Intraspinal and Intracranial Neurotuberculosis, Clinical and Imaging Characteristics and Outcomes in Hospitalized Patients: A Cohort Study (2000-2022).
Neurotuberculosis (neuroTB) is a devastating disease, and is difficult to diagnose. The aim of this study was to analyze the clinical and imaging characteristics, and outcomes of a retrospective cohort (2000-2022) of hospitalized patients diagnosed with intraspinal and intracranial neuroTB. This work was designed through clinical, laboratory and imaging findings. Variables included: demographic data, history of tuberculosis, neurological complications, comorbidities and outcomes. Morbi-mortality risk factors were identified by univariate analysis. The cohort included: 103 patients with intraspinal and 82 with intracranial neuroTB. During the study period, in-hospital mortality of 3% for intraspinal and 29.6% for intracranial neuroTB was estimated. Motor deficit was found in all patients with intraspinal neuroTB. Risk factors for the unfavorable outcome of patients with intraspinal neuroTB were: age ≥ 40 years, diabetes mellitus (DM), diagnostic delay, kyphosis and spondylodiscitis ≥ 3 levels of involvement. Among the patients with intracranial neuroTB, 79/82 (96.3%) had meningitis and 22 patients had HIV infection (10 of them died). Risk factors for mortality from intracranial neuroTB were: HIV infection, hydrocephalus, stroke, lymphopenia and disseminated and gastrointestinal TB. Patients with intraspinal neuroTB had a significant number of destroyed vertebrae that determined their neurological deficit status. The mortality burden in intracranial neuroTB was conditioned by HIV infection and renal transplantation patients.


Hanging Deaths: A Retrospective Study Regarding 260 Cases.
Hanging is a form of asphyxia caused by external pressure on the upper airways deriving from a band tightened by the gravitational weight of the body. During a 33-year period from 1983 to 2015, there were 260 hanging deaths examined at the Brescia Institute of Forensic Medicine (Northern Italy), which represented approximately 40% of all the asphyxial deaths recorded during this period. Almost all of the cases were represented by suicidal events, 1 case was a homicide event and there also was a case of sexual asphyxia. Eighty-two percent of the victims were men; 18% were women. There was an increasing tendency in the ages between 20 and 60 years, and the highest number of cases was observed in the 41- to 50-year age group (23% of the cases). The most common place chosen by the victim was the home setting followed by isolated outdoor places. The most common ligature material was a rope. The pathological findings were evaluated in all cases.


[Health risk assessment of typical metalloid and heavy metals in rural drinking water in Shaanxi Province in 2020].
Evaluate the health risks of metalloid and heavy metals in rural drinking water in Shaanxi Province, and provide a scientific basis for ensuring the safety of drinking water for rural residents. In 2020, the rural drinking water in Shaanxi Province were monitored, referring to the "Sanitary Standards for Drinking Water"(GB 5749-2006) for arsenic(As), cadmium(Cd), chromium(Cr~(6+)), lead(Pb), and mercury(Hg) in the water. To evaluate the concentration of five metalloid and heavy metals, the health risk assessment method recommended by United States Environmental Protection Agency was used to evaluate the health risks of adults in rural areas exposed to metalloid and heavy metals through drinking water. In 2020, a total of 6232 water samples were monitored. The concentrations of Cd, Pb and Hg in the water all met the standards, and the compliance rates of As and Cr~(6+) were 99.98% and 98.09%, respectively. The carcinogenic risk level of As was 3.53×10~(-5), and the non-carcinogenic health risk levels of the four heavy metals in descending order were Pb>Cr~(6+)>Cd>Hg, and the total risk level was 0.105. The concentration level of As and the distribution of health risk levels were all in northern Shaanxi>Guanzhong region>southern Shaanxi(P<0.05). The concentration level and health risk level distribution of As and Cr~(6+) were all groundwater>surface water(P<0.05), and the concentration level and health risk level distribution of Cd, Pb and Hg were all surface water>groundwater(P<0.05). There was a potential health risk of As exposure in rural drinking water in Shaanxi Province in 2020. The non-carcinogenic health risks of four heavy metals intake of Cd, Hg, Pb and Cr~(6+) through drinking water were still at an acceptable level. The control of arsenic pollution in drinking water should be further strengthened to ensure drinking water safety.


The potential for dissemination of Mycobacterium tuberculosis through the anesthesia breathing circuit.
Respiratory pathogens that pass through the anesthesia breathing system potentially can infect other patients. This study was designed to determine if bacteria can pass through contemporary anesthesia breathing systems and if the environment within the machine is hostile to these organisms. Staphylococcus aureus, Pseudomonas aeruginosa, and Mycobacterium tuberculosis were nebulized into the expiratory limb of an anesthesia breathing circuit and collected from the inspiratory and expiratory limbs in an impinger system that provided a quantitative determination of the number of organisms entering the circuit and the number that would reach the patient in the inspiratory gas. Bacteria were collected before, during, and after nebulization. A second experiment determined if a saturated solution of soda lime was bactericidal. When the gas flow through the circuit was interrupted for < 1 h following the nebulization period, large numbers of microorganisms (1 x 10(3) to 1 x 10(5), around 100% of the nebulized organisms) were collected from the inspiratory gas. Soda lime itself was not bactericidal for any of the organisms tested, but solutions of this material with a pH of 12 were bactericidal. Cross contamination between patients may occur unless the gas flow through the anesthesia breathing system is interrupted for > 1 h.


9-Borabicyclo[3.3.2]decanes and the asymmetric hydroboration of 1,1-disubstituted alkenes.
The syntheses of the optically pure asymmetric hydroborating agents 1 (a, R = Ph; b, R = TMS) in both enantiomeric forms are reported. These reagents are effective for the hydroboration of cis-, trans- and trisubstituted alkenes. More significantly, they exhibit unprecedented levels of selectivity in the asymmetric hydroboration of 1,1-disubstituted alkenes (28-92% ee), a previously unanswered challenge in the nearly 50 year history of this reagent-controlled process. For example, the hydroboration of alpha-methylstyrene with 1a produces the corresponding alcohol 6f in 78% ee (cf., Ipc2BH, 5% ee). Suzuki coupling of the intermediate adducts 5 produces the nonracemic products 7 very effectively (50-84%) without loss of optical purity.


Calcifying cystic odontogenic tumor associated with other lesions: case report with cone-beam computed tomography findings.
The calcifying cystic odontogenic tumor (CCOT) simultaneously occurring with other lesions at different locations in the same patient is rare. We report a patient with CCOT associated with an odontoma, a supernumerary tooth, and a dentigerous cyst simultaneously occurring in the maxilla. Cone-beam computed tomography (CBCT) images showed a well-defined expansile lesion with internal calcification, high-density masses surrounded by low-density area, and a supernumerary tooth at the anterior maxilla. Posterolaterally to these lesions, an embedded canine with pericoronal radiolucency was detected. Histopathologic examination revealed a CCOT associated with an odontoma, a supernumerary tooth, and a dentigerous cyst of the embedded canine. Enucleation was performed, and a 2-year postoperative follow-up was uneventful. CBCT was useful in giving the differential diagnosis by depicting internal calcification of CCOT, and in revealing the extent and complex relationship of these lesions.


[Angiomyolipoma of the kidney: report of three cases and a statistical study of 194 cases in Japan].
Three cases of renal angiomyolipoma are reported. The first case was a 53-year-old female with the complaint of left flank pain. In both cases selective angiography revealed a renal tumor, and computerized tomography disclosed a renal mass with low density corresponding to the fat tissue. From several examinations these two cases were preoperatively diagnosed as renal angiomyolipoma and nephrectomy was performed. Histopathological diagnosis was renal angiomyolipoma. The third case was a 64-year-old female with the complaints of left flank pain and macrohematuria. In this case computerized tomography revealed a renal mass which did not have a low density area. The possibility of renal cell carcinoma was considered and nephrectomy was performed. Histological diagnosis was renal angiomyolipoma which was primarily composed of smooth muscle cells. The first case had a calcified lesion in the brain. But there was no evidence of tuberous sclerosis in the following two cases. Some problems in diagnosis and treatment of renal angiomyolipoma are presented, and a statistical study is made on 194 reported cases of renal angiomyolipoma in Japan.


The South-American distribution and southernmost record of Biomphalaria peregrina-a potential intermediate host of schistosomiasis.
Schistosomiasis remains a major parasitic disease, endemic in large parts of South America. Five neotropical species of Biomphalaria have been found to act as intermediate hosts of Schistosoma mansoni in natural populations, while others have been shown to be susceptible in experimental infections, although not found infected in the field. Among these potential intermediate hosts, Biomphalaria peregrina represents the most widespread species in South America, with confirmed occurrence records from Venezuela to northern Patagonia. In this study, we report the southernmost record for the species at the Pinturas River, in southern Patagonia, which finding implies a southward reassessment of the limit for the known species of this genus. The identities of the individuals from this population were confirmed through morphological examination, and by means of two mitochondrial genes, cytochrome oxidase subunit I (COI) and 16S-rRNA. With both markers, phylogenetic analyses were conducted in order to compare the genetic background of individuals from the Pinturas River with previously genetically characterized strains of B. peregrina from various South-American locations. In addition, we produced a potential distribution model of B. peregrina in South America and identified the environmental variables that best predict that distribution. The model was estimated through a maximum entropy algorithm and run with occurrence points obtained from several sources, including the scientific literature and international databases, along with climatic and hydrographic variables. Different phylogenetic analyses with either the COI or 16S-rRNA sequences did not conflict, but rather gave very similar topological organizations. Two major groups were identified, with sequences from the Pinturas River grouping together with haplotypes from subtropical and temperate regions. The model developed had a satisfactory performance for the study area. We observed that the areas with higher habitat suitability were found to be mainly linked to subtropical and temperate regions of South America between 15° and 45° south latitude, with different moderate- and low-suitability areas outside this range. We also identified the coldest temperatures as the main predictors of the potential distribution of this snail. Susceptibility surveys would be required to evaluate if southern populations of B. peregrina still retain their potential as intermediate hosts of S. mansoni.


