Inverse bremsstrahlung absorption with nonlinear effects of high laser intensity and non-Maxwellian distribution.
Inverse bremsstrahlung (IB) absorption and evolution of the electron distribution function (EDF) in a wide laser intensity range (10;{12}-10;{17} W/cm;{2}) have been studied systematically by a two velocity-dimension Fokker-Planck code. It is found that Langdon's IB operator overestimates the absorption rate at high laser intensity, consequently with an overdistorted non-Maxwellian EDF. According to the small anisotropy of EDF in the oscillation frame, we introduce an IB operator which is similar to Langdon's but without the low laser intensity limit. This operator is appropriate for self-consistently tackling the nonlinear effects of high laser intensity as well as non-Maxwellian EDF. Particularly, our operator is capable of treating IB absorption properly in the indirect and direct-drive inertial confinement fusion schemes with the National Ignition Facility and Laser MegaJoule laser parameters at focused laser intensity beyond 10;{15} W/cm;{2} .


Population Pharmacokinetic Analyses for Rezafungin (CD101) Efficacy Using Phase 1 Data.
Rezafungin (CD101) is a novel echinocandin antifungal agent currently in clinical development for the treatment of candidemia and invasive candidiasis. Rezafungin has potent in vitro activity against Candida albicans and Candida glabrata, including azole- and echinocandin-resistant isolates. The objective of this analysis was to develop a population pharmacokinetic (PK) model to characterize the disposition of rezafungin in plasma following intravenous (i.v.) administration. Data from two phase 1 studies, a single-ascending-dose study and a multiple-ascending-dose study, were available. Candidate population PK models were fit to the pooled data using the Monte Carlo parametric expectation maximization algorithm in S-ADAPT. The data were best described using a linear four-compartment model with zero-order drug input via i.v. infusion and first-order elimination. In order to account for the relationships between the structural PK parameters and subject body weight, all parameters in the model were scaled to subject body weight using standard allometric coefficients (a power of 0.75 for the clearance terms and 1.0 for the volume terms). The final model fit the observed data with very little bias and excellent precision. The prediction-corrected visual predictive check demonstrated that the final model could accurately simulate both the central tendency and the variability of observed rezafungin plasma concentrations. Given this, the final rezafungin population PK model is expected to provide reliable simulated concentration-time profiles and can provide dose selection decision support for future clinical studies.


Human fibrin sealant in pancreatic surgery: it is useful in preventing fistulas? A prospective randomized study.
Some Authors have suggested the use of human fibrin sealants in pancreatic surgery to prevent fistulas. We performed a prospective randomized study including 97 patients (34F, 63M). Forty six were affected by pancreatic inflammatory diseases and 51 had pancreatic or peripancreatic neoplasms. All the patients were managed by the same surgical staff. Surgical treatment included 30 pancreaticoduodenectomies, 40 pancreatico-jejunostomies, 23 left pancreatic resections and 4 tumour excisions. The patients were randomized at the moment the surgical treatment was chosen and divided into 2 different groups: group A, including 43 subjects who had intraoperative fibrin sealing, and group B, including 54 patients who had no fibrin sealing during surgery. At the end of the trial, 6 patients in group A (13.9%) and 6 in group B (11.1%) developed a pancreatic fistula. No statistically significant difference was detected between the 2 groups. The highest incidence of fistulas was observed in the patients with pancreatic cancer in group A (18.7%) and in the patients who underwent pancreatico-duodenectomy in group A (25.0%).


Engineering cyanobacteria to synthesize and export hydrophilic products.
Metabolic engineering of cyanobacteria has the advantage that sunlight and CO(2) are the sole source of energy and carbon for these organisms. However, as photoautotrophs, cyanobacteria generally lack transporters to move hydrophilic primary metabolites across membranes. To address whether cyanobacteria could be engineered to produce and secrete organic primary metabolites, Synechococcus elongatus PCC7942 was engineered to express genes encoding an invertase and a glucose facilitator, which mediated secretion of glucose and fructose. Similarly, expression of lactate dehydrogenase- and lactate transporter-encoding genes allowed lactate accumulation in the extracellular medium. Expression of the relevant transporter was essential for secretion. Production of these molecules was further improved by expression of additional heterologous enzymes. Sugars secreted by the engineered cyanobacteria could be used to support Escherichia coli growth in the absence of additional nutrient sources. These results indicate that cyanobacteria can be engineered to produce and secrete high-value hydrophilic products.


Collaborative community-based research and innovation.
This work describes the results and lessons learned from a community-academic partnership to research the effect of training on the capacity of rural home care aides to care for older persons with dementia. The research study increased the aides' knowledge of Alzheimer's and related disorders and, for one group, the aides' satisfaction. The authors used content analysis to identify barriers and facilitators of success of the research partnership. These factors are discussed and placed within a framework of innovation concepts.


H2O2 transit through the mitochondrial intermembrane space promotes tumor cell growth in vitro and in vivo.
Cancer cells experience increased levels of oxidant stress as a consequence of oncogene activation, nucleotide biosynthesis, and growth factor receptor signaling. Mitochondria contribute to this redox stress by generating reactive oxygen species (ROS) along the electron transport chain, which are released to the matrix and the intermembrane space (IMS). Assessing the contribution of mitochondrial ROS in cancer cells is technically difficult, as electron transport chain inhibitors can increase or decrease ROS generation, while they also block oxidative phosphorylation and ATP synthesis. Mitochondria-targeted antioxidant compounds can scavenge ROS in the matrix compartment but do not act on ROS released to the IMS. We assessed the importance of mitochondrial ROS for tumor cell proliferation, survival, and for tumor xenograft growth by stably expressing a hydrogen peroxide (H2O2) scavenger, peroxiredoxin-5, in the mitochondrial IMS (IMS-Prdx5) in 143B osteosarcoma and HCT116 colorectal cancer cell lines. IMS-Prdx5 attenuates hypoxia-induced ROS signaling as assessed independently in cytosol and IMS, HIF-1α stabilization and activity, and cellular proliferation under normoxic and hypoxic culture conditions. It also suppressed tumor growth in vivo. Stable expression of nondegradable HIF-1α only partially rescued proliferation in IMS-Prdx5-expressing cells, indicating that mitochondrial H2O2 signaling contributes to tumor cell proliferation and survival through HIF-dependent and HIF-independent mechanisms.


A new surgical modality for breast reconstruction in patients with breast cancer: a case report and literature review.
Breast preservation can considerably improve the postoperative living quality of breast cancer patients. Through this study, we proposed a novel, safe, and effective surgical modality for breast preservation in patients with early breast cancer. Herein, we present a case report of a patient with early-stage breast cancer (T1cN0M0), who underwent skin-sparing nipple areola hypodermic gland resection combined with primary breast reconstruction using silicone implants. The patient was administered with general anesthesia, and the implants were inserted using a insufflation-free suspension and hook suspension under the pectoralis major muscle. The patient was followed up on postoperative days 1, 2, 7, 14, 30, 60, and 100 to check for any complications, such as upper limb edema, paresthesia, or flap necrosis. The patient experienced no complications. No obvious surgical scars or axillary surface infections were observed. The patient was satisfied with the surgical outcome, and this treatment approach reduced her treatment costs by approximately USD 2,600. The new surgical procedure for breast reconstruction considerably improved the quality of life of the patient; no postoperative complications such as skin flap necrosis, paresthesia, or upper limb edema were experienced by the patient; and the treatment costs were reduced. In addition, this method effectively overcomes the concerns related to axillary space instability and limited operative space, rendering it worthy of promotion in clinical practice.


SPIDER as A Rehabilitation Tool for Patients with Neurological Disabilities: The Preliminary Research.
(1) Background and purpose: SPIDER (Strengthening Program for Intensive Developmental Exercises and activities for Reaching health capability) is dedicated for patients suffering from Cerebral Palsy, Sclerosis Multiplex, Spinal Bifida, Spinal Muscular Atrophy and strokes. Authors proposed a computer model for the evaluation patient's condition and the rehabilitation progress. (2) Methods: The 2-year-old and 76-year-old patients with neurological problems, who underwent individual therapy included balancing and coordination practising with SPIDER device. The model comparing the forces, which act during the therapy process, such as the expander and gravity forces, was worked out using Matlab software. (3) Results: The model allowed controlling the changes into the patients centre of gravity forces continuous adjustment and postural stability during any patient's movement. After rehabilitation sessions, lasted for 28 days during which patients received the progress information and the therapist got the numeric data, regarding the period of the therapy. (4) Conclusions: The first patient was able to move, dramatically improved the ability to balance and coordination. The second one presented change in gait, improvement in mobility, motor function and decreased fall risk. The proposed computer model gives information about the forces acting to the patient body. The physiotherapist can evaluate the progress of patient verticalization and receive information, in the form of numbers and charts.


Prevalence of mental distress and associated factors among university students in Ethiopia: a meta-analysis.
Mental distress is an important public health problem and is becoming common health problems among university students. This study aimed to provide a pooled prevalence of mental distress and associated factors among university students in Ethiopia. We systematically searched PubMed, EMBASE and PsycINFO databases. A further search was performed at Google Scholar search engine for additional studies. All observational studies reporting the prevalence of mental distress and/or associated factors among university students in Ethiopia were included. Pooled prevalence with 95% confidence interval (95% CI) were calculated using random effects and quality effects models. Subgroup and sensitivity analyses were performed. Heterogeneity between studies and evidence of publication bias were assessed. The pooled prevalence of mental distress was 35% (95% CI; 28%-43%). Being female, participating in religious programmes, having close friends, experiencing financial distress, alcohol use, khat use, conflict with friends, lack of interest in their field of study and a family history of mental illness were factors associated with mental distress among students. We found significant heterogeneity, but no evidence of publication bias. More than one third of university students in Ethiopia have suffered with mental distress. The finding provides evidence that university students are at risk population for mental health problems and suggests the need for early intervention to prevent severe mental illness.


