Barriers and Enablers for Adherence to Antiretroviral Therapy Among People Living With HIV/AIDS in the Era of COVID-19: A Qualitative Study From Pakistan.
Background: With the increased availability of safe antiretroviral therapy (ART) in recent years, achieving optimal adherence and patient retention is becoming the biggest challenge for people living with HIV (PLWH). Care retention is influenced by several socioeconomic, socio-cultural, and government policies during the COVID-19 pandemic. Therefore, we aim to explore barriers and facilitators to adherence to ART among PLWH in Pakistan in general and COVID-19 pandemic related in particular. Methods: Semi-structured interviews were conducted among 25 PLWH from December 2020 to April 2021 in the local language (Urdu) at the ART centre of Pakistan Institute of Medical Sciences, Islamabad, Pakistan. Interviews were audio-recorded in the local Urdu language, and bilingual expert (English, Urdu) transcribed verbatim, coded for themes and sub-themes, and analyzed using a phenomenological approach for thematic content analysis. Results: Stigma and discrimination, fear of HIV disclosure, economic constraints, forgetfulness, religion (Ramadan, spiritual healing), adverse drug reactions, lack of social support, alternative therapies, and COVID-19-related lock-down and fear of lesser COVID-19 care due to HIV associated stigma were identified as barriers affecting the retention in HIV care. At the same time, positive social support, family responsibilities, use of reminders, the beneficial impact of ART, and initiation of telephone consultations, courier delivery, and long-term delivery of antiretrovirals during COVID-19 were identified as facilitators of HIV retention. Conclusion: Improving adherence and retention is even more challenging due to COVID-19; therefore, it requires the integration of enhanced access to treatment with improved employment and social support. HIV care providers must understand these reported factors comprehensively and treat patients accordingly to ensure the continuum of HIV care. A coordinated approach including different stakeholders is required to facilitate patient retention in HIV care and consequently improve the clinical outcomes of PLWH.


A High-Speed Vision-Based Sensor for Dynamic Vibration Analysis Using Fast Motion Extraction Algorithms.
The development of image sensor and optics enables the application of vision-based techniques to the non-contact dynamic vibration analysis of large-scale structures. As an emerging technology, a vision-based approach allows for remote measuring and does not bring any additional mass to the measuring object compared with traditional contact measurements. In this study, a high-speed vision-based sensor system is developed to extract structure vibration signals in real time. A fast motion extraction algorithm is required for this system because the maximum sampling frequency of the charge-coupled device (CCD) sensor can reach up to 1000 Hz. Two efficient subpixel level motion extraction algorithms, namely the modified Taylor approximation refinement algorithm and the localization refinement algorithm, are integrated into the proposed vision sensor. Quantitative analysis shows that both of the two modified algorithms are at least five times faster than conventional upsampled cross-correlation approaches and achieve satisfactory error performance. The practicability of the developed sensor is evaluated by an experiment in a laboratory environment and a field test. Experimental results indicate that the developed high-speed vision-based sensor system can extract accurate dynamic structure vibration signals by tracking either artificial targets or natural features.


Fibrous scaffolds fabricated by emulsion electrospinning: from hosting capacity to in vivo biocompatibility.
Electrospinning is a versatile method for preparing functional three-dimensional scaffolds. Synthetic and natural polymers have been used to produce micro- and nanofibers that mimic extracellular matrices. Here, we describe the use of emulsion electrospinning to prepare blended fibers capable of hosting aqueous species and releasing them in solution. The existence of an aqueous and a non-aqueous phase allows water-soluble molecules to be introduced without altering the structure and the degradation of the fibers, and means that their release properties under physiological conditions can be controlled. To demonstrate the loading capability and flexibility of the blend, various species were introduced, from magnetic nanoparticles and quantum rods to biological molecules. Cellular studies showed the spontaneous adhesion and alignment of cells along the fibers. Finally, in vivo experiments demonstrated the high biocompatibility and safety of the scaffolds up to 21 days post-implantation.


Thyroid hormones inhibit type 2 iodothyronine deiodinase in the rat cerebral cortex by both pre- and posttranslational mechanisms.
The type 2 5'-deiodinase (D2) appears to play an important role in maintaining the intracerebral T3 content relatively constant during changes in thyroidal state. Previous studies have demonstrated that the regulation of this enzyme by thyroid hormone and its analogs occurs at a posttranslational level. The availability of the rat D2 complementary DNA now allows an assessment of whether pretranslational regulation of this enzyme also occurs in the cerebral cortex. In rats rendered hypothyroid by the addition of methimazole to the drinking water, D2 messenger RNA (mRNA) is increased 70% (P = 0.03). Treatment with L-T3 (50 microg/100 g BW) for 4 days results in an 80% decrease in D2 mRNA compared with that in euthyroid controls (P < 0.001). Administration of lower doses of L-T3 (0.25-3 microg/100 g BW x day) is associated with a dose-dependent decrease in cortical D2 mRNA, but little or no change in D2 activity. The decrease in D2 mRNA in response to T3 treatment can be demonstrated within 4 h. Treatment of hypothyroid rats for 2 weeks with graded doses of L-T4 (0.1-1.5 microg/100 g BW x day) results in a significant decrease in cortical D2 activity, but not mRNA. The association between D2 activity and D2 mRNA in euthyroid, hypothyroid, and hormone-treated rats across a full range of thyroidal states suggests that L-T4 treatment is associated with greater changes in cortical D2 activity (via posttranslational effects) than mRNA, whereas L-T3 treatment has a greater effect on decreasing D2 mRNA (i.e. pretranslational effects). In conclusion, these studies demonstrate both pre- and posttranslational regulation of cortical D2 expression. The relative contribution of each mechanism depends on the ambient thyroid hormone concentration.


DNA vaccination against neu reduces breast cancer incidence and metastasis in mice.
The gene for HER2/neu is overexpressed in 30-40% of breast and ovarian cancers, and this overexpression correlates with increased metastasis and poor prognosis. The HER2/neu gene product, a transmembrane protein kinase member of the EGF receptor family, has significant potential as a tumor antigen for vaccination. We inserted the sequence for neu into a novel plasmid called ELVIS containing a Sindbis virus replicon that reproduces multiple copies of mRNA. Mice vaccinated one time intramuscularly demonstrated a strong antibody response against A2L2, a murine breast cancer cell line transfected to express neu. Vaccinated mice challenged in the mammary fatpad with A2L2 had reduced tumor incidence and reduced tumor mass compared to mice challenged with tumor cells lacking the neu insert. Intradermal vaccination was also protective and required 80% less plasmid for a similar level of protection. Vaccination reduced the incidence of lung metastasis from mammary fatpad tumors and reduced the number of lung metastases resulting from intravenous injection of A2L2 cells. Cytotoxic T lymphocytes cultures of immune spleen cells with P815-neu cells produced high levels of interferon-gamma indicating an antigen-specific Th1-type immune response resulting from the vaccination. In a spontaneous breast tumor model using neu transgenic mice, vaccination with ELVIS-neu protected against development of spontaneous breast tumors. Our preclinical data indicate that therapeutic vaccination of patients with ELVIS-neu may reduce metastasis from HER2/neu-expressing breast and ovarian tumors.


Evidence of User-Expert Gaps in Health App Ratings and Implications for Practice.
Searching the commercial Google Play Store and App Store is one of the most common strategies for discovering mobile applications for digital health, both among consumers and healthcare professionals. However, several studies have suggested a possible mismatch between this strategy and the objective of finding apps in physical and mental health that are both clinically relevant and reliable from a privacy standpoint. This study provides direct evidence of a gap between the five-star user rating system and expert ratings from a curated library of over 1,200 apps that cover both physical and mental health. An objective metric is derived to assess the strength of the user-expert gap for each app, which in turn allows identifying missed opportunities-low user ratings and high expert ratings-and overrated apps-high user ratings and low expert ratings. Implications for practice and care delivery are discussed.


Cartilage Formation In Vivo Using High Concentration Collagen-Based Bioink with MSC and Decellularized ECM Granules.
The aim of this study was to verify the applicability of high-concentration collagen-based bioink with MSC (ADSC) and decellularized ECM granules for the formation of cartilage tissue de novo after subcutaneous implantation of the scaffolds in rats. The printability of the bioink (4% collagen, 2.5% decellularized ECM granules, derived via 280 μm sieve) was shown. Three collagen-based compositions were studied: (1) with ECM; (2) with MSC; (3) with ECM and MSC. It has been established that decellularized ECM granules are able to stimulate chondrogenesis both in cell-free and MSC-laden scaffolds. Undesirable effects have been identified: bone formation as well as cartilage formation outside of the scaffold area. The key perspectives and limitations of ECM granules (powder) application have been discussed.


Combination of IL-6, IL-10, and MCP-1 with traditional serum tumor markers in lung cancer diagnosis and prognosis.
Early detection and treatment is critically important for lung cancer patients. Inflammatory mediators such as IL-6, IL-10, and MCP-1 participate in lung cancer regulation. CEA, CA125, and ProGRP are commonly used serum tumor markers for lung cancer. In this study, we assessed the sensitivity and specificity of CEA, CA125, and ProGRP when used in combination with IL-6, IL-10, and MCP in lung cancer diagnosis. Serum from three different groups (healthy controls, individuals with high risk for lung cancer, and lung cancer patients) was collected. Electrochemiluminescence was used to detect expressions of CEA, CA125, and ProGRP; ELISA was used to examine serum levels of IL-6, IL-10, and MCP-1. Specificity and sensitivity of single as well as combination markers in lung cancer diagnosis were determined. Results indicated that CEA, CA125, ProGRP, and MCP-1 were significantly up-regulated in lung cancer patients as compared to those in controls and high risk individuals. Higher IL-6 and IL-10 levels were observed in both lung cancer patients and high-risk individuals as compared to those in controls. Highest sensitivity (95.2%) in cancer diagnosis was achieved when all six markers were used. This was followed by a combination of IL-6, IL-10, CEA, CA125, and ProGRP (92.6%). The most sensitive (88.6%). Four-marker combination was composed of IL-6, CEA, CA125, and ProGRP. As the combined usage of CEA, CA125, ProGRP, IL-6, IL-10, and MCP-1 significantly improved sensitivity of lung cancer detection; this biomarker arrangement may be beneficial for early diagnosis, treatment, and prognosis of lung cancer.


