Diagnostic Accuracy of 18F-FDG PET/CT in Infective Endocarditis and Implantable Cardiac Electronic Device Infection: A Cross-Sectional Study.
Early diagnosis of infective endocarditis (IE) is based on the yielding of blood cultures and echocardiographic findings. However, they have limitations and sometimes the diagnosis is inconclusive, particularly in patients with prosthetic valves (PVs) and implantable cardiac electronic devices (ICEDs). The primary aim of this study was to evaluate the diagnostic accuracy of 18F-FDG PET/CT in patients with suspected IE and ICED infection. A prospective study with 80 consecutive patients with suspected IE and ICED infection (65 men and 15 women with a mean age of 68 ± 13 y) between June 2013 and May 2015 was performed in our hospital. The inclusion criteria were clinically suspected IE and ICED infection at the following locations: native valve (NV) (n = 21), PV (n = 29), or ICED (n = 30) (automatic implantable defibrillator [n = 11] or pacemaker [n = 19]). Whole-body 18F-FDG PET/CT with a myocardial uptake suppression protocol with unfractionated heparin was performed in all patients. The final diagnosis of infection was established by the IE Study Group according to the clinical, echocardiographic, and microbiologic findings. A final diagnosis of infection was confirmed in 31 patients: NV (n = 6), PV (n = 12), and ICED (n = 13). Sensitivity, specificity, positive predictive value, and negative predictive value for 18F-FDG PET/CT were 82%, 96%, 94%, and 87%, respectively. 18F-FDG PET/CT was false-negative in all cases with infected NV. 18F-FDG PET/CT was able to reclassify 63 of 70 (90%) patients initially classified as possible IE by modified Duke criteria. In 18 of 70 cases, 18F-FDG PET/CT changed possible to definite IE (26%) and in 45 of 70 cases changed possible to rejected IE (64%). Additionally, 18F-FDG PET/CT identified 8 cases of septic embolism and 3 of colorectal cancer in patients with a final diagnosis of IE. 18F-FDG PET/CT proved to be a useful diagnostic tool in suspected IE and ICED infection and should be included in the diagnostic algorithm for early diagnosis. 18F-FDG PET/CT is not useful in the diagnosis of IE in NV but should be also considered in the initial assessment of this complex scenario to rule out extracardiac complications and possible neoplasms.


[Negative emergency laparotomies 1950-1989].
In order to list the negative emergency laparotomies, the records of 24,494 laparotomies performed from 1950 to 1989 were examined. 211 negative laparotomies were performed over this 40 years period: 49 for abdominal trauma, 42 for supposed intestinal obstruction, 44 for supposed peritonitis or visceral infection, 46 for presumed early post-operative abdominal complications and 30 for gastrointestinal bleeding. Over these 4 decades, the emergency laparotomy rate and negative laparotomy rate remained stable despite changes in the diagnostic tools, in the age of the patients and the frequency of their diseases.


Applications for self-administered mobile cognitive assessments in clinical research: A systematic review.
Frequent, brief and repeated self-administered mobile assessments of cognitive function, conducted in everyday life settings, are a promising complementary tool to traditional assessment approaches. Mobile cognitive assessments promote patient-centered care and might enhance capacity to inform individual-level outcomes over time (i.e. detecting subtle declines in cognitive function), as well as in assessing cognition and its correlates in the naturalistic environment. The goal of this systematic review was to assess the feasibility and psychometric properties of mobile cognitive assessments. Through a comprehensive search, we identified 12 articles using self-administered, mobile phone-based cognitive assessments. Studies sampled participants between 1 and 6 times per day for 1-14 days. Samples ranged in age from 14 to 83 years old and were generally healthy populations without cognitive impairment. Working memory was the most frequently-assessed cognitive domain (n = 7), followed by attention/reaction time (n = 4). Seven studies reported adherence, with mean adherence rates of 79.2%. In addition to positive evidence of feasibility, there was general support for high levels of between- and within-person reliability and construct validity. While research has only begun to explore the utility of mobile cognitive assessments, studies to-date indicate they may be a promising complementary tool to traditional assessment methods with potential to improve clinical care and research.


Interferon regulatory factor 7 participates in the M1-like microglial polarization switch.
Microglia are generally considered the immune cells of the central nervous system. Recent studies have demonstrated that under specific polarization conditions, microglia develop into two different phenotypes, termed M1-like and M2-like microglia. However, the phenotypic characteristics of M1-like- and M2-like-polarized microglia and the mechanisms that regulate polarization are largely unknown. In this study, we characterized lipopolysaccharide-treated M1-like and IL-4-treated M2-like microglia and investigated the mechanisms that regulate phenotypic switching. The addition of M2-like microglial conditioned medium (CM) to primary neurons resulted in an increase in neurite length when compared with neurons treated with M1-like microglial CM, possibly because of the enhanced secretion of neurotrophic factors by M2-like microglia. M1-like microglia were morphologically characterized by larger soma, whereas M2-like microglia were characterized by long processes. M2-like microglia exhibited greater phagocytic capacity than M1-like microglia. These features switched in response to polarization cues. We found that expression of interferon regulatory factor 7 (IRF7) increased during the M2-like to M1-like switch in microglia in vitro and in vivo. Knockdown of IRF7 using siRNA suppressed the expression of M1 marker mRNA and reduced phosphorylation of STAT1. Our findings suggest that IRF7 signaling may play an important role in microglial polarization switching.


Evaluated kinetics of terminal and non-terminal addition of hydrogen atoms to 1-alkenes: a shock tube study of H + 1-butene.
Single-pulse shock tube methods have been used to thermally generate hydrogen atoms and investigate the kinetics of their addition reactions with 1-butene at temperatures of 880 to 1120 K and pressures of 145 to 245 kPa. Rate parameters for the unimolecular decomposition of 1-butene are also reported. Addition of H atoms to the π bond of 1-butene results in displacement of either methyl or ethyl depending on whether addition occurs at the terminal or nonterminal position. Postshock monitoring of the initial alkene products has been used to determine the relative and absolute reaction rates. Absolute rate constants have been derived relative to the reference reaction of displacement of methyl from 1,3,5-trimethylbenzene (135TMB). With k(H + 135TMB → m-xylene + CH3) = 6.7 × 10(13) exp(-3255/T) cm(3) mol(-1) s(-1), we find the following: k(H + 1-butene → propene + CH3) = k10 = 3.93 × 10(13) exp(-1152 K/T) cm(3) mol(-1) s(-1), [880-1120 K; 145-245 kPa]; k(H + 1-butene → ethene + C2H5) = k11 = 3.44 × 10(13) exp(-1971 K/T) cm(3) mol(-1) s(-1), [971-1120 K; 145-245 kPa]; k10/k11 = 10((0.058±0.059)) exp [(818 ± 141) K/T), 971-1120 K. Uncertainties (2σ) in the absolute rate constants are about a factor of 1.5, while the relative rate constants should be accurate to within ±15%. The displacement rate constants are shown to be very close to the high pressure limiting rate constants for addition of H, and the present measurements are the first direct determination of the branching ratio for 1-olefins at high temperatures. At 1000 K, addition to the terminal site is favored over the nonterminal position by a factor of 2.59 ± 0.39, where the uncertainty is 2σ and includes possible systematic errors. Combining the present results with evaluated data from the literature pertaining to temperatures of <440 K leads us to recommend the following: k∞(H + 1-butene → 2-butyl) = 1.05 × 10(9)T(1.40) exp(-366/T) cm(3) mol(-1) s(-1), [220-2000 K]; k∞(H + 1-butene → 1-butyl) = 9.02 × 10(8)T(1.40) exp(-1162/T) cm(3) mol(-1) s(-1) [220-2000 K]. Analogous rate constants for other unbranched 1-olefins should be very similar. Despite this, a factor of three discrepancy in the branching ratio for terminal and nonterminal addition is noted when comparing the present values with recommendations from a recent model of the important H + propene reaction. This difference is suggested to be well outside of the possible experimental errors of the present study or the expected differences with 1-butene. There thus appear to be inconsistencies in the current model for propene. In particular the addition branching ratio from that model should not be used as a reference value in extrapolations to other systems via rate rules or automated mechanism generation techniques.


Zooplankton mortality and the dynamical behaviour of plankton population models.
We investigate the dynamical behaviour of a simple plankton population model, which explicitly simulates the concentrations of nutrient, phytoplankton and zooplankton in the oceanic mixed layer. The model consists of three coupled ordinary differential equations. We use analytical and numerical techniques, focusing on the existence and nature of steady states and unforced oscillations (limit cycles) of the system. The oscillations arise from Hopf bifurcations, which are traced as each parameter in the model is varied across a realistic range. The resulting bifurcation diagrams are compared with those from our previous work, where zooplankton mortality was simulated by a quadratic function-here we use a linear function, to represent alternative ecological assumptions. Oscillations occur across broader ranges of parameters for the linear mortality function than for the quadratic one, although the two sets of bifurcation diagrams show similar qualitative characteristics. The choice of zooplankton mortality function, or closure term, is an area of current interest in the modelling community, and we relate our results to simulations of other models.


Long-term renal allograft outcome after simultaneous kidney and pancreas transplantation.
In selected young patients with type 1 diabetes mellitus and end-stage renal failure, simultaneous pancreas and kidney (SPK) transplantation is the treatment of choice. We conducted a retrospective, case-controlled study to compare the function, survival and pathology of renal allografts after SPK and kidney-alone (KA) transplantations. We studied 26 consecutive SPK patients and 67 KA controls matched for time of transplantation. Renal function was assessed by routine evaluation of serum creatinine and its course by the 1/serum creatinine vs time curve. Histologic evaluation of early biopsies (0-3 months post-transplantation, n=63), intermediate biopsies (3 months-1 year, n=75) and late biopsies (after 1 year, n=35) were performed by two independent reviewers. SPK and KA recipients differed significantly with regard to donor and recipient age, time on the waiting list, HLA sensitization, renal cold ischaemia time (CIT) and the incidence of delayed graft function. Acute rejection was more frequent after SPK than KA (54 vs 27%; P=0.01), despite higher trough levels of calcineurin inhibitors. After SPK and KA, actuarial patient and renal allograft survival and renal function were comparable at 1 and 4 years. Severe chronic lesions, especially vascular lesions, and calcineurin-inhibitor nephrotoxicity were more frequent in intermediate and late biopsies in the SPK group. We confirmed that patient and graft survival is comparable between SPK and KA recipients. Despite the use of optimal organs and shorter CIT in SPK, renal graft function was not different in the two groups. Histologic chronic lesions were more severe in SPK than in KA recipients. This might be caused by acute rejection episodes or be due to more severe nephrotoxicity after SPK, because of higher doses of calcineurin inhibitors, or higher sensitivity to calcineurin-inhibitor nephrotoxicity.


