Treatment of children with attention-deficit/hyperactivity disorder (ADHD) and irritability: results from the multimodal treatment study of children with ADHD (MTA).
Clinically impairing irritability affects 25% to 45% of children with attention-deficit/hyperactivity disorder (ADHD); yet, we know little about what interventions are effective in treating children with ADHD and co-occurring irritability. We used data from the Multimodal Treatment Study of Children With ADHD (MTA) to address 3 aims: to establish whether irritability in children with ADHD can be distinguished from other symptoms of oppositional defiant disorder (ODD); to examine whether ADHD treatment is effective in treating irritability; and to examine how irritability influences ADHD treatment outcomes. Secondary analyses of data from the MTA included multivariate analyses, and intent-to-treat random-effects regression models were used. Irritability was separable from other ODD symptoms. For treating irritability, systematic stimulant treatment was superior to behavioral management but not to routine community care; a combination of stimulants and behavioral treatment was superior to community care and to behavioral treatment alone, but not to medication alone. Irritability did not moderate the impact of treatment on parent- and teacher-reported ADHD symptoms in any of the 4 treatment groups. Treatments targeting ADHD symptoms are helpful for improving irritability in children with ADHD. Moreover, irritability does not appear to influence the response to treatment of ADHD. Multimodal Treatment Study of Children With Attention Deficit and Hyperactivity Disorder (MTA); http://www.clinicaltrials.gov; NCT00000388.


[Renal involvement in systemic lupus erythematosus].
Lupus nephropathy belongs to the most severe clinical manifestations of systemic lupus erythematosus (SLE). In 40-60% of patients impairment in renal function is stated on diagnosis and in 10-25% of them the disease progresses to the end-stage renal failure. There is an ample of evidence that the kidney is involved very early in the course of SLE and the occurrence of low-level proteinuria and haematuria may be associated with a significant renal disease. Glomerular lesions are the main prognostic factor. Two classifications of these lesions exist at present, i.e.: the World Health Organization classification from 1982 and the new one developed by the International Society of Nephrology/Renal Pathology Society in 2003. Since new morphological presentations with glomerular necrosis and crescent formation, associated with the presence of anti-neutrophil cytoplasmic antibodies have been reported, some difficulties in the interpretation of glomerular lesions further exist. Despite this complexity, the assessment of the kidney biopsy specimen remains the "gold standard" in handling with patients with lupus nephropathy.


Preparation and structures of enantiomeric dinuclear zirconium and hafnium complexes containing two homochiral N atoms, and their catalytic property for polymerization of rac-lactide.
The hydroxy- and phenoxy-bridged dinuclear zirconium and hafnium complexes and of an amine-pyridine-bis(phenolate) ligand (H(2)L) were prepared from the reaction of Na(2)L and ZrCl(4) in the presence of 0.5 equiv of water in THF, while the reaction of H(2)L with NaH and then with ZrCl(4) in the freshly distilled THF gave an eight-coordinate bis(homoleptic) mononuclear complex L(2)Zr (). Two homochiral N atoms were created in each complex upon coordination of the unsymmetric tertiary amine ligands to the metal centers. Enantiomeric dinuclear complexes and both undergo spontaneous resolution during crystallization. The molecular structure of each enantiomer of and , as well as the structure of , was determined by X-ray analysis and the circular dichroism spectra of N(R)N(R)- and N(S)N(S)- were studied. The racemates of and catalyzed controlled polymerization of rac-lactide in terms of the linearity of molecular weight versus conversion, forming isotactic-rich polylactide in high yields with a narrow polydispersity.


Germline mutation of CBL is associated with moyamoya disease in a child with juvenile myelomonocytic leukemia and Noonan syndrome-like disorder.
Germline mutations in CBL have been identified in patients with Noonan syndrome-like phenotypes, while juvenile myelomonocytic leukemia (JMML) harbors duplication of a germline CBL, resulting in acquired isodisomy. The association between moyamoya disease and Noonan syndrome carrying a PTPN11 mutation has recently been reported. We present a patient with JMML who developed moyamoya disease and neovascular glaucoma. Our patient exhibited a Noonan syndrome-like phenotype. Genetic analysis revealed acquired isodisomy and a germline heterozygous mutation in CBL. This is a rare case of CBL mutation associated with moyamoya disease. Prolonged RAS pathway signaling may cause disruption of cerebrovascular development.


Studying enzymatic bioreactions in a millisecond microfluidic flow mixer.
In this study, the pre-steady state development of enzymatic bioreactions using a microfluidic mixer is presented. To follow such reactions fast mixing of reagents (enzyme and substrate) is crucial. By using a highly efficient passive micromixer based on multilaminar flow, mixing times in the low millisecond range are reached. Four lamination layers in a shallow channel reduce the diffusion lengths to a few micrometers only, enabling very fast mixing. This was proven by confocal fluorescence measurements in the channel's cross sectional area. Adjusting the overall flow rate in the 200 μm wide and 900 μm long mixing and observation channel makes it possible to investigate enzyme reactions over several seconds. Further, the device enables changing the enzyme/substrate ratio from 1:1 up to 3:1, while still providing high mixing efficiency, as shown for the enzymatic hydrolysis using β-galactosidase. This way, the early kinetics of the enzyme reaction at multiple enzyme/substrate concentrations can be collected in a very short time (minutes). The fast and easy handling of the mixing device makes it a very powerful and convenient instrument for millisecond temporal analysis of bioreactions.


R Loops in the Regulation of Antibody Gene Diversification.
For nearly three decades, R loops have been closely linked with class switch recombination (CSR), the process that generates antibody isotypes and that occurs via a complex cascade initiated by transcription-coupled mutagenesis in switch recombination sequences. R loops form during transcription of switch recombination sequences in vitro and in vivo, and there is solid evidence that R loops are required for efficient class switching. The classical model of R loops posits that they boost mutation rates by generating stable and long tracts of single-stranded DNA that serve as the substrate for activation induced deaminase (AID), the enzyme that initiates the CSR reaction cascade by co-transcriptionally mutating ssDNA in switch recombination sequences. Though logical and compelling, this model has not been supported by in vivo evidence. Indeed, several reports suggest that R loops may not be involved in recruiting AID activity to switch regions, meaning that R loops probably serve other unanticipated roles in CSR. Here, I review the key findings in this field to date and propose hypotheses that could help towards elucidating the precise function of R loops in CSR.


Strain specific genotype-environment interactions and evolutionary potential for body mass in brook charr (Salvelinus fontinalis).
Discriminating between genetic and environmental causes of phenotypic variation is an essential requirement for understanding the evolutionary potential of populations. However, the extent to which genetic variation differs among conspecific groups and environments during ontogeny has rarely been investigated. In this study, the genetic basis of body mass was measured in three divergent strains of brook charr (Salvelinus fontinalis) in different rearing environments and at different time periods. The results indicate that body mass was a heritable trait in all strains but that the level of heritability greatly differed among strains. Moreover, heritability estimates of each strain varied differently according to environmental rearing conditions, and cross-environments correlations were all significantly lower than unity, indicating strain-specific patterns of genotype-environment interactions. Heritability estimates also varied throughout ontogeny and decreased by 50% from 9 to 21 months of age. This study highlights the divergence in genetic architecture and evolutionary potential among these strains and emphasizes the importance of considering the strain-specific potential of the response to selection according to environmental variation.


The Agreement Between Reverse Transcriptase-Polymerase Chain Reaction (RT-PCR) and Rapid Antigen Test (RAT) in Diagnosing COVID-19.
Background False-negative results derived from RT-PCR tests for diagnosing coronavirus disease (COVID-19) have raised questions about whether to consider them the gold standard for the detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Using an imperfect gold standard to assess other diagnostic tests would never let the other tests show better diagnostic performance. The best strategy in such cases is to do an agreement analysis, and this study aims to estimate the agreement between real-time reverse transcriptase-polymerase chain reaction (RT-PCR) and rapid antigen test (RAT) for COVID-19 detection. Methods A retrospective study was done using paired data of individuals tested for COVID-19, both by RT-PCR and RAT, obtained from the virology laboratory of Government Bundelkhand Medical College, Sagar, Madhya Pradesh, India. A sample size of 93 was calculated, and the data were abstracted in a data abstraction sheet. Variables included were results of RT-PCR and RAT, age, gender, presence of symptoms, test kit used, and the time duration between sampling for RT-PCR and RAT. Apart from descriptive statistics, keeping in mind the binary outcome of RT-PCR and RAT, Cohen's kappa was calculated for agreement analysis. A p-value of <0.05 was considered significant. Results The data on 100 participants suspected to be infected with COVID-19 (58 male and 42 female) with a mean age of 39.8 (±19.0) years were analysed. The number of discordant pairs was eight. Cohen's kappa showed substantial agreement between RT-PCR and RAT, κ=0.646, (95% CI 0.420 to 0.871), p<0.001. Conclusion Considering the ease of conducting RAT with quick results and substantial agreement with RT-PCR, RAT could be a better choice in detecting SARS-CoV-2 and, hence, COVID-19 disease on a large scale.


Advantages and dangers of artificial ventilation.
In modern anesthesiology artificial ventilation has many advantages, especially when compared to manual ventilation, nonetheless the "educated hand" of the anesthesiologist. However many dangers and pitfalls exist during controlled ventilation. A survey of them is given. In more detail are discussed: hyperventilation, hypoventilation, accidental deconnection of the tubings, accidental hyperpression, failure of the cycling mechanism, faults in fresh gas administration. A plea is made for immediate observation of the patient and respiratory dynamics when connecting a respirator.


Transplantation of A2 kidneys into B and O recipients leads to reduction in waiting time: USRDS experience.
Strategy of transplanting kidneys from A2 donors into patients with blood group B and O recipients has been used to alleviate the long waiting times. We used an inception cohort of US Renal Data System data base with patients older than 18 years who underwent renal transplantation between January 1995 and July 2006. The primary outcome variable was allograft loss (including death). Bivariate analysis of factors associated with receiving A2 or A2B kidneys was performed with chi-square testing for categorical variables (Fisher's exact test used for violations of Cochran's assumptions) and Student's t test for continuous variables (Mann-Whitney U test used for nonnormally distributed variables). There were 150,118 first kidney transplants of whom 113 received kidney transplant from A2 to O, and 125 patients received A2 to B kidney transplant. Compared with other recipients from the same blood group, recipients of A2 kidneys had significantly shorter wait times. O recipients had a median wait time of 1.63 years (range 0.00-17.21 years), whereas O recipients who received A2 kidneys had a median wait time of 0.70 years (range 0.02-1.47 years; P<0.001). B recipients had a median wait time of 1.90 years (range 0.00-17.52 years), whereas B recipients who received A2 kidneys had a median wait time of 0.74 years (range 0.10-5.21 years; P<0.001). There was no significant difference in graft loss or death between A2 to O and B versus all other recipients. The results showed that comparatively few patients received A2 to B or O kidney transplant.