Review: update on the management of calciphylaxis.
Calciphylaxis is a disease of significant morbidity and mortality, predominantly affecting dialysis patients. The term 'calciphylaxis' was coined by Seyle et al. in 1961 to describe calcium deposition in the skin and subcutaneous soft tissue of uremic rats in response to 'triggers' (e.g. trauma, metallic salts) after exposure to 'sensitizing agents' (e.g. vitamin D and parathyroid hormone). In humans, calciphylaxis, however, is not a disorder of induced hypersensitivity. Instead, it is a disorder of cutaneous microvascular occlusion caused by thrombosis and calcification. Progressive, excruciatingly painful, non-healing wounds develop in these patients, pre-disposing them to high risk of sepsis and death. Calciphylaxis has no approved therapies. Increased awareness and research in this field have facilitated identification of risk factors and causation pathways. Development of therapeutic options and wound care management, however, are still at a nascent stage. Certain therapies have shown a promise that needs evaluation in prospective clinical trials. It is hoped that ongoing research will help us better understand the pathogenesis of this complex disease and develop efficacious treatment options. In this review, we outline the components involved in calciphylaxis diagnosis and treatment.


The effect of mindfulness-based therapy on anxiety and depression: A meta-analytic review.
Although mindfulness-based therapy has become a popular treatment, little is known about its efficacy. Therefore, our objective was to conduct an effect size analysis of this popular intervention for anxiety and mood symptoms in clinical samples. We conducted a literature search using PubMed, PsycINFO, the Cochrane Library, and manual searches. Our meta-analysis was based on 39 studies totaling 1,140 participants receiving mindfulness-based therapy for a range of conditions, including cancer, generalized anxiety disorder, depression, and other psychiatric or medical conditions. Effect size estimates suggest that mindfulness-based therapy was moderately effective for improving anxiety (Hedges's g = 0.63) and mood symptoms (Hedges's g = 0.59) from pre- to posttreatment in the overall sample. In patients with anxiety and mood disorders, this intervention was associated with effect sizes (Hedges's g) of 0.97 and 0.95 for improving anxiety and mood symptoms, respectively. These effect sizes were robust, were unrelated to publication year or number of treatment sessions, and were maintained over follow-up. These results suggest that mindfulness-based therapy is a promising intervention for treating anxiety and mood problems in clinical populations.


Gastrointestinal perforations in neonates with anorectal malformations.
We describe the presentation and management of gastrointestinal perforation in four neonates with anorectal malformations. Two neonates with high malformation had pneumoperitoneum on X-ray; surgery revealed sigmoid perforation in one patient and transverse colon perforation in the other. Colostomy was done, followed by posterior sagittal anorectoplasty at four months; both recovered satisfactorily. The third neonate had no radiological feature of gut perforation but cecal perforation was found at surgery; the neonate recovered following right hemicolectomy with stoma followed by anorectoplasty at five months. The fourth neonate presented with clinical and radiological features of perforation and recovered satisfactorily after anoplasty and colostomy.


An experimental test of the immunocompetence handicap hypothesis in a teleost fish: 11-ketotestosterone suppresses innate immunity in three-spined sticklebacks.
The immunocompetence handicap hypothesis (ICHH) provides a functional explanation for how sexual ornaments can provide honest signals of male quality. A key aspect of this hypothesis is that testosterone (T) has a bimodal effect: a higher T level enhances the expression of ornaments (increasing mating success and, ultimately, fitness); however, at the same time, it suppresses immune function. Tests of the latter assumption, which have focused mainly on aspects of adaptive immunity in birds, led to equivocal results. We performed a hormone-implant experiment in male three-spined sticklebacks (Gasterosteus aculeatus) to test the key assumptions of the ICHH in a fish, where the dominant circulating androgen is 11-ketotestosterone (11kT) rather than T. Males were implanted with 11-ketoandrostenedione, which is a natural precursor of 11kT. Each individual's circulating 11kT level, ornamentation, and immunocompetence were measured 2 weeks later. In addition, we quantified oxidative tissue damage because the ICHH has been hypothesized to work via oxidative stress. We found that the males' 11kT levels correlated positively with ornamentation but negatively with immunocompetence, in particular, measures of innate immunity. Moreover, there was a trend for fish with high 11kT levels to suffer more from oxidative stress. Thus, our data provide support for the ICHH.


Girls' spatial abilities: charting the contributions of experiences and attitudes in different academic groups.
Gender-related differences in spatial abilities favouring males are well established but have also generated a great deal of controversy. Cross-cultural research, meta-analyses and training studies could show the influence of socio-cultural and experiential factors on spatial-test performance. However, little is known about how experiences and gender-role stereotypes mediate performance differences in this area. The relationship between specific experiences (spatial activities, computer experience), achievement-related attitudes, and spatial abilities, i.e., mental-rotation ability was investigated with males and females in different academic subgroups. The sample comprised 112 female and 71 male undergraduates, majoring in arts, humanities and social sciences, sports, psychology and computational visualistics. A redrawn version of the Vandenberg and Kuse Mental Rotations Test (MRT) was administered and the participants completed a questionnaire about their spatial activities, computer experience, self-ratings regarding everyday spatial abilities, and attitudes towards mathematics and physics. Mental Rotations Test performance was mainly affected by academic programme and gender, but the effect size of gender differences varied. It was largest with students majoring in arts, humanities and social sciences and smallest with those majoring in computational visualistics. Data analyses revealed statistically significant correlations with spatial activities and computer experience only for females. The relationship between test performance and scales of achievement-related self-concept also depended on gender. Compared to males, females' spatial abilities are extremely vulnerable to and thus modifiable through attitudinal and experiential factors. This has considerable consequences for intervention programmes that could help to overcome the gender gap in spatial abilities.


Characterization and morphology of prepared titanium dioxide nanofibers by electrospinning.
Dispersed titanium dioxide in polymer nanofibers were prepared by sol-gel processing and electrospinning techniques using titanium isopropoxide (TiP)/polyvinylpyrrolidone (PVP) solution. The prepared titanium dioxide nanofibers were characterized by FE-SEM, TEM, XRD, and FT-IR. Pure titanium dioxide nanofibers were obtained from calcination of inorganic-organic composite fiber. The diameter of titanium oxide nanofibers were in the range of 70 nm to 150 nm. Prepared titanium dioxide nanofibers show rough surface and rather small diameter compare with TiP/PVP composite nanofibers. After calcined at 500 degrees C, TiO2 nanofibers convert into anatase and rutile mixed phased from amorphous structure. Calcination of these composite fibers above 600 degrees C resulted in pure rutile TiO2 nanofibers.


Randomized, double-blind, placebo-controlled study of divalproex extended release loading monotherapy in ambulatory bipolar spectrum disorder patients with moderate-to-severe hypomania or mild mania.
To determine whether divalproex extended release (ER) would be effective in outpatients with DSM-IV-TR-diagnosed ambulatory bipolar spectrum disorder (BSD) and moderate-to-severe hypomanic or mild manic symptoms (hypomania/mild mania). An 8-week, randomized, double-blind, placebo-controlled trial of divalproex ER oral loading (begun at 15 mg/kg/d and titrated to a maximum of 30 mg/kg/d) in ambulatory BSD with hypomania/mild mania patients, operationally defined as a Young Mania Rating Scale (YMRS) score >or= 10 but < 21 at baseline and at 1 other study visit at least 3 days apart over the 2 weeks before baseline, was conducted. Patients were enrolled from October 2003 through November 2007. Sixty patients (n = 30 in the divalproex ER group) had at least 1 postbaseline assessment. The divalproex ER group showed a significantly greater rate of reduction in mean total YMRS score than the placebo group (longitudinal analysis, P = .024). The divalproex ER group also showed more improvement in depressive symptoms the greater the severity of baseline depression (P = .11 for analysis of covariance treatment-by-baseline interaction). Baseline-to-endpoint change scores using last-observation-carried-forward showed that divalproex ER was associated with a marginally significant change in mean total YMRS score (P = .080). Comparable numbers of patients discontinued divalproex ER (n = 17) and placebo (n = 15), including those that discontinued use because of adverse events (n = 4 and 3, respectively). Divalproex ER begun at 15 mg/kg/d was superior to placebo in reducing hypomanic/mild manic symptoms in ambulatory BSD. It was associated with fairly good tolerability but a high discontinuation rate. Controlled trials of divalproex ER and other mood stabilizers in larger groups of ambulatory BSD patients with hypomanic/mild manic symptoms appear warranted. clinicaltrials.gov Identifier: NCT00278772.


Nursing workforce issues and trends affecting emergency departments.
Explore current nursing workforce issues--staffing issues, nurse-to-patient ratios, current emergency department benchmarking data, and operational factors--that affect the quality of care and safety in emergency departments. Learn several recommended strategies to improve care for patients and increase the recruitment and retention of qualified nurses and personnel in emergency care settings.


Effects of hearing loss, age, noise exposure, and listening skills on envelope regularity discrimination.
The envelope regularity discrimination (ERD) test assesses the ability to discriminate irregular from regular amplitude modulation (AM). The measured threshold is called the irregularity index (II). It was hypothesized that the II at threshold should be almost unaffected by the loudness recruitment that is associated with cochlear hearing loss because the effect of recruitment is similar to multiplying the AM depth by a certain factor, and II values depend on the amount of envelope irregularity relative to the baseline modulation depth. To test this hypothesis, the ERD test was administered to 60 older adults with varying degrees of hearing loss, using carrier frequencies of 1 and 4 kHz. The II values for the two carrier frequencies were highly correlated, indicating that the ERD test was measuring a consistent characteristic of each subject. The II values at 1 and 4 kHz were not significantly correlated with the audiometric thresholds at the corresponding frequencies, consistent with the hypothesis. The II values at 4 kHz were significantly positively correlated with age. There was an unexpected negative correlation between II values and a measure of noise exposure. This is argued to reflect the confounding effects of listening skills.


Synthesis, Properties, and Aggregation Behavior of Tetrasiloxane-Based Anionic Surfactants.
Three silicone surfactants, 3-tris(trimethylsiloxy)silylpropyl sulfonate with different alkaline counterions (lithium, sodium, and potassium), were synthesized for the first time. Their chemical structures were confirmed by FT-IR spectra, 1H NMR, and ESI-MS, and their behaviors in aqueous solutions were investigated by surface tensiometry, electrical conductivity, dynamic light scattering, and different transmission electron microscopy techniques. These anionic silicone surfactants exhibited remarkable surface activity and could reduce the surface tension of water to as low as 19.8 mN/m at the critical aggregate concentration (CAC). The adsorption and aggregation behaviors of these surfactants were assessed by determining the adsorption efficiency, minimum average area per surfactant molecule, and thermodynamic parameters. The cryo-TEM results verified that these molecules could form vesicles in water above the CAC. Moreover, the lowest surface tension, the smallest CAC value, and the largest aggregate size have been reached with potassium counterions. Thus, the different behavior of these surfactants in water can be explained by the different sizes of the hydrated ions.


Health care in the Spanish social security system: public-private relationships.
The Spanish socialist regime is faced with the decision of whether to operate its own health facilities or to pay private entrepreneurs for this function. This paper analyzes four policy areas of the Spanish social security system: contracting arrangements, primary care, pharmaceuticals, and methods of financing. The implications of the public-private question in Spain for the United States are discussed.


