Application for simulating public health problems during floods around the Loei River in Thailand: the implementation of a geographic information system and structural equation model.
Floods cause not only damage but also public health issues. Developing an application to simulate public health problems during floods around the Loei River by implementing geographic information system (GIS) and structural equation model (SEM) techniques could help improve preparedness and aid plans in response to such problems in general and at the subdistrict level. As a result, the effects of public health problems would be physically and mentally less severe. This research and development study examines cross-sectional survey data. Data on demographics, flood severity, preparedness, help, and public health problems during floods were collected using a five-part questionnaire. Calculated from the population proportion living within 300 m of the Loei River, the sample size was 560 people. The participants in each subdistrict were recruited proportionally in line with the course of the Loei River. Compared to the empirical data, the data analysis examined the causal model of public health problems during floods, flood severity, preparedness, and help. The standardized factor loadings obtained from the SEM analysis were substituted as the loadings in the equations for simulating public health problems during floods. The results revealed that the causal model of public health problems during floods, flood severity, preparation, and help agreed with the empirical data. Flood severity, preparedness, and aid (χ2 = 479.757, df = 160, p value <.05, CFI = 0.985, RMSEA = 0.060, χ2/df = 2.998) could explain 7.7% of public health problems. The computed values were applied in a GIS environment to simulate public health problem situations at the province, district, and subdistrict levels. Flood severity and public health problems during floods were positively correlated; in contrast, preparedness and help showed an inverse relationship with public health problems. A total of 7.7% of the variance in public health problems during floods could be predicted. The analysed data were assigned in the GIS environment in the developed application to simulate public health problem situations during floods.


AperFix versus transfix in reconstruction of anterior cruciate ligament.
The aim of this retrospective study was to compare clinical outcomes of the TransFix (Arthrex Inc., Naples, FL) fixation method and the brand-new AperFix (Cayenne Medical, Scottsdale, AZ) device in arthroscopic reconstruction of anterior cruciate ligament. A total of 38 patients with isolated complete anterior cruciate ligament rupture underwent arthroscopic reconstruction via two different fixation methods using hamstring autografts. Patients were evaluated in terms of range of motion values, Lysholm scores, laxity testing, and complications. Average flexion was 136.53 +/- 6.9 degrees in the TransFix group and 126.32 +/- 4.9 degrees in the AperFix group (p < 0.001). Mean Lysholm score was 82.42 +/- 8.5 in the TransFix group and 88.68 +/- 9.4 in the AperFix group (p < 0.022). There was no significance between the two groups in terms of laxity testing and complication rates. In the early postoperative period, satisfactory and comparable clinical results were achieved with the AperFix system when compared with cross-pin fixation in arthroscopic anterior cruciate ligament reconstruction.


Star volume in bone research. A histomorphometric analysis of trabecular bone structure using vertical sections.
Conventional bone histomorphometry performed on iliac crest biopsies does not generally provide unbiased stereological estimates of parameters related to bone structure due to the anisotropy of trabecular bone; this, however, can be obtained with vertical sections, which are anisotropic sections, in combination with an anisotropic test system. A practical procedure for obtaining vertical sections from bone is described. The new stereological parameter, the star volume, can provide an unbiased estimation of the absolute mean size of the marrow space and thus give an indirect estimate of the connectivity of trabecular bone structure. The marrow space star volume of vertebral bodies and iliac crest increases with age in both sexes demonstrating that the structural bone changes which occur with age is a topological one with changes in trabecular connectivity. The practical procedure including sampling efficiency for marrow space star volume is described.


Automatic delineation of functional lung volumes with 68Ga-ventilation/perfusion PET/CT.
Functional volumes computed from 68Ga-ventilation/perfusion (V/Q) PET/CT, which we have shown to correlate with pulmonary function test parameters (PFTs), have potential diagnostic utility in a variety of clinical applications, including radiotherapy planning. An automatic segmentation method would facilitate delineation of such volumes. The aim of this study was to develop an automated threshold-based approach to delineate functional volumes that best correlates with manual delineation. Thirty lung cancer patients undergoing both V/Q PET/CT and PFTs were analyzed. Images were acquired following inhalation of Galligas and, subsequently, intravenous administration of 68Ga-macroaggreted-albumin (MAA). Using visually defined manual contours as the reference standard, various cutoff values, expressed as a percentage of the maximal pixel value, were applied. The average volume difference and Dice similarity coefficient (DSC) were calculated, measuring the similarity of the automatic segmentation and the reference standard. Pearson's correlation was also calculated to compare automated volumes with manual volumes, and automated volumes optimized to PFT indices. For ventilation volumes, mean volume difference was lowest (- 0.4%) using a 15%max threshold with Pearson's coefficient of 0.71. Applying this cutoff, median DSC was 0.93 (0.87-0.95). Nevertheless, limits of agreement in volume differences were large (- 31.0 and 30.2%) with differences ranging from - 40.4 to + 33.0%. For perfusion volumes, mean volume difference was lowest and Pearson's coefficient was highest using a 15%max threshold (3.3% and 0.81, respectively). Applying this cutoff, median DSC was 0.93 (0.88-0.93). Nevertheless, limits of agreement were again large (- 21.1 and 27.8%) with volume differences ranging from - 18.6 to + 35.5%. Using the 15%max threshold, moderate correlation was demonstrated with FEV1/FVC (r = 0.48 and r = 0.46 for ventilation and perfusion images, respectively). No correlation was found between other PFT indices. To automatically delineate functional volumes with 68Ga-V/Q PET/CT, the most appropriate cutoff was 15%max for both ventilation and perfusion images. However, using this unique threshold systematically provided unacceptable variability compared to the reference volume and relatively poor correlation with PFT parameters. Accordingly, a visually adapted semi-automatic method is favored, enabling rapid and quantitative delineation of lung functional volumes with 68Ga-V/Q PET/CT.


Purification and investigation of some kinetic properties of glucose-6-phosphate dehydrogenase from parsley (Petroselinum hortense) leaves.
In this study, glucose-6-phosphate dehydrogenase (D-glucose-6-phosphate: NADP+ oxidoreductase, EC 22.214.171.124; G6PD) was purified from parsley (Petroselinum hortense) leaves, and analysis of the kinetic behavior and some properties of the enzyme were investigated. The purification consisted of three steps: preparation of homogenate, ammonium sulfate fractionation, and DEAE-Sephadex A50 ion exchange chromatography. The enzyme was obtained with a yield of 8.79% and had a specific activity of 2.146 U (mg protein)(-1). The overall purification was about 58-fold. Temperature of +4 degrees C was maintained during the purification process. Enzyme activity was spectrophotometrically measured according to the Beutler method, at 340 nm. In order to control the purification of enzyme, SDS-polyacrylamide gel electrophoresis was carried out in 4% and 10% acrylamide for stacking and running gel, respectively. SDS-polyacrylamide gel electrophoresis showed a single band for enzyme. The molecular weight was found to be 77.6 kDa by Sephadex G-150 gel filtration chromatography. A protein band corresponding to a molecular weight of 79.3 kDa was obtained on SDS-polyacrylamide gel electrophoresis. For the enzymes, the stable pH, optimum pH, and optimum temperature were found to be 6.0, 8.0, and 60 degrees C, respectively. Moreover, KM and Vmax values for NADP+ and G6-P at optimum pH and 25 degrees C were determined by means of Lineweaver-Burk graphs. Additionally, effects of streptomycin sulfate and tetracycline antibiotics were investigated for the enzyme activity of glucose-6-phosphate dehydrogenase in vitro.


Genome-wide functional analysis on the molecular mechanism of specifically biosynthesized fluorescence Eu complex.
Fluorescence imaging as an attractive diagnostic technique is widely employed for early diagnosis of cancer. Self-biosynthesized fluorescent Eu complex in situ in Hela cells have realized specifically and accurately fluorescence imaging for cancer cells. But the molecular mechanism of the in situ biosynthesized process is still unclear. In order to reveal this mechanism, we have investigated whole-genome expression profiles with cDNA microarray, incubated with Eu solution in Hela cells for 24 h. Methylthiazoltetrazolium (MTT) assay and laser confocal fluorescence microscopy study showed the low cytotoxicity and specifically fluorescence imaging of Eu complex in Hela cells. It is observed that 563 up-regulated genes and 274 down-regulated genes were differentially expressed. Meanwhile, quantitative RT-PCR was utilized to measure the expression of some important genes, which validated the results of microarray data analysis. Besides, GO analysis showed that a wide range of differential expression functional genes involved in three groups, including cellular component, molecular function and cellular biological process. It was evident that some important biological pathways were apparently affected through KEGG pathway analysis, including focal adhesion pathway and PI3K (phosphatidylinositol 3' -kinase)-Akt signaling pathway, which can influence glycolytic metabolism and NAD(P)H-oxidases metabolic pathway.


Transjugular liver biopsy: method of choice for taking a biopsy.
A transjugular liver biopsy is a route of obtaining a biopsy of the liver for the diagnosis and management of patients with hepatic disease. In this article the author will demonstrate how a liver biopsy via the transjugular route is taken using X-ray guidance and will describe the method step-by-step as it is performed at the Royal Free Hospital. Finally, the indications and advantages of using this method will be considered. This article should increase awareness of what a transjugular liver biopsy is and inform the reader of how a tissue sample is taken, thus enabling further understanding of the procedure. It is concluded that the transjugular route of obtaining a liver biopsy enables a good size and quality of sample to be taken in a safe and effective manner with only one pass (one attempt) being required. This method involves minimal complications and has many advantages.


[A clinicopathological study of corticobasal degeneration].
To elucidate clinical and pathological features of corticobasal degeneration. Clinical and image materials of 2 the aged with movement disturbances and dementia were reviewed, their brain tissues were investigated by routine pathological methods, Gallyas-Braak staining and Tau immunohistochemical staining. Both cases early presented movement disturbance on unilateral extremity including akinesia, rest tremor, postural instability, and then gradually developed rigidity of axial and four extremities, myoclonus, impaired ocular movement, cognitive disturbance from moderate dementia to decorticate state. On SPECT, one case showed hypoperfusion of left frontal-temporal cortices, another presented asymmetric atrophy of frontal-parietal cortices on CT. Main findings on routine pathological examination were prominent atrophy of the frontal-parietal lobe, the basal ganglia, the midbrain and upper pons. The cortical layers of the frontal, parietal and insular lobe showed mild neuronal loss with gliosis and scattered ballooned neurons. Neuron losses and extensive gliosis of basal ganglia and substantia nigra were remarkable. Gallyas-Braak and tau staining showed globous inclusion in remaining neurons of basal ganglia, substantia nigra and locus ceruleus et at, substantive glial cytoskeletol degeneration including astrocyte plaques, tuft-shaped astrocyte were also found in cortex on frontal and parietal lobe and in basal ganglia. Based on the above-mentioned clinical and pathological features, it may be not difficult to diagnosis corticobasal degeneration.