Llama oviductal sperm reservoirs: involvement of bulbourethral glands.
The aim of this study was to elucidate the role of llama seminal plasma in the formation of oviductal sperm reservoirs. Female llamas with follicles in the mature phase were mated with a bulbourethral glands-removed male. Females mated with nonbulbourethral glands-removed males were used as control. Oviducts were obtained by surgery 24 h after mating. The uterotubal junction and isthmus were examined by scanning electron microscopy, and mucopolysaccharides were identified by Alcian blue staining. To know the proteins probably involved in sperm reservoir formation, SDS-PAGE of seminal plasma (8% and 18% resolving gel) was made. Spermatozoa only adhered to the oviductal mucosa surface of uterotubal junction of females mated with nonbulbourethral glands-removed males confirming that seminal plasma and, in particular, bulbourethral secretions are related with the oviductal sperm reservoir formation. Histological sections showed sperm in the lumen, immersed in substance, positive for acid mucopolysaccharides. Alcian blue staining of seminal plasma proteins SDS-PAGE showed a band of high molecular weight containing mucopolysaccharides, only present in nonbulbourethral glands-removed males. Bulbourethral glands would secrete at least eight different proteins that most likely participate in the process of sperm storage in the oviduct.


A Comparison of Sepsis-2 (Systemic Inflammatory Response Syndrome Based) to Sepsis-3 (Sequential Organ Failure Assessment Based) Definitions-A Multicenter Retrospective Study.
Recently, the definition of sepsis has changed from a physiologic derangement (Sepsis-1 and -2) to organ dysfunction (Sepsis-3) based. We sought to determine the concordance between the different sepsis phenotypes and how that affected mortality. Retrospective, multicenter study. Three academic medical centers. 29,459 patients who had suspected infection, defined as obtaining blood cultures and receiving antibiotics: 18,183 (62%) had either Sepsis-2 or Sepsis-3. Kappa was used to show agreement between phenotypes. Conditional logistic regression was used to create models of associations between factors and phenotypes and between factors and mortality. About 12,981 patients had Sepsis-2; 12,043 had Sepsis-3; and 6,841 patients had both Sepsis-2 and Sepsis-3. Fifty-three percent of Sepsis-2 patients also had Sepsis-3, whereas 57% of Sepsis-3 patients also had Sepsis-2. Agreement between the two phenotypes was poor: kappa = 0.213 ± 0.006. Mortality was 6% in patients with only Sepsis-2, 10% with only Sepsis-3, and 18% in patients who had both phenotypes. Combining the variables in Sepsis-2 and Sepsis-3 improved the discrimination (C-statistic = 0.742 ± 0.005, p < 0.001) of mortality. We found that Sepsis-2 and Sepsis-3-based sepsis diagnoses represent separate phenotypes with poor agreement. Patients who have both phenotypes are at increased risk of mortality compared with having either phenotype alone. Inclusion of both systemic inflammatory response syndrome and Sequential Organ Failure Assessment criteria in the same model improves the discrimination of mortality.


Effect of a GP desktop resource on smoking cessation activities of general practitioners.
To evaluate an intervention aimed at increasing the quantity and quality of brief opportunistic general practitioner (GP) advice to smokers encouraging and supporting quit attempts. Randomized controlled trial with two groups: (1) control and (2) GP desktop resource (GDR). Smoking cessation activities of GPs were assessed by an independent postal survey 1 month after distribution of resource. One hundred and seven GPs in West Dorset. GPs' self-reported rates of advising and counselling smokers on cessation over the previous week. The rate of opportunistic advice per week in the GDR group was 4.9 (SD = 4.1), compared with 2.8 (SD = 1.8) in the control group, F = 8.2, p = 0.0025, one-tailed. The rate of giving counselling was also higher 2.2 (SD = 3.2) in the intervention group versus 1.0 (SD = 1.4) in the control group, F = 4.0), p = 0.025, one-tailed. The proportion who had recommended or prescribed NRT was greater, although not significantly (54%, versus 46%, Fisher's exact p = 0.1, one-tailed). The findings indicate that the GDR can increase the rate of delivery of opportunistic advice and provision of counselling. Given the importance of this activity, a larger trial appears to be warranted to examine the long-term effect and the effect on cessation rates in patients.


Radiobiology of Small Hive Beetle (Coleoptera: Nitidulidae) and Prospects for Management Using Sterile Insect Releases.
Small hive beetle, Aethina tumida Murray (Coleoptera: Nitidulidae), is considered a serious threat to beekeeping in the Western Hemisphere, Australia, and Europe mainly due to larval feeding on honey, pollen, and brood of the European honeybee, Apis mellifera L. Control methods are limited for this pest. Studies were conducted to provide information on the radiobiology of small hive beetle and determine the potential for sterile insect releases as a control strategy. Adult males and females were equally sensitive to a radiation dose of 80 Gy and died within 5-7 d after treatment. In reciprocal crossing studies, irradiation of females only lowered reproduction to a greater extent than irradiation of males only. For matings between unirradiated males and irradiated females, mean reproduction was reduced by >99% at 45 and 60 Gy compared with controls, and no larvae were produced at 75 Gy. Irradiation of prereproductive adults of both sexes at 45 Gy under low oxygen (1-4%) caused a high level of sterility (>99%) while maintaining moderate survivorship for several weeks, and should suffice for sterile insect releases. Sterile insect technique holds potential for suppressing small hive beetle populations in newly invaded areas and limiting its spread.


Isolation and expansion of resident cardiac progenitor cells.
After myocardial infarction, loss of viable cardiomyocytes severely impairs cardiac function. Recently, stem cell transplantation has been put forward as a promising approach to repair the damaged heart. Although several clinical trials have already been performed, the dominant beneficial effects are probably due to neoangiogenesis and arteriogenesis. However, replacement of cardiomyocytes is vital to improve cardiac function in the long term. Stem cells and progenitor cells, with the capacity to differentiate into cardiomyocytes, have been described in both embryonic and adult tissues. Upon stimulation, cardiac progenitor cells proliferate and differentiate into cardiomyocytes, vascular smooth muscle cells, and endothelial cells. Currently however, high proliferation rates and differentiation of cardiac progenitor cells beyond the fetal stage have not yet been achieved. Full differentiation into adult cardiomyocytes in vitro and in vivo might be important for efficient integration with the host environment and therefore more research is needed to study factors that influence proliferation and differentiation. Here we will discuss the isolation of cardiac progenitor cells, their potential to differentiate into various cell types needed for cardiac repair, the possible mechanisms behind these events, and how these cells may be implemented in future clinical settings.


Seroepidemiological survey of morbillivirus infection in Kuril harbor seals (Phoca vitulina stejnegeri) of Hokkaido, Japan.
Serological analysis was performed to detect morbillivirus infection in Kuril harbor seals in Hokkaido, Japan. Serum samples were collected from the seals at Nosappu (231 sera), Akkeshi (16), and Erimo (75) between 1998 and 2005. Antibodies to phocine distemper virus (PDV) were detected by ELISA in seals from Nosappu and Erimo. Antibodies to PDV were found in 56% (5/9) of the sampled seals from Nosappu in 1998, versus only 5% (3/66) for 2003, 1% (1/79) for 2004, and 1% (1/77) for 2005. These suggest epidemic caused by the virus in or before 1998. As antibody-positive seals included juvenile seals in 2003 and 2005, sporadic infections of the virus are thought to have occurred in recent years. In Erimo, antibodies to PDV were found in 50% (14/28) of sampled seals in 2004, versus only 13% (1/8) for 1999, 7% (1/15) for 2003, and 0% (0/24) for 2005. These suggest sporadic infection by the virus before 2003 and the epizootic between after autumn in 2003, when samples of 2003 were collected, and 2004. Since antibodies to canine distemper virus (CDV) were detected in one adult seal from Nosappu in each year from 2003 to 2005, sporadic infections of the virus were suggested. There were no difference in incidence of seals with antibodies to the viruses between males and females and between juveniles and adults.


In Defense of P Values.
Recently, a controversy has erupted regarding the use of statistical significance tests and the associated P values. Prominent academic statisticians have recommended that the use of statistical tests be discouraged or not used at all. This has naturally led to a lot of confusion among research investigators about the support in the academic statistical community for statistical methods in general. In fact, the controversy surrounding the use of P values has a long history. Critics of P values argue that their use encourages bad scientific practice, leading to the publication of far more false-positive and false-negative findings than the methodology would imply. The thesis of this commentary is that the problem is really human nature, the natural proclivity of scientists to believe their own theories and present data in the most favorable light. This is strongly encouraged by a celebrity culture that is fueled by academic institutions, the scientific journals, and the media. The importance of the truth-seeking tradition of the scientific method needs to be reinforced, and this is being helped by current initiatives to improve transparency in science and to encourage reproducible and replicable research. Statistical testing, used correctly, has an important and valuable place in the scientific tradition.


Molecular Characterization of the Bacterial Community in Biofilms for Degradation of Poly(3-Hydroxybutyrate-co-3-Hydroxyhexanoate) Films in Seawater.
Microplastics are fragmented pieces of plastic in marine environments, and have become a serious environmental issue. However, the dynamics of the biodegradation of plastic in marine environments have not yet been elucidated in detail. Polyhydroxyalkanoates (PHAs) are biodegradable polymers that are synthesized by a wide range of microorganisms. One of the PHA derivatives, poly(3-hydroxybutyrate-co-3-hydroxyhexanoate) (PHBH) has flexible material properties and a low melting temperature. After an incubation in seawater samples, a significant amount of biofilms were observed on the surfaces of PHBH films, and some PHBH films were mostly or partially degraded. In the biofilms that formed on the surfaces of unbroken PHBH films, the most dominant operational taxonomic units (OTUs) showed high similarity with the genus Glaciecola in the family Alteromonadaceae. On the other hand, the dominant OTUs in the biofilms that formed on the surfaces of broken PHBH films were assigned to the families Rhodobacteraceae, Rhodospirillaceae, and Oceanospirillaceae, and the genus Glaciecola mostly disappeared. The bacterial community in the biofilms on PHBH films was assumed to have dynamically changed according to the progression of degradation. Approximately 50 colonies were isolated from the biofilm samples that formed on the PHBH films and their PHBH-degrading activities were assessed. Two out of three PHBH-degrading isolates showed high similarities to Glaciecola lipolytica and Aestuariibacter halophilus in the family Alteromonadaceae. These results suggest that bacterial strains belonging to the family Alteromonadaceae function as the principal PHBH-degrading bacteria in these biofilms.


