Cytogenetic/mutation profile of chronic lymphocytic leukemia/malignant melanoma collision tumors of the skin.
Collision tumors are rare entities that consist of two histologically distinct tumor types arising in the same anatomic site. An association between chronic lymphocytic leukemia (CLL) and malignant melanoma (MM) has been already described. Up to now, they have been documented only at positive regional lymph nodes while we focused on collision tumor in a skin lesion. We characterized the genomic profile of a skin CLL/MM collision tumor in a patient with a 9-years story of CLL. Typical high-grade genomic biomarkers featured the CLL: the immunoglobulin heavy variable genes were unmutated; a clonal del(11q), involving ATM and BIRC3, was present in the peripheral blood (PB) and skin lesion, while a subclonal large del(13q)/D13S319-RB1 was detected only in the PB. Interestingly, the del(13q) clone, increased from 10% to 46% from diagnosis to relapse. NOTCH1, SF3B1, and TP53 were wild type. The MM lesion carried a BRAFV600E and a TERT promoter mutation.As the family story was consistent with a genetic predisposition to cancer, we performed mutational analysis of genes involved in familial melanoma and CLL, and of BRCA1 and BRCA2. No germinal mutation known to predispose to CLL, MM, or breast cancer was found. Interestingly, conventional cytogenetic detected a constitutional t(12;17)(p13;p13). Our data are consistent with distinct genetic landscape of the two tumors which were characterized by specific disease-related abnormalities. CLL cells carried poor prognostic imbalances, i.e. large deletions of the long arm of chromosomes 11 and 13, while in MM cells two functionally linked mutations, i.e. BRAFV600E and a TERT promoter occurred. Although, known germline variations predisposing to MM and/or CLL were ruled out, genetic counseling suggested the proband family was at high risk for MM.


Magnetic measurements at pressures above 10 GPa in a miniature ceramic anvil cell for a superconducting quantum interference device magnetometer.
A miniature ceramic anvil high pressure cell (mCAC) was earlier designed by us for magnetic measurements at pressures up to 7.6 GPa in a commercial superconducting quantum interference magnetometer [N. Tateiwa et al., Rev. Sci. Instrum. 82, 053906 (2011)]. Here, we describe methods to generate pressures above 10 GPa in the mCAC. The efficiency of the pressure generation is sharply improved when the Cu-Be gasket is sufficiently preindented. The maximum pressure for the 0.6 mm culet anvils is 12.6 GPa when the Cu-Be gasket is preindented from the initial thickness of 300-60 μm. The 0.5 mm culet anvils were also tested with a rhenium gasket. The maximum pressure attainable in the mCAC is about 13 GPa. The present cell was used to study YbCu(2)Si(2) which shows a pressure induced transition from the non-magnetic to magnetic phases at 8 GPa. We confirm a ferromagnetic transition from the dc magnetization measurement at high pressure. The mCAC can detect the ferromagnetic ordered state whose spontaneous magnetic moment is smaller than 1 μ(B) per unit cell. The high sensitivity for magnetic measurements in the mCAC may result from the simplicity of cell structure. The present study shows the availability of the mCAC for precise magnetic measurements at pressures above 10 GPa.


Clinical epidemiology of lymphatic filariasis and community practices and perceptions amongst the ado people of benue state, Nigeria.
As part of efforts to initiate lymphatic filariasis elimination activities in Benue State, this study employed the use of lymphatic filariasis-related clinical signs as rapid diagnostic features, immunochromatographic card test (ICT) to detect circulating filarial antigen (CFA) and questionnaire to investigate community perceptions and beliefs. 81 (32.6%) out of the 248 persons were positive for circulating filarial antigen (CFA). Infection rates denoted by CFA ranged from 41 (46.1%) in Uffia to 1(6.6%) in Ijigbam districts. Distribution of community ICT prevalence showed a significant variation (X(2), P < 0.05). The prevalence of clinical signs and/or symptoms in the communities also showed significant variations (X(2), P < 0.05). Community hydrocoele prevalence ranged from 8 (9.0%) in Uffia to 1(6.6%) in Ijigbam. The overall hydrocoele prevalence was 21 (8.5%), while the overall lymphoedema prevalence was 16 (6.4%) and women accounted for 14 (87.5%) of persons with swollen limbs. Only about 14 (15.9%) of unaffected respondents knew that lymphatic filariasis is transmitted through mosquito bites, this differ significantly from affected respondents 10 (66.6%) (X(2), P < 0.05). The communities' capacity to protect themselves is hindered by a lack of understanding of the true cause, symptoms, transmission route and prevention of the disease. Our study demonstrates the need for the development of health education programmes that will enable people to protect themselves against mosquito bites. As Nigeria commence her lymphatic filariasis elimination programmes, there is an urgent need to develop morbidity management activities that will alleviate the burden of patients.


Compliance with infection control practices in an university hospital dental clinic.
Compliance with infection control practices is the key to quality care and excellence in dentistry. Infection control remains one of the most cost-beneficial interventions available. However, implementing control procedures requires full compliance of the whole dental team. The aim of our study was to measure the compliance in daily clinical practice. The compliance with infection control practices in dentistry by dental health care personnel (DHCP) in a German university dental clinic was observed during clinical work. In addition, a survey was conducted to assess the individual knowledge about infection control procedures. Contamination of the workplace during invasive dental procedures was tested, as well. A total of 58 invasive dental treatments implying close contacts between HCWs and patients were scrutinized. All HCWs (100%) wore gloves during dental work, but in some cases (female dentists: 14.3%; dental assistants: 28.6%) gloves were neither changed nor hands were disinfected between different activities or patient contacts (female dentists: 68.6%; male dentists: 60.9%; dental assistants: 93%). Only 31.4% of female and 39.1% of male dentists carried out adequate hygienic hand disinfection after removing gloves. Male dentists wore significantly more often (100%) protective eyewear compared to 77.1% of female dentists (p<0.05). In addition, most of female dentists (62.9%) and dental assistants (80.7%) wore jewelry during dental procedures. Despite the knowledge of distinct hygiene procedures only a small percentage of dental staff performs hygiene practices according to recommended guidelines. Strict audit is clearly needed in the dental setting to ensure compliance with infection control guidelines to prevent transmission of pathogens. Our results provide insights for the development of a targeted education and training strategy to enhance compliance of dental staff especially of dental assistants with infection control procedures.


Value of duplex Doppler ultrasonography in renal colic.
The aim of our study was to determine the value of duplex Doppler ultrasonography (DDU) in the patients' evolution with renal colic. The study of the resistive index (RI), difference of the RI (ARI) associated with a DDU intravesical recording (ureteral jets) were compared with renographic findings in renal colic. Between October 1998 and January 2001 we studied 377 cases with suspected renal colic by intravenous pyelography (IVP), grey-scale ultrasonography and DDU with determination of the RI, the difference between the RI of ipsilateral and contralateral kidneys (ARI) and the amplitude (maximum length of the intravesical ureteral jet), velocity and frequency of the urine bolus. We considered normal values RI < or = 0.70 and ARI < or = 0.06. VP was used as a referee investigation and the ureteral intravesical jets were determined in standard conditions. All patients came to the hospital between 4 and 12 h after the onset of the renal colic. We found four series of patients: 1, acute (complete) obstructed kidney (IVP nonfunctional) and dilatation at normal grey-scale, with normal contralateral kidney (n = 153). In this series we found RI > 0.70 in 87%, RI > 0.06 in 90% and absent ureteral intravesical jet of the obstructed kidney site in 89%; 2, acute (complete) obstructed kidney (IVP nonfunctional) without abnormalities at normal grey-scale, with normal contralateral kidney (n = 57). In this series we found RI > or = 0.70 in 73.5%, deltaRI > 0.06 in 82.5% of patients, absent or asymmetric ureteral intravesical jet in 80.7% of cases; 3, incomplete obstructed kidney (IVP with various degree of ureterohydronephrosis) with normal contralateral kidney (n = 96). In this series we found RI > or = 0.70 in 58.3% and deltaRI > 0.06 in 64.5% of patients, asymmetric ureteral intravesical jets in 74% of cases; 4, normal both kidneys normal IVP) were found in 71 cases (18.8%). In this series we found RI < 0.70 in 80.2%, deltaRI < or = 0.06 in 89% of cases, normal ureteral intravesical jets in 93% of cases. The mean RI was 0.76 (0.05) in 306 obstructed kidneys, significantly higher than the mean RI of 0.62 (0.05) in 448 normal kidneys (P < 0.001). The ARI in patients with obstruction was significantly higher than in patients with normal both kidneys, at 0.08 (0.05) and -0.001 (0.03), respectively (P < 0.001). The RI was sensitive in 75.5% and specific in 92.5% and ARI was sensitive in 80.7% and specific in 95.7% (versus IVP, considered the referee value). The presence of the intravesical ureteral jets of the renal colic side, associated with the values of RI (RI < or = 0.70) and deltaRI (deltaRI < or = 0.06), was followed by spontaneous passage of the stones in 71% of cases. Renal DDU and consecutively, intravesical evaluation of ureteral jets could detect acute renal obstruction and, as a functional investigation, could have a predictive value regarding the ureteral stones passage. It could replace the IVP, being a sensitive and highly specific test.


Receptor-guided alignment-based comparative 3D-QSAR studies of benzylidene malonitrile tyrphostins as EGFR and HER-2 kinase inhibitors.
The overexpression and/or mutation of the epidermal growth factor receptor family of tyrosine kinases, namely EGFR and HER-2, have been implicated in poor prognosis of human solid tumors and are under investigation as molecular targets for cancer therapy. To gain insights into selectivity in the interaction of inhibitors at the ATP site of the two kinases, we have carried out docking, comparative molecular field analysis (CoMFA), and comparative molecular similarity analysis (CoMSIA) 3D-QSAR studies on 50 benzylidene malonitrile derivatives. Docking studies indicate different binding modes (A, B, C, D, and E) that are dependent on the R(1) substituent of the compounds. Binding modes A and B are favored by compounds having a hydroxyl substituent at R(1) whereas a methoxy substituent at R(1) results in compounds occupying binding modes, C, D, and E. The compounds preferred modes A, B, and C in the apo-enzyme whereas modes B, D, and E were preferred in the enzyme in complex with erlotinib. For 3D QSAR studies, based on the multiple binding modes obtained from the docking, four composite alignment strategies (I, II, III, IV) were employed and compared with alignment V, which is based on pairwise atom alignment of the common structural elements. Alignments I and II produced models with better predictive ability than those from alignments III and IV against an external test set. In the EGFR kinase results, alignments I and II produced comparable 3D-QSAR models with alignment II being slightly better than I, whereas in the HER-2 results, alignment I was better than alignment II in its predictive ability. It appears that differences in binding mode preferences at the ATP site might constitute a reason for the selectivity of the dihydroxy compounds as inhibitors of EGFR relative to HER-2. They are more likely to have multiple binding modes at the ATP site of EGFR, i.e., either modes A or B, than in the ATP site of HER-2 where they are possibly limited to only binding mode, A. Selectivity of the methoxy compounds on the other hand appears to depend on hydrogen bonding interactions involving the cyano group and residue 751 in the ATP site.