Venous varix on the dorsal aspect of the thumb: report of two cases.
Venous varix on the volar aspect of the digits or the hand is a rare subcutaneous lesion that is usually described as a firm, blue, and painful single nodule that contains thrombus. However, there have been no reports about venous varix on the dorsal aspect of the digits or the hand, so its features are unknown. We treated two patients who each had a soft blue painless mass on the dorsal aspect of the thumb that became enlarged with the tourniquet test. Ultrasonography and/or magnetic resonance imaging were used for assisting with the preoperative diagnosis, and showed each lesion was composed of two or more varicosities. Each mass was removed and was diagnosed as a venous varix without thrombus by histological examination.


Contrast-associated AKI and use of cardiovascular medications after acute coronary syndrome.
AKI after coronary angiography is associated with poor long-term outcomes. The relationship between contrast-associated AKI and subsequent use of prognosis-modifying cardiovascular medications is unknown. A cohort study of 5911 participants 66 years of age or older with acute coronary syndrome who received a coronary angiogram in Alberta, Canada was performed between November 1, 2002, and November 30, 2008. AKI was identified according to Kidney Disease Improving Global Outcomes AKI criteria. In multivariable logistic regression models, compared with participants without AKI, those with stages 1 and 2-3 AKI had lower odds of subsequent use of angiotensin-converting enzyme inhibitors/angiotensin receptor blocker within 120 days of hospital discharge (adjusted odds ratio, 0.65; 95% confidence interval, 0.53 to 0.80 and odds ratio, 0.34; 95% confidence interval, 0.23 to 0.48, respectively). Subsequent statin and β-blockers use within 120 days of hospital discharge was significantly lower among those with stages 2-3 AKI (adjusted odds ratio, 0.44; 95% confidence interval, 0.31 to 0.64 and odds ratio, 0.46; 95% confidence interval, 0.31 to 0.66, respectively). These associations were consistently seen in patients with diabetes mellitus, heart failure, low baseline eGFR, and albuminuria; 952 participants died during subsequent follow-up after hospital discharge (mean=3.1 years). The use of each class of cardiovascular medication was associated with lower mortality, including among those who had experienced AKI. Strategies to optimize the use of cardiac medications in people with AKI after coronary angiography might improve care.


Enhanced bioavailability after oral and pulmonary administration of baicalein nanocrystal.
The aim of the study was to investigate the potential of oral and pulmonary nanocrystal to enhance the bioavailability of baicalein, a bioactive flavonoid isolated from the root of Scutellaria baicalensis Georgi. So far, the nano-sized delivery system of baicalein and its pulmonary delivery have received no exploration. In the present investigation, the baicalein nanocrystal was prepared by anti-solvent recrystallization followed by high pressure homogenization. In vitro characterization was performed including particle size and distribution, Zeta potential, dissolution, scanning electron microscopy, differential scanning calorimetry and X-ray powder diffractometry. It was indicated that no crystalline change was observed after nanocrystal preparation. The baicalein nanocrystal containing only trace of stabilizer exhibited a significantly enhanced dissolution of baicalein. In vivo test was also carried out in rats and pharmacokinetic parameters of the baicalein crystal and the baicalein nanocrystal after gavage and pulmonary administration were compared, based on the simultaneous determination of baicalein and baicalin by high performance liquid chromatography. The mean relative bioavailability of oral baicalein nanocrystal was 1.67-fold that of oral baicalein crystal. The pulmonary baicalein nanocrystal had rapid and extensive absorption and had almost identical pharmacokinetic parameters to intravenous baicalein injection.


Rapid throat-culture as diagnostic aid: ineffective in decreasing antibiotic prescriptions.
An overnight slide-culture for the detection of group A streptococci was introduced in a Finnish health centre. The number of patients from whom a throat culture was obtained increased from 55% to 70% with the new method. Despite this increase, the prescribing habits of primary care physicians did not change. Treatment was in most cases (84-90% of those treated) still initiated before culture results were available, and antibacterial medication was discontinued only occasionally (1-3%). Physicians usually decided the treatment during the first consultation. These findings contradict earlier studies where prescriptions decreased during rapid culture. Use of throat cultures as diagnostic aid should be reconsidered, especially when more rapid methods now are available.


Looking at Silver-Based Nanoparticles in Environmental Water Samples: Repetitive Cloud Point Extraction Bridges Gaps in Electron Microscopy for Naturally Occurring Nanoparticles.
The growing use of silver-based nanoparticles (Ag-b-NPs) in everyday products goes hand in hand with their release into the environment, resulting in ng L-1 traces in natural water bodies. In order to assess their fate, possible transformations and ecotoxicology-essential information to proper risk assessment-particle size, shape, and chemical composition have to be determined. Transmission electron microscopy coupled with energy dispersive X-ray spectroscopy (TEM-EDX) is a powerful tool for determining these particle characteristics, but it requires high particle concentrations in order to produce statistically reliable results. In this study, we will present the extraction of Ag-b-NPs at environmentally relevant concentrations down to 5 ng L-1 from artificial as well as environmental water samples via cloud point extraction on a repetitive basis. The combination with an on-grid centrifugation technique ensures an efficient concentration and deposition of the extracted particles onto the TEM grid for subsequent TEM-EDX measurements. Furthermore, electron microscopy investigations were supplemented by single particle inductively coupled plasma mass spectrometry (sp-ICP-MS) measurements. Ag-b-NPs were successfully visualized and characterized at environmentally relevant concentrations of 5 ng L-1 with TEM-EDX and sp-ICP-MS measurements. Their size, shape, and chemical composition were not affected by the sample preparation.


Architectonics of phage-liposome nanowebs as optimized photosensitizer vehicles for photodynamic cancer therapy.
Filamentous M13 phage can be engineered to display cancer cell-targeting or tumor-homing peptides through phage display. It would be highly desirable if the tumor-targeting phage can also carry anticancer drugs to deliver them to the cancer cells. We studied the evolution of structures of the complexes between anionic filamentous M13 phage and cationic serum-stable liposomes that encapsulate the monomeric photosensitizer zinc naphthalocyanine. At specific phage-liposome ratios, multiple phage nanofibers and liposomes are interwoven into a "nanoweb." The chemical and biological properties of the phage-liposome nanoweb were evaluated for possible application in drug delivery. This study highlights the ability of phage-liposome nanowebs to serve as efficient carriers in the transport of photosensitizers to cancer cells.


Relation between aryl hydrocarbon hydroxylase inducibility, serum gamma-glutamyltransferase and serum cholesterol in middle-aged smokers and non-smokers.
Aryl hydrocarbon hydroxylase (AHH) inducibility, carbon monoxide in expired air (CO), serum gammaglutamyl-transferase (GGT), and total cholesterol were compared in equal-sized, age-matched samples of healthy middle-aged males born in 1921, 1934-1936, and 1946 attending the ongoing preventive medical population program in Malmö. AHH did not differ in various age - and smoking or non-smoking groups, and there were no correlations between AHH, GGT, and cholesterol. The findings provide evidence against the recent hypothesis that low cholesterol may mediate or reflect a carcinogenic mechanism through a state of general enzyme induction in the body.


Predicting cervical screening and HPV vaccination attendance of Roma women in Hungary: community nurse contribution is key.
HPV screening/vaccination has been observed lower for ethic minorities. Understanding factors that predict and can improve attendance is therefore key. Hence, the aim was to identify causes, especially concerning the quality of the patient-provider relationship, that predict past HPV screening and vaccination turnout of Roma women in Hungary. Cross-sectional research design with self-developed, culturally sensitive questionnaire. A final, female Roma sample of 368 participants was randomly selected from census register. Community nurses contacted participants and distributed surveys. Surveys were mailed-in by participants. Bivariate logistic regression was used to predict former participation in HPV screening/vaccination. Of the total sample, 17.4% of women attended at least one cervical screening and HPV vaccination in the past. Bad screening experience was positively associated with racially unfair behaviors of physicians. The odds of past attendance were 4.5 times greater if 'no negative earlier experience' occurred, 3.3 times likelier if community nurse performed screening/immunization and 1.6 times more probable if respondent felt 'no shame'. Evaluating the screening/vaccination process painful, being only financially motivated and attendance involving a lot of travel decreased the odds of 'no show' by 50%, 40% and 41%, respectively. When considering the ratio of past cervical screening attendance, we conclude that our female Roma sample did not behave differently from the general population. We saw no evidence that racial mistreatment made any contribution to explaining cervical screening participation. Past positive screening experience and the quality of patient-provider relationship increased the odds of participation the most. Cancer of friends, pain, financial motivation and travel distance decreased odds of participation to a lesser extent. In order to improve future screening and immunization, community nurses should play more central and advanced role in the organization and implementation of such services specifically targeting Roma populations.


Self-Assembled Perylene Bisimide-Cored Trigonal Prism as an Electron-Deficient Host for C60 and C70 Driven by "Like Dissolves Like".
Poor processability of fullerenes is a major remaining drawback for them to be studied monomolecularly and to find real-life applications. One of the strategies to tackle this problem is to encapsulate them within a host, which is however quite often, accompanied by significant alteration of their physical/chemical properties as encountered in chemical modification. To minimize the effect, an electron-deficient entities-based, dissolvable, and fluorescence active supramolecular host was designed and constructed via coordination-driven self-assembly of o-tetrapyridyl perylene bisimide (PBI) with cis-(PEt3)2Pt(OTf)2. The trigonal prism 1 possesses a trigonal-prismatic inner cavity with 14.7 Å as the diameter of its inscribed circle. Host-guest chemistry investigations revealed that both C60 and C70 could be quantitatively encapsulated by the host in a 1:1 ratio. Further studies demonstrated that the produced host-guest complex 1⊃C70 is significantly more stable than 1⊃C60, allowing complete transformation of the latter to the former and separation of C70 from its mixture with C60. The fullerenes in the inclusion state could rotate freely within the cavity. Electrochemistry and spectroscopy studies disclosed that the encapsulation of the guests shows little effect upon the reduction of the host and its fluorescence properties. Thus, "like dissolves like" is believed to be the main driving force for the formation of the host-guest complexes. Moreover, the host and host-guest complexes can be fabricated into monomolecular membranes using the conventional Langmuir-Blodgett technique. We propose that these unique host-guest complexes could be used as model ensembles for further studies of the physical/chemical properties of fullerenes in both single molecular and 2D membrane states. In addition, their reversible four-electron reduction property may allow them to find applications in photo/electrocatalysis, organic electronics, etc.


