Ultraviolet fluorescence of human sera: I. Sources of characteristic differences in the ultraviolet fluorescence spectra of sera from normal and cancer-bearing humans.
The ultraviolet fluorescence emission spectra of sera from apparently healthy persons and of sera from cancer patients frequently show significantly different curve shapes. A biparametric fluorescence method has been developed to use these deviations to detect patients with malignant diseases (Clin Chem 1986;32:1974-8). However, the pathobiochemical reasons for these differences of diagnostic importance have thus far been unclear. To find a relevant explanation for the described effect, we focused our interest on human serum proteins, the materials mainly responsible for the intrinsic fluorescence of sera in this spectral region. Human sera of various protein compositions were selected according to their protein pattern, determined by cellulose acetate electrophoresis, and their intrinsic fluorescence properties were investigated. We found that the emission spectra of human sera were correlated with their relative protein compositions, albumin and alpha-2 globulins being the most significantly correlated with the fluorescence intensity ratios. Because increased percentages of alpha-2 globulins and decreased percentages of albumin frequently accompany malignancies, we suggest that this condition accounts for the differences between the emission spectra of sera from normal and cancer-bearing humans.


[Not Available].
The paper describes the feat of the Russian Navy medical officers and marines of the Baltic Guard-Marine repart, which gave medical aid to the victims of the earthquake in Calabria (28 December, 1908). The first psychiatrist offering psychiatric assistance to the affected and investigated the psycho-pathological sequelae of the disaster was the Russian research Bachenov. The high assessment by and gratitude of the Italian public for the heroism and self-denying attitude of the Russian medical personnel under the conditions of the earthquake was extensively reflected in the Italian press.


The rise and fall of Escherichia coli O15 in a London teaching hospital.
A marked increase in the prevalence of bacteraemia due to Escherichia coli of serogroup O15 was noted during November and December 1986 at Charing Cross Hospital. This multiresistant strain had been reported by several hospitals in south London. All isolates of E. coli from patients with bacteraemia between October 1986 and the end of September 1988 were assessed for the presence of the O15 antigen and for the unusual pattern of resistance to six antimicrobial agents. As a guide to faecal carriage, isolates from urine were similarly assessed during seven 4-week periods between January 1987 and June 1988. Of the 123 E. coli isolates from blood, 25 (20%) were serogroup O15 and 20 of these expressed the same pattern of multiresistance; 17 of these multiresistant isolates occurred in the 4-month period 1 Nov. 1986-28 Feb. 1987. During the remaining 19 months of the study only eight isolates were serogroup O15 of which only three were multiresistant. In the first 4-week period that urine isolates were studied 21 Jan. 1987-17 Feb. 1987, 26 (13.2%) of the 195 isolates were serogroup O15 of which 20 were multiresistant. The proportion of serogroup O15 isolates fell gradually until, in June 1988, the last period studied, only 8 (4.2%) of the 189 isolates were serogroup O15, of which only one was multiresistant. In a preliminary study of plasmids in six serogroup O15 isolates from blood, three multiresistant isolates and one that was sensitive to chloramphenicol appeared to carry a similar plasmid of c. 100 Mda.(ABSTRACT TRUNCATED AT 250 WORDS)


Sphingosine 1-phosphate receptor 1 inhibition induces a pro-apoptotic signaling cascade in T cells.
Effective immunity requires a large, diverse naïve T cell repertoire circulating among lymphoid organs in search of antigen. Sphingosine 1-phosphate (S1P) and its receptor S1PR1 contribute by both directing T cell migration and supporting T cell survival. Here, we address how S1P enables T cell survival, and the implications for patients treated with S1PR1 antagonists. Contrary to expectations, we found that S1PR1 limits apoptosis by maintaining the appropriate balance of BCL2 family members via restraint of JNK activity. Interestingly, the same residues of S1PR1 that enable receptor internalization are required to prevent this pro-apoptotic cascade. Findings in mice were recapitulated in ulcerative colitis patients treated with the S1PR1 antagonist ozanimod, and the loss of naïve T cells limited B cell responses. Our findings highlight an unexpected effect of S1PR1 antagonists on the ability to mount immune responses within lymph nodes, beyond their effect on lymph node egress, and suggest both limitations and novel uses of this important class of drugs.


Facilitation of alternative one-lung and two-lung ventilation by use of an endotracheal tube exchanger for pediatric empyema during video-assisted thoracoscopy.
Video-assisted thoracoscopic surgery (VATS) has emerged as an innovative and popular procedure for the management of postpneumonic empyema in children refractory to medical response. Alternative uses of two- and one-lung ventilations have been required during VATS. This study evaluated the efficacy of alternating one- and two-lung ventilation through intraoperatively through the same single-lumen endobronchial tube using a tube exchanger during a thoracoscopic procedure for pediatric empyema. Between May 1995 and August 2001, 62 consecutive pediatric patients undergoing VATS for evacuation of the loculated empyema cavity were studied. The same single-lumen endobronchial tube was used, with an indwelling endotracheal tube exchanger in place for readjustment of the tube position to provide alternation of one- and two-lung ventilations in a thoracosopic procedure. Duration of operation, heart rate, mean arterial pressure, peak airway pressure, an partial pressure of oxygen (PaO(2)) and carbon dioxide (PaCO(2)) changes during one- and two-lung ventilations were recorded. The quality of lung deflation and inflation was rated by the surgeon using direct visualization as excellent, fair or poor. The mean operating time was 90 min (range, 50-120 min). No differences were found in heart rate, mean arterial pressure, or PaO(2) during one- and two-lung ventilations. Peak airway pressure and PaCO(2) during two-lung ventilation were significantly higher than during one-lung ventilation. The quality of lung deflation and inflation was judged excellent for all the patients. The VATS procedure can be performed safely and effectively in children using proper anesthetic technique. Retention of a tube exchanger within a single-lumen endobronchial tube an easily provide alternative one- and two-lung ventilations without inducing any significant airway flow obstruction during the operation.


Cataract surgery in patients with neovascular age-related macular degeneration.
To examine the outcome after cataract surgery in patients with neovascular age-related macular degeneration (AMD) treated with intravitreal anti-vascular endothelial growth factor (VEGF) injections in routine clinical practice. We extracted information about patients recorded in electronic databases managing anti-VEGF injections and cataract surgery. We compared Early Treatment of Diabetic Retinopathy Study (ETDRS) visual acuity and frequency of anti-VEGF injections before and after cataract surgery. We identified 89 eyes from 89 patients who had cataract surgery after being treated with a median of 10 (range 3-36) anti-VEGF injections for neovascular AMD. Visual acuity improved by a mean of 7.1 [95% confidence interval (CI) 4.6-9.6] ETDRS letters in the first 6 months after cataract surgery. The need of anti-VEGF injections did not change after cataract surgery with an average of 1.5 in the 6 months before surgery versus 1.7 in the 6 months after surgery (p = 0.25). Visual improvement was greater in patients when the time from latest injection to cataract surgery was lower. Cataract surgery improves vision in patients undergoing treatment for neovascular AMD. Cataract surgery was not associated with an increased need for anti-VEGF treatment and patients who were in active anti-VEGF treatment had better visual outcomes than patients who had cataract surgery after long injection-free periods.


An improved tet-on system for gene expression in neurons delivered by a single lentiviral vector.
In most cases, the successful application of gene therapy requires the development of vectors that can provide regulated control of therapeutic gene expression. We have reconstituted the Tet-On (tetracycline-regulated transgene expression) two-component system in a single lentiviral vector with insertion of a chicken chromatin insulator (cHS4) element between the two expression cassettes. Optimization of this vector included an improved reverse tetracycline-dependent trans-activator (rtTA) sequence developed through HIV viral evolution, and an rtTA-dependent, Tet-responsive element containing modifications of the tetO sequence (TRE-tight1) to improve leaky basal transcription. Transduction of HeLa cells with these lentiviral vectors resulted in a high level of rtTA expression in the presence of doxycycline. In neuronal cells, rtTA expression driven by a neuron-specific enolase (NSE) promoter was more efficient than gene expression from a murine cytomegalovirus promoter. Transgene expression from the NSE promoter also provided tightly regulated gene expression in neurons in vivo.


Highlights of the Fifth International Symposium on Lipid Science and Health.
The International Symposium on Lipid Science and Health (ISLSH) has been organized annually by the Oil Crops Research Institute of Chinese Academy of Agricultural Sciences (OCRI-CAAS) since 2016. The purpose of the symposium was to bring together the leading lipid science and health researchers throughout the world to discuss the current state of knowledge as well as research needs with respect to chemistry and beneficial health properties of lipids. The Fifth International Symposium on Lipid Science and Health was held on October 2020 in Wuhan, Hubei, China. Speakers from China, the United States, Australia, Finland, and other countries delivered wonderful presentations. The presentations covered such diverse topics as lipid profiling and characterization, lipid preparation and modification, lipid improvement and regulation, and lipid nutrition and health. As a record of the symposium proceedings, this special issue comprises a selection of 27 papers from oral presentations and poster contributions and is prefaced by this introduction.


Rural landscape dynamics over time and its consequences for habitat preference patterns of the grey partridge Perdix perdix.
Intensification of agricultural practices has drastically shaped farmland landscapes and generally caused a decline in spatial and temporal heterogeneity, thus leading to changes in habitat quality and food resources and a decline for most farmland birds Europe-wide. The relationship between complex landscape changes and habitat preferences of animals still remains poorly understood. Particularly, temporal and spatial changes in diversity may affect not only habitat choice but also population sizes. To answer that question, we have looked into a severely declining typical farmland bird species, the grey partridge Perdix perdix in a diverse farmland landscape near Vienna to investigate the specific habitat preferences in respect to the change of agricultural landscape over two decades and geographic scales. Using a dataset collected over 7.64 km² and between 2001 and 2017 around Vienna, we calculated Chesson's electivity index to study the partridge's change of habitat selection over time on two scales and between winter and spring in 2017. Although the farmland landscape underwent an ongoing diversification over the two decades, the grey partridges declined in numbers and shifted habitat use to less diverse habitats. During covey period in winter, partridges preferred also human infrastructure reservoirs such as roads and used more diverse areas with smaller fields than during breeding where they selected harvested fields but surprisingly, avoided hedges, fallow land and greening. Known as best partridge habitats, those structures when inappropriately managed might rather function as predator reservoirs. The avoidance behaviour may further be a consequence of increasing landscape structuring and edge effects by civilisation constructions. Besides, the loss in size and quality of partridge farmland is altered by crop choice and pesticides reducing plant and insect food. With declining breeding pairs, the grey partridge does not seem to adjust to these unsustainable landscape changes and farmland practices.


