under a range of solution conditions has been studied by means of ab initio molecular dynamics simulations. While the Bi(III) aqua ion is stable in pure water, there is an increasing degree of hydrolysis with the number of hydroxide anions in the medium. This is accompanied by a monotonic decrease of the total coordination number to an asymptotic value of ∼6, reached under extreme basicity conditions. Comparison of the simulated Bi(III) hydrolyzed species with the experimental species distribution at different degrees of basicity suggests that, at the PBE/DFT level of theory here employed, liquid water shows an overly acidic character. Predictions of theoretical EXAFS and XANES spectra were generated from the AIMD trajectories for different Bi hydrolyzed species, [Bi(HO)m(H2O)n]3-m+, m = 0-3 and n = 7-2. Comparison with available experimental spectra is presented. Spectral features joined to the degree of hydrolysis and hydration are analyzed.


THE GENETIC BASIS OF EVOLUTION OF THE MALE COURTSHIP SOUNDS IN THE DROSOPHILA VIRILIS GROUP.
When courting, males of the Drosophila virilis group vibrate their wings and emit species-specific courtship sounds consisting of trains of polycyclic sound pulses. To analyze the genetic basis of evolutionary changes in the sounds we made an F1 diallel set of reciprocal crosses between the members of the virilis phylad of the group (two stocks of D. virilis and one of D. americana americana, D. a. texana, D. novamexicana, and D. lummei). We also crossed the D. virilis stocks with the members of the montana phylad of the same group (D. kanekoi, D. littoralis, D. borealis, D. flavomontana, D. lacicola, and D. montana) and made a backcross (D. virilis x D. littoralis) x D. virilis using a D. virilis marker stock (b; sv t tb gp; cd; pe). The sounds of the hybrids were analyzed using the following parameters: the length of a pulse train (PTL), the number of pulses in a train (PN), the interpulse interval (IPI), the length of a pulse (PL), the number of cycles in a pulse (CN), and the length of a cycle (CL). In the virilis phylad, the differences between species appeared to be determined mainly by autosomal genes in each sound trait. The heritabilities (narrow-/broad-sense) obtained from the diallel tables were the following: PTL 0.662/0.817, PN 0.651/0.841, IPI 0.193/0.546, PL 0.408/0.552, CN 0.425/0.719, and CL 0.361/0.764. The direction of dominance is for longer PTL, higher PN and CN, and shorter IPI and CL. PL shows ambidirectional dominance. In the sounds of the virilis phylad species, PTL and PL seem to be phenotypically the most important parameters, since their components (PN and IPI for PTL, CN and CL for PL) are negatively correlated. In crosses between D. virilis and D. littoralis or D. flavomontana reciprocal hybrids differed from each other in PTL, IPI, PL, and CN indicating X-chromosomal or cytoplasmic inheritance. In the backcrosses between D. virilis and D. littoralis the role of the X chromosome was ascertained to be decisive. We conclude that an X-chromosomal major change allowing variation in IPI has occurred during the separation of the two D. virilis group phylads, the long IPI allowing variation also in PL (and CN). The evolution of the sounds in the virilis phylad has probably gone towards longer and denser pulse trains, while in the montana phylad the sounds have evolved in different directions.


Magnetic helicity evolution in a periodic domain with imposed field.
In helical hydromagnetic turbulence with an imposed magnetic field (which is constant in space and time) the magnetic helicity of the field within a periodic domain is no longer an invariant of the ideal equations. Alternatively, there is a generalized magnetic helicity that is an invariant of the ideal equations. It is shown that this quantity is not gauge invariant and that it can therefore not be used in practice. Instead, the evolution equation of the magnetic helicity of the field describing the deviation from the imposed field is shown to be a useful tool. It is demonstrated that this tool can determine steady state quenching of the alpha-effect. A simple three-scale model is derived to describe the evolution of the magnetic helicity and to predict its sign as a function of the imposed field strength. The results of the model agree favorably with simulations.


