Control of vertical posture while elevating one foot to avoid a real or virtual obstacle.
The purpose of this study is to investigate the control of vertical posture during obstacle avoidance in a real versus a virtual reality (VR) environment. Ten healthy participants stood upright and lifted one leg to avoid colliding with a real obstacle sliding on the floor toward a participant and with its virtual image. Virtual obstacles were delivered by a head mounted display (HMD) or a 3D projector. The acceleration of the foot, center of pressure, and electrical activity of the leg and trunk muscles were measured and analyzed during the time intervals typical for early postural adjustments (EPAs), anticipatory postural adjustments (APAs), and compensatory postural adjustments (CPAs). The results showed that the peak acceleration of foot elevation in the HMD condition decreased significantly when compared with that of the real and 3D projector conditions. Reduced activity of the leg and trunk muscles was seen when dealing with virtual obstacles (HMD and 3D projector) as compared with that seen when dealing with real obstacles. These effects were more pronounced during APAs and CPAs. The onsets of muscle activities in the supporting limb were seen during EPAs and APAs. The observed modulation of muscle activity and altered patterns of movement seen while avoiding a virtual obstacle should be considered when designing virtual rehabilitation protocols.


Prevalence of hepatitis G virus infection in patients with liver diseases in Singapore.
The prevalence of hepatitis G virus (HGV) infection in patients with liver diseases in Singapore and its pathogenic role in these patients was studied. One hundred and forty-eight patients who had chronic hepatitis or acute non A-E hepatitis were studied. Presence of HGV RNA was determined by nested polymerase chain reaction of the 5'non-coding region of the virus in all the patients. Hepatitis G IgG antibody to the envelope (E2) antigen was tested with an enzyme immunoassay (Boehringer Mannheim, Singapore) in 76 of them. Most patients (93%) were ethnically Chinese, predominantly males (74%) and chronic hepatitis B (72%) patients. Others had chronic hepatitis C (19%) or cryptogenic cirrhosis (6%). Four patients had acute non A-E hepatitis. HGV RNA and anti-HGenv were present in 3.5% and 8.3% of those with chronic liver disease. HGV infection did not account for any of the acute non A-E hepatitis and most of the cryptogenic cirrhosis.


[Polymorphism of c-Ha-ras 3'VNTR in hydatidiform mole and its relationship with the development of postmolar tumor].
To study the polymorphism of c-Ha-ras 3' variable number of tandem repeat (VNTR) and its relationship with development of postmolar tumor. The cases of hydatidiform mole (HM) were retrospectively analyzed by amplified fragment length polymorphism-polyacrylamide gel electrophoresis. The DNA origin of HM was determined by comparison with the parents' DNA amplified results. Among the samples from 15 cases, DNA from only paternal origin was found in 2 cases. DNA from both parents was in 13 cases, and of these 13 cases, 2 were found to be had balanced DNA origin, 11 had more DNA form paternal origin than DNA from maternal origin. The HM which has DNA from both parents origin and predominantly from paternal origin developed to postmolar tumor more frequently.


[Physiopathological concept of chronic cor pulmonale].
The chronic cor pulmonale is not a disease but a syndrome. The peripheral arterial gasometry is essential for the etiological diagnosis and consequently for treatment, as enabling to differentiate between CCP by alveolar hypoventilation and CCP by alveolar hyperventilation. The distinction is all the more important that with an identical hypoxia, acidosis increases the average pressure of the pulmonary artery and alkalosis decreases it.


Development of a continuous fermentation process for the production of recombinant uricase enzyme by Pichia pastoris.
Recent studies in the biopharmaceutical industry have shown an increase in the productivity and production efficiency of recombinant proteins by continuous culture. In this research, a new upstream fermentation process was developed for the production of recombinant uricase in the methylotrophic yeast Pichia pastoris. Expression of recombinant protein in this system is under the control of the AOX1 promoter and therefore requires methanol as an inducing agent and carbon/energy source. Considering the biphasic growth characteristics of conventional fed-batch fermentation, physical separation of the growth and induction stages for better control of the continuous fermentation process resulted in higher dry-cell weight (DCW) and enhanced recombinant urate oxidase activity. The DCW and recombinant uricase activity enzyme for fed-batch fermentation were 79 g/L and 6.8 u/mL. During the continuous process, in the growth fermenter at a constant dilution rate of 0.025 h-1 , DCW increased to 88.39 g/L. In the induction fermenter, at methanol feeding rates of 30, 60, and 80 mL/h, a recombinant uricase activity was 4.13, 7.2, and 0 u/mL, respectively. The optimum methanol feeding regime in continuous fermentation resulted in a 4.5-fold improvement in productivity compared with fed-batch fermentation from 0.04 u/mL/h (0.0017 mg/mL/h) to 0.18 u/mL/h (0.0078 mg/mL/h).


Renal carcinoma with solitary distant metastasis.
Our experience with 14 patients with renal cell carcinoma and solitary distant metastasis is reported. The treatment of choice is tumor nephrectomy and surgical removal of the metastasis simultaneously or within a short period of time. The average survival time with this treatment is 18.5 months (maximum 4 years, minimum 2 months).


Small-angle X-ray scattering insights into the architecture-dependent emulsifying properties of amphiphilic copolymers in supercritical carbon dioxide.
The supramolecular assembly of a series of copolymers combining poly(ethylene oxide)-rich hydrophilic and fluorinated CO2-philic sequences is analyzed by synchrotron small-angle X-ray scattering (SAXS) in supercritical CO2, as well as in water/CO2 emulsions. These copolymers were designed to have the same molecular weight and composition and to differ only by their macromolecular architecture. The investigated copolymers have random, block, and palm-tree architectures. Besides, thermoresponsive copolymer is also analyzed, having a hydrophilic sequence becoming water-insoluble around 41 °C, i.e., just above the critical point of CO2. At the length scale investigated by SAXS, only the random copolymer appears to self-assemble in pure CO2, in the form of a disordered microgel-like network. The random, block, and thermoresponsive copolymers are all able to stabilize water/CO2 emulsions but not the copolymer with the palm-tree architecture, pointing at the importance of macromolecular architecture for the emulsifying properties. A modeling of the SAXS data shows that the block and the thermoresponsive copolymers form spherical micelle-like structures containing about 70% water and 30% polymer.


[Postoperative peritonitis: pronostic factors of mortality].
The postoperative peritonitis (POP) remains formidable conditions due to a high mortality rate of between 20 and 80%. The purpose of this study is to identify risk factors for mortality. This study is a retrospective, descriptive analysis carried out over a period of 09 years (1/1/2003 - 30/11/2011) and interesting 102 patients supported for POP following general surgery. Achieved in department of General Surgery B Charles Nicolle hospital Tunis. The parameters measured included epidemiological data, data related to the Initial Surgical Intervention and reoperation for POP, terms of management and evolution. Bacteriological data were also seized. The incidence of POP was 0.90%. The average age of our patients was 58 +/- 19 years with a sex ratio of 1.08. Forty-seven percent of our patients belonged to the ASAII class. The initial operation was performed urgently in 49 patients (48%) with a majority belonging to the class II Altemeier (49.01%). Colorectal pathology (373%) and hepatobiliay (176%) were the most frequent reasons for the initial intervention. The frequency of clinical signs were fever (75.5%), hypothermia (6.9%), abdominal pain (725%), abdominal distension (46.1%), productive gastric aspiration (30.4%), abdominal defense (25.5%), externalizing the digestive fluid (25.5%), vomiting (19.6%), diarrhea (12.7%), tachycardia (569%), oliguria (42.2%), respiratory failure (40.2%), hypotension (35.3%), neuropsychiatric disorders ( 23.5%) and jaundice (69%). The treatment period was 2.95 +/- 3.16 days. The surgical recovery time was 78 days +/- 5.66. At the time of reoperation, the APACHE II score was 8.43 +/- 6.26 and 25.1 +/- MPI score 8.53. The POP was generalized in 52.9% of cases with purulent peritoneal fluid in 51% of cases. The most common cause was the dropping of the anastomosis (59.8%). Empirical antibiotic therapy was appropriate in 69.44 % of cases. The mortality rate was 39.2%. Multivariate analysis using multiple logistic regression identified the following factors as independent mortality factors: Age > or = 60 years (RR = 6.089), multiple organ failure (RR = 18.019), non-appropriate empiric antibiotic therapy (RR = 6.541), stercoral aspect of peritoneal fluid (RR 6.412). Despite a low frequency, the POP are burdened with a high mortality rate. The improved prognosis requires early diagnosis in order to allow a appropriate load medicosurgical support before the installation of multiorgan failure syndrome. Among the independent factors associated with mortality that we have identifed, the not adapted empiric antibiotic therapy is the main factor on which we can act.


Social Support for Changing Multiple Behaviors: Factors Associated With Seeking Support and the Impact of Offered Support.
Social support is important for behavior change, and it may be particularly important for the complexities of changing multiple risk behaviors (MRB). Research is needed to determine if participants in an MRB intervention can be encouraged to activate their social network to aid their change efforts. Healthy Directions 2, a cluster-randomized controlled trial of an intervention conducted in two urban health centers, targeted five behaviors (physical activity, fruit and vegetable intake, red meat consumption, multivitamin use, and smoking). The self-guided intervention emphasized changing MRB simultaneously, focused on self-monitoring and action planning, and encouraged participants to seek support from social network members. An MRB score was calculated for each participant, with one point being assigned for each behavioral recommendation that was not met. Analyses were conducted to identify demographic and social contextual factors (e.g., interpersonal, neighborhood, and organizational resources) associated with seeking support and to determine if type and frequency of offered support were associated with changes in MRB score. Half (49.6%) of participants identified a support person. Interpersonal resources were the only contextual factor that predicted engagement of a support person. Compared to individuals who did not seek support, those who identified one support person had 61% greater reduction in MRB score, and participants identifying multiple support persons had 100% greater reduction. Engagement of one's social network leads to significantly greater change across multiple risk behaviors. Future research should explore strategies to address support need for individuals with limited interpersonal resources.


Damselfish as keystone species in reverse: intermediate disturbance and diversity of reef algae.
Substrates located within the defended territories of Hawaiian damselfish for 1 year were subjected to intermediate grazing intensity and, as a result, showed greater diversity of algae than substrates either protected within fish-exclusion cages or exposed to intense fish grazing outside territories. Thus, this damselfish enhances local diversity on reefs through "intermediate-disturbance" effects, and is a keystone species that decreases rather than increases overall predation intensity relative to areas where it is absent.