Central Nervous System Outcomes of Lazertinib Versus Gefitinib in EGFR-Mutated Advanced NSCLC: A LASER301 Subset Analysis.
Lazertinib, a third-generation mutant-selective EGFR tyrosine kinase inhibitor, improved progression-free survival compared with gefitinib in the phase 3 LASER301 study (ClinicalTrials.gov Identifier: NCT04248829). Here, we report the efficacy of lazertinib and gefitinib in patients with baseline central nervous system (CNS) metastases. Treatment-naive patients with EGFR-mutated advanced NSCLC were randomized one-to-one to lazertinib (240 mg/d) or gefitinib (250 mg/d). Patients with asymptomatic or stable CNS metastases were included if any planned radiation, surgery, or steroids were completed more than 2 weeks before randomization. For patients with CNS metastases confirmed at screening or subsequently suspected, CNS imaging was performed every 6 weeks for 18 months, then every 12 weeks. End points assessed by blinded independent central review and Response Evaluation Criteria in Solid Tumors version 1.1 included intracranial progression-free survival, intracranial objective response rate, and intracranial duration of response. Of the 393 patients enrolled in LASER301, 86 (lazertinib, n = 45; gefitinib, n = 41) had measurable and or non-measurable baseline CNS metastases. The median intracranial progression-free survival in the lazertinib group was 28.2 months (95% confidence interval [CI]: 14.8-28.2) versus 8.4 months (95% CI: 6.7-not reached [NR]) in the gefitinib group (hazard ratio = 0.42, 95% CI: 0.20-0.89, p = 0.02). Among patients with measurable CNS lesions, the intracranial objective response rate was numerically higher with lazertinib (94%; n = 17) versus gefitinib (73%; n = 11, p = 0.124). The median intracranial duration of response with lazertinib was NR (8.3-NR) versus 6.3 months (2.8-NR) with gefitinib. Tolerability was similar to the overall LASER301 population. In patients with CNS metastases, lazertinib significantly improved intracranial progression-free survival compared with gefitinib, with more durable responses.


Delayed recurrent nerve paralysis following post-traumatic aortic pseudoaneurysm.
Blunt trauma to the neck or to the chest are increasingly observed in the emergency clinical practice. They usually follow motor vehicle accidents or may be work or sports related. A wide pattern of clinical presentation can be potentially encountered. We report the uncommon case of a patient who was referred to our observation presenting with hoarseness and disphagia. Twenty days before he had sustained a car accident with trauma to the chest, neck and the mandible. Laryngoscopy showed a left recurrent laryngeal nerve palsy. Further otolaryngo-logical examination showed no other abnormality. At CT and MR imaging a post-traumatic aortic pseudoaneurysm was revealed. The aortic pseudoaneurysm was consequently repaired by implantation of an endovascular stent graft under local anesthesia. The patient was discharged 10 days later. At 30-days follow-up laryngoscopy the left vocal cord palsy was completely resolved. Hoarseness associated with a dilated left atrium in a patient with mitral valve stenosis was initially described by Ortner more than a century ago. Since then several non malignant, cardiovascular, intrathoracic disease that results in embarrassment from recurrent laryngeal nerve palsy usually by stretching, pulling or compression; thus, the correlations of these pathologies was termed as cardiovocal syndrome or Ortner's syndrome. The reported case illustrates that life-threatening cardiovascular comorbidities can cause hoarseness and that an impaired recurrent laryngeal nerve might be correctable.


Resource patch formation and exploitation throughout the marine microbial food web.
Exploitation of microscale (microm-mm) resource patches by planktonic microorganisms may influence oceanic trophodynamics and nutrient cycling. However, examinations of microbial behavior within patchy microhabitats have been precluded by methodological limitations. We developed a microfluidic device to generate microscale resource patches at environmentally realistic spatiotemporal scales, and we examined the exploitation of these patches by marine microorganisms. We studied the foraging response of three sequential levels of the microbial food web: a phytoplankton (Dunaliella tertiolecta), a heterotrophic bacterium (Pseudoalteromonas haloplanktis), and a phagotrophic protist (Neobodo designis). Population-level chemotactic responses and single-cell swimming behaviors were quantified. Dunaliella tertiolecta accumulated within a patch of NH4(+), simulating a zooplankton excretion, within 1 min of its formation. Pseudoalteromonas haloplanktis cells also exhibited a chemotactic response to patches of D. tertiolecta exudates within 30 s, whereas N. designis shifted swimming behavior in response to bacterial prey patches. Although they relied on different swimming strategies, all three organisms exhibited behaviors that permitted efficient and rapid exploitation of resource patches. These observations imply that microscale nutrient patchiness may subsequently trigger the sequential formation of patches of phytoplankton, heterotrophic bacteria, and protozoan predators in the ocean. Enhanced uptake and predation rates driven by patch exploitation could accelerate carbon flux through the microbial loop.


A pilot study evaluating the safety and toxicity of epirubicin, cisplatin, and UFT (ECU regimen) in advanced gastric carcinoma.
Best response rates have been achieved with three-drug regimens containing 5-FU in the treatment of advanced gastric cancer (AGC) and oral fluoropyrimidines are the best alternatives as substitutes for infusional 5-FU. This study aimed to evaluate the safety and toxicity of epirubicin, cisplatin, and UFT (ECU regimen) regimens in AGC outpatients. Forty-one patients with AGC received epirubicin, cisplatin, and oral UFT plus leucovorin. Epirubicin 50 mg/m(2) and cisplatin 60mg/m(2) were administered on Day 1. Three hundreds (300) mg/m(2)/day UFT was administered with leucovorin at a fixed oral dose of 90 mg/day for 21 days, followed by a 7-day rest period. Cycles were repeated every 4 weeks. Performance status was either as 0 and 1. Among the 41 patients enrolled, complete and partial response was achieved in 7.3% and 36.6% of patients, respectively, with an overall response rate of 43.9%. Stable disease was observed in 34.1% of patients and 22% showed disease progression. Median time to progression was 5.2 months and median survival was 12.3 months. A median of 4 cycles (range: 1-6) of chemotherapy were administered. The main grade III-IV toxicities were nausea/vomiting (19.4%) and neutropenia (12.1%). Grade IV toxicities were gastric perforation and renal failure. ECU appears to be an effective regimen in the treatment of AGC, with acceptable tolerability and manageable toxicity. In three-drug regimens, substitution of infusional 5-FU by UFT offers the possibility of increased AGC outpatient compliance.


[Determination of the concentration of serum free fatty acids in type 2 diabetic].
To evaluate the diagnostic value of serum free fatty acids (FFA) concentration in type 2 diabetics. The concentration of serum free fatty acids in type 2 diabetics were measured by enzymology in Hitachi 7170A automatic analyzer, and compared with that of surgical patients without diabetes mellitus. FFA level of type 2 diabetic (0.6268 +/- 0.2971) mmol/L was higher than that of the comparison (0.5333 +/- 0.2230) mol/L (P <0.05). Type 2 diabetes mellitus could cause the increase of the serum free fatty acids,and hyperlipidemia, specially. High free fatty acids disease was one of the risky factors in type 2 diabetes mellitus.


Associations Between Bioavailable Vitamin D and Remnant Cholesterol in Patients With Type 2 Diabetes Mellitus.
Introduction In circulation, 99% vitamin D is transported by binding to vitamin D binding protein (VDBP) and albumin. Vitamin D at free form and vitamin D binding to albumin are defined as bioavailable vitamin D. Vitamin D deficiency is associated with atherogenic lipid profile and insulin resistance. Remnant cholesterol is defined as the cholesterol component of triglyceride-rich lipoproteins and contributes to the atherosclerotic burden. The aim of this study was to investigate the association between bioavailable vitamin D and remnant cholesterol in patients with type 2 diabetes mellitus (T2DM). Methods A total of 198 T2DM patients and 208 non-diabetic subjects underwent biochemical measurements of lipid profiles, 25(OH)D, VDBP, CRP and albumin levels. Their demographic characteristics (age, sex) were questioned. Subjects with thyroid, kidney and liver dysfunction and using lipid-lowering therapy were not included in the study. The diagnosis of T2DM was made according to the American Diabetes Association ADA 2016 criteria. Classification of vitamin D levels was done according to the Endocrine Society. Bioavailable vitamin D concentrations were calculated. Results High-density lipoprotein cholesterol (HDL), 25(OH)D, free vitamin D and bioavailable vitamin D levels were significantly lower in diabetic patients than in non-diabetic patients while triglyceride, remnant cholesterol and CRP levels were found to be significantly higher. VDBP was positively correlated with CRP and remnant cholesterol in diabetic patients, but not in non-diabetic patients. Cut-off values were determined from non-diabetics as 3.56 ng/mL for bioavailable vitamin D and 26.56 mg/dL for remnant cholesterol. Logistic regression analysis in the control group showed that the odds ratio for increasing remnant cholesterol above the cut-off value was determined as 2.01 for low bioavailable vitamin D and 1.1 for elevated CRP. However, in T2DM there was no significant relationship. In all subjects, low bioavailable vitamin D increased the remnant cholesterol above the cut-off by 2.18-fold independent of the presence of T2DM. However, there was no significant risk to increase remnant cholesterol, considering a total 25(OH) D deficiency in all groups. Conclusions Low bioavailable vitamin D was found to be a risk factor for elevated remnant cholesterol. This relationship was not detected in patients with T2DM. We believe that the inflammation observed in Diabetes Mellitus may increase the concentrations of VDBP and a decrease in bioavailable vitamin D levels. Therefore, measuring VDBP and calculating the bioavailable vitamin D may provide additional information about the actual vitamin D status.


Triple-negative breast cancer: the importance of molecular and histologic subtyping, and recognition of low-grade variants.
Triple-negative breast cancers (TNBCs), defined by lack of expression of estrogen receptor, progesterone receptor and HER2, account for 12-17% of breast cancers and are clinically perceived as a discrete breast cancer subgroup. Nonetheless, TNBC has been shown to constitute a vastly heterogeneous disease encompassing a wide spectrum of entities with marked genetic, transcriptional, histological and clinical differences. Although most TNBCs are high-grade tumors, there are well-characterized low-grade TNBCs that have an indolent clinical course, whose natural history, molecular features and optimal therapy vastly differ from those of high-grade TNBCs. Secretory and adenoid cystic carcinomas are two histologic types of TNBCs underpinned by specific fusion genes; these tumors have an indolent clinical behavior and lack all of the cardinal molecular features of high-grade triple-negative disease. Recent studies of rare entities, including lesions once believed to constitute mere benign breast disease (e.g., microglandular adenosis), have resulted in the identification of potential precursors of TNBC and suggested the existence of a family of low-grade triple-negative lesions that, despite having low-grade morphology and indolent clinical behavior, have been shown to harbor the complex genomic landscape of common forms of TNBC, and may progress to high-grade disease. In this review, we describe the heterogeneity of TNBC and focus on the histologic and molecular features of low-grade forms of TNBC. Germane to addressing the challenges posed by the so-called triple-negative disease is the realization that TNBC is merely a descriptive term, and that low-grade types of TNBC may be driven by distinct sets of genetic alterations.