Large-scale quantitative LC-MS/MS analysis of detergent-resistant membrane proteins from rat renal collecting duct.
In the renal collecting duct, vasopressin controls transport of water and solutes via regulation of membrane transporters such as aquaporin-2 (AQP2) and the epithelial urea transporter UT-A. To discover proteins potentially involved in vasopressin action in rat kidney collecting ducts, we enriched membrane "raft" proteins by harvesting detergent-resistant membranes (DRMs) of the inner medullary collecting duct (IMCD) cells. Proteins were identified and quantified with LC-MS/MS. A total of 814 proteins were identified in the DRM fractions. Of these, 186, including several characteristic raft proteins, were enriched in the DRMs. Immunoblotting confirmed DRM enrichment of representative proteins. Immunofluorescence confocal microscopy of rat IMCDs with antibodies to DRM proteins demonstrated heterogeneity of raft subdomains: MAL2 (apical region), RalA (predominant basolateral labeling), caveolin-2 (punctate labeling distributed throughout the cells), and flotillin-1 (discrete labeling of large intracellular structures). The DRM proteome included GPI-anchored, doubly acylated, singly acylated, cholesterol-binding, and integral membrane proteins (IMPs). The IMPs were, on average, much smaller and more hydrophobic than IMPs identified in non-DRM-enriched IMCD. The content of serine 256-phosphorylated AQP2 was greater in DRM than in non-DRM fractions. Vasopressin did not change the DRM-to-non-DRM ratio of most proteins, whether quantified by tandem mass spectrometry (LC-MS/MS, n=22) or immunoblotting (n=6). However, Rab7 and annexin-2 showed small increases in the DRM fraction in response to vasopressin. In accord with the long-term goal of creating a systems-level analysis of transport regulation, this study has identified a large number of membrane-associated proteins expressed in the IMCD that have potential roles in vasopressin action.


Plasma zinc status, growth, and maturation in children with sickle cell disease.
The objective of this study was to determine the relation of plasma zinc (Zn) status to growth and maturation in children with SS genotype sickle cell disease. A cross-sectional study of 104 subjects who were 50% female and ranged in age from 0.4 to 18 years was performed. Measures included plasma Zn concentration (Znp), height, weight, skinfold thicknesses, elbow breadth, upper arm muscle area, and fat-free mass and fat mass by total body electrical conductivity. Skeletal maturation was assessed by hand-wrist x-ray evaluation and sexual maturation by Tanner stage. A total of 44% of the patients had low Znp (<10.7 micromol/L [70 microg/dl]); those with low Znp had significantly lower SD scores for height (p = 0.003), weight (p = 0.003), upper arm muscle area (p = 0.045), fat-free mass (p = 0.025), and elbow breadth (p = 0.017) and greater skeletal maturation delay (p = 0.04). In older children (>9 years) low Znp was associated with decreased Tanner scores for pubic hair (p = 0.001) and breast and genital maturation (p = 0.009). No significant differences were seen in age, sex, or fat stores according to Zn status. Decreased plasma Zn is common in children with SS genotype sickle cell disease and is associated with decreased linear growth, skeletal growth, muscle mass, and sexual and skeletal maturation.


Preparing a nursing department for downshifting.
1. Downshifting is a movement away from intense job attention and a focus toward the family. Many individuals in all parts of America are shifting their focus away from materialism and financial prosperity, and toward a simpler lifestyle and homelier values. This increasing focus on family--rather than career--can also be seen in nursing. 2. Motivation to downshift because of decreasing interest in career is less likely when the employee is a nurse. However, rising emphasis on the hazards of latchkey children and the need for quality parenting have increased nurses' concerns about the effect of being out of the home for extended periods. 3. With today's nursing shortage, personnel policies must be responsive to the priorities of the prospective job applicant. To be desirable, an employer must appear responsive to personal needs. The national trend to make positions more compatible with home responsibilities must be incorporated in personnel strategies if nurses are to remain in nursing positions and be satisfied.


First experience with direct factor Xa inhibition in patients with stable coronary disease: a pharmacokinetic and pharmacodynamic evaluation.
Thrombin generation is critical to the formation of an arterial thrombus after rupture of an atherosclerotic plaque. In patients with stable coronary disease receiving standard medical therapy, we evaluated the pharmacokinetics, pharmacodynamics, and safety profile of DX-9065a, a novel small-molecule anticoagulant that directly, selectively, and reversibly inhibits factor Xa. In a double-blind trial, 73 patients (median age, 63 years; 29% women) were randomly assigned to receive a fixed-dose intravenous bolus, followed by a 72-hour infusion of placebo or 1 of 4 weight-adjusted regimens of DX-9065a. Plasma samples were collected during infusion and a 24-hour elimination period. Only minor bleeding occurred, predominantly ecchymoses at infusion sites, and its incidence did not differ significantly among the groups, including placebo. Median hemoglobin, platelet count, serum creatinine level, and liver function tests did not change significantly from baseline during infusion or elimination. Significant predictors of pharmacokinetic response included infusion dose and weight. At 60 hours into the DX-9065a infusion, plasma drug levels correlated strongly with anti-factor Xa activity (r=0.97), prothrombin time (r=0.77), and international normalized ratio (r=0.72) but less so with activated partial thromboplastin time (r=0.56; all P<0.001). This is the first study of a selective, reversible, and direct small-molecule factor Xa inhibitor in patients with stable coronary disease. These data lay the foundation for further investigation of factor Xa inhibitors in the treatment of patients with coronary atherothrombosis.


Aqueous extract of Stevia rebaudiana (Bertoni) Bertoni abrogates death-related signaling pathways via boosting the expression profile of oxidative defense systems.
Indigenous inhabitants of South America and other areas have been using stevia as a traditional medicine for years, but its impact on cell signaling pathways has not been well studied yet. We evaluated the impacts of aqueous extract of Stevia rebaudiana (Bertoni) Bertoni on the expression of the selected genes involved in significant cell death modalities, including p53-DNA damage and the cellular antioxidative defense in pancreatic tissues in STZ-induced diabetic rats and murine pancreatic cell lines. The in vivo study revealed that aqueous extract of Stevia significantly upregulated the expression of GSTM1 and P1 and GPX (4.67, 12.08, and 2.81 fold, respectively; all p < .05) along with significant downregulation of the genes which were upregulated by STZ, including apoptotic genes caspase-3 and -9 (-9.80 and -4.16 fold, p < .05, respectively) and necroptotic genes, RIP1K, 2 K, and 3 K (-9.48, -2.70, and -12.9 fold, respectively, all p < .05). In vitro studies also revealed comparable results. In conclusion, the observed clinical improvements in diabetic rats are the result of overexpression of major genes of antioxidative defense systems in the course of a significant downregulation of major cell death modalities. PRACTICAL APPLICATIONS: The popularity of noncaloric sweeteners, including stevia, has rocketed in recent years, but the consumption of stevia as traditional medicine has a long history. The findings of the current study provide strong mechanistic lines of evidence supporting the beneficial biological effects of stevia as a noncaloric sweetener in diabetes.


trans-Resveratrol ameliorates anxiety-like behaviors and fear memory deficits in a rat model of post-traumatic stress disorder.
trans-Resveratrol, a natural polyphenol enriched in grape seed and skin, has been extensively investigated for its antioxidant, anti-inflammatory and anti-psychiatric properties. The present study examined the effects of trans-resveratrol on ameliorating anxiety-like behaviors and fear memory deficits induced by time-dependent sensitization (TDS) procedure, which is a classical animal model for mimicking posttraumatic stress disorder (PTSD). The results suggested that trans-resveratrol at doses of 10, 20 and 40 mg/kg (via gavage, i.g.) reversed TDS-induced decreases in the percentage of time spent in the center of arena, the open arm entries and time spent in the open arms in the open field and elevated plus maze tests. It also decreased the percentage of freezing time in the contextual fear paradigm that was increased in TDS treated rats. Further study suggested that TDS-induced abnormality in the limbic hypothalamus-pituitary-adrenal gland (L-HPA) axis was reversed by trans-resveratrol, i.e. it reversed increased adrenal gland index and corticotropin-releasing factor (CRF) levels, and rescued the differential expression of glucocorticoid receptor (GR) in the hypothalamus, hippocampus and amygdala. Neurobiological studies suggested that trans-resveratrol increased phosphorylation of cAMP response element binding protein (pCREB) and brain derived neurotrophic factor (BDNF) levels, which were decreased in rats subjected to TDS. These results provide compelling evidence that trans-resveratrol protects neurons against PTSD-like stress insults by regulation of L-HPA axis function and activation of downstream neuroprotective molecules, such as pCREB and BDNF expression.


Orthodontic treatment need in the Italian child population.
To assess orthodontic treatment need in the Italian child population using the R.O.M.A. (Risk Of Malocclusion Assessment) Index. Observational study (cross-sectional). The ROMA Index was used in examining a sample of 420 children (214 males and 206 females; mean age: 9.3 years), none of whom had previously undergone orthodontic treatment. This basic sample was large enough to become the object of an epidemiological study and to be analysed through inferential statistics. After calculating the prevalence of malocclusion on the basis of the degrees of orthodontic risk determined by the Index, we evaluated the distribution of the most frequent characteristics, signs and symptoms within each risk grade. The percentage of children in each risk category was then worked out, together with its 95% confidence interval, in order to verify whether our results could be generalised to the reference population. Significantly, 50% of the examined children were classified as 'at moderate risk', as defined by grade 3 of the Index (non-severe alterations in dental and/or skeletal relationships, but tending to persist and often worsen with growth). Equally remarkably, a further 36% fell within grade 4 of the Index ('great risk'), presenting major craniofacial skeletal malformations and alterations of the occlusion, often in association with systemic or growth disorders likely to worsen the prognosis. Thus, since patients at moderate or great risk amounted to 86% of the basic sample, it appears that our estimate can be generalised to the reference population of Italian pre-adolescent children. The study showed a high percentage of children at moderate or great risk (86%), and that this estimate can be generalised to the reference population of Italian pre-adolescent children. These findings should be taken into great account in devising strategies to improve patient service quality, whether in public or private settings, and also in planning preventive measures and interventions.