Alterations in angina threshold with nifedipine during pacing induced angina.
Changes in coronary haemodynamics and angina threshold were determined during atrial pacing in 11 patients with fixed obstructive coronary artery disease with effort angina before and after the administration of 20 mg of oral nifedipine. Coronary vascular resistance decreased at resting and at "subangina" heart rates but not at "angina" rates. Primary coronary vasodilatation with nifedipine was also suggested by higher coronary sinus oxygen content whether at rest or at subangina or angina heart rates. After nifedipine angina occurred at a lower double product and lower myocardial oxygen consumption. These findings suggest that nifedipine is a coronary vasodilator, but angina can occur at a lower angina threshold in some patients with obstructive coronary artery disease.


Ruthenium-catalyzed cyclization of alkyne-epoxide functionalities through alternation of the substituent and structural skeleton of epoxides.
Treatment of 1-(o-ethynylphenyl)-2-alkyl-2-aryl epoxides with TpRuPPh(3)(CH(3)CN)(2)PF(6) catalyst (10 mol %) in hot toluene (100 degrees C, 12 h) led to an atypical cyclization and gave 1-aryl-2-alkyl-1H-indene derivatives and carbon monoxide efficiently. The cyclization of 1-cis-enynyl-2-alkyl epoxides with this catalyst in hot toluene (10 mol %, 100 degrees C, 12 h) gave 2,5-disubstituted phenols in 45-72% yields. Under the same conditions, 1-cis-enynyl- 2,2-dialkyl epoxides and 1-cis-enynyl- 2-alkyl-2-aryl epoxides gave the corresponding 6,6-disubstituted cyclohexa-2,4-dien-1-ones in good yields (85-91%). Mechanisms for these new cyclization reactions are proposed on the basis of trapping experiments and isotope labeling experiments. The formation of 1H-indene products likely involves ruthenium-acyl intermediates whereas cyclohexa-2,4-dien-1-ones are thought to derive from ruthenium-ketene intermediates.


Anatomy and histology of the scapholunate ligament.
The scapholunate ligament links the scaphoid to the lunate. It runs transversally at its posterior aspect and obliquely at its anterior aspect, allowing significant relative motion between the two bones. From the neutral position to the full extension position, the lunate rotates by 28 degrees and the scaphoid by 30 degrees; from the neutral position to the full flexion position, the lunate rotates by 30 degrees, whereas the scaphoid rotation is 60 degrees because of the motion of the scaphoid around the capitate. The ligament's dorsal part is shorter and more resistant than the anterior part, allowing a pseudodissociation during flexion. Kauer described an additional movement of the scapholunate pair attributable to differences in the shapes of the scaphoid and lunate proximal poles. The scaphoid curve is more important and the scaphoid needs to glide on the lunate to maintain radioscaphoid congruity. As a result, there is sagittal ligament torsion. This can be a partial explanation for failure of scapholunate arthrodesis. This description of the scapholunate ligament is of interest to understand the relative importance of the three parts of this ligament. It can, in particular, explain the failure of ligamentous reconstruction that considers the scapholigament as a homogeneous structure. In addition, the three parts do not have the same tensile strength. The posterior part is the most resistant to tear forces and needs more than a 300 N tensile stress to fail. The anterior part fails with 150 N stress and the intermediary portion can withstand only a 25 N to 50 N stress. In comparison, the triquetrolunate ligament (which is also divided in three parts--anterior intermediate, and posterior) has failure coefficients opposite those of the scapholunate ligament: The anterior part is more resistant (300 N) than the posterior (150 N); the intermediate part has the same tensile strength as the scapholunate intermediate part. These biomechanical studies demonstrate the importance of the scapholunate ligamentous posterior part in controlling flexion and extension motion and the anterior part for rotational control. Both parts of the ligament are necessary for an harmonious functioning of the scapholunate pair.


Paradoxical worsening of tuberculous chorioretinitis in a Chinese gentleman.
We report a case of paradoxical worsening of tuberculous chorioretinitis after initiation of anti-tuberculous therapy (ATT). The patient had left panuveitis with tuberculous chorioretinitis and was started on systemic ATT and oral steroids a week later. However, he developed paradoxical worsening 2 months after initiation of therapy. He was continued on ATT, oral steroids and intravitreal amikacin with resolution of the chorioretinal lesion subsequently. Ocular tuberculosis often poses a diagnostic challenge, and clinicians should be aware of the possibility of paradoxical worsening despite appropriate ATT. Clinicians should strongly consider starting oral steroids concurrently with ATT when managing ocular tuberculosis.


[Discolored amniotic fluid--results of prenatal diagnosis and clinical significance].
7000 pregnancies were analysed after genetic amniocentesis in respect of the further course and results of prenatal diagnosis (observation period 1975-1988). In 3.1% (217 cases) samples of amniotic fluid were discoloured. Vaginal haemorrhages prior to amniocentesis were recorded with significantly higher incidence (18%) in patients with discoloured amniotic fluid than in a control group (n = 217) with normal colour of the amniotic fluid (4.6%) (p less than 0.001). Miscarriages and chromosome anomalies occurred more often in the study group (3.7%/2.8%, control group: 0.9%/1.8%, n.s.). The risk of miscarriages was increased in cases with sanguineous amniotic fluid if the amniotic fluid alpha-fetoprotein values were enhanced at the same time. Significant differences were observed in respect of the incidence of foetal malformations in patients with discoloured amniotic fluid (7.8%) and in the control group (2.3%) (p less than 0.01). Borderline or definitely pathological amniotic fluid AFP concentrations were found often if the amniotic fluid was discoloured (6.9%, control group 3.2%). If discoloured amniotic fluid was sampled, foetal malformations should be excluded sonographically. In 82% of all cases with discoloured amniotic fluid and foetal malformations pathological sonographic findings and/or enhanced MS-AFP values were recorded even prior to amniocentesis.


Childlessness and marital satisfaction: a further assessment.
Utilizing a stratified random sample of respondents married after the age of 21, this article estimates models of marital satisfaction for theoretically relevant groups of women--voluntarily childless wives, undecided wives, postponing wives, and mothers. Results indicate that all three groups of childless wives have higher mean levels of marital satisfaction than do mothers. More important, the results also suggest that the processes generating marital satisfaction for wives differ depending not only on the presence or absence of children, but also on future childbearing intentions among the childless. Specifically, models of marital satisfaction for the voluntarily childless and undecideds are quite different from those for postponers and mothers. These results are discussed in terms of differences in marital structures and differences in the implied systems of reciprocities characterizing marital interaction and bargaining.


Serotonin in the control of blood pressure and ultrafiltration in CAPD.
Urinary 5-OH-Indoloacetic acid (5-HIAA) indicates the turnover of almost all circulating serotonin (5-HT), a potent vasoactive agent. We tried to investigate the possible excretion of 5-HIAA in the dialysate of CAPD patients and its possible effects on blood pressure control (BP) and/or ultrafiltration (UF). The 24 h excretion of 5-HIAA in the urine of 10 patients with chronic renal failure (CRF) and 8 healthy persons (CONTROL), and in the dialysate of 15 patients on CAPD was measured by FPIA. In CRF 5-HIAA excretion was less than that in control (p less than 0.01). In CAPD patients two distinct patterns of 5-HIAA excretion were found. Patients with high excretion (greater than 6 mg) had high BP and low UF, while those with low excretion (less than 3.14) had low BP, high UF and frequent hypotensive episodes. Excretion of 5-HIAA in the dialysate had a negative correlation with UF (r = -0.779, p less than 0.001) and a positive correlation with B.P. (r = 0.487, n.s.). A highly significant (p less than 0.01) correlation between BP and UF was also found. As no differences between the two groups in factors that could affect UF or BP were found, the implication that 5-HT affects ultrafiltration and/or BP regulation is suggested.


Atomic-scale spin-polarized scanning tunneling microscopy applied to Mn3N2(010).
Atomic-scale spin-polarized scanning tunneling microscopy is demonstrated in the case of the unique surface spin structure of Mn3N2(010) at 300 K. We find that the surface spin structure is manifested as a modulation of the normal atomic row height profile. The atomic-scale spin-polarized image is thus shown to contain two components, one the normal, nonpolarized part, and the other the magnetic, spin-polarized part. A method is presented for separating these two spatially correlated components, and the results are compared with simulations based on integrated local spin density of states calculated from first principles.


Fragment-based screening for inhibitors of PDE4A using enthalpy arrays and X-ray crystallography.
Fragment-based screening has typically relied on X-ray or nuclear magnetic resonance methods to identify low-affinity ligands that bind to therapeutic targets. These techniques are expensive in terms of material and time, so it useful to have a higher throughput method to reliably prescreen a fragment library to identify a subset of compounds for structural analysis. Calorimetry provides a label-free method to assay binding and enzymatic activity that is unaffected by the spectroscopic properties of the sample. Conventional microcalorimetry is hampered by requiring large quantities of reagents and long measurement times. Nanocalorimeters can overcome these limitations of conventional isothermal titration calorimetry. Here we have used enthalpy arrays, which are arrays of nanocalorimeters, to perform an enzyme activity-based fragment screen for competitive inhibitors of phosphodiesterase 4A (PDE4A). Several inhibitors with K ( I ) <2 mM were identified and moved to X-ray crystallization trials. Although the co-crystals did not yield high-resolution data, evidence of binding was observed, and the chemical structures of the hits were consistent with motifs of known PDE4 inhibitors. This study shows how array calorimetry can be used as a prescreening method for fragment-based lead discovery with enzyme targets and provides a list of candidate fragments for inhibition of PDE4A.


Structural determinants of photoreactivity of triplex forming oligonucleotides conjugated to psoralens.
Triplex-forming oligonucleotides (TFOs) with both DNA and 2'-O-methyl RNA backbones can direct psoralen photoadducts to specific DNA sequences. However, the functional consequences of these differing structures on psoralen photoreactivity are unknown. We designed TFO sequences with DNA and 2'-O-methyl RNA backbones conjugated to psoralen by 2-carbon linkers and examined their ability to bind and target damage to model DNA duplexes corresponding to sequences within the human HPRT gene. While TFO binding affinity was not dramatically affected by the type of backbone, psoralen photoreactivity was completely abrogated by the 2'-O-methyl RNA backbone. Photoreactivity was restored when the psoralen was conjugated to the RNA TFO via a 6-carbon linker. In contrast to the B-form DNA of triplexes formed by DNA TFOs, the CD spectra of triplexes formed with 2'-O-methyl RNA TFOs exhibited features of A-form DNA. These results indicate that 2'-O-methyl RNA TFOs induce a partial B-to-A transition in their target DNA sequences which may impair the photoreactivity of a conjugated psoralen and suggest that optimal design of TFOs to target DNA damage may require a balance between binding ability and drug reactivity.


