Associations Between Anxiety Symptoms and Child and Family Factors in Pediatric Obesity.
This study compared child weight status, social skills, body dissatisfaction, and health-related quality of life (HRQOL), as well as parent distress and family functioning in youth who are overweight or obese (OV/OB) with versus without clinical anxiety symptoms. Participants included 199 children 7 to 12 years of age (mean age = 9.88 years) who were OV/OB, and their parents. Children completed social skills, body dissatisfaction, and HRQOL questionnaires. Parents completed the Child Behavior Checklist (CBCL) and child HRQOL, parent distress, family functioning, and demographic questionnaires. Children were placed in 2 groups based on CBCL anxiety problems scale scores: the OV/OB + clinical anxiety group included children with T scores ≥65 (n = 23) and children with T scores ≤59 comprised the OV/OB group (n = 176). After controlling for covariates, children in the OV/OB + clinical anxiety group reported more body dissatisfaction (F[1,198] = 5.26, p = .023, partial η = .027) and lower total HRQOL (F[1,198] = 8.12, p = .005, η = .041) and had parents who reported higher psychological distress (F[1,198] = 5.48, p = .020, η = .028) and lower child total HRQOL (F[1,198] = 28.23, p < .001, η = .128) compared with children in the OV/OB group. Group differences were not significant for child weight status, social skills, or family functioning. Clinically significant anxiety among children who are OV/OB is associated with increased body dissatisfaction and parent psychological distress, as well as decreased HRQOL. Findings have implications for the assessment and treatment of anxiety symptoms in pediatric obesity.


Giant cell arteritis: a systemic vascular disease.
Giant cell arteritis (GCA) is increasingly being recognized as a systemic vascular disease, not confined to the cranial arteries. Epidemiological studies have shown that almost one-third of the patients with GCA develop serious peripheral vascular complications during long-term follow up, and there is growing evidence that unrecognized extracranial involvement may be even more common. GCA of large- and medium-sized peripheral arteries typically leads to long tapering and occlusion of the arterial lumen due to concentric intimal thickening, sometimes accompanied by spontaneous dissection. Depending on the extent of the arterial obliteration and on the anatomy of the involved arterial segment, this may result in severe ischemia of the limbs during the acute phase of the disease. GCA of the aorta usually remains asymptomatic for many years, and leads to a markedly increased risk of aneurysms and dissections, particularly of the thoracic aorta. Evolving vascular imaging techniques such as duplex ultrasound, computer tomography (CT), magnetic resonance imaging (MRI), and fluorine-18-desoxyglucose positron emission tomography (18F-FDG-PET) have greatly improved our ability to detect and study arterial changes in large-artery vasculitis. Boosted by these advances in vascular imaging, vascular specialists are increasingly involved in the early diagnosis, follow-up and treatment of patients with large-vessel vasculitis.


A reverse localization scheme for underwater acoustic sensor networks.
Underwater Wireless Sensor Networks (UWSNs) provide new opportunities to observe and predict the behavior of aquatic environments. In some applications like target tracking or disaster prevention, sensed data is meaningless without location information. In this paper, we propose a novel 3D centralized, localization scheme for mobile underwater wireless sensor network, named Reverse Localization Scheme or RLS in short. RLS is an event-driven localization method triggered by detector sensors for launching localization process. RLS is suitable for surveillance applications that require very fast reactions to events and could report the location of the occurrence. In this method, mobile sensor nodes report the event toward the surface anchors as soon as they detect it. They do not require waiting to receive location information from anchors. Simulation results confirm that the proposed scheme improves the energy efficiency and reduces significantly localization response time with a proper level of accuracy in terms of mobility model of water currents. Major contributions of this method lie on reducing the numbers of message exchange for localization, saving the energy and decreasing the average localization response time.


Proteins released by cultured Day 15-16 conceptuses prolong luteal maintenance when introduced into the uterine lumen of cyclic ewes.
Experiments were performed to determine whether proteins, produced and released into the incubation medium by Day 15-16 sheep conceptuses cultured for 24-48 h, could prolong the functional lifespan of the corpus luteum (CL) when infused into the uterine lumen of cyclic ewes. Beginning on Day 12 (oestrus = Day 0) either a concentrated (2 ml) solution of total conceptus culture medium protein (2.2 mg) or diluted sheep serum (2.2 mg protein) was introduced daily via an indwelling catheter into the uterine lumen of 3 ewes for 7 days (Days 12-18). Peripheral blood samples were collected daily for 14 days (Days 12-25). On Day 25 all ewes were laparotomized and ovaries observed to determine whether CL previously marked with India ink were maintained. All controls had ovulated and formed new CL. By contrast none of the conceptus protein-treated ewes had ovulated, and their peripheral progesterone levels remained elevated. One ewe maintained a functional CL until Day 52 when she was hysterectomized. Light microscopy of histological sections prepared from the endometrium revealed glandular development comparable to that in the endometrium of cyclic animals during late dioestrus. The cells of the CL were similar to those from cyclic animals during mid- to late dioestrus. Ovine trophoblast protein ( oTP -1), a major protein secreted by the sheep conceptus between Days 13 and 21 of pregnancy, was purified from conceptus incubation medium and injected (0.2 mg protein/day) into the uterine lumen of 3 animals. Plasma progesterone concentrations indicated that oTP -1-treated animals maintained luteal function 4 days longer than did control animals.(ABSTRACT TRUNCATED AT 250 WORDS)


Distinct expression profiles of stromelysin-2 (MMP-10), collagenase-3 (MMP-13), macrophage metalloelastase (MMP-12), and tissue inhibitor of metalloproteinases-3 (TIMP-3) in intestinal ulcerations.
Programmed expression of matrix metalloproteinases is involved in wound healing in various organs. We have previously demonstrated enhanced expression of collagenase-1, stromelysin-1, matrilysin, and tissue inhibitor of metalloproteinases (TIMP-1) in gastrointestinal ulcerations. To further define the role of matrix-degrading enzymes and their inhibitors in intestinal inflammation and ulcerations, the expression of stromelysin-2 (MMP-10), collagenase-3 (MMP-13), macrophage metalloelastase (HME, MMP-12), and TIMP-3 mRNAs was studied using in situ hybridization and immunohistochemistry in 38 samples representing ulcerative colitis, Crohn's disease, ischemic colitis, and normal intestine. As controls for normally healing intestinal wounds, 12 postoperative samples of rat experimental jejunal anastomoses were also examined. The colitis types studied did not essentially differ in their MMP expression. We found stromelysin-2 mRNA in laminin-5-positive and Ki-67-negative enterocytes bordering the ulcerations. HME was abundantly expressed by macrophages in the vicinity of shedding mucosal epithelium and beneath the necrotic surface of the ulcers. Collagenase-3 and TIMP-3 were expressed by fibroblast-like cells deeper in the remodeling intestinal wall. Expression for stromelysin-2 and collagenase-3 was observed in granulation tissue, but not the epithelium, of the rat anastomoses. Our results suggest a role for stromelysin-2 in epithelial migration and for metalloelastase in macrophage movement and epithelial cell shedding.


Caloric restriction but not exercise-induced reductions in fat mass decrease plasma triiodothyronine concentrations: a randomized controlled trial.
Caloric restriction (CR) decreases circulating triiodothyronine (T(3)) concentration. However, it is not known if this effect is due to body fat mass reductions or due to CR, per se. The purpose of this study was to test the hypothesis that plasma T(3) concentration decreases with CR-induced reductions in fat mass but not in response to similar decreases in fat mass that are induced by exercise. Sedentary, nonobese 50- to 60-year-old men and women with no clinical evidence of cardiovascular or metabolic disease and not taking thyroid medications were randomly assigned to 12 months of caloric restriction (n = 18) or exercise-induced weight loss (n = 17) or to a control group (n = 9). Body weight and composition and plasma concentrations of the thyroid hormones T(3), thyrotropin (TSH), thyroxine (T(4)), and free thyroxine (FT(4)) were measured at baseline and 12 months. Fat mass changed significantly in the CR (-6.3 +/- 1.0 kg) and exercise (-5.5 +/- 1.0 kg) groups but not in the control group (-0.6 +/- 1.4 kg). The changes were not significantly different between the CR and exercise groups. Plasma T(3) concentration decreased in the CR group (-9.8 +/- 2.0 ng/dL, p < 0.0001) but not in the exercise (-3.8 +/- 2.1 ng/dL, p = 0.07) or control (-1.3 +/- 2.8 ng/dL, p = 0.65) groups. TSH, T(4), and FT(4) did not change in any of the study groups. Twelve months of CR decreased circulating T(3) concentrations in middle-aged adults. This effect does not appear to be attributable to changes in body fat mass because a comparable decrease in T(3) concentration was not observed in response to an exercise-induced fat mass reduction.


The mixed kidney cell-lymphocyte reaction in rats.
Optimal conditions for obtaining the proliverative response in mixed kidney cell-lymphocyte culture (MKLC) have been determined in rats. The addition of 2-mercaptoethanol to the culture medium was essential for successful stimulation of lymphocytes by allogeneic kidney cells. Proliferative responses by standard MLC and MKLC were compared in rats with the same or a different Ag-B locus. In most strain combinations, there was a significant correlation between MLC and MKLC reactions, However, the DA-ACI combination, compatible at the Ag-B locus, consistently showed negative MLC and positive MKLC reactions. This suggested the possibility that this technique allowed the expression of kidney specific antigens.


Role of the institutional animal care and use committee in monitoring research.
During the 1980s, federal regulations transferred significant portions of the responsibility for monitoring the care and use of research animals from animal care programs to Institutional Animal Care and Use Committees (IACUCs). After a brief review of the history of the regulation of the use of animals in research preceding and during the 4 decades following World War II, this article raises 4 problems associated with the role IACUCs currently play in monitoring the use of animals in research: (a) lack of expertise, (b) diverted resources, (c) conflict of interest, and (d) restrictions of academic freedom. It is concluded that the care and treatment of animals used in research would be served better and organized more rationally if the day-to-day responsibilities for approving projects and caring for animals were separated more clearly from broader, oversight functions, with the former being assigned to animal care programs and the latter to IACUCs.