Medical decision-making inspired from aerospace multisensor data fusion concepts.
In recent years, Internet-delivered treatments have been largely used for pain monitoring, offering healthcare professionals and patients the ability to interact anywhere and at any time. Electronic diaries have been increasingly adopted as the preferred methodology to collect data related to pain intensity and symptoms, replacing traditional pen-and-paper diaries. This article presents a multisensor data fusion methodology based on the capabilities provided by aerospace systems to evaluate the effects of electronic and pen-and-paper diaries on pain. We examined English-language studies of randomized controlled trials that use computerized systems and the Internet to collect data about chronic pain complaints. These studies were obtained from three data sources: BioMed Central, PubMed Central and ScienceDirect from the year 2000 until 30 June 2012. Based on comparisons of the reported pain intensity collected during pre- and post-treatment in both the control and intervention groups, the proposed multisensor data fusion model revealed that the benefits of technology and pen-and-paper are qualitatively equivalent [Formula: see text]. We conclude that the proposed model is suitable, intelligible, easy to implement, time efficient and resource efficient.


Standardised early warning scores in rural interfacility transfers: A pilot study into their potential as a decision-making aid.
While 12.4% of British Columbians live rurally, only 2.0% of specialists practise rurally, making interfacility transport of high-acuity patients vital. Decision-making aids have been identified as a way to improve the interfacility transfer process. We conducted a pilot study to explore the potential of the Standardised Early Warning Score (SEWS) as a decision-making aid for staff at sending facilities. SEWSs were calculated from a database of 418 transfers from sending facilities in rural, small and medium population centres to larger receiving facilities. The SEWSs were compared against one another over time using McNemar's and the Wilcoxon signed-ranks tests. The SEWSs were then tested for their association with six outcomes using Pearson's or Fisher's Chi-squared test and the Mann-Whitney U-test. While at the sending facility, both the number of SEWSs that was four or greater and the average SEWS decreased over time (P < 0.001 for both). A first SEWS of four or greater was predictive of more intervention categories during transport (P = 0.047), an adverse event during transport (P = 0.004), an adverse event within 30 min of arrival at the receiving facility (P = 0.004) and death before discharge from the receiving facility (P = 0.043) but not deterioration during transport, or the length of stay at the receiving facility. Overall, the performance of the SEWS in the context of rural interfacility transport suggests that the tool will have utility in supporting decision-making.


Probable Primary Cutaneous CD8+ Aggressive Epidermotropic Cytotoxic T-cell Lymphoma: A Case Report of a Diagnostic Challenge.
Primary cutaneous CD8+ aggressive epidermotropic cytotoxic T-cell lymphoma is a rare variety of cutaneous lymphoma. This subtype has an aggressive and quickly progressive clinical course with a survival time of 32 months from the commencement of skin lesions. This article describes a probable case of primary cutaneous CD8+ aggressive epidermotropic cytotoxic T-cell lymphoma in a 63-year-old female, which manifested as diffuse non-pruritic erythematous plaques and nodules. The diagnosis of this possible entity was aided by the histopathological and immunohistochemical findings, while immunohistochemistry for T-cell receptor (TCR) gamma/delta could not be done.


[Sociocultural factors and the presence of psychopathologies in populations of various localities in Argentina].
This report presents and compares data got from seventeen Argentine communities surveys. The Present State Examination was used for "case-finding"; the CATEGO-ID computations programmes made possible to cluster symptoms in different syndromes as well as to obtain the Index of Definition of the disorders which incorporates a set of rules defining the thresholdes points below which too few symptoms are present to allow a descriptive classification. We found in the communities studied an average of 25.4% of the population without symptoms; 51.4% with some type of psychopathology and 23.3% that can be considered "case". In all the populations women showed a higher percentage of psychopathologies than men (means women: 27.6%; means men: 12.6%). We did not find any statistical association between prevalence and age; only in two communities we did find one between prevalence and familiar structure, being higher in subjects married and rearing children.


[Referral of patients with non-odontogenic oral diseases to an oral and maxillofacial surgeon].
Patients with non-odontogenic oral diseases may be referred to an oral and maxillofacial surgeon by a dentist, a general medical practitioner or a medical specialist. At the department of Oral and Maxillofacial Surgery of a medical centre, a survey involving 96 referred patients with a non-odontogenic oral disease addressed the clinician who was responsible for the referral, the patient characteristics, and the nature and location of the oral disease. From the patients who regularly visited a dentist, 53% were referred by a dentist. From the patients who visited a dentist irregularly, 73% were referred by a general medical practitioner. No significant correlation was found between the nature and location of the non-odontogenic oral disease and the profession of the clinician who was responsible for the referral, with an exception for the tongue, for which a medical specialist was more often responsible for the referral.


Seroprevalence of antibodies to Coxiella burnetii among employees of the Veterinary University in Kosice, eastern Slovakia.
Coxiella burnetii is an obligate intracellular pathogen known to be the causative agent of Q fever, a zoonosis with worldwide occurrence. The organism has been found in many wild and domestic animals. Infected animals shed highly stable bacteria in urine, faeces, milk, and through placental and birth fluids. Humans acquire the infection mainly by inhaling infected aerosols, or by ingesting contaminated raw milk or fresh dairy products; tick transmission has been proven but is probably rare. The aim of the present study was to determine the titres of immunoglobulin IgG against phase I and II of C. burnetii, and to evaluate the risk factors that might be associated with exposure to C. burnetii among employees of the Veterinary University. Venous blood was obtained from 92 employees. IgG antibodies were determined by ELISA method modified in our laboratory using whole cells of the Nine Mile C. burnetii strain. The questionnaire was filled out by every subject to obtain epidemiological and clinical date. Phase I antibodies were detected in 35 subjects, i.e. in 38%, and phase II antibodies in 58 subjects, i.e. in 63%. When using the titre > or = 1:800 as a cut-off level, 2 samples were positive for phase I antibodies (2.1%) and 12 for phase II antibodies (13%). Factors predisposing to infection or exposure to C. burnetii included professional orientation and regular contact with farm animals and pets. Clinical history of some seropositive subjects revealed substantial problems, such as fever of unknown origin, rheumatic disease, disease of heart, liver, respiratory tract (particularly atypical pneumonia), chronic fatigue syndrome and spontaneous abortion in females. Q fever is a profession-related disease and prevention of its spreading within the risk population groups requires observation of basic safety rules.


En bloc pelvic peritoneal resection of the intraperitoneal pelvic viscera in patients with advanced epithelial ovarian cancer.
We report the results of 30 patients who underwent en bloc resection of the pelvic peritoneum and all intraperitoneal pelvic viscera in the management of advanced epithelial ovarian cancer. Between 1989 and 1993, 30 consecutive patients with advanced epithelial ovarian cancer underwent en bloc resection of the pelvic peritoneum and all pelvic viscera, except for the bladder, with a rectosigmoid reanastomosis below the peritoneal reflection. All 30 patients were managed with gastrostomy and hyperalimentation. All patients received six cycles of platinum-based combination chemotherapy; the first cycle was administered prior to discharge. All patients underwent cytoreduction to the largest residual mass less than 1 cm. No major complications were attributed to the gastrointestinal surgery itself. The median hospital stay was 11 days (range, 7-23). We found 26 recurrences (87%) and 14 deaths (47%). The median times to recurrence and death were 12.5 months (range, 8-24) and 23 months (range, 8-63), respectively. Sixteen of the 26 relapses (62%) were found in extraperitoneal locations and 10 (38%) in intraperitoneal locations. Only 3 (12%) of the 26 relapses presented with bowel obstruction. En bloc resection of the uterus, ovaries, pelvic peritoneum, and rectosigmoid followed by low anterior anastomosis is a safe operation that facilitates complete cytoreductive surgery in poor prognosis patients with advanced epithelial ovarian cancer.


The Evaluation of Clinical Status of Endoscopic Retrograde Cholangiography for the Placement of Metal and Plastic Stents in Cholangiocarcinoma Therapy.
Cholangiocarcinoma is a common malignant tumor that occurs in the bile duct system, which can be treated by using the endoscopic retrograde cholangiography (ERCP). This study was aimed at exploring the therapeutic effect of ERCP with metal stent and plastic stent for cholangiocarcinoma. The clinical data of 71 patients with cholangiocarcinoma treated by ERCP in our hospital from June 2020 to October 2021 were retrospectively analyzed. According to different stent types, the patients were divided into plastic stent group (n = 43) and metal stent group (n = 28). Patients in the plastic stent group and metal stent group were received with plastic stent and metal stent, respectively. The indexes of liver function (serum alkaline phosphatase (ALT), direct bilirubin (DBIL), glutamic oxaloacetic transaminase (AST), alkaline phosphatase (ALP), and total bilirubin (TBIL)), postoperative complications, success rate of stent implantation, and survival time of patients in the two groups were determined. Logistic multivariate regression analysis was used to analyze the prognostic factors of postoperative cholangiocarcinoma. The liver function indexes of the two groups were significantly improved after treatment with the stent, in which the ameliorative effect in the metal stent group was better than that in the plastic stent group (P < 0.05). The incidence of postoperative complications in the plastic stent group and the metal stent group was 53.49% and 14.29%, respectively, and the success rate of stent placement was 60.47% and 96.43%, respectively. The incidence of complications in the metal stent group was lower than that in the plastic stent group, and the success rate of stent placement was higher than that in the plastic stent group (P < 0.05). The median survival time of patients in the plastic stent group and the metal stent group was 8.15 and 11.83 months, respectively. The survival time of patients in the metal stent group was longer than that of the plastic stent group. The median survival time of patients with types I, II, III, and IV was 12.73, 11.54, 10.57, and 9.36 months, respectively. The survival time of patients with stage I was significantly higher than that of patients with types II, III, and IV. There was an inverse relationship between the disease type and the survival time of patients. Logistic multivariate regression analysis showed that tumor diameter ≥ 5 cm, portal vein invasion, lymph node metastasis, and classification of hilar cholangiocarcinoma were the risk factors (P < 0.05) and metal stent type was the protective factor (P < 0.05). In the clinical treatment of patients with cholangiocarcinoma, the placement of metal stent and plastic stent under ERCP plays an important role. The placement of the metal stent under ERCP has a higher success rate and better prognosis and can prolong the survival time of patients to a greater extent, but the price of the metal stent is relatively expensive. For patients with an expected survival period of more than 4-6 months, the metal stent should be considered; otherwise, the plastic stent can be used to maintain cost-effectiveness. Therefore, it is necessary to comprehensively analyze the patient's economic affordability, expected survival time, stent drainage time, and personal needs and then select an appropriate treatment method.