Phase-shifting interferometry with equal phase steps by use of a frequency-tunable diode laser and a Fabry-Perot cavity.
A phase-shifting interferometry (PSI) with equal phase steps by use of a frequency-tunable diode laser and a Fabry-Perot cavity is proposed for the Carré algorithm. The measurement accuracy of the Carré algorithm depends on the equality of the phase steps. Using the Fabry-Perot cavity as a highly stable optical frequency reference, a high degree of phase step equality can be realized in PSI with an optical frequency shift. Our experimental scheme realizes an optical frequency step equality higher than 5.1 x 10(-5) and a measurement repeatability of lambda/800.


Helicobacter pylori infection, gastrin and cyclooxygenase-2 in gastric carcinogenesis.
Gastric cancer is one of the most frequent neoplasms and a main cause of death worldwide, especially in China and Japan. Numerous epidemiological, animal and experimental studies support a positive association between chronic Helicobacter pylori (H. pylori) infection and the development of gastric cancer. However, the exact mechanism whereby H. pylori causes gastric carcinogenesis remains unclear. It has been demonstrated that expression of cyclooxygenase-2 (COX-2) is elevated in gastric carcinomas and in their precursor lesions. In this review, we present the latest clinical and experimental evidence showing the role of gastrin and COX-2 in H. pylori-infected patients and their possible association with gastric cancer risk.


Nonclassic cystic fibrosis and CFTR-related diseases.
To review the spectrum of disease caused by mutations in the cystic fibrosis (CF) gene. The growing recognition of "atypical" cases of cystic fibrosis presenting in adolescence or adulthood and manifested by disease in only one or two organ systems, along with CF diagnostic criteria based not only on sweat chloride values but genetic screening and nasal ion transport measurements, have made the diagnosis of CF less straightforward for many clinicians. This review seeks to clarify the key diagnostic criteria for CF and uses the Cystic Fibrosis Foundation's Consensus Diagnostic Guidelines and recent publications to discuss the characteristics of classic CF, nonclassic CF, and CFTR-related diseases.


[The analysis of a diet food of the persons working with sources of an ionizing radiation in Moscow and Moscow region].
An actual food, including a food represented at the enterprise to workers, contacting to ionizing radiation sources is analysed. The considerable contribution of a treatment-and-prophylactic food to food and power value of a diet is established. It is revealed that the majority of the surveyed persons eat with infringement of principles of a balanced diet. It is established that an actual food of the surveyed contingent includes the elements which are risk factors of development of cardiovascular diseases, diabetes, etc. metabolism diseases. Prevalence of superfluous weight of a body and adiposity aged is more senior 40 years has made 70%. A treatment-and-prophylactic food demands correction, working out approximate 7-10 day menus is necessary.


Depletion of CD8+ or CD4+ lymphocytes enhances susceptibility to transplantable ultraviolet radiation-induced skin tumours.
Immunosuppressed patients are extremely susceptible to cutaneous squamous cell carcinoma, suggesting that immunosurveillance by T lymphocytes protects against this ultraviolet radiation-induced tumour. To determine the relative contribution of CD8+ and CD4+ lymphocytes to immunosurveillance, we tested the effects of CD8+ or CD4+ T lymphocyte depletion on the susceptibility of C3H/HeN mice to a syngeneic UVR-induced skin tumour cell line. Both anti-CD8 and anti-CD4 treatment significantly enhanced the growth of transplanted tumours. In CD8-depleted animals, tumours grew rapidly in all animals. Tumour growth in CD4-depleted animals was slower, and 50% of these mice eventually rejected their tumours. In CD4-depleted mice that did not reject their tumours, an early period of tumour growth was followed by partial regression of the tumour; a second phase of rapid tumour growth then supervened. Our findings suggest that both CD8+ and CD4+ lymphocytes contribute to immunosurveillance against skin cancer.


Primitive Neuroectodermal Tumor in a Child with Human Immunodeficiency Virus Infection: A Rare Association.
Children with human immunodeficiency virus (HIV) infection are reported to have various malignancies, most common being Non-Hodgkin lymphoma. Despite higher risk of malignancies, brain tumors are infrequently described in these children. We report Primitive Neuroectodermal tumor (PNET) in a young boy with HIV infection. PNET has never been described in association with HIV infection. Though a causative association cannot be established, it does emphasize that with longer survivals on effective antiretroviral therapy, we may see a wide range of malignancies more frequently.


Ultrasound-guided infrapatellar nerve block in human volunteers: description of a novel technique.
Despite the use of various treatment strategies arthroscopic knee surgery is still associated with clinically important postoperative pain. As the infrapatellar nerve (IPN) innervates vital anterior knee structures we decided to investigate the feasibility of a novel ultrasound-guided IPN block technique as a potential therapeutic option for out-patient arthroscopic knee surgery. The IPN was blocked under ultrasonographic guidance in 10 adult volunteers using 5 ml of levobupivacaine 5 mg ml(-1). Success rate, time to maximum cutaneous distribution of the block, distribution of cutaneous analgesia and time until full recovery of cutaneous sensation was noted as was the incidence of concomitant blockade of the saphenous nerve (SN). The IPN was successfully blocked in 9/10 subjects. However, a varying degree of concomitant SN block was observed as part of all blocks. The time to maximum cutaneous distribution of the block was 8.4 (sd 3.6) min and the duration until complete recovery of cutaneous sensation was 27.5 (19.1) h. Reliable blockade of the IPN can be achieved with ultrasonographic guidance. Because of the very close anatomical relationship between the IPN and the SN it appears inevitable to also get a variable degree of concomitant SN block. The duration of the IPN block was in the majority of subjects greater than 16 h, a finding that may make this block useful for postoperative analgesia in out-patient arthroscopic surgery.


[Results of the differentiated use of catecholamines and vasodilators in the early post-bypass phase].
Presented are the results of a procedure to characterize the haemodynamic situation and the required therapy in the early post-bypass period by including haemodynamic parameters (Part, CVP, PLA, TPR, PVR, f, Cl) in a system of seven parameter constellations although directly measured values must be supplemented by clinical data. In this way situations with increased or normal cardiac output and pathological peripheral resistance can be more easily distinguished from situations with reduced cardiac output. The investigations were performed in 300 patients who underwent cardiac surgery in 1985 and 1986. In more than 80% of the patients increased volume alone was not able to end the bypass, and so therapy including catecholamines and/or vasodilatators was instituted. Due to a relatively intensive but specific treatment, a favourable result with a 3% mortality was achieved. The frequency of patients after coronary surgery, valve replacement or correction of congenital heart defects in the seven situations of parameters corresponded to the expected haemodynamic peculiarities. In the group treated with catecholamines only, including 34% of the coronary patients, no increased mortality occurred compared with the total number. In patients in whom the constellation of parameters required a treatment with catecholamines combined with vasodilators, a higher mortality of 8.6% occurred compared with the total result. Here patients are concentrated with whom a good surgical result could not be obtained or the changes of myocardial stimulation were exhausted. Our findings emphasize the importance of the following points for further practice: improvement of invasive monitoring to apply vasodilators more intensively especially in infancy, careful selection of patients for coronary surgery, reduction of negative inotropic drugs preoperatively in high risk patients for improving postoperative stimulation of the myocardium.


Middle frontal horizontal partial laryngectomy (MFHPL): a treatment for stage T1b squamous cell carcinoma of the glottic larynx involving anterior vocal commissure.
The therapeutic effect of middle frontal horizontal partial laryngectomy (MFHPL) in treating stage T1b squamous cell carcinoma of the glottic larynx involving anterior vocal commissure (AVC) was compared with that of the anterior frontolateral vertical partial laryngectomy (AFVPL). The feasibility and practical significance of MFHPL in clinical application was discussed in the present study. From January 1996 to January 2010, a total of 65 patients diagnosed with stage T1bN0M0 glottic laryngeal cancer were treated with MFHPL or AFVPL. The postoperative complications, glottic reconstruction, recurrence rate, voice quality and survival rates were evaluated and compared between two treatments. AFVPL and MFHPL were performed in 34 and 31 patients, respectively. Flexible fiberoptic laryngoscopy revealed that in the MFHPL-treated patients the reconstructed glottis was spacious and symmetric. In contrast, AFVPL treatment resulted in irregular glottic area with poor symmetry and tubular glottis. The incidence of postoperative laryngeal stenosis significantly differed between the MFHPL- and AFVPL-treated groups (P = 0.025). No significant difference was detected in the 3- and 5-year overall- or tumor-free survival rates between two treatments. The Voice Handicap Index (VHI) and maximum phonation time (MPT) after surgery were 51.0±12.99 and 12.42±3.44 sec in the AFVPL-treated group; while in the MFHPL-treated patients they were 31.81±7.48 and 7.65±1.98 sec, respectively. Both differences in VHI (P = 0.012) and MPT (P = 0.024) were significant between two treatments. MFHPL was comparable to AFVPL with respect to postoperative complications, recurrence rate and survival rates, but possessed advantages over AFVPL in terms of the incidence of laryngeal stenosis and voice quality. Our study indicated that MFHPL has a potential value in clinical practice of treating stage T1b squamous cell carcinoma of the glottic larynx involving AVC.


[Construction of multifunctonal nano-delivery system crossing blood brain barrier].
To construct multifunctonal nano-delivery system crossing the blood brain barrier (BBB). The magnetic nanoparticles were preprared with O-carboxylmethylated chitosan (O-CMC) and conjugated with a peptide sequence from the human immunodeficiency virus 1-tat protein and transferrin (Tf), and anti-tumor drug methotrexate (MTX), and thus constructed a O-CMC magnetic nanoparticles carrier system conjugating with Tat and Tf (O-MNPs-Tat-Tf) that combines multiple functions including crossing BBB, magnetism, receptor-mediated dual targets and anti-tumor capabilities. The appearance, diameter, and magnetism of MTX-O-MNPs-Tat-Tf carrier system were characterized with transmission electronic microscopy, atomic force microscopy and vibrating samples magnetometer. The cytotoxicity of MTX-loaded O-MNPs-Tat-Tf was investigated with C6 glioma cells. The ability of O-MNPs-Tat-Tf crossing BBB was investigated in rats by single photon emission computed tomography. The mean particle diameter was 75 nm, along with good anti-tumor property. The multi-functioned carrier system successfully crossed the BBB in rat. The establishment of MTX-O-MNPs-Tat-Tf carrier model implies a promising future for its application in therapy of cerebral diseases.


