Resveratrol reduces endothelial progenitor cells senescence through augmentation of telomerase activity by Akt-dependent mechanisms.
Recent studies have shown that resveratrol increased endothelial progenitor cells (EPCs) numbers and functional activity. However, the mechanisms remain to be determined. Previous studies have demonstrated that increased EPC numbers and activity were associated with the inhibition of EPC senescence, which involves activation of telomerase. Therefore, we investigated whether resveratrol inhibits the onset of EPC senescence through telomerase activation, leading to potentiation of cellular activity. After prolonged in vitro cultivation, EPCs were incubated with or without resveratrol. The senescence of EPCs were determined by acidic beta-galactosidase staining. The bromo-deoxyuridine incorporation assay or a modified Boyden chamber assay were employed to assess proliferative or migratory capacity, respectively. To further examine the underlying mechanisms of these effects, we measured telomerase activity and the phosphorylation of Akt by western blotting. Resveratrol dose dependently prevented the onset of EPCs senescence and increased the proliferation and migration of EPCs. The effect of resveratrol on senescence could not be abolished by eNOS inhibitor or by an oestrogenic receptor antagonist. Resveratrol significantly increased telomerase activity and Akt phosphorylation. Pre-treatment with the PI3K inhibitor, LY294002, significantly attenuated resveratrol-induced telomerase activity. Resveratrol delayed the onset of EPC senescence and this effect was accompanied by activation of telomerase through the PI3K-Akt signalling pathway. The inhibition of EPCs senescence by resveratrol might protect EPCs against dysfunction induced by pathological factors in vivo and improve EPC functional activities in a way that may be important for cell therapy.


[Behçet's disease, a current disease].
The treatment of Behçet's is essentially symptomatic and depends on the severity of the manifestations. Colchicine is useful in the minor forms, especially the mucocutaneous, forms. It can be safely used at a dose of 1 mg/day as maintenance treatment to prevent or limit the acute episodes. Other immunomodulators have been proposed : levamisole, disulon, thalidomide, the indications for which are limited by the side effects. Non-steroidal anti-inflammatory agents are indicated in the articular forms. Steroid therapy remains essential in the severe neurological and ophthalmological forms at an initial dose of 1 mg/kg/day. It can be preceded by the intravenous bolus administration of high doses of methylprednisone. Immunosuppressants are useful in the same indications. Although some authors propose them right from the start, we prefer to reserve them for second line treatment in the event of steroid dependence or recurrence, because of their short-term infectious and long-term oncogenic risks. Cyclosporin, which has been proven to be effective by randomised studies, is difficult to manage and responsible for complications, in particular renal. It can therefore only be used as second line treatment by experienced users. Plasmapheresis is reserved as an emergency procedure for functionally threatening forms. Venous or arterial thromboses justify longterm anticoagulation, possibly associated which platelet anti-aggregants. In this chronic disease, the quality of follow-up and the patient's cooperation are essential in order to intervene rapidly and to detect as early as possible the complications of the disease and of the treatment.


An incidental finding of a bicuspid aortic valve and pseudocoarctation of the descending aorta in a patient presenting with an acute coronary syndrome: a case report.
Aortic pseudocoarctation (PsCoA) is an elongation of the supra-isthmic aorta with kinking and low-grade narrowing. Consequently, no collateral circulation is found. It is frequently associated with other congenital heart anomalies, such as bicuspid aortic valve (BAV). We report the case of 60-year-old patient who presented to the ED with acute chest pain. Physical examination was remarkable for an elevated blood pressure (BP) and the presence of a systolic murmur on the left lower sternal border. An acute coronary syndrome was suspected and the patient underwent urgent coronary angiogram which showed an occluded obtuse marginal artery. Additionally, the presence of an aortic anomaly was noted during the aortography, and additional work-up, including a thoracic computed tomography angiography and transoesophageal echocardiography, revealed a BAV and a PsCoA of the descending aorta. The patient was discharged after optimizing BP control with oral medication and periodical follow-up was arranged. Aortic PsCoA may mimic true coarctation (CoA), but the absence of a haemodynamically significant descending aortic narrowing and of the typical clinical findings associated with aortic CoA, distinguishes both entities. Treatment is therefore conservative and based on the control of cardiovascular risk factors and in particular of arterial hypertension. Work-up should include imaging of the entire aorta and the search for associated congenital cardiac anomalies, which, if present, should be managed in consequence.


[Modification of the infrared light coagulator LC 250. Development of probes for endoscopic use].
With regard to prior positive results using the infrared-light-coagulator LC 250 for hemostasis of bleeding parenchymal organs and inoperable tumors, new tubes with 5 and 10 mm diameter were developed for laparoscopic purposes. The first clinical experiences showed the secure and rapid hemostasis after bleedings of the liver following a cholecystectomy, smaller resections and biopsies also resulted after lesions of the abdominal wall. The newly developed applicator consisting of a metal or teflon grip, improved the performance of these probes.


Health Promotion Behaviors and Chronic Diseases of Aging in the Elderly People of Iranshahr*- IR Iran.
Aging is considered as the phenomenon of the day in the health arena of the world and Iran. It is anticipated that there will be an explosion of aging population in Iran in about 2031 and 20-25% of the population will be aged over 60 years. With aging, chronic diseases also increase and diminish the functional ability of older people. On the other hand, increased healthcare costs should be also added to this issue. Health promotion is a concept of process that continues throughout life. As much as health promotion is important in children and adults, it is equally important in older people. In fact, the elderlies, as a group, also acquire many benefits from health promotion behaviors. Due to the increasing elderly population, geriatric health promotion and enhancing the health level of older people is proposed as a health priority that should be properly planned. Hence, the present study has been conducted in this regard and aims to identify behaviors of health promotion and chronic diseases of aging in the elderly people of Iranshahr-Iran. The present research is a cross-sectional descriptive study whose population consists of 425 elderly people aged 60 years and over, who lived in the city of Iranshahr*, IR Iran. The random cluster sampling method has been used to select the research samples. The required information was collected using a questionnaire which was distributed among the older people through visiting their homes; then, the collected data was statistically analyzed using the statistical software of SPSS version 13. the research findings show that the mean age of older people is and the highest frequency belongs to the age group of 60 years and the maximum age is 92 years. 69.5% of the older people were in the age group of the young elderly (60-69 years) and 44% of them lived with their married children; also 55.8%, 81.9%, 70.5%, and 74.4% of them were respectively female, illiterate, married, and unemployed. The mean score of geriatric health promotion behaviors was in the range of 0-11 and 54.9% of them got the score of the inappropriate health promotion behavior. The most frequent chronic diseases of older people were respectively joint problems (78.9%), sensory problems (64.1%), and hypertension (56.6%). No significant relationship was observed between the score of health promotion behaviors and "the gender, lifestyle and marital status of the older people", but there was statistically a significant relationship between the score of health promotion behaviors and "the age, education, and job of the older people". Providing training programs for health promotion behaviors in elderly people can improve these behaviors and enhance their health and quality of life and reduce the incidence of chronic diseases in them. The goal of health promotion behaviors is to maintain performance, independence and quality of life; and many studies have demonstrated that the elderly people who aged 60 years and over benefit from health promotion behaviors more than middle-aged people.


Effects of a 5 alpha-reductase inhibitor, finasteride, on the developing prostate and testis of a marsupial.
This study examines the role of dihydrotestosterone in virilization of the developing male tammar. The onset of prostate differentiation in this marsupial species normally occurs around 25 days postpartum, long after the onset of testicular testosterone production immediately after birth and the appearance of 5 alpha-reductase in the urogenital sinus before day 10. Males treated with the 5 alpha-reductase inhibitor Finasteride had reduced prostatic growth and development, and their testicular structure was disorganized. Exogenous testosterone in males enhanced the development of prostatic buds but also caused damage to the testis structure. Treatment of female tammars with testosterone between days 20-30 postpartum stimulated prostatic tissue formation and Wolffian duct development, confirming that prostatic differentiation is initiated by androgens and occurs over a relatively narrow window of time. Testosterone had a deleterious effect on the ovary, destroying the germ cells. Although treatment with testosterone damaged gonadal cellular structure in both male and female tammar young, dihydrotestosterone is apparently necessary for stability of the seminiferous tubules in the testis. Taken together, these results suggest that dihydrotostesterone initiates prostatic development between days 20 and 25 after birth in this marsupial.


Cytotoxic activity of unsaturated fatty acids to lymphocytes.
Cytotoxic activities of unsaturated fatty acids against lymphocytes were studied by demonstrating the inhibition of RNA synthetic activity of incubated lymphocytes. In general, the cytotoxic activity of fatty acids increases with decreasing number of carbon atoms and increasing number of double bonds. An empirical formula predicting the degree of impairment of lymphocytes by various fatty acids was proposed. Furthermore, protective effects of serum on cytotoxic actions of unsaturated fatty acids to lymphocytes were studied and the significance of these findings was discussed.


Macroscopic and microscopic evaluation of flapless alveolar perforations on experimental tooth movement.
The aim of this study was to evaluate a flapless surgical technique as an alternative to traditional alveolar corticotomy used to accelerate orthodontic tooth movement (OTM). To induce OTM in Wistar rats, 40 cN of orthodontic force were applied to the maxillary left first molars. Forty rats were distributed into control groups (CG1, CG3, CG7 and CG14) and experimental groups (n= 5), in which alveolar perforations were made using a spear-shaped guide bur (EG1, EG3, EG7, EG14). Euthanasia dates were set at 1, 3, 7 and 14 days, respectively, after tooth movement began. The amount of OTM was measured with a caliper, and osteoclasts present in the periodontal ligament of the mesial root of the moved tooth were counted by means of histological evaluation (tartrate-resistant acid phosphatase staining, TRAP). Although there was no difference in the amount of OTM within subgroups of corresponding experimental periods (p> 0.05), when EG14 and CG14 were compared, a larger number of osteoclasts was counted in the experimental group (p< 0.00). The authors concluded that flapless cortical alveolar perforations led to more intense osteoclastic activity on the fourteenth day; nevertheless, no evidence of accelerated OTM could be noted.


