Serologic ambiguity and allelic frequency of the HLA-B40 family in the Korean population.
The most frequently identified HLA-B type in Koreans is HLA-B40 (13.4%). Due to the lack of mono-specific alloantisera and cross reactivity of sera used as typing reagents, discrimination between the serologic splits of B40, B60 and B61, has been a problem in tissue typing laboratories. In this study, an efficient PCR-SSP typing system was established to distinguish B60 and B61 and to assess the difficulty in serologic assignment for these types. The SSP system was also used to elucidate the frequency of B40 alleles (B*4001-B*4008) encoding B40 molecules in the Korean population. Eighty eight unrelated individuals identified serologically as B40 positive were selected from 358 consecutive volunteers from the unrelated bone marrow registry. Seven sets of PCR that amplify exons 2 and 3 of the HLA-B gene using 10 sequence specific primers (SSP) were used for discrimination between B60 and B61, and for B40 allelic typing. A clear discrimination of B60 and B61 was possible in all samples including 48 serologically ambiguous samples (B60-14/48; B61-34/48) and 5 potentially B40 homozygous samples (B60/ B61 heterozygotes-4/5; B60 homozygote-1/5). Therefore, the use of a focused SSP approach enhances serologic definition of HLA types in routine clinical testing. In allelic typing, all B60 samples (26) appeared to be B*4001, but B61 samples revealed more heterogeneity (B*4002-36/58, B*4003-4/ 58, B*4006-18/58). In addition, B*4003 seemed to be closely associated with the A24-Cw3-DRB1*02 haplotype (3/4). The characterization of allele frequency as well as haplotypic association will be helpful in determination of the optimal size of the volunteer marrow donor pool in the Korean population.


The role of biomechanics in orthopedic and neurological rehabilitation.
Movement is fundamental to human well-being, function and participation in work and leisure activities. As a result, regaining optimal movement abilities and independence frequently become central foci of rehabilitation programs developed for individuals recovering from serious orthopedic and neurologic injuries. Further, preventing additional injury to the locomotor system becomes essential for effective long-term management of chronic medical conditions such as tendon dysfunction and diabetes. The primary aim of this perspective is to illustrate the role of biomechanics in orthopedics, musculoskeletal and neurological rehabilitation. Specifically, this paper discusses selected examples, ranging from the tissue to whole body biomechanics level, that highlight how scientific evidence from the theoretical and applied sciences have merged to address common and sometimes unique clinical problems.


Obstructive sleep apnoea in a case of thyroglossal duct cyst carcinoma.
To report a rare case of thyroglossal duct cyst carcinoma which presented with obstructive sleep apnoea, and to highlight the difficulties in making this clinical diagnosis. Case report and review of the English language literature concerning thyroglossal duct cyst carcinoma. Thyroglossal duct cyst carcinoma is a rare clinical entity found in only approximately 1 per cent of all patients operated upon for thyroglossal duct cyst. This condition usually presents in an identical manner to its benign counterpart; atypical presentations have not previously been reported. Our patient is the first reported case of a thyroglossal duct cyst carcinoma first presenting with symptoms of obstructive sleep apnoea, without a neck mass. Complete surgical excision with total thyroidectomy and lymph node clearance was performed, in view of the positive lymph node metastases (seen on imaging) and the need for post-operative radioiodine therapy. Thyroglossal duct cyst carcinomas may present atypically, posing a diagnostic dilemma for the clinician. For patients diagnosed with obstructive sleep apnoea, it is imperative that a thorough otolaryngological examination be performed to exclude any underlying pathology.


[Clinical features, prevention and treatment of respiratory distress syndrome in neonates of different gestational ages in tertiary hospitals in Northwest China].
To investigate the clinical features, prevention and treatment of respiratory distress syndrome (RDS) in neonates of different gestational ages (GA) in the tertiary hospitals in Northwest China. A total of 440 neonates diagnosed with RDS between January and December, 2011 in 12 tertiary hospitals in Northwest China were enrolled and classified into three groups: early preterm (GA<34 weeks; n=247), late preterm (GA 34-36(+6) weeks; n=131) and full-term (GA≥37 weeks; n=62). The clinical data, including perinatal factors, prevention and treatment, complications and prognosis, were comparatively analyzed among the three groups. The rate of multiple births in the early preterm group was higher than the other two groups. The two preterm groups showed a higher incidence of premature rupture of membranes than the full-term group. The full-term group had a higher rate of cesarean section without contractions than the two preterm groups. The early preterm group had the highest application rate of antenatal steroids. Compared with the other two groups, the early preterm group had a higher application rate of pulmonary surfactants (PS) and an earlier time of first application of PS. The full-term group had a lower resuscitation rate than the two preterm groups. The early preterm group showed a higher incidence of patent ductus arteriosus and intracranial hemorrhage than the other two groups. The cure rate of RDS (78.2%) was the highest in the full-term group, followed by the late preterm group (58.6%) and the early preterm group (42.9%). RDS infants of different GA in Northwest China have significant differences in perinatal factors, antenatal prevention, PS treatment, complications and prognosis.


Effects of colored light, color of comparison stimulus, and illumination on error in perceived depth with binocular and monocular viewing.
Two experiments assessed the effects of colored light, color of a comparison stimulus, and illumination on error in perceived depth with binocular and monocular vision. Exp. 1 assessed effects of colored light, color of comparison stimulus, and source of depth cues on error in perceived depth. A total of 29 women and 19 men, Taiwanese college or graduate students ages 20 to 30 years (M=24.0, SD= 2.5) participated; they were randomly divided into five groups, each being assigned to one of five possible colored light conditions. Analyses showed color of the comparison stimulus significantly affected the error in perceived depth, as this error was significantly greater for a red comparison stimulus than for blue and yellow comparison stimuli. Colored light significantly affected error in perceived depth since error under white and yellow light was significantly less than that under green light. Moreover, error in perceived depth under white light was significantly less than that under blue light but not sensitive to white, yellow, and red light. Error in perceived depth for binocular viewing was significantly less than that for monocular viewing but not sex. In Exp. 2, the effect of illumination on error in perceived depth was explored with 21 women and 15 men, Taiwanese college students with a mean age of 19.8 yr. (SD= 1.1). Analysis indicated that illumination significantly affected error in perceived depth, as error for a 40-W condition was significantly greater than under 20- and 60-W conditions, although the latter were not different.


Ocular manifestations of skin diseases with pathological keratinization abnormalities.
Keratinization means cytodifferentiation of keratinocytes turning into corneocytes in the stratum corneum. Disorders of keratinization (hyperkeratosis, parakeratosis and dyskeratosis) are causing many dermatological diseases, including various types of ichthyoses, pachyonychia congenita, pityriasis rubra pilaris, all subtypes of psoriasis, pityriasis lichenoides, dyskeratosis congenita, leukoplakia and keratosis follicularis, which apart from skin lesions may affect the eye's adnexae causing ectropion, entropion, blepharitis, madarosis, and trichiasis, the ocular surface causing keratitis, conjunctivitis, corneal ulceration and episcleritis, which in turn cause uveitis and various fundoscopic changes (proliferative retinopathy, retinal vasculopathy, macular oedema and birdshot chorioretinopathy). Knowledge of ocular symtoms associated with pathological keratinization is crucial, preventing sight-threatening complications such as corneal perforation, lagophthalmus, phthisis bulbi, retinal neovascularization, retinal vasculopathy and optic nerve atrophy. This review encourages dermatologists to monitor patients for ocular symptoms and encourage ophthalmologists to monitor patients for dermatological symptoms.


Androgen receptor polymorphisms and endometrial cancer risk.
The androgen receptor (AR) gene is a transcription factor responsible for mediating the physiological effects of androgens. Evidence suggests that androgens and the androgen receptor are involved in uterine cell proliferation. A polymorphic CAG repeat in exon 1 of the AR gene encodes a polyglutamine tract that is inversely correlated with the transcriptional activity of this gene. We assessed the association between the functional CAG repeat polymorphism and AR haplotypes and the risk of endometrial cancer in two nested case-control studies within the Nurses' Health Study (n = 222 cases, 666 controls) and the Women's Health Study (n = 137 cases, 411 controls) using conditional and unconditional logistic regression. Associations between AR CAG repeat polymorphism and endometrial cancer risk were similar in the 2 case-control studies. In the pooled analysis, women with an average repeat allele > or =22 repeats compared to <22 repeats were at a statistically significant decreased risk of endometrial cancer (odds ratio (OR) = 0.76; 95% confidence interval (CI), 0.59-0.98). Women with one or two long alleles (> or =27 repeats) compared to both alleles <22 repeats were also at a statistically significant decreased risk (OR = 0.60; 95% CI, 0.36-0.99). We observed a modest yet statistically significant association for each one unit increase in the average repeat length and endometrial cancer risk (OR = 0.94; 95% CI, 0.88-1.00). Associations for the AR CAG average repeat length and endometrial cancer risk differed by menopausal status (p = 0.02). No significant associations between the AR haplotypes and endometrial cancer risk were observed. Our findings suggest that an increasing number of functional CAG repeats may be associated with endometrial carcinogenesis because of AR's reduced ability to recruit coregulators and other transcriptional components. (supplementary material for this article can be found on the International Journal of Cancer website at http://www.interscience.wiley.com/jpages/0020-7136/suppmat/index.html).


The Application of sEMG in Aging: A Mini Review.
The aim of this mini-review is to describe the potential application of surface electromyography (sEMG) techniques in aging studies. Aging is characterized by multiple changes of the musculoskeletal system physiology and function. This paper will examine some of the innovative methods used to monitor age-related alterations of the neuromuscular system from sEMG signals. A description of critical assumptions which underlie some of these approaches is emphasized. The first part focuses on the evolution of the recording techniques and describes some methodological issues. The second part focuses on how to use the following techniques to characterize aging: amplitude and spectral sEMG signal analysis, muscle fiber conduction velocity estimation, and myoelectric fatigue assessment. The last part describes a number of advanced sEMG approaches which seem promising in the geriatric population to estimate motor unit number, size, recruitment thresholds, and firing rates.


Gelfoam-assisted amplatzer vascular plug technique for rapid occlusion in proximal splenic artery embolization.
The objective of this study was to prospectively investigate the role of rapid Gelfoam-assisted occlusion of the splenic artery with an Amplatzer Vascular Plug (AVP). Ten consecutive proximal splenic artery embolizations were performed with AVP as the primary embolic agent and Gelfoam slurry as an adjunct. These cases were then compared with 10 retrospective cases of splenic artery embolization performed with AVP and augmented with coils or additional AVPs, or both, in patients with similar indications. Successful proximal splenic artery embolization using a single Amplatzer Vascular Plug and Gelfoam slurry occurred in all cases. No recanalization was identified on imaging follow-up at an average interval of 5.1 months. Gelfoam can be used as an adjunct to AVP in proximal splenic artery embolization. Using adjunctive Gelfoam is a simple, safe, and cost-saving method of improving the occlusion efficiency of the Amplatzer Vascular Plug.