Age-related changes of white matter association tracts in normal children throughout adulthood: a diffusion tensor tractography study.
The aim of this study is to study the age, gender and lateral asymmetry-related white matter changes of long association tracts throughout late childhood and adolescence into adulthood using diffusion tensor tractography (DTT). DTT was performed in 44 healthy subjects aged 7-45 years. Fractional anisotropy (FA), radial diffusivity (RD), axial diffusivity (AD), Trace, density and volume were calculated for long association tracts, namely the inferior fronto-occipital fasciculus (IFOF), inferior longitudinal fasciculus (ILF), uncinate fasciculus, superior longitudinal fasciculus (SLF) and its arcuate fibres. FA and diffusivity indices were correlated as function of age using Pearson correlation test. Comparison between males and females, and comparison between both hemispheres among all participants were also performed. A p value less than .01 was considered significant. The majority of the examined tracts (SLF and IFOF of both hemispheres, and the arcuate fasciculus, uncinate fasciculus, and ILF of the left hemisphere) followed a common pattern of metric changes with age. This pattern was characterized by significant FA increase accompanied by reduction in RD, Trace without significant AD changes. The right arcuate fasciculus showed similar pattern but without significant FA changes. The right uncinate and right ILF fasciculus demonstrated significant reduction in RD, Trace and AD, with and without significant FA increase, respectively. Left hemispheric dominance regarding the FA and diffusivity indices was demonstrated in uncinate fasciculus with no significant gender-related differences. Significant microstructural tract-specific maturation processes continue throughout late childhood into adulthood. These processes may represent stages in a cascade of age-related maturation in white matter microstructure.


Blood-brain barrier disruption during spontaneous canine visceral leishmaniasis.
Visceral leishmaniasis is a complex disease caused by Leishmania infantum, and in dogs, besides the classical symptoms, there are descriptions of inflammatory alterations in the brain. Brain inflammation is a strictly controlled process, and as the brain counts on the efficiency of the blood-brain barrier (BBB), we aimed to assess BBB integrity in dogs with spontaneous visceral leishmaniasis. Therefore, we evaluated markers in the cerebrospinal fluid (CSF) and in brain tissue related to BBB disruption and brain inflammation. Elevated albumin quota revealed BBB breakdown, corroborated by increased concentrations of anti-Leishmania antibodies in the CSF. In the brain, albumin and IgG staining formed halos around blood vessels, a classical indicator of BBB leakage. Soluble IgG was also detected in the choroid plexus and ependyma, and in these structures, IgG stained random resident cells. IgG(+) cells and Fcγ-RI(+) cells were identified in the choroid plexus, ependyma and perivascular in the brain parenchyma. The data support the occurrence of BBB disruption in dogs with spontaneous visceral leishmaniasis, and IgG as a key molecule that is capable of initiating and/or maintaining the inflammatory stimuli in the nervous milieu and the CSF as an important disseminator of inflammatory stimuli within the CNS.


Working in a war zone. The impact on humanitarian health workers.
The work challenges faced by doctors, nurses and other health professionals in the humanitarian field are overwhelming. This article highlights the psychological effects on humanitarian workers and the support available, both while on a 'mission' and on return home. It is impossible not to be psychologically affected by witnessing gross acts of violence, starvation, epidemics, displacement and despair, or hearing tales of slaughter, rape and killing. Just as those populations who are subjected to traumatic experiences develop post-traumatic psychological problems, so too can those humanitarian workers who assist them.


TiO2 Nanorod Arrays Based Self-Powered UV Photodetector: Heterojunction with NiO Nanoflakes and Enhanced UV Photoresponse.
The self-powered ultraviolet photodetectors (UV PDs) have attracted increasing attention due to their potential applications without consuming any external power. It is important to obtain the high-performance self-powered UV PDs by a simple method for the practical application. Herein, TiO2 nanorod arrays (NRs) were synthesized by hydrothermal method, which were integrated with p-type NiO nanoflakes to realize a high performance pn heterojunction for the efficient UV photodetection. TiO x thin film can improve the morphological and carrier transport properties of TiO2 NRs and decrease the surface and defect states, resulting in the enhanced photocurrent of the devices. NiO/TiO2 nanostructural heterojunctions show excellent rectifying characteristics (rectification ratio of 2.52 × 104 and 1.45 × 105 for NiO/TiO2 NRs and NiO/TiO2 NRs/TiO x, respectively) with a very low reverse saturation current. The PDs based on the heterojunctions exhibit good spectral selectivity, high photoresponsivity, and fast response and recovery speeds without external applied bias under the weak light radiation. The devices demonstrate good stability and repeatability under UV light radiation. The self-powered performance could be attributed to the proper built-in electric field of the heterojunction. TiO2 NRs and NiO nanoflakes construct the well-aligned energy-band structure. The enhanced responsivity and detectivity for the devices with TiO x thin films is related to the increased interfacial charge separation efficiency, reduced carrier recombination, and relatively good electron transport of TiO2 NRs.


Rheology of nanostructured lipid carriers (NLC) suspended in a viscoelastic medium.
Colloidal lipid nanoparticle dispersions have been characterized by rheological measurements using two different nanostructured lipid carrier (NLC)-based formulations intended for cosmetic application of substances like sunflower oil and alpha-tocopherol. This study has shown that rheological and viscoelastic properties of aqueous NLC dispersions are quantitatively very different depending on the composition of the oil phase and the temperature of storage despite similar or even identical particle size. NLC were loaded with 30% active ingredient relative to the particle mass. Stearyl alcohol was used as lipid matrix and the particle sizes determined by photon correlation spectroscopy were in the range 210-270 nm. In general, sun flower oil-loaded NLC dispersions showed distinctly higher storage modulus (G'), loss modulus (G") and complex viscosity (eta*). Storage at lower temperature (4 degrees C versus 20 degrees C) delay the build up of a microstructure affected not only by size and stabilizer but also loaded ingredient and storage history after preparation, i.e. storage at room temperature accelerates the build up of a final suspension structure.


Measurement of functional residual capacity by modified multiple breath nitrogen washout for spontaneously breathing and mechanically ventilated patients.
There is a need for a bedside functional residual capacity (FRC) measurement method that performs well in intensive care patients during many modes of ventilation including controlled, assisted, spontaneous, and mixed. We developed a modified multiple breath nitrogen washout method for FRC measurement that relies on end-tidal gas fractions and alveolar tidal volume measurements as inputs but does not require the traditional measurements of volume of nitrogen or oxygen. Using end-tidal measurements, not volume, reduces errors from signal synchronization. This study was designed to assess the accuracy, precision, and repeatability of the proposed FRC system in subjects with variable ventilation patterns including some spontaneous effort. The accuracy and precision of measurements were assessed by comparing the novel N₂ washout FRC values to the gold standard, body plethysmography, in 20 spontaneously breathing volunteers. Repeatability was assessed by comparing subsequent measurements in 20 intensive care patients whose lungs were under controlled and assisted mechanical ventilation. Compared with body plethysmography, the accuracy (mean bias) of the novel method was -0.004 litre and precision [1 standard deviation (sd)] was 0.209 litre [mean (sd)] [-0.1 (5.9)% of body plethysmography]. The difference between repeated measurements was 0.009 (0.15) litre [mean (sd)] [0.4 (6.4)%]. The coefficient of repeatability was 0.31 litre (12.7%). The modified multiple breath nitrogen washout method for FRC measurement provides improved precision and equivalent accuracy and repeatability compared with existing methods during ventilation with variable ventilation patterns. Further study of the novel N₂ washout method is needed.


Cancer risk in hereditary nonpolyposis colorectal cancer due to MSH6 mutations: impact on counseling and surveillance.
Hereditary nonpolyposis colorectal carcinoma (HNPCC) is caused by a mutated mismatch repair (MMR) gene. The aim of our study was to determine the cumulative risk of developing cancer in a large series of MSH6 mutation carriers. Mutation analysis was performed in 20 families with a germline mutation in MSH6. We compared the cancer risks between MSH6 and MLH1/MSH2 mutation carriers. Microsatellite instability (MSI) analysis and immunohistochemistry (IHC) were performed in the available tumors. A total of 146 MSH6 mutation carriers were identified. In these carriers, the cumulative risk for colorectal carcinoma was 69% for men, 30% for women, and 71% for endometrial carcinoma at 70 years of age. The risk for all HNPCC-related tumors was significantly lower in MSH6 than in MLH1 or MSH2 mutation carriers (P = 0.002). In female MSH6 mutation carriers, the risk for colorectal cancer was significantly lower (P = 0.0049) and the risk for endometrial cancer significantly higher (P = 0.02) than in MLH1 and MSH2 mutation carriers. In male carriers, the risk for colorectal cancer was lower in MSH6 mutation carriers, but the difference was not significant (P = 0.0854). MSI analysis in colorectal tumors had a sensitivity of 86% in predicting a MMR defect. IHC in all tumors had a sensitivity of 90% in predicting a mutation in MSH6. We recommend starting colonoscopic surveillance in female MSH6 mutation carriers from age 30 years. Prophylactic hysterectomy might be considered in carriers older than 50 years. MSI and IHC analysis are sensitive tools to identify families eligible for MSH6 mutation analysis.


Time-dependent pharmacokinetics and toxicity of cyclosporine.
Although the circadian pattern of cyclosporine (CSA) pharmacokinetics and toxicity has been described previously in both animal and clinical studies, the mechanism of this action is unknown. The present study compared the pharmacokinetics and experimental nephrotoxicity of chronic CSA in both the genetically-hyperlipidemic rat model and the lean litter-mate. Once daily dosing (25 mg/kg via gavage) was either at the start of the active (1900) or inactive (0700) cycle (Nov 1987 to Jan 1988). Serial serum samples following the final dose were assayed by both polyclonal (nonspecific) and monoclonal (specific for parent CSA) RIA. Renal toxicity was assessed by 24-hr creatinine clearances, fractional clearances of sodium and potassium, and inulin clearances (CIN). Despite a greater than 2-fold increase in serum CSA concentrations, there were no changes in renal function in obese rats dosed at the start of the active period compared to the inactive period. Furthermore, mean CIN of the lean group administered drug at the start of the active period was not significantly different from time-matched placebo-treated lean rats. However, there was an 80% drop in CIN in rats treated with CSA at the start of the inactive period compared to control group. There were no differences in electrolyte handling. Insulin concentrations, independent of time of dosing, were markedly elevated in obese rats dosed CSA compared to placebo-treated obese or both lean groups. Serum triglyceride levels were significantly correlated with pharmacokinetic parameters of total but not parent CSA. In summary, significant differences in toxicity were observed due to time of dosing and lipid profiles. Although the mechanism of this action remains unclear, it appears that increased non-fasting serum triglyceride levels following the active period most likely reduced CSA distribution into kidney tissue preventing the dose-limiting nephrotoxicity.