Engineered micro-objects as scaffolding elements in cellular building blocks for bottom-up tissue engineering approaches.
A material-based bottom-up approach is proposed towards an assembly of cells and engineered micro-objects at the macroscale. We show how shape, size and wettability of engineered micro-objects play an important role in the behavior of cells on these objects. This approach can, among other applications, be used as a tool to engineer complex 3D tissues of clinically relevant size.


Effect of triangular pillar geometry on high- frequency piezocomposite transducers.
Piezocomposite materials are used extensively in biomedical transducer array fabrication. However, developing high-frequency piezocomposite materials for imaging systems is still a challenge due to the extremely small pillar dimensions required to avoid the interference from lateral resonances. The use of triangular pillar piezocomposite material has been shown to suppress lateral resonances that appear in square pillar composite designs. To further understand how the geometry of the pillars affects the lateral resonances, piezocomposite materials with triangular pillars of different angles have been simulated and fabricated. Simulations were performed on composite transducers of 70-microm pitch, 18-microm kerf width, and 100-microm thickness with isosceles triangular pillars in which the isosceles angle varied from 30 degrees to 60 degrees using a finite-element analysis. By varying the pillar geometry, the composite transducers show large differences in lateral resonances. The simulation results demonstrate that the composite with 45 degrees angle pillars has the lowest secondary pulse amplitude. The secondary pulse becomes larger when the pillar angle deviates from 45 degrees . To study whether the pillar height (which determines the resonance frequency) and aspect ratio would change the optimum angle, composites with 40-mum pitch, 15-microm kerf width, and 45-microm thickness were also simulated. Finally, the composite with triangle pillars was compared with composites with square and round pillars. The simulation results show that the 45 degrees triangular pillar geometry is, for high-frequency applications, the best configuration among all investigated in this work. Composite samples have also been fabricated to confirm results from finite-element modeling. Acoustical and electrical measurements were carried out to compare with theoretical predictions. Three composite transducers with pillar angles of 30 degrees, 45 degrees, and 60 degrees were fabricated using a dice-and-fill technique. The measured electrical impedances and one-way pulse responses agreed well with the theoretical predictions and confirm the optimal nature of the 45 degrees design.


Computational study of the effect of glyoxal-sulfate clustering on the Henry's law coefficient of glyoxal.
We have used quantum chemical methods to investigate the molecular mechanism behind the recently reported ( Kampf , C. J. ; Environ. Sci. Technol . 2013 , 47 , 4236 - 4244 ) strong dependence of the Henry's law coefficient of glyoxal (C2O2H2) on the sulfate concentration of the aqueous phase. Although the glyoxal molecule interacts only weakly with sulfate, its hydrated forms (C2O3H4 and C2O4H6) form strong complexes with sulfate, displacing water molecules from the solvation shell and increasing the uptake of glyoxal into sulfate-containing aqueous solutions, including sulfate-containing aerosol particles. This promotes the participation of glyoxal in reactions leading to secondary organic aerosol formation, especially in regions with high sulfate concentrations. We used our computed equilibrium constants for the complexation reactions to assess the magnitude of the Henry's law coefficient enhancement and found it to be in reasonable agreement with experimental results. This indicates that the complexation of glyoxal hydrates with sulfate can explain the observed uptake enhancement.


Influence of surface cooling and rewarming on whole-body oxygen supply-demand balance.
The influence of moderate hypothermia induced by surface cooling was studied on haemodynamic variables and whole-body oxygen consumption in a 43-yr-old female undergoing clipping of multiple cerebral aneurysms. Decreasing oesophageal temperature to 32 degrees C lowered the whole-body oxygen consumption by about 40%. The decrease in oxygen consumption was matched by a proportional decrease in cardiac output. During the rewarming phase, there was a progressive increase in oxygen consumption, which was matched by a proportional increase in cardiac output. This resulted in a constant oxygen extraction ratio, as evidenced by oxyhaemoglobin saturation which remained constant at different body temperatures. While the temperature-corrected PVO2 decreased progressively with cooling, the temperature-uncorrected PVO2 remained constant at all body temperatures. Thus the use of temperature-uncorrected PO2 during hypothermia may simplify clinical interpretation because of our familiarity with normothermic PO2 values and the normothermic oxyhaemoglobin dissociation curve.


The value of laparoscopy in localising the impalpable undescended testis.
The impalpable undescended testis poses a diagnostic and management problem for the surgeon. This report describes the technique of laparoscopy in localising such a testis in 38 patients (45 testes). The testis was absent or atrophic in 11 patients (24.5%); it was in the inguinal canal in 7 cases (15.5%) and within the abdomen in 27 (60%). A distinction is made between the truly abdominal testis and one which lies close to the internal ring (just canalicular). The influence of the endoscopic findings on the operative approach is detailed.


GATA3 Positivity in Benign Radiated Prostate Glands: A Potential Diagnostic Pitfall.
Histologic changes following radiation therapy to the prostate include multilayering of glands, atrophy, squamous metaplasia, and often marked random nuclear atypia. We have seen multiple consultation cases where the differential diagnosis of these radiated prostate glands included urothelial carcinoma, with multilayered to solid-appearing proliferations that were positive by immunohistochemistry for GATA3. To formally investigate this issue, 30 cases of benign prostate tissue with radiation atypia, from 1990 to 2015, were obtained from our institution. Cases were evaluated by immunohistochemistry for the prostate-specific markers prostate-specific antigen (PSA), P501S (Prostein), and NKX3.1 and urothelial markers GATA3 and uroplakin 2. GATA3 was positive in 100% of cases, with 70% showing moderately strong to strong staining in a mostly patchy manner within a gland. PSA was positive in 93.3% of cases, with 89.2% showing moderately strong to strong staining in a mostly diffuse manner. P501S was positive in 96.7% of cases, with 93.1% showing moderately strong to strong staining in a mostly patchy manner. NKX3.1 was positive in 82.8% of cases, with 33.3% showing moderately strong to strong staining in a mostly patchy manner. Uroplakin 2 was negative in 100% of cases. Our findings highlight that GATA3 is often positive in benign prostate glands with radiation atypia, which along with the morphologic features present a pitfall for the misdiagnosis of urothelial carcinoma. A combination of PSA and P501S is the best prostate-specific panel for use in radiated prostate, with the caveat that they are often patchy and do not stain all radiated glands.


A general method to assess similarity of protein structures, with applications to T4 bacteriophage lysozyme.
A method is proposed that permits the structural similarity between any pair of proteins to be analyzed in a completely general manner. In the proposed procedure, all possible structural segments of a given length from one protein are compared with all possible segments from the other protein. This set of comparisons reveals any structural similarities between the two proteins being compared, and also provides a basis for estimating the probability that a particular degree of structural homology could have occurred by chance. Application of the method to the comparison of T4 bacteriophage lysozyme and carp calcium-binding protein suggests that the previously reported structural similarity between parts of these two proteins [Tufty, R. M.& Kretsinger, R. H. (1975) Science 187, 167-169] is no better than would be expected by chance. On the other hand, the structural correspondence between phage lysozyme and hen egg-white lysozyme [Rossman, M.G. & Argos, P. (1976) J. Mol. Biol. 105, 75-96] does appear to be significant.


Insulin-like growth factor-1 stimulation of lymphopoiesis.
We show that treatment of adult mice with recombinant human insulin-like growth factor 1 (rhIGF-1) induces striking modifications in lymphocyte number and function. 9-mo-old male mice received rhIGF-1 (4 mg/kg per d) or its excipient by subcutaneous infusion from osmotic minipumps for 7 or 14 d. Mice were weighed daily and bled at sacrifice; the spleen and thymus were harvested and single cell suspensions were made for analysis of cell phenotype and cell number. The responses of splenocytes to mitogens (concanavalin A, lipopolysaccharide, and pokeweed mitogen), alloantigens and dinitrophenyl ovalbumin were measured. After either 7 or 14 d of treatment, rhIGF-1 had an overall whole-body anabolic effect, resulting in increased body and organ weights with prominent increases in the weight of the spleen and thymus. Furthermore, the rhIGF-1 treated mice were normoglycemic but had reduced blood urea nitrogens, again reflecting the anabolic activity of rhIGF-1. The increased spleen and thymus weights were associated with a large increase in the number of lymphocytes in both organs. In addition to an increase in T cells, specifically CD4+ T cells, a dramatic increase in splenic B cells was also observed. This increase was accompanied by an enhanced responsiveness to dinitrophenyl ovalbumin resulting in increased immunoglobulin production. However, despite the increases in cellularity, there was a decrease in the in vitro responses of spleen cells to mitogens after 7 d of rhIGF-1 treatment. In contrast, treatment with rhIGF-1 for 14 d increased both the cell number and mitogenic responses of splenocytes suggesting that some time is required for the cells populating the peripheral organs to gain mitogenic responsiveness. It is clear from these data that rhIGF-1, at doses that have whole-body anabolic activity, can expand cell number in lymphoid tissue in a normal adult mouse. These dual effects of rhIGF-1, of increasing lymphocyte number and activity, indicate that, in a normal adult animal, rhIGF-1 can cause major changes in lymphoid tissues that are of potential benefit to the functioning of the immune system.


"Chromohysteroscopy" for evaluation of endometrium in recurrent miscarriage.
"Chromoendoscopy" results in 34 recurrent miscarriage (MR) patients in whom conventional hysteroscopy did not show any apparent endometrial pathology. 5 ml of 1% methylene blue dye was introduced through the hysteroscopic inlet. The study group was classified according to the staining characteristics. Group I included 19 patients in whom focal dark staining was observed. Group II included 15 patients in whom diffuse light blue staining was observed. There was no significant difference between the two groups in age, smoking, status, BMI, number of miscarriages and in mean gestational age of the miscarriages. Time to hysteroscopy after the last miscarriage was shorter in Group I (63.9 vs 95.3 days). Then, the study group was classified according to the histopathology result. Group I included ten cases of endometritis while Group II included 24 cases with a normal histopathology. The mean number of miscarriages was higher in Group I (3.4 vs 2.5). Chromohysteroscopy improves the efficacy of hysteroscopy in RM cases and is warranted after three miscarriages in two cycles time.


Free ribosomal RNA genes in Paramecium are tandemly repeated.
The genes coding for 17S and 25S rRNA in Paramecium tetraurealia were isolated. The macronuclear ribosomal DNA (rDNA) exists as relatively small, extrachromosomal molecules with both linear and circular forms. Electron microscopy and restriction endonuclease analysis revealed that the rDNA is arranged as tandem repeats with an average repeat size of 5.5 X 10(6) daltons. Some heterogeneity of repeat lengths was found both by electron microscopy and by restriction enzyme analysis. The rDNA does not snap back after denaturation. This study provides additional evidence that extrachromosomal rDNA may be a common feature among lower eukaryotes. However, in contrast to several other cases, the rDNA of Paramecium is not palindromic, but occurs as tandem repeats as in higher eukaryotes.