The importance of source behavior in distinguishing populations of epileptic foci.
The interictal spike discharge is usually analyzed in terms of amplitude, morphology, location of spike negativity, frequency or pattern of occurrence, and the effect of sleep/wake cycle. Such information derived from the routine EEG supports the clinician in the diagnosis, treatment, and management of the epileptic patient. Detailed analytical or computerized studies of spike characteristics have not had a great deal of clinical impact to date. This communication presents an argument for characterizing the epileptic focus based on interictal spikes. Some findings from quantitative analysis of spike properties are reviewed. By facilitating the creation and refinement of hypotheses relating to the underlying neuronal mechanisms, mathematical source modeling (or dipole modeling) may enhance our understanding of the epileptic process. Such an approach is applied to rolandic epilepsy as an example, and a model is proposed that is parsimonious with experimental data and clinical observations.


Renal transplantation in children with thrombosis of the inferior vena cava requires careful assessment and planning.
Children with end-stage renal disease and inferior vena cava (IVC) thrombosis are rare, and their condition is complex and high risk for renal transplantation. Detailed imaging studies of the recipient's abdominal vasculature should be carried out prior to transplantation, followed by careful pre-operative joint planning by the pediatric transplant surgeon and nephrologist. Critical decisions need to be made as to whether a deceased child's kidney or an adult-sized kidney is to be used, and if the latter, whether it should be from a deceased or living donor. In addition, the contemplated site of the donor's renal vein anastomosis needs to be determined with a consideration of the possible consequences of the various choices. Sixteen cases of renal transplantation in children with pre-existing IVC thrombosis are reviewed, including the three reported by Shenoy et al. in this journal. With a full understanding of the difficulties noted, renal transplantation in a small child with IVC thrombosis can be successful. However, it requires thorough recipient assessment, coupled with a careful and thoughtful examination of options, to determine the best possible approach to the transplantation.


Dietary phosphatidylinositol protects C57BL/6 mice from concanavalin A-induced liver injury by modulating immune cell functions.
Several recent studies have demonstrated that phospholipids (PLs) supplementation can modulate the function of cultured-immune cells. Furthermore, dietary PLs have been shown to ameliorate inflammatory processes and immune responses in arthritic and diabetic murine models, respectively. Thus, the aim of this study was to examine the immune-modulating activities of dietary soybean PLs in mice, with particular emphasis on the immune cell functions. Mice were fed semisynthetic diets for 6 weeks, which contained either 7% soybean oil or 5% soybean oil plus 2% of either PL: phosphatidylcholine (PC), phosphatidylinositol (PI), or phosphatidylserine (PS). Production of concanavalin A (Con A)-induced proinflammatory cytokines was significantly decreased in the splenocytes isolated from mice fed PI compared to other lipids. Supplementation of the diet with PI, but not with the other lipids, significantly suppressed the proinflammatory cytokine serum levels and the development of Con A-induced liver damages. These observations suggest that dietary PI influenced immune functions, resulting in the prevention of pathogenesis and development of the liver injury in mice.


Effects of an EDTA infusion on the urinary elimination of several elements in healthy subjects.
Ethylene diamine tetraacetate calcium disodium salt (EDTA Ca Na2), 1 g dissolved in 250 ml of 5% w/v glucose solution, was infused intravenously over 1 h into 10 healthy subjects (eight males and two females). Urines were collected over 24 h, the day before and on the day of the EDTA Ca Na2 infusion test. The elements Al, B, Ba, Cu, Fe, Mn, Si, Sr, Zn, Na, K, Ca, Mg, S and P were measured by inductively coupled plasma optical emission spectrometry. Pb was measured by inductively coupled plasma mass spectrometry. The EDTA Ca Na2 infusion increased the 24 h elimination of Al from 9.8 micrograms to 58 micrograms, of Fe from 66 to 121 micrograms, of Mn from 2.9 to 16.5 micrograms, of Pb from 9.8 to 56 micrograms and of Zn from 623 to 8847 micrograms. The ratio of the increase of urinary elimination induced by EDTA Ca Na2 was about 2 for Fe, 5 for Al, Pb and Mn, and 15 for Zn.


Effectiveness of programme approaches to improve the coverage of maternal nutrition interventions in South Asia.
The nutritional status of women before pregnancy, during pregnancy, and after delivery has far reaching consequences for maternal health and child survival, growth, and development. In South Asia, the high prevalence of short stature, thinness, and anaemia among women of reproductive age underlie the high prevalence of child undernutrition in the region, whereas overweight and obesity are rising concerns. A systematic review of evidence (2000-2017) was conducted to identify barriers and programme approaches to improving the coverage of maternal nutrition interventions in the region. The search strategy used 13 electronic bibliographic databases and 14 websites of development and technical agencies and identified 2,247 citations. Nine studies conducted in Bangladesh (n = 2), India (n = 5), Nepal (n = 1), and Pakistan (n = 1) were selected for the review, and outcomes included the receipt and consumption of iron and folic acid and calcium supplements and the receipt of information on dietary intake during pregnancy. The studies indicate that a range of barriers acting at the individual (maternal), household, and health service delivery levels affects intervention coverage during pregnancy. Programme approaches that were effective in improving intervention coverage addressed barriers at multiple levels and had several common features: use of formative research and client assessments to inform the design of programme approaches and actions; community-based delivery platforms to increase access to services; engagement of family members, as well as pregnant women, in influencing behavioural change; actions to improve the capacity, supervision, monitoring, and motivation of front-line service providers to provide information and counselling; and access to free supplements.


Parental and individual predictors of trajectories of depressive symptoms in Chilean adolescents.
Depressive symptoms are prevalent in adolescence, but not all adolescents experience the same level or evolution of symptoms, suggesting the need to identify differences in trajectories of symptoms. We used Growth Mixture Modeling to analyze different trajectories of depressive symptoms in a sample of 1,072 Chilean adolescents (12-15 years old, 54% female). First, a baseline model was selected and then adolescent irritability, maternal warmth, demandingness and disrespect were introduced to the model as predictors of class membership. Four latent class trajectories of depressive symptoms were identified: high persistent (12%), low stable (56%), high decreasing (15%) and low increasing (17%). Low stable was the most prevalent class, and was characterized by higher maternal warmth and lower maternal disrespect and adolescent irritability while high persistent was characterized by the opposite maternal characteristics. Significant gender differences in class membership were observed. The results highlight the importance of identifying different trajectories of depressive symptoms and specific predictors of each trajectory. The association of parenting dimensions with trajectories of persistent depressive symptoms provides evidence that parenting can serve as both a protective and risk factor for adolescent adjustment.


Genetic and environmental relationships of metabolic and weight phenotypes to metabolic syndrome and diabetes: the healthy twin study.
We aimed to examine the relationships, including genetic and environmental correlations, between metabolic and weight phenotypes and factors related to diabetes and metabolic syndrome. Participants of the Healthy Twin Study without diabetes (n=2687; 895 monozygotic and 204 dizygotic twins, and 1588 nontwin family members; mean age, 42.5±13.1 years) were stratified according to body mass index (BMI) (<25 vs. ≥25 kg/m(2)) and metabolic syndrome categories at baseline. The metabolic traits, namely diabetes and metabolic syndrome, metabolic syndrome components, glycated hemoglobin (HbA1c) level, and homeostasis model assessment of insulin resistance (HOMA-IR), were assessed after 2.5±2.1 years. In a multivariate-adjusted model, those who had metabolic syndrome or overweight phenotypes at baseline were more likely to have higher HbA1C and HOMA-IR levels and abnormal metabolic syndrome components at follow-up as compared to the metabolically healthy normal weight subgroup. The incidence of diabetes was 4.4-fold higher in the metabolically unhealthy but normal weight individuals and 3.3-fold higher in the metabolically unhealthy and overweight individuals as compared with the metabolically healthy normal weight individuals. The heritability of the metabolic syndrome/weight phenotypes was 0.40±0.03. Significant genetic and environmental correlations were observed between the metabolic syndrome/weight phenotypes at baseline and the metabolic traits at follow-up, except for incident diabetes, which only had a significant common genetic sharing with the baseline phenotypes. The genetic and environmental relationships between the metabolic and weight phenotypes at baseline and the metabolic traits at follow-up suggest pleiotropic genetic mechanisms and the crucial role of lifestyle and behavioral factors.


Exploring Incontinence-Associated Dermatitis in a Single Center Intensive Care Unit: A Longitudinal Point Prevalence Survey.
The purpose of this study was to provide longitudinal prevalence rates of incontinence-associated dermatitis (IAD) in patients in an intensive care unit (ICU) and to identify patient characteristics associated with IAD development. Prospective observational. The sample comprised 351 patients aged 18 years and older in a major metropolitan public hospital ICU in Queensland, Australia. All consenting, eligible participants at risk of developing IAD underwent weekly skin inspections to determine the presence of IAD. Data were collected weekly for 52 consecutive weeks. Descriptive statistics described the study sample and logistic regression analysis was used to identify patient characteristics associated with development of IAD. The weekly IAD prevalence ranged between 0% and 70%, with IAD developing in 17% (n = 59/351) of ICU patients. The odds of IAD developing increased statistically significantly with increasing age (odds ratio [OR]: 1.029, 95% confidence interval [CI]: 1.005-1.054, P = .016), time in the ICU (OR = 1.104; 95% CI: 1.063-1.147, P < .001), and Bristol Stool chart score (OR = 4.363, 95% CI: 2.091-9.106, P < .001). Patients with respiratory (OR = 3.657, 95% CI: 1.399-9.563, P = .008) and sepsis (OR = 3.230, 95% CI: 1.281-8.146, P = .013) diagnoses had increased odds of developing IAD. These data show the high variability of IAD prevalence over a 1-year period. Characteristics associated with the development of IAD in patients in the ICU included older age, longer lengths of ICU stay, incontinent of liquid feces, and having respiratory or sepsis diagnoses.