Toxicity of inhaled particulate matter on the central nervous system: neuroinflammation, neuropsychological effects and neurodegenerative disease.
Particulate matter (PM) combined with meteorological factors cause the haze, which brings inconvenience to people's daily life and deeply endanger people's health. Accumulating literature, to date, reported that PM are closely related to cardiopulmonary disease. Outpatient visits and admissions as a result of asthma and heart attacks gradually increase with an elevated concentration of PM. Owing to its special physicochemical property, the brain could be a potential target beyond the cardiopulmonary system. Possible routes of PM to the brain via a direct route or stimulation of pro-inflammatory cytokines have been reported in several documents concerning toxicity of engineered nanoparticles in rodents. Recent studies have demonstrated that PM have implications in oxidative stress, inflammation, dysfunction of cellular organelles, as well as the disturbance of protein homeostasis, promoting neuron loss and exaggerating the burden of central nervous system (CNS). Moreover, the smallest particles (nano-sized particles), which were involved in inflammation, reactive oxygen species (ROS), microglial activation and neuron loss, may accelerate the process of the neurodevelopmental disorder and neurodegenerative disease. Potential or other undiscovered mechanisms are not mutually exclusive but complementary aspects of each other. Epidemiology studies have shown that exposure to PM could bring about neurotoxicity and play a significant role in the etiology of CNS disease, which has been gradually corroborated by in vivo and in vitro studies. This review highlights research advances on the health effects of PM with an emphasis on neurotoxicity. With the hope of enhancing awareness in the public and calling for prevention and protective measures, it is a critical topic that requires proceeding exploration. Copyright © 2017 John Wiley & Sons, Ltd.


Oxidative stress may modify zinc protoporphyrin/heme ratio in hematofluorometry.
Washed red blood cells (RBCs), supplemented or non-supplemented with sodium azide (to inhibit catalase activity), were exposed to different concentrations of hydrogen peroxide as well as ascorbic acid. Strikingly, catalase within RBCs protected the cells against exogenic hydrogen peroxide even at millimolar concentrations. However, the activity of the erythrocytic catalase failed to protect the RBCs when they were exposed to an oxidative burst of stimulated polymorphonuclear cells (PMNCs) in the presence of several reactive species in addition to peroxide. Oxyhemoglobin, with an excess of hydrogen peroxide, formed oxidized hemoglobin species and caused protein denaturation as well as the rise of heme degradation products which was suspected to falsify zinc protoporphyrin/heme (ZPP/heme) ratio as assessed by hematofluorometry. Our experiments may thus imply that the non-fluorescent hemoglobin background can be modified by reactive oxygen species (ROS) and this can lead to a spurious ZPP/heme ratio. We discuss this phenomenon with respect to ZPP quantification in clinical practice.


Heterozygote excess through life history stages in Cestrum miradorense Francey (Solanaceae), an endemic shrub in a fragmented cloud forest habitat.
Comparisons of genetic diversity and population genetic structure among different life history stages provide important information on the effect of the different forces and micro-evolutionary processes that mould diversity and genetic structure after fragmentation. Here we assessed genetic diversity and population genetic structure using 32 allozymic loci in adults, seeds, seedlings and juveniles of eight populations of the micro-endemic shrub Cestrum miradorense in a highly fragmented cloud forest in central-eastern Mexico. We expected that due to its long history or rarity, this species may have endured the negative effects of fragmentation and would show moderate to high levels of genetic diversity. High genetic diversity (H(e) = 0.445 ± 0.03), heterozygote excess (F(IT) = -0.478 ± 0.034, F(IS) = -0.578 ± 0.023) and low population differentiation (F(ST) = 0.064 ± 0.011) were found. Seeds had higher genetic diversity (H(e) = 0.467 ± 0.05) than the later stages (overall mean for adults, seedlings and juveniles H(e) = 0.438 ± 0.08). High gene flow was observed despite the fact that the fragmentation process began more than 100 years ago. We conclude that the high genetic diversity was the result of natural selection, which favours heterozygote excess in all stages, coupled with a combination of a reproductive system and seed/pollen dispersal mechanisms that favour gene flow.