Long-term follow-up of the anterior lumbar interbody fusion procedure.
To evaluate the long-term clinical results and the effectiveness of the anterior lumbar interbody fusion procedure. Between 1999 and 2005, 60 ALIFs were performed in 59 patients. Mean age was 41.1 years. Clinically, patients were evaluated at a mean follow-up of 9.5 years using the Visual Analogue Scale grading scale, the Oswestry Disability score and the SF-36 questionnaire. Preoperative and postoperative clinical evaluation scores of 38 patients were available. Nineteen patients were lost to follow-up, and 2 patients died during the follow-up. The fusion rate was 84%. Mean preoperative VAS-score for back pain was 6.69 (±2.15) ; in the long term, the mean VAS-score was 4.95 (±2.95), which was a significant improvement. (p<0.01). The postoperative ODI-score was 36.11 (±22.32), while the preoperative ODI-score was 59.31 (±17.16), which demonstrates a significant improvement. According to the SF-36, mild to good results were observed. The ALIF procedure can offer significant pain relief and improved function if a strict indication policy is followed.


Effective submodularity of influence maximization on temporal networks.
We study influence maximization on temporal networks. This is a special setting where the influence function is not submodular, and there is no optimality guarantee for solutions achieved via greedy optimization. We perform an exhaustive analysis on both real and synthetic networks. We show that the influence function of randomly sampled sets of seeds often violates the necessary conditions for submodularity. However, when sets of seeds are selected according to the greedy optimization strategy, the influence function behaves effectively as a submodular function. Specifically, violations of the necessary conditions for submodularity are never observed in real networks, and only rarely in synthetic ones. The direct comparison with exact solutions obtained via brute-force search indicates that the greedy strategy provides approximate solutions that are well within the optimality gap guaranteed for strictly submodular functions. Greedy optimization appears, therefore, to be an effective strategy for the maximization of influence on temporal networks.


Minimally invasive navigated knee surgery: an American perspective.
Minimally invasive total knee replacement surgery may make it possible for patients to undergo the procedure with less pain and recover from the surgery more quickly than has been previously possible. However, minimally invasive techniques have the potential for being associated with a number of complications, including implant and limb malalignment. Computer-assisted technologies used in conjunction with minimally invasive techniques allow the accuracy with which the procedures are performed to be retained.


[Genetics and schizophrenia].
Studies of twins, adoption and familial incidence have demonstrated that heredity plays a role in the genesis of schizophrenia. Owing to recent advances in molecular biology and computerized statistical models, analyses of pedigrees and genetic linkage have made it possible to progress in the identification and mode of transmission of genetic factors in schizophrenia. The methodology and conflicting results of these studies are reviewed, together with modern hypotheses on the mode of transmission of schizophrenia. The contribution of genetic studies to the concept of schizophrenia clinical spectrum and the new strategies of research in genetics are presented.


Dipyridamole potentiates pulmonary vasodilation induced by acetylcholine and nitric oxide in the ovine fetus.
Nitric oxide (NO) modulates pulmonary vascular resistance (PVR) in the normal fetus by increasing the cyclic guanosine 3',5'-monophosphate (cGMP) content of pulmonary vascular smooth muscle cells. Although several vasodilator stimuli, including acetylcholine, decrease fetal PVR through the release of endogenous NO, fetal pulmonary vasodilation is often transient despite prolonged treatment. Because cGMP is hydrolyzed and inactivated by cGMP-specific (type 5) phosphodiesterases (PDE5), we hypothesized that PDE5 activity contributes to high fetal PVR and limits the capability of the fetal pulmonary circulation to dilate or sustain vasodilation in response to cGMP-dependent stimuli. To test this hypothesis, we studied the hemodynamic effects of dipyridamole in 19 late-gestation fetal lambs. To determine whether dipyridamole-induced vasodilation is dependent upon basal NO release, we measured the response to dipyridamole before and after pretreatment with the NO synthase antagonist nitro-L-arginine (L-NA) in five fetal lambs. L-NA completely blocked dipyridamole-induced pulmonary vasodilation. To evaluate the effect of dipyridamole on pulmonary vasodilation due to the stimulated release of NO, we studied effects of prolonged intrapulmonary acetylcholine infusions, with and without concomitant administration of low-dose dipyridamole, in six fetal lambs. During prolonged (2-h) infusions, acetylcholine and dipyridamole individually caused transient pulmonary vasodilation. When administered together, pulmonary vasodilation was of greater magnitude and was sustained for the entire study period. To determine the effects of dipyridamole on endothelium-independent pulmonary vasodilation, we investigated the hemodynamic effects of inhaled NO (5 and 20 ppm) alone and in combination with dipyridamole during mechanical ventilation with low FlO2. The combination of dipyridamole with inhaled NO resulted in a greater degree of pulmonary vasodilation than that achieved with inhaled NO alone. We conclude that dipyridamole-induced pulmonary vasodilation is dependent on endogenous (basal) NO production and that dipyridamole potentiates vasodilator responses to endothelium-dependent and -independent dilators in the ovine fetal pulmonary circulation. We speculate that PDES activity opposes vasodilation and maintains high PVR in the normal fetal lung.


Superiorly Based Middle Turbinate Flap for Repair of Cerebrospinal Fluid Rhinorrhea: A Cadaveric Feasibility Study and Case Series.
Objectives Cerebrospinal fluid (CSF) leaks of the anterior cranial base are frequently repaired with endonasal, multilayered reconstructions. Vascularized tissue flaps are superior to free mucosal grafts and biomaterials in many cases. Limitations of previously described flaps include reach, rotation, pedicle availability, and postoperative sinonasal morbidity. The objective of this study is to describe the superiorly based middle turbinate flap, a novel vascularized mucosal reconstruction option, and to present a case series demonstrating flap utility. Design Cadaveric feasibility study with technical description and illustrative case series. Setting Tertiary medical center. Participants Three silicone-injected cadaveric specimens (6 sides); 7 patients with CSF rhinorrhea from bony dehiscence of the anterior cranial fossa repaired with a superiorly based middle turbinate flap. Outcome Measures Cadaveric feasibility, in vivo repair outcomes, sinonasal symptoms, and postoperative healing. Results Cadaveric dissection demonstrated a consistent vascular plexus arising from the anterior and posterior ethmoid arteries, originating at the superior attachment of the middle turbinate and traveling inferiorly to supply the mucosa of the middle turbinate. Mean surface area of the flap was 776.67 ± 114.60 mm 2 . The clinical series of 7 patients involved leaks around the cribriform plate and fovea ethmoidalis. There were no instances of repair failure. All cases showed rapid and complete remucosalization without significant sinonasal morbidity. Conclusion The superiorly based middle turbinate flap is a reliable, versatile, and effective option for a vascularized mucosal flap onlay that can be used in anterior skull base reconstruction. This flap is particularly useful in the repair of defects involving the cribriform plate and fovea ethmoidalis.


The in vitro effect of human polymorphonuclear leukocyte azurophil granule components on natural killer cell cytotoxicity.
We previously demonstrated that human polymorphonuclear leukocyte (PMN) secretions are capable of activating and inhibiting natural killer cell (NK) cytotoxicity depending on the eliciting PMN stimulus. Serum-opsonized zymosan induced PMN to secrete substances that enhanced NK activity in vitro. Serum-opsonized zymosan stimulates the release of PMN azurophil granules, which contain both human neutrophil peptides (HNPs) and neutral serine proteases (NSPs). When HNPs and NSPs were tested for their ability to activate NK cells in peripheral blood lymphocytes, all but cathepsin G consistently enhanced cytotoxicity above control values. HNP-induced cytotoxicity was significantly enhanced within 12 h, peaking at approximately 24 h. Of the HNPs, HNP-1 was the most potent activator, enhancing NK activity at 1.25 micrograms/ml. Interleukin-2 and interferon-gamma were not involved in this activational process, as antibodies to interleukin-2 and interferon-gamma did not block activation by HNPs and NSPs, and interleukin-2 receptor expression was unaltered after 24 h of incubation. Enzymatically inactivated elastase and cathepsin G produced equivalent activational effects to their active counterparts. Antisera to elastase and cathepsin G decreased but did not eliminate NK activation over untreated peripheral blood lymphocytes. These data suggest that certain PMN azurophil granule components, including HNPs and NSPs directly increase the cytotoxic activity of NK cells.


In ovo silver nanoparticle supplementation for improving the post-hatch immunity status of broiler chickens.
Silver nanoparticles (AgNano) are known for their unique physical, chemical and biological properties, enabling cell penetration and anti-inflammatory response. In Experiment 1, the effect of an in ovo administration of AgNano (15 µg/egg; n = 360) at different incubation times (d 7 and d 18) on hatchability parameters was explored. In Experiment 2, post-hatch performance of broilers (42 d, n = 250) was studied after in ovo AgNano administration: Group T1 remained un-injected, Group T2 was the sham control and Groups T3, T4 and T5 were injected with 12.5, 25 and 50 µg AgNano, respectively, at 18 d of incubation. Chick weight, chick to egg weight ratio and hatchability as well average daily gain, average daily feed intake and feed conversion ratio were similar in all treatment groups. No variation was seen in the weight of thymus; however, the bursa and spleen weight was increased (p < 0.05) in Groups T4 and T5 in comparison to Group T1. The in vivo immune response to phytohaemagglutinin-P was increased in Group T3 in comparison to Groups T1 and T2 (p < 0.05), while the response to sheep red blood cells was increased in all AgNano-treated groups in comparison with Group T1 (p < 0.01). The expression of toll-like receptors 2 and 4 genes was up-regulated in AgNano groups in comparison with Groups T1 and T2 (p < 0.01). In summary, an in ovo supplementation of AgNano carried out at d 18 of incubation is effective and modulates the post-hatch immune response without affecting the hatchability, growth and other performance parameters in broilers.


New diffusion phantoms dedicated to the study and validation of high-angular-resolution diffusion imaging (HARDI) models.
We present new diffusion phantoms dedicated to the study and validation of high-angular-resolution diffusion imaging (HARDI) models. The phantom design permits the application of imaging parameters that are typically employed in studies of the human brain. The phantoms were made of small-diameter acrylic fibers, chosen for their high hydrophobicity and flexibility that ensured good control of the phantom geometry. The polyurethane medium was filled under vacuum with an aqueous solution that was previously degassed, doped with gadolinium-tetraazacyclododecanetetraacetic acid (Gd-DOTA), and treated by ultrasonic waves. Two versions of such phantoms were manufactured and tested. The phantom's applicability was demonstrated on an analytical Q-ball model. Numerical simulations were performed to assess the accuracy of the phantom. The phantom data will be made accessible to the community with the objective of analyzing various HARDI models.


