A study of hospital and medical libraries in Riyadh, Kingdom of Saudi Arabia.
The study reported examined the status of hospital libraries, their sponsoring organizations, their staff, the academic qualifications of the head of the library, collection size, available space, buildings, and services. The study was limited to the hospitals with libraries for staff in Riyadh, the capital of Saudi Arabia. The data were collected through questionnaires sent to a sample of fifteen hospitals with medical libraries. Twelve libraries responded. This is the first study of its kind in Saudi Arabia, and it is hoped that similar surveys will be done covering the whole kingdom.


Enhanced amino acid selection in fully evolved tryptophanyl-tRNA synthetase, relative to its urzyme, requires domain motion sensed by the D1 switch, a remote dynamic packing motif.
We previously showed (Li, L., and Carter, C. W., Jr. (2013) J. Biol. Chem. 288, 34736-34745) that increased specificity for tryptophan versus tyrosine by contemporary Bacillus stearothermophilus tryptophanyl-tRNA synthetase (TrpRS) over that of TrpRS Urzyme results entirely from coupling between the anticodon-binding domain and an insertion into the Rossmann-fold known as Connecting Peptide 1. We show that this effect is closely related to a long range catalytic effect, in which side chain repacking in a region called the D1 Switch, accounts fully for the entire catalytic contribution of the catalytic Mg(2+) ion. We report intrinsic and higher order interaction effects on the specificity ratio, (kcat/Km)Trp/(kcat/Km)Tyr, of 15 combinatorial mutants from a previous study (Weinreb, V., Li, L., and Carter, C. W., Jr. (2012) Structure 20, 128-138) of the catalytic role of the D1 Switch. Unexpectedly, the same four-way interaction both activates catalytic assist by Mg(2+) ion and contributes -4.4 kcal/mol to the free energy of the specificity ratio. A minimum action path computed for the induced-fit and catalytic conformation changes shows that repacking of the four residues precedes a decrease in the volume of the tryptophan-binding pocket. We suggest that previous efforts to alter amino acid specificities of TrpRS and glutaminyl-tRNA synthetase (GlnRS) by mutagenesis without extensive, modular substitution failed because mutations were incompatible with interdomain motions required for catalysis.


[Anesthesia with epidural spinal cord stimulation--I). Its application to general anesthesia].
Epidural spinal cord stimulation (SCS) has been used for the relief of pain. We tried to apply SCS for general anesthesia. The subjects were 76 patients, undergoing thoracotomy (3 cases), thoraco-laparotomy (4), laparotomy (57) and others (12). A monopolar electrode was introduced to the epidural space via a Touhy needle. The conditions of the electrical stimulation were 12.5-50 Hz, 1.0 ms and 2-8 V. The voltage was adjusted to give comfortable sensation to the patients. After the electrode had been introduced, induction of anesthesia and tracheal intubation were performed with thiopental, diazepam and pancuronium or vecuronium. Anesthesia was maintained with nitrous oxide (70%-50%) and SCS. Nine patients inhaled low concentrations of enflurane in addition to nitrous oxide, and 39 patients received injection of vasodilators because of hypertension. All the patients were not awake during operation, and recovered their consciousness soon after the end of operations. SCS was continued for 17 hrs after operation. During 24 hrs after operation, 16 patients required no analgesics, 32 patients once and others twice or more. We conclude that SCS added to general anesthesia is useful to control pain, not only intraoperatively, but also postoperatively.


A uniform activated B-cell-like immunophenotype might explain the poor prognosis of primary central nervous system lymphomas: analysis of 83 cases.
Most primary central nervous system lymphomas (PCNSLs) in immunocompetent patients are diffuse large B-cell lymphomas (DLBCLs), characterized by poor prognosis, compared with systemic forms. A germinal center B-cell-like (GCB) origin of PCNSL was hypothesized on the basis of BCL-6 expression and ongoing mutational activity. Our goal herein was to determine, for 83 PCNSLs, the percentages of GCB and activated B-cell-like (ABC) phenotypes and their prognostic significance. CD10, BCL-6, MUM1, BCL-2, and CD138 antigens were immunohistochemically labeled on paraffin-embedded sections; the first 4 were positive in 2.4%, 55.5%, 92.6%, and 55.5% of the tumors, respectively. None of the 56 tested samples expressed CD138. Among the 82 patients with complete information, 79 (96.3%) were classified as ABC; 42 (51.2%) expressed BCL-6+ MUM1+, suggesting an "activated GCB" origin; 33 (40.2%) were exclusively MUM1+, and the remaining 4 (4.9%) were negative for all markers tested. These findings provide new insights into interpreting the poor PCNSL prognostic, which may, in part, be due to biologic aggressiveness associated with its activated B-cell-like pattern. We postulate assigning PCNSL a histogenetic "time-slot," overlapping late GC and early post-GC, that could explain the predominant ABC phenotype observed.


The face of bimodal bilingualism: grammatical markers in American Sign Language are produced when bilinguals speak to English monolinguals.
Bimodal bilinguals, fluent in a signed and a spoken language, provide unique insight into the nature of syntactic integration and language control. We investigated whether bimodal bilinguals who are conversing with English monolinguals produce American Sign Language (ASL) grammatical facial expressions to accompany parallel syntactic structures in spoken English. In ASL, raised eyebrows mark conditionals, and furrowed eyebrows mark wh-questions; the grammatical brow movement is synchronized with the manual onset of the clause. Bimodal bilinguals produced more ASL-appropriate facial expressions than did nonsigners and synchronized their expressions with the onset of the corresponding English clauses. This result provides evidence for a dual-language architecture in which grammatical information can be integrated up to the level of phonological implementation. Overall, participants produced more raised brows than furrowed brows, which can convey negative affect. Bimodal bilinguals suppressed but did not completely inhibit ASL facial grammar when it conflicted with conventional facial gestures. We conclude that morphosyntactic elements from two languages can be articulated simultaneously and that complete inhibition of the nonselected language is difficult.


The Effects of Recovery Sleep on Experimental Pain.
Recent research suggests that recovery sleep (RS) has the potential to restore pain sensitivity and modulation after hyperalgesia due to preceding sleep deprivation. However, it has not yet been systematically examined whether the restoration of these pain parameters is driven by sleep characteristics of RS. Thus, the present study assessed changes in experimental pain during RS after total sleep deprivation (TSD) to test whether RS parameters predicted the restoration of the pain system. Thirty healthy participants completed one night of habitual sleep, one night of TSD and a subsequent recovery night. At-home sleep during baseline and recovery was assessed using portable polysomnography and a questionnaire. Before and after each night pressure pain thresholds (PPTs), temporal pain summation (TSP) and conditioned pain modulation (CPM) were assessed. PPTs decreased after TSD and increased following RS, indicating a restoration of pain sensitivity after hyperalgesia. RS characteristics did not predict this restoration, suggesting other mechanisms (eg, changes in serotonergic activity) underlying the observed pain changes. TSP indicated a lack of effect of experimental sleep manipulations on excitatory processes whereas CPM lacked sufficient reliability to investigate inhibitory processes. Thus, results indicate moderate effects of sleep manipulations on pain sensitivity, but not on pain modulation. PERSPECTIVE: This article highlights the potential of recovery sleep to let pain thresholds return to normal following their decrease after a night of total sleep deprivation. In contrast, endogenous pain modulation (temporal pain summation, conditioned pain modulation) was not affected by sleep deprivation and recovery sleep.


Progressive compressive myelopathy induced by a rare primary isolated thoracic vertebral hydatid cyst: A case report.
Hydatid cyst is a disease caused by the larvae of Echinococcus spp. The larvae often reside in the liver, lungs, and brain. Occasionally, a primary isolated thoracic vertebral hydatid cyst is reported to cause severe complications. Various diseases may lead to the development of progressive compressive myelopathy. Herein, we report a rare case of a primary isolated thoracic vertebral hydatid cyst with compressive myelopathy. A 57-year-old female had numbness and weakness in the lower limbs for a span of 3-months. Thoracic magnetic resonance imaging (MRI) showed that an isolated mass was observed in the T5 vertebral body, which compressed the spinal cord. The diagnosis was confirmed after surgical excision, and Echinococcus granulosus was found to be the etiologic factor. The patient underwent laminectomy with no complications. After surgical decompression, the patient made slow and measurable progress. While relatively rare in the non-pastoral area, the primary isolated thoracic vertebral column hydatid cyst may be considered as a possible etiology of atypical extradural spinal compression. This case illustrates the complexity of spinal echinococcosis manifestations and the necessity of an interdisciplinary approach.


Retinal image analysis: concepts, applications and potential.
As digital imaging and computing power increasingly develop, so too does the potential to use these technologies in ophthalmology. Image processing, analysis and computer vision techniques are increasing in prominence in all fields of medical science, and are especially pertinent to modern ophthalmology, as it is heavily dependent on visually oriented signs. The retinal microvasculature is unique in that it is the only part of the human circulation that can be directly visualised non-invasively in vivo, readily photographed and subject to digital image analysis. Exciting developments in image processing relevant to ophthalmology over the past 15 years includes the progress being made towards developing automated diagnostic systems for conditions, such as diabetic retinopathy, age-related macular degeneration and retinopathy of prematurity. These diagnostic systems offer the potential to be used in large-scale screening programs, with the potential for significant resource savings, as well as being free from observer bias and fatigue. In addition, quantitative measurements of retinal vascular topography using digital image analysis from retinal photography have been used as research tools to better understand the relationship between the retinal microvasculature and cardiovascular disease. Furthermore, advances in electronic media transmission increase the relevance of using image processing in 'teleophthalmology' as an aid in clinical decision-making, with particular relevance to large rural-based communities. In this review, we outline the principles upon which retinal digital image analysis is based. We discuss current techniques used to automatically detect landmark features of the fundus, such as the optic disc, fovea and blood vessels. We review the use of image analysis in the automated diagnosis of pathology (with particular reference to diabetic retinopathy). We also review its role in defining and performing quantitative measurements of vascular topography, how these entities are based on 'optimisation' principles and how they have helped to describe the relationship between systemic cardiovascular disease and retinal vascular changes. We also review the potential future use of fundal image analysis in telemedicine.