Predicting the compressive mechanical behavior of bone.
The principal objectives of this study were to determine the mathematical dependency of the compressive mechanical properties of human bone on several commonly used measures of bone composition, and to assess variations in this dependency based upon the composition range spanned by the data. Destructive mechanical tests were conducted along the superior-inferior axis of 496 cubic specimens of human trabecular and cortical bone from five male donors (ages 46-84 yr), including specimens from lumbar vertebrae and femoral metaphyses and diaphyses. There was over a 3000-fold variation in strength (S, ultimate stress) and over a 20,000-fold variation in stiffness (E, elastic modulus) over the range of apparent dry density (rho a = 0.05-1.89 g cm-3), apparent ash density (rho alpha = 0.03-1.22 g cm-3) and mineral content (alpha = 17.4-66.2%) examined. Both linear and power models produced very high correlations (R2 > 0.81) between mechanical properties and bone composition, but the linear models resulted in a much greater percent deviation (PD) of the predicted dependent variable with respect to the measured value, in comparison to power models. The best correlations were obtained using rho alpha as the only independent variable: S (MPa) = 117 rho alpha 1.93 +/- 0.04 (R2 = 0.969, PD = 29.9, E (GPa) = 10.5 rho alpha 2.57 +/-0.04 (R2 = 0.965, PD = 46.7). Power models of bone stiffness and strength, incorporating only low density data (rho alpha < 0.2 g cm-3, rho a < 0.3), were characterized by approximately squared exponents and these models underestimated the stiffness (five-fold) and overestimated the strength (two-fold) for higher density data, which were characterized by exponents greater than two. Using a subset of the data based upon an apparent dry density range of 0.22 < rho a < 1.89 g cm-3, it was possible to obtain a mathematical relationship in which bone stiffness and strength were precisely proportional to the cube and square, respectively, of the apparent dry density. These results indicate that the mathematical dependency of bone compressive mechanical properties on composition is closely dependent upon the density and mineral content range examined and, in terms of a single compositional measure, is best predicted by apparent ash density expressed as a power function.


[Value of functional magnetic resonance imaging in predicting outcomes of neoadjuvant chemoradiotherapy in rectal cancer].
Rectal cancer is one of the common cancers which poses a threat to the health of mankind. In recent years. Multi-modality treatment strategies for locally advanced rectal cancer improve the treatment efficiency. Accurate prediction of the treatment response after the neoadjuvant chemoradiotherapy (CRT) can guide more suitable treatment strategy. MERCURY study proved the prognostic value of post-CRT standard morphologic MRI(T2-weighted) assessment of tumor regression grade(TRG), and MRI assessment of circumferential resection margin can guide the definitive surgery. Compared with standard morphologic MRI (T2-weighted), functional MRI, including diffusion weighted imaging (DWI) and dynamic contrast enhanced (DCE) MRI, has shown more promising results for the prediction of therapeutic response in rectal cancer. The addition of diffusion-weighted images to T2-weighted images improves the accuracy of restaging examinations for determination of complete pathologic responders. DCE can reflect the tumor micro-vascular environment, and the change of perfusion in response to treatment. These images have the potential to improve the accuracy of therapeutic response in rectal cancer.


Aggregation across multiple indicators improves the detection of malingering: relationship to likelihood ratios.
Recent literature shows that aggregating across multiple symptom validity test (SVT) failures increases the probability of malingering over use of one indicator alone, supporting the criteria proposed by Slick, Sherman, and Iverson (1999) that require multiple sources of evidence for diagnosis of malingering. The present study reanalyzes with likelihood ratios data previously published by Larrabee (2003a) on litigants with definite malingering, contrasted with non-malingering patients with moderate and severe traumatic brain injury. Chaining of likelihood ratios demonstrated an increase in probability of malingering when multiple test scores were positive, with values ranging from. 713 to. 837 for one failed SVT,. 936 to. 973 for two failed SVTs, and. 989 to. 995 for three failed SVTs. Posterior probabilities of malingering derived from chaining of likelihood ratios closely approximated those obtained by direct computation of Positive Predictive Power, particularly when three SVTs were failed. Moreover, the five SVTs employed in these analyses did not intercorrelate significantly, satisfying the assumption that the tests be independent for chaining of likelihood ratios. Posterior probabilities derived from chaining of likelihood ratios, holding sensitivity and specificity constant at. 50 and. 90, respectively, and varying the malingering base rate from. 10 to. 90, showed a wide range of values,. 357 to. 978, for failure of one SVT. Failure of two SVTs yielded probabilities ranging from. 735 to. 996. Failure of three SVTs yielded values ranging from. 933 to. 999, demonstrating high probabilities of malingering irrespective of the base rate. These data support the Slick et al. recommendation that multiple positive findings are necessary for diagnosis of malingering. Suggestions are made for modification of the Slick et al. criteria based on the current results.


A proposal for a new classification of complications in craniosynostosis surgery.
OBJECTIVE Complications have been used extensively to facilitate evaluation of craniosynostosis practice. However, description of complications tends to be nonstandardized, making comparison difficult. The authors propose a new pragmatic classification of complications that relies on prospective data collection, is geared to capture significant morbidity as well as any "near misses" in a systematic fashion, and can be used as a quality improvement tool. METHODS Data on complications for all patients undergoing surgery for nonsyndromic craniosynostosis between 2010 and 2015 were collected from a prospective craniofacial audit database maintained at the authors' institution. Information on comorbidities, details of surgery, and follow-up was extracted from medical records, anesthetic and operation charts, and electronic databases. Complications were defined as any unexpected event that resulted or could have resulted in a temporary or permanent damage to the child. RESULTS A total of 108 operations for the treatment of nonsyndromic craniosynostosis were performed in 103 patients during the 5-year study period. Complications were divided into 6 types: 0) perioperative occurrences; 1) inpatient complications; 2) outpatient complications not requiring readmission; 3) complications requiring readmission; 4) unexpected long-term deficit; and 5) mortality. These types were further subdivided according to the length of stay and time after discharge. The overall complication rate was found to be 35.9%. CONCLUSIONS The proportion of children with some sort of complication using the proposed definition was much higher than commonly reported, predominantly due to the inclusion of problems often dismissed as minor. The authors believe that these complications should be included in determining complication rates, as they will cause distress to families and may point to potential areas for improving a surgical service.


The Association of Social Factors and Time Spent in the NICU for Mothers of Very Preterm Infants.
Evaluate the association between maternal social factors and maternal time spent in the NICU for very preterm infants admitted to 4 level III and IV NICUs. In this prospective observational cohort study, we enrolled mother-infant dyads whose infants were born <32 weeks' gestation. Enrollment occurred after 2 weeks of NICU exposure, when maternal social factors and demographic information was collected. Maternal time spent in the NICU was abstracted from the electronic medical record and was dichotomized into 0 to 6 days and ≥6 days per week. Demographic differences between the 2 groups were compared by using χ2 tests. Logistic regression was used to assess the independent association between maternal social factors and the average number of days per week spent in the NICU. A total of 169 mother-infant dyads were analyzed. Maternal social factors associated with more time spent in the NICU included an annual household income of >$100 000, compared with those with an annual household income of <$50 000 (adjusted odds ratio [aOR]: 5.68; 95% confidence interval [CI] 1.77-18.19), a travel time <30 minutes to the NICU (compared with those who traveled >60 minutes [aOR: 7.85; 95% CI 2.81-21.96]), and the lack of other children in the household, compared with women with other children (aOR: 3.15; 95% CI 1.39-7.11). Maternal time spent in the NICU during a prolonged birth hospitalization of a very preterm infant differed by socioeconomic status, travel time, and presence of other dependents. Strategies to better identify and reduce these disparities to optimize engagement and, subsequently, improve infant health outcomes is needed.


Does progressive stage transition mean getting better? A test of the Transtheoretical Model in alcoholism recovery.
To test two central assumptions of stage movement in the Transtheoretical Model (TTM) vis-à-vis alcoholism recovery: (assumption 1) individuals making a forward transition to the action-oriented stages (i.e. preparation/action) will manifest relatively greater drinking improvements than their counterparts remaining in the pre-action stages (i.e. pre-contemplation, contemplation); and (assumption 2) individuals remaining in the pre-action stages across time will not demonstrate clinically relevant improvement in drinking outcomes. Secondary data analyses of data from Project MATCH, a large multi-site alcoholism treatment-matching study. At baseline and 3 months post-treatment, the following variables were measured: stage-of-change (based on the University of Rhode Island Change Assessment measure and the most recent stage assignment algorithm), drinks per drinking day (DDD) and percentage days abstinent (PDA). Six of the eight tests of assumptions 1 and 2 failed to support the basic tenets of the TTM. Our study demonstrated that individuals making a progressive stage transition to the action-oriented stages (i.e. preparation/action) do not necessarily manifest greater improvements in drinking-related behavior than individuals remaining in the pre-action stages (i.e. pre-contemplation, contemplation), and that individuals remaining in the pre-action stages over time actually do manifest statistically significant and clinically important improvements in drinking-related behavior. Our findings challenge not only the criterion validity associated with stage movement in the TTM account of alcoholism recovery, but also recent TTM-based substance abuse treatment approaches which systematically promote forward stage transition as a primary clinical goal and marker of therapeutic success.


Evaluation and optimum use of directed horizontal filtered air flow for surgeries.
Airborne micro-organisms, a suspected cause of surgical wound infection, are significantly reduced by the use of filtered unidirectional air flow (UAF) in operating rooms. A horizontal UAF system was installed at UCLA for evaluation and to determine procedures which would optimize its use. Major findings are listed: though the air flow was found to be somewhat turbulent and non-uniform in velocity downstream from the filter-bank entrance, the gross flow direction was maintained throughout the protected region; airborne particles were swept downstream with little vertical drop and no large scale recirculation; proper orientation and placement of objects in the clean air stream maximized its purging effect; correlation of non-viable with viable particle counts was not possible; better control of sources of contamination, particularly the operating team, would further reduce the potential for airborne infection; as yet there is no definitive proof that the addition of filtered UAF in a modern operating room reduces occurrences of deep wound sepsis.