The effects of task-oriented training with altered sensory input on balance in patients with chronic stroke.
[Purpose] The purpose of this study was to identify the effects of task-oriented training with altered somatosensory input on the balance ability of chronic stroke patients. [Subjects and Methods] Twenty-six subjects with chronic stroke were divided into an experimental group (n=14) and a control group (n=12). Both groups attended physical therapy sessions five times a week for four weeks. The experimental group performed additional, task-oriented training with altered sensory input three times a week for four weeks. Limit-of-stability tests were conducted before and after the intervention. In addition, all subjects were evaluated using the Berg Balance Scale (BBS) and Korean Activities-Specific Balance Confidence Scale before and after the intervention. [Results] There was a significant interaction between time and group on BBS scores, on the total surface area of the limit of stability, and on the surface area of the limit of stability of the affected side. However, an analysis of covariance in which the baseline values of each variable served as the covariates showed that only the post-intervention BBS score of the experimental group was significantly higher than that of the control group. [Conclusion] Task-oriented training with altered somatosensory input can improve functional balance in patients with chronic stroke.


Transposition of the great arteries with coexisting sinus of valsalva aneurysm.
Transposition of the great arteries, with or without ventricular septal defect, and sinus of valsalva aneurysm (SVA) are lesions with well-established surgical therapies associated with excellent early and late outcomes. They have never, however, been reported as coexisting lesions. Their occurrence together has significant implications regarding sites of origin and rupture or obstruction in light of the altered relationships of the arterial roots and the ventricular masses. We report the diagnosis and successful treatment of a neonate with d-transposition of the great arteries with intact ventricular septum, and unruptured SVA. The implications of the altered spatial relationships in the patient with transposition and SVA are discussed. Our understanding of the morphogenesis of SVA may be impacted by this novel association as well.


Negligible and non-negligible risks in radiodiagnostic examination of patients.
Ionizing radiation is regarded as a health hazard, but one is prepared to neglect this factor on the basis of certain motives. In 1975, KNOX published an analysis of these motives, none of which proved tenable. He concluded that a situation which in daily usage is described as safe, is one which entails risks considered to be negligible so that no safety measures are taken. It can be empirically established that in various health-endangering situations a health hazard of less than 1 X 10(-5) is being neglected. This article studies the risk factors to the individual patient in radiodiagnostic examinations involving low, medium and high radiation exposures. The estimates show that radiohygenic measures on behalf of the patient are advisable.


Non-anti TNFα biologic agents for noninfectious uveitis associated with systemic inflammatory diseases: a systematic review.
Noninfectious uveitis related to systemic inflammatory diseases represents a leading cause of blindness. Anti-TNFα agents are the first-line biologic therapy after traditional immunosuppressants, for ocular and systemic involvement. However, some patients fails anti-TNFα agents, due to primary inefficacy, loss of efficacy or adverse events. This systematic review summarizes evidence on the efficacy and safety of non-anti-TNFα biologics in adult patients with noninfectious uveitis associated with systemic inflammatory diseases. The systematic review of PubMed and Embase yielded 3663 records, from which 16 studies were included (13 non-controlled, 3 controlled trials). Most studies focused on Behçet's syndrome (BS) and juvenile idiopathic arthritis (JIA) and assessed the efficacy of tocilizumab (n = 11), rituximab (n = 3), secukinumab (n = 1), or anakinra/canakinumab (n = 1). A body of evidence supports the use of tocilizumab BS and JIA-associated uveitis, for improving visual acuity, reducing central macular thickness, inducing ocular remission, and sparing corticosteroids. Preliminary data suggest that rituximab may represent a valid alternative, particularly in JIA, while anakinra/canakinumab might play a role in BS-associated uveitis. The role of secukinumab appears limited. Current evidence encourages investigations on the efficacy and safety of non-anti-TNFα agents in noninfectious non-idiopathic uveitis.


Attention Deficit/Hyperactivity Disorder and pediatric burn injury: important considerations regarding premorbid risk.
The purpose of this review is to provide an overview of the literature on the effects of Attention Deficit/Hyperactivity Disorder on pediatric burn injury, to identify specific considerations and trends relevant to this topic, and to call attention to areas for future research. There is growing evidence for increased risk of burn injury in children with Attention Deficit/Hyperactivity Disorder and externalizing behavioral disorders. Research indicates increased risk of burn morbidity and poorer adjustment following burn injury in these patients. Evidence suggests that stimulant treatment may be useful for reducing risk of burn injury and questions the use of 'drug holidays'. Research suggests prevention measures specific to this population, including increased supervision. Primary care providers can further educate patients and families regarding increased risk for injury due to Attention Deficit/Hyperactivity Disorder or symptoms of impulsivity and inattention that accompany other behavioral disorders, neurological conditions, and disabilities. Information regarding the risk of burn injury in children with symptoms of Attention Deficit/Hyperactivity Disorder is gradually gaining more attention. There is continued need for further investigation in this area, as well as critical assessment of intervention programs for this subgroup of individuals.


Saturation of thermoacoustic mixture separation.
The theory for thermoacoustic mixture separation is extended to include the effects of a nonzero concentration gradient. New data are presented, which are in excellent agreement with this theory. The maximum concentration gradient which may be achieved in a binary mixture of gases through this separation process is intrinsically limited by the fractional pressure amplitude, by the tidal displacement, and by the size of the thermal diffusion ratio. Ordinary diffusion further detracts from the attainable final concentration gradient and can become the dominant remixing process as the cross section of the duct is increased. Rayleigh streaming also works against thermoacoustic separation, and an estimate of the molar flux from streaming is given.


Psychological interventions for children with asthma.
Asthma is a chronic disease of inflammation and smooth muscle dysfunction, including bronchoconstriction. These symptoms are usually associated with widespread but variable airflow obstruction that is often reversible either spontaneously or with treatment. Psychological factors may influence the symptoms and management of asthma in children in many ways, for example, evidence suggests that emotional stress can either precipitate or exacerbate both acute and chronic asthma. To assess the efficacy of psychological interventions in improving health and behavioural outcomes for children with asthma. The Cochrane Airways Group Specialised Register and PsycINFO were searched with pre-defined terms up until March 2005. Randomised controlled trials published in any language assessing the effects of a psychological intervention compared with a control intervention in children and adolescents with asthma were included in the review. Cross-over trials were considered inappropriate for studies using psychological interventions and were therefore excluded from this systematic review. Two reviewers assessed the relevance of abstracts identified by electronic searching and retrieved agreed studies for further scrutiny. The studies that met the inclusion criteria were assembled and data extracted. Twelve studies (588 children) were included in the review. Study quality was poor and sample sizes were frequently small. A meta-analysis was possible on two studies only examining the effects of relaxation therapy on PEFR which favoured the treatment group (32 L/min, 95% CI 13 to 50 L/min). No other meta-analysis could be performed due to the diversity of interventions and the outcomes assessed. In addition, many studies reported insufficient data. This review was unable to draw firm conclusions for the role of psychological interventions for children with asthma. This review demonstrates the absence of an adequate evidence base and highlights the need for well-conducted and reported randomised trials in this area.


[Laparoscopic partial nephrectomy: A series of 17 cases].
The objective of this study was to evaluate the Feasibility, the morbidity and the carcinologic results of laparoscopic partial nephrectomy. Between August 2001 and December 2005, 17 partial nephrectomies were performed by laparoscopy in patients with a mean age of 59.2 years. Postoperative complications, the conversion rate, operating time, arterial clamping time, length of hospital stay and oncological results were studied for each patient. The mean operating time was 190 min, the mean arterial clamping time was 30 min and the mean hospital stay was 6.3 days. There were 2 complications including one postoperative haematoma requiring surgical revision for drainage and repositioning of a stent for urine leak. Two conversions had to be performed early in our experience. A tumour recurrence 2 years after the initial operation was treated by total nephrectomy. Our results in terms of morbidity are similar to those reported for open surgery, but the recurrence rate appears to be slightly higher than that observed with open partial nephrectomy. Laparoscopic partial nephrectomy remains a difficult operation requiring a learning curve even for a department that regularly performs laparoscopic surgery.


The peri-implant hard and soft tissues at different implant systems. A comparative study in the dog.
The aim of this study of the present experiment was to study the marginal periimplant tissues at intentionally non-submerged (1-stage implants) and initially submerged and subsequently exposed implants (2-stage implants). 5 beagle dogs, about 1-year-old, were used, 3 months after the extraction of the mandibular premolars, fixtures of the Astra Tech Implants Dental System, the Brånemark System and the Bonefit--ITI system were installed. In each mandibular quadrant, 1 fixture of each implant system was installed in a randomised order. The installation procedure followed the recommendations given in the manuals for each system. Thus, following installation, the bone crest coincided with the fixture margin of the Astra Tech Implants Dental System and the Brånemark System, whereas the border between the plasma sprayed and the machined surface of the Bonefit-ITI implant system was positioned at the level of the bone crest. Following a healing period of 3 months, abutment connection was carried out in the 2-stage systems (the Astra Tech Implants Dental System and the Brånemark system). A 6-month period of plaque control was initiated. The animals were sacrificed and biopsies representing each important region dissected. The tissue samples were prepared for light microscopy and exposed to histometric and morphometric measurements. The mucosal barrier which formed to the titanium surface following 1-stage and 2-stage implant installations comprised an epithelial and a connective tissue component, which for that 3 systems studied, had similar dimensions and composition. The amount of lamellar bone contained in the periimplant region close to the fixture part of the 3-implant systems was almost identical. It is suggested that correctly performed implant installation may ensure proper conditions for both and hard tissue healing, and that the geometry of the titanium implant seems to be of limited importance.