[Effect of polycaprolactone-ascobic acid scaffold in repairing articular cartilage defects in rabbits].
To investigate the effect of polycaprolactone-ascobic acid (PCL-AA) scaffolds in promoting repair of articular cartilage defects in a rabbit model. The cartilage defects (3.5 mm in diameter and 3.0 mm in depth) were created in the trochlear groove of the bilateral knees of eight 6-month-old male New Zealand white rabbits. The rabbit models were then randomized into 3 groups to receive implantation of PCL-AA scaffolds (group A, n=8), implantation of PCL scaffolds without AA (group B, n=5), or no treatment (group C, n=3). In groups A and B, the mixture of fibrin gel (10 µg) and thrombinogen (10 µg) was injected into the defects to fix the scaffolds during the surgery. Histological analyses and quantitative assessments of defect repair were conducted at 6 and 12 weeks after implantation of the scaffold. At 6 weeks after scaffold implantation, macroscopic observation showed better filling of the cartilage defects in group A than in group B, while no obvious defect repair was observed in group C. The rabbits in group A showed a significant improvement of the Wakitani score than those in group B (4.05∓1.11 vs 7.05∓0.98, P<0.05). HE staining revealed the presence of newly generated cells in and around the PCL-AA scaffolds without inflammatory cells. Safranin O staining showed a significantly greater ECM of the newly regenerated tissue in groups A and B than in group C (P<0.05), and the volume of the regenerated cartilage and cells was significantly greater in group A than in group B (P<0.05). Samples harvested at 12 weeks showed more hyalione-like cartilage formation than that at 6 weeks in group A. PCL-AA scaffolds have a good biocompatibility and promotes the healing of articular cartilage defects. Adding ascorbic acid into PCL scaffolds better promotes cartilage formation in terms of both quantity and quality of the regenerated tissues. PCL-AA scaffolds can serve as a promising biomaterial to promote the regeneration of articular cartilage using tissue engineering techniques.


Ecological risk assessment of heavy metals in brown trout (Salmo trutta m. fario) from the military training area Boletice (Czech republic).
This study to assess the environmental pollution status in streams (Loutecky, Spicak, Olsina, Trebovicky, Polecnicky and Luzny) from the Boletice area. Were determined of some metal (Hg, Pb, Cd) concentrations in the muscle and correlations among selected metals as well as standard length and total weight in brown trouth - Salmo trutta morpha fario. The contents of the analyzed metals in muscles were Hg 0.19-0.72, Pb 0.01-0.6 and Cd 0.020-0.083 mg/kg wet weight basis and these concentrations did not exceed the limits admissible in the Czech Republic. The Czech republic permissible limit for Hg (0.5 mg/kg to omnivors, 1 mg/kg to predators), Pb (0.3 mg/kg) and Cd (0.05 mg/kg) defined in the Codex Alimentarius for safe human consumption exceeded in 6%, 3%, and 0% of analyzed samples for Hg, Pb and Cd respectively. On an average, the order of metal concentrations in the fish muscle was: Hg>Pb>Cd.


Different effects of physical exercise on cold pain sensitivity in fighter pilots with and without the history of acute in-flight neck pain attacks.
The cold pain sensitivity in fighter pilots was studied by using a cold pressor test. The pilots were divided into two groups: one group consisting of eight pilots (N = 8) who had experienced several acute in-flight neck pain attacks, and the control group (N = 8) who had not experienced these pain conditions under similar work and environment conditions. In each pilot cold pain thresholds and pain and unpleasantness responses to suprathreshold cold stimulations were recorded during repeated tests. The ratings of pain and unpleasantness responses to cold stimulations were evaluated by visual analog scales (VAS). The effect of exercise on cold pain sensitivity was tested in a separate experiment. Exercise was performed on a cycle ergometer at different workload levels (50-200 W). In the control conditions (resting measures) of this study during repeated cold pressor tests, the average pain thresholds and pain or unpleasantness responses to suprathreshold cold stimulation were not different between groups. Physical exercise increased pain thresholds (P < 0.001) in pilots with a history of neck pain attacks but not in control group. Exercise induced a significant decrease in pain responses and unpleasantness responses to suprathreshold stimulation in both groups. This exercise effect was more marked both in pain intensity (P < 0.05) and unpleasantness responses (P < 0.01) in pilots with a history of neck pain attacks. Moreover, exercise more markedly (P < 0.05) decreased unpleasantness than pain intensity responses in both groups of pilots. The results suggest that exercise stress-related analgesia mechanisms may be enhanced in pilots with a history of acute in-flight neck pain attacks. Moreover, sensory and nonsensory aspects of pain experience may be differentially influenced by exercise stress.


