Noninvasive positive pressure ventilation following esophagectomy: safety demonstrated in a pig model.
Respiratory complications occur in 20% to 65% of patients who have undergone esophagectomy. While noninvasive positive pressure ventilation (NPPV) is associated with fewer complications than endotracheal intubation (ET), it is relatively contraindicated after esophagectomy due to potential injury to the anastomosis. We created ex vivo and in vivo pig models to determine the pressure tolerance of an esophagectomy anastomosis and compare it to esophageal pressure during NPPV. We created a stapled side-to-side, functional end-to-end esophagogastric anastomosis. With continuous intraluminal pressure monitoring, we progressively insufflated the anastomosis with a syringe until we detected an anastomotic leak, and recorded the maximum pressure before leakage. We performed this experiment in 10 esophageal specimens and 10 live pigs. We then applied a laryngeal mask airway (LMA) to five live pigs and measured the pressure in the proximal esophagus with increasing ventilatory pressures. The perforation was always at the anastomosis. The ex vivo and in vivo anastomoses tolerated a mean of 101 ± 44 cm H2O and 84 ± 38 cm H2O before leak, respectively. There was no significant difference between the pressure thresholds of ex vivo and in vivo anastomoses (P = .51). When 20, 30, and 40 cm H2O of positive pressure via LMA were delivered, the esophagus sensed 5 ± 4 cm H2O (25%), 11 ± 11 cm H2O (37%), and 15 ± 9 cm H2O (38%), respectively. Our pig model suggests that an esophagectomy anastomosis can tolerate a considerably higher pressure than is transmitted to the esophagus during NPPV. NPPV may be a safe alternative to ET after esophagectomy.


Self-management in adrenal insufficiency - towards a better understanding.
Patients with adrenal insufficiency (AI) require life-long glucocorticoid (GC) replacement treatment and dose adjustment in stress situations to prevent life-threatening adrenal crises. Herein this study we evaluated the patients' healthcare situation and their knowledge on AI, comparing various aspects to a prior survey in 209 physicians. Using a questionnaire, we conducted a comprehensive survey among 33 AI patients who were treated at the endocrine outpatient clinics of two University Hospitals in Germany. The majority of AI patients (97%) named their treating physician as main source for information. Overall, 89.7% of interviewees were satisfied with their medical treatment; however, about 1/3 reported controversies with healthcare professionals regarding GC replacement in various situation. Two thirds of AI patients increased their substitution dose temporarily within the last 12 months. However, not all patients had an emergency ID, and only 64.5% an emergency kit. None of the interviewed patients identified the need for adjustment in all given situations correctly. Almost 80% of patients did not correctly identify all symptoms of GC over- and under-replacement. Interestingly, we found no significant differences between patients and physicians regarding specific aspects of GC replacement. We showed that: (i) AI patients have some knowledge gaps on modalities and adequacy of GC replacement therapy; (ii) long-term management of patients with AI remains a challenge requiring an experienced specialist; and (iii) further education of physicians as primary source of information is necessary. Additional education may help AI patients to empower them to adequate self-treatment.


Improved formula for evaluating color-differential thresholds.
A new group of color-difference formulas is proposed that gives better results than the previous formulas supplied by Romero et al. [Appl. Opt. 28, 4697-4702 (1989)]. The new formulas are deduced from chromatic discrimination data and behave more consistently at the boundaries between regions of similar hue in the CIE-1931 diagram. They also fit well with experimental color-difference data.


Increasing drug concentration in a rat lung tumor model by combining isolated lung perfusion with hypertensive chemotherapy.
Isolated left lung perfusion (ILP) with cisplatin was performed in Fisher 344 rats. Before perfusion, bolus injection with endothelin was given via the pulmonary artery. The vasoconstrictive potency was estimated by monitoring the perfusion pressure. The toxicity was estimated by tracking body weight change, survival rate after right pneumonectomy, arterial blood gas analysis and histological findings. To observe the pharmacokinetic changes, a solitary Methylcholanthrene-induced sarcoma model was established in a rat lung and the total platinum concentration in perfused lung and tumor tissues was measured. Perfusion pressure was increased significantly in a dose-dependent manner. Pulmonary toxicity from ILP with cisplatin was limited by the use of endothelin. Significantly higher levels of total platinum were obtained in tumors but not in normal lung tissues by endothelin injection before ILP than by ILP alone. The combination of ILP and hypertensive chemotherapy should be one of the available treatments for unresectable pulmonary carcinoma.


Micro-positron emission tomography imaging of rat brain metabolism during expression of contextual conditioning.
Using (18)F-fluorodeoxyglucose microPET imaging, we investigated the neurocircuitry of contextual anxiety versus control in awake, conditioned rats (n = 7-10 per group). In addition, we imaged a group expressing cued fear. Simultaneous measurements of startle amplitude and freezing time were used to assess conditioning. To the best of our knowledge, no neuroimaging studies in conditioned rats have been conducted thus far, although visualizing and quantifying the metabolism of the intact brain in behaving animals is clearly of interest. In addition, more insight into the neurocircuitry involved in contextual anxiety may stimulate the development of new treatments for anxiety disorders. Our main finding was hypermetabolism in a cluster comprising the bed nucleus of the stria terminalis (BST) in rats expressing contextual anxiety compared with controls. Analysis of a subset of rats showing the best behavioral results (n = 5 per subgroup) confirmed this finding. We also observed hypermetabolism in the same cluster in rats expressing contextual anxiety compared with rats expressing cued fear. Our results provide novel evidence for a role of the BST in the expression of contextual anxiety.


CD39 improves survival in microbial sepsis by attenuating systemic inflammation.
Sepsis remains the leading cause of morbidity and mortality in critically ill patients. Excessive inflammation is a major cause of organ failure and mortality in sepsis. Ectonucleoside triphosphate diphosphohydrolase 1, ENTPDase1 (CD39) is a cell surface nucleotide-metabolizing enzyme, which degrades the extracellular purines ATP and ADP, thereby regulating purinergic receptor signaling. Although the role of purinergic receptor signaling in regulating inflammation and sepsis has been addressed previously, the role of CD39 in regulating the host's response to sepsis is unknown. We found that the CD39 mimic apyrase (250 U/kg) decreased and knockout or pharmacologic blockade with sodium polyoxotungstate (5 mg/kg; IC50 ≈ 10 μM) of CD39 increased mortality of mice with polymicrobial sepsis induced by cecal ligation and puncture. CD39 decreased inflammation, organ damage, immune cell apoptosis, and bacterial load. Use of bone marrow chimeric mice revealed that CD39 expression on myeloid cells decreases inflammation in septic mice. CD39 expression is upregulated during sepsis in mice, as well as in both murine and human macrophages stimulated with Escherichia coli. Moreover, E. coli increases CD39 promoter activity in macrophages. Altogether, these data indicate CD39 as an evolutionarily conserved inducible protective pathway during sepsis. We propose CD39 as a novel therapeutic target in the management of sepsis.


trans-Pyridyl and naphthyridyl cinnamides as alternatives for urea in complexation of carboxylic acid and formation of water-templated assemblies in the solid state.
A series of alpha,beta-unsaturated amides of pyridine and naphthyridine (1-4) derived from trans-cinnamic acid and its derivatives has been synthesized. The hydrogen-bonding behavior of these simple amides in the solid state has been established by solving X-ray structures. In solution and in the solid state, the above compounds 1-4 were found to bind carboxylic acid utilizing both conventional and unconventional hydrogen bonds. Hence, the possibility has been revealed of using this motif as an alternative of urea for the design of task-specific hosts. The experimental results have been rationalized with an accompanying theoretical study involving density functional calculations on the structure and the relative energies of different rotamers of the host systems as well as the binding energy of the complexes formed with trans-cinnamic acid. Generally, small binding energies (0.58-0.70 eV) are calculated for the complexes in the gas phase which become even smaller in chloroform solvent.


Pierre Ambroise-Thomas: a loyal friend and a strong supporter of tropical medicine in Brazil.
Our colleagues at the Sociedade Brasileira de Medicina Tropical have been informed of the demise of Professor Pierre Ambroise-Thomas (1937-2014). However, considering that the tribute we paid to him in 2015 - at the 20th anniversary of the Seminário Laveran & Deane sobre Malária - is equally true today, it is worth sharing it with the readers of the RSBMT, in recognition of his many virtues. Pierre Ambroise-Thomas (MD in 1963 and DSc in 1969) was Honorary Professor of Parasitology and Tropical Medicine at the Faculté de Médecine de Grenoble (France), Honorary President of the Académie Nationale de Médecine, member of the Académie Nationale de Pharmacie and Officier dans l'Ordre de La Légion d'Honneur. In addition to his important contributions to tropical medicine and parasitology, working in France during his long and productive career (50 years and 300 publications), Ambroise-Thomas became an admirer and supporter of Brazilian activities related to research, teaching and information in Tropical Medicine.


Atypical variant of lichen planus mimicking normal skin histology.
We present the case of a 69-year-old Caucasian and non-smoker patient with erythematous, itchy, violaceous lesions on the ankles, wrists, lower legs, forearms and trunk developed within 15 months. Her condition was diagnosed as prurigo and she was treated for a long period of time with antihistaminic drugs, with no resolution of lesions. In October 2008, she presented to a Private Practice of Dermatology in Timisoara. The dermatologist noticed the development of violaceous lesions on her trunk. The patient had similar lesions on the ankles, wrists, lower legs, and forearms for the last eight months. At physical examination many hyperpigmented, 1 to 6 cm, thin plaques were present on the flanks, shoulders, and infra-mammary area. There was no vaginal involvement. This eruption had a good response to topical glucocorticoids, but recurred multiple times after discontinuation of treatment. A biopsy specimen showed some histopathological features of lichen planus.


Alternative splicing of SV40 early pre-mRNA is determined by branch site selection.
Splicing of SV40 early pre-mRNA to alternative large-T and small-t mRNAs involves the utilization of multiple lariat branch sites. To determine the functional significance of these sites, we constructed and analyzed a set of base substitution mutants in which the major branch acceptors were altered, either singly or in combination. The ratio of large-T to small-t mRNAs produced in vivo was found to vary by over 100-fold between different mutants. When splicing was assayed in vitro with a standard pre-RNA, which results in splicing almost exclusively to large-T mRNA, the patterns of branch site utilization were altered dramatically, although the mutations were essentially without effect on splicing efficiency. However, use of a 5' truncated pre-RNA, which results in a splicing pattern that reflects the in vivo alternative splicing potential of this pre-RNA, revealed a strong correlation between the effects of the base substitutions on branch site selection and alternative splice-site utilization. An RNase protection analysis of factor interactions with the 5' splice sites and branch sites in wild-type and mutant pre-RNAs suggests that a competition for different branch sites plays a crucial role in the assembly of 'alternative' spliceosomes, thereby controlling alternative splice-site selection.