Temporal and spatial regulation of bone morphogenetic protein signaling in late lung development.
Bone morphogenetic proteins (BMPs) play important roles in early lung development. No study to date has addressed a role for BMP signaling in late lung development. We describe changes in the expression and localization of BMP receptors (Bmpr1a, Bmpr1b, and Bmpr2) and Smad (Smad1, Smad4, Smad5, and Smad8) intracellular signaling proteins during the saccular and alveolarization stages of late lung development. BMP signaling, assessed by Smad1/5 phosphorylation, nuclear translocation, and induction of id1, id2, and id3 gene expression, was evident throughout late lung development. Our data indicate that BMP signaling is active during late lung development, and points to roles for the BMP system in septal and vascular development, and in the homeostasis of the epithelial layer of large conducting airways in the mature lung.


Stereological Assessments of Neuronal Pathology in Auditory Cortex in Schizophrenia.
It has long been known that auditory processing is disrupted in schizophrenia. More recently, postmortem studies have provided direct evidence that morphological alterations to neurons in auditory cortex are implicated in the pathophysiology of this illness, confirming previous predictions. Potential neural substrates for auditory impairment and gray matter loss in auditory cortex in schizophrenia have been identified, described, and are the focus of this review article. Pyramidal cell somal volume is reduced in auditory cortex, as are dendritic spine density and number in schizophrenia. Pyramidal cells are not lost in this region in schizophrenia, indicating that dendritic spine reductions reflect fewer spines per pyramidal cell, consistent with the reduced neuropil hypothesis of schizophrenia. Stereological methods have aided in the proper collection, reporting and interpretation of this data. Mechanistic studies exploring relationships between genetic risk for schizophrenia and altered dendrite morphology represent an important avenue for future research in order to further elucidate cellular pathology in auditory cortex in schizophrenia.


One-level one-sided lumbar disc surgery with and without microscopic assistance: 1-year outcome in 114 consecutive patients.
The aim of this study was to compare the outcomes following macrodiscectomy and microsurgery for one-level one-sided lumbar disc excision. The authors prospectively studied 114 consecutive patients who underwent microdiscectomy (Group A, 63 patients [36 men, 27 women]) and macrodiscectomy (Group B, 51 patients [29 men, 22 women]) for one-level unilateral first-time lumbar disc herniation. Microdiscectomy was considered to involve a small incision with removal or opening of the ligamentum flavum, no or minimal bone excision, and use of the operating microscope to remove the disc material. Laminectomy combined with macrodiscectomy was defined as any operation requiring a large opening in or complete removal of the unilateral lamina. Diagnosis was confirmed by magnetic resonance imaging. A 1-year follow-up investigation was also conducted. Relief of radicular pain, improvement in muscle power, and changes in sensory and/or reflex abnormality were documented. Assessment of outcome was performed using the modified Stauffer-Coventry criteria. Good or excellent results were demonstrated in 90% of Group A and 89% of Group B patients (p > 0.05). One patient in each group underwent reoperation. There was infection over the fascia in two Group A patients. Mean operative time (+/- standard deviation) was 54 +/- 5.65 minutes in Group A and 25 +/- 7.07 minutes in Group B (p < 0.01). Median length of the incision was 4 and 6 cm in Group A and Group B, respectively (p < 0.05). The length of postoperative inpatient stay was 1 day in both groups (p > 0.05). Patients in the microsurgery-treated group returned to work in less time: 85% of Group A and 58% of Group B patients returned to their work within 4 weeks (p < 0.001). Some patients in each group (15% in Group A and 45% in Group B) needed narcotic analgesic medication at least twice between the 1st month and 1st year after the surgery (p < 0.001). Microdiscectomy allows the surgeon good visualization and is less traumatic to the involved tissues. Interestingly, the results of this study indicated that microsurgery does not reduce hospitalization time, nor does it improve the overall surgery-related outcome. The main differences between the two procedures were length of the incision and operative time. The author found that lumbar microdiscectomy allows patients earlier return to work and/or normal life with less reliance on postoperative narcotic analgesic agents.


The effect of estrogen on passive length-tension relationship in the uterus of ovariectomized progesterone-treated pregnant rats.
Passive length-tension curves of uterine strips obtained on day 20 of pregnancy from ovariectomized, progesterone-treated (OVX-P), progesterone + estrogen-treated (OVX-PE), and intact pregnant rats (control) were determined, and the effects of ovarian hormones on the length of the collagenous framework (LZ), tension at in vivo length (TV), and distensibility (D) of the strips, which were obtained from the curves, were evaluated. LZ of circular strips, but not of longitudinal strips, of OVX-P rats was smaller than the in situ length (20 mm) of the strips, whereas the value of control rats was greater than 20 mm; TV of these strips was 4.5-fold of controls. Treatment with estrogen restored both LZ and TV to the control levels. D of both longitudinal and circular strips of OVX-P rats was smaller than the controls, estrogen increased D to longitudinal direction predominantly. Examination in Ca-free Tyrode's had no influence on any of LZ, TV or D. Results suggest that estrogen with progesterone develops the collagenous framework of the connective tissue to radial direction and distensibility of the uterine wall mainly to longitudinal direction, and thereby maintains the tension of the uterine wall to accommodate the product of conception in the rat.


Trigeminal Neuralgia Induced by Sour and Spicy Foods: What Is the Underlying Mechanism? A Case Report.
This article is a case report of a female patient in whom sour and spicy foods evoked trigeminal neuralgia (TN). An attempt to reveal the underlying pain mechanism is described and discussed. The 81-year-old woman had been suffering from classical TN since the age of 50. Attacks occurred spontaneously or in response to mechanical stimuli. In addition, sour and spicy foods also evoked TN attacks and were therefore avoided for years. Medical treatment was initially effective, but two radiofrequency ablations of the gasserian ganglion were required later on and yielded good, albeit incomplete, pain relief. Sensory examination consisted of application of a mechanical stimulus and sweet, salty, sour, and spicy solutions to the anterior part of the tongue and the mandibular mucosa on both sides. Mechanical stimuli were felt but produced no pain. When applied to the tongue, the tastes of all solutions were identified but produced no pain. When applied to the mucogingival line, none of the solutions was identified but the sour and the spicy solutions provoked TN immediately following their application. These findings suggest that in this patient, sour and spicy solutions may have evoked TN attacks by direct activation of trigeminal C-nociceptors, possibly via interactions with transient receptor potential vanilloid 1 receptors.


Using case studies based on a nursing conceptual model to teach medical-surgical nursing.
Nurse educators are continually challenged to develop teaching strategies that enhance students' critical thinking, problem-solving, and decision-making skills. Case studies are a creative learning strategy that fosters these skills through the use of in-depth descriptions of realistic clinical situations. Conceptual models of nursing provide a unique body of knowledge that can be used to guide construction of case studies and enhance application of didactic course content to nursing practice. In this column, the author discusses the use of case studies constructed within the context of the Roy adaptation model for a senior level medical-surgical nursing course.


Hands-Free Conventional Radiographic Ventrodorsal Hip Extended View.
Hip dysplasia (HD) is an important hereditary orthopedic disease in the dog associated with osteoarthritis and inadequate welfare for affected animals. The radiographic ventrodorsal hip extended (VDHE) view is used worldwide to select the better animals for breeding. This view normally is performed with manual restraining of the dog to obtain radiographs with acceptable technical quality. The veterinarian exposition to ionizing radiation is inevitable. In this study, the technical quality of VDHE radiographs and hip measurements was compared in 65 dogs radiographed twice, one with the common veterinarian manual restraining and the other obtained using a hind limb holder device, without the veterinarian within the X-ray room. The variables studied were pelvic tilting, patella displacement index, Norberg angle (NA), and subluxation hip category. The results showed a random distribution of right and left pelvic tilting, patella lateral or medial displacement, and hip subluxation categories in both samples (P > 0.05). The holder device positioning showed a better pelvic symmetry (P < 0.05) and a similar patellar displacement (P > 0.05). The mean ± standard deviation of NA was 101.1° ± 6.2° and 100.9° ± 6.1° in the manual and holder device hind limb restraining, respectively (P > 0.05), and the lower limit of 95% confidence interval of intraclass correlation coefficient was >0.75. These results showed statistical reproducibility of NA measurements by the hind limb holder device, and the examiner was protected from exposure to ionizing radiation within the X-ray room.


Cyclic AMP in dendritic cells: A novel potential target for disease-modifying agents in asthma and other allergic disorders.
Allergic diseases are immune disorders that are a global health problem, affecting a large portion of the world's population. Allergic asthma is a heterogeneous disease that alters the biology of the airway. A substantial portion of patients with asthma do not respond to conventional therapies; thus, new and effective therapeutics are needed. Dendritic cells (DCs), antigen presenting cells that regulate helper T cell differentiation, are key drivers of allergic inflammation but are not the target of current therapies. Here we review the role of dendritic cells in allergic conditions and propose a disease-modifying strategy for treating allergic asthma: cAMP-mediated inhibition of dendritic cells to blunt allergic inflammation. This approach contrasts with current treatments that focus on treating clinical manifestations of airway inflammation. Disease-modifying agents that target cAMP and its signalling pathway in dendritic cells may provide a novel means to treat asthma and other allergic diseases.


Stenotrophomonas maltophilia intestinal colonization in hospitalized oncology patients with diarrhea.
A 6-week surveillance study was performed to determine the prevalence of Stenotrophomonas maltophilia intestinal colonization among patients hospitalized in an oncology unit who developed diarrhea. Ninety-two stool samples obtained from 41 patients were cultured, and 4 patients (4 [9.5%] of 41 patients) had cultures that were positive for S. maltophilia. After controlling for duration of diarrhea, patients colonized with S. maltophilia had received a greater number of different types of antibiotics than noncolonized patients (5 vs. 3 different drugs; P=.04).


Increased thyroid cancer incidence in a basaltic volcanic area is associated with non-anthropogenic pollution and biocontamination.
The increased thyroid cancer incidence in volcanic areas suggests an environmental effect of volcanic-originated carcinogens. To address this problem, we evaluated environmental pollution and biocontamination in a volcanic area of Sicily with increased thyroid cancer incidence. Thyroid cancer epidemiology was obtained from the Sicilian Regional Registry for Thyroid Cancer. Twenty-seven trace elements were measured by quadrupole mass spectrometry in the drinking water and lichens (to characterize environmental pollution) and in the urine of residents (to identify biocontamination) in the Mt. Etna volcanic area and in adjacent control areas. Thyroid cancer incidence was 18.5 and 9.6/10(5) inhabitants in the volcanic and the control areas, respectively. The increase was exclusively due to the papillary histotype. Compared with control areas, in the volcanic area many trace elements were increased in both drinking water and lichens, indicating both water and atmospheric pollution. Differences were greater for water. Additionally, in the urine of the residents of the volcanic area, the average levels of many trace elements were significantly increased, with values higher two-fold or more than in residents of the control area: cadmium (×2.1), mercury (×2.6), manganese (×3.0), palladium (×9.0), thallium (×2.0), uranium (×2.0), vanadium (×8.0), and tungsten (×2.4). Urine concentrations were significantly correlated with values in water but not in lichens. Our findings reveal a complex non-anthropogenic biocontamination with many trace elements in residents of an active volcanic area where thyroid cancer incidence is increased. The possible carcinogenic effect of these chemicals on the thyroid and other tissues cannot be excluded and should be investigated.