THSD7A Positivity Predicts Poor Survival and Is Linked to High FAK Expression and FGFR1-Wildtype in Female Patients with Squamous Cell Carcinoma of the Lung.
Lung cancer is the leading cause of cancer-related deaths in the western world, with squamous cell carcinoma being one of the most common histological subtypes. Prognostic and predictive markers are still largely missing for squamous cell carcinoma of the lung (LSCC). Several studies indicate that THSD7A might at least play a role in the prognosis of different tumors. FAK seems to play an important role in lung cancer and is discussed as a potential therapeutic target. In addition, there is evidence that FAK-dependent signaling pathways might be affected by THSD7A. For that reason, we investigated the role of THSD7A as a potential tumor marker in LSCC and whether THSD7A expression has an impact on the expression level of FAK. A total of 101 LSCCs were analyzed by immunohistochemistry using tissue microarrays. THSD7A positivity was associated with poor overall survival in female patients and showed a relation to high FAK expression in this subgroup. To our knowledge, we are the first to report these correlations in lung cancer. The results might be proof of the assumed activation of FAK-dependent signaling pathways by THSD7A and that as a membrane-associated protein, THSD7A might serve as a putative therapeutic target in LSCC.


Earlier onset of Alzheimer's disease in men with Down syndrome.
Virtually all individuals with Down syndrome (DS) have neuropathologic changes characteristic of Alzheimer's disease (AD) beginning at 40 years of age. Few studies have examined factors that influence age at onset of AD in DS. We investigated whether sex differences in age at onset and risk of AD among adults with DS are similar to those observed in the general population and whether the effect of sex on risk of AD is modified by apolipoprotein E (APOE) genotype. A community-based sample of 111 adults with cytogenetically confirmed DS (34 to 71 years of age) was ascertained through the New York State Developmental Disabilities system. A semistructured interview with caregivers and review of medical records was used to ascertain the presence or absence of AD. APOE genotyping was carried out without knowledge of the subject's medical history or clinical diagnosis. Both male gender and the presence of an APOE epsilon4 allele were associated with an earlier onset of AD. Compared with women, men with DS were three times as likely to develop AD. Compared with those with the APOE 3/3 genotype, adults with DS with the 3/4 or 4/4 genotypes were four times as likely to develop AD. No individual with an APOE epsilon2 allele developed AD. No evidence of interaction of sex and APOE genotype was found in risk of AD. The higher risk of AD in men may be related to differences in hormonal function between men and women with DS that are distinct from those in the general population.