LESIONS OF THE GASTROINTESTINAL TRACT RESEMBLING REGIONAL ENTERITIS--A GRANULOMATOUS DISEASE; A REPORT OF THREE CASES.
Although regional enteritis classically involves the terminal ileum, lesions showing similar histology may involve other segments of the gastrointestinal tract, either independently or concomitantly with terminal ileum involvement. Histologically the basic reaction is non-specific chronic inflammation with a granulomatous component and a variable degree of fibrosis. Such lesions in the upper gastrointestinal tract resulted in nonspecific intestinal complaints and roentgenographically showed mucosal alterations and loss of normal motility. Those with colonic involvement were difficult to differentiate from ulcerative colitis, clinically and, in the early stages, roentgenographically. With more advanced involvement, roentgenographical diagnosis was possible.Three patients with lesions illustrating the aforementioned features were diagnosed and treated. One had lesions in the colon and terminal ileum. In the others the terminal ileum was not involved; in the second the stomach, duodenum and upper jejunum were involved, and in the third the colon was involved.


Coronary angiography in smokers undergoing evaluation for lung transplantation: is routine use justified?
Many patients referred for lung transplantation have a history of smoking. For the exclusion of the possibility of asymptomatic coronary artery disease, these patients undergo coronary angiography as part of their preoperative evaluation. The usefulness of this approach remains unknown. We reviewed the records of all smokers referred for lung transplantation who underwent coronary angiography (n = 77). Nine patients (12%) had significant coronary artery disease; six (8%) of these patients had their clinical management altered because of findings on angiography. Eight of nine patients with coronary artery disease (89%) and all of the six patients (100%) whose management was altered had coronary artery disease risk factors other than a history of smoking; therefore, no patient with clinically significant coronary artery disease had history of smoking as the only risk factor. The presence of other coronary artery disease risk factors was significantly associated (p < 0.0001) with the positive findings on angiography. A nonsignificant trend toward older age was found, and a higher proportion of male patients existed in the group with coronary artery disease. Routine angiography for all patients with a history of smoking referred for angiography is unjustified. A subset of patients with high risk identified primarily by the presence of additional coronary artery disease risk factors may benefit from routine angiography.


[Autologous versus allogeneic stem cell transplantation in adult patients with acute lymphoblastic leukemia].
To explore the efficacy of autologous or allogeneic stem cell transplantation in adult patients with acute lymphoblastic leukemia (ALL) and investigate its relevant prognostic factors. A total of 96 adult patients with ALL who had admitted to our hospital from November 1986 to June 2004 were followed up till February 28, 2005. They were divided into autologous stem cell transplantation (Auto-SCT) group (n = 56) and allogeneic stem cell transplantation (Allo-SCT) group (n = 40). Auto-SCT group was further divided to treated subgroup, in which patients received graft-purified transplantation and (or) maintenance immunotherapy or chemotherapy after transplantation (n = 26), and non-treated subgroup (n = 30). Clinical characteristics of these groups were retrospectively analyzed. Survival date were analyzed by the Kaplan-Meier method and the prognostic factors were analyzed with the COX regression model. The 1-, 3-, and 5-year leukemia-free-survival (LFS) were not significantly different between the auto-SCT group and the allo-SCT group. The 3-and 5-year LFS of auto-SCT treated subgroup, auto-SCT non-treated subgroup and allo-SCT group were [(73.0 +/- 8.7)%, (69.2 +/- 9.0)%], [(42.2 +/- 10.1)%, (35.1 +/- 10.0)%], and [(50.9 +/- 8.2)%, (50.9 +/- 8.2)%], respectively, which showed statistical significance (P < 0.05). The long-term LFS is similar after auto-SCT and after allo-SCT. Purified graft and maintain immunotherapy or chemotherapy post-transplantation may decrease the relapse rate after auto-SCT and improve survival.


Methylprednisolone fails to preserve retinal ganglion cells and visual function after ocular ischemia in rats.
Methylprednisolone (MP) is commonly used to treat traumatic optic neuropathy and optic neuritis, but its benefit in terms of neuronal survival remains controversial. The aim of this study was to investigate the effects of MP on retinal ganglion cell (RGC) survival and visual function after ischemia in rats. Ocular ischemia was induced by elevated intraocular pressure. Rats were treated with NaCl, 1 mg/kg/d, or 30 mg/kg/d intraperitoneal MP over 3 days. RGCs were labeled retrogradely 4 days after ischemia and were quantified 6 days later. Post-ischemic retinal function was assessed by scotopic and photopic electroretinography (ERG). Optic nerve function was investigated on days 4 and 10 after ischemia by visual evoked potentials (VEPs). Compared with nonischemic eyes, ischemia reduced RGCs with NaCl to 47% +/- 3% (mean +/- SEM) and to 46% +/- 3% and 43% +/- 6% with 1 mg/kg/d and 30 mg/kg/d MP. ERG did not differ significantly for any parameter among the three groups. Four days after ischemia, the VEPs of rats receiving any dose of MP were significantly higher than the control. VEPs in both steroid groups fell to control levels 10 days after ischemia. Treatment with MP did not improve RGC survival or retinal function. The VEP showed a short-term benefit because of steroids.


Pharmacokinetics and pharmacodynamics of naproxen in acute experimental hepatitis.
The pharmacokinetics of intravenous naproxen (CAS 22204-53-1) 6 mg kg-1, were studied in Wistar rats under control conditions and 1, 3 and 10 days after the induction of acute hepatitis by a single intraperitoneal injection of galactosamine 375 mg kg-1. In non-intoxicated rats t1/2 was 5.31 +/- 0.90 h, Vd was 0.21 +/- 0.01 l.kg-1, Cl was 17 +/- 5 ml.h-1.kg-1, AUC was 354.4 +/- 8.8 micrograms.h.ml-1 and 99.18 +/- 0.09% of naproxen was bound to plasma proteins. One day after intoxication the liver was considerably damaged; cytochrome P450, the main enzymatic system for naproxen metabolism, was decreased in 90%. Naproxen t1/2 was increased to 11.9 +/- 1.2 h but Vd did not change significantly, therefore clearance was reduced to 37%. Binding to plasma proteins was decreased to 83.21 +/- 0.27%. At day 3 liver function and naproxen pharmacokinetics exhibited a partial recovery, t1/2 was 6.59 +/- 0.92 h and clearance was 12.2 +/- 5 ml.h-1.kg-1 being not significantly different from controls; notwithstanding AUC was still significantly different from that of non-intoxicated rats. 10 days after galactosamine injection all pharmacokinetic parameters, as well as those of liver function, returned to basal levels. The results indicate that acute hepatitis produces an important reduction in naproxen elimination. Changes in naproxen disposition, which exhibit a time course similar to that of liver damage, are mainly determined by a decrease in intrinsic hepatic clearance and in the binding to plasma proteins.


Response of UK interventional radiologists to the COVID-19 pandemic - survey findings.
The COVID-19 pandemic has had an unprecedented effect upon the National Health Service (NHS). Like other specialties, Interventional Radiology (IR) rapidly adapted to the evolving situation. Members of BSIR were surveyed to obtain a snapshot of the experiences of UK IRs in response to COVID-19. An electronic survey was compiled using Google Forms, approved by the BSIR Council Officers and distributed to BSIR members by email on 18 th April 2020. A total of 228 responses were received. The survey was open for a 14-day period and the data analysed in Microsoft Excel 365. The response rate was 29% (228/800). Two thirds of respondents work in a Tertiary unit and 33% deliver IR in a District Hospital. 84% have a day-case facility. After the COVID-19 crisis, 81% of respondents were able to maintain 24-7 On-call service. 59% of respondents had been required change their day to day practice to allow the on-call service to continue. 55% of respondents were involved in providing a central line service. Of those questioned, 91% continued to offer endovascular services, 98% genitourinary and 92% hepatobiliary services, although a degree of service reduction was described. 38% have provided IR trainees with additional training material during this pandemic. This survey has confirmed that the responses of UK IR departments to the COVID-19 crisis have ensured vital on-call and urgent services have continued, including ongoing availability of most IR sub-specialties. Availability of a day case facility has possibly influenced the positive response.


Paediatric genomic testing: Navigating genomic reports for the general paediatrician.
Monogenic rare disorders contribute significantly to paediatric morbidity and mortality, and elucidation of the underlying genetic cause may have benefits for patients, families and clinicians. Advances in genomic technology have enabled diagnostic yields of up to 50% in some paediatric cohorts. This has led to an increase in the uptake of genetic testing across paediatric disciplines. This can place an increased burden on paediatricians, who may now be responsible for interpreting and explaining test results to patients. However, genomic results can be complex, and sometimes inconclusive for the ordering paediatrician. Results may also cause uncertainty and anxiety for patients and their families. The paediatrician's genetic literacy and knowledge of genetic principles are therefore critical to inform discussions with families and guide ongoing patient care. Here, we present four hypothetical case vignettes where genomic testing is undertaken, and discuss possible results and their implications for paediatricians and families. We also provide a list of key terms for paediatricians.


Novel effects of beraprost sodium on vasculatures.
Beraprost sodium (BPS) is a stable orally active prostacyclin analogue with vasodilatory and anti-platelet effects, and has been widely used as therapeutics for pulmonary artery hypertension and chronic arterial obstruction. In order to elucidate its effects on endothelium, we first examined the short-term effects of BPS on nitric oxide (NO) production and endothelial NO synthase (eNOS) activation using bovine aortic endothelial cells. Short-term treatment of BPS induced NO production as well as eNOS phosphorylation at Ser-1179 mediated via cAMP/protein kinase A (PKA) pathway. The effects of BPS on capillary-like tube formation were next determined using human umbilical vein ECs (HUVECs)/normal human dermal fibroblasts co-culture system. BPS was observed to induce capillary-like tube formation mediated via cAMP/PKA pathway, but not via NO generation. Finally, we performed DNA microarray analyses using RNA extracted from BPS treated HUVECs. Interestingly, BPS up-regulated several genes involved in angiogenesis, anti-atherosclerosis, and endothelial function, while down-regulated several genes involved in atherosclerosis. Our data therefore indicate that BPS may be useful not only for patients with pulmonary artery hypertension and chronic arterial obstruction, but also for general atherosclerotic patients complicated with endothelial dysfunction. Further studies are needed to clarify molecular mechanisms of these BPS effects including the involvement of peroxisome proliferator-activated receptor-delta.