Tamsulosin, Solifenacin, and Their Combination for the Treatment of Stent-Related Symptoms: A Randomized Controlled Study.
To properly use the Ureteric Symptom Score Questionnaire (USSQ) to evaluate, in a randomized control study, the effect of tamsulosin, solifenacin, and their combination in improving symptoms and quality of life in patients with indwelling ureteral stents. After institutional review board approval, 260 patients with a ureteral stent were randomly assigned to receive tamsulosin 0.4 mg, solifenacin 5 mg, or placebo and further randomized to receive their combination. The validated USSQ was completed 1 and 4 weeks after stent insertion and 4 weeks after stent removal. Kruskal-Wallis test, chi-squared test (or Fisher's exact test), one-way analysis of variance, and T-test (or Wilcoxon rank-sum test if not normal data) were used for statistical analysis. The results were considered significant at p < 0.05. Patients receiving tamsulosin or solifenacin expressed significantly lower urinary (p < 0.001), pain (p < 0.001 with stent in situ), and general health index (p = 0.002 in first and p < 0.001 in fourth week with stent in situ) scores. Sexual life and quality of work were also positively influenced. Patients on combination therapy expressed lower urinary (p < 0.001) and pain (p < 0.001) scores in the fourth week with stent in situ and work performance in the first week and with stent in situ (p = 0.001) and after stent removal (p = 0.005). No patients had to discontinue medication due to side effects. Stent-related morbidity is a reality in the majority of patients. Simple medication, such as tamsulosin and solifenacin alone or in combination, improves stent-related symptoms and has a positive impact on quality of life.


Characterization of an exported protease from Shiga toxin-producing Escherichia coli.
The gene for a novel, high molecular weight protein secreted by Shiga toxin-producing Escherichia coli (STEC) has been cloned, sequenced and characterized with respect to its activity. This gene, designated pssA, is localized on the large plasmid that also harbours the STEC haemolysin operon. Sequencing of a region comprising 10630nt revealed that the sequences flanking the pssA gene are composed of several remnants of different insertion elements. The PssA protein is produced as a 142kDa precursor molecule that, after N- and C-terminal processing, is released into the culture supernatant as a mature polypeptide of approximately 104kDa. The primary sequence of PssA is highly related to a family of autonomously transported putative virulence factors from different Gram-negative pathogens, which includes the Tsh protein of an avian-pathogenic E. coli strain, the SepA protein from Shigella flexneri and the EspC protein from enteropathogenic E. coli. A common motif present in all four proteins is reminiscent of the catalytic centre of certain serine proteases. PssA (protease secreted by STEC) indeed shows serine protease activity in a casein-based assay and is moreover cytotoxic for Vero cells. This activity of PssA and probably of other proteins of the Tsh family may be of functional importance during infection of the mucosal cell layer by the bacterial pathogen.


Effect of pubertal developmental stages and lower limb kinetics during vertical jump task in Sepak Takraw sport.
Sepak Takraw is a sport which actively involves the lower limb. A cross sectional study was performed to investigate the lower limb kinetics (ground reaction force, flight time and contact time) involved during the vertical jumping and landing task between the early pubertal and late pubertal stages in National level Sepak Takraw athletes in Malaysia. Twenty athletes (8 pre pubertal and 12 late pubertal) with no previous history of any physical injuries were taken for the study. The kinetics data of the vertical jump task was calculated using a force platform 3-AMTI Biomechanics Force Platform. The Silicon ProCoach (Chart 5 software) was used to collect the ground reaction force signals, flight time and contact time. The results showed a non-significant decrease in peak ground reaction force in the post pubertal group as compared to the pre pubertal group (t(18)=0.659, p=0.518,CI(95)(-2.54, 4.86). Comparison of flight time between the two age groups showed a significant increase in the post pubertal group with mean and SD (0.7773 + or - 0.03) as compared to the pre pubertal group mean and SD (0.7296 + or - 0.05), which was statistically considered significant (p<0.05) (t(18)=-2.401, p<0.05,CI(95)(-0.089, -0.005). The findings from this study demonstrated that the flight time of the vertical jump task differed between the pre and post pubertal athletes with the post pubertal group having an improved ability in maintaining longer duration of flight phase.


Genetic analysis of feline caliciviruses associated with a hemorrhagic-like disease.
Feline calicivirus (FCV) is 1 of the most common causes of upper respiratory tract disease in cats. Other disease syndromes associated with FCV infection have been reported. Recently, calicivirus infection associated with a hemorrhagic-like disease leading to significant mortality in cats has been reported. The clinical signs are similar to those observed with the calicivirus of rabbit hemorrhagic disease. This study characterized 2 FCV isolates associated with hemorrhagic-like disease. Nucleotide sequencing of the complete genome has been done for these 2 isolates as well as for 4 additional isolates representing other disease syndromes. Previously reported sequence data for the entire genome of classical FCV (6 isolates) and a portion of the capsid gene for hemorrhagic-like FCV (3 isolates), isolated in different regions of United States were used in the genetic analysis. Sequence data were used to determine relationships among the isolates and any correlation with phenotype. Nucleotide sequence comparisons of the entire genome and individual open reading frames revealed high homology among all isolates. Data suggest that the virulence may have genetic determinants on the basis of phylogenetic clustering of the isolates associated with hemorrhagic-like disease.


Executive functions and physical aggression after controlling for attention deficit hyperactivity disorder, general memory, and IQ.
This study examined the role of ADHD in the association between physical aggression and two types of executive functions. Boys received a cognitive-neuropsychological test battery over the ages of 13, 14, and 15 years. Diagnostic Interview Schedule for Children (DISC 2.25) data were collected from the boys and one parent between ages 14 and 16, and an IQ estimate was obtained at age 15. Three groups, differing in stability and level of physical aggression since kindergarten, were formed: Stable Aggressive, Unstable Aggressive, and Non-aggressive. Composite scores of validated executive function tests of working memory representing subjective ordering and conditional association learning were formed. A MANCOVA (N = 149) using ADHD status, teacher-rated negative emotionality, general memory abilities, and IQ as covariates was performed on the two composite scores. ADHD and teacher-rated emotionality did not provide significant adjustment to the dependent variables. Number of ADHD symptoms was negatively associated only with general memory and IQ. General memory contributed significantly to adjusting for conditional association test scores. Group differences indicated lower conditional association scores for Unstable Aggressive boys relative to the other groups. Both IQ and general memory abilities interacted with subjective ordering within the groups. Specifically, Stable Aggressive boys performed poorly on this measure and did not benefit from increases in IQ whereas Nonaggressive boys performed best and were not disadvantaged by lower general memory abilities. This suggests a relationship exists between aspects of working memory and a history of physical aggression regardless of ADHD and IQ.


Effect of praziquantel therapy on testes of mice infected with Schistosoma mansoni.
Histopathological changes in the testes of mice infected with S. mansoni before and after praziquantel therapy in early infection and late infection were studied. In early infection, 150 mg/kg of praziquantel regimen gave a very good effect comparable with 300 mg/kg dose. In both regimens the testes returned almost to normal activity after treatment. In late infection 150 mg/kg of praziquantel gave moderate improvement in spermatogenic activity compared to almost complete cure and return to full activity with 300 mg/kg praziquantel regimens. Also, any possible side effects of the drug on the testicles were looked for. The present study proved the safety use of the drug as regard to its testicular effects.


Inflammation and the activated protein C anticoagulant pathway.
After a coagulation stimulus, the blood clotting cascade amplifies largely unchecked until very high levels of thrombin are generated. Natural anticoagulant mechanisms (for example, the protein C anticoagulant pathway) are amplified to prevent excessive thrombin generation. Thrombin binds to thrombomodulin (TM) and this complex and then activates protein C approximately 1000 times faster than free thrombin. Protein C activation is enhanced approximately 20-fold further by the endothelial cell protein C receptor (EPCR). Activated protein C proteolytically inactivates factor Va (FVa) and FVIIIa, thereby blocking the amplification of the coagulation system, a process that is accelerated by protein S. TM not only accelerates protein C activation, but also decreases endothelial cell activation by blocking high-mobility group protein-B1 inflammatory functions and suppressing both nuclear factor-kappa B nuclear translocation and the mitogen-activated protein kinase pathways. The thrombin-TM complex also activates thrombin-activatable fibrinolysis inhibitor, a procarboxypeptidase that renders fibrin resistant to clot lysis and neutralizes vasoactive molecules such as complement C5a. Activated protein C has a variety of antiinflammatory activities. It suppresses inflammatory cytokine elevation in animal models of severe sepsis, inhibits leukocyte adhesion, decreases leukocyte chemotaxis, reduces endothelial cell apoptosis, helps maintain endothelial cell barrier function through activation of the sphingosine-1 phosphate receptor, and minimizes the decrease in blood pressure associated with severe sepsis. Most of these functions are dependent on binding to EPCR. Overall this pathway is critical to both regulation of the blood coagulation process, and control of the innate inflammatory response and some of its associated downstream pathologies.


Siderophore receptor IroN is an important protective antigen against Salmonella infection in chickens.
In iron-limiting environments, Salmonella enterica serovar Enteritidis and Salmonella enterica serovar Typhimurium synthesize and secrete several types of siderophore to trap trivalent ferric ions; these bacteria then express siderophore receptors called iron-regulated outer membrane proteins (IROMPs). In this study, we experimentally reproduced iron-limiting environments using a divalent metal chelator. IroN, one of the IROMPs, was purified by affinity chromatography with an anti-IroN-MAb-immobilized column. Thirty-day-old chickens were immunized intramuscularly with purified IroN from Salmonella Typhimurium mixed with Freund's incomplete adjuvant; the chickens were then challenged intravenously with Salmonella Enteritidis. The mortality rate of immunized chickens was 10%. On the other hand, that of control chickens was 80%. By Western blot analysis, specific IgG antibody responses against IroN of Salmonella Enteritidis were identified in chickens immunized with purified IroN. These results indicate that IroN might be promising as an important vaccine component against Salmonella infection in chickens.