The relationship of sperm DNA integrity with serum vitamin levels (folate and cobalamin) and food consumption in infertile men.
The aim of this study was to investigate the relationships of serum folate (vitamin B9), cobalamin (vitamin B12) levels and diet with semen parameters (semen standard parameters [SSP] and DNA fragmentation index [DFI]) in infertile men. Sperm samples were assessed for SSP and DFI (using the sperm chromatin dispersion test). Serum vitamin concentrations were measured with an immuno-electrochemiluminescence assay, and men completed a semi-quantitative food frequency questionnaire (FFQ). Serum folate levels were positively correlated with sperm progressive motility and DFI. A comparison of SSP between two groups of patients according to serum folate concentration (B9 <4.840 ng/mL and B9 ≥4.840 ng/mL) showed significantly higher sperm concentration and sperm progressive motility in the latter group. However, there was no difference between these groups regarding DFI. Interestingly, serum folate levels were significantly higher in patients with a high DFI (using the cut-offs of 30% or 18%). FFQ data showed that the consumption of fruits and egg yolk correlated positively with sperm concentration and sperm motility, respectively. Serum folate levels showed significant associations with sperm concentration and sperm progressive motility. However, the positive association of serum folate with DFI raises the need for careful prescription of folate supplements.


Photoswitchable fluorescent proteins: ten years of colorful chemistry and exciting applications.
Reversibly photoswitchable fluorescent proteins (RSFPs) are fluorescent proteins whose fluorescence, upon excitation at a certain wavelength, can be switched on or off by light in a reversible manner. In the last 10 years, many new RSFPs have been developed and novel applications in cell imaging discovered that rely on their photoswitching properties. This review will describe research on the mechanisms of reversible photoswitching and recent applications using RSFPs. While cis-trans isomerization of the chromophore is believed to be the general mechanism for most RSFPs, structural studies reveal diversity in the details of photoswitching mechanisms, including different effects of protonation, chromophore planarity, and pocket flexibility. Applications of RSFPs include new types of live-cell superresolution imaging, tracking of protein movements and interactions, information storage, and optical control of protein activity.


Protease activity of Per a 10 potentiates Th2 polarization by increasing IL-23 and OX40L.
Proteases are implicated in exacerbation of allergic diseases. In this study, the role of proteolytic activity of Per a 10 was evaluated on Th2 polarization. Intranasal administration of Per a 10 in mice led to allergic airway inflammation as seen by higher IgE levels, cellular infiltration, IL-17A, and Th2 cytokines, whereas, inactive (Δ)Per a 10 showed attenuated response. There was an increased OX40L expression on lung and lymph node dendritic cells in Per a 10 immunized group and on Per a 10 stimulated BMDCs. Reduction in CD40 expression without any change at transcript level in lungs of Per a 10 immunized mice suggested CD40 cleavage. BMDCs pulsed with Per a 10 showed reduced CD40 expression with lower IL-12p70 secretion as compared to heat inactivated Per a 10. IL-23, TNF-α, and IL-6 levels were significantly higher in Per a 10 stimulated BMDCs supernatant. In DC-T cell coculture studies, Per a 10 pulsed BMDCs showed higher levels of IL-4 and IL-13 that were reduced on blocking of either IL-23 or OX40L. In conclusion, the data suggests a critical role of protease activity of Per a 10 in promoting Th2 polarization by increasing IL-23 secretion and OX40L expression on dendritic cells.


Human melanocortin 1 receptor variants, receptor function and melanocyte response to UV radiation.
Cutaneous pigmentation is determined by the amounts of eumelanin and pheomelanin synthesized by epidermal melanocytes and is known to protect against sun-induced DNA damage. The synthesis of eumelanin is stimulated by the binding of alpha-melanotropin (alpha-melanocyte-stimulating hormone) to the functional melanocortin 1 receptor (MC1R) expressed on melanocytes. The human MC1R gene is highly polymorphic and certain allelic variants of the gene are associated with red hair phenotype, melanoma and non-melanoma skin cancer. The importance of the MC1R gene in determining skin cancer risk led us to examine the impact of specific polymorphisms in this gene on the responses of human melanocytes to alpha-melanotropin and UV radiation. We compared the ability of human melanocyte cultures, each derived from a single donor, to respond to alpha-melanotropin with dose-dependent stimulation of cAMP formation, tyrosinase activity and proliferation. In each of those cultures the MC1R gene was sequenced, and the eumelanin and pheomelanin contents were determined. Human melanocytes homozygous for Arg160Trp, heterozygous for Arg160Trp and Asp294His, or for Arg151Cys and Asp294His substitutions, but not melanocytes homozygous for Val92Met substitution, in the MC1R demonstrated a significantly reduced response to alpha-melanotropin. Additionally, melanocytes with a non-functional MC1R demonstrated a pronounced increase in their sensitivity to the cytotoxic effect of UV radiation compared with melanocytes expressing functional MC1R. We conclude that loss-of-function mutations in the MC1R gene sensitize human melanocytes to the DNA damaging effects of UV radiation, which may increase skin cancer risk.


[The first 25 years of digestive radiology].
The first medical radiological attempts used the natural contrasts of the human body: bones of the limbs, intra-alveolar air of the lung; but as regards the abdomen, one could only observe gases or eventually calcified calculi. Whence the idea of a product opaque to the X-rays, not toxic, in order to obtain an internal cast of the various segments of the digestive tractus, making them thus visible by radiology. After little demonstrative trials of opaque sounds and capsules containing opacifying substances, there was an orientation towards the bismuth salts: sub-nitrate and carbonate generally used as therapeutical agents. In all the countries, engineers and physicians thrived to fit the equipment and experiment techniques of serial radiographies. Rieder, a radiologist from Munich perfected in 1905 the "meal" wearing his name (gruel of food and bismuth salts) adapted nearly everywhere. The radiological technology developed itself accordingly, creating progressively performant material. Finally, Paul Krause from Bonn and his team preconized in 1910 the use of insoluble baryum sulfate in watery suspension of which the purification was from now on assured. This product will be universaly used as a "gruel" or a "baryted milk" for the aesophago-gastro-duodenal transit and as a baryted enema for the examination of the colon.


Relation between microRNAs and Apoptosis in Hepatocellular Carcinoma.
To determine the relation between serum microRNAs and apoptotic markers as regards development of HCC to understand the underlying mechanism of HCV related hepatocarcinogenesis. A total of 65 serum samples (25 samples from controls, 20 samples from hepatitis and 20 samples from HCC patients) were collected for miRNAs (mir 21, mir 199-a, and mir 155) detection. Human Programmed cell death protein-4 (PDCD-4) and Human Cytochrome-C (CYT-C) were determined. miRNAs 21 and 155 were over expressed in sera of patients with HCC compared to patients with chronic hepatitis (p < 0.0001). While serum means values of miR 199a was significantly decreased among HCC group patients when compared to patients with chronic hepatitis (p < 0.0001). The serum levels of PCDC4 and CYTC were increased in patients with HCC when compared to chronic hepatitis patients. They were also increased in patients with chronic hepatitis when compared to controls (p < 0.05, significant). There was direct correlations between apoptotic markers and oncomirs miRNAs 21 and 155 while apoptotic markers were inversely correlated with miRNA 199-a. Both microRNAs and apoptotic markers have roles in HCC pathogenesis. It seems that oncogenic microRNAs induce liver carcinogenesis in HCV patients irrespective of suppression of apoptosis.


Predicting Adherence to Internet-Delivered Psychotherapy for Symptoms of Depression and Anxiety After Myocardial Infarction: Machine Learning Insights From the U-CARE Heart Randomized Controlled Trial.
Low adherence to recommended treatments is a multifactorial problem for patients in rehabilitation after myocardial infarction (MI). In a nationwide trial of internet-delivered cognitive behavior therapy (iCBT) for the high-risk subgroup of patients with MI also reporting symptoms of anxiety, depression, or both (MI-ANXDEP), adherence was low. Since low adherence to psychotherapy leads to a waste of therapeutic resources and risky treatment abortion in MI-ANXDEP patients, identifying early predictors for adherence is potentially valuable for effective targeted care. The goal of the research was to use supervised machine learning to investigate both established and novel predictors for iCBT adherence in MI-ANXDEP patients. Data were from 90 MI-ANXDEP patients recruited from 25 hospitals in Sweden and randomized to treatment in the iCBT trial Uppsala University Psychosocial Care Programme (U-CARE) Heart study. Time point of prediction was at completion of the first homework assignment. Adherence was defined as having completed more than 2 homework assignments within the 14-week treatment period. A supervised machine learning procedure was applied to identify the most potent predictors for adherence available at the first treatment session from a range of demographic, clinical, psychometric, and linguistic predictors. The internal binary classifier was a random forest model within a 3×10-fold cross-validated recursive feature elimination (RFE) resampling which selected the final predictor subset that best differentiated adherers versus nonadherers. Patient mean age was 58.4 years (SD 9.4), 62% (56/90) were men, and 48% (43/90) were adherent. Out of the 34 potential predictors for adherence, RFE selected an optimal subset of 56% (19/34; Accuracy 0.64, 95% CI 0.61-0.68, P<.001). The strongest predictors for adherence were, in order of importance, (1) self-assessed cardiac-related fear, (2) sex, and (3) the number of words the patient used to answer the first homework assignment. For developing and testing effective iCBT interventions, investigating factors that predict adherence is important. Adherence to iCBT for MI-ANXDEP patients in the U-CARE Heart trial was best predicted by cardiac-related fear and sex, consistent with previous research, but also by novel linguistic predictors from written patient behavior which conceivably indicate verbal ability or therapeutic alliance. Future research should investigate potential causal mechanisms and seek to determine what underlying constructs the linguistic predictors tap into. Whether these findings replicate for other interventions outside of Sweden, in larger samples, and for patients with other conditions who are offered iCBT should also be investigated. ClinicalTrials.gov NCT01504191; https://clinicaltrials.gov/ct2/show/NCT01504191 (Archived at Webcite at http://www.webcitation.org/6xWWSEQ22).


The value of MALDI-TOF MS for the identification of clinically relevant anaerobic bacteria in routine laboratories.
Between 2010 and 2011, 283 clinically relevant non-duplicate anaerobic isolates were analysed by MALDI-TOF MS and the results were compared with conventional identification. Immediately after isolation, an ethanol precipitation was carried out on isolated colonies and the stabilized samples were anonymized and sent to the laboratory of Bruker Daltonik, Bremen, Germany, where the identification was done using the standard protocol for micro-organism identification on a Microflex LT mass spectrometer equipped with the MALDI Biotyper 3.0 software. Of 283 isolates, 218 (77 %) were identified at species level [log(score) ≥2.0], 31 isolates (10.95 %) were identified at genus level [log(score) 1.7-2.0] and 34 (12 %) gave non-reliable identification [log(score) <1.7]. Out of the 31 isolates with log(score) 1.7-2.0, in the case of 24 isolates the species name given by the MALDI Biotyper was accepted if it was the same as for the classical identification. Of 218 isolates identified at species level, 40 results were discordant with phenotypic identification, and of the 31 isolates identified at genus level according to the manufacturer's score cut-off, four gave results discordant with the phenotypic method. For the 44 discordant results, 16S rRNA gene sequencing confirmed MALDI-TOF MS identification in 41 cases, leaving three isolates (0.7 %) that had been misidentified by MALDI-TOF MS.