Timing Spring Insecticide Applications to Target both Amyelois transitella (Lepidoptera: Pyralidae) and Anarsia lineatella (Lepidoptera: Gelechiidae) in Almond Orchards.
Amyelois transitella (Walker) (Lepidoptera: Pyralidae) and Anarsia lineatella Zeller (Lepidoptera: Gelechiidae) are key Lepidoptera pests of almonds in California. Spring insecticide applications (early to mid-May) targeting either insect were not usually recommended because of the potential to disrupt natural enemies when broad-spectrum organophosphates and pyrethroids were applied. The registration of reduced risk compounds such as chlorantraniliprole, methoxyfenozide, and spinetoram, which have a higher margin of safety for natural enemies, makes spring (early to mid-May) application an acceptable control approach. We examined the efficacy of methoxyfenozide, spinetoram, and chlorantraniliprole at three spring application timings including the optimum spring timing for both A. lineatella and A. transitella in California almonds. Our study also examined the possibility of reducing larval populations of A. lineatella and A. transitella simultaneously with a single spring insecticide application. There were no significant differences in the field efficacy of insecticides targeting either A. lineatella or A. transitella, depending on application timing for the three spring timings examined in this study. In most years (2009-2011), all three timings for each compound resulted in significantly less A. transitella and A. lineatella damage when compared with an untreated control, though there was some variation in efficacy between the two species. Early to mid-May applications of the reduced-risk insecticides chlorantraniliprole and spinetoram can be used to simultaneously target A. transitella and A. lineatella with similar results across the potential timings.


A SNAI2-PEAK1-INHBA stromal axis drives progression and lapatinib resistance in HER2-positive breast cancer by supporting subpopulations of tumor cells positive for antiapoptotic and stress signaling markers.
Intercellular mechanisms by which the stromal microenvironment contributes to solid tumor progression and targeted therapy resistance remain poorly understood, presenting significant clinical hurdles. PEAK1 (Pseudopodium-Enriched Atypical Kinase One) is an actin cytoskeleton- and focal adhesion-associated pseudokinase that promotes cell state plasticity and cancer metastasis by mediating growth factor-integrin signaling crosstalk. Here, we determined that stromal PEAK1 expression predicts poor outcomes in HER2-positive breast cancers high in SNAI2 expression and enriched for MSC content. Specifically, we identified that the fibroblastic stroma in HER2-positive breast cancer patient tissue stains positive for both nuclear SNAI2 and cytoplasmic PEAK1. Furthermore, mesenchymal stem cells (MSCs) and cancer-associated fibroblasts (CAFs) express high PEAK1 protein levels and potentiate tumorigenesis, lapatinib resistance and metastasis of HER2-positive breast cancer cells in a PEAK1-dependent manner. Analysis of PEAK1-dependent secreted factors from MSCs revealed INHBA/activin-A as a necessary factor in the conditioned media of PEAK1-expressing MSCs that promotes lapatinib resistance. Single-cell CycIF analysis of MSC-breast cancer cell co-cultures identified enrichment of p-Akthigh/p-gH2AXlow, MCL1high/p-gH2AXlow and GRP78high/VIMhigh breast cancer cell subpopulations by the presence of PEAK1-expressing MSCs and lapatinib treatment. Bioinformatic analyses on a PEAK1-centric stroma-tumor cell gene set and follow-up immunostaining of co-cultures predict targeting antiapoptotic and stress pathways as a means to improve targeted therapy responses and patient outcomes in HER2-positive breast cancer and other stroma-rich malignancies. These data provide the first evidence that PEAK1 promotes tumorigenic phenotypes through a previously unrecognized SNAI2-PEAK1-INHBA stromal cell axis.


Effects of the pan-selectin antagonist bimosiamose (TBC1269) in experimental human endotoxemia.
Selectins mediate the adhesion of leukocytes to activated endothelial cells and activated platelets. In addition to these cell-to-cell interactions, they influence the fibrin content and size of venous thrombi in different animal models. However, the exact role of selectins in human endotoxemia still remains unclear. We aimed to investigate the effect of selectin inhibition in lipopolysaccharide (LPS)-induced tissue factor (TF)-dependent activation of coagulation in a well-standardized model of human endotoxemia. To explore whether selectin blockade attenuates LPS-induced coagulation in humans, we performed a randomized, double-bind placebo-controlled crossover trial in 16 healthy male volunteers. All subjects received 2 ng/kg of LPS and, 10 min thereafter, a 15-min infusion of either 30 mg/kg of the pan-selectin antagonist bimosiamose or equal volumes of placebo in random order, with a washout period of 6 weeks between both periods. Treatment with bimosiamose had no significant effect on LPS-induced TF expression, as quantified by TF mRNA levels, or on LPS-induced coagulation response, reflected by increases in plasma thrombin-antithrombin (TAT) complexes and prothrombin fragment (F1 + 2) levels. Furthermore, bimosiamose did not affect the LPS-dependent changes in leukocyte subpopulations or the increase in platelet-leukocyte aggregates, as determined in the level of CD41+ monocytes. Finally, neither the LPS-induced release of tumor necrosis factor, interleukin 6, leukocyte expression of CD11b, nor intercellular adhesion molecule 1 were affected by administration of bimosiamose. The pan-selectin antagonist bimosiamose does not attenuate TF-triggered coagulation or inflammation in human endotoxemia. This indicates a minor influence of this selectin antagonist in this model. In addition, infusion of bimosiamose was safe and well tolerated in human endotoxemia.