Clinical evaluation of SyvekPatch in patients undergoing interventional, EPS and diagnostic cardiac catheterization procedures.
The SyvekPatch (Marine Polymer Technologies, Danvers, Massachusetts) has received Food and Drug Association market clearance for the rapid control of bleeding from vascular access sites and percutaneous catheters. A clinical evaluation was designed to determine the efficacy and safety of this vascular closure device in 1,000 consecutive patients after routine diagnostic and interventional procedures. During a 3-month period, a total of 364 interventional patients (stenting, 55%; PTCA, 30%; EPS, 15%) and 636 diagnostic patients (left heart catheterization, 77%; right/left heart catheterization, 23%) were treated. Catheter sheaths ranged in size from 4 12 French (Fr). Antiplatelet therapy was employed in 35% of the interventional procedures. In approximately 20% of the cases, same-side repuncture occurred within 2 3 days. The use of the SyvekPatch on a total of 1,000 consecutive patients resulted in the rapid control of bleeding with only 1 major complication (0.1%; pseudoaneurysm) and few minor complications (1.3%). The pseudoaneurysm was most likely caused by the aberrant location of the sheath. All minor complications were either small hematomas (< 2.5 cm; rate, 0.75%) or slight oozing from the puncture site (rate, 0.6%). Outcomes measured included clinical effectiveness, ability to maintain the femoral access site for future interventions, major complication rates (access-site related hematoma that required blood transfusion or an extended hospital stay, pseudoaneurysm, arteriovenous fistula, arterial or venous thrombosis, and infection), patient comfort and operational efficiency. The strong safety and efficacy profile of the SyvekPatch has made a significant impact in our cardiac catheterization lab. Unlike existing vascular closure devices, the SyvekPatch was used following a diagnostic procedure even when a future interventional procedure was scheduled. The effectiveness of the SyvekPatch was not altered by anticoagulation or antiplatelet therapy. The patients and clinical staff were extremely satisfied with the use of the SyvekPatch .


Inverse stochastic resonance in networks of spiking neurons.
Inverse Stochastic Resonance (ISR) is a phenomenon in which the average spiking rate of a neuron exhibits a minimum with respect to noise. ISR has been studied in individual neurons, but here, we investigate ISR in scale-free networks, where the average spiking rate is calculated over the neuronal population. We use Hodgkin-Huxley model neurons with channel noise (i.e., stochastic gating variable dynamics), and the network connectivity is implemented via electrical or chemical connections (i.e., gap junctions or excitatory/inhibitory synapses). We find that the emergence of ISR depends on the interplay between each neuron's intrinsic dynamical structure, channel noise, and network inputs, where the latter in turn depend on network structure parameters. We observe that with weak gap junction or excitatory synaptic coupling, network heterogeneity and sparseness tend to favor the emergence of ISR. With inhibitory coupling, ISR is quite robust. We also identify dynamical mechanisms that underlie various features of this ISR behavior. Our results suggest possible ways of experimentally observing ISR in actual neuronal systems.


Restrictions cancelled in Iraq.
The Office of the President of Iraq has cancelled Health Ministry regulations banning female sterilization and the taking of oral contraceptives without a doctor's prescription, according to a report in the Middle East Economic Digest of May 23, 1980.


Increased LDL cholesterol in non-insulin-dependent diabetics with maculopathy.
Serum cholesterol and its various lipoprotein fractions and triglycerides were measured in 50 non-insulin-dependent diabetic patients, 25 without retinopathy (group A) and 25 with diabetic maculopathy (group B) initially before control of diabetes, and again, after achieving good metabolic control. The lipid parameters were also estimated in 25 healthy non-diabetic subjects. The groups were well matched for sex, age, duration of diabetes and body weight. Mean serum total cholesterol and LDL cholesterol levels were significantly higher in group B when compared to group A, before and after achieving good metabolic control of diabetes (p less than 0.001). Mean total/HDL cholesterol and mean LDL/HDL cholesterol ratios were also significantly increased in group B as compared to group A (p less than 0.01) both before and after good diabetic control in these patients. Mean serum HDL and VLDL cholesterol and triglyceride concentrations were similar in groups A and B. The mean serum lipid concentrations in the diabetic patients without retinopathy (group A) were comparable to those of non-diabetic subjects.


Age-Related Variations in Intestinal Microflora of Free-Range and Caged Hens.
Free range feeding pattern puts the chicken in a mixture of growth materials and enteric bacteria excreted by nature, while it is typically unique condition materials and enteric bacteria in commercial caged hens production. Thus, the gastrointestinal microflora in two feeding patterns could be various. However, it remains poorly understood how feeding patterns affect development and composition of layer hens' intestinal microflora. In this study, the effect of feeding patterns on the bacteria community in layer hens' gut was investigated using free range and caged feeding form. Samples of whole small intestines and cecal digesta were collected from young hens (8-weeks) and mature laying hens (30-weeks). Based on analysis using polymerase chain reaction-denaturing gradient gel electrophoresis and sequencing of bacterial 16S rDNA gene amplicons, the microflora of all intestinal contents were affected by both feeding patterns and age of hens. Firmicutes, Bacteroidetes, Actinobacteria, Proteobacteria, and Fusobacteria were the main components. Additionally, uncultured environmental samples were found too. There were large differences between young hens and adult laying hens, the latter had more Firmicutes and Bacteroidetes, and bacterial community is more abundant in 30-weeks laying hens of all six phyla than 8-weeks young hens of only two phyla. In addition, the differences were also observed between free range and caged hens. Free range hens had richer Actinobacteria, Bacteroidetes, and Proteobacteria. Most of strains found were detected more abundant in small intestines than in cecum. Also the selected Lactic acid bacteria from hens gut were applied in feed and they had beneficial effects on growth performance and jejunal villus growth of young broilers. This study suggested that feeding patterns have an importance effect on the microflora composition of hens, which may impact the host nutritional status and intestinal health.


Bias in research.
By writing scientific articles we communicate science among colleagues and peers. By doing this, it is our responsibility to adhere to some basic principles like transparency and accuracy. Authors, journal editors and reviewers need to be concerned about the quality of the work submitted for publication and ensure that only studies which have been designed, conducted and reported in a transparent way, honestly and without any deviation from the truth get to be published. Any such trend or deviation from the truth in data collection, analysis, interpretation and publication is called bias. Bias in research can occur either intentionally or unintentionally. Bias causes false conclusions and is potentially misleading. Therefore, it is immoral and unethical to conduct biased research. Every scientist should thus be aware of all potential sources of bias and undertake all possible actions to reduce or minimize the deviation from the truth. This article describes some basic issues related to bias in research.


Infrared spectroscopy of surface charges in plasma-facing dielectrics.
We propose to measure the surface charge accumulating at the interface between a plasma and a dielectric by infrared spectroscopy using the dielectric as a multi-internal reflection element. The surplus charge leads to an attenuation of the transmitted signal from which the magnitude of the charge can be inferred. Calculating the optical response perturbatively in first order from the Boltzmann equation for the electron-hole plasma inside the solid, we can show that in the parameter range of interest a classical Drude term results. Only the integrated surface charge enters, opening up thereby a very efficient analysis of measured data.


Endogenous erythroid colony formation in chronic myeloid leukemia: a recurrent finding associated with persistent minimal residual disease under imatinib.
In vitro endogenous erythroid colony (EEC) formation is a common finding in BCR-ABL-negative myeloproliferative neoplasms. The aim of the present study was to determine the prevalence and the clinical significance of EEC growth in chronic myeloid leukemia (CML). Results of clonogeneic progenitor cell assays from 52 patients with newly diagnosed CML were correlated with disease characteristics at presentation and molecular response to imatinib. EECs (median 7 per dish, range 1-39) were detectable in 16 patients (31%). The proportion of patients with a high-risk Sokal score was lower in the EEC group (7% vs. 30%, respectively). The cumulative incidence of achieving a major molecular response after 2 years of imatinib was similar for both groups. However, patients with EECs were less likely to achieve a more profound decline of BCR-ABL transcripts. After 6 years of imatinib, the cumulative probability [95% CI] of reaching a ≥4 log reduction of BCR-ABL was 48% [16%; 92%] for patients of the EEC group and 84% [63%; 97%] for patients of the No EEC group. The probability [95% CI] of achieving a >4.5 log reduction of BCR-ABL after 7 years was 13% [2%; 61%] for patients with EECs and 52% [30%; 78%] for patients without EECs. In vitro EECs disappeared after achievement of a major molecular response in all evaluable patients. The data indicate that EEC formation is a recurrent finding in patients with CML which deserves further attention as a possible biomarker predicting the degree of molecular response to imatinib.


Beyond the Psychopathological Approach to Study the Relationship between Body Dissatisfaction and Suicide: A Moderate and Mediated Analysis.
This paper provides a comprehensive review of the literature to date on body dissatisfaction and suicide. A moderate and mediated regression analysis suggests that the relationship between these two variables is mediated by depression, anxiety, impulse control, self-esteem, and hopelessness. The relationship is not moderated by gender, ethnicity, or socioeconomic status. The implications for mental health practitioners are discussed in relation to management strategies for body dissatisfaction and suicide risk. Another finding showed that psychological distress had a significant effect on performance achievement and served as a mediating variable for the effect of social justice on performance achievement. This study only focused on the effect of psychological distress on the performance achievement of human resources in the context of Islamic microfinance institutions. Besides, in explaining the model, this study only focused on one point of view of the grand theory, i.e., social exchange theory. This study provided information on alternative strategies in managing and minimizing the risks of psychological distress to improve performance achievement in Islamic microfinance institutions. Apart from that, this study also provided an overview of how to manage social exchange relationships in the context of an organization, so they could be well-maintained. This study examined the effect of psychological distress on the performance achievement of human resources in the context of Islamic microfinance institutions. This study also specifically examined the role of formal justice and social justice as an antecedent of psychological distress. Eventually, this study used the perspective of social exchange theory for the first time in explaining the psychological distress model on the performance achievement of human resources.