[Role of androgen in the elderly. What is LOH syndrome?].
Late-onset Hypogonadism (LOH) syndrome has been established for a few years. It was formally called as "ADAM (Androgen deficiency in aging male) " or "PADAM (Partial androgen deficiency in aging male) " , and the international guideline has been developed. LOH is defined by reduced serum testosterone levels (either total testosterone or free testosterone). Considering "Men's health" , LOH is an important issue for the quality of life of elderly males.


Genetic determinants of white matter hyperintensities on brain scans: a systematic assessment of 19 candidate gene polymorphisms in 46 studies in 19,000 subjects.
White matter hyperintensities (WMH) are highly heritable and associated with small artery ischemic stroke, so they may be a useful trait for studying the genetics of small vessel disease. Many studies have attempted to find associations between polymorphisms in various candidate genes and WMH. We aimed to evaluate the evidence for these associations by performing a systematic review and series of meta-analyses. We used a comprehensive search strategy to identify studies of the association between any genetic polymorphism and WMH. For all polymorphisms in genes studied in >2000 subjects we performed meta-analyses, calculating pooled odds ratios or standardized mean differences. We identified 46 studies of polymorphisms in 19 genes in approximately 19 000 subjects. Most genes were involved in lipid metabolism, control of vascular tone, or blood pressure regulation. Polymorphisms in the apolipoprotein E, angiotensin-converting enzyme, methylenetetrahydrofolate reductase, and angiotensinogen genes had been studied in >2000 subjects and were evaluated by meta-analysis. There was no evidence for an association between apolipoprotein E (epsilon 4+/-), methylenetetrahydrofolate reductase (677 cytosine/thymine polymorphism [C/T]), or angiotensinogen (Met235Thr) and WMH. For the angiotensin-converting enzyme insertion/deletion polymorphism (I/D) there appeared to be a significant association (OR, 1.95; 95% CI, 1.09-3.48), but this may be partly attributable to the small study (mainly publication) and other biases. No genetic polymorphism has yet shown convincing evidence for an association with WMH. Much larger studies will be needed to detect and confirm genetic associations with this promising trait in the era of genome-wide association studies.


[A case of motor neuropathy with pyramidal sign due to prolonged administration of high dose of pancuronium bromide (Myoblock)].
We reported a case of motor neuropathy with pyramidal sign following prolonged administration of a high dose of muscle relaxant, pancuronium bromide (Myoblock). A 40-year-old male was admitted to our hospital with acute episode of pancreatitis. He was treated with artificial ventilation and Myoblock to manage delirious state, disseminated intravascular coagulation and multiple organ failure. Total dose of 823 mg (24 mg/day) of Myoblock was given intravenously over 36 days. After Myoblock was discontinued, he regained his consciousness and marked muscle weakness with atrophy was noted in both limbs, more severe in distal lower limbs, without any noticeable sensory and sphincter disturbances. Motor nerve conduction studies showed normal nerve conduction velocities with markedly decreased amplitude of compound muscle action potentials. Repetitive nerve stimulation studies revealed decrement response after tetanic stimulation, which disappeared later. Needle EMG showed active denervation potentials and marked polyphasic motor unit potentials. Muscle biopsy revealed neurogenic muscle atrophy with fragmented acetylcholine esterase-positive postsynaptic sites. Sural nerve biopsy showed slight to moderate degree of axonal degeneration of myelinated fibers. Clinical, electrophysiological, and pathological studies above indicated that the main affected sites were neuromuscular junctions including the terminal twigs of motor neurones and postsynaptic membrane, and pyramidal tracts, predominant in lower limbs. About one month after the recognition of the muscle weakness, his muscle strength improved gradually, however, spasticity with hyperreflexia and pathologic reflexes of both legs were found, and became more prominent thereafter. Intensive physiotherapy and rehabilitation led improvement to the point that he became able to ambulate with walking-aids about 7 months later, but marked spasticity persisted.(ABSTRACT TRUNCATED AT 250 WORDS)


A Review on CAD/CAM Yttria-Stabilized Tetragonal Zirconia Polycrystal (Y-TZP) and Polymethyl Methacrylate (PMMA) and Their Biological Behavior.
Yttria-stabilized tetragonal zirconia polycrystal (Y-TZP) and polymethyl methacrylate (PMMA) are used very often in dentistry. Y-TZP is the most widely used zirconia dental ceramic, and PMMA has classically been used in removable prosthesis manufacturing. Both types of materials are commercialized in CAD/CAM system blocks and represent alternatives for long-lasting temporary (PMMA) or definitive (Y-TZP) implantological abutments. The aim of the present work is to reveal that human gingival fibroblasts (HGFs) have a favorable response when they are in contact with Y-TZP or PMMA as a dental implant abutment or implant-supported fixed prosthesis, and also to review their principal characteristics. We conducted an electronic search in the PubMed database. From an initial search of more than 32,000 articles, the application of filters reduced this number to 5104. After reading the abstracts and titles, we reduced the eligible articles to 23. Ultimately, we have included eight articles in this review.


Preconception care of women with diabetes: a review of current guideline recommendations.
The prevalence of type 2 diabetes mellitus (T2DM) continues to rise worldwide. More women from developing countries who are in the reproductive age group have diabetes resulting in more pregnancies complicated by T2DM, and placing both mother and foetus at higher risk. Management of these risks is best achieved through comprehensive preconception care and glycaemic control, both prior to, and during pregnancy. The aim of this review was to compare the quality and content of current guidelines concerned with the preconception care of women with diabetes and to develop a summary of recommendations to assist in the management of diabetic women contemplating pregnancy. Relevant clinical guidelines were identified through a search of several databases (MEDLINE, SCOPUS and The Cochrane Library) and relevant websites. Five guidelines were identified. Each guideline was assessed for quality using the AGREE instrument. Guideline recommendations were extracted, compared and contrasted. All guidelines were assessed as being of high quality and strongly recommended for use in practice. All were consistent in counselling about the risk of congenital malformation related to uncontrolled blood sugar preconceptionally, ensuring adequate contraception until glycaemic control is achieved, use of HBA1C to monitor metabolic control, when to commence insulin and switching from ACE inhibitors to other antihypertensives. Major differences were in the targets recommended for optimal metabolic control and opinion regarding the usage of metformin as an adjunct or alternative treatment before or during pregnancy. International guidelines for the care of women with diabetes who are contemplating pregnancy are consistent in their recommendations; however some are more comprehensive than others. Having established current standards for the preconception care of diabetic women, there is now a need to focus on guideline implementation through an examination of the barriers and enablers to successful implementation, and the applicability of the recommendations in the local setting.


Body dissatisfaction among Chinese undergraduates and its implications for eating disorders in Hong Kong.
To study the body dissatisfaction of Chinese undergraduates and its implications for eating disorders in Hong Kong. A large sample of 1,581 subjects completed a "Body Dissatisfaction Questionnaire" (BDQ) which included 25 items about various body parts and questions on body indices, body shape dissatisfaction, and dieting. Whereas male subjects wanted to be taller and stronger in their upper body, the majority of female subjects felt fat in their lower body and were cognitively inclined to weigh less even though they were not obese. They desired a slimming of the stomach, thighs, waist and hip, but not the breasts. Body dissatisfaction was substantially intensified in females who reported a history of dieting in the previous year. Factor analysis of the BDQ affirmed the gender specificity and multidimensionality of body dissatisfaction. The typically "Western" pattern of body dissatisfaction has overshadowed the traditional Chinese notions of female beauty based on the face and other nontruncal features. In the context of a rapidly urbanizing Chinese society, this will predispose more females to weight control behavior and eating disorders.


Pd on thermo-responsive composite of silica-coated carbon nanotube and 1-vinyl-3-butylimidazolium-based ionic liquid copolymers as an efficient catalyst for hydrogenation of nitro compounds.
In this work, an ionic liquid-containing thermo-responsive heterogeneous catalyst with utility for promoting hydrogenation of nitro-compounds in aqueous media is developed. To prepare the catalyst, silica-coated carbon nanotubes were synthesized and vinyl-functionalized. The resulted compound was then polymerized with 1-viny-3-butylimidazolium bromide and N-isopropylacrylamide. The obtained ionic liquid-containing thermo-responsive composite was palladated via wet-impregnation method to give the final catalyst. Study of the performance of the catalyst confirmed high catalytic activity of the catalyst at temperature above the lower critical solution temperature. Furthermore, the catalyst was highly recyclable and showed negligible Pd leaching upon recycling. Broad substrate scope and selectivity of the catalyst towards reduction of nitro functionality were also confirmed. Furthermore, hot filtration test implied the heterogeneous nature of the catalysis. The comparison of the activity of Pd/CNT-P with some control catalysts approved the importance of hybridization of P and CNT and the presence of ionic liquid for the catalytic activity.


Melatonin rhythms in seasonal affective disorder.
We examined 24-hour melatonin rhythms from 20 patients with seasonal affective disorder (SAD) and 20 healthy volunteers. Patients and controls were individually matched for age, sex, and month of study. Plasma samples were taken at hourly intervals, and were assayed for melatonin by radio-immunoassay. The 24-hourly melatonin estimations for each individual were fitted to a cosine curve, and the significance of the curve fits was calculated. Two analyses were performed. In analysis 1 the following were calculated: (a) cosine fit, (b) significance of fits, (c) mean amplitude and acrophase (peak) and (d) mean melatonin levels. The curve fits were highly significant for all but three subjects (two patients, one control), but there were no significant differences in any measure between the two groups. In analysis 2 the comparisons were repeated and restricted to the 18 patients and 19 controls in whom there was a significantly significant melatonin rhythm. Again there were no significant differences between groups. These results suggest that the circadian rhythm of melatonin is not abnormal in SAD, and that the therapeutic effect of light in SAD is not mediated by phase shifts in melatonin secretion.