CD147/EMMPRIN and CD44 are potential therapeutic targets for metastatic prostate cancer.
Prostate cancer (CaP) is a major health problem in males in Western countries. Current therapeutic approaches are limited and many patients die of secondary disease (metastases). There is no cure for metastatic castration-resistant prostate cancer (CRPC). Targeting tumor-associated antigens is fast emerging as an area of promise to treat late stage and recurrent CaP. Extracellular matrix metalloproteinase inducer, EMMPRIN (CD147) is a multifunctional glycoprotein that can modify the tumor microenvironment by activating proteinases, inducing angiogenic factors in tumor and stromal cells, and regulating growth and survival of anchorage-independent tumor cells (micrometastases) and multidrug resistance (MDR). CD44 is a multifunctional protein involved in cell adhesion, migration and drug resistance, and is a primary receptor for hyaluronan (HA), a major component of the extracellular matrix (ECM) with a critical role in cell signaling and cell-ECM interactions in cancer. Our recent studies indicate both CD147 and CD44 are involved in cancer drug resistance and play very important roles in CaP metastasis. Thus, CD147 and CD44 may be ideal therapeutic targets to control metastatic and CRPC disease. This review will discuss their putative roles in CaP metastasis and MDR, and give an overview of literature regarding their expression on human CaP tissues. Additional focus will be on the potential of therapeutic strategies targeting CD147 and CD44 to prevent CaP metastasis and overcome drug resistance.


Measuring Quality of Life in Diabetic Retinal Disease: A Narrative Review of Available Patient-Reported Outcome Measures.
Several patient-reported outcome measures (PROMs) are available to measure health-related quality of life (HRQoL) in patients with late-stage clinical diabetic retinal diseases (DRDs). However, an understanding of the psychometric properties of PROMs is needed to assess how they could relate to severity levels of a revised DRD grading system. This narrative review assessed the available generic-, vision-, and DRD-related PROMs used in DRD research and highlights areas for improvement. Diabetic retinal disease is a common complication of diabetes and can lead to sight-threatening complications with a devastating effect on HRQoL. The Quality of Life working group is one of 6 working groups organized for the DRD Staging System Update Effort, a project of the Juvenile Diabetes Research Foundation Mary Tyler Moore Vision Initiative. PubMed, Cochrane Library, Embase, and Google Scholar databases were searched using core keywords to retrieve ophthalmology-related review articles, randomized clinical trials, and prospective, observational, and cross-sectional studies in the English language. A detailed review of 12 PROMs (4 QoL questionnaires and 8 utilities) that met a minimum level of evidence (LOE) was conducted. The relevance of each PROM to DRD disease stage and Biomarker Qualification guidelines (Biomarkers, EndpointS, and other Tools) categories was also defined. The National Eye Institute 25-item Visual Function Questionnaire (NEI VFQ-25), Impact of vision impairment-computerized adaptive testing, and Diabetic Retinopathy and Macular Edema Computerized Adaptive Testing System had a LOE of II in detecting change due to late-stage DRD (diabetic macular edema), although several areas for improvement (e.g., psychometrics and generalizability) were identified. Other PROMs, particularly the utilities, had a LOE of III due to cross-sectional evidence in late-stage clinical DRD. Although the NEI VFQ-25 has been the most widely used PROM in late-stage DRD, more work is required to improve its multidimensional structure and other psychometric limitations. No PROM was deemed relevant for subclinical or early/mid-DRD. This narrative review found that the most commonly used PROM is NEI VFQ-25, but none meets the ideal psychometric, responsiveness, and clinical setting digital administration requirements that could be included in an updated DRD staging system for diagnosis and monitoring of DRD progression. Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.


Homesickness and adjustment in university students.
The transition to college or university can be an exciting new experience for many young adults. For some, intense homesickness can make this move difficult, even unsustainable. Homesickness--defined as the distress or impairment caused by an actual or anticipated separation from home--carries the unique hallmark of preoccupying thoughts of home and attachment objects. Sufferers typically report depression and anxiety, withdrawn behavior, and difficulty focusing on topics unrelated to home. For domestic and international university students, intense homesickness is particularly problematic. It can exacerbate preexisting mood and anxiety disorders, precipitate new mental and physical health problems, and sometimes lead to withdrawal from school. New research, consolidated here for the first time, points to promising prevention and treatment strategies for homesick students, the result of which can be a healthy, gratifying, and productive educational experience.


Docetaxel and thalidomide as a treatment option for androgen- independent, nonmetastatic prostate cancer.
Prostate cancer usually presents with early-stage disease, yet a significant proportion of patients present or will progress to androgen-independent, nonmetastatic prostate cancer (AIPC). Chemotherapy has demonstrated statistically significant improvements in palliation of AIPC. Docetaxel in particular has demonstrated high response rates as a single agent. Thalidomide is effective in treating many malignancies, including prostate cancer. Thalidomide may act synergistically with docetaxel through their antiangiogenic effects. We performed a phase II trial of docetaxel with or without thalidomide in patients with AIPC and demonstrated encouraging response rates with combination therapy. We advocate further investigation of this promising combination regimen.


The efficacy of multi-zone cross-cylinder method for astigmatism correction.
The purpose of this study is to assess the efficacy of the multi-zone cross-cylinder method as compared with the single method for astigmatism correction using LASIK. This prospective study enrolled 40 patients (52 eyes) who underwent the cross-cylinder method using LASIK, and 52 patients (60 eyes) who underwent the single method using LASIK: all patients were given a diagnosis of complex myopic astigmatism from the department of ophthalmology of this hospital between January 2002 and July 2003. Preoperatively, the mean spherical equivalent refraction was -3.85 +/- 1.13 D in the cross-cylinder group and -4.05 +/- 1.20 D in the single method group (p = 0.23). The mean cylinder was -2.05 +/- 1.58 D in the cross-cylinder group and -1.95 +/- 1.12 D in the single method group (p = 0.31). 6 months after treatment the results were a mean spherical equivalent refraction of -0.26 +/- 0.30 D in the cross-cylinder group and -0.34 +/- 0.35 D in the single method group (p = 0.13). The mean cylinder was -0.38 +/- 0.29 D in the cross-cylinder group and -0.45 +/- 0.30 D in the single method group (p = 0.096). There were no statistically significant differences between the two groups. The mean BCVA was not different from mean preoperative BCVA in both groups (i.e., 0.98 +/- 0.10, 0.96 +/- 0.25, p = 0.86). Postoperatively, patient complications that included night halo, glare and corneal haze were not noted in either group. In conclusion, the results of cross-cylinder method are no different from the single method for the correction of a complex astigmatism. In the future, studies will have to be conducted to assess the efficacy of the cross-cylinder method in consideration of those factors that can affect the postoperative outcome.


Presence of high-grade intraepithelial lesions among women deprived of their liberty: a documental study.
The aim of this study was to analyze the results of the Pap smears of women deprived of their liberty. It is a retrospective, documental study, with a quantitative approach, performed in a female prison of Ceará, Brazil, with a sample of 672 patient records. Regarding the microbiological findings, it was verified that the main cervical-vaginal colonization was by bacilli suggestive of Gardnerella/Mobiluncus (21.8%), followed by Trichomonas vaginalis (12%), and Candida sp (5.8%). The frequencies of samples with atypical cells presented rates of 4.1% for Atypical Cells of Undetermined Significance; 3.2% for Low-grade Intraepithelial Lesions; and 2.5% for High-grade Intraepithelial Lesions. The importance of screening for cervical cancer in female prisons was highlighted, as well as the inclusion of the nurse in this environment, ensuring individualized, quality care for women deprived of their liberty.


Important role of the long terminal repeat of the helper Moloney murine leukemia virus in Abelson virus-induced lymphoma.
The helper virus has been shown to play a critical role in the development of lymphoma induced by the defective Abelson murine leukemia virus (A-MuLV). Indeed, A-MuLV pseudotyped with some viruses, such as the Moloney MuLV, has been shown to be highly lymphogenic, whereas A-MuLV pseudotyped with other viruses, such as the BALB/c endogenous N-tropic MuLV, has been shown to be devoid of lymphogenic potential (N. Rosenberg and D. Baltimore, J. Exp. Med. 147:1126-1141, 1978; C. D. Scher, J. Exp. Med. 147: 1044-1053, 1978). To map the viral DNA sequences encoding the determinant of the lymphogenic potential of Moloney MuLV when complexed with A-MuLV, we constructed chimeric helper viral DNA genomes in vitro between parental cloned infectious viral DNA genomes from Moloney MuLV and from BALB/c endogenous N-tropic MuLV. Chimeric helper MuLVs, recovered after transfection of NIH 3T3 cells were used to rescue A-MuLV, and the pseudotypes were inoculated into newborn NIH Swiss, CD-1, and SWR/J mice to test their lymphogenic potential. We found that a 0.44-kilobase-pair PstI-KpnI long terminal repeat-containing fragment from the Moloney MuLV was sufficient to confer some, but not complete, lymphogenic potential to a chimeric virus (p7M2) in NIH Swiss and SWR/J mice, but not in CD-1 mice. The addition of the 3'-end env sequences (comprising the carboxy terminus of gp70 and all p15E) to the U3 long terminal repeat sequences restored the full lymphogenic potential of the Moloney MuLV. Our data indicate that the 3'-end sequences of the helper Moloney MuLV are somehow involved in the development of lymphoma induced by A-MuLV. The same sequences have previously been found to harbor the determinant of leukemogenicity and of disease specificity of Moloney MuLV when inoculated alone.


Spermidine Oxidation-Mediated Degeneration of Retinal Pigment Epithelium in Rats.
Retinal pigment epithelium (RPE) degeneration is a crucial event in dry age-related macular degeneration and gyrate atrophy. The polyamine spermidine has been shown to induce RPE cell death in vitro. The present study aimed to establish a novel in vivo model of spermidine-induced RPE degeneration and to determine whether spermidine-induced RPE cell death involves oxidative mechanisms. In this study, spermidine caused ARPE-19 cell death in a concentration-dependent manner. This effect was prevented by removal of serum from the culture medium or treatment with amine oxidase inhibitors, N-acetylcysteine (NAC), or aldehyde dehydrogenase (ALDH). Intravitreal injection of spermidine into rats significantly increased the permeability of the blood-retinal barrier and decreased the amplitudes of scotopic electroretinogram a- and b-waves. Histological analysis revealed that spermidine induced vacuolation, atrophy, and dropout of RPE cells, leading to the disruption of photoreceptor outer segments. Simultaneous intravitreal administration of NAC and ALDH with spermidine prominently inhibited the functional and morphological changes induced by spermidine. In conclusion, this study demonstrated that the intravitreal administration of spermidine induced RPE cell dysfunction and death followed by photoreceptor degeneration in rats. These effects of spermidine are thought to be mediated by oxidative stress and a toxic aldehyde generated during spermidine oxidation.