Low temperature Thomson scattering on MAST-U.
A new divertor Thomson scattering system has been developed for the MAST-U tokamak. The diagnostic will produce electron density and temperature profiles along the Super-X strike leg. The existing polychromator design has been adapted for low temperature measurements. A new 1061 nm channel with 2 nm bandwidth has been added to enable measurements down below the previous ∼5 eV limit on the core system. The optical filters used in the system have OD6 light rejection alongside a 1064.1 nm laser line filter to reduce stray light in the digitized channels. A new averaging technique has been applied to the scattered signal traces to improve the core Thomson data in the scrape-off layer. The technique reduces the systematic noise level in this region. This leads to a reduction in the error values for electron density and temperature measurements and, in particular, the digitizer noise. The technique has been applied to produce a radial profile for a number of L-mode MAST discharges down to very low densities of ∼1 × 1018 m-3.


Ultrasound evaluation of the popliteal space. Comparison with arthrography and physical examination.
Ultrasound scanning techniques were used to examine the popliteal space in 102 knees. In 30 of 34 knees in which arthrograms were also obtained, the information obtained from both tests was the same. In two instances in which there were different results, the presence of palpable popliteal cysts was confirmed by ultrasound scans but not by arthrography, and in two other cases, small asymptomatic cysts were seen on arthrograms but not on ultrasound scans. In the 68 other knees, ultrasound scans were helpful in the differential diagnosis of popliteal cysts, popliteal artery aneurysms, thrombophlebitis, and a solid poplitieal mass. The results indicate that ultrasound scanning is a valuable, rapid, safe, accurate technique in evaluating patients with symptoms or findings related to the popliteal space.


U.S. Healthcare Insurance Market Concentration from 2001 to 2016: Increased Growth in Direct Written Premiums and Overall Decreased Market Consolidation.
With the establishment of state-based health insurance marketplaces, how U.S. health insurers are responding to market pressures and influencing premiums have represented important questions. We made novel use of the Standard and Poor's (S&P) Financial, a Wall Street financial dataset platform, to analyze trends in market capitalization and total direct written premiums (DWPs) from 2001 to 2016 of the top 5, 10, and 25 health insurance companies. Our results indicate that the market concentration of publicly traded companies has remained relatively stable over the past decade. The top 5, 10, and 25 health insurance companies were 43.5%, 57.5%, and 78.6% of the total market share in 2001 and 39.4%, 52.9%, and 72.8% in 2016, respectively. DWPs have grown nearly four-fold from $177 billion to $631 billion at a compounded annual rate of 8.8%, consistent with overall healthcare sector growth. Aggregating state-specific data, the overall U.S. health insurance market has become slightly less consolidated over recent years, as measured using the population-weighted Herfindahl-Hirschman index, a measure for market concentration, falling from 3,817 to 2,174 during this time period. As health insurance costs place a growing burden on American families, additional efforts are needed to study the impact on choice, quality, access, cost, and value to patients and providers from evolving health insurance markets.


Lipoprotein lipase hydrolysis products induce pro-inflammatory cytokine expression in triple-negative breast cancer cells.
Breast cancer cell growth and proliferation requires lipids for energy production, cell membrane synthesis, or as signaling molecules. Lipids can be delivered to cells by lipoprotein lipase (LPL), an extracellular lipase that hydrolyzes triacylglycerols and phospholipids from lipoproteins, that is expressed by adipose tissue and some breast cancer cell lines. Studies have shown that lipoprotein hydrolysis products induce pro-inflammatory cytokine secretion by endothelial cells. Thus, our objective was to determine if hydrolysis products generated by LPL from total lipoproteins can also promote pro-inflammatory cytokine secretion from breast cancer cells. Using cytokine arrays, we found that MDA-MB-231 cells increased secretion of seven cytokines in response to treatment with lipoprotein hydrolysis products. In contrast, MCF-7 cells showed decreased secretion of two cytokines. Expanding the analysis to additional cell lines by ELISA, we found increased secretion of TNF-α and IL-6 by MDA-MB-468 cells, and increased secretion of IL-4 by MDA-MB-468 and SKBR3 cells. The changes to cytokine secretion profiles of the breast cancer cell types examined, including the non-cancerous MCF-10a breast cells, were independent of increased cell metabolic activity. These results provide information on how lipoprotein hydrolysis products within the tumor microenvironment might affect breast cancer cell viability and progression.


Axion-mediated electron-electron interaction in ytterbium monohydroxide molecule.
The YbOH triatomic molecule can be efficiently used to measure the electron electric dipole moment, which violates time-reversal (T) and spatial parity (P) symmetries of fundamental interactions [Kozyryev and Hutzler, Phys. Rev. Lett. 119, 133002 (2017)]. We study another mechanism of the T, P-violation in the YbOH molecule-the electron-electron interaction mediated by the low-mass axionlike particle. For this, we calculate the molecular constant that characterizes this interaction and use it to estimate the expected magnitude of the effect to be measured. It is shown that this molecular constant has the same order of magnitude as the corresponding molecular constant corresponding to the axion-mediated electron-nucleus interaction. According to our estimation, an experiment on YbOH will allow one to set updated laboratory constraints on the CP-violating electron-axion coupling constants.


High-peak-power subnanosecond passively Q-switched ytterbium-doped fiber laser.
A passively Q-switched ytterbium doped fiber laser has been demonstrated with a Cr(4+):yttrium aluminum garnet saturable absorber and distributed stimulated Brillouin scattering. A linearly polarized output with approximately 375 kW peak power and a pulse duration as short as 490 ps have been obtained. A theoretical model is developed to simulate passive Q switching with the stimulated Brillouin scattering, which shows good agreement with the experiment.


Influence of blood lipids on plasma and blood viscosity.
The relationship between hyperlipidemia and blood and plasma viscosity is not completely clear. While increasing viscosity is often reported with increasing blood lipids, lipid-lowering treatments are often unable to normalize the viscosity values. Aim of this study is to try to clarify the relationship between blood lipids and viscosity. Apparently healthy subjects were enrolled (n = 410). Smokers, diabetics, obese, and hypertriglyceridemic (above 400 mg/dl) were excluded. Blood (at shear rate 225/s) and plasma viscosity were measured at 37°C. Erythrocyte rigidity (Tk) was calculated according to Dintenfass. Blood lipids and glucose were measured by routine methods. Hyperlipidemic subjects (n = 315) had higher values of plasma viscosity (1.44 ± 0.13 vs. 1.40 ± 0.12 cP, p = 0.007), and blood viscosity (4.51 ± 0.54 vs. 4.35 ± 0.55 cP, p = 0.013), compared to normolipidemic subjects (n = 95). In simple correlation analysis, plasma viscosity was directly associated with LDL cholesterol, and inversely with Tk and HDL cholesterol. In multiple regression analysis the association with LDL and HDL was strengthened, though these two variables as a whole accounted for only 5% (adjusted R2) of the variability of plasma viscosity. Blood viscosity was significantly associated with haematocrit, plasma viscosity, Tk and all considered variables but age in simple correlation analysis, but only with haematocrit, plasma viscosity and Tk in multiple regression analysis. LDL cholesterol and HDL cholesterol influence plasma viscosity, but not blood viscosity. Triglycerides up to values of 400 mg/dl do not seem to have important effects, at least in apparently healthy subjects and at the shear rates used in the present study. The contribution of LDL and HDL cholesterol to plasma viscosity seems however quite limited.


Interventions for preventing and ameliorating cognitive deficits in adults treated with cranial irradiation.
Cognitive deficits are common in people who have received cranial irradiation and have a serious impact on daily functioning and quality of life. The benefit of pharmacological and non-pharmacological treatment of cognitive deficits in this population is unclear. To assess the effectiveness of interventions for preventing or ameliorating cognitive deficits in adult patients treated with cranial irradiation. In August 2014. we searched the Cochrane Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE and PsycINFO and checked the reference lists of included studies. We also searched for ongoing trials via ClinicalTrials.gov, the Physicians Data Query and the Meta Register of Controlled Trials. We included randomised controlled trials (RCTs) that evaluated pharmacological or non-pharmacological interventions in cranial irradiated adults, with objective cognitive functioning as a primary or secondary outcome measure. Two review authors (JD, KZ) independently extracted data from selected studies and carried out a 'Risk of bias' assessment. Cognitive function, fatigue and mood outcomes were reported. No data were pooled. Sixteen studies were identified for possible inclusion in the review, six of which were included. Three studies investigated prevention and three studies investigated amelioration. Due to differences between studies in the interventions being evaluated, a meta-analysis was not possible. Two studies investigated a pharmacological intervention for the prevention of cognitive deficits; memantine compared with placebo, and d-threo-methylphenidate HCL compared with placebo. In the first study the primary cognitive outcome of memory at six months did not reach significance, but there was significant improvement in overall cognitive function compared to placebo, with similar adverse events across groups. The second study found no statistically significant difference between arms, with few adverse events. The third study investigated a rehabilitation program for the prevention of cognitive deficits but did not carry out a statistical comparison of cognitive performance between groups.Three studies investigated the use of a pharmacological intervention for the treatment of cognitive deficits; methylphenidate compared with modafinil, two different doses of modafinil, and donepezil compared with placebo. The first study found improvements in cognitive function in both the methylphenidate and modafinil arms; few adverse events were reported. The second study combined treatment arms and found improvements across all cognitive tests, however, a number of adverse events were reported. Both studies were limited by a small sample size. The third study did not find an improvement in the primary cognitive outcome of overall performance, but did find improvement in an individual test of memory, compared to placebo; adverse events were not reported. No non-pharmacological studies for the amelioration of cognitive deficits were eligible. There were a number of limitations across studies but few without high risks of bias. There is supportive evidence that memantine may help prevent cognitive deficits for adults with brain metastases receiving cranial irradiation. There is supportive evidence that donepezil may have a role in treating cognitive deficits in adults with primary or metastatic brain tumours who have been treated with cranial irradiation. Patient withdrawal affected the statistical power of both studies. Further research that tries to minimise the withdrawal of consent, and subsequently reduce the requirement for imputation procedures, may offer a higher quality of evidence.There is no strong evidence to support any non-pharmacological interventions (medical or cognitive/behavioural) in the prevention or amelioration of cognitive deficits. Non-randomised studies appear promising but are as yet to be conclusive via translation into high quality evidence. Further research is required.


