Intraoperative Coronary Artery Imaging for Planning.
A clear understanding of coronary anatomy is critical in congenital heart surgery, especially when a ventriculotomy is planned, as in right ventricular outflow tract reconstructions and biventricular repairs. Typically, major epicardial coronary arteries are easily identified during first-time operations. However, in reoperative surgery, epicardial adhesions can obscure coronary vessels making their identification challenging. This paper describes the application of intraoperative fluorescence imaging in congenital heart surgery to obtain real-time coronary artery visualization for operative planning in order to avoid coronary injury. The fluorescence imaging utilizes indocyanine green (ICG). ICG is diluted to 0.28 mg/mL, and 0.1-1.0 mL of ICG solution is delivered via the cardioplegia cannula into the coronaries. A handheld imaging probe illuminates the field with near-infrared laser light, which excites ICG fluorescence. The fluorescence is captured by a camera, and the signal is transmitted to a monitor for real-time viewing. The imaging probe shows the precise coronary anatomy, enabling identification of the optimal ventriculotomy site. Intraoperative fluorescence imaging is a safe and effective technique for characterizing coronary anatomy. This technique enhances procedural planning and helps minimize the risk of coronary injury during reoperative congenital heart surgery.


[Lumbar reprolapse or scar tissue? An attempt at differentiation via a computer tomographic bicolor mode].
The bicolour mode for computer tomography is explained. It replaces the soft tissue level of the computer tomogram by setting the window level to +55 Hu and its width to 1 Hu. Structures in the spinal canal with attenuation values greater than 56 Hu appear white. The cauda equina has an attenuation value of less than +45 Hu. Disc prolapses, scar tissue and solid tumours (with the exception of lipomas) have attenuation values greater than +55 Hu. The use of the bicolour mode combined with intravenous contrast in patients with post-operative symptoms can often help to differentiate between reprolapse and scarring. A time-saving method for the bicolour mode is described.


Aortic arch reconstruction without circulatory arrest: review of techniques, applications, and indications.
The majority of neonatal intracardiac repairs can now be performed with the use of low-flow cardiopulmonary bypass. However, aortic arch reconstruction still requires a period of circulatory arrest. Recently, a number of surgeons have reported techniques of limiting or completely avoiding circulatory arrest during arch reconstruction in an attempt to reduce the risk of neurologic injury. Several techniques are currently in use that have been successfully applied during biventricular repair and the Norwood operation for a wide range of aortic arch pathology including hypoplastic or interrupted aortic arch, the hypoplastic left heart syndrome, and its equivalents. These techniques maintain continuous low-flow cerebral perfusion via the innominate artery, directly or indirectly. In the last 2 years at the Montreal Children's Hospital (Montreal, Canada) we have consistently used such techniques for all arch reconstructions, including the Norwood operation, completely avoiding the use of circulatory arrest. These techniques are still in evolution with regard to flow rates, temperature, and safe period of low flow. Although the early results are encouraging, long-term follow-up with respect to neurodevelopmental outcome is essential to help us decide which techniques are optimal. This chapter provides an overview of the currently used techniques allowing cerebral perfusion during aortic arch reconstruction and summarizes our early experience at the Montreal Children's Hospital.


Halo lipids. VI. Stimulation of human and rabbit blood platelets by racemic halo analogues of O-alkyl-glycerophosphocholine.
Halo analogues of O-alkyl- glycerophosphocholines are shown to stimulate human and rabbit blood platelets. Using 50-500 microM, a concentration dependent platelet aggregation is triggered in human platelet-rich plasma. Distinctly lower concentrations up to 10 microM activate the platelets in rabbit platelet-rich plasma. Moreover, the halo analogues enhance aggregation and release reaction triggered by suboptimal concentrations of ADP. In protein poor mediums the halo lipids in a concentration of 50 microM or higher cause a complete lysis of platelets. These results indicate that the halo lipids tested show the typical behaviour reported on lysophosphatidic acids which has to be taken into account using these compounds for other purposes.


Apical ballooning (Takotsubo syndrome) in mitochondrial disorder during mechanical ventilation.
Takotsubo syndrome may be associated with neuromuscular disorders, but has never been described in a patient with mitochondrial disorder. A 75-year-old woman developed muscle cramps, ptosis, fasciculations and slowly progressive weakness and wasting of all four limbs, starting 2.5 years earlier. After exclusion of various differential diagnoses, including non-specific granulomatous myositis, inclusion body myositis, and motor neuron disease, mitochondrial disorder was assumed. Muscle weakness progressed to respiratory insufficiency, requiring mechanical ventilation. Five days after intubation, she developed hypotension, torsades de pointes, ST-segment elevation, and negative T waves. Echocardiography revealed apical ballooning with akinesia of the left ventricular anteroseptal, apical, apicolateral and inferior segments. Coronary angiography was normal, and ventriculography confirmed apical hypokinesia and ballooning. Takotsubo syndrome was diagnosed, resolving completely within 7 weeks under bisoprolol. This case shows that Takotsubo syndrome occurs also in mitochondrial disorder and under mechanical ventilation, and may be triggered by stress from respiratory insufficiency, intubation, pain from tracheostomy, stress from mechanical ventilation, medication, or from the uncertain prognosis.


Problem of nonadherence in chronically ill adolescents: strategies for assessment and intervention.
Nonadherence to medical treatment is a significant problem for adolescents with chronic illness, with significant morbidity and mortality. Yet efforts to assess and treat the problem have been limited. We reviewed the literature on the factors associated with nonadherence and focused on nonadherence in a series of interviews with staff at a pediatric transplant program. This paper describes some of our findings, offers guidelines for assessing nonadherence in a primary care setting, and discusses strategies and interventions aimed at enhancing adherence. We refer to clinical cases derived from our interviews with renal transplant staff and our own clinical practice. Nonadherence to treatment recommendations occurs in approximately one-third of adolescents with a chronic illness. Factors that have been associated with nonadherence include psychiatric illness, psychological factors, family issues, and health problems. Although extensive research has been done on the problem of poor patient adherence in pediatric chronic illnesses, the prevalence of nonadherence remains high, and the research itself is problematic because of different definitions and methods of assessment used. Novel treatment strategies to improve adherence have been proposed, and data on these are emerging. Nonadherence in adolescents with chronic illness is a serious problem in need of greater recognition and intervention and further research. The primary care physician may be able to reduce nonadherence by routinely evaluating for adherence issues and initiating a targeted strategy to combat nonadherence when it is found. This review describes strategies and specific approaches for identifying and treating nonadherence in adolescents and their families.


Random walker in temporally deforming higher-order potential forces observed in a financial crisis.
Basic peculiarities of market price fluctuations are known to be well described by a recently developed random-walk model in a temporally deforming quadratic potential force whose center is given by a moving average of past price traces [M. Takayasu, T. Mizuno, and H. Takayasu, Physica A 370, 91 (2006)]. By analyzing high-frequency financial time series of exceptional events, such as bubbles and crashes, we confirm the appearance of higher-order potential force in the markets. We show statistical significance of its existence by applying the information criterion. This time series analysis is expected to be applied widely for detecting a nonstationary symptom in random phenomena.


Salvage cryosurgery-how I do it.
Prostate cryosurgery has advanced over the last decade, and is now recognized as a treatment option for patients who have failed radiotherapy. Appropriate patient selection is imperative for successful salvage. Because the treatment is a local therapy, the recurrent cancer must be confined to the prostate and its immediate area, and up to half of patients who undergo salvage cryotherapy may eventually fail treatment because of occult synchronous metastases. Yet some patients with poor prognosticators may still benefit from salvage treatment.


Synthetic maize centromeres transmit chromosomes across generations.
Centromeres are long, often repetitive regions of genomes that bind kinetochore proteins and ensure normal chromosome segregation. Engineering centromeres that function in vivo has proven to be difficult. Here we describe a tethering approach that activates functional maize centromeres at synthetic sequence arrays. A LexA-CENH3 fusion protein was used to recruit native Centromeric Histone H3 (CENH3) to long arrays of LexO repeats on a chromosome arm. Newly recruited CENH3 was sufficient to organize functional kinetochores that caused chromosome breakage, releasing chromosome fragments that were passed through meiosis and into progeny. Several fragments formed independent neochromosomes with centromeres localized over the LexO repeat arrays. The new centromeres were self-sustaining and transmitted neochromosomes to subsequent generations in the absence of the LexA-CENH3 activator. Our results demonstrate the feasibility of using synthetic centromeres for karyotype engineering applications.


Mesocarnivores affect hispid cotton rat (Sigmodon hispidus) body mass.
Predator communities are changing worldwide: large carnivores are declining while mesocarnivores (medium-sized mammalian predators) are increasing in number and ecological influence. Predator choice of prey is not random and different predators select prey with different characteristics. Changes in predator communities can change predation patterns experienced by prey. Little is known about how mesocarnivore communities influence prey morphology. We used 14 years of mark-recapture data to investigate how mesocarnivore exclusion affected body mass of hispid cotton rats (Sigmodon hispidus). Finding adult male cotton rats were 9% heavier with mesocarnivore exclusion, we developed hypotheses to explain this observation. Greater adult male body mass in exclosures resulted from: (1) a non-significant trend of increased survival of large males, (2) faster juvenile male growth during the fall and a similar non-significant trend among adult males, and (3) spatial partitioning by size among males. Taxa-specific predation rates (i.e., rates of predation by snakes, raptors, or mesocarnivores) did not differ among male body mass classes. Mesocarnivores disproportionately preyed on large females while raptors targeted small females, but female body mass was not influenced by mesocarnivore exclusion. Changes in predator communities can result in multiple small effects that collectively result in large differences in prey morphology.


Direct current electrotherapy for internal haemorrhoids: experience in a tertiary health institution.
Haemorrhoids disease is one of the most frequently occurring disabling conditions of the anorectum. We re-present the method, advantages and results of using direct current electrotherapy in the treatment of haemorrhoids. Symptomatic grades 1, 2 or 3 internal and mixed haemorroids were treated. Exposure and evaluation was with an operative proctoscope which visualized one-eighth of the anal canal at a time. All diseased segments were treated per visit, indicators of successful treatment were, darkening of the treated segment, immediate shrinking of the haemorrhoid and ceasation of popping sound of gas release at the probe tip. Patients were followed up for two weeks. No bowel preparations, medications, anesthesia nor admission was required. Four hundred and fifty six segments were exposed, 252(55.3%) were diseased. eight patients with either grades 2 or 3 diseases required two treatment visits. The most common symptom was rectal bleeding (94.7%), followed by prolapsed but manually reduced hemorrhoids (68%). Prolapse of tuft of haemorrhoidal tissue with spontaneous return was seen in 59.6%, anal pain in 29.8%, and itching in 3.5%. the median number treated segments per patient was 4. No complication was encountered. All patients treated remained symptom free at a mean duration of follow up of 16 months. Direct current electrotherapy is an effective, painless and safe out-patient treatment method for grades 1 to 3 internal and mixed hemorrhoid disease.