Anti-obesity Effect of Capsaicin in Mice Fed with High-Fat Diet Is Associated with an Increase in Population of the Gut Bacterium Akkermansia muciniphila.
Capsaicin (CAP) reduces body weight mainly through activation of transient receptor potential vanilloid 1 (TRPV1) cation channel. However, recent evidence indicates that the gut microbiota influences many physiological processes in host and might provoke obesity. This study determined whether the anti-obesity effect of CAP is related to the changes in gut microbiota. C57BL/6 mice were fed either with high-fat diet (HFD) or HFD with CAP (HFD-CAP) for 9 weeks. We observed a significantly reduced weight gain and improved glucose tolerance in HFD-CAP-fed mice compared with HFD-fed mice. 16S rRNA gene sequencing results showed a decrease of phylum Proteobacteria in HFD-CAP-fed mice. In addition, HFD-CAP-fed mice showed a higher abundance of Akkermansia muciniphila, a mucin-degrading bacterium with beneficial effects on host metabolism. Further studies found that CAP directly up-regulates the expression of Mucin 2 gene Muc2 and antimicrobial protein gene Reg3g in the intestine. These data suggest that the anti-obesity effect of CAP is associated with a modest modulation of the gut microbiota.


Immunosuppressive treatment in bilateral vestibulopathy with inner ear antibodies.
Although vestibular recovery was observed after steroid treatment, it remains uncertain whether this improvement was spontaneous or due to medication. These data do not allow us to generally recommend corticosteroid treatment in patients with BVF and inner ear antibodies. A retrospective study was performed based on the observation of two patients with suspected autoimmune bilateral vestibular failure (BVF) with normal hearing and antilabyrinthine or nervous tissue-specific serum antibodies who showed vestibular recovery after corticosteroid treatment. Twelve patients with BVF and serum inner ear antibodies who had received imuunosuppressive treatment with corticosteroids were evaluated in terms of medical history, repetitive caloric irrigation and repetitive determination of inner ear antibodies. BVF was complete in four patients and incomplete in eight. After immunosuppressive therapy, four of the 12 patients showed a moderate recovery of the peak slow-phase velocity of horizontal nystagmus induced by bithermal caloric stimulation, which was only transient in two of them.


Highly active, air-stable palladium catalysts for the C-C and C-S bond-forming reactions of vinyl and aryl chlorides: use of commercially available [(t-Bu)(2)P(OH)](2)PdCl(2), [(t-Bu)(2)P(OH)PdCl(2)](2), and [[(t-Bu)(2)PO...H...OP(t-Bu)(2)]PdCl](2) as catalysts.
Air-stable palladium complexes [(t-Bu)(2)P(OH)](2)PdCl(2), [(t-Bu)(2)P(OH)PdCl(2)](2), and [[(t-Bu)(2)PO...H...OP((t-Bu)(2)]PdCl](2) serve as efficient catalysts for a variety of cross-coupling reactions of vinyl and aryl chlorides with arylboronic acids, arylzinc reagents, and thiols to yield the corresponding styrene derivatives, biaryls, and thioethers. (31)P NMR and mechanistic studies argue that the phosphinous acid ligands in the complexes can be deprotonated in the presence of a base to yield an electron-rich anionic species, which is likely a catalyst intermediate, and dimeric [[(t-Bu)(2)PO...H...OP((t-Bu)(2)]PdCl](2) was isolated and cystallographically characterized. These anionic complexes are anticipated not only to accelerate the rate-determining oxidative addition of aryl chlorides but also to stabilize the palladium complexes in the catalytic cycle.


A comparison of simulation and traditional local anesthesia teaching methods among dental hygiene students.
The COVID-19 pandemic forced dental educators to quickly modify the teaching-learning platform without testing outcomes of alternative teaching methods prior to implementation. One critical course affected was the teaching of local anesthesia (LA) that moved from practicing injections using the traditional student-to-student method to the simulation model using manikins. This study compared two LA teaching methods (student-to-student versus simulation) in two consecutive cohorts before and during the pandemic to assess differences in students' skill level and self-confidence. This quasi-experimental study recruited a convenience sample of dental hygiene students at the University of Minnesota during 2020 and 2021. Consent was collected prior to student-to-student injection practice and survey distribution. Data collected were clinical and summative clinical assessments to determine LA skill level, and student surveys to assess self-confidence. Analyses included descriptive statistics, linear models within and between cohorts, and inductive analysis for qualitative survey responses. Fifty of 57 students (88%) completed the survey, and 54 (95%) consented access to their clinical assessments. Skill level was significantly higher for the simulation cohort compared to the student-to-student cohort on the LA summative clinical assessment (59.0 vs. 55.6, p = 0.004). No differences were found in self-confidence between cohorts. A positive association was found between students' self-confidence and skill levels for both cohorts, but only student-to-student cohort results were statistically significant (student-to-student: r = 0.44, p = 0.02; simulation: r = 0.24, p = 0.26). Results support incorporating simulation manikin teaching methods for LA with a student-to-student partner component.


Static posturography and intravenous alcohol.
Twelve health subjects were assessed using static posturography before and after intravenous alcohol infusion in a double-blind experiment. The dose was 0.5 g ethanol per kg body weight in 15 minutes, which raised the blood alcohol concentration to a level of approximately 1 mg/mL. Among other parameters, the average body sway velocity (BSV) and area of body sway (BSA) were measured. BSV was the most sensitive parameter for detecting increased body sway after alcohol infusion, and a significant effect of alcohol on its values was seen at 0.46 to 1.0 mg/mL alcohol concentrations. The second best indicator was the BSA. There was a positive correlation between the BSV and the BSA. The other parameters were not affected. The Romberg quotient remained constant during the alcohol test. The test battery used was relevant to distinguish the effect of alcohol on balance. In this study, acute blood alcohol concentrations of around 0.5 to 1.0 mg/mL affected BSV more significantly than BSA. The authors do not, however, recommend the test for forensic purposes in examining drivers with alcohol in their blood, as there is too much interindividual dispersion in the results.


Psychological correlates of blood pressure: a closer examination of hostility, anxiety, and engagement.
Recent studies by other investigators have shown that hypertensives are more hostile and anxious than normotensives. The first part of this study examined the relationship between blood pressure measured daily over a one-week period and responses to a series of questions specifically developed to distinguish hypertensives from normotensives. Responses from this sample of undergraduates did not distinguish those with high blood pressure from those with normal values. Mean resting blood pressure was related to hostility and anxiety factor scores among males but not among females. Our second study used a sample of municipal employees and examined blood pressure as a function of comparable anxiety and hostility scores as well as a trait measure of overall "engagement-involvement." More highly engaged workers were no different in anxiety or hostility than less engaged workers. There was some evidence of more variable blood pressure for the former group. It is suggested that stable personality traits such as hostility and anxiety may both precede and follow the diagnosis of blood pressure. For nurses it is important to assess the patient's general psychological profile as well as his of her emotional state at the time of measurement. Repeated blood pressure readings are recommended especially for highly engaged individuals.


Artificial eustachian tube-induced keratin foreign-body granuloma.
The pathogenesis of granulation tissue that arises periodically around artificial Eustachian tubes was elucidated by histologic examination of 15 cases of tube granuloma. All cases showed the presence of a keratin foreign-body granuloma. The implanted squames incited a foreign-body type of granulomatous reaction and produced a friable vascular exuberant mass that surrounded the artificial Eustachian tube. Histologically, the tube granuloma was characterized by the presence of irregular ovoid slit-like spaces that contained keratin squames, and it was surrounded by foreign-body giant cells.


Sr++-induced inhibition of human natural killer (NK) cell-mediated cytotoxicity.
The cell believed to be responsible for human spontaneous cytotoxicity or natural killing (NK) has been described recently as a large granular lymphocyte (LGL). Because the intracytoplasmic granules of LGL appear to be peculiar to the subpopulation of mononuclear cells containing NK effectors, we have investigated their possible requirement in the cytolytic process. Experiments reported here show that Sr++, a cation known to cause degranulation of granulocytes, caused a dose- and time-dependent inhibition of the NK activity of human peripheral blood mononuclear cells. A single-cell NK assay showed that the number of cytotoxic cells was not significantly reduced, but that Sr++ inhibited NK by preventing individual effector cells from engaging in multiple lethal hits. Moreover, the inhibition of NK appeared to be reversible; culture in vitro of Sr++-treated PBMC resulted in the eventual return of cytolytic activity in these cells. Augmentation of NK by interferon (IFN) was similarly blocked by Sr++. In addition, Sr++ also inhibited the NK activity of IFN-prestimulated effector cells and, as before, NK function returned during subsequent culture. These results indicated that the return of NK function after Sr++ treatment was the result of reactivation of cytotoxic cells rather than recruitment of new effectors. We have shown in other studies that Sr++ degranulates LGL, and the data presented here provide support for the hypothesis that the intracytoplasmic granules of LGL are required for NK-mediated cytotoxicity.


[A brief history of adrenal gland surgery].
The adrenal gland surgery, an important part of the surgery, has a history of more than 100 years. This paper reviewed its history from three aspects, viz. the physiological function of adrenal gland, expecting to shed light on the study and perfection for adrenal gland surgery in China.


Generation of Saccharomyces cerevisiae deletants and basic phenotypic analysis of eight novel genes from the left arm of chromosome XIV.
The disruption of eight novel genes was realized in two genetic backgrounds. Among these open reading frames, NO333, NO348 and NO364 presented homologies with other proteins of yeast or other organisms, whereas NO320, NO325, NO339, NO384 and NO388 showed no similarity with any protein. Tetrad analysis of heterozygous deletant strains revealed that NO348, NO364 and NO388 are essential genes for vegetative growth, whereas NO320, NO325, NO333, NO339 and NO384 are non-essential. Basic phenotypic analyses of the non-lethal deletant strains as suggested in the six-pack B0 programme did not reveal any significant differences between parental and mutant strains.


Knowledge, Attitudes and Practices of Agricultural Workers towards Tetanus Vaccine: a Field Report.
Agricultural Workers are both more exposed to tetanus and at higher risk to be inadequately immunized than other usual recipients of the same vaccine. Our cross-sectional questionnaire-based study aimed to evaluate tetanus vaccination status, knowledge, attitudes and practices in Agricultural Workers in North-Eastern Italy. Bivariate and multivariate logistic regression analyses were used to identify, from individual and work-related characteristics, factors significantly associated with appropriate vaccination status. Among 707 participants, 58.4% had an up-to-date immunization status. In 33.1%, last booster was performed by an Emergency Department. The main reason for inadequate immunization was having forgotten the recommended periodic booster (146/707; 20.7%). Attitude towards tetanus vaccination was somehow favourable in 79.5% of participants, and 72.7% correctly identified tetanus vaccination as mandatory for Agricultural Workers. A lower degree of false beliefs and better knowledge of official recommendations were significant predictors of vaccine propensity. The main predictor for an appropriate vaccination status was interaction with a healthcare provider, in general (adjusted Odds Ratio, adjOR 2.516 95%CI 1.707-3.710), and specifically regarding vaccine counseling, (adjOR 6.275 3.184-12.367 and adjOR 9.739 95%CI 3.933-24.111 for general practitioners and occupational physicians, respectively). Our study enlightens the key role of healthcare providers in recalling and promoting vaccination policies, as well in increasing the general awareness of Agricultural Workers regarding vaccines and official recommendations.