When Appearance Misleads: The Role of the Entomopathogen Surface in the Relationship with Its Host.
Currently, potentially harmful insects are controlled mainly by chemical synthetic insecticides, but environmental emergencies strongly require less invasive control techniques. The use of biological insecticides in the form of entomopathogenic organisms is undoubtedly a fundamental resource for the biological control of insect pests in the future. These infectious agents and endogenous parasites generally act by profoundly altering the host's physiology to death, but their success is closely related to the neutralization of the target insect's immune response. In general, entomopathogen parasites, entomopathogenic bacteria, and fungi can counteract immune processes through the effects of secretion/excretion products that interfere with and damage the cells and molecules typical of innate immunity. However, these effects are observed in the later stages of infection, whereas the risk of being recognized and neutralized occurs very early after penetration and involves the pathogen surface components and molecular architecture; therefore, their role becomes crucial, particularly in the earliest pathogenesis. In this review, we analyze the evasion/interference strategies that entomopathogens such as the bacterium Bacillus thuringiensis, fungi, nematocomplexes, and wasps implement in the initial stages of infection, i.e., the phases during which body or cell surfaces play a key role in the interaction with the host receptors responsible for the immunological discrimination between self and non-self. In this regard, these organisms demonstrate evasive abilities ascribed to their body surface and cell wall; it appears that the key process of these mechanisms is the capability to modify the surface, converting it into an immunocompatible structure, or interaction that is more or less specific to host factors.


Immunotoxicological effects of dermal application of scum of waste crankcase oil in mice.
The scum of waste crankcase oil (SWCO) forms due to weathering of waste crankcase oil, deposited on the surface of water bodies. It is known to attach to the feathers of aquatic birds and cause toxicity to the eggs of nestling birds. The water bodies contaminated with SWCO can also be a source of toxicity to the human beings and animals entering such bodies. Since SWCO used in the present study had an appreciable content of heavy metals like Zn, Pb, Cd, Mn, Cr and Ni, the present investigation was undertaken to study a probable effect on immune system of mice. Animals treated with SWCO at a dose of 0.5, 1.0, 2.0, or 4.0 g/kg body weight for 28 days, had no effect on the weight gain of vital organs. A depressing effect was observed on the cell population of spleen and thymus. The number of primary antibody (IgM) producing cells was significantly depressed in spleen. The IgM antibody titer of serum, reduction of NBT dye by peritoneal exudat cells and mounting of delayed hypersensitivity response were not affected. In view of above immunotoxic effects of SWCO, the waste crankcase oil should be carefully disposed of, away from water bodies.


Piloting an HIV self-test kit voucher program to raise serostatus awareness of high-risk African Americans, Los Angeles.
Up to half of all new HIV cases in Los Angeles may be caused by the 20-30% of men who have sex with men (MSM) with unrecognized HIV infection. Racial/ethnic minority MSM are at particularly high risk for being sero-unaware and due to stigma and poor healthcare access might benefit from novel private, self-testing methods, such as the recently FDA-approved OraQuick® In-Home HIV Test. From July-November 2013, we undertook a pilot study to examine the feasibility of a voucher program for free OraQuick® tests targeting African American MSM in Los Angeles. We determined feasibility based on: (1) the establishment of a voucher redemption and third-party payment system, (2) the willingness of community-based organizations (CBOs) to disseminate vouchers, and (3) the collection of user demographics, test and linkage-to-care results with an anonymous telephone survey. We partnered with Walgreens® to create a voucher and third-party reimbursement system for free OraQuick® tests. Voucher distribution was divided into two periods. In total, 641 vouchers were supplied to CBOs: 274 (42.7%) went to clients and of those 53 (19.3%) were redeemed. Fifty (18.2%) of the 274 clients were surveyed: 44 (88%) were African American, 39 (78%) reported being likely to repeat voucher use, 44 (88%) reported reviewing pre-test information, and 37 (74%) the post-test information. Three (6%) of 50 survey respondents reported newly testing HIV-positive of whom all (100%) reported seeking medical care. Two withheld their results, both of whom also sought medical care. Developing and partnering with a commercial pharmacy to institute a voucher system to facilitate HIV self-testing with linkage-to-care was feasible. Our findings suggest the voucher program was associated with increasing the identification of new cases of HIV infection with high rates of linkage to care. Expanded research and evaluation of voucher programs for HIV self-test kits among high-risk groups is warranted.


[Ultrasonic diagnosis of 22 gastric tumors].
A report is presented on 22 patients with advanced stomach cancer in whom echography revealed the characteristic signs ("pseudokidney", "cockade", "target", "doughnut", etc.). Though not considered wholly specific indicators of gastric neoplasm (they may be artefacts or errors of interpretation) they are helpful in the diagnosis of the stomach. Ultrasound has made it possible to identify the site (antrum and body) and spread of the cancer both locally and at a distance and only a few forms (not encountered in the present series) have presented characteristic images. Endoscopic ultrasonography and the high resolution intraoperative type offer the chance for significant progress in this diagnostic field.


Association of lack of cell wall teichuronic acid with formation of cell packets of Micrococcus lysodeikticus (luteus) mutants.
Morphological mutants of Micrococcus lysodeikticus (luteus) were isolated by treatment with N-methyl-N'-nitro-N-nitrosoguanidine. They occurred on plates in large, regular cell packets, whereas the parent cells usually grew as groups of two or four cells or as short chains. The mutants required a much higher concentration of Mg2+ for growth than the parent cells. The concentrations of Mg2+ and other components of the culture medium tested did not significantly affect the morphology of either the parent or mutant strains. The mutant strains were not agglutinated by antiserum to M. lysodeikticus, which mainly interacts with teichuronic acid on the cell surface, and chemical analysis of isolated cell walls of the mutants indicated the absence of teichuronic aicd. No significant differences were detected between the parent and mutant strains in the amounts of other cell wall components, e.g., peptidoglycan, protein, and teichoic acid. They possible roles of teichuronic acid in cell separation and attachment of divalent cations are discussed.


[Myocardial fibrosis--the theoretical bases, clinical aspects and therapeutic implications].
A review on the present knowledges of the myocardial structure, with particular emphasis on the collagen network and its degradation/synthesis process was performed. Myocardial fibrosis and cardiac remodeling concepts are analysed, explaining them in the context of ventricular hypertrophy, arterial hypertension, myocardial remodeling in ischemic heart disease and cardiac remodeling in the aged. We also review the role of the renin-angiotensin-aldosterone system in myocardial fibrosis, as well as the results of preventing action of angiotensin converting enzyme inhibitors and aldosterone antagonists in myocardial fibrosis and consequent cardiac remodeling in the animal experimentation. Clinical and therapeutic implications of this knowledge are discussed as well as therapeutic implication in man, in view of recent studies.


The effects of imperatorin on anxiety and memory-related behavior in male Swiss mice.
The purpose of the reported experiments was to examine the effects of imperatorin [9-(3-methylbut-2-enyloxy)-7H-furo[3,2-g]chromen-7-one], a bioactive furanocoumarin isolated from the fruits of Angelica archangelica (Angelica officinalis) on anxiety and memory-related behaviors of mice. Male Swiss mice were tested for anxiety and cognition, in the elevated plus maze test (EPM), using two different procedures. In the present experiments, imperatorin was administered acutely (at the doses of 5, 10, 20, 30, and 50 mg/kg); injections were made 15, 30, and 60 min before test (anxiety); 30 min before the first trial (memory acquisition); or immediately after the first trial (memory consolidation), as well as subchronically, twice a day for 6 days. On the seventh day, the mice were injected once with imperatorin (10 and 20 mg/kg, i.p.) 30 min before the test (anxiety) and 30 min before the first trial (memory acquisition), or immediately after the first trial (memory consolidation). We observed that imperatorin when administered acutely and repeatedly, at the doses of 10 and 20 mg/kg, exerted an anxiolytic effect on mice tested 30 min after the injection measured in the EPM test. By contrast, no such effect was observed after the acute administration of imperatorin at the doses of 5, 30 and 50 mg/kg. Moreover, other observations carried out 15 and 60 min after a single injection of the drug did not reveal any effect of imperatorin on anxiety behavior in the EPM test. Furthermore, acute and repeated administration of imperatorin (10 and 20 mg/kg) improved different stages of memory processes (both acquisition and consolidation) in a modified EPM test (mEPM). The results of our research suggest imperatorin to be an interesting therapeutical option in disorders with high anxiety levels and memory impairment.


Evaluating the Effect of Lifestyle Education Based on Health Belief Model for Mothers of Obese and Overweight School-age Children on Obesity-Related Behaviors.
Nowadays, childhood obesity is a matter of significant concern because of its negative effects on personal health and harmful socioeconomic consequences. The purpose of the present study was to evaluate the effectiveness of lifestyle education based on the health belief model for mothers of obese and overweight school-age children on obesity-related behaviors. In this quasi-experimental study, 64 obese and overweight elementary students and their mothers who met the inclusion criteria participated. The participants were randomly categorized into two groups (experimental and control). The experimental group received the considered interference, which consisted of four educational sessions based on the health belief model. Data collection tool was a standard questionnaire. The questionnaire filled by the participants during interviews conducted before, immediately after, and two months after the intervention. Data were analyzed using Mann-Whitney, Chi-square, student's t-test, repeated-measures analysis of variance, and least significant difference tests. Mean scores of obesity-related behavior before the intervention were not significantly different between the experimental and control group (53.41 (6.78). vs 54.72 (4.63); P = 0.37), however, were different immediately after (58.41 (6.88) vs 54.81 (4.66); P = 0.02) and two months after the intervention (62.34 (8.62) vs 55.84 (7.59); P = 0.002). This study indicated the effectiveness of lifestyle education based on the health belief model for improving obesity-related behaviors. Therefore, the use of this educational program is recommended for mothers.


Synchronous distance learning as an effective and feasible method for delivering residency didactics.
Providing effective multisite didactic teaching in residency programs remains a challenge. There is limited evidence regarding the educational equivalency of the traditional and distance learning methods for delivery of didactics. We introduced a synchronous two-way audio and video Internet-transmitted distance learning methodology in two sites. The study assessed both residents' satisfaction and knowledge gain at the face-to-face lecture site as compared with the distance learning site. The study was conducted over 1 year at the Wayne State University family medicine residency program, involving all 36 residents. Seventeen distance learning sessions were conducted, and the results from the lecture and distance learning sites were evaluated. The didactic sessions were rated highly by both groups, with no significant differences on the resident satisfaction survey. The distance learning method was received positively by learners. The residents in both groups scored higher on posttests compared to the pretests, and there was no statistical difference in knowledge gain between the lecture and the distance learning group. Synchronous interactive instructor-led distance learning is an effective method for delivering residency didactics at more than one site. The new technology is well accepted by learners and is a promising approach to multi-site education.