Molecular packing and packing defects in helical membrane proteins.
The packing of helices spanning lipid bilayers is crucial for the stability and function of alpha-helical membrane proteins. Using a modified Voronoi procedure, we calculated packing densities for helix-helix contacts in membrane spanning domains. Our results show that the transmembrane helices of protein channels and transporters are significantly more loosely packed compared with helices in globular proteins. The observed packing deficiencies of these membrane proteins are also reflected by a higher amount of cavities at functionally important sites. The cavities positioned along the gated pores of membrane channels and transporters are noticeably lined by polar amino acids that should be exposed to the aqueous medium when the protein is in the open state. In contrast, nonpolar amino acids surround the cavities in those protein regions where large rearrangements are supposed to take place, as near the hinge regions of transporters or at restriction sites of protein channels. We presume that the observed deficiencies of helix-helix packing are essential for the helical mobility that sustains the function of many membrane protein channels and transporters.


A critical narrative analysis of psychiatrists' engagement with psychosis as a contentious area.
Psychosis, characterised by altered perceptions or interpretations of reality, remains a contested area. Lately, perspectives and conceptualisations of psychosis that have traditionally been more peripheral have gained greater recognition. Both the British Psychological Society and Critical Psychiatry Network have highlighted some contentious areas in recent publications. The aim was to use critical narrative analysis to consider what facilitates and inhibits medical professionals with clinical experience of psychosis to engage with the topic of psychosis as a contentious area. Semi-structured interviews were conducted with 12 medical professionals, who were at trainee or qualified level with a minimum of 6 months' clinical experience within psychiatry, across three Trusts within the United Kingdom. This purposive sample had a diverse range of perspectives regarding psychosis. Critical narrative analysis comprising six distinct stages, informed the analysis. Participants positioned themselves broadly within one of three groups: biological psychiatrists, critical psychiatrists and those more conflicted. Narrative analysis was undertaken for each participant before being integrated for this article. The research highlighted several factors which either limit or facilitate opportunities within the psychiatric profession to engage with a plurality of views regarding psychosis. These included the significance of power and hierarchy within the profession, the role of dialogue and the prevalence of reflexivity within the profession. A pattern was identified of psychiatrists generally associating with like-minded others and not engaging with wider evidence regarding psychosis, partly as a result of the inherent threats to the power and hierarchy of the profession. This led to new ideas being widely unknown or undervalued, potentially to the disservice of clinical practice.


Multiple ossified spinal meningiomas in the thoracic spine: A case report and literature review.
Ossified spinal meningioma (OSM) is a rare form of a spinal tumor. The surgical strategies and pathologic findings related to OSM have been investigated in recent years. However, multiple OSMs are rarely reported. Here, we intend to present a rare case of multiple OSMs and review the relevant published literature. A 76-year-old woman experienced a progressive sensorimotor disturbance in her bilateral lower limbs for the past 2 years. She complained of inability to walk, urinary incontinence, and chronic constipation when referred to our hospital. A neurological examination revealed a diminished sensation below the bilateral T7, and her neurological status was Nurick Grade 6. Magnetic resonance imaging (MRI) revealed multiple intradural-extramedullary neoplasms at the T7-T11 level. Computed tomography (CT) scans showed five high-density masses of varying sizes in the spinal canal at the T7-T12 level. The patient underwent tumor resection through T7-T11 laminectomy. A histopathological examination revealed multiple OSMs. We reported a rare case of multiple OSMs in an elderly patient. After one-stage complete resection, the patient recovered with satisfactory curative effect. Although elderly patients will face various postoperative complications due to their poor physical condition, we still recommend one-stage complete resection of multiple OSMs to reduce recurrence.


The diastolic flow-pressure gradient relation in coronary stenoses in humans.
We assessed the feasibility and reproducibility of the instantaneous diastolic coronary flow velocity-pressure gradient relation to characterize different degrees of coronary stenoses. Assessment of the hemodynamic significance of coronary stenoses can be difficult. Using sensor-tipped guidewires, various physiologic indexes can be determined in the catheterization laboratory. Each of the current methods, however, has limitations. After positioning a Doppler flow wire and a pressure wire distal of a coronary stenosis, the flow velocity signals and the proximal and distal pressure were sampled simultaneously, at baseline and after intracoronary administration of adenosine. The instantaneous diastolic flow velocity and pressure gradient of single cardiac cycles at baseline, at maximal and intermediate hyperemia were plotted. Data were fitted with a regression line using the equation: Delta P = 0 +kv+Sv(2). Measurements were performed in 11 normal coronary arteries, 20 intermediate stenoses and in 7 severe stenoses before and after percutaneous transluminal coronary angioplasty plus stenting. We found significant differences between normal coronary arteries, intermediate and severe stenoses. Percutaneous transluminal coronary angioplasty nearly normalized the highly abnormal flow-pressure gradient relation in the severe stenoses. A high degree of reproducibility was observed. In 3% of the measurements, analysis was not possible due to the occurrence of pressure drift or bad flow velocity signals. It is feasible to assess the diastolic flow velocity-pressure gradient relation over a wide range of stenoses. It characterizes the hemodynamics of epicardial coronary stenoses and allows discrimination between normal coronary arteries, intermediate and severe stenoses.


Diabetes knowledge of primary health care and specialist nurses in a major urban area.
To examine trends since a previous 2006-2008 survey in diabetes knowledge held by primary health care nurses and their use of national diabetes guidelines, perceived ability to advise diabetes patients and preferences for further diabetes education. The obesity epidemic has led to a rapid increase in the prevalence of prediabetes and type 2 diabetes and to greater expectations for an expanded role for primary health care nurses in the prevention and community management of diabetes. Cross-sectional survey using a self-administered questionnaire and telephone interview and adheres to the STROBE guidelines. All nurses who provide community-based care in a major urban area were identified, and stratified by group, prior to random selection to participate in the study. A total of 1,416 practice, district (home care) and specialist nurses were identified who provide community-based care. Of the 459 who were randomly selected, 336 (73%) participated in 2016 and were compared with a representative sample of 287 nurses surveyed in 2006-2008. Compared with nurses in 2006-2008, significantly more nurses in 2016 used diabetes guidelines, knew that stroke was a diabetes-related complication, had a greater understanding of the pathology of diabetes and reported having sufficient knowledge to advise patients on laboratory results and improving outcomes through lifestyle changes. Despite these improvements, in 2016, only 24% of nurses could state that stroke was a complication of type 2 diabetes, only 37% felt sufficiently knowledgeable to advise patients on medications, and <20% could state that hypertension, smoking and the dyslipidaemia profile were important modifiable risk factors. There have been improvements in nurse's knowledge but gaps remain for cardiovascular outcomes and associated modifiable risk factors and medication management. Education programmes should focus on improving cardiovascular risk management in patients with type 2 diabetes.


[Medical technological equipment for correction of impaired homeostasis in humans].
The paper considers how to correct impaired human homeostasis and to maintain it at an adequate level, describes some correction methods, such as an original method of intracorporeal detoxification and technical means for the use of these methods, including a perfusion roller pump that has better operating characteristics.


In Vivo Evaluation of the Cardiovascular System of Mouse Embryo and Fetus Using High Frequency Ultrasound.
Genetically engineered mice have been widely used for studying cardiovascular development, physiology and diseases. In the past decade, high frequency ultrasound imaging technology has been significantly advanced and applied to observe the cardiovascular structure, function, and blood flow dynamics with high spatial and temporal resolution in mice. This noninvasive imaging approach has made possible longitudinal studies of the mouse embryo/fetus in utero. In this chapter, we describe detailed methods for: (1) the assessment of the structure, function, and flow dynamics of the developing heart of the mouse embryo during middle gestation (E10.5-E13.5); and (2) the measurement of flow distribution throughout the circulatory system of the mouse fetus at late gestation (E17.5). With the described protocols, we are able to illustrate the main cardiovascular structures and the corresponding functional and flow dynamic events at each stage of development, and generate baseline physiological information about the normal mouse embryo/fetus. These data will serve as the reference material for the identification of cardiovascular abnormalities in numerous mouse models with targeted genetic manipulations.


Effectiveness of a short-term multimodal prehabilitation program in adult patients awaiting selective cardiac surgery: study protocol for an open-label, pilot, randomized controlled trial.
Prehabilitation has been demonstrated to positively impact postoperative recovery in patients undergoing selective cardiac surgery. However, the optimal modules included in prehabilitation programs are yet to be fully explored, as existing studies have primarily focused on exercise. This study will explore the effectiveness of a three-arm prehabilitation program among adult patients awaiting selective cardiac surgery. A single-center, parallel-group randomized controlled trial will be conducted at the Second Affiliated Hospital of Zhejiang University School of Medicine (SAHZU). A total of 152 adult patients scheduled for elective cardiac surgery (coronary artery bypass grafting or valvular surgery) will be recruited from a tertiary teaching hospital. The patients will be randomly assigned to either the control group or the prehabilitation group. Patients assigned to the control group will receive standard care, which includes patient education and counseling as well as personal guidance on exercise, breathing, and coughing. Patients in the intervention group will be provided a multimodal prehabilitation program, including nutrition guidance, a diet journal, mindfulness training, and exercise guidance. The interventions will begin with home-based training and continue after hospital admission and before surgery. The primary outcome will be the perioperative 6-minute walk distance (6 MWD). The secondary outcomes will include preoperative readiness, postoperative recovery, and patient experience with the program. The purpose of the study is to examine whether a short-term multimodal prehabilitation program will be associated with improved preoperative readiness and postoperative outcomes. The findings of this study will provide evidence to support the development of a perioperative program aimed at enhancing patient recovery. www.ClinicalTrials.gov; identifier: NCT05503004.