Digital Ocular Compressions Reduce Intraocular Pressure in Eyes With Tube Shunts.
Digital ocular compressions (DOCs) decrease intraocular pressure in eyes with tube shunts by significantly greater magnitude and duration when compared with fellow eyes without filtering surgery. DOCs are commonly used by glaucoma surgeons to reduce intraocular pressure (IOP) in the early postoperative period. Little is known, however, about the effects of DOC in eyes with tube shunts. We therefore examined these effects in eyes with long-established, functional glaucoma tube shunts. In this masked prospective study, adult subjects with primary open angle glaucoma and an Ahmed tube shunt in only 1 eye were recruited. After obtaining baseline IOP with Goldmann applanation tonometry a single transpalpebral DOC was applied to each eye (in random order). Postcompression IOP was measured after 10, 20, 30, 60, 90, 120, 150, 180, 210, and 240 minutes or until the measured IOP returned to baseline. The fellow (nonsurgical) eye was a control. Magnitude and duration of IOP reduction were evaluated using Kaplan-Meier analysis. The pressure applied to eyes in each cohort was standardized through the use of a force sensitive resistor and impulse was analyzed for differences. Twenty-two eyes of 11 patients underwent DOC. There was no significant difference in the impulse applied to eyes in each cohort (P=0.6). A mean initial IOP reduction of 5.36 mm Hg occurred in tube shunt eyes and 2.55 in control eyes (P=0.014). Log-rank analysis demonstrated longer survival in the tube shunt group (P=0.049). DOC is an effective method for transiently reducing IOP in eyes with long-established, patent tube shunts for about an hour. To maintain this decrease in pressure, compressions will have to be performed on a scheduled basis.


The shrunk genetic diversity of coral populations in North-Central Patagonia calls for management and conservation plans for marine resources.
The Chilean Patagonia is a complex puzzle of numerous fjords, channels, bays, estuaries, and islands. The largest part of it is very remote, hampering the generation of scientific knowledge and effective management planning that could balance conservation of the marine resources with the increasing development of aquaculture activities. The present study focuses on the deep-water emergent cold-water coral Desmophyllum dianthus, dwelling in Chilean Patagonia, with the aim to illustrate its population genetic structure, demography and adaptation of the species along this coast. Microsatellite loci analysis included D. dianthus individuals from twelve sampling localities along bathymetric and oceanographic gradients from the latitude 40°S to 48°S. The results showed a lack of genetic structure with an asymmetric dispersion of individuals, and relevant heterozygosity deficiency in some populations. This study also analyses the natural and human impacts affecting the region (e.g., climate change, increasing salmon farming activities), and stresses the importance of including genetic information in the process of management and conservation of marine resources. In particular, the relevance of using interdisciplinary approaches to fill the gaps in scientific knowledge especially in remote and pristine areas of western Patagonia. Therefore, information on genetic spatial distribution of marine fauna could become pivotal to develop a holistic ecosystem-based approach for marine spatial planning.


Compensating optical systems. Part 3: achromatic fourier transformation.
This paper shows the requirements for the achromatization of an irradiance distribution which is a function of a space coordinate multiplied by wavelength raised to a power. The particular requirements for achromatic Fourier transformation are then presented. The theory is applied to the following problems: achromatization of Newton's ring patterns and Fraunhofer diffraction patterns and frequency plane. filtering of an object illuminated with a broadband light source. Experimental systems that perform these functions are presented.


Prevalence and intensity of soil-transmitted helminthiasis, prevalence of malaria and nutritional status of school going children in honduras.
Many small studies have been done in Honduras estimating soil-transmitted helminthiasis (STH) prevalence but a country-wide study was last done in 2005. The country has the highest burden of malaria among all Central American countries. The present study was done to estimate country-wide STH prevalence and intensity, malaria prevalence and nutritional status in school going children. A cross-sectional study was conducted following PAHO/WHO guidelines to select a sample of school going children of 3rd to 5th grades, representative of ecological regions in the country. A survey questionnaire was filled; anthropometric measurements, stool sample for STH and blood sample for malaria were taken. Kato-Katz method was used for STH prevalence and intensity and rapid diagnostic tests, microscopy, and polymerase chain reaction (PCR) were used for malaria parasite detection. A total of 2554 students were studied of which 43.5% had one or more STH. Trichuriasis was the most prevalent (34%) followed by ascariasis (22.3%) and hookworm (0.9%). Ecological regions II (59.7%) and VI (55.6%) in the north had the highest STH prevalence rates while IV had the lowest (10.6%). Prevalence of one or more high intensity STH was low (1.6%). Plasmodium vivax was detected by PCR in only 5 students (0.2%), all of which belonged to the same municipality; no P. falciparum infection was detected. The majority of children (83%) had normal body mass index for their respective age but a significant proportion were overweight (10.42%) and obese (4.35%). Biannual deworming campaigns would be necessary in ecological regions II and VI, where STH prevalence is >50%. High prevalence of obesity in school going children is a worrying trend and portends of future increase in obesity related diseases. Malaria prevalence, both symptomatic and asymptomatic, was low and provides evidence for Honduras to embark on elimination of the disease.


Cysteinyl-tRNA Synthetase from Astragalus Species.
l-Cysteinyl-tRNA synthetases (EC 22.214.171.124) from four Astragalus species were partially purified. The substrate specificities of the cysteinyl-tRNA synthetase from three selenium accumulator species (A. crotalariae, A bisulcatus, and A. racemosus) were compared with those from two nonaccumulator species (A. lentigenosus and Phaseolus aureus). All species had similar K(m) values for cysteine, selenocysteine, and alpha-aminobutyric acid except A. bisulcatus which failed to use selenocysteine as a substrate and which had a K(m) for cysteine four times greater than the K(m) values for other species.


Schizophrenic strategies of survival.
This quotation contains a message as to how a robotlike and dead reality comes alive, or let us say-how the innate ego potential emerges as a personal ego experience. An individual can on the basis of this felt experience leave an early isolation and enter into a personal being, that being the individual came into the world equipped to take over but has been unable to do so because of a neglected ego development with its attendant deficient capacity to integrate an inner and outer reality.


Endometrial ultrasonography - An alternative to invasive assessment in women with postmenopausal vaginal bleeding.
To test the reliability of endometrial sonography in selecting women with abnormal postmenopausal vaginal bleeding for further diagnostic assessment. Endometrial thickness was measured in 368 consecutive women by abdominal or vaginal sonography prior to invasive assessment (hysteroscopy, curettage). The association of abnormal and endometrial thickness (4 mm or greater) with endometrial cancer was determined. Abnormal endometrial thickness was observed in 116 of 368 women. Subsequent assessment diagnosed endometrial carcinoma in 16 subjects, 15 of whom had abnormal endometrial thickness. One case with normal endometrial thickness was suspected at sonography because of the irregular appearance of the endometrium. Had it been used to select subjects for further assessment, sonography would have missed no cancer, and unnecessary invasive assessment (under general anesthesia in 20% of cases) would have been spared in 68% (251/368) of the subjects. Endometrial sonography should be routinely used to select women with postmenopausal vaginal bleeding for further investigations.


Exposure to biomass smoke and chronic airway disease in Mexican women. A case-control study.
A case-control study was performed in women older than 40 yr of age to evaluate the risk of cooking with traditional wood stoves for chronic bronchitis and chronic airway obstruction (CAO). The subjects were recruited from patients attending a referral chest hospital in Mexico City. We selected 127 patients with chronic bronchitis or CAO, of which 63 had chronic bronchitis alone, 23 had CAO alone (FEV1 less than 75% of predicted), and 41 had both chronic bronchitis and CAO (cases). Four control groups were selected: 83 patients with pulmonary tuberculosis, 100 patients with interstitial lung diseases, 97 patients with ear, nose and throat ailments, and 95 healthy visitors to the hospital (controls). Exposure to wood smoke, assessed as any or none, and as hour-years (years of exposure multiplied by average hours of exposure per day) was significantly higher in cases than in controls. Crude odds ratios for wood smoke exposure were 3.9 (95% CI, 2.0 to 7.6) for chronic bronchitis only, 9.7 (95% CI, 3.7 to 27) for CAO plus chronic bronchitis, and 1.8 (95% CI, 0.7 to 4.7) for CAO only. Differences in exposure to wood smoke persisted after adjusting by stratification and logistic regression for age, income, education, smoking, place of residence, and place of birth. Risk of chronic bronchitis alone and chronic bronchitis with CAO increased linearly with hour-years of cooking with a wood stove; odds ratios for exposure to more than 200 hour-years compared with nonexposed were 15.0 (95% CI, 5.6 to 40) for chronic bronchitis only and 75 (95% CI, 18 to 306) for chronic bronchitis with CAO. The findings support a causal role of domestic wood smoke exposure in chronic bronchitis and chronic airflow obstruction.


Designing a 3D Printed Model of the Skull-Base: A Collaboration Between Clinicians and Industry.
The role of three dimensional (3D) printing in neurosurgical education is becoming increasingly common. Notably, 3D printing can simulate complex anatomical pathways that may be difficult to regularly and accurately reproduce in cadavers. One such example is the course of the facial nerve within the temporal bone and its relation to the labyrinth. This can aid pre-surgical planning and minimise surgical complications. Here we aim to develop a novel anatomically accurate model of the skull base which demonstrates key neuro vascular components and the course of the facial nerve within the temporal bone by developing a 3D printed model of the skull-base that can be used for medical education and pre-surgical planning. We utilised a combination of Computed Tomography (CT) and angiography scans to reconstruct the skull base and its vascular contents. Neural components were digitally incorporated under the guidance of the Oxford neurosurgical team and the anatomy department. The model was integrated and printed using polymer jetting. The model was successfully printed, with all neurovascular components included. Notably we were able to highlight the intra-temporal course of the facial nerve by creating a bony window within the temporal bone. Through a collaboration with industry and a multidisciplinary team, we were able to reproduce the base of the skull from patient neuro-imaging. Our model is both cost-effective, reproducible and can aid both medical students and neurosurgical trainees in their training/education.