Structural variations of the supratubal recess: the anterior epitympanic space.
We sought to classify the shape and structure of the anterior epitympanic space (AES) and produce measurements of its dimensions together with its relationships with the facial nerve and geniculate ganglion. The AES is limited by the middle cranial fossa superiorly, zygoma root anteriorly, cog posteriorly, chorda tympani laterally, facial nerve medially, and tensor tympanic semicanal inferiorly. The AES was examined in 30 human temporal bones using two different methods. Twenty bones were cut vertically and a modified radical mastoidectomy was performed in the other 10 bones. The AES showed two types in the vertically cut bones according to its shape and structure. Type I, found in 17 (85%) of the bones, showed two cavities that were separated by a bony landmark and the tensor tympanic fold. The name "supratubal ridge" is suggested for this bony landmark. In type II, which was seen in three (15%) of the bones, there was only one cavity. In the mastoidectomy group, again two types of AES were found: eight (80%) were type I and two (20%) were found to be type II. If we combine these findings with the vertically cut bones, we find that 25 (83.3%) possess an AES type I, whereas five (16.7%) are type II. These variations in the structure of the AES and its close relationships with a number of vital structures such as the facial nerve, cochlea, and middle fossa dura must be taken into account during the surgical management of middle ear disease.


Why do men buy sex and what are their assessments of the HIV-related risks when they do?
The belief that female prostitution might play a key role in the heterosexual spread of HIV infection has led to a great deal of attention being focused on the activities of women who sell sex. By contrast, the activities of men who buy sex has been largely ignored. One of the reasons for this has undoubtedly been the difficulties of contacting such men. In this paper data from telephone interviews with 70 men who had recently purchased sex are presented. It is shown that there was a wide range of factors that the men cited in explaining the appeal of commercial sex. The paper also reports on the males' views as to the risks of HIV associated with commercial sex. Although the men believed HIV to be very widespread amongst women selling sex, hardly any of them felt at risk themselves as a result of their commercial sexual encounters. The basis for the men's optimism about avoiding HIV and their preparedness to inform other sexual partners about their prostitute contacts are also described.


Posterior Epidural Migration of a Sequestrated Lumbar Disk Fragment Causing Cauda Equina Syndrome in an Old Patient: A Case Report.
Disk fragment relocation is commonly limited to the anterior epidural space, although posterior epidural movement of a sequestrated disk piece to the posterior epidural space is infrequent. We present an uncommon case of dorsal extradural sequestration of lumbar disk herniation. A 77-year-old man presented with severe leg pain, low back pain, and urinary incontinence. Deep tendon reflexes were inattentive at the knee and ankle, and the motor power in terms of ankle dorsiflexion and great toe dorsiflexion was 2/5 in both lower limbs. There was hypoesthesia in the S1, S2, and S3 dermatomes. Magnetic resonance imaging displayed a large isointensity lesion at the L4-L5 level on the T2 sagittal image, indenting circumferentially the thecal sac from lateral to posterior of the thecal sac. The patient underwent an L4-L5 central laminectomy. A large, solid epidural disk fragment was recognized dorsally, with major compression of the thecal sac. The patient report improved lower extremity motor function at three-month follow-up. A displaced disk fragment should be considered as causative when patients present with cauda equine syndrome and be treated as a surgical emergency.


Patient experience of, and satisfaction with, delayed-immediate vs. delayed single-tooth implant placement.
Recent investigations have focused on patients' subjective assessment of implant treatment. The aim of this study was to compare the patients' experience of surgical and prosthetic procedures, as well as satisfaction with function and aesthetics following single-tooth replacements mounted to early vs. delayed placed dental implants. Forty-six patients were treated with a single-tooth implant in the anterior or premolar region. Twenty-three implants were placed on average 10 days after tooth extraction (Im), while 23 implants were placed approximately 3 months after tooth extraction (De). Forty-one patients completed a questionnaire regarding the treatment using visual analog scales (VAS) and check boxes 16-18 months after delivery of the restoration. In all, 90% of the respondents rated 88 or higher on the VAS regarding satisfaction with the crown. Satisfaction with the restoration in general and the appearance was significantly greater in the Im group than in the De group (96 vs. 93; P<0.02). Assessment of the implant surgery was not significantly different between the delayed-immediate and the delayed group. Approximately 25% of the patients experienced unpleasantness in relation to the prosthetic procedures, and in 8 of 11 cases, impression taking was the cause. When evaluating satisfaction with the overall implant treatment, the VAS scores for the delayed-immediate group were significantly higher than for the delayed group (96 vs. 90; P<0.02). The patients in the present study were highly satisfied with the outcome of the treatment and experienced it to be without significant unpleasantness irrespective of the treatment concept.


Capturing and explaining preference heterogeneity for wetland management options in the Kilombero Valley, Tanzania.
Wetland degradation has recently received considerable research attention. Although wetlands are valuable ecosystems, their actual value is difficult to measure because the services they provide often do not have market values. The current study seeks to investigate the preferences for wetland management options in the Kilombero Valley, central Tanzania using choice modeling. The results show that both respondents from the Kilombero Valley and Morogoro Municipality desire improvements in the condition of the wetlands. This indicates that the ongoing degradation is not socially optimal. A second finding is that the preferences for wetland conservation are heterogeneous and can be linked to livelihood characteristics. Communities living in the area, for example, are highly dependent on the wetland for their livelihood and would be impacted by conservation measures. Therefore, in order to reduce the pressure on wetlands, it is necessary and imperative to explore the options for alternative income-generating activities or to focus, for example, on technologies to improve efficiency and effectiveness in crop production.


Overweight and obesity in preschoolers: Prevalence and relation to food consumption.
To determine overweight and obesity prevalence in preschool children from public education, and to determine their relation to food consumption. Cross-sectional study with children aged between 2 and 5 years, of both sexes, enrolled at municipal day care centers. Socioeconomic, demographic and anthropometric data were collected, in order to calculate the body mass index (BMI) for age. Data on food consumption were assessed using a Food Frequency Questionnaire. χ2 test, Kruskal-Wallis test, Student's t-test and Pearson's correlation were used at a significance level of 5%. Of 548 children, 52% were male, with mean age of 4.2 years old. Most families had incomes between 1 and 2 minimum wages (59.7%), in addition to 10 years (mothers) of education. Anthropometric parameters did not differ significantly between sexes. According to the BMI-for-age, it was found that most of children were well-nourished (85.2%), 8.2% had the risk of becoming overweight, and 4.2% were overweight. The most consumed foods were: rice (100%), beans (99.4%), bread (98.5%), fruit (98.5%), red meat (97.1%), butter and margarine (95.4%), biscuits, cakes and sweet pies (94.1%), dairy products (94.1%), chocolate milk (91.7%), and soft drinks (90.2%). Consumed foods that were strongly correlated (r > 0.7) to the risk of/excess weight were, as follows: bread; biscuits, cakes, sweet pies; dairy products; chocolate milk; sausages. There was low prevalence of overweight and absence of obesity among the population assessed. The risk of overweight was greater among girls. Data from the study showed deviations in food consumption.


[Optimization of a novel mucoadhesive drug deliver system with ion-exchange resin core loaded with berberine hydrochloride using central composite design methodology].
A novel mucoadhesive microcapsule with drug-resin complex core loaded with berberine hydrochloride (BH) was developed and optimized. Drug-ion exchange resin (IER) complex was prepared by static method which stirring IER in drug solution at certain conditions. The influences of different IERs, different temperature, pH values and concentrations of drug solution on the drug loading were investigated. IER complex was coated by emulsion-solvent evaporation method. The coating fluid formulation was optimized using central composite design-response surface methodology, where the ratio between Carbopol 934 and IER (X1), the ratio between Eudragit and IER (X2) and the ratio between Eudragit RL and RS (X3) were taken as independent variables. Time of cumulative release 85% (Y1) and percentage of gastric retention (Y2) were taken as response variables. Drug loading achieved a high level and more drug available in the condition of IER (IRP 88), 37 degrees C, pH 5 and 1.0 mg x mL(-1) drug solution. When X1 = 0.75, X2 = 0.9, X3 = 0.6, the time of cumulative release reached 85% at 300 min, the highest percentage of gastric retention in the range of this experiment were procured.


[Upside down stomach].
The recent view on the treatment strategy with a rare diagnosis of gastric volvulus with the help of a literature review inspired by the case of the elderly patient with "upside down stomach".


In vivo targeting capacities of different nanoparticles to prostate tissues based on a mouse model of chronic bacterial prostatitis.
Chronic bacterial prostatitis usually occurs in men and seriously affects the quality of life of patients. The efficacy of chronic bacterial prostatitis treatment is limited by the difficulty for free drugs (e.g., antibiotics) to penetrate the prostate epithelium and target inflammatory tissues. The advent of nanotechnology offers the possibility to address this issue, such as the development of targeted nanoparticle delivery strategies that may overcome these important limitations. The physicochemical properties of nanoparticles, such as particle size, shape and surface modification ligands, determine their targeting effectiveness. In this study, nanoparticles with different physicochemical properties were prepared to explore and confirm their targeting capacities to inflammatory prostate tissues of chronic bacterial prostatitis, focusing on the effects of size and different modification ligands on the targeting performance. In vivo and ex vivo imaging results verified that folic acid-modified nanoparticles with a particle size of 180-190 nm via tail intravenous injection had the optimal targeting efficiency to prostate tissues. Our results provide an experimental basis and reference value for targeted therapy of prostate-related diseases with nanotechnology in the future.