Alteration of complex IV and acetylcholine-related enzymes in experimental spinal cord injury.
Acute, severe injury of the rabbit spinal cord, induced by the weight-drop method, causes alterations of the enzyme activities related to cholinergic and energy metabolism. Morphological examinations at the trauma site show degenerative processes in neurons 0.5 hr posttrauma and a marked decrease in the number of living cells 24 hrs later. Both biochemical and cytochemical findings show that the tissue metabolic and morphologic derangement, caused by severe spinal cord injury, is mostly confined to the gray matter at an early stage (0.5 hr), whereas 24 hrs later the white matter is also involved. The decrease in choline acetyl-transferase and acetylcholinesterase activities in the gray matter parallels the impairment of complex IV (cytochrome c oxidase) of the respiratory chain and the presence of morphological alteration in neurons. The dramatic drop in the enzyme activities, observed 24 hrs after the induction of the severe trauma is clearly associated with the loss of cells.


Lovastatin for hypercholesterolemia.
Lovastatin is the first 3-hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) reductase inhibitor approved for the treatment of primary hypercholesterolemia. It is indicated as adjunctive therapy to dietary control and should be initiated at 20 mg/d in the evening. With higher dosages, twice-daily dosing is preferred, particularly when the dosage reaches the maximum recommended 80 mg/d. Compared with other drugs available, lovastatin has been shown to have good efficacy and a low incidence of side effects. Limited pharmacokinetic information available from the manufacturer reports absorption approximately 30 percent, protein binding greater than 95 percent, and a dual pathway for elimination through both urine (10 percent) and feces (83 percent). The drug has been clinically tested versus placebo and in combination with other cholesterol-lowering drugs. Lovastatin is effective in lowering total cholesterol and low-density lipoprotein cholesterol by 25-30 percent, with nonfamilial (hypercholesterolemic) patients responding better than those with the familial form of the disease. One percent of lovastatin patients have discontinued therapy because of intolerable side effects. The most common complaints are flatulence and diarrhea; more severe abnormalities include elevation of liver enzymes and an unclear propensity for producing lens opacities. The monthly cost to a patient taking 20 mg/d is approximately $44. Although the drug should be added to hospital formularies, long-term safety experience and competition from other HMG-CoA reductase inhibitors will determine lovastatin's final therapeutic role.


Decoupling motor memory strategies: effects of sleep deprivation and amphetamine.
The purpose of this study was to examine motor memory strategies using sleep deprivation as a probe. Eighteen healthy men participated in a three-day study in which they underwent repeated testing on a kinesthetic arm position replication task. On the morning of Day 3, after approximately 48 hr sleep deprivation, they ingested either 20 mg d-amphetamine or placebo. Results showed that throughout Day 3 performance remained relatively unimpaired at medial positions for both groups. For positions shifted 25 degrees laterally, accuracy was also relatively unimpaired for the amphetamine group but was compromised for the placebo group. It was concluded that sleep deprivation-induced decrements in positioning ability were due to disruption of kinesthetic memory, a narrowing of attention, or both. Kinesthetic feedback, and encoding and retrieval processes of the spatial reference system were preserved.


Diagnostic stability in children and adolescents with bipolar disorder, a nationwide register-based study.
Diagnostic stability of bipolar disorder (BD) in children and adolescents, beyond the first contact has been investigated sparsely. The aim of this study was to investigate the diagnostic stability of BD in children and adolescents using over two decades of nationwide register-based data, and to examine factors associated with change from BD to schizophrenia (ICD-10: F20.x), schizoaffective disorder (ICD-10: F25.x) or other primary psychotic disorders (ICD-10 F23.x-24.x and F28.x-29.x). Danish register-based data for all incident BD patients diagnosed prior to age 18 years, between January 1st 1995 and December 31st 2014 (N = 519). We graphically illustrated diagnostic change at different follow-up times and studied variables associated with diagnostic change after 3-year follow-up using Poisson regression with robust standard error estimates. The diagnosis of incident BD was relatively stable. The diagnosis did not change for 93% of those followed for at least 6 months, and remained unchanged for 86% and 73% of those followed at least 3 years and 10 years, respectively. In patients followed for at least 3 years after index BD (N = 478), the risk of diagnostic change was 61% higher in males versus females. The risk of diagnostic change for patients diagnosed during hospitalization was 74% higher compared to patients diagnosed at outpatient clinics/emergency rooms. The risk of diagnostic change for patients abusing substances other than alcohol and cannabis was 173% higher compared to patients not abusing such substances. The risk of diagnostic change for patients previously diagnosed with schizophrenia or related diagnosis was 257% higher compared to patients not having been diagnosed with such diagnosis previously, while the risk of diagnostic change in offspring of parents with schizophrenia or related diagnosis was 126% higher compared to patients who did not have parents diagnosed with such disorders. Overall, the stability of the BD diagnosis in the Danish nationwide healthcare registers was high. Factors associated with risk of diagnostic change within 3 years of the initial diagnosis were being male, diagnosis given during hospitalization, substance abuse other than alcohol and cannabis, and a prior diagnosis of schizophrenia or related diagnosis in the patient or in their parents.


Detection of genes for ordinal traits in nuclear families and a unified approach for association studies.
There is growing interest in genomewide association analysis using single-nucleotide polymorphisms (SNPs), because traditional linkage studies are not as powerful in identifying genes for common, complex diseases. Tests for linkage disequilibrium have been developed for binary and quantitative traits. However, since many human conditions and diseases are measured in an ordinal scale, methods need to be developed to investigate the association of genes and ordinal traits. Thus, in the current report we propose and derive a score test statistic that identifies genes that are associated with ordinal traits when gametic disequilibrium between a marker and trait loci exists. Through simulation, the performance of this new test is examined for both ordinal traits and quantitative traits. The proposed statistic not only accommodates and is more powerful for ordinal traits, but also has similar power to that of existing tests when the trait is quantitative. Therefore, our proposed statistic has the potential to serve as a unified approach to identifying genes that are associated with any trait, regardless of how the trait is measured. We further demonstrated the advantage of our test by revealing a significant association (P = 0.00067) between alcohol dependence and a SNP in the growth-associated protein 43.


Overexpression of cyclooxygenase-2 protein and its relationship to apoptosis in cervical carcinoma treated with neoadjuvant chemotherapy.
The aims of this study were to examine the overexpression of COX-2 protein and its relationship to apoptosis in cervical carcinoma patients treated with neoadjuvant chemo-therapy (NAC), and to assess the potential role of COX-2 as a predictor of the response to NAC in a series of patients with cervical carcinoma. For immunohistochemical analysis, cervical cancer tissue samples were collected before NAC and 3 weeks after NAC using transcatheter arterial infusion of cisplatin from 40 patients who underwent surgery for advanced cervical carcinoma in stages IB, IIA and IIB and from 5 normal cervical tissues between 1991 and 2000 at the Department of Obstetrics and Gynecology, under informed consent. Patients were randomly assigned to receive one or two arterial infusions of cisplatin. COX-2 protein expression was detected by immunohistochemical staining and was classified as no expression for tumors with negative or <10%, while > or =10% positive staining was defined as overexpression. Detection of apoptosis was done by the TUNEL method. The percentage of cells with DNA fragmentation (apoptotic index, AI) was calculated before NAC and 3 weeks after NAC. The AI ratio (AI after NAC/AI before NAC) was also calculated. COX-2 expression was not detected in the normal cervix. Overexpression of COX-2 protein was detected in 18 out of 40 (45.0%) cervical cancers. A higher incidence of COX-2 protein overexpression was observed in patients with adenocarcinoma than in those with squamous cell carcinoma (p=0.1797, Fisher's exact text). The average AI value before and after NAC was 8.85 versus 11.82 respectively. In COX-2 protein-negative patients with squamous cell carcinoma, the AI ratio was 0.96+/-0.46 following one arterial infusion of cisplatin and 3.19+/-2.72 following two infusions of cisplatin. There was a significant positive correlation between apoptosis and the number of infusions of cisplatin (p=0.0098, Mann-Whitney, U-test). Our findings suggest that COX-2 protein expression could be used as a predictor of chemoresistance and that assessment of the COX-2 status could be useful to identify cervical cancer patients who may benefit from NAC.


Assessment of the Prevalence of Diabetic Gastroparesis and Validation of Gastric Emptying Scintigraphy for Diagnosis.
Gastroparesis is defined as delayed gastric emptying and is a common medical condition in diabetic patients. Scintigraphy is commonly used as a standard diagnostic procedure for the quantitative assessment of gastroparesis. The aims of this study were to determine an optimum imaging time for the diagnosis of gastroparesis, to assess the prevalence of gastroparesis, to evaluate the correlation between endoscopy and scintigraphy findings as well as the correlation between gastric emptying with patient genders, blood glucose concentration, and functional dyspepsia. Gastric emptying was assessed in 50 diabetic patients with a mean age of 50.16 years. For evaluation of gastric emptying, a test meal containing 2 pieces of toast, 120 cc non-labeled water and fried egg labeled with 1 mCi of 99mTc was given to each patient. The scintigraphy was performed immediately after ingestion and was repeated at 1, 1.5, 2 and 4 hours after ingestion. In some patients, an additional 90-minute dynamic scan was also acquired. The prevalence of gastroparesis in this study population was determined as 64%. Also, the results of this study revealed that a 4-hour scan after ingestion is more relevant than a 90-minute dynamic scan for the evaluation of delayed gastric emptying. There was no statistically significant difference between 1-hour and 2-hour scans, 1-hour and 90-minute scans, 2-hour and 90-minute scans, 2-hour and 4-hour scans. Likewise there was no significant correlation between blood glucose levels, gender and calculated values of gastric emptying time in all groups. According to our findings, it can be suggested that the prevalence of gastroparesis is higher than that mentioned in some previous studies. Also, this study indicates that a gastric emptying scintigraphy at 2 and 4 hours after meal ingestion might provide the anticipated clinical information in diabetic patients with dyspepsia without other evident reasons.