p53 Gene (NY-CO-13) Levels in Patients with Chronic Myeloid Leukemia: The Role of Imatinib and Nilotinib.
The p53 gene is also known as tumor suppressor p53. The main functions of the p53 gene are an anticancer effect and cellular genomic stability via various pathways including activation of DNA repair, induction of apoptosis, and arresting of cell growth at the G1/S phase. Normally, the p53 gene is inactivated by mouse double minute 2 proteins (mdm2), but it is activated in chronic myeloid leukemia (CML). Tyrosine kinase inhibitors are effective chemotherapeutic agents in the management of CML. The purpose of the present study was to evaluate the differential effect of imatinib and nilotinib on p53 gene serum levels in patients with CML. A total number of 60 patients with chronic myeloid leukemia with ages ranging from 47 to 59 years were recruited from the Iraqi Hematology Center. They started with tyrosine kinase inhibitors as first-line chemotherapy. They were divided into two groups-Group A, 29 patients treated with imatinib and Group B, 31 patients treated with nilotinib-and compared with 28 healthy subjects for evaluation p53 serum levels regarding the selective effect of either imatinib or nilotinib. There were significantly (p < 0.01) high p53 gene serum levels in patients with CML (2.135 ± 1.44 ng/mL) compared to the control (0.142 ± 0.11 ng/mL). Patients with CML that were treated with either imatinib or nilotinib showed insignificant differences in most of the hematological profile (p > 0.05) whereas, p53 serum levels were high (3.22 ± 1.99 ng/mL) in nilotinib-treated patients and relatively low (1.18 ± 0.19 ng/mL) in imatinib-treated patients (p = 0.0001). Nilotinib is more effective than imatinib in raising p53 serum levels in patients with chronic myeloid leukemia.


[DNA topoisomerases targeting anticancer agents and mechanism for acquirement of drug resistance].
DNA topoisomerase(topo) I and II regulate the topological conformation and DNA molecules by catalyzing the concerted breakage of single or double strands. Topo I and II targeting anticancer agents such as camptothecins (CPT-II), epipodophyllotoxins (VP16 and VM26), and amsarcine are widely used in cancer chemotherapy. To enhance their therapeutic efficacies, one should understand how cellular sensitivities to these topo-targeting agents are regulated, and one should also understand what mechanisms or factors are involved in the appearance of tumor cells resistant to them. We will discuss if there is any marker useful for determining drug sensitivity to these topo-targeting agents in cancer cells.


Activation of yeast pyruvate carboxylase: interactions between acyl coenzyme A compounds, aspartate, and substrates of the reaction.
Chicken liver pyruvate carboxylase has an absolute requirement for short-chain acyl coenzyme A (CoA), whereas the same enzyme from yeast has less stringent requirements. The yeast enzyme has now been studied in an effort to elucidate the mechanism by which acyl-CoA stimulates pyruvate carboxylase activity. Yeast pyruvate carboxylase has an apparent basal level of activity above which CoA and acyl-CoAs of 2-20 carbons activate; the concentration of acyl-CoA required for half-maximum activation (K0.5) decreases as the chain length of the acyl moiety increases to 16 carbons. Activation of yeast pyruvate carboxylase by acyl-CoA is brought about in part by increasing the affinity of pyruvate carboxylase for two substrates, bicarbonate and pyruvate. The affinity of pyruvate carboxylase for bicarbonate is also increased by potassium ions. The observation of only low levels of activity in the absence of acyl-CoA or potassium ion leads to the conclusion that the basal activity so frequently referred to is probably due to the presence of activating monovalent cations. Pyruvate carboxylase from yeast probably has an absolute requirement for monovalent cations or acyl-CoA with a combination of the two being required for optimum conditions for maximal activity. Stimulation by acyl-CoA and inhibition by aspartate are mutually antagonistic with each affecting the activation or inhibition constant and the degree of cooperativity brought about by the other. The enzyme from liver is unaffected by aspartate.


TAZ is involved in transcriptional complexes regulating smooth muscle cell differentiation.
TGFβ signaling plays an important role in the differentiation of vascular smooth muscle cells (VSMCs), yet the mechanism remains largely unknown. The study by Pagiatakis et al. identifies the transcriptional coactivator TAZ as a mediator of TGFβ signaling in VSMC-specific transcription. TAZ is involved in the formation of stable ternary complexes of SRF/Myocardin on CArG elements that are required for the transcription of VSMC structural genes.


Fasciola hepatica reinfection potentiates a mixed Th1/Th2/Th17/Treg response and correlates with the clinical phenotypes of anemia.
Fascioliasis is a severe zoonotic disease of worldwide extension caused by liver flukes. In human fascioliasis hyperendemic areas, reinfection and chronicity are the norm and anemia is the main sign. Herein, the profile of the Th1/Th2/Th17/Treg expression levels is analyzed after reinfection, correlating them with their corresponding hematological biomarkers of morbidity. The experimental design reproduces the usual reinfection/chronicity conditions in human fascioliasis endemic areas and included Fasciola hepatica primo-infected Wistar rats (PI) and rats reinfected at 8 weeks (R8), and at 12 weeks (R12), and negative control rats. In a cross-sectional study, the expression of the genes associated with Th1 (Ifng, Il12a, Il12b, Nos2), Th2 (Il4, Arg1), Treg (Foxp3, Il10, Tgfb, Ebi3), and Th17 (Il17) in the spleen and thymus was analyzed. After 20 weeks of primary infection, PI did not present significant changes in the expression of those genes when compared to non-infected rats (NI), but an increase of Il4, Arg1 and Ifng mRNA in the spleen was observed in R12, suggesting the existence of an active mixed Th1/Th2 systemic immune response in reinfection. Foxp3, Il10, Tgfb and Ebi3 levels increased in the spleen in R12 when compared to NI and PI, indicating that the Treg gene expression levels are potentiated in chronic phase reinfection. Il17 gene expression levels in R12 in the spleen increased when compared to NI, PI and R8. Gene expression levels of Il10 in the thymus increased when compared to NI and PI in R12. Ifng expression levels in the thymus increased in all reinfected rats, but not in PI. The clinical phenotype was determined by the fluke burden, the rat body weight and the hemogram. Multivariate mathematical models were built to describe the Th1/Th2/Th17/Treg expression levels and the clinical phenotype. In reinfection, two phenotypic patterns were detected: i) one which includes only increased splenic Ifng expression levels but no Treg expression, correlating with severe anemia; ii) another which includes increased splenic Ifng and Treg expression levels, correlating with a less severe anemia. In animals with established F. hepatica infection a huge increase in the immune response occurs, being a mixed Th2/Treg associated gene expression together with an expression of Ifng. Interestingly, a Th17 associated gene expression is also observed. Reinfection in the chronic phase is able to activate a mixed immune response (Th1/Th2/Th17/Treg) against F. hepatica but T and B proliferation to mitogens is strongly suppressed in all infected rats vs control in the advanced chronic phase independently of reinfection The systemic immune response is different in each group, suggesting that suppression is mediated by different mechanisms in each case. Immune suppression could be due to the parasite in PI and R8 rats and the induction of suppressive cells such as Treg in R12. This is the first study to provide fundamental insight into the immune profile in fascioliasis reinfection and its relation with the clinical phenotypes of anemia.


Artificial zinc(II) complexes regulate cell cycle and apoptosis-related genes in tumor cell lines.
Various proteins involved in transcriptional regulation possess highly selective DNA-binding domains, known as zinc fingers. However, little is known about small-molecule zinc(II) complexes in the regulation of gene expression and programmed cell death. A new family of zinc(II) complexes is reported, which might be useful against human cancer cells. By using template synthesis and in vitro cell-line screening, a set of zinc(II) complexes has been found to induce apoptosis of cancer cells and display single-reagent in vitro cytotoxicity. The method used to synthesize the molecules resulted in "built-in" luminescent behavior. Confocal optical imaging clearly demonstrated penetration through the cell membrane by these metal complexes. We have discovered that C3, the meso-zinc(II) complex is an extremely efficient regulator of the cell cycle and anti-apoptosis genes bcl-2 and bcl-xL. This study provides a new insight into the development of zinc(II) complexes as potential drugs.


Relation of Hemoglobin A1C Levels to Risk of Ischemic Stroke and Mortality in Patients With Diabetes Mellitus and Atrial Fibrillation.
Diabetes mellitus (DM) is associated with an increased risk of complications in atrial fibrillation (AF). This study aimed to assess the incidence and risks of ischemic stroke and mortality according to baseline HbA1c levels in patients with DM and AF. We conducted a cohort study using Clalit Health Services electronic medical records. The study population included all Clalit Health Services members aged ≥25 years, with the first diagnosis of AF between January 1, 2010, and December 31, 2016, who had a diagnosis of DM. The risk of stroke and all-cause death were compared according to HbA1c levels at the time of AF diagnosis: <7.0%, between 7% and 9%, and ≥9%. A total of 44,451 patients with DM and AF were identified. The median age was 75 years (interquartile 65 to 83), and 52.5% were women. During a mean follow-up of 38 months, higher levels of HbA1c were associated with an increased risk of stroke with a dose-dependent response when compared with patients with HbA1c <7% (Adjusted hazard ratio [aHR] =1.30 [95% confidence interval 1.10 to 2.05] for levels between 7% and 9% and 1.60 (95% confidence interval 1.25 to 2.03) for HbA1c >9%, even after adjusting for CHA2DS2-Vasc risk factors and use of oral anticoagulants. The risk for overall mortality was significantly higher in the HBA1C >9% group (aHR = 1.17 [1.07 to 1.28]). In conclusion, in this cohort of patients with AF and DM, HbA1c levels were associated with the risk of stroke in a dose-dependent manner even after accounting for other recognized risk factors for stroke.