Age-related variations in the microstructure of human tibial cancellous bone.
A thorough understanding of the microstructure of cancellous bone is crucial for diagnosis, prophylaxis, and treatment of age-related skeletal diseases. Until now, little has been known about age-related variations in the microstructure of peripheral cancellous bone. This study quantified age-related changes in the three-dimensional (3D) microstructure of human tibial cancellous bone. One hundred and sixty cylindrical cancellous bone specimens were produced from 40 normal proximal tibiae from 40 donors, aged 16-85 years. These specimens were micro-computed tomography (micro-CT) scanned, and microstructural properties were determined. The specimens were then tested in compression to obtain Young's modulus. The degree of anisotropy, mean marrow space volume, and bone surface-to-volume ratio increased significantly with age. Bone volume fraction, mean trabecular volume, and bone surface density decreased significantly with age. Connectivity did not have a general relationship with age. Bone volume fraction together with anisotropy best predicted Young's modulus. Age-related changes in the microstructural properties had the same trends for both medial and lateral condyles of the tibia. The observed increase of anisotropy and constant connectivity suggest a bone remodeling mechanism that may reorient trabecular volume orientation in aging tibial cancellous bone. The aging trabeculae align more strongly to the primary direction--parallel to the tibial longitudinal loading axis.


Distinct calcitonin gene-related peptide expression pattern in primary afferents contribute to different neuropathic symptoms following chronic constriction or crush injuries to the rat sciatic nerve.
Although calcitonin gene-related peptide is a recognized pain transducer, the expression of calcitonin gene-related peptide in primary afferents may be differentially affected following different types of nerve injury. Here, we examined whether different calcitonin gene-related peptide expression patterns in primary afferents contributes to distinct sensory disturbances in three animal models of sciatic nerve injury: chronic constriction injury, mild (100 g force) or strong (1000 g force) transient crush in rats. Assessments of withdrawal reflexes and spontaneous behavior indicated that chronic constriction injury and mild crush resulted in positive neuropathic symptoms (static/dynamic mechanical allodynia, heat hyperalgesia, cold allodynia, spontaneous pain). However, strong crush led to both positive (dynamic mechanical allodynia, cold allodynia, spontaneous pain) and negative symptoms (static mechanical hypoesthesia, heat hypoalgesia). Calcitonin gene-related peptide immunoreactivity in dorsal root ganglia and corresponding spinal cord segments, and calcitonin gene-related peptide mRNA levels in dorsal root ganglia, indicated that the primary afferent calcitonin gene-related peptide supply was markedly reduced only after strong crush. This reduction paralleled the development of negative symptoms (static mechanical hypoesthesia and heat hypoalgesia). Administration of exogenous calcitonin gene-related peptide intrathecally after strong crush did not alter heat hypoalgesia but ameliorated static mechanical hypoesthesia, an effect blocked by a calcitonin gene-related peptide receptor antagonist. Thus, reducing the primary afferent calcitonin gene-related peptide supply contributed to subsequent negative neuropathic symptoms, especially to static mechanical stimuli. Moreover, nerve injury caused a subcellular redistribution of calcitonin gene-related peptide from small- and medium-size dorsal root ganglia neurons to large-size dorsal root ganglia neurons, which paralleled the development of positive neuropathic symptoms. Intrathecal administration of the calcitonin gene-related peptide receptor antagonist ameliorated these positive symptoms, indicating that the expression of calcitonin gene-related peptide in large-size dorsal root ganglia neurons is important for the positive neuropathic symptoms in all three models. Taken together, these results suggest that distinct calcitonin gene-related peptide expression pattern in primary afferents contribute to different neuropathic symptoms following chronic constriction or crush injuries to the rat sciatic nerve.


Earlier radiosurgery leads to better pain relief and less medication usage for trigeminal neuralgia patients: an international multicenter study.
Trigeminal neuralgia (TN) is a chronic pain condition that is difficult to control with conservative management. Furthermore, disabling medication-related side effects are common. This study examined how stereotactic radiosurgery (SRS) affects pain outcomes and medication dependence based on the latency period between diagnosis and radiosurgery. The authors conducted a retrospective analysis of patients with type I TN at 12 Gamma Knife treatment centers. SRS was the primary surgical intervention in all patients. Patient demographics, disease characteristics, treatment plans, medication histories, and outcomes were reviewed. Overall, 404 patients were included. The mean patient age at SRS was 70 years, and 60% of the population was female. The most common indication for SRS was pain refractory to medications (81%). The median maximum radiation dose was 80 Gy (range 50-95 Gy), and the mean follow-up duration was 32 months. The mean number of medications between baseline (pre-SRS) and the last follow-up decreased from 1.98 to 0.90 (p < 0.0001), respectively, and this significant reduction was observed across all medication categories. Patients who received SRS within 4 years of their initial diagnosis achieved significantly faster pain relief than those who underwent treatment after 4 years (median 21 vs 30 days, p = 0.041). The 90-day pain relief rate for those who received SRS ≤ 4 years after their diagnosis was 83.8% compared with 73.7% in patients who received SRS > 4 years after their diagnosis. The maximum radiation dose was the strongest predictor of a durable pain response (OR 1.091, p = 0.003). Early intervention (OR 1.785, p = 0.007) and higher maximum radiation dose (OR 1.150, p < 0.0001) were also significant predictors of being pain free (a Barrow Neurological Institute pain intensity score of I-IIIA) at the last follow-up visit. New sensory symptoms of any kind were seen in 98 patients (24.3%) after SRS. Higher maximum radiation dose trended toward predicting new sensory deficits but was nonsignificant (p = 0.075). TN patients managed with SRS within 4 years of diagnosis experienced a shorter interval to pain relief with low risk. SRS also yielded significant decreases in adjunct medication utilization. Radiosurgery should be considered earlier in the course of treatment for TN.


Methylated trivalent arsenicals as candidate ultimate genotoxic forms of arsenic: induction of chromosomal mutations but not gene mutations.
Arsenic is a prevalent human carcinogen whose mutagenicity has not been characterized fully. Exposure to either form of inorganic arsenic, As(III) or As(V), can result in the formation of at least four organic metabolites: monomethylarsonic acid, monomethylarsonous acid (MMA(III)), dimethylarsinic acid, and dimethylarsinous acid (DMA(III)). The methylated trivalent species, as well as some of the other species, have not been evaluated previously for the induction of chromosome aberrations, sister chromatid exchanges (SCE), or toxicity in cultured human peripheral blood lymphocytes; for mutagenicity in L5178Y/Tk(+/-) mouse lymphoma cells or in the Salmonella reversion assay; or for prophage-induction in Escherichia coli. Here we evaluated the arsenicals in these assays and found that MMA(III) and DMA(III) were the most potent clastogens of the six arsenicals in human lymphocytes and the most potent mutagens of the six arsenicals at the Tk(+/-) locus in mouse lymphoma cells. The dimethylated arsenicals were also spindle poisons, suggesting that they may be ultimate forms of arsenic that induce aneuploidy. Although the arsenicals were potent clastogens, none were potent SCE inducers, similar to clastogens that act via reactive oxygen species. None of the six arsenicals were gene mutagens in Salmonella TA98, TA100, or TA104; and neither MMA(III) nor DMA(III) induced prophage. Our results show that both methylated As(V) compounds were less cytotoxic and genotoxic than As(V), whereas both methylated As(III) compounds were more cytotoxic and genotoxic than As(III). Our data support the view that MMA(III) and DMA(III) are candidate ultimate genotoxic forms of arsenic and that they are clastogens and not gene mutagens. We suggest that the clastogenicity of the other arsenicals is due to their metabolism by cells to MMA(III) or DMA(III).


Application of flow cytometry in detection of red-cell-bound IgG in Coombs-negative AIHA.
Coombs negative autoimmune hemolytic anemia (AIHA) is characterized by laboratory evidence of in vivo hemolysis along with a negative direct antiglobulin test (DAT) performed by conventional tube technique (CTT) in clinically suspected AIHA patients. The sensitive gel test (GT) and flow cytometry (FC) can effectively diagnose such patients where CTT does not detect low level of red cell autoantibodies. We investigated the use of FC in the serological evaluation of CTT DAT negative AIHA and its comparison with GT DAT. Of the 50 patients with suspected AIHA, CTT DAT was negative in 5 patients (Coombs negative AIHA). GT DAT could detect red cell autoantibodies in 4 of these 5 patients. Monospecific GT DAT showed IgG and/or C3d as the responsible autoantibody. FC was considered as reactive when MFI was >3.6 (mean of 20 healthy negative volunteers +2SD). FC was reactive in all five Coombs negative AIHA patients. The mean MFI in five known CTT DAT positive samples taken for comparison was significantly higher compared to 5 DAT negative AIHA (18.3 +/- 7.78 vs. 7.88 +/- 1.35, p < 0.05). There was poor correlation between strength of GT DAT and MFI by FC. We conclude that FC is more sensitive test than the CTT and helps in the serological diagnosis of Coombs negative AIHA. However, in resource poor settings, GT DAT can be a good alternative to FC.


Counting multiple solutions in glassy random matrix models.
This is a first step in counting the number of multiple solutions in certain glassy random matrix models introduced by N. Deo [Phys. Rev. E 65, 056115 (2002)]. We are able to do this by reducing the problem of counting the multiple solutions to that of a moment problem. More precisely, we count the number of different moments when we introduce an asymmetry (tapping) in the random matrix model and then take it to vanish. It is shown here that the number of moments grows exponentially with respect to N, the size of the matrix. As these models map onto models of structural glasses in the high temperature phase (liquid), this may have interesting implications for the supercooled liquid phase in these spin glass models. Further, it is shown that the nature of the asymmetry (tapping) is crucial in finding the multiple solutions. This also clarifies some of the puzzles raised by E. Brézin and N. Deo [Phys. Rev. E 59, 3901 (1999)].


Ab initio evidence for strong correlation associated with Mott proximity in iron-based superconductors.
We predict that iron-based superconductors discovered near d(6) configuration (5 Fe 3d orbitals filled by 6 electrons) is located on the foot of an unexpectedly large dome of correlated electron matter centered at the Mott insulator at d(5) (namely, half filling). This is based on the many-variable variational Monte Carlo results for ab initio low-energy models derived by the downfolding. The d(5) Mott proximity extends to subsequent emergence of incoherent metals, orbital differentiations due to the Mott physics, and Hund's rule coupling, followed by antiferromagnetic quantum criticality, in quantitative accordance with available experiments.