Immune responses, intestinal microbiota, performance and blood characteristics of Japanese quail fed on diets containing camphor.
This study aimed to investigate the effect of supplemental camphor on the performance and immune functions of Japanese quail by feeding graded levels (0 (control), 250, 500, 750, 1000, 5000 or 10 000 ppm) of camphor during a 42-day feeding trial. In all, 280 1-day-old quail chicks were randomly assigned into 28 cages of 10 chicks each with separate feeders. The results clearly demonstrated that camphor did not have a significant effect on BW, BW gain, total experimental average daily feed intake, feed conversion ratio, internal organ relative weights and biochemical parameters such as uric acid, albumin, total protein and triglyceride; however, plasma cholesterol concentration was significantly different in a linear manner, in which 500 ppm of camphor resulted in a lower level of cholesterol. Alternatively, greater concentrations of glucose and high-density lipoprotein (HDL) were also found in 5000 and 1000 ppm of camphor groups, respectively. Cellular responses to the phytohaemagglutinin-P and 2,4-dinitro 1-chlorobenzene skin test were not influenced by dietary camphor. Humoral responses to secondary sheep red blood cells, avian influenza virus (AIV) and Newcastle disease virus (NDV) immunisations were positively influenced by camphor supplementation, in which greater secondary response to sheep erythrocytes belonged to 750 and 1000 ppm of camphor groups; whereas, diet supplementation with camphor had no significant effect on lymphoid organ weights and heterophil-to-lymphocyte ratio. The greatest AIV antibody titers were seen in groups, which received 1000 and 5000 ppm of camphor (P<0.05) and the values of NDV antibody titers increased with an increase in the camphor consumption. Furthermore, dietary inclusion of 500 ppm of camphor positively decreased coliform populations in the gastrointestinal tract (GIT). In addition, an increase in lactic acid bacteria was also observed in quails, which were fed on the diets containing 750 ppm camphor. Collectively, these data suggest that as a phytogenic feed additive, camphor may effectively act as a modulator of health status (by increasing glucose and HDL), GIT microbiota and immunological responses of the Japanese quail.


Nicotinic activation of CRH neurons in extrahypothalamic regions of the rat brain.
Nicotine is known to have multiple effects on neuroendocrine, autonomic, and behavioral responses. Its neuroendocrine effect on the stress-responsive hormone, ACTH, depends on central pathways that act on corticotropin-releasing hormone (CRH) neurons in the paraventricular nucleus of the hypothalamus (PVN). Other CRH neurons throughout the brain also are involved in coordinating aspects of the stress response, but very little is known about the effect of nicotine on CRH neurons in extrahypothalamic regions that are involved in the autonomic and behavioral responses to stress. The current study sought to determine the extent of nicotinic activation of extrahypothalamic CRH neurons, since these neurons may be involved in mediating the central effects of nicotine. Freely moving rats were pretreated with a low dose of colchicine, infused with nicotine (0.045 mg/kg/30 s or 0.135 mg/kg/90 s, i.v.), and cardiac perfused 1 h later. Double-label immunocytochemistry identified the activated (positive for cFos protein) CRH neurons in limbic structures (bed nucleus of the stria terminalis [BNST] and central nucleus of the amygdala [CNA]), the dorsal raphe (DR), and Barrington's nucleus (BN); comparisons were made to the PVN. In all of these areas, nicotine activated CRH neurons in a dose-dependent manner, showing differential sensitivity and efficacy with respect to region. CNA CRH neurons were most responsive and were maximally stimulated by the low dose of nicotine (62% of CRH neurons were cFos+, compared to 10-27% of the CRH population in other regions, including the PVN). Although the BNST also was activated by the low dose, only the non-CRH+ neurons were involved; in contrast, 41% of the BNST CRH neurons responded to the higher dose. Nicotinic activation of DR neurons was dose-dependent, with 22% of the CRH neurons activated by the high dose. Few BN neurons were activated by the low dose of nicotine, but 26% of the CRH population responded to the higher dose. These results indicate that the effect(s) of nicotine on the brain may be mediated, in part, by the selective activation of specific extrahypothalamic regions containing CRH neurons that also are involved in autonomic and behavioral responses to stress. The large fraction of CRH neurons responding to the low dose of nicotine in the CNA suggests that this limbic region may be particularly important in mediating these CNS effects of nicotine.


Experimental observation of superluminal pulse reflection in a double-Lorentzian photonic band gap.
We report on the experimental observation of superluminal reflection of picosecond optical pulses at 1.5 microm using a specially designed 30-cm-long fiber Bragg grating (FBG) that realizes a spectral reflectivity profile given by the superposition of two closely spaced Lorentzian lines. Probing pulses of 380 ps duration tuned midway between the two Lorentzian lines are reflected without appreciable distortion with a measured peak pulse advancement of approximately 60 ps. The achievement of the negative group delay is due to the interference of the two resonance modes of the FBG structure and has a close connection to the phenomenon of negative group velocity for pulse propagation in an inverted medium possessing a doublet line.


DYSPHONIA AS AN UNCOMMON PRESENTATION OF PONTOCEREBELLAR CHOROID PLEXUS PAPILLOMA.
A case is presented of a patient with dysphonia, hearing loss and ataxia due to vestibulocochlear and vagal nerve compression by choroid plexus papilloma in the cerebellopontine angle. Choroid plexus papillomas are rare tumors usually arising in the lateral and fourth ventricle, and rarely found in the cerebellopontine angle, making the neuroimaging characteristics usually not sufficient for diagnosis. Patients usually present with headache and hydrocephalus but tumors in the cerebellopontine angle can cause vestibulocochlear dysfunction and cerebellar symptoms. Dysphonia along with hearing loss was a dominant symptom in the case presented. After complete surgical removal of the tumor, deterioration of dysphonia was noticed; it could be explained as peripheral vagal nerve neuropathy due to tumor compression and intraoperative manipulation. In this case report, we describe dysphonia as an uncommon presentation of a rare posterior fossa tumor. To our knowledge, a case of choroid plexus papilloma presenting with dysphonia has not been described before. Our case extends the differential diagnosis of dysphonia from the otorhinolaryngological to the neurosurgical field.


MAP3K6 Mutations in a Neurovascular Disease Causing Stroke, Cognitive Impairment, and Tremor.
To describe a possible novel genetic mechanism for cerebral small vessel disease (cSVD) and stroke. We studied a Swedish kindred with ischemic stroke and intracerebral hemorrhage, tremor, dysautonomia, and mild cognitive decline. Members were examined clinically, radiologically, and by histopathology. Genetic workup included whole-exome sequencing (WES) and whole-genome sequencing (WGS) and intrafamilial cosegregation analyses. Fifteen family members were examined clinically. Twelve affected individuals had white matter hyperintensities and 1 or more of (1) stroke episodes, (2) clinically silent lacunar ischemic lesions, and (3) cognitive dysfunction. All affected individuals had tremor and/or atactic gait disturbance. Mild symmetric basal ganglia calcifications were seen in 3 affected members. Postmortem examination of 1 affected member showed pathologic alterations in both small and large arteries the brain. Skin biopsies of 3 affected members showed extracellular amorphous deposits within the subepidermal zone, which may represent degenerated arterioles. WES or WGS did not reveal any potentially disease-causing variants in known genes for cSVDs or idiopathic basal ganglia calcification, but identified 1 heterozygous variant, NM_004672.4 MAP3K6 c.322G>A p.(Asp108Asn), that cosegregated with the disease in this large family. MAP3K6 has known functions in angiogenesis and affects vascular endothelial growth factor expression, which may be implicated in cerebrovascular disease. Our data strongly suggest the MAP3K6 variant to be causative for this novel disease phenotype, but the absence of functional data and the present lack of additional families with this disease and MAP3K6 mutations still limit the formal evidence for the variant's pathogenicity.


Nitrogen removal in a shallow maturation pond with sludge accumulated during 10 years of operation in Brazil.
Accumulated sludge in polishing (maturation) ponds reduces the hydraulic retention time (smaller useful volume), and this could potentially lead to a decrease in performance. However, settled biomass, present in the sediments, can contribute to nitrogen removal by different mechanisms such as nitrification and denitrification. This study investigated the influence of the bottom sludge present in a shallow maturation pond treating the effluent from an anaerobic reactor on the nitrification and denitrification processes. Nitrification and denitrification rates were determined in sediment cores by applying ammonia pulses. Environmental conditions in the medium were measured and bacteria detected and quantified by real-time polymerase chain reaction (real-time PCR). The pond showed daily cycles of mixing and stratification and most of the bacteria involved in nitrogen removal decreased in concentration from the upper to the lower part of the sludge layer. The results indicate that denitrifiers, nitrifiers and anammox bacteria coexisted in the sludge, and thus different metabolic pathways were involved in ammonium removal in the system. Therefore, the sediment contributed to nitrogen removal, even with a decrease in the hydraulic retention time in the pond due to the volume occupied by the sludge.


Pituitary function in pseudocyesis.
Neuroendocrine assessments were made in a 16-year-old girl with pseudocyesis of 38 weeks duration. Basal levels of pituitary LH and PRL, but not of FSH, were markedly elevated and the pulsatile pattern of LH and PRL appears to be exaggerated compared with those found in normal cycling women. Growth hormone levels were normal, with an appropriate increase after arginine infusion and l-dopa. The increased luteotropic action resulting from increased plasma LH and the lactogenic action of increased plasma PRL were associated with the presence of luteal function and galactorrhea. The dominant role of psychic mechanism(s) in causing hypersecretions of LH and PRL is suggested by the almost immediate fall in the serum concentrations and the rapid resolution of abdominal distention after the diagnosis was revealed to the patient.


Mechanism of the induction of angiogenesis by human neoplastic lymphoid tissue: studies employing bovine aortic endothelial cells in vitro.
Extracts of human neoplastic tissue (three Hodgkin's lymphomas; three gliomas and one liposarcoma) previously shown to induce angiogenesis in vivo did not stimulate the proliferation of bovine aortic endothelial cell monolayers when tested in vitro. Proliferation was induced by coculture of endothelial cells with human or animal macrophages or with supernatants derived from these cells. However, angiogenic extracts were chemotactic both for guinea pig peritoneal macrophages and human mononuclear cells in vitro. These results imply that tumour extracts act indirectly to induce angiogenesis in vivo via their effect on host macrophages.