Equating Errors and Scale Drift in Linked-Chain IRT Equating with Mixed-Format Tests.
In linked-chain equating, equating errors may accumulate and cause scale drift. This simulation study extends the investigation on scale drift in linked-chain equating to mixed-format test. Specifically, the impact of equating method and the characteristics of anchor test and equating chain on equating errors and scale drift in IRT true score equating is examined. To evaluate equating results, a new method is used to derive true linking coefficients. The results indicate that the characteristic curve methods produce more accurate and reliable equating results than the moment methods. Although using more anchor items or an anchor test configuration with more IRT parameters can lower the variability of equating results, neither of them help control equating bias. Additionally, scale drift increases when an equating chain runs longer or poorly calibrated test forms are added to the chain. The role of calibration precision in evaluating equating results is highlighted.


In vitro degradation of a 3D porous Pennisetum purpureum/PLA biocomposite scaffold.
The in vitro degradation and mechanical properties of a 3D porous Pennisetum purpureum (PP)/polylactic acid (PLA)-based scaffold were investigated. In this study, composite scaffolds with PP to PLA ratios of 0%, 10%, 20%, and 30% were immersed in a PBS solution at 37°C for 40 days. Compression tests were conducted to evaluate the compressive strength and modulus of the scaffolds, according to ASTM F451-95. The compression strength of the scaffolds was found to increase from 1.94 to 9.32MPa, while the compressive modulus increased from 1.73 to 5.25MPa as the fillers' content increased from 0wt% to 30wt%. Moreover, field emission scanning electron microscopy (FESEM) and X-ray diffraction were employed to observe and analyse the microstructure and fibre-matrix interface. Interestingly, the degradation rate was reduced for the PLA/PP20 scaffold, though insignificantly, this could be attributed to the improved mechanical properties and stronger fibre-matrix interface. Microstructure changes after degradation were observed using FESEM. The FESEM results indicated that a strong fibre-matrix interface was formed in the PLA/PP20 scaffold, which reflected the addition of P. purpureum into PLA decreasing the degradation rate compared to in pure PLA scaffolds. The results suggest that the P. purpureum/PLA scaffold degradation rate can be altered and controlled to meet requirements imposed by a given tissue engineering application.


Update on intra-arterial thrombolysis in patients with lower limb ischemia.
Intra-arterial thrombolysis has become the most important minimally-invasive treatment option to treat acute lower limb ischemia. Although hemorrhagic stroke is a dreaded complication, intra-arterial thrombolysis is considered beneficial to many fragile and elderly patients where vascular surgery is not an option. This review outlines current results after intra-arterial thrombolysis with low dose recombinant tissue plasminogen activator (rtPA) from 2001 to 2012 in two large vascular centers in Sweden. There was an increasing number of thrombolysis of occluded endoprosthesis and decreasing thrombolysis of occluded bypasses during this time period. Technical success rate for thrombolysis of occluded endoprostheses, bypasses and native artery occlusion was 91%, 89% and 73%, respectively. Amputation-free survival rate at one year was 73%. Popliteal arterial aneurysm and anemia were independently associated with dismal amputation-free survival at 30 days. Independent factors associated with dismal amputation-free survival at long-term were foot ulcers, motor deficit, renal insufficiency and anemia. Major hemorrhage occurred in 104 procedures (13.9%); 43 (5.7%) were so severe that thrombolysis was discontinued in advance. All three (0.4%) hemorrhagic strokes were fatal. Preoperative severe limb ischemia with motor deficit was the only independent risk factor for major bleeding. Simultaneous heparin infusion was not associated with increased risk of major bleeding or improved leg salvage or survival. In conclusion, intra-arterial thrombolysis with rtPA for lower limb ischemia was effective, with few major bleeding complications. Simultaneous heparin infusion offered no advantage. Thrombolysis in embolism due to popliteal artery aneurysm is the most important step to improve run-off and a prerequisite to succeed with operative treatment.


EFFECT OF CATIONS UPON HYDROPHOBICITY OF YEASTS GROWN IN AMINO ACID MEDIA.
Hedrick, L. R. (Illinois Institute of Technology, Chicago), and C. J. Feren. Effect of cations upon hydrophobicity of yeasts grown in amino acid media. J. Bacteriol. 86:1288-1294. 1963.-Cells of four species of Hansenula, namely, H. holstii Y2154, H. subpelliculosa Y1683 and Y1542, and H. anomala Y365, were cultured for 3 days in a glucose-salts medium with one amino acid or (NH(4))(2)SO(4) as a nitrogen source. The l-amino acids used were glutamic acid, valine, proline, lysine, histidine, phenylalanine, tyrosine, and tryptophan. After growth, the cells were washed three times and added to small tubes which contained varying concentrations of chlorides of the cations Cs(+), K(+), Na(+), and Al(+++). The concentration of salt in ionic strength required for sedimenting yeast cells to form a fixed pellet represents an index of hydrophobicity of the cells, i.e., the smaller the ionic strength, the greater the hydrophobicity. All species grown in (NH(4))(2)SO(4) had a high degree of hydrophobicity. Cells of H. holstii and H. subpelliculosa Y1683 were very hydrophilic when cultured in the three aromatic amino acids as a nitrogen source and in proline as a carbon and a nitrogen source; cells of the latter species were much more hydrophobic if grown with proline as a nitrogen source. Cells of H. holstii cultured in l-glutamic acid as a nitrogen source were much more hydrophobic than those grown in proline as either a nitrogen or a carbon source. Cells of all species grown in l-lysine were more hydrophobic than cells cultured in the other amino acids tested. H. subpelliculosa Y1542 cells were somewhat more hydrophilic than those of H. anomala Y365, but both were much more hydrophobic than the other two yeasts studied. The concentration of cations required to detect an identical degree of hydrophobicity of cells decreased in the order Cs, Li, K, Na, and Al. This order corresponds to the compressibility method for estimating the water of hydration of the cations.


8-Isoprostane, a marker of oxidative stress, is increased in exhaled breath condensate of patients with obstructive sleep apnea after night and is reduced by continuous positive airway pressure therapy.
Obstructive sleep apnea (OSA) is characterized by recurrent apnea during sleep that may compromise oxidative balance. Oxidative stress is increased in the blood and in the airways of OSA patients. The aim of this study was to investigate whether oxidative stress is determined by nocturnal apneas and could be reduced by CPAP therapy, and whether there is a relation between local and systemic oxidative stress in these patients. Eighteen patients with OSA (13 men; mean [+/- SD] age, 48 +/- 3 years) and 12 healthy age-matched and weight-matched subjects (8 men; mean age, 46 +/- 7 years) were recruited. 8-Isoprostane was measured in exhaled breath condensate and blood by a specific enzyme immunoassay. Higher concentrations of 8-isoprostane were found in the morning exhaled condensate (9.5 +/- 1.9 pg/mL) and plasma (9.7 +/- 1.5 pg/mL) of OSA patients compared to healthy obese subjects (6.7 +/- 0.2 and 7.1 +/- 0.3 pg/mL, respectively; p < 0.0001). Elevated mean concentrations of exhaled 8-isoprostane were observed in the OSA patients at 8:00 AM (9.5 +/- 1.9 pg/mL) but not at 8:00 PM (7.6 +/- 0.8 pg/mL; p < 0.0005), and a significant reduction was seen after continuous positive airway pressure (CPAP) therapy (7.7 +/- 0.9 pg/mL; before treatment, 9.6 +/- 1.7 pg/mL; p < 0.005). A positive correlation was found between morning exhaled 8-isoprostane levels and the apnea-hypopnea index (r = 0.8; p < 0.0001), and 8-isoprostane levels and neck circumference (r = 0.6; p < 0.0001). These findings suggest that systemic and local oxidative stress are increased in OSA patients, and that they are higher after nocturnal apnea and reduced by CPAP therapy.


Effect of hCG administration during corpus luteum establishment on subsequent corpus luteum development and circulating progesterone concentrations in beef heifers.
This study examined the effect of a single administration of human chorionic gonadotrophin (hCG) on Day 1 to 4 after oestrus on corpus luteum (CL) development and circulating progesterone (P4). Oestrus-synchronized heifers (n=43) were administered a single intramuscular injection of saline on Day 1 (control) or 3000IU hCG on Day 1, 2, 3 or 4 after oestrus. Administration of hCG on Day 1 had no effect on CL area, on Day 2 increased CL area from Day 6 to 12 (P<0.05), on Day 3 increased CL area from Day 9 to 11, while on Day 4 increased CL size on Days 9 and 10 (P<0.05). Administration of hCG on Day 4 induced the formation of an accessory CL in 89% of heifers, resulting in a significant increase in total luteal tissue area on the ovaries compared with all other groups. Consistent with the effects on the CL, hCG on Day 1 did not affect P4 concentrations, on Day 2 significantly increased P4 compared with the control from Day 6 to 11 (P<0.05), on Day 3 resulted in a non-significant increase in P4 while hCG on Day 4 increased P4 from Day 8 to 13 compared with the control (P<0.05). In conclusion, administration of hCG as early as Day 2 after oestrus results in increased P4 in circulation from Day 6, which should have beneficial downstream effects in terms of uterine receptivity and conceptus elongation.


Discussing adolescent sexual health in African-American churches.
This study describes the ways in which two African-American churches discuss adolescent sexual health topics. Six focus groups were conducted in two churches in Flint, Michigan, that reported no formal sexual health programming for their congregants. Three themes emerged to highlight the different perspectives about the role of churches in adolescent sexual decision-making and sexual health education: (1) churches as sources of sexual information, (2) churches as complex communities, and (3) recommendations for sexual education in churches. Participant responses suggest that churches can and should serve a resource for sexual health information. Implications for practice and research are discussed.