Sharing of four DR-beta sequence motifs between HLA-DRB1*1601 and DRB1*1101 correlates with frequent degenerate T-cell recognition of HA306-320 peptide complexed to these two molecules.
This paper shows that the seven HA306-320 specific T-cell clones isolated from one individual recognize the peptide complexed to both autologous HLA-DRB1*1101 and allogeneic HLA-DRB1*1601 (or DRB5*0201) molecules. For each T-cell clone, a single T-cell receptor (TCR) is involved in the recognition of these two different peptide-DR complexes as evidenced by cold target competition experiments. Yet, the seven T-cell clones express several different TCRs as judged by V beta-J beta usage and fine specificities. Furthermore, one representative clone has the same fine specificity for HA306-320 analogues mutated at epitopic residues irrespective of the use of DR1101 or DR1601 APC. These results suggest that structural differences between DRB1*1101 and DRB1*1601 (or DRB5*0201) do not dramatically influence the orientation of HA306-320 in the grooves such that most residues interacting with TCRs are conserved. In another individual, the same pattern of restriction, i.e. DR1101 + DR1601, was found for several HA306-320 specific clones. Two additional patterns, DR1101 + DR0801 and DR1101 + DR0801 + DR1601, were identified. By comparing DR sequences the authors found that DRB1*1101 and DRB1*1601 share four important motifs, i.e. beta 85-86, beta 67-71, beta 57 and beta 28-31 supposed to line three distinct HLA-DR pockets. Three of these motifs are also shared with DRB1*0801. All the results further support that the motif similarities allow the peptide to adopt very similar orientations in the cross-reacting DR molecules.


Deleterious mutations in esophageal carcinoma cuniculatum detected by next generation sequencing.
Esophageal carcinoma cuniculatum (ECC) is a rare form of extremely well-differentiated squamous cell carcinoma of esophagus that is often misdiagnosed preoperatively. The molecular changes underlying ECC remain unknown. This study aimed to explore the molecular signature of ECC using next-generation sequencing (NGS). Five cases of ECC were collected from our pathology database from 2014 to 2019. One patient received chemoradiation and the remaining four patients were treatment-naïve. Areas of normal squamous mucosa, non-invasive component, and invasive component of ECC were circled and macrodissected. Genomic DNA extracted from the macrodissected tissue was sequenced using GatorSeq NGS Panel. Deleterious mutations, predicted by Sorting Intolerant from Tolerant (SIFT), were identified using tumor/normal pairs and annotated by amino acid change. The normal-appearing squamous mucosa in the ECC harbored recurrent deleterious somatic mutations in ROS1 and POLE genes. ECC tumor-specific deleterious mutations were identified on TP53, NOTCH1, and PIK3CA genes. Our results support a mutually exclusive pattern in NOTCH1 and PIK3CA mutation. Non-invasive and invasive components in ECC had identical mutation profiles. Chemoradiation therapy led to disappearance of NOTCH1 mutation in one ECC case. Our results suggest molecular testing may help pre-operative diagnosis, and provide therapeutic targets in patients with advanced or unresectable ECC.


Muscle oxygenation profiles between active and inactive muscles with nitrate supplementation under hypoxic exercise.
Whether dietary nitrate supplementation improves exercise performance or not is still controversial. While redistribution of sufficient oxygen from inactive to active muscles is essential for optimal exercise performance, no study investigated the effects of nitrate supplementation on muscle oxygenation profiles between active and inactive muscles. Nine healthy males performed 25 min of submaximal (heart rate ~140 bpm; EXsub) and incremental cycling (EXmax) until exhaustion under three conditions: (A) normoxia without drink; (B) hypoxia (FiO2 = 13.95%) with placebo (PL); and (c) hypoxia with beetroot juice (BR). PL and BR were provided for 4 days. Oxygenated and deoxygenated hemoglobin (HbO2 and HHb) were measured in vastus lateralis (active) and biceps brachii (inactive) muscles, and the oxygen saturation of skeletal muscle (StO2; HbO2/total Hb) were calculated. During EXsub, BR suppressed the HHb increases in active muscles during the last 5 min of exercise. During EXmax, time to exhaustion with BR (513 ± 24 sec) was significantly longer than with PL (490 ± 39 sec, P < 0.05). In active muscles, BR suppressed the HHb increases at moderate work rates during EXmax compared to PL (P < 0.05). In addition, BR supplementation was associated with greater reductions in HbO2 and StO2 at higher work rates in inactive muscles during EXmax Collectively, these findings indicate that short-term dietary nitrate supplementation improved hypoxic exercise tolerance, perhaps, due to suppressed increases in HHb in active muscles at moderate work rates. Moreover, nitrate supplementation caused greater reductions in oxygenation in inactive muscle at higher work rates during hypoxic exercise.


[Methods of psychotherapy case studies: current perspectives].
There is a renewal of interest among psychotherapy researchers and psychotherapists towards psychotherapy case studies. This article presents two paradigms that have greatly influenced this increasing interest in psychotherapy case studies : the pragmatic case study and the theory-building case study paradigm. The origins, developments and key-concepts of both paradigms are presented, as well as their methodological and ethical specificities. Examples of case studies, along with models developed, are cited. The differential influence of the post-modern schools on both paradigms are presented, as well as their contribution to the field of methods of psychotherapy case studies discussed and assessed in terms of relevance for the researcher and the psychotherapist.


At which stage of sensory recovery can a tingling sign be expected? a review and proposal for standardization and grading.
The phenomenon of paresthesia elicited by percussion of regenerating axons is usually associated with Tinel and Hoffmann, who both described it separately in 1915, although the same phenomenon had been described previously, in 1909, by Trotter and Davies. This sign is used widely, but its standardization is almost completely lacking, its grading is seldom used, and its reliability or validity is scarcely mentioned in the literature. The authors present a method of standardization and grading of the tingling response by means of a vibrostimulator, which permits precise localization of the trigger point and uniform stimulation. The tingling response may then be classified according to its location and to the magnitude threshold at which the response is triggered. In the distal part of the nerve, after neurotmesis repair, the tingling sign is graded T++ (tingling after a weak stimulus) and T+ (tingling only after a strong stimulus). At the site of the injury, the initial tingling sign is graded T0. The sign is graded T00 if, independent of recovery, a slight positivity persists at the initial site of injury. Grading of sensory recovery is poorly standardized, since different authors use different variations and modifications of existing classifications. The authors of this paper present a cross-matching of these classifications and propose to use Dellon's modification of Zachary's classification in eight stages, from S0 to S4. A discussion of the probability of eliciting a tingling sign during axonal regeneration concludes that the clinician can expect to trigger a T+ + sign when sensory recovery evolves from stage S0 to stage S1 and should no longer expect to trigger one when sensory recovery improves from stage S2+ to stage S3.


Examining an Integrative Cognitive Model of Predicting Health App Use: Longitudinal Observational Study.
Specifying the determinants of using health apps has been an important research topic for health scholars as health apps have proliferated during the past decade. Socioeconomic status (SES) has been revealed as a significant determinant of using health apps, but the cognitive mechanisms underlying the relationship between SES and health app use are unknown. This study aims to examine the cognitive mechanisms underlying the relationships between SES and use of health apps, applying the integrative model of behavioral prediction (IM). The model hypothesizes the indirect influences of SES on intentions to use health apps, which in turn predict actual use of health apps. The relationships between SES and intentions to use health apps were assumed to be mediated by proximal variables (attitudes, perceived behavioral control [PBC], injunctive norms, and descriptive norms). We conducted path analyses using data from a two-wave opt-in panel survey of Korean adults who knew about health apps. The number of respondents was 605 at baseline and 440 at follow-up. We compared our model with two alternative theoretical models based on modified IM to further clarify the roles of determinants of health app use. Attitudes (β=.220, P<.001), PBC (β=.461, P<.001), and injunctive norms (β=.186, P<.001) were positively associated with intentions to use health apps, which, in turn, were positively related to actual use of health apps (β=.106, P=.03). Income was positively associated with intentions to use health apps, and this relationship was mediated by attitudes (B=0.012, 95% CI 0.001-0.023) and PBC (B=0.026, 95% CI 0.004-0.048). Education was positively associated with descriptive norms (β=.078, P=.03), but descriptive norms were not significantly related to intentions to use health apps. We also found that PBC interacted with attitudes (B=0.043, SE 0.022, P=.046) and jointly influenced intentions to use health apps, whereas the results did not support direct influences of education, income, and PBC on health app use. We found that PBC over using health apps may be the most important factor in predicting health app use. This suggests the necessity of designing and promoting health apps in a user-friendly way. Our findings also imply that socioeconomic inequalities in using health apps may be reduced by increasing positive attitudes toward, and boosting PBC over, health app use among individuals with low income.


[Long-term results after recanalization of acute and subacute thrombotic occlusions of the infra-aortic arteries and bypass-grafts using a rotational thrombectomy device].
Evaluation of the acute and long-term results after recanalization of thrombotic occlusions of infra-aortic native arteries, stented arteries and bypass-grafts using a rotational thrombectomy device (8F Straub-Rotarex TM). From July 2000 to February 2002, in 98 patients (64 % male, mean age 66 +/- 9 (range 47 to 90) years, mean duration of occlusion 31 +/- 33 (range 0 to 140) days, mean occlusion length 21 +/- 11 [range 2 to 40] cm) 100 vessel recanalizations were performed. 42 % of the interventions were performed during the first 14 days after the onset of the symptoms (acute occlusions). These patients were classified according to the after the TASC protocol modified SVS/ISCVS-classification: Class I: n = 22 (52 %); class lla: n = 13 (32 %); class llb: n = 6 (14 %); class III: n = 1 (2 %). Subacute and chronic occlusions were classified according to Rutherford (58 %): Stage 1: n = 5 (9 %); stage 2 and 3: n = 39 (68 %); stage 4: n = 6 (10 %); stage 5: n = 8 (13 %). Primary success rate was 96 % (ipsilateral interventions 99 %, cross-over 40 %). The restenosis rate after a mean follow-up of 13 +/- 4 months was 33 % for native arteries (group 1), 74 % for instent-recanalizations (group 2) and 86 % for bypass-graft occlusions (group 3). 3 % severe complications occurred: two amputations below the knee after unsuccessful recanalizations of a native artery and a bypass-graft, respectively. One death because of multiorgan failure in patient who was already in cardiac shock before the successful intervention. Further 16 complications could be solved periinterventionally. The ancle-brachial index was significantly improved during follow-up (from 0.37 +/- 0.19 to 0.82 +/- 0.22 before discharge, 0.70 +/- 0.21 after 12 months, p < 0.001). The Straub-Rotarex TM device is useful in the treatment of acute and subacute thrombotic occlusions of infra-aortic arterial and bypass-graft occlusions, with promising long-term results in native vessels but unchanged high restenosis of stented arteries and bypass-grafts.