1-aminocyclopropane-1-carboxylic acid (ACC) in plants: more than just the precursor of ethylene!
Ethylene is a simple two carbon atom molecule with profound effects on plants. There are quite a few review papers covering all aspects of ethylene biology in plants, including its biosynthesis, signaling and physiology. This is merely a logical consequence of the fascinating and pleiotropic nature of this gaseous plant hormone. Its biochemical precursor, 1-aminocyclopropane-1-carboxylic acid (ACC) is also a fairly simple molecule, but perhaps its role in plant biology is seriously underestimated. This triangularly shaped amino acid has many more features than just being the precursor of the lead-role player ethylene. For example, ACC can be conjugated to three different derivatives, but their biological role remains vague. ACC can also be metabolized by bacteria using ACC-deaminase, favoring plant growth and lowering stress susceptibility. ACC is also subjected to a sophisticated transport mechanism to ensure local and long-distance ethylene responses. Last but not least, there are now a few exciting studies where ACC has been reported to function as a signal itself, independently from ethylene. This review puts ACC in the spotlight, not to give it the lead-role, but to create a picture of the stunning co-production of the hormone and its precursor.


Physical activity and sleep relate to antibody maintenance following naturalistic infection and/or vaccination in older adults.
Health behaviours such as being physically active and having good quality sleep have been associated with decreased susceptibility to infection and stronger antibody responses to vaccination. Less is known about how such factors might influence the maintenance of immunity following naturalistic infection and/or prior vaccination, particularly among older adults who may have formed initial antibodies some time ago. This analysis explored antibody levels against a range of common infectious diseases in 104 older adults (60 women) aged 65+ years, and whether these relate to self-reported physical activity (PA) and sleep. PA and sleep were measured subjectively through standardized questions. Antibody levels to a range of common pathogens, including pneumococcal (Pn) and meningococcal (Men) serotypes, Haemophilus influenza type b, diphtheria, and tetanus were assayed using Multiplex technology. Higher PA at baseline related to higher antibody levels against three Pn serotypes and MenY, and higher PA at one month with higher levels against six Pn serotypes. Longer time in bed related to higher antibody levels against Pn4, and longer sleep related to higher levels against Pn19f. More difficulty staying awake in the day related to lower antibodies against Pn19a, Pn19f, MenA and MenY, and more frequent daytime napping related to lower levels against three Pn serotypes and MenY. Using clinically protective antibody thresholds as an outcome showed similar results for PA, but effects for sleep became non-significant, with the exception of time in bed. This extends beyond existing literature demonstrating associations between PA and sleep and peak antibody response to vaccination to antibody maintenance. Longitudinal research with objective measures of health behaviours is warranted.


[Influence of fluvastatin on left ventricular remodeling after myocardial infarction in rats].
To investigate the effect of long-term administration of fluvastatin on improvement of ventricular remodeling of rats after myocardial infarction and its mechanism. Sprague-Dawley rats were subjected to ligation in anterior descending branch of coronary artery and treated with fluvastatin (20 mg.kg(-1) d(-1)) or distilled water for 8 weeks. Doppler echocardiography, hemodynamic study and cardiac histomorphometry were used to estimate the ventricular remodeling and cardiac function. Laser scanning confocal microscope was used to definite the distribution of superoxide anion (O(2)(*-)) and nitrogen monoxide. RT-PCR and immunohistochemistry were used to detect the expression of NOS2 and p22phox in mRNA and protein level. The level of lipid peroxidation, glutathione peroxidase, nitrogen monoxide and total cholesterol were detected too. Administration of fluvastatin ameliorated left ventricular remodeling without affecting the infarct size [(40 +/- 6 vs 42 +/-5)%, P>0.05]. The level of left ventricular end-diastolic pressure [(18.24 +/-6.58 vs 10.74 +/-4.71) mmHg, P<0.05], right ventricular ameliorated relative weight [(0.92 +/-0.19 vs 0.71 +/-0.13) g/kg, P<0.05], the thickness of left ventricular posterior wall [(3.04 +/-0.28 vs 2.60 +/-0.36) mm, P<0.05] decreased after fluvastatin treatment. The left ventricular ejection fraction was not influenced, the relative lung weight and the left atrium diameter reduced [(5.79 +/-2.92 vs 3.69 +/-0.68) g/kg, (0.55 +/-0.12 vs 0.45 +/-0.04) mm, P<0.05]; the expressions of LPO in the plasma and myocardium [(8.64 +/-0.59 vs 7.71 +/-0.66) U/dl, P<0.05; (3.12 +/-0.38 vs 1.93 +/-0.40) ng/microg.pro, P<0.01] were reduced, and the overexpressed NO was inhibited [(436.87 +/-47.22 vs 313.78 +/-34.35) mg/dl, P<0.01], but the expression of GPx increased [(66.13 +/-8.31 vs 79.78 +/-2.38) mg/dl, P<0.01]. The expression of O(2)(*-) and the activity of NADPH oxidase subunit p22phox increased; NOS2 and its products NO were over-expressed too. Ventricular remodeling and hemodynamics are improved profoundly in MI rats treated with fluvastatin. The effect of antioxidative stress of fluvastatin might be involved in the mechanism.


Complications and associated risk factors after surgical management of proximal femoral fractures.
This work aimed at answering the following research questions: 1) What is the rate of mechanical complications, nonunion and infection for head/neck femoral fractures, intertrochanteric fractures, and subtrochanteric fractures in the elderly USA population? and 2) Which factors influence adverse outcomes? Proximal femoral fractures occurred between 1 January 2009 and 31 December 2019 were identified from the Medicare Physician Service Records Data Base. The Kaplan-Meier method with Fine and Gray sub-distribution adaptation was used to determine rates for nonunion, infection, and mechanical complications. Semiparametric Cox regression model was applied incorporating 23 measures as covariates to identify risk factors. Union failure occured in 0.89% (95% confidence interval (CI) 0.83 to 0.95) after head/neck fracturs, in 0.92% (95% CI 0.84 to 1.01) after intertrochanteric fracture and in 1.99% (95% CI 1.69 to 2.33) after subtrochanteric fractures within 24 months. A fracture-related infection was more likely to occur after subtrochanteric fractures than after head/neck fractures (1.64% vs 1.59%, hazard ratio (HR) 1.01 (95% CI 0.87 to 1.17); p < 0.001) as well as after intertrochanteric fractures (1.64% vs 1.13%, HR 1.31 (95% CI 1.12 to 1.52); p < 0.001). Anticoagulant use, cerebrovascular disease, a concomitant fracture, diabetes mellitus, hypertension, obesity, open fracture, and rheumatoid disease was identified as risk factors. Mechanical complications after 24 months were most common after head/neck fractures with 3.52% (95% CI 3.41 to 3.64; currently at risk: 48,282). The determination of complication rates for each fracture type can be useful for informed patient-clinician communication. Risk factors for complications could be identified for distinct proximal femur fractures in elderly patients, which are accessible for therapeutical treatment in the management.


Measurement of the K(L) charge asymmetry.
We present a measurement of the charge asymmetry delta(L) in the mode K(L)-->pi(+/-)e(-/+)nu based on 298 x 10(6) analyzed decays. We measure a value of delta(L) = [3322+/-58(stat)+/-47(syst)]x10(-6), in good agreement with previous measurements and 2.4 times more precise than the current best published result. The result is used to place more stringent limits on CPT and DeltaS = DeltaQ violation in the neutral kaon system.


Hypertension Knowledge-Level Scale (HK-LS): a study on development, validity and reliability.
This study was conducted to develop a scale to measure knowledge about hypertension among Turkish adults. The Hypertension Knowledge-Level Scale (HK-LS) was generated based on content, face, and construct validity, internal consistency, test re-test reliability, and discriminative validity procedures. The final scale had 22 items with six sub-dimensions. The scale was applied to 457 individuals aged ≥ 18 years, and 414 of them were re-evaluated for test-retest reliability. The six sub-dimensions encompassed 60.3% of the total variance. Cronbach alpha coefficients were 0.82 for the entire scale and 0.92, 0.59, 0.67, 0.77, 0.72, and 0.76 for the sub-dimensions of definition, medical treatment, drug compliance, lifestyle, diet, and complications, respectively. The scale ensured internal consistency in reliability and construct validity, as well as stability over time. Significant relationships were found between knowledge score and age, gender, educational level, and history of hypertension of the participants. No correlation was found between knowledge score and working at an income-generating job. The present scale, developed to measure the knowledge level of hypertension among Turkish adults, was found to be valid and reliable.


"When I am lonely the mountains call me": the impact of sacred geography on Navajo psychological well being.
As we approach the twenty-first century, sacred geography continues to have a profound impact on Navajo psychological well being. This article explores the extent of the Navajo's bond with their homeland through an emphasis on orderly conditions in their world view, myths, and ceremonies. When traditional Navajos leave their homeland to pursue educational and professional endeavors or to seek biomedical treatment, a sense of emotional dislocation can undermine their success. The emotional trauma goes far beyond mere homesickness because it is based on an often unconscious sense of having violated the moral order of the universe. It is essential that mental health professionals respond with sensitivity to this issue by understanding the extent to which the sacred mountains and other landforms serve as a vital source of spiritual strength.


Minimal Explanation of Flavor Anomalies: B-Meson Decays, Muon Magnetic Moment, and the Cabibbo Angle.
Significant deviations from the standard model are observed in semileptonic charged and neutral-current B decays, the muon magnetic moment, and the extraction of the Cabibbo angle. We propose that these deviations point towards a coherent pattern of new physics effects induced by two scalar mediators, a leptoquark S_{1} and a charged singlet ϕ^{+}. While S_{1} can provide solutions to charged-current B decays and the muon magnetic moment, and ϕ^{+} can accommodate the Cabibbo-angle anomaly independently, their one-loop level synergy can also address neutral-current B decays. This framework provides the most minimal explanation to the above-mentioned anomalies, while being consistent with all other phenomenological constraints.


Congenital nevi with hypomelanosis and fine scales.
Nevus is a hamartoma or malformation of one or more skin components, resulting in aberrant differentiation of the cell lineage(s) mostly during developmental stages. Although multiple lineages may be involved in a nevus, the combination of melanocyte and keratinocyte abnormalities has been rarely discussed. To present two cases of congenital nevi with hypomelanosis and superficial fine scales. Skin specimens of the patients were analysed by immunohistochemistry and electron microscopy. Morphological and immunohistochemical studies indicated aberrant epidermal differentiation in the lesional skin specimens. Electron microscopy showed defective melanosome maturation in the melanocytes of the nevi samples. These results demonstrate that both epidermal and melanocytic lineages can concomitantly contribute to the formation of a nevus lesion.