Gender difference in the relationship between passive smoking exposure and HDL-cholesterol levels in late adolescence.
High-density lipoprotein-cholesterol (HDL-C) levels are influenced by gender and by genetic and environmental factors. We aimed to assess the impact of passive smoking exposure since birth on HDL-C levels of nonsmoking adolescents at age 17 years and to determine whether there was a gender difference in the relationship between smoking exposure and HDL-C. A total of 804 nonsmoking adolescents with biochemical, anthropometric, and lifestyle data from a cohort of 1754 adolescents (mean age, 17 ± 0.25 y) of the Western Australian Pregnancy Cohort (Raine) Study had data of maternal smoking during pregnancy and smoking exposure in the household over 17 years. HDL-C was analyzed using multivariable linear regression, with adjustment for early-life, adiposity, and current lifestyle confounders. HDL-C levels were significantly lower in girls exposed to passive smoking compared to those not exposed (regression coefficient b = -0.09 [95% confidence interval, -0.15, -0.03]); this was not observed in boys (b = 0.02 [95% confidence interval, -0.04, 0.08]), with a significant sex interaction P = .009. The effects of passive smoking in girls persisted after adjusting for oral contraceptive use. This study has shown a gender difference in the relationship between passive smoking exposure since birth and HDL-C in late adolescence. Exposure to passive smoking in girls could have adverse consequences on their risk of cardiovascular disease in adulthood. These findings reinforce the need for future public health measures to reduce children's exposure to passive smoking.


Predescemetic dissection for healed hydrops--judicious use of air and fluid.
To demonstrate the efficacy of a planned near-Descemet dissection deep anterior lamellar keratoplasty (nddDALK) in posthydrops corneal scarring. In a retrospective noncomparative case series, nddDALK was performed on 22 consecutive eyes of 22 patients with posthydrops scarring because of keratoconus. After a partial thickness corneal trephination, air was injected at superficial to midstromal depth, followed by an anterior keratectomy. Multiple episodes of stromal hydration with a blunt cannula followed by air injection were repeated to leave a thin stromal layer. A #69 Beaver blade (BD, Franklin Lakes, NJ) was used to remove the scar. The best spectacle-corrected visual acuity (BSCVA), spherical equivalent, and refractive cylinder were recorded 12, 24, and 36 months after surgery. Intraoperative and postoperative complications were noted. Twelve months after surgery, the BSCVA was ≥ 20/40 in 68.1% of patients. The mean spherical equivalent was -3.53 ± 2.94 diopters (D), and the average refractive cylinder was 3.42 ± 1.7 D. Microperforations occurred in 6 patients, all of which were successfully tamponaded by an intracameral air injection alone. nddDALK gives good visual results and quality of vision. In developing countries, lamellar-grade donor corneas are almost the only option available. Apart from visual benefits, the procedure puts the patient at a minimal risk of immune rejection, which is a major complication of penetrating keratoplasty.


Machine learning in optical coherence tomography angiography.
Optical coherence tomography angiography (OCTA) offers a noninvasive label-free solution for imaging retinal vasculatures at the capillary level resolution. In principle, improved resolution implies a better chance to reveal subtle microvascular distortions associated with eye diseases that are asymptomatic in early stages. However, massive screening requires experienced clinicians to manually examine retinal images, which may result in human error and hinder objective screening. Recently, quantitative OCTA features have been developed to standardize and document retinal vascular changes. The feasibility of using quantitative OCTA features for machine learning classification of different retinopathies has been demonstrated. Deep learning-based applications have also been explored for automatic OCTA image analysis and disease classification. In this article, we summarize recent developments of quantitative OCTA features, machine learning image analysis, and classification.


Does hemineglect affect visual mental imagery? Imagery deficits in representational and perceptual neglect.
To give new insight about the relationship between imagery processes and different types of hemispatial neglect, we assessed different mental imagery abilities in a sample of right- and left-brain-damaged patients. Furthermore, because of reports of a mental representation disorder for environments in patients affected by representational neglect we also tested their navigational imagery ability. We found that patients with no signs of perceptual or representational neglect performed flawlessly on our imagery tasks regardless of whether they had left- or right-sided lesions. By contrast, patients affected by neglect failed most of the tests; in particular, representational neglect patients failed one test of mental transformation and tests requiring the manipulation of cognitive maps. These results suggest there is a specific relationship between hemispatial neglect and deficits in visual mental imagery and demonstrate that the right hemisphere plays a specific role in visual mental imagery.


Response to erythropoietin in erythroid subclones of the factor-dependent cell line 32D is determined by translocation of the erythropoietin receptor to the cell surface.
Regulation of the expression of the erythropoietin (Epo) receptor (EpoR) gene is under the control of transcriptional regulatory factor GATA-1. GATA-1 is expressed widely among the nonerythroid, factor-dependent subclones of the interleukin 3-dependent mouse cell line 32D. Consequently, to determine whether GATA-1 and EpoR gene expression are linked even in nonerythroid cells, we have studied the correlation of GATA-1 expression with expression and function of EpoR in these cell lines. EpoR mRNA (by RNase protection analysis) and EpoR protein (by specific antibody immunoprecipitation of metabolically labeled EpoR protein) were detectable not only in 32D and 32D Epo (an Epo-dependent subclone) but also in 32D GM, a subclone dependent for growth on granulocyte/macrophage colony-stimulating factor. EpoR mRNA also was detectable by PCR in 32D G, a subclone dependent for growth on granulocyte colony-stimulating factor. However, only 32D Epo cells bound 125I-labeled Epo and expressed EpoR protein on the cell surface, as determined by immunoprecipitation of surface-labeled proteins. These results indicate that, in these factor-dependent cell lines, the major regulatory step determining the erythroid-specific response to Epo is the efficiency of EpoR protein translocation to the cell surface. Mechanisms that could affect lineage-specific translocation are the presence of a chaperone protein, erythroid-specific editing of EpoR mRNA, or altered processing of the EpoR protein to the cell surface. In this model, lineage-restricted responses to growth factors such as Epo are determined not by expression of the genes for growth factor receptors but, rather, by appropriate processing of the receptor protein.


Bioptics in phakic and pseudophakic intraocular lens with the Nidek EC-5000 excimer laser.
To evaluate predictability, safety, stability, and complications related to bioptics in patients that received phakic and those that received pseudophakic intraocular lenses. Both groups had LASIK with the Nidek EC-5000 excimer laser following IOL implantation. We evaluated retrospectively 281 eyes of 196 patients with posterior chamber phakic implantation (ICL) and 64 pseudophakic eyes of 55 patients. All patients had LASIK 1 month or more after the first surgery. We used a treatment zone of 5.5 mm with a 7.00-mm transition zone. The flap was made with the Automated Corneal Shaper (ACS). In the group of phakic ICL eyes with bioptics, preoperative mean spherical equivalent refraction was -5.50 D (range, -1.37 to -16.00 D). The first day after LASIK, mean spherical equivalent refraction was -0.06 D, and at 1 month, -0.40 D. In pseudophakic bioptics eyes, preoperative mean spherical equivalent refraction was -2.61 D (range, +0.50 to -5.50 D). The first day after LASIK it was +0.27 D, and 1 month after LASIK it was +0.09 D. The incidence of complications was similar in both groups of patients. The most frequent complication was keratitis sicca (approximately 10% in each group). Interstitial edema (2.1%) was present only in phakic bioptics eyes. No retinal complications were observed. Refraction was stable 4 years after surgery. Target achieved refraction was +/- 0.50 D, showing the predictability of the procedure. Predictability and safety were demonstrated according to results and absence of severe complications related with this technique. Older patients did not develop more complications than younger people; dry eye incidence was similar in both groups. In extreme myopia patients did not present retinal complications related to surgical procedures.


Atomic scale interface engineering by modulated ion-assisted deposition applied to soft x-ray multilayer optics.
Cr/Sc and Ni/V multilayers, intended as normal incidence soft x-ray mirrors and Brewster angle polarizers, have been synthesized by employing a novel modulated low-energy and high-flux ion assistance as a means of engineering the interfaces between the subnanometer layers on an atomic scale during magnetron sputter deposition. To reduce both roughness and intermixing, the ion energy was modulated within each layer. The flat and abrupt interfaces yielded soft x-ray mirrors with near-normal incidence reflectances of R = 20.7% at the Sc 2p absorption edge and R = 2.7% at the V 2p absorption edge. Multilayers optimized for the Brewster angle showed a reflectance of R = 26.7% and an extinction ratio of R(s)/R(p)=5450 for Cr/Sc and R = 10% and R(s)/R(p)=4190 for Ni/V. Transmission electron microscopy investigations showed an amorphous Cr/Sc structure with an accumulating high spatial frequency roughness. For Ni/V the initial growth mode is amorphous and then turns crystalline after approximately 1/3 of the total thickness, with an accumulating low spatial frequency roughness as a consequence. Elastic recoil detection analyses showed that N was the major impurity in both Cr/Sc and Ni/V with concentrations of 15 at. % and 9 at. %, respectively, but also O (3 at. % and 1.3 at. %) and C (0.5 at. % and 1.9 at. %) were present. Simulations of the possible normal incidence reflective properties in the soft x-ray range of 100-600 eV are given, predicting that reflectivities of more than 31% for Cr/Sc and 5.8% for Ni/V can be achieved if better control of the impurities and the deposition process is employed. The simulations also show that Cr/Sc is a good candidate for mirrors for the photon energies between the absorption edges of B (E = 188 eV) and Sc (E = 398.8 eV).


A cost-effectiveness evaluation of enamel matrix derivatives alone or in conjunction with regenerative devices in the treatment of periodontal intra-osseous defects.
To identify the most cost-effective approach to treatment of infrabony lesions with enamel matrix derivatives (EMD). We incorporated costs and clinical outcomes of 12 different treatment techniques (including flap operation, EMD alone, and EMD in association with other reconstructive devices) within a decision tree model in which costs were based on insurance regulations in Germany and health outcomes followed a recent meta-analysis. The most cost-effective treatment option was identified on the basis of the maximum net benefit criterion. Treatment techniques using EMD were cost-efficient if the decision maker's willingness-to-pay (WTP) was at least €150-175 per incremental mm of pocket probing depth reduction and clinical attachment level gain, respectively (1-year perspective). When EMD was affordable, the maximum net benefit was achieved by treatment with EMD in conjunction with bioactive glass or bovine bone substitutes. Additional application of platelet-rich plasma (PRP) or a resorbable membrane came at relatively high costs. If EMD use is indicated, EMD in conjunction with either bioactive glass or bovine bone substitutes is more cost-effective than EMD alone. The additional use of PRP or a resorbable membrane may only be justifiable when monetary resources for treatment are very generous.