Nice guys: Homozygocity for the TPH2 -703G/T (rs4570625) minor allele promotes low aggressiveness and low anxiety.
Tryptophan hydroxylase (TPH) is the rate-limiting enzyme in the synthesis of serotonin. We examined whether the TPH2 polymorphism -703G/T (rs4570625) is associated with aggressiveness and impulsivity, and the prevalence of psychiatric disorders, in a population-representative sample. We used self and proxy reports on aggressive behaviour in the younger birth cohort of the longitudinal Estonian Children Personality, Behaviour and Health Study collected at age 25, and earlier collected impulsivity and related data of both ECPBHS cohorts. The TT homozygous males reported less aggressive behaviour in the Life History of Aggression interview at age 25. They also had significantly lower scores in Illinois Bully Scale peer reports, and less ADHD symptoms rated by teachers both at ages 9 and 15. The TT homozygotes of both sexes had the lowest Maladaptive Impulsivity at ages 18 and 25, and the highest Adaptive Impulsivity at age 25. The TT homozygotes also had low depressiveness and trait anxiety by age 25, and the odds ratio for the prevalence of anxiety disorders was 9.38 for the G-allele carriers. The main limitation of the study is the naturally occurring low number of subjects with the TT genotype. Subjects with the TPH2 rs4570625 TT genotype, especially males, exhibit less aggression and a favourable impulsivity profile, and develop anxiety disorders by young adulthood less often.


[Levels of serum brain natriuretic peptide and the correlation to heart function in children with Kawasaki disease].
To study serum levels of brain natriuretic peptide (BNP) in children with Kawasaki disease (KD) and the correlation between BNP levels and the heart function. Forty-three children with KD and thirty healthy children were enrolled. Serum levels of BNP were measured using ELISA. KD children received an echocardiographic examination, including measurements of left ventricular ejection fraction (LVEF), left ventricular shorten fraction (LVSF), cardiac index (CI) and left ventricular inflow velocity through the mitral annulus. Mean serum level of BNP at the acute stage in children with KD was significantly higher than that at the recovery stage as well as the control group (p<0.01). The LVEF, LVSF and CI levels at the acute stage were significantly lower than those at the recovery stage in children with KD (p<0.05). The linear regression analysis showed that the BNP level was negatively correlated with the levels of LVEF, LVSF and CI (r=-0.63, -0.52, -0.53, p<0.05). The serum BNP levels increase significantly in KD children at the acute stage, and are negatively correlated with the levels of LVEF, LVSF and CI. Measurement of serum BNP level is useful for the early diagnosis of KD.


Persistent umbilical discharge from an omphalomesenteric duct cyst containing gastric mucosa.
Umbilical discharge in infancy is often attributed to infection or an umbilical granuloma. It is important to investigate if such a discharge is due to an underlying congenital abnormality because corrective surgical intervention may then be required. We present the first case of an infant with a persistent umbilical discharge from an omphalomesenteric duct cyst. The discharge was associated with periumbilical dermatitis. The dermatitis was most likely due to irritation of the skin by gastric acid produced by the ectopic gastric mucosa contained in the omphalomesenteric duct cyst. Both discharge and dermatitis resolved after surgical removal of the cyst.


Previous exposure to chronic intermittent hypoxia blunts the development of one-kidney, one-clip hypertension in rats.
What is the central question of this study? Chronic intermittent hypoxia (CIH) and one-kidney, one-clip experimental models lead to sympathetic overactivity and hypertension. The present study explored the impact of previous exposure to CIH on one-kidney, one-clip renal hypertension; we hypothesized that CIH potentiates its development. What is the main finding and its importance? The development of one-kidney, one-clip renal hypertension was attenuated by previous exposure to CIH, and this protective effect was eliminated by carotid body denervation. These findings indicate that inputs from peripheral chemoreceptors in CIH-preconditioned rats play a role in preventing the increase in sympathetic activity and arterial pressure induced by one-kidney, one-clip renal hypertension. Chronic intermittent hypoxia (CIH) and one-kidney, one-clip (1K, 1C) experimental models lead to sympathetic overactivity and hypertension. We hypothesized that previous exposure to CIH potentiates the development of 1K, 1C renal hypertension. Male rats were divided into the following four groups: Control-1K, 1C, maintained under normoxia followed by 1K, 1C surgery (n = 19); Control-Sham, maintained under normoxia, followed by sham surgery (n = 19); CIH-1K, 1C, exposed to CIH (10 days) and 1K, 1C surgery (n = 19); and CIH-Sham, exposed to CIH and sham surgery (n = 18). Animals were catheterized 8 days after 1K, 1C or Sham surgeries and cardiovascular and respiratory parameters recorded on the following day. Baseline mean arterial pressure was higher in Control-1K, 1C than in Control-Sham rats (P < 0.05) and was higher in CIH-1K, 1C than in CIH-Sham rats (P < 0.05). However, the increase in mean arterial pressure in CIH-1K, 1C animals was significantly blunted in comparison to Con-1K, 1C rats (P < 0.05), indicating that previous exposure to CIH attenuates the development of renal hypertension. Systemic administration of hexamethonium, a ganglionic blocker, promoted a larger hypotensive response in Con-1K, 1C compared with CIH-1K, 1C rats (P < 0.05), suggesting that sympathetic activity was attenuated in rats previously exposed to the CIH protocol. In addition, removal of the carotid bodies before 1K, 1C renal hypertension eliminated the protective effect of CIH preconditioning on the development of the 1K, 1C hypertension. We conclude that previous exposure to CIH attenuates the development of renal hypertension via a carotid body-dependent mechanism.


Postsynaptic VAMP/Synaptobrevin Facilitates Differential Vesicle Trafficking of GluA1 and GluA2 AMPA Receptor Subunits.
Vertebrate organisms adapt to a continuously changing environment by regulating the strength of synaptic connections between brain cells. Excitatory synapses are believed to increase their strength by vesicular insertion of transmitter glutamate receptors into the postsynaptic plasma membrane. These vesicles, however, have never been demonstrated or characterized. For the first time, we show the presence of small vesicles in postsynaptic spines, often closely adjacent to the plasma membrane and PSD (postsynaptic density). We demonstrate that they harbor vesicle-associated membrane protein 2 (VAMP2/synaptobrevin-2) and glutamate receptor subunit 1 (GluA1). Disrupting VAMP2 by tetanus toxin treatment reduces the concentration of GluA1 in the postsynaptic plasma membrane. GluA1/VAMP2-containing vesicles, but not GluA2/VAMP2-vesicles, are concentrated in postsynaptic spines relative to dendrites. Our results indicate that small postsynaptic vesicles containing GluA1 are inserted directly into the spine plasma membrane through a VAMP2-dependent mechanism.


Spinal Cord Infarction in Hemoglobin SC Disease as an Amusement Park Accident.
Spinal cord infarction (SCI) is extremely rare in children, and only 2 other reports have described the occurrence of SCI in patients with hemoglobin SC disease (HbSC). Amusement park accidents are serious injuries. Patients with preexisting conditions, such as hypertension, cardiac disease, and recent back or neck injuries, may be at an increased risk. We report the case of a 12-year-old girl with HbSC with a past history of only 2 admissions for pain crises, who presented to the emergency department with symptoms of SCI after riding a roller coaster. Fibrocartilaginous embolism (FCE) is an increasingly recognized cause of SCI after events that put strain on the axial skeleton, such as many amusement park rides. Although radiologic criteria for FCE have been proposed, FCE remains a diagnosis of exclusion. To the best of our knowledge, this is the first documented case of SCI in a patient with HbSC and the first case of FCE after an amusement park accident. This case report highlights that HbSC may confound the differential diagnosis of SCI and aims to document an association with FCE in pediatric patients.


The role of evidence-based media advocacy in the promotion of tobacco control policies.
This article discusses the role of evidence-based media advocacy in the promotion of tobacco control policies. Evidence is a driving force for campaigns seeking to implement a tobacco control policy. An effective campaign is based in evidence that demonstrates why a policy should be implemented, and what the potential benefits are. Media advocacy is the process of disseminating information through the communications media where the aim is to effect action, such as a change of policy, or to alter the public's view of an issue. Discussion focuses on: 1) the importance of, and methods for, collecting and communicating evidence and information to make it clear and usable for legislators, the media, and the public; and 2) the role of earned and paid media in advancing tobacco control issues. The discussion is made within the context of a specific advocacy example; in this case the 2010 campaign to increase the tobacco tax in Mexico.


Direct energy delivery improves tissue perfusion after resuscitated shock.
Conventional resuscitation (CR) from hemorrhagic shock (HS) does not restore intestinal blood flow. Indicators of anaerobic metabolism suggest that cellular energy production also is compromised. We hypothesize that the direct intravenous delivery of lipid-encapsulated high-energy phosphates to cells improves intestinal perfusion during HS and resuscitation (RES). MAP (MAP) was monitored in male rats (200 g), terminal ileum microvessel diameters were measured by in vivo videomicroscopy, and blood flow (Doppler velocimetry) was calculated. Cellular energy delivery was accomplished by intravenous infusion during RES of fusogenic unilamellar lipid vesicles that contain adenosine triphosphate (ATP; VitaSol). Our protocol was HS to 50% baseline MAP for 60 minutes, 30 minutes of RES, and continued microscopy observation for 120 minutes. Experimental groups (n=8 each) were HS+CR (group I); HS+CR+ VitaSol (group II); HS+CR+Vehicle, Vehicle is the phospholipid vesicles without magnesium ATP, (group III); HS+ VitaSol (group IV); sham-operated control+VitaSol (group V); and a time-matched sham-operated control (group VI). The survival outcome and total tissue water from wet weight/dry weight ratio as a function of adjunct VitaSol resuscitation were evaluated in separate intact animal experiments. HS caused a selective vasoconstriction of the intestinal inflow arterioles (100 microm), which was not seen in the smaller intestinal premucosal arterioles (7-15 microm). CR, which restored baseline hemodynamics, resulted in an initial restoration of intestinal microvascular diameters at all arteriolar levels. However, this was followed by a progressive vasoconstriction and hypoperfusion in premucosal vessels at 120 minutes after RES (-20.48% +/- 2.95% from baseline diameters). In contrast, VitaSol with CR caused enhanced premucosal dilation (+34.27% +/- 4.62%) and augmented flow (+20.50% +/- 10.70%) above prehemorrhage baseline. Vesicles alone had no effect, and VitaSol alone caused only a modest dilation. CR of moderate HS (40% of baseline MAP for 60 minutes, n=10) caused 20% mortality, whereas adjunct VitaSol resuscitation had a 100% survival and less tissue water content. Our data confirms that CR causes progressive intestinal hypoperfusion. Cellular resuscitation with direct intravenous energy delivery improves intestinal perfusion after CR and results in improved survival and less tissue edema.