Patellofemoral arthroplasty: an update.
The rationale for presenting this updated study is to report long-term clinical and survival results of patellofemoral arthroplasty and to ascertain whether the preoperative diagnosis influenced outcomes and therefore indications. We retrospectively updated a previous evaluation of 66 patients who had unilateral patellofemoral arthroplasty between 1972 and 1990. The mean age of the patients at the initial surgery was 57 years (range, 21-82 years). The patients had an average followup of 16.2 years (range, 12-20 years). Preoperative diagnosis included instability, fracture, and primary arthritis. Revision surgery was done in 14 patients for femorotibial osteoarthritis, in 11 for loosening, and in four for stiffness. Survivorship was 58% at 16 years. The knee function score improved from 40 points preoperatively to 81 points at last followup. The best results were in patients with preoperative instability and corrected alignment of the extensor mechanism. Stiffness occurred only in those patients with osteoarthritis from previous fracture. Progressive degeneration of the tibiofemoral joint was noted mainly in the primary osteoarthritis etiologic group. This long-term evaluation of patellofemoral arthroplasty showed the importance of patient selection while excluding knees with significant frontal tibiofemoral malalignment. Therapeutic study, Level IV-1 (case series). See the Guidelines for Authors for a complete description of levels of evidence.


Superhydrophilic PLGA-Graft-PVP/PC Nanofiber Membranes for the Prevention of Epidural Adhesion.
The frequent occurrence of failed back surgery syndrome (FBSS) seriously affects the quality of life of postoperative lumbar patients. Epidural adhesion is the major factor in FBSS. A safe and effective antiadhesion material is urgently needed. A superhydrophilic PLGA-g-PVP/PC nanofiber membrane (NFm) was prepared by electrospinning. FTIR was performed to identify its successful synthesis. Scanning electron microscopy, thermogravimetric analysis, differential scanning calorimetry, and water contact angle measurement were performed. CCK-8 assays were performed in primary rabbit fibroblasts (PRFs) and RAW264.7 cells to explore the cytotoxicity of PLGA-g-PVP/PC NFm. Calcein-AM/PI staining was used to measure the adhesion status in PRFs. ELISA was performed to measure the concentrations of TNF-α and IL-10 in RAW264.7 cells. In addition, the anti-epidural adhesion efficacy of the PLGA-g-PVP/PC NFm was determined in a rabbit model of lumbar laminectomy. The PLGA-g-PVP/PC NFm exhibited ultrastrong hydrophilicity and an appropriate degradation rate. Based on the results of the CCK-8 assays, PLGA-g-PVP/PC NFm had no cytotoxicity to PRFs and RAW264.7 cells. Calcein-AM/PI staining showed that PLGA-g-PVP/PC NFm could inhibit PRF adhesion. ELISAs showed that PLGA-g-PVP/PC NFm could attenuate lipopolysaccharide-induced macrophage activation. In vivo experiments further confirmed the favorable anti-epidural adhesion effect of PLGA-g-PVP/PC NFm and the lack of a strong inflammatory response. In this study, PLGA-g-PVP/PC NFm was developed successfully to provide a safe and effective physical barrier for preventing epidural adhesion. PLGA-g-PVP/PC NFm provides a promising strategy for preventing postoperative adhesion and has potential for clinical translation.


Coenzyme Q0 from Antrodia cinnamomea in Submerged Cultures Induces Reactive Oxygen Species-Mediated Apoptosis in A549 Human Lung Cancer Cells.
We investigated the anticancer effects of Antrodia cinnamomea, a medicinal mushroom from Taiwan, on A549 human lung cancer cells using the ethyl acetate extract from submerged culture filtrates. Our results showed that 2,3-dimethoxy-5-methyl-1,4-benzoquinone (coenzyme Q0; CoQ0) derived from A. cinnamomea submerged culture filtrates has anticancer activity. CoQ0 treatment reduced the viability of A549, HepG2, and SW480 cancer cell lines. Furthermore, CoQ0 induced reactive oxygen species (ROS) generation and apoptosis in A549 cells, which was inhibited by the antioxidant ascorbic acid. To our knowledge, these data demonstrate for the first time that CoQ0 derived from A. cinnamomea submerged culture filtrates exerts its anticancer effect through the induction of ROS-mediated apoptosis in A549 human lung cancer cells.


Epidermal growth factor receptor inhibition in metastatic anal cancer.
Metastatic squamous cell carcinoma (SCCA) anal cancer is relatively rare. With limited data, cisplatin plus 5-fluorouracil has traditionally been utilized in the first-line setting. Treatment beyond front-line cisplatin progression is not well defined. Epidermal growth factor receptor (EGFR) is highly overexpressed in SCCA anal cancer and EGFR inhibition may represent a potential treatment target for this population in need. Our case series evaluated metastatic SCCA anal cancer patients who received an EGFR monoclonal antibody as second-line or third-line therapy. Data collected consisted of demographics, previous treatment, metastatic disease sites, localized therapy received, regimen received, first radiographic result, progression-free survival, and overall survival. A total of 17 patients were included, with most (76%) patients receiving an EGFR monoclonal antibody in the second-line setting. Common regimens identified combined cetuximab or panitumumab with a fluoropyrimidine plus platinum (35%), carboplatin plus paclitaxel (29%), or cisplatin plus vinorelbine (18%). Thirty-five percent of patients achieved a response and 24% had stable disease. The overall median progression-free survival and overall survival were 7.3 and 24.7 months, respectively. Compared with our large retrospective study in the front-line metastatic anal cancer setting, our study suggests that anti-EGFR therapy in combination with certain chemotherapy derived additional benefit in the refractory setting. In the metastatic setting, there is a need to discover effective therapies. We present a diverse metastatic SCCA anal cancer patient population who received cetuximab or panitumumab with chemotherapy in the second-line or third-line setting. Our case series strengthens the concept of EGFR inhibition in metastatic SCCA anal cancer.


Particle-mediated cytokine gene therapy leads to antitumor and antimetastatic effects in mouse carcinoma models.
We investigated the effects of continuous cancer gene therapy including (antigen-presenting cell) (APC) engineering and local stimulation of the immune system. Lewis lung carcinomas and B16 melanomas, intradermally established on C57/Bl6 mice, were shot using a gene gun every 4th day with a combination of plasmids. The first therapy group received plasmids coding the genes for interleukin (IL)-12 and IL-2. The second therapy group was treated with plasmids coding for B7.1 interferon-gamma (IFN-gamma)/IL-12 alternated by a plasmid coding IL-2. Control were mice without any therapy or treatment with the empty plasmid. Gene therapy led to reduced tumor sizes in the therapy groups of both models (significant for the Lewis lung carcinoma). We found an enhanced survival and reduced tumor growth rate in the therapy groups; however, the effects were not significant. IL- 12/IL-2 therapy was more effective, compared to B7.1/IFN-gamma/IL-12 and IL-2. Cytokine gene transfer let to a significantly lower metastasis rate in Lewis lung carcinoma. Continuous particle-mediated gene transfer is easy to handle and shows good results. Gene therapy combining the genes coding for IL-12 and IL-2 was superior to additional IFN-gamma/B7.1. APC engineering does not appear to be sufficient in these poorly antigenic tumors.


Microfluidic devices for the isolation of circulating rare cells: a focus on affinity-based, dielectrophoresis, and hydrophoresis.
Circulating rare cells have attracted interest because they can be good indicators of various types of diseases. For example, enumeration of circulating tumor cells is used for cancer diagnosis and prognosis, while DNA analysis or enumeration of nucleated red blood cells is useful for prenatal diagnosis or hypoxic anemia, and that of circulating stem cells to diagnose cancer metastasis. Isolation of these cells and their downstream analyses can provide significant information such as the origin and characteristics of a disease. Novel approaches based on microfluidics have many advantages, including the continuous process and integration with other components for analysis. For these reasons, a variety of microfluidic devices have been developed to isolate and characterize rare cells. In this article, we review several microfluidic devices, with a focus on affinity-based isolation (e.g. antigen-antibody reaction) and label-free separation (DEP and hydrophoresis).


On assessing the quality of particle tracking through computational fluid dynamic models.
Quantification of particle deposition patterns, transit times, and shear exposure is important for computational fluid dynamic (CFD) studies involving respiratory and arterial models. To numerically compute such path-dependent quantities, it is necessary to employ a Lagrangian approach where particles are tracked through a pre-computed velocity field. However, it is difficult to determine in advance whether a particular velocity field is sufficiently resolved for the purposes of tracking particles accurately. Towards this end, we propose the use of volumetric residence time (VRT)--previously defined for 2-D studies of platelet activation and here extended to more physiologically relevant 3-D models--as a means of quantifying whether a volume of Lagrangian fluid elements (LFE's) seeded uniformly and contiguously at the model inlet remains uniform throughout the flow domain. Such "Lagrangian mass conservation" is shown to be satisfied when VRT=1 throughout the model domain. To demonstrate this novel concept, we computed maps of VRT and particle deposition in 3-D steady flow models of a stenosed carotid bifurcation constructed with one adaptively refined and three nominally uniform finite element meshes of increasing element density. A key finding was that uniform VRT could not be achieved for even the most resolved meshes and densest LFE seeding, suggesting that care should be taken when extracting quantitative information about path-dependent quantities. The VRT maps were found to be useful for identifying regions of a mesh that were under-resolved for such Lagrangian studies, and for guiding the construction of more adequately resolved meshes.


Inflammatory fibroid polyp of the ileum causing intussusception: a case report.
Inflammatory fibroid polyp is a rare polypoid lesion of the gastrointestinal tract, histologically characterized by an admixture of numerous small blood vessels, fibroblasts and edematous connective tissue, accompanying a marked inflammatory cell infiltrate which contains eosinophils. Although it generally presents as a polypoid mass in the gastric antrum, it can be seen throughout the gastrointestinal tract. It is believed to represent a reactive, nonneoplastic condition, but its histogenesis remains controversial. A case of inflammatory fibroid polyp of the ileum presenting clinically as intestinal obstruction due to intussusception is presented here.