The BCL11A transcription factor directly activates RAG gene expression and V(D)J recombination.
Recombination-activating gene 1 protein (RAG1) and RAG2 are critical enzymes for initiating variable-diversity-joining (VDJ) segment recombination, an essential process for antigen receptor expression and lymphocyte development. The transcription factor BCL11A is required for B cell development, but its molecular function(s) in B cell fate specification and commitment is unknown. We show here that the major B cell isoform, BCL11A-XL, binds the RAG1 promoter and Erag enhancer to activate RAG1 and RAG2 transcription in pre-B cells. We employed BCL11A overexpression with recombination substrates in a cultured pre-B cell line as well as Cre recombinase-mediated Bcl11a(lox/lox) deletion in explanted murine pre-B cells to demonstrate direct consequences of BCL11A/RAG modulation on V(D)J recombination. We conclude that BCL11A is a critical component of a transcriptional network that regulates B cell fate by controlling V(D)J recombination.


Central Obesity as a Risk Factor for Non-Erosive Reflux Disease.
Although central obesity is a risk factor for erosive esophagitis, information regarding the association between central obesity and non-erosive reflux disease (NERD) is still scarce. The purpose of this study was to investigate the risk factors for NERD by comparing NERD patients and healthy controls. Comprehensive clinical data from 378 patients who underwent esophagogastroduodenoscopy from December 2012 to May 2013 and had no visible esophageal mucosal breakage were analyzed. The Korean version of GerdQ questionnaire was used to diagnose NERD. The association between central obesity and NERD was assessed after matching subjects according to propensity scores. There were 119 NERD patients and 259 controls. In multivariate analysis, central obesity, female gender, and younger age were significantly associated with NERD [odds ratio (OR)=2.55, 1.93, and 1.80; p=0.001, 0.005, and 0.011, respectively]. After adjusting for 12 clinical variables using propensity score matching, 114 NERD patients were matched to 114 controls. All variables were well balanced between the two groups (average D before matching: 0.248, after matching: 0.066). Patients with NERD were more likely to have central obesity than healthy controls (28.1% vs. 7.9%). After adjusting for propensity scores and all covariates in multivariable logistic regression analyses, central obesity was still found to be a significant risk factor for NERD (OR=4.55, p<0.001). Central obesity appears to be an independent risk factor for NERD. This result supports the presence of an association between GERD and central obesity, even in the absence of esophageal erosion (NERD).


Reactive oxygen species - sources, functions, oxidative damage.
Reactive oxygen species (ROS) are molecules capable of independent existence, containing at least one oxygen atom and one or more unpaired electrons. This group includes oxygen free radicals, e.g. superoxide anion radical, hydroxyl radical, hydroperoxyl radical, singlet oxygen, as well as free nitrogen radicals. Under physiological conditions, small quantities of ROS are formed during cell processes, such as aerobic respiration or inflammatory processes, mainly in hepatocytes and macrophages. Reactive oxygen species are primarily signalling molecules. In addition, they induce cell differentiation and apoptosis, thus contributing to the natural ageing process. They also participate in muscle contractions, regulation of vascular tone, and determine bactericidal and bacteriostatic activity. Increased production of free radicals is caused by excessive exposure to UV radiation, long-term stress conditions, intense physical exercise, improper diet and use of stimulants. Under physiological conditions, there is a balance between the generation and removal of free radicals from the body. The aim of the article was to review the current state of knowledge regarding oxidative stress, free radical function and free radical diseases. The search was performed using search engines such as PubMed and Google Scholar. The keywords used in the search included: oxygen radicals, oxidative stress, free radical-related diseases. Excessive formation of free radicals contributes to oxidative stress, causing damage at the molecular and cellular level. Reactive oxygen species in vitro cause chemical modifications as well as damaging effects to proteins (aggregation, denaturation), lipids (peroxidation), carbohydrates and nucleotides (changes in the DNA structure). These changes contribute to the development of many free radical-mediated diseases. Oxidative stress has a particularly adverse effect on the circulatory, respiratory and nervous systems.


Does presence of anterior greater tuberosity cysts change the function in patients with chronic rotator cuff tear?
This study aims to compare rotator cuff muscle atrophy with fatty degeneration, tear size, range of motion, shoulder muscle strength, pain and upper extremity function in patients with chronic rotator cuff tear, and with or without anterior greater tuberosity cyst. A total of 101 patients (32 males, 69 females; mean age 51 ± 12.9 years; range 17 to 76 years) were evaluated in this study. Fifty-eight patients were excluded due to traumatic or acute rotator cuff tears and neck pain. Forty-three patients of chronic rotator cuff tear were divided into two groups as patients with (n=15) and without (n=28) an anterior greater tuberosity cyst. Patients were evaluated for range of motion, shoulder muscle strength, pain and upper extremity function, and radiologically. Statistical differences were investigated between two groups. The number of patients with tears larger than 1 cm and the number of patients who had muscle atrophy were higher in the group of patients with a cyst. Also, upper extremity function was reduced in the group of patients with a cyst (Western Ontario Rotator Cuff Index, p=0.03, Nine-Hole Peg Test, p=0.02). Our findings demonstrated that decreased function, larger cuff tears and muscle atrophy can be observed patients with anterior greater tuberosity cysts. Anterior greater tuberosity cysts can be detected by plain X-rays. The presence of these cysts should warn the physician regarding the possibility of decreased shoulder function, muscle atrophy and larger cuff tear before ordering a magnetic resonance imaging.


Facile Attachment of TAT Peptide on Gold Monolayer Protected Clusters: Synthesis and Characterization.
High affinity thiolate-based polymeric capping ligands are known to impart stability onto nanosized gold nanoparticles. Due to the stable gold-sulfur bond, the ligand forms a protective layer around the gold core and subsequently controls the physicochemical properties of the resultant nanogold mononuclear protected clusters (AuMPCs). The choice of ligands to use as surfactants for AuMPCs largely depends on the desired degree of hydrophilicity and biocompatibility of the MPCs, normally dictated by the intended application. Subsequent surface modification of AuMPCs allows further conjugation of additional biomolecules yielding bilayer or multilayered clusters suitable for bioanalytical applications ranging from targeted drug delivery to diagnostics. In this study, we discuss our recent laboratory findings on a simple route for the introduction of Trans-Activator of Transcription (TAT) peptide onto the surface of biotin-derivatised gold MPCs via the biotin-strepavidin interaction. By changing the surface loading of biotin, controlled amounts of TAT could be attached. This bioconjugate system is very attractive as a carrier in intercellular delivery of various delivery cargoes such as antibodies, proteins and oligonucleotides.


A theory to guide families and carers of people who are at risk of suicide.
The aim of this study was to explore family members' and ex-patients' perceptions of caring for people who had previously attempted suicide. Suicide is a major public health problem in Taiwan. Official figures demonstrate that suicide was one of the top 10 causes of death in the last eight years, with 18.8 per 100,000 people taking their own lives in 2005. The Taiwanese Government has set targets to reduce this rate. All members of the population play a role in the prevention of suicide, including families and carers of those at risk. Evidence is sparse on the role that families take in caring for members who have been discharged from hospital following a suicide attempt. Grounded theory using one-to-one tape-recorded interviews were conducted with patients who had just been discharged from hospitals following a suicide attempt (n = 15) and family members (n = 15). Data were analysed using open, axial and selective coding. The core category that emerged was 'Impending burnout', depicting family members' experience of caring for people who had attempted suicide. Other key categories linked to and embraced within this core category were: on guard day and night, maintaining activities of daily living and creating a nurturing environment. Families and carers could use the emergent theory as a guide to caring for people at risk of suicide. Psychiatric nurses could use the theory as a framework to educate family members on enhancing the quality of care provided to this group of people. The theory could go some way towards reducing suicidal attempts and decreasing re-hospitalisation rates. The finding indicated that family members experienced difficulties when caring for those who had previously attempted suicide. Consequently, nurses have a pivotal role in educating families and carers on preventive strategies before suicidal patients are discharged from hospitals.


Novel roles for arrestins in G protein-coupled receptor biology and drug discovery.
The G protein-coupled receptors (GPCRs) are the largest family of membrane proteins and represent some of the most important pharmaceutical targets. These receptors, encoded by several hundred genes, are activated by a wide variety of endogenous and synthetic ligands. The study of the signal transduction pathways activated by these receptors and the associated mechanisms controlling biological responses have been pivotal in identifying key intracellular molecules for regulating receptor responsiveness. The beta-arrestin proteins, which were initially discovered due to their role in GPCR desensitization, serve equally important roles in regulating internalization and alternative signaling events. This review focuses on the different functions of beta-arrestins to demonstrate how these proteins can help to identify new ligands for GPCRs and how they can serve as a platform for drug discovery.


[Optimal lamivudine treatment duration and the relationship between its early response and long term effect].
To investigate the relationship between the method of administration of lamivudine and the therapeutic effect of the treatment in patients with chronic hepatitis B virus (HBV) infection. One hundred and seventy-nine patients were given lamivudine 100 mg daily for 1 to 3 years. The relationships of the therapeutic effect and the early response, YMDD mutants and duration of treatment were analyzed. Alanine aminotransferase normalization rate, the negativity rate of HBV DNA and HBeAg, and HBeAg sero-conversion all were increased gradually with prolonged treatment. At the end of 1 year, HBV DNA negativity rate (57.0%) reached its peak, HBeAg negativity rate (39.7%) and HBeAg sero-conversion rate (16.8%) were higher than those at the end of 3 months (chi2 = 28.489, 33.238, 12.690, P<0.01). The lower the HBV DNA level was at the end of 3 months, the higher the HBV DNA negativity and HBeAg sero-conversion rates were at the end of 52 weeks and at the end of the 6 months follow-up. When the duration of treatment reached 1 year and 1.5 years, HBV DNA rebound rate in the patients (40.0% and 40.0% respectively) with HBeAg sero-conversion was obviously less (chi2 = 12.424, 10.237, P<0.01) than in those without sero-conversion (88.2% and 85.0% respectively). Lamivudine therapy for HBV infection is safe and effective. The optimal duration of treatment was 1.5 years. The early responders had better therapeutic effects. HBV DNA positivity persisting at the end of 3 months medication or no HBeAg sero-conversion in 1 year predicts poor therapeutic effects.