Quantitative assessment of demyelination in ischemic stroke in vivo using macromolecular proton fraction mapping.
A recent MRI method, fast macromolecular proton fraction (MPF) mapping, was used to quantify demyelination in the transient middle cerebral artery occlusion (MCAO) rat stroke model. MPF and other quantitative MRI parameters (T1, T2, proton density, and apparent diffusion coefficient) were compared with histological and immunohistochemical markers of demyelination (Luxol Fast Blue stain, (LFB)), neuronal loss (NeuN immunofluorescence), axonal loss (Bielschowsky stain), and inflammation (Iba1 immunofluorescence) in three animal groups ( n = 5 per group) on the 1st, 3rd, and 10th day after MCAO. MPF and LFB optical density (OD) were significantly reduced in the ischemic lesion on all days after MCAO relative to the symmetrical regions of the contralateral hemisphere. Percentage changes in MPF and LFB OD in the ischemic lesion relative to the contralateral hemisphere significantly differed on the first day only. Percentage changes in LFB OD and MPF were strongly correlated (R = 0.81, P < 0.001) and did not correlate with other MRI parameters. MPF also did not correlate with other histological variables. Addition of T2 into multivariate regression further improved agreement between MPF and LFB OD (R = 0.89, P < 0.001) due to correction of the edema effect. This study provides histological validation of MPF as an imaging biomarker of demyelination in ischemic stroke.


[Cohort analysis for treatment outcomes TB pulmonary cases bacteriologically confirmed in Poland].
In Poland since 1986 system of treatment outcomes monitoring (TOM) of all confirmed pulmonary TB (PTB) cases has been introduced. This system is based on the Central Tuberculosis Register TB detected and registered in given year from the whole network tuberculosis and lung diseases dispensaries in the country--/ 400 disp. in 2004 yr/. The aim of the study was to asses treatment results of PTB confirmed cases registered in 2003 and in the period 2001-2003. In 2003 5558 cases were registered, The treatment outcomes were assessed according to WHO/Euro TB-categories after 12 months after start of treatment as PTB: cured--67.8%; completed--10.4% (success ratio--77.8%); failed--1.5%, died--5.1% (from TB--2.1%); defaulted--7.6%, still on treatment--0.6%; transferred--1.9%. and unknown--5.5% all registered PTB cases. In period 2001-2003 proportion patients with success of treatment was stable. In 2003 proportion of patients with success of treatment was significantly higher in a groups of new cases--83.7 than in patients with relapses--73.9%; among women--85.4% than in men--80.9%. Among PTB cases smear positive success ratio--81.3 was lower than among PTB cases culture positive--84.0. Among patients with diabetes and alcohol abuse the success of treatment was significantly lower than more patients without these diseases/habit. Alcoholics three times more frequently defaulted treatment than patients without this habit. The improvement of treatment outcomes is impossible without generalize directly observed treatment in all patients in continuation phase of treatment.


Bedside monitoring of patients with shock using a portable spatially-resolved near-infrared spectroscopy.
Clinical monitoring of shock mainly depends on blood-oxygen-indices obtained from invasive blood sample tests. The central internal jugular central vein oxygenation level (ScvO2) has been considered as a gold standard indicator for shock prediction. We developed a noninvasive spatially-resolved near-infrared spectroscopy (SR-NIRS) to measure tissue blood oxygen saturation (StO2) surrounding the region of taking blood sample for the ScvO2 test in 25 patients with shock. StO2 values were found to be highly correlated (r = 0.84, p < 0.001) with ScvO2 levels and the concordance coefficient of 0.80 is high. The results suggest the potential of noninvasive SR-NIRS for bedside shock monitoring.


Approaching the clinical application of xenotransplantation.
Interspecies transplantation or xenotransplantation is seen increasingly as a potential approach to overcoming the severe shortage of human organs and tissues for transplantation. Much has been learned recently about the immunologic hurdles of transplanting porcine organs into humans. These hurdles can be addressed, in part, by the genetic engineering of donors and by specific therapies directed at the salient immune events. As we succeed in dealing with the immunologic aspects of xenotransplantation, other issues, including zoonosis, and regulatory aspects will need to be addressed.


GABAA receptor gamma subunits in the prefrontal cortex of patients with schizophrenia and bipolar disorder.
Immunohistochemical and immunoblot techniques were employed in order to examine alterations of the GABAA receptor gamma subunits in the prefrontal cortex from postmortem subjects with schizophrenia and bipolar disorder. Immunohistochemically, gamma 1/3 immunolabeling in the neuronal soma in the prefrontal cortex from subjects with bipolar disorder was more intense than that of the controls and the subjects with schizophrenia. The intensity of gamma 1/3 immunolabeling of the schizophrenic subjects was comparable with that of the controls. Immunoblot analysis demonstrated a significant increase in the gamma 1 subunit in the bipolar subjects, whereas no remarkable difference was detected in the schizophrenic subjects. The present study suggests that the GABAA receptor gamma subunit is differentially involved in schizophrenia and bipolar disorder, and that the gamma subunit is up-regulated in the prefrontal cortex of subjects with bipolar disorder.


Reconstruction of Wassel Type VI Radial Polydactyly with Triphalangeal Thumb Using an On-top Osteotomy.
The purpose of this study was to present a novel surgical technique using an on-top osteotomy and to assess the clinical and radiographic outcomes for the triphalangeal Wassel type VI thumb duplication patients. The surgical technique involves ablation of the radial thumb at distal one-third of the metacarpal, corresponding metacarpal osteotomy of the ulnar thumb, with amalgamation of 2 metacarpals and reconstruction of the ulnar thumb by a series of soft tissue procedures. Clinical and radiologic outcomes were evaluated by using the Japanese Society for Surgery of the Hand evaluation form at a minimum of 30 months. The size of the metacarpal was measured and compared to the opposite one to assess the growth of the thumb. Five patients, including 4 males and 1 female, were observed for an average of 37 months. All amalgamated metacarpal showed bone union in 6 weeks after surgery and revealed growth with the age. The average length of the metacarpal was 86% of the opposite one at the final follow-up. Motion at the metacarpophalangeal and interphalangeal joints showed no restriction after surgery, and they reached excellent function for gripping and pinching. According to the JHHS scoring system, the results were excellent in 3 cases, good in 2. This novel surgical technique for the reconstruction of Wassel type VI radial polydactyly with triphalangeal shows encouraging results in both clinical and radiologic evaluations; meanwhile long-term results are under evaluation.


Comparison of Four Methods of RNA Extraction and cDNA Synthesis from The Venom of Peruvian Snakes of the Genus Bothrops of Clinical Importance.
RNA purification and cDNA synthesis represents the starting point for molecular analyses of snake venom proteins-enzymes. Usually, the sacrifice of snakes is necessary for venom gland extraction to identify protein-coding transcripts; however, the venom can be used as a source of transcripts. Although there are methods for obtaining RNA from venom, no comparative analysis has been conducted in the Bothrops genus. In the present study, we compared four commercial methods for RNA purification and cDNA synthesis from venom (liquid, lyophilized, or long-term storage) of four clinically relevant species of Peruvian Bothrops. Our results show that the TRIzol method presents the highest yield of RNA purified from venom (59 ± 11 ng/100 µL or 10 mg). The SuperScript First-Strand Synthesis System kit produced high amounts of cDNA (3.2 ± 1.2 ng cDNA/ng RNA), and the highest value was from combination with the Dynabeads mRNA DIRECT kit (4.8 ± 2.0 ng cDNA/ng RNA). The utility of cDNA was demonstrated with the amplification of six relevant toxins: thrombin-like enzymes, P-I and P-III metalloproteinases, acid and basic phospholipases A2, and disintegrins. To our knowledge, this is the first comparative study of RNA purification and cDNA synthesis methodologies from Bothrops genus venom.


Preferential effects of 1,3-bis(2-chloroethyl)-1-nitrosourea (BCNU) on pulmonary glutathione reductase and glutathione/glutathione disulfide ratios: possible implications for lung toxicity.
Single doses (8-80 mg/kg) of 1,3-bis(2-chloroethyl)-1-nitrosourea (BCNU) inhibited lung glutathione disulfide (GSSG) reductase in a dose- and time-dependent manner. The loss of enzyme activity persisted up to 8 days after 20 mg of BCNU per kg. A multiple dosing regimen consisting of 5 mg of BCNU per kg/week for 6 weeks decreased lung reductase activity by at least 70%. Recovery was very slow, still remaining well below (68%) control activity for 2 weeks after cessation of BCNU treatment. In contrast, liver GSSG reductase was only slightly decreased by the multi-dose BCNU regimen and rapidly returned to control levels. Pulmonary GSSG concentrations were increased to about 300% of control. This elevation persisted up to 2 weeks after BCNU treatment was completed. There was no effect on total pulmonary glutathione levels during or after BCNU treatment. BCNU administration did not alter hepatic GSSG, although there was a delayed elevation of total liver glutathione. The multi-dose BCNU regimen used in this study leads to the delayed onset of striking pulmonary damage which develops in severity over several weeks after the BCNU treatment is completed. The present results, therefore, suggest that a relatively preferential destruction of lung GSSG reductase by BCNU may precede the development of severe lung toxicity. Considering the probable importance of GSSG reductase in maintaining normal lung homeostasis, this biochemical lesion merits further attention as to its possible role in the pathogenesis of BCNU-induced lung disease.


Two years research on efficiency of two intercrops, birdsfoot trefoil and summer savory, to reduce damage caused by onion thrips(Thrips tabaci Lindeman, Thysanoptera, Thripidae) on leek.
In 2009 and 2011, a field experiment was carried out at the Laboratory Field at the Biotechnical Faculty in Ljubljana, Slovenia, with the aim to investigate suitability of two intercrops, birdsfoot trefoil (Lotus corniculatus L) and summer savory (Satureja hortensis L.), for reducing damage caused by onion thrips (Thrips tabaci Lindeman) on leek (Allium porrum L.). Four leek cultivars--'Columbus', 'Forrest', 'Lancelot' and 'Lincoln'--were used in the research (Bejo Zaden B.V., Netherlands). In both years, the mean index of damage caused by feeding of the pest on the leek leaves increased from the first evaluation (13 July 2009 and 18 June 2011) in both treatments with intercrops and in control treatment (without intercrop). Leek grown with birdsfoot trefoil as intercrop was in both years statistically the least damaged from thrips. Also summer savory was efficient in the same context in comparison with control treatment. In year 2009 cultivar 'Lancelot' was the least damaged in all treatments, and in year 2011 'Lancelot' and 'Forrest'. In both years intercrop and cultivar also had a significant influence on the yield of leek. The highest yield was obtained on the control plots, meanwhile birdsfoot trefoil and summer savory were pretty competitive and yield of leek grown with them as intercrops was therefore significantly lower.