Cytotoxicity of a novel fibroblast growth factor receptor targeted immunotoxin on a human ovarian teratocarcinoma cell line.
Basic fibroblast growth factor (bFGF) is an important tumor-associated growth factor that contributes to proliferation and angiogenesis of tumor. The high-affinity receptor for bFGF, fibroblast growth factor receptor (FGFR), is found to be overexpressed in a number of tumor cells. For the purpose of exploring the significance of bFGF/FGFR in tumor-targeted therapy, a recombinant immunotoxin contained the N-terminal 389 residues of diphtheria toxin (DT), and the full length of human bFGF was designed, expressed, and purified. The bioactivity of the product was evaluated by testing the cytotoxicity on PA-1 cells (a human ovarian teratocarcinoma cell line with high-level expression of FGFR) in vitro. The immunotoxin showed a significant cytotoxicity on PA-1 cells (IC(50) 8 - 9 ng/mL), and this effect could be antagonized by equine diphtheria antitoxin (DAT), bFGF, anti-bFGF monoclonal antibody (MAb), and anti- FGFR polyclonal antibody (PAb), respectively. Additionally, Chinese hamster ovary (CHO) cells and Hep-2 cells (a human epidermoid laryngocarcinoma cell line) with low expression of FGFR were tested to be resistant to the immunotoxin. The results indicated that FGFR might be an effective target for tumor therapy, and bFGF-mediated immunotoxin could be a potential candidate in the treatment of cancer.


The effect of enriching denture adhesives with chlorhexidine diacetate on the proliferation of Candida albicans: an in vitro analysis.
Denture adhesives are widely used in dentistry. The growth of Candida albicans on the denture base is common on both jaws, particularly in elderly patients. A strong correlation has been found between the growth of Candida albicans and dentures, potentially leading to denture stomatitis. Recent studies show that the addition of chlorhexidine diacetate (CHDA) to denture adhesives can have a protective effect against denture stomatitis. The aim of this research is to examine the antifungal properties of three denture adhesives when CHDA is added. We hypothesize that the addition of CHDA to denture adhesives will result in antifungal activity against Candida albicans. Three denture adhesive materials (Corega, Protefix and Kukident) were prepared with and without the addition of CHDA in order to measure whether CHDA increased the resistance of the adhesives to the growth of Candida albicans. Dynamic and static intercellular changes were assessed through direct contact test (DCT) and confocal microscopy. The tested materials were evaluated immediately after setting and at 14 days post-setting. When combined with CHDA, all three denture adhesive materials decreased Candida albicans growth compared to the control (p less than 0.0001). This inhibition of growth was more prominent in the first 24 h. The confocal microscopy results supported the DCT findings. The addition of CHDA to denture adhesive pastes inhibits growth of Candida albicans, and may potentially reduce the incidence of denture stomatitis. Further studies are warranted.


High salt intake and blood pressure in lower primates (Papio hamadryas).
One year of increased salt intake in monkeys elevates mean blood pressure significantly. This effect is more marked in animals exposed just after birth. In animals exposed as adults, the response in males is more pronounced than in females, mainly due to a marked increase of pulse pressure. Th hypertensive response was potentiated by reduction of renal mass, which caused GFR values (in terms of body weight) to decrease compared with intact salt-fed animals, in which GFR values were elevated above the control level. It is concluded that the mechanisms involved in the hypertensive response are similar to those in the rat and dog.


Assessment on the lung injury of mice posed by airborne PM2.5 collected from developing area in China and associated molecular mechanisms by integrated analysis of mRNA-seq and miRNA-seq.
Some epidemiological evidences showed exposure of airborne fine particulate matter (PM2.5) was associated with lung dysfunction. However, the adverse effects of PM2.5 from mid-scale city of China on the respiratory system were unknown. Correspondingly, the mechanisms, especially the epigenetic mechanism regulated by miRNAs, involved in PM2.5-induced lung injury has not been fully understood. In this study, male Balb/C mice were exposed to PM2.5 collected from mid-scale city (Baoji), China for 8 weeks (mean concentration 298.52 ± 25.86 μg/m3 at exposure chamber) using a whole-body exposure system. The carbon component was the main ingredient (45.80%) of PM2.5 followed by ions (43.19%). Meanwhile, the sum concentrations of polycyclic aromatic hydrocarbons (PAHs) and n-alkanes (C18-C33) were 570.48 and 2029.13 ng/m3 in the exposure chamber, respectively. Obvious lung injury including pulmonary inflammation and fibrosis (p < 0.05 compared with the control) were found from PM2.5 exposure group determined by micro-CT and histopathological assays, respectively, suggesting the health risk posed by PM2.5 from mid-scale city of China should be concerned. The integrated analysis between mRNA-seq and miRNA-seq revealed the differentially expression genes in lung tissues were enriched in immune pathways including B cell receptor signaling (p = 0.078) and cell adhesion molecules (CAMs) (p = 0.0068). The expression profiles of the genes and corresponding mRNAs involved into the immune pathways determined by RT-qPCR analysis were consistent with them conducted by transcriptome. Moreover, the expression levels of the proteins (i.e., CD19, CD81, PIK3CD, and CD22) involved into B cell receptor signaling pathway from exposure group were 1.71- to 6.948- folds compared with the control, validating the results of the genes expression profiles. Further, canonical correlation analysis (CCA) and multiple correlation analysis between the target genes and components of PM2.5 documented the organic compounds (i.e., Benzo(a)pyrene (p = 0.012) and octadecane (p = 0.05)) and inorganic elements (i.e., Cl-, Ti, Al, and Zn) was the key environmental factors. Cd19, Pik3cd, and Cd8b1 might be the key genes for lung dysfunction induced by PM2.5 illuminated using interactive analysis (p < 0.05). This work for the first time showed the adverse effects of PM2.5 in mid-scale city in China on respiratory system should be concerned, and the associated epigenetic mechanism regulated by miRNA were revealed. These results may provide new insight into the development of future assessment on the air pollution associated respiratory disease.


Women's teeth. A cross-sectional and longitudinal study of women in Gothenburg, Sweden, with special reference to tooth loss and restorations.
A population study comprising a representative sample of women in five age strata between 38 and 60 was carried out in Gothenburg, Sweden, in 1968-69. Altogether 1418 women participated in the dental part of the study (87.4% of those sampled). The women were re-examined in 1980-81. A new group of 38-year-old women was invited in 1980-81. In this way cross-sectional comparisons could be made between women who were 38 and 50 years of age at the time of the two studies in 1968-69 and 1980-81 respectively. In addition, those who participated in both investigations could be studied longitudinally. Panoramic radiography was used to evaluate different dental health variables, for which the technique was found as valid as the more extensive intraoral full mouth radiographic examination. An improvement in dental health in terms of a decrease in tooth loss occurred over the twelve-year period. There was, among middle-aged and older women, no sign of a decrease in the proportion of restored teeth during the same period. A decrease in the differences between social groups had occurred, although differences in number of remaining teeth between women of various educational and socio-economic background to some extent still existed. Social factors seemed, however, to be of minor importance as discriminating factor for tooth loss during the follow-up period. The effect of smoking was also studied. Smoking seemed to be an important actor influencing tooth loss. An association between a low number of remaining teeth and impaired well-being was noted. Presence of amalgam fillings did not, on the population level, play any demonstrable role for impaired well-being among the women.


Regulation of Apetala2/Ethylene Response Factors in Plants.
Multiple environmental stresses affect growth and development of plants. Plants try to adapt under these unfavorable condition through various evolutionary mechanisms like physiological and biochemical alterations connecting various network of regulatory processes. Transcription factors (TFs) like APETALA2/ETHYLENE RESPONSE FACTORS (AP2/ERFs) are an integral component of these signaling cascades because they regulate expression of a wide variety of down stream target genes related to stress response and development through different mechanism. This downstream regulation of transcript does not always positively or beneficially affect the plant but also they display some developmental defects like senescence and reduced growth under normal condition or sensitivity to stress condition. Therefore, tight auto/cross regulation of these TFs at transcriptional, translational and domain level is crucial to understand. The present manuscript discuss the multiple regulation and advantage of plasticity and specificity of these family of TFs to a wide or single downstream target(s) respectively. We have also discussed the concern which comes with the unwanted associated traits, which could only be averted by further study and exploration of these AP2/ERFs.


Diagnosis and molecular aspects of solid-pseudopapillary neoplasms of the pancreas.
Solid-pseudopapillary neoplasm of the pancreas (SPN) is an uncommon low-grade malignant neoplasm occurring mostly in young women. In addition to its distinctive pathological appearance of pseudopapillae with poorly cohesive neoplastic cells, rare variants exist raising the differential diagnosis especially with neuroendocrine neoplasms. The overall prognosis for patients with SPNs is excellent after surgical resection. Nevertheless, 10% of cases may have malignant behavior characterized by tumor recurrence and/or metastasis. Despite numerous studies, the histogenesis of this neoplasm remains unclear. Distinctive molecular alterations such as the presence of CTNNB1 mutations are observed in nearly all cases, while mutations classically observed in ductal adenocarcinoma, such as KRAS, TP53, and SMAD4, are not observed in SPNs, reinforcing its distinct nature compared to all other pancreatic neoplasms. Recent transcriptional studies have shown that activation of the Wnt/beta-catenin pathway in these tumors is associated with the upregulation of genes belonging to Notch, Hedgehog, and androgen receptor signaling pathways.


DNA arrays in allergy and immunology.
The DNA array technique allows the simultaneous analysis of multiple genes. This makes it an interesting tool for studies of gene expression in various diseases that are caused by or depend on multiple genes. DNA arrays are particularly applied to define certain immunological conditions such as allergic diseases. We summarize strategies on gene expression profiling of inflammatory disease and immunologically relevant cells using DNA array technology. Using DNA arrays, gene expression analysis of CD4+ T cells of allergy patients revealed interesting differences compared to healthy individuals, but also between different allergic conditions. This comparison demonstrated that T cells differed in their capacity to regulate peripheral tolerance, neuronal innervation, chemotaxis, neovascularization and epidermal growth. On the basis of these findings the DNA array technique appears to be especially interesting for the development of powerful diagnostic tools allowing fine specification and subtyping of allergic conditions, monitoring of therapy and of tailored therapy concepts.