Enantiodivergent Synthesis of Bis-Spiropyrrolidines via Sequential Interrupted and Completed (3 + 2) Cycloadditions.
Both (5R)- and (5S)-1,7-diazaspiro[4.4]nonan-6-ones are obtained via a sequence of interrupted and completed stepwise (3 + 2) cycloadditions between azomethine ylides and π-deficient alkenes. The only source of chirality along the whole process is an enantiopure ferrocenyl pyrrolidine catalytic ligand. When the starting imine incorporates two aryl groups or one aryl group with one electron-releasing substituent, the reaction between the azomethine ylide and the alkene stops at the first step, leading to the corresponding Michael adduct. When imines derived from p-methoxybenzaldehyde are used, the corresponding syn-α-amino-γ-nitro ester is obtained with almost complete enantiocontrol. In contrast, imines derived from benzophenone lead to the corresponding anti analogue. From this interrupted (3 + 2) cycloaddition, cis- and trans-α-amino-γ-lactams can be obtained via hydrogenation of the nitro group followed by in situ cyclization. Imines derived from these latter compounds are the precursors of N-metalated azomethine ylides from which up to four new chiral centers can be generated via completed (3 + 2) cycloaddition reactions with full regio- and diastereocontrol. Cis- and trans-γ-lactams lead to opposite bis-spiropyrrolidine enantiomers. Therefore, both enantiomeric series of spiro compounds can be obtained by means of the same catalytic system. The potential of these rigid, densely substituted homochiral compounds in medicinal chemistry is briefly described.


Hybrid repair of aortic arch aneurysms: a comprehensive review.
Open total arch replacement (TAR) has become safer with refinements in cerebral protection techniques. The frequent extension of aortic arch aneurysms into the descending thoracic aorta customarily requires a two-staged conventional elephant trunk procedure, carrying relatively high mortality and morbidity risks and high rates of rupture in the interval between the two open surgeries. The technical demands and invasive nature of TAR has therefore precluded many high-risk patients from being surgical candidates for aneurysm repair. As a result, hybrid techniques and approaches to the aortic arch have become common since the adoption of thoracic endovascular aortic repair (TEVAR) and advancement in the commercial grafts that are available. The results of hybrid aortic arch repairs have been encouraging, though with higher rates of re-interventions than TAR and variable reported rates of stroke and spinal cord ischemia. The aim of this publication is to review the current literature on hybrid repair of aortic arch aneurysms.


Roles of type II myosin and a tropomyosin isoform in retrograde actin flow in budding yeast.
Retrograde flow of cortical actin networks and bundles is essential for cell motility and retrograde intracellular movement, and for the formation and maintenance of microvilli, stereocilia, and filopodia. Actin cables, which are F-actin bundles that serve as tracks for anterograde and retrograde cargo movement in budding yeast, undergo retrograde flow that is driven, in part, by actin polymerization and assembly. We find that the actin cable retrograde flow rate is reduced by deletion or delocalization of the type II myosin Myo1p, and by deletion or conditional mutation of the Myo1p motor domain. Deletion of the tropomyosin isoform Tpm2p, but not the Tpm1p isoform, increases the rate of actin cable retrograde flow. Pretreatment of F-actin with Tpm2p, but not Tpm1p, inhibits Myo1p binding to F-actin and Myo1p-dependent F-actin gliding. These data support novel, opposing roles of Myo1p and Tpm2 in regulating retrograde actin flow in budding yeast and an isoform-specific function of Tpm1p in promoting actin cable function in myosin-driven anterograde cargo transport.


Linking assumptions in amblyopia.
Over the last 35 years or so, there has been substantial progress in revealing and characterizing the many interesting and sometimes mysterious sensory abnormalities that accompany amblyopia. A goal of many of the studies has been to try to make the link between the sensory losses and the underlying neural losses, resulting in several hypotheses about the site, nature, and cause of amblyopia. This article reviews some of these hypotheses, and the assumptions that link the sensory losses to specific physiological alterations in the brain. Despite intensive study, it turns out to be quite difficult to make a simple linking hypothesis, at least at the level of single neurons, and the locus of the sensory loss remains elusive. It is now clear that the simplest notion-that reduced contrast sensitivity of neurons in cortical area V1 explains the reduction in contrast sensitivity-is too simplistic. Considerations of noise, noise correlations, pooling, and the weighting of information also play a critically important role in making perceptual decisions, and our current models of amblyopia do not adequately take these into account. Indeed, although the reduction of contrast sensitivity is generally considered to reflect "early" neural changes, it seems plausible that it reflects changes at many stages of visual processing.


Gender Differences in the Social Determinants of the Long-term Prognosis for Severely Decompensated Acute Heart Failure in Patients over 75 Years of Age.
Objective The aim of present study was to elucidate the gender differences in social determinants among patients with acute heart failure (AHF). Methods A total of 1,048 AHF patients were enrolled, and the 508 AHF patients who were ≥75 years old and the 540 patients who were <75 years old were evaluated as the elderly and non-elderly cohorts, respectively. Participants who met one of the three marital status-, offspring-, and living status-related criteria were considered socially vulnerable, and subjects were thus classified into socially vulnerable and non-socially vulnerable groups by gender in both the non-elderly and elderly cohorts. Social vulnerability was significantly more common in the elderly cohort (n=246, 48.4%) than in the non-elderly cohort (n=197, 36.5%) and significantly more common in the elderly women (n=157, 69.4%) than in the elderly men (n=89, 31.5%). Kaplan-Meier curves showed that the survival rate of the socially vulnerable group was significantly poorer than that of the non-socially vulnerable group in the elderly male cohort (p=0.010). Social vulnerability was an independent predictor of the 1,000-day mortality in the elderly male cohort (hazard ratio: 1.942, 95% confidence interval: 1.102-3.422) but not in the elderly female cohort according to a multivariate analysis. Conclusion Social vulnerability was shown to be more common in elderly female AHF patients than in elderly men, although it was associated with a poor prognosis in elderly men. Reinforcing the social structure of elderly male AHF patients might help improve their prognosis.


Breeding for Anthracnose Disease Resistance in Chili: Progress and Prospects.
Chili anthracnose is one of the most devastating fungal diseases affecting the quality and yield production of chili. The aim of this review is to summarize the current knowledge concerning the chili anthracnose disease, as well as to explore the use of marker-assisted breeding programs aimed at improving anthracnose disease resistance in this species. This disease is caused by the Colletotrichum species complex, and there have been ongoing screening methods of chili pepper genotypes with resistance to anthracnose in the field, as well as in laboratories. Conventional breeding involves phenotypic selection in the field, and it is more time-consuming compared to molecular breeding. The use of marker-assisted selection (MAS) on the basis of inheritance, the segregation ratio of resistance to susceptibility, and the gene-controlling resistance may contribute to the development of an improved chili variety and speed up the selection process, while also reducing genetic drag in the segregating population. More importantly, by using molecular markers, the linkage groups are determined dominantly and co-dominantly, meaning that the implementation of a reliable method to produce resistant varieties is crucial in future breeding programs. This updated information will offer a supportive direction for chili breeders to develop an anthracnose-resistant chili variety.


Cooperation between MASP-1 and MASP-2 in the generation of C3 convertase through the MBL pathway.
The complement system is an important part of the innate immune system. Three pathways, the classical, the alternative and the lectin pathway, lead to the cleavage of complement factor C3, a central event in the activation of the complement system. We investigated the deposition of C3b (solid-phase C3 activation product) on a mannan-coated surface at high concentration of human serum (17%). At these conditions, mannan-binding lectin (MBL) promoted the activation of C3 through the combined action of MBL-associated serine protease (MASP)-1 and MASP-2 without appreciable involvement of the alternative pathway. In serum depleted of MASP-1, MASP-2 and MASP-3, we observed synergetic effect of reconstitution with MASP-1 and MASP-2. This was inhibited by MASP-3. No C3b deposition was observed with C2- or C4-depleted serum. Depletion of factor B had no effect on the MBL-MASP-promoted C3b deposition. Our results demonstrate a function of the orphan protease MASP-1 by providing evidence that this enzyme collaborates with MASP-2 in the generation of C3 convertase, a process observable at high serum concentration, but not at low serum concentration.


[The development of SH-C1 autobiochemical analyzer].
As a miniature automatic analyzer, SH-C1 analyzer can be divided into five parts: the diluter, the circular reaction plate, the photometer, the electronic control board and the main microcomputer system with CRT monitor. The paper discusses its general structure and its key parts: the double-beam high precision photometer and the diluter controlled by microprocessors. The paper also describes the software system and the properties of the instrument.


Serum aminotransferase levels and histological disease in chronic hepatitis C.
The reliability of serum aminotransferase (ASAT and ALAT) levels, currently used in deciding on performing liver biopsy and to assess interferon therapy in chronic hepatitis C has been questioned. In Belgium, interferon therapy is actually only reimbursed for treatment of chronic hepatitis C when serum aminotransferase levels are more than twice the upper limit of normal. The aim of the present study was to assess the relationship between serum aminotransferase levels and histological severity of chronic hepatitis C. Sixty-seven liver biopsies from 51 different patients with chronic hepatitis C and presenting with elevated ASAT and/or ALAT levels, were retrospectively evaluated using the original terminology (minimal hepatitis, chronic persistent hepatitis, chronic active hepatitis, cirrhosis), the Knodell score and the components of the Bianchi-Gudat score, where grading (portal inflammation, piecemeal necrosis, intra-acinar necrosis and inflammation) and staging components (fibrosis/ cirrhosis) are quantitated separately. The correlation between amino-transferase levels measured at or near to the biopsy date and histological criteria were evaluated using Spearman's rank correlation. About one third of the patients, including patients with chronic active hepatitis and cirrhosis, presented with ASAT and ALAT levels less than twice the upper limit of normal. ASAT levels correlated with originally determined histological severity, the numerical Knodell score and the numerical scores for piecemeal necrosis, for intra-acinar necrosis and inflammation and for fibrosis in the Bianchi-Gudat score. ALAT levels correlated only with intra-acinar necrosis and inflammation. It is concluded that limiting interferon therapy to patients with aminotransferase levels over twice the upper limit of normal excludes a large proportion of patients from potentially curative treatment. ASAT levels are more useful than ALAT to assess the histological severity of the disease, probably because this mitochondrial enzyme is present in higher quantities in the liver as compared to the cytosolic ALAT, and is more released when tissue damage is more severe.


Bootstrapping a change-point Cox model for survival data.
This paper investigates the (in)-consistency of various bootstrap methods for making inference on a change-point in time in the Cox model with right censored survival data. A criterion is established for the consistency of any bootstrap method. It is shown that the usual nonparametric bootstrap is inconsistent for the maximum partial likelihood estimation of the change-point. A new model-based bootstrap approach is proposed and its consistency established. Simulation studies are carried out to assess the performance of various bootstrap schemes.