Cervical vertebral body replacement using a modern in situ expandable and angulable corpectomy cage system: early clinical and radiological outcome.
Vertebral body replacement (VBR) cages are commonly implanted to reconstruct the cervical vertebrae in cases of tumour, trauma, spondylodiscitis, and degeneration. Expandable cages have been widely used for this purpose; however, the lacking congruence at the implant-bone interface and consequent implant displacement were considered as a serious drawback of such systems. Aim of this study is to evaluate the early clinical and radiological outcome of a modern in situ not only expandable but also angulable cervical corpectomy cage system. A total of 42 patients who underwent a single or multilevel cervical VBR procedure were included and retrospectively evaluated in this single-centre case series. The neurological status was assessed using American Spinal Injury Association (ASIA) score. Complications were categorized into surgical (including implant-associated) and general medical. Radiographic parameters included regional angulation, segmental height, and coronal alignment. Mean age was 59.5 ± 20.6 years. The recorded ASIA score improved postoperatively by 10 points (p 0.0001). Surgical including implant-associated complication rates were 19.05%. Radiographic evaluation showed a height gain of 11.2 mm (p < 0.0001), lordotic correction of 7° (p < 0.0001), and coronal alignment of 3° (p < 0.0001). At the last follow-up, loss of angulation correction of 1.9° (p 0.0002), subsidence of 1.92 mm (p 0.0006), and fusion rates of 68.42% were observed. The use of an in situ angulable and expandable cage system in cervical VBR seems to offer better results compared to conventional static or expandable cages regarding segmental height gain, lordotic correction, and clinical improvement as well as low complication and revision rates. Significant height gain in multilevel surgeries is associated with higher rates of implant-associated complications.


Preoperative anesthesia evaluation.
The preoperative evaluation is the first step in ensuring the safe conduct of anesthetic care in pediatric patients of all ages. Over time, this process has changed significantly from a time when patients were admitted to the hospital the night before surgery to a time when the majority of patients, including those scheduled for major surgical procedures, arrive the day of surgery. For most patients, the preoperative examiantion can be conducted over the phone by a trained nurse or on-line via a survey thereby eliminating the need for a separate visit merely for the preoperative evaluation. Regardless of where or how it occurs, the goals of the preoperative evaluation are to gain information regarding the patient's current status, comorbid conditions, and the intended procedure. This process allows the identification of patients who require additional preoperative testing or those patients who need to be seen by an anesthesiolgoist prior to the day of surgery. During the preopeative evalaution, decisions are made regarding further laboratory or investigative work-up that are required. The preoperative meeting provides an arena to develop the initial parent-physcian rapport, outline anesthetic risks, and discuss the intended anesthetic plan including options for postoperative analgesia. The process facilitates the care of patients during the perioperative period while limiting surgical cancellations resulting from patient-related issues. The following chapter reviews the essential components of the preoperative evaluation including the appropraite use of preoperative laboratory testing and other investigative procedures including radiologic imaging. Key components of the physical examinatino including the airway examination are reviewed.


Plasma levels of superoxide dismutase and its isomers in patients with chronic renal disease.
To evaluate the significance of Cu,Zn-superoxide dismutase (SOD) in chronic renal disease, we evaluated the plasma SOD activity and analyzed the plasma Cu,Zn-SOD isomers employing gel column chromatography. The plasma SOD activity was determined as the biological activity using the nitrite method and the Cu,Zn-SOD concentration was assayed from the immunological activity using enzyme-linked immunosorbent assay (ELISA). The subjects comprised 185 patients with chronic glomerular disease and 20 hemodialysis patients. Plasma from 170 healthy persons was employed as a control. Both the plasma biological activity and plasma level of Cu,Zn-SOD determined by ELISA were elevated in patients with chronic glomerular disease. In hemodialysis patients, a marked increase in Cu,Zn-SOD level (ELISA) was noted in comparison with the increase in SOD biological activities. Gel column chromatography demonstrated a marked increase in Cu,Zn-SOD monomer which was enzymatically inactive. From these results, we conclude that a marked elevation of the plasma level of Cu,Zn-SOD in hemodialysis patients was caused by an increase in the enzymatically inactive Cu,Zn-SOD monomer.


Public opinion on human rights in Putin-era Russia: Continuities, changes, and sources of variation.
Major setbacks in the protection of human rights during the Putin regime have produced little public outcry, suggesting that there is scant support for human rights in Russian public opinion. However, analysis of survey data spanning 2001-2015 yields several surprising conclusions. In contrast to findings from earlier studies, the data indicate that Russians think of rights in two distinct dimensions: material rights (including economic rights and rights of personal integrity) and (conventionally understood) civil liberties. Support for the former has been strong throughout the Putin era, and support for the latter has grown steadily and consistently. Moreover, support for civil liberties has increased most among less-educated and younger Russians who do not reside in Moscow and St. Petersburg: Contrary to theoretical expectations, variation in support has become less systematically linked to standard socioeconomic and demographic variables. Russians are divided over whether political NGOs should be allowed to receive foreign funding, a major issue for human rights advocates given the Russian government's crackdown on such funding and on human rights NGOs.


Acute abdomen. The history.
Correct decision, when managing the acute abdomen in children, are based on careful clinical assessment. An accurate history and a detailed examination will provide more information than a multitude of investigations. The chronological order to appearance and the progression of each individual symptom must be obtained. Consideration of these dynamic changes will often yield an accurate diagnosis. This article outlines a structured approach to history taking and details the common causes of acute abdomen in childhood.


Study of retinal microvessels in a Rhesus monkey model of chronic high intraocular pressure.
To investigate the changes in retinal vessels, especially macular capillaries, under high IOP using the Rhesus monkey high IOP model. The trabecular meshwork of the adult Rhesus monkey was cauterized by laser to induce increased IOPs with different degrees of damage. The eyeballs were enucleated, and the optic nerves were stained with toluidine blue in semithick slices. Part of the retina was observed under electron microscope, and the rest was stained by the ADPase method. The damage levels of the optic nerve were evaluated by axon count, and the pathological appearance of the macular capillaries were observed. Five mildly damaged eyes, three moderately damaged eyes and three severely damaged eyes were evaluated. Dense and intact perifoveal vascular rings were observed in all the eyes. The vessels' area percentages, as well as area, perimeter and diameter of the foveal avascular zones, were measured, and no statistically differences were found among different groups (P-values were 0.269, 0.500, 0.951, and 0.555 separately). The ultra structures of the normal capillaries showed regular tubes and intact basement membranes, while lipoid substances in capillary tubes, swollen mitochondria in endothelial cell bodies, and uneven basement membranes were found in the high IOP-damaged eyes. Compared with normal eyes, no obvious differences were found in macular microvessels and foveal avascular zones in the Rhesus monkey model of high IOP. However, presence of swollen mitochondria in endothelial cells and lipoid substances in capillary tubes might suggest that high IOP could damage the capillary endothelial cells.


Enteric colibacillosis: evaluation of strains of Escherichia coli utilizing the ligated loop technique in gnotobiotic swine.
The enteropathogenicity of 6 strains of Escherichia coli was evaluated via the ligated loop technique in 15 gnotobiotic swine 3 to 4 weeks old. Strain enteropathogenicity in gnotobiotic swine, as determined on the basis of visual loop distention and light microscopic evaluation of intestinal sections, compared favorably with that reported in conventional swine, except that jejunal loops of gnotobiotic swine may be somewhat less sensitive to certain strains. In addition, postoperative mortality rate among gnotobiotic pigs was greater than that reported in conventional pigs. Two types of aberrant loop reactions were observed during the experiment. The 1st, and the more commonly encountered type, was due to the leakage of enteropathogenic organisms or enterotoxin from one loop to another; this was considered to be a true false-positive reaction. The 2nd type of unexpected positive reaction occurred in 2 sacs inoculated with the nonenteropathogenic strain 115. This latter reaction may have represented either a reversion of the organism to its previous enteropathogenic state or a unique reaction of the gnotobiotic intestine to this strain. False-positive loops were not identified in any other sacs, whether inoculated or not. Results of these experiments support the hypothesis that false-positive loops originate from naturally occurring infection.


Obtaining outpatient referrals for clinical research.
Two methods of recruiting patients with generalised anxiety disorder (GAD) were compared. One hundred general practitioners in the immediate neighbourhood of a major urban hospital were approached for referrals, and an article on generalised anxiety asking for volunteers was placed in the evening newspaper. The former resulted in ten doctor-initiated referrals, two of whom fulfilled DSM-III criteria for GAD. The latter resulted in over 500 volunteers. In a random selection of 136 volunteers who secured their doctors' approval, 56 fulfilled GAD criteria. The majority of the remainder had a depressive illness. The newspaper article was more economical of researchers' time and more successful in finding suitable subjects than directly approaching general practitioners.


Solid-Liquid Interface Structure of Muscovite Mica in SrCl2 and BaCl2 Solutions.
The structure of the solid-liquid interface formed by muscovite mica in contact with two divalent ionic solutions (SrCl2 and BaCl2) is determined using in situ surface X-ray diffraction using both specular and non-specular crystal truncation rods. The 0.5 monolayer of monovalent potassium present at the surface after cleavage is replaced by approximately 0.25 monolayer of divalent ions, closely corresponding to ideal charge compensation within the Stern layer in both cases. The adsorption site of the divalent ions is determined to be in the surface ditrigonal cavities with minor out-of-plane relaxations that are consistent with their ionic radii. The divalent ions are adsorbed in a partly hydrated state (partial solvation sphere). The liquid ordering induced by the presence of the highly ordered crystalline mica is limited to the first 8-10 Å from the topmost crystalline surface layer. These results partly agree with previous studies in terms of interface composition, but there are significant differences regarding the structural details of these interfaces.


Long-lasting amelioration of walking trajectory in neglect after prismatic adaptation.
In the present study we explored the effect of prismatic adaptation (PA) applied to the upper right limb on the walking trajectory of a neglect patient with more severe neglect in far than in near space. The patient was asked to bisect a line fixed to the floor by walking across it before and after four sessions of PA distributed over a time frame of 67 days. Gait path was analyzed by means of an optoelectronic motion analysis system. The walking trajectory improved following PA and the result was maintained at follow-up, 15 months after treatment. The improvement was greater for the predicted bisection error (estimated on the basis of the trajectory extrapolated from the first walking step) than for the observed bisection error (measured at line bisection). These results show that PA may act on high level spatial representation of gait trajectory rather than on lower level sensory-motor gait components and suggest that PA may have a long-lasting rehabilitative effect on neglect patients showing a deviated walking trajectory.