[Lasers in dentistry 3. The use of lasers for the prevention of dental caries].
Studies in our laboratories have demonstrated that specifically chosen CO2 laser treatment of dental enamel can markedly inhibit subsequent caries-like progression compared to controls in a laboratory model. Optimum caries inhibition in enamel appears to be achieved by pretreatments that produce surface temperatures in the range of 800-1200 degrees C. For clinical application the surface enamel heating must not lead to consequent pulp chamber temperature rises of > 4 degrees C. To meet these conditions a pulsed laser is required with a sufficiently high absorption coefficient (wavelength = 9.3 or 9.6 microns), pulse duration of 5-100 microseconds, 10-25 pulses per spot, repetition rate of 10-30 pulses per second, and low but effective fluence (approximately 1-5 J/cm2/pulse). A human intra-oral study has confirmed inhibition of caries progression in the human mouth. The clinical potential is good for caries preventive treatments by specific carbon dioxide laser conditions.


A century after Fisher: time for a new paradigm in quantitative genetics.
Quantitative genetics traces its roots back through more than a century of theory, largely formed in the absence of directly observable genotype data, and has remained essentially unchanged for decades. By contrast, molecular genetics arose from direct observations and is currently undergoing rapid changes, making the amount of available data ever greater. Thus, the two disciplines are disparate both in their origins and their current states, yet they address the same fundamental question: how does the genotype affect the phenotype? The rapidly accumulating genomic data necessitate sophisticated analysis, but many of the current tools are adaptations of methods designed during the early days of quantitative genetics. We argue here that the present analysis paradigm in quantitative genetics is at its limits in regards to unraveling complex traits and it is necessary to re-evaluate the direction that genetic research is taking for the field to realize its full potential.


Comparative study of uptake and cellular distribution of Hg203-labeled phenyl-mercuric acetate and mercuric acetate by pea roots.
Uptake and cellular distribution of mercury(203) from dilute mercuric acetate or phenylmercuric acetate solutions by excised pea roots (Pisum sativum) have been investigated. The time course of uptake showed that the amount of mercury uptake was increased with the time of incubation, and was similar for inorganic mercury or phenylmercuric acetate. The trend of mercury(203) incorporation into cellular components from mercuric acetate and phenylmercuric acetate differed greatly as the time of incubation increased. The concentrations of mercuric acetate and phenylmercuric acetate solutions or the temperature of incubation also affected the mercury(203) uptake as well as its cellular distribution. Longer time of exposure or higher concentration resulted in a greater mercury incorporation into mitochondrial fraction from phenylmercuric acetate than from inorganic mercury. This difference in intracellular distribution may be responsible for the degree of toxicity between inorganic mercury and phenylmercuric acetate in biological systems.


Pronounced ST-segment depression during paroxysmal supraventricular tachycardia.
To determine the clinical significance of ST-segment depression observed in paroxysmal supraventricular tachycardia (PSVT), we evaluated the 12-lead electrocardiogram (ECG) during spontaneous PSVT in 54 patients (27 men and 27 women: mean age +/- SD; 47 +/- 18 years), who came to our clinic for the treatment of PSVT. Coronary angiography was performed in 16 patients (16 to 74 years; mean = 50 +/- 18) and treadmill exercise testing was performed in 21 patients. A cardiac electrophysiological study was carried out in 24 patients. During PSVT, ST-segment score was calculated as the sum of the ST-segment depression in 12 leads. The correlations between the ST-segment score, PSVT rate and age of the patient were analyzed as follows: The most significant positive correlation was observed between the ST-segment score and the PSVT rate (r = 0.615, p < 0.000001). The next most significant correlation was found between the PSVT rate and the age of the patient (r = -0.500, p = 0.00011). A negative correlation was also observed between the ST-segment score and the age of the patient (r = -0.429, p = 0.0012). In 13 of 16 patients, coronary angiography did not reveal any significant (> or = 75% in area) stenosis. Exercise testing induced significant ST-segment depression in 3 patients, of whom two had significant coronary artery lesions. PSVT was due to atrioventricular reentry via an overt (n = 3) or concealed accessory pathway (n = 15), atrioventricular nodal reentry (n = 5) and sinus node reentry (n = 1). In conclusion, patients with a faster PSVT rate revealed more pronounced ST-segment depression than did those with a slower PSVT rate, possibly reflecting the modified repolarization process instead of coronary artery involvement.


Relative contributions of dietary sodium sources.
Information on the relative contributions of all dietary sodium (Na) sources is needed to assess the potential efficacy of manipulating the component parts in efforts to implement current recommendations to reduce Na intake in the population. The present study quantified the contributions of inherently food-borne, processing-added, table, cooking, and water sources in 62 adults who were regular users of discretionary salt to allow such an assessment. Seven-day dietary records, potable water collections, and preweighted salt shakers were used to estimate Na intake. Na added during processing contributed 77% of total intake, 11.6% was derived from Na inherent to food, and water was a trivial source. The observed table (6.2%) and cooking (5.1%) values may overestimate the contribution of these sources in the general population due to sample characteristics, yet they were still markedly lower than previously reported values. These findings, coupled with similar observations from other studies, indicate that reduction of discretionary salt will contribute little to moderation of total Na intake in the population.


Adequate asparaginase is important to prevent central nervous system and testicular relapse of pediatric Philadelphia chromosome-negative B-cell acute lymphoblastic leukemia.
Asparaginase (Asp) is one of the most important drugs for treating acute lymphoblastic leukemia (ALL). However, off-protocol Asp administration (OPAA) or hypersensitivity may disturb its pharmacokinetic profile. In this retrospective study, we sought to determine whether OPAA and hypersensitivity to Escherichia coli asparaginase (E coli Asp) impaired extramedullary relapse prevention in a pediatric ALL cohort treated according to SCMC-ALL-2005 protocol from 2005 to 2014 at the Shanghai Children's Medical Center (SCMC). In total, 676 patients were enrolled in this study, including 369 with OPAA and 60 exhibiting hypersensitivity to E coli Asp. At the end of the most recent follow-up, 58 patients had extramedullary relapse. The 5-year cumulative extramedullary relapse incidence in patients with OPAA was 11.01%, whereas that in patients without OPAA was 5.28% (P = .0036). Moreover, the 5-year cumulative extramedullary relapse incidence in patients that exhibited hypersensitivity to E coli Asp was 16.48%, whereas that in patients without hypersensitivity was 7.59% (P = .0195). Concerning the relapse site, OPAA not only increased central nervous system (CNS) relapse but testicular relapse as well. Based on Fine and Gray multivariate analysis, OPAA and hypersensitivity to Asp were independent risk factors for extramedullary relapse. In conclusion, to prevent extramedullary relapse of ALL, adequate duration to administrate Asp was more important than the total dosage, and more attention should be paid to Asp inadequate due to hypersensitivity.


Development of a brief psychological intervention for perinatal depression (BIND-P).
Lack of recognition in national programs, poor referral system, and non-availability of trained human resources are the important barriers for the delivery of perinatal depression (PND) services in low- and middle-income countries (LAMICs). To address this there is an urgent need to develop an integrative and non-specialist-based stepped care model. As part of its research thrust on target areas of India's National Mental Health Programme (NMHP), the Indian Council of Medical Research funded a research project on the outcome of PND at four sites. In this article, we describe the development of the primary health care worker-based stepped care model and brief psychological intervention for PND. A literature review focused on various aspects of PND was conducted to develop a model of care and intervention under NMHP. A panel of national and international experts and stakeholders reviewed the literature, opinions, perspectives, and proposal for different models and interventions, using a consensus method and WHO implementation toolkit. A consensus was reached to develop an ANM (Auxillary nurse midwife)-based stepped-care model consisting of the components of care, training, and referral services for PND. Furthermore, a brief psychological intervention (BIND-P) was developed, which includes the components of the low-intensity intervention (eg, exercise, sleep hygiene). The BIND-P model and intervention provide a practical approach that may facilitate effective identification, treatment, and support women with PND. We are currently evaluating this model across four study sites in India, which may help in the early detection and provision of appropriate and integrative care for PND.


Coupled wave equations theory of surface-enhanced femtosecond stimulated Raman scattering.
We present a coupled wave semiclassical theory to describe plasmonic enhancement effects in surface-enhanced femtosecond stimulated Raman scattering (SE-FSRS). A key result is that the plasmon enhanced fields which drive the vibrational equation of motion for each normal mode results in dispersive lineshapes in the SE-FSRS spectrum. This result, which reproduces experimental lineshapes, demonstrates that plasmon-enhanced stimulated Raman methods provide unique sensitivity to a plasmonic response. Our derived SE-FSRS theory shows a plasmonic enhancement of |gpu|(2)ImχR(ω)gst (2)/ImχR(ω), where |gpu|(2) is the absolute square of the plasmonic enhancement from the Raman pump, χR(ω) is the Raman susceptibility, and gst is the plasmonic enhancement of the Stokes field in SE-FSRS. We conclude with a discussion on potential future experimental and theoretical directions for the field of plasmonically enhanced coherent Raman scattering.


Genome-wide comparison reveals great inter- and intraspecies variability in B. pseudomallei and B. mallei pathogens.
Burkholderia mallei and B. pseudomallei, closely related Gram-negative bacteria, are causative agents of serious infectious diseases of humans and animals: glanders and melioidosis, respectively. Despite numerous studies of these pathogens, the detailed mechanism of their pathogenesis is still unknown. The problem is even more complicated due to natural variability of B. pseudomallei and B. mallei strains, the understanding of which is a prerequisite for rational design of tools for diagnostics, prophylaxis and therapy of the diseases. Using a subtractive hybridization technique, we compared the genomes of B. pseudomallei C-141 and B. mallei C-5 strains. A subtracted library of DNA fragments specific for B. pseudomallei C-141 and absent from B. mallei C-5 was obtained and analyzed. A variety of differences have been detected and mapped on the recently sequenced genome of B. pseudomallei K96243. A comparative sequence analysis also revealed considerable genomic differences between B. pseudomallei C-141 and B. mallei ATCC 23344 strains sequenced at The Institute for Genomic Research (TIGR). We also observed significant genomic differences between B. pseudomallei C-141 and B. pseudomallei K96243. Some of the differential DNA fragments displayed similarity to different mobile elements which have not yet been described for B. pseudomallei, whereas the others matched various prophage components, components of active transport systems, different enzymes and transcription regulators. A substantial proportion of the differential clones had no database matches either at the nucleotide or protein level. The results provide evidence for great genome-wide variability of B. pseudomallei, further confirmed by Southern blot analysis of various B. pseudomallei strains. The data obtained can be useful for future development of efficient diagnostic tools allowing rapid identification of species, strains and isolates of B. mallei and B. pseudomallei.