Biosynthesis and metabolism of native and oxidized neuropeptide Y in the hippocampal mossy fiber system.
Neuropeptide Y (NPY) gene expression is known to be modulated in the mossy fiber projection of hippocampal granule cells following seizure. We investigated NPY biosynthesis and metabolism in an attempt to characterize NPY biochemically as a neurotransmitter in the granule cell mossy fiber projection. NPY biosynthesis was compared in normal control animals and in animals that had experienced a single pentylenetetrazole-induced seizure. In situ hybridization analysis established the postseizure time course of preproNPY mRNA expression in the hippocampal formation, localizing the majority of increased preproNPY mRNA content to the hilus of the dentate gyrus. Radioimmunoassay analysis of the CA3/mossy fiber terminal subfield confirmed a subsequent increase in NPY peptide content. Biosynthesis of NPY peptide by granule cells and transport to the CA3/mossy fiber subfield was demonstrated by in vivo radiolabel infusion to the dentate gyrus/hilus followed by sequential HPLC purification of identified radiolabeled peptide from the CA3/mossy fiber terminal subfield. Additional in vivo radiolabeling studies revealed a postseizure increase in an unidentified NPY-like immunoreactive (NPY-LI) species. HPLC/radioimmunoassay analyses of CA3 subfield tissue extracts comparing normal control animals and pentylenetetrazole-treated animals confirmed the increased total NPY-LI, and demonstrated that the increased NPY-LI was comprised of a minor increase in native NPY and a major increase in the unknown NPY-LI. Data from subsequent and separate analyses incorporating immunoprecipitation with anti-C-terminal flanking peptide of NPY, further HPLC purification, and matrix-assisted laser desorption/ionization mass spectrometry support the conclusion that the unknown NPY-LI is methionine sulfoxide NPY. NPY and NPY-sulfoxide displayed differential calcium sensitivity for release from mossy fiber synaptosomes. Similar to NPY, NPY sulfoxide displayed high-affinity binding to each of the cloned Y1, Y2, Y4, and Y5 receptor subtypes. Postrelease inactivation of NPY was demonstrated in a mossy fiber synaptosomal preparation. Thus, the present study in combination with previously reported electrophysiological activity of NPY in the CA3 subfield demonstrates that NPY fulfills the classical criteria for a neurotransmitter in the hippocampal granule cell mossy fiber projection, and reveals the presence of two molecular forms of NPY that display differential mechanisms of release while maintaining similar receptor potencies.


Standardization of the capillary electrophoresis procedures Capillarys® CDT and Minicap® CDT in comparison to the IFCC reference measurement procedure.
CDT is at present the most relevant routinely available biological marker of alcohol use and is widely used for screening and monitoring of patients. The lack of standardization leads to specific reference intervals for each procedure. The IFCC working group devoted to CDT demonstrated that the standardization is possible using calibrators assigned to the reference measurement procedure. In this study, we compare the capillary electrophoresis (CE) techniques Capillarys® CDT and Minicap® CDT (Sebia, Lisses, France) to the reference procedure before and after standardization in 126 samples covering the range of CDT measurement. Both capillary electrophoresis procedures show a high correlation (r=0,997) with the reference procedure and the concordance correlation coefficient evaluated according to Mc Bride is "almost perfect" (>0.997 for both CE procedures). The number of results with a relative difference higher than the acceptable difference limit is only 1 for Capillarys® CDT and 5 for Minicap® CDT. These results demonstrate the efficiency of the standardization of CDT measurements for both CE techniques from Sebia, achieved using calibrators assigned to the reference measurement procedure.


Exposure of gasoline road-tanker drivers to methyl tert-butyl ether and methyl tert-amyl ether.
Organic oxygenates, namely, methyl tert-butyl ether (MTBE) and methyl tert-amyl ether (MTAE), are added to gasoline to reduce carbon monoxide in exhausts and to enhance the octane number. The aim of this study was to investigate road-tanker drivers' exposure to oxygenate vapors during road-tanker loading and unloading as well as to evaluate the measurements of these ethers and their metabolites in the urine as a means of assessing the uptake of the ethers. A total of 11 drivers in different parts of Finland were trained to monitor their exposure with personal samplers, to report their working conditions, and to collect their whole-day urine samples. Charcoal tubes of the air samples were analyzed for MTBE, MTAE, benzene, toluene, and aliphatic hydrocarbons. For biological monitoring purposes the two main oxygenates, tertiary ethers MTBE and MTAE, as well as their main metabolites, tertiary alcohols tert-butanol (TBA) and tert-amyl alcohol (TAA), were determined in urine specimens. On average the drivers were exposed to vapors for short periods (21 +/- 14 min) three times during a work shift. The mean concentrations of MTBE and MTAE (mean +/- SD) were 8.1 +/- 8.4 and 0.3 +/- 0.4 mg/m3. The total MTBE uptake during the shift was calculated to be an average of 106 +/- 65 mumol. The mean concentrations of MTBE, TBA, MTAE and TAA detected in the first urine after the work shift were 113 +/- 76, 461 +/- 337, 16 +/- 21, and 40 +/- 38 nmol/l, and those found the next morning, 16 h later, were 18 +/- 12, 322 +/- 213, 9 +/- 10, and 20 +/- 27 nmol/l. The good relationship (r = 0.84) found between MTBE exposure and postshift excretion suggests that urinary MTBE can be used for biological monitoring of exposure, but at the present low level of exposure the corresponding metabolite TBA is not equally reliable. The determination of MTAE and its metabolite TAA in urine is sensitive enough to detect the low degree of exposure to MTAE, but in this study the data were too scarce to allow calculation of the correlations due to very low levels of MTAE exposure.


Scoring of orthopaedic residency applicants: is a scoring system reliable?
The purpose of the current study was to examine the interobserver reliability of a scoring system designed to objectify the screening of orthopaedic residency applications. Forty residency applications were selected randomly from those received in 1998 and were scored independently by six observers. The scoring system used included objective and subjective elements. Weights were assigned to individual data elements based on the results of a previous investigation. Interobserver reliability was calculated using an intraclass correlation coefficient. The overall reliability of the scoring system revealed an intraclass correlation coefficient of 0.80. The intraclass correlation coefficients for individual elements in the scoring system ranged from 0.28 to 0.98. The intraclass correlation coefficient was high for elements that were numeric, but was low for elements that were more subjective. Observers thought the scoring form was easy to complete but found some of the subjective data elements difficult to score. No benchmarks exist by which to define an acceptable intraclass correlation coefficient of a scoring model for resident applicants. Even with the use of careful definitions, raters had poor reliability in scoring elements such as letters of recommendation and personal statements. The results of the current study indicate that one score of objective data elements is adequate to screen a residency application for these elements. Programs screening applicants based on subjective elements, however, should be aware that great interobserver variability exists in the interpretation of those elements.


Characterization of defectiveness in endogenous antigen presentation of novel murine cells established from methylcholanthrene-induced fibrosarcomas.
Three cell lines (4A1, 4C2 and 6D1 cells) derived from fibrosarcoma induced by the inoculation of 3-methylcholanthrene into C3H/HeN (H-2k) mice were examined for their ability to present antigens to CD8+ cytotoxic T lymphocytes (CTL). 6D1 and 4C2 cells were deficient in presenting endogenously synthesized influenza virus antigens to CTL, but they were able to present antigens when they were sensitized with a synthetic epitope peptide. The expression of the H-2 Kk gene in 4C2 and 6D1 cells was much reduced and was detectable only with Northern blot hybridization. The expression of two transporter genes (TAP1 and TAP2), examined by Northern hybridization, was also reduced in both cells, and negligible particularly in 4C2 cells. Interferon-gamma (IFN-gamma) treatment of these cells induced expression of Kk, TAP1 and TAP2 genes and rescued the defect of class I-restricted antigen presentation in 4C2 and 6D1 cells. Even after this treatment, however, antigen-presentation capability of 4C2 cells was still much lower than that of normal 4A1 cells. This finding suggests that 4C2 cells might have an additional defective gene(s), whose products are involved in the processing of class I-restricted antigen, besides the Kk and TAP genes, and this may explain the difficulty of 4C2 cells to induce tumour-specific immunity, as described previously. To our knowledge, the 4C2 cell is the first tumour cell postulated to have more than three defective genes involved in class I-restricted antigen presentation.


Clinical trial of the Penn test for cancer.
An independent clinical trial of the Penn seroflocculation test for cancer was carried out in order to learn whether this test might be clinically useful either in differential diagnosis or as a screening test for the detection of cancer. In addition, studies were made of the flocculation titer of sera giving positive Penn tests. Incidental observations were made concerning the reproducibility of the test. The trial provided no evidence that the test might be useful in cancer detection. The test should be improved technologically before further clinical evaluations are undertaken. Further study of the basic mechanisms that bring about the positive Penn reaction appears desirable.


Role of Cathepsin S in Periodontal Inflammation and Infection.
Cathepsin S is a cysteine protease and regulator of autophagy with possible involvement in periodontitis. The objective of this study was to investigate whether cathepsin S is involved in the pathogenesis of periodontal diseases. Human periodontal fibroblasts were cultured under inflammatory and infectious conditions elicited by interleukin-1β and Fusobacterium nucleatum, respectively. An array-based approach was used to analyze differential expression of autophagy-associated genes. Cathepsin S was upregulated most strongly and thus further studied in vitro at gene and protein levels. In vivo, gingival tissue biopsies from rats with ligature-induced periodontitis and from periodontitis patients were also analyzed at transcriptional and protein levels. Multiple gene expression changes due to interleukin-1β and F. nucleatum were observed in vitro. Both stimulants caused a significant cathepsin S upregulation. A significantly elevated cathepsin S expression in gingival biopsies from rats with experimental periodontitis was found in vivo, as compared to that from control. Gingival biopsies from periodontitis patients showed a significantly higher cathepsin S expression than those from healthy gingiva. Our findings provide original evidence that cathepsin S is increased in periodontal cells and tissues under inflammatory and infectious conditions, suggesting a critical role of this autophagy-associated molecule in the pathogenesis of periodontitis.


Thermal action of 2.45 GHz microwaves on the cytoplasm of Chinese hamster cells.
In order to demonstrate possible specific effects of microwaves at the cellular level V-79 Chinese hamster cells were exposed to 2.45-GHz radiation at power levels of 20-200 mW/cm2 and at specific absorption rates of 10-100 mW/g. Intracellular cytoplasmic changes were observed by fluorescence polarization using a method based on the intracellular enzymatic hydrolysis of nonfluorescent fluorescein diacetate (FDA). At levels of absorbed energy below 90 J/g, modifications of microviscosity and mitochondrial state were absent, but a slight stimulation of enzymatic hydrolysis of FDA was observed which may be explained by microwave-induced alterations of cellular membranes possibly due to differences in heating pattern of microwaves compared to water-bath heating. At levels of absorbed energy above 90 J/g, the decrease of enzymatic hydrolysis of FDA, increase in degree of polarization, and increase of permeation of the fluorescent marker correlated well with the decrease in cell viability as measured by the exclusion of trypan blue. At equal absorbed energy, microwaves were found to exert effects comparable to classical heating except that permeation was slightly more affected by microwave than by classical heating. This suggests that membrane alteration produced by microwaves might differ from those induced by classical heating or that microwaves may have heated the membrane to higher temperatures than did classical heating.