Stimulating and blocking thyroid-stimulating hormone (TSH) receptor autoantibodies from patients with Graves' disease and autoimmune hypothyroidism have very similar concentration, TSH receptor affinity, and binding sites.
The distinct biological properties of TSH receptor (TSH-R) autoantibodies (TRAbs) from patients with Graves' disease (GD) are yet unexplained on the molecular level. Here we compare serum concentration, affinity to the TSH-R, and binding sites on the TSH-R of stimulating (TSAb) and blocking (TBAb) TRAbs. Four-step affinity purification using human recombinant TSH-R was performed with 22 TRAb-positive sera from GD patients (11 with only TSAb and 11 with only TBAb) and five control sera. Antibody concentration, TSH binding inhibition (TBII), and TSAb/TBAb activity of the purified TRAb were assessed. Labeled purified TRAbs were used for displacement studies with TRAb and an additional 30 patients and 10 control sera. TRAbs could be purified to 80-93% purity with recovery of the TBII and TSAb and TBAb activity. No TRAbs could be purified from healthy individuals. The mean +/- SD concentration of TRAb was 17.3 +/- 5.4 microg/IU for the TSAb sera (range, 9.6-25.9) and 18.2 +/- 8.5 microg/IU for the TBAb sera (range, 4.6-29.2), respectively (P = 0.79). Affinity was in the picomolar range for both TRAb subtypes with mean +/- sd dissociation constant of 167 +/- 109 pM (60-410 pM) for TSAb and 253 +/- 132 pM (80-410 pM) for TBAb (P = 0.12). Purified and labeled TSAb and TBAb showed a very similar binding pattern to the TSH-R in displacement studies with unlabeled TSAb/TBAb or unpurified patients sera, indicating binding sites on the TSH-R in close proximity to each other. TSAbs and TBAbs in the serum of patients with GD have similar characteristics. They are of low concentration with high affinity and have also similar binding epitopes on the TSH-R.


Diabetic Foot Ulcer in Malaysia: Consensus on Treatment Patterns, Health Care Utilization and Cost.
Healthcare resource utilization for Diabetic foot ulcers (DFUs) in Malaysia needs to be clarified. This modified Delphi panel study aimed to describe the clinical pathways for diabetic foot ulcer in Malaysia and to define the healthcare resources used and their costs. A systematic review of the literature was carried out on the management of diabetic foot ulcer in Malaysia. A modified Delphi panel involving 7 local experts was organized to validate the statements, in order to arrive at a consensus on the resources used for the treatment of DFU patients in Malaysia and their costs. A Markov model was then used to estimate the financial burden of DFU patients in Malaysia.The total cost per patient per annum was MYR 5981 in public and MYR 8581 in private setting. In the public setting, outpatient visits costs represent 50% of the overall cost, followed by medical devices which represent 38% of total costs. In the private setting, as in the public, outpatient visits and devices contribute the most to overall costs with 51% and 21%, respectively. However, hospital inpatient costs are higher in private setting and represent 14% of the total costs versus 5% in public setting.These findings may prove useful for clinicians and decision makers in understanding the economic implications of managing DFUs in Malaysia and the need for innovative therapies to reduce the burden for patients but also for the society.


Use of additives to improve collective biogas plant performances: A comprehensive review.
Nowadays, anaerobic digestion (AD) is being increasingly encouraged to increase the production of biogas and thus of biomethane. Due to the high diversity among feedstocks used, the variability of operating parameters and the size of collective biogas plants, different incidents and limitations may occur (e.g., inhibitions, foaming, complex rheology). To improve performance and overcome these limitations, several additives can be used. This literature review aims to summarize the effects of the addition of various additives in co-digestion continuous or semi-continuous reactors to fit as much as possible with collective biogas plant challenges. The addition of (i) microbial strains or consortia, (ii) enzymes and (iii) inorganic additives (trace elements, carbon-based materials) in digester is analyzed and discussed. Several challenges associated with the use of additives for AD process at collective biogas plant scale requiring further research work are highlighted: elucidation of mechanisms, dosage and combination of additives, environmental assessment, economic feasibility, etc.


Virtual Interviews for the Integrated Plastic Surgery Residency Match: The Program Director Perspective.
Interviews for the integrated plastic surgery residency match took place in a virtual format for the 2020-2021 application cycle. Current literature lacks the perspectives of program directors (PDs) on virtual interviews compared with traditional in-person interviews. Following institutional review board approval, an anonymous 17-question survey was distributed by email to 82 program directors of integrated plastic surgery residency programs in the United States. Participants were asked baseline program information, the number of positions and interview invites offered, and their perspectives on various aspects of the virtual interview process. Sixty-two (75.6%) PDs completed the survey. Thirty-seven percent reported increasing the number of interview offers per available residency spot. On a five-point Likert scale (1, not well at all; 5, extremely well), PDs showed no significant differences in their ability judge an applicant's professionalism (3.1 ± 1.1), interpersonal and communication skills (3.2 ± 1.1), and "fit" with their program (2.9 ± 0.9) during virtual interviews (P = 0.360). Sixty-eight percent reported being satisfied (15.3% extremely satisfied, 52.5% somewhat satisfied) with the virtual interview process, though 76.3% preferred in-person interviews. This study is the first to provide insight into PDs' impressions of virtual residency interviews. Although most reported being satisfied with the virtual interview process, the majority still preferred in-person interviews. Further long-term studies evaluating the pros and cons of each interview modality may provide more information on whether virtual interviews could become a sustainable alternative to the traditional in-person residency interview.


Conceptualizing Internet use disorders: Addiction or coping process?
This paper problematizes the tendency to study Internet use disorders from a perspective of addiction. It is argued that an addiction perspective, grounded in our understanding of substance use disorders, has not contributed much to an improved understanding of the antecedents and etiology of Internet use disorders. Despite this, researchers continue to frame Internet use disorders as an addiction, recently exemplified by the inclusion of Internet gaming disorder in the DSM-5 research appendix as a behavioral addiction. This paper claims that the decision to use an addiction framework to study Internet use disorders has consequences for the way in which results are interpreted, which impacts the potential for theoretical and etiological contributions negatively. The paper argues that a perspective of addiction may not be the most useful approach because it causes a mismatch between theory and findings in empirical work: it is not uncommon to find that a study is positioned as a study of addiction, but presents findings more illustrative of coping behaviors. The paper draws on two examples from the literature to illustrate this mismatch and discusses how this hinders theoretical and etiological development. The question that is asked going forward is what alternative explanations we might identify by not exclusively adhering to an addiction framework for purposes of research. Recommendations are given for how to usefully approach the study of Internet use disorders outside a framework of addiction. It also discusses how scholars who still prefer a framework of addiction might strengthen their conceptual position to ensure improved contributions to etiology and theoretical development.


An analysis of student performance benchmarks in dental hygiene via distance education.
Three graduate programs, 35 undergraduate programs and 12 dental hygiene degree completion programs in the United States use varying forms of Distance Learning (DL). Relying heavily on DL leaves an unanswered question: Is learner performance on standard benchmark assessments impacted when using technology as a delivery system? A 10 year, longitudinal examination looked for student performance differences in a Distance Education (DE) dental hygiene program. The purpose of this research was to determine if there was a difference in performance between learners taught in a traditional classroom as compared to their counterparts taking classes through an alternative delivery system. A longitudinal, ex post facto design was used. Two hundred and sixty-six subject records were examined. Seventy-seven individuals (29%) were lost through attrition over 10 years. One hundred and eighty-nine records were used as the study sample, 117 individuals were located face-to-face and 72 were at a distance. Independent variables included time and location, while the dependent variables included course grades, grade point average (GPA) and the National Board of Dental Hygiene Examination (NBDHE). Three research questions were asked: Were there statistically significant differences in learner performance on the National Board of Dental Hygiene Examination (NBDHE)? Were there statistically significant differences in learner performance when considering GPAs? Did statistically significant differences in performance exist relating to individual course grades? T-tests were used for data analysis in answering the research questions. From a cumulative perspective, no statistically significant differences were apparent for the NBDHE and GPAs or for individual courses. Interactive Television (ITV), the synchronous DL system examined, was considered effective for delivering education to learners if similar performance outcomes were the evaluation criteria.


hP1.B, a human P-domain peptide homologous with rat intestinal trefoil factor, is expressed also in the ulcer-associated cell lineage and the uterus.
The six-cysteine P-domain motif forms the basic repeat unit of a growing family of mucin-associated peptides. A precursor for a human secretory polypeptide has been discovered by molecular cloning and deduced to have a single P-domain, termed hP1.B. The pre-pro-peptide has 67% amino acid identity with rat intestinal trefoil factor. We find, using the techniques of RNA analysis and in situ hybridization, that this P-domain peptide is expressed in the human gastrointestinal tract, where a number of pathological conditions affect its expression, and surprisingly find it is expressed in the uterus also. In the intestine, hP1.B is expressed by goblet cells, but in Crohn disease this peptide is synthesized and secreted additionally by the ulcer-associated cell lineage that is known to secrete two other trefoil peptides, pS2 and spasmolytic polypeptide (hSP). In the stomach, hP1.B mRNA is relatively scarce but is more abundant in foci of intestinal metaplasia and near to ulceration. Mucin-rich epithelial cells in hyperplastic polyps of the colon also express this peptide. The discovery of this P-domain peptide and its expression in association with mucins support the hypothesis that P-domains with mucins may subserve related functions in the maintenance and repair of mucosal function.


Metabotropic glutamate receptor subtype-1 alpha (mGluR1 alpha) immunoreactivity in ependymal cells of the rat caudal medulla oblongata and spinal cord.
Immunohistochemical study of the distribution of glutamate receptor subunits 1-4 (GluR1-4), NMDA receptor subunit 1 and metabotropic glutamate receptor subtypes 1-3 (mGluR1-3) in the ependymal cells of the caudal medulla oblongata and upper thoracic spinal cord was carried out. The results showed that ependymal cells and tanycytes expressed only the metabotropic receptor subtype, mGluR1 alpha. Some of the mGluR1 alpha-positive long basal processes of the tanycytes reached the pia mater; some made contact with capillaries. It was suggested that the activity of the these mGluR 1 a-positive tanycytes may be regulated by the CSF and blood. The presence of many mGluR1 alpha positive fibres in the area postrema suggests that mGluR1 alpha subtype in this region may be involved in cardiovascular regulation.


Colorectal cancer care at Falmouth Hospital: an assessment of progress through registry statistics.
The purpose of this study is to assess the improvement of one aspect of colorectal cancer care at Falmouth Hospital as compared to a prior quality assessment report published in 2011. This quality assessment by I. Hopewood reported the need to increase the average number of lymph nodes removed and examined per patient in order to improve compliance with national guidelines.1 Falmouth Hospital pathology implemented a new alcohol-formalin fixation technique in 2011 to increase the number of resected lymph nodes examined. By comparing care based on the quality of surgery (ie, number of nodes examined) and stage of diagnosis, this study aimed to assess whether the quality improvement measures implemented may have an impact. Data were obtained from the hospital's tumor registry and the National Cancer Data Base. Results showed an increase in average number of nodes examined per patient, but no statistically significant change in the distribution of stage at diagnosis or evidence for detection of later stage cancers.