Isolation and Characterization of Phosphoenolpyruvate Phosphatase from Germinating Mung Beans (Vigna radiata).
A phosphoenolpyruvate (PEP) phosphatase was purified to homogeneity from germinating mung beans (Vigna radiata). It was found to be a tetrameric protein (molecular mass 240,000 daltons) made up of apparently identical subunits (subunit molecular mass 60,000 daltons). It was free from bound nucleotides. It did not show pyruvate kinase activity. The enzyme showed high specificity for PEP. Pyrophosphate and some esters (nucleoside di- and triphosphates) were hydrolyzed slowly and phosphoric acid monoesters were not hydrolyzed. The enzyme showed maximum activity at pH 8.5. At this pH, the K(m) of PEP was 0.14 millimolar and the V(max) was equal to 1.05 micromoles pyruvate formed per minute per milligram enzyme protein. Dialysis of the enzyme against 10 millimolar triethanolamine buffer (pH 6.5), led to loss of the catalytic activity, which was restored on addition of Mg(2+) ions (K(m) = 0.12 millimolar). Other divalent metal ions inhibited the Mg(2+) -activated enzyme. PEP-phosphatase was inhibited by ATP and several other metabolites.


Neural stem cell depletion and CNS developmental defects after enteroviral infection.
Coxsackieviruses are significant human pathogens causing myocarditis, meningitis, and encephalitis. We previously demonstrated the ability of coxsackievirus B3 (CVB3) to persist within the neonatal central nervous system (CNS) and to target neural stem cells. Given that CVB3 is a cytolytic virus and may therefore damage target cells, we characterized the potential reduction in neurogenesis within the developing brain and the subsequent developmental defects that occurred after the loss of these essential neural stem cells. Neonatal mice were inoculated with a recombinant CVB3 expressing eGFP (eGFP-CVB3), and alterations in neurogenesis and brain development were evaluated over time. We observed a reduction in proliferating cells in CNS neurogenic regions simultaneously with the presence of nestin(+) cells undergoing apoptosis. The size of the brain appeared smaller by histology, and a permanent decrease in brain wet weight was observed after eGFP-CVB3 infection. We also observed an inverse relationship between the amount of virus material and brain wet weight up to day 30 postinfection. In addition, signs of astrogliosis and a compaction of the cortical layers were observed at 90 days postinfection. Intriguingly, partial brain wet weight recovery was observed in mice treated with the antiviral drug ribavirin during the persistent stage of infection. Hence, long-term neurological sequelae might be expected after neonatal enteroviral infections, yet antiviral treatment initiated long after the end of acute infection might limit virus-mediated neuropathology.


Giant sublingual hamartoma with medial cleft tongue: a case report and literature review.
Hamartomas commonly occur in respiratory and digestive organs, such as the lungs, pancreas, and liver; they rarely occur in the oral cavity, especially in the sublingual region. This report describes a 5-month-old boy who presented with a giant sublingual hamartoma and medial cleft tongue. He underwent corrective operations at 5 months, 11 months, and 31 months of age. Histopathological analysis revealed features suggestive of hamartoma. There have been no signs of recurrence. The boy exhibited normal speech development at 3 years of age; all other oral functions were unaffected at that time. This report includes a review of relevant literature. The findings in this report and previous literature suggest that a multidisciplinary approach, carefully planned staged surgery, and rehabilitation are needed to achieve favorable outcomes in patients with hamartoma in the oral cavity.


Tetanus toxoid vaccination coverage and differential between urban and rural areas of Bangladesh.
Government commitment and support from a range of partnerships have led to a massive increase in tetanus toxoid immunization coverage among women of childbearing age, ensuring that both mothers and babies are protected against tetanus infection in Bangladesh. In order to control and eliminate the vaccine preventable diseases it is important to know the vaccination coverage. The major objective of this study is to determine the complete vaccination rate and the predictors that influence vaccination of mothers during pregnancy and to see whether there is any gap lies between the women of urban and rural areas regarding the tetanus toxoid injection receiving. This study utilizes the data extracted from Bangladesh Demographic and Health Survey 2004 (BDHS).To meets the objectives this study considers bivariate and multivariate analysis. The study represents that 88 per cent urban mothers and 84 per cent rural mothers receive tetanus toxoid injection during their pregnancy period. Logistic regression model is adjusted by wealth index, mother's age at last birth, education, husband's occupation, ever using contraception, fertility preference, wanted last child, having permission to go to hospital/health center, telling about pregnancy complications and mass media exposure for receiving TT injection. All these explanatory variables come out to be as significant determinants of receiving TT injection for all mothers as well as for rural mothers in Bangladesh. On the other hand ever using contraception, wanted last child, telling about pregnancy complications, mass media exposure and wealth index are the significant determinants of receiving TT injection for mothers of urban area.


Helicobacter pylori infection and gastric carcinoma among Japanese Americans in Hawaii.
Helicobacter pylori are gram-negative spiral bacteria that are associated with chronic gastritis, a known precursor of gastric carcinoma. Persons at high risk for gastric carcinoma have been shown to have a high prevalence of H. pylori infection. We studied the relation of H. pylori infection and gastric carcinoma in a cohort of Japanese American men living in Hawaii. The 5908 men were enrolled and examined from 1967 to 1970. By 1989, 109 cases of pathologically confirmed gastric carcinoma had been identified. The store serum of each patient with gastric carcinoma and of each matched control subject were tested for the presence of serum IgG antibody to H. pylori. Ninety-four percent of the men with gastric carcinoma and 76 percent of the matched control subjects had a positive test for H. pylori antibodies, for an odds ratio of 6.0 (95 percent confidence interval, 2.1 to 17.3). As the level of antibody to H. pylori increased, there was a progressive increase in the risk of gastric carcinoma (P for trend = 0.0009). The association was strong even for men in whom the diagnosis was made 10 or more years after the serum sample was obtained (odds ratio, 10.5; 95 percent confidence interval, 2.5 to 44.8). Infection with H. pylori is strongly associated with an increased risk of gastric carcinoma. However, most persons infected with H. pylori will never have gastric carcinoma. Therefore, other factors that increase the risk of gastric carcinoma among persons infected with H. pylori need to be identified.


The association between plasma uric acid level and cardiovascular events in patients with stable coronary artery disease: a short-term follow-up study.
Aim The association of uric acid (UA) level with major cardiovascular risk factors has been well-known. However, whether UA is a risk factor for coronary artery disease (CAD) still remains controversial. We aimed to examine the short term effect of plasma UA level on cardiovascular events (CVEs) in patients with stable CAD. Methods The study included 147 consecutive patients with CAD. The patients were evaluated in two groups. Group 1: 101(68.7%) patients with UA level higher than 6.5 mg/dL for females and 7 mg/dL for males (n= 38 and 63, respectively); Group 2: 46 (31.3%) patients with UA level lower than those values (n= 15 and 31, respectively). The patients were followed for 15.3 ± 5.5 months. Death, acute coronary syndrome, stroke and other cardiovascular hospitalizations were defined as CVE. The relationship between CVEs and plasma UA level was examined using the Cox-regression analysis. Results The mean age was 63 ± 11 years [94 (63.9%) males, 53 (36.1%) females]. Forty-five (30.6%) had diabetes mellitus and 106 (72.1%) had hypertension. The mean UA level was 6.0 ± 1.5 mg/dL. In the follow-up, 23 (15.6%) had any defined CVEs. Only two patients died. No statistical significance was found in terms of the association between plasma UA level and CVEs (p = 0.61). Conclusion In patients with stable CAD no relation between plasma UA level and CVEs in the short-term was found. However, this subject still needs further studies with longer follow-up period.


Evaluation and advantages of an automatic magnetic mixing of syringes integrated to a whole blood gas analyser.
Arterial blood gases are essential for the diagnostic and therapeutic management of severely ill patients. The pre-analytic phase is crucial to the quality and interpretation of the results. Whole blood specimens used for blood gas analysis must be thoroughly mixed prior to analysis. Producing a homogeneous sample is important to obtain accurate results. The availability of a new system able to automate the standardization of the sample mixing would be a way to improve this step. We evaluated the quality of automatic mixing with the use of SafePICO syringes and ABL 825 FLEX blood-gas analyser. Quantitative measurements of total hemoglobin and potassium were performed on ABL 825 FLEX from 216 whole blood specimens collected in SafePICO syringes and were compared with those obtained with LH 750 for hemoglobin and LX 20 for potassium. Quantitative results showed excellent agreement with a reference analyser for the analytes with correlation coefficients greater than 0.97. No bias was observed for hemoglobin and the small difference observed for potassium is not clinically significant and was not due to hemolysis but to the differences between the methods. ABL 825 FLEX produces a homogeneous specimen which minimizes the pre-analytical errors manipulator dependent.


Growth inhibition and induction of differentiation by panaxydol in rat C6 glioma cells.
Panaxydol is a naturally occurring non-peptidyl small molecule isolated from the lipophilic fractions of Panax notoginseng, a well-known Chinese traditional medicine. In this study, we aimed to investigate the effects of panaxydol on growth inhibition and its mechanisms in C6 rat glioma cells. The effects of panaxydol on cell proliferation, morphologic changes, glial fibrillary acidic protein (GFAP) expression and cell cycle regulation in rat C6 cells were evaluated using 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide (MTT) assay, hematoxylin and eosin (HE) staining, immunocytochemistry, flow cytometric analysis and Western blot respectively. Panaxydol markedly inhibited the proliferation of C6 cells in a dose-dependent manner with IC50 of 39.5 +/- 2.3 microM. In addition, the cell morphologic changes and increased expression of GFAP in C6 cells in the presence of panaxydol implied a cellular differentiation. Flow cytometric analysis revealed that panaxydol-treated cells accumulated in G0/G1 phase with a marked decrease in the number of C6 cells at S phase. Western blot analysis demonstrated that panaxydol resulted in an increase in the protein expression of p27 in C6 cells as early as 3 hours after treatment consistent with the differentiation response, but protein expression of p53, p21, p16 and pRb remained unchanged. These findings suggest that panaxydol inhibits the proliferation of C6 cells via G0/G1 cell cycle arrest in association with induction of p27 expression and differentiation.