Candidate genes affecting Drosophila life span identified by integrating microarray gene expression analysis and QTL mapping.
The current increase in life expectancy observed in industrialized societies underscores the need to achieve a better understanding of the aging process that could help the development of effective strategies to achieve healthy aging. This will require not only identifying genes involved in the aging process, but also understanding how their effects are modulated by environmental factors, such as dietary intake and life style. Although the human genome has been sequenced, it may be impractical to study humans or other long-lived organisms to gain a mechanistic understanding about the aging process. Thus, short-lived animal models are essential to identifying the mechanisms and genes that affect the rate and quality of aging as a first step towards identifying genetic variants in humans. In this study, we investigated gene expression changes between two strains of Drosophila (Oregon and 2b) for which quantitative trait loci (QTLs) affecting life span were identified previously. We collected males and females from both strains at young and old ages, and assessed whole genome variation in transcript abundance using Affymetrix GeneChips. We observed 8217 probe sets with detectable transcripts. A total of 2371 probe sets, representing 2220 genes, exhibited significant changes in transcript abundance with age; and 839 probe sets were differentially expressed between Oregon and 2b. We focused on the 359 probe sets (representing 354 genes) that exhibited significant changes in gene expression both with age and between strains. We used these genes to integrate the analysis of microarray gene expression data, bioinformatics, and the results of genetic mapping studies reported previously, to identify 49 candidate genes and four pathways that could potentially be responsible for regulating life span and involved in the process of aging in Drosophila and humans.


[A new hypothesis for the treatment of amblyopia: the flicker stimulator].
A variety of cells are involved in the pathogenesis of amblyopia : ON, OFF, ON-OFF cells, postsynaptic cells, neurons of striate cortex and the select interest of the macula. The need for stimulation of these cells in treating amblyopia forms the theoretical basis of the Flicker stimulator with red monochromatic light (LED, 655 nm). The authors present a clinical investigation on 35 subjects with anisometropic or strabismic amblyopia, before extensive treatment with classic anti-amblyopic techniques without satisfactory improvement obtaining significant statistical results (p less than 0,001).


Remote Sensing Image Recognition Based on LOG-T-SSA-LSSVM and AE-ELM Network.
Aiming at the influence of different working conditions on recognition accuracy in remote sensing image recognition, this paper adopts hierarchical strategy to construct a network. Firstly, in order to establish the classification relationship between different samples, labeled samples are used for classification. A Logistic-T-distribution-Sparrow Search Algorithm-Least Squares Support Vector Machines (LOG-T-SSA-LSSVM) classification network is proposed. LOG-T-SSA algorithm is used to optimize parameters in LSSVM to establish a better network to achieve accurate classification between sample sets and then identify according to different categories. Through UCI dataset test, the accuracy of LOG-T-SSA-LSSVM network classification is significantly improved compared with that of contrast network. The autoencoder is integrated with Extreme Learning Machine, and the autoencoder is used to realize data compression. The advantages of Extreme Learning Machine (ELM) network, such as less training parameters, fast learning speed, and strong generalization ability, are fully utilized to realize efficient and supervised recognition. Experiments verify that the autoencoder-extreme learning machine (AE-ELM) network has a good recognition effect when the sigmoid activation function is selected and the number of hidden layer neurons are 2000. Finally, after image recognition under different working conditions, it is proved that the recognition accuracy of AE-ELM based on LOG-T-SSA-LSSVM classification is significantly improved compared with traditional ELM network and Particle Swarm Optimization-Extreme Learning Machine (PSO-ELM) network.


Skin dose from radiotherapy X-ray beams: the influence of energy.
Skin-sparing properties of megavoltage photon beams are compromised by electron contamination. Higher energy beams do not necessarily produce lower surface and basal cell layer doses due to this electron contamination. For a 5 x 5 cm field size the surface doses for 6 MVp and 18 MVp X-ray beams are 10% and 7% of their respective maxima. However, at a field size of 40 x 40 cm the percentage surface dose is 42% for both 6 MVp and 18 MVp beams. The introduction of beam modifying devices such block trays can further reduce the skin-sparing advantages of high energy photon beams. Using a 10 mm perspex block tray, the surface doses for 6 MVp and 18 MVp beams with a 5 x 5 cm field size are 10% and 8%, respectively. At 40 x 40 cm, surface doses are 61% and 63% for 6 MVp and 18 MVp beams, respectively. This trend is followed at the basal cell layer depth. At a depth of 1 mm, 18 MVp beam doses are always at least 5% smaller than 6 MVp doses for the same depth at all field sizes when normalized to their respective Dmax values. Results have shown that higher energy photon beams produce a negligible reduction of the delivered dose to the basal cell layer (0.1 mm). Only a small increase in skin sparing is seen at the dermal layer (1 mm), which can be negated by the increased exit dose from an opposing field.


Three-Dimensional Photon Counting Imaging with Axially Distributed Sensing.
In this paper, we review three-dimensional (3D) photon counting imaging with axially distributed sensing. Under severely photon-starved conditions, we have proposed various imaging and algorithmic approaches to reconstruct a scene in 3D, which are not possible by using conventional imaging system due to lack of sufficient number of photons. In this paper, we present an overview of optical sensing and imaging system along with dedicated algorithms for reconstructing 3D scenes by photon counting axially distributed sensing, which may be implemented by moving a single image sensor along its optical axis. To visualize the 3D image, statistical estimation methods and computational reconstruction of axially distributed sensing is applied.


Flexible Photodriven Actuator Based on Gradient-Paraffin-Wax-Filled Ti3C2Tx MXene Film for Bionic Robots.
Due to their high flexibility and adaptability, bionic robots have great potential in applications such as healthcare, rescue, and surveillance. The flexible actuator is an essential component of the bionic robot and determines its performance. Even though much progress has been achieved in bionic robot research, there still exists a great challenge in preparing a flexible actuator with a large stroke, high sensitivity, fast response, low triggering power, and long lifetime. This study presents a flexible actuator based on a paraffin wax and Ti3C2Tx MXene (PW-MX) film composite. Such a flexible actuator delivers an excellent actuation performance, including a large curvature change (2.2 × 102 m-1), high thermal sensitivity (4.6 m-1/°C), low triggering power of light (76 mW/cm2), wavelength selectivity, fast response (0.38 s), and long lifetime (>20000 cycles). Due to the high thermal sensitivity and the strong infrared absorption of the PW-MX film, crawling motion of an inchworm robot based on PW-MX film can be triggered by infrared irradiation from the human finger. To mimic living organisms with bioluminescence, we prepared a PW-MX actuator with green fluorescence by doping PW-MX film with CdSe/ZnS quantum dots. The integration of luminescent function enables the PW-MX actuator to deliver information under light stimulation and to camouflage under a background of green foliage actively. With its merits of ease of fabrication and high actuation performance, the flexible PW-MX actuator is expected to lend itself to more applications in the future.


Compartment Syndrome of the Foot: An Evidence-Based Review.
Compartment syndrome of the foot (CSF) is a surgical emergency, with high risk of morbidity and poor outcome, including persistent neurologic deficits or amputation. Uncertainty remains regarding surgical approaches, pressure monitoring values, and the extent of surgical treatment. This review provides a summary of the current knowledge and reports evidence-based diagnostic and therapeutic management options for CSF. Articles describing CSF were identified from MEDLINE, PubMed, and Cochrane databases up until February 2018. Experimental and original articles, systematic and nonsystematic reviews, case reports, and book chapters, independent of their level of evidence, were included. Crush injuries are the leading cause of CSF, but CSF can present after fractures of the tarsal or metatarsal bones and dislocations of the Lisfranc or Chopart joints. CSF is often associated with persistent neurologic deficits, claw toes, amputations, and skin healing problems. Diagnosis is made after accurate clinical evaluation combined with intracompartmental pressure monitoring. A threshold value of <20 mmHg difference between the diastolic blood pressure and the intracompartmental pressure is considered diagnostic. Management consists of surgery, whereby 2 dorsal incisions are combined with a medioplantar incision to the calcaneal compartment. The calcaneal compartment can serve as an "indicator compartment," as the highest-pressure values can regularly be measured within this compartment. Appropriately powered studies of CSF are necessary to further evaluate and compare diagnostic and therapeutic options.


Micafungin for Candida infections in Slovenia and Romania: A multicenter, observational, prospective study.
An echinocandin, such as micafungin, is recommended as first-line treatment for invasive Candida infections in immunocompromised patients. This multicenter, observational, prospective, non- interventional study evaluated the real-world use of micafungin in clinical practice in Slovenia and Romania, as this remains unexplored. The primary endpoint was evaluation of micafungin use, including rationale for prescription, treatment duration, and daily dose. Secondary endpoints included recordings of patient baseline characteristics and evaluations of efficacy and safety. Across 11 centers in two countries, 118 patients (18 children [< 16 years] and 100 adults [≥ 16 years]) received micafungin for the first time according to their clinic's standard practice. Micafungin was prescribed for treatment in 57.6% of patients and for prophylaxis in 40.7% of patients. The median (range) treatment duration was 9.0 (0 - 54) days and 13.0 (2 - 6)] days, respectively. The median dose of micafungin was higher than recommended for children receiving prophylaxis or treatment for invasive candidiasis and for adults receiving prophylaxis. Fever was the most commonly observed clinical sign at baseline (16 children [88.9%] and 31 adults [31%]) and hematologic malignancy was the most frequent primary diagnosis at admission (11 children [61.1%] and 40 adults [40%]). Candida species were the most commonly identified causal agents of invasive fungal infections (2 children [11.1%] and 48 adults [48%]). The efficacy and safety profiles of micafungin use in Slovenia and Romania based on clinician's own experiences in local clinical practice were consistent with those reported in other real-world studies.