RNA-templated semiconductor nanocrystals.
The use of a biomolecular RNA template for the synthesis of CdS semiconductor nanocrystals is described. Transfer RNA, with a well-defined three-dimensional structure, is used as a scaffold and ligand system in the aqueous synthesis of CdS. We have found that nanocrystal structures can be modulated by the structure of the templating tRNA. When possessing a folded three-dimensional structure, tRNA-templated synthesis yields a single product. If the same tRNA is rendered unstructured through the introduction of destabilizing mutations, a range of products are observed. The results reported indicate that biomolecules can be used to systematically engineer the structures and properties of semiconductor-based materials, and that the synergy between the dimensions of nanostructures and biomolecules provides a means to tune the properties of materials with nanoscale precision.


Congenital bilateral adductor vocal cord paralysis.
Bilateral adductor vocal cord paralysis (BAdP), presenting with features of laryngeal incompetence, is a rare form of congenital bilateral vocal cord paralysis, and only 2 small series of BAdP have previously been published. Three cases are reported here. The BAdP occurred as an isolated abnormality in 1 child, and was associated with a recognizable syndrome (Robinow's syndrome and 22q deletion) in the other 2 children. Gastrostomy tube feeding was required in 2 children, who both remain gastrostomy tube-dependent at 26 months and 10 years 9 months of age. The child with Robinow's syndrome received parenteral nutrition until 2 months, but was then able to feed orally after partial improvement in vocal cord function. The global impairment in vocal cord constrictor function observed in these 3 children is consistent with the site of lesion's being at the level of the laryngeal constrictor motoneurons in BAdP.


[The effect of uropolinum on phagocytosis of sperm by cultured peritoneal macrophages in rats].
Peritoneal macrophages and sperm were cultured with and without uropolinum. The macrophages were isolated from female rat peritoneal cavities and sperm from male rat cauda epididymis. Sperm phagocytosis index was estimated in cultures with increasing concentrations of uropolinum. Authors concluded that uropolinum inhibited sperm phagocytosis by peritoneal macrophages. The results were verified by electron microscopic examinations. The latter additionally revealed that uropolinum enhanced an adhesion between the macrophages.


Social learning and health plan choice.
I use data from the University of California to empirically examine the role of social learning in employees' choices of health plans. The basic empirical strategy starts with the observation that if social learning is important, health plan selections should appear to be correlated across employees within the same department. Estimates of discrete choice models in which individuals' perceived payoffs are influenced by coworkers' decisions reveal a significant (but not dominant) social effect. The strength of the effect depends on factors such as the department's size or the employee's demographic distance from her coworkers. The estimated effects are present even when the model allows for unobserved, department-specific heterogeneity in employee preferences, so the results cannot be explained away by unobservable characteristics that are common to employees of the same department.


Catheter-related infections in pediatric patients with cancer.
Central venous catheters (CVCs) are essential in the management of pediatric patients receiving antineoplastic therapy or bone marrow transplants, and have significantly improved their quality of life, but CVC-related infectious complications are a major source of morbidity. It has been estimated that 14-51 % of the CVCs implanted in children with malignancies may be complicated by bacteremia, and that the incidence of infections is 1.4-1.9 episodes per 1,000 CVC days. However, there are few recent data concerning the epidemiology of CVC-related infections, the prevalence of antimicrobial resistance in their etiology, or the main factors associated with an increased risk of infection by type of catheter, patient age, the type of cancer, or the presence of neutropenia. Moreover, although various new strategies have been proposed in an attempt to reduce the risk of CVC-related infections, such as catheters impregnated with antiseptics/antibiotics, lock antibiotic prophylaxis, the use of ointments at the exit site, and antithrombotic prophylaxis, their real efficacy in children has not yet been demonstrated. The management of CVC-related infections remains difficult, mainly because of the number of still open questions (including the choice of optimal antimicrobial therapy because of the increasing isolation of multiresistant bacterial strains, treatment duration, whether catheters should be removed or not, the feasibility of guidewire exchange, and the usefulness of antibiotic lock therapy) and the lack of studies of children with cancer. Only well-designed, prospective clinical trials involving pediatric cancer patients can clarify optimal prevention and treatment strategies for CVC-related infections in this population.


Primitive chest wall neuroectodermal tumor in a pediatric patient.
A 13-year-old boy with a primitive neuroectodermal tumor of the chest wall is presented. After four cycles of chemotherapy, a computed tomography scan of his chest showed a larger mass invading the left upper lobe of the lung. He underwent resection of the left chest wall from the left fourth to sixth ribs, including the tumor, combined with left upper lobectomy and lymph node dissection. A diagnosis of primitive neuroectodermal tumor was confirmed histopathologically and immunohistochemically. After surgery, four cycles of chemotherapy with ifosfamide and etoposide were given. One year after treatment, the patient is currently doing well without evidence of recurrence.


[Pancreatic-pleural fistula in children: a rare cause of great abundant pleurisy].
Pancreatic-pleural fistula is a very rare complication of false cysts of the pancreas. Our study aimed to describe this rare pathology affecting children. We emphasized the importance of evoking this diagnosis in the presence of great abundant pleurisy even in the absence of the digestive signs. We here report the case of a 2-year old child with false cyst of the pancreas complicated by pleural fistula detected after great abundant pleurisy with no digestive signs associated.


Comparing tear film stability prolongation evaluated by Javal-Schiotz keratometer and slitlamp.
To innovatively compare the tear film stability assessed noninvasively by Javal-Schiotz keratometer (tear deformation time [TDT]) and invasively by slitlamp (invasive tear breakup time [I-TBUT]). Tear deformation time and I-TBUT were assessed in only 1 eye of 100 healthy young participants aged from 18 to 25 years (mean±standard deviation=20.49±1.80). Healthy ocular surface was considered as inclusive criteria. Nonparametric statistical analysis was performed to compare the TDT with I-TBUT and reveal correlation between them. The TDT values (mean: 22.84±20.14 sec) were significantly higher than the I-TBUT (mean: 15.73±8.89 sec) data (P=0.027). Neither TDT nor I-TBUT was affected by gender of the subjects. A significant direct correlation was detected between the TDT and I-TBUT data (Spearman ρ=0.458, P<0.0001). Neither I-TBUT nor TDT showed a significant relationship with age and sex factors. Our findings indicated that tear stability prolongation results obtained by TDT technique were significantly higher than the I-TBUT method outcomes. Noninvasive nature, easiness, basal tear film evaluation, availability, inexpensiveness, Fluorescein nonuse, and accessibility in the clinic (no need for para-clinical equipment) are benefits of the TDT technique. Future studies must be aimed at evaluating validity and reliability of the TDT technique on normal and dry eye populations.


Inference of cross-level interaction between genes and contextual factors in a matched case-control metabolic syndrome study: a Bayesian approach.
Genes, environment, and the interaction between them are each known to play an important role in the risk for developing complex diseases such as metabolic syndrome. For environmental factors, most studies focused on the measurements observed at the individual level, and therefore can only consider the gene-environment interaction at the same individual scale. Indeed the group-level (called contextual) environmental variables, such as community factors and the degree of local area development, may modify the genetic effect as well. To examine such cross-level interaction between genes and contextual factors, a flexible statistical model quantifying the variability of the genetic effects across different categories of the contextual variable is in need. With a Bayesian generalized linear mixed-effects model with an unconditional likelihood, we investigate whether the individual genetic effect is modified by the group-level residential environment factor in a matched case-control metabolic syndrome study. Such cross-level interaction is evaluated by examining the heterogeneity in allelic effects under various contextual categories, based on posterior samples from Markov chain Monte Carlo methods. The Bayesian analysis indicates that the effect of rs1801282 on metabolic syndrome development is modified by the contextual environmental factor. That is, even among individuals with the same genetic component of PPARG_Pro12Ala, living in a residential area with low availability of exercise facilities may result in higher risk. The modification of the group-level environment factors on the individual genetic attributes can be essential, and this Bayesian model is able to provide a quantitative assessment for such cross-level interaction. The Bayesian inference based on the full likelihood is flexible with any phenotype, and easy to implement computationally. This model has a wide applicability and may help unravel the complexity in development of complex diseases.


Multi-parametric qualitative and quantitative MRI assessment as predictor of histological grading in previously treated meningiomas.
Meningiomas are mainly benign tumors, though a considerable proportion shows aggressive behaviors histologically consistent with atypia/anaplasia. Histopathological grading is usually assessed through invasive procedures, which is not always feasible due to the inaccessibility of the lesion or to treatment contraindications. Therefore, we propose a multi-parametric MRI assessment as a predictor of meningioma histopathological grading. Seventy-three patients with 74 histologically proven and previously treated meningiomas were retrospectively enrolled (42 WHO I, 24 WHO II, 8 WHO III) and studied with MRI including T2 TSE, FLAIR, Gradient Echo, DWI, and pre- and post-contrast T1 sequences. Lesion masks were segmented on post-contrast T1 sequences and rigidly registered to ADC maps to extract quantitative parameters from conventional DWI and intravoxel incoherent motion model assessing tumor perfusion. Two expert neuroradiologists assessed morphological features of meningiomas with semi-quantitative scores. Univariate analysis showed different distributions (p < 0.05) of quantitative diffusion parameters (Wilcoxon rank-sum test) and morphological features (Pearson's chi-square; Fisher's exact test) among meningiomas grouped in low-grade (WHO I) and higher grade forms (WHO II/III); the only exception consisted of the tumor-brain interface. A multivariate logistic regression, combining all parameters showing statistical significance in the univariate analysis, allowed discrimination between the groups of meningiomas with high sensitivity (0.968) and specificity (0.925). Heterogeneous contrast enhancement and low ADC were the best independent predictors of atypia and anaplasia. Our multi-parametric MRI assessment showed high sensitivity and specificity in predicting histological grading of meningiomas. Such an assessment may be clinically useful in characterizing lesions without histological diagnosis. Key points • When surgery and biopsy are not feasible, parameters obtained from both conventional and diffusion-weighted MRI can predict atypia and anaplasia in meningiomas with high sensitivity and specificity. • Low ADC values and heterogeneous contrast enhancement are the best predictors of higher grade meningioma.