Effects of point massage of liver and stomach channel combined with pith and trotter soup on postpartum lactation start time.
Delay in lactation initiation causes maternal anxiety and subsequent adverse impact on maternal exclusive breast feeding. It is important to explore a safe and convenient way to promote lactation initiation. The feasibility of point massage of liver and stomach channel combined with pith and trotter soup on prevention of delayed lactation initiation was investigated in the present study. 320 women were enrolled and randomly divided into four groups, control group (80 women), point massage group (80 women), pith and trotter soup group (80 women), and massage + soup group (80 women) to compare the lactation initiation time. We found that women in point massage group, pith and trotter soup group and massage + soup group had earlier initiation of lactation compared with control group. Women in massage + soup group had the earliest initiation time of lactation. There were significant differences between massage + soup group and pith and trotter soup group. But, there were no significant differences between massage + soup group and massage group. We conclude that point massage of the liver and stomach channel is easy to operate and has the preventive effect on delayed lactation initiation. Impact statement What is already known on this subject: Initiation of lactation is a critical period in postpartum milk secretion. Delays in lactation initiation lead to maternal anxiety and have an adverse impact on maternal exclusive breastfeeding. Sucking frequently by babies and mammary massage might be effective but insufficient for delayed lactation initiation. What the results of this study add: We found in the present study that lactation initiation is significantly earlier in women receiving routine nursing combined with point massage of liver and stomach channel, or pith trotters soup, or massage of liver and stomach channel with pith and trotters soup than in a control group receiving routine nursing. These three methods are all effective, while the most effective method is point massage combined with pith trotter soup. There was no maternal drug allergy, postpartum bleeding or other adverse reactions noted in all women. What the implications are of these findings for clinical practice and/or further research: The present study suggested that the application of point massage in clinic might be useful for preventing lack of milk postpartum by delayed lactation initiation and improving the exclusive breastfeeding rate. Further research might explore that molecular mechanism of lactation promotion by point massage using blood samples or animal models.


Dental Considerations in Children with Glucose-6-phosphate Dehydrogenase Deficiency (Favism): A Review of the Literature and Case Report.
Glucose-6-phosphate dehydrogenase (G6PD) deficiency is an uncommon inherited enzyme deficiency characterized by hemolytic anemia, caused by the inability of erythrocytes to detoxify oxidizing agents such as drugs, infectious diseases, or fava bean ingestion. In this later case, the disorder is known as favism. The aim of the present report was to present a review of the literature in this disease, to describe a case report concerning an affected 9-year-old male, and to review the main implications and precautions in pediatric dental management.


Sequential administration of GM-CSF (Sargramostim) and IL-2 +/- autologous vaccine as adjuvant therapy in cutaneous melanoma: an interim report of a phase II clinical trial.
Granulocyte-macrophage colony-stimulating factor (GM-CSF) and interleukin-2 (IL-2) are 2 cytokines with distinct mechanisms of action that complement one another in the adjuvant management of melanoma. Forty-five patients with high-risk melanoma were enrolled in an open-label, single-arm, phase II clinical trial to examine the safety, tolerability, and effectiveness of this combination. After potentially curative surgery, each patient received 12 months of GM-CSF 125 microg/m2/d subcutaneously (SC) for 14 days followed by IL-2, 9 million IU/m2/d SC for 4 days (given every other cycle from months 7-12), followed by 10 days of no treatment. In addition, patients who had tumors yielding an adequate number of live cells received autologous melanoma vaccines. For months 13-24, patients received only GM-CSF 250 microg/m2 twice weekly. This is an interim analysis based on the 45 enrolled patients with a median of 15.9 months follow-up (range, 1-50 months). Thirty-two patients are alive: 9 of 13 with stage IV resected melanoma, 16 of 25 with stage III disease, and 7 of 7 with stage II disease. Twelve died of the disease, and one due to stroke. Adjuvant use of sequential GM-CSF and IL-2 +/- autologous vaccine was well tolerated with good patient compliance and seemed to benefit high-risk patients with surgically resected melanoma.


Predicting structural properties of fluids by thermodynamic extrapolation.
We describe a methodology for extrapolating the structural properties of multicomponent fluids from one thermodynamic state to another. These properties generally include features of a system that may be computed from an individual configuration such as radial distribution functions, cluster size distributions, or a polymer's radius of gyration. This approach is based on the principle of using fluctuations in a system's extensive thermodynamic variables, such as energy, to construct an appropriate Taylor series expansion for these structural properties in terms of intensive conjugate variables, such as temperature. Thus, one may extrapolate these properties from one state to another when the series is truncated to some finite order. We demonstrate this extrapolation for simple and coarse-grained fluids in both the canonical and grand canonical ensembles, in terms of both temperatures and the chemical potentials of different components. The results show that this method is able to reasonably approximate structural properties of such fluids over a broad range of conditions. Consequently, this methodology may be employed to increase the computational efficiency of molecular simulations used to measure the structural properties of certain fluid systems, especially those used in high-throughput or data-driven investigations.


A strategy for surveying nursing practice in institutional settings.
Two major obstacles encountered when surveying nursing practice in institutional settings are obtaining a representative sample and collecting an adequate number of observations at a reasonable cost. Past efforts to deal with these problems are reviewed briefly, and results are reported from a two-stage mail survey of a national sample of critical-care nurses. The first stage involved attempts to procure a list of staff nurses from head nurses of critical-care units at 240 randomly selected institutions. An 86% response rate was obtained. The second stage involved mailing questionnaires to a random sample of 600 critical-care nurses listed. Completed, mailed questionnaires were obtained from 87%. Little evidence of bias due to administrative selection and/or volunteerism was found in the lists of staff nurses. An analysis of membership in professional nursing organizations indicates that more than one half of the nurses who responded to this survey would not have been included had the sample been selected from organizational membership lists.


The use of a polyglycolic acid polymer graft in Peyronie's disease - preliminary outcomes.
Plaque incision and grafting is indicated for patients with Peyronie's Disease [PD] and severe curvature, complex deformities or for patients with significant penile shortening. To date, no graft studied has been considered ideal. The aim of this study is to conduct a descriptive analysis about functional results with the use of a bioabsorbable graft for PD treatment. A single-center, retrospective evaluation of a cohort of patients who were treated by plaque incision and grafting with a polyglycolic acid polymer graft (Gore® Bio-A®) between 2018 and 2021 was conducted. Correction of penile curvature was the main outcome. Loss of penile sensitivity, de novo erectile dysfunction and any other adverse event were the secondary endpoints. 14 patients were included in this study (mean age 59.5 ± 7.2 years). The median follow-up time was 12 months (range 3-12). The curvature correction rate was 78.5%. Glans hypoesthesia was present in one of 14 patients (7.1%) and refractory erectile dysfunction was reported in 64.2%. None of the patients presented any major adverse event based on Clavien-Dindo classification. Curvature correction and changes in penile sensitivity rates were similar to those found in the literature. No major surgical complications, such as graft rejection, infection, and extrusion, occurred in this sample. Although a population with a higher prevalence of erectile dysfunction was included in this sample, higher rates of refractory erectile dysfunction were observed and these findings should be confirmed in further studies.


A cost of living longer: Projections of the effects of prospective mortality improvement on economic support ratios for 14 advanced economies.
The economic implications of increasing life expectancy are important concerns for governments in developed countries. The aims of this study were as follows: (i) to forecast mortality for 14 developed countries from 2010 to 2050, using the Poisson Common Factor Model; (ii) to project the effects of the forecast mortality patterns on support ratios; and (iii) to calculate labour force participation increases which could offset these effects. The forecast gains in life expectancy correlate negatively with current fertility. Pre-2050 support ratios are projected to fall most in Japan and east-central and southern Europe, and least in Sweden and Australia. A post-2050 recovery is projected for most east-central and southern European countries. The increases in labour force participation needed to counterbalance the effects of mortality improvement are greatest for Japan, Poland, and the Czech Republic, and least for the USA, Canada, Netherlands, and Sweden. The policy implications are discussed.


Higher Activities of Defense-Associated Enzymes may Contribute to Greater Resistance of Manchurian Ash to Emerald Ash Borer Than A closely Related and Susceptible Congener.
Emerald ash borer (EAB) is an invasive beetle native to Asia that infests and kills ash (Fraxinus spp.) in North America. Previous experiments indicated that larvae feeding on co-evolved, resistant Manchurian ash (F. mandshurica) have increased antioxidant and quinone-protective enzyme activities compared to larvae feeding on susceptible North American species. Here, we examined mechanisms of host-generated oxidative and quinone-based stress and other putative defenses in Manchurian ash and the closely related and chemically similar, but susceptible, black ash (F. nigra), with and without exogenous application of methyl jasmonate (MeJA) to induce resistance mechanisms. Peroxidase activities were 4.6-13.3 times higher in Manchurian than black ash, although both species appeared to express the same three peroxidase isozymes. Additionally, peroxidase-mediated protein cross-linking activity was stronger in Manchurian ash. Polyphenol oxidase, β-glucosidase, chitinase, and lipoxygenase activities also were greater in Manchurian ash, but only lipoxygenase activity increased with MeJA application. Phloem H2O2 levels were similar and were increased by MeJA application in both species. Lastly, trypsin inhibitor activity was detected in methanol and water extracts that were not allowed to oxidize, indicating the presence of phenolic-based trypsin inhibitors. However, no proteinaceous trypsin inhibitor activity was detected in either species. In response to MeJA application, Manchurian ash had higher trypsin inhibitor activity than black ash using the unoxidized water extracts, but no treatment effects were detected using methanol extracts. Based on these results we hypothesize that peroxidases, lignin polymerization, and quinone generation contribute to the greater resistance to EAB displayed by Manchurian ash.


In vitro protein engineering using synthetic tRNA(Ala) with different anticodons.
The use of synthetic tRNA for in vitro protein engineering was tested in a coupled transcription/translation system prepared from Escherichia coli. DNA sequences similar to the natural tRNA(Ala/UGC) gene from E. coli but with different anticodons were synthesized in vitro, cloned into a DNA plasmid, and then transcribed in vitro with T7 RNA polymerase. The UGC alanine anticodon was changed to CUA corresponding to the UAG stop codon, CCU corresponding to the rarely used AGG arginine codon, and two four-nucleotide anticodons used to suppress stop codons. Bacterial dihydrofolate reductase was the test protein. Its cloned coding sequence was mutagenized at the GUG codon for valine-75 to correspond to the anticodons of the tRNA constructs, and then the plasmids were used to direct the synthesis of dihydrofolate reductase in the coupled transcription/translation system containing the corresponding synthetic tRNA. The results indicate that all four synthetic tRNAs were functionally active in the synthesis of full-length, enzymatically active dihydrofolate reductase protein.


[Antimalaria campaign in the Middle-east army (1917): the illustrated postcard as a means of information and propaganda by pictures].
The authors take out from oblivion the series of illustrated post-cards published in 1917 by the French under-secretariat of state for Military Health Service in order to promote the malaria control within the Middle-East French Army. They give some details on how these post-cards were originated, they also illustrate some principles of prevention against malaria made compulsory for the Armed Forces Personnel. The authors also demonstrate how that simple and easy to handle medium, fast vector of sanitary information, was able to support effectively the antimalaria Mission in the Middle-East French Army in its malaria prophylactic action.