Serum free thyroxine and triiodothyronine concentrations in subacute thyroiditis.
Serum absolute free T4 (AFT4) and T3 (AFT3) concentrations were studied in 10 patients with subacute thyroiditis whose total serum T4 levels were elevated, and values were compared with those obtained in 10 patients with untreated Graves' disease, whose total serum T4 concentrations were elevated to the same level as in the former group. The mean (+/- SD) basal metabolic rate in patients with subacute thyroiditis was 16 +/- 14.8%, significantly (P less than 0.001) lower than that in patients with Graves' disease (48.7 +/- 15.7%). Serum T4-binding globulin concentrations measured by RIA were normal and did not differ from those in Graves' disease patients. The percentage of free T4 and AFT4 were both elevated in subacute thyroiditis to a degree comparable to that seen in Graves' disease. The serum total T3, serum free T3 fraction and AFT3 were also elevated, but both total T3 and AFT3 were significantly (P less than 0.05 and P less than 0.05, respectively) lower than in Graves' disease patients. Therefore, the ratios of T3 to T4 and AFT3 to AFT4 were significantly (P less than 0.01 and P less than 0.01, respectively) lower than in Graves' disease patients. These results indicate that the significantly lower basal metabolic rate and milder manifestations of thyrotoxic symptoms in subacute thyroiditis than in Graves' disease might be explained by the low ratios of T3 to T4 and AFT3 to AFT4 as well as the short duration of chemical hyperthyroidism.


[Fungal peritonitis episodes in a peritoneal dialysis centre during a 10-year period: a report of 11 cases].
Fungal peritonitis is a rare cause of peritonitis, but it is associated to poorer prognosis and higher mortality than bacterial peritonitis. Until now, predisposing factors and treatment have not been well established. We retrospectively reviewed all the cases of fungal peritonitis diagnosed for ten years in 218 patients undergoing continuous ambulatory peritoneal dialysis. In all we detected 11 episodes of fungal peritonitis in 11 patients, that means the 4% of continuous ambulatory peritoneal dialysis peritonitis. All the cases of fungal peritonitis were caused by Candida species. As a result of fungal peritonitis 36% of the patients died, 55% had to change to long-term hemodialysis because of failure in peritoneal dialysis technique. Only one case (9%) managed to continue peritoneal dialysis. The factors associated with the development of fungal peritonitis were: the presence of antibiotic use within 1 month before fungal peritonitis, patient older than 70 years old, low levels in albumine plasmatic and long permanence in continuous ambulatory peritoneal dialysis. The treatment consisted in intraperitoneal fluconazol combined with oral 5-flucytosine for 4 to 6 weeks. In the two last cases we associated intravenous caspofungine too. Given that no improvement was seen within 72 hours of treatment, the catheter must be removed in all the cases.


Antitumor effect of two oral steroids, mepitiostane and fluoxymesterone, on a pregnancy-dependent mouse mammary tumor (TPDMT-4).
Pregnancy-dependent TPDMT-4 mammary tumors, characterized by requiring estrogen, progesterone, and pituitary hormones for growth, grew continuously in female DDD mice carrying pituitary isografts. The experimental model was used to investigate the antitumor effects of two p.o. steroids, mepitiostane and fluoxymesterone. When tumors implanted with pituitary isografts into the fat-pad reached palpable size, animals received 6 doses/week of 0.1, 0.3, 1.0, and 3.0 mg of either steroid intragastrically. Mepitiostane significantly suppressed tumor growth with regression in 25 and 29 percent of animals at 1.0 and 3.0 mg, respectively, but had no inhibitory effects at other doses. Fluoxymesterone retarted tumor growth during the first week of treatment at 3.0 mg but finally had no inhibitory effects at any doses. Under similar conditions ovariectomy caused tumor regression immediately, and epitiostanol, the parent steroid of mepitiostane, significantly suppressed tumor growth when given in 3 injections/week of 0.5 mg s.c. Tumous had papillary structures and almost lacked secretory activity. A comparison of these findings to those obtained with earlier generations suggests that TPDMT-4 tumors became less sensitive to the antitumor effect of epitiostanol and were able to grow at lower hormone levels with succeeding generations. Morphologically, progression to more cancer and less secretory activity was noticed.


Potentially avoidable hospitalisations of German nursing home patients? A cross-sectional study on utilisation patterns and potential consequences for healthcare.
Demand for nursing home (NH) care is soaring due to gains in life expectancy and people living longer with chronic illness and disability. This is dovetailing with workforce shortages across the healthcare profession. Access to timely and appropriate medical care for NH residents is becoming increasingly challenging and can result in potentially avoidable hospitalisations (PAHs). In light of these factors, we analysed PAHs comparing NH patients with non-NH patients. Cross-sectional study with claims data from 2015 supplied by a large German health insurance company within the federal state of Baden-Wuerttemberg. One-year observation of hospitalisation patterns for NH and non-NH patients. 3 872 245 of the 10.5million inhabitants of Baden-Wuerttemberg were covered. Patient data about hospitalisation date, sex, age, nationality, level of care and diagnoses were available. PAHs were defined based on international classification of diseases (ICD-10) diagnoses belonging to ambulatory care sensitive conditions (ACSCs). Adjusted ORs for PAHs for NH patients in comparison with non-NH patients were calculated with multivariable regression models. Of the 933 242 hospitalisations in 2015, there were 23 982 for 13 478 NH patients and 909 260 for 560 998 non-NH patients. Mean age of hospitalised NH patients and level of care were significantly higher than those of non-NH patients. 6449 PAHs (29.6%) for NH patients and 136 543 PAHs (15.02%) for non-NH patients were identified. The adjusted OR for PAHs was significantly heightened for NH patients in comparison with non-NH patients (OR: 1.22, CI (1.18 to 1.26), p<0.0001). Moreover, we could observe that more than 90% of PAHs with ACSCs were unplanned hospitalisations (UHs). Large numbers of PAHs for NH patients calls for improved coordination of medical care, especially general practitioner service provision. Introduction of targeted training programmes for physicians and NH staff on health problem management for NH patients could perhaps contribute to reduction of PAHs, predominantly UHs.


Phorbol ester and calcium ionophore are sufficient to promote cell replication in cultures of quiescent human B lymphocytes.
Highly purified, resting B cells could be induced to grow for up to 10 days by culturing in the presence of a synergistic combination of a tumour-promoting phorbol ester and the calcium ionophore ionomycin. In spite of evident cell death occurring, four to five times as many viable B lymphocytes could be harvested at the end of culture than were initially plated. Soluble factors derived from T cells (interleukin-2, commercial B-cell growth factor) or monocytes (interleukin-1) failed to augment further the growth-promotion observed. Evidence is presented to suggest that an autocrine component might be necessary for maintenance of the cell-cycle and growth initiated by the phorbol ester and calcium ionophore combination. The significance of these findings to B-cell physiology are discussed.


The management of multiple paraganglioma of the head and neck.
During the years 1984 to 1991, of 32 patients who had one large glomus or carotid body tumour, six were found to have other paragangliomas. Excluded from the above total of 32 are patients whose only lesion was a solitary glomus tympanicum. No two patients had identical problems and no pattern emerged on which patient management in any particular case could be based. The major problems associated with the tumours themselves and their treatment is the risk to hearing and the lower cranial nerves. Individual cases and their treatment are discussed.


Proteinuria reduction: mandatory consideration or option when selecting an antihypertensive agent?
Proteinuria is a known risk factor for both cardiovascular disease and progression of established kidney disease. Observational studies and intervention trials have established that even low levels of albuminuria (microalbuminuria) are associated with increased risk for cardiovascular morbidity and mortality in general, and especially in high-risk populations such as those with diabetes mellitus. People with hypertension are at increased risk for proteinuria and arguably should be treated with regimens that not only lower blood pressure but also reduce proteinuria. Clinical trials indicate that lowering proteinuria in those with chronic kidney disease is associated with reduced risk for progression to end-stage kidney disease and cardiovascular outcomes. Many of these trials employ antihypertensive agents that block the renin-angiotensin-aldosterone system (RAAS), and indicate that these drugs are, in general, more effective than other antihypertensive regimens for reducing proteinuria. In addition, several small studies suggest that nondihydropyridine calcium channel blockers are comparable with angiotensin-converting enzyme inhibitors and more effective than dihydropyridine calcium channel blockers for reducing proteinuria in type 2 diabetics with advanced kidney disease. Based on the combined evidence from epidemiologic and intervention studies, it seems prudent to make proteinuria reduction a mandatory consideration in the selection of antihypertensive regimens.


Identification of iodinated proteins in cultured thyrocytes and their possible significance for thyroid hormone formation.
The thyroid gland is known to generate the iodinated hormones T3 and T4 from the prohormone thyroglobulin. In this report we examined whether polypeptides other than thyroglobulin are iodinated and hormonogenic in thyrocytes and the prerequisites for their iodination. In primary cultures of porcine thyrocytes, a substantial portion of organified radioiodine was incorporated into cellular proteins other than thyroglobulin. Some of these were identified by immunoprecipitation. They included proteins of the extracellular matrix, plasma membrane proteins, and lysosomal enzymes, which follow in part a secretion and recapture pathway. All of these proteins come into contact with the iodinating system of thyrocytes located on the apical plasma membrane and possess iodination consensus sequences. Immunoprecipitation with T3- or T4-specific antibodies showed that thyroid hormones were detectable only within thyroglobulin. This was confirmed by an analysis of the iodoamino acids of thyroglobulin, cathepsin-D (representing a secretory protein), and aminopeptidase-N (a membrane-integrated protein) by two-dimensional TLC, which revealed the presence of T3 and T4 only within the polypeptide chain of thyroglobulin. These results indicate that iodoproteins other than thyroglobulin do not participate in the generation of thyroid hormones in situ.


[Multidisciplinary tailoring of therapy of metastatic colon cancer].
Treatment of colon cancer requires multidisciplinary team work. The multitude of therapies in metastatic colon cancer have led to longer overall survival with fewer symptoms. Median survival has increased from 5 months with the best supportive care to 30-40 months in randomized studies, even with curative treatment in some patients. Tailoring of the treatment is best done by a multidisciplinary team considering radiotherapy and operation of the primary tumor, resection of liver, lung and peritoneal metastases, medical treatment alternatives, palliative care, ablative methods etc. Without skillful surgeons, oncologists, pathologists, geneticists, radiologists etc. the best treatment opportunities may be missed.