Case Report: Formation of 3D Osteoblast Spheroid Under Magnetic Levitation for Bone Tissue Engineering.
Skeletal reconstruction is necessary in cases of bone defects created by tumors, trauma, and abnormalities. Regeneration of bone defects remains a critical problem, and current approaches are based on biocompatible scaffolds. Spheroids represent a simple 3D system since no supporting material is required for cell growth. Different techniques are used to generate spheroids, such as hanging drop, low-attachment plates, and magnetic nanoparticles. The idea of using magnetic nanoparticles is to cross-link through cell membrane overnight to create complex 3D cellular spheroid by using magnets to guide the cellular response. Herein, the current study aimed to achieve 3D human fetal osteoblast (hFOB) spheroid under magnetic levitation. Formation of 3D spheroid culture under magnetic levitation was evaluated by cell viability at 3, 7, and 14 days. Morphology of the 3D hFOB spheroid was analyzed by SEM and fluorescence microscopy and the differentiation towards mineralized lineage by ALP assay, qPCR, and alizarin red staining. The cell viability indicated that the 3D hFOB spheroid still viable after 14 days of culture. ALP assay, qPCR analysis expression of Col1, ALP, and Itg-β1 molecules, and calcium deposition with alizarin red showed a high level of bioactivity of the 3D hFOB spheroid. SEM images allowed the morphological analysis of the 3D microtissue-like spheroid with the presence of matrix deposition. These results indicate that magnetic levitation culture enables 3D stable osteoblast spheroids and could be a promising strategy for engineering application in the 3D construct in surgery regeneration of mineralized tissue.


Association between maternal serum ionized magnesium levels at delivery and neonatal intraventricular hemorrhage.
To determine whether magnesium sulfate (MgSO(4)) exposure is associated with a reduced risk for neonatal intraventricular hemorrhage (IVH). In a randomized, controlled trial, women in preterm labor were randomly assigned to receive MgSO(4), "other" tocolytic, or saline control. At delivery, we collected maternal antecubital and umbilical cord blood for determination of serum ionized magnesium levels. Neonatal IVH was diagnosed by cranial ultrasonogram. Among 144 infants, 24 were diagnosed with IVH. Using crude intention-to-treat analysis, we found that 18% (13/74) of survivors exposed after birth to MgSO(4) had IVH compared with 16% (11/70) of babies who were not exposed. Infants who had IVH were more likely to have been delivered by mothers with higher serum ionized magnesium (Mg) levels (0.75 vs 0.56 mmol/L) (P =.01). Using multivariable logistic regression, we confirmed that higher Mg levels are a significant predictor of neonatal IVH (adjusted odds ratio, 15.8; 95% CI, 1.4-175.0) even when adjusted for birth weight, gestational age, antenatal hemorrhage, and neonatal glucocorticoid exposure. In mothers with preterm labor, our data indicate that antenatal MgSO(4) exposure may be associated with an increased risk for IVH among their newborns.


Vascular surgery training after primary certification: where we go from here.
Program directors in vascular surgery have an increasingly complex set of responsibilities in the management of a vascular surgery residency, now that primary certification has been approved for vascular surgery and new training paradigms have been created in addition to the previous sequential training and certification in both general and vascular surgery. With the availability of new training paradigms, such as the 3+3 curriculum or entrance into a vascular residency program of 5 or 6 years directly out of medical school, the program director will become responsible for ensuring adequate training in basic surgical principals as well in the management of vascular pathology. Areas of added responsibility will include recruiting trainees, maintaining training case volumes, developing effective educational curricula and certifying the quality of the residents. This article discusses these tasks in detail, identifying special problem areas, such as changing lifestyle expectations, particularly in recruiting women, now approaching one half of medical students; expansion to meet the increasing need for vascular surgeons in the future as the population ages; funding vascular fellowship training; maintaining open surgical case loads while providing the facilities and supervision for adequate endovascular surgical training; providing a useful experience in both noninvasive vascular diagnosis and nonoperative management of vascular disease--in short, an experience that will result in Board certification and obtaining hospital privileges and a career that satisfies their choice of vascular surgery as a specialty.


Follow-up of five severely deprived and malnourished siblings, after their placement in foster care.
Five siblings, neglected and malnourished to the extent that they had become nutritional dwarfs, were placed in foster care. Their weights and heights were recorded at the time of placement, and at intervals for the following 6 years. In all cases there was an initial spurt in weight, which lasted for 1 to 2 years. Thereafer, the gains in weight and height continued on lines parallel with, but below the centile lines, except in the cases of the 2 youngest children, both of whom achieved the 3rd centile for weight and approached it for height. The eldest sibling was the most severely dwarfed.


[Comparison of unfractionated heparin and low molecular weight heparin in pulmonary thromboembolism: meta-analysis].
To pool the data of studies about anticoagulation in non-massive pulmonary thromboembolism (PTE) and evaluate the efficacy and safety of low molecular weight heparin (LMWH) and unfractionated heparin (UFH) as the initial treatment. MEDLINE CD-ROM from January 1966 to August 2003 and CBM CD-ROM from January 1978 to August 2003 were chosen for searching the randomized clinical trials (RCTs) that compared the efficacy or safety of LMWH and UFH in non-massive PTE. A meta-analysis was employed to evaluate the results of these two therapies. Five RCTs including 999 cases were analyzed. Compared with UFH, the combined odds ratio (OR) of LMWH in treating PTE was as follows: (1) The total OR of mortality of PTE patients treated with LMWH was 0.81 (95%CI 0.36-1.81, P > 0.05); (2) The total OR of recurrence of venous thromboembolism (VTE) in PTE patients treated with LMWH was 0.37 (95%CI 0.14-1.00, P=0.05); (3) The total OR of bleeding in LMWH was 0.47 (95%CI 0.16-1.39, P > 0.05);(4) The total OR of heparin-induced thrombocytopenia (HIT) in LMWH was 0.66 (95%CI 0.06-6.92, P > 0.05). LMWH and UFH can reduce the mortality and recurrence of VTE in patients with PTE in the same degree. The risk of major bleeding was similar in the two treatment groups. Initial subcutaneous therapy with the LMWH appeared to be as effective and safe as intravenous UFH in the initial treatment of PTE.


Genetic Variability, Genotype × Environment Interaction, Correlation, and GGE Biplot Analysis for Grain Iron and Zinc Concentration and Other Agronomic Traits in RIL Population of Sorghum (Sorghum bicolor L. Moench).
The low grain iron and zinc densities are well documented problems in food crops, affecting crop nutritional quality especially in cereals. Sorghum is a major source of energy and micronutrients for majority of population in Africa and central India. Understanding genetic variation, genotype × environment interaction and association between these traits is critical for development of improved cultivars with high iron and zinc. A total of 336 sorghum RILs (Recombinant Inbred Lines) were evaluated for grain iron and zinc concentration along with other agronomic traits for 2 years at three locations. The results showed that large variability exists in RIL population for both micronutrients (Iron = 10.8 to 76.4 mg kg-1 and Zinc = 10.2 to 58.7 mg kg-1, across environments) and agronomic traits. Genotype × environment interaction for both micronutrients (iron and zinc) was highly significant. GGE biplots comparison for grain iron and zinc showed greater variation across environments. The results also showed that G × E was substantial for grain iron and zinc, hence wider testing needed for taking care of G × E interaction to breed micronutrient rich sorghum lines. Iron and zinc concentration showed high significant positive correlation (across environment = 0.79; p < 0.01) indicating possibility of simultaneous effective selection for both the traits. The RIL population showed good variability and high heritabilities (>0.60, in individual environments) for Fe and Zn and other traits studied indicating its suitability to map QTL for iron and zinc.


Identification of DDX39A as a Potential Biomarker for Unfavorable Neuroblastoma Using a Proteomic Approach.
Malignant potential in unfavorable neuroblastoma (NB) is dependent on an undifferentiated status. The aim of this study was to identify a novel biomarker associated with the undifferentiated status of NB in vitro and to evaluate its prognostic implication. Shotgun proteomic analysis was performed in undifferentiated and all trans-retinoic acid induced differentiated NB cells in vitro. An identified protein was verified by multiple reaction monitoring (MRM) and evaluated by Western blot analysis. Immunohistochemistry (IHC) was used to examine the expression of the identified protein in 33 primary NB tissues. Twelve proteins, including ATP-dependent RNA helicase (DDX39A), were only detected in undifferentiated NB cells. A peptide of DDX39A was detected at a significantly higher level in undifferentiated IMR-32 (P = 0.002) and LA-N-1 (P < 0.001) cells by MRM. Western blot analysis revealed that DDX39A expression was significantly higher in undifferentiated IMR-32 (P = 0.02) and LA-N-1 (P = 0.025) cells. IHC demonstrated that DDX39A was highly expressed in the primary tumor tissues of patients with poor prognosis, and univariate and multivariate survival analyses showed that DDX39A expression could be an independent unfavorable prognostic factor (P = 0.027). DDX39A is a potential biomarker for unfavorable NB using a proteomic approach. Evaluation of DDX39A protein expression in NB tumor tissues may provide complementary prognostic information for further subclassification of these tumors.


Biomechanical Analysis Methods to Assess Professional Badminton Players' Lunge Performance.
Under the condition of simulating a badminton court in the laboratory, this study used the injury mechanism model to analyze the maximal right lunge movements of eight professional badminton players and eight amateur players. The purpose of this protocol is to study the differences in kinematics and joint moment of the right knee and ankle. A motion capture system and force plate were used to capture data of the joint movements of the lower extremity and the vertical ground reaction force (vGRF). Sixteen young men who did not have any sports injuries in the past 6 months took part in the study. The subjects performed a maximal right lunge from the start position with their right foot, stepping on and fully contacting with the force plate, hit the shuttlecock with an underhand stroke to the designated position in the backcourt, and then returned to the start/end position. All subjects wore the same badminton shoes to avoid a difference in impact from different badminton shoes. The amateur players showed a greater range of ankle movement and reverse joint moment on the frontal plane, and a larger internal joint rotation moment on the horizontal plane. The professional badminton players exhibited greater knee moment on the sagittal and frontal planes. Therefore, these factors should be considered in the development of the training program to reduce the risk of sports injuries in knee and ankle joints. This study simulates the real badminton court and calibrates the range of activities of each movement of the subjects so that the subjects complete the experimental action in a natural state with high quality. A limitation of this study is that it does not combine joint load and muscle activity. Another limitation is that the sample size is small and should be expanded in future studies. This research method can be applied to the lower limb biomechanical research of other footwork in the badminton project.