America's mental health: goals and programs of the National Institute of Mental Health.
During any given year in the 80s, an estimated 15 percent of the U.S. population--some 33 million people and more, as the population grows--will suffer a diagnosable mental disorder. An estimated two million Americans have been or will be diagnosed schizophrenic, ten to 14 million will suffer from depressive disorders, and more than one million will have organic psychoses of toxic or neurologic origin or permanently disabling mental conditions of various causes. Severe anxiety disorders, phobias, alcoholism, and drug dependence can be as debilitating as the psychoses mentioned above and require as much skilled care. Recent estimates place the direct clinical costs for mental health services annually at approximately $17 billion, about 12 percent of total national health care costs. This figure does not reflect indirect costs stemming from loss of productivity, chronic disability, and death. Nor does it fully reflect the findings of recent studies that mentally ill individuals experience higher than normal rates of physical illness and use general medical services at about double the rate of the mentally well.


Clinical study on coupling interval of ventricular premature contraction in patients with organic heart disease.
The characteristics of the coupling interval (CI) of ventricular premature contraction (VPC) were studied in 100 patients with frequent VPCs using 24 h ambulatory ECG recording. All R-R intervals were registered on computer to determine the mean value of CIs (Mean CI) and the standard deviation of CIs (SD-CI). We compared the Mean CI and the SD-CI between idiopathic VPCs and VPCs with organic heart disease (OHD). In addition, we evaluated the efficacy of disopyramide (DP) and mexiletine (MX) and we examined the relationship between the efficacy of these drugs and the characteristics of CI. The Mean CI of VPCs with OHD was longer than that of idiopathic VPCs (530 vs. 494 msec, p less than 0.05). The SD-CI of VPCs with OHD was larger than that of idiopathic VPCs (54.1 vs. 39.3 msec, p less than 0.01). In all treated cases, the drug efficacy was not different between DP (11/18, 61%) and MX (9/19, 47%). However when we isolated cases of OHD, we found a tendency that DP (9/12, 75%) was more effective than MX (7/16, 44%). In cases where DP was administered, the Mean CI of VPCs was not different between effective and ineffective cases, while in cases where MX was administered, the Mean CI of ineffective cases had a tendency to be longer than that of effective cases (552 vs. 506 msec, p less than 0.1).(ABSTRACT TRUNCATED AT 250 WORDS)


Ischaemic priapism as a presentation of chronic myeloid leukaemia.
To describe ischemic priapism as an atypical presentation of chronic myeloid leukaemia. We discuss two patients diagnosed with chronic myeloid leukaemia presenting an episode of priapism, adequately resolved after applying the treatment protocol established in our center. Priapism is defined as a persistent erection that persists despite not having sexual stimulus, without involvement of the spongy tissue of the penis. Its debut appearance as a hematologic dyscrasia is a rare event. It is a urological emergency, requiring early multidisciplinary (Urology and Hematology) management, since the speed in treatment will result in good functional results and the preservation of a good quality of life.


Spontaneous cerebrospinal fluid otorrhoea via oval window: an obscure cause of recurrent meningitis.
Spontaneous cerebrospinal fluid (CSF) leak via the oval window is uncommon and can result in recurrent bacterial meningitis. Current understanding of spontaneous CSF otorrhoea is reviewed and a diagnostic algorithm is presented. A seven-year-old boy presented with bilateral congenital deafness and recurrent meningitis. High-resolution computed tomography (HRCT) of the temporal bone showed a labyrinthine deformity and communication between the internal auditory canal (IAC) and the cochlea. Subtotal petrosectomy with closure of the external acoustic meatus and eustachian tube was performed. Post-operatively, the child had no further episodes of meningitis. This rare and obscure cause of recurrent childhood meningitis requires a high index of suspicion and the use of diagnostic tools, especially HRCT.


Application of inorganic element ratios to chemometrics for determination of the geographic origin of welsh onions.
The composition of concentration ratios of 19 inorganic elements to Mg (hereinafter referred to as 19-element/Mg composition) was applied to chemometric techniques to determine the geographic origin (Japan or China) of Welsh onions (Allium fistulosum L.). Using a composition of element ratios has the advantage of simplified sample preparation, and it was possible to determine the geographic origin of a Welsh onion within 2 days. The classical technique based on 20 element concentrations was also used along with the new simpler one based on 19 elements/Mg in order to validate the new technique. Twenty elements, Na, P, K, Ca, Mg, Mn, Fe, Cu, Zn, Sr, Ba, Co, Ni, Rb, Mo, Cd, Cs, La, Ce, and Tl, in 244 Welsh onion samples were analyzed by flame atomic absorption spectroscopy, inductively coupled plasma atomic emission spectrometry, and inductively coupled plasma mass spectrometry. Linear discriminant analysis (LDA) on 20-element concentrations and 19-element/Mg composition was applied to these analytical data, and soft independent modeling of class analogy (SIMCA) on 19-element/Mg composition was applied to these analytical data. The results showed that techniques based on 19-element/Mg composition were effective. LDA, based on 19-element/Mg composition for classification of samples from Japan and from Shandong, Shanghai, and Fujian in China, classified 101 samples used for modeling 97% correctly and predicted another 119 samples excluding 24 nonauthentic samples 93% correctly. In discriminations by 10 times of SIMCA based on 19-element/Mg composition modeled using 101 samples, 220 samples from known production areas including samples used for modeling and excluding 24 nonauthentic samples were predicted 92% correctly.


Spectrum of disease associated with partial lipodystrophy: lessons from a trial cohort.
Partial lipodystrophy (PL) is associated with metabolic co-morbidities but may go undiagnosed as the disease spectrum is not fully described. The objective of the study was to define disease spectrum in PL using genetic, clinical (historical, morphometric) and laboratory characteristics. Cross-sectional evaluation. Twenty-three patients (22 with familial, one acquired, 78·3% female, aged 12-64 years) with PL and non-alcoholic fatty liver disease (NAFLD). Genetic, clinical and laboratory characteristics, body composition indices, liver fat content by magnetic resonance imaging (MRI), histopathological and immunofluorescence examinations of liver biopsies. Seven patients displayed heterozygous pathogenic variants in LMNA. Two related patients had a heterozygous, likely pathogenic novel variant of POLD1 (NM002691·3: c.3199 G>A; p.E1067K). Most patients had high ratios (>1·5) of percentage fat trunk to percentage fat legs (FMR) when compared to reference normals. Liver fat quantified using MR Dixon method was high (11·3 ± 6·3%) and correlated positively with haemoglobin A1c and triglycerides while leg fat by dual-energy X-ray absorptiometry (DEXA) correlated negatively with triglycerides. In addition to known metabolic comorbidities; chronic pain (78·3%), hypertension (56·5%) and mood disorders (52·2%) were highly prevalent. Mean NAFLD Activity Score (NAS) was 5 ± 1 and 78·3% had fibrosis. LMNA-immunofluorescence staining from select patients (including one with the novel POLD1 variant) showed a high degree of nuclear atypia and disorganization. Partial lipodystrophy is a complex multi-system disorder. Metabolic parameters correlate negatively with extremity fat and positively with liver fat. DEXA-based FMR may prove useful as a diagnostic tool. Nuclear disorganization and atypia may be a common biomarker even in the absence of pathogenic variants in LMNA.


[Conservative treatment of post-traumatic periduodenal hematoma: presentation of a clinical case and review of the literature].
The authors describe a case of post-traumatic hematoma of the duodenum in a two years old child. This is a very rare condition in paediatric age, but with the increasing incidence of traumatic pathology it can be predicted an increase of this condition. The duodenal hematoma can be treated either with surgical approach or with conservative treatment. The authors discuss the characteristics of the pathology, the etiopathogenetic mechanism, and propose the same classification adopted by some french authors. The type of lesion indicates the adequate therapy; in particular in the case report (type 1) a conservative treatment is adopted. The laboratory parametres are significative but none is diagnostic. In the present case the amylasemia is not elevated until two weeks after the trauma. Very important for diagnosis are T.C., roentgenography and echotomography, the last one can be easily used for the control of the resolution of the hematoma. The conservative treatment is based on nasogastric suction and parenteral nutrition; although the role of nonoperative treatment is emphasized, the importance of careful assessment for signs of peritonitis or enlarging tender mass cannot be overlooked.


Adult and childhood acute lymphocytic leukemia: are they different diseases?
Age has long been recognized as an important factor in predicting response to treatment for acute lymphocytic leukemia (ALL). Specifically, the results of treatment of childhood ALL have been far superior to the treatment of what appears to be the same disease in adults. However, from an analysis of the clinical and biological prognostic factors known to be predictive in childhood ALL, there is a striking difference in their distribution in adults with ALL. It appears that there is a special form of ALL seen in children of some populations with a peak incidence of three to seven years. This treatment responsive leukemia appears to be different clinically, biologically, and epidemiologically from adult ALL.


Triiodothyronine treatment increases substrate cycling between pyruvate carboxylase and malic enzyme in perfused rat liver.
The relative roles of pyruvate kinase and malic enzyme in substrate cycling between pyruvate and oxaloacetate were examined in perfused livers of 24-hour-fasted normal and triiodothyronine (T3)-treated rats using an inhibitor of malic enzyme (hydroxymalonate). Livers were perfused for 60 minutes in a recirculating system with [3-13C]alanine (10 mmol/L, 99% 13C-enriched). The combined flux through pyruvate kinase plus malic enzyme relative to pyruvate carboxylase flux was assessed by the 13C-enrichment ratio of alanine C2 to glucose C5 in the perfusate, determined with 13C and 1H nuclear magnetic resonance (NMR) spectroscopy. In normal rat livers, the relative carbon flux through pyruvate kinase plus malic enzyme to pyruvate carboxylase was 0.18 +/- 0.04, and increased to 0.44 +/- 0.08 (P < .05) in the T3-treated group. After addition of hydroxymalonate, this relative carbon flux was unchanged in normal rat livers, but decreased to 0.15 +/- 0.04 (P < .01) in the T3-treated group, suggesting that the increased carbon flux in T3-treated livers was caused by increased flux through malic enzyme. Malic enzyme activity increased from 0.36 +/- 0.05 U/g liver in normal livers to 2.51 +/- 0.50 U/g liver (P < .05) in the T3-treated group, whereas there was no effect of T3 treatment on pyruvate kinase activity.(ABSTRACT TRUNCATED AT 250 WORDS)


Global genomic and RNA profiles for novel risk stratification of neuroblastoma.
Neuroblastoma is one of the most common solid tumors in children. Its clinical behavior ranges widely from spontaneous regression to life-threatening aggressive growth. The molecular etiology of neuroblastoma is still enigmatic and the overall cure rate of advanced disease is still very poor. Recent microarray-based technology provided us with important information such as comprehensive genomic alterations and gene expression profiles to help us understand the molecular characteristics of each tumor in detail. Several retrospective studies have revealed that these signatures are strongly correlated with patient prognoses and led to the construction of new risk stratification systems, some of which are considered for evaluation in upcoming clinical studies in a prospective way. Large-scale analyses using a variety of genetic tools also discovered a major familial neuroblastoma predisposition gene ALK, as well as new candidate susceptibility genes at 6q22 and 2q35 for sporadic neuroblastoma. Of note, ALK is mutated in 6-9% of sporadic cases, and is either amplified or constitutively activated through mutations mainly within the kinase domain, promoting the possibility of new therapeutic strategies using ALK inhibitors. Additional candidates for outcome predictors such as the methylation phenotype of tumor DNA and expression profiles of microRNA have also been proposed. Such variety of information will help us understand the heterogeneity of neuroblastoma biology and further, the combined use of these signatures will be beneficial in predicting prognosis with high accuracy, as well as choosing a suitable therapy for the individual patient.