Hepatoprotective effects of mushrooms.
The particular characteristics of growth and development of mushrooms in nature result in the accumulation of a variety of secondary metabolites such as phenolic compounds, terpenes and steroids and essential cell wall components such as polysaccharides, b-glucans and proteins, several of them with biological activities. The present article outlines and discusses the available information about the protective effects of mushroom extracts against liver damage induced by exogenous compounds. Among mushrooms, Ganoderma lucidum is indubitably the most widely studied species. In this review, however, emphasis was given to studies using other mushrooms, especially those presenting efforts of attributing hepatoprotective activities to specific chemical components usually present in the mushroom extracts.


[Integrated treatment for azoospermia caused by radiotherapy after surgical treatment of spermatocytoma: a case report].
To investigate a therapeutic method for male infertility caused by radiotherapy after surgical treatment of spermatocytoma. A case of azoospermia caused by radiotherapy after surgical treatment of spermatocytoma was reported and the Chinese medicine Jiaweishuiluerxiandan was used as a major therapy for 3 years. The patient's health condition was improved dramatically two years after being treated by the Chinese medicine but no sperm was found in his semen. However, three years after the treatment, his spermatozoon density was recovered from zero to 2.0 x 10(6)/ml with normal morphology. His sperm was subsequently used for intracytoplasmic sperm injection, which made his spouse pregnant successfully, and an healthy male infant was born by caesarean birth. Chinese medicine is a successful try at treating male infertility caused by radiotherapy after surgical treatment of spermatocytoma. For those who have failed to get their sperm frozen before surgery, Chinese medicine is a choice for remediation.


Comparison of the use of a standard cytology brush versus a mini cytology brush to obtain conjunctival samples for cytologic examination in healthy dogs.
To compare the quality of conjunctival samples for cytologic examination obtained with 2 conjunctival exfoliative brushes, a mini cytology brush (MCB) and a standard cytology brush (SCB), in healthy dogs. 20 client-owned dogs that were free of ocular disease. A prospective single-center randomized trial was performed. For each dog, conjunctival samples of the right eye were obtained with the 2 brushes (ie, SCB or MCB) at 2 time points that were 5 to 11 days apart. The left eye was used as a control. Cytologic quality of conjunctival samples was scored on the basis of cellularity, clearness of background, uniformity of distribution of cells on the cytology slide, artifacts, cellular overlapping, cell preservation, presence of mucus on the cytology slide, and number of RBCs. On cytologic evaluation, conjunctival samples collected with an SCB scored significantly better in terms of higher cellularity, less background debris, and more uniformity in the distribution of cells, compared with conjunctival samples collected with an MCB. Conjunctival samples collected with an MCB scored significantly better in terms of less cellular overlapping and less mucus in the background, compared with conjunctival samples collected with an SCB. Overall conjunctival samples obtained with an SCB for cytologic evaluation had better diagnostic quality, compared with conjunctival samples obtained with an MCB. Use of an MCB, however, was advantageous to access localized conjunctival areas as well as collect conjunctival samples from patients with small palpebral fissures.


How should we manage an acute exacerbation of COPD?
Would you order a chest film to evaluate an acute exacerbation of chronic obstructive pulmonary disease (COPD)? Which medication would you first prescribe-a short-acting inhaled beta-2 agonist or an anticholinergic bronchodilator? These are important questions for family physicians who commonly manage acute exacerbations of COPD. The guideline summarized here was developed by a joint expert panel of the American College of Physicians-American Society of Internal Medicine and the American College of Chest Physicians. Three outcomes were considered: treatment efficacy, 6-month mortality, and relapse, as defined by return visit to the emergency department within 14 days of initial presentation. Systematic reviews with evidence tables were used to analyze data. The rationale for each recommendation is clear and well documented. We added strength-of-recommendation ratings, which are not in the original guideline.


Investigating variations of fluorescent dissolved organic matter in wastewater treatment using synchronous fluorescence spectroscopy combined with principal component analysis and two-dimensional correlation.
Synchronous fluorescence spectroscopy (SFS) combined with principal component analysis (PCA) and two-dimensional (2D) correlation was applied to investigate removal efficiencies and variations of dissolved organic matter (DOM) fractions in the wastewater treatment plant (WWTP) with an A2O craft. A decreasing order of total removal efficiencies was tyrosine-like fluorescence component (89.58%) > humic-like fluorescence (HLF) component (39.83%) > tryptophan-like fluorescence component (36.89%) > microbial humic-like fluorescence (HLF) component (12.47%) > fulvic-like fluorescence component (6.37%). The tyrosine-like, tryptophan-like and HLF components were deeply decomposed by anaerobic bacteria in the anaerobic zone. The tyrosine-like component was the preponderant fraction of DOM in the raw water and primary sediment tank. The tyrosine-like component was the dominant component of DOM too in the anaerobic and anoxic zones, but its proportion was slightly more than the tryptophan-like component. The tryptophan-like component was the dominant component in the facultative zone, the oxic zone and the secondary sediment tank. Based on the changing band order of 279 → 304 → 490 → 330 → 380 → 430 nm, the decreasing variation order was tyrosine-like > tryptophan-like > humic-like > microbial humic-like > fulvic-like component. Therefore, the SFS combined with PCA and 2D correlation is an effective tool for not only monitoring the removal of DOM components but also characterizing variations of DOM fractions in the WWTP.


An Approach for Peptide Identification by De Novo Sequencing of Mixture Spectra.
Mixture spectra occur quite frequently in a typical wet-lab mass spectrometry experiment, which result from the concurrent fragmentation of multiple precursors. The ability to efficiently and confidently identify mixture spectra is essential to alleviate the existent bottleneck of low mass spectra identification rate. However, most of the traditional computational methods are not suitable for interpreting mixture spectra, because they still take the assumption that the acquired spectra come from the fragmentation of a single precursor. In this manuscript, we formulate the mixture spectra de novo sequencing problem mathematically, and propose a dynamic programming algorithm for the problem. Additionally, we use both simulated and real mixture spectra data sets to verify the merits of the proposed algorithm.


The influence of prior expectations on emotional face perception in adolescence.
Prior expectations influence the way incoming stimuli are processed. A standard, validated way of manipulating prior expectations is to bias participants to perceive a stimulus by instructing them to look out for this type of stimulus. Here, we investigated the influence of prior expectations on the processing of incoming stimuli (emotional faces) in adolescence. Using functional magnetic resonance imaging, we assessed activity and functional connectivity in 13 adolescents and 13 healthy adults (matched for gender and intelligence quotient), while they were presented with sequences of emotional faces (happy, fearful, or angry). A specific instruction at the start of each sequence instructed the participants to look out for fearful or angry faces in the subsequent sequence. Both groups responded more accurately and with shorter reaction times (RTs) to faces that were congruent with the instruction. For anger, this bias was lower in the adolescents (for RTs), and adults demonstrated greater activation than adolescents in the ventro-medial prefrontal cortex (vMPFC) and greater functional connectivity between the vMPFC and the thalamus when the face was congruent with the instruction. Our results demonstrate that the influence of prior expectations (in the form of an instruction) on the subsequent processing of face stimuli is still developing in the adolescent brain.


Distribution of estrogen receptor-immunoreactive cells in the sheep brain.
The distribution of immunoreactive (IR) estrogen receptor (ER)-containing cells was studied in the brains of adult Suffolk ewes using a rat monoclonal antibody (H222) which recognizes the human estrogen receptor. IR cells were characterized by dense nuclear reaction product, and in some instances, cytoplasmic immunostaining which filled dendrite-like processes. The greatest densities of ER-IR cells were found in the medial preoptic area, the mediobasal hypothalamus, and in a number of limbic system structures (amygdala, bed nucleus of the stria terminalis, lateral septum). ER-IR cells were found at lower densities in several other subregions of the hypothalamus and limbic system, and in the periaqueductal gray of the caudal midbrain. Cytoplasmic ER immunoreactivity was most prominent among ER-IR cells in the ventrolateral-ventromedial nucleus, the bed nucleus of the stria terminalis, the midbrain periaqueductal gray, and some ER-IR cells in the substantia innominata. The distribution of ER-containing cells in the sheep brain closely parallels that seen in other mammals. ER-IR cells are found in sites such as the medial preoptic area and ventrolateral-ventromedial hypothalamus which have been implicated as targets in this species and others for the influence of estradiol on sexual behavior and reproductive neuroendocrine function.


Characterization of DNA Substrate Binding to the Phosphatase Domain of the DNA Repair Enzyme Polynucleotide Kinase/Phosphatase.
Polynucleotide kinase/phosphatase (PNKP) is a DNA strand break repair enzyme that uses separate 5' kinase and 3' phosphatase active sites to convert damaged 5'-hydroxyl/3'-phosphate strand termini to ligatable 5'-phosphate/3'-hydroxyl ends. The phosphatase active site has received particular attention as a target of inhibition in cancer therapy development. The phosphatase domain dephosphorylates a range of single- and double-stranded substrates; however, structural studies have shown that the phosphatase catalytic cleft can bind only single-stranded substrates. Here we use a catalytically inactive but structurally intact phosphatase mutant to probe interactions between PNKP and a variety of single- and double-stranded DNA substrates using an electrophoretic mobility shift assay. This work indicates that the phosphatase domain binds 3'-phosphorylated single-stranded DNAs in a manner that is highly dependent on the presence of the 3'-phosphate. Double-stranded substrate binding, in contrast, is not as dependent on the 3'-phosphate. Experiments comparing blunt-end, 3'-overhanging, and frayed-end substrates indicate that the predicted loss of energy due to base pair disruption upon binding of the phosphatase active site is likely balanced by favorable interactions between the liberated complementary strand and PNKP. Comparison of the effects on substrate binding of mutations within the phosphatase active site cleft with mutations in surrounding positively charged surfaces suggests that the surrounding surfaces are important for binding to double-stranded substrates. We further show that while fluorescence polarization methods can detect specific binding of single-stranded DNAs with the phosphatase domain, this method does not detect specific interactions between the PNKP phosphatase and double-stranded substrates.