Quantitative MRI-Based Analysis Identifies Developmental Limbic Abnormalities in PCDH19 Encephalopathy.
Protocadherin-19 (PCDH19) is a calcium dependent cell-adhesion molecule involved in neuronal circuit formation with prevalent expression in the limbic structures. PCDH19-gene mutations cause a developmental encephalopathy with prominent infantile onset focal seizures, variably associated with intellectual disability and autistic features. Diagnostic neuroimaging is usually unrevealing. We used quantitative MRI to investigate the cortex and white matter in a group of 20 PCDH19-mutated patients. By a statistical comparison between quantitative features in PCDH19 brains and in a group of age and sex matched controls, we found that patients exhibited bilateral reductions of local gyrification index (lGI) in limbic cortical areas, including the parahippocampal and entorhinal cortex and the fusiform and lingual gyri, and altered diffusivity features in the underlying white matter. In patients with an earlier onset of seizures, worse psychiatric manifestations and cognitive impairment, reductions of lGI and diffusivity abnormalities in the limbic areas were more pronounced. Developmental abnormalities involving the limbic structures likely represent a measurable anatomic counterpart of the reduced contribution of the PCDH19 protein to local cortical folding and white matter organization and are functionally reflected in the phenotypic features involving cognitive and communicative skills as well as local epileptogenesis.


Effects of specific activation of mu-, delta- and kappa-opioid receptors on the secretion of luteinizing hormone and prolactin in the ovariectomized rat.
With the recent development of highly specific ligands for the mu, delta and kappa opioid receptors it was of interest to define the effects of activation of each of these receptor types on LH and prolactin (PRL) secretion. The compounds were infused (10 microliters/h) at various concentrations into the third cerebroventricle of unanesthetized, ovariectomized rats. The mu agonist, DAGO, at both 1 and 10 micrograms/h caused a significant suppression of LH secretion and a significant stimulation of PRL release. DPDPE, the delta agonist, had no effect on either hormone at 1 microgram/h but inhibited LH secretion at 10 micrograms/h. There was still no effect of this high dose of DPDPE on PRL release. The kappa agonist, U50,488H, had no effect on either hormone at 10 micrograms/h, but at 100 micrograms/h produced a significant suppression of LH release and a highly variable increase in PRL. Coinfusion of 100 micrograms/h of naloxone with the high dose of each of the agonists completely blocked the responses of both hormones to each of the agonists with one exception: the highly variable stimulation of PRL by U50,488H was not affected, thus indicating a nonspecific effect of U50,488H on PRL secretion. These results demonstrate that: activation of the mu receptors produces an inhibition of LH secretion and a stimulation of PRL release; activation of the delta receptors produces an inhibition of LH secretion but has no effect on PRL release, and activation of the kappa receptors produces an inhibition of LH release and a variable stimulation of PRL secretion.


Genomic structural analysis of porcine fatty acid desaturase cluster on chromosome 2.
Fatty acid composition is an economically important trait in meat-producing livestock. To gain insight into the molecular genetics of fatty acid desaturase (FADS) genes in pigs, we investigated the genomic structure of the porcine FADS gene family on chromosome 2. We also examined the tissue distribution of FADS gene expression. The genomic structure of FADS family in mammals consists of three isoforms FADS1, FADS2 and FADS3. However, porcine FADS cluster in the latest pig genome assembly (Sscrofa 10.2) containing some gaps is distinct from that in other mammals. We therefore sought to determine the genomic structure, including the FADS cluster in a 200-kbp range by sequencing gap regions. The structure we obtained was similar to that in other mammals. We then investigated the porcine FADS1 transcription start site and identified a novel isoform named FADS1b. Phylogenetic analysis revealed that the three members of the FADS cluster were orthologous among mammals, whereas the various FADS1 isoforms identified in pigs, mice and cattle might be attributable to species-specific transcriptional regulation with alternative promoters. Porcine FADS1b and FADS3 isoforms were predominantly expressed in the inner layer of the subcutaneous adipose tissue. Additional analyses will reveal the effects of these functionally unknown isoforms on fatty acid composition in pig fat tissues.


Serum 25-hydroxyvitamin D levels are associated with carotid atherosclerosis in normotensive and euglycemic Chinese postmenopausal women: the Shanghai Changfeng study.
The role of serum 25-hydroxyvitamin D (25 (OH) D) in atherogenesis is unclear. We investigated whether the 25 (OH) D is independently associated with the carotid intima-media thickness (CIMT) and carotid plaques in normotensive and euglycemic postmenopausal women. A total of 671 normotensive and euglycemic postmenopausal women (mean age, 58.8 years) were enrolled from the Changfeng Study. A standard interview, anthropometrics measurements and laboratory analyses were performed for each participant. Bilateral CIMTs were measured using ultrasonography, and the presence of carotid plaques was assessed. The serum 25 (OH) D was measured using electrochemiluminescence immunoassay. Serum 25 (OH) D was 43.6 ± 18.2 nmol/L in the postmenopausal women. Compared with subjects with 25 (OH) D in the first, second and third quartiles, subjects with 25 (OH) D in the fourth quartile had decreased CIMT and prevalence of carotid plaque (0.684 ± 0.009 mm vs 0.719 ± 0.009 mm, 0.708 ± 0.009 mm and 0.709 ± 0.009 mm; 10.8% vs 19.0%, 14.8% and 16.8%, respectively). After adjusting for conventional CVD risk factors, PTH, liver and renal function, postmenopausal women with 25 (OH) D in the fourth quartile still had lower CIMT than those in the first, second and third quartiles (p = 0.039) and the subjects in the fourth quartile had a 0.421-fold decreased risk of carotid plaques relative to those in the lowest quartile (95% confidence interval 0.209 to 0.848). These results suggest serum 25 (OH) D is independently and inversely associated with carotid atherosclerosis in postmenopausal women with normal blood pressure and normal glucose tolerance.


[Basic study of nephrotoxicity of antibiotics. I. Studies of the effects of antibiotics on nucleic acids and protein metabolism in rat kidneys].
In order to evaluate the nephrotoxicity by antibiotics, effects of these agents were investigated in terms of protein synthesis and nucleic acid metabolism in the kidneys of Wistar rats. Aminoglycoside antibiotics (streptomycin, kanamycin, gentamycin), tetracycline (doxytetracycline), chloramphenicol, and cephems (cephalothin, cephaloridine, ceftezol, latamoxef) were used. These antibiotics were given to the rats for 5 successive days. On the 6th day 14C-6-orotic acid and 14C-1-leucine were administered intraperitoneally. Incorporation rates of these tracers into ribonucleic acid and protein fraction in rat kidney ribosomes (polysomes) were measured. Another experiment was undertaken in vitro by separating the polysome fraction from the rat kidneys. In vitro acellular protein synthesis using these polysomes was established. Effects of antibiotics on the incorporation rates of 14C-1-leucine were examined. Marked reduction of incorporation of these tracers into nucleic acid and protein in vivo and in vitro was induced by aminoglycoside antibiotics. These facts suggest that aminoglycoside antibiotics develop nephrotoxicity by interfering with the metabolism of ribosomal RNA and protein.


Renal osteodystrophy in CAPD.
At start of dialysis most patients have histological bone abnormalities. These can be divided into two groups--high turnover and low turnover bone disease. Low turnover aplastic disease was previously attributed to aluminum accumulation but is now known to occur even in patients with less than 5% surface stainable aluminium. It is characterised by a mineralisation defect, thin osteoid seams, decreased numbers of osteoclasts and osteoblasts and absent aluminium staining. We have avoided aluminium containing phosphate binders (ACPBs) completely, with a combination of oral calcium carbonate and "low calcium" (1.25 mMol/l) dialysis fluid. Phosphate control has been good (mean less than 1.6 mMol/l) and over the first twelve months serum PTH levels have fallen significantly. Transient asymptomatic episodes of hypercalcaemia have occurred but no patient required ACPBs. Bone biopsies at the start of CAPD in 34 patients showed over 50% to have osteitis fibrosa (OF) but in five cases (15.6%) the aplastic lesion was found without aluminium staining. In seven follow-up biopsies OF improved in 3 cases, osteomalacia improved in 1, became aplastic in 1, while aplastic bone worsened in 1 and changed to mild OF in 1. We conclude that the predominant bone lesion in our patients at start of CAPD is OF, but 15% already have aplastic bone. "Low calcium" dialysis fluid enables ACPBs to be avoided in the majority of CAPD patients.


The risk of overweight and obesity in children after tonsillectomy: a cross-sectional study.
The aim of this cross-sectional study was to determine the prevalence of tonsillectomy among secondary school children and to investigate whether tonsillectomy with or without adenoidectomy is a risk factor for childhood obesity. A total of 27 secondary schools with 12,296 students between the ages 11 and 17 were screened in Denizli, Turkey. We determined 129 students who had undergone tonsillectomy; each student was matched with two healthy control subjects of the same age and sex (n = 258). A 28-item questionnaire on nutrition and physical exercise was completed by the parents. Age-adjusted body mass index and waist circumference percentiles of Turkish boys and girls were used for the assessment of overweight and obesity. The prevalence of tonsillectomy was 1.0 %. There was no significant relationship between having tonsillectomy and being overweight or obese and physical exercise and screen time (p > 0.05 for each). Logistic regression analyses suggested no significant effect of tonsillectomy on overweight or obesity of the subjects (p > 0.05). It seems that tonsillectomy had no effect on overweight and obesity among children.


Alu elements and hominid phylogenetics.
Alu elements have inserted in primate genomes throughout the evolution of the order. One particular Alu lineage (Ye) began amplifying relatively early in hominid evolution and continued propagating at a low level as many of its members are found in a variety of hominid genomes. This study represents the first conclusive application of short interspersed elements, which are considered nearly homoplasy-free, to elucidate the phylogeny of hominids. Phylogenetic analysis of Alu Ye5 elements and elements from several other subfamilies reveals high levels of support for monophyly of Hominidae, tribe Hominini and subtribe Hominina. Here we present the strongest evidence reported to date for a sister relationship between humans and chimpanzees while clearly distinguishing the chimpanzee and human lineages.