Primary pleomorphic liver liposarcoma: A case series and literature review.
Primary hepatic liposarcoma is an extremely rare mesenchymal tumor that accounts for only 0.1% to 2% of primary malignant liver tumors. Due to its rarity, there is a lack of knowledge about its clinical course, management, and prognosis. Only 15 cases of primary liposarcoma of the liver have been reported since 1973. Among these 15 cases, only two involved primary liver liposarcoma with a pleomorphic subtype. Here we report the third and fourth cases of primary pleomorphic liver liposarcoma. A 57-year-old female presented with abdominal discomfort and progressive abdominal distension for two weeks. Computed tomography (CT) of her abdomen revealed a large well-defined solid nodule mass with an area of necrosis and hemorrhage occupying segment IV-B of the liver. Wide local excision was performed. She had an uneventful recovery and remained well at six months post-treatment. A 65-year-old male presented with an abdominal mass for two-month. CT demonstrated a mass in the left lobe of the liver with mixed soft tissues and fat attenuation. He underwent wide local excision. He was discharged on day three postoperatively. Histological analysis for both cases revealed liposarcoma of the liver with a pleomorphic subtype.


[Pyogenic infections of the hand].
Thanks to modern antibacterial methods pyogenic infections of the hand, including their complications, will have a favourable prognosis. The experiences of many decades have proved that the principles of treatment worked out by Kanavel [6] and Zur Verth [12] are still valid, and that local processes require immediate surgical intervention. Individual and detailed proceedings are explained giving up-to-date therapeutical directions and improved incisions. The aim of all actions is to preserve the function of the hand.


[The frequency of the combination of arterial occlusive disease in supraaortic and leg range. An analysis in the patient population of a vascular surgical department (author's transl)].
Among 337 male patients who were hospitalized because of chronic ischemia of the leg, 103 (=30.6%) were shown to suffer from concomitant occlusive vascular disease of supraaortic branches. This was evaluated by simple examination like auscultation, bilateral blood pressure measurements, and palpation of pulses. In 52% the patients history revealed dizziness, hemiparesis and transient ischemic attacks (TIA). Arteriell hypertension promotes supraaortic vascular diseases as is shown by a relative frequency of 0.52 in contrast to 0.39. Combined occlusions of the iliac and femoropopliteal arteries are accompanied by supraaortic vascular disease in 40%, in femoropopliteal occlusion alone in only 20%. If the basic diagnostic approach is improved by directional ultra-sonic examinations of the carotid arteries, approximately 20% of all patients with advanced vascular disease of the iliac and femoropopliteal arteries have to be operated on for cerebrovascular disease.


Hemodynamic changes in post-suspension rats during gradual hemorrhage.
We examined the changes of hemodynamic parameters in nembutal-anesthetized rats during gradual hemorrhage (2 ml/100 g body weight during 30 min). In control rats blood pressure began to decline starting from 3rd min of bleeding and from 5th min it was accompanied by cardiac deceleration. Hindlimb vascular resistance was only slightly increased up to 15th min (by 20-30%) and then began to grow drastically. Less prominent changes of hemodynamics were observed in post-suspension rats. The results indicate that when activity of sympathetic nervous system is blunted with anesthetic post-suspension rats demonstrate higher hemodynamic stability during acute hemorrhage.


ADCC against hamster transplantable melanoma cells in relation to the diversity of their cell surface.
Antibody-dependent cellular cytotoxicity (ADCC) mediated by peripheral blood lymphocytes was determined in hamsters bearing two lines of transplantable melanomas of common origin but differing in surface glycoprotein contents, heterogeneity, antigenicity and immunogenicity. Amelanotic melanoma cell line, characterized by a higher growth rate and more prominent changes in surface glycoproteins, displayed statistically significant decrease in susceptibility of ADCC in comparison to the native line of the tumor. The relationship between changes in the surface glycoproteins of the target cells and the extent of specific lysis of melanoma cells was discussed.


Pre-administration of remifentanil in target-controlled propofol and remifentanil anesthesia prolongs anesthesia induction in neurosurgical patients: A double-blind randomized controlled trial.
Pre- and co-administration of remifentanil in target-controlled propofol and remifentanil anesthesia are the most common methods in clinical practice. However, anesthesia induction time by timing remifentanil administration was not identified. Therefore, we investigated the induction time of anesthesia based on type of remifentanil administration in target-controlled anesthesia. A total of 60 patients were randomly assigned to 1 of 2 groups: Pre-administered with remifentanil before propofol infusion (Group R, n = 30) and co-administered with remifentanil with propofol (Group N, n = 30). The primary outcome was total induction time based on the order of remifentanil administration. Secondary outcomes were from start of the propofol infusion time to loss of consciousness (LOC), rocuronium onset time, time to Bispectral index (BIS) 60, and hemodynamic variables. The mean ± SD of total induction time was 180.5 ± 49.0 s in Group N and 246.3 ± 64.7 s in Group R (mean difference: 65.8 seconds; 95% CI: 35.0-96.5 s, P < .01). Time to BIS 60 and rocuronium onset time were longer in the Group R (P < .01 and P < .01, respectively). The Δheart rate and Δcardiac output values were lower in the Group R (P = .02 and P = .04, respectively). Injection pain was reported by 11 of 28 (39%) in the Group N and in 2 of 28 (7%) in the Group R (difference in proportion: 32%, 95% CI: 10-51%, P = .01). Pre-administration of remifentanil in target-controlled propofol and remifentanil anesthesia prolongs total induction time about 35% compared to co-administration of remifentanil and propofol by decreased CO.


Reduced Mucosa-associated Butyricicoccus Activity in Patients with Ulcerative Colitis Correlates with Aberrant Claudin-1 Expression.
Butyricicoccus is a butyrate-producing clostridial cluster IV genus whose numbers are reduced in the stool of ulcerative colitis [UC] patients. Conditioned medium of Butyricicoccus [B.] pullicaecorum prevents tumour necrosis factor alpha [TNFα]-induced increase in epithelial permeability in vitro. Since butyrate influences intestinal barrier integrity, we further investigated the relationship between the abundance of mucosa-associated Butyricicoccus and the expression of butyrate-regulated tight junction [TJ] genes. Tight junction protein 1 [TJP1], occludin [OCLN], claudin-1 [CLDN1], and Butyricicoccus 16S rRNA expression was analysed in a collection of colonic biopsies of healthy controls and UC patients with active disease. The effect of butyrate and B. pullicaecorum conditioned medium on TJ gene expression was investigated in TNFα-stimulated Caco-2 monolayers and inflamed mucosal biopsies of UC patients. TJP1 expression was significantly decreased in inflamed UC mucosa, whereas CLDN1 mRNA levels were increased. OCLN did not differ significantly between the groups. Mucosa-associated Butyricicoccus 16S rRNA transcripts were reduced in active UC patients compared with healthy controls. Interestingly, Butyricicoccus activity negatively correlated with CLDN1 expression. Butyrate reversed the inflammation-induced increase of CLDN1 protein levels, and stimulation of inflamed UC biopsies with B. pullicaecorum conditioned medium normalized CLDN1 mRNA levels. Butyricicoccus is a mucosa-associated bacterial genus under-represented in colonic mucosa of patients with active UC, whose activity inversely correlates with CLDN1 expression. Butyrate and B. pullicaecorum conditioned medium reduce CLDN1 expression, supporting its use as a pharmabiotic preserving epithelial TJ integrity.


Electrical stimulation of several limbic areas suppressed the growth hormone (GH) release induced by human pancreatic GH-releasing factor in pentobarbital-anesthetized rats.
The present study was designed to clarify the topography in the limbic system related to the suppression of GH release induced by iv injected human pancreatic GH-releasing factor (hpGRF) in pentobarbital-anesthetized rats. Bipolar concentric stimulating electrodes were implanted in certain limbic areas 1 week before the stimulation. Under pentobarbital anesthesia, 10 micrograms hpGRF dissolved in 0.3 ml saline were injected iv, which increased the plasma GH level from 19.8 +/- 3.6 (mean +/- SE) to 846.0 +/- 40.5 ng/ml in 10 min. After the plasma GH level showed its highest value (at 10 min), it gradually decreased to 30.5 +/- 3.0 ng/ml by 60 min. This hpGRF-induced response was suppressed by the electrical stimulation (for the first 10 min) of the medial amygdaloid nucleus (Me), the lateral septum, or the bed nucleus of the stria terminalis. The inhibition rate ranged between 31.9-42.4% of control at 10 min. This inhibition was abolished by prior lesion of the periventricular nucleus of the hypothalamus, where the somatostatinergic nerve terminals in the median eminence originate. Sectioning the stria terminalis also abolished the inhibitory effect of GH release due to Me stimulation. The electrical stimulation of other amygdaloid nuclei or of the medial septum exerted no inhibitory effect on hpGRF-induced GH release. These results indicate that stimulation of the Me, the lateral septum, or the bed nucleus of the stria terminalis exerts an inhibitory effect on GH release, and the periventricular nucleus of the hypothalamus and the stria terminalis (in the case of Me stimulation) are important for this inhibitory effect.


Similarities and differences in the propagation of slow waves and peristaltic waves.
The relationship between slow waves and peristaltic reflexes has not been well analyzed. In this study, we have recorded the electrical activity of slow waves together with that generated by spontaneous peristaltic contractions at 240 extracellular sites simultaneously. Recordings were made from five isolated tubular and six sheet segments of feline duodenum superfused in vitro. In all preparations, slow waves propagated as broad wave fronts along the longitudinal axis of the preparation in either the aborad or the orad direction. Electrical potentials recorded during peristalsis (peristaltic waves) also propagated as broad wave fronts in either directions. Peristaltic waves often spontaneously stopped conducting (46%), in contrast to slow waves that never did. Peristaltic waves propagated at a lower velocity than the slow waves (0.98 +/- 0.25 and 1.29 +/- 0.28 cm/s, respectively; P < 0.001; n = 24) and in a direction independent of the preceding slow wave direction (64% in the same direction, 46% in the opposite direction). In conclusion, slow waves and peristaltic waves in the isolated feline duodenum seem to constitute two separate electrical events that may drive two different mechanisms of contraction in the small intestine.