Membrane protein analysis of human breast cancer cell line MCF-7 by different membrane washing methods.
Membrane and membrane-associated proteins are rich in known or potential pharmaceutical drug targets for carcinogenesis. In order to systemically analyze membrane proteins of human breast cancer, we isolated membrane from MCF-7 cells by sequential extraction by washing with three different buffers, namely, phosphate buffer (5 mM, pH 8.0), Tris (40 mM, pH 9.5), and sodium carbonate (100 mM pH 11). The extracted proteins were separated by two-dimensional gel electrophoresis (2-DE) using cup-loading and were then analyzed by peptide mass fingerprinting (PMF). A total of 137 spots from the gels of the three procedures were successfully identified. They corresponded to 79 distinct proteins. Among them, 22 exclusive proteins belonging to each washing procedure were also found, including P-glycoprotein, endoplasmin, Stress-70 protein, ADAM 10, protein disulfide isomerase, and glutamate receptor. These results indicate phosphate buffer to be the most beneficial for enrichment of peripheral membrane proteins, and sodium carbonate is beneficial for the presentation of integral membrane proteins but usually with poor resolution. The reference maps and identified proteins will serve as a basis for the further investigation of breast cancer, especially the proteomic comparison among different cell types of breast cancer, or among the different stages in the drug interfering process of the MCF-7 cell line.


Peptides derived from a wild-type murine proto-oncogene c-erbB-2/HER2/neu can induce CTL and tumor suppression in syngeneic hosts.
In this analysis, we examined whether peptides derived from a wild-type murine proto-oncogene, c-erbB-2, function as tumor rejection Ags. Expression of murine c-erbB-2 examined by means of reverse transcription-PCR was observed in several normal adult tissues, such as intestine, kidney, and testis. We then transduced human and murine c-erbB-2 cDNA into two mutually noncross-reactive fibrosarcoma lines of BALB/c origin, CMS7 and CMS17. In BALB/c mice immunized with CMS17HE (CMS17 transduced with human c-erbB-2 cDNA), the growth of subsequently challenged CMS7HE (CMS7 transduced with human c-erbB-2 cDNA) was significantly suppressed. CTL against human c-erbB-2-expressing cells were generated from BALB/c spleen cells in vivo and in vitro sensitized by CMS17HE. The CTL activity was also directed against murine c-erbB-2-expressing cells, CMS7ME and CMS17ME, and was blocked by anti-CD8 or anti-Kd mAbs. A series of peptides of human or murine c-erbB-2 compatible with the Kd binding motif was synthesized. The CTL were reactive with P1.HTR (H-2d) pulsed with three of these peptides, p63-71 (human c-erbB-2 derived), p63-71(A) (murine c-erbB-2 derived), and p780-788 (common for human and murine c-erbB-2). Spleen cells immunized in vivo and in vitro with syngeneic spleen cells pulsed with these peptides became cytotoxic for CMS17HE and/or CMS17ME, but not CMS17neo (CMS17 transduced with control vector). The growth of CMS7ME was suppressed in mice immunized with the murine c-erbB-2-derived peptide, p63-71(A) or p780-788. There was no apparent pathologic change in mice that rejected CMS7ME after vaccination with these peptides.


[Specific features of the pathogenesis of epichlorohydrin eye burns and their treatment (an experimental clinico-morphological study)].
Specific features in the pathogenesis of ocular burns with a solution of an organic product, epichlorohydrin, are analyzed. Abnormalities in the vascular system anterior portion were revealed, related to the toxic effect of the agent on tissue vessels and to enhanced permeability and involvement of not only the cornea, but (and even more so) of the iris, where necrotic changes and hemorrhages eventuating in iris atrophy were detectable. Contrykal (hordox) therapy promoted a drastic inhibition of leukocytic and lymphocytic migration into burnt tissue, this resulting in a month in the formation of gentle cicatricial tissue with negligible residual inflammatory infiltration in the burn wound. Iris changes still persisted, since the drug appeared to have no effect on this process.


Employment and Patient Satisfaction after Liver Transplantation.
Background and Aims: This study serves to revisit the effects of liver transplantation (LT) on employment in an era of improving survival outcomes post-transplant, and to identify areas of improvement in the transplant process to better optimize post-LT employment and patient satisfaction. Methods: Prospectively, patients who had undergone LT at a single tertiary LT center were surveyed in person and by e-mail. Primary outcomes included employment rate pre- and post-LT, annual salary, weekly hours worked, barriers to re-employment, and patient satisfaction. Results: Responses were collected and analyzed from 121 patients who underwent LT. Pre-LT, 68 (56.1%) reported full-time employment, 13 (10.7%) part-time employment, and 40 (33.1%) unemployment. Post-LT, 26 (21.4%) reported continued full-time employment, 18 (14.9%) part-time employment, and 77 (63.6%) unemployment. Average weekly work hours decreased post-LT (16.1 h/week vs. 39.9 h/week). Mean annual salaries decreased post-LT (17 earning salary ≥$40,000 vs. 56 earning salary ≥$40,000). These outcomes differed from patient pre-LT expectations, with 81.0% of previously employed patients believing they would return to employment, resulting in decreased patient satisfaction. Patients working physically demanding jobs pre-LT were less likely to return to work. Reasons cited for lack of return to full employment included early fatigue and difficulty regaining physical strength. Conclusions: Re-employment rates remain low post-LT, which is particularly true for patients working physically active jobs. Fatigue is a significant barrier to re-employment and increased physical rehabilitation post-LT may prove to be beneficial. Patients should be given realistic expectations about return to employment prior to their LT.


Component Identification and Functional Analysis of Outer Membrane Vesicles Released by Avibacterium paragallinarum.
Avibacterium paragallinarum, the causative agent of infectious coryza, is known to release outer membrane vesicles (OMVs). In the present study, we investigated the composition, bioactivities, and functional properties of the OMVs of A. paragallinarum. Following extraction and purification, the OMVs were observed to be spherical in shape, with diameters ranging from 20 to 300 nm. The vesicles contained endotoxin as well as genomic DNA. The molecular weights of the OMV-contained protein fragments were mostly concentrated at 65 and 15 kDa. The components of the OMV proteins were mainly various functional enzymes (e.g., ATP-dependent RNA helicase), structural components (e.g., streptomycin B receptor and membrane protein), and some hypothetical proteins with unknown functions. The expression levels of inflammation-related factors, such as interleukin (IL)-2, IL-6, IL-1β, IL-10, and inducible nitric oxide synthase (iNOs), were significantly upregulated in chicken macrophage cells HD11 incubated with OMVs. Serum IgG antibodies were measured after two intramuscular injections of an OMV-based vaccine into specific pathogen-free (SPF) chickens. The vaccinated chickens were then challenged by A. paragallinarum of homologous and heterologous serovars. It was noted that the vaccinated chickens produced immunoglobulin G (IgG) antibodies against A. paragallinarum. The OMVs conferred an acceptable level of protection (70%), defined as an absence of colonization and of clinical signs, against the homologous strain (serovar A), while the cross-protection against heterologous challenge with serovars B and C was much weaker. However, the OMVS did provide significant protection against clinical signs for all three serovars. Overall, this study laid a foundation for further unraveling the functional roles of OMVs released by A. paragallinarum.


Tonic sympathetic chemoreflex after blockade of respiratory rhythmogenesis in the rat.
1. We sought to determine whether the increase in sympathetic nerve discharge (SND) caused by carotid chemoreceptor stimulation requires the integrity of ventrolateral medullary structures involved in generating respiratory rhythm and pattern. Experiments were done in urethane-anaesthetized, vagotomized, aortic deafferented, ventilated rats except when indicated (see paragraph 3). 2. Brief hypoxia (N2 for 5-12 s) or I.V. NaCN (50-100 micrograms kg-1) activated SND in bursts synchronized with the phrenic nerve discharge (PND). No effect was produced in chemo-deafferented rats. 3. In unanaesthetized vagotomized decerebrated rats, ligation of the internal carotid arteries preserved peripheral chemoreceptor function but abolished baroreflexes. In this preparation, stimulation of peripheral chemoreceptors (N2 for 2-6 s) also activated SND in bursts synchronized with PND. 4. Bilateral microinjection of the GABAA receptor agonist muscimol into the caudal ventrolateral medulla (CVLM) instantly blocked the sympathetic baroreflex, eliminated PND at rest and during chemoreceptor stimulation but did not change the mean increase in SND produced by chemoreceptor stimulation. Sympathoactivation in response to chemoreceptor stimulation became tonic after 1-13 min and was still totally dependent on the integrity of the carotid sinus nerves. 5. Muscimol injection instantly eliminated the respiratory outflow of the Xth and XIIth cranial nerves, both at rest and during chemoreceptor stimulation. 6. Muscimol eliminated the on-off respiratory pattern of neurons in the rostral ventrolateral medulla (RVLM). During chemoreceptor stimulation, these cells became activated or inhibited tonically. 7. Muscimol injection raised the resting discharge rate of vasomotor presympathetic cells in RVLM, blocked their baroreceptor inputs but did not change the magnitude of their excitation by chemoreceptor stimulation. Muscimol injection eliminated their respiratory modulation. 8. In conclusion, the sympathetic response to chemoreceptor stimulation may be due to convergence and integration in RVLM of two processes: respiration-independent excitatory input to RVLM neurons and respiratory patterning of their activities via inputs from the pre-Bötzinger complex.