Effects of partial liquid ventilation on cerebral blood flow and cerebral metabolism in neonatal lambs.
Liquid ventilation is a promising therapy for respiratory failure. The effects of perfluorochemical on cardiac output have not been well described. The purpose of this study was to compare cerebral blood flow (Q(CAROTID)) and cerebral metabolic rates (CMR) during conventional ventilation (CV) and partial liquid ventilation (PLV). Five 2-week-old lambs underwent tracheostomy and central venous, aortic, and postcerebral venous catheter placement. Doppler flow probes were placed around the common ovine trunk, and the lambs underwent CV for 1 hour. Ventilation was adjusted to maintain physiologic blood gases. Pre- and postcerebral blood gas, glucose, and lactate samples were obtained every 15 minutes. Perfluorodecalin then was instilled endotracheally. The lambs underwent 1 hour of PLV with similar sampling. Data were analyzed using the Wilcoxon matched pairs test, significance at P </=.05. The authors observed no difference in mean Q(CAROTID) or carotid vascular resistance between CV and PLV (P =.35 and.34, respectively). The CMR of oxygen, glucose, and lactate were calculated using the Fick principle. CMR was unchanged between modes (P =.5). PLV did not adversely alter Q(CAROTID) or CMR in lambs, implying that this mode of ventilation should be safe in neonatal patients at risk for neurologic injury.


Two-Way Radio Modem Data Transfer for Newborn Hearing Screening Devices.
The success of a newborn hearing screening program depends on successful tracking and follow-up to ensure that children who have had positive screening results in the first few days of life receive appropriate and timely diagnostic and intervention services. The easy availability, through a suitable infrastructure, of the data necessary for the tracking, diagnosis, and care of children concerned is a major key to enhancing the quality and efficiency of newborn hearing screening programs. Two systems for the automated two-way transmission of newborn hearing screening and configuration data, based on mobile communication technology, for the screening devices MADSEN AccuScreen® and Natus Echo-Screen® were developed and tested in a field study. Radio modem connections were compared with conventional analogue modem transmissions from Natus Echo-Screen devices for duration, transmission rate, number of lost connections, and frequency of use. The average session duration was significantly lower with the MADSEN AccuScreen (12 s) and Natus Echo-Screen both with radio modem (15 s) than the Natus Echo-Screen with analogue modem (108 s). The transmission rate was significantly higher (898 and 1,758 vs. 181 bytes/s) for the devices with radio modems. Both radio modem devices had significantly lower rates of broken connections after initial connection (2.1 and 0.9 vs. 5.5%). An increase in the frequency of data transmission from the clinics with mobile radio devices was found. The use of mobile communication technology in newborn hearing screening devices offers improvements in the average session duration, transmission rate, and reliability of the connection over analogue solutions. We observed a behavioral change in clinical staff using the new technology: the data exchange with the tracking center is more often used. The requirements for on-site support were reduced. These savings outweigh the small increase in costs for the Internet service provider.


[Left adrenal pseudomass. Apropos of a case of splenorenal anastomosis by the vein of the left pillar of the diaphragm].
A case of hepatocarcinoma on cirrhosis with portal hypertension is described. The anatomy of splenorenal anastomoses and their ultrasound and CT scan imaging characteristics are reviewed, and the interest of differential diagnosis from adrenal masses emphasized. Its importance is enhanced by the fact that the portal hypertension may be unrecognized as in the present case. Diagnostic effectiveness of ultrasound and CT scan imaging is discussed.


Assignment of fourteen microsatellite markers to the chicken linkage map.
A large mapping population, with 874 F2 individuals, was generated by reciprocally intercrossing 2 chicken lines. A genetic map of 2,426.6 cM comprising 25 linkage groups was established based on 145 microsatellite markers. Chromosome locations were assigned for 14 previously unmapped markers. The marker ADL0132 was previously mapped to chromosome 9; however, here close linkage to the MCW0091 marker on chromosome 4 was found. With this exception, the derived linkage map was in excellent agreement with the chicken consensus map. A comparison with the chicken genome assembly (http://genome.ucsc.edu; February 2004) suggested a few minor errors in the assembly. A PCR-RFLP test was used to genotype a single nucleotide polymorphism in the melanocortin receptor 3 (MC3R) gene in the intercross, and pyrosequencing was used to map the genes for Hemopoetic Cell Kinase (HCK) and Bone Morphogenic Protein 7 (BMP7). The HCK and BMP7 genes on linkage group E32 showed significant linkage to MC3R on the distal end of linkage group E47W24, consequently joining the 2 linkage groups. A comparison between the linkage data in the current study and the physical location of markers as revealed in the chicken genome sequence assembly (February 2004) showed a 3-fold higher recombination rate on microchromosomes than on macrochromosomes.


Metastatic septic endophthalmitis in pyogenic liver abscess.
In a consecutive series of 180 patients with pyogenic liver abscess, three patients (two men and one woman, between 46 and 75 years of age) had metastatic Klebsiella endophthalmitis. The incidence of metastatic endophthalmitis was 1.7% in patients with pyogenic liver abscess, 5.2% in patients with Klebsiella liver abscess, and 7.8% in patients with Klebsiella liver abscess having Klebsiella bacteremia. Despite aggressive therapeutic measures, the men permanently lost their vision and the woman eventually required an evisceration of her right eye. Delayed recognition and/or treatment as well as the nature of bacteria probably contributed to the tragic outcome. The findings suggest that a high index of suspicion is critical and a combined effort of the internist and ophthalmologist is mandatory.


OUTCOME OF IMPLEMENTATION OF A MULTIDISCIPLINARY TEAM APPROACH TO THE CARE OF PATIENTS AFTER TRANSSPHENOIDAL SURGERY.
Transsphenoidal surgery (TS) for sellar lesions is an established and safe procedure, but complications can occur, particularly involving the neuroendocrine system. We hypothesized that postoperative care of TS patients would be optimized when performed by a coordinated team including a pituitary neurosurgeon, endocrinologists, and a specialty nurse. We implemented a formalized, multidisciplinary team approach and standardized postoperative protocols for the care of adult patients undergoing TS by a single surgeon (J.N.B.) at our institution beginning in July 2009. We retrospectively compared the outcomes of 214 consecutive TS-treated cases: 113 cases prior to and 101 following the initiation of the team approach and protocol implementation. Outcomes assessed included the incidence of neurosurgical and endocrine complications, length of stay (LOS), and rates of hospital readmission and unscheduled clinical visits. The median LOS decreased from 3 days preteam to 2 days postteam (P<.01). Discharge occurred on postoperative day 2 in 46% of the preteam group patients compared to 69% of the postteam group (P<.01). Rates of early postoperative diabetes insipidus (DI) and readmissions within 30 days for syndrome of inappropriate antidiuretic hormone (SIADH) or other complications did not differ between groups. Implementation of a multidisciplinary team approach was associated with a reduction of LOS. Despite earlier discharge, postoperative outcomes were not compromised. The endocrinologist is central to the success of this team approach, which could be successfully applied to care of patients undergoing TS, as well as other types of endocrine surgery at other centers.


Comparison of vitality states of finishers and withdrawers in trail running: An enactive and phenomenological perspective.
Studies on ultra-endurance suggest that during the races, athletes typically experience three vitality states (i.e., preservation, loss, and revival) at the phenomenological level. Nevertheless, how these states contribute to the management and outcome of performance remains unclear. The aim of this study was to determine whether and how the vitality states experienced by runners and their evolution during a trail race can be used to distinguish finishers from withdrawers. From an enactive and phenomenological framework, we processed enactive interviews and blog posts of race narratives. We distinguished units of meaning, which were grouped into sequences of experience; each sequence was then categorized as one of the three vitality states: state of vitality preservation (SVP), state of vitality loss (SVL) or state of vitality revival (SVR). We analyzed the distribution of these vitality states and their temporal organization at the beginning, in the second and third quarters, and at the end of the races, and we qualitatively characterized runners' adaptations to SVL. Results showed that finishers completed the race in SVP, with overall significantly more sequences in SVP and significantly fewer sequences in SVL than withdrawers. SVR did not discriminate finishers from withdrawers. The temporal organization of the vitality states showed a significant difference in the emergence of SVP from the second quarter of the race, as well as a significant difference in the emergence of SVL from the third quarter of the race. The analysis of adaptations to SVL confirmed that finishers were more capable of exiting SVL by enacting a preservation world when they felt physical or psychological alerts, whereas withdrawers remained in SVL. Our results showed that finishers and withdrawers did not enact the same phenomenological worlds in the race situation, especially in the organization of vitality adaptations and their relationships to difficulties; the cumulative effect of the succession of experienced vitality states differed, as well.


Self-defining memories in female patients with anorexia nervosa.
Overgeneral autobiographical memory (AM) was reported in patients with anorexia nervosa (AN) using AM cueing tasks that did not directly indexes memories that are personally important to the individual, that is, self-defining memories (SDMs). The aim of this study is to investigate characteristics of SDMs in females with AN. A total of 46 outpatients with chronic AN and 52 healthy controls (HC) were asked to recall three SDMs. Compared to HC, patients with AN presented less specific SDMs, but have preserved ability to give meaning to their memories. Patients' SDMs were associated with more negative emotions, more tension (i.e. explicit expression of discomfort, disagreement or unease) and more contamination (i.e. transformation in the memory narrative from a positive to a negative affective state). Content of SDMs differed between patients with AN and HC. Finally, no difference was found in SDMs characteristics between the two subtypes of anorexia nervosa (restricting type and binge eating / purging type). Patients with AN recalled overgeneral SDMs with negative content and emotions. In this context, a clinical intervention based on SDMs together with cognitive and emotional remedial therapies could help patients with AN to improve emotion processing and redefine their identity in a more positive way.


Metastatic transitional cell carcinoma of the ovary from superficial bladder tumour.
A 60-year-old female underwent transurethral resection of superficial grade 2 transitional cell carcinoma (TCC) of the urinary bladder. Six months later, intravesical Mitomycin C instillation was given following two superficial recurrences. A further recurrence of TCC grade I was resected transurethrally 39 months later. Forty-eight months after the original diagnosis the patient developed an abdominal mass, which turned out to be TCC grade 3 involving the left ovary. She underwent laparotomy which showed a left ovarian mass. Total abdominal hysterectomy, bilateral oophorectomy and partial omentectomy were carried out. She developed pelvic metastases 3 months later and died.