[Cartography of psychoactive heterotopias: a look at the medical, legal and social discourses regarding drug use].
This article traces a map of the social control of drugs through the politics of space, according to the Foucaultian concept of "heterotopia." Firstly, a brief genealogy of the use of psychotropic substances in different times and cultures is described, up to the introduction of the prohibitionist paradigm. Attention is paid to the way in which power has marked, separated and enclosed certain rituals and uses of pleasure in physical and symbolic sites. The itinerary is focused on the Spanish context to establish a dialogue between the various policies of space that have come into being and have overlapped in the construction and management of a problem which has been rendered an object to the gazes, mechanics and discourses of the medical, legal, and social fields. In this way, the intersections between the liminal spaces of drug use and the harm reduction paradigm are analyzed, including therapeutic strategies with prescribed drugs, from methadone programs to the new heroin programs.


Adjuvant chemoradiotherapy for resected pancreas cancer.
The purpose of this article is to review pertinent literature assessing the evidence regarding adjuvant chemoradiotherapy for adenocarcinoma of the pancreas following curative resection. This review looks at randomized controlled studies with the emphasis on adjuvant chemoradiotherapy. In assessing the evidence from the studies reviewed in this article, the trials have been grouped according to the positive or negative results for or against adjuvant treatment. In addition, data from two large, single-institution studies affirming the role for adjuvant chemoradiotherapy has been included. Understanding the evidence from all of the randomized studies is important in shaping current practice recommendations for adjuvant therapy of surgically resected pancreas cancer. Adjuvant chemoradiotherapy following surgery is the current approach at many cancer treatment centers in the United States. In Europe, chemotherapy alone is the preferred adjuvant therapy. However, the type of adjuvant treatment recommended remains controversial due to conflicting study results. The debate will likely continue. Current practice should be based on the weight of evidence available at this time, which is in favor of adjuvant chemotherapy with chemoradiotherapy.


The Transcriptomic Analysis of the Response of Pinus massoniana to Drought Stress and a Functional Study on the ERF1 Transcription Factor.
Pinus massoniana is a major fast-growing timber tree species planted in arid areas of south China, which has a certain drought-resistant ability. However, severe drought and long-term water shortage limit its normal growth and development. Therefore, in this study, physiological indices, and the transcriptome sequencing and cloning of AP2/ERF transcription factor of P. massonsiana were determined to clarify its molecular mechanism of drought stress. The results showed that stomatal conductance (Gs) content was significantly decreased, and superoxide dismutase (SOD) activity, and malondialdehyde (MDA) and abscisic acid (ABA) content were significantly increased under drought stress. Transcriptomic analysis revealed that compared to the control, 9, 3550, and 4142 unigenes with differential expression were identified by comparing plants subjected to light, moderate or severe drought. AP2/ERF with high expression was screened out for cloning. To investigate the biological functions of ERF1, it was over-expressed in wild-type Populus davdianaand × P. bolleana via the leaf disc method. Under drought stress, compared to wild-type plants, ERF1 over-expressing poplar lines (OE) maintained a higher photosynthetic rate and growth, while the transpiration rate and stomatal conductance significantly decreased and water use efficiency was improved, indicating that drought tolerance was enhanced. This study provides an insight into the molecular mechanism of drought stress adaptation in P. massoniana.


Molecular cloning and sequencing of feline melanoma antigen 2 (fMAGE-2) obtained from a lymphoma cell line.
Melanoma antigens (MAGE), thought to induce tumor-specific immune responses, are used as potential therapeutical targets for cancer immunotherapy. We hereby report the cloning and sequencing of MAGE cDNA clone, called feline MAGE-2 (fMAGE-2), obtained from a lymphoma cell line. fMAGE-2 cDNA is 1535 base pairs (bp) in length and contains an open reading frame (ORF) of 1131 bp encoding a protein of 376 amino acids. The predicted amino acid sequence shows 45%, 32-42%, 44-47%, and 33% homology with feline MAGE-1, human MAGE-A, human MAGE-B, and human MAGE-C proteins, respectively. mRNA transcripts of fMAGE-2 were detected by RT-PCR in some feline tumors, as well as in testis of adult cat, but not in other normal tissues, indicating that the expression pattern of fMAGE-2 is similar to that of the human MAGE family genes in tumors and normal tissues.


Drug Rash with Eosinophilia and Systemic Symptoms (DRESS) syndrome induced by celecoxib and anti-tuberculosis drugs.
Drug Rash with Eosinophilia and Systemic Symptoms (DRESS) syndrome reflects a serious hypersensitivity reaction to drugs, characterized by skin rash, fever, lymph node enlargement, and internal organ involvement. So far, numerous drugs such as sulfonamides, phenobarbital, sulfasalazine, carbamazepine, and phenytoin have been reported to cause the DRESS syndrome. We report a case in a 29-yr-old female patient who had been on celecoxib and anti-tuberculosis drugs for one month to treat knee joint pain and pulmonary tuberculosis. Our patient's clinical manifestations included fever, lymphadenopathy, rash, hypereosinophilia, and visceral involvement (hepatitis and pneumonitis). During the corticosteroid administration for DRESS syndrome, swallowing difficulty with profound muscle weakness had developed. Our patient was diagnosed as DRESS syndrome with eosinophilic polymyositis by a histopathologic study. After complete resolution of all symptoms, patch tests were positive for both celecoxib and ethambutol. Although further investigations might be needed to confirm the causality, celecoxib and ethambutol can be added to the list of drugs as having the possibility of DRESS syndrome.


Net calcium exchange in adult rat ventricular myocytes: an assessment of mitochondrial calcium accumulating capacity.
Net calcium exchange has been measured in a suspension of cardiac myocytes after treatment with digitonin. The exchange is believed to be across the mitochondrial membranes and can be stimulated or inhibited by agents augmenting or blocking mitochondrial electron transport. The uptake of calcium shows a strong dependence on suspension pCa but is not evident below 1 microM (pCa 6.0). It is suggested that the net calcium exchange is a balance of the two processes which are equivalent at pCa 6.0. The measurement of mitochondrial specific activity for calcium uptake allows a calculation of the rapidity with which the cardiac mitochondria would affect sarcoplasmic calcium after a sudden rise. It is suggested that the organelle could partly affect relaxation especially at the peak of contraction.


Ostial RCA intervention: guiding catheter challenges and use of a buddy wire to perform focused-force angioplasty on a severely calcific ostial right coronary lesion.
Ostial coronary disease presents a challenge from multiple perspectives with regard to percutaneous intervention. We present a novel case of a technically challenging ostial right coronary artery calcified lesion with a bar of calcium at the aorto-ostial junction which prevented intubation with multiple guiding catheters. We describe the use of a buddy wire as a technique for focused-force angioplasty with slow incremental balloon inflation of increasing diameter for plaque modification prior to stenting in a situation where rotational atherectomy and cutting balloon angioplasty were not an option.


Behavioral adjustments by a small neotropical primate (Callithrix jacchus) in a semiarid Caatinga environment.
We provide the first information on the behavior of a small primate (Callithrix jacchus) inhabiting a semiarid Caatinga environment in northeastern Brazil. We observed behavioral variations in response to temperature fluctuation throughout the day. Due to the high temperatures, low precipitation, and resource scarcity in the Caatinga, as well as the lack of physiological adaptations (e.g., a highly concentrated urine and a carotid rete to cool down the brain) of these primates, we expected that the common marmosets would exhibit behavioral adjustments, such as a prolonged resting period or the use of a large home range. During the six-month period, we collected 246 hours of behavioral data of two groups (10 individuals) of Callithrix jacchus. Most of the observed behavioral patterns were influenced by temperature fluctuation. Animals rested longer and reduced other activities, such as foraging, when temperatures were higher. Both study groups exploited home ranges of 2.21-3.26 ha, which is within the range described for common marmosets inhabiting the Atlantic Forest. Our findings confirm that common marmosets inhabiting the Caatinga adjust their behavioral patterns to cope with the high temperatures that characterize this environment and highlight their ability to survive across a wide range of different environmental conditions.


Development of 2D soft X-ray measurement system in the large helical device.
A fast two-dimensional soft X-ray camera using silicon photo diode array is being developed in order to investigate high frequency MHD instability with high mode number. The advantage of the adopted diode is a large sensor area of 10 mm × 10 mm and small diode capacitance which enable us to measure signals with the short response time. The characteristic of the prototype is summarized as follows: Channel number is 6 × 8 = 48, detection range 1∼10 keV, the spatial resolution 128 mm at the plasma location, and frequency range DC∼100 kHz. Synthetic image of the prototype in the Large Helical Device is estimated by using perturbation model of MHD mode.


Melanoma and Nanotechnology-Based Treatment.
Melanoma is a malignant tumor arising in melanocytes from the basal layer of the epidermis and is the fifth most commonly diagnosed cancer in the United States. Melanoma is aggressive and easily metastasizes, and the survival rate is low. Nanotechnology-based diagnosis and treatment of melanoma have attracted increasing attention. Importantly, nano drug delivery systems have the advantages of increasing drug solubility, enhancing drug stability, prolonging half-life, optimizing bioavailability, targeting tumors, and minimizing side effects; thus, these systems can facilitate tumor cytotoxicity to achieve effective treatment of melanoma. In this review, we discuss current nanosystems used in the diagnosis and treatment of melanoma, including lipid systems, inorganic nanoparticles, polymeric systems, and natural nanosystems. The excellent characteristics of novel and effective drug delivery systems provide a basis for the broad applications of these systems in the diagnosis and treatment of melanoma, particularly metastatic melanoma.