Regulation of T-cell differentiation by CD2 and CD28 accessory molecules.
It was analysed to what extent the functional T-cell responses that result from T-cell receptor (TcR)/CD3 triggering differ from responses that are induced after simultaneous ligation of CD2 and CD28 accessory molecules. To allow a quantitative comparison of these activation pathways, purified lymphocytes were stimulated with either graded densities of immobilized anti-CD3 monoclonal antibodies (mAb) or with increasing amounts of anti-CD28 mAb in the presence of a constant concentration of anti-CD2 mAb. Both activation systems were sensitive to the regulatory properties of CD11a/CD18 molecules. T-cell stimulation via CD2/CD28 molecules induced a more potent release of interleukin-2 (IL-2) and more pronounced T helper (Th) cell responses than T-cell stimulation via the TcR/CD3 complex, whereas CD25 expression was more readily initiated after T-cell activation via the TcR/CD3 complex. Optimal Th cell differentiation was detected under conditions of suboptimal receptor occupancy whereas, in contrast, optimal cytolytic T lymphocyte (CTL) differentiation required optimal TcR/CD3 or CD2/CD28 engagement. The findings indicate that T-cell differentiation can be influenced in a qualitative manner by the strength of the activation signal provided, and suggest that antigen-specific T-cell responses might be regulated in a quantitative manner through CD2 and CD28 accessory molecules.


[The application of ultrasound in the diagnosis of small bowel volvulus in adults].
Objective: To analyze the ultrasound characteristics of small bowel volvulus among adults and to investigate the value of ultrasound in the diagnosis of small bowel volvulus. Methods: Totally 34 adults with small bowel volvulus confirmed by clinical diagnosis or surgery and who underwent ultrasound examination at Peking Union Medical College Hospital from August 2017 to October 2022 were enrolled, including 19 males and 15 females, aged (55.0±21.8) years (range: 19 to 94 years). The clinical characteristics, CT images and ultrasound images of the patients were retrospectively reviewed, and the ultra, sound features of small bowel volvulus and its diagnostic efficacy were analyzed. Results: Abdominal pain was the typical clinical symptom of all patients. Other symptoms included 21 cases of abdominal distension, 19 cases of nausea and vomiting, and 13 cases of cessation of passage of stool or flatus. Eight patients had signs of peritonitis and 22 patients had abnormal bowel sounds. Twenty patients had a history of abdominal surgery. Twenty-seven patients underwent surgery for intestinal obstruction, and the remaining 7 patients improved after conservative treatment. All cases were evaluated by ultrasound, 11 cases showed a "whirl sign" and were diagnosed as small bowel volvulus, the diagnostic accuracy rate was 32.4% (11/34), ultrasound simultaneously diagnosed intestinal obstruction in 21 cases, 17 cases of abdominal effusion, 4 cases of intestinal wall thickening, 2 cases of abdominal mass, 1 case of intussusception, 1 case of right sided inguinal hernia. CT and ultrasound had a consistent positive discovery in 88.2% (30/34) of all the patients. Conclusion: Ultrasound is valuable in the diagnosis of small bowel volvulus and the evaluation of complications.


[Direct drug delivery to the brain].
The authors of the review discuss the present-day state of and promising approaches to directed delivery of biological agents into the brain. Special attention is drawn to micellar and liposomal transport through the blood-brain barrier (BBB) targeted by immunochemical vectors, such as native or hydrophobized antibodies to specific antigens located at the BBB or in the brain parenchyma.


Phenol, chlorobenzene and chlorophenol isomers: resonant states and dissociative electron attachment.
This paper reports a study of resonant dissociative electron attachment (DEA) to the phenol, chlorobenzene, p-, m-, and o-chlorophenol molecules. On the basis of spectroscopic and thermochemical approaches the resonant states of the molecular negative ions (NIs) and the structures of some dissociative decay products are assigned. In the electron energy range up to 3 eV, DEA processes are determined by the two 2[pi*]-shape resonances resulting mainly in formation of [M-H]- and/or Cl- ions. At higher electron energies the energy correlation between peaks in the negative ion effective yield curves and bands of UV spectra allowed identification of the core-excited resonances. The peculiarities of Cl- ion formation and the vibrational fine structure on the effective yield curves of the [M-H]- ions are discussed. The mass spectrometric procedures for measurement of relative cross sections for NI formation are described.


[Review of pseudocysts and bone lacunae of the jaws].
Non-odontogenic cystic lesions and so-called "pseudocystic" lesions of the jaws are reviewed, summarizing most recent data from the literature and with illustrations. Pseudocyst lesions include the aneurysmal bone cyst, the solitary bone cyst and Stafne's lacunae. Non-odontogenic cystic lesions, characterized by the presence of a non-odontogenic epithelial lining, are represented by the nasopalatin cyst, the nasoalveolar cyst and an entity currently covering globulomaxillary, midline palatin, midline mandibular and midline alveolar cysts.


Enzymatic and hemolytic activities of Candida dubliniensis strains.
Candida dubliniensis is an opportunistic yeast that has been recovered from several body sites in many populations; it is most often recovered from the oral cavities of human immunodeficiency virus-infected patients. Although extensive studies on epidemiology and phylogeny of C. dubliniensis have been performed, little is known about virulence factors such as exoenzymatic and hemolytic activities. In this study we compared proteinase, hyaluronidase, chondroitin sulphatase and hemolytic activities in 18 C. dubliniensis and 30 C. albicans strains isolated from AIDS patients. C. albicans isolates produced higher amounts of proteinase than C. dubliniensis (p < 0.05). All the tested C. dubliniensis strains expressed hyaluronidase and chondroitin sulphatase activities, but none of them were significantly different from those observed with C. albicans (p > 0.05). Hemolytic activity was affected by CaCl2; when this component was absent, we did not notice any significant difference between C. albicans and C. dubliniensis hemolytic activities. On the contrary, when we added 2.5 g% CaCl2, the hemolytic activity was reduced on C. dubliniensis and stimulated on C. albicans tested strains (p < 0.05).


Unexplained Hyperthyroglobulinemia in Differentiated Thyroid Cancer Patients as an Indication for Radioiodine Adjuvant Therapy: A Prospective Multicenter Study.
The management for totally thyroidectomized differentiated thyroid cancer (TT-DTC) patients with unexplained hyperthyroglobulinemia remains indeterminate because of evidence scarcity. This multicenter study aimed at prospectively evaluating the response to radioiodine (131I) adjuvant therapy (RAT) and its potential role in risk stratification and causal clarification. Methods: TT-DTC patients with stimulated serum thyroglobulin levels greater than 10 ng/mL but no structurally evident disease were consecutively enrolled in 5 tertiary-care institutions. After the administration of 5.55 GBq of 131I, the risk of persistent, recurrent, or metastatic differentiated thyroid cancer (prmDTC) was compared with that before RAT. The causes of hyperthyroglobulinemia were explored-and the response to RAT assessed-6-12 mo after RAT. The change in suppressed thyroglobulin level was reported. Results: A cohort of 254 subjects with a median stimulated thyroglobulin level of 27.1 ng/mL was enrolled for the analyses. Immediately after RAT, low, intermediate, and high risk were identified in 5.9%, 88.6%, and 5.5% patients, respectively, with no significant difference in risk stratification compared with that before RAT (P = 0.952). During the follow-up (median, 10.6 mo), hyperthyroglobulinemia was ultimately attributed to a thyroid remnant, biochemical disease, and structural or functional disease in 17.3%, 54.3%, and 28.4% of subjects, respectively. In addition, responses that were excellent, indeterminate, biochemically incomplete, and structurally or functionally incomplete were achieved in 18.1%, 27.2%, 36.2%, and 18.5% of patients, respectively. Notably, the distribution for either cause of hyperthyroglobulinemia or response to RAT was comparable among the 3 postoperative risk groups. Suppressed thyroglobulin levels in patients who merely received RAT declined significantly over time. Conclusion: Our study demonstrated that over 90% of TT-DTC patients with unexplained hyperthyroglobulinemia are stratified as being at intermediate to high risk, and RAT using 5.55 GBq of 131I reveals biochemical, functional, or structural disease and yields a non-structurally or -functionally incomplete response in more than 80% patients, suggesting that TT-DTC patients with unexplained hyperthyroglobulinemia are explicit candidates for RAT.


Nonparametric methods for measurements below detection limit.
Analytical data are often subject to left-censoring when the actual values to be quantified fall below the limit of detection. The primary interest of this paper is statistical inference for the two-sample problem. Most of the current publications are centered around naive approaches or the parametric Tobit model approach. These methods may not be suitable for data with high censoring rates and relatively small sample sizes. In this paper, we establish the theoretical equivalence of three nonparametric methods: the Wilcoxon rank sum, the Gehan, and the Peto-Peto tests, under fixed left-censoring and other mild conditions. We then develop a nonparametric point and interval estimation procedure for the location shift model. A large set of simulations compares 14 methods including naive, parametric, and nonparametric methods. The results clearly favor the nonparametric methods for a range of sample sizes and censoring rates. Simulations also demonstrate satisfactory point and interval estimation results. Finally, a real data example is given followed by discussion.


Oxytocin receptor gene, childhood maltreatment and borderline personality disorder features among male inmates in China.
Borderline personality disorder (BPD) is caused by a variety of biological and environmental factors. Accumulating evidence suggests that childhood maltreatment is a risk environmental factor in the development of BPD, but research on the genetic pathology of BPD is still in its early stages, and very little is known about the oxytocin receptor (OXTR) gene. The purpose of this study is to further explore the interactive effects between OXTR gene polymorphisms and childhood maltreatment on BPD risk. Among the 1804 Chinese Han male inmates, 765 inmates who had BPD or antisocial personality disorder (ASPD) or highly impulsive or violent crime were considered as high-risk inmates and included in this study. Childhood maltreatment, BPD, antisocial personality disorder (ASPD) and impulsivity were measured by self-reported questionnaires. Peripheral venous blood was collected for the genotype test. Analyses revealed that the BP group (inmates with BPD features) had higher rs53576 AA genotype frequency and rs237987 AA genotype frequency than the non-BP group, while the statistical significances were lost after Bonferroni correction. Total childhood maltreatment score, emotional abuse and neglect could positively predict BPD risk. Among the high-risk samples, rs53576 GG genotype carriers had higher BPD scores at higher levels of physical abuse and sexual abuse and had lower BPD scores at lower levels of physical abuse and sexual abuse. The findings suggest that the interaction between OXTR gene variations and childhood maltreatment is an important mechanism for the development of BPD. The moderating role of the OXTR gene provides evidence for gene plasticity.