Slow optical soliton pairs via electron spin coherence in a quantum well waveguide.
In this paper, we theoretically investigate the propagation properties of probe and mixing fields in a quantum well waveguide. This waveguide is driven by two strong control (pumping and coupling) fields and a weak probe field. Under appropriate parameters condition, the electron spin coherence can suppress the absorption and enhance the nonlinear susceptibilities of the probe (or mixing) field. This study reveals that probe (or mixing) field can form soliton pairs and propagate in the quantum well waveguide with slow group velocity. We also study the soliton collision and dynamics evolution. The results show that the propagation of soliton can be strongly modified by the electron spin coherence.


Self-assembled monolayer-assisted chemical transfer of in situ functionalized carbon nanotubes.
A low-temperature flexible process, named "chemical transfer", was developed to assemble well-aligned carbon nanotube (ACNT) structures onto various substrates. The technology was featured by (1) in situ functionalization of ACNTs with reactive functional groups during the CVD process and (2) covalently bonded interface with a self-assembled monolayer (SAM) of conjugated thiol molecules as the bridging ligand and conduction path at the ACNT/gold interface. The effectiveness of the in situ functionalization was characterized by X-ray photoelectron spectroscopy (XPS) and Fourier transform infrared spectroscopy (FTIR). I-V response and the interfacial strength of the chemically transferred structure were studied. Results showed an Ohmic contact, low electrical resistivity, and improved CNT-substrate adhesion. This novel technique shows promising applications for positioning ACNTs as electrical interconnects or thermal interface materials on temperature-sensitive substrates.


Ultrasound-Guided Intrauterine Labeling of Rat Fetuses.
To compare intra-amniotic versus fetal subcutaneous injections for selective fetal labeling in multifetal rat pregnancies. A total of 14 pregnant rats were randomized to receive intra-amniotic injections of dyes (including Fluorescein, Indigo Carmine, or Evans Blue) or fetal subcutaneous injections (of commercial tattoo ink) both guided by ultrasound at 15-17 days of gestation. Survival, injection, and labeling success rates of both techniques were compared. Survival rates (84.4% for intra-amniotic injections vs. 90.9% for fetal subcutaneous injections) and injection success rates (94% for intra-amniotic injections vs. 100% for fetal subcutaneous injections) were similar among both groups. None of the neonates from the intra-amniotic injections group were labeled at birth, while 93% of the neonates from fetal subcutaneous injections group were tagged, showing a visible spot in the skin at birth. Our results suggest that ultrasound-guided fetal subcutaneous injections might be an adequate strategy for selectively labeling fetuses in multifetal pregnant animals.


Mosquito survey in Tripura.
Vector survey carried out in Tripura revealed the presence of 17 species of anophelines with a density of 92.39 per trap night. Major malaria vector encountered was Anopheles philippinensis which formed 30% of the total collection and is exophagic in nature. Another efficient malaria vector An. minimus which formed 5% of the total collection prevails equally both indoors and outdoors. The high parity rate of An. philippinensis (59%) and An. minimus (63.9%) gives a strong indication about their vectorial status in Tripura.


Caffeine-containing energy drink improves sprint performance during an international rugby sevens competition.
The aim of this study was to determine the effects of a caffeine-containing energy drink on physical performance during a rugby sevens competition. A second purpose was to investigate the post-competition urinary caffeine concentration derived from the energy drink intake. On two non-consecutive days of a friendly tournament, 16 women from the Spanish National rugby sevens Team (mean age and body mass = 23 ± 2 years and 66 ± 7 kg) ingested 3 mg of caffeine per kg of body mass in the form of an energy drink (Fure(®), ProEnergetics) or the same drink without caffeine (placebo). After 60 min for caffeine absorption, participants performed a 15-s maximal jump test, a 6 × 30 m sprint test, and then played three rugby sevens games against another national team. Individual running pace and instantaneous speed during the games were assessed using global positioning satellite (GPS) devices. Urine samples were obtained pre and post-competition. In comparison to the placebo, the ingestion of the energy drink increased muscle power output during the jump series (23.5 ± 10.1 vs. 25.6 ± 11.8 kW, P = 0.05), running pace during the games (87.5 ± 8.3 vs. 95.4 ± 12.7 m/min, P < 0.05), and pace at sprint velocity (4.6 ± 3.3 vs. 6.1 ± 3.4 m/min, P < 0.05). However, the energy drink did not affect maximal running speed during the repeated sprint test (25.0 ± 1.5 vs. 25.0 ± 1.7 km/h). The ingestion of the energy drink resulted in a higher post-competition urine caffeine concentration than the placebo (3.3 ± 0.7 vs. 0.2 ± 0.1 μg/mL; P < 0.05). In summary, 3 mg/kg of caffeine in the form of a commercially available energy drink considerably enhanced physical performance during a women's rugby sevens competition.


Ascites matters.
The excess accumulation of intra-peritoneal fluid, referred to as ascites, is an important clue that points to a significant underlying illness. This may be due to a pathological event within the peritoneal cavity or secondary to an underlying systemic condition. Ascites is broadly classified into transudate and exudate, based on protein content, with a potential wide range of differential diagnoses. Traditionally, computed tomography has been regarded as the imaging modality of choice to demonstrate ascites and diagnose the underlying cause. However, ultrasound can reliably detect small volumes of fluid and is a useful first-line imaging modality for clinical triage. For instance, in the emergency setting, the detection of a trace of ascites may be the earliest indicator of an acute abdomen needing surgery. Ultrasound can quantify the volume of ascites and aid in the decision process for fluid drainage. Ultrasound is superior to computed tomography in the qualitative assessment of fluid. Broadly, simple fluid is anechoic, whereas complex fluid may appear particulate, layered or contain septations. On computed tomography, both have a uniform hypo-dense appearance and are often indistinguishable. Given ultrasound, in comparison to computed tomography, is safe, relatively inexpensive and readily available, it is a valuable tool in the assessment of ascites. Once ascites is detected on ultrasound, it is imperative for the operator to have a systematic approach to attempt to provide an underlying diagnosis. Through a series of cases, this article aims to increase awareness and reaffirm the role of ultrasound in the assessment of ascites.


99mTc tetrofosmin scintigraphy in acute leukaemia: the relationship between marrow uptake of tetrofosmin and P-glycoprotein and chemotherapy response.
The non-invasive detection of P-glycoprotein (Pgp) and multidrug resistance related proteins in vivo, will represent the greatest challenge in overcoming multidrug resistance. Although 99mTc tetrofosmin has been used previously as a myocardial perfusion agent, it is now also being used in the imaging of various tumours. In the current study, Tc tetrofosmin was used in the investigation of acute leukaemia. To show the uptake pattern of 99mTc tetrofosmin in the bone marrow of patients with acute leukaemia, and to ascertain the relationship between 99mTc tetrofosmin uptake and the level of Pgp expression and their relation to the response to chemotherapy. In addition, CD95, which is an indicator of apoptosis (programmed cell death), has also been assessed. Pgp and CD95 were detected by using flow cytometry. Of the 27 acute leukaemia patients assessed, nine had previously received chemotherapy, and 18 had had an initial diagnosis. All patients had undergone 99mTc tetrofosmin scintigraphy, and their Pgp and CD95 levels had been determined. The same parameters were studied again for 14 patients. The responses to chemotherapy were assessed by patients' clinicians. A control group of 37 patients without bone marrow pathology was also studied in order to provide comparisons for the scintigraphy results. The control images were assessed only qualitatively. In leukaemia patients the uptake of 99mTc tetrofosmin into bone marrow was found to be considerably higher than in control patients (P=0.000). An analysis of the relationship between Pgp, CD95, and the qualitative and quantitative tetrofosmin uptake ratios (URs) showed that there was an inverse correlation only between Pgp and the quantitative uptake ratio (P=0.016, r=-0.461). When the patients were grouped as 'good' and 'poor', as related to the chemotherapy response, there were no meaningful differences between these two groups regarding Pgp, CD95 and tetrofosmin URs (P>0.05). By evaluating the scintigraphic findings of the 'repeated' 14 patients, we showed that if the 99mTc tetrofosmin UR in the second imaging test was reduced by >0.08, the response to chemotherapy tended to be good. This method, based on follow-up scanning with tetrofosmin, showed a sensitivity of 83% and a specificity of 62% in the prediction of a 'good' response, if a decrease of 0.08 was taken into consideration. In this study, patients with acute leukaemia showed significant uptake of tetrofosmin into the bone marrow. The addition of basal and repeated 99mTc tetrofosmin scintigraphy to the management protocol for leukaemia could lead to the preferential determination of responses to chemotherapy, by evaluating whole bone marrow non-invasively. This method seems promising, but it needs further support from various similar investigations comprising more patients in order to confirm our results.


Systemic-pulmonary artery shunt using PTFE prosthesis (Gore-Tex). Early results and long-term follow-up on 105 consecutive cases.
One hundred-five patients (median age 14 months) in whom a PTFE prosthesis was used to create a systemic-pulmonary artery shunt were studied between 1978 and 1980. The prosthesis was mainly used to create a modified Blalock-Taussig anastomosis. Nine patients died in hospital (8.5%, 70% confidence limits: 5.7% to 12.3%). The clinical condition did not appear to be an incremental risk factor, while the young age and the underlying type of disease accounted for the hospital mortality to a large extent. All 96 survivals were available for follow-up information. One graft, which was damaged intraoperatively, occluded 3 months later. The remaining patients have a patent graft 3 months to 36 months (mean 24 months) postoperatively. In 6 patients the patency was assessed angiographically and no damages of the pulmonary artery were observed, therefore this type of palliation is advisable for any patient, particularly in the first year of life.


The M and N genes-based simplex and multiplex PCRs are better than the F or H gene-based simplex PCR for Peste-des-petits-ruminants virus.
Nucleocapsid (N), matrix (M) and hemagglutinin (H) genes-based simplex PCRs and an N and M genes-based multiplex PCR were developed for detection of Peste-des-petits-ruminants virus (PPRV). The M gene PCR was the most sensitive, followed by N, H and an already described fusion (F) gene PCRs, as they could detect the virus in samples with titers of 101, 102, 104and 105 TCID50/ml, respectively. The multiplex PCR was as sensitive as the M gene PCR, but it had the advantage of differentiating PPRV from Rinderpest virus (RPV).