BARTONELLA HENSELAE NEURORETINITIS ASSOCIATED WITH CENTRAL RETINAL VEIN OCCLUSION, CHOROIDAL ISCHEMIA, AND ISCHEMIC OPTIC NEUROPATHY.
We describe a healthy 37-year-old man with Bartonella henselae (B. henselae) neuroretinitis with concurrent central retinal vein occlusion and ischemic optic neuropathy resulting in optic atrophy and choroidal ischemia. Case report. A 37-year-old man presented with unilateral decreased vision and a fundus examination consistent with neuroretinitis. Further imaging review supported a concurrent diagnosis of central retinal vein occlusion. Although initially negative, repeat serological testing for B. henselae infection was positive. Multimodal imaging displayed severe outer retinal disruption, ischemic optic neuropathy, and choroidal ischemia. The patient demonstrated near complete resolution of fundus findings and restoration of outer retinal architecture. Residual findings included optic disk pallor and ischemic choroidopathy. B. henselae neuroretinitis may be associated with concurrent retinal vascular occlusive disease and ischemic optic neuropathy. Central retinal vein occlusion and choroidal ischemia leading to optic nerve atrophy are additional sequelae further expanding the clinical spectrum of this entity.


Who's In and Who's Out-Compositional Control of Biomolecular Condensates.
Biomolecular condensates are two- and three-dimensional compartments in eukaryotic cells that concentrate specific collections of molecules without an encapsulating membrane. Many condensates behave as dynamic liquids and appear to form through liquid-liquid phase separation driven by weak, multivalent interactions between macromolecules. In this review, we discuss current models and data regarding the control of condensate composition, and we describe our current understanding of the composition of representative condensates including PML nuclear bodies, P-bodies, stress granules, the nucleolus, and two-dimensional membrane localized LAT and nephrin clusters. Specific interactions, such as interactions between modular binding domains, weaker interactions between intrinsically disorder regions and nucleic acid base pairing, and nonspecific interactions, such as electrostatic interactions and hydrophobic interactions, influence condensate composition. Understanding how specific condensate composition is determined is essential to understanding condensates as biochemical entities and ultimately discerning their cellular and organismic functions.


Youth's Perceptions of Parental Support and Parental Knowledge as Moderators of the Association Between Youth-Probation Officer Relationship and Probation Non-compliance.
As a community-based sanction, juvenile probation exemplifies the potential of both communities and families to make significant contributions in promoting positive changes among offending youth. Yet, surprisingly little research has explored the nature of these relationships and its association with offending. This study (1) examined the associations between youth-officer relationships, youth perceptions of parental support and knowledge, and probation non-compliance and (2) explored the role of parental support and knowledge as moderators of the association between youth-officer relationships and probation non-compliance among 110 youth supervised on probation (23 % females; 60 % African American). The findings showed that tough or punitive youth-officer relationships were associated with greater counts of technical violations, but fewer counts of delinquent offenses. Parental support was associated with fewer counts of delinquent offenses and parental knowledge was associated with fewer counts of both delinquent offenses and technical violations. These findings provide evidence to the important role of both parents and probation officers and underscore the potential benefits of parent-officer collaboration in facilitating successful interventions among offending youth.


Immunohistochemical localization of S-100 protein in granular cell myoblastoma.
The presence and distribution of S-100 protein were studied in three cases of granular cell myoblastoma using the peroxidase-anti-peroxidase method. Positive immunostaining was observed in all cases. The densely brown reaction products were found both in the nuclei and in the cytoplasm of myoblastoma cells. The staining of the nuclei was more intense than that of the cytoplasm. In addition, both normal Schwann cells and tumor cells of Schwannomas were also stained with anti-S-100 antibody. This result further supports the concept of the neurogenic origin of the granular cell myoblastoma.


Risk factors and prognostic factors of local recurrence after radiofrequency ablation of hepatocellular carcinoma.
Local recurrence rates after radiofrequency ablation (RFA) of hepatocellular carcinoma (HCC) vary from 2% to 36% in the literature. Limited data were available about the prognostic significance of local recurrence. Between April 2001 and March 2006, 273 patients with 357 hepatocellular carcinoma nodules underwent RFA, with radiologically complete tumor ablation after a single session of RFA. The risk factors of local recurrence and its impact on overall survival of patients were analyzed. With a median followup period of 24 months, local recurrence occurred in 35 patients (12.8%). By multivariate analysis, tumor size > 2.5 cm was the only independent risk factor for local recurrence. There was no notable difference in overall survival between patients with and without local recurrence. By multivariate analysis, local recurrence more than 12 months after RFA and complete response after additional treatment of local recurrence were associated with better overall survival in patients with local recurrence. This study demonstrated that tumor size > 2.5 cm was the main risk factor for local recurrence after RFA of hepatocellular carcinoma. Our data suggested that additional aggressive treatment of local recurrence aimed at complete tumor response improves overall survival of patients. Late local recurrence was also associated with better prognosis, suggesting different tumor biology between early and late local recurrent tumors after RFA.


Cytochemical identification of the leukocytes of torpedoes (Torpedo marmorata Risso and Torpedo ocellata Rafinisque).
The authors subjected peripheral blood smears of Torpedoes to cytochemical analysis of lipids, protein, neutral and acid polysaccahrides and of some enzymatic activities, i.e. adenosine triphosphatase (ATP-ase), acid and alkaline phosphatase, aliesterase and peroxidase. It was found that neutrophilic granulocytes are intensely PAS and aliesterase positive and weakly ATP-ase positive. Eosinophilic granulocytes show the presence of neutral polysaccharides in the matrix (which is PAS positive) and strong ATP-ase and acid phosphatase activities in the granules. Lymphocytes sometimes contain weakly PAS and aliesterase positive granules. Monocytes show some small PAS positive granules and weak acid phosphatase and aliesterase activities. Thrombocytes contain some peripheral granules which are PAS positive and slightly ATP-ase positive. There are no transitional forms between the various cellular types. The results confirm the classification of leukocytes of Torpedoes into neutrophilic granulocytes, eosinophilic granulocytes, lymphocytes, monocytes and thrombocytes and contribute some informations about the histoenzymatic content of Elasmobranch leukocytes.


Platinum(II)-adenosine phosphothiorate complexes: kinetics of formation and phosphorus-31 NMR characterization studies.
Reactions of chloro(diethylenetriamine)platinum(II) chloride with adenosine 5'-O-thiomonophosphate, adenosine 5'-O-(2-thiodiphosphate), and adenosine 5'-O-(3-thiotriphosphate) yielded exclusively (phosphothiorato)platinum(II) complexes. Phosphorus-31 NMR data for the coordinated phosphothiorate phosphorus atom exhibited about 15-20 ppm upfield chemical shift compared to chemical shifts for free nucleotides. Uncoordinated phosphate groups exhibited insignificant changes in the chemical shift upon complexation. Likewise, proton NMR data indicate no significant changes in chemical shift for the purine or ribose protons. Reactions between phosphothiorates and the platinum complex predominately take place through a second-order process, first order with respect to each of the reactants indicating that the aquated pathway contributes insignificantly toward complexation. The second-order rate constants, 1.9 +/- 0.1 M-1 s-1 for the AMP-S, 2.4 +/- 0.2 M-1 s-1 for the ADP-beta-S, and 2.7 +/- 0.2 M-1 s-1 for the ATP-gamma-S reactions were evaluated at pH 6.5 and at 25 degrees C. These rate data were compared with those reactions of adenosine 5'-monophosphate (AMP) and guanosine 5'-monophosphate (GMP) with the same platinum(II) complex. These reactions proceed through the direct interaction between the starting platinum complex and nucleotides as well as through the reaction between the aquaplatinum complex and nucleotides. The rate constant for the aquation process was evaluated to be (2.0 +/- 0.1) x 10(-4) s-1 for both AMP and GMP reactions.(ABSTRACT TRUNCATED AT 250 WORDS)


Transient Occlusion of Uterine Arteries in Procedures with High Risk of Uterine Bleeding.
Uterine-conservative surgery via laparoscopy is a challengeable and high risk because of heavy intra-operative bleeding events in reproductive women with highly vascular uterine benign disease. There are three reported cases of women with highly vascular uterine benign diseases and high risk of intra-operative heavy bleeding, but were treated successfully to control intra-operative heavy bleeding risk by transient occlusion of the uterine artery (TOUA) through laparoscopy and resulted in safe conservation of the uterus. The cases of women with high risk of heavy bleeding during therapeutic procedure included cesarean scar pregnancy, hydatid form mole on cesarean scar, and cervical pregnancy. All these women had the strong desire to presere their fertility and uterus. In all the three cases, we used the method of TOUA and performed therapeutic surgeries successfully, with less bleeding and safe conservation of the uterus through laparoscopy. Laparoscopic TOUA could be a therapeutic option to manage heavy intra-operative bleeding during conservative uterine surgeries associated with the risk of heavy bleeding.


Pharmacokinetics of lidocaine after prolonged intravenous infusions in uncomplicated myocardial infarction.
The kinetics of the elimination of lidocaine upon discontinuation of lidocaine infusions lasting more than 24 h were studied in 12 patients with uncomplicated myocardial infarctions. In this group of patients the mean half-life of the elimination phase was found to be 3.22 h. This is significantly different from the half-life of 100 min that has been reported after bolus injections or infusions lasting less than 12 h. This longer half-life should be taken into consideration in estimating the duration of toxicity and the rate of administration of the drug during and after intravenous infusions lasting 24 h or more.


[Clinical observation on therapeutic effect of electroacupuncture on chronic prostatitis and detection of urethral sphincter EMG].
To observe the clinical therapeutic effect of electroacupuncture for chronic prostatitis and investigate its mechanism. Forty-eight cases were randomly divided into an electroacupuncture group and a western medicine group, 24 cases in each group. The electroacupuncture group was treated by electroacupuncture and Guanyuan (CV 4), Zhongji (CV 3). Ciliao (BL 32) and Huiyang (BL 35) were selected as main acupoints. The western medicine group was treated by oral administration of Sparfloxacin tablets and Prostat tablets. The scores of NIH-CPSI, changes in uroflow rate-urethral sphincter EMG and their therapeutic effects were observed. The total effective rate was 87.5 % in the electroacupuncture group which, was better than 62. 5% in the western medicine group (P(<0. 05). There were significant differences in the scores of NIH-CPSI and Q(max), Q(ave), TL value before and after treatment in the electroacupuncture group (all P<0.05), and with a significant difference in the scores of NIH-CPSI and Q(max). Q(ave), TL value after treatment between the two groups (all P<0.05). Electroacupuncture based on syndrome differentiation has better therapeutic effect on chronic prostatitis than that of routine clinical medicine.