Posaconazole bioavailability of the solid oral tablet is reduced during severe intestinal mucositis.
This study aimed to describe the absolute oral bioavailability of the solid oral formulation of posaconazole and the impact of severe intestinal mucositis in haematology patients. This study also aimed to describe posaconazole protein binding in haematology patients. A pharmacokinetic study was performed of patients receiving induction chemotherapy or a haematopoietic cell transplantation who were randomized to receive 7 days of intravenous posaconazole therapy followed by 9 days of oral therapy, or vice versa. Patients received a posaconazole licensed dose until day 12, after which a reduced once-daily dose of 200 mg was given. At days 7, 12, and 16, blood samples were obtained for pharmacokinetic curves, and trough samples were collected on all other days. Total and unbound posaconazole pharmacokinetics were analyzed by population pharmacokinetic modelling. The presence of severe intestinal mucositis was assessed by plasma citrulline levels and analyzed as a binary covariate using 10 μmol/L as the cut-off. Monte Carlo simulations were performed to simulate posaconazole exposure at a steady state. Twenty-three patients were included for analysis, with 581 total posaconazole concentrations and 91 paired unbound concentrations. Absolute bioavailability in the final model was estimated at 51.4% (percentage relative standard error (%RSE): 56.5) and 67.6% (%RSE: 75.0) in patients with and without severe intestinal mucositis, respectively. Posaconazole unbound fraction was estimated at 2.7% (%RSE: 3.9). Posaconazole bioavailability is reduced in haematological patients with severe intestinal mucositis, requiring an increase in oral posaconazole dose to 400 mg twice daily on day 1, followed by 400 mg once daily or a switch to intravenous therapy.


Graphene-like Carbon from Calcium Hydroxide.
The development of inexpensive and environmentally friendly graphene-like carbon is critical for its integration into industrial products. This work highlights the production of graphene-like carbon structures from calcium hydroxide. The chemical vapor deposition conditions to grow graphitic carbon on a calcium hydroxide catalyst are reported. Acetylene, steam, and calcium hydroxide are used to grow a crumpled carbon morphology. The crumpled carbon resulted in a high surface area of 1276 m2/g and high electrical conductivity (>105 S/m). Additionally, the significance and origin of the C 1s X-ray photoelectron spectroscopy (XPS) π-π* plasmon loss peak as it is related to high electrical conductivity is reported. A unique mechanism for the catalytic process involving calcium acetylide is proposed. Several deposition times, steam concentration, and catalyst morphology were tested to synthesize a variety of carbon morphologies from calcium-based materials. Crumpled carbon, hollow nanospheres, bamboo-like carbon nanotubes, multi-walled carbon nanotubes, and graphene fiber morphologies were all formed using calcium-based catalysts. Multiple reaction conditions, a scaled reaction (300 g), and catalyst recyclability were investigated. Calcium-based materials were then used as catalysts for the growth of other graphene-like carbons.


Eradication of infectious bovine rhinotracheitis in Switzerland: review and prospects.
Ten years after the first outbreak of infectious bovine rhinotracheitis (IBR) in Swiss dairy cows, the national cattle herd is almost free from infection with IBR virus (bovine herpesvirus 1, BHV 1). The national programme for the eradication of IBR was divided into four phases: (1) Prevention of transmission of the infection by restrictions on trade of bovines and assessment of the prevalence of cattle with antibodies to BHV 1. (2) Slaughtering animals with antibodies to BHV 1 in order to eradicate BHV 1 from breeding herds. (3) Detection and eradication of further BHV 1 reservoirs (e.g. fattening cattle). (4) Monitoring programme and legal actions in order to maintain the favourable situation. Approximately 50,000 animals were slaughtered in the course of the eradication of IBR. The total costs amounted to approximately SFr. 110,000,000 over 10 years. The costs for maintaining the situation are estimated at approximately SFr. 5,000,000 per annum.


[Ureteral endometriosis in estrogen-treated postmenopausal woman].
A 56-year-old woman was admitted to our hospital due to gross hematuria. Cystoscopy and contrast-enhanced abdominal CT scan revealed a solid tumor at the right terminal ureter. She underwent transurethral resection of the right ureteral tumor. The ureteral tumor included proliferative endometrial stroma and glands under urothelial cells, and the histopathological diagnosis was ectopic endometriosis. Before the surgery, the patient had underwent hormone replacement therapy using estrogen patches to treat menopausal disorders, however, the dose of estrogen was five times higher than regular dose. Therefore, in this case, the serum level of estrogen was elevated over the normal value. Ectopic endometriosis is rare in urinary tract especially ureter. Furthermore, endometriosis is an uncommon disease in women during postmenopausal period. Our case suggests that an excessive hormone replacement therapy might cause endometriosis in postmenopausal women.


Genome organization of human 48-kDa oligosaccharyltransferase (DDOST).
The enzyme oligosaccharyltransferase (dolichyl-diphosphooligosaccharide-protein glycosyltransferase; EC 2. 4.1.119) (DDOST) catalyzes the transfer of a high-mannose oligosaccharide (GlcNac2Man9Glc3) from a dolichol-linked oligosaccharide donor (dolichol-P-GlcNac2Man9Glc3) onto the asparagine acceptor site within an Asn-X-Ser/Thr consensus motif in nascent polypeptide chains across the membrane of the endoplasmic reticulum. We isolated mouse and human DDOST cDNAs from retinoic acid-treated mouse P19 EC cells and human NT-2 cells, respectively. DDOST mRNA is expressed intensely in heart and pancreas, but at lower levels in brain. Here we show that the human DDOST 48-kDa subunit gene (HGMW-approved symbol DDOST) is organized into 11 exons expanding about 9 kb. This DDOST subunit gene is localized on chromosome 1p36.1 by fluorescence in situ hybridization analysis.


Simvastatin pre-treatment improves survival and mitochondrial function in a 3-day fluid-resuscitated rat model of sepsis.
Statins may offer protective effects in sepsis through anti-inflammatory, mitochondrial protection and other actions. We thus evaluated the effects of simvastatin on survival, organ and mitochondrial function, tissue and plasma ubiquinone levels and liver transcriptomics in a 3-day rat model of sepsis. Comparisons of rat plasma simvastatin and ubiquinone levels were made against levels sampled in blood from patients with acute lung injury (ALI) enrolled into a trial of statin therapy. Animals received simvastatin by gavage either pre- or post-induction of faecal peritonitis. Control septic animals received vehicle alone. Seventy-two-hour survival was significantly greater in statin pre-treated animals (43.7%) compared with their statin post-treated (12.5%) and control septic (25%) counterparts (P<0.05). Sepsis-induced biochemical derangements in liver and kidney improved with statin therapy, particularly when given pre-insult. Both simvastatin pre- and post-treatment prevented the fall in mitochondrial oxygen consumption in muscle fibres taken from septic animals at 24 h. This beneficial effect was paralleled by recovery of genes related to fatty acid metabolism. Simvastatin pre-treatment resulted in a significant decrease in myocardial ubiquinone. Patients with ALI had a marked variation in plasma simvastatin acid levels; however, their ubiquinone/low-density lipoprotein (LDL) cholesterol ratio did not differ regardless of whether they were receiving statin or placebo. In summary, despite protective effects seen with statin treatment given both pre- and post-insult, survival benefit was only seen with pre-treatment, reflecting experiences in patient studies.


Hydrogen peroxide affects ion channels in lily pollen grain protoplasts.
Ion homeostasis plays a central role in polarisation and polar growth. In several cell types ion channels are controlled by reactive oxygen species (ROS). One of the most important cells in the plant life cycle is the male gametophyte, which grows under the tight control of both ion fluxes and ROS balance. The precise relationship between these two factors in pollen tubes has not been completely elucidated, and in pollen grains it has never been studied to date. In the present study we used a simple model - protoplasts obtained from lily pollen grains at the early germination stage - to reveal the effect of H2 O2 on cation fluxes crucial for pollen germination. Here we present direct evidence for two ROS-sensitive currents on the pollen grain plasma membrane: the hyperpolarisation-activated calcium current, which is strongly enhanced by H2 O2 , and the outward potassium current, which is modestly enhanced by H2 O2 . We used low concentrations of H2 O2 that do not cause an intracellular oxidative burst and do not damage cells, as demonstrated with fluorescent staining.


Endoscopic CO2 laser surgery for supraglottic cancer--ten years of experience.
We present our experience with primary CO2 laser surgery for planocellular supraglottic carcinoma. During a ten-year period, we performed 64 curative supraglottic laryngectomies. Twenty-nine patients presented with T1 and 35 with T2 carcinoma. There were 46 patients without regional and/or distant metastases (N0 neck), and 18 patients with N+ neck. Thirty-three (52%) patients were treated with surgery alone, and in 31 (48%) patients surgical procedure was combined with radiotherapy. Estimated overall 5-year survival for all patients was 89%. Local and regional tumor control as well as survival rate were comparable with the results of other therapeutic options, i.e. radiotherapy or open supraglottic laryngectomy. Functional results outline the advantages of endoscopic laser surgery for laryngeal carcinoma. Transoral endoscopic CO2 laser surgery is efficacious treatment for T1 and T2 supraglottic carcinoma, and can be combined with neck dissection and postoperative irradiation.


PCR-based diagnosis of Helicobacter pylori infection and real-time determination of clarithromycin resistance directly from human gastric biopsy samples.
A novel PCR detection assay that amplifies the Helicobacter pylori-specific vacuolating cytotoxin gene (vacA) and thus enables rapid diagnosis of infection is described. Additionally, a real-time probe hybridization melting point analysis assay to detect all three mutations in the 23S rRNA gene associated with clarithromycin resistance was applied directly to antral gastric biopsy samples. Comparison with culture and an alternative PCR assay targeting the 16S rrn gene showed that the vacA assay was sensitive and specific when tested on biopsy samples from 121 patients. Clarithromycin susceptibilities could be determined in the majority (92.3%) of culture-positive gastric biopsy samples analyzed, four of which generated melting peaks indicative of clarithromycin resistance by either an A-->G or A-->C mutation. The presence of the mutations correlated with the clarithromycin disk diffusion sensitivities of matched cultures. This PCR-based system was simple to perform and could be completed in 3 to 4 h, thereby overcoming the delays associated with conventional culture methods for H. pylori identification and susceptibility testing.