Gas chromatographic/thin-layer chromatographic analysis of acetylated codeine and morphine in urine.
This procedure positively identifies codeine and morphine in urine. Urine samples are hydrolyzed and extracted with organic solvent, and the extracts are evaporated and acetylated. The presence of codeine and morphine is ascertained by gas chromatography (3% OV-25 and 3% Poly-A 103 columns) and confirmed by thin-layer chromatography (system: ethyl acetate/acetone/concd ammonium hydroxide, 100/10/4.5 by vol; reagent: iodoplatinate). As little as 0.5 mg each of codeine and morphine per liter, in free and conjugated forms, is detectable by this method.


[Effect of chronic intake of dietary fiber complex on the intestinal structure and function in hypercholesterolemic rats].
To investigate the long-term effect of dietary fiber complex (DFC) on intestinal structure and function in hypercholesterolemic rats, 60 healthy SD rats were feed with food rich in lipids and hypercholesterolemic animal models were established. The animals were randomly divided into 5 groups. Rats were fed DFC at levels of 4%, 16%, or 64% for three month in the experimental groups. Wheat fiber was used in the hypercholesterolemic control (HC) group and rats feeding on normal food were used as normal control (NC). Morphology of the small intestine, reticum and caecum were observed by light and electron microscope examination. Intestinal function was measured physically. The results showed that (1) compared with NC group, fecal weight was significantly raised in DFC group of higher level (group D and E, P < 0.05); (2) the weights of small intestine wall in D and E group were significantly higher than those of NC and HC group and weights of caecum wall in E group were significantly higher than those of NC and HC group (P < 0.05); (3) widen villi and thickened muscle layer of small intestine were observed in DFC group of higher level. No demonstrable changes in reticulum morphology in any group of animals were found under the observation of light microscope (4) microvilla becoming short and/or absent, mitochondria swelling, impairment of the integrity of the cristae were commonly observed in DFC groups. Conclusions Long-term intake of DFC composed mainly of Hippophae rhamnoides L, Bran, oat bran and guar gum at higher levels might induce some morphological changes of intestine and caecum. Therefore, DFC might be used at low level as an effective cholesterol-lowering agent.


Theory of optical trapping by an optical vortex beam.
We propose a theory to explain optical trapping by optical vortices (OVs), which are emerging as important tools to trap mesoscopic particles. The common perception is that the trapping is solely due to the gradient force and that it may be characterized by three real force constants. However, we show that the OV trap can exhibit complex force constants, implying that the trapping must be stabilized by ambient damping. At different damping levels, particles exhibit remarkably different dynamics, such as stable trapping and periodic and aperiodic orbital motions.


Developing a valid and reliable Perceived Global Future Scale.
To develop a valid and reliable data collection tool to define individuals' perceptions of the global future. This methodological study was carried out on 870 participants in Istanbul, a city with the country's highest and most diverse population. Content validity, construct validity, item analyses, and stability of the draft tool were tested. The seven-factor scale structure was confirmed. Cronbach's alpha coefficient of the scale was .93. The Perceived Global Future Scale, consisting of 36 items and seven dimensions, was used. It is a valid and reliable tool to define perceptions of individuals on the global future.


Pre-operative selective arterial embolization as a neoadjuvant therapy for proximal humerus giant cell tumor of bone: radiological and histological evaluation.
The management of giant cell tumor of the proximal humerus that extends to the joint is challenging. Here, we report a case of proximal humerus giant cell tumor with cortical bone destruction extending to the shoulder joint. Pre-operative selective arterial embolization induced peripheral tumor ossification. Subsequently, the lesion was removed by intralesional curettage, and the cavity was filled with cement. Macroscopically, the inner wall of the cavity was found to be lined with a thick fibrous membrane. Histologically, massive fibrosis and resultant remodeling of the destroyed cortical bone were induced, which was consistent with the peripheral ossification on the plain radiograph. We believe that selective arterial embolization can be an effective neoadjuvant therapy for giant cell tumors of the extremities, especially for tumors with large cortical defects or joint involvement.


Extraction and Optimization of Potato Starch and Its Application as a Stabilizer in Yogurt Manufacturing.
Starch is increasingly used as a functional group in many industrial applications and foods due to its ability to work as a thickener. The experimental values of extracting starch from yellow skin potato indicate the processing conditions at 3000 rpm and 15 min as optimum for the highest yield of extracted starch. The effect of adding different concentrations of extracted starch under the optimized conditions was studied to determine the acidity, pH, syneresis, microbial counts, and sensory evaluation in stored yogurt manufactured at 5 °C for 15 days. The results showed that adding sufficient concentrations of starch (0.75%, 1%) could provide better results in terms of the minimum change in the total acidity, decrease in pH, reduction in syneresis, and preferable results for all sensory parameters. The results revealed that the total bacteria count of all yogurt samples increased throughout the storage time. However, adding different concentrations of optimized extracted starch had a significant effect, decreasing the microbial content compared with the control sample (YC). In addition, the results indicated that coliform bacteria were not found during the storage time.


XEN Glaucoma Implant with Mitomycin C 1-Year Follow-Up: Result and Complications.
Purpose. To evaluate gel microstent (XEN, Aquesys, Inc) for treatment of primary open angle glaucoma (POAG). Methods. In this prospective interventional study, 13 eyes with POAG underwent XEN implantation with subconjunctival mitomycin-C. Of those eyes, 3 were pseudophakic and 10 underwent simultaneous phacoemulsification and XEN. Patients had uncontrolled IOP, had intolerance to therapy, or had maximal therapy but undergoing cataract extraction. Follow-up visits included IOP, number of medications, vision, and complications and lasted for 1 year. Complete success was defined as IOP reduction ≥20% from preoperative baseline at 1 year without any glaucoma medications while partial success as IOP reduction of ≥20% at 1 year with medications. Results. IOP dropped from 16 ± 4 mmHg pre-op to 9 ± 5, 11 ± 6, 12 ± 5, 12 ± 4, and 12 ± 3 mmHg at 1 week, 1, 3, 6, and 12 months (p = 0.004, 0.026, 0.034, 0.01, and 0.01, Wilcoxon Signed Ranks) consecutively. BCVA (LogMAR) was 0.33 ± 0.34 and improved to 0.13 ± 0.11 at 1 year. Mean number of medications dropped from 1.9 ± 1 preoperatively to 0.3 ± 0.49 (p = 0.003) at 1 year. 42% of eyes achieved complete success and 66% qualified success. Complications included choroidal detachment in 2 eyes, and implant extrusion in 1 eye, and 2 eyes underwent trabeculectomy. Conclusion. XEN implant is an effective surgical treatment for POAG, with significant reduction in IOP and glaucoma medications at 1 year follow-up.


[Genetic anomalies of colorectal cancers. Their role in guiding therapeutic indications].
Progress in detecting genetic anomalies with proven prognostic value in colorectal cancers offers a means of selecting adjuvant therapy with the best probability of success. Several methods are currently used. With flow cytometry, a significant correlation between primary tumour ploidy and hepatic metastasis has been demonstrated. Caryotypes of tumour cells provides a means of exposing segmental or total chromosome loss and subsequent classification leads to a better understanding of tumour heterogeneity. New techniques in molecular biology are used to describe mutations. Monoclonal antibodies can then be developed against the epitopes involved. Based on these different methods clinicians and fundamentalists can analyse treatment results with more precision and thus adopt the most effective treatment protocol.


LL-37 and HMGB1 induce alveolar damage and reduce lung tissue regeneration via RAGE.
The receptor for advanced glycation end-products (RAGE) has been implicated in the pathophysiology of chronic obstructive pulmonary disease (COPD). However, it is still unknown whether RAGE directly contributes to alveolar epithelial damage and abnormal repair responses. We hypothesize that RAGE activation not only induces lung tissue damage but also hampers alveolar epithelial repair responses. The effects of the RAGE ligands LL-37 and HMGB1 were examined on airway inflammation and alveolar tissue damage in wild-type and RAGE-deficient mice and on lung damage and repair responses using murine precision cut lung slices (PCLS) and organoids. In addition, their effects were studied on the repair response of human alveolar epithelial A549 cells, using siRNA knockdown of RAGE and treatment with the RAGE inhibitor FPS-ZM1. We observed that intranasal installation of LL-37 and HMGB1 induces RAGE-dependent inflammation and severe alveolar tissue damage in mice within 6 h, with stronger effects in a mouse strain susceptible for emphysema compared with a nonsusceptible strain. In PCLS, RAGE inhibition reduced the recovery from elastase-induced alveolar tissue damage. In organoids, RAGE ligands reduced the organoid-forming efficiency and epithelial differentiation into pneumocyte-organoids. Finally, in A549 cells, we confirmed the role of RAGE in impaired repair responses upon exposure to LL-37. Together, our data indicate that activation of RAGE by its ligands LL-37 and HMGB1 induces acute lung tissue damage and that this impedes alveolar epithelial repair, illustrating the therapeutic potential of RAGE inhibitors for lung tissue repair in emphysema.


Recent developments in the use of synthetic oligonucleotides for in situ hybridization histochemistry.
Synthetic oligonucleotides have been used with increasing frequency as probes for the detection and study of the regulation of specific mRNAs by in situ hybridization histochemistry. These probes can be easily obtained and used by the nonmolecular biologist, and they have been shown to be effective for the study of a wide range of mRNAs in neuronal and neuroendocrine tissues. Considerations in oligonucleotide probe design, synthesis, purification, and labeling are described in this article, and current procedures for tissue preparation and hybridization are discussed. In addition, control procedures and methods for the quantitation of in situ hybridization by image analysis are discussed. Finally, the combination of this technique with immunocytochemistry and retrograde tract-tracing is reviewed. The coupling of quantitative in situ hybridization with other neuronal markers, e.g., of connectivity, provides an increasingly valuable technology for exploring the regulation of gene expression in a rich anatomical context.


Transient model of thermal deactivation of enzymes.
The kinetics of enzyme deactivation provide useful insights on processes that determine the level of biological function of any enzyme. Photinus pyralis (firefly) luciferase is a convenient enzyme system for studying mechanisms and kinetics of enzyme deactivation, refolding, and denaturation caused by various external factors, physical or chemical by nature. In this report we present a study of luciferase deactivation caused by increased temperature (i.e., thermal deactivation). We found that deactivation occurs through a reversible intermediate state and can be described by a Transient model that includes active and reversibly inactive states. The model can be used as a general framework for analysis of complex, multiexponential transient kinetics that can be observed for some enzymes by reaction progression assays. In this study the Transient model has been used to develop an analytical model for studying a time course of luciferase deactivation. The model might be applicable toward enzymes in general and can be used to determine if the enzyme exposed to external factors, physical or chemical by nature, undergoes structural transformation consistent with thermal mechanisms of deactivation.