Akt1 genetic deficiency limits hypothermia cardioprotection following murine cardiac arrest.
Therapeutic hypothermia (TH) cardioprotection has recently been associated with increased Akt signaling in a rat model of cardiac arrest. However, it is not known whether Akt is required for this beneficial effect of TH. We used a mouse model of cardiac arrest demonstrating TH cardioprotection to study the response of mice deficient in an Akt1 allele. We hypothesized that Akt1 mediates TH cardioprotection and that decreases in Akt1 content would diminish such protection. Adult C57BL/6 wild-type (WT) mice underwent an 8-min cardiac arrest. After 6 min, the mice were randomized to normothermia (WT(NT), 37 degrees C) or TH (WT(TH), 30 degrees C). Following cardiopulmonary resuscitation and the return of spontaneous circulation (ROSC), the animals were hemodynamically monitored for 240 min (R240). At R240, cardiac tissue Akt content and phosphorylation were assayed. Studies were repeated in Akt1 heterozygous (Akt1(+/-)) mice. As a result, baseline characteristics and ROSC rates were equivalent across groups. At R240, WT(TH) mice exhibited lower heart rate, larger stroke volume, and higher cardiac output than WT(NT) animals (P < 0.05). Cardioprotection in WT(TH) at R240 was associated with increased cardiac Akt phosphorylation at Ser473 and Thr308 compared with that in WT(NT) (P < 0.05). TH-associated alterations in Akt phosphorylation, stroke volume, heart rate, and cardiac output were abrogated in Akt1(+/-) animals. In conclusion, TH improves post-ROSC cardiac function and increases Akt phosphorylation in WT, but not Akt1(+/-), mice. The Akt1 isoform appears necessary for TH-mediated cardioprotection.


A multilocus assessment reveals two new synonymies for East Asian Cyclommatus stag beetles (Coleoptera, Lucanidae).
Cyclommatus scutellaris Möllenkamp, 1912, Cyclommatus elsae Kriesche, 1921 and Cyclommatus tamdaoensis Fujita, 2010 are East Asian stag beetle species with long-debated taxonomic relationships due to high intraspecific morphological variability. In this study, we applied multilocus phylogenetic analyses to reassess their relationships. Two mitochondrial genes (16S rDNA, COI) and two nuclear genes (28S rDNA, Wingless) were used to reconstruct the phylogeny through the Bayesian inference (BI) and Maximum Likelihood (ML) methods. Both topologies supported two clades: the clade C. scutellaris was sister to the clade (C. elsae + C. tamdaoensis) with the subclade C. tamdaoensis embedded in the subclade C. elsae. The Kimura 2-parameter (K2P) genetic distance analysis yielded a low mean value (≤0.035) among the three taxa, which was well below the minimum mean value between other Cyclommatus species (≥0.122). We also compared the accuracy and efficiency of two approaches, GMYC and ABGD, in delimitating the three lineages. The result shows that ABGD is a better approach than GMYC. Our molecular data recognizes the three species as different populations of a single species, ranging from Taiwan Island to the continent. Therefore, we propose two new junior synonyms for C. scutellaris: C. tamdaoensis, syn. nov. and C. elsae syn. nov.


Prenatal diagnosis of fetal primary cytomegalovirus infection.
To evaluate the validity of prenatal diagnosis work-up for congenital cytomegalovirus (CMV) in women with primary infection. Sixty-three pregnant women with primary cytomegalovirus disease (including two with twin pregnancies), referred to three tertiary perinatal centers over 4 years, underwent evaluation for congenital cytomegalovirus. Fetal diagnosis was made after 21 weeks' gestation by amniocentesis and fetal blood sampling (40 subjects), or amniocentesis only (23 subjects). Twenty-two (35%) pregnancies showed evidence of vertical transmission: 13 of them underwent funipuncture, but only ten (77%) of the 13 showed positive immunoglobulin (Ig)-M results in fetal blood. No cases of positive fetal serum Ig-M with negative amniotic fluid culture or polymerase chain reaction were observed. In nine (41%) of the 22 pregnancies with evidence of vertical transmission, abnormal ultrasonographic findings were recorded. Six (27%) women with evidence of vertical transmission continued their pregnancies and in only one (with prenatal ultrasonographic abnormalities) was an infant born with neurologic sequelae. In 41 (65%) pregnancies, no evidence of vertical transmission was found, and 37 continued to term. Only one newborn from this subgroup subsequently showed mild motor disability during a median of 23 months of follow-up. Among pregnant patients with primary CMV infection, analysis of amniotic fluid detected all of the infected fetuses. Thus, this is a reliable tool for counseling pregnant women with primary infection. This may guide the patient as to whether or not pregnancy can be continued with a high level of confidence.


Immune signalling responses in intestinal epithelial cells exposed to pathogenic Escherichia coli and lactic acid-producing probiotics.
Enterohaemorrhagic Escherichia coli O157:H7 and adherent-invasive Escherichia coli are two groups of enteric bacterial pathogens associated with haemorrhagic colitis and Crohn's Disease, respectively. Bacterial contact with host epithelial cells stimulates an immediate innate immune response designed to combat infection. In this study, immune responses of human epithelial cells to pathogens, either alone or in combination with probiotic bacteria were studied. Industrially prepared Lactobacillus helveticus strain R0052 was first examined by microarray analysis and then compared to broth-grown strains of R0052 and Lactobacillus rhamnosus strain GG using quantitative realt-time polymerase chain reaction. Results showed host immune activation responses increased following pathogen exposure, which were differentially ameliorated using probiotics depending on both the preparation of probiotics employed and conditions of exposure. These findings provide additional support for the concept that specific probiotic strains serve as a promising option for use in preventing the risk of enteric bacterial infections.


Reversible C-C coupling in a uranium biheterocyclic complex.
The C-C coupling of two molecules of 1-methylbenzimidazole was effected by a neutral uranium dibenzyl complex supported by a ferrocene 1,1'-diamide ligand. The transformation involves the C-H activation of two heterocycles and the coupling of one eta(2)-N,C-imidazolyl fragment with a coordinated 1-methylbenzimidazole ligand. The solid-state structure of this product was studied by both single-crystal and powder X-ray diffraction methods and confirms the formation of the biheterocyclic moiety. In solution, the C-C coupling event was found to be reversible, as assessed by variable-temperature (1)H and (2)H NMR spectroscopy as well as DFT calculations and reactivity studies.


Ethical questions inherent in compliance.
Promoting patient compliance is considered to be good clinical practice. However, compliance conveys a sense of being submissive or obedient to another; therefore, promoting compliance becomes a paternalistic action. The author uses a clinical situation to demonstrate some of the ethical questions related to compliance (i.e., who decides, who knows best, and how noncompliant patients are treated) and discusses these questions using the ethical precepts of doing no harm and respecting autonomy.


Clinical assessment of wireless ECG transmission in real-time cardiac telemonitoring.
This paper presents a complete study of wide-area wireless ECG transmission for real-time cardiac tele-monitoring taking into account both technical and clinical aspects, in order to provide recommendations for real-time monitoring considering both channel parameters and the tolerance of cardiologists to the effects of interruptions introduced during transmission. By using extensive wireless simulated scenarios, the compressed ECG signal is monitored on reception. A new protocol [real-time ECG transmission protocol, reliable ECG transmission protocol (RETP)] is used to perform the retransmissions of erroneous packets, introducing a monitoring buffer that mitigates possible negative effects. Assessments by cardiologists have shown that the maximum percentage of time for which the monitoring process could be stopped without their feeling uncomfortable is around 15% with a maximum monitoring delay of 3 or 4 s, depending on the scenario in question. Taking into account these values and the results obtained in the simulations, it is a straightforward step to obtain working areas for the wireless channel parameters where transmission is not recommended from a clinical point of view.


Knowledge, attitudes, and practices toward cervical cancer prevention among women in Kampong Speu Province, Cambodia.
There is little information concerning the preventive behaviors against cervical cancer among women in Cambodia, a country without organized cervical cancer screening programs and national human papillomavirus (HPV) vaccination policies. We aimed to examine the cervical cancer knowledge, attitudes, and practices as well as cervical cancer prevention methods among Cambodian women. A community-based cross-sectional survey on cervical cancer prevention was conducted. We conducted a face-to-face interview survey for women aged 20-69 years who lived in Kampong Speu Province. The data collection was conducted by a nurse and a trained health worker using a structured questionnaire from January 8 to February 19, 2016. The questionnaire comprised 46 questions on demographic and reproductive characteristics, knowledge of cervical cancer, related risk factors and preventive methods, and attitudes toward and practices of Pap test and HPV vaccination. A logistic regression analysis was used to evaluate the relationship between preventive behaviors against cervical cancer and related factors such as age, education, income, and knowledge of cervical cancer. Among the 440 respondents, 74 and 34% of women had heard about cervical cancer and the Papanicolaou (Pap) Smear test, respectively, and 7% of women had ever been screened by a Pap test. The participants showed high willingness to undergo a Pap test (74%). Furthermore, 35% of women were aware that cervical cancer is preventable by vaccination and 62% of women were willing to get the HPV vaccine, but only 1% of women had been vaccinated against HPV. Women of a younger age (odds ratio: 76.7; 95% confidence interval: 19.2-306.5 among women aged 20-29 years compared to 60-69 years, P-for-trend< 0.0001) and those who were married (odds ratio: 2.8; 95% confidence interval: 1.3-6.3) were more likely to be willing to receive the vaccination. Women in the Kampong Speu province of Cambodia had a low awareness of cervical cancer screening and rarely practiced cervical cancer screening. However, the willingness to get Pap test and HPV vaccination is high.


Multicentric Clinical Data Collection: A Game-Changer for Rare Neurological Diseases.
Although neuropsychiatric symptoms are a hallmark of the behavioral variant of frontotemporal degeneration (FTD), there is limited evidence on the optimal therapeutic management of these symptoms. In this issue, Katisko et al. report real-world multicentric data on the use of psychopharmacological medication in newly diagnosed patients with FTD. Such reports contribute to knowledge sharing between clinicians caring for patients with FTD. Here, we outline how improved collection of clinical data can assure more robust evidence for future therapies in FTD and other rare neurological diseases.