Transforming food systems: a gendered perspective on local agricultural innovation in Cuba.
Compared to many countries, Cuba has made significant progress in advancing women's rights and gender equity; however, disparities remain. In the country's rural communities and agricultural sector, women continue to face barriers to equal participation and recognition for the value of their work. This case study shares the story of gender equity efforts that have been conducted within the framework of a broader development project-the Project to Strengthen a System of Innovation in Local Agricultural Development (PIAL, for its initials in Spanish). PIAL began in 2001 as a participatory plant-breeding initiative aimed at increasing the genetic diversity of key crops such as maize and beans. Over the course of two decades, the project's goals expanded to include an emphasis on increasing women's participation. In the beginning, those efforts focused on including women in the participatory plant-breeding activities, which enabled them to prioritize traits they cared about such as grain texture, cooking speed, and taste in the selection process. Over time, the participatory nature of the PIAL methodology empowered women to identify and pursue capacity-building in other areas of local agricultural innovation. While PPB remained central to PIAL, women also chose to pursue opportunities in seed bank management, leadership training, and small-scale farm-based entrepreneurship. The results of the PIAL work on gender have included not just more inclusive plant breeding, but also important economic improvements for rural women as they have been able to diversify their livelihoods, and social change as they have gained confidence and recognition as leaders in their households, communities, and beyond.


Meropenem exists in equilibrium with a carbon dioxide adduct in bicarbonate solution.
Evidence is provided for the existence of a second discrete chemical form of meropenem at clinically relevant concentrations prepared from the marketed formulation of the drug. Proton and carbon-13 NMR spectra in D2O, coupled with tandem mass spectroscopy (MS/MS) and cross polarization/magic angle spinning (CP-MAS) NMR experiments, allow structural assignment of the compound as a covalent carbon dioxide adduct of meropenem. This carbon dioxide adduct exists in equilibrium with the free drug in solution and can be observed in the solid state following lyophilization. The equilibrium constant of formation of the adduct (Keq = 20 +/- 8 M-1) was estimated in D2O at 25 degreesC.


Isolation and identification of a novel peptide from the accessory sex gland of the female house fly, Musca domestica.
A peptide of novel structure was isolated from accessory glands of the female house fly, Musca domestica by molecular-weight limit centrifugal ultrafiltration and reversed-phase HPLC. After amino acid and protein sequence analyses, the structure of this peptide was confirmed by chemical synthesis and plasma desorption mass spectral analysis to be Leu-Leu-Asn-Ala-Leu-Pro-Leu-Asp-Ala-Leu-Ser-Ser-Leu-Thr-Gly-NH2. The accessory gland peptide stimulated contraction of the house fly oviduct at concentrations of 10(-7) M and above.


[The relation between time and violence in the nursing work at emergency and urgency].
Believing that the organization form of work and the quantity of time given to the assistance work in the hospital can become a cause of violence that affects workers'and usuaries'life, this article analyzed the workers'perception about the time they have for their activities and the violence demonstration in the context of emergency and urgency work of a public hospital of Mato Grosso. It's a qualitative research done close to the members of the nursing staff, with data collected through participative observation and interviews. The data thematically analyzed revealed that the insufficient time makes part of the violence genesis at the nursing work and it is characterized as: classical, structural, repressive and alienation violence.


Watching small molecules move: interrogating ionic channels using neutral solutes.
Whether they are small enough to wriggle through the current-carrying part of an ionic channel or big enough to be kept outside and thus able to exert an osmotic stress on the channel space, polymers interact with channels in several instructive ways. The osmotic stress of excluded polymers allows one to measure the number of water molecules that come out of the channel in transitions between various "open" to "closed" states. The loss of osmotic activity, due to the partial or completely unrestricted admission of small polymers becomes a measure of the transfer probabilities of polymers from solution to small cavities; it provides an opportunity to study polymer conformation in a perfectly sieved preparation. Current fluctuations due to the partial blockage by a transient polymer are converted into estimates of times of passage and diffusion constants of polymers in channels. These estimates show how a channel whose functional states last for milliseconds is able to average over the interactions with polymers, interactions that last only microseconds. One sees clearly that in this averaging, the macromolecular channel is large enough to react like a macroscopic object to the chemical potentials of the species that modulate its activity.


Effects of ultra-strong static magnetic field on the gut microbiota of humans and mice.
To explore the effect of ultra-strong static magnetic field on gut microbiota, 16 T static magnetic field was used to study the changes in the structure and composition of human and mouse gut microbiota in this environment. In the mouse gut microbiota, at the genus level, the magnetic field significantly decreased the relative abundances of Escherichia-Shigella, Lactobacillus, Enterococcus, Burkholderia-Caballeronia-Paraburkholderia, Parasutterella, and Ralstonia and significantly increased those of Parabacteroides, Alloprevotella, Alistipes, Odoribacter, Bacteroides, Mucispirillum, Sutterella, and Prevotellaceae_UCG-001. Similarly, at the genus level, the relative abundances of Bacteroides, Parabacteroides, Romboutsia, and Streptococcus significantly decreased in the human gut microbiota. Contrary to the changing trend of the abundance in the mouse gut, the abundances of Bacteroides and Parabacteroides in the human gut were significantly reduced under magnetic field. The BugBase phenotypic prediction analysis showed that the relative abundances of five phenotypes, including anaerobism, mobile elements, potential pathogenicity, stress-tolerant, and biofilm formation, changed significantly in the mouse gut microbiota, while the relative abundances of two phenotypes, including Gram-positive and Gram-negative phenotypes, changed significantly in the human gut microbiota. The 16 T magnetic field could differently affect the composition, structure, and phenotypes of gut microbiota in human and mice, suggesting the importance of model selection in studying the biological effects of magnetic field.


Adjustable up-conversion luminescence color in rare earth co-doped transparent oxyfluoride nano-glass-ceramics.
Transparent oxyfluoride nano-glass-ceramics with highly efficient up-conversion and adjustable color luminescence were developed in the 28SiO2 x 17Al2O3 28PbF2 x 22CdF2 x 0.1NdF3 x xYbF3 x yHoF3 zTmF3 x (4.9 - x - y - z)GdF3 composition, in mol%. X-ray diffraction and transmission electron microscopy measurements revealed that heat treatments of the oxyfluoride glasses cause the homogeneous precipitation of rare-earth ions co-doped fluorite-type Pb(x)Cd1-xF2 nanocrystals of about 10 nm in diameter in the glass matrix. Under single 808 nm laser excitation, intense red, green and blue up-conversion luminescences were simultaneously observed in these transparent nano-glass-ceramics owing to the successive energy transfer from Nd3+ ions to Ho3+ and Tm3+ via Yb3+ ions. Various colors of luminescence, including bright perfect white light, can be tuned by adjusting the concentrations of the Tm3+ ions in the material. A possible energy transfer process and up-conversion luminescence mechanism in the nano-glass-ceramics are proposed and discussed.


Differences in Ostomy Pouch Seal Leakage Occurrences Between North American and European Residents.
The purpose of this study was to compare experiences and concerns about pouch seal leakage between persons with ostomies residing in North America (Canada and the United States) and Europe (United Kingdom, Netherlands, Sweden, Germany, Belgium, France, and Italy). Differences in reported pouch wear time and accessories used between the 2 groups were also examined. Secondary analysis of data from a cross-sectional study (Ostomy Life Study). Responses from persons residing in European countries (n = 1939) were compared with responses of 1387 individuals residing in North American countries. Persons with an ostomy completed a questionnaire that focused on 4 topics related to the daily use of an ostomy pouching system (pouch seal leakage, ballooning, appearance of pouching system such as color and size of the pouch and whether it is discrete under clothing, and coupling failure of 2-piece pouching systems). Pouch seal leakage was defined as stomal effluent seeping between the skin and the wafer of the ostomy pouching system. Statistical analysis was performed using a proportional odds model including various variable effects. Special attention was given to frequency of pouch seal leakage occurrences. All tests were 2-sided; P values ≤.05 were deemed statistically significant. Participants living in the North American countries indicated they were more likely to experience leakage from the ostomy (odds ratio = 2.610, 95% CI 2.187-3.115; P < .0001). Findings also indicated they were more likely to worry about pouch seal leakage than those in the European countries' data set (odds ratio = 2.722, 95% CI 2.283-3.246; P < .0001). Participants residing in the North American countries had significantly longer wear times than those participants in the European countries (P < .0001, χ test). The use of accessories was associated with a longer pouching system wear time. Study results suggest that participants from the North American countries indicated significantly more experience with and worries about leakage and longer wear time than the participants from the European population. Additional research is needed to determine the reasons for these differences.


A case of complete atrioventricular block in secondary hemophagocytic syndrome/hemophagocytic lymphohistiocytosis recovered by plasma exchange and cytokine absorbing therapy with AN69ST continuous hemodiafiltration.
We report a case of incipient systemic lupus erythematosus (SLE) that rapidly progressed to complete atrioventricular block (cAVB). A 20-year-old man was admitted with facial erythema, painless oral aphtha, polyarthritis, and myalgia of each extremity. On admission, he developed first-degree atrioventricular block, pericarditis, pleuritis, renal failure, hemophagocytic lymphohistiocytosis, neurophychiatric SLE (left cerebellar infarction), and Staphylococcus aureus bacteremia. He was subsequently diagnosed with SLE based on several positive findings on immunological tests (including positive for antinuclear antibody). Despite immediate glucocorticoid pulse therapy and plasma exchange (PE) along with antibiotic, he developed cAVB that required temporary pacing on day 2. Because it was thought that hypercytokinemia exacerbated pericarditis, which progressed to myocarditis and cAVB, we decided to PE and cytokine-adsorbing therapy with AN69ST-continuous hemodiafiltration (CHDF). Other than renal failure, his organ dysfunctions improved with the multidisciplinary therapy. CAVB improved and temporary pacing was no longer required on day 11. Even a first-degree atrioventricular block can rapidly progress to cAVB; therefore, strict attention to electrocardiogram is necessary in severe SLE cases. When presenting with organ dysfunctions caused by hypercytokinemia such as severe SLE cases or SLE with severe infection cases, use of the combination of PE and AN69ST-CHDF might be beneficial.