Selection of hepatitis B virus polymerase mutations in HIV-coinfected patients treated with tenofovir.
Tenofovir (TDF) is an adenosine nucleotide analogue that has been approved for the treatment of HIV-1 infection. It also shows activity against hepatitis B virus (HBV) in patients with or without lamivudine (LAM)-associated mutations. Development of clinical or virological HBV breakthrough during TDF therapy has not been reported so far. The aim of this study was to analyse the HBV polymerase (pol) from HIV/HBV-coinfected patients with detectable serum levels of HBV DNA during treatment with TDF for longer than 6 months. The HBV pol was sequenced from 43 patient's serum before and during TDF therapy. Phenotypic analyses were performed using HBV replication-competent plasmids carrying unique mutations selected under TDF therapy. Mean exposure to LAM was 35.3 +/- 27.5 months and to TDF 11.2 +/- 6.7 months. Genotypic analyses from 21 of the patients revealed LAM-associated mutations, and a further two patients developed a novel mutation, rtA194T, along with LAM-resistance-associated mutations. Phenotypic analyses revealed that constructs harbouring rtA194T combined with rtL180M and rtM204V displayed an over 10-fold increase in the IC50 for TDF compared with the wild type. The selection of HBV mutations in HBV/HIV-coinfected patients failing TDF therapy is an unlikely event within the first 12 months of treatment. However, HBV from two of the 43 patients treated with TDF for more than 12 months was found to contain one novel mutation located distal to the catalytic site of the HBV pol. In vitro, rtA194T conferred a reduced susceptibility to TDF in the presence of LAM-associated mutations.


Foetithiophenes C-F, thiophene derivatives from the roots of Ferula foetida.
Ferula foetida Regel (Apiaceae) is an Iranian medicinal plant with various biological activities including antispasmodic and anthelmintic. The sulfur compounds from the roots of F. foetida were isolated and characterized to test their cytotoxic and antimicrobial activities. The methanolic extract of the roots of F. foetida was fractionated using silica column chromatography. The components of each fraction were further purified using RP-HPLC. Their structures were elucidated by 1- and 2-D NMR spectroscopy as well as HREIMS. Their cytotoxic and antimicrobial activities were evaluated using Alamar Blue assay and broth microdilution method, respectively. Four new thiophene derivatives, namely foetithiophenes C-F (3-6), together with four known compounds, foetithiophenes A (1) and B (2), coniferaldehyde, and sinapic aldehyde, were isolated from the roots of F. foetida. Antimicrobial activities were observed in particular against the Gram-positive bacteria. The best antimicrobial activity was observed for compound 6 against B. cereus with a MIC value 50 µg/mL. The tested compounds did not show cytotoxic properties against MCF-7 and K562 cells. Four new thiophene derivatives including foetithiophenes C-F (3-6) were characterized from the roots of F. foetida. Foetithiophene F (6) exhibited the most potent activity against the Gram-positive bacteria B. cereus.


Inserting spaces before and after words affects word processing differently in Chinese: Evidence from eye movements.
Unlike in English, there are no spaces between printed words in Chinese. In this study, we explored how inserting a space before or after a word affects the processing of that word in Chinese reading. Native Chinese readers' eye movements were monitored as they read sentences with different presentation conditions. The results show that inserting a space after a word facilitates its processing, but inserting a space before a word does not show this effect and inhibits the processing of that word in some cases. Our results are consistent with the prediction of a word segmentation and recognition model in Chinese Li et al., 2009, Cognit. Psychol., 58, 525. Additionally, we found that a space guides the initial landing position on the word: the initial landing position was further away from the space that inserted into the text, whether it was before or after a word.


Salvage of the Exposed Cardiac Pacemakers With Fasciocutaneous Local Flaps.
This study aims to investigate the efficacy of salvage of the mechanically exposed cardiac pacemakers with fasciocutaneous local flaps in elderly patients. Between January 2014 and January 2018, ten patients (six females, four males; mean age 66.2 years) who were treated due to pacemaker exposition were retrospectively analyzed in this study. Exposed pacemaker and the wires were dissected, and capsulectomy was performed. The expose pacemaker was covered with the fascioutaneous flap. Only one patient had hematoma formation at early stage and revision was performed. All patients were treated successfully. No complication was observed during the follow-up period. Reconstruction with fasciocutaneous local flaps is an effective treatment modality in case of mechanically cardiac pacemaker expositions in elderly patients.


Preventive Effects of Resveratrol on Endocannabinoid System and Synaptic Protein Modifications in Rat Cerebral Cortex Challenged by Bilateral Common Carotid Artery Occlusion and Reperfusion.
This study aims to evaluate the putative roles of a single acute dose of resveratrol (RVT) in preventing cerebral oxidative stress induced by bilateral common carotid artery occlusion, followed by reperfusion (BCCAO/R) and to investigate RVT's ability to preserve the neuronal structural integrity. Frontal and temporal-occipital cortices were examined in two groups of adult Wistar rats, sham-operated and submitted to BCCAO/R. In both groups, 6 h before surgery, half the rats were gavage-fed with a single dose of RVT (40 mg/per rat in 300 µL of sunflower oil as the vehicle), while the second half received the vehicle alone. In the frontal cortex, RVT pre-treatment prevented the BCCAO/R-induced increase of lipoperoxides, augmented concentrations of palmitoylethanolamide and docosahexaenoic acid, increased relative levels of the cannabinoid receptors type 1 (CB1) and 2 (CB2), and peroxisome-proliferator-activated-receptor (PPAR)-α proteins. Increased expression of CB1/CB2 receptors mirrored that of synaptophysin and post-synaptic density-95 protein. No BCCAO/R-induced changes occurred in the temporal-occipital cortex. Collectively, our results demonstrate that, in the frontal cortex, RVT pre-treatment prevents the BCCAO/R-induced oxidative stress and modulates the endocannabinoid and PPAR-α systems. The increased expression of synaptic structural proteins further suggests the possible efficacy of RVT as a dietary supplement to preserve the nervous tissue metabolism and control the physiological response to the hypoperfusion/reperfusion challenge.


Efficacy of Periarticular Infiltration with Dexamethasone and Bupivacaine plus Adductor Canal Block Relative to That of Adductor Canal Block Alone for Patients Undergoing Total Knee Arthroplasty: A Retrospective Case-Matched Study.
Periarticular infiltration (PI) is a common procedure during total knee arthroplasty (TKA) for postoperative pain management. This retrospective, case-matched study aimed to evaluate the effectiveness of PI with dexamethasone and bupivacaine in combination with an adductor canal block (ACB) and compare it with that of ACB alone in reducing postoperative pain in patients with TKA. Data were collected from 66 patients who underwent TKA performed by a single surgeon. Thirty-three of them received ACB + PI, and 33 received ACB alone. However, both groups underwent identical surgical techniques and postoperative care protocols. The pain scores and fentanyl consumption of the two groups were compared. The ACB + PI group had significantly lower pain scores than the ACB alone group at 8, 16, 24, and 48 hours postoperatively (p=0.033, 0.004, 0.038, and 0.049, respectively). The percentage of patients requiring fentanyl as a rescue medication was significantly higher for the ACB alone group (90.9%) than for the ACB + PI group (69.7%, p=0.03). The total fentanyl consumption was also lower for the ACB + PI group (p < 0.001). The periarticular injection of the combination of dexamethasone and bupivacaine plus ACB was more effective than ACB alone in reducing postoperative pain and fentanyl consumption in patients undergoing TKA. Further studies comparing different doses of dexamethasone or other cocktail regimens may provide additional insights into this approach.


Structural Characterization of Core Region in Erwinia amylovora Lipopolysaccharide.
Erwinia amylovora (E. amylovora) is the first bacterial plant pathogen described and demonstrated to cause fire blight, a devastating plant disease affecting a wide range of species including a wide variety of Rosaceae. In this study, we reported the lipopolysaccharide (LPS) core structure from E. amylovora strain CFBP1430, the first one for an E. amylovora highly pathogenic strain. The chemical characterization was performed on the mutants waaL (lacking only the O-antigen LPS with a complete LPS-core), wabH and wabG (outer-LPS core mutants). The LPSs were isolated from dry cells and analyzed by means of chemical and spectroscopic methods. In particular, they were subjected to a mild acid hydrolysis and/or a hydrazinolysis and investigated in detail by one and two dimensional Nuclear Magnetic Resonance (NMR) spectroscopy and ElectroSpray Ionization Fourier Transform-Ion Cyclotron Resonance (ESI FT-ICR) mass spectrometry.


Cerebral venous congestion during cardio-pulmonary bypass: role of bispectral index monitoring.
A 58-year-old male patient was posted for double valve replacement under hypothermic cardiopulmonary bypass (CPB). During aortic cross-clamp (AXC), the central venous pressure (CVP) was found to have increased to 22 mmHg. After 4 minutes of sustained increase in CVP, burst suppression (SR) started increasing. After 5 min of increase in SR, bispectral index (BIS) declined rapidly to 17. Propofol infusion was stopped and re-evaluation of signs of facial congestion showed changes to that effect. The perfusionist noted steadily decreasing venous return. As soon as the superior vena cava (SVC) cannula was withdrawn by 3 cm, CVP immediately declined to 6 mmHg. The venous return in the CPB reservoir normalized and BIS returned to 42 after a transient rise to a maximum of 58 and SR decreased to 0 within 2 min of repositioning of the venous cannula. The patient was successfully extubated after 7 hours without any sequelae.


Stabilization and Solvent Driven Crystal-to-Crystal Transition between New Bismuth Halides.
The investigations of bismuth halide chemistry in DMSO/MeOH solutions led to the discovery of a new solvent-stabilized compound with a chemical formula of Cs3BiBr6·3DMSO. In addition, a new phase of Cs3BiBr6 was generated as a result of a crystal-to-crystal transition driven by the change in the solvent composition. The solvent stabilized Cs3BiBr6·3DMSO adopts an orthorhombic P212121 type crystal structure with unit cell dimension of a = 13.6160(6) Å, b = 14.4359(8) Å, and c = 14.6487(7) Å. Bulk single crystals of Cs3BiBr6·3DMSO with average size of 4.5 × 3.5 × 3.5 mm3 were grown by the antisolvent crystal growth method. With the change of the solvent composition from 2:1 DMSO: MeOH to 1:1 DMSO: MeOH, the single crystals of Cs3BiBr6·3DMSO underwent a crystal-to-crystal transition yielding another structurally distinct Cs3BiBr6 phase, with a tetragonal P42/m type structure and unit cell dimensions of a = 9.8394(5) Å, b = 9.8394(5) Å, and c = 8.0950(6) Å. Both compounds exhibit isolated BiBr6 octahedral resembling the structures of the zero-dimensional (0D) perovskites.