Mandatory Reporting of Health Professional Incompetence and Incapacity: Is it Time to Adopt the Australian Regime?
Identifying poor or unsafe practice is an important aspect of professional regulation. One way that health profession regulators access this information is through legislated mandatory reporting of incompetence or incapacity. Australia's mandatory reporting provisions are far-reaching and have become a touchstone issue in Australia's regulatory framework. In Ontario, mandatory reporting of health professionals is more limited. In this article, we compare the mandatory reporting regimes in these two jurisdictions through a historical and legal analysis examining the development and reform of mandatory reporting. Regulators' access to and handling of information about professionals has been under a critical media spotlight recently. Canadian policymakers and nurse leaders should consider advocating for more comprehensive mandatory reporting regimes with clear reporting structures to improve public confidence in regulation and protect the public.


The relationship between juxtapapillary duodenal diverticula and biliary stone disease.
To assess the relationship between juxtapapillary duodenal diverticula (JDD) and common bile duct stones and biliary stone disease in general. A retrospective study. We analysed 1115 patients who underwent consecutive endoscopic retrograde cholangiopancreatography examinations. The patients were subdivided into three groups: the first group (group I; n = 482) had no biliary stone disease, the second one (group II; n = 329) had common bile duct stones, and the third group (group III; n = 304) had biliary stone disease of the gallbladder but without evidence of common bile duct stones. Additionally, the patients were subdivided into age groups of < 50, 50-59, 60-69, 70-79, and > or = 80 years of age. Logistic regression was applied for statistical analysis. Juxtapapillary duodenal diverticula were diagnosed in 111 (10.0%) patients. The incidence of JDD was 6.9% in group I, 14.3% in group II and 10.2% in group III. Age was the most dominant influence factor for JDD, common bile duct stones, and biliary stone disease (P < 0.0001). Sex was also a factor, female patients having a higher risk for common bile duct stones (P = 0.01) and biliary stone disease (P < 0.0001). After adjustment for age and sex, JDD was found to have a noticeable, but not statistically significant (P = 0.073), influence on common bile duct stones and no influence on biliary stone disease (P = 0.15). Our data support only moderately the existence of a relationship, which had been conjectured in a part of the literature, between JDD and common bile duct stones. No noticeable influence on biliary stone disease was found.


Hiding in plain sight: a case of chronic disseminated histoplasmosis with central nervous system involvement.
A 64-year-old man presented with gradual onset of confusion, ataxia and 25-pound weight loss over 3 months. MRI of the brain revealed two enhancing cerebellar lesions suspicious for metastases. Positron emission tomography-CT showed enhancement of cervical and axillary lymph nodes. Left axillary lymph node biopsy showed no evidence of malignancy but instead showed fungal organisms morphologically consistent with Histoplasma spp. Disseminated histoplasmosis with central nervous system involvement was suspected. Further history revealed that the patient had been having subjective fever for the past several months. He has had mild pancytopenia for about 2 years, which had not been further evaluated. Additionally, he had an oesophagogastroduodenoscopy 3 months prior to admission, which had shown granulomatous gastritis. Subsequently, the diagnosis of disseminated histoplasmosis was confirmed by serological testing and bone marrow biopsy. The patient was started on liposomal amphotericin B. Unfortunately, the patient had a catastrophic stroke and was transitioned to comfort care measures.


Nanoparticle-assembled capsule synthesis: formation of colloidal polyamine-salt intermediates.
There is current interest in developing new synthesis strategies for multifunctional hollow spheres with tunable structural properties that would be useful in encapsulation and controlled release applications. A new route was reported recently, in which the sequential reaction of polyamines, multivalent anions, and charged nanoparticles leads to the formation of polymer-filled and water-filled organic/inorganic micron-sized structures known as nanoparticle-assembled capsules. This technique is unique among other capsule preparation routes, as it allows the rapid and scalable formation of robust shells at room temperature, in near-neutral water, and with readily available precursors. This nanoparticle assembly synthesis route involves two steps: the formation of polymer aggregates and the subsequent deposition of particles around the aggregates. The purpose of this paper is to understand in greater detail the noncovalent chemistry of the polymer-salt aggregation step. With poly(allylamine hydrochloride) (PAH) as the model polymer, aggregate formation was investigated as a function of charge ratio, pH, and time through dynamic light scattering, electrophoretic mobility measurements, chloride ion measurements, and optical microscopy. PAH formed aggregates by the cross-linking action of divalent and higher-valent anions above a critical charge ratio and in a pH range defined by the pKa values of PAH and the anion. The aggregates grew in size through coalescence and with growth rates that depended on their surface charge. Controlling polymer aggregate growth provided a direct and simple means to adjust the size of the resultant capsule materials.


Altered dendritic complexity affects firing properties of cortical layer 2/3 pyramidal neurons in mice lacking the 5-HT3A receptor.
We have previously shown that the serotonergic input on Cajal-Retzius cells, mediated by 5-HT(3) receptors, plays an important role in the early postnatal maturation of the apical dendritic trees of layer 2/3 pyramidal neurons. We reported that knockout mice lacking the 5-HT(3A) receptor showed exuberant apical dendrites of these cortical pyramidal neurons. Because model studies have shown the role of dendritic morphology on neuronal firing pattern, we used the 5-HT(3A) knockout mouse to explore the impact of dendritic hypercomplexity on the electrophysiological properties of this specific class of neurons. Our experimental results show that hypercomplexity of the apical dendritic tuft of layer 2/3 pyramidal neurons affects neuronal excitability by reducing the amount of spike frequency adaptation. This difference in firing pattern, related to a higher dendritic complexity, was accompanied by an altered development of the afterhyperpolarization slope with successive action potentials. Our abstract and realistic neuronal models, which allowed manipulation of the dendritic complexity, showed similar effects on neuronal excitability and confirmed the impact of apical dendritic complexity. Alterations of dendritic complexity, as observed in several pathological conditions such as neurodegenerative diseases or neurodevelopmental disorders, may thus not only affect the input to layer 2/3 pyramidal neurons but also shape their firing pattern and consequently alter the information processing in the cortex.


Ultrastructural Changes in Clinical and Microbiota Isolates of Klebsiella pneumoniae Carriers of Genes bla SHV, bla TEM, bla CTX-M, or bla KPC When Subject to β-Lactam Antibiotics.
The aim of this study was to characterize the ultrastructural effects caused by β-lactam antibiotics in Klebsiella pneumoniae isolates. Three K. pneumoniae clinical isolates were selected for the study with resistance profiles for third-generation cephalosporins, aztreonam, and/or imipenem and with different resistance genes for extended-spectrum β-lactamases (ESBL) or Klebsiella pneumoniae carbapenemase (KPC). Two K. pneumoniae isolates obtained from the microbiota, which were both resistant to amoxicillin and ampicillin, were also analyzed. In accordance with the susceptibility profile, the clinical isolates were subjected to subminimum inhibitory concentrations (sub-MICs) of cefotaxime, ceftazidime, aztreonam, and imipenem and the isolates from the microbiota to ampicillin and amoxicillin, for analysis by means of scanning and transmission electron microscopy. The K. pneumoniae isolates showed different morphological and ultrastructural changes after subjection to β-lactams tested at different concentrations, such as cell filamentation, loss of cytoplasmic material, and deformation of dividing septa. Our results demonstrate that K. pneumoniae isolates harboring different genes that encode for β-lactamases show cell alterations when subjected to different β-lactam antibiotics, thus suggesting that they possess residual activity in vitro, despite the phenotypic resistance presented in the isolates analyzed.


Stereotactic Dorsolateral Irradiation of Spinal Nerve Roots: A Novel Technique for the Treatment of Spasticity and Pain.
Selective dorsal rhizotomy is an established surgical treatment to improve the neurological and functional status of children with spastic cerebral palsy and adults with spasticity and pain caused by a variety of brain and spinal injuries. This procedure requires a dorsolumbar laminectomy to expose the appropriate dorsal rootlets, which are sectioned according to the presence of sustained electromiographic discharges. Image-guided robotic radiosurgery targeting the intracisternal sensory root of the trigeminal nerve has been described as a safe and effective non-invasive treatment for trigeminal neuralgia, a paroxystic pain disorder which often responds poorly to medical therapy. Image-guided radiosurgery requires no frame placement and can treat brain or spinal targets with submillimetric precision. This technique can be used to treat cervical or lumbar dorsal roots. A 44-year-old patient with von Hippel-Lindau disease developed severe spastic tetraparesis following multiple brain and spinal procedures. Spasticity and related pain mostly affected the right leg, with sustained electromiographic discharges originating from the right L4 nerve root. Response to medical therapy with baclofen and cannabinoids was poor. Due to geographical and logistical issues, the patient declined the placement of an intrathecal baclofen pump. Considering the poor general condition of the patient and his decision to avoid invasive procedures, a novel treatment option was offered to provide relief from spasticity and pain: stereotactic image-guided irradiation delivered to the sensory root. The patient underwent a right intraforaminal dorsolateral L4 root stereotactic irradiation with a delivered dose of 45 Gy prescribed to the 82% isodose. The treatment was well tolerated, without side effects. Resolution of spasticity and related pain in the right leg was found six months after the procedure. A marked reduction of spasticity and pain was also evident in the contralateral leg. These improvements have been stable over the last 18 months. So far, two additional patients underwent stereotactic dorsolateral spinal root irradiation (one delivered to a cervical, the other to a lumbar), with similar positive outcomes. These preliminary results suggest that spinal root stereotactic image-guided irradiation, a novel treatment option in the neurosurgical armamentarium, is a safe and effective procedure and deserves further investigation.


Assessment of efficacy of specialized food products with modified carbohydrate profile in patients with type 2 diabetes.
Objective - To evaluate the effect of diet therapy with the inclusion of specialized food product with a modified carbohydrate profile (fruit jelly) on glycemic and metabolic parameters in patients with type 2 diabetes mellitus. The study included 45 patients (aged 35 to 69 years) with type 2 diabetes with concomitant obesity I-III degree. The study was conducted in two stages. The first phase evaluated the effect of jelly intake on postprandial glycemia with determination of blood glucose levels on an empty stomach and 30, 60, 120 and 180 minutes after consumption of fruit jelly with maltitol, pectin and sublimated raspberry juice and traditional marmalade with fructose (control), containing 25 g of digestible carbohydrates. In the second phase the effectiveness of combination therapy during 2 weeks of the inclusion of fruit jelly with a modified carbohydrate profile in a standard hypocaloric diet (1550 kcal/day) has been assessed. It has been shown that the dynamics of postprandial glycemia in patients with type 2 diabetes after the consumption of fruit jelly with a modified carbohydrate profile was comparable to the dynamics of blood glucose after eating traditional marmalade with fructose. Inclusion of fruit jelly with a modified carbohydrate profile in the standard diet therapy of patients with type 2 diabetes during 2 weeks was accompanied by positive dynamics of carbohydrate and lipid metabolism, as well as a decrease in the content of lipid peroxidation products in blood plasma: reducing the level of conjugated dienes and malondialdehyde averaged 15.2 and 17.4% from baseline (p<0.05), respectively, while content of lipid peroxidation products in blood plasma did not changed in patients from the control group.