Measurement of Oxygen Desaturation Is Not Useful for the Detection of Aspiration in Dysphagic Stroke Patients.
Dysphagia is one of the most dangerous symptoms of acute stroke. Various screening tools have been suggested for the early detection of this condition. In spite of conflicting results, measurement of oxygen saturation (SpO2) during clinical swallowing assessment is still recommended by different national guidelines as a screening tool with a decline in SpO2 ≥2% usually being regarded as a marker of aspiration. This paper assesses the sensitivity of SpO2 measurements for the evaluation of aspiration risk in acute stroke patients. Fifty acute stroke patients with moderate to severe dysphagia were included in this study. In all patients, fiberoptic endoscopic evaluation of swallowing (FEES) was performed according to a standardised protocol. Blinded to the results of FEES, SpO2 was monitored simultaneously. The degree of desaturation during/after swallows with aspiration was compared to the degree of desaturation during/after swallows without aspiration in a swallow-to-swallow analysis of each patient. To minimise potential confounders, every patient served as their control. In each subject, a swallow with and a swallow without aspiration were analysed. Overall, aspiration seen in FEES was related to a minor decline in SpO2 (mean SpO2 without aspiration 95.54 ± 2.7% vs. mean SpO2 with aspiration 95.28 ± 2.7%). However, a significant desaturation ≥2% occurred only in 5 patients during/after aspiration. There was no correlation between aspiration/dysphagia severity or the amount of aspirated material and SpO2 levels. According to this study, measurement of oxygen desaturation is not a suitable screening tool for the detection of aspiration in stroke patients.


[Position paper of the Italian Society of Invasive Cardiology (SICI-GISE) on indications for coronary angiography in patients with stable angina].
Available data suggest a steep increase in stable coronary artery disease with age. Its prevalence reaches a peak of almost 12-14% in men aged 65-84 years with an annual mortality ranging from 1.2% to 2.4%. The diagnosis of stable angina is primarily based on history and therefore relies on clinical judgment. In addition, its diagnosis can be extremely challenging because of the frequent transition from unstable to stable angina. Current European guidelines on the management of stable coronary artery disease give increased importance to the pre-test probability, which strongly affects the diagnostic algorithms. Imaging techniques play a greater role in the diagnosis of stable angina than in the past. Conversely, despite recent advances in technology and in the physiological assessment of coronary stenosis, an ever decreasing relevance is conferred to coronary angiography. Another difficult and controversial issue relates to the prognostic benefit of myocardial revascularization. The aim of this position paper is to review the most relevant clinical aspects of the European guidelines on the management of stable coronary artery disease.


Molecular structure of the lecithin ripple phase.
Molecular dynamics simulations of lecithin lipid bilayers in water as they are cooled from the liquid crystalline phase show the spontaneous formation of rippled bilayers. The ripple consists of two domains of different length and orientation, connected by a kink. The organization of the lipids in one domain of the ripple is found to be that of a splayed gel; in the other domain the lipids are gel-like and fully interdigitated. In the concave part of the kink region between the domains the lipids are disordered. The results are consistent with the experimental information available and provide an atomic-level model that may be tested by further experiments.


Insulin receptor substrate-1 is an important mediator of ovarian cancer cell growth suppression by all-trans retinoic acid.
There is a need to identify more effective drugs for the treatment of ovarian cancer as it is the leading cause of death among gynecologic tumors. All-trans retinoic acid (ATRA), a natural retinoid, arrests the growth of CA-OV3 ovarian carcinoma cells in G(0)-G(1). Because the insulin-like growth factor-I receptor has been implicated in the proliferation of various tumors, we investigated its potential role in the suppression of ovarian cancer cell growth by ATRA. Our studies revealed that insulin receptor substrate-1 (IRS-1) protein levels decrease in CA-OV3 cells on ATRA treatment, whereas no differences in IRS-1 levels were seen in the ATRA-resistant SK-OV3 cells. Moreover, CA-OV3 clones overexpressing IRS-1 were growth inhibited less by ATRA, whereas SK-OV3 clones in which levels of IRS-1 were reduced by expression of antisense IRS-1 became sensitive to growth inhibition by ATRA treatment. Studies to determine the mechanism by which ATRA reduced IRS-1 expression showed that ATRA altered steady-state levels of IRS-1 mRNA and the stability of IRS-1 protein. Finally, the role of IRS-1 as a potential molecular target of ATRA in ovarian tumors was assessed by immunohistochemistry in an ovarian cancer tissue array. Compared with normal ovary, the majority of malignant epithelial ovarian tumors overexpressed IRS-1. Thus, there seems to be a correlation between IRS-1 expression and malignancy in ovarian tumors. Our results suggest that IRS-1 is in fact an important growth-regulatory molecule that can be a potential effective target for chemotherapeutic intervention with growth-suppressive agents, including retinoids.


[Anesthesia in surgical treatment of patients with cerebral palsy (a review)].
Anesthesia in surgical treatment and anesthetization in post operative period in patients with children cerebral palsy (CCP) is considered as an actual problem due to some specific features. The authors review the current state of the problem in aspects of efficacy and setting priorities in the development of methods of anesthesia in patients with CCP. Some methods of anesthesia, positive and negative sides of their application in CCP are characterized.


Reversible, PET-positive, generalized lymphadenopathy and splenomegaly during high-dose interferon-alpha-2b adjuvant therapy for melanoma.
A patient with resected stage III nodular melanoma treated with high-dose interferon-alpha-b2 adjuvant therapy went on to develop generalized lymphadenopathy and splenomegaly. The total body positron emission tomography showed a high F-fluorodeoxyglucose uptake (standardized uptake values >9), indicating possible lymph node and spleen malignancies. Histologic examinations of an axillary lymph node biopsy and an osteomedullar biopsy were negative, excluding both melanoma metastases and hematopoietic tumors. The symptoms completely regressed after suspension of treatment and a follow-up positron emission tomography was negative. It remains to be seen whether this unusual event can be ascribed to an autoimmune phenomenon linked to potential treatment efficacy and survival.


The Relationships between the Structure and Properties of PA56 and PA66 and Their Fibers.
Bio-based polymers can reduce dependence on nonrenewable petrochemical resources and will be beneficial for future sustainable developments due to their low carbon footprint. In this work, the feasibility of bio-based polyamide 56 (PA56) substituting petroleum-based PA66 is systematically investigated. The crystallization, melting, and decomposition temperature of PA56 were all lower than that of PA66. PA56 formed a γ crystal type with larger grain size and took a longer amount of time to complete the crystallization process since its crystallization rate was lower than that of PA66. Compared with PA66, PA56 exhibited a higher tensile strength of 71.3 ± 1.9 MPa and specific strength of 64.8 ± 2.0 MPa but lower notched impact strength. More importantly, the limited oxygen index and vertical combustion measurement results indicated that the flame retardancy of PA56 was better than PA66, and the LOI values and the UL94 result of PA56 were 27.6% ± 0.9% and V-2. It is worth noting that the PA56 fiber had superior biodegradability compared to the PA66 fiber. PA56 showed significant biodegradation from the eighth week, whereas PA66 remained clean until the sixteenth week (without obvious biodegradation taking place). Eventually, PA56 did not show significant differences compared to PA66 in terms of thermal and mechanical properties. However, PA56 had great advantages in flame retardancy and biodegradability, indicating that the bio-based PA56 could potentially replace petroleum-based PA66 in many fields.


Urethan (ethyl carbamate) alone is carcinogenic for mouse skin.
Nine groups of 32 hairless mice (16 males and 16 females in each) were painted on the back skin with approximately 200 microliters solution of urethan twice a week for up to 58 weeks. The following treatments were given: acetone alone, propylene glycol alone, 10% urethan in acetone, 15% urethan in propylene glycol, 20% urethan in acetone, 30% urethan in propylene glycol, 40% urethan in acetone, 75% urethan in propylene glycol, and approximately 100% melted urethan. Histological examinations revealed no development of general epidermal hyperplasia or inflammatory reactions. Tumors developed in skin, liver and lymph nodes, and one mouse also developed leukemic infiltrations in kidneys and lungs. The rate and yield of skin tumors were registered and statistically analyzed. The number of other tumors occurring was also recorded. The results confirm that urethan is a tumorigen for the lung and several other organs, and that it is also a complete carcinogen for hairless mouse skin, even in a dose as low as 10% urethan in acetone. There is also a significant dose-response relationship.


Preparation of Quinazolines via a 2+2+2 Annulation from Aryldiazonium Salts and Nitriles.
A (2+2+2) modular synthesis of multisubstituted quinazolines has been realized by the direct reaction of aryldiazonium salts with two equivalent of nitriles. Reaction of aryldiazonium salt with a nitrile provides the initial formation of a reactive nitrilium ion, which is attacked by another molecule of nitrile followed by electrophilic cyclization to deliver the desired product. Notable flexibility in the substitution patterns, readily available substrates, short reaction time, transition metal-free, and gram-scale synthesis are the advantages of this method.


Calcium intake trends and health consequences from childhood through adulthood.
Issues involving low calcium intake and dairy product consumption are currently the focus of much debate and discussion at both the scientific and lay community levels. In this review, we examine the following major areas of interest: (1). the role of calcium intake and dairy product consumption in chronic diseases, (2). nutritional qualities of milk and other dairy products, (3). trends in calcium intake and dairy product consumption, (4). current status of calcium intakes and dairy product consumption in children, (5). tracking of calcium intake and diary product consumption, (6). the impact of school meal participation on calcium intake and dairy product consumption, (7). concerns related to calcium-fortified foods and beverages and (8). factors influencing children's milk consumption. To date, the findings indicate that calcium intake and dairy product consumption have beneficial roles in a variety of chronic diseases; dairy products provide an abundant source of vitamins and minerals; calcium intakes of children have increased over time, yet intakes are not meeting the current adequate intake (AI) calcium recommendations; dairy consumption has decreased, and soft drink consumption and, possibly, consumption of calcium-fortified products have increased; consumption of dairy products have a positive nutritional impact on diets of children, particularly from school meals, and there are many factors which influence children's milk consumption, all of which need to be considered in our efforts to promote adequate calcium intakes by children. Based on this review, areas that need immediate attention and future research imperatives are summarized in an effort to further our understanding on what we already know and what we need to know to promote healthier eating habits early in life.