Docosahexaneoic acid (22:6,n-3) regulates rat hepatocyte SREBP-1 nuclear abundance by Erk- and 26S proteasome-dependent pathways.
Insulin induces and dietary n-3 PUFAs suppress hepatic de novo lipogenesis by controlling sterol-regulatory element binding protein-1 nuclear abundance (nSREBP-1). Our goal was to define the mechanisms involved in this regulatory process. Insulin treatment of rat primary hepatocytes rapidly augments nSREBP-1 and mRNA(SREBP-1c) while suppressing mRNA(Insig-2) but not mRNA(Insig-1). These events are preceded by rapid but transient increases in Akt and Erk phosphorylation. Removal of insulin from hepatocytes leads to a rapid decline in nSREBP-1 [half-time (T1/2) approximately 10 h] that is abrogated by inhibitors of 26S proteasomal degradation. 22:6,n-3, the major n-3 PUFA accumulating in livers of fish oil-fed rats, suppresses hepatocyte levels of nSREBP-1, mRNA(SREBP-1c), and mRNA(Insig-2) but modestly and transiently induces mRNA(Insig-1). More importantly, 22:6,n-3 accelerates the disappearance of hepatocyte nSREBP-1 (T1/2 approximately 4 h) through a 26S proteasome-dependent process. 22:6,n-3 has minimal effects on microsomal SREBP-1 and sterol-regulatory element binding protein cleavage-activating protein or nuclear SREBP-2. 22:6,n-3 transiently inhibits insulin-induced Akt phosphorylation but induces Erk phosphorylation. Inhibitors of Erk phosphorylation, but not overexpressed constitutively active Akt, rapidly attenuate 22:6,n-3 suppression of nSREBP-1. Thus, 22:6,n-3 suppresses hepatocyte nSREBP-1 through 26S proteasome- and Erk-dependent pathways. These studies reveal a novel mechanism for n-3 PUFA regulation of hepatocyte nSREBP-1 and lipid metabolism.


Evaluating the treatment effects model for estimation of cross-sectional associations between risk factors and cardiovascular biomarkers influenced by medication use.
In cross-sectional observational data, evaluation of biomarker-to-exposure associations is often complicated by nonrandom medication use. Traditional approaches often lead to biased estimates, consistent with known results involving confounding by indication. More sophisticated, yet easy to implement approaches such as inverse probability weighting and censored normal regression can address medication use in certain settings but have poor performance when medication use depends on off-medication biomarker values. More sophisticated approaches are necessary. Heckman's treatment effects model resembles the process that gives rise to cross-sectional data. In this study, we conduct a variety of simulation studies to illustrate why traditional approaches are inappropriate when medication use depends on underlying biomarker values. We illustrate how Heckman's model can accommodate this feature. We also apply the models to data from the Multi-Ethnic Study of Atherosclerosis. Inverse probability weighting and censored normal regression are sensitive to how strongly medication use is associated with untreated biomarker values (the untreated value acts as an unmeasured predictor of medication use in this context). Heckman's model can often adequately remove bias and is robust to certain forms of model misspecification but relies on knowing important predictors of medication use, even when they are independent of the biomarker. The advantages of Heckman's model can be negated if the effect of medication on biomarker values is proportionate to the underlying biomarker. If predictors of medication use are measured, data are cross-sectional, and effects are approximately additive, then Heckman's model is more accurate relative to alternative approaches.


Combined Approach to Phacoemulsification and Trabeculectomy Results in Less Ideal Refractive Outcomes Compared With the Sequential Approach.
To compare the refractive outcomes of combined versus sequential trabeculectomy and then phacoemulsification. We compared eyes that underwent uncomplicated combined phacotrabeculectomy (combined group, 87 eyes), phacoemulsification at least 3 months after trabeculectomy (sequential group, 56 eyes), and phacoemulsification only (control group, 78 eyes) between January 1, 2006 and January 1, 2014. The main outcome measure was refractive prediction error (RPE)-defined as postoperative subjective spherical equivalent refraction minus predicted spherical equivalent refraction. The study population was predominantly Chinese and the mean age at their cataract surgery was 67.2±9.59 years. Compared with controls, RPE (-0.40±0.70 vs. -0.01±0.50, P<0.001) and mean absolute error (0.62±0.50 vs. 0.39±0.31, P=0.003) were greater for the combined group but not for the sequential group. Proportionately fewer patients in the combined group achieved final subjective refraction within ±0.5D (27.6% vs. 46.2%, P=0.01) compared with controls. Within the sequential group, there were no differences in RPE when the fellow eye axial length was used to predict refractive outcome (P=0.17) or between the group with precataract surgery IOPs of ≤11 mm Hg (-0.28±0.82) and the group with >11 mm Hg (-0.28±0.53, P=0.99). For the sequential group, the use of contact A scan yielded less RPE compared with IOLMaster (P=0.01). Combined approach to trabeculectomy and phacoemulsification resulted in greater myopic RPEs that were expectedly greater than those found in the phacoemulsification group.


Humoral and cellular immunological factors as possible markers of clinical relapse in HLA-typed Graves' patients followed with time.
Humoral and cellular immune factors were studied in 33 newly diagnosed Graves' patients at diagnosis and in 12 of these patients at regular intervals thereafter. All the patients were treated with carbimazole for 15 months (initially 60 mg and then 20 mg supplemented with L-Thyroxine). The incidence of relapse after treatment was 42%. Thyrotropin receptor antibodies (TRAb), T-cell subsets, K and NK cells and mononuclear cells expressing surface antigen markers of different activation were evaluated respectively by the use of a radioimmunoassay and a panel of monoclonal antibodies. Patients in the follow-up study were HLA-A, B, C and D typed. TRAb levels (91%) and levels of 4F2-positive cells (73%) and class II-positive lymphocytes (69.6%) were significantly increased in newly diagnosed Graves' patients in comparison with normal controls, whereas CD8 cells were significantly decreased. There was a significant inverse correlation between the increase in 4F2-positive cells and TRAb values. In the follow-up study both humoral and cellular immunological parameters showed a wide variation in levels, but TRAb, 4F2 and L243 values declined on average with respect to diagnosis. After 15 months some patients still showed abnormal values of activated T cells and TRAb values. All patients who relapsed (42%) after medical treatment showed a significant increase of 4F2-positive cells, and some of TRAb, some time before the appearance of clinical symptoms. Finally, no correlation was found between HLA type and relapse of the disease.(ABSTRACT TRUNCATED AT 250 WORDS)


Expression of auxiliary beta subunits of sodium channels in primary afferent neurons and the effect of nerve injury.
Multiple voltage-gated sodium channels are the primary mediators of cell excitability. They are multimers that consist of the pore-forming alpha subunit and auxiliary beta subunits. Although ion permeability and voltage sensing are primarily determined by the alpha subunit, beta subunits are important modulators of sodium channel function. The purpose of this study was to assess the effect of axotomy on the expression of beta subunits (beta(1), beta(2) and beta(3)) and coexpression of Na(v)1.3 and beta(3) subunits in the dorsal root ganglion (DRG). We used sciatic nerve transection models or spared nerve injury (SNI) models in the rat. In reverse transcriptase-polymerase chain reaction analysis, there were no significant differences between contralateral and ipsilateral DRGs of beta(1) and beta(2) mRNA 3 days after axotomy. beta(3) mRNA expression in ipsilateral DRGs increased significantly compared with contralateral DRGs 3 days after axotomy. In in situ hybridization histochemistry, beta(1) mRNA was predominantly expressed in medium- to large-size neurons, whereas beta(2) mRNA was expressed in small- to large-size neurons. There were no significant differences in beta(1) and beta(2) mRNA between contralateral and ipsilateral DRGs 3 days after axotomy. In contrast, beta(3) mRNA was mainly expressed in small neurons and occasionally in medium- to large-size neurons, and beta(3) mRNA expression in small c-type neurons in ipsilateral DRGs was increased significantly compared with contralateral DRGs. We examined beta(3) mRNA expression with one of alpha subunits, Na(v)1.3-ir, in DRG neurons after axotomy using the double labeling method. We found a high percentage of coexpression in injured DRG neurons: 83.6+/-2.8% of neurons expressing beta(3) mRNA were labeled for Na(v)1.3-ir; 70.1+/-3.1% of Na(v)1.3-ir neurons expressed beta(3) mRNA. We also examined the expression of beta(3) mRNA in DRG neurons in the SNI model, a neuropathic pain model. We used activating transcription factor 3 to identify axotomized neurons, and found that beta(3) mRNA up-regulation occurred mainly in axotomized neurons in the neuropathic pain model. These data strongly suggest that beta(3) expression in injured DRG neurons following axotomy might be an important pathomechanism of post-nerve injury pain in primary sensory neurons.


[Role of Medical Oncologists in Regional Hospitals].
Medical oncologists are required to propose and implement the optimal treatment for individual patients with cancer in cooperation with doctors and medical staff in each area as the control tower of the cancer treatment team within the medical institute. On the other hand, core hospitals in regional areas have limited numbers of medical oncologists, as well as doctors and staff in each specialized field, and cannot necessarily cover all areas like core cancer hospitals in metropolitan areas. Therefore, it is necessary for each medical facility in the local area to cooperate with the limited number of personnel and equipment and to deal across the region. To this mission, it is desirable to plan and manage areas such as the training of specialists and specialist staff, research and practice activities, enlightenment in cooperation with the government, cancer- related information, cancer education, and cancer advocacy. In order to fulfill this role smoothly, oncologists should take the initiative in demonstrating their social skills.


The nerve of legal entrapment.
Chordomas are a rare type of bone tumor that arises from the embryological remnant of the notochord. They originate at any point along the axial spine with the sacrum and the skull based region being the most commonly affected sites. Chordomas are slowly growing, indolent tumors, presenting insidiously, but also carry a high recurrence rate with a tendency to invade contiguous structure making their treatment challenging. The current standard of care for localized chordoma is aggressive cytoreductive surgery followed by high dose adjuvant radiotherapy. We present a unique case of a 72-year-old lawyer with a skull base chordoma invading into the hypoglossal canal and causing isolated hypoglossal nerve paralysis.


In vivo measurement of oxygen concentration using sonochemically synthesized microspheres.
Proteinaceous microspheres filled with nitroxides dissolved in an organic liquid have been synthesized for the first time using high intensity ultrasound; these were used to measure oxygen concentrations in living biological systems. The microspheres have an average size of 2.5 microns, and the proteinaceous shell is permeable to oxygen. Encapsulation of the nitroxides into the microsphere greatly increased the sensitivity of the electron paramagnetic resonance signal line width to oxygen because of the higher solubility of oxygen in organic solvents. The encapsulation also protected the nitroxide from bioreduction. No decrease in intensity of the electron paramagnetic resonance signal was observed during 70 min after intravenous injection of the microspheres into a mouse. Measurement of the changes in oxygen concentration in vivo by means of restriction of blood flow, anesthesia, and change of oxygen content in the respired gas were made using these microspheres.