Which behaviour change techniques are associated with interventions that increase physical activity in pre-school children? A systematic review.
Insufficient physical activity (PA) is a significant risk factor that contributes to several health problems and there is a need to improve our understanding of how to increase PA, particularly among young children. This review (PROSPERO registration: CRD42022328841) investigated the relationship between behaviour change techniques (BCTs) and interventions that increased PA among pre-school children aged < 6 years old. Systematic searches of six databases were undertaken from inception to July 2022, updated in December 2022, to locate studies that evaluated interventions and reported a positive change in PA levels in children aged < 6 years old. A total of 5,304 studies were screened, and 28 studies involving 10,605 subjects aged 2.5 to 5.9 years met the eligibility criteria. Each eligible study (n = 28) was independently appraised by two researchers using the Cochrane risk of bias tool. The BCT Taxonomy v1 and the Template for Intervention Description and Replication (TIDieR) guided the extraction and analysis of data, and this process led to the identification of 27 BCTs. Potentially promising BCTs for increasing PA among young children included 'shaping knowledge,' 'antecedents,' 'goals and planning,' and 'comparison of behaviour.' Future PA interventions that target young children should consider integrating these promising BCTs into their programmes. However, such consideration needs to be tempered by the fact that most of the reviewed studies were deemed to have a high or unclear risk of bias and/or were limited with respect to the populations that they targeted. Further research using rigorous methodologies is required to establish a higher standard that addresses the needs of young children who are expected to have insufficient levels of physical activity.


Cellular Uptake and Tissue Biodistribution of Functionalized Gold Nanoparticles and Nanoclusters.
In this study, the in vitro uptake by fibroblasts and in vivo biodistribution of 15 nm 11-mercaptoundecanoicacid-protected gold nanoparticles (AuNPs-MUA) and 3 nm glutathione- and 3 nm bovine serum albumin-protected gold nanoclusters (AuNCs@GSH and AuNCs@BSA, respectively) were evaluated. In vitro cell viability was examined after gold nanoparticle treatment for 48 h, based on MTT assays and analyses of morphological structure, the cycle cell, cellular doubling time, and the gold concentration in cells. No potential toxicity was observed at any studied concentration (up to 10 ppm) for AuNCs@GSH and AuNCs@BSA, whereas lower cell viability was observed for AuNPs-MUA at 10 ppm than for other treatments. Neither morphological damage nor modifications to the cell cycle and doubling time were detected after contact with nanoparticles. Associations between cells and AuNPs and AuNCs were demonstrated by inductively coupled plasma mass spectrometry (ICP-MS). AuNCs@GSH exhibited fluorescence emission at 611 nm, whereas AuNCs@BSA showed a band at 640 nm. These properties were employed to confirm their associations with cells by fluorescence confocal microscopy; both clusters were observed in cells and maintained their original fluorescence. In vivo assays were performed using 9 male mice treated with 1.70 μg Au/g body weight gold nanoparticles for 24 h. ICP-MS measurements showed a different biodistribution for each type of nanoparticle; AuNPs-MUA mainly accumulated in the brain, AuNCs@GSH in the kidney, and AuNCs@BSA in the liver and spleen. Spleen indexes were not affected by nanoparticle treatment; however, AuNCs@BSA increased the thymus index significantly from 1.28 to 1.79, indicating an immune response. These nanoparticles have great potential as organ-specific drug carriers and for diagnosis, photothermal therapy, and imaging.


Distinct patterns of lymphokine requirement for the proliferation of various subpopulations of activated thymocytes in a single cell assay.
The frequency and capacity for clonal expansion of several murine thymocyte subpopulations responsive to various IL (fetal day 15, and adult CD4-8-, CD4+8- and CD4-8+) were investigated using a single-cell limiting-dilution cell culture system without filler cells. This assay requires the presence of PMA and ionomycin. The main conclusions of these studies are the following: 1) IL-4 is a better growth factor than IL-2 for immature thymocytes (fetal day 15 or adult CD4-8-). 2) IL-2 is a better growth factor than IL-4 for mature phenotype thymocytes (CD4+8- and CD4-8+). 3) IL-4 is a relatively poor growth factor for adult CD4-CD8- thymocytes and CD4+CD8- thymocytes, while it induced strong responses in fetal day 15 and CD4-8+ thymocytes. 4) IL-6 enhanced the response of CD4+8- thymocytes to either IL-2 or IL-4. 5) Cortisone-resistant thymocytes grown initially with IL-4 and then switched to IL-2 showed a significant decrease in cloning efficiency. No inhibitory effect was observed when cells were cultured first with IL-2 and then switched to IL-4. 6) Finally, supernatant from Con-A stimulated rat spleen cells induced maximal growth of all adult thymocyte populations tested, suggesting that unidentified thymocyte growth factor(s) remain to be characterized. These results indicate that the maturational stage of thymocytes determines their requirements for activation and proliferation.


Elongated hindguts in desert-living dung beetles (Scarabaeidae: Scarabaeinae) feeding on dry dung pellets or plant litter.
Most adult dung beetles (Scarabaeidae: Scarabaeinae) feed on fresh, wet dung of larger herbivorous or omnivorous mammals. As refractory plant fragments are selected out before ingestion, the food is presumed easily digestible. However, members of the desert-living scarabaeine genus Pachysoma (probably evolved from an ancestor closely related to the wet-dung feeding genus Scarabaeus) select dry dung pellets and/or plant litter. Thus, they ingest a much higher proportion of structural plant material, which nevertheless appears to be digested rather efficiently. This study investigates morphological modifications of the gut for this digestion in adults of eight Pachysoma species, both pellet and litter feeders. To ascertain hypothesized ancestral conditions, four fresh-dung feeding Scarabaeus species were also examined. The latter have the usual dung beetle gut consisting of a long, simple midgut, followed by an equally simple, much shorter hindgut of the same width. Lengths of midguts (M) and hindguts (H) divided by body length (B) for comparison between species of different size are: 4.9-6.3 (M/B) and 0.7-0.8 (H/B), which is normal for dung feeders. In Pachysoma, lengths are 6.3-6.5 (M/B) and 1.0-1.4 (H/B) in pellet feeders, and 4.4-5.0 (M/B) and 2.0-2.5 (H/B) for litter feeders. Hindguts are still morphologically undifferentiated and of midgut width, but clearly longer, particularly in litter feeders. Presumably, plant fragments in the food are digested, at least partly, in the hindgut. If so, the morphological adaptation is unusual: simple elongation rather than the expansion of part of the hindgut, as found in several other plant- or detritus-feeding scarabaeids.


Altered energy balance may account for growth failure in Rett syndrome.
To determine whether alterations in energy balance account for growth failure in Rett syndrome, we measured dietary energy intakes, fecal fat losses, activity patterns, and sleeping as well as quietly and actively awake metabolic rates in Rett syndrome girls and healthy controls. Dietary energy intakes and fecal fat losses did not differ between the groups. Metabolic rates while sleeping and quietly awake were 23% lower (P < .05) in Rett syndrome girls than in controls; metabolic rates while actively awake did not differ between the groups. However, because of the 2.4-fold greater time (P < .001) spent in involuntary motor movement, energy expenditure associated with activity was twofold greater (P < .05) in Rett syndrome girls than in controls. Although total daily energy expenditure of the two groups did not differ significantly, energy balance was less positive in the Rett syndrome girls than in the controls. This small difference in energy balance, if sustained over months to years, is sufficient to account for growth failure in Rett syndrome girls.


Optimizing intermittent reaction paths.
Various examples of biochemical reactions in cells, such as DNA/protein interactions, reveal that in extremely diluted regimes reaction paths are not always simple brownian trajectories. They can rather be qualified as intermittent, since they combine slow diffusion phases on one hand and a second mode of faster transport on the other hand, which can be either a faster diffusion mode, as in the case of DNA-binding proteins, or a ballistic mode powered by molecular motors in the case of intracellular transport. In this article, we introduce simple theoretical models which permit to calculate explicitly the reaction rates for reactions limited by intermittent transport. This approach shows quantitatively that intermittent reaction pathways are actually very efficient, since they permit to significantly increase the reaction rates, which could explain why they are observed so often. Moreover, we give theoretical arguments which suggest that intermittent transport could also be useful for in vitro chemistry. Indeed, we show that intermittent transport naturally pops up in the context of reaction at interfaces, where reactants combine surface diffusion phases and bulk excursions, and could permit to enhance reactivity. In this case, adjusting chemically the affinity of reactants with the interface makes possible to optimize the reaction rate.


Review article: Left ventricular dysfunction and heart failure in metabolic syndrome and diabetes without overt coronary artery disease--do we need to screen our patients?
The metabolic syndrome and its components, glucose intolerance, T2DM, hypertension, dyslipidaemia and obesity are increasingly common. Patients with the metabolic syndrome have a higher prevalence of chronic heart failure (CHF) and, once diagnosed, CHF in such subjects is associated with a higher mortality than in those without this co-morbidity. However, early diagnosis of LV systolic dysfunction and symptomatic heart failure may prevent deterioration of heart failure and improve prognosis. The aim of this article is to summarise the prevalence of CHF in people with obesity, hypertension and T2DM, and to review how each co-morbid condition might predispose to and complicate the clinical diagnosis of CHF.


Red blood cell transfusion independence following the initiation of iron chelation therapy in myelodysplastic syndrome.
Iron chelation therapy is often used to treat iron overload in patients requiring transfusion of red blood cells (RBC). A 76-year-old man with MDS type refractory cytopenia with multilineage dysplasia, intermediate-1 IPSS risk, was referred when he became transfusion dependent. He declined infusional chelation but subsequently accepted oral therapy. Following the initiation of chelation, RBC transfusion requirement ceased and he remained transfusion independent over 40 months later. Over the same time course, ferritin levels decreased but did not normalize. There have been eighteen other MDS patients reported showing improvement in hemoglobin level with iron chelation; nine became transfusion independent, nine had decreased transfusion requirements, and some showed improved trilineage myelopoiesis. The clinical features of these patients are summarized and possible mechanisms for such an effect of iron chelation on cytopenias are discussed.


The effect of animated diagrams on the understanding of a mathematical demonstration in 11- to 14-year-old pupils.
One hundred and eight children from 11 to 14 years were given instruction on shears and rotations, and how these transformations could be used to show the truth of Pythagoras's Theorem. The experimental group, which saw a computer-presented animated display of the transformations, scored more highly on a subsequent test than either of two control groups, the first of which saw no computer at all, but only a diagram sheet which was in the possession of all the children. The second control group saw a computer-presented display which showed only the same ten discrete stages of the transformations as the diagram sheet. It was concluded that animation per se can facilitate the understanding of a mathematical task.