Experimental investigation of quantum entropic uncertainty relations for multiple measurements in pure diamond.
One unique feature of quantum mechanics is the Heisenberg uncertainty principle, which states that the outcomes of two incompatible measurements cannot simultaneously achieve arbitrary precision. In an information-theoretic context of quantum information, the uncertainty principle can be formulated as entropic uncertainty relations with two measurements for a quantum bit (qubit) in two-dimensional system. New entropic uncertainty relations are studied for a higher-dimensional quantum state with multiple measurements, and the uncertainty bounds can be tighter than that expected from two measurements settings and cannot result from qubits system with or without a quantum memory. Here we report the first room-temperature experimental testing of the entropic uncertainty relations with three measurements in a natural three-dimensional solid-state system: the nitrogen-vacancy center in pure diamond. The experimental results confirm the entropic uncertainty relations for multiple measurements. Our result represents a more precise demonstrating of the fundamental uncertainty principle of quantum mechanics.


Chemical sympathectomy and diurnal fluctuations of noradrenaline calorigenic action in the rat.
In the rat, in which a diurnal fluctuation of the sensitivity to noradrenaline was previously found, the effect of injected 6-hydroxydopamine (6-OHDA) was investigated. The heat production and catecholamines contents in the interscapular brown adipose tissue, heart and adrenals were measured. Chemical sympathectomy induces a disappearance of diurnal fluctuation in the sensitivity to injected noradrenaline. In these animals a lower capacity for heat production was found. However, a significant calorigenic effect of injected noradrenaline in 6-OHDA-treated animals was still present. In sympathectomized animals a depletion of noradrenaline from interscapular brown adipose tissue and the heart was observed. Besides, a change in adrenaline/noradrenaline ratio was found in the adrenals.


Sitting and supine esophageal pressures in overweight and obese subjects.
Esophageal pressure (P(Es)) can be used to approximate pleural pressure (P(pl)) and might be clinically useful, particularly in the obese e.g., to guide mechanical ventilator settings in critical illness. However, mediastinal artifact (the difference between true P(pl) and P(Es)) may limit acceptance of the measurement, and reproducibility of P(Es) measurements remains unknown. Therefore, we aimed to assess the effect of body posture on P(Es) in a cohort of obese, but healthy subjects, some of whom had multiple measurements, to address the clinical robustness of esophageal manometry. Twenty-five overweight and obese subjects (BMI > 25 kg/m(2)) and 11 control lean subjects (BMI < 25 kg/m(2)) underwent esophageal manometry with pressures measured seated and supine. Twenty overweight and obese subjects had measurements repeated after ~1 to 2 weeks. Anthropometric data and sitting and supine spirometry were recorded. The average end-expiratory P(Es) sitting and supine were greater in the overweight and obese group than the lean group (sitting -0.1 ± 2.1 vs. -3.3 ± 1.2 cm H(2)O, supine 9.3 ± 3.3 vs. 6.9 ± 2.8 cm H(2)O, respectively). The mean differences between repeated measurements were small (-0.3 ± 1.7 cm H(2)O sitting and -0.1 ± 1.5 cm H(2)O supine). P(Es) correlated with a number of anthropometric and spirometric variables. In conclusion, P(Es) are slightly greater in overweight and obese subjects than lean subjects; but changes with position are similar in both groups. These data indicate that mediastinal weight and postural effects on P(Es) are within a clinically acceptable range, and suggest that esophageal manometry can be used to inform clinical decision making across wide range of body types.


Body mass index and physical function in older women.
We modified existing standardized measurement tools in the Physical Performance Test and tasks from the Frailty and Injuries: Cooperative Studies of Intervention Technique Study to evaluate physical function in older women. Our objectives were (1) to characterize physical function themes based on combinations of tasks (deriving factors or components) and (2) to quantify the correlation between derived factors and body mass index (BMI). Nutrition risk screens from enrollees in a Medicare-managed risk program served as the sampling frame. To obtain adequate representation for a range of BMI, a random sample was obtained of 90 women from the following BMI strata: BMI, 22 to <27 kg/m(2); BMI, 27 to <30 kg/m(2); and BMI, > or =30 kg/m(2). Subjects were asked to perform a series of 18 functional tasks during a home visit. The mean age was similar in the three BMI groups with an overall mean age of 71 +/- 4.9 years (SD). Factors characterized by lower-body function, upper-body function, coordination, and strength were responsible for 30%, 11%, 9%, and 9% of the variance in task scores, respectively. BMI, controlling for age, explained 5%, 14%, 3%, and 0% of the variation in these factors, respectively. Higher BMI is associated significantly with poorer upper- and lower-body function but is not associated significantly to strength or coordination. Higher BMI seems to differentially impede specific aspects of physical function, especially upper-body function, and to a lesser extent, lower-body function. BMI does not seem to be associated with levels of coordination or strength. Better understanding of how BMI impacts physical function will aid in the design of interventions to promote independent living in elderly, obese women.


Tumor recurrence and drug resistance properties of side population cells in high grade ovary cancer.
The presence of subset of cancer stem cells (CSCs) called "Side population" (SP) cells has been identified in several solid tumors, responsible for treatment failure especially chemotherapy, and cancer relapse. The present study was aimed to isolate and characterize cancer stem like cells side population cells from high grade ovarian cancer. The collected cancer samples were analyzed for presence of SP cells by FACS using Hoechst 33342 exclusion technique. Further the FACS sorted SP and non-SP cells were subjected to analysis of stem cell surface protein expression by western blot and immunocytochemistry, drug resistance and sphere formation assay. By FACS, we have identified 3.7% of cancer stem cell like side population cells in ovarian cancer whose prevalence was reduced to 0.5% upon treatment with verapamil an inhibitor of ABC transporter. Further, these sorted SP cells showed over expression of ABCG2 (ABC transporter), stem cell proteins such as CD144, CD44, EpCAM and antiapoptotic factor Bcl-2. Also the SP cells showed high resistance to chemotherapy drugs, have high survival rate and they are highly potential to form tumor spheres. Our data suggest that ovarian cancer contain small sub-population of side population cells which shares some characteristics of stem cells. The co-expression of ABC transporters and stem cells surface markers in SP cells may associate with resistance to chemotherapeutic agents, apoptosis and also supports a role for these cells in tumor recurrence, metastasis and invasion.


Local cerebral glucose abnormalities in mild closed head injured patients with cognitive impairments.
Mild-moderate closed head injury (CHI) can be followed by neuropsychological impairments in recent memory and attention, despite the absence of discernible structural abnormalities in a significant number of patients. To determine whether CHI may result in cerebral glucose metabolic abnormalities, we used fluorodeoxyglucose (FDG) technique with PET imaging to measure local cerebral metabolic rates for glucose (LCMRGlu) in three CHI patients and three matched normal controls. The CHI patients were between 3-12 months post-injury. All had deficits in attention and recent memory shown by neuropsychological testing. CT, MRI, EEG and drug screens were negative at the time of PET scanning. Subjects were engaged in a vigilance task throughout the initial 30 min following FDG administration. Group comparisons were made using t tests. There were no significant group differences found in global glucose metabolic rate. Nevertheless, the CHI group exhibited significantly decreased LCMRGLu in medial temporal, posterior temporal, and posterior frontal cortices, as well as in the left caudate nucleus. LCMRGlu was significantly increased, relative to controls, in anterior temporal and anterior frontal cortices. These results suggest that CHI patients can have regional glucose metabolic abnormalities, indicative of altered neuronal function, despite the absence of discernible anatomic abnormalities.


Calcineurin Aalpha but not Abeta augments ICl(Ca) in rabbit pulmonary artery smooth muscle cells.
Activation of Ca(2+)-dependent Cl(-) currents (I(Cl(Ca))) increases membrane excitability in vascular smooth muscle cells. Previous studies showed that Ca(2+)-dependent phosphorylation suppresses I(Cl(Ca)) in pulmonary artery myocytes, and the aim of the present study was to determine the role of the Ca(2+)-dependent phosphatase calcineurin on chloride channel activity. Immunocytochemical and Western blot studies with isoform-specific antibodies revealed that the alpha and beta forms of the CaN catalytic subunit are expressed in PA cells but that only the alpha variant translocated to the cell periphery upon a rise in intracellular [Ca(2+)]. I(Cl(Ca)) evoked by pipette solutions containing a [Ca(2+)] set at 500 nm was considerably larger when the pipette solution included constitutively active CaN containing the alpha catalytic isoform. This stimulatory effect was lost by boiling the enzyme or by the inclusion of a specific CaN inhibitory peptide and was not shared by the inclusion of the beta form of the catalytic subunit. In the absence of constitutively active CaN, cyclosporin A, an inhibitor of CaN, suppressed I(Cl(Ca)) evoked by 500 nm Ca(2+) when the current amplitude was relatively large but was ineffective in cells with smaller currents. In perforated patch recordings, cyclosporin A consistently inhibited I(Cl(Ca)) evoked as a consequence of Ca(2+) influx through voltage-dependent calcium channels. These novel data show that in PA myocytes activation of I(Cl(Ca)) is enhanced by Ca(2+)-dependent dephosphorylation and that the regulation of this conductance is highly isoform-specific.


Ability of optical coherence tomography-determined ganglion cell complex thickness to total retinal thickness ratio to diagnose glaucoma.
To evaluate the usefulness of the spectral-domain optical coherence tomography (SD OCT)-determined ganglion cell complex thickness to total retinal thickness ratio (G/T ratio) in diagnosing glaucoma. A total of 99 eyes with primary open-angle glaucoma and 35 normal eyes were enrolled in the study. SD OCT (RTVue-100) was used to measure the macular ganglion cell complex thickness, total retinal thickness, outer retinal thickness, and circumpapillary retinal nerve fiber layer (RNFL) thickness. A new macular parameter, the G/T ratio, was also calculated. The ability of each parameter to diagnose glaucoma was examined by analyzing the area under the receiver operating characteristics curve (AUROC) and the sensitivity at fixed specificity. The G/T ratio was 36.0 ± 1.5% in normal eyes, 31.8 ± 1.7% in early glaucoma, and 30.2 ± 2.6% in advanced glaucoma. These decreases in the ratio were statistically significant. For the AUROC, the individual SD OCT parameters were 0.982 for the G/T ratio, 0.968 for the macular ganglion cell complex thickness, 0.942 for the RNFL thickness, and 0.841 for the total retinal thickness. The AUROC for the G/T ratio was significantly higher than that seen for the total retinal and RNFL thicknesses (P<0.05). Analyses of the sensitivity at a specificity of >90% indicated that the G/T ratio (sensitivity, 93.94%) was the best diagnostic parameter. Decreases in the G/T ratio occur during the early stages of glaucoma. When using SD OCT to diagnose glaucoma, the G/T ratio may improve the diagnostic ability of the macular parameter.