Hedging against terrorism: Are US businesses prepared?
Private US companies face risks in connection with financial matters, but are not necessarily prepared to cope with risks that can seriously disrupt or even halt their operations, notably terrorist attacks and natural disasters. Enhancing the resilience of businesses when dealing with terrorism is especially challenging, as these groups or individuals can adapt tactics to exploit the vulnerabilities of companies they wish to target. Business managers need to formulate flexible preparedness plans that reduce risks from large-scale natural disasters as well as terrorist attacks. In doing so, they can take advantage of post-9/11 US government guidance for these endeavours as well as programmes that eliminate risks to private insurance entities so they can issue policies that cover terrorist strikes of high consequences. Just as business executives use hedging strategies in the world of finance, they also need operational hedging strategies as a means of exploiting as well as lowering the risks surrounding future uncertainties. Resources devoted to planning and hedging are investments that can increase the odds of businesses surviving and thriving, even if they experience high-impact terrorist attacks, threats or large-scale natural disasters, making suppliers, customers and stakeholders happy. The purpose of this paper is to give executives the incentive to take steps to do just that.


Lollipop-induced oral lichenoid reaction in a child.
Oral lichenoid reactions (OLRs) have been rarely reported in pediatric patients. This article reports an unusual case of a 15-year-old girl who had white plaques in tongue and buccal mucosa oral which initially were diagnosed as oral lichen planus (OLP). At first, the patient and her family denied systemic or local medication use. Biopsy was performed, and histopathological aspects were suggestive of OLP. Despite the attempt of treatment with topical corticoid, the lesions did not recede. Patient's behavior and medical history were again investigated and revealed that she had been using almost daily in her school an artificially colored and flavored lollipop. One week after removing lollipop use behavior, the oral lesions showed complete resolution and OLR diagnosis was defined. The present case denotes that OLR should be considered in the differential diagnosis of oral white plates in children and artificially colored sweets can be its causal agent.


Peripheral and central contribution to the difficulty of speech in noise perception in dyslexic children.
Noise typically induces both peripheral and central masking of an auditory target. Whereas the idea that a deficit of speech in noise perception is inherent to dyslexia is still debated, most studies have actually focused on the peripheral contribution to the dyslexics' difficulties of perceiving speech in noise. Here, we investigated the respective contribution of both peripheral and central noise in three groups of children: dyslexic, chronological age matched controls (CA), and reading-level matched controls (RL). In all noise conditions, dyslexics displayed significantly lower performance than CA controls. However, they performed similarly or even better than RL controls. Scrutinizing individual profiles failed to reveal a strong consistency in the speech perception difficulties experienced across all noise conditions, or across noise conditions and reading-related performances. Taken together, our results thus suggest that both peripheral and central interference contribute to the poorer speech in noise perception of dyslexic children, but that this difficulty is not a core deficit inherent to dyslexia.


Participation of lymphocyte activating factor (Interleukin 1) in the induction of cytotoxic T cell responses.
The initiation of murine alloantigen-specific cytotoxic T cell responses is macrophage dependent. The requirement for macrophages can be replaced in macrophage-depleted cytotoxic T lymphocyte assay by a soluble factor released from phorbol myristic acetate-stimulated mouse peritoneal adherent cells or P388D1 macrophage tumor cells. On the basis of the cell of origin, m.w. (15,000), and elution profiles on DEAE cellulose and polyacrylamide gels, this macrophage-replacing factor for T cell-mediated cytotoxicity was identical to lymphocyte activating factor (LAF). The stimulatory effect of LAF was totally dependent on the presence of the priming alloantigen. The results presented in this report support the hypothesis that macrophage-mediated antigen-induced T cell activation is dependent on two signals, antigen and LAF.


Maturation of buffalo oocytes in vitro with acetyl-L-carnitine improves cryotolerance due to changes in mitochondrial function and the membrane lipid profile.
The effects of acetyl-l-carnitine (ALC) supplementation during IVM on subsequently vitrified buffalo oocytes were evaluated, followed by determination of the mitochondrial DNA copy number, measurement of mitochondrial membrane potential (MMP) and identification of the lipid profile of oocyte membranes as markers of oocyte quality after vitrification. Supplementation with ALC during IVM significantly improved the rates of oocyte cleavage and morula and blastocyst formation, and increased MMP after vitrification compared with unsupplemented vitrified oocytes (P<0.05). Using a bidirectional orthogonal projection to latent structures discriminant analysis based on positive ion matrix-assisted laser desorption ionisation time-of-flight mass spectrometry data, five phospholipid ions (m/z 728.7 (phosphatidylcholine (PC) 32:3), 746.9 (PC 32:5), 760.6 (PC 34:1), 768.8 (PC P-36:3) and 782.6 (PC 36:4); P<0.05) were identified as significantly more abundant in fresh oocytes than in unsupplemented vitrified oocytes. Meanwhile, three phospholipid ions (m/z 734.6 (PC 32:0), 760.6 (PC 34:1), and 782.6 (PC 36:4); P<0.05) were more abundant in ALC-supplemented vitrified oocytes than in unsupplemented vitrified oocytes. Therefore, supplementation with ALC during IVM may improve buffalo oocyte quality after vitrification by enhancing mitochondrial function and altering the phospholipid composition of vitrified oocyte membranes.


Galanin stimulates luteinizing hormone-releasing hormone secretion from arcuate nucleus-median eminence fragments in vitro: involvement of an alpha-adrenergic mechanism.
Galanin (GAL), a 29-amino acid peptide originally isolated from porcine intestine, has been shown to be widely distributed not only in the gut, but also in the central nervous system. Several studies have shown that GAL participates in the hypothalamic regulation of PRL, GH, and LH secretion. In this study, we evaluate the effects of rat GAL (rGAL) on LHRH and prostaglandin (PG) E2 release from arcuate nucleus-median eminence fragments in vitro. Fragments were incubated for 30-min periods in Krebs-Ringer bicarbonate buffer containing the different test substances. The addition to the medium of rGAL in concentrations ranging from 5-1000 nM increased the release of both LHRH and PGE2 in a concentration-dependent manner. The ED50 values were approximately 55 and 80 nM for LHRH and PGE2, respectively. rGAL-induced LHRH and PGE2 release were related, as suggested by the finding that the addition to the medium of indomethacin (10 microM), a PG synthesis blocker, completely blocked rGAL-induced LHRH release. In addition, an active catecholaminergic system appears to be necessary for obtaining the stimulatory effect of rGAL. The addition to the medium of the alpha-adrenergic blocker phentolamine or prazosin impaired the ability of rGAL to release both LHRH and PGE2. rGAL-induced stimulation of LHRH and PGE2 release was blocked by phentolamine at doses of 1-10 microM, while prazosin was able to block it at doses as low as 0.1 microM. In summary, rGAL stimulates LHRH and PGE2 release from arcuate nucleus-median eminence fragments in vitro in a dose-dependent fashion. Such an effect is blocked by both indomethacin and alpha-adrenergic blockers, indicating that rGAL-induced stimulation of LHRH secretion is exerted through alpha-adrenergic receptors and requires PGE2 as an intracellular mediator.


[Clinical assessment of pulmonary hypertension in collagen diseases].
The occurrence of pulmonary hypertension (PH) has been reported in association with collagen diseases. Because of its grave consequences it is of greatest importance to make an early diagnosis of PH and initiate adequate treatment. For this purpose we have carried out right heart catheterization study to determine pulmonary arterial pressure (PAP), pulmonary vascular resistance (PVR), and cardiac index in thirty-four consecutive patients with collagen diseases including cases of mixed connective tissue disease (MCTD). We also compared the hemodynamic data with clinical pictures and the results of non-invasive cardiopulmonary tests which were done before catheterization study. Pulmonary hypertension as defined by the mean PAP of greater than 20 mmHg was observed in 11 of the 34 cases. PH was observed in five of 6 cases with MCTD and six of 17 cases with PSS including 2 cases with overlapping SLE and PM. The frequencies of positive anti-nRNP antibody, serositis, Raynaud's phenomenon and muscle involvement were significantly higher in cases with PH than in cases without PH. Catheterization study was most useful for diagnosis of cases with mean PAP of less than 25 mmHg, whereas echocardiographic study identified all cases with mean PAP of greater than 25 mmHg. No significant correlation was observed between mean PAP and vital capacity, total lung capacity or diffusion capacity measured as the percent of predicted normal values, which suggests that vascular abnormalities play a more significant role in the pathogenesis of PH than pulmonary fibrosis in collagen diseases.


Toll-like receptor 6 plays an important role in host innate resistance to Brucella abortus infection in mice.
Brucella abortus is recognized by several Toll-like receptor (TLR)-associated pathways triggering proinflammatory responses that affect both the nature and intensity of the immune response. Previously, we demonstrated that B. abortus-mediated dendritic cell (DC) maturation and control of infection are dependent on the adaptor molecule MyD88. However, the involvement of all TLRs in response to B. abortus infection is not completely understood. Therefore, we decided to evaluate the requirement for TLR6 in host resistance to B. abortus. Here, we demonstrated that TLR6 is an important component for triggering an innate immune response against B. abortus. An in vitro luciferase assay indicated that TLR6 cooperates with TLR2 to sense Brucella and further activates NF-κB signaling. However, in vivo analysis showed that TLR6, not TLR2, is required for the efficient control of B. abortus infection. Additionally, B. abortus-infected dendritic cells require TLR6 to induce tumor necrosis factor alpha (TNF-α) and interleukin-12 (IL-12). Furthermore, our findings demonstrated that the mitogen-activated protein kinase (MAPK) signaling pathway is impaired in TLR2, TLR6, and TLR2/6 knockout (KO) DCs when infected with B. abortus, which may account for the lower proinflammatory cytokine production observed in TLR6 KO mouse dendritic cells. In summary, the results presented here indicate that TLR6 is required to trigger innate immune responses against B. abortus in vivo and is required for the full activation of DCs to induce robust proinflammatory cytokine production.


Morphology and Morphometry of the Lung in Corn Snakes (Pantherophis guttatus) Infected with Three Different Strains of Ferlavirus.
Ophidian paramyxovirus (ferlavirus) is a global threat to reptilian sauropsids in herpetological collections, with occasional but fatal effects. This study characterizes the effects of three different genetic strains of ferlavirus on the dynamic changes of histology and morphometry of the lung of corn snakes (Pantherophis guttatus). Lungs from 42 corn snakes were either sham-infected or infected experimentally under standardized conditions. From 4 to 49 days after intratracheal inoculation, the lungs were examined qualitatively and quantitatively. Progressive microscopical changes were seen in the lung. Initially, increased numbers of heterophils were observed in the interstitium followed by proliferation and vacuolation of epithelial cells lining faveoli. Electron microscopy revealed loss of type-I pneumocytes, hyperplasia of type-II pneumocytes, and interstitial infiltrates of heterophils and mononuclear cells. With progression of disease the respiratory epithelium was initially overgrown by transformed type-II pneumocytes and later became multilayered. The results of the study suggest that the respiratory capacity of the lungs declines with disease development. The dynamics of disease development and histopathology differed in snakes infected with different ferlavirus genogroups. Animals infected with virus genogroup B developed histopathological changes and morphometric changes more rapidly and of greater intensity than snakes infected with viruses from genogroups A or C.