Neutrinos: the key to ultrahigh energy cosmic rays.
Observations of ultrahigh energy cosmic rays (UHECR) do not uniquely determine both the injection spectrum and the evolution model for UHECR sources--primarily because interactions during propagation obscure the early Universe from direct observation. Detection of neutrinos produced in those same interactions, coupled with UHECR results, would provide a full description of UHECR source properties.


Atrioventricular nodal reentrant tachycardia treatment using novel potential.
Radiofrequency ablation of atrioventricular nodal reentrant tachycardia is commonly guided by slow and sharp bipolar potentials of the atrioventricular slow nodal pathway. We optimized the morphology of the guiding potential by unipolar mapping of the slow nodal pathway. We identified a novel unipolar dual-component atrial electrogram at the anterior limb of the coronary sinus ostium. The first component was a positive delta-wave type that corresponded to the isoelectric phase on a bipolar electrogram. The second component had fast biphasic morphology and corresponded to the R wave on a bipolar atrial electrogram. Of 104 consecutive patients with typical atrioventricular nodal reentrant tachycardia, 51 were treated with ablation guided by the novel potential, and 53 underwent ablation using the conventional technique. There was no recurrence of tachycardia in any of these patients. In those treated by the novel potential, there was significantly less radiofrequency power applied and a shorter duration of application than in patients treated by the traditional approach. The novel approach to mapping and ablation of the slow nodal pathway in atrioventricular nodal reentrant tachycardia guided by unipolar recording was safe and effective, and comparable to the traditional technique.


Metformin Reduces the Risk of Hearing Loss: A Retrospective Cohort Study.
To compare the risk of hearing loss with regard to metformin exposure. Retrospective cohort. Taiwan's National Health Insurance database. We enrolled 292,071 ever users and 18,200 never users of metformin with new-onset diabetes mellitus from 1999 to 2005 and followed them for hearing loss from January 1, 2006, to December 31, 2011. Hazard ratios (HRs) weighted by propensity score were estimated. Hearing loss was newly diagnosed in 10,085 ever users and 1072 never users. Their respective incidence rates (per 100,000 person-years) were 738.09 and 1366.83. The HR comparing ever-to-never users was 0.534 (95% confidence interval [CI]: 0.501-0.569]. The HR (95% CI) for the first (<27.07 months), second (27.07-59.13 months), and third (>59.13 months) tertiles of cumulative duration of metformin therapy were 0.912 (0.852-0.975), 0.544 (0.508-0.582), and 0.275 (0.255-0.295), respectively; and were 0.900 (0.841-0.962), 0.531 (0.496-0.569), and 0.293 (0.273-0.315), respectively, for the first (<796.70 g), second (796.70-2020.15 g), and third (>2020.15 g) tertiles of cumulative dose. The magnitude of risk reduction became more remarkable in corresponding to the increasing tertiles of the defined daily dose prescribed. Subtype analyses suggested that the risk reduction was more significant for sensorineural than conductive hearing loss. Findings derived from a propensity score-matched cohort did not substantially change the conclusions, and the risk reduction for mixed hearing loss was not statistically significant in the matched cohort as significantly observed in the unmatched cohort. The risk of hearing loss is reduced in a dose-response pattern in patients who use metformin.


[Expression of annexins Al and A2 in the mucosa of the upper airdigestive tract].
Annexins A1 and A2 have been related with the maintenance of tissue integrity. They have been identified in a wide variety of tissues, but little is known regarding their expression in upper the aerodigestive tract. The aim of this work is to describe the expression of these proteins in the mucosa of the upper aerodigestive tract. Tissue samples from respiratory (nasal and laryngeal) and digestive (oral and pharyngeal) mucosa from non-oncological patients were studied. Annexin A1 and A2 expression was determined by immunohistochemistry. Both annexins were expressed in the ciliated and in the stratified non-keratinized epithelia, but with a different pattern; ANXA1 was expressed in the more differentiated cells whereas ANXA2 was expressed in the less differentiated ones (with the exception of the cilia of ciliated cells). Although annexins A1 and A2 are structurally and philogenetically related its expression pattern in the upper aerodigestive tract suggests that they have different functions.


[Immunological Analysis of Human Atherosclerotic Plaques in ex vivo Culture System].
to analyze the dynamics of lymphocytic composition of human atherosclerotic plaques in ex vivo culture system. The study included 15 atherosclerotic plaques obtained from patients who underwent carotid endarterectomy. Plaques were cultured as ring-shaped explants on collagen rafts in culture medium of special composition in CO2 incubator according to the previously developed technique. On day 0, and also on the 4th and 19th days of culture we extracted cells from plaque explants and analyzed B- and T-lymphocytic content of the tissue, as well as the percentage of CD16+ natural killer (NK) cells, using multichromatic flow cytometry. For this purpose we digested the explants with an original enzymatic cocktail, which allows preservation of cell surface markers, and we stained extracted cells with fluorescence-labelled monoclonal antibodies against CD45, CD3, CD19, CD4, CD8, CD16. In addition, we estimated the amount of interleukin 2 (IL-2) and interferon-gamma (IFN-)-producing T-cells by means of flow cytometry. After 4 days of culture the amount of lymphocytes in plaques explants decreased, however live lymphocytes were still preserved (2619.3 [1680.4, 3478.2] cells/100mg tissue). Viable lymphocytes population included T cells (2123.4 [484.9; 3181.2] cells/100 mg tissue), B cells (5.6 [3.4, 27.9] cell/100 mg tissue) and CD16+ NK cells (10.6 [1.8, 23.7] cell/100mg tissue). On the 4th day of culture T cells were presented by CD4+CD8- (797 [475.5, 1000.7] cells/100mg tissue, 37.5 [32.1; 46.3]%) and CD4-CD8+ (686.2 [423.6; 1158.4] cells/100 mg tissue, 45.6 [38.1; 47.9]%) populations. The percentage of CD4+CD8- T cell population decreased compared to the 1st day of culture, and this decrease correlated with the increase in CD4-CD8- T cells content (p<0.05). Additionally, after 4 days of culture we found in tissue explants both CD8+ (17.5[13.3;19.9]%) and CD8- (9.9 [6.4; 14]%) IFN--producing T-cells, however, their percentage, as well as the percentage of IL-2-producing T cells tended to decrease. After 19 days of culture explants of atherosclerotic plaques also contained lymphocytes (2830.1 [2350.3, 5900.2] cells/100mg tissue). Lymphocytes population included T cells (2594.5 [2035.7, 5306.7] cells/100mg tissue), presented by CD4+CD8- (1016.8 [671.2, 2201.7] cells/100mg tissue, 42.3 [34.3; 47.8]%) and CD4-CD8+ (1534.3 [813.8; 2207.2] cells/100mg tissue, 50.8 [45.6; 56.5]%) subsets, B cells (31 [18.3; 64.4] cell/100 mg tissue) and CD16+ NK cells (44.9 [33.4; 138.9] cells/100 mg of tissue). An ex vivo model of human atherosclerotic plaque culture that we previously developed enables to preserve viability of various lymphocyte subsets for up to 19 days. We also found that cultured tissue explants retain T cells that can maintain T-helper-1-dependent immune response, which demonstrates inflammation in atherosclerotic plaques. Our results allow to perform experiments on immunological mechanisms of atherogenesis and to develop new approaches for treatment of atherosclerosis, devoted to the suppression of local inflammatory processes in atherosclerotic plaques. An ex vivo model of human atherosclerotic plaque preserves CD4+CD8- and CD4-CD8+ T cells, B cells, and CD16+ NK cells for a long time. Moreover, after 4 days of culture tissue explants also retain IFN-++ T cells.


Screening and Inhibition Mechanism of Xanthine Oxidase Inhibitors in Ethanolic Extracts of Chimonanthus salicifolius Hu Leaves.
This study aimed to evaluate the inhibition of the ethanol elutions of Chimonanthus salicifolius Hu leaves (CsHL) against xanthine oxidase (XO). The results of XO inhibition assay and enzymatic superoxide free radical scavenging assay in vitro showed that 70 % ethanol eluate (EE) had the best inhibitory effect and followed by 40 % EE. High performance liquid chromatograph analysis showed that quercetin and kaempferol were the potential active components of XO inhibition. The inhibition mechanism of quercetin and kaempferol on XO was investigated by kinetic analysis and fluorescence quenching titration assay. The molecular simulation further revealed that quercetin and kaempferol bind to XO mainly by hydrogen bonding and van der Waals, blocking the entry of substrates and leading to the inhibition of XO. In conclusion, the CsHL have inhibitory effects on XO activity, which provides a theoretical basis for relieving or preventing hyperuricemia and gout as a natural food or medicinal plant in the future.


[Safety and efficacy of duodenal stenting for malignant gastric outlet obstruction].
Malignant gastric outlet obstruction( GOO) compromises the ability to eat and drink. Surgical gastrojejunostomy has long been the standard palliative procedure for patients with GOO. However, it might not be applicable for patients with a poor general condition. In Japan, duodenal stenting for malignant GOO has been covered by health insurance since April 2010. In our hospital, 5 patients with malignant GOO underwent duodenal stenting using a WallFlexTM stent( Boston Scientific Corporation). Subsequently, we evaluated the safety and efficacy of duodenal stenting for malignant GOO. Most of the patients in this study were elderly, had systemic inflammation, and were malnourished. We achieved 100% technical and clinical success rates. Four patients were discharged from the hospital. No major complications such as perforation were noted. The median survival time after stenting was 86 days. In conclusion, endoscopic duodenal stenting for malignant GOO is safe and effective, and it could be an option for palliative therapy.


The Deaf Mentor Experimental Project for young children who are deaf and their families.
The Deaf Mentor Experimental Project investigated the efficacy of deaf mentor services to young deaf children and their families. These services focused on deaf adults (mentors), who made regular home visits to the children and their families; shared their language (American Sign Language), culture, and personal knowledge of deafness with the families; and served as role models for the children. The children also received regular home visits from a hearing parent adviser who helped the family promote the child's early listening, English, and literacy skills. The result was a bilingual-bicultural home environment for these children. The children who received deaf mentor services were compared to matched children who did not receive these services but who received parent adviser services. Children receiving this early bilingual-bicultural programming made greater language gains during treatment time, had considerably larger vocabularies, and scored higher on measures of communication, language, and English syntax than the matched children.