Sterilization by Cooling in Isochoric Conditions: The Case of Escherichia coli.
High hydrostatic pressure (HHP) affects the structure, metabolism and survival of micro-organisms including bacteria. For this reason HHP is a promising treatment in the food industry. The aim of this work is to evaluate the effect of high pressure, under isochoric cooling conditions, on Escherichia coli, where such high pressure develops due to the fact water cannot expand. We combine survival curves obtained by spectrophotometry and images of atomic force microscopy in this study. Our results show that cooling at -20 and -30°C leads to a partial destruction of a Escherichia coli population. However, cooling at -15°C causes a total extermination of bacteria. This intriguing result is explained by the phase diagram of water. In the first case, the simultaneous formation of ice III and ice Ih crystals provides a safe environment for bacteria. In the second case (-15°C) Escherichia coli remains in a metastable and amorphous free-of-crystals liquid subjected to high pressure. Our work is the first experimental study carried out to inactivate Escherichia coli under isochoric cooling conditions. Unlike HHP, which is based on the application of an external load to augment the pressure, this technique only requires cooling. The method could be used for annihilation of other Escherichia coli strains and perhaps other micro-organisms.


Statins Protect the Blood Brain Barrier Acutely after Experimental Intracerebral Hemorrhage.
The goal of this study was to measure the impact of simvastatin and atorvastatin treatment on blood brain barrier (BBB) integrity after experimental intracerebral hemorrhage (ICH). Primary ICH was induced in 27 male Wistar rats by stereotactic injection of 100 µL of autologous blood into the striatum. Rats were divided into three groups (n= 9/group): 1) oral treatment (2 mg/kg) of atorvastatin, 2) oral treatment (2 mg/kg) simvastatin, or 3) phosphate buffered saline daily starting 24-hours post-ICH and continuing daily for the next 3 days. On the fourth day, the animals underwent magnetic resonance imaging (MRI) for measurements of T1sat (a marker for BBB integrity), T2 (edema), and cerebral blood flow (CBF). After MRI, the animals were sacrificed and immunohistology or Western blotting was performed. MRI data for animals receiving simvastatin treatment showed significantly reduced BBB dysfunction and improved CBF in the ICH rim compared to controls (P<0.05) 4 days after ICH. Simvastatin also significantly reduced edema (T2) in the rim at 4 days after ICH (P<0.05). Both statin-treated groups demonstrated increased occludin and endothelial barrier antigen levels within the vessel walls, indicating better preservation of BBB function (P<0.05) and increased number of blood vessels (P<0.05). Simvastatin treatment administered acutely after ICH protects BBB integrity as measured by MRI and correlative immunohistochemistry. There was also evidence of improved CBF and reduced edema by MRI. Conversely, atorvastatin showed a non-significant trend by MRI measurement.


Heterotopic bone formation: irradiation of high risk patients.
The Royal Marsden Hospital has adopted a policy for patient selection for the use of adjuvant radiotherapy to prevent heterotopic new bone formation (HTBF) limited to those at greater than 50% risk. The treatment protocol is 7 Gy post-operative megavoltage radiotherapy at mid-plane, in one fraction, given within 72 h of surgery. Since the introduction of this protocol in 1993, 26 joints have been treated in 25 patients. The majority of cases were young people with acetabular fractures resulting from road traffic accidents, often alcohol related. Follow-up studies in this group of patients has proved difficult, as many fail to attend for follow up, and others have moved out of the catchment area. Of the 14 cases for which follow-up data is available, 13 remain fully mobile. One has not mobilized since the time of treatment and continues to use crutches. There is one case of recurrent HTBF seen on X-ray after 8 months, but the joint was mobile. By 5 years, all cases have failed to attend for follow-up. The true long-term risks of this treatment policy may not be known for 30 years. The failure of patients to attend even short-term follow-up is a potential problem for clinical oncologists.


Immunological basis of systemic sclerosis.
Systemic sclerosis (SSc) is a disease of unknown aetiology characterized by excessive and often progressive fibrosis in skin and multiple internal organs, an aberrant immune activation marked by multiple humoral and cellular immunological abnormalities and pronounced alterations in the microvasculature. The pathogenesis of SSc is complex and, although progress in the understanding of the multiple processes underlying SSc has been made in recent years, no single unifying hypothesis explaining all aspects of this disease exists. Recent studies have suggested that the activation of the immune system is a key stimulus to vascular abnormalities and fibrosis. Once T-cells are activated, they infiltrate the skin lesions early, and produce the profibrotic cytokine IL-4. They are also required for autoantibody production. B-cells may contribute to fibrosis, as deficiency of CD19, a B-cell signal transduction molecule, results in decreased fibrosis in animal models. In recent years, clinical advances have occurred in parallel with a better understanding of the underlying disease mechanisms. In this article, the immunological aspects and multiple altered immunological processes found in SSc are discussed.


[Analysis of sudden death caused by intestinal obstruction].
Five autopsy cases of sudden death caused by intestinal obstruction are reported. The causes of death of the cases were duodenal obstruction of impacted food stuff, ileocaecal obstruction caused by Crohn's disease, incarceration of inguinal hernia, intestinal obstruction caused by heterotopic pancreas and paralytic ileus. In three cases, the patient was in cardiopulmonary arrest on arrival at hospital, and in the remaining cases the patient died within 12 hours from the beginning of treatment; therefore, a correct clinical diagnosis was not made before the death in all cases. All the patients had from one to three days history of nausea and abdominal pain, major complications of intestinal obstruction. Among all cases, the duration from the onset to death was the shortest in the case of a patient complicated with schizophrenia. It is characteristic that the patients of all cases died suddenly and resuscitation was not successful. Regarding the laboratory data of a hospitalized patient, marked hemoconcentration and an increased level of BUN/Cr ratio and blood sugar were shown. The patient who died from duodenal obstruction caused by impacted food-stuff had suffered from depression for six years, and the patient who died from paralytic ileus had suffered from schizophrenia for about 23 years. In both cases, it is characteristic that the complaints of the patient were poorer than what would be expected. Furthermore, these patients had been taking medication of psychotic, anti-depressant and anti-parkinsonism drugs; therefore the combination of these drugs was thought to be reflected in the bowel movement.


Cefamandole in gastroduodenal surgery: a controlled, prospective, randomized, double-blind study.
Acceptance of the value of antibiotic prophylaxis in gastroduodenal surgery is growing, but only one controlled, double-blind study justifying this is available. In this second, controlled, randomized, double-blind study 60 patients underwent urgent and elective gastroduodenal operations. Among 32 patients receiving cefamandole perioperatively for prophylaxis, only 1 subsequently had a wound infection, but wound infections occurred in 8 of the 28 patients who received a placebo (P less than 0.01). Infection rates were higher in contaminated wounds and in urgent operations than in clean-contaminated wounds and elective surgery. The results confirm the value of antibiotic prophylaxis in this setting.


[Obligatory treatment: ethical, medical and legal issues].
Legislation passed on 30 June 1838 created a medico-administrative and legal framework for forced hospitalization. Updated in 1990, this law has been evaluated twice. The last evaluation, in 2005, recommended a 72-hour observation period before deciding whether hospitalization was necessary. The situation of violent patients remains unclear. On the one hand, the psychiatrist has no means of impinging on these patients if they decide to stop their treatment once outside the hospital. On the other hand, for patients who are declared to be irresponsible, it would be wise to consider the possibility of being able to judge them, and adapt their sentences accordingly.


Using spatial, temporal and evidence-status data to improve ballistic imaging performance.
Firearms identification imaging systems help solve crimes by comparing newly acquired images of cartridge casings or bullets to a database of images obtained from past crime scenes. We formulate an optimization problem that bases its matching decisions not only on the similarity between pairs of images, but also on the time and spatial location of each new acquisition and each database entry. The objective is to maximize the detection probability subject to a constraint on the false positive rate. We use data on all cartridge casings matches detected in Israel during 2006-2008 to estimate most of the model parameters. We estimate matching accuracy from two different studies and predict that the optimal use of extraneous information would increase the detection probability from 0.931 to 0.987 and from 0.707 to 0.844, respectively. These improvements are achieved by favoring pairs of images that are closer together in space and time.


Calcific tendinitis of the longus colli muscle.
Facility in the evaluation of the cervical prevertebral soft tissues should be a skill of any otolaryngologist. Tendinitis of the longus colli muscle mimics more serious disease processes of the prevertebral cervical region that the otolaryngologist may be required to evaluate. It has, however, received little attention in otolaryngological literature. Five cases from the Massachusetts Eye and Ear Infirmary are presented. Calcific tendinitis of the longus colli muscle is an easily recognized clinical and radiological syndrome. Characteristic features include cervical pain, dysphagia, and distinctive radiographs. The pathognomonic lateral neck film reveals prevertebral soft tissue swelling and an amorphous radiodensity anterior to the C-1 and C-2 vertebral bodies. Symptoms usually manifest over a few days and resolve benignly within 2 weeks.


Automated in vivo delineation of lumen wall using intravascular ultrasound imaging.
This paper presents a novel methodology for automated detection and extraction of the lumen wall from Intravascular Ultrasound (IVUS) frames. IVUS is an in-vivo pull back imaging technique and provides a sequential frame of images for diagnosis of atherosclerotic heart disease. The detection and segmentation of lumen wall is necessary for predicting the arterial wall blockage. Lumen wall is recognized and segmented with the help of seed refinement and random walks algorithms, in tunica and lumen area. The proposed methodology was tested on 147 frames of 13 patients. Proposed method achieves significant performances for automated lumen wall detection and extraction as compared with existing literature.


Region-based current-source reconstruction for the inverse EEG problem.
This paper presents a new method for the reconstruction of current sources for the electroencephalography (EEG) inverse problem, which produces reconstructed sources, which are confined to a few anatomical regions. The method is based on a partition of the gray matter into a set of regions, and in the construction of a simple linear model for the potential produced by feasible source configurations inside each one of these regions. The proposed method computes the solution in two stages: in the first one, a subset of active regions is found so that the combined potentials produced by sources inside them approximate the measured potential data. In the second stage, a detailed reconstruction of the current sources inside each active region is performed. Experimental results with synthetic data are presented, which show that the proposed scheme is fast, computationally efficient and robust to noise, producing results that are competitive with other published methods, especially when the current sources are effectively distributed in few anatomical regions. The proposed method is also validated with real data from an experiment with visual evoked potentials.


Ribostamycin, as an intermediate in the biosynthesis of neomycin.
A mutant of a neomycin-producting Streptomyces fradiae was found which synthesizes ribostamycin instead of neomycin. After a reverse mutation new colonies were obtained producting neomycin again. Ribostamycin might thus be considered as an intermediate in the biosynthesis of neomycin.