Managed health care and orofacial pain.
Dental and insurance communities must find common ground to manage orofacial pain effectively. By screening patients with orofacial pain for earlier referral, the incidence of improper medical utilization and the potential for chronic pain may be reduced.


Brain-derived neurotrophic factor and epilepsy--a missing link?
It has been known for some time that brain-derived neurotrophic factor (BDNF) is critical to normal development of the CNS, and more recently, studies also have documented the ability of BDNF to modify adult CNS structure and function. Therefore, it is no surprise that BDNF has been linked to diseases, such as epilepsy, which may involve abnormal cortical development or altered brain structure and function after maturity. This review evaluates the evidence, particularly from recent studies, that BDNF contributes to the development of temporal lobe epilepsy (TLE).


Heavy metal and genetic diversity studies in three populations of Snail (Achatina achatina Linnaeus, 1758) from Southwest, Nigeria.
Environmental pollutants may often alter the genetic components of natural populations. In this study, heavy metals and genetic diversity in land snail (Achatina achatina) from three populations of south-western Nigeria were investigated, using the Atomic Absorption Spectrometry and DNA Sequencing technology respectively. Metal analysis revealed that the snails accumulated lead (Pb) and nickel (Ni) in high concentrations in two of the three states, while cadmium (Cd) was the least detected. Editing and alignment of the sequences of all snail accessions generated a range of 384bp to 419 bp. Analysis of Molecular Variance (AMOVA) in all 18 accessions was low at only 16%. The query coverage (QC) ranged between 96% and 100%, with 14 (77.8%) of the 18 accessions showing 100% identity. Pairwise comparison of the accessions studied also showed a high genetic similarity. The unweighted pair group method with arithmetic mean (UPGMA) generated two main clusters. Cluster I was unique and contain one sample (AaOy06) while the other cluster are very closely related and can be further sub-divided into sub-clusters. The similarity index of between the clusters is 0.5357. The close similarity among the accessions may be due to the geographical proximity of the three states. The uniqueness of accession AaOy06 in comparison to other accessions might be due to the negative influence of heavy metal, particularly lead. The determination of evolutionary relationships among snail populations may be useful towards the breeding efforts of the species in Nigeria.


Remote ischemic postconditioning protects the brain from focal ischemia/reperfusion injury by inhibiting autophagy through the mTOR/p70S6K pathway.
Remote ischemic postconditioning (RIPostC) has been recognized as an applicable strategy for protecting against cerebral ischemia/reperfusion (I/R) injury. This study was performed to examine the effect of RIPostC on cerebral I/R and to explore its underlying mechanism. Healthy male SD rats (N = 36) were assigned randomly into 3 groups of 12 each: sham group, I/R model group and RIPostC group. Animal models were performed by filament insertion for 2 h with middle cerebral artery occlusion(MCAO) followed by 24 h of reperfusion. RIPostC was induced by 15 min occlusion of femoral arteries followed by 15 min of reperfusion for 3 cycles at the beginning of middle cerebral artery reperfusion. The neurological deficits, infarct size and brain edema were determined. Autophagy was examined by transmission electron microscopy (TEM). The protein levels of microtubule-associated protein light chain 3 (LC3-II), mammalian target of rapamycin (mTOR), serine/threonine kinase p70S6 kinase (p70S6K), and their phosphorylation (p-mTOR and p-p70S6K) in the brain tissue of the rats were determined by western blotting. Our results suggested that RIPostC significantly reduced I/R-induced brain injury, as exhibited by a significantly decreased infarct size, mitigated brain edema and improved neurological deficits. RIPostC also significantly reduced the LC3-II/LC3-I ratio and protein expression of Beclin 1. Much less severe neuronal injury and fewer autophagosomes were observed by TEM in the RIPostC group. These results suggest that RIPostC attenuates cerebral I/R injury by inhibiting autophagy through the activation of the mTOR/p70S6K signaling pathway.


Fc receptor biology.
This review deals with membrane Fc receptors (FcR) of the immunoglobulin superfamily. It is focused on the mechanisms by which FcR trigger and regulate biological responses of cells on which they are expressed. FcR deliver signals when they are aggregated at the cell surface. The aggregation of FcR having immunoreceptor tyrosine-based activation motifs (ITAMs) activates sequentially src family tyrosine kinases and syk family tyrosine kinases that connect transduced signals to common activation pathways shared with other receptors. FcR with ITAMs elicit cell activation, endocytosis, and phagocytosis. The nature of responses depends primarily on the cell type. The aggregation of FcR without ITAM does not trigger cell activation. Most of these FcR internalize their ligands, which can be endocytosed, phagocytosed, or transcytosed. The fate of internalized receptor-ligand complexes depends on defined sequences in the intracytoplasmic domain of the receptors. The coaggregation of different FcR results in positive or negative cooperation. Some FcR without ITAM use FcR with ITAM as signal transduction subunits. The coaggregation of antigen receptors or of FcR having ITAMs with FcR having immunoreceptor tyrosine-based inhibition motifs (ITIMs) negatively regulates cell activation. FcR therefore appear as the subunits of multichain receptors whose constitution is not predetermined and which deliver adaptative messages as a function of the environment.


Versatile and efficient synthesis of protein-polysaccharide conjugate vaccines using aminooxy reagents and oxime chemistry.
Applications of oxime chemistry are described for the efficient bioconjugation of proteins and polysaccharides for the preparation of conjugate vaccines. A number of approaches are described in this manuscript to functionalize proteins and polysaccharides with aminooxy (AO) groups and aldehydes which could then be covalently linked to each other via oxime formation, without the need for reduction. By using limiting numbers of active groups on each component, the extent of inter- and intramolecular crosslinking could be controlled. The approaches described are compatible and complementary to a number of chemistries currently used in conjugate vaccine synthesis. Oxime chemistry can be used to both simplify the synthesis of and increase yields of conjugate vaccines. Mice immunized with pneumococcal type 14 conjugates that were made using oxime chemistry mounted significant anti-polysaccharide immune responses. The primary immune response could be boosted, indicating that the polysaccharide conjugate had characteristics of a T cell dependent antigen.


Carotid artery stenting protected with an emboli containment system.
Fear of distal embolization and stroke has aroused concern regarding carotid stenting. Devices to protect the cerebral circulation may make carotid stenting safer. A multidisciplinary study group tested a balloon occlusion-aspiration emboli entrapment device in conjunction with carotid stenting. The device consists of an elastomeric balloon on a steerable wire with a detachable adapter that inflates and deflates the distal temporary occlusion balloon. An aspiration catheter is used to remove trapped emboli after stenting and before occlusion balloon deflation. Seventy-five patients with severe internal carotid artery stenosis were treated with stents deployed with this cerebrovasculature protection system. All 75 patients (100%) had grossly visible particulate material aspirated, and all were treated successfully without major or minor stroke or death at 30 days. Preintervention stenosis was 81+/-10%, and residual stenosis was 5+/-7%. Nine patients (12%) had angiographic evidence of thrombus before intervention, but no patient had thrombus or vessel cutoff after the procedure. Four patients (5%) developed transient neurological symptoms during protection balloon occlusion, but symptoms resolved with balloon deflation. The 22 to 667 particles aspirated per patient ranged from 3.6 to 5262 microm in maximum diameter (mean, 203+/-256 microm). These particles included fibrous plaque debris, lipid or cholesterol vacuoles, and calcific plaque fragments. Protected carotid stenting was performed successfully and safely in this study early in the experience with cerebrovascular protection devices. Particulate emboli are frequent with stenting, and cerebral protection will likely be necessary to minimize stroke. Randomized trials comparing protected carotid stenting with endarterectomy are warranted.


Perineural spread of salivary duct carcinoma to the internal auditory canal.
Salivary duct carcinomas (SDCs) are high-grade malignant tumors exhibiting aggressive growth with early regional and distant metastasis. We report a case of SDC in a 63-year-old male with early recurrent disease in the cerebellopontine angle (CPA) after total parotidectomy and adjuvant radiotherapy. The tendency of the tumor to recur or metastasize despite radical surgical measures and radiotherapy continues to pose a therapeutic challenge.


BioMe: biologically relevant metals.
In this article, we introduce BioMe (biologically relevant metals), a web-based platform for calculation of various statistical properties of metal-binding sites. Users can obtain the following statistical properties: presence of selected ligands in metal coordination sphere, distribution of coordination numbers, percentage of metal ions coordinated by the combination of selected ligands, distribution of monodentate and bidentate metal-carboxyl, bindings for ASP and GLU, percentage of particular binuclear metal centers, distribution of coordination geometry, descriptive statistics for a metal ion-donor distance and percentage of the selected metal ions coordinated by each of the selected ligands. Statistics is presented in numerical and graphical forms. The underlying database contains information about all contacts within the range of 3 Å from a metal ion found in the asymmetric crystal unit. The stored information for each metal ion includes Protein Data Bank code, structure determination method, types of metal-binding chains [protein, ribonucleic acid (RNA), deoxyribonucleic acid (DNA), water and other] and names of the bounded ligands (amino acid residue, RNA nucleotide, DNA nucleotide, water and other) and the coordination number, the coordination geometry and, if applicable, another metal(s). BioMe is on a regular weekly update schedule. It is accessible at http://metals.zesoi.fer.hr.


Cognitive Correlates of Reading Fluency in Chinese School-Aged Children.
Previous studies have showed that reading fluency is strongly associated with cognitive skills, including rapid automatized naming, phonological awareness, orthographical awareness, and so on. However, these studies are largely based on alphabetic languages, and it remains unclear which cognitive factors contribute to the development of reading fluency in logographic Chinese, a language in which the graphic forms map onto morphemes (meaning) rather than phonemes. In Study 1, we tested 179 Chinese children aged 6 to 9 on a set of cognitive tasks as well as for word reading accuracy and sentence reading fluency. The results showed that rapid naming, writing fluency, and phonological awareness significantly predicted reading fluency in both beginning and intermediate readers. In addition, while the contribution of rapid naming and writing fluency increased with grades, the effect of phonological awareness decreased. In Study 2, we examined the role of visual crowding in reading fluency in a subgroup of 86 children and found that visual crowding accounted for the unique variance of individual differences in reading fluency. The findings reflect both universal and language-specific cognitive correlates of reading fluency and provide important implications for potentially effective treatment for individuals suffering from Chinese reading disabilities, particularly in terms of reading fluency.