A review of 105 subscapular-based flaps harvested using a new dorsal decubitus position: how far can we go?
Interest in flaps based on the subscapular vascular system has decreased because of the need for intraoperative patient repositioning and the inability to employ a simultaneous 2-team approach. The aims of this study are to review our experience using dorsal decubitus patient positioning for subscapular-based flap harvest and to demonstrate the effectiveness and safety of this approach. A retrospective review of all subscapular-based flap cases performed by the senior author at 2 hospital centers from 1995 to 2010 was conducted. Variables studied included indications for reconstruction, flap characteristics, and postoperative complications. A longitudinal roll placed between the scapulae as well as an optional perpendicularly placed shoulder roll are used to achieve dorsal decubitus patient positioning. One hundred five flaps were performed during the study period, and dorsal decubitus positioning was used in all cases. Eighty-four flaps were free and 21 were pedicled. Indications for reconstruction included cancer resection (n = 58), trauma (n = 32), infection (n = 9), and others (n = 6). A simultaneous 2-team approach was carried out in 70 cases. Major complications included 9 cases of arterial or venous thrombosis/insufficiency, 2 of which resulted in total flap failure. Intraoperative conversion to lateral decubitus positioning was never required. Dorsal decubitus harvesting for subscapular-based flaps is a practical and effective technique that enables a simultaneous 2-team approach in complex reconstructive cases. Previous limitations of these highly versatile flaps, such as the need for intraoperative patient repositioning, can thus be avoided. This approach is employed for all subscapular-based flap reconstructions performed by the senior author.


Diabetic ketoacidosis in pregnancy.
The development of diabetic ketoacidosis in pregnancy is a medical emergency, requiring treatment in an intensive care setting. Both the mother and the fetus are at risk for significant morbidity and mortality. Physiologic changes unique to pregnancy provide a background for the development of diabetic ketoacidosis. An understanding of these physiologic changes assists in the management of the two patients being treated. Treatment of the patient with diabetic ketoacidosis includes insulin therapy and careful fluid management; recommendations for management are presented. Pregnant women, either with preexisting diabetes or with diabetes diagnosed during pregnancy. Prompt recognition of the clinical manifestations of diabetic ketoacidosis, followed by appropriate, timely treatment will optimize outcome for the pregnant woman and her fetus.


Design of Cecal Ligation and Puncture and Intranasal Infection Dual Model of Sepsis-Induced Immunosuppression.
Sepsis, a severe and complicated life-threatening infection, is characterized by an imbalance between pro- and anti-inflammatory responses in multiple organs. With the development of therapies, most patients survive the hyperinflammatory phase but progress to an immunosuppressive phase, which increases the emergence of secondary infections. Therefore, improved understanding of the pathogenesis underlying secondary hospital-acquired infections in the immunosuppressive phase during sepsis is of tremendous importance. Reported here is a model to test infectious outcomes by creating double-hit infections in mice. A standard surgical procedure is used to induce polymicrobial peritonitis by cecal ligation and puncture (CLP) and followed by intranasal infection of Staphylococcus aureus to simulate pneumonia occurring in immune suppression that is frequently seen in septic patients. This dual model can reflect the immunosuppressive state occurring in patients with protracted sepsis and susceptibility to secondary infection from nosocomial pneumonia. Hence, this model provides a simple experimental approach to investigate the pathophysiology of sepsis-induced secondary bacterial pneumonia, which may be used for discovering novel treatments for sepsis and its complications.


Highly Foldable, Super-Sensitive, and Transparent Nanocellulose/Ceramic/Polymer Cover Windows for Flexible OLED Displays.
Polymer cover windows are important components of flexible OLED displays but they easily generate wrinkles because of their weak folding resistance. Increasing the polymer thickness can improve the folding resistance but it decreases the touch sensitivity. Thus, fabricating highly foldable and supersensitive polymer cover windows is still challenging. Here, by incorporating cellulose nanocrystals (CNCs) and zirconia (ZrO2) into colorless polyimide (CPI), we developed a highly foldable and supersensitive hybrid cover window. Inspired by the theory of elasticity, we added rigid CNCs into CPI to improve the elastic modulus and hence the foldability. ZrO2 was introduced to improve dielectric properties, which leads to improved touch sensitivity. After these modifications, the elastic modulus of the cover windows was increased from 1432 to 2221 MPa, whereas its dielectric constant was increased from 2.95 to 3.46 (@1 × 106 Hz), resulting in significantly enhanced foldability and sensitivity. Meanwhile, because of the nano size of CNCs and ZrO2, the hybrid cover windows exhibit excellent optical properties with the transmittance of ∼88.1%@550 nm and haze of 2.39%. With improved and balanced mechanical, dielectric, and optical properties, these hybrid cover windows overcome current cover windows' defects and could be widely used in next-generation flexible displays.


Inhibition of spindle elongation by taxol.
During anaphase B spindle elongation, interzonal microtubules lengthen to accomplish pole-pole separation, while at the same time remaining highly dynamic [Shelden and Wadsworth, J. Cell Sci. 97:273-281, 1990]. To further examine the role of microtubule polymerization and dynamics during spindle elongation, cells have been treated with taxol, which induces microtubule polymerization and stabilizes microtubules. Taxol was added to PtK1 cells 3 minutes after initial chromatid separation, so that the effect on anaphase B could be observed with minimal disruption to anaphase A movement. In 20 microM taxol, the rate and extent of pole-pole separation, measured from time-lapse video records, are reduced to 4% and 9.5% of controls, respectively. The organization of microtubules in taxol treated cells was examined using tubulin immunofluorescence and confocal fluorescence microscopy. Taxol induces a dramatic reorganization of interzonal microtubules resulting in a narrow gap, which is nearly completely lacking in MTs, across the center of the interzone. Furthermore, microtubules in taxol treated cells are resistant to nocodazole induced microtubule disassembly. Our results reveal that taxol rapidly inhibits anaphase B spindle elongation; inhibition is accompanied by a depletion of interdigitated interzonal microtubules and a reduction in microtubule dynamic behavior.


Cardiac Disorders in Patients With Leber Hereditary Optic Neuropathy.
Cardiac abnormalities have been described in patients with Leber hereditary optic neuropathy (LHON). Some are life-threatening because of the risk of ventricular fibrillation and sudden death. The purpose of our study was to better characterize the cardiac abnormalities in a large patient cohort with LHON. A retrospective study of the electrocardiogram (EKG) results performed on all patients with LHON evaluated at The Reference Center for Rare Diseases in Ophthalmology, Paris, France, from January 2015 to June 2017. Our series included 73 patients with LHON (9 women/64 men) with a mean age of 30.29 ± 14.48 years. Although only 1 patient had cardiac complaints, cardiac abnormalities were detected in 17 patients (23.2%): 9 patients had an excitation syndrome, 6 had atrioventricular block, and 2 had repolarization abnormalities. All patients harbored mtDNA point mutations 11778 or 3460. Cardiac abnormalities occur frequently enough in patients with LHON that a baseline EKG is warranted. However, further studies are needed to determine the true cardiac risk associated with specific LHON mtDNA mutations.


Visual search strategies of baseball batters: eye movements during the preparatory phase of batting.
The aim of this study was to analyze visual search strategies of baseball batters during the viewing period of the pitcher's motion. The 18 subjects were 9 experts and 9 novices. While subjects viewed a videotape which, from a right-handed batter's perspective, showed a pitcher throwing a series of 10 types of pitches, their eye movements were measured and analyzed. Novices moved their eyes faster than experts, and the distribution area of viewing points was also wider than that of the experts. The viewing duration of experts of the pitching arm was longer than those of novices during the last two pitching phases. These results indicate that experts set their visual pivot on the pitcher's elbow and used peripheral vision properties to evaluate the pitcher's motion and the ball trajectory.


Serological and molecular epidemiological outcomes after two decades of universal infant hepatitis B virus (HBV) vaccination in Nunavut, Canada.
Chronic hepatitis B virus (HBV) infection within the Canadian Arctic is considered endemic (>2% prevalence). Within the Arctic region of Nunavut, a vaccination program targeted at newborn infants was initiated approximately 20years ago, along with interim grade school catch-up programs, with the result that individuals born after 1980 are presumed vaccinated. This study investigates the effectiveness of these programs and is the first seroepidemiological survey to determine HBV prevalence in Nunavut in the post-vaccination era. Anonymized serum specimens scheduled for destruction following medical testing were collected between April 2013 and April 2014 from individuals granting consent. Specimens were tested for HBV antibodies, surface antigen (HBsAg), and HBV DNA to perform molecular characterization. Four thousand eight hundred and two specimens (13% of the population) were collected, with a resulting median age of 29years (range 1week to 93years). The prevalence of antibody to the HBV core protein was 9.4%; however, a 10-fold decrease in the rate of HBV exposure was noted among those born after 1980 compared to those born before (1.8% vs. 19.8%, p<0.01). HBsAg positivity was primarily documented in individuals born before 1980 (2.5%), although cases still occurred among the vaccine age cohort (0.3%). HBV subgenotype B5 (previously B6) was the most prevalent genotype observed (81.8%) indicating persistence of locally acquired infection. Vaccine-based antibody as the sole serological marker was evident in the vaccine age cohort, although the rate of decay with increasing age was much greater than predicted (less than 10% in those aged 5-19years). Nearly two decades after the advent of HBV vaccination in Nunavut, HBV prevalence has decreased to 1.2%, indicating non-endemic prevalence. However, the persistence of infection and a lower than expected prevalence of vaccine-based immunity in the vaccine age cohort will require further investigation to understand the causes and consequences.


The classification of esterases: an important gene family involved in insecticide resistance--a review.
The use of chemical insecticides continues to play a major role in the control of disease vector populations, which is leading to the global dissemination of insecticide resistance. A greater capacity to detoxify insecticides, due to an increase in the expression or activity of three major enzyme families, also known as metabolic resistance, is one major resistance mechanisms. The esterase family of enzymes hydrolyse ester bonds, which are present in a wide range of insecticides; therefore, these enzymes may be involved in resistance to the main chemicals employed in control programs. Historically, insecticide resistance has driven research on insect esterases and schemes for their classification. Currently, several different nomenclatures are used to describe the esterases of distinct species and a universal standard classification does not exist. The esterase gene family appears to be rapidly evolving and each insect species has a unique complement of detoxification genes with only a few orthologues across species. The examples listed in this review cover different aspects of their biochemical nature. However, they do not appear to contribute to reliably distinguish among the different resistance mechanisms. Presently, the phylogenetic criterion appears to be the best one for esterase classification. Joint genomic, biochemical and microarray studies will help unravel the classification of this complex gene family.