Effect of postnatal nutrition restriction on the oxidative status of neonates with intrauterine growth restriction in a pig model.
In offspring with intrauterine growth restriction (IUGR), where oxidative stress may play an important role in inducing metabolic syndrome, nutrition restriction has been shown to improve oxidative status. In this study, we aimed to investigate the effect of postnatal nutrition restriction on the oxidative status of IUGR neonates. A total of twelve pairs of piglets, of normal birth-weight (NBW) and with IUGR (7 days old), respectively, were randomly allocated to have adequate nutritional intake (ANI) and restricted nutritional intake (RNI) for a period of 21 days, respectively. This design produced 4 experimental groups: NBW-ANI, IUGR-ANI, NBW-RNI and IUGR-RNI (n = 6 per group). Serum, ileum and liver samples were analyzed for antioxidant parameters and the mRNA expression of genes with regard to oxidative status. The data were subjected to general linear model analysis and Duncan's test with a 5% significance level. Irrespective of nutritional intake, the IUGR pigs had markedly lower activity of glutathione peroxidase (GPX), gene expressions of liver mitochondrial manganese superoxide dismutase (Mn-SOD) and ileum cytoplasmic copper/zinc (CuZn)-SOD and, accordingly, there was a markedly higher malondialdehyde concentration in the liver of these pigs compared to in the NBW pigs. Irrespective of body weight, pigs receiving ANI treatment had significantly lower activities of antioxidant enzymes in the serum (total antioxidative capability, CuZn-SOD and GPX) and liver (total SOD and glutathione reductase) and decreased gene expression of liver CuZn-SOD and Mn-SOD compared to the pigs receiving RNI. In addition, the IUGR pigs had a markedly lower concentration of liver reduced glutathione (GSH), ratio of GSH to oxidized glutathione, gene expression of ileum CuZn-SOD and extracellular SOD than the NBW pigs when receiving ANI, but not all of these differences were observed in those receiving RNI. IUGR neonates may have poor antioxidant defense systems, and postnatal nutrition restriction has the potential to prevent oxidative stress.


Veno-Venous Extracorporeal Membrane Oxygenation for Continuous Renal Replacement in a Neonate with Propionic Acidemia.
The usual indications for extra corporeal membrane oxygenation (ECMO) are for respiratory or cardiac failure. Although continuous renal replacement therapy (CRRT) is frequently used when patients are on ECMO, the need for CRRT as the primary indication for ECMO is rare. A case of a neonate placed onto veno-venous ECMO for the use of CRRT to treat hyperammonemia from propionic acidemia is presented.


[Effect of agmatine on proliferation of rat PASMCs induced by serum].
To determine the effect of agmatine on the proliferation of PASMCs induced by serum. Primary culture of rat PASMCs was prepared from adult male Wistar rat pulmonary artery by the method of tissue block anchorage. PASMCs were divided into two groups: control group and agmatine administration group. The activity of LDH in the medium was measured by chromatometry. The 3H-TdR incorporation was measured by liquid scintillometry. The cell cycle was measured by flow cytometry. The PCNA content was measured by image analysis. Agmatine did not exert significant effect on the activity of LDH in the medium. Agmatine significantly decreased the 3H-TdR incorporation and PCNA content of PASMCs. Agmatine significantly decreased the cell ratio of G2/M phase and increased the cell ratio of G0/G1 phase. With the increment of the concentration of agmatine, 3H-TdR incorporation was significantly decreased correspondingly. Agmatine has no significant cytotoxic effect on PASMCs. Agmatine can dose-dependently inhibit the proliferation of rat PASMCs induced by serum.


Mining online e-liquid reviews for opinion polarities about e-liquid features.
In recent years, the emerging electronic cigarette (e-cigarette) marketplace has developed prosperously all over the world. By analyzing online e-liquid reviews, we seek to identify the features attracting users. We collected e-liquid reviews from one of the largest online e-liquid review websites and extracted the e-liquid features by keywords. Then we used sentiment analysis to classify the features into two polarities: positive and negative. The positive sentiment ratio of a feature reflects the e-cigarette users' preference on this feature. The popularity and preference of e-liquid features are not correlated. Nuts and cream are the favorite flavor categories, while fruit and cream are the most popular categories. The top mixed flavors are preferable to single flavors. Fruit and cream categories are most frequently mixed with other flavors. E-cigarette users are satisfied with cloud production, but not satisfied with the ingredients and throat hit. We identified the flavors that e-cigarette users were satisfied with, and we found the users liked e-cigarette cloud production. Therefore, flavors and cloud production are potential factors attracting new users.


Random urine calcium/osmolality in the assessment of calciuria in children with decreased muscle mass.
Random urine Ca/creatinine (UCa/Cr) is used to estimate 24-hour Ca excretion. However, due to decreased urine creatinine excretion in children with decreased muscle mass (DMM), UCa/Cr overestimates their Ca excretion. To evaluate whether in children with DMM random urine Ca/osmolality (UCa/Osm) can accurately predict hypercalciuria (24-hour urine Ca > 4.0 mg/kg) and at which "cutoff" value. 19 children with DMM and 29 with normal muscle mass (NMM), ages 6 - 17 years, were studied. DMM was diagnosed based on clinical findings and decreased serum creatinine, and confirmed by low urine creatinine excretion. Over 24 hours, subjects collected each void separately. After each sample was analyzed, samples of each participant were combined to form a 24-hour specimen from which an aliquot (AL) was obtained; 24-hour urine Ca was first correlated with the corresponding AL Ca/Cr and Ca/Osm. As an internal control, a similar assessment ofproteinuria was conducted. In the next step, AL data were compared with individual urine samples to identify the time of day when a random sample best correlates with AL. The correlation coefficient between 24-hour Ca and AL Ca/Cr in all children was 0.61, in NMM 0.96, and in DMM 0.69 (in all p < 0.001). The correlation coefficient between 24-hour urine Ca and AL Ca/Osm in all children was 0.90, in NMM 0.90, and in DMM 0.91 (in all p < 0.001). In children with DMM, the correlation coefficient of 24-hour protein with AL protein/Cr was 0.75, and with protein/Osm 0.98 (both p < 0.001). Receiver operating characteristic curves showed UCa/Cr as a better predictor of 24-hour Ca > 4.0 mg/kg in NMM, whereas UCa/Osm was a better predictor of hypercalciuria in DMM patients. In NMM, UCa/Cr ratio > 0.20 had sensitivity of 88% and specificity of 96% in detecting 24-hour Ca > 4.0 mg/kg, whereas in those with DMM UCa/Osm (x 10) ratio of > 0.25 had sensitivity of 100% and specificity of 93% in detecting hypercalciuria. It was further found that random urine specimens collected between 9:00 a.m. and 2:00 p.m. best represented 24-hour urine data. In children with DMM, UCa/Osm can successfully replace UCa/Cr as a screening tool for hypercalciuria.


Discrimination and classification of olive tree varieties and cultivation zones by biophenol contents.
The peak areas from a high-performance liquid chromatography-diode array (HPLC-DAD) analysis of biophenols extracted from olive leaves have been used as chemotaxonomic markers to construct chemometric models in order to discriminate and classify (1) 13 varieties of Olea europaea olive trees, namely, Alameño, Arbequina, Azulillo, Chorna, Hojiblanca, Lechín, Manzanillo, Negrillo, Nevadillo, Ocal, Pierra, Sevillano, and Tempranillo, from the same cultivation zone and (2) Arbequina samples from six different geoghaphical origins, namely, Córdoba, Mallorca (north and south), Ciudad Real, Lleida, and Navarra. Models based on principal component analysis (PCA) and hierarchical cluster analysis (HCA) were used for discrimination between samples as a function of the tree varieties and cultivation zone, whereas K nearest neighbors (KNN) and soft independent modeling of class analogy (SIMCA) models were generated to classify the samples used to validate the models into one of the groups previously established by PCA and HCA. KNN classified correctly 93 and 92% of the samples into the variety and cultivation zone, respectively; meanwhile, the SIMCA models predicted 85 and 92%, respectively.


Understanding the distributional impacts of health insurance reform: Evidence from a consumer cost-sharing program.
We examine the heterogeneous effects of reference pricing, a health insurance reform introduced by the California Public Employees' Retirement System (CalPERS), on the distribution of spending by patients and insurers. Using medical claims data for CalPERS and a comparison group not subject to reference pricing, we use the changes-in-changes approach to estimate the quantile treatment effects of the program across different medical procedures. We find that the quantile treatment effects vary across the patient spending distributions, with a range of positive and negative estimates of the QTE, depending on the medical procedure considered. However, across all procedures, the insurer's spending distributions tend to shift left, with the largest reductions occurring in the right-tail of the spending distributions. These effects are not captured by mean estimates but have important policy implications.


IgD paraproteinemias.
In a series of 2038 paraproteinemic sera, 9 IgD paraproteins (0.44%) were found. Clinical diagnosis of all the 9 was multiple myeloma. One patient had an IgD-lambda plasmacytoma which developed into plasmocellular leukemia. Our series of IgD paraproteins consisted of 6 females and 3 males with a mean age of 58.5 years. The mean concentrations of IgD paraproteins were 6.7 +/- 4.26 g/l and the mean proteinuria was 5.1 +/- 4.76 g/24 h. Eight IgD paraproteins had light chains lambda and one had light chains kappa.


A dynamic and complex network regulates the heterosis of yield-correlated traits in rapeseed (Brassica napus L.).
Although much research has been conducted, the genetic architecture of heterosis remains ambiguous. To unravel the genetic architecture of heterosis, a reconstructed F(2) population was produced by random intercross among 202 lines of a double haploid population in rapeseed (Brassica napus L.). Both populations were planted in three environments and 15 yield-correlated traits were measured, and only seed yield and eight yield-correlated traits showed significant mid-parent heterosis, with the mean ranging from 8.7% (branch number) to 31.4% (seed yield). Hundreds of QTL and epistatic interactions were identified for the 15 yield-correlated traits, involving numerous variable loci with moderate effect, genome-wide distribution and obvious hotspots. All kinds of mode-of-inheritance of QTL (additive, A; partial-dominant, PD; full-dominant, D; over-dominant, OD) and epistatic interactions (additive × additive, AA; additive × dominant/dominant × additive, AD/DA; dominant × dominant, DD) were observed and epistasis, especially AA epistasis, seemed to be the major genetic basis of heterosis in rapeseed. Consistent with the low correlation between marker heterozygosity and mid-parent heterosis/hybrid performance, a considerable proportion of dominant and DD epistatic effects were negative, indicating heterozygosity was not always advantageous for heterosis/hybrid performance. The implications of our results on evolution and crop breeding are discussed.