[Fall risk and fracture. Fall risk assessment].
For the prevention of fall and its associated injuries including various fractures among the elderly, some simple and clinical screening tools for prediction of falls for the community-dwelling elderly have been developed. In Japan, Toba et al. (2005) explored a portable Fall Risk Index (FRI) consisting of 22items for the elderly living in the community. Among these 22 items, selected seven items which were revealed as independent risk factors for previous falls, are also now considered as good predictor for future falls with the sensitivity and specificity of 0.65 and 0.72, respectively. Thus, FRI is considered as useful screening tools to identify high risk elderly people of falls in the community in Japan.


Selective chemical vestibulectomy: preliminary results with human application.
The involved membranous labyrinth of patients with medically intractable Meniere's disease is being accessed by means of a fenestration of the bony horizontal semicircular canal in preparation for the application of a 125 or 250 mcg flake of solid streptomycin. Sensory information originating in the affected vestibular end organ is selectively blocked from reaching the central nervous system. This uniformly results in the rapid elimination of vertiginous symptoms, and at these calculated doses yields preservation of (or in some cases improvement in) preoperative cochlear thresholds. The rationale for this procedure, as detailed in earlier investigations of animals, will be briefly reviewed before highlighting our preliminary results in adult clinical trials.


Comparison of proteinase inhibitor-inducing activities and phytoalexin elicitor activities of a pure fungal endopolygalacturonase, pectic fragments, and chitosans.
Rhizopus stolonifer endopolygalacturonase, an elicitor of casbene synthetase activity in castor bean seedlings, was found to be a potent elicitor of the phytoalexin pisatin in pea pods and of proteinase Inhibitor I in tomato leaves. The enzyme was an active elicitor or inducer only in its active native state; heat-denatured enzyme was inactive in all three systems. The activities of (a) the tomato pectic polysaccharide proteinase inhibitor-inducing factor, (b) a partially acid hydrolyzed proteinase inhibitor-inducing factor, (c) citrus pectic fragments, and (d) chitosan, were also compared in the three bioassay systems. The four oligosaccharide preparations were active in all three systems, but with different degrees of potency. In tomato leaves and pea pods, chitosans were most active, whereas in castor beans, the citrus pectic fragments were the best elicitors. The data presented support the hypothesis that plant and fungal cell wall fragments are important signals in mobilizing a wide variety of biochemically different types of plant defense responses, and that endopolygalacturonases play a key role in releasing the plant cell wall fragments during pest attacks.


Idiopathic edema in a male.
A 15-year-old boy who suffered from leg edema of unknown origin is described. The exclusion of any other cause for the edema, the clinical features, and the results of the dynamic tests performed suggested the diagnosis of "idiopathic edema," a syndrome described previously in women only. Spironolactone therapy brought about the disappearance of the edema and enabled the patient to return to his normal activities. This case report suggests that "idiopathic edema" is a syndrome common to both sexes, and is therefore not related to estrogen disturbances.


A strength study utilizing the electro-stim 180.
lncreased interest has developed in the use of electrical stimulation as either an adjunct or a substitution for voluntary muscle contraction as a technique to improve strength in normal individuals. This study was conducted in an attempt to determine if electrical stimulation does significantly increase the strength of normal musculature. A sample using 17 normal subjects (1 0 male, 7 female) with an average mean age of 26 years was obtained. In this study the subjects were divided into two groups. Three different speeds (0, 60, and 240 degrees /sec) with 3-5 contractions at each speed were used to determine the maximum strength of each subject's nondominant leg as measured by a Cybex(R) II dynamometer. Group A consisted of 8 subjects (3 male, 5 female) who served as a control group. Group B consisted of 9 subjects (7 male, 2 female) who received electrical stimulation to the nondominant leg for 20 treatment sessions (5 days/week for 4 weeks). Results indicate that group B did have a significant strength gain which was achieved after 4 weeks of stimulation. These results were only significant at an isometric mode (OO/sec) and did not carry over to dynamic measurement. J Orthop Sports Phys Ther 1985;7(2):50-53.


Construction and analysis of new vector systems with improved interleukin-18 secretion in a xenogeneic human tumor model.
Interleukin (IL)-18 plays an important role in enhancing cellular immunity against cancer and bacteria. We constructed retroviral and adenoviral vectors that show improved secretion of bioactive murine IL-18 that could further enhance antitumor immunity in a murine model. Secretion of bioactive IL-18 was facilitated by fusing the leader sequences of prepro-parathyroid hormone (PTH) or IL-1 receptor antagonist (IL-1ra) to the 5; end of the mature murine IL-18 cDNA. Transfectants established by the retroviral vector carrying IL-1ra/IL-18 hybrid showed about 100-fold more IL-18 production and interferon (IFN)-gamma induction from splenocytes when compared with those carrying PTH/IL-18 hybrid. Repeated intraperitoneal injection of an adenoviral vector with IL-1ra/IL-18 hybrid ligated to IL-18 (Ad.IL-1ra.IL-18) successfully prevented establishment of human colon cancer cells in the abdominal cavity of mice. Treatment with Ad.IL-1ra.IL-18 was associated with significantly elevated levels of serum IL-18 and IFN- gamma. IL-18 administration also enhanced the cytostatic activity of peritoneal exudate cells against cancer cells. These improved viral vectors, which efficiently produce bioactive IL-18, could be used as a useful tool for cancer gene therapy.


Impact of Altered Medication Administration Time on Interdisciplinary Bedside Rounds on Academic Medical Ward.
Interdisciplinary rounds provide a valuable venue for delivering patient-centered care but are difficult to implement due to time constraints and coordination challenges. In this article, we describe a unique model for fostering a culture of bedside interdisciplinary rounds through adjustment of the morning medication administration time, auditing physician communication with nurses, and displaying physician performance in public areas. Implementation of this model led to measurable improvements in physician-to-nurse communication on rounds, teamwork climate, and provider job satisfaction.


HC-HA/PTX3 Purified From Amniotic Membrane as Novel Regenerative Matrix: Insight Into Relationship Between Inflammation and Regeneration.
Human limbal palisade of Vogt is an ideal model for studying and practicing regenerative medicine due to their accessibility. Nonresolving inflammation is a common manifestation of limbal stem cell deficiency, which is the major cause of corneal blindness, and presents as a threat to the success of transplanted limbal epithelial stem cells. Clinical studies have shown that the efficacy of transplantation of limbal epithelial stem cells can be augmented by transplantation of cryopreserved human amniotic membrane (AM), which exerts anti-inflammatory, antiscarring, and antiangiogenic action to promote wound healing. Review of published data to determine the molecular action mechanism explaining how AM exerts the aforementioned therapeutic actions. From the water-soluble extract of cryopreserved AM, we have biochemically purified one novel matrix component termed heavy chain (HC)-hyaluronan (HA)/pentraxin 3 (PTX3) as the key relevant tissue characteristic responsible for the aforementioned AM's efficacy. Heavy chain-HA is a complex formed by a covalent linkage between HA and HC1 of inter-α-trypsin inhibitor (IαI) by tumor necrosis factor-stimulated gene-6 (TSG-6). This complex may then be tightly associated with PTX3 to form HC-HA/PTX3 complex. Besides exerting an anti-inflammatory, antiscarring, and antiangiogenic effects, HC-HA/PTX3 complex also uniquely maintains limbal niche cells to support the quiescence of limbal epithelial stem cells. We envision that HC-HA/PTX3 purified from AM can be used as a unique substrate to refine ex vivo expansion of limbal epithelial stem cells by maintaining stem cell quiescence, self-renewal and fate decision. Furthermore, it can also be deployed as a platform to launch new therapeutics in regenerative medicine by mitigating nonresolving inflammation and reinforcing the well-being of stem cell niche.


Prolactin-induced immunoglobulin and autoantibody production by peripheral blood mononuclear cells from systemic lupus erythematosus and normal individuals.
Prolactin (PRL) has been shown to have immunoregulatory effects on a variety of immune responses. Its effect on B cell immune responses is suggested by in vitro data demonstrating a direct effect on B cell activation and differentiation, and also in vivo data demonstrating a biphasic stimulation of antibody production to sheep red blood cells. In addition, it has been shown both in animal models and patients with hyperprolactinemia that PRL may influence the presence of certain autoantibodies. The objective of this work was to study the effect of PRL on the induction of immunoglobulins, and anti-DNA and rheumatoid factor (RF) autoantibody production from peripheral blood mononuclear cells (PBMCs) from normal individuals and systemic lupus erythematosus (SLE) patients. Six female SLE patients and 10 normal individuals (5 females and 5 males) were studied. Ficoll-Hypaque-isolated PBMCs (1x10(6) cells/ml) with high concentrations of PRL (10(-4)-10(-8)M) and pokeweed mitogen (PWM) diluted to 1:400. An ELISA assay was used for immunoglobulins, RF and anti-dsDNA antibodies. PRL stimulated IgG and IgM production in a biphasic manner in normal PBMCs. Enhanced synthesis was observed at 10(-6) M, and a stimulatory effect was again observed at higher doses of PRL (10(-4))M. In contrast, only a mild stimulatory effect was observed in IgG synthesis by SLE PBMCs. These changes in Ig synthesis, however, did not reach statistical significance. PRL also induced IgG and IgM anti-dsDNA antibodies by both normal and SLE lymphocytes, but no differences were observed when compared to PWM stimulation. PRL induced IgM RF synthesis by normal lymphocytes but had no effect on SLE PBMCs. This study demonstrates that PRL induced immunoglobulin synthesis by normal and to a lesser degree by SLE lymphocytes, and also induced anti-dsDNA antibody by normal and SLE PBMCs, and IgM RF by normal PBMCs. However, the exact mechanism(s) of PRL action on the immune response awaits elucidation.


Optical discrimination of harmful Cochlodinium polykrikoides blooms in Korean coastal waters.
We investigated the possibility of optically discriminating harmful algal blooms (HABs), focusing on Cochlodinium polykrikoides, the major HAB causative dinoflagellate species in Korean waters. We produced a large data set of simulated remote sensing reflectance (Rrs) spectra in a wide range of bio-optical conditions using Hydrolight software and bio-optical data provided by the International Ocean-Color Coordinating Group. The two Rrs band ratios (Rrs(555)/Rrs(531) and Rrs(488)/Rrs(443)) were determined to be effective in discriminating high-density C. polykrikoides blooms. The results were consistent with in situ observations and seem applicable to diverse coastal environments. Our findings provide theoretical and quantitative criteria upon which in-water HAB detecting algorithms can be developed.