Environmental microbial challenges to an aseptic Blow-Fill-Seal process--a practical study.
A Blow-Fill-Seal machine, set to aseptically fill sterile liquid TSB medium into 20 ml plastic containers, was subjected to a series of environmental microbial challenges in order to evaluate the effects of the room environment, and of the actions of persons in the room, on the sterility of the product. Despite a series of relatively severe stresses to the system, none of the units filled (approximately 44,000) were found, following incubation, to display growth.


Lymphoma of mucosa-associated lymphoid tissue in common variable immunodeficiency.
Common variable immunodeficiency (CVID) is the most common symptomatic primary immunodeficiency characterized by reduced levels of all major immunoglobuline classes and recurrent c infections. The risk of non-Hodgkin's lymphoma (NHL) among patients with CVID was found to be increased in different studies. Mucosa-associated lymphoid tissue (MALT) lymphomas are a recently recognized sub-set of low-grade B-cell NHL composed of marginal zone-related cells. MALT lymphomas appear in the lymphoid tissues as a result of chronic inflammatory or autoimmune stimulation. This study briefly reviews previously published cases and reports a patient suffering from CVID with a history of chronic diarrhea and recurrent sinopulmonary infections. Despite treatment with intravenous immunoglobulin, chronic cough and wheezing progressed. Open lung biopsy showed a MALT lymphoma. Although a rare complication, pulmonary low grade B-cell lymphoma is a diagnosis that must be kept in mind in CVID patients with chronic pulmonary symptoms unresponsive to conventional therapies.


Activation of FAK and Src are receptor-proximal events required for netrin signaling.
The axon guidance cue netrin is importantly involved in neuronal development. DCC (deleted in colorectal cancer) is a functional receptor for netrin and mediates axon outgrowth and the steering response. Here we show that different regions of the intracellular domain of DCC directly interacted with the tyrosine kinases Src and focal adhesion kinase (FAK). Netrin activated both FAK and Src and stimulated tyrosine phosphorylation of DCC. Inhibition of Src family kinases reduced DCC tyrosine phosphorylation and blocked both axon attraction and outgrowth of neurons in response to netrin. Mutation of the tyrosine phosphorylation residue in DCC abolished its function of mediating netrin-induced axon attraction. On the basis of our observations, we suggest a model in which DCC functions as a kinase-coupled receptor, and FAK and Src act immediately downstream of DCC in netrin signaling.


[Pancreatic surgery in a regional hospital].
Recently it was shown that in several surgical procedures the case load of an institution correlated in direct proportion with the outcome. Therefore, the German authorities with effect from January 1, 2008 have defined the minimum case load per year of an institution for selected surgical procedures in order to increase the medical quality and improve the outcome. Until now, however, there is no experience in establishing a medical centre for pancreatic surgery according to these regulations. The aim of this study was, therefore, to describe the possibilities and the prerequisites necessary to establish a new pancreatic centre according to the requirements of the German official regulations. In a prospective clinical study, the data of 269 patients who underwent a resective surgical procedure for pancreatic diseases between May 1998 and August 2007 were analysed. All included patients underwent a defined surgical procedure for malignant and benign lesions of the pancreatic gland. Indication for operation, operative procedure, postoperative morbidity and mortality were analysed in this study. After the year 2000, the annual case load of pancreatic resections per year amounted to over 30 patients. In most cases (n = 127) the indication for operation was a malignant disease of the pancreatic head, in 94 cases the patients were operated for chronic pancreatitis with a benign tumour of the pancreatic head. In most cases (n = 106) a pylorus-preserving partial duodenopancreatectomy was performed followed by the duodeno-preserving pancreatic head resection (Beger procedure, n = 55). The overall complication rate amounted to 30.2 %, overall mortality 0.7 %. Two patients died on the 37 (th) and 44 (th) day postoperatively. The establishment of a medical centre for pancreatic surgery is possible according to the regulations of the German authorities. Nevertheless, there are multiple factors influencing medical quality apart from the case load of a hospital. These are a well-functioning intensive care unit and the possibility for radiological and/or gastroenterological interventions 24 hours a day. Most important is the personal motivation of the doctors and nurses in successfully supporting such a programme. So far the prospective implication on health care or medical education cannot be finally anticipated. The different independent factors of medical quality concerning pancreatic surgery have still to be identified and should reasonably influence any governmental or institutional regulations.


Towards Long-Term Stable Polyimide-Based Flexible Electrical Insulation for Chronically Implanted Neural Electrodes.
For chronic applications of flexible neural implants, e.g., intracortical probes, the flexible substrate material has to encapsulate the electrical conductors with a long-term stability against the saline environment of the neural tissue. The biocompatible polymer polyimide is often used for this purpose. Due to its chemical inertness, the adhesion between two polyimide layers is, however, a challenge, which can lead to delamination and, finally, to short circuits. The state-of-the-art method to improve the adhesion strength is activating the polyimide surface using oxygen reactive ion etching (O2 RIE). However, the influence of the process variations (etching time, bias power) on the long-term stability is still unclear. Therefore, we establish a test method, where the aging of a gold interdigital structure embedded in two polyimide layers and immersed in saline solution is accelerated using an elevated temperature, mechanical stress and an electrical field. A continuous measurement of a leakage current is used to define the failure state. The results show that the variation of the O2 RIE plasma process has a significant effect on the long-term stability of the test samples. Comparing the two different plasma treatments 0.5 min at 25 W and 1 min at 50 W, the long-term stability could be increased from 20.9 ± 19.1 days to 44.9 ± 18.9 days. This corresponds to more than a doubled lifetime. An ideal solution for the delamination problem is still not available; however, the study shows that the fine-tuning of the fabrication processes can improve the long-term stability of chronically implanted neural electrodes.


Epigenetic control of gene function in schistosomes: a source of therapeutic targets?
The discovery of the epigenetic regulation of gene expression has revolutionized both our understanding of how genomes function and approaches to the therapy of numerous pathologies. Schistosomes are metazoan parasites and as such utilize most, if not all the epigenetic mechanisms in play in their vertebrate hosts: histone variants, histone tail modifications, non-coding RNA and, perhaps, DNA methylation. Moreover, we are acquiring an increasing understanding of the ways in which these mechanisms come into play during the complex schistosome developmental program. In turn, interest in the actors involved in epigenetic mechanisms, particularly the enzymes that carry out epigenetic modifications of histones or nucleic acid, as therapeutic targets has been stimulated by the finding that their inhibitors exert profound effects, not only on survival, but also on the reproductive function of Schistosoma mansoni. Here, we review our current knowledge, and what we can infer, about the role of epigenetic mechanisms in schistosome development, differentiation and survival. We will consider which epigenetic actors can be targeted for drug discovery and what strategies can be employed to develop potent, selective inhibitors as drugs to cure schistosomiasis.


Platelet-rich fibrin is a Bioscaffold and reservoir of growth factors for tissue regeneration.
The platelet-rich fibrin (PRF) is known as a rich source of autologous cytokines and growth factors and universally used for tissue regeneration in current clinical medicine. However, the microstructure of PRF has not been fully investigated nor have been studied the key molecules that differ PRF from platelet-rich plasma. We fabricated PRF under Choukroun's protocol and produced its extract (PRFe) by freezing at -80°C. The conventional histological, immunohistological staining, and scanning electron microscopy images showed the microstructure of PRF, appearing as two zones, the zone of platelets and the zone of fibrin, which resembled a mesh containing blood cells. The PRFe increased proliferation, migration, and promoted differentiation of the human alveolar bone marrow stem cells (hABMSCs) at 0.5% concentration in vitro. From the results of proteome array, matrix metalloproteinase 9 (MMP9) and Serpin E1 were detected especially in PRFe but not in concentrated platelet-rich plasma. Simultaneous elevation of MMP9, CD44, and transforming growth factor β-1 receptor was shown at 0.5% PRFe treatment to the hABMSC in immunoblot. Mineralization assay showed that MMP9 directly regulated mineralization differentiation of hABMSC. Transplantation of the fresh PRF into the mouse calvarias enhanced regeneration of the critical-sized defect. Our results strongly support the new characteristics of PRF as a bioscaffold and reservoir of growth factors for tissue regeneration.


Multiple roles of carbonic anhydrase in cellular transport and metabolism.
Carbonic anhydrase (CA) is a central enzyme to both transport and metabolic processes at the cellular level. In metabolically active tissue such as muscle, CA in the cytoplasm and on the sarcolemma appears to be important in facilitating CO2 transport out of the cell. Membrane-associated CA, with an extracellular orientation, also appears to be important in acidifying the outer boundary layer through the catalyzed hydration of excreted CO2. This facilitates cellular ammonia transport by providing H+ ions for the protonation of NH3, thus maintaining the trans-membrane NH3 gradient. Mitochondrial CA is known to supply HCO3- for the initial reactions of gluconeogenesis and ureagenesis in mammalian tissues, but systematic comparative studies of CA as a metabolic enzyme are lacking. CA probably evolved as an enzyme of trans-membrane facilitated CO2 transport and took on a secondary metabolic role later in metazoan evolution.


Technical determinants of success in professional women's soccer: A wider range of variables reveals new insights.
Knowledge of optimal technical performance is used to determine match strategy and the design of training programs. Previous studies in men's soccer have identified certain technical characteristics that are related to success. These studies however, have relative limited sample sizes or limited ranges of performance indicators, which may have limited the analytical approaches that were used. Research in women's soccer and our understanding of optimal technical performance, is even more limited (n = 3). Therefore, the aim of this study was to identify technical determinants of match outcome in the women's game and to compare analytical approaches using a large sample size (n = 1390 team performances) and range of variables (n = 450). Three different analytical approaches (i.e. combinations of technical performance variables) were used, a data-driven approach, a rational approach and an approach based on the literature in men's soccer. Match outcome was modelled using variables from each analytical approach, using generalised linear modelling and decision trees. It was found that the rational and data-driven approaches outperformed the literature-driven approach in predicting match outcome. The strongest determinants of match outcome were; scoring first, intentional assists relative to the opponent, the percentage of shots on goal saved by the goalkeeper relative to the opponent, shots on goal relative to the opponent and the percentage of duels that are successful. Moreover the rational and data-driven approach achieved higher prediction accuracies than comparable studies about men's soccer.


Temperature-Dependent Fractional Dynamics in Pseudo-Capacitors with Carbon Nanotube Array/Polyaniline Electrodes.
Pseudo-capacitors with electrodes based on polyaniline and vertically aligned multiwalled carbon nanotubes (PANI/VA-MWCNT) composite are studied. Fractional differential models of supercapacitors are briefly discussed. The appropriate fractional circuit model for PANI/MWCNT pseudo-capacitors is found to be a linearized version of the recently proposed phase-field diffusion model based on the fractional Cahn-Hilliard equation. The temperature dependencies of the model parameters are determined by means of impedance spectroscopy. The fractional-order α is weakly sensitive to temperature, and the fractional dynamic behavior is related to the pore morphology rather than to thermally activated ion-hopping in PANI/MWCNT composite.