Asymmetric free-standing 2-D photonic crystal films and their Janus particles.
We report the fabrication of large area, thin asymmetric free-standing two-dimensional (2-D) photonic crystals. We fabricate large area 2-D close-packed monodisperse polystyrene (PS) particle monolayers at air/water interfaces by using our needle tip flow method. We then layer tetraethyl orthosilicate (TEOS) onto the 2-D array to form a thin TEOS layer on the 2-D particle array on water. The hemispheres of PS particles located within the TEOS phase swell such that the adjacent particle hemispheres fuse. After TEOS evaporation, we obtain a free-standing connected photonic crystal film of hemispheres that efficiently diffracts light. The other side of the photonic crystal film consists of a fused connecting thin, flat sheet. Reactive ion etching (RIE) of the asymmetric films forms unusual, rough particle 2-D arrays and 2-D flower-like arrays. Mechanical abrasion allows one to separate the resulting novel Janus particles.


Do Inflammatory Cytokines Affect Patient Outcomes After ACDF?
Prospective cohort study. The aim was to determine the relationship between serum inflammatory mediators, preoperative cervical spine disease severity, and clinical outcomes after anterior cervical discectomy and fusion (ACDF). Given the role of the inflammatory cascade in spinal degenerative disease, it has been hypothesized that inflammatory markers may serve as a predictor of patient outcomes after surgery. All patients over age 18 who underwent ACDF for cervical spondylosis with associated radiculopathy and/or myelopathy between 2015 and 2017 from a single institution were prospectively recruited. Preoperative serum inflammatory markers including interleukin (IL)-6, IL-8, tumor necrosis factor-α, high-mobility group box-1 (HMGB1), and white blood cells were measured and correlated to patient demographics, surgical characteristics, duration of symptoms, previous opioid use, and preoperative and 1-year postoperative patient-reported outcomes measures (PROMs) including the neck disability index (NDI), visual analog scale neck pain, visual analog scale arm pain, and Physical and Mental Component Scores of the Short Form-12 (PCS and MCS, respectively) using spearman's rho coefficient. A total of 77 patients were enrolled with follow-up PROMs available for 62% (n=48) of patients at a minimum of 1-year after ACDF. The absolute concentrations of IL-6 and tumor necrosis factor-α were found to be weakly correlated with one another (ρ=0.479). Preoperative symptoms lasting <1-year were weakly correlated with elevation in HMGB1 (ρ=0.421). All other patient demographics exhibited negligible correlation with the preoperative inflammatory markers. Lower preoperative PCS (ρ=0.355) and higher preoperative NDI (ρ=0.336) were weakly correlated with elevated HMGB1. Lower MCS (ρ=0.395) and higher NDI (ρ=0.317) preoperatively were weakly correlated with elevated white blood cells. Postoperative improvement in MCS (ρ=0.306) and MCS recovery ratio (ρ=0.321) exhibited a weakly positive correlation with IL-6. Preoperative cytokine levels demonstrated minimal correlation with preoperative symptoms or clinical improvement, suggesting that profiling of patient cytokines has limited utility in predicting outcomes after ACDF. Level III.


Hydrogen bis[tris(4-fluorophenyl)phosphane oxide] triiodide.
In the title compound, C(36)H(25)F(6)O(2)P(2)(+)·I(3)(-), hydrogen-bonded [{(p-FC(6)H(4))(3)PO}(2)H](+) dimers assemble along the crystallographic c axis to form channels that house extended chains of triiodide anions. Although the I-I bond lengths of 2.9452 (14) and 2.9023 (15) Å are typical, the inter-ion I...I distance of 3.5774 (10) Å is unusually short. A posteriori modelling of nonmerohedral twinning about (100) has been only partially successful, achieving a reduction in the maximum residual electron density from 5.28 to 3.24 e Å(-3). The inclusion of two low-occupancy I-atom sites (total 1.7%), which can be interpreted as translational disorder of the triiodide anions along the channels, reduced the maximum residual electron density to 2.03 e Å(-3). The minor fractional contribution volume of the nonmerohedral twin domains refined to 0.24 and simultaneous refinement of the inversion twin domains showed the crystal to be a 0.5:0.5 inversion twin.


Clinical Evaluation of Endoscopic Bronchial Occlusion with an Endobronchial Watanabe Spigot for the Management of Intractable Pneumothorax, Pyothorax with Bronchial Fistula, and Postoperative Air Leakage.
Objective The present study aimed to evaluate the clinical effectiveness of endoscopic bronchial occlusion (EBO) with endobronchial Watanabe spigots (EWSs) for the management of prolonged pulmonary air leaks, such as intractable pneumothorax, pyothorax with bronchial fistula, and postoperative air leakage. Methods This was a retrospective study. Between April 2005 and March 2018, we recruited 21 patients with intractable pneumothorax (10 cases), pyothorax with bronchial fistula (7 cases), and postsurgical pulmonary fistula (4 cases) in whom appropriate drainage for 2 weeks had been unsuccessful and who were unsuitable for surgery. An EWS was inserted using a flexible bronchoscope via an endotracheal or a tracheostomy tube. Results The mean number of sessions with EWS procedures was 1.94, and the mean number of inserted EWS per patient was 6.5. In addition to EWS procedures, pleural washing and pleural adhesion therapy were performed in all cases with pyothorax, whereas pleural adhesion therapy was performed in three patients with pneumothorax. The successful treatment rate was 85.7%. Reduction of air leakage was observed in 19/21 patients. The mean duration of reduction of air leaks was 4.1 days (median, 1; range, 0-24 days) following EWS procedures. The mean duration from tube insertion to chest tube removal was 43.4 days (median, 29; range, 16-105 days). Complications included spigot migration and infection (aspergillosis); no complications caused significant mortality. Conclusion Performing EBO using an EWS appears to be a reasonable option for the management of intractable pneumothorax, pyothorax with pulmonary fistula, and postoperative air leakage.


[Level of and change in road traffic mortality in Argentina, Chile, Colombia and Mexico, 2000-2011].
The aim of this study was to estimate the effect of run-over fatalities and traffic collisions in life expectancy in Argentina, Chile, Colombia and Mexico, between 2000 and 2011. Years of life expectancy lost (YLEL) were calculated for the periods 2000-2002 and 2009-2011. The results show that road traffic deaths made up between 1% and 4% of all deaths in each country. In the first period, the highest level of mortality occurred in Colombia (YLEL=0.96) and the lowest in Argentina (YLEL=0.59). In all the countries studied except Argentina, the impact of these deaths on life expectancy was reduced in the second period. The main change took place in Colombia, reaching 0.72 YLEL in the second period. It is concluded that traffic-related deaths have a negative impact on health systems, victims, the productive sector, and society in general. From this point of view, the issue of road transit must be considered a matter of public health, requiring multi-sector intervention in the design of national and regional policies.


Genetic polymorphisms of TP53 Arg72Pro and Pro47Ser among Egyptian patients with colorectal carcinoma.
Previous reports demonstrated the role of TP53 gene polymorphisms with CRC risk among several ethnic populations. The purpose of this study is to assess the association of the TP53 Arg72Pro and Pro47Ser variants with CRC risk among Egyptian patients. This work was conducted on 120 unrelated CRC Egyptian patients who were compared to 140 healthy controls. DNA was genotyped for these variants using the PCR-RFLP technique. CRC patients observed a significant association of the rare genotype of TP53 Arg72Pro polymorphism compared with healthy controls. On the contrast, all genetic models showed no statistical association of TP53 Pro47Ser polymorphism among CRC patients compared with healthy controls. On the contrast, CRC patients of the TP53 gene polymorphisms indicated no significant difference regarding their clinical and laboratory markers. Our findings indicate a strong association with TP53 Arg72Pro variant within increased risk of CRC among Egyptian patients.


Myocardial lineage development.
The myocardium of the heart is composed of multiple highly specialized myocardial lineages, including those of the ventricular and atrial myocardium, and the specialized conduction system. Specification and maturation of each of these lineages during heart development is a highly ordered, ongoing process involving multiple signaling pathways and their intersection with transcriptional regulatory networks. Here, we attempt to summarize and compare much of what we know about specification and maturation of myocardial lineages from studies in several different vertebrate model systems. To date, most research has focused on early specification, and although there is still more to learn about early specification, less is known about factors that promote subsequent maturation of myocardial lineages required to build the functioning adult heart.


Nickel adsorption onto polyurethane ethylene and vinyl acetate sorbents.
The present study was conducted to appraise the efficiencies of polyurethane ethylene sorbent (PES) and vinyl acetate sorbent (VAS) for nickel (Ni) adsorption. Process variables, i.e. Ni(II) ions initial concentration, pH, contact time and adsorbent dosage were optimized by response surface methodology (RSM) approach. The Ni(II) adsorption was fitted to the kinetic models (pseudo-first-order and pseudo-second-order) and adsorption isotherms (Freundlich and Langmuir). At optimum conditions of process variables, 171.99 mg/g (64.7%) and 388.08 mg/g (92.7%) Ni(II) was adsorbed onto PES and VAS, respectively. The RSM analysis revealed that maximum Ni(II) adsorption can be achieved at 299 mg/L Ni(II) ions initial concentration, 4.5 pH, 934 min contact time and 1.3 g adsorbent dosage levels for PES, whereas the optimum values for VAS were found to be 402 mg/L Ni(II) ions initial concentration, 4.6 pH, 881 min contact time and 1.2 g adsorbent dosage, respectively. The -OH and -C = O- were involved in the Ni(II) adsorption onto PES and VAS adsorbents. At optimum levels, up to 53.67% and 80.0% Ni(II) was removed from chemical industry wastewater using PES and VAS, respectively, which suggest that PES and VAS could possibly be used for Ni(II) adsorption from industrial wastewater.


Guideline-Directed Medical Therapies for Heart Failure with a Reduced Ejection Fraction in Older Adults: A Narrative Review on Efficacy, Safety and Timeliness.
Heart failure is a prevalent syndrome among older adults, with a major impact on morbidity and mortality. Higher age is correlated with underuse of guideline-directed medical therapies which, in turn, has been linked to worse clinical outcomes. Importantly, most evidence so far has been collected in adults who were younger, less multi-morbid and polymedicated compared with those who are commonly treated in daily clinical practice. Hence, we aimed to assess and describe the evidence base for pharmacotherapy in older adults with heart failure with a reduced ejection. First, a narrative review was undertaken using Medline, from inception to January 2023. Four foundational therapies were selected based on the latest European Society of Cardiology clinical practice guideline: angiotensin-converting enzyme inhibitors/angiotensin receptor neprilysin inhibitors, beta blockers, mineralocorticoid receptor antagonists and sodium-glucose cotransporter-2 inhibitors. Post hoc analyses from landmark heart failure drug trials were searched and included if they contained data on the impact of age on efficacy, safety and/or timeliness of therapies in the management of heart failure with a reduced ejection fraction. Second, a proposal was developed to support and promote the use of evidence-based heart failure pharmacotherapy in complex, older adults. In total, 11 articles were selected: 4 meta-analyses, 6 post hoc analyses and 1 review paper. No attenuation of efficacy for any of the foundational agents was found in older adults. Regarding safety, dedicated analyses showed that beta blockers, mineraloid receptor antagonists, sacubitril-valsartan, dapagliflozin and empagliflozin retained their overall benefit-risk profile regardless of age. Time to benefit was short and occurred generally within 1 month. Consensus was achieved on a five-step proposal to manage complex medication regimens in older adults suffering from heart failure. In conclusion, older adults suffering from heart failure with a reduced ejection fraction should not be denied treatment based on their age.