Differences in radiographic findings between scaphoid fracture patterns.
Scaphoid fracture patterns can be divided into volar and dorsal type using three-dimensional computed tomography. Ninety-nine patients underwent this examination plus radiography to determine how often fracture pattern was identifiable by radiography including proximal fragment ratio (PFR) measurement. Oblique radiographs obtained at 45 degrees of pronation demonstrated a volar displacement in 28 of 37 volar type fractures in three-dimensional computed tomography (76%), while as oblique view with 45 degrees of supination could identify the dorsal type in ten of 18 (56%). PFR showed a significant difference, with means of 0.59 for volar type and 0.43 for dorsal type. Using oblique views in the two rotational directions together with the PFR, the two fracture patterns could be differentiated in 35 of 43 fractures (81%). No differences were evident between the two fracture patterns with respect to prevalence of dorsal intercalated segment instability deformity.


Efficacy of Natuphos in sorghum-based diets of finishing swine.
The efficacy of a recombinantly derived microbial phytase (Natuphos 5000, BASF Corp.) was evaluated in sorghum-soybean meal-based diets of finishing swine. During the 50- to 80- and 80- to 118-kg BW intervals, diets contained .40 and .39% plant P, respectively; control diets fed during the two weight intervals were supplemented with .08 and .04% inorganic P from dicalcium phosphate. The all plant-P diets were supplemented with 0, 300, or 500 phytase units (FTU) per kilogram of diet. Supplemental P (P = .09) and phytase (linear, P = .01) increased growth rate but did not affect feed efficiency. Dietary treatment did not affect quantitative carcass traits, CP, fat, or moisture content of the loin or taste panel scores of the cooked loin other than a quadratic decrease (P = .02) in connective tissue amount as phytase supplementation increased. Apparent ileal and total tract digestibilities of DM, GE, and N were not affected (P > .25) by phytase supplementation, whereas ileal and total tract digestibilities of Ca and P increased (P < .05 or P < .01) with increasing phytase supplementation. Ultimate load and ash content of the third and fourth metacarpals and metatarsals and serum P levels increased in response to inorganic P and phytase supplementation. Pig performance, carcass traits, and bone traits were essentially equal for the 300 and 500 FTU/kg treatments. These results show that phytase effectively liberates P in sorghum-based diets, and that 300 FTU/kg (or less) will optimize performance and carcass merit of finishing swine.


[Corpus luteum function and female sterility. Comparative studies of endometrial biopsy and pregnanediol secretion within the same cycle].
In 129 patients with sterility or endocrine menstrual cycle disturbances the pregnandiol concentrations in the urine were measured and in the same cycle the endometrium of the 1st day of menstruation histologically examined. The length of the corpus luteum phases was classified into 6 groups (over 14, 11--14, 9--10, 7--8, 1--6, 0 days), also the endometrial findings (over stimulated, normal, slightly, moderately, significantly retarded secretory transformation, no secretory signs). In 77.5% of the cases a complete accordance between the pregnandiol output and the endometrial biopsy was found, in 18% a difference of one step between the two parameters. Only in 4.5% great discrepancies were found, which partly could be explained by simultaneous medication in the same cycle. The two methods do not compete with each other but complete each other, because pregnandiol output is a parameter for corpus luteum function and endometrial histology reveals the reaction of the target organ to the hormonal stimulus. A statement about the etiology of the corpus luteum insufficiency is not possible by these two methods. For that further examination, i.a. serial evaluation of the sexual steroids and gonadotropins in serum are necessary.