Doubly Tuned Exchange-Correlation Functionals for Mixed-Reference Spin-Flip Time-Dependent Density Functional Theory.
It is demonstrated that significant accuracy improvements in MRSF-TDDFT can be achieved by introducing two different exchange-correlation (XC) functionals for the reference Kohn-Sham DFT and the response part of the calculations, respectively. Accordingly, two new XC functionals of doubly tuned Coulomb attenuated method-vertical excitation energy (DTCAM-VEE) and DTCAM-AEE were developed on the basis of the "adaptive exact exchange (AEE)" concept in the framework of the Coulomb-attenuating XC functionals. The values by DTCAM-VEE are in excellent agreement with those of Thiel's set [mean absolute errors (MAEs) and the interquartile range (IQR) values of 0.218 and 0.327 eV, respectively]. On the other hand, DTCAM-AEE faithfully reproduced the qualitative aspects of conical intersections (CIs) of trans-butadiene and thymine and the nonadiabatic molecular dynamics (NAMD) simulations on thymine. The latter functional also remarkably exhibited the exact 1/R asymptotic behavior of the charge-transfer state of an ethylene-tetrafluoroethylene dimer and the accurate potential energy surfaces (PESs) along the two torsional angles of retinal protonated Schiff base model with six double bonds (rPSB6). Overall, DTCAM-AEE generally performs well, as its MAE (0.237) and IQR (0.41 eV) are much improved as compared to BH&HLYP. The current idea can also be applied to other XC functionals as well as other variants of linear response theories, opening a new way of developing XC functionals.


Time estimates for dental treatment in four age cohorts of an adult population.
Needs for tooth extractions, conservative dental treatment--including periodontal and caries treatment--and occlusal rehabilitation--including stomatognathic and prosthetic treatment or a combination of these--in a Finnish adult population were summarized and time estimates for the treatment calculated. The study population consisted of 1,275 adults in four age cohorts--25, 35, 50, and 65 years. A decrease was observed from five hours of total dental treatment time needed at ages 25 and 35 years to four hours at age 50 years and three hours at 65 years. At the age of 25 years, 86 percent of the treatment time (255 min) was needed for conservative therapy, the corresponding figures at 65 years being 35 percent (66 min). On the other hand, a fivefold increase (from 13% to 62%) in the proportion of time needed for occlusal rehabilitation was observed between age 25 and 65. A combination of stomatognathic and prosthetic treatment was most frequently needed. The percent of time needed for tooth extractions varied from 1 to 3 percent among the four age cohorts.


Hoffmann Reflex Measured From Lateral Gastrocnemius Is More Reliable Than From Soleus Among Elderly With Peripheral Neuropathy.
Peripheral neuropathy (PN) affects up to 20% of the population over the age of 60. Hoffmann reflex (H-reflex) may assess PN adaptation by measuring the function of the peripheral neural system and central nervous system (CNS) modulation. This project aimed to find a reliable muscle among triceps surae muscles during standing and walking among the PN population. Sixteen older adults (> 65 years of age) diagnosed with PN were recruited in this study. The H-reflex test was conducted on the muscle belly of the soleus (SOL), the medial (MG), and lateral gastrocnemius (LG) during standing and walking (heel contact, midstance, and toe-off phases). All measurements were collected on two occasions, separated by at least 7 days. Intraclass correlation coefficients (ICCs) and their confidence intervals (CIs) were used to examine the consistency of the H-reflex outcome variables in the repeated tests for all three tested muscles. The ICCs of H-index during standing and the three walking phases were poor to moderate in SOL (0.486∼0.737) and MG (0.221∼0.768), and moderate to high in LG (0.713∼0.871). The ICCs of H/M ratio were poor to moderate in SOL (0.263∼0.702) and MG (0.220∼0.733), and high in LG (0.856∼0.958). The H-reflex of LG was more reliable than SOL and MG during standing and walking among older adults with peripheral neuropathy. It is crucial for future studies in this population to study H-reflex of LG, not SOL and MG, for more reliable results.


Incidence of Primary Mitochondrial Disease in Children Younger Than 2 Years Presenting With Acute Liver Failure.
Mitochondrial liver disease (MLD), and in particular mitochondrial DNA (mtDNA) depletion syndrome (MDS) is an important cause of acute liver failure (ALF) in infancy. Early and accurate diagnosis is important because liver transplantation (LT) is often contraindicated. It is unclear which methods are the best to diagnose MLD in the setting of ALF. The aim of the study was to determine the incidence of MLD in children younger than 2 years with ALF and the utility of routine investigations to detect MLD. Thirty-nine consecutive infants with ALF were admitted to a single unit from 2009 to 2011. All were extensively investigated using an established protocol. Genes implicated in mitochondrial DNA depletion syndrome were sequenced in all cases and tissue mtDNA copy number measured where available. Five infants (17%) had genetically proven MLD: DGUOK (n = 2), POLG (n = 2), and MPV17 (1). Four of these died, whereas 1 recovered. Two had normal muscle mtDNA copy number and 3 had normal muscle respiratory chain enzymes. An additional 8 children had low hepatic mtDNA copy number but pathogenic mutations were not detected. One of these developed fatal multisystemic disease after LT, whereas 5 who survived remain well without evidence of multisystemic disease up to 6 years later. Magnetic resonance spectroscopy did not distinguish between those with and without MLD. Low liver mtDNA copy number may be a secondary phenomenon in ALF.Screening for mtDNA maintenance gene mutations may be the most efficient way to confirm MLD in ALF in the first 2 years of life.


Insulin-Derived Cutaneous Amyloidosis: A Possible Complication of Repeated Insulin Injections.
Primary localized cutaneous amyloidosis (PLCA) is characterized by extracellular deposition of pathological fibril aggregation of proteins in the skin without systemic involvement. Macular amyloidosis, lichen (papular) amyloidosis, and nodular amyloidosis are three different subtypes of PLCA. Although the pathological mechanism of PLCA has not yet been clarified, it is assumed that a nucleus formation of amyloid fibril is formed due to repeated external stimulation, such as subcutaneous injection, which often poses diagnostic challenges. Herein, we present a 54-year-old Korean male patient with cutaneous localized amyloidosis which occurred after repeated local insulin injections, and discuss the relationship between insulin therapy in patients with diabetes mellitus and dermal amyloid deposition.


The costs and benefits of a cigarette ban.
The death toll from tobacco is staggering: it might contribute to one billion premature deaths over the course of the 21st century. In 'The case for banning cigarettes', Kalle Grill and Kristin Voigt argue that the well-being and equality benefits of a complete ban on cigarettes more than justify the restrictions on autonomy that such a ban would impose. Their argument depends on two crucial simplifications: an assumption that the ban would be effective and the restriction of the analysis to a comparison with the status quo, rather than a broader range of policy options. I argue that despite the authors' claims, these two simplifications make it impossible for their argument to 'bring into focus the fundamental normative issues' surrounding a possible cigarette ban, since they dramatically overstate the benefits and obscure the most significant costs of such a ban.


Successful treatment of Acanthamoeba rhinosinusitis in a patient with AIDS.
Acanthamoeba infection is a rare, difficult-to-treat, and often fatal, opportunistic parasitic infection in immunocompromised hosts, such as patients infected with HIV. We describe an aggressive nasal and sinus infection by Acanthamoeba spp. in a person with AIDS. The resolution of this Acanthamoeba infection was secondary to a multidisciplinary treatment approach involving a combination of surgery as well as high-dose amphotericin B plus 5-fluorocytosine. In the era of the HIV/AIDS pandemic, the present report underscores the need for early identification and prompt aggressive treatment to ensure successful management of this rare but potentially fatal opportunistic infection.


Identifying Muir-Torre syndrome in a patient with glioblastoma multiforme.
Patients with Muir-Torre syndrome, an autosomal-dominant familial tumor condition caused by germline mutation of the DNA mismatch repair genes, MSH2 or MLH1, present with tumors of the sebaceous gland and visceral malignancies characterized by microsatellite instability. Here we show development of glioblastoma multiforme in a patient with Muir-Torre syndrome. Immunohistochemical analysis of the brain tumor and colon cancer revealed loss of the DNA mismatch repair gene detected by the genetic test, suggesting a pathogenic link.


A Silicon-tipped Fiber-optic Sensing Platform with High Resolution and Fast Response.
In this article, we introduce an innovative and practically promising fiber-optic sensing platform (FOSP) that we proposed and demonstrated recently. This FOSP relies on a silicon Fabry-Perot interferometer (FPI) attached to the fiber end, referred to as Si-FOSP in this work. The Si-FOSP generates an interferogram determined by the optical path length (OPL) of the silicon cavity. Measurand alters the OPL and thus shifts the interferogram. Due to the unique optical and thermal properties of the silicon material, this Si-FOSP exhibits an advantageous performance in terms of sensitivity and speed. Furthermore, the mature silicon fabrication industry endows the Si-FOSP with excellent reproducibility and low cost toward practical applications. Depending on the specific applications, either a low-finesse or high-finesse version will be utilized, and two different data demodulation methods will be adopted accordingly. Detailed protocols for fabricating both versions of the Si-FOSP will be provided. Three representative applications and their according results will be shown. The first one is a prototype underwater thermometer for profiling the ocean thermoclines, the second one is a flow meter to measure flow speed in the ocean, and the last one is a bolometer used for monitoring exhaust radiation from magnetically confined high-temperature plasma.


Rules of Thumb: Hints for the psychiatric nursing student.
The eight "rules of thumb" offered here are representative of numerous more that have been helpful stimulators for psychiatric nursing students. The suggest to the students a consistent approach based upon a rationale and do not encourage rote memorization of techniques. Students are encouraged to critically analyze the reasons and conceptual underpinnings for each encounter they have with patients. The "rules of thumb" encourage this self-exploration and attention to "What is it I'm really asking, or feeling, or thinking?" Only with this sort of continuous evaluation and reassessment can even the most novice of students begin to establish a therapeutic treatment approach with psychiatric patients.


Potential life-threatening complication of tonsillectomy: cervicofacial surgical emphysema.
A 30-year-old woman presented to the accident and emergency department 3 days post-tonsillectomy with bleeding from the tonsillar fossa and left-sided facial swelling. The patient denied any dysphagia or breathing difficulties but experienced pain on neck movement. On examination, although the bleeding had stopped on reaching the emergency department, a small clot was noted in her left tonsillar fossa. A left facial/submandibular swelling was seen, which had been present since her operation and was slowly enlarging. Flexible nasendoscopy showed a mild left sided oropharyngeal swelling but was otherwise normal. She was treated initially with antibiotics and hydrogen peroxide gargles. After 24 hours of observation and a slight worsening of the swelling she underwent a CT of the neck. This showed widespread indurated subcutaneous surgical emphysema, originating from the left tonsillar bed. Following a period of observation and improvement in her symptoms, she was discharged home with safety netting.