Tyrosine kinase cell signaling pathways of rat mesangial cells in 3-dimensional cultures: response to fetal bovine serum and platelet-derived growth factor-BB.
Cells grown in 3-dimensional collagen gels adopt a nonproliferative, contractile phenotype which is more characteristic of cells in vivo than cells grown in 2-dimensional culture. The floating collagen gel contraction assay is a well-defined system used to study cell-extracellular matrix interactions grown in 3-dimensional culture. Although the cell biology of this system is well defined, the cell signaling associated with gel contraction has not been well characterized. In this study we demonstrate that fetal bovine (FBS) and platelet-derived growth factor (PDGF)-induced mesangial cell-collagen gel contraction is associated with increased tyrosine phosphorylation of a number of proteins including focal adhesion kinase (FAK) and the 42-kDa isoform of MAPK (ERK2). FBS-induced gel contraction is not affected by the presence of the MEK inhibitor PD098059. Low concentrations of PDGF-BB (10 ng/ml) induce gel contraction; however, at higher PDGF-BB concentrations (80 ng/ml) gel contraction is not observed. PDGF-BB-induced gel contraction as well as tyrosine phosphorylation of FAK are inhibited in the presence of the PI-3 kinase inhibitor wortmanin. Minimal autophosphorylation of the PDGF-beta receptor is observed under 3-dimensional culture conditions following PDGF-BB stimulation; however, when mesangial cells grown in 2-dimensional culture are exposed to PDGF-BB, the PDGF-beta receptor was prominently phosphorylated. We conclude that induction of collagen gel contraction by FBS and PDGF-BB is associated with tyrosine kinase phosphorylation and that these responses differ substantially from what occurs in 2-dimensional cultures in the presence of the same agonists.


DNA-unwinding activity of Saccharomyces cerevisiae Pif1 is modulated by thermal stability, folding conformation, and loop lengths of G-quadruplex DNA.
G-quadruplexes (G4s) are four-stranded DNA structures formed by Hoogsteen base pairing between stacked sets of four guanines. Pif1 helicase plays critical roles in suppressing genomic instability in the yeast Saccharomyces cerevisiae by resolving G4s. However, the structural properties of G4s in S. cerevisiae and the substrate preference of Pif1 for different G4s remain unknown. Here, using CD spectroscopy and 83 G4 motifs from S. cerevisiae ranging in length from 30 to 60 nucleotides, we first show that G4 structures can be formed with a broad range of loop sizes in vitro and that a parallel conformation is favored. Using single-molecule FRET analysis, we then systematically addressed Pif1-mediated unwinding of various G4s and found that Pif1 is sensitive to G4 stability. Moreover, Pif1 preferentially unfolded antiparallel G4s rather than parallel G4s having similar stability. Furthermore, our results indicate that most G4 structures in S. cerevisiae sequences have long loops and can be efficiently unfolded by Pif1 because of their low stability. However, we also found that G4 structures with short loops can be barely unfolded. This study highlights the formidable capability of Pif1 to resolve the majority of G4s in S. cerevisiae sequences, narrows the fractions of G4s that may be challenging for genomic stability, and provides a framework for understanding the influence of different G4s on genomic stability via their processing by Pif1.


[Pseudotumoral neurobehçet: a case report].
Neurological involvement occurs in 5.3% to 30% of patients with Behçet's disease. Neurological manifestations can be secondary to direct central nervous system involvement (encephalitis, encephalomyelitis) or vascular angeitis (essentially cerebral venous, thrombosis and, rarely, intracranial aneurysms). Neurological pseudotumoral presentation is rarely reported. We report a case of 26-year-old woman suffering from left hemiplegia. MRI was performed and showed pseudotumoral lesion in the protuberance and the right cerebral pedicule. Oral and genital aphtous ulcers were found. HLAB51 was positive. The patient improved with steroid therapy.


Jack fruit lectin-specific glycoconjugate expression during the progression of cervical intraepithelial neoplasia: a study on exfoliated cells.
The expression of glycoconjugates specific to Jack fruit lectin (JFL) was studied in the exfoliated squamous cells of different grades of intraepithelial and invasive neoplasia of the uterine cervix. It was observed that while normal cells showed almost negative binding, the lectin binding percentage of squamous cells significantly increased with increasing atypia of the epithelium. Correlation analysis between different groups revealed that mild lectin binding in cells had a negative correlation and intense binding had a positive correlation with various stages of tumor progression. These results indicate that the number of cells with aberrant expression of glycoconjugates increases as neoplastic transformation advances. The percentage of labeled and unlabeled cells also shows a continuous transition from low to severe grades of cervical intraepithelial neoplasia and invasive carcinomas. The present study therefore shows that JFL may be used as a probe for further elaboration of detection and grading of precancerous and cancerous lesions of the uterine cervix.


Synthesis of RNA using 2'-O-DTM protection.
tert-Butyldithiomethyl (DTM), a novel hydroxyl protecting group, cleavable under reductive conditions, was developed and applied for the protection of 2'-OH during solid-phase RNA synthesis. This function is compatible with all standard protecting groups used in oligonucleotide synthesis, and allows for fast and high-yield synthesis of RNA. Oligonucleotides containing the 2'-O-DTM groups can be easily deprotected under the mildest possible aqueous and homogeneous conditions. The preserved 5'-O-DMTr function can be used for high-throughput cartridge RNA purification.


Investigation of Structure of the Ribosomal L12/P Stalk.
This review contains recent data on the structure of the functionally important ribosomal domain, L12/P stalk, of the large ribosomal subunit. It is the most mobile site of the ribosome; it has been found in ribosomes of all living cells, and it is involved in the interaction between ribosomes and translation factors. The difference between the structures of the ribosomal proteins forming this protuberance (despite their general resemblance) determines the specificity of interaction between eukaryotic and prokaryotic ribosomes and the respective protein factors of translation. In this review, works on the structures of ribosomal proteins forming the L12/P-stalk in bacteria, archaea, and eukaryotes and data on structural aspects of interactions between these proteins and rRNA are described in detail.


Motorbike-handlebar hernia - a rare traumatic abdominal wall hernia: a case report and review of the literature.
Handlebar hernias are very rare and arise following a sudden force from a handle-like object impacting a focal area of the abdomen, which results in a disruption of the underlying abdominal muscle and fascia without necessarily disrupting the overlying skin. Other than a reducible swelling on the abdominal wall, the physical examination of such patients is usually unremarkable and the diagnosis could easily be missed. An 8-year-old Cameroonian boy with no significant past history presented to our emergency service with a tender left flank swelling following a road traffic accident. He was knocked down by a motorbike with resulting impact of the handlebar on his abdomen. A handlebar hernia was diagnosed on the basis of a reducible abdominal swelling with a positive cough impulse. A herniorrhaphy was done the following day after resuscitation and his postoperative period was uneventful. Handlebar hernias, although rare, should be suspected when patients present with an abdominal swelling following blunt abdominal trauma involving a handlebar-like object. A good history and physical examination are usually enough to pose an early diagnosis of handlebar hernia. Management typically involves surgical intervention to prevent complications. The timing and surgical approach should be decided on a case-by-case basis.


Value of early rest myocardial perfusion imaging with SPECT in patients with chest pain and non-diagnostic ECG in emergency department.
Evaluation of atypical presentation of angina chest pain in emergency department is difficult. Hospitalization of this patient may impose additional costs and waste the time, early discharge may lead to miss the patients. The aim of this study was to determine volubility of Single Photon Emission Computed Tomography (SPECT) in management of patients admitted to emergency department with atypical manifestations of angina pain, un-diagnostic Electrocardiogram (ECG) and negative enzyme. Half of 100 patients admitted to emergency department with atypical chest pain and un-diagnostic ECG who were candidate for admission, underwent ECG gated resting SPECT. According to the results of SPECT, low risk patient discharged after negative stress SPECT. All discharged patients were followed up for major cardiac events (cardiac death, nonfatal myocardial infarction and repeat admission for congestive heart failure) for 12 months. According to rest SPECT Myocardial Perfusion Imaging (MPI), about 70% of patients in case group was low risk and 30% of them had moderate or high risk. Case group represented lower hospitalization rate and lower need for Coronary Artery Angiography (CAG) in comparison with control group. Mean cost in case group was significantly lower than control group (175.15$ vs. 391.33$, P < 0.001). In one year follow- up no cases of mortality or major cardiovascular events as cardiac infraction were found in discharged patients in case group. our study showed that rest SPECT fulfillment in admitted patients in emergency department was validated method for assessing patients' risk which avoids unnecessary hospitalizations and additional costs.


Breaching confidentiality: medical mandatory reporting laws in Iran.
Medical ethics is a realm where four important subjects of philosophy, medicine, theology and law are covered. Physicians and philosophers cooperation in this area will have great efficiency in the respective ethical rules formation. In addition to respect the autonomy of the patient, physician's obligation is to ensure that the medical intervention has benefit for the patient and the harm is minimal. There is an obvious conflict between duty of confidentiality and duty of mandatory reporting. Professional confidentiality is one of the basic components in building a constant physician-patient relationship which nowadays, beside the novelty, it is the subject of discussion. Legal obligation of confidentiality is not absolute. In physician-patient relationship, keeping patient's secrets and maintaining confidentiality is a legal and ethical duty, and disclosure of such secrets is mainly through specific statutes. Thus, there are a number of situations where breach of confidentiality is permitted in different legal systems. One of the situations where breaching confidentiality is permitted is the medical mandatory reporting to the relevant authority which is in accordance with many countries' legal systems. Some situations are considered in many countries legal systems' such as notification of births and deaths, infectious diseases, child abuse, sport and relevant events, medical errors, drug side effects and dangerous pregnancies. In this paper, we will examine and discuss medical mandatory reporting and its ethical and legal aspects in the judicial and legal system of Iran and few other countries. Finally we will suggest making Medical Mandatory Reporting Law in Iran.