Direct DNA sequencing of the rat neu oncogene transmembrane domain reveals no mutation in urinary bladder carcinomas induced by N-butyl-N-(4-hydroxybutyl)nitrosamine, N-[4-(5-nitro-2-furyl)-2-thiazolyl]formamide or N-methyl-N-nitrosourea.
Epidermal growth factor (EGF) and EGF-related growth factors are present in the urine, and EGF has been identified as a urinary component that enhances urinary bladder tumor formation in rats. Neu oncogene encodes a cell surface receptor similar to the EGF receptor and is known to be activated by a point mutation of DNA that encodes the transmembrane domain of the neu protein (p185). In this study, we examined the possible mutational activation of neu oncogene in 50 urinary bladder transitional cell carcinomas (TCC) induced in F344 rats by the following carcinogenesis models: (i) 0.05% N-butyl-N-(4-hydroxybutyl)nitrosamine (BBN) (4 weeks)----3% uracil (20 weeks); (ii) 0.2% N-[4-(5-nitro-2-furyl)-2-thiazolyl]formamide (FANFT) (6 weeks)----5% sodium saccharin (72 weeks); and (iii) N-methyl-N-nitrosourea (MNU) 20 mg/kg body wt, i.p. twice per week for 4 weeks----3% uracil (20 weeks). The DNA sequence around the transmembrane domain of neu gene was amplified by PCR and sequenced. The results showed no mutation within the examined DNA sequences, indicating that neu oncogene is not activated by a point mutation in the transmembrane domain in urinary bladder carcinomas induced by BBN, FANFT or MNU.


Results of recent salvage chemotherapy regimens for lymphoma and Hodgkin's disease.
From 1981 to 1983, 208 patients with recurrent or refractory lymphoma were treated with methylglyoxal-bis-guanylhydrazone (methyl-GAG), ifosfamide, methotrexate, etoposide (MIME). The complete remission (CR) rate was 24% and CR plus partial remission (PR) was 60%. Response was higher for aggressive than for indolent cell types. Median duration of CRs was 16.5 months and median survival of all patients was 9 months. In view of the in vitro synergism between cisplatin and high-dose cytarabine, we recently designed the DHAP regimen, which consists of cisplatin, 100 mg/m2 IV over 24 hours; cytarabine, 2 g/m2 IV over two hours every 12 hours for two doses; and dexamethasone, 40 mg orally daily for 4 days. There were 28 of 90 (31%) CRs and 22 of 90 (24%) PRs. Median duration of CR is 15 months; median survival of all patients is 6 months. The major toxicities have been infection (31%) and moderate to severe renal dysfunction (20%). In contrast to MIME, response rates did not differ significantly between aggressive and indolent cell types. A high-dose regimen (CBV) consisting of cyclophosphamide, 6 g/m2; carmustine, 300 mg/m2; and etoposide, 250 mg/m2 daily for 3 days followed by autologous bone marrow transplant (ABMT) has been successfully used to treat 62 patients with Hodgkin's disease recurrent or refractory after mechlorethamine, vincristine, procarbazine, prednisone, doxorubicin, bleomycin, vinblastine, dacarbazine (MOPP/ABVD)-like regimens. A CR rate (47%) has been observed; 83% of these CRs remain alive and free of disease with a median follow-up of 19 months. This regimen appears to have curative potential in 40% of all cases and in 60% of cases treated after the first or second relapse.(ABSTRACT TRUNCATED AT 250 WORDS)


Clinical Significance of the Levator Veli Palatini Muscle in Velocardiofacial Syndrome Patients: Implications in Velopharyngeal Incompetence and Pharyngeal Flap Surgery.
Anatomical variation and deficits of velocardiofacial syndrome patients are related to unsatisfactory treatment results in surgical correction of speech abnormalities. The main purpose of the article is to investigate the clinical significance of thinned levator veli palatini muscle in VCFS patients. The authors reviewed medical records of all children with velocardiofacial syndrome who received pharyngeal flap surgery between March 2007 and September 2015. Data including thickness of levator veli palatini in magnetic resonance examination; preoperative velopharyngeal gap size from nasoendoscopy; and preoperative and postoperative speech outcomes were collected. Total of 36 velocardiofacial syndrome patients with preoperative objective data and postoperative speech outcomes were identified. Preoperative velopharyngeal gap showed significant correlation with thickness of levator veli palatini (correlation coefficient: 0.297/0.397, P = .02/.03) and gap size showed correlation with postoperative speech improvement (0.347/0.413, P = .04/.02). However, muscle thickness showed no correlation with speech outcomes (0.046/0.037, P = .77/.86). Thinned levator veli palatini muscle in velocardiofacial syndrome patients are related to widened velopharyngeal gap and production of hypernasal speech, and can give negative impact on postoperative surgical outcome of pharyngeal flap surgery.


Fully oral targeted antibiotic therapy for Gram-positive cocci-related periprosthetic joint infections: a real-life before and after study.
The optimal length of the intravenous antibiotic treatment of periprosthetic joint infections (PJIs) generally ranges from one to six weeks and is a matter of debate. Most antibiotics active against Gram-positive cocci (GPC) exhibit both high oral bioavailability and bone diffusion. Thus, early oral therapy may be a reasonable option in GPC-related PJIs. A 2 year before and after monocentric study that aimed to compare two antibiotic strategies. Empirical intravenous postoperative antibiotic treatment was followed by 7 to 10 days of intravenous targeted therapy ('before' group) or by full orally targeted antibiotic treatment ('after' group). The primary outcome was a treatment failure during follow-up. A total of 93 patients were analysed, 43 and 50 in the before and the after groups, respectively. Both groups were comparable in terms of surgical procedures, comorbidities, microbiological documentation and infection site. Antibiotics prescribed to our patients had high oral bioavailability and bone diffusion with rifampicin/fluoroquinolone combinations being the most frequent antibiotic regimens. Both hospital stay and intravenous antibiotic treatment mean durations were shorter in the before group than in the after group [15.0 versus 11.0 days; (P < 0.01) and 13.0 versus 7.0 days; P < 0.001, respectively]. The remission rate assessed after at least a year of follow-up was comparable in the before and the after groups (hazard ratio = 0.70; 95% CI 0.30-1.58). Full oral targeted antibiotic therapy using a drug regimen with high oral bioavailability and good bone diffusion is an option for the treatment of patients with GPC-related PJIs.


Separation of Mycobacterium leprae from contamination with armadillo-liver-derived "pigment" particles.
Mycobacterium leprae isolated from armadillo liver by the widely used IMMLEP protocol is sometimes contaminated with a particulate "pigment." This paper describes a simple, efficient, and rapid method for purifying large quantities of contaminated bacteria, which may readily be used as an additional step added at the end of the protocol when necessary. The process involves a discontinuous Percoll gradient and generates an essentially pure fraction containing greater than 90% of the original bacteria, and a fraction of "pigment" slightly contaminated with bacteria. Use of the system should release large additional numbers of pure M. leprae suitable for use in human vaccine trials.


Acid stability of carbon paste enzyme electrodes.
This note reports on the unusual protection of several enzymes against harsh pH conditions provided by carbon paste electrodes. Both glucose oxidase and polyphenol oxidase carbon paste amperometric biosensors display a remarkable resistance to acid deactivation compared to conventional biosensors prepared by electropolymeric entrapment of enzymes. For example, the carbon paste enzyme electrodes fully retain their activity upon stressing in strongly acidic conditions (pH approximately 2.0-2.5) for prolonged periods, where conventional (polymer-based) biosensors rapidly lose most of their response. Such unusual acid stability of carbon paste enzyme electrodes is attributed to the "pH memory" of enzymes in the hydrophobic paste environment, to the barrier to hydronium ions provided by the pasting liquid and to decreased conformational mobility.


Preoperative serum thyroglobulin as an adjunct to fine-needle aspiration in predicting well-differentiated thyroid cancer.
when fine-needle aspiration biopsy (FNAB) of a thyroid nodule yields indeterminate pathology, management decisions become complex, and other preoperative predictors of thyroid cancer must be employed to assess the risk of malignancy. Although thyroglobulin (Tg) is currently accepted as the serum marker of choice in the detection of well-differentiated thyroid cancer (WDTC) recurrence, its preoperative role in the workup of a thyroid nodule remains controversial. The purpose of this study was to evaluate the potential role for Tg as a preoperative indicator of primary WDTC, specifically in patients with indeterminate FNAB. this was a retrospective review of 861 consecutive thyroidectomy patients; 297 patients had indeterminate FNAB, of which 68 had serum levels of Tg measured prior to surgery. The predictive value of various threshold levels of preoperative Tg for WDTC was evaluated. Patients with nonindeterminate FNAB or final pathology containing medullary carcinoma, anaplastic carcinoma, or lymphoma were excluded. eighty-one percent (25 of 31) of patients with both indeterminate FNAB and preoperative Tg ≥ 75 microg/L had well-differentiated cancer on final pathology compared to 58% (172 of 297) of patients with indeterminate cytology alone (p = .014, RR = 1.4). In addition, mean preoperative Tg levels were found to be significantly higher in patients with WDTC compared to those with benign pathology (223 vs 53 microg/L, p = .007). our results imply that elevated preoperative serum Tg levels may be predictive of WDTC. This marker may be useful as an aid when making management decisions in patients with indeterminate cytology.


Evaluation of brain injuries in children deceased due to head trauma.
Traumatic brain injuries (TBIs) present an ever-growing prevalence, especially in the developing countries. Although 80-95% are mild to average injuries, they determine multiple severe neurological sequelae and disabilities. Most of these injuries are caused by traffic accidents. We studied a number of 29 cases of severe TBIs, in children who deceased immediately or after a few days of survival. Most of them (over 68%) were caused by traffic accidents. The incidence of traumas increased by age, most cases being recorded in the age group 10-15 years old. The TBIs were complex ones. In 86.21% of the cases, the forensic examination highlighted the presence of cranial fractures; in 93% of the cases, there were highlighted complex meningo-cerebral injuries: leptomeningeal hemorrhage associated with brain contusion injuries and with intraventricular blood flood, as well as destructive lesions of brain dilaceration; only in 7% of the cases there were highlighted meningeal lesions, with no brain lesions. The severity of the brain injuries was quite varied, according to the force of the cause agent. The histopathological and immunohistochemical examinations showed that the severity of TBIs increased according to the survival time, by adding secondary lesions caused by brain ischemia and local inflammatory reaction.