Subtyping of Campylobacter jejuni Penner serotypes 9, 38 and 63 from human infections, animals and water by pulsed field gel electrophoresis and flagellin gene analysis.
Pulsed field gel electrophoresis and PCR-RFLP flagellin gene profiling were used to discriminate 44 isolates of Campylobacter jejuni Penner heat stable (HS) serotypes 9, 38 and 63 from sporadic human infections and other sources. Genomic similarities between HS9 and HS38 strains were demonstrated. HS63 and HS1 strains of Camp. jejuni ssp. jejuni were similar but were genomically distinct from Camp. jejuni ssp. doylei HS63. The molecular analyses provided a basis for assessing associations between cross-agglutinating strains of Camp. jejuni and for subtyping within those serogroups.


Compliance with Recommended Practices for Management of Controlled Substances in a Health Care Facility and Corrective Actions.
Pharmacists are required to maintain a secure inventory of medications and to ensure proper, safe, and diversion-free dispensing practices. The primary objectives of this study were to determine compliance with recommended practices for the management of controlled substances in a mother-child teaching hospital and to identify actions to improve compliance. The secondary objective was to identify steps in the drug pathway for controlled substances and associated failure modes in the study hospital. This descriptive cross-sectional study used a framework developed by the California Hospital Association (CHA) to assess compliance with recommended practices for the management of controlled substances in hospitals. For each criterion, a research assistant observed practices within the pharmacy, on patient care units, at outpatient care clinics, and in operating and delivery rooms. The level of compliance was recorded as compliant, partially compliant, or noncompliant. An Ishikawa diagram was developed to illustrate steps in the drug pathway and associated failure modes related to the use of controlled substances in the study hospital. The pathway for controlled substances at the study hospital was compliant for 56 (49.6%) of the 113 CHA criteria, partially compliant for 27 (23.9%) of the criteria, and noncompliant for 24 (21.2%) of the criteria; the remaining 6 (5.3%) criteria were not applicable. This practice evaluation highlighted 22 corrective actions, 12 (55%) that could be implemented in the short term, 8 (36%) suitable for implementation in the medium term, and 2 (9%) suitable for both the short and medium term. A total of 57 potential failure modes related to the use of controlled substances were identified. The pathway for controlled substances at the study hospital was compliant with almost half of the CHA criteria, and 22 corrective actions were identified. Pharmacists, physicians, and nurses should be mobilized to optimize the use of controlled substances throughout the drug-use process.


Liver Sinusoidal Endothelial Cells.
The liver sinusoidal endothelial cell (LSEC) forms the fenestrated wall of the hepatic sinusoid and functions as a control post regulating and surveying the trafficking of molecules and cells between the liver parenchyma and the blood. The cell acts as a scavenger cell responsible for removal of potential dangerous macromolecules from blood, and is increasingly acknowledged as an important player in liver immunity. This review provides an update of the major functions of the LSEC, including its role in plasma ultrafiltration and regulation of the hepatic microcirculation, scavenger functions, immune functions, and role in liver aging, as well as issues that are either undercommunicated or confusingly dealt with in the literature. These include metabolic functions, including energy metabolic interplay between the LSEC and the hepatocyte, and adequate ways of identifying and distinguishing the cells.


Structure and diversity of mycorrhizal fungi communities of different part of Bulbophyllum tianguii in three terrestrial environments.
Mycorrhizal fungi plays important roles in the seed germination and subsequent growth of orchids. The research of fungi in orchid roots, especially dominant mycorrhizal fungi is critical for orchids protection. In this study, the fungal community and composition of mycorrhizal fungi in roots, rhizomes and rhizosphere soil of Bulbophyllum tianguii grown in three terrestrial environments were analyzed by the second generation sequencing technology. The results of OTU clustering and α and β diversity analysis showed that there were significant differences in fungal communities in roots, rhizomes and rhizosphere soil of B. tianguii. The total number of OTUs in rhizomes was much less than that in roots and rhizosphere soil. The number of OTUs in rhizosphere soil and the diversity of mycorrhizal fungi were the highest. Meanwhile, the species and abundance of mycorrhizal fungi in roots and rhizomes of B. tianguii were different from those in rhizosphere soil. For different elevations, compared with B. tianguii that grow in middle of Tiankeng and top of Tiankeng, the OTUs number of B. tianguii in orchid garden is richest, and the diversity of mycorrhizal fungi in orchid garden was significantly higher than other locations. Among the three different habitats of B. tianguii, the number of OTUs in humus soil and stone habitats was notably higher than tree habitats, and the diversity of mycorrhizal fungi in humus soil was the highest. The analysis of mycorrhizal fungi in different habitats and altitudes of B. tianguii showed that Sebacina and Exophiala were the dominant mycorrhizal fungi in B. tianguii. The results of species annotation, phylogenetic tree and co-occurrence network analysis showed the dominant mycorrhizal fungi of B. tianguii mainly included Sebacina, Cladosporium, Exophiala, Fusarium. This study reveals the symbiotic relationship between Sebacina, Exophiala, Cladosporium and the B. Tianguii. It will provide a theoretical basis for the protection and biological function study of B. Tianguii.


A case of gastric-type adenoma with chief cell and parietal cell differentiation surrounded by complete intestinal metaplasia.
A man in his 70s received Helicobacter pylori eradication therapy after endoscopic submucosal dissection (ESD) of the stomach. A small, yellowish, protuberant lesion was later observed on the anterior wall of the lower body of the stomach on surveillance esophagogastroduodenoscopy. Narrow band imaging-magnified endoscopy showed an irregular pit and net-like vascular pattern, with the background mucosa having a light blue crest pattern. A biopsy was performed, which led to a diagnosis of adenoma with a gastric phenotype, so repeat ESD was performed. The freshly resected specimen showed a small, protuberant, flat lesion with a clear margin, and hematoxylin and eosin staining showed mild architectural and nuclear atypia. The shape of the atypical gland was similar to that of a fundic gland. MUC5AC, MUC6, pepsinogen A, and H+/K+ ATPase expressions were positive, and CD10 expression was negative, indicating that this tumor could not only differentiate to mucous neck cells but also to chief cells, parietal cells and foveolar epithelium. Therefore, this 4-mm tumor was diagnosed as a type 0-IIa tubular adenoma with fundic gland differentiation. The background mucosa showed complete intestinal metaplasia. Traditionally, gastric-type adenoma has been defined as the pyloric gland-type, but our case had a fundic gland phenotype. Therefore, a new fundic-gland adenoma subtype should be considered in this case.


Making a choice of catheterisation gel and the role of chlorhexidine.
It is estimated that over 90 000 people in the UK community live with an indwelling catheter ( Wilson, 2016 ). It is essential that a lubricating gel is used during catheterisation, as this helps to reduce the risk of pain, trauma and infection ( Loveday et al, 2014 ; National Institute for Health and Care Excellence, 2012 ). Chlorhexidine is an antiseptic contained in many catheterisation gels. Evidence demonstrates that increasing numbers of patients are experiencing hypersensitivity reactions to this ingredient ( Australian and New Zealand College of Anaesthetists, 2014 ). This article considers the range of catheterisation gel choices available to clinicians and the importance of selecting the correct gel for each patient. It addresses the benefits of using OptiLube Active CHG Free (with lidocaine 2%) - the only catheterisation gel currently available in the UK that contains the benefits of local anaesthetic without chlorhexidine - and recommends that this should be the gel of choice for non-specialist staff conducting catheterisations without individual patient assessments.


Anticancer effect of fucoidan on cell proliferation, cell cycle progression, genetic damage and apoptotic cell death in HepG2 cancer cells.
The centre of the attraction of this article is inevitably associated with fucoidan polymers in terms of brown seaweed such as Turbinaria conoides. Fucoidan is a sulphated polysaccharide constitutes fucose as a major principle sugar along with other monosugars such as glucuronic acid, xylose and galactose. The core value of fucoidan in terms of various cancer types were substantially exhibited through targeting the key apoptotic molecules and subsequently mitigate the toxicity that are essentially included in the chemotherapeutic agents and radiation. The pragmatic investigation about the anti-cancer effect of fucoidan in a hepatoblastoma-derived (HepG2) cell line was thoroughly analyzed by the typical techniques such as cell viability, colony formation, cell migration, cell cycle progression, genetic damage and apoptosis along with their nuclear morphology and mitochondrial membrane potential. Following the analyzes, the cell viability was precisely evaluated by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay. And hence, cell cycle arrest and apoptosis was appropriately examined staining with propidium iodide (PI) and annexin V-fluorescein isothiocyante (FITC) by flowcytometer, respectively. Primarily, genetic damage by fucoidan in HepG2 cell line was evaluated by following Trevigen's comet assay kit. In addition, alteration of nuclear content and mitochondrial membrane potential were also detected with Hoechst and mitochondrial membrane potential dye (JC-1: 5,5'6,6'-tetrachloro-1,1'3,3'tetraethylbenzimi-dazolycarbocyanine iodide) by fluorescence microscopy, respectively. The results of the present study showed that cells constituted with fucoidan/quercetin standard at 50, 100 and 200 μg/ml exhibited cell viability about 71, 60 & 40/80, 65 & 45%, respectively. The above recorded effect of fucoidan was a concentration-dependant inhibition on the basis of decline in colony forming and cell migration potential of HepG2 cancer cells. Compared with untreated control, fucoidan consituted cells were significantly (p ≤ 0.05) accumulated proliferative cells in the G0/G1 phase of the cell cycle in a concentration dependent manner. Increasing concentration of fucoidan (50,100 and 200 μg/ml) was remarkably enhanced the DNA damage which reflected through tail moment value of 3.8, 7.1 & 12.8 folds with respect to the untreated control. Fucoidan induced total apoptotic cells were observed ∼20-40% at 50-200 μg/ml concentrations. The apoptotic cell formation effected by change in the nuclear content and mitochondrial membrane potential was confirmed in HepG2 cancer cells under fluorescence microscopy. It was eventually concluded that the fucoidan display promising anti-cancer activity against HepG2 cancer cells by promoting the inhibition of cell proliferation, migration and cell arrest on concentration dependent-manner that was well correlated with genetic damage and apoptosis.


Effect of amantadine in essential tremor: a randomized, placebo-controlled trial.
There is a need for new medication for essential tremor (ET). Preliminary evidence suggests that amantadine may be effective in the treatment of ET. We studied the effects of amantadine in a double-blind, cross-over, placebo-controlled trial in ET patients. Sixteen patients with ET received amantadine 100 mg b.i.d. and placebo for 15 days, with a 1-week wash-out period between treatments. Major evaluation outcomes consisted of a tremor clinical rating scale, accelerometric recordings, and a self-reported disability scale obtained before drug intake and on study days 1 and 15 of each treatment period. A two-way repeated measures analysis of variance (treatment, time) was applied. Any P value < 0.05 was considered significant. On day 15, amantadine did not demonstrate any significant efficacy in reducing tremor with respect to baseline in any tremor measures. An increase in postural tremor as an adverse effect of amantadine was referred by 37.5% of patients. Results from the present trial indicate amantadine at 100 mg b.i.d. is not effective as a treatment for ET.