Regulation of the expression of IL-6 in human monocytes.
IL-6 is a cellular regulatory molecule with various cell-dependent functions. We have studied the control of IL-6 expression in human monocytes because they play a key role in the production of this molecule. The effects of adherence and different cytokines including CSF-1, IFN-gamma, IL-1 alpha, and granulocyte-macrophage-CSF were tested on IL-6 expression. IL-6 mRNA was usually not detected in the starting population of PBMC. Adherence induced IL-6 gene expression in monocytes in less than 2 h and subsequently IL-6 secretion. Priming of monocytes by adherence was more efficient for IL-6 overinduction by CSF-1. In contrast, high level induction of IL-6 by IFN-gamma in unfractionated PBMC did not require adherence and in situ hybridization revealed that IL-6 mRNA was present in monocytes but not in lymphocytes. A similar phenomenon was observed for IL-1 alpha and granulocyte-macrophage-CSF. Two cell lines, HL-60 and U937, in which monocytic differentiation occurs after induction by PMA, were subsequently investigated. IL-6 was not constitutively detectable in these two cell lines, whereas PMA treatment induced IL-6 expression. This effect was rapid (30 min) and transitory in HL-60, whereas IL-6 mRNA was still detected after 72 h of induction in U937. Addition of human rIL-6 on U937 and HL-60 cells inhibited their proliferation and enhanced expression of HLA class I Ag.


[Castleman's angiofollicular lymphoma as a cause of anemia and splenomegaly with indications for splenectomy].
The physiology of the spleen is very complex and has a series of factors, which request a more detailed explanation. With different blood diseases, namely, the reticulo endothelium system the spleen more or less, plays the central part in the general pathological events. Indication for splenectomy requests many internal, haemotologic, immunologic examinations and a close cooperation with the surgeon. The failure of a performed splenectomy is seldom related, directly to the surgical techniques, more frequent with a bad ante operationem assessment, namely predictable assessory spleen, which continues to play the splenogenous disfunction. Such a "clinical misunderstanding" we had in the case presented in the paper. We spoke of our experiences with a patient who suffered from anaemia and an enormous enlargement of the spleen. After the splenectomy anaemia, unfortunately, was persistent. During the operation we found a tomefact (as big as a nut) located on the right side, paravertebral in peritoneum. The probatory cutting off was sent to the pathologist, we asked for a verification. We were warned by the pathologist to extract in toto. Only in that way the mentioned symptoms might disappear, the existing anaemia, too.


Affinity purification and binding analysis of the hemolymph juvenile hormone binding protein from Manduca sexta.
A high-affinity juvenile hormone binding protein was purified from the hemolymph of the tobacco hornworm, Manduca sexta, employing ammonium sulfate precipitation and affinity and size-separation chromatography. The naturally occurring enantiomer of juvenile hormone III (10R) was converted to juvenile hormone III acid and then covalently attached to aminohexyl-Sepharose 4B. Hemolymph from early fifth stadium (60 h postecdysis) larvae was used as the source of hJHBP. The yield of hJHBP was approximately 25% of the starting material, with 3.5 mg of highly purified, biologically active hJHBP recovered from 100 mL of hemolymph. Binding parameters were examined using equilibrium dialysis and highly purified, enantiomerically correct juvenile hormone I and II and racemic JH III. The equilibrium dissociation constants for juvenile hormone I and II were approximately 6 x 10(-10) M at 4 degrees C, while racemic juvenile hormone III displayed an equilibrium dissociation constant of 1.9 x 10(-9) M. At 25 degrees C the equilibrium dissociation constant for juvenile hormone I was 1.6 x 10(-9) M. Half-times of dissociation were also determined for the three homologs. The half-time of dissociation was 30 s for juvenile hormone I, 20 s for juvenile hormone II, and 13 s for juvenile hormone III at either 4 or 25 degrees C. Using the new equilibrium dissociation constants, we calculate that better than 99% of the circulating juvenile hormone titer may be bound to this hemolymph protein.


Autogenous venous graft with one-stage prepared Schwann cells as a conduit for repair of long segmental nerve defects.
The use of autogenous venous graft with intraluminal injection of Schwann cells to enhance nerve regeneration of long segmental nerve defects was evaluated in a rabbit tibial nerve-repair model. Schwann cells were isolated from the excised rabbit tibial nerve by using the polylysine differential adhesion method. The cultured cells were identified by immunocytochemical labeling for S-100 protein. Tibial nerve defects in 4-cm segments were created in 24 animals, which were then divided into three groups. In Group 1, the tibial nerve defect was repaired with interposition vein graft alone; in Group 2, the nerve defect was repaired with a vein graft with intraluminal injection of Schwann-cell suspension; in Group 3, the nerve defect was repaired by autogenous nerve graft alone. At 2 months postoperatively, electrophysiologic evaluation showed that an evoked muscle action potential was recorded for the animals in Group 2, with vein grafting plus Schwann cells, and for those in Group 3, with autogenous nerve grafting, but not for those in Group 1, where vein grafting alone was used. The average motor nerve conduction velocity in the group with vein grafting and Schwann cells was 3.4 +/- 1.5 m/sec, which was slower than the nerve grafting group (7.8 +/- 1.8 m/sec). Histologic analysis confirmed there was formation of new nerve fascicles with myelination in the vein graft filled with Schwann cells. No nerve regrowth was found in the vein grafts without Schwann cells. These results suggested that isolated Schwann cells are able to survive in a vein graft, and that the vein graft with intraluminal seeded Schwann cells could be an alternative for repairing injured nerves with long gaps.


Intracranial solitary chondroma. Case report.
A patient is described who had a solitary left frontal intracranial chondroma originating from the falx cerebri. The tumor was totally removed. The diagnostic value of computerized tomography and the surgical findings in this rare pathological condition are discussed.


Irritable bowel syndrome.
Irritable bowel syndrome (IBS) is a disease of unclear, complex pathophysiology characterised by abdominal pain and discomfort and altered bowel activity. It affects an estimated 10-15% of individuals worldwide and has a large impact on quality of life (QOL) and both direct and indirect healthcare costs. Symptoms of IBS are usually triggered by disruption of gastrointestinal (GI) function secondary to infection, dietary factors, lifestyle changes or psychological stress. While most currently available pharmacological treatments of IBS focus on symptomatic treatment of the syndrome, agents that attempt to address the pathophysiology of the disease, in particular the role of serotonin, have received much attention in recent years. However, there is growing concern that serotonergic agents as a class may be associated with rare, but serious, episodes of ischaemic colitis, with several cases of this complication having been reported in association with use of serotonergic agents that have reached the market. Thus, there remains an important need for safe and effective agents that treat the symptoms of IBS. Otilonium bromide, a spasmolytic agent, has been widely used worldwide and has been found to be effective and safe for managing abdominal pain. Clinical trials indicate that it improves baseline abdominal pain and distension, and is particularly effective in reducing diarrhoea. Combining otilonium bromide with benzodiazepines, such as diazepam, may improve the efficacy of the agent with respect to GI symptoms, while also treating underlying anxiety disorders. More research is required to confirm the efficacy and mechanisms of action associated with this combination therapy in IBS. Safety data from clinical trials and postmarketing sources indicate that otilonium bromide is well tolerated, with a safety profile comparable to placebo in clinical trials and only two reported cases of adverse reactions (urticaria) among 10-year postmarketing data. This article reviews the pathophysiology and treatment of IBS with a particular focus on the role of otilonium bromide in the management of this condition.


MicroRNAs as early biomarkers in obesity and related metabolic and cardiovascular diseases.
The increasing prevalence of obesity has significant implications for healthcare, more particularly since it is a major risk factor for type 2 diabetes and cardiovascular diseases. However, not every obese patient is at the same risk of developing future metabolic and cardiovascular complications. Therefore, there is an urgent need for novel biomarkers for early identification of obese patients at high risk. Possible candidate biomarkers are microRNAs, which are highly conserved non-coding RNA molecules of approximately 22 nucleotides that exert post-transcriptional effects on gene expression. They are expressed in a tissue- and cell-type specific manner, play essential roles in many biological and pathological processes and are released in human peripheral blood in a disease-specific manner where they remain stable due to association with lipoprotein and phospholipids. All these characteristics suggest that they are putative diagnostic biomarkers. This review summarizes microRNAs with a functional role in the pathogenesis of atherosclerosis, myocardial infarction, ischemia/reperfusion injury and cardiac remodeling. It emphasizes those which have already been deregulated in association with obesity-related risk factors clustered in the metabolic syndrome. It demonstrates that several microRNAs which have been claimed to be biomarkers for cardiovascular diseases have already been deregulated in association with metabolic disorders prior to cardiovascular diseases. Finally, it summarizes which of these functionally validated microRNAs are deregulated in the circulation making them easily accessible for detection and thus into candidate biomarkers for early diagnosis of obesity-induced cardiovascular events.


Clinical Use of Continuous Glucose Monitoring in Adults with Type 1 Diabetes.
With the emphasis on intensive management of type 1 diabetes, data from studies support frequent monitoring of glucose levels to improve glycemic control and reduce glucose variability, which can be related to an increase in macro and microvascular complications. However, few perform capillary blood glucose that frequently. There are currently two available alternatives that this review will discuss, continuous glucose monitoring (CGM) and flash glucose monitoring. CGM has become an important diagnostic and therapeutic option in optimizing diabetes management. CGM systems are now more accurate, smaller, and easier to use compared to original models. Randomized controlled trials (RCTs) have demonstrated that CGM can improve Hemoglobin A1c (HbA1C) and reduce glucose variability in both continuous subcutaneous insulin infusion and multiple daily injection users. When used in an automated "insulin-suspend" system, reduced frequency of hypoglycemia and shorter time spent in hypoglycemic range have been demonstrated. Despite the potential benefits CGM has to offer in clinical practice, concerns exist on the accuracy of these devices and patient compliance with therapy, which may prevent the true clinical benefit of CGM being achieved, as observed in RCTs. Flash glucose monitoring systems FreeStyle® Libre™ (Abbott Diabetes Care, Alameda, CA) are as accurate as many CGM systems available and have the added benefit of being factory calibrated. Studies have shown that flash glucose monitoring systems are very well tolerated by patients and effectively reduce glucose variability, increasing time in range.