Elastomer Reinforced with Regenerated Chitin from Alkaline/Urea Aqueous System.
Novel hybrid elastomer/regenerated chitin (R-chitin) composites were developed, for the first time, by introducing chitin solution (dissolved in alkaline/urea aqueous solution at low temperature) into rubber latex, and then cocoagulating using ethanol as the cocoagulant. During the rapid coprecipitation process, the chitin solution showed rapid coagulant-induced gelation and a porous chitin phase was generated, and the rubber latex particles were synchronously demulsificated to form the rubbery phase. The two phases interlaced and interpenetrated simultaneously to form an interpenetrating polymer network (IPN) structure, which was evidenced by SEM observation. The ensuing compound was also characterized by thermogravimetric analysis (TGA), X-ray diffraction (XRD), and swelling experiments. The unique porous structure of R-chitin could result in strong physical entanglements and interlocks between filler and matrix, thus a highly efficient load transfer between the filler and the matrix was achieved. Accordingly, R-chitin endows the elastomer with a remarkable reinforcement. We envisage that this work may contribute new insights on novel design of chitin-based elastomer hybrids with IPN structure.


High-Efficiency Removal of Lead and Nickel Using Four Inert Dry Biomasses: Insights into the Adsorption Mechanisms.
In this study, inert dry bioadsorbents prepared from corn cob residues (CCR), cocoa husk (CH), plantain peels (PP), and cassava peels (CP) were used as adsorbents of heavy metal ions (Pb2+ and Ni2+) in single-batch adsorption experiments from synthetic aqueous solutions. The physicochemical properties of the bioadsorbents and the adsorption mechanisms were evaluated using different experimental techniques. The results showed that electrostatic attraction, cation exchange, and surface complexation were the main mechanisms involved in the adsorption of metals onto the evaluated bioadsorbents. The percentage removal of Pb2+ and Ni2+ increased with higher adsorbent dosage, with Pb2+ exhibiting greater biosorption capacity than Ni2+. The bioadsorbents showed promising potential for adsorbing Pb2+ with monolayer adsorption capacities of 699.267, 568.794, 101.535, and 116.820 mg/g when using PP, CCR, CH, and CP, respectively. For Ni2+, Langmuir's parameter had values of 10.402, 26.984, 18.883, and 21.615, respectively, for PP, CCR, CH, and CP. Kinetics data fitted by the pseudo-second-order model revealed that the adsorption rate follows this order: CH > CP > CCR > PP for Pb2+, and CH > CCR > PP > CP for Ni2+. The adsorption mechanism was found to be controlled by ion exchange and precipitation. These findings suggest that the dry raw biomasses of corn cob residues, cocoa husk, cassava, and plantain peels can effectively remove lead and nickel, but further research is needed to explore their application in industrial-scale and continuous systems.


[What is left of invasive electrophysiological explorations?].
After a golden period during which invasive electrophysiological investigations improved our understanding of the physiopathology of cardiac arrhythmias the clinical indications have now become more restricted. In the investigation of syncope, electrophysiological studies are only envisaged when the diagnosis is uncertain after clinical examination, resting ECG and non-invasive investigations. Holter monitoring in particular. Three types of arrhythmia may confirm our positive diagnostic criteria: sinoatrial block in patients with a sinus node recovery time greater than 1,000 ms uninfluenced by atropine atrioventricular block in patients with distal conduction defects during sustained atrial pacing, if necessary after injection of ajmaline: ventricular tachycardia in patients sustained monomorphic VT induced by 2 or 3 extrastimuli. The selection of the clinical indications has significantly improved the diagnostic value of electrophysiological investigations. The negativity of a strictly performed protocol, even though not giving a precise diagnosis of a syncopal episode, does provide reassuring prognostic information. In VT, electrophysiological studies may also be used to evaluate the secondary prognosis but with a diagnostic value no greater than that of non-invasive investigations. Programmed ventricular stimulation is not systematic for guiding antiarrhythmic therapy in France. Reserved for recurrent VT, electrophysiological studies are of additional value in the adaptation of treatment and improve the secondary prognosis.


Posteromedial Tibial Bone Bruise After Anterior Cruciate Ligament Injury: An MRI Study of Bone Bruise Patterns in 208 Patients.
Bone bruise patterns after anterior cruciate ligament (ACL) rupture may predict the presence of intra-articular pathology and help explain the mechanism of injury. Lateral femoral condyle (LFC) and lateral tibial plateau (LTP) bone bruises are pathognomic to ACL rupture. There is a lack of information regarding medial tibial plateau (MTP) and medial femoral condyle (MFC) bone bruises. To summarize the prevalence and location of MTP bone bruises with acute ACL rupture and to determine the predictors of MTP bone bruises. Cross-sectional study; Level of evidence, 3. Inclusion criteria were patients who underwent ACL reconstruction between February 2015 and November 2017, magnetic resonance imaging (MRI) within 90 days of injury, and participation in the database. Exclusion criteria included previous ipsilateral surgery, multiligamentous injuries, and incomplete imaging. Due to the large number of cases remaining (n = 600), 150 patients were selected randomly from each year included in the study, for a total of 300 patients. Two readers independently reviewed injury MRI scans using the Costa-Paz bone bruise grading system. Logistic regression was used to identify factors associated with MTP bone bruises. Included were 208 patients (mean age, 23.8 years; mean body mass index, 25.6). The mechanism of injury was noncontact in 59% of injuries, with over half from soccer, basketball, and football. The median time from injury to MRI scan was 12 days. Of the 208 patients, 98% (203/208) had a bone bruise, 79% (164/208) had an MTP bone bruise, and 83% (172/208) had bruises in both medial and lateral compartments. The most common pattern, representing 46.6% of patients (97/208), was a bruise in all 4 locations (MFC, LFC, MTP, and LTP). Of the 164 MTP bruises, 160 (98%) involved the posterior third of the plateau, and 161 were grade 1. The presence of an MFC bruise was the only independent risk factor for an MTP bruise (odds ratio, 3.71). The resulting nomogram demonstrated MFC bruise, sport, and mechanism of injury were the most important predictors of an MTP bruise. MTP bruise after acute ACL rupture was as prevalent as lateral bruises. The presence of a posterior MTP bruise suggested anterior tibial translation at the time of injury and could portend more medial compartment pathology at the time of injury than previously recognized.


Effects of various compounds on the accumulation of macrophages in mice.
The effects of different anti-inflammatory and anti-rheumatic compounds on the accumulation of macrophages in mice have been investigated. Glass coverslips were inserted subcutaneously and the cellular accumulation evaluated by measuring the surface covered by cells or the cellular potassium. Among the non-steroidal anti-inflammatory compounds tested, only niflumic acid and BW 755C were found active in this assay. Hydrocortisone, chloroquine and cyclophosphamide inhibited partially the migration of cells. Na- aurothiopropanol sulfonate, levamisole and methotrexate were inactive. MK 447 and d-penicillamine increased the accumulation of macrophages. The activity of the different substances is discussed in terms of their modes of action.


Ocular Manifestations in Pregnancy-Induced Hypertension at a Tertiary Level Hospital in Karnataka, India.
Introduction Pregnancy-induced hypertension (PIH) is a hypertensive disorder in pregnancy that occurs after 20 weeks of pregnancy in the absence of previously known hypertension. PIH is a common and serious complication accompanying pregnancy. Pre-eclampsia and eclampsia are multisystem disorders that can involve end organs like kidneys, liver, eyes, haematopoietic system and placenta. Though ocular involvement is not uncommon in PIH, ocular examination is not always done in all cases of PIH. Timely detection of changes in retinal vasculature can be a hint to the underlying changes in the vascular system of the various end organs of the human body including placental circulation. Adequate management of PIH is very important for both fetal and maternal well-being. Aim To evaluate the ocular manifestations in women affected by PIH (mild pre-eclampsia, severe pre-eclampsia and eclampsia) presenting to a tertiary-level hospital. Methodology This was a hospital-based cross-sectional study carried out for a period of one year at a tertiary-level hospital. A total of 120 subjects diagnosed as cases of pre-eclampsia/eclampsia admitted to the eclampsia ward of the obstetric unit formed the study population. After taking history, a detailed ocular examination was done for all patients and the findings were noted. Results The mean age of the study population was 31.91 ± 4.38 years (range 21 to 39 years). The mean gestational age was 30.89 ± 3.98 weeks. Fifty-three (44.17%) were primigravida, 64 (53.33%) were multiparous, and three (2.5%) were grand multiparous. Sixty-two (51.67%) had mild pre-eclampsia, 50 (41.67%) had severe pre-eclampsia and eight (6.67%) had eclampsia. The mean systolic blood pressure (SBP) and diastolic blood pressure (DBP) recorded in the study were 155.32 ± 11.89 mmHg and 104.3 ± 11.41 mmHg respectively. Ocular symptoms were present in 43 (35.83%) participants. Blurring of vision (19.17%) was the commonest ocular symptom observed in the study population followed by photopsia (13.33%), diplopia (9.17%), intermittent loss of vision (5.83%), ocular pain (6.67%), and scotoma (1.67%). Systemic symptoms included headache (11.67%), epigastric pain (3.33%), and nausea (5%). Anterior segment findings like conjunctival congestion, lid edema, and subconjunctival hemorrhage each accounted for 1.67% of the study population. Fundal changes were present in 33.33% of cases. Arteriolar narrowing was the commonest fundal finding amounting to 15.83%, followed by arteriovenous (AV) crossing changes also in 15.83%, cotton wool spots in 5.83%, retinal haemorrhages in 8.33%, papilledema in 2.5%, and choroidal infarcts in 1.67% participants. Grade 1 hypertensive retinopathy was observed in 15.83% of participants, grade 2 in 8.33% of participants, grade 3 in 6.67% of participants and grade 4 in 2.5% of participants. The mean SBP and mean DBP were high among those with fundal changes (163.35 ± 10.25 mmHg and 111.15 ± 10.29 mmHg) compared to those without fundal changes (151.3 ± 10.58 mmHg and 100.88 ± 10.41 mmHg). This was statistically significant. Proteinuria showed significant correlation with retinal changes. Conclusion The retinal vasculature changes correlate with the severity of hypertension, hence, it is very important to seek ophthalmologic opinion for evaluation, diagnosis and prompt management of PIH.