Evaluation of the Intel Xeon Phi 7120 and NVIDIA K80 as accelerators for two-dimensional panel codes.
To optimize the geometry of airfoils for a specific application is an important engineering problem. In this context genetic algorithms have enjoyed some success as they are able to explore the search space without getting stuck in local optima. However, these algorithms require the computation of aerodynamic properties for a significant number of airfoil geometries. Consequently, for low-speed aerodynamics, panel methods are most often used as the inner solver. In this paper we evaluate the performance of such an optimization algorithm on modern accelerators (more specifically, the Intel Xeon Phi 7120 and the NVIDIA K80). For that purpose, we have implemented an optimized version of the algorithm on the CPU and Xeon Phi (based on OpenMP, vectorization, and the Intel MKL library) and on the GPU (based on CUDA and the MAGMA library). We present timing results for all codes and discuss the similarities and differences between the three implementations. Overall, we observe a speedup of approximately 2.5 for adding an Intel Xeon Phi 7120 to a dual socket workstation and a speedup between 3.4 and 3.8 for adding a NVIDIA K80 to a dual socket workstation.


A study of medial pallidotomy for Parkinson's disease: clinical outcome, MRI location and complications.
We have studied the effects of unilateral ventral medial pallidotomy in 26 patients with medically intractable Parkinson's disease with marked drug-induced dyskinesias. Preoperatively, all patients were assessed during one 5-day admission according to the Core Assessment Programme for Intracerebral Transplantation (CAPIT) protocol, including rating in the 'practically defined off' and 'best on' states before and during a single-dose levodopa challenge. Motor performance was assessed with subset categories of the Unified Parkinson's Disease Rating Scale (UPDRS), timed motor tests and a standard dyskinesia rating scale. Pallidotomy was performed under stereotaxic CT guidance with intra-operative extracellular microelectrode recording made from the basal ganglia. All patients were re-assessed 3 months postoperatively and a subgroup (n = 9) have so far also been re-assessed after 1 year. Pre- and postoperative performance scores were compared in order to determine which categories of performance improved postoperatively. Significance was accepted at P < 0.005 in order to take into account the multiple number of comparisons performed. Patient medication was compared pre- and postoperatively and the morbidity associated with surgery was also recorded. The most significant improvement postoperatively was the diminution of 'on' dyskinesias contralaterally (67%, P = 0.0001); however, ipsilateral (45%, P = 0.0006) and axial (50%, P = 0.0008) dyskinesias also improved. Contralateral to pallidotomy, the median 'off' motor UPDRS score improved by 27% (P = 0.001) and a significant improvement was also observed in contralateral rigidity by 25% (P = 0.001). There were trends towards improvement in contralateral tremor (33%, P = 0.016) and bradykinesia (24%, P = 0.013) scores. Ipsilateral rigidity improved by 22% (P = 0.005), but other ipsilateral motor scores did not alter significantly. The 'off' gait/postural instability score and 'off' walking time showed marginally significant improvements by 7% (P = 0.007) and 29% (P = 0.014), respectively. On medication, no significant postoperative improvements in parkinsonism were detected. Anti-parkinsonian medication increased by 11% postoperatively. In the subgroup who were available for assessment 1 year postoperatively, responses were generally maintained. Two (7.7%) of the 26 patients had fatal complications (one cerebral haemorrhage and one haemorrhagic infarct) directly related to surgery. Among the remaining 24 patients, four (15.4% of the total 26) had major complications (two persisting and two transient). Ten patients (38.5%) had minor complications. The majority of the complications (major and minor) occurred in the earlier operated patients and the complication rate subsequently declined with increasing operative experience. The remaining 10 patients (38.5%) had no significant side-effects. One of these 10 patients died from an incidental malignant glioma 6 months postoperatively. These findings confirm that levodopa-induced dyskinesias are dramatically reduced following ventral medial pallidotomy and constitute the principal indication for pallidotomy. Improvements in underlying parkinsonism were of smaller magnitude. Pallidotomy may also offer some patients an opportunity to increase antiparkinsonian medication. Patient selection for medial pallidotomy should, therefore, be based largely on anticipated improvements in levodopa-induced dyskinesias, but this must be balanced against the associated morbidity and mortality.


Gangrenous Cystitis Secondary to a Spontaneous Hematoma of the Lesser Pelvis.
Gangrenous cystitis is considered a life-threatening but rather rare clinical entity due to the widespread use of antibiotics. We herein report a case of a 78-year-old female with gangrenous cystitis secondary to a spontaneous expanded hematoma of the lesser pelvis who underwent partial cystectomy followed by bilateral ureterostomies with no favorable outcome.


Psychiatry's Dark Secrets: Black Lives Don't Matter.
There have been significant advances in the diagnosis and treatment of psychiatric disorders; however, racial disparities continue to create inequity in mental health care. In this commentary, we explore mental health disparities disfavoring African Americans in the psychiatric literature. We discuss how discrimination over time has resulted in a difference of perception, misdiagnoses, and conflicts in patient care. The literature reviewed reveals a pattern wherein African Americans are more likely to be misdiagnosed for all types of mental illness compared with other ethnicities due to fallacies perpetuated throughout the history of African Americans. In addition, the aggregation of current information and research on the current COVID-19 pandemic will justify future research on the epidemic of police brutality and shootings of unarmed African Americans. If we address this issue, we will reduce medical mistrust and ultimately reduce racial health inequities.


[Pathological anatomy of adenocarcinoma of the prostate in 1988].
After going through gross and microscopic features of prostatic adenocarcinoma, the author stresses upon cytological diagnosis on fine-needle (Franzén) aspiration biopsies. Histological or cytological diagnosis may be difficult. And prostatic dysplasia is an especially difficult subject. There are too many definitions of Stage A1 adeno-carcinoma of the prostate. One would be enough! Histoprognosis only has a statistical value. The Gleason classification is the one we would choose. Any other system could be used as a second classification. PSA (prostate specific antigen) is the best marker for the prostate and for prostatic adenocarcinoma. The idea of an "endocrine prostate" is a new contribution for a better histoprognosis. Carcinoid tumor is only one extreme part of the subject. New methods are reviewed, which will probably make diagnosis and prognosis much easier.


Stable, chloride-induced monohapto-bonding mode for an allyl ligand in a Pd(II) complex bearing a new bidentate phosphonite-oxazoline ligand.
Bidentate ligands can lead to stable eta(1)-allyl complexes of Pd(II). A novel chelating phosphonite-oxazoline P,N ligand, abbreviated NOPO(Me2), has been prepared by reaction of 6-chloro-6H-dibenz[c,e][1,2]oxaphosphorin with the lithium alcoholate derived from 4,4-dimethyl-2-(1-hydroxy-1-methylethyl)-4,5-dihydrooxazole. Its reaction with [Pd(eta(3)-C(3)H(5))(micro-Cl)](2) afforded the new eta(1)-allyl Pd complex [PdCl(eta(1)-C(3)H(5))(NOPO(Me2))] 2 in 91% yield. This constitutes a still rare example of structurally characterized eta(1)-allyl Pd(II) complex. Chloride abstraction led to the corresponding cationic eta(3)-allyl complex [Pd(eta(3)-C(3)H(5))(NOPO(Me2))]PF(6) 3, which has also been characterized by X-ray diffraction. CO insertion into the Pd-C sigma-bond of the eta(1)-allyl ligand of 2 afforded the corresponding 3-butenoyl palladium complex [PdCl[C(O)C(3)H(5)](NOPO(Me2))] 4 under mild conditions, which supports the view that CO insertion into eta(3)-allyl palladium cationic complexes occurs via first coordination of the counterion to form a more reactive eta(1)-allyl intermediate.


Induction of SCE by indirect mutagens in cultured rat hepatoma cells and in Chinese hamster V79 cells co-cultivated with hepatocyte primary cultures.
The continuous rat hepatoma cell line H4IIEC3/G- and rat hepatocyte primary cultures (hpc) were compared with regard to their capacity to metabolize structurally different promutagens. The sensitivities of both activation systems were evaluated by comparing the induction of SCE in H4IIEC3/G- cells themselves with that ih V79 cells co-cultured with hpc. Of the six chemicals tested, aflatoxin B1 (AFB1), cyclophosphamide, dimethylnitrosamine and nitrosomorpholine (NM) were shown to be inducers of SCE in H4IIEC3/G- cells as well as in V79 cells with hepatocyte activation. 7,12-Dimethylbenzanthracene gave positive responses in hpc/V79 co-cultures but not in H4IIEC3/G- cells whereas benzo[a]pyrene was negative in both systems. These results suggest that H4IIEC3/G- cells retain metabolic activities to convert different indirect mutagens into their active forms and clearly indicate the presence of liver specific cytochrome P-450-dependent mono-oxygenases. However, freshly isolated hepatocytes are more efficient in metabolizing the test compounds. Although hpc provide only external activation, the V79 cells system appears to be more sensitive for the detection of promutagens.


The quality of European dermatological guidelines: critical appraisal of the quality of EDF guidelines using the AGREE II instrument.
Clinical practice guidelines are systematically developed tools to assist clinicians and health policy makers in decision making for clearly defined clinical situations. In the light of the demand for evidence-based medicine and quality in health care and the increasing methodological requirements concerning guidelines development, it is important to evaluate existing practice guidelines to systematically identify strengths and weaknesses. Currently, the most accepted tool for the methodological evaluation of guidelines is the Appraisal of Guidelines for Research & Evaluation (AGREE) Instrument. Intention of this assessment is to identify and critically appraise clinical practice guidelines commissioned by the European Dermatology Forum (EDF). A quality assessment of a predefined set of guidelines, including all available clinical practice guidelines published on the EDF guidelines internet site, was performed using the AGREE II instrument. To assure an objective assessment, four independent assessments were performed by evaluators situated in different European countries. Twenty-five EDF guidelines covering different dermatological topics were identified and evaluated. The assessment included seven guidelines developed on the highest methodological standard (systematic literature search and structured consensus conference, S3). Eighteen guidelines were identified that were based on either a structured consensus process (S2k), a systematic literature assessment (S2e) or on informal consensus only (S1). The methodological and reporting quality among the evaluated guidelines was heterogeneous. S3 guidelines generally received the highest scores. The domains 'clarity of presentation' and 'scope and purpose' achieved the highest mean ratings within the different domains of assessment, whereas the domains of 'applicability', 'stakeholder involvement' and 'editorial independence' scored poorly. Considering the large variations in the achieved scores, there is need for methodological harmonization within the EDF guidelines to achieve comparable methodological standards.