[Cytotoxic effector mechanism and genetic control of non-immunized hybrid resistance to mouse T cell lymphoma transplanted outside and inside the brain].
A Moloney virus-induced T cell lymphoma, YAC-1, derived from A/Sn (H-2a) inbred mouse origin, was tested for hybrid resistance (HyR) after subcutaneous (s.c.) or intracerebral (i.c.) tumor cell inoculation into syngeneic and semi-syngeneic mice. The F1 hybrids (H-2a/b) between A/Sn and C57BL/6 mice more strongly resisted the s.c. inoculation of 10(6) and 5 x 10(5) cells than did syngeneic recipients. In contrast, no HyR to the i.c. inoculation of 10(4) and 10(3) cells was seen in the F1 hybrid mice. Natural killer (NK) cell activity was much higher in F1 hybrids than in syngeneic mice. 125I-iododeoxyuridine-labeled YAC-1 cells were more efficiently eliminated from the highly resistant F1 hybrids than from the parental strain in both 4 and 18 hour in vivo rejection assays via intravenous (i.v.) and s.c. injection, respectively. The remaining radioactivity of the brain, however, did not differ between these mice. Thus, there was a correlation between the in vivo resistance of F1 hybrid mice to challenge s.c. inoculation of parental tumors and their expression of lymphocyte-mediated natural cytotoxicity in vitro against those tumors. T cell depletion by thymectomy followed by irradiation and fetal liver reconstitution did not abrogate the s.c. HyR against YAC-1, whereas NK cell depletion by i.v. administration of anti-asialo-GM1 antibodies resulted in the disappearance of the resistance. Furthermore, genotypic study segregating (A/Sn x C57BL/6) F1 x A/Sn backcross mice indicated that the s.c. HyR might be attributable primarily to heterozygosity within the H-2 complex.(ABSTRACT TRUNCATED AT 250 WORDS)


Plantar space abscesses in the diabetic foot: diagnosis and treatment.
Plantar space abscesses in the diabetic foot are relatively uncommon. These abscesses are an anatomic type of foot infection. Three plantar spaces have been identified: the medial, central, and lateral. The central plantar space is by far the most important. Within the central plantar space are tendons of the flexor digitorum longus, flexor digitorum brevis, quadratus plantae, lumbricales pedes, the medial and lateral plantar nerves, and the plantar arterial arch. Located within the lateral and medial spaces are the short flexor and abductor muscles to the first and fifth rays. Plantar space infections may arise from a variety of causes. Infections of the fibrofatty tissue of the toe pad or the long flexor tendon sheaths and lumbrical tendons secondary to web space infections, poor nail care, trauma, and mal perforans ulcers have been implicated. A medial incision is recommended for drainage of both the medial and central plantar spaces. This avoids a painful plantar scar and allows for extensive incision and drainage of these abscesses. The lateral plantar space is best drained by a lateral incision. Both incisions heal without a sensitive scar. Control of sepsis is of primary importance. If left uncontrolled, obliteration of the plantar arterial arch occurs. Necrosis of the distal foot and central three toes results, thereby preventing any effort to save the diabetic foot.


Bacillus subtilis impact on plant growth, soil health and environment: Dr. Jekyll and Mr. Hyde.
The increased dependence of farmers on chemical fertilizers poses a risk to soil fertility and ecosystem stability. Plant growth-promoting rhizobacteria (PGPR) are at the forefront of sustainable agriculture, providing multiple benefits for the enhancement of crop production and soil health. Bacillus subtilis is a common PGPR in soil that plays a key role in conferring biotic and abiotic stress tolerance to plants by induced systemic resistance (ISR), biofilm formation and lipopeptide production. As a part of bioremediating technologies, Bacillus spp. can purify metal contaminated soil. It acts as a potent denitrifying agent in agroecosystems while improving the carbon sequestration process when applied in a regulated concentration. Although it harbours several antibiotic resistance genes (ARGs), it can reduce the horizontal transfer of ARGs during manure composting by modifying the genetic makeup of existing microbiota. In some instances, it affects the beneficial microbes of the rhizosphere. External inoculation of B. subtilis has both positive and negative impacts on the endophytic and semi-synthetic microbial community. Soil texture, type, pH and bacterial concentration play a crucial role in the regulation of all these processes. Soil amendments and microbial consortia of Bacillus produced by microbial engineering could be used to lessen the negative effect on soil microbial diversity. The complex plant-microbe interactions could be decoded using transcriptomics, proteomics, metabolomics and epigenomics strategies which would be beneficial for both crop productivity and the well-being of soil microbiota. Bacillus subtilis has more positive attributes similar to the character of Dr. Jekyll and some negative attributes on plant growth, soil health and the environment akin to the character of Mr. Hyde.


[Peripheral keratinizing ameloblastoma in a dwarf rabbit (Oryctolagus cuniculus f. dom.)].
A 3.5-year-old, male, neutered dwarf rabbit was presented with a history of a fast-growing gingival mass at the maxilla. The neoplasm was surgically completely excised. Histopathologically, an expansively growing, multilobulated, partially cystic, peripheral, keratinizing ameloblastoma was diagnosed. The immunohistochemical phenotyping of the tumour cells resulted in cytoplasmic labelling with various pan-cytokeratin antibodies. The cytokeratins 5/6, 7, 10 and 14 were expressed variably. Cytokeratin 20 was not detected. Vimentin was expressed in the cytoplasm of mesenchymal cells of the tumour stroma. In addition, in the nuclei of approximately 10% of the tumour cells the protein of the tumour suppressor gene p53 was expressed while in approximately 5% the proliferation marker Ki67 was expressed. Odontogenic tumours should be considered as a differential diagnosis of oral masses in rabbits.


Degeneration of long-term fetal neostriatal allografts in the rhesus monkey: an electron microscopic study.
Primate fetal neostriatal neurons were implanted into the ibotenic acid-lesioned primate striatum and the animals were allowed to survive for 8 months. Light microscopic examination of the transplanted tissue demonstrated that the grafts were between 1.0 and 1.5 mm in diameter. The transplants were highly gliotic, but contained both normal appearing and degenerating neurons. At the electron microscopic level, the transplanted neurons displayed ultrastructural features identical to those of medium spiny, medium aspiny, and large aspiny striatal neurons. However, the majority of the grafted neurons showed evidence of degeneration. The grafts' neuropil demonstrated numerous glial processes, as well as mature axodendritic and axospinous synapses. Although this study was limited to only two graft recipients, the degenerative changes seen in the long-term primate allografts suggest that extension of these techniques into the clinical setting may be premature at the present time.


Structures and chitin-binding properties of two N-terminal lysin motifs (LysMs) found in a chitinase from Volvox carteri.
Two N-terminal lysin motifs (LysMs) found in a chitinase from the green alga Volvox carteri (VcLysM1 and VcLysM2) were produced, and their structures and chitin-binding properties were characterized. The binding affinities of VcLysM1 toward chitin oligomers determined by isothermal titration calorimetry (ITC) were higher than those of VcLysM2 by 0.8-1.1 kcal/mol of ΔG°. Based on the NMR solution structures of the two LysMs, the differences in binding affinities were found to result from amino acid substitutions at the binding site. The NMR spectrum of a two-domain protein (VcLysM1+2), in which VcLysM1 and VcLysM2 are linked in tandem through a flexible linker, suggested that the individual domains of VcLysM1+2 independently fold and do not interact with each other. ITC analysis of chitin-oligomer binding revealed two different binding sites in VcLysM1+2, showing no cooperativity. The binding affinities of the VcLysM1 domain in VcLysM1+2 were lower than those of VcLysM1 alone, probably due to the flexible linker destabilizing the interaction between the chito-oligosaccahrides and VcLysM1 domain. Overall, two LysMs attached to the chitinase from the primitive plant species, V. carteri, were found to resemble bacterial LysMs reported thus far.


The spectrum of renal histologies seen in HIV with outcomes, prognostic indicators and clinical correlations.
Two hundred and twenty-one HIV-positive renal biopsies were analysed from Groote Schuur Hospital to determine outcomes and prognostic indicators based on histology and clinical features. The histology findings were compared with patient demographics, clinical and renal parameters, mortality, CD4 count and date of commencing combined anti-retroviral therapy (cART). Follow-up was between 1 and 3.5 years. We found a spectrum of renal histologies in HIV-positive patients of which HIV-associated nephropathy (HIVAN) was the most common histology. cART reduced the mortality in those with any feature of HIVAN by 57% [adjusted hazard ratio (AHR) 0.43, 95% confidence interval (CI) 0.22-0.85]. Of those patients with HIVAN who died, 79% died of renal failure as registered on their death certificate. Proteinuria and microcysts were shown to be poor prognostic indicators (AHR 1.36: 1.09-1.70 and 2.04: 1.24-3.37). In patients with HIVAN alone followed for up to 2 years on cART, estimated glomerular filtration rate remained stable and there was a trend towards decreased proteinuria. cART improved survival in patients with isolated immune complex disease. As mortality is improved in patients with any feature of HIVAN or isolated immune complex disease, cART should be initiated once any of these histological features are established. We believe the spectrum of disease that constitutes HIVAN needs to be more specifically defined. The ultimate outcome may be determined by the histological subtype.


Signal to noise ratio comparisons for ultrasound attenuation slope estimation algorithms.
Attenuation imaging has a promising role in the detection of tissue abnormalities. The authors have previously compared three different frequency domain ultrasound attenuation estimation methods, for accuracy and bias. The mean estimated attenuation value in a region of interest has been the determining factor of how well a method performs; however, the noise level has not been quantified for attenuation estimated using different methods. The authors compare three different frequency domain ultrasound attenuation estimation methods [the reference phantom method (RPM), the centroid downshift method (CEN), and the hybrid method (HYB)] using the signal to noise ratio (SNR) metric. Both simulated and experimental tissue-mimicking phantoms are used in the performance comparison study, evaluating the impact of the variation in acoustical properties. For attenuation estimation in a tissue-mimicking phantom with a known attenuation coefficient of 0.5 dB/cm/MHz, all the three methods estimated the attenuation coefficient to be ≈ 0.49 dB/cm/MHz for a transmit center frequency of 6 MHz, however, the signal to noise ratio obtained was found to be 8.5, 5.7, and 2.2 for the HYB, RPM, and CEN methods, respectively. These results demonstrate the need for the SNR metric in the comparison of different algorithms and to evaluate the impact of varying different ultrasound system and tissue parameters. In this paper, the authors demonstrate that although the estimated mean attenuation value with a region of interest may be closely estimated using different methods, the signal to noise ratio obtained of the estimates can vary significantly. The centroid downshift method presented with the lowest signal-to-noise ratio of the methods compared. The hybrid method was the least susceptible to changes in the acoustical properties and provided unbiased attenuation coefficient estimates with the highest signal-to-noise ratios.