Flavonoid ampelopsin inhibits the growth and metastasis of prostate cancer in vitro and in mice.
The objective of this study was to evaluate the chemopreventive effect of a novel flavonoid, ampelopsin (AMP) on the growth and metastasis of prostate cancer cells. AMP showed the more potent activity in inhibiting the proliferation of androgen-sensitive LNCaP and, to less extent, androgen-independent PC-3 human prostate cancer cell lines in vitro, primarily by induction of apoptosis associated with down-regulation of bcl-2. On the other hand, AMP showed much less activity in inhibiting the proliferation of normal prostate epithelial cells than that of prostate cancer cell lines. AMP also inhibited the migration and invasion of PC-3 cells in vitro associated with down-regulation of CXCR4 expression. In the animal study using an orthotopic prostate tumor model, AMP (150 and 300 mg/kg body weight) inhibited the growth of PC-3 tumors and lymph node and lung metastases in a dose-dependent manner. Compared to the control mice, mice treated with AMP at 300 mg/kg BW had reduced final tumor weight by 49.2% (P<0.05), lymph node metastases by 54.5% (P = 0.3) and lung metastases by 93% (P<0.05), but had no apparent alteration on food intake or body weight. The in vivo anti-growth and anti-metastasis activities of AMP were associated with induction of apoptosis and inhibition of proliferation of prostate cancer cells, reduction of prostate tumor angiogenesis, and reduction of CXCR4 expression. Our results provide supporting evidence to warrant further investigation to develop AMP as a novel efficacious and safe candidate agent against progression and metastasis of prostate cancer.


Ultrasonographic findings identifying the faecal-impacted appendix: differential findings with acute appendicitis.
The aim of this study was to identify ultrasonographic findings that show the normal faecal-impacted appendix, in order to avoid unnecessary surgery via a misdiagnosis of acute appendicitis. Of 160 patients who underwent ultrasonography between January 2004 and July 2005 for right lower quadrant pain, 22 cases (including 7 cases confirmed pathologically and 15 confirmed clinically and on follow-up ultrasonography) were diagnosed as a normal faecal-impacted appendix. The criteria that we used to distinguish a faecal-impacted appendix from acute appendicitis include preservation of the normal wall layering of the appendix, maximum mural thickness, presence of peri-appendiceal fat infiltration and increased blood flow in the appendiceal wall. The maximum measured outer diameter of a normal faecal-impacted appendix was 0.54-1.03 cm, with a mean diameter of 0.68 cm. The maximum mural thickness ranged from 0.08 cm to 0.26 cm, with a mean thickness of 0.15 cm. The normal wall layers of the appendix were preserved and no evidence was seen of peri-appendiceal fat infiltration in any case. No demonstrably increased blood flow in the appendiceal wall was observed. In conclusion, faecal impaction increases the outer transverse diameter of the normal appendix, frequently leading to a misdiagnosis of acute appendicitis. Recognition of preservation of the normal layering of the appendiceal wall, smaller maximal outer diameter, thinner maximal mural thickness, the absence of peri-appendiceal mesenteric infiltration and no demonstrably increased blood flow in the appendiceal wall should help to prevent unnecessary surgery.


Cone photoreceptor macular function and recovery after photostress in early non-exudative age-related macular degeneration.
To identify parameters from cone function and recovery after photostress that detect functional deficits in early non-exudative age-related macular degeneration (AMD) and to determine the repeatability of these parameters. Cone-mediated visual function recovery after photostress was examined in three groups of subjects: young normal subjects (ages 20-29; N=8), older normal subjects (ages 50-90; N=9), and early non-exudative AMD subjects (ages 50-90; N=12). Eight AMD and four normal subjects were retested 1 year after the initial evaluation. Early Treatment Diabetic Retinopathy Study (ETDRS) visual acuity (VA) and parameters of cone function (baseline cone sensitivity and cone recovery half-life following photobleach) were measured and compared between AMD and normal subjects. Short-term repeatability was assessed for each subject's initial evaluation. Long-term repeatability was assessed by comparing outcomes from the initial evaluation and 1-year follow-up. The mean baseline cone threshold was significantly worse in subjects with early AMD compared to older normal subjects (-1.80±0.04 vs -1.57±0.06 log cd/m2p=0.0027). Moreover, the baseline cone threshold parameter exhibited good short-term (intraclass correlation coefficient [ICC]=0.88) and long-term (ICC=0.85) repeatability in all subjects. The cone intercept parameter and ETDRS VA were not significantly different between AMD and older normal subject groups. Cone recovery half-life was significantly different between older normal and AMD subject groups (p=0.041). Neither ETDRS VA nor cone function parameters were significantly different for any group at the 1-year follow-up. The baseline cone threshold shows potential as a novel parameter to assess visual dysfunction in early AMD. This outcome consistently detected deficits in AMD subjects, and differentiated them from age-matched controls with high test-retest repeatability.


PAI1: a novel PP1-interacting protein that mediates human plasma's anti-apoptotic effect in endothelial cells.
Activation of apoptotic signalling in endothelial cells contributes to the detrimental effects of a variety of pathological stimuli. In investigating the molecular events underlying the anti-apoptotic effect of human plasma in cultured human endothelial cells, we unexpectedly uncovered a novel mechanism of apoptosis suppression by human plasma through an interaction between two previously unrelated proteins. Human plasma inhibited hypoxia-serum deprivation-induced apoptosis and stimulated BADS136 and AktS473 phosphorylation. Akt1 silencing reversed part (~52%) of the anti-apoptotic effect of human plasma, suggesting the existence of additional mechanisms mediating the anti-apoptotic effect other than Akt signalling. Human plasma disrupted the interaction of BAD with protein phosphatase 1 (PP1). Mass spectrometry identified fourteen PP1-interacting proteins induced by human plasma. Notably, a group of serine protease inhibitors including plasminogen activator inhibitor 1 (PAI1), a major inhibitor of fibrinolysis, were involved. Silencing of PAI1 attenuated the anti-apoptotic effect of human plasma. Furthermore, combined Akt1 and PAI1 silencing attenuated the majority of the anti-apoptotic effect of human plasma. We conclude that human plasma protects against endothelial cell apoptosis through sustained BAD phosphorylation, which is achieved by, at least in part, a novel interaction between PP1 with PAI1.


The tardigrade Hypsibius exemplaris has the active mitochondrial alternative oxidase that could be studied at animal organismal level.
Mitochondrial alternative oxidase (AOX) is predicted to be present in mitochondria of several invertebrate taxa including tardigrades. Independently of the reason concerning the enzyme occurrence in animal mitochondria, expression of AOX in human mitochondria is regarded as a potential therapeutic strategy. Till now, relevant data were obtained due to heterologous AOX expression in cells and animals without natively expressed AOX. Application of animals natively expressing AOX could importantly contribute to the research. Thus, we decided to investigate AOX activity in intact specimens of the tardigrade Hypsibius exemplaris. We observed that H. exemplaris specimens' tolerance to the blockage of the mitochondrial respiratory chain (MRC) cytochrome pathway was diminished in the presence of AOX inhibitor and the inhibitor-sensitive respiration enabled the tardigrade respiration under condition of the blockage. Importantly, these observations correlated with relevant changes of the mitochondrial inner membrane potential (Δψ) detected in intact animals. Moreover, detection of AOX at protein level required the MRC cytochrome pathway blockage. Overall, we demonstrated that AOX activity in tardigrades can be monitored by the animals' behavior observation as well as by measurement of intact specimens' whole-body respiration and Δψ. Furthermore, it is also possible to check the impact of the MRC cytochrome pathway blockage on AOX level as well as AOX inhibition in the absence of the blockage on animal functioning. Thus, H. exemplaris could be consider as a whole-animal model suitable to study AOX.


The DAS28 in rheumatoid arthritis and fibromyalgia patients.
To compare the DAS28 (Disease Activity Score including a 28-joint count) values of rheumatoid arthritis (RA) and fibromyalgia (FM) patients, and to establish whether high pain levels and impaired mood influence DAS28 values. DAS28 values were calculated in 62 consecutive patients with RA and in 26 patients suffering from FM. Values for DAS28 scores as well as for the single items of the patient cohorts were compared using Student's t-tests. To evaluate the item weighting and internal consistency of the total score factor analysis was performed and Cronbach's alpha calculated. RA patients showed a mean DAS28 score of 4.23 (+/-1.2; range 0.77-7.46) and in FM patients the mean DAS28 came to 4.04 (+/-1.13; range 1.19-6.28). DAS28 values of RA and FM patients were not significantly different statistically. Comparing the single components of the score, however, highly significant differences (P<0.0005) occurred between RA and FM patients. Cronbach's alpha for the DAS28 in RA patients amounted to 0.7329, indicating high internal consistency, whereas in FM patients it was 0.4832. The DAS28, as expected, proved to be inappropriate to express disease activity in FM patients. DAS28 values for expressing disease activity in RA patients may be flawed by coexisting FM and should therefore be regarded with caution as high pain levels more than impaired mood may lead to higher total scores.


Integrated analysis of microRNA and mRNA expression profiles in HBx-expressing hepatic cells.
To identify the miRNA-mRNA regulatory network in hepatitis B virus X (HBx)-expressing hepatic cells. A stable HBx-expressing human liver cell line L02 was established. The mRNA and miRNA expression profiles of L02/HBx and L02/pcDNA liver cells were identified by RNA-sequencing analysis. Kyoto Encyclopedia of Genes and Genomes pathway enrichment analysis was performed to investigate the function of candidate biomarkers, and the relationship between miRNA and mRNA was studied by network analysis. Compared with L02/pcDNA cells, 742 unregulated genes and 501 downregulated genes were determined as differentially expressed in L02/HBx cells. Gene ontology analysis suggested that the differentially expressed genes were relevant to different biological processes. Concurrently, 22 differential miRNAs were also determined in L02/HBx cells. Furthermore, integrated analysis of miRNA and mRNA expression profiles identified a core miRNA-mRNA regulatory network that is correlated with the carcinogenic role of HBx. Collectively, the miRNA-mRNA network-based analysis could be useful to elucidate the potential role of HBx in liver cell malignant transformation and shed light on the underlying molecular mechanism and novel therapy targets for hepatocellular carcinoma.