Systemic immune mechanisms in atopic dermatitis and psoriasis with implications for treatment.
Atopic dermatitis (AD) and psoriasis are inflammatory skin diseases that negatively affect patients' quality of life. Although distinctions exist between these diseases, both are characterized by erythematous, thickened epidermal lesions that vary in intensity and affected body surface area. Early models of aetiology attributed symptoms of both diseases to cutaneous inflammation at lesion sites, but recent studies have established that activated immune mediators in the circulation drive disease severity. Activation of T helper 2 (Th2) and Th22 cells in the circulation appears to be the principal initiator of acute AD pathology, with the emergence of Th1 and Th17/interleukin (IL)-23 pathway activation marking the transition to a chronic state. The Th17/IL-23 pathway also has an important role in psoriasis. The role of systemic inflammation in AD and psoriasis is supported by the occurrence of non-cutaneous comorbidities that affect patients, most of which intensify morbidity and disability associated with lesional skin. Atopic dermatitis is associated with allergic disorders consisting of the "atopic march," whereas psoriasis is frequently accompanied by psoriatic arthritis. Patients with both disorders are at significantly higher risk of obesity, metabolic disorders, and cardiovascular diseases, all of which feature inflammatory components in their pathology models. These insights have led to novel therapeutics aimed at addressing psoriasis by targeting tumor necrosis factor- and Th17-related cytokine pathways. The success of these agents in psoriasis management is driving new therapeutic approaches for moderate-to-severe AD, including agents targeting the Th2 and Th17/Th22 cytokine pathways.


A Pilot Study Examining ADHD and Behavioural Disturbance in Female Mentally Disordered Offenders.
Compared with general population rates, prevalence rates of ADHD have been consistently reported to be higher in both male and female offender populations, the latter estimated to range between 10-29%. Research in forensic institutional settings has reported that aggressive behaviour is a particularly prominent source of impairment among men with ADHD. However there is a paucity of research investigating the type of behavioural incidents that may arise in female offenders with ADHD. This pilot study therefore aimed to further our understanding of ADHD within a cohort of female mentally disordered offenders by ascertaining estimated rates of ADHD and associated functional disturbance presenting in this population. Fifty female offenders completed the Barkley ADHD rating scales. Data on aggressive and self-harming behaviours were obtained from patients' clinical records. Almost one-third of patients (28%) screened positive for ADHD, most commonly hyperactive/impulsive and combined subtypes. They were significantly younger than their peers and there were no significant differences in behavioural disturbance records between groups. When controlling for age, hyperactive/impulsive symptoms and combined symptoms were significantly and positively correlated with measures of behavioural disturbance. ADHD symptoms correlated more strongly with self-harm than outward aggression, which is a novel finding. This pilot study has contributed to the knowledge base about the rate and functional problems of female offenders with ADHD. Future research should replicate the study using a larger sample and explore the effect of treatment (pharmacological and psychological) on the reduction of ADHD symptoms, behavioural disturbance, length of stay and quality of life.


Chronicity and Sex Affect Genetic Risk Prediction in Schizophrenia.
Schizophrenia (SCZ) is a severe mental disorder with immense personal and societal costs; identifying individuals at risk is therefore of utmost importance. Genomic risk profile scores (GRPS) have been shown to significantly predict cases-control status. Making use of a large-population based sample from Sweden, we replicate a previous finding demonstrating that the GRPS is strongly associated with admission frequency and chronicity of SCZ. Furthermore, we were able to show a substantial gap in prediction accuracy between males and females. In sum, our results indicate that prediction accuracy by GRPS depends on clinical and demographic characteristics.


Erratum: Medicine, Volume 95, Issue 24: Erratum.
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