Exposure to ionizing radiation during liver transplantation evaluation, waitlist time, and in the postoperative period: a cause for concern.
Substantial evidence has linked ionizing radiation exposure (RE) to oncogenesis. Patients evaluated for transplantation undergo extensive diagnostic imaging and have increased baseline cancer risk factors. The objective was to examine exposure in a cohort of patients undergoing evaluation and liver transplantation. Radiation exposure from all diagnostic examinations and procedures were retrospectively recorded. Radiation exposure is reported in mSv, a standardized measure of the detrimental biologic effect of radiation which allows for population-level comparisons. Seventy-four patients (69% male, mean 57 years) were evaluated, of which 13 of 35 subsequently listed patients were transplanted; an additional 18 previously evaluated patients were also transplanted during 2010. The most common indications were hepatitis C (55%) and hepatocellular carcinoma (HCC) (30%). The median observation period was 14 months. In all, 1,826 imaging examinations were performed, of which 408 (22%) involved considerable ionizing radiation and were the focus of investigation. Median annualized effective RE was 51 mSv (interquartile range [IQR]: 19,126), with 10% exposed to almost twice the amount of radiation recommended for a 5-year period. Patients with HCC received significantly (P < 0.00001) higher median annualized effective RE than patients without HCC, 137 mSv (IQR: 87,259) versus 32 mSv (IQR: 13,57), respectively. Computed tomography (CT) abdomen (23%) and chest (16%) accounted for the most common exposures, with CT abdomen accounting for 46% of overall cohort RE. Patients undergoing evaluation and liver transplantation at our center are exposed to very high levels of ionizing radiation. Although long-term effects in these patients are yet to be defined, the theoretical increased risk of malignancy must be given its due consideration. Routine use of nonradiation imaging and reconsideration of indications may be preferred and justified in this population.


Spirituality Concern Toward Patients in Hospice Care during COVID-19 Pandemic in China.
Tension, anxiety, or fear spread all over the world during COVID-19 pandemic. How health professionals provide terminally ill patients with humanistic care to deal with fear is worth consideration. A more abundant spirituality concern in the body-mind-spirit care mode on patients in hospice care is appied in our practice.


Obesity and breast cancer: status of leptin and adiponectin in pathological processes.
It is well recognized that obesity increases the risk of various cancers, including breast malignancies in postmenopausal women. Furthermore, obesity may adversely affect tumor progression, metastasis, and overall prognosis in both pre- and postmenopausal women with breast cancer. However, the precise mechanism(s) through which obesity acts is/are still elusive and this relationship has been the subject of much investigation and speculation. Recently, adipose tissue and its associated cytokine-like proteins, adipokines, particularly leptin and adiponectin, have been investigated as mediators for the association of obesity with breast cancer. Higher circulating levels of leptin found in obese subjects could be a growth-enhancing factor as supported by in vitro and preclinical studies, whereas low adiponectin levels in obese women may be permissive for leptin's growth-promoting effects. These speculations are supported by in vitro studies which indicate that leptin promotes human breast cancer cell proliferation while adiponectin exhibits anti-proliferative actions. Further, estrogen and its receptors have a definite impact on the response of human breast cancer cell lines to leptin and adiponectin. More in-depth studies are needed to provide additional and precise links between the in vivo development of breast cancer and the balance of adiponectin and leptin.


Fructose consumption impairs serotonergic signaling in the murine enteric nervous system.
The intake of free fructose has increased substantially since the development of high-fructose corn syrup. This has not only been associated with metabolic disorders but recent evidence also indicates that chronic fructose consumption can affect neuronal and cognitive function. In this study we investigated the effects of fructose consumption on serotonergic signaling and neuronal activity in the mouse submucous plexus. Male mice were put on a control or fructose (23% solution) diet for 6 weeks or were assigned to a recovery group that received normal water (2 weeks) after 4 weeks of fructose. At the end of the diet, gene expressions and enteric neuronal activity, after depolarization with high K(+) and 5-HT, were measured using Ca(2+) imaging and RT-qPCR, respectively. Even in the lack of gain weight and the absence of changes in duodenal permeability, the total number of 5-HT-responding neurons and the depolarization and 5-HT-evoked Ca(2+) amplitudes were significantly lower after fructose consumption. Expression of synaptobrevin CaV 2.1 and CaV 2.2 mRNA did not differ after fructose intake; however, CaV 2.1 mRNA levels were significantly higher in the recovery animals. SERT mRNA concentration, isolated from submucosal plexus containing mucosal epithelium, was significantly decreased after fructose consumption. Chronic fructose consumption impairs serotonergic signaling in the mouse submucous plexus, prior to weight gain and detectable intestinal permeability problems.


Time Delay of Microdialysis in vitro.
Microdialysis is a specific and local sampling method to collect free molecules from the extracellular fluid, however, there are no reports on time delay issues of microdialysis applications. This study was to check the time gap between the start of target molecule changes in detected fluid and corresponding stable concentration formation in the sampled dialysate. A designated microdialysis system for free calcium ion was set up in vitro and perfused with saline. The dialysate was diluted synchronously, and collected in a vial every 10 min. The free calcium concentration [Ca++] of the sample was measured by an atomic absorption spectrophotometer. A signal-switching method was introduced to mimic the target molecule [Ca++] changes in the detected fluid, standard calcium solution and saline. There was a notable lag in dialysates [Ca++] for both uprising and down going course in spite of instant switching between the detected fluids. The recovery time (RT) of the microdialysis system was extrapolated to be 20 min for [Ca++] detection. With 10 min sampling interval, [Ca++] time delay of the microdialysis system existed, and could not be estimated precisely beforehand. The signal-switching method was applicable for RT calibration in vitro with a dedicated microdialysis system.


One-stage correction of proximal hypospadias and penoscrotal transposition.
Total correction of proximal hypospadias and penoscrotal transposition (PST) is a challenge to surgeons. Staged operation is usually recommended because the blood supply to the neourethra or the skin covering the penile shaft may be severed during scrotoplasty. This paper describes results obtained using a new technique for total correction, which preserves the blood supply to the neourethra in a one-stage operation. Between July 1998 and March 2000, five boys (mean age 4 yr) with proximal hypospadias and PST underwent total correction in a one-stage operation. The urethral meatus of these patients was located at mid shaft in one, at the penoscrotal junction in two, and at the scrotum in two. Hypospadias was repaired using the Snodgrass procedure and PST was corrected using the Ehrlich and Scardino technique. Radical bulbar urethra dissection and tunica albugineal plication were used to correct penile curvature in all five cases. The urethral stent was removed on the seventh or eighth postoperative day. The meatus was then dilated using the cone tip of an ophthalmic ointment tube two or three times per day for 2 to 4 weeks. Postoperative urinary flow was observed in the outpatient clinic. The mean follow-up period was 11.2 months. There was no postoperative fistula. One patient had postoperative meatal stenosis that was successfully treated by dilation. Postoperatively, the penile base was well above the scrotal rhugae and the meatus was at the tip of the glans in each patient. The postoperative urinary flow was straight in all patients. Combining Snodgrass hypospadias repair and Ehrlich and Scardino PST repair in a one-stage operation preserved the blood supply to the neourethra and achieved excellent functional and cosmetic results.


Recovery of Ca2+ pools and growth in Ca2+ pool-depleted cells is mediated by specific epoxyeicosatrienoic acids derived from arachidonic acid.
Depletion of Ca2+ pools using the irreversible Ca2+ pump blocker, thapsigargin, induces DDT1MF-2 smooth muscle cells to enter a stable nonproliferative state. Reversal of this state can be mediated by high (20%) serum treatment, which induces new Ca2+ pump protein, return of Ca2+ pools, and reentry of cells into the cell cycle; the effect of serum can be mimicked by the essential fatty acids (EFA), arachidonic, linoleic, and alpha-linolenic acids (Graber, M.N., Alfonso, A., and Gill, D.L., (1996) J. Biol. Chem. 271, 883-888). The possible requirement for EFA metabolism in inducing recovery of Ca2+ pool-depleted growth-arrested cells was investigated. Neither cyclooxygenase or lipoxygenase inhibitors had any effect on arachidonic acid-induced growth recovery of thapsigargin-treated cells. In contrast, the cytochrome P-450 epoxygenase inhibitors, SKF525A and metyrapone, substantially reduced arachidonic acid-induced recovery of growth while having minimal effects on control cell growth. Both epoxygenase inhibitors completely prevented the arachidonic acid-induced recovery of bradykinin-releasable Ca2+-pumping pools, whereas cyclooxygenase and lipoxygenase inhibitors had no effect. The effectiveness of the four cytochrome P-450 metabolites of arachidonic acid on recovery of Ca2+ pools were compared; 8,9- and 11,12-epoxyeicosatrienoic acid (EET) at 1.5 microM were completely effective in recovering agonist-sensitive Ca2+ pools, whereas the 5,6- and 14,15-EETs were without effect. SKF525A did not block the action of 8,9- or 11, 12-EET indicating further P-450 metabolism was not required. Hydration of the active EET molecules prevented Ca2+ pool recovery since the dihydroxy-derivatives of both 8,9- and 11,12-EET were ineffective. The specificity of effectiveness among EET molecules for subsequent resumption of growth of thapsigargin-treated cells was the same as for Ca2+ pool recovery. Significantly, the P-450 inhibitors, SKF525A and metyrapone, both prevented the action of 20% serum in inducing recovery of thapsigargin-treated cells, whereas cyclooxygenase and lipoxygenase inhibitors were ineffective, indicating that EFAs are the active component within serum that is responsible for recovery of Ca2+ pool-depleted cells. The specific action of EETs in mediating recovery of Ca2+ pools and growth of thapsigargin-treated cells represents not only a novel action of epoxygenase products from EFAs, but also a potentially significant new signaling pathway that may effect translational control and regulate transition from a stationary to proliferative growth state.