Extracellular polymeric substance (EPS)-degrading enzymes reduce staphylococcal surface attachment and biocide resistance on pig skin in vivo.
Staphylococcal extracellular polymeric substances (EPS) such as extracellular DNA (eDNA) and poly-N-acetylglucosamine surface polysaccharide (PNAG) mediate numerous virulence traits including host colonization and antimicrobial resistance. Previous studies showed that EPS-degrading enzymes increase staphylococcal biocide susceptibility in vitro and in vivo, and decrease virulence in animal models. In the present study we tested the effect of EPS-degrading enzymes on staphylococcal skin colonization and povidone iodine susceptibility using a novel in vivo pig model that enabled us to colonize and treat 96 isolated areas of skin on a single animal in vivo. To quantitate skin colonization, punch biopsies of colonized areas were homogenized, diluted, and plated on agar for colony forming unit enumeration. Skin was colonized with either Staphylococcus epidermidis or Staphylococcus aureus. Two EPS-degrading enzymes, DNase I and the PNAG-degrading enzyme dispersin B, were employed. Enzymes were tested for their ability to inhibit skin colonization and detach preattached bacteria. The effect of enzymes on the susceptibility of preattached S. aureus to killing by povidone iodine was also measured. We found that dispersin B significantly inhibited skin colonization by S. epidermidis and detached preattached S. epidermidis cells from skin. A cocktail of dispersin B and DNase I detached preattached S. aureus cells from skin and increased their susceptibility to killing by povidone iodine. These findings suggest that staphylococcal EPS components such as eDNA and PNAG contribute to skin colonization and biocide resistance in vivo. EPS-degrading enzymes may be a useful adjunct to conventional skin antisepsis procedures in order to further reduce skin bioburden.


The airway microbiome and pediatric asthma.
Asthma is the most common chronic disease of childhood. Investigations of the lower and upper airway microbiomes have significantly progressed over recent years, and their roles in pediatric asthma are becoming increasingly clear. Early studies identified the existence of upper and lower airway microbiomes, including imbalances in both associated with pediatric asthma. The infant airway microbiome may offer predictive value for the development of asthma in later childhood, and it may also be influenced by external factors such as respiratory viral illness. The airway microbiome has also been associated with the clinical course of asthma, including rates of exacerbation and level of control. Advances in -omics sciences have enabled improved identification of the airway microbiome's relationships with host response and function in children with asthma. Investigations are now moving toward the application of the above findings to explore risk modification and treatment options. The airway microbiome provides an intriguing window into pediatric asthma, offering insights into asthma diagnosis, clinical course, and perhaps treatment. Further investigation is needed to solidify these associations and translate research findings into clinical practice.


Polymorphism A36G of the tumor necrosis factor receptor 1 gene is associated with PAI-1 levels in obese women.
The tumor necrosis factor (TNF) pathway may be implicated in etiopathogenesis of PAI-1 overexpression during obesity. The aim of this study was to investigate the influence of polymorphism A36G of the TNF receptor 1 (TNFRSF1A +36A/G) on plasma concentrations of PAI-1 in 163 obese (31 with the metabolic syndrome, MetS) and 150 lean, healthy women. Genotypic and allele frequencies did not significantly differ between obese and lean subjects. TNFRSF1A genotypes were significantly associated with sTNFR1 plasma levels in obese women only (p < 0.01); TNFRSF1A +36G/G obese carriers exhibited higher sTNFR1 and PAI-1 levels than A carriers (p < 0.01 and p < 0.05, respectively). In obese women, the presence of the MetS significantly potentiated the elevation of sTNFR1 and PAI-1 levels observed in the TNFRSF1A + 36G/G carriers. Our results suggest that association between TNFRSF1A +36G/G genotype and the MetS renders obese women more prone to activation of the TNF pathway reflected by high circulating sTNFR1 and PAI-1 levels.


Role of purified serum components in polymorphonuclear leukocyte chemotaxis.
Three highly purified serum proteins are examined for their role during leukocyte chemotaxis. In the absence of added proteins, migration of eosinophils towards eosinophil chemotactic factor and of neutrophils towards bacterial factor does not occur at all. Dose-response curves with human serum albumin (HSA) show that chemotaxis proceeds well after addition of HSA, with an optimum at 1 mg/ml. SHA has to be present in the buffer during chemotaxis since preincubation of cells followed by washing is ineffective. In contrast, alpha 2-macroglobulin and alpha 1-antitrypsin enhance leukocyte migration at doses close to physiological serum levels and affect cells irreversibly. The data suggest a complex and powerful modulating influence of serum proteins on the influx of eosinophils and neutrophils to tissue sites.


Laparoscopy In Unexplained Abdominal Pain: Surgeon's Perspective.
Unexplained abdominal pain is a common but difficult presenting feature faced by the clinicians. Such patients can undergo a number of investigations with failure to reach any diagnosis. The objective of this study was to evaluate the use of laparoscopy in the diagnosis and management of patients with unexplained abdominal pain. This cross-sectional study was conducted at Pakistan Institute of Medical Sciences Islamabad from January 2009 to December 2013. This study included 91 patients of unexplained abdominal pain not diagnosed by routine clinical examination and investigations. These patients were subjected to diagnostic laparoscopy for evaluation of their conditions and to confirm the diagnosis. These patients presented 43% of patients undergoing investigations for abdominal pain. Patients diagnosed with gynaecological problems were excluded to see surgeon's perspective. The findings and the outcomes of the laparoscopy were recorded and data was analyzed. Unexplained abdominal pain is common in females than in males. The most common laparoscopic findings were abdominal tuberculosis followed by appendicitis. Ninety percent patients achieved pain relief after laparoscopic intervention. Laparoscopy is both beneficial and safe in majority of patients with unexplained abdominal pain. General surgeons should acquire training and experience in laparoscopic surgery to provide maximum benefit to these difficult patients.


Relationship between progesterone level on the day of human chorionic gonadotropin administration with outcomes of intra-cytoplasmic sperm injection in infertile couples.
Gonadotropin-releasing hormone agonists or antagonists are used in assisted reproductive technique cycles as premature luteinizing hormone secretion inhibition. Studies have been reported different and contradictory results on the serum progesterone effect on intra-cytoplasmic sperm injection. The purpose of this study was to evaluate the effect of serum progesterone level on the day of Human chorionic gonadotropin (HCG) administration on the intra-cytoplasmic sperm injection (ICSI) outcome in infertile women. 249 infertile couples candidated for ICSI were enrolled in the study. Their serum progesterone level on the day of HCG administration was measured and according to serum level, patients were divided into four groups of less than 0.9, 0.9-1.4, 1.5-1.9, and ≥2 ng/mL. The four groups were compared with each other regarding fertility outcomes. Pregnancy rate was not significantly different among the four groups (p>0.05). Also, there was no significant difference among the groups regarding frequency of abortion and ectopic pregnancy. Serum progesterone level on the day of HCG administration does not have any significant effect on pregnancy outcomes, including abortion, ectopic pregnancy, and pregnancy rate in patients undergoing ICSI treatment.


Effect of Monomer Sequence along Network Chains on Thermoresponsive Properties of Polymer Gels.
The effect of monomer sequence along the network chain on the swelling behavior of polymer gels should be clarified for the advanced control of swelling properties of gel materials. To this end, we systematically investigated the swelling properties of poly(acrylamide derivative) gels with the same composition but different monomer sequence by utilizing two gel synthetic methods: copolymerization giving a random network and co-crosslinking giving a blocky network. Both of the copolymerization and the co-crosslinking gels were prepared from the combination of two of the three following monomers: hydrophilic N,N-dimethylacrylamide (DMAAm), hydrophobic N-n-butylacrylamide (NBAAm), and thermoresponsive N-isopropylacrylamide (NIPAAm) with various monomer compositions. The swelling measurement of the obtained gels showed totally different behaviors between the copolymerization and the co-crosslinking gels, even with the same monomer composition. The copolymerization gels had the average property from the two monomers, depending on monomer composition, because random monomer distribution changed the affinity of each network chain to water. On the other hand, the co-crosslinking gels behaved as if two components independently contributed to the swelling properties, probably due to the domain structure derived from two kinds of prepolymers.


Intermediate results of percutaneous endovascular therapy of femoropopliteal occlusive disease: a contemporary series.
Percutaneous endovascular therapy is becoming a primary option for managing infrainguinal occlusive disease. This study examined the results of femoropopliteal percutaneous transluminal angioplasty (PTA) with intermediate (mean, 24 months) follow-up in a contemporary series of patients presenting with critical limb ischemia or claudication. Femoropopliteal PTA was performed on 238 consecutive limbs (208 patients) from January 2002 to July 2004. Study end points, including primary patency, assisted patency, and limb salvage (Society of Vascular Surgery reporting standards), were assessed by Kaplan-Meier life-table analysis, and factors predictive of hemodynamic or clinical failure, or both, were evaluated by univariate and multivariate methods. Clinical and demographic features included a mean age, 72 years; male (62%); critical limb ischemia (46%); diabetes mellitus (49%); and renal insufficiency (creatinine >or= 1.5 mg/dL) (29%). Lesions were classified as TransAtlantic Inter-Society Consensus (TASC) A (11%), B (43%), C (41%), and D (5%). PTA was confined to the femoropopliteal segment in 77 patients (33%), and 161 (67%) underwent concurrent interventions in other anatomic locations. Femoropopliteal interventions included angioplasty only in 183 (78%), and the remaining 53 (22%) received at least one stent. Technical success was achieved in 97% of patients, with no deaths and a major morbidity rate of 3%. The 36-month actuarial primary patency was 54.3%, and assisted patency was 92.6% (37 peripheral reinterventions), resulting in a limb preservation rate of 95.4% in all patients regardless of clinical presentation. Interval conversion to bypass surgery occurred in 19 patients (8%). Comparison between critical limb ischemia and claudication revealed a primary patency of 40.8% vs 64.8%, assisted patency of 93.8% vs 92.6%, and limb salvage of 89.7% vs 100%, respectively. Negative predictors of primary patency determined by multivariate analysis included history of congestive heart failure (P = .02) and TASC C/D (P = .02). However, further evaluation of TASC C/D vs A/B revealed an assisted patency of 89.7% vs 94.3% (P = .37) and limb salvage of 94.3% vs 96.4% (P = .58). Femoropopliteal PTA can be performed with a low perioperative morbidity and mortality. Intermediate primary patency is directly related to TASC classification. Although secondary intervention is often necessary to maintain patency in TASC C/D lesions, these data suggest that it would be appropriate to use PTA as initial therapy for chronic femoropopliteal occlusive disease regardless of clinical classification at presentation or TASC category of lesion severity.