Ligation of the ovarian pedicles in dogs with a resorbable self-locking device--a long-term follow-up study.
A prospective clinical trial was performed to evaluate applicability, hemostatic efficiency, and long-term tissue reactions of a novel medical device. The device was made of polydioxanone and designed in principle as a cable-tie with a flexible band running through a locking case. It was tested for ligation of the ovarian pedicles during ovariohysterectomy in nine intact female dogs. The dogs were followed-up monthly by physical examination and ultrasonography of the abdomen for 5-12 months after surgery. Macroscopic and histological post mortem examinations were performed in two dogs 7 and 18 months after surgery. Hemostasis was achieved with the devices although 1 of the 18 devices needed further tightening during a reoperation. Ultrasonography revealed a hyperechoic device that caused acoustic shadowing, which decreased over time indicating gradual resorption. Post mortem examinations demonstrated adhesions and a local transient tissue reaction at site of the device. The results show that the device may be a future alternative for ligation of ovarian pedicles in dogs.


The effects of smoking on labour after uncomplicated pregnancy: a comparison between the progress and outcome of labour in 400 smokers and 400 matched non-smokers.
A comparison was made between the progress of labour and its outcome after an uncomplicated pregnancy, in 400 smokers and 400 non-smokers. Strict selection criteria were applied to eliminate, as far as possible, the variables which might have influenced labour in both groups and to ensure that the two groups of women were matched. The duration of labour was longer in smokers, who also had a higher incidence of caesarean sections. Smokers had a higher incidence of retained placenta and postpartum haemorrhage. The neonates of smokers had a higher incidence of problems in the immediate post-delivery period.


Age group and health status effects on health behavior change.
The authors explored health behavior change during 5 years, considering age/cohort, health status, and gender effects. The authors divided the sample (n = 1,064) into 4 age/cohort groups: young adults (n = 139; 19-42 years), middle-aged adults (n = 386; 43-62 years), young-old adults (n = 296; 63-72 years), and old-old adults (n = 243; 73+ years) and health status: cardiovascular disease and physical disability. Smoking and seat belt behaviors remained stable, whereas alcohol, food consumption, food preparation, physical activity, dental, and medical behaviors showed change. Change in health behaviors differed by age/cohort group and health status for food consumption, food preparation, and medical care, primarily showing negative change for old-old adults and positive change for individuals with cardiovascular disease. Health behavior interventions need to focus on the old-old, individuals with physical disability, and on smoking and seat belt use. These specific populations and behaviors need to be targeted to promote positive health behavior change, to limit future onsets of disability and morbidity, and to prevent the occurrence of premature death.


RNA-electroporated T cells for cancer immunotherapy.
Adoptive T cell therapy has proven effective against hematologic malignancies and demonstrated efficacy against a variety of solid tumors in preclinical studies and clinical trials. Nonetheless, antitumor responses against solid tumors remain modest, highlighting the need to enhance the effectiveness of this therapy. Genetic modification of T cells with RNA has been explored to enhance T-cell antigen specificity, effector function, and migration to tumor sites, thereby potentiating antitumor immunity. This review describes the rationale for RNA-electroporated T cell modifications and provides an overview of their applications in preclinical and clinical investigations for the treatment of hematologic malignancies and solid tumors.


Apolipoprotein E epsilon 4 allele is a risk factor for familial and sporadic presenile Alzheimer's disease in both homozygote and heterozygote carriers.
While apoliprotein E (ApoE) epsilon 4 allele is now a well established risk factor for familial and sporadic senile Alzheimer's disease (AD), its role in the development of the rarer presenile or early onset type is controversial. Early studies showed no association; later ones found enrichment for the epsilon 4 allele in familial or sporadic types or both. We have ApoE genotyped a series of Scottish people (n = 85) with early onset AD. We find highly significant enrichment for both homozygote and heterozygote ApoE epsilon 4 allele carriers in familial and sporadic early onset AD with a pattern closely resembling that in late onset AD.


Sleep problems in autism spectrum disorders: prevalence, nature, & possible biopsychosocial aetiologies.
As considerably more people are diagnosed with an autism spectrum disorder (ASD), interest in the associated behaviours, including sleep problems has increased. This has resulted in a subsequent increase in the research related to the sleep problems occurring in people with an ASD. This article summarizes and evaluates the current literature related to a) the higher prevalence of a sleep problem compared to typically developing children, b) the specific types of sleep problems for people with an ASD, and c) the possible aetiology of sleep problems in the ASDs within a biopsychosocial framework. It is concluded that recent studies confirm that the majority of this population are likely to experience sleep difficulties, with settling issues in children with an ASD the most commonly reported. However, exploration of the types of sleep difficulties and associated aetiological factors in the ASDs is still in its infancy.


Systemic amyloidosis associated with hepatocellular carcinoma. Case report and literature review.
We describe the case of a male patient with biopsy-proven non-resectable liver adenoma at age 32 who presented 17 years later with hepatocellular carcinoma and nephrotic syndrome. Autopsy demonstrated systemic amyloidosis A. Review of the medical literature disclosed only three previous published cases of liver tumors associated with systemic amyloidosis. The association of non-hematologic neoplasias with systemic amyloidosis is rare and our literature review revealed only three cases of systemic amyloidosis in patients with liver tumors. We present here the case of a patient with apparent transition of liver adenoma to hepatocellular carcinoma with associated systemic amyloidosis.


[Epidemiological analysis on inpatients with epidemic encephalitis B at No. 1 Hospital of Lian Yungang from 1988-1996].
To study the morbidity and mortality of inpatients with epidemic encephalitis B (EEB) admitted to No. 1 hospital of Lian Yungang city from 1988-1996, 107 inpatients with EEB in the pediatrics department the hospital were analyzed epidemiologically. Results showed that 107 children with EEB had a proportion of 0.65% to all children admitted in the pediatrics department during that 9 years including 98 cases from the countryside and 9 cases from cities. The ratio was 10.8/1.0 when comparing countryside to city. 87 inpatients (81.3%) of EEB children were below 4 year of age consisting. Most patients were infected in late July or early August in 1990 and 1992 with number of 55 out of 107 (51.4%) that consisted 1.56% and 1.53% of the inpatients in pediatrics those years. It was concluded that EEB had a strict seasonal feature. By comparing data from the first 4 years with the latter 5 years, we noticed that the incidence of the latter had a considerable decrease with more milder cases. The morbidity and mortality of the whole city also appeared a decreasing tendency.


A national Israeli survey of neuraxial anesthesia for cesarean delivery: pre-operative block assessment and intra-operative pain management.
Neuraxial protocols for cesarean delivery differ among institutions, with various means of assessing the block prior to incision and managing breakthrough intra-operative pain. The different approaches used to deal with these issues in Israel have not been assessed. Questionnaires were distributed to all anesthesiologists working in obstetric units in Israeli hospitals. The survey included several non-identifying respondent details intended to allow a description of the study population as a whole and multiple-choice questions addressing neuraxial techniques, method of pre-operative block assessment and medications used to treat intra-operative pain. Three hundred and sixty-one doctors completed the survey in 24 medical centers, an 81.1% response rate. Thirteen different protocols for spinal anesthesia and 20 different protocols for epidural anesthesia were described. Nine different protocols for assessment of the block prior to incision were identified, with significant inter-institutional differences (P <0.001). For treatment of intra-operative pain prior to delivery, 35.7% of spinals given and 40% of epidurals given were converted to general anesthesia whereas, after delivery, conversion of spinal to general anesthesia was 18% and epidural to general anesthesia was 18.6%. There were a variety of spinal and epidural regimens used as well as different methods for assessing the block and managing intra-operative pain. Further studies should be performed to identify optimal techniques for neuraxial anesthesia for pre-operative block assessment and for management of intra-operative pain.


[Trophoblastic interferons and embryonal immune tolerance].
Current evidence support the hypothesis that trophoblast interferons play a key role in preventing maternal immunologal rejection of the embryonic semi-allograft. The information of this review is divided in two sections. In the first section we described molecular and biological characteristics of type I (alpha, beta, omega, tau and spl) and type II (gamma) interferons. In the second section we emphasize studies on immunoendocrine functions of IFN-tau (oTP-1 or trophoblastins) in the network of cytokines and hormonal environment at the uterine embryonic interface.


Current use of clozapine in Parkinson disease and related disorders.
Clozapine has been shown to be effective in the treatment of Parkinson disease psychosis and tremor; however, use of clozapine has been limited because of potential adverse effects and stringent monitoring criteria. To evaluate safety and efficacy in a naturalistic setting, we conducted a retrospective chart review of all patients ever treated with clozapine at a movement disorders clinic in Rhode Island. Clozapine was indicated for psychosis in 39 patients, for tremor in 19, and for both tremor and psychosis in an additional 6 patients. Fifty of 61 patients reported improvement in their symptoms. Clozapine use was interrupted in 26 patients, for various reasons including transition to hospice care (3), worsening of motor symptoms (4), agranulocytosis (1), intolerable adverse effects (9), symptom resolution (2), and other or unknown reasons (7). Clozapine may be useful in the management of movement disorders and related symptoms so long as adequate supervision and monitoring can be provided.


Migraine, triptans, and the risk of developing rosacea: a population-based study within the United Kingdom.
Rosacea is a common skin disease, involving neurogenic inflammation and neurovascular dysregulation. Migraine has been associated with vascular changes and sterile inflammation. The 2 diseases have been associated over decades, but evidence is scarce. Triptans have vasoconstricting and antiinflammatory properties, but a potential impact of this drug class on rosacea remains uninvestigated. We sought to analyze the association between migraine or triptan exposure and the risk of developing rosacea within the United Kingdom. We conducted a case-control study using the United Kingdom-based General Practice Research Database. We identified patients with incident rosacea between 1995 and 2009 (cases), and matched 1 rosacea-free control subject to each case. We compared the prevalence of diagnosed migraine and exposure to triptans before the first-time rosacea diagnosis between cases and controls using multivariate conditional logistic regression. Among 53,927 cases and 53,927 controls, we observed a small overall association between rosacea and migraine in women (adjusted odds ratio 1.22, 95% confidence interval 1.16-1.29), but not in men. This effect was somewhat more distinct in female migraineurs aged 50 to 59 years (odds ratio 1.36, 95% confidence interval 1.21-1.53). Female triptan users also revealed slightly increasing risk estimates with increasing age, with the highest odds ratio of 1.66 (95% confidence interval 1.30-2.10) in women aged 60 years or older. This is a retrospective case-control study, for which a certain degree of bias and confounding cannot be ruled out. We observed a slightly increased risk for female migraineurs to develop rosacea, particularly in women with severe migraine aged 50 years or older.