Immunological control of chronic Trypanosoma brucei gambiense in outbred rodents.
Recent human isolates of Trypanosoma brucei gambiense generally fail to become or remain patent in laboratory rodents. The purpose of this study was to determine if this was due to acquired immunity and if so which immunosuppressive method was the most efficient in raising parasitemia levels. Prior to infection, rats and mice were immunosuppressed by treatments with cobra venom factor, anti-lymphocyte sera, hydrocortisone acetate, cyclophosphamide; by splenectomy; or by lethal X-irradiation. While no parasites were detected in the blood of most of the untreated rodents for 30 days postinfection, all immunosuppressive procedures resulted in patent parasitemias in at least fifty percent of the treated animals. The most effective method, lethal X-irradiation, consistently caused fulminating infections typical of acute African trypanosomiasis. Cyclophosphamide had the same effect as X-irradiation in rats but was less effective in mice. Splenectomy allowed fulminating first peak parasitemias in two-thirds of the rodents while cobra venom factor and anti-lymphocyte sera in general allowed only low first peaks of parasitemia that were resolved within 10 days of infection. Hydrocortisone acetate allowed low grade and sporadically patent infections throughout the 30-day study. To determine if in untreated rodents, the parasites were eliminated or maintained in a subpatent state, rodents infected for 30-45 days were immunosuppressed with cyclophosphamide.(ABSTRACT TRUNCATED AT 250 WORDS)


Coupled Cluster Study of the Heats of Formation of UF6 and the Uranium Oxyhalides, UO2X2 (X = F, Cl, Br, I, and At).
The atomization enthalpies of the U(VI) species UF6 and the uranium oxyhalides UO2X2 (X = F, Cl, Br, I, and At) were calculated using a composite relativistic Feller-Peterson-Dixon (FPD) approach based on scalar relativistic DKH3-CCSD(T) with extrapolations to the CBS limit. The inherent multideterminant nature of the U atom was mitigated by utilizing the singly charged atomic cation in all calculations with correction back to the neutral asymptote via the accurate ionization energy of the U atom. The effects of SO coupling were recovered using full 4-component CCSD(T) with contributions due to the Gaunt Hamiltonian calculated using Dirac-Hartree-Fock. The final atomization enthalpy for UF6 (752.2 kcal/mol) was within 2.5 kcal/mol of the experimental value, but unfortunately the latter carries a ±2.4 kcal/mol uncertainty that is predominantly due to the experimental uncertainty in the formation enthalpy of the U atom. The analogous value for UO2F2 (607.6 kcal/mol) was in nearly exact agreement with the experiment, but the latter has a stated experimental uncertainty of ±4.3 kcal/mol. The FPD atomization enthalpy for UO2Cl2 (540.4 kcal/mol) was within the experimental error limit of ±5.5 kcal/mol. FPD atomization energies for the non-U-containing molecules (used for reaction enthalpies) H2O and HX (X = F, Cl, Br, I, and At) were within at most 0.3 kcal/mol of their experimental values where available. The FPD atomization enthalpies, together with FPD reaction enthalpies for two different reactions, were used to determine heats of formation for all species of this work, with estimated uncertainties of ±4 kcal/mol. The calculated heat of formation for UF6 (-511.0 kcal/mol) is within 2.5 kcal/mol of the accurately known (±0.45 kcal/mol) experimental value.


High-order parametric generation of coherent XUV radiation.
Extreme ultraviolet (XUV) radiation finds numerous applications in spectroscopy. When the XUV light is generated via high-order harmonic generation (HHG), it may be produced in the form of attosecond pulses, allowing access to unprecedented ultrafast phenomena. However, the HHG efficiency remains limited. Here we present an observation of a new regime of coherent XUV emission which has a potential to provide higher XUV intensity, vital for applications. We explain the process by high-order parametric generation, involving the combined emission of THz and XUV photons, where the phase matching is very robust against ionization. This introduces a way to use higher-energy driving pulses, thus generating more XUV photons.


Uveitic Granulomas Masquerading as Ocular Tumors.
Solitary uveal lesions confer a diagnostic challenge to ophthalmologists. Uveitic lesions most abundantly appear amelanotic and commonly involve the choroid. Most amelanotic choroidal lesions are either neoplastic or inflammatory in origin. In our study, we aimed to describe six uveitic granuloma cases, which were referred to a tertiary ophthalmology center as intraocular tumors. Retrospective chart review of 6 patients (7 eyes) who had uveitic granulomas and were referred to a tertiary ophthalmology center as having intraocular tumors. Mean age on presentation was 47 ± 12.5 years. One lesion was involving the ciliary body only, five lesions had pure choroidal involvement, and one had ciliochoroidal involvement. Mean visual acuity on presentation was 1.7 ± 0.75 (Snellen = 20/1,000) and ranged from 20/80 to light perception. Mean basal diameter of all lesions was 7.7 ± 1.8 mm. Three lesions had moderate echogenicity, two lesions were low to moderate echoic, and one lesion had moderate to high echogenicity on ultrasonography. Three lesions were associated with retinal detachments. Five eyes showed an early hypofluorescence with late hyperfluorescence. Leakage of fluorescein at borders was noticed in 3 lesions. Final diagnosis was presumed intraocular tuberculosis in 4 patients, probable ocular sarcoidosis in 1 patient, and idiopathic solitary uveitic granulomas in 1 patient. Upon treatment, the vision improved to 0.3 ± 0.27 (Snellen = 20/40) and ranged from 20/20 to 20/100 after 4.7 ± 2.9 years of follow-up. Uveitic granulomas can demonstrate features of ocular tumors. Proper uveitis management leads to a favorable visual outcome and ocular preservation.


Chemotherapy in heterogeneous cultures of cancer cells with interconversion.
Recently, the interconversion between differentiated and stem-like cancer cells has been observed. Here, we model the in vitro growth of heterogeneous cell cultures in the presence of interconversion from differentiated cancer cells to cancer stem cells (CSCs), showing that, by targeting only CSC with cytotoxic agents, it is not always possible to eradicate cancer. We have determined the kinetic conditions under which cytotoxic agents in in vitro heterogeneous cultures of cancer cells eradicate cancer. In particular, we have shown that the chemotherapeutic elimination of in vitro cultures of heterogeneous cancer cells is effective only if it targets all cancer cell types, and if the induced death rates for the different subpopulations of cancer cell types are large enough. The quantitative results of the model are compared and validated with experimental data.


[Relationship between wrist bone mineral density and synovitis, erosion by ultrasonography in female rheumatoid arthritis patients].
To find the correlation of wrist bone mineral density (BMD) to wrist synovitis and erosion, by comparing wrist BMD and ultrasonography. A number of 80 female RA patients were examined by BMD measurement of the femoral neck, spine and non-dominant wrist using dual-energy X-ray absorptiometry (DXA). Synovitis of the wrist was examined by ultrasonography. The wrist joint (radiocarpal joint, dorsal midline, and carpoulnar joint) was assessed in the same side of DXA, with transverse and longitudinal scans for USGS synovial hypertrophy and proliferation, tenosynovitis,tendinitis and bone erosion. Colour and power doppler ultrasonography (PDUS) were used to sum the synovitis score. We found: (1) In the study, 80 female RA patients were enrolled, the mean age was 54.6±13.3 (27.0-80.0) years, the disease duration was 48 (12-116) months, and the body Mass Index was 23.0±4.0 (14.8-31.2) kg/m2. The Wrist BMD (g/cm2) in RA significantly reduced, compared with normal controls(0.297±0.121 vs. 0.420±0.180,P<0.01). (2) The Wrist BMD (g/cm2) exceeded in early RA compared with the established RA (0.326±0.103 vs. 0.285±0.132,P<0.01); the positive rate of severe osteoporosis in wrist was lower in early RA compared with the established RA (47.8% vs. 64.9%, P<0.05); the positive rate of bone erosion in wrist by ultrasound was lower in early RA compared with the established RA (39.1% vs. 56.1%, P<0.01). (3) The wrist BMD (g/cm2) in RA with high disease activity reduced compared with moderate and low disease activity (0.267±0.140 vs. 0.280±0.126) and (0.267±0.140 vs. 0.320±0.103) respectively, P<0.05). The percentages of positive ACPA in the high and moderate disease activity groups were significantly higher than those in the remission group (85% vs. 81.8% and 92.6% vs. 81.8%, respectively). DAS28ESR was correlated with wrist BMD (r=-0.288, P<0.01). (4) A significant positive correlation was found between wrist and spine/femur BMD (r=0.634, P<0.01, r=0.795, P<0.01), and a negative correlation between wrist and disease duration and DAS28ESR (r=-0.286, r=-0.301, P<0.01). There was a highly significant positive correlation between wrist BMD and femur BMD (r=0.95, P<0.05). (5) RA patients in wrist osteoporosis group had higher RF positive rate and ACPA rate than wrist osteopenia group (75.5% vs. 55.6%, P<0.05,100% vs. 83.3%, P<0.05). The patients of BMD osteoporosis group had higher DAS28ESR compared with osteopenia group (5.3±1.8 vs. 3.7±1.5, P<0.01). The percentages of synovitis (61.5% vs. 51.7%, P<0.05), tendenitis (14.3% vs. 10.0%, P<0.05) and bone erosion (54.2% vs. 46.2%, P<0.05) in wrist by ultrasonography in osteoporosis group were higher than those of osteopenia group. (6) The wrist BMD in negative bone erosion group by ultrasonography was lower than that in positive bone erosion group [(0.333±0.107) g/cm2 vs. (0.264±0.125) g/cm2, P<0.01], also the PDUS score was higher than positive bone erosion group (4.53±1.40 vs. 2.55±2.66, P<0.01). Compared with negative bone erosion group, the patients in positive bone erosion group had longer disease duration (96.0±104.7) months vs. (66.2±78.0) months, P<0.05), higher percentage of RF (81.0% vs. 53.8%, P<0.01), ACPA (92.7% vs. 79.5%, P<0.05). and higher DAS28ESR (5.4±1.8 vs. 4.2±2.0, P<0.05). The percentage of wrist synovitis in positive bone erosion group was higher (75.6% vs. 30.8%, P<0.01) than that of negative bone erosion group, and moreover, the percentage of severe osteoporosis in the wrist was significantly higher (75.0% vs. 46.4%, P<0.01). (7) A stepwise multivariate linear regression model was constructed to explore the relationship between the different clinical factors studied and a low wrist BMD. Statistically significant variables were age (P=0.001), disease duration (P=0.017), DAS28ESR (P=0.021), and ACPA (P=0.05). This study shows a highly significant correlation between hand BMD with disease duration and disease activity, and female RA patients with high titer of ACPA have lower wrist BMD.