Highly efficient and large-scale fabrication of superhydrophobic alumina surface with strong stability based on self-congregated alumina nanowires.
In this study, a large-area superhydrophobic alumina surface with a series of superior properties was fabricated via an economical, simple, and highly effective one-step anodization process, and subsequently modified with low-surface-energy film. The effects of the anodization parameters including electrochemical anodization time, current density, and electrolyte temperature on surface morphology and surface wettability were investigated in detail. The hierarchical alumina pyramids-on-pores (HAPOP) rough structure which was produced quickly through the one-step anodization process together with a low-surface-energy film deposition [1H,1H,2H,2H-perfluorodecyltriethoxysilane (PDES) and stearic acid (STA)] confer excellent superhydrophobicity and an extremely low sliding angle. Both the PDES-modified superhydrophobic (PDES-MS) and the STA-modified superhydrophobic (STA-MS) surfaces present fascinating nonwetting and extremely slippery behaviors. The chemical stability and mechanical durability of the PDES-MS and STA-MS surfaces were evaluated and discussed. Compared with the STA-MS surface, the as-prepared PDES-MS surface possesses an amazing chemical stability which not only can repel cool liquids (water, HCl/NaOH solutions, around 25 °C), but also can show excellent resistance to a series of hot liquids (water, HCl/NaOH solutions, 30-100 °C) and hot beverages (coffee, milk, tea, 80 °C). Moreover, the PDES-MS surface also presents excellent stability toward immersion in various organic solvents, high temperature, and long time period. In particular, the PDES-MS surface achieves good mechanical durability which can withstand ultrasonication treatment, finger-touch, multiple fold, peeling by adhesive tape, and even abrasion test treatments without losing superhydrophobicity. The corrosion resistance and durability of the diverse-modified superhydrophobic surfaces were also examined. These fascinating performances makes the present method suitable for large-scale industrial fabrication of chemically stable and mechanically robust superhydrophobic surfaces.


Gigantic floating leaves occupy a large surface area at an economical material cost.
The giant Amazonian waterlily (genus Victoria) produces the largest floating leaves in the plant kingdom. The leaves' notable vasculature has inspired artists, engineers, and architects for centuries. Despite the aesthetic appeal and scale of this botanical enigma, little is known about the mechanics of these extraordinary leaves. For example, how do these leaves achieve gigantic proportions? We show that the geometric form of the leaf is structurally more efficient than those of other smaller species of waterlily. In particular, the spatially varying thickness and regular branching of the primary veins ensures the structural integrity necessary for extensive coverage of the water surface, enabling optimal light capture despite a relatively low leaf biomass. Leaf gigantism in waterlilies may have been driven by selection pressures favoring a large surface area at an economical material cost, for outcompeting other plants in fast-drying ephemeral pools.


Preparative separation of 1,3,6-pyrenetrisulfonic acid trisodium salt from the color additive D&C Green No. 8 (pyranine) by pH-zone-refining counter-current chromatography.
In developing analytical methods for batch certification of the color additive D&C Green No. 8 (G8), the U.S. Food and Drug Administration needed the trisodium salt of 1,3,6-pyrenetrisulfonic acid (P3S) for use as a reference material. Since P3S was not commercially available, preparative quantities of it were separated from portions of a sample of G8 that contained ∼3.5% P3S. The separations were performed by pH-zone-refining counter-current chromatography using dodecylamine (DA) as the hydrophobic counterion. The added DA enabled partitioning of the polysulfonated components into the organic stationary phase of the two-phase solvent system used, 1-butanol-water (1:1). Thus, a typical separation that involved 20.3g of G8, using sulfuric acid as the retainer acid and 20% DA in the stationary phase and 0.1M sodium hydroxide as the mobile phase, resulted in ∼0.58 g of P3S of greater than 99% purity. The identification and characterization of the separated P3S were performed by elemental analyses, proton nuclear magnetic resonance, high-resolution mass spectrometry, ultra-violet spectra, and high-performance liquid chromatography.


Hydrocephalus associated with subarachnoid hemorrhage: clinical study by computed tomography, radioisotope cisternography and constant infusion test.
Thirteen patients exhibited a communicating hydrocephalus following subarachnoid hemorrhage secondary to ruptured intracranial aneurysms and were treated with shunt procedures. The interval between subarachnoid hemorrhage and surgery averaged 9 weeks. Seven of the patients showed improvement. The prognostic value for surgical management was evaluated on the basis of three different diagnostic examinations (computed tomography(CT), cisternography and constant infusion test). A correct diagnosis was obtained in 78 per cent in cisternography, and 63 per cent in infusion test and CT. All patients responding to surgery showed a typical pattern in cisternography, consisting of ventricular retention of radiopharmaceutical tracer for 48 h or longer in association with no radioactivity over the cerebral hemispheres. The constant infusion test correlated well with typical cisternographic patterns. CT is useful in demonstrating pathophysiological changes in hydrocephalus. Periventricular hypodensity was visible in patients with normal or slightly elevated intracranial pressure, accompanied by fairly rapid deterioration. All of them responded well to shunting. In most cases which benefited from the shunt, the postoperative CT showed not only normal-sized ventricles but also marked regression of the hypodensity over a short period.


Predictors of long-term outcome in an elderly group after laminectomy for lumbar stenosis.
This is a retrospective long-term outcome study of results after laminectomy for lumbar spinal stenosis in an elderly group of patients. The study was designed to evaluate possible demographic, comorbidity, and clinical prognosticators for pain reduction and functional improvement in this population. Because the assessment of functional outcome in the elderly is complicated by several specific factors, the use of outcome measurement parameters should be revised and refined. Moreover, despite numerous relevant studies, the results of various techniques remain equivocal, particularly among the elderly, which renders the implementation of focused studies necessary. New data could be used to refine patient selection and choice of technique to improve prognosis. During a 5-year period, lumbar laminectomies were performed in 182 elderly patients. Of these 182, 125 patients (68.8%) were followed up for a mean period of 60.8 months. The outcome was assessed by means of pain visual analog scale (VAS) pain score, Oswestry Disability Index (ODI), and patient satisfaction questionnaire, and results were correlated to demographic (age, sex), comorbidity (Charlson Comorbidity Index, diabetes, depression, and history of lumbar spine surgery), and clinical (main preoperative complaint, preoperative VAS score, and ODI) factors. In terms of the VAS score, 106 patients (84.8%) exhibited improvement at follow-up. The corresponding ODI improvement rate was 69.6% (87 patients). The mean VAS and ODI differences were 5.1 and 29.1, respectively. One hundred two patients (81.6%) were satisfied with the results of the operation. Univariate analysis for possible prognostic factors revealed the significant influence of low-back pain on VAS score (p = 0.024) and ODI (p < 0.001) not improving, while the ODI was also affected by sex (females had a poorer outcome [p = 0.019]). In contrast, patient satisfaction was not related to any of the preoperative parameters recorded; nevertheless, it was strongly related to all functional measurements on follow-up. Considering the methodological issues of such studies, particularly in elderly patients, the authors conclude that the ODI is more sensitive than the VAS score in assessing prognostic value and that patient satisfaction is difficult to prognosticate, underscoring the particularities that this population presents regarding functionality assessment. Considering the prognostic value of preoperative factors, a negative influence of low-back pain and female sex is reported.


New assist method for orthotopic heart transplantation in the dog.
We used cross circulation as an assist method for orthotopic heart transplantation in eight dogs. Seven of the eight dogs could be extubated on the first to third postoperative day and were able to eat and walk several hours after extubation. The survival times and the causes of death in these eight dogs were as follows: 436 days (alive), 5 days (sudden death), 17 days (rejection), 17 days (pyothorax), 3 days (accidental death), 59 days (rejection), 19 days (pneumothorax), and 188 days (alive). None of the dogs died of any problems related to the use of cross circulation. Hematologic and biochemical studies revealed that the CK, CK-MB, LDH, GOT, GPT, and lactate levels increased shortly after the operation and returned to the preoperative values within 14 days. The blood urea nitrogen, creatinine, amylase, hematocrit, and total protein levels remained almost unchanged. No free hemoglobin was detected. These findings indicated that no severe damage occurred to the recipient's organs. The key factors for performing successful cross circulation are as follows: (1) The body weight of the support dog should be at least three times that of the recipient. (2) The systolic pressure of the support dog and the pressure gradient between the support and the recipient should be kept above 150 mm Hg and 50 mm Hg, respectively. (3) The flow rate in the arterial tube should be maintained at between 30% and 50% of the basal cardiac output of the recipient. In conclusion, cross circulation is a suitable assist method for orthotopic heart transplantation in the dog.


Parkin overexpression during aging reduces proteotoxicity, alters mitochondrial dynamics, and extends lifespan.
Aberrant protein aggregation and mitochondrial dysfunction have each been linked to aging and a number of age-onset neurodegenerative disorders, including Parkinson disease. Loss-of-function mutations in parkin, an E3 ubiquitin ligase that functions to promote the ubiquitin-proteasome system of protein degradation and also in mitochondrial quality control, have been implicated in heritable forms of Parkinson disease. The question of whether parkin can modulate aging or positively impact longevity, however, has not been addressed. Here, we show that ubiquitous or neuron-specific up-regulation of Parkin, in adult Drosophila melanogaster, increases both mean and maximum lifespan without reducing reproductive output, physical activity, or food intake. Long-lived Parkin-overexpressing flies display an increase in K48-linked polyubiquitin and reduced levels of protein aggregation during aging. Recent evidence suggests that Parkin interacts with the mitochondrial fission/fusion machinery to mediate the turnover of dysfunctional mitochondria. However, the relationships between parkin gene activity, mitochondrial dynamics, and aging have not been explored. We show that the mitochondrial fusion-promoting factor Drosophila Mitofusin, a Parkin substrate, increases in abundance during aging. Parkin overexpression results in reduced Drosophila Mitofusin levels in aging flies, with concomitant changes in mitochondrial morphology and an increase in mitochondrial activity. Together, these findings reveal roles for Parkin in modulating organismal aging and provide insight into the molecular mechanisms linking aging to neurodegeneration.


Multi-Repeated Projection Lithography for High-Precision Linear Scale Based on Average Homogenization Effect.
A multi-repeated photolithography method for manufacturing an incremental linear scale using projection lithography is presented. The method is based on the average homogenization effect that periodically superposes the light intensity of different locations of pitches in the mask to make a consistent energy distribution at a specific wavelength, from which the accuracy of a linear scale can be improved precisely using the average pitch with different step distances. The method's theoretical error is within 0.01 µm for a periodic mask with a 2-µm sine-wave error. The intensity error models in the focal plane include the rectangular grating error on the mask, static positioning error, and lithography lens focal plane alignment error, which affect pitch uniformity less than in the common linear scale projection lithography splicing process. It was analyzed and confirmed that increasing the repeat exposure number of a single stripe could improve accuracy, as could adjusting the exposure spacing to achieve a set proportion of black and white stripes. According to the experimental results, the effectiveness of the multi-repeated photolithography method is confirmed to easily realize a pitch accuracy of 43 nm in any 10 locations of 1 m, and the whole length accuracy of the linear scale is less than 1 µm/m.