[Enterohemorrhagic Escherichia coli and hemolytic-uremic syndrome].
Enterohemorrhagic Escherichia coli (EHEC) are increasingly identified as the cause of diarrhea and hemorrhagic colitis in countries with highly developed livestock. In 5-10% of patients, full-blown hemolytic uremic syndrome (HUS) occurs as a postinfectious life-threatening complication. Up to 1996, 5 out of 39 patients (12.8%) with EHEC O157 infections in Austria developed HUS. Acute complications of HUS such as brain edema may also lead to death; one fatal outcome has been observed so far in Austrian patients. Aside from the cytotoxic Shiga toxins, other different pathogenic factors are often found in clinical EHEC isolates. These include a cytolysin termed EHEC-hemolysin and a low molecular heat-stabile enterotoxin. Furthermore, most EHEC strains express an important surface protein, intimin, which is important for adherence to intestinal epithelial cells. EHEC are heterogeneous in their antigenic structure (O-, H-antigens). In Austria O157:H7 and O157:H- are the dominating serogroups; in 1997 the first Austrian case of HUS due to EHEC O26:H11 was documented. Because there are no known reliable phenotypical markers for EHEC, diagnostic strategies should focus on the demonstration of Shiga toxins or Shiga toxin genes. For epidemiological purposes it is also important to attempt to isolate the causative agent. Cows and other ruminants are reservoirs for EHEC. In the Tyrol 3% of unpasteurised milk samples, up to 10% of minced beef samples, and 6% of calves yield EHEC O157. Aside from transmission via contaminated food, direct transmission from person to person also plays a major role in the chain of EHEC infection. In contrast to Italy and Bavaria, Austria has not experienced a major outbreak due to this organism so far. A nationwide surveillance system of HUS has shown an incidence of 0.37 HUS cases per 100,000 residents in the age group 0-14 years for 1995 (Italy: 0.2 cases per 100,000; Bavaria: approx. 1.5 cases per 100,000).


[Nuss procedure for multiple floating rib and sternum fractures].
One of the most severe forms of blunt chest trauma is multiple floating rib fractures. Incidence of this event is up to 20% of all chest injuries. Mortality rate is about 40%. Modern surgical approach involves new technologies for rib osteosynthesis and chest stabilization. These procedures can reduce mortality by 8-10%. One of the possible options for chest stabilization in victims with anterior floating fractures, including sternal fractures, is insertion of a chest plate according to the principle of Nuss procedure. The last technique is used for correction of pectus excavatum. We report our first experience of Nuss procedure in a patient with multiple trauma, floating rib fractures and sternal fracture. Surgical intervention is described in detail. The authors emphasize an important role of thoracoscopy in a patient with chest trauma. Several modern trends in surgery for chest trauma are discussed: active surgical approach for multiple floating rib fractures, combination of surgical and resuscitation methods for chest stabilization, minimized surgical trauma by using of high-tech and endoscopic surgery.


Outcomes and Long-term Follow-up of Patients with Cystine Stones: a Systematic Review.
Cystine stone patients can be difficult to manage with frequent recurrences. We performed a systematic review with a view to assessing interventions, compliance and their long-term outcomes. Ten retrospective observational studies (253 patients) assessed the outcomes and long-term follow-up of cystine stone patients. The mean length of follow-up was 9.6 years (range 3.5-21.8 years). The overall mean number of surgical procedures/patient was 5.7 (range 2-9.8/patient) with the overall mean number of surgical procedures/patient/year at 0.59 (range 0.22-1.32/patient/year). While open surgery has decreased over the last decade and PCNL has been stable, there seems to be a rise of RIRS during this period. Patients with cystine stones need periodic interventions for stone recurrences despite medical management, with limited data showing the impact on renal function. While the management is individualised, wide variability exists with often poor and incomplete patient data.


Efficacy of intravenous neridronate in transient osteoporosis of the hip.
To evaluate the efficacy and safety of intravenous (iv) neridronate in patients affected by transient osteoporosis of the hip (TOH). We retrospectively evaluated the clinical records of patients affected by TOH treated with iv neridronate in our department. We treated patients with a value of visual analogue scale (VAS)-pain ≥ 80/100 mm at diagnosis, limited range of movement and magnetic resonance images (MRI) findings suggestive of TOH. The regimen used was: one iv infusion at day 0, 3, 6, 9 (100 mg for each infusion: total of 400 mg). This protocol was repeated in refractory cases. Recovery was defined as VAS-pain level ≤20/100. Concomitant use of analgesics was allowed. Paired Student t-test was used to assess VAS-pain change. Five patients were male, 3 were female. Mean age was 54.5±2.12 years old. Mean body mass index was 26.57±2.22. Mean time to diagnosis, since the onset of the symptoms, was 75±21.21 days. Mean number of neridronate infusions was 7.5±2.56. Mean time of recovery was 57±45.96 days. Mean VAS-pain at baseline was 84±2,24. Mean VAS-pain after treatment was significantly reduced (p<0.001) with a value of 12.12±6.46. None of the patients needed analgesics after treatment. No adverse event was reported. In 5 cases, post-treatment MRI showed complete bone marrow oedema resolution. Intravenous neridronate is effective and safe in the treatment of TOH and its use may lead to a faster resolution of the disease.


In Honor of Dr. Abdul Hussein Taba: Iranian Physician and Former Director of the Eastern Mediterranean Region of the World Health Organization.
The honorable Abdul Hussein Tabatabaei was born in 1911 in Iran and received his medical education in the United Kingdom. Famously known as Dr. A.H. Taba, he was a well-respected man for his significant impact on the improvement of the national and global healthcare services and support for social justice. Before joining the World Health Organization (WHO), he was twice elected to the Iranian national assembly and served as the under-secretary of health services in Iran. Later, he joined the WHO and was elected as the Director of the Eastern Mediterranean Region (EMRO) in Alexandria in 1957 - a position he maintained for 25 years. During his tenure as the Regional Director, he rendered valuable assistance to the development and expansion of major health issues such as development and expansion of the health workforce, improvement of the national health services and controlling of various communicable diseases in the member countries and across the WHO regional offices.


Investigation of the film formation of magnesium stearate by applying a flow-through dissolution technique.
The film formation of magnesium stearate on the surface of acetylsalicylic acid was investigated by applying a flow-through dissolution technique. The effect of mixing time, lubricant surface area, and the addition of colloidal silica was studied. The film formation increased by increasing mixing time. The final level reached was independent of the specific surface area of the lubricants, but granular magnesium stearate gave a lower surface coverage than the powdered lubricants. The lubricating effect was independent of the mixing time and specific surface area of the lubricants. Colloidal silica was found to interact primarily with the free fraction of magnesium stearate.


CoronaVR: A Computational Resource and Analysis of Epitopes and Therapeutics for Severe Acute Respiratory Syndrome Coronavirus-2.
In December 2019, the Chinese city of Wuhan was the center of origin of a pneumonia-like disease outbreak with an unknown causative pathogen. The CDC, China, managed to track the source of infection to a novel coronavirus (2019-nCoV; SARS-CoV-2) that shares approximately 79.6% of its genome with SARS-CoV. The World Health Organization (WHO) initially declared COVID-19 as a Public Health Emergency of International Concern (PHEIC) and later characterized it as a global pandemic on March 11, 2020. Due to the novel nature of this virus, there is an urgent need for vaccines and therapeutics to control the spread of SARS-CoV-2 and its associated disease, COVID-19. Global efforts are underway to circumvent its further spread and treat COVID-19 patients through experimental vaccine formulations and therapeutic interventions, respectively. In the absence of any effective therapeutics, we have devised h bioinformatics-based approaches to accelerate global efforts in the fight against SARS-CoV-2 and to assist researchers in the initial phase of vaccine and therapeutics development. In this study, we have performed comprehensive meta-analyses and developed an integrative resource, "CoronaVR" (http://bioinfo.imtech.res.in/manojk/coronavr/). Predominantly, we identified potential epitope-based vaccine candidates, siRNA-based therapeutic regimens, and diagnostic primers. The resource is categorized into the main sections "Genomes," "Epitopes," "Therapeutics," and Primers." The genome section harbors different components, viz, genomes, a genome browser, phylogenetic analysis, codon usage, glycosylation sites, and structural analysis. Under the umbrella of epitopes, sub-divisions, namely cross-protective epitopes, B-cell (linear/discontinuous), T-cell (CD4+/CD8+), CTL, and MHC binders, are presented. The therapeutics section has different sub-sections like siRNA, miRNAs, and sgRNAs. Further, experimentally confirmed and designed diagnostic primers are earmarked in the primers section. Our study provided a set of shortlisted B-cell and T-cell (CD4+ and CD8+) epitopes that can be experimentally tested for their incorporation in vaccine formulations. The list of selected primers can be used in testing kits to identify SARS-CoV-2, while the recommended siRNAs, sgRNAs, and miRNAs can be used in therapeutic regimens. We foresee that this resource will help in advancing the research against coronaviruses.


Enhanced antibacterial, antioxidant and anticancer activity of caffeic acid by simple acid-base complexation with spermine/spermidine.
Caffeic acid (CA) is a naturally occurring plant-derived polyphenol possessing diverse biological properties. However, the poor water-solubility of CA restricts its widespread applications. On the other hand, biogenic amines such as spermine and spermidine are natural constituents in eukaryotes. In this work, we present water-soluble complexes of CA with spermine and spermidine by exploiting the acid-base interaction. Four different compositions have been prepared by varying the CA to amine ratios, whose chemical structures have been probed in detail using Fourier-transform infrared spectroscopy (FT-IR) and nuclear magnetic resonance (NMR) studies that have revealed the acid-base interaction between the constituent precursors. The obtained acid-base complexes at their native pH values have shown enhanced antibacterial and antioxidant activities than pristine CA. Further, the CA-polyamine complexes have shown high anticancer performances in the concentration range that is compatible with the normal cell lines.