Accessory lateral pectoral nerves supplying the pectoralis major.
Certain surgical treatment failures of the brachial plexus lesions are due to the presence of anatomical variations. Anatomical knowledge of the pectoral nerves is of clinical importance during mastectomy, neurotization or other surgical procedures in the axilla. The present case describes three nerves arising from the lateral cord of brachial plexus supplying the pectoralis major muscle one below the other which was observed during routine dissection for undergraduate students. Knowledge of certain variations as in the present case may be advantageous for cosmetic augmentations during radical mastectomy where pectoralis major can be preserved because of its additional nerve supply in the lower part.


Surgical Treatment of Giant Liver Hemangioma, Case Report and Literature Review.
Hemangiomas are the most common benign primary hepatic neoplasms, often being incidentally discovered. In most of the cases, they are small, asymptomatic and often require follow up. Giant hemangiomas are known as being larger than 5 cm and mostly consists of a cavernous haemangioma, is usually asymptomatic, diagnosed incidentally. In this study, we aimed to show that giant hemangiomas would be treated safely with surgical resection without transarterial embolization before the surgery. We present a 56-year-old male patient with liver hemangioma, who was diagnosed incidentally on thorax computarised tomography and consulted to thorax disease clinic with coughing complaint for a month. A case, which is rarely mentioned in literature, of a 30 cm sized asymptomatic giant cavernous hemangioma treated by surgical resection without any complication. We suggest that some patients should go through surgical treatment even if they do not have any complaint. Not only symptoms but also size and risk of rupture by trauma should be considered in these cases. However, all possible circumstances must be taken under consideration. Transarterial embolization is not the necessary.


Autoimmunity Links Vinculin to the Pathophysiology of Chronic Functional Bowel Changes Following Campylobacter jejuni Infection in a Rat Model.
Acute gastroenteritis can precipitate irritable bowel syndrome (IBS) in humans. Cytolethal distending toxin is common to all pathogens causing gastroenteritis. Its active subunit, CdtB, is associated with post-infectious bowel changes in a rat model of Campylobacter jejuni infection, including small intestinal bacterial overgrowth (SIBO). To evaluate the role of host antibodies to CdtB in contributing to post-infectious functional sequelae in this rat model. Ileal tissues from non-IBS human subjects, C. jejuni-infected and control rats were immunostained with antibodies to CdtB, c-Kit, S-100, PGP 9.5 and vinculin. Cytosolic and membrane proteins from mouse enteric neuronal cell lysates were immunoprecipitated with anti-CdtB and analyzed by mass spectrometry. ELISAs were performed on rat cardiac serum using CdtB or vinculin as antigens. Anti-CdtB antibodies bound to a cytosolic protein in interstitial cells of Cajal (ICC) and myenteric ganglia in C. jejuni-infected and naïve rats and human subjects. Mass spectrometry identified vinculin, confirmed by co-localization and ELISAs. Anti-CdtB antibodies were higher in C. jejuni-infected rats (1.27 ± 0.15) than controls (1.76 ± 0.12) (P < 0.05), and rats that developed SIBO (2.01 ± 0.18) vs. rats that did not (1.44 ± 0.11) (P = 0.019). Vinculin expression levels were reduced in C. jejuni-infected rats (0.058 ± 0.053) versus controls (0.087 ± 0.023) (P = 0.0001), with greater reductions in rats with two C. jejuni infections (P = 0.0001) and rats that developed SIBO (P = 0.001). Host anti-CdtB antibodies cross-react with vinculin in ICC and myenteric ganglia, required for normal gut motility. Circulating antibody levels and loss of vinculin expression correlate with number of C. jejuni exposures and SIBO, suggesting that effects on vinculin are important in the effects of C. jejuni infection on the host gut.


Effect of Typha capensis (Rohrb.)N.E.Br. rhizome extract F1 fraction on cell viability, apoptosis induction and testosterone production in TM3-Leydig cells.
Typha capensis (Rohrb.)N.E.Br. (bulrush) is used by traditional healers in Southern Africa to treat male reproductive problems. This study aimed at investigating the effects of T. capensis on TM3-Leydig cells. T. capensis rhizome crude extract obtained from autumn, winter, spring and summer harvest was fractionated using HPLC into four fractions, and TM3-Leydig cells were incubated with different concentrations of the F1 fraction (0.01, 0.02, 0.1, 1, 10 and 100 μg/ml) for 24, 48 and 96 hr respectively. The following parameters were evaluated: cell morphology, viability (MTT assay), testosterone production (testosterone ELISA test), apoptosis (Annexin V-Cy3 binding) and DNA fragmentation (TUNEL assay). Results revealed that the summer harvest obtained the highest amount of extract. The F1 fraction of all harvests was the most effective. This fraction significantly enhanced testosterone production in TM3 cells in a dose-dependent manner with maximum effect at 0.1 μg/ml. At higher concentrations, lower testosterone production was observed. Cell viability including apoptosis was not affected at concentrations used by the traditional healers to treat patients. This study shows that T. capensis enhanced testosterone production and might be useful to treat male infertility and ageing male problems.


POCS-Augmented CycleGAN for MR Image Reconstruction.
Recent years have seen increased research interest in replacing the computationally intensive Magnetic resonance (MR) image reconstruction process with deep neural networks. We claim in this paper that the traditional image reconstruction methods and deep learning (DL) are mutually complementary and can be combined to achieve better image reconstruction quality. To test this hypothesis, a hybrid DL image reconstruction method was proposed by combining a state-of-the-art deep learning network, namely a generative adversarial network with cycle loss (CycleGAN), with a traditional data reconstruction algorithm: Projection Onto Convex Set (POCS). The output of the first iteration's training results of the CycleGAN was updated by POCS and used as the extra training data for the second training iteration of the CycleGAN. The method was validated using sub-sampled Magnetic resonance imaging data. Compared with other state-of-the-art, DL-based methods (e.g., U-Net, GAN, and RefineGAN) and a traditional method (compressed sensing), our method showed the best reconstruction results.


[The tegument of Euzetrema knoepffleri, endoparasitic Monogenean of an amphibian: ultrastructure and evolution during the life cycle (author's transl)].
Euzetrema knoepffleri is an endoparasitic monogenean from the bladder of an Amphibian. Ultrastructural studies of the integument are made during the three stages of the life cycle: oncomiracidium, renal post-larva and adult. The meaning of the structures is discussed during the larval evolution to the adult and is compared with that of other monogeneans. The transition from fresh water to an urinary environment is in relation with the folding of the internal cytoplasmic membrane. This adaptation is specialized in water and ion transport through the integument, necessary for for the osmotic readjustment of the parasite: It has been noted that the tegument integrates ultrastructural adaptations to the biotope, independent of the phylogeny.


[Management of type 2 diabetic patients in primary care in Spain].
We assess the metabolic control, complications, quality of life related to health (QLRH) and the type and amount of medical resource consumption (MRC) in type 2 diabetic patients (2DMp) followed by primary care physicians (PCP) in Spain. We studied 628 2DMp divided in 4 cohorts: 1. Either newly diagnosed 2DMp who required pharmacological treatment or failed to non-pharmacological measures; 2. Patients pharmacologically treated for less than 1 year; 3. Patients with pharmacological treatment for more than 1 year; 4. Patients with impaired fasting glucose (control group). Eighty percent of the subjects were overweight. At baseline, 27.9, 23.5 and 36.9% of patients from cohorts 1, 2 and 3, respectively, had HbA1C < 8%. After 6 months of follow-up, 14.6, 21.3 and 22.8% of patients from cohorts 1, 2 and 3, respectively, still had "bad control". At baseline, 38.0%, 21.2% and 20.7% of patients from cohorts 1, 2, and 3, respectively, had "bad lipid profile". After 6 months, 57.4%, 54.2% and 45.3% of cohorts 1, 2 and 3, respectively, still had plasma cLDL levels > 130 mg/dl. Complications were more frequent in cohort 3. During the 6-month period, MRC was higher among 2DMp than controls (p < 0.05) and higher among patients from cohort 3 (p < 0.05) compared with all the other patients. More diabetic than control patients and more patients from cohort 3 than patients from cohort 1 and 2 reported that their expected quality of life would be better without diabetes. One out of four of diabetic patients studied had HbA1C and lipids higher than the limits suggested by guidelines. Type 2 diabetes is associated with higher MRC and worse QLRH. This situation is worse among long-term diabetic patients.


Depression of catalase gene expression after immortalization and transformation of mouse liver cells.
To understand the molecular basis of the remarkable decrease of catalase activity after immortalization and malignant transformation of mouse liver cells, expression of the catalase gene was studied in in vivo mouse liver cells and nontransformed normal mouse liver cell line as well as liver cell lines transformed by N-methyl-N-nitro-N-nitrosoguanidine, SV40 virus or by conventional subcultivation. In vivo liver cells had much greater levels of catalase mRNA and immunoreactive protein than in vitro cell lines, which correlates with elevated enzyme activity. Among the cell lines, normal cells had in general higher mRNA levels and more catalase protein than that of the transformed cell lines, also correlating with enzyme activity. The down regulation of catalase gene expression seen in transformed lines may occur transcriptionally rather than posttranscriptionally as demonstrated by cycloheximide and/or actinomycin D treatment. The striking difference in catalase gene expression seen between liver tissue and liver cell lines was unlikely due to gross structural alterations in the catalase gene, but might be explained by a remarkable difference in methylation status of the catalase gene, as demonstrated by Southern blot analysis following HpaII digestion. Our results suggested that during cellular immortalization and malignant transformation, a change in the oxidant stress ultimately led to a cellular response that, in turn, led to down regulation of the catalase gene.