Munc-18-1 regulates the initial release rate of exocytosis.
Carbon fiber amperometry is a popular method for measuring single exocytotic events; however, the functional interpretation of the data can prove hazardous. For example, changes to vesicle transmitter levels can appear to cause changes in the timing and rate of the fusion process itself. Use of an analytical technique based on differentiation revealed that an increase in dense-core granule catecholamine content by exogenous application of l-DOPA did not affect initial release rates. Changes to the timing and amplitude of amperometric spikes from l-DOPA-treated cells are, then, likely a reflection of the increased quantal size rather than any direct effect on exocytosis itself. Applying this new analysis to individual fusion events from cells expressing Munc-18-1 with various specific point mutations demonstrated that Munc-18-1 functions at a late stage involved in the determination of the initial rate of fusion. Furthermore, a mutation of the protein that inhibits its biochemical interaction with the t-SNARE syntaxin-1 in a closed conformation caused premature termination of the fusion event. Through these two late-stage functions, Munc-18-1 could act as a key protein involved in the presynaptic control of signaling strength and duration.


Analysis of six elements (Ca, Mg, Fe, Zn, Cu, and Mn) in several wild vegetables and evaluation of their intakes based on Korea National Health and Nutrition Examination Survey 2010-2011.
Wild vegetables, those edible among naturally grown vegetables, have been reported to contain many bioactive substances, dietary fibers, vitamins, and minerals. The purpose of this study is to examine the six elements of the wild vegetables frequently consumed by Koreans and assess the element intakes through them. Contents of six kinds of elements (Ca, Mg, Fe, Zn, Cu, and Mn) in 11 wild vegetables were analyzed by inductively coupled plasma optical emission spectroscopy. Using these analysis data, the 6-element intakes from the wild vegetables were evaluated in healthy Korean adults aged 19-64 years from the Korea National Health and Nutrition Examination Survey (2010-2011). Sedum and shepherd's purse contained over 100 mg of Ca in 100 g of their edible portion. The Mg content per 100 g of the 11 wild vegetables ranged from 12.1 mg to 43.4 mg. The wild vegetable with the highest mineral content per 100 g was sedum for Ca, spinach for Mg, shepherd's purse for Fe, spinach for Zn, bracken for Cu, and fragrant edible wild aster for Mn. The element intakes from the 11 wild vegetables compared with dietary reference intakes in the healthy Koreans were 1.0 % for Ca, 2.1 % for Mg, 5.3 % for Fe, 1.4 % for Zn, 0.3 % for Cu, and 1.8 % for Mn. Considering the low intake ratio (1.2 %) of the wild vegetable to total food intake, wild vegetables may contribute to some element intakes. Our results show the nutritional value of the wild vegetables in the aspect of mineral nutrition; however, further research is needed to evaluate the bioavailability of various elements in wild vegetables.


Distinct roles of group I mGlu receptors in striatal function.
In the recent past, evidence accumulated in favour of a central role of group I metabotropic glutamate (mGlu) receptors, mGlu1 and mGlu5, in the modulation of cell excitability both of striatal medium spiny projection neurons (MSNs) and interneuronal population. Electrophysiological and pharmacological studies have clearly shown that activation of mGlu1 and mGlu5 receptors exerts distinct actions, depending on the neuronal subtype involved. MGlu5 receptor activation mediates the potentiation of NMDA responses in MSNs, and underlies the retrograde inhibitory signaling by endocannabinoids at corticostriatal synapses. Conversely, both group I mGlu receptors are involved in long-term synaptic plasticity of MSNs. Likewise, either mGlu1 or mGlu5 receptors are engaged in shaping the excitability of large cholinergic interneurons, playing different roles in the membrane responses. Differently, although GABAergic parvalbumin-positive, fast-spiking interneurons have been shown to express both group I receptors, only mGlu1 receptor seems to mediate membrane and synaptic responses. This review provides a brief survey of the cellular and synaptic actions of group I mGlu receptors, and discusses the potential relevance of these findings in neostriatal function and motor control.


Mitral valve prolapse: a marker for anxiety or overlapping phenomenon?
In symptomatic mitral valve prolapse patients (MVP): (1) the frequency and nature of symptoms were analyzed (n = 313); (2) metabolic studies were performed (n = 20), and (3) the response to isoproterenol infusions were studied (n = 16). Chest pain is more often the initial symptom in men; palpitations are more common initially in women. Fatigue, palpitations, dyspnea and arrhythmias are more frequent in women. Chest pain and neurologic events occur with the same frequency in both sexes. Women have more symptoms than men. MVP patients have normal thyroid function tests, normal plasma cortisol, normal diurnal variation of cortisol and normal 24-hour 17-ketosteroids and 17-hydroxycortico-steroids excretion. They have a normal response to oral glucose but higher glucose and insulin levels than controls. MVP patients have increased 24-hour urinary catecholamine excretion. Isoproterenol infusions produce symptoms in a dose-related fashion in MVP patients but not in controls. Isoproterenol infusion-related symptoms included chest pain (7), extreme fatigue (6), dyspnea (6), dizziness (4), numbness (2), panic attacks (2). Isoproterenol infusions produced a greater increase in heart rate in MVP patients compared to controls. Thus, MVP patients have increased catecholamines and hyperresponse to isoproterenol infusion which indicates that their symptoms may be catecholamine related or mediated. The complex relationships of MVP symptoms are not clear; the coexistence of anxiety states and MVP is one explanation; another equally plausible explanation is that MVP may be a specific marker for the symptom complex.


Prevalence of dry eye syndrome and Sjogren's syndrome in patients with rheumatoid arthritis.
Rheumatoid arthritis has manifestations in various organs including ophthalmic involvement. The present study evaluates prevalence of dry eye and secondary Sjogren's syndrome using salivary scintigraphy which has not been used in previous reports. To evaluate the prevalence of secondary Sjogren's syndrome in patients with rheumatoid arthritis, including clinical characteristics and dry eye, compared with non-Sjogren's syndrome. Descriptive cross sectional study Sixty-one patients with rheumatoid arthritis were recruited at Siriraj Hospital during March 2009-September 2010 and filled in the questionnaires about dry eye for Ocular Surface Disease Index (OSDI) with a history taking of associated diseases, medications, duration of symptoms of dry eyes and dry mouth. The Schirmer I test without anesthesia, tear break-up time, rose bengal staining score, severity of keratitis and salivary scintigraphy were measured and analyzed. Prevalence of secondary Sjogren's syndrome and dry eye were 22.2% (95% CI 15.4 to 30.9) and 46.7% (95% CI 38.0 to 55.6), respectively. Dry eye interpreted from OSDI, Schirmer 1 test, tear break-up time and rose bengal staining was 16.4%, 46.7%, 82% and 3.3% respectively. Fifty-two percent of patients had a history of dry eye and dry mouth with mean duration 27.4 and 29.8 months, respectively. Superficial punctate keratitis and abnormal salivary scintigraphy were found in 58.2% and 77.8%. Duration of rheumatoid arthritis, erythrocyte sedimentation rate were not correlated with secondary Sjogren's syndrome. Dry eye from OSDI with secondary Sjogren's syndrome (33.3%) compared with non-Sjogren's syndrome (9.5%) was significant difference (p = 0.008). Adjusted odds ratio for secondary Sjogren's syndrome in OSDIL score > 25 was 13.8 (95% CI 2.6 to 73.8, p = 0.002) compared to OSDI score < 25. Awareness and detection of dry eye syndrome and secondary Sjogren's syndrome in rheumatoid arthritis was crucial for evaluation of their severity and proper management.


Supramastoid crest, safety landmark for craniotomy?
Bony landmarks are important in identifying and avoiding various structures, and thus, decreasing surgical morbidity. Knowledge of frontal bone was studied to help surgeons with safe craniotomy as temporooccipital region study was rare. To identify usefulness of supramastoid crest and relationship to venous and Labbe's vein. Twenty fresh cadaveric heads, the vessels were injected with colorized silicone, were studied on both sides, yielded 40 sides. The relationship of the supramastoid crest to the transverse, sigmoid sinus, Labbe's vein was also determined and measured. The following distances were measured utilizing the digital caliper for all measurements. Supramastoid crest was found in all cadavers (100%) and skull opened along supramastoid crest 100% safe from injury to venous sinus. Anterior border of supramastoid crest was close in relation to middle cranialfossa floor, 85% on right side and 90% on left side and the same level of middle cranial. The authors defined supramastoid point with turning of supramastoid crest and found distance from supramastoid point to nearest venous sinuse (always transverse sinus) 1.0-22.41 mm in range and average 12.94 mm on right side and 11.87 mm on left side. The last distance, from supramastoid point to nearest Labbe's vein, was measured and found to be 5.94-24.97 mm in range and average 17.23 mm on both sides. Supramastoid crest is bony landmark and easy to identify in the adult cadaver and craniotomy along supramastoid crest and always safe from injuring the venous sinus and Labbe s vein. 87.5% anterior border of supramastoid crest is the same level for middle cranial fossa floor.


The correlation between brain near-infrared spectroscopy and cerebral blood flow in piglets with intracranial hypertension.
Cerebral perfusion pressure (CPP) is used as a surrogate for measurement of cerebral blood flow (CBF) but its determination requires that intracranial pressure be directly measured. Near-infrared spectroscopy (NIRS) can noninvasively measure tissue oxygenation. We hypothesized that NIRS would correlate well with CBF, with cerebral metabolism of oxygen (CMRO2) and glucose and with lactate production as CPP was reduced. Seven anesthetized piglets were subjected to reductions in CPP to 60, 50, 40, 30, and 20 mmHg by infusing an artificial cerebral spinal fluid into the lateral ventricle of the brain. After a period of equilibration, NIRS over the left temporal cortex and regional CBF (microspheres) were measured at each CPP level as well as arterial and internal jugular PaO2 , glucose, and lactate. CMRO2 and glucose consumption and lactate production were calculated by standard formulae. NIRS correlated very well (P < 0.05) with CBF in the left temporal cortex [mean r (95% CI) = 0.95 (0.91-0.99)] and with left hemispheric CMRO2 [0.94 (0.90-0.98)], glucose consumption [0.87 (0.76-0.97)], and lactate production [0.89 (0.81-0.97)]. The correlation of NIRS with CBF was slightly better (P < 0.05) than that of CPP with CBF [0.89 (0.84-0.94)]. In this model of global cerebral hypertension, NIRS correlated well with CBF and measures of cerebral metabolism, and might be useful as a surrogate for CPP. Further studies are warranted to determine if NIRS is associated with these variables in focal cerebral injury.