Review: DNA molecular electrostatic potential: novel perspectives for the mechanism of action of anticancer drugs involving electron transfer and oxidative stress.
This report examines the mechanism of action of DNA-binding anticancer drugs that involve electron transfer and oxidative stress, and primarily focuses on neglected issues surrounding molecular electrostatic potentials (MEP), the energetics of initial guanine oxidation and the consequences of the sequence dependence of DNA structure on electron transport within a DNA duplex. We argue that an appreciation of electrostatic effects aids in shaping a more complete view of the electron transfer and DNA oxidation process. Some aspects concerning the MEP of DNA relevant to these events have lain dormant, whereas others represent novel insights. We discuss the impact of electrostatics on ligand binding to DNA, guanine oxidation, axial charge transport and hopping termination reactions. Another ignored feature for intercalating redox-active agents is the reversible nature of their interaction with DNA, which in principle permits catalytic regeneration of the unmodified ligand via redox cycling with generation of reactive oxygen species. Therefore, oxidative stress may be exerted on DNA at both ends of the charge transport chain. Hence, mechanistic treatments that neglect to take into account the importance of the MEP of DNA may be flawed or deficient in many cases. An increased understanding of the basic mechanisms of redox chemistry within DNA may aid in improved anticancer drug design.


[Value of circular mechanical colon and rectum anastomosis. Prospective study of 91 patients].
A prospective study was carried out on 91 patients to evaluate colonic and rectal anastomoses constructed with an EEA stapling gun. The concept comprises the following: orthograde lavage, cecal fistula or colostomy, intraoperative sufficiency control of the anastomosis, intraoperative direct measurement of the height of the anastomosis, postoperative X-ray control of the anastomosis using standardized techniques, classification of the cases into three groups according to the height of the anastomosis: 3-5 cm, and over 9 cm. Characterization of the patients was accomplished biostatistically using the Median-Quartil system. Primary hospital letality of 2% was due to heart failure. Imparied wound healing occurred in 11%. Secondary suture dehiscence was roentgenologically identified in a total of 18% of which only 7% showed clinical symptoms. Stenosis was determined by X-ray in 11% with only 1% demonstrating a temporary clinical correlation. For especially low rectal anastomoses at 3-5 cm the EEA stapling gun appears to have a great technical advantage over hand-placed sutures, allowing extension of indications for low anastomoses.


Growth factor receptors are differentially expressed in cancers of the papilla of vater and pancreas.
To compare growth factor receptor expression in papilla of Vater cancer and pancreatic cancer. Cancer of the papilla of Vater has a much better prognosis than pancreatic cancer. Earlier symptoms may result in earlier diagnosis, but different biologic growth behaviors and genetic alterations might also be explanations. Surgical specimens from papilla of Vater cancers (24 patients) and pancreatic cancers (80 patients), normal papilla of Vater tissues (20 patients), and normal pancreatic tissues (24 patients) were frozen and fixed. The authors compared the expression of the epidermal growth factor receptor (EGFR) and c-erbB2 and c-erbB3 by Northern blot, in situ hybridization, and immunohistochemistry. In papilla of Vater cancer, Northern blots showed comparable EGFR and c-erbB2 mRNA expression but significantly lower c-erbB3 mRNA levels than in normal papilla. In pancreatic cancer, mRNA expression was enhanced compared with normal controls for EGFR (4-fold), c-erbB2 (2.5-fold), and c-erbB3 (5.2-fold). In situ hybridization confirmed this and showed mRNA expression only in cancer cells. EGFR immunohistochemical staining scores were comparable in papilla of Vater cancer (1.17 +/- 0.22) and normal papilla (1.42 +/- 0.25). Staining scores for c-erbB2 (2.72 +/- 0.40 vs. 3.89 +/- 0.37) and c-erbB3 (2.78 +/- 0.35 vs. 3.89 +/- 0.53) were slightly lower than controls in papilla of Vater cancer. In pancreatic cancer, immunostaining scores for EGFR, c-erbB2, and c-erbB3 were significantly higher than controls. Members of the EGFR family show similar or lower expression in papilla of Vater cancer than in normal controls. In pancreatic cancer, these receptors are upregulated. This supports the hypothesis that papilla of Vater cancer and pancreatic cancer have biologic differences that may contribute to the different growth of these tumors.


[New Trains of Thoughts About Acupuncture Analgesia-Acupuncture Analgesia Feb Involve Multi-dimensional Regulation of Pain].
With the development of pain study, researchers gradually recognized that pain is composed of three main dimensions, namely "sensory-discriminative" "affective-motivational" and "cognitive-evaluative" which influence each other and are also independent from each other. Pain study has shifted away from focusing on the single mode of nociception to the multi-dimensional mode of sensory-affection-cognition. It is held early in traditional Chinese medicine that "when there is a stoppage, there is a pain" and a worsening disease Feb induce depression, which has already shown a multi-dimensional recognition about pain. Acupuncture therapy has been considered to be an effective adjuvant approach for relieving pain. In the present paper, the authors introduced applicability of acupuncture analgesia by modulating the abovementioned multi-dimensions of pain from the following 4 aspects:1) multi-dimensions of pain and related brain regions; 2) recognitions of traditional Chinese medicine about pain; 3) development of researches on acupuncture analgesia, including a) balancing activities of endogenous analgesic and algogenic substances, and triggering intracellular mitogen-activated protein kinase (MAPK) signaling to reduce algesia, b) improving psychological symptoms of patients with depression, anxiety, insomnia, etc., c) modulating functional activities of some common brain regions (as hippocampus, anterior cingutate, frontal lobe of cerebral cortex, etc.) sharing both pain information and learning-memory processing. Hence, the authors hold that if the clinical study and application and experimental researches conducted on the underlying mechanisms of acupuncture analgesia extend towards the multi-dimensions of pain, a series of new concepts or thoughts will be brought out, thereby possibly opening a bright applicable prospect for acupuncture analgesia.


Interaction between genetic variants and exposure to Hurricane Katrina on post-traumatic stress and post-traumatic growth: a prospective analysis of low income adults.
There is considerable variation in psychological reactions to natural disasters, with responses ranging from relatively mild and transitory symptoms to severe and persistent posttraumatic stress (PTS). Some survivors also report post-traumatic growth (PTG), or positive psychological changes due to the experience and processing of the disaster and its aftermath. Gene-environment interaction (GxE) studies could offer new insight into the factors underlying variability in post-disaster psychological responses. However, few studies have explored GxE in a disaster context. We examined whether ten common variants in seven genes (BDNF, CACNA1C, CRHR1, FKBP5, OXTR, RGS2, SLC6A4) modified associations between Hurricane Katrina exposure and PTS and PTG. Data were from a prospective study of 205 low-income non-Hispanic Black parents residing in New Orleans prior to and following Hurricane Katrina. We found a significant association (after correction) between RGS2 (rs4606; p=0.0044) and PTG, which was mainly driven by a cross-over GxE (p=0.006), rather than a main genetic effect (p=0.071). The G (minor allele) was associated with lower PTG scores for low levels of Hurricane exposure and higher PTG scores for moderate and high levels of exposure. We also found a nominally significant association between variation in FKBP5 (rs1306780, p=0.0113) and PTG, though this result did not survive correction for multiple testing. Although the inclusion of low-income non-Hispanic Black parents allowed us to examine GxE among a highly vulnerable group, our findings may not generalize to other populations or groups experiencing other natural disasters. Moreover, not all participants invited to participate in the genetic study provided saliva. To our knowledge, this is the first study to identify GxE in the context of post-traumatic growth. Future studies are needed to clarify the role of GxE in PTS and PTG and post-disaster psychological responses, especially among vulnerable populations.


Erythrocytes metabolically enhance collagen-induced platelet responsiveness via increased thromboxane production, adenosine diphosphate release, and recruitment.
Erythrocytes promoted platelet reactivity in a plasma medium, as demonstrated in an in vitro system that independently evaluated the biochemistry of platelet activation and recruitment. The prothrombotic erythrocyte effects were metabolically regulated, as evidenced by lack of activity of ATP-depleted or glutaraldehyde-fixed erythrocytes. They occurred in the absence of cell lysis as verified by lactate dehydrogenase assays, and had an absolute requirement for platelet activation. The presence of erythrocytes induced a twofold increase in platelet thromboxane B2 (TXB2) synthesis upon collagen stimulation, indicating that erythrocytes modulated platelet eicosanoid formation. Cell-free releasates from stimulated platelet-erythrocyte suspensions, which exhibited increased recruiting capacity, contained 6.9-fold more ADP and 4.9-fold more ATP than releasates from stimulated platelets alone. Following aspirin ingestion, TXB2 formation was blocked, but erythrocyte promotion of platelet reactivity persisted at those doses of collagen that reinduced platelet activation. Moreover, when platelet mixtures consisted of as little as 10% obtained before aspirin plus 90% obtained post-aspirin ingestion, significant erythrocyte enhancement of platelet reactivity occurred, even at low agonist concentrations. These erythrocyte effects would decrease the therapeutic potential of inhibition of platelet cyclooxygenase by aspirin. The erythrocyte-induced modulation of platelet biochemistry and function emphasizes the importance of cell-cell interactions in stimulus-response coupling.


[Psychiatric hospitalization for delirium in Israel].
Despite growing recognition that patients in delirium merit the full facilities of general hospitals, they still continue to be admitted to psychiatric hospitals. The Israel national psychiatric case register data of psychiatric in-patients with delirium was examined. During 1984-1993, 805 patients with a diagnosis of delirium were admitted to psychiatric hospitals, constituting 0.86% of total psychiatric admissions. 4 major categories were identified: dementia with delirium (33.4%) delirium tremens (DT; 26.9%), drug-induced delirium (10.0%) and acute and, subacute delirium (29.5%). About half were under 65 years of age. Clinical variables associated with emergency psychiatric hospitalization were not found in most cases. Average in-patient stay for dementia with delirium was longer than the national average for active psychiatric hospitalization. A significant proportion of patients in all categories were hospitalized longer than a month. In dementia with delirium, there were both high rates of death (18.1%) and of referrals to general hospitals (20.8%). The referral rate of cases of acute and subacute delirium to general hospitals was also high (16.2%). These outcome variables were much lower in DT and drug-induced delirium. The issue of "justification" of psychiatric hospitalization of cases of delirium is discussed. More accurate screening is suggested, as well as wider collaboration with other facilities responsible for the management of delirious patients.


[Current changes in the characteristics of reproduction in the Czech Republic and the international situation].
The author analyzes reproduction trends in the Czech Republic and compares them with patterns in some other European countries since World War II. "Population in the East has a stronger feeling of insecurity and of a certain personal distress and this fact contributes apparently towards creating...different family strategies compared to the past." (SUMMARY IN ENG)