Impact of surgeon and hospital experience on outcomes of abdominal aortic aneurysm repair in New York State.
This study aimed to assess the impact of the surgeon's and hospital's experience on the outcomes of open surgical repair (OSR) and endovascular aneurysm repair (EVAR) of intact and ruptured abdominal aortic aneurysms (AAAs) in New York State. New York Statewide Planning and Research Cooperative System data were used to identify patients undergoing AAA repair from 2000 to 2011. Characteristics of the provider and hospital were determined by linkage to the New York Office of Professions and National Provider Identification databases. Distinct hierarchical logistic regression models for EVAR and OSR for intact and ruptured AAAs were created to adjust for the patient's comorbidities and to evaluate the impact of the surgeon's and hospital's experience on outcomes. The provider's years since medical school graduation as well as annual volume of the facility and provider are examined in tertiles. Adjusted odds ratios and 95% confidence intervals are presented. A total of 18,842 patients underwent AAA repair by a vascular surgeon. For intact AAAs (n = 17,118), 26.2% of patients underwent OSR and 73.8% underwent EVAR. For ruptured AAAs (n = 1724), 63.9% underwent OSR and 36.1% underwent EVAR. After intact AAA repair, OSR adjusted outcomes were significantly influenced by the surgeon's annual volume but not by the facility's volume or the surgeon's age. The lowest volume providers (1-4 OSRs) had higher in-hospital mortality rates than high-volume (>11 OSRs) surgeons (adjusted odds ratio, 1.87 [95% confidence interval, 1.1-3.17]). Low-volume providers also had higher odds of major complications (1.23 [1-1.51]). For patients with intact AAA undergoing EVAR, mortality was higher at low-volume facilities (2.6 [1.3-5.3] and 2.7 [1.5-4.8] for <33 EVARs and 34-81 EVARs, respectively). After OSR for ruptured AAA, treatment at a low-volume facility (<9 OSRs for ruptured AAA) was associated with greater mortality than at high-volume (>27 OSRs for ruptured AAA) centers (1.56 [1.02-2.39]), whereas low-volume physicians (<4 OSRs for ruptured AAA) had higher odds of major complications (1.58 [1.04-2.41]). In the case of EVAR for rupture, there were no characteristics of the hospital or surgeon significantly associated with poorer outcomes. For intact AAA, the surgeon's volume was an important factor for OSR outcomes, whereas low facility volume was associated with worse outcomes after EVAR. For ruptured AAA, low-volume surgeons and low-volume facilities had worse outcomes after OSR but not after EVAR. The interaction between the surgeon's volume and the hospital's volume is complex and varies on the basis of the acuity of presentation and treatment modality.


Inhibition of mite-induced immunoglobulin E synthesis, airway inflammation, and hyperreactivity by herbal medicine STA-1.
The availability of STA-1 in suppressing allergen-induced immunoglobulin E (IgE) synthesis, airway inflammation and hyperreactivity in a murine model was investigated. The mice were intraperitoneally sensitized with Dermatophagoides pteronyssinus group 5 allergen (Der p 5) and orally treated with 300 mg/kg of STA-1 every other day for 14 days. The Der p 5-specific immunologic responses including changes of specific immunoglobulin G and E, cells in the broncholarvage fluid, and airway hyperreactivity were measured when mice received inhalation challenge with Der p 5 after sensitization for 21 days. By comparing with sham-treated groups, the synthesis of Der p 5-specific IgE was downregulated while the influx of eosinophils and neutrophils in the airway were remarkably reduced. In addition, Der p 5-induced airway hyperreactivity also was significantly eliminated by STA-1 treatment. These results showed that STA-1 could effectively suppress the Der p 5-induced allergic reactions, and the availability of STA-1 for the treatment of allergic asthma was demonstrated in this study.


Micropatterning of light-sensitive liquid-crystal elastomers.
We demonstrate that photoisomerizable liquid-crystal elastomer soft films can be used as tunable holographic gratings. Optomechanical mechanism of imprinting one-dimensional grating structure into the soft matrix by two-beam uv laser interference can be clearly resolved from the time dependence of the reading beam diffraction patterns. We analyze the observed response in terms of cis-trans isomerization-controlled modulation of the grating profile. The grating period can be tuned reversibly by stretching or contraction of the specimen, either thermomechanically or by applying external stress. Temperature-induced modifications of the grating parameters in the vicinity of the nematic-paranematic phase transition are also examined.


[Role of free radicals in the development of acute mild and severe pancreatitis in mice].
In order to clarify the role of free radicals in the pathogenesis of acute pancreatitis, we observed the effect of a new synthetic free radical scavenger (CV-3611) on the pathological state in the models of both caerulein and CDE-diet induced acute pancreatitis in mice. In both models of acute pancreatitis, the levels of serum amylase activity were reduced significantly by the treatment of CV-3611. Pancreatic edema formation was also reduced significantly at 3.5 and 9 h after the first caerulein i.p. injection. The 4 days survival rate in CDE-diet induced pancreatitis was significantly elevated from 41.2% to 81.3% by the treatment of CV-3611. These results indicate that this synthetic scavenger, which has a long circulation half life, high affinity to biomembrane and good cell penetration ability, is effective on the development of both severe and mild pancreatitis. The main pathogenesis of both models is suggested to be radical reactions on the biomembrane which is caused by the interreaction between endothelium and neurophile in caerulein induced pancreatitis, and by the lipid peroxidation on the biomembrane of the organella in the cell in CDE-diet induced pancreatitis.


Non compliance to therapeutic prescriptions in paediatric patients: role of social communication.
The aim of this pilot study was to identify prevalent non-compliance behaviour in paediatric antibiotic therapy and to investigate the possible role of its social correlates. Patients' parents were surveyed at two paediatric practices in Catania, Italy, using an interviewer-administered questionnaire. The two practices were chosen for their location, in two different urban areas, to represent different sets of parents in terms of social status. Anticipated suspension of prescribed antibiotic therapy was the most frequently encountered form of non-compliance, shown by 41.2% of the parents. After partitioning the sample by mothers' occupational status--housewives versus working women--anticipated suspension revealed a positive association with educational level among the former group and a negative one, although not statistically significant, among the latter. Exposition to mass media messages about bacterial antibiotic resistance appeared to be a key intervening variable in interpreting these results, especially among more educated parents. Non-compliance was also associated with perceived characteristics of doctor-parents communication, particularly, with parents' perceived understanding of prescribed therapy.


Personality and substance dependence symptoms: modeling substance-specific traits.
Personality traits related to neuroticism and disinhibition have been consistently associated with substance use disorders (SUDs). It is unclear, however, whether different personality traits predict distinct forms of substance dependence. Additionally, it is unclear whether personality traits continue to predict alcohol, drug, and tobacco dependence after controlling for comorbid antisociality and other SUDs. The current study addresses these questions by characterizing relations between personality traits and substance dependence symptoms in a longitudinal sample of 3,720 college students. Results revealed that antisociality and certain core personality traits predicted multiple types of substance pathology. In addition, several personality traits were differentially associated with alcohol, drug, and tobacco symptomatology.


Resveratrol glucoside (Piceid) synthesis in seeds of transgenic oilseed rape (Brassica napus L.).
Resveratrol is a phytoalexin produced in various plants like wine, peanut or pine in response to fungal infection or UV irradiation, but it is absent in members of the Brassicaceae. Moreover, resveratrol and its glucoside (piceid) are considered to have beneficial effects on human health, known to reduce heart disease, arteriosclerosis and cancer mortality. Therefore, the introduction of the gene encoding stilbene synthase for resveratrol production in rapeseed is a tempting approach to improve the quality of rapeseed products. The stilbene synthase gene isolated from grapevine (Vitis vinifera L.) was cloned under control of the seed-specific napin promotor and introduced into rapeseed (Brassica napus L.) by Agrobacterium-mediated co-transformation together with a ds-RNA-interference construct deduced from the sequence of the key enzyme for sinapate ester biosynthesis, UDP-glucose:sinapate glucosyltransferase (BnSGT1), assuming that the suppression of the sinapate ester biosynthesis may increase the resveratrol production in seeds through the increased availability of the precursor 4-coumarate. Resveratrol glucoside (piceid) was produced at levels up to 361 microg/g in the seeds of the primary transformants. This value exceeded by far piceid amounts reported from B. napus expressing VST1 in the wild type sinapine background. There was no significant difference in other important agronomic traits, like oil, protein, fatty acid and glucosinolate content in comparison to the control plants. In the third seed generation, up to 616 microg/g piceid was found in the seeds of a homozygous T3-plant with a single transgene copy integrated. The sinapate ester content in this homozygous T3-plant was reduced from 7.43 to 2.40 mg/g. These results demonstrate how the creation of a novel metabolic sink could divert the synthesis towards the production of piceid rather than sinapate ester, thereby increasing the value of oilseed products.


Exogenous Gene Transmission of Isocitrate Dehydrogenase 2 Mimics Ischemic Preconditioning Protection.
Ischemic preconditioning confers organ-wide protection against subsequent ischemic stress. A substantial body of evidence underscores the importance of mitochondria adaptation as a critical component of cell protection from ischemia. To identify changes in mitochondria protein expression in response to ischemic preconditioning, we isolated mitochondria from ischemic preconditioned kidneys and sham-treated kidneys as a basis for comparison. The proteomic screen identified highly upregulated proteins, including NADP+-dependent isocitrate dehydrogenase 2 (IDH2), and we confirmed the ability of this protein to confer cellular protection from injury in murine S3 proximal tubule cells subjected to hypoxia. To further evaluate the role of IDH2 in cell protection, we performed detailed analysis of the effects of Idh2 gene delivery on kidney susceptibility to ischemia-reperfusion injury. Gene delivery of IDH2 before injury attenuated the injury-induced rise in serum creatinine (P<0.05) observed in controls and increased the mitochondria membrane potential (P<0.05), maximal respiratory capacity (P<0.05), and intracellular ATP levels (P<0.05) above those in controls. This communication shows that gene delivery of Idh2 can confer organ-wide protection against subsequent ischemia-reperfusion injury and mimics ischemic preconditioning.


Summary of the Czech medical resources in the Internet.
The article describes the most important features of the computer network Internet. Various information services are presented such as E-mail, Listserv, Gopher, FTP and World Wide Web. The Internet contribution to medical education, research contacts, and information exchange is particularly emphasized. Medical information sources from the Czech and Slovak Republics are summarized in appendices.