The Use of Biomarkers in Sepsis: A Systematic Review.
Despite the extended laboratory and clinical study of sepsis, its diagnosis remains a clinical challenge. The initiation of sepsis activates many different biochemical and immunological pathways being expressed by alterations of various molecules in human tissues. The detection and measurement of the concentration of such molecules, known as biomarkers, may be a diagnostic tool of great significance for clinicians dealing with suspected sepsis. Additionally, biomarkers may predict patients ´ outcome and may play a role in monitoring response to therapy. Most relevant clinical and experimental biomarker studies on sepsis were retrieved and reviewed in this article. Although many biomarkers were evaluated for the diagnosis and prognosis in sepsis, until now not one has been proven to be absolutely reliable in the clinical field. Currently C-reactive proteine (CPR) and procalcitonin (PCT) are used worldwide routinely, nevertheless their values may elevate in clinical settings without sepsis, while they often fail to provide reliable prediction of the patient outcome. This review outlines most relevant circulating biomarkers in sepsis.


How Can We Realize the Clinical Benefits of Continuous Glucose Monitoring?
Controlling glycemia in diabetes remains key to prevent complications in this condition. However, glucose levels can undergo large fluctuations secondary to daily activities, consequently creating management difficulties. The current review summarizes the basics of glucose management in diabetes by addressing the main glycemic parameters. The advantages and limitation of HbA1c, the gold standard measure of glucose control, are discussed together with the clinical importance of hypoglycemia and glycemic variability. The review subsequently moves focus to glucose monitoring techniques in diabetes, assessing advantages and limitations. Monitoring glucose levels is crucial for effective and safe adjustment of hypoglycemic therapy, particularly in insulin users. Self-monitoring of blood glucose (SMBG), based on capillary glucose testing, remains one of the most widely used methods to monitor glucose levels, given the relative accuracy, familiarity, and manageable costs. However, patient inconvenience and the sporadic nature of SMBG limit clinical effectiveness of this approach. In contrast, continuous glucose monitoring (CGM) provides a more comprehensive picture of glucose levels, but these systems are expensive and require constant calibration which, together with concerns over accuracy of earlier devices, restrict CGM use to special groups of patients. The newer flash continuous glucose monitoring (FCGM) system, which is more affordable than conventional CGM devices and does not require calibration, offers an alternative glucose monitoring strategy that comprehensively analyzes glucose profile while sparing patients the inconvenience of capillary glucose testing for therapy adjustment or CGM calibration. The fast development of new CGM devices will gradually displace SMBG as the main glucose testing method. Avoiding the inconvenience of SMBG and optimizing glycemia through alternative glucose testing strategies will help to reduce the risk of complications and improve quality of life in patients with diabetes.


Microscopic kinetic determinants of macroscopic currents: insights from coupling and uncoupling of GABAA receptor desensitization and deactivation.
The time course of inhibitory postsynaptic currents (IPSCs) reflects GABA(A) receptor deactivation, the process of current relaxation following transient activation. Fast desensitization has been demonstrated to prolong deactivation, and these processes have been described as being 'coupled'. However, the relationship between desensitization and deactivation remains poorly understood. We investigated the 'uncoupling' of GABA(A) receptor macroscopic desensitization and deactivation using experimental conditions that affected these two processes differently. Changing agonist affinity preferentially altered deactivation, changing agonist concentration preferentially altered macroscopic desensitization, and a pore domain mutation prolonged deactivation despite blocking fast desensitization. To gain insight into the mechanistic basis for coupling and uncoupling, simulations were used to systematically evaluate the interplay between agonist affinity, gating efficacy, and desensitized state stability in shaping macroscopic desensitization and deactivation. We found that the influence of individual kinetic transitions on macroscopic currents depended not only on model connectivity, but also on the relationship among transitions within a given model. In addition, changing single rate constants differentially affected macroscopic desensitization and deactivation, thus providing parsimonious kinetic explanations for experimentally observed uncoupling. Finally, these findings permitted development of an algorithmic framework for kinetic interpretation of experimental manipulations that alter macroscopic current properties.


Applicability and procedural success rate of bioresorbable -vascular scaffolds for percutaneous coronary intervention in an all-comer cohort of 383 consecutive patients.
Objectives The purpose of this study was to determine applicability and procedural success of bioresorbable vascular scaffolds (BVS) for percutaneous coronary intervention (PCI) in an all-comer cohort. Background BVS use in bifurcations and severely calcified lesions is not recommended, and a relatively large crossing profile may cause limitations. It is has never been studied how widely BVS can be applied in all-comer cohorts. Methods In 383 consecutive patients (acute coronary syndrome: 124, stable coronary disease 259), a BVS (Absorb) was used as first-line device unless any of the following contraindications were present: bifurcation with side branch >2.0 mm, reference diameter <2.5 mm or >4.0 mm, required device length <12 mm, in-stent stenosis, or contraindications to 6 months of DAPT. Patients and lesions were evaluated regarding suitability for BVS treatment, procedural success (successful BVS placement and residual stenosis <30%), and outcome. Results Of 588 lesions, 303 (52%) were unsuitable for BVS placement due to presence of a bifurcation (30% of unsuitable lesions), reference -diameter >4.0 mm (13%) or <2.5 mm (12%), contraindication to 6 months DAPT (13%), in-stent stenosis (14%), and desired device length <12 mm (4%). If BVS use was attempted, procedural success with a scaffold was 95% (271/285). Crossing failure occurred in 14 cases (5%), affected lesions were significantly more calcified. After a mean follow-up period of 259 days, definite/probable scaffold thrombosis occurred in 1.1% of patients. Conclusions Approximately one-half of lesions in an all-comer population can successfully be treated with BVS. Crossing failure is rare.


[Epidemiological investigation of allergic rhinitis in the primary school students in grade three of Shihezi city].
To investigate the epidemic features of allergic rhinitis(AR)and correlative risk factors in Shihezi city, Xinjiang province, China. A questionnaire survey on AR and airway diseases was conducted among 2 300 elementary school children in 12 schools, aged from 9 to 10 years old, from july 10 to 25, 2008 . in Shihezi city, Xinjiang province. Suspects of AR was identified by the survey, then they were recommended to specialist examinations for accurate diagnosis. Allergen skin tests were performed to explore the allergenic varieties of allergic rhinitis. Diagnosis criteria of AR were that of ARIA (Allergic rhinitis and its impact on asthma). RE-SULT: Two thousand two hundred and eleven questionnaires were returned. The response rate was 96.1% and 2205 questionnaires were available. The prevalence rate of AR in children aged from 9 to 10 was 12.56% (277/2 205) in Shihezi city. The difference of prevalence between female 13.76% (153/1112) and male 11. 34% (124/1093) was insignificant statistically(CHI2 = 2.924, P > 0. 05). The positive rate of the allergen skin test was 65. 3%. The most common allergen of allergic rhinitis were plants of the mugwort and house dust mite. According to the classification criteria of ARIA in 2001, of 155 children suffered from intermittent AR, 112 cases were mild and 43 cases were moderate-severe, while 122 suffered from persistent AR,110 cases were mild and 12 cases were moderate severe. 5.4% (15/277) patients with AR also had bronchial asthma. 25. 3% (70/277) of the children with AR had inherent predisposition. The prevalence rate of AR in children aged from 9 to 10 in Shihezi city is 12.56%. Strategy of prevention and treatment of AR can be worked out according to the epidemical feature of AR.


Right Ventricular Flow Vorticity Relationships With Biventricular Shape in Adult Tetralogy of Fallot.
Remodeling in adults with repaired tetralogy of Fallot (rToF) may occur due to chronic pulmonary regurgitation, but may also be related to altered flow patterns, including vortices. We aimed to correlate and quantify relationships between vorticity and ventricular shape derived from atlas-based analysis of biventricular shape. Adult rToF (n = 12) patients underwent 4D flow and cine MRI imaging. Vorticity in the RV was computed after noise reduction using a neural network. A biventricular shape atlas built from 95 rToF patients was used to derive principal component modes, which were associated with vorticity and pulmonary regurgitant volume (PRV) using univariate and multivariate linear regression. Univariate analysis showed that indexed PRV correlated with 3 modes (r = -0.55,-0.50, and 0.6, all p < 0.05) associated with RV dilatation and an increase in basal bulging, apical bulging and tricuspid annulus tilting with more severe regurgitation, as well as a smaller LV and paradoxical movement of the septum. RV outflow and inflow vorticity were also correlated with these modes. However, total vorticity over the whole RV was correlated with two different modes (r = -0.62,-0.69, both p < 0.05). Higher vorticity was associated with both RV and LV shape changes including longer ventricular length, a larger bulge beside the tricuspid valve, and distinct tricuspid tilting. RV flow vorticity was associated with changes in biventricular geometry, distinct from associations with PRV. Flow vorticity may provide additional mechanistic information in rToF remodeling. Both LV and RV shapes are important in rToF RV flow patterns.


Victimization and Perception of Abuse in Adolescent and Young Homosexual and Heterosexual Couples in Spain.
Currently, violence in adolescent and young couples has a significant social impact on young people's physical and psychological health. However, the study of violence in homosexual couples must also be addressed. This research analyzes the levels of violent victimization and the perception of abuse in both homosexual and heterosexual couples. Participants' ages ranged between 14 and 29 years (M = 20.14, SD = 3.464). We used The Dating Violence Questionnaire-Revised (CUIVNO-R), which was applied in two consecutive studies. The results indicate high levels of victimization, especially in the sample of homosexual participants. The scores generally show a low perception of couple violence but high victimization rates. The results of this study reveal the importance of the issue of violence in couples from minority groups and suggest that couple violence should not be understood as unidirectional, i.e., exclusively from men to women. These findings show the need for education in healthy relationships and consideration of different types of couples in these relationships.


[Thallium-201 single photon emission computed tomography in the evaluation of therapeutic response for brain tumors].
To evaluate the effectiveness of radiation and chemotherapy of malignant brain tumors, 201TlCl-SPECT (Tl-SPECT) was compared with CT and MRI. The subjects were 14 patients with malignant brain tumors; 12 malignant astrocytomas, 1 medulloblastoma and 1 malignant lymphoma. Tl-SPECT was performed before and immediately after the therapy. On the Tl-SPECT, count ratio (Tl-index) of tumor to normal brain tissue was measured. To evaluate the size of tumor, CT or MRI was performed before and immediately after the therapy, and 1-2 months after the therapy. The change of Tl-index immediately after therapy was compared with the change of the size of tumor. Though the change of Tl-index did not correlate with the change of tumoral size immediately after therapy, it correlated with the change of tumoral size 1-2 months after the therapy, i.e., it was thought that Tl-index reflected the change of tumoral size 1-2 months after the therapy. Tl-SPECT will be feasible for the evaluation of the effectiveness of the therapy for malignant brain tumors, because it reflects the effectiveness of the therapy earlier than CT or MRI.