Cytotoxicity of cholestane 3 beta,5 alpha,6 beta-triol on cultured intestinal epithelial crypt cells (IEC-6).
The effects of cholestane 3 beta,5 alpha,6 beta-triol on intestinal epithelial crypt cells were investigated using the IEC-6 cell line. Cholestane 3 beta,5 alpha,6 beta-triol decreased SH groups (glutathione and protein SH) in the cell, and showed cytotoxicity in a time-dependent manner. Although the concentration of cholestane 3 beta,5 alpha,6 beta-triol used in this study (100 microM) was very high compared with that in plasma of experimental animals, cholestane 3 beta,5 alpha,6 beta-triol did not show any cytotoxicity on IEC-6 cells without fetal calf serum (FCS). The level of cytotoxicity was dependent upon the concentration of FCS in the culture medium. Unknown components in FSC (not VLDL or LDL) were suggested to be associated with the cytotoxicity of cholestane 3 beta,5 alpha,6 beta-triol. Moreover, the fact that even heat-treated FCS (100 degrees C for 30 min) still mediated the cytotoxicity suggested the participation of non-protein components.


Family caregiver experiences with asthma in school-age children.
To examine family caregiver perspectives and experiences of having a school-age child with asthma. Semistructured interview with caregivers of children 6-11 years of age using a grounded theory approach. A theory of the process of becoming a vigilant caregiver was generated. The process of vigilance is three-fold, consisting of a diagnosis phase followed by a battling phase and finally a resolution phase that uses various strategies to minimize the impact of asthma on the child and family. This theory of vigilance is useful for health care workers seeking to understand families' experiences with asthma. Knowledge of families in the process of becoming vigilant may assist nurses in developing and planning interventions to improve the quality of care.


[Preparation of rotundine-chitosan gelled granules and their drug-release tests].
The paper described a delivery system prepared from granulation of a chitosan solution containing rotundine in a coagulating bath and examined the effects of the ratios of rotundine: chitosan, crosslinking agents and molecular weight of chitosan on the analgesic release rate. It was shown that the rotundine (56.7%)-chitosan (Mw:5.70 x 10(5) degree of deacetylation: 72.4%) gelled granules in an artificial gastroenteric juice (pH 1.0 and 7.2) have T50 of 40 and 180 min respectively, and the total release time sustained over 540 min.


The antioxidant 3H-1,2-dithiole-3-thione potentiates advanced glycation end-product-induced oxidative stress in SH-SY5Y cells.
Oxidative stress is implicated as a major factor in the development of diabetes complications and is caused in part by advanced glycation end products (AGEs). AGEs ligate to the receptor for AGEs (RAGE), promoting protein kinase C (PKC)-dependent activation of nicotinamide adenine dinucleotide phosphate (NADPH) oxidase and superoxide radical generation. While scavenging antioxidants are protective against AGEs, it is unknown if induction of endogenous antioxidant defenses has the same effect. In this study, we confirmed that the compound 3H-1,2-dithiole-3-thione (D3T) increases reduced-state glutathione (GSH) concentrations and NADPH:quinone oxidoreductase 1 (NQO1) activity in SH-SY5Y cells and provides protection against H(2)O(2). Surprisingly, D3T potentiated oxidative damage caused by AGEs. In comparison to vehicle controls, D3T caused greater AGE-induced cytotoxicity and depletion of intracellular GSH levels while offering no protection against neurite degeneration or protein carbonylation. D3T potentiated AGE-induced reactive oxygen species (ROS) formation, an effect abrogated by inhibitors of PKC and NADPH oxidase. This study suggests that chemical induction of endogenous antioxidant defenses requires further examination in models of diabetes.


Pregnant Women with Inflammatory Bowel Disease Are at Increased Risk of Vitamin D Insufficiency: A Cross-Sectional Study.
Vitamin D insufficiency is prevalent in individuals with inflammatory bowel disease [IBD], as well as in pregnant women; however, the prevalence of vitamin D insufficiency in pregnant women with IBD is unknown. This study assessed the prevalence of vitamin D insufficiency in pregnant women with IBD and the adequacy of recommended supplementation. A cross-sectional study was conducted in pregnant women with inflammatory bowel disease [Crohn's disease = 61, ulcerative colitis = 41] and without inflammatory bowel disease [n = 574]. Chi square tests and log binomial regression were used to examine the prevalence of vitamin D insufficiency. Covariates included ethnicity and season. Adequacy of vitamin D supplementation during pregnancy was also assessed. The prevalence of vitamin D insufficiency [25-OHD ≤75 nmol/L] in those with Crohn's disease was 50.8% (95% confidence interval [CI]: 38.4%-63.2%) and 60.9% [95% CI: 45.3%-74.7%] with ulcerative colitis compared with 17.4% [95% CI: 14.6%-20.8%] without inflammatory bowel disease. Women with inflammatory bowel disease were more likely to be vitamin D insufficient after adjusting for ethnicity and season (Crohn's disease-adjusted relative risk [aRR] = 2.98,;: 2.19-4.04; ulcerative colitis-aRR = 3.61; 95% CI: 2.65-4.93). Despite vitamin D supplementation, 32.3% [95% CI: 17.8%-51.2%] of those with Crohn's disease, 58.3% [95% CI: 37.1%-76.9%] of those with with ulcerative colitis, and 10.8% [95% CI: 6.9%-16.6%] of those without inflammatory bowel disease were still vitamin D insufficient. Pregnant women with inflammatory bowel disease are at increased risk of vitamin D insufficiency compared with those without inflammatory bowel disease. The current guidelines for vitamin D supplementation may be inadequate for pregnant women with inflammatory bowel disease.


Does Economic Abuse Affect the Health Outcomes of Women in Ghana?
Although academically underexplored, economic abuse is common in most societies. Using data collected from 2,289 ever-married Ghanaian women, this study employed regression techniques to examine dimensions of economic abuse (employment sabotage, economic exploitation, and economic deprivation) on the cardiovascular, psychosocial, and overall general health of respondents. Results showed respondents with experiences of economic sabotage had poor psychosocial health. Meanwhile, compared with those with no such experiences, respondents with experiences of economic exploitation not only reported poor psychosocial health but were also more likely to live with cardiovascular diseases. Women with experiences of economic deprivation reported poor psychosocial health, were more likely to live with cardiovascular diseases, and more likely to report poor or good than very good health. Our findings suggest the need to screen for economic abuse as a correlate of poor health among women in Ghana.


XX male syndrome in a cryptorchid stallion.
A bilateral cryptorchid stallion with mild development of mammary glands was identified as an XX male by karyotyping. Necropsy revealed underdeveloped accessory sex organs and hypoplastic, inguinally located testes that were deficient of spermatogonia. Evaluation of routine hormonal profiles (without karyotyping) would have failed to diagnose this syndrome.


Von Hippel-Lindau disease: an overview.
Von Hippel-Lindau disease is a rare, familial disease consisting of multiple tumors, which can present in the eyes, brain, adrenal gland, pancreas, liver, spinal cord, kidneys, or other areas of the body. The renal tumors are primarily renal cell carcinoma. Renal involvement may be the primary manifestation, but most frequently it is a secondary manifestation. This article presents an overview of von Hippel-Lindau disease and the nursing care of the patient with renal involvement.


Responding during reinforcement delay in a self-control paradigm.
Eight pigeons chose between a small, immediate reinforcer and a large, increasingly delayed reinforcer. Responding during the large-reinforcer delays was examined. During large-reinforcer delays, pecks on one key produced the small, immediate reinforcer; pecks on the other key had no effect. Thus, a pigeon could reverse its initial choice of the large, delayed reinforcer, or it could maintain its original choice. Pigeons that made a relatively high number of initial large-reinforcer choices tended to maintain these choices, and those pigeons that actually received a relatively high number of large reinforcers, tended to respond more frequently on the ineffective key during the delay periods. The findings suggest that some previous studies of self-control training in pigeons may have resulted in increased self-control partially due to a lack of opportunity for the pigeons to change their choices.


Dementia and legal competency.
The legal competency or capability to exercise rights is level of judgment and decision-making ability needed to manage one's own affairs and to sign official documents. With some exceptions, the person entitles this right in age of majority. It is acquired without legal procedures, however the annulment of legal capacity requires a juristic process. This resolution may not be final and could be revoked thorough the procedure of reverting legal capacity - fully or partially. Given the increasing number of persons with dementia, they are often subjects of legal expertise concerning their legal capacity. On the other part, emphasis on the civil rights of mentally ill also demands their maximal protection. Therefore such distinctive issue is approached with particular attention. The approach in determination of legal competency is more focused on gradation of it's particular aspects instead of existing dual concept: legally capable - legally incapable. The main assumption represents how person with dementia is legally capable and should enjoy all the rights, privileges and obligations as other citizens do. The aspects of legal competency for which person with dementia is going to be deprived, due to protection of one's rights and interests, are determined in legal procedure and then passed over to the guardian decided by court. Partial annulment of legal competency is measure applied when there is even one existing aspect of preserved legal capability (pension disposition, salary or pension disposition, ability of concluding contract, making testament, concluding marriage, divorce, choosing whereabouts, independent living, right to vote, right to decide course of treatment ect.). This measure is most often in favour of the patient and rarely for protection of other persons and their interests. Physicians are expected to precisely describe early dementia symptoms which may influence assessment of specific aspects involved in legal capacity (memory loss, impaired task execution, language difficulties, loosing perception of time and space, changes in mood and behaviour, personality alterations, loss of interests and initiative). Towards more accurate determination of legal competency the psychometric tests are being used. The appliance of these tests must be guided with basic question during evaluation: "For what is or is not he/she capable?" In prediction of possible dementia development, the modern diagnostic procedures are used as help for potentially demented individuals in order to plan own affairs and by oneself determine future guardian. This ensures the maximal respect and protection of rights among persons with dementia in order to independently manage life one step ahead of progressive illness. Finally, it is to be distinguished medical concept of legal capacity which is universal and judicial concept which is restricted by rules of national legal system differing from country to country.


[Solid organ retransplantation].
The need for solid organ retransplantation is a major factor in the shortage of available organs. Between 1972 and 1992, 56 out of 309 kidney transplants and 2 out of 20 liver transplants performed in our hospital were retransplantations. The present study evaluates local and world experience with organ retransplantations in terms of the medical and ethical issues.


Conformational analysis and receptor modelling of m1 and m2 selective antagonists.
On the basis of an elaborate conformational analysis of m1- and m2-selective antagonists a respective pharmacophore was deduced. This then was introduced into models of the two muscarinic receptor subtypes. These models were constructed starting from bacteriorhodopsin as a template in accordance with alignment data and mutation experiments. The validity of the interaction geometries between ligands and receptor subtypes is supported by a significant correlation between calculated interaction energies and experimentally determined affinity data.