Nanoparticle-Integrated Hydrogels as Multifunctional Composite Materials for Biomedical Applications.
This review focuses on the most recent developments in the field of nanocomposite hydrogels intended for biomedical applications. Nanocomposite hydrogels are hydrated polymeric networks with a physically or covalently crosslinked three-dimensional (3D) structure swollen with water, in the presence of nanoparticles or nanostructures. A wide array of nanomaterials (polymeric, carbon-based, metallic, ceramic) can be incorporated within the hydrogel network to obtain reinforced nanocomposite hydrogels. Nanocomposites represent a new class of materials with properties absent in the individual components. In particular, the incorporation of nanomaterials within a polymeric hydrogel network is an attractive approach to tailor the mechanical properties of the hydrogels and/or to provide the nanocomposite with responsiveness to external stimuli.


Post-infectious Painful Sensory Neuronopathy Following Giardia Infection Responsive to Intravenous Immunoglobulin Treatment.
Sensory neuronopathy is a rare pure sensory disorder with characteristic clinical features of early-onset ataxia and a multifocal distribution of non-length-dependent sensory deficits. Diabetes is the most common cause of length-dependent peripheral neuropathy. However, in acute to subacute presentations, conditions such as autoimmune diseases, paraneoplastic syndrome, exposure to toxins, and viral infection could be common etiologies. This report presents a patient with sensory neuronopathy following a Giardia infection. Gait disturbance, neuropathic pain, ataxia, and pseudoathetosis improved by varying degrees following the monthly maintenance of intravenous immunoglobulin (IVIG). An immune-mediated or direct pathogenic attack can explain the underlying pathogenesis behind this patient's peripheral nerve dysfunction.


Hypothesis testing and confidence interval construction in 2 x 2 tables of correlated proportions.
The 2 x 2 table is an invaluable tool for displaying bivariate binary data. It is easy to find examples of correlated binary response in biopharmaceutical experiments and clinical research and analysis of these data is a current research topic. The most common hypothesis tested for 2 x 2 tables of correlated proportions is that of homogeneity of the marginal proportions or, equivalently, the hypothesis of table symmetry. The 2 x 2 table of correlated proportions is rich with information and we present a survey of some of the analyses relevant for these data. Using asymptotic theory, we develop estimators of relevant parameters and associated test statistics that are of interest. We discuss interval estimation using arguments proposed by Quesenberry and Hurst (1) and Goodman (2). These interval estimators do not rely on estimation of the covariance matrix and are not necessarily equivalent to those obtained using modified chi-square statistics.


Logistic regression analysis of repeated radioiodine therapy treatments for papillary thyroid carcinoma patients.
Radioiodine ablation treatment (RAT) is administered to papillary thyroid carcinoma patients post thyroidectomy. Multivariable logistic regression analysis can be applied to predict treatment failure. In this study, we propose a logistic regression model (LRM) to estimate the probability of repeating the treatment more than one time. A retrospective review of the last 5 years of RAT data revealed that 30 patients had received the RAT more than one time. Various factors including age, sex, pretreatment serum thyroglobulin (Tg), thyroid-stimulating hormone (TSH) and administered activity were analyzed to predict RAT failure and therefore the necessity to repeat the treatment by administering additional doses of radioiodine. The administered activity, the patient age, the presence of distant lymph nodes on the whole-body radioiodine scan (WBS) and the level of Tg before the treatment were found to be the predictive variables. The following LRM is proposed: Y = 7.8295 - 0.0012 [Activity in (MBq) - 0.0541 (Age) - 34.3 (Lymph Nodes) - 0.0042 (Tg)]. The prediction accuracy of the LRM was assessed using receiver operating characteristic (ROC) curve by calculating the area under the curve (AUC). We found the AUC = 0.8972. Patients who are older in age, who receive higher administered radioiodine activity, have higher serum thyroglobulin levels and have lymph node uptake reported in their post-ablation WBS are more likely to have unsuccessful treatment outcome and will repeat the treatment. This LRM could help in adjusting RAT options in order to reduce the repeat rate.


Microvascular invasion is an independent prognostic factor in patients with prostate cancer treated with radical prostatectomy.
Current published data regarding the prognostic value of microvascular invasion (MVI) in patients with prostate cancer (PCa) have yielded mixed results. Furthermore, most important series had surgical procedures performed by multiple surgeons and surgical specimens analyzed by multiple pathologists. We determined the relation of MVI with other pathologic features and whether this finding can be used as an independent prognostic factor in patients with PCa. We selected 428 patients with clinically localized PCa treated with radical prostatectomy (RP). MVI was correlated to other pathologic features. The Kaplan-Meier method was used to evaluate survival curves and statistical significance was determined by the log-rank test. Multivariate analysis was performed through a Cox proportional hazards regression model. Eleven percent out of the 428 patients presented MVI. Except for the lack of association with biopsy Gleason score, MVI was related to all clinical and pathologic features of RP specimens. Mean follow up after surgery was 53.9 +/- 20.1 months. Patients with MVI presented a recurrence rate of 44.6% compared to only 20.2% for patients without MVI (Log-rank test - p < 0.001). After Cox regression analysis, MVI was an independent prognostic feature related to biochemical recurrence. MVI is associated to advanced pathologic features of PCa and is an important prognostic factor regarding disease recurrence in patients treated with RP. These findings support the recommendations to the routine evaluation of this variable in pathologic reports of RP specimens.


Multicultural Differences in Women's Expectations of Birth.
This review surveyed qualitative and quantitative studies to explore the expectations around birth that are held by women from different cultures. These studies are grouped according to expectations of personal control expectations of support from partner/others/family; expectations of carel behavior from providers such as nurses, doctors, and/or midwives; expectations about the health of the baby; and expectations about pain in childbirth. Discussed are the findings and the role that Western culture in medicine, power and privilege are noted in providing care to these women.


α-Band oscillations in intracellular membrane potentials of dentate gyrus neurons in awake rodents.
The hippocampus and dentate gyrus play critical roles in processing declarative memories and spatial information. Dentate granule cells, the first relay in the trisynaptic circuit through the hippocampus, exhibit low spontaneous firing rates even during locomotion. Using intracellular recordings from dentate neurons in awake mice operating a levitated spherical treadmill, we found a transient membrane potential α-band oscillation associated with the onset of spontaneous motion, especially forward walking movements. While often subthreshold, α oscillations could regulate spike timing during locomotion and may enable dentate gyrus neurons to respond to specific cortical afferent pathways while maintaining low average firing rates.


cis-acting components in the replication origin from ribosomal DNA of Saccharomyces cerevisiae.
The ribosomal DNA (rDNA) repeats of Saccharomyces cerevisiae contain an autonomously replicating sequence (ARS) that colocalizes with a chromosomal origin of replication. We show that a minimal sequence necessary for full ARS function corresponds to a 107-bp rDNA fragment which contains three 10-of-11-bp matches to the ARS consensus sequence. Point mutations in only one of the 10-of-11-bp matches, GTTTAT GTTTT, inactivate the rDNA ARS, indicating that this consensus sequence is essential. A perfect match to a revised ARS consensus is present but not essential. Sequences up to 9 bp 5' from the essential consensus are dispensable. A broad DNA region directly 3' to the essential consensus is required and is easily unwound as indicated by: (i) hypersensitivity to nicking of an approximately 100-bp region by mung bean nuclease in a negatively supercoiled plasmid and (ii) helical instability determined by thermodynamic analysis of the nucleotide sequence. A correlation between DNA helical instability and replication efficiency of wild-type and mutated ribosomal ARS derivatives suggests that a broad region 3' to the essential ARS consensus functions as a DNA unwinding element. Certain point mutations that do not stabilize the DNA helix in the 3' region but reduce ARS efficiency reveal an element distinct from, but overlapping, the DNA unwinding element. The nucleotide sequence of the functionally important constituents in the ARS appears to be conserved among the rDNA repeats in the chromosome.


Early onset neonatal sepsis: diagnostic dilemmas and practical management.
Early onset neonatal sepsis is persistently associated with poor outcomes, and incites clinical practice based on the fear of missing a treatable infection in a timely fashion. Unnecessary exposure to antibiotics is also hazardous. Diagnostic dilemmas are discussed in this review, and suggestions offered for practical management while awaiting a more rapidly available 'gold standard' test; in an ideal world, this test would be 100% sensitive and 100% specific for the presence of organisms.


[Sociocultural aspects of rheumatological practices in Sub-Saharan Africa].
Conceived by the patient as the result of a surnatural origin, rheumatism, as most diseases in Black Africa, justifies the consultation of a witch or a quack. This consultation occurring upstream or downstream that of the modern physician aims to determine the exact cause of the disease in order to prescribe a suitable treatment. The recourse to traditional medicine is far from being influenced by the level of instruction of the patient. It occurs frequently during rheumatic diseases of which the symptomatology is dominated by pain and the physiopathology often obscure. The patient while looking for a solution to his problem does not act alone. He must take notice of the advice and requirements of his family of which he constitutes an indissociable element. The theory of humours is still present in the minds and is expressed by the recourse to purgative and vomitive drugs and to bloodletting. Thus by some of its conceptual and practical features, traditional African medicine reminds that which had prevailed in the west before the scientific and technical discoveries or the 19th century.


Hierarchies of healing in gut mucosal injury.
The mucosal response to injury can best be understood as a complex layering of different responses that may be invoked depending upon the size and nature of the injury, the persistence of the injurious stimulus, and the availability of various trophic host factors that stimulate repair. There is a hierarchy of responses that ranges from small rapid resealing of acute apical membrane or single cell wounds through the long term attempt to heal a giant peptic ulcer or respond to inflammatory bowel disease. Although much previous attention has been paid to the local factors that regulate these pathways and responses, there is increasing interest in systemic factors that may act either by the production of cytokines and trophic factors or by the direct migration of bone marrow derived stem cells into the mucosal wound.


[Histopathological and immunohistochemical diagnosis of intractable vasculitis syndromes].
Vasculitis has a simple definition--primary inflammation of the blood vessels, often with necrosis and occlusive changes--but its clinical manifestations are diverse and complex. In the absence of pathognomonic clinical features and laboratory tests, the diagnosis of vasculitis relies heavily on the correct interpretation of histologic changes but these too may not be specific in any given case. A positive biopsy is always helpful whereas a negative biopsy does not exclude the disease under consideration because the vasculitis may be focal and segmental in distribution, as in polyarteritis nodosa. Pathologic and immunohistochemical characteristics of some of the major categories of systemic vasculitis were described; 1) polyarteritis nodosa; 2) Churg-Strauss syndrome; 3) hypersensitivity vasculitis; 4) Wegener's granulomatosis; 5) Kawasaki disease; 6) malignant rheumatoid arthritis; 7) systemic lupus erythematosus; 8) scleroderma; 9) polymyositis-dermatomyositis; 10) mixed connective tissue disease; 11) polyangiitis overlap syndrome; 12) giant cell arteritis; 13) Takayasu arteritis; 14) Behçet disease; 15) Buerger disease; and 16) inflammatory aortic aneurysm. Each of these major vasculitic syndromes has its own unique histopathologic features, but overlap still occurs.