Climate drivers of vector-borne diseases in Africa and their relevance to control programmes.
Climate-based disease forecasting has been proposed as a potential tool in climate change adaptation for the health sector. Here we explore the relevance of climate data, drivers and predictions for vector-borne disease control efforts in Africa. Using data from a number of sources we explore rainfall and temperature across the African continent, from seasonality to variability at annual, multi-decadal and timescales consistent with climate change. We give particular attention to three regions defined as WHO-TDR study zones in Western, Eastern and Southern Africa. Our analyses include 1) time scale decomposition to establish the relative importance of year-to-year, decadal and long term trends in rainfall and temperature; 2) the impact of the El Niño Southern Oscillation (ENSO) on rainfall and temperature at the Pan African scale; 3) the impact of ENSO on the climate of Tanzania using high resolution climate products and 4) the potential predictability of the climate in different regions and seasons using Generalized Relative Operating Characteristics. We use these analyses to review the relevance of climate forecasts for applications in vector borne disease control across the continent. Timescale decomposition revealed long term warming in all three regions of Africa - at the level of 0.1-0.3 °C per decade. Decadal variations in rainfall were apparent in all regions and particularly pronounced in the Sahel and during the East African long rains (March-May). Year-to-year variability in both rainfall and temperature, in part associated with ENSO, were the dominant signal for climate variations on any timescale. Observed climate data and seasonal climate forecasts were identified as the most relevant sources of climate information for use in early warning systems for vector-borne diseases but the latter varied in skill by region and season. Adaptation to the vector-borne disease risks of climate variability and change is a priority for government and civil society in African countries. Understanding rainfall and temperature variations and trends at multiple timescales and their potential predictability is a necessary first step in the incorporation of relevant climate information into vector-borne disease control decision-making.


Grafted Alkene Chains: Triggers for Defeating Contact Thermal Resistance in Composite Elastomers.
The pursuit of enhancing the heat transfer performance of composite elastomers as the thermal interface materials (TIMs) is a compelling and timely endeavor, given the formidable challenges posed by interfacial thermal transport in the domains of energy science, electronic technology, etc. Despite the efficacy of phase change materials (PCMs) in enhancing composite elastomers' interfacial compatibility, thereby reducing contact thermal resistance for heat transfer improvement, their leakage post-transition has impeded the widespread adoption of this approach. Herein, a strategy is proposed for developing a solid-solid phase change composite elastomer by grafting alkene chains onto the crosslink network to eliminate the possibility of leakage. A series characterization suggest that the resulting material possesses a self-adjusting interfacial compatibility feature to help reduce contact thermal resistance for heat transfer facilitating. The investigations on adhesion strength and surface energy reveal that the presence of amorphous grafted alkane chains at the interface facilitates easier absorption onto the contacting solid surface, enhancing intermolecular interactions at the interface to promote across-boundary heat transfer. By integrating these findings with the thermal performance evaluation of composite elastomers using a real test vehicle, valuable insights are gained for the design of composite elastomers, establishing their suitability as TIMs in relevant fields.


Dietary fat, olive oil intake and breast cancer risk.
As part of a population-based case-control study on diet and breast cancer in Spain, the role of dietary fat and vegetable oils in breast cancer etiology was examined. A validated, semi-quantitative food-frequency questionnaire was completed by 762 women, 18-75 years of age, with histologically confirmed, newly diagnosed breast cancer, and 988 randomly selected female controls. For each food item and nutrient, the study subjects were divided into quartiles according to intake levels, with the lowest quartile serving as the reference category. Adjustment for total energy intake and other potential confounders was made using multiple logistic regression for all women as well as separately for pre- and post-menopausal women. Neither total fat intake nor specific types of fat were significantly associated with breast cancer in pre- or post-menopausal women. However, higher consumption of olive oil (rich in monounsaturated fat) was significantly related to a lower risk of breast cancer [for highest vs. lowest quartile of consumption, odds ratio (OR) = 0.66; 95% CI, 0.46-0.97] with a significant dose-response trend. While these findings do not support a relation between total fat intake and breast cancer risk, they do provide evidence for an inverse association between olive oil (and suggest one between monounsaturated fat) and risk of breast cancer.


Effective Light Trapping in Thin Film Silicon Solar Cells with Nano- and Microscale Structures on Glass Substrate.
For thin film silicon-based solar cells, effective light trapping at a broad range of wavelengths (400-1100 nm) is necessary. Normally, etching is only carried out with TCOs, such as SnO2:F and impurity doped ZnO, to form nano-sized craters in the surface morphology to confer a light trapping effect. However, in this study, prior to ZnO:Al etching, periodic structures on the glass substrates were made by photolithography and wet etching to increase the light scattering and internal reflection. The use of periodic structures on the glass substrate resulted in higher haze ratios in the range from 550 nm to 1100 nm, which is the optical absorption wavelength region for thin film silicon solar cells, than obtained by simple ZnO:Al etching. The periodically textured glass with micro-sized structures compensates for the low haze ratio at the middle and long wavelengths of wet etched ZnO:Al. ZnO:Al was deposited on the periodically textured glass, after which the ZnO:Al surface was also etched randomly using a mixed acid solution to form nano-sized craters. The thin film silicon solar cells with 350-nm-thick amorphous silicon absorber layer deposited on the periodic structured glass and etched ZnO:Al generated up to 10.68% more photocurrent, with 11.2% increase of the conversion efficiency compared to the cell deposited on flat glass and etched ZnO:Al.


Concentrations and human health risk assessment of DDT and its metabolites in free-range and commercial chicken products from KwaZulu-Natal, South Africa.
Organochlorine pesticides such as dichlorodiphenyltrichloroethane (DDT) have been used in agriculture and for disease control purposes over many decades. Reports suggest that DDT exposure may result in a number of adverse effects in humans. In the KwaZulu-Natal Province of South Africa, DDT is sprayed annually in homes (indoor residual spraying) to control the mosquito vector of malaria. In the northern part of the Province, samples of free-range chicken meat (n = 48) and eggs (n = 13), and commercially produced chicken meat (n = 6) and eggs (n = 11), were collected and analysed. Of the free-range chicken meat samples, 94% (45/48) contained DDTs (ΣDDTs median 6.1 ng/g wet weight [ww], maximum 79.1 ng/g ww). Chicken egg contents were also contaminated (ΣDDTs in free-range eggs median 9544 ng/g ww, maximum 96.666 ng/g ww; and in commercial eggs median 1.3 ng/g ww, maximum 4.6 ng/g ww). The predominant DDT congener detected was p,p'-DDE in both free-range meat (>63%) and eggs (>66%), followed by p,p'-DDT and then p,p'-DDD. Based on estimated daily intake values, calculated human risk ratio (carcinogenic) values were >1 for DDTs detected in both free-range chicken products. Consumption of free-range eggs poses a particularly high health risk.


End-of-life care in advanced dementia.
In the next 30 years, the average age of the population will continue to increase, as will the prevalence of dementia. The management of advanced dementia requires the careful orchestration of communication, prognostication, patient care, and caregiver education. Understanding the specific tools available to establish prognosis and guide medical management in these complicated medical patients greatly improves patient and caregiver satisfaction at the end of the patient's life. In caring for patients with advanced-stage dementia, providers should be knowledgeable regarding the terminal nature of the condition and its common comorbid diseases, and should be prepared to educate the patients' caregivers, building a structure of support for the patient's benefit and navigating the complexities of end-of-life care.


Drug-coated balloon: an effective alternative to stent strategy in small-vessel coronary artery disease-a meta-analysis.
Small-vessel coronary artery disease (CAD) is frequently observed in coronary angiography and linked to a higher risk of lesion failure and restenosis. Currently, treatment of small vessels is not standardized while having drug-eluting stents (DES) or drug-coated balloons (DCBs) as possible strategies. We aimed to conduct a meta-analytic approach to assess the effectiveness of treatment strategies and outcomes for small-vessel CAD. Comprehensive literature search was conducted using PubMed, Embase, MEDLINE, and Cochrane Library databases to identify studies reporting treatment strategies of small-vessel CAD with a reference diameter of ≤3.0 mm. Target lesion revascularization (TLR), target lesion thrombosis, all-cause death, myocardial infarction (MI), and major adverse cardiac events (MACE) were defined as clinical outcomes. Outcomes from single-arm and randomized studies based on measures by means of their corresponding 95% confidence intervals (CI) were compared using a meta-analytic approach. Statistical significance was assumed if CIs did not overlap. Thirty-seven eligible studies with a total of 31,835 patients with small-vessel CAD were included in the present analysis. Among those, 28,147 patients were treated with DES (24 studies) and 3,299 patients with DCB (18 studies). Common baseline characteristics were equally distributed in the different studies. TLR rate was 4% in both treatment strategies [0.04; 95% CI 0.03-0.05 (DES) vs. 0.03-0.07 (DCB)]. MI occurred in 3% of patients receiving DES and in 2% treated with DCB [0.03 (0.02-0.04) vs. 0.02 (0.01-0.03)]. All-cause mortality was 3% in the DES group [0.03 (0.02-0.05)] compared with 1% in the DCB group [0.01 (0.00-0.03)]. Approximately 9% of patients with DES developed MACE vs. 4% of patients with DCB [0.09 (0.07-0.10) vs. 0.04 (0.02-0.08)]. Meta-regression analysis did not show a significant impact of reference vessel diameter on outcomes. This large meta-analytic approach demonstrates similar clinical and angiographic results between treatment strategies with DES and DCB in small-vessel CAD. Therefore, DES may be waived in small coronary arteries when PCI is performed with DCB.


[Cholera epidemics in Kanagawa].
In 1822 cholera first arrived in Japan, but it did not reach Edo, which is the old name of Tokyo, nor Kanagawa, a prefecture located next to Tokyo. During a second epidemic in 1858, 30,000 or so Japanese died and Kanagawa had a heavy toll. Cholera raged in Japan in 1877, 1879, 1882, 1886, 1890, 1891 and 1895. In 1877, an American doctor named D.B. Simmons was working at Jūzen Hospital (the previous hospital of Yokohama Medical College) in the Noge area in Yokohama, Kanagawa. He and his team tried to cure cholera patients by disinfecting the patients and their wastes with carbolic acid or phenol. They knew that isolating the patients was a good way to prevent the epidemic. As there was no hospital for infectious diseases in Kanagawa, they hurriedly built a small temporary hospital near Jūzen Hospital and named it Ota Isolation Hospital, where cholera patients were sent and treated. In 1879 as people suffered again from an epidemic Ota Hospital was replaced by Izumicho Isolation Hospital, which became a hospital for infectious diseases two decades later in 1900 and was called Yokohama Manji Hospital. Manji means to cure all. Wilhermus Hubertus van der Heyden, a Dutch doctor, worked for this hospital. The first regulation of cholera prevention in Japan was issued by the Bureau of Health of the Ministry of Internal Affairs in 1879. ...