Raman spectroscopic investigations of nanoparticles of Sn(x)Ti(1-x)O2 solid solution.
SnO2 nanoparticles dispersed in TiO2 matrix are prepared at a relatively low temperature of approximately 185 degrees C. Nanoparticles of Sn(x)Ti(1-x)O2 solid solution without significant aggregation have been prepared by annealing them at approximately 500 and 900 degrees C. X-ray diffraction and high-resolution transmission electron microscopy studies have clearly established the nano-size nature of the samples. Raman spectroscopic investigations of these samples show mixed vibrational modes, some of them being similar to TiO2 (A(1g), E(g)), while some of them are similar to SnO2 (B(2g)). The E(g) mode shows significant red shift and B(2g) mode shows significant blue shift. Unlike this A(1g) mode remains unaffected. These results are explained based on the combined effects of random alloy formation and the nano-size nature of samples.


Atomic mapping of periodic dipole waves in ferroelectric oxide.
A dipole wave is composed of head-to-tail connected electric dipoles in the form of sine function. Potential applications in information carrying, transporting, and processing are expected, and logic circuits based on nonlinear wave interaction are promising for dipole waves. Although similar spin waves are well known in ferromagnetic materials for their roles in some physical essence, electric dipole wave behavior and even its existence in ferroelectric materials are still elusive. Here, we observe the atomic morphology of large-scale dipole waves in PbTiO3/SrTiO3 superlattice mediated by tensile epitaxial strains on scandate substrates. The dipole waves can be expressed in the formula of y = Asin (2πx/L) + y 0, where the wave amplitude (A) and wavelength (L) correspond to 1.5 and 6.6 nm, respectively. This study suggests that by engineering strain at the nanoscale, it should be possible to fabricate unknown polar textures, which could facilitate the development of nanoscale ferroelectric devices.


Postimmunization activity of oligoadenylate synthetase in peripheral blood lymphocytes from healthy individuals.
The effect of immunizing healthy individuals with either tetanus toxoid or yellow fever live attenuated vaccine was examined by measuring interferon (IFN)-dependent oligoadenylate synthetase (2-5A) activity. This enzyme converts ATP into oligonucleotides coupled together in 2'-5'diester bonds. The synthetized products possess among other effects growth inhibiting properties and stimulate a latent RNase, thus playing an important role in the defense against viral infections. Although 2-5A activity is known to increase following virus infections and perhaps therefore to reflect a previous IFN exposure, little is known about the ability of vaccines to activate 2-5A in healthy individuals. Controlled dosages of commercially available vaccine preparations were therefore administered to 17 healthy Danish volunteers. In one study, the effect of a primary stimulus, yellow fever, was tested. It was found that the 2-5A activity increased to reach a peak by 1,000% by day nine. In another study, the effect of a secondary stimulus or booster, Tetanus toxoid, was tested. The response to this antigen was a 40% decrease in 2-5A activity from day 1 to day 18. Thus, the 2-5A activity highly reflects the type of antigen used for immunization and possibly even whether the individuals previously had been exposed to the given antigen. As IFNs are very shortlived in vivo measuring 2-5A activity is a sensitive way of estimating changes in blood immune cells to exogenous antigens.


Understanding the physiological effects of unrelieved pain.
Pain produces a physiological stress response that includes increased heart and breathing rates to facilitate the increasing demands of oxygen and other nutrients to vital organs. Failure to relieve pain produces a prolonged stress state, which can result in harmful multisystem effects. Good acute pain management is an essential part of holistic nursing care.


Optimization of iron-enhanced anaerobic digestion of agro-wastes for biomethane production and phosphate release.
In this study, the optimization of additives (polypyrrole magnetite nanocomposites (Ppy/Fe3O4) and antagonists (humic acid and arsenic oxide)) for simultaneous recovery of biomethane and phosphate release from enhanced anaerobic co-digestion of okra waste and pig manure was investigated. The pre-determined dosages of additives from our previous studies were used for the batch anaerobic digestion at different ratios under mesophilic conditions based on the two level-four factors central composite design (CCD) response surface methodology (RSM). After the anaerobic digestion processes, the biomethane yields were recorded and the digestates were characterized to determine the quantity of soluble phosphates. Both the independent variables and the responses were used to model and optimize the biogas yield and phosphate release conditions. The result showed that the maximum biomethane yield and P release were respectively 502.743 mLCH4/gVS and 168.674 mg/L at the optimum conditions of Ppy/Fe3O4 (20.0014 mg/L), HA (5.0018 mg/L), As (1.448 mg/L) and co-digestion (25.0001%). The response models predicted biomethane yield and P release to be 528.635 mLCH4/gVS and 164.405 mg/L respectively. All the response models were highly significant with appropriate goodness of fit and had prediction differences of 4.90% and 2.597% respectively for both biomethane yield and P release. Although both the accelerants and antagonists had influences on the anaerobic digestion processes by achieving enhanced biomethane production and P release, the influence of long exposure of anaerobic digestion processes to these additives on both responses is recommended for further investigation.


Advances in understanding cytomegalovirus infection after transplantation.
Susceptibility to infection and disease caused by CMV varies with the degree of immunosuppression, the antecedent immunity to CMV, the source of the virus, and a complex set of host responses. These responses include the development of humoral and cellular immunity and also immunopathologic responses. HLA-restricted responses may facilitate CMV disease by facilitating the survival and activation of latently infected cells, or by facilitating MHC-class I or class II cellular immune responses underlying both protective effects and pathologic inflammation.


Effect of sodium tungstate on visual evoked potentials in diabetic rats.
To evaluate the effect of sodium tungstate on visual evoked potentials (VEPs) in diabetic rats. Wistar rats were randomly divided into three groups as normal control, diabetic control and diabetic rats treated with sodium tungstate. Diabetes was induced by single intraperitoneal injection of streptozotocin (50 mg/kg). Sodium tungstate [40 mg/(kg·d)] was administered for 12wk and then VEPs were recorded. Additionally, thiobarbituric acid reactive substance (TBARS) levels were measured in brain tissues. The latencies of P1, N1, P2, N2 and P3 waves were significantly prolonged in diabetic rats compared with control group. Diabetes mellitus caused an increase in the lipid peroxidation process that was accompanied by changes in VEPs. However, prolonged latencies of VEPs for all components returned to control levels in sodium tungstate-treated group. The treatment of sodium tungstate significantly decreased brain TBARS levels and depleted the prolonged latencies of VEP components compared with diabetic control group. Sodium tungstate shows protective effects on visual pathway in diabetic rats, and it can be worthy of further study for potential use.


Protection of lipids from oxidation by epicatechin, trans-resveratrol, and gallic and caffeic acids in intestinal model systems.
Consumption of polyphenols is associated with health promotion through diet, although many are poorly absorbed in animals and humans alike. Lipid peroxides may reach the intestine and initiate deleterious oxidation. Here we measured inhibition of the oxidation of linoleic acid (LA) in authentic fluid from rat small intestine (RIF) by two dietary polyphenols, a flavonoid, epicatechin (EC), and a stilbene, resveratrol (RV), and by gallic (GA) and caffeic (CA) acids, and their partition coefficients. Both polyphenols inhibited 80%, and CA inhibited 65%, of the production of hexanal. GA was the weakest antioxidant in this assay. Interestingly, measuring peroxides production in RIF showed that only epicatechin inhibited the first stage of oxidation. The oxidizing agent, the antioxidant comound, the solution pH and lipophilicity are known to affect the total antioxidative activity. We suggest that the mechanism of this activity changes in accord with the environment: i.e., RV may act as a free radial scavenger, but here, in protecting lipids in intestinal fluid from oxidation, it acts as a hydrogen atom donor. Since the concentration of phenolics is much higher in the intestinal fluid than is ever achieved in plasma or other body tissues, it is suggested that their antioxidant activity could be exerted in the gastrointestinal tract (GIT), breaking the propagation of lipid peroxides oxidation and production of toxic compounds.


Use of eye movement desensitization and reprocessing (EMDR) in the treatment of dermatologic disorders.
The use of psychological therapies in dermatology is being increasingly recognized because stress and negative emotions are major factors in a wide range of dermatologic disorders. Eye movement desensitization and reprocessing (EMDR) is a relatively new psychological intervention which was first described to be effective in post-traumatic stress disorder, a condition associated with extremely stressful life situations. We evaluated the efficacy of EMDR in primary dermatologic disorders where psychological stress plays an important part in the pathogenesis of the disorder, and in clinical situations where the dermatologic symptom is the feature of a stress-related psychiatric disorder. Four patients (two patients with atopic dermatitis and psoriasis, respectively, whose symptoms were exacerbated by stress, one patient with acne excoríee associated with body image pathology as a result of childhood emotional abuse, and one patient with generalized urticaria associated with post-traumatic stress disorder) were treated using the standard EMDR protocol with 3-6 sessions for a period ranging from 4 to 12 weeks, and followed up for 6-12 months after the end of EMDR therapy. All 4 patients experienced a marked improvement in their symptoms after 3-6 sessions of EMDR, within a period of </= 3 months, and maintained improvement during followup periods of 6-12 months. Our preliminary findings suggest that EMDR may be beneficial in the treatment of a wide range of stress-mediated dermatologic symptoms.


Expression of invasion markers CD44v6/v3, NM23 and MMP2 in laryngeal and hypopharyngeal carcinoma.
Twelve laryngeal squamous cell carcinoma cases (7 laryngeal and 5 hypopharyngeal cancer; 15 samples) were analysed by immunohistochemistry for the expression of invasion markers CD44v6/v3, NM23 and matrix metalloproteinase, MMP2. The laryngeal epithelium showed CD44v6+/v3+/NM23-/MMP2- phenotype. When tumors were grouped into TNM categories the phenotype of the T2 and T3 tumors was similar, characterised by decreased CD44v3+ and lack of MMP2 expressions. Meanwhile the NM23 expression was more frequent in T3 tumors. In T4 stage the frequency of NM23 and MMP2 positive cases increased (5/6 and 4/6, respectively) but there was no correlation with the appearence of lymph node metastasis. Comparison of the phenotype of laryngeal and hypopharyngeal tumors, irrespective of the TNM stages, revealed characteristic differences: T2 stage laryngeal tumors showed decreased CD44v3 and occasional NM23 and MMP2 positivity, while in T3 stage these tumors were characterised by increased frequency of NM23 positivity. The phenotype of the hypopharyngeal tumors was significantly different with a high frequency of MMP2 positive cases (5/6) and NM23+/low CD44v3+ phenotype. The sharp differences in the phenotypes of laryngeal and hypopharyngeal carcinomas were connected to the differences in their invasive capacity unlike to the size of the tumors, since the T4 stage hypopharyngeal tumors had a significantly smaller size than laryngeal ones, even at lower stages.