Pulmonary resection for localized lesions of cryptococcosis (torulosis): a review of eight cases.
Torulosis is an uncommon, but potentially lethal disease. The aim of this report is to indicate that resection of isolated pulmonary lesions due to torulosis is a safe procedure. Resection has proved useful in the definitive diagnosis and treatment of eight cases seen in this thoracic surgical unit.


Comparative effects of bicarbonate, tris-(hydroxymethyl)aminomethane and dichloroacetate in newborn swine with normoxic lactic acidosis.
A total of 20 newborn piglets age 11.5 +/- 0.3 days and weighing 3.7 +/- 0.1 kg were studied under pentobarbital anesthesia. After stabilization following surgical procedures, baseline values for blood gases, base excess (BE), heart rate (HR), aortic pressure (AoP), left-ventricular contractility (LV dP/dtmax), carotid artery flow (CarF) and renal artery flow (RenF) were measured and normal lactic acid 0.2 ml/kg was infused over 1 h and the same parameters repeated. Then sodium bicarbonate (BC, n = 8), Tris-(hydroxymethyl)aminomethane (THAM, n = 6) or dichloroacetate (DCA, n = 6) were infused over 1 h. The doses of BC and THAM were calculated from the standard formula: Mmol = Base deficit x kg x 0.3. DCA was given at a dose of 300 mg/kg. Following lactic acid infusion, pH was 7.00 +/- 0.4 and BE was -20.6 +/- 1.2. Acidosis was associated with a significant (p < 0.05) increase in AoP (+18.6 +/- 7.4%) and decreases in HR (-13.9 +/- 2.7%) and RenF (-43.8 +/- 10.4%). Values of dP/dtmax and CarF were higher during acidosis in all but 3 animals. Following infusion of alkalizing agents pH and BE values were highest with BC and lowest with DCA and the differences were statistically significant (p < or = 0.05). In general, all three alkalizing agents reversed, in part or completely, the changes in cardiovascular parameters associated with acidosis so that following alkali infusion the changes were not statistically significant when compared to baseline values.(ABSTRACT TRUNCATED AT 250 WORDS)


Multicenter trial of fluoxetine as an adjunct to behavioral smoking cessation treatment.
The authors evaluated the efficacy of fluoxetine hydrochloride (Prozac; Eli Lilly and Company, Indianapolis, IN) as an adjunct to behavioral treatment for smoking cessation. Sixteen sites randomized 989 smokers to 3 dose conditions: 10 weeks of placebo, 30 mg, or 60 mg fluoxetine per day. Smokers received 9 sessions of individualized cognitive-behavioral therapy, and biologically verified 7-day self-reported abstinence follow-ups were conducted at 1, 3, and 6 months posttreatment. Analyses assuming missing data counted as smoking observed no treatment difference in outcomes. Pattern-mixture analysis that estimates treatment effects in the presence of missing data observed enhanced quit rates associated with both the 60-mg and 30-mg doses. Results support a modest, short-term effect of fluoxetine on smoking cessation and consideration of alternative models for handling missing data.


Mechanisms of the Feulgen acid hydrolysis.
Our present knowledge of the two main reactions responsible for the form of the Feulgen hydrolysis curve is summarized. A suggestion that hydrolysis slightly above room temperature and in 5 M HCl is preferable is made and discussed. A formula making it possible to calculate the appropriate hydrolysis time at any normally used acid concentration and temperature is presented.


[Cardiac magnetic resonance and uremic cardiomyopathy].
Cardiovascular disease (CV) represents the main risk factor for morbidity and mortality in chronic kidney disease (CKD) patients. Large epidemiological studies have shown direct association between severity of CKD and CV event rates. Although patients with end-stage renal disease (ESRD), including dialysis ones, are at greater CV risk, cardiovascular involvement is already evident at the early stages of CKD. End-stage CKD is characterized conventional atherosclerotic risk factor but they cannot account for CV risk as reflected in high rates of sudden cardiac death, heart failure and myocardial infarction. Non-atherosclerotic processes, including left ventricular hypertrophy and fibrosis, mostly account for the excess risk of CV. Employment of cardiac magnetic resonance (CMR) in CKD has brought an improved understanding of the adverse CV changes, known as uremic cardiomyopathy. It is due to ability of cardiac magnetic resonance to provide a comprehensive non - invasive examination of cardiac structure and function, arterial function, myocardial tissue characterization (T1 mapping and inversion recovery imaging), and myocardial metabolic function (spectroscopy).


Hypopituitarism associated with myalgia.
A patient with panhypopituitarism who presented with muscle pain and stiffness is described. These symptoms responded rapidly to treatment with thyroxine and cortisone acetate. The association between muscle disease and hypopituitarism is briefly reviewed.


Gonadotrophin and prolactin secretion in castrated male sheep following subcutaneous or intracranial treatment with testicular hormones.
Interactions between testosterone, estradiol, and inhibin in the control of gonadotrophin secretion in males are poorly understood. Castrated rams were treated with steroid-free bovine follicular fluid (bFF), testosterone, or estradiol and for 7 d (2 x 2 x 2 factorial design). Given independently, none of the exogenous hormones affected follicle-stimulating hormone (FSH) concentrations, but the combination of one or both steroids with bFF reduced FSH secretion. Testosterone and estradiol reduced luteinizing hormone (LH) pulse frequency (there was no synergism), and bFF had no effect. Plasma prolactin concentrations were not affected by any treatment. To locate the central sites of steroid action, castrated rams were bilaterally implanted in the preoptic area (POA), ventromedial nucleus (VMH), or arcuate nucleus (ARC). These implants did not affect FSH or prolactin concentrations, or LH pulse amplitude. The frequency of the LH pulses was not affected by testosterone in any site. Estradiol located in the ARC, but not the POA or VMH, decreased LH pulse frequency. In summary, FSH secretion is controlled by synergistic interactions between inhibin and estradiol or testosterone, whereas GnRH/LH pulse frequency is controlled by testicular steroids. Estradiol acts partly, at least, in the ARC, but the central site of action, testosterone remains unknown.


The relative biological effectiveness in V79 Chinese hamster cells of the neutron capture reactions in boron and nitrogen.
V79 Chinese hamster cells were irradiated in the presence of different amounts of boric acid with thermal neutrons at the Medical Research Reactor at Brookhaven National Laboratory. From the linear dose-survival curves observed, a D0 value of 66 rad for the 10B(n, alpha) 7Li neutron capture reaction was obtained. No dependence of this value on the concentration of boric acid was found. Comparing this value to the D0 value of 150 rad obtained with 250 kVp X rays between 10 and 0.01% survival, an extrapolated RBE value of 2.3 was calculated. By irradiation of the same line of cells with cold neutrons at the Institut Laue - Langevin , a D0 value for the 14N(n,p)14C reaction of 77 rad was obtained, with a corresponding RBE value of 1.9. Comparison is made with previously published RBE values for the 10B(n, alpha) 7Li reaction.


Introduction of a multilayered fluorescent nanofilm into lateral flow immunoassay for ultrasensitive detection of Salmonella typhimurium in food samples.
Fast and sensitive identification of foodborne bacteria in complex samples is the key to the prevention and control of microbial infections. Herein, an ultrasensitive lateral flow assay (LFIA) based on multilayered fluorescent nanofilm (GO/DQD)-guided signal amplification was developed for the rapid and quantitative determination of Salmonella typhimurium (S. typhi). The film-like GO/DQD was prepared through the electrostatic mediated layer-by-layer assembly of numerous carboxylated CdSe/ZnS quantum dots (QDs) onto an ultrathin graphene oxide (GO) nanosheet, which possessed advantages including higher QD loading, larger surface areas, superior luminescence, and better stability, than traditional spherical nanomaterials. The antibody-modified GO/DQD can effectively attach onto a target bacterial cell to form a GO/DQD-bacteria immunocomplex containing almost ten thousand QDs, thus greatly improving the detection sensitivity of LFIA. The constructed GO/DQD-LFIA biosensor achieved the rapid and sensitive detection of S. typhi in 14 min with detection limits of as low as 9 cells/mL. Moreover, compared with traditional LFIA techniques for bacteria detection, the proposed assay exhibited excellent stability and accuracy in real food samples and enormously improved sensitivity (2-3 orders of magnitude), demonstrating its great potential in the field of rapid diagnosis.


Microtubule motors regulate ISOC activation necessary to increase endothelial cell permeability.
Calcium store depletion activates multiple ion channels, including calcium-selective and nonselective channels. Endothelial cells express TRPC1 and TRPC4 proteins that contribute to a calcium-selective store-operated current, I(SOC). Whereas thapsigargin activates the I(SOC) in pulmonary artery endothelial cells (PAECs), it does not activate I(SOC) in pulmonary microvascular endothelial cells (PMVECs), despite inducing a significant rise in global cytosolic calcium. Endoplasmic reticulum exhibits retrograde distribution in PMVECs when compared with PAECs. We therefore sought to determine whether endoplasmic reticulum-to-plasma membrane coupling represents an important determinant of I(SOC) activation in PAECs and PMVECs. Endoplasmic reticulum organization is controlled by microtubules, because nocodozole induced microtubule disassembly and caused retrograde endoplasmic reticulum collapse in PMVECs. In PMVECs, rolipram treatment produced anterograde endoplasmic reticulum distribution and revealed a thapsigargin-activated I(SOC) that was abolished by nocodozole and taxol. Microtubule motors control organelle distribution along microtubule tracks, with the dynein motor causing retrograde movement and the kinesin motor causing anterograde movement. Dynamitin expression reduces dynein motor function inducing anterograde endoplasmic reticulum transport, which allows for direct activation of I(SOC) by thapsigargin in PMVECs. In contrast, expression of dominant negative kinesin light chain reduces kinesin motor function and induces retrograde endoplasmic reticulum transport; dominant negative kinesin light chain expression prevented the direct activation of I(SOC) by thapsigargin in PAECs. I(SOC) activation is an important step leading to disruption of cell-cell adhesion and increased macromolecular permeability. Thus, microtubule motor function plays an essential role in activating cytosolic calcium transitions through the membrane I(SOC) channel leading to endothelial barrier disruption.