Perioperative and oncologic outcomes of minimally invasive liver resection for colorectal metastases: A case-control study of 130 patients.
Our aim was to compare the perioperative and oncologic outcomes of open liver resection and minimally invasive liver resection in the management of colorectal liver metastases. Patients who underwent minimally invasive liver resection for colorectal liver metastases between January 2006 and June 2015 at a single center were identified and matched by extent of resection to consecutive open liver resection patients from the same period. Clinicopathologic characteristics, perioperative data, recurrence, and survival outcomes were collected and analyzed based on intention-to-treat. Sixty-five patients underwent minimally invasive liver resection during this period and were matched to 65 consecutive open liver resection patients, with similar baseline demographic, tumor, and chemotherapy parameters. Conversion to open occurred in 5 (7.7%) minimally invasive liver resection patients. R0 resection rates and operative times were comparable, but the estimated blood loss was less in the minimally invasive liver resection group (median 200 mL vs 400 mL, P < .001), as were perioperative transfusion rates (4.6% vs 15.4%, P = .04). The duration of stay was shorter after minimally invasive liver resection (median 4 days vs 6 days, P < .001), while major and minor complication rates were similar and no perioperative mortality was recorded. At a median follow-up of 28 months, there was no difference regarding disease-free (P = .90) or overall survival (P = .37). In selected patients with colorectal liver metastases, minimally invasive liver resection resulted in similar oncologic outcomes, with decreased blood loss and shorter duration of stay compared to patients who underwent open liver resection.


Percutaneous transcatheter ventricular septal defect closure in adults with Amplatzer septal occluders.
The interest in transcatheter ventricular septal defect (VSD) closure is continuously growing. Therefore, we report our experience in perimembranous (Pm) and postinfarction (Pi) VSD closure. All patients, older than 16 years, were selected from a data base, in which Pm and Pi VSDs were registered. The patients' files were reviewed until the most recent follow-up date. Nine (7 male, 37.4 +/- 12.8 y) and 8 (6 male, 76.3 +/- 6.2 y) patients underwent a Pm (group A) and Pi VSD (group B) closure, respectively. One female patient was treated for a posttraumatic VSD (26 y). In group A, 7 patients were closed with the Amplatzer perimembranous VSD occluder, one with the muscular VSD occluder, and one patient with the atrial septal defect occluder. All patients in group B were treated with the muscular VSD occluder. In the post-traumatic VSD an Amplatzer patent foramen ovale occluder was used. Device implantation was feasible in all, except in two patients with extremely large VSDs (one Pm and one PiVSD). Total transcatheter closure or small residual leakage was achieved in 7/8 patients in group A, but one patient needed surgical VSD repair because of massive haemolysis, another patient died 9 months later. A small or moderate shunt was present immediately after the procedure in all patients of group B. No device-related complications were reported, but all, except one patient, died within 2 weeks after the procedure because of an extremely high co-morbidity (logistic Euroscore 70 +/- 25%). Total closure was achieved in the post-traumatic VSD. Transcatheter closure of Pm and Pi VSD with Amplatzer septal occluders in adults is feasible and safe, but the post-procedural prognosis totally depends on the aetiology of the VSD and its co-morbidity.


Nanotechnology-Based Cardiac Targeting and Direct Cardiac Reprogramming: The Betrothed.
Cardiovascular diseases represent the first cause of morbidity in Western countries, and chronic heart failure features a significant health care burden in developed countries. Efforts in the attempt of finding new possible strategies for the treatment of CHF yielded several approaches based on the use of stem cells. The discovery of direct cardiac reprogramming has unveiled a new approach to heart regeneration, allowing, at least in principle, the conversion of one differentiated cell type into another without proceeding through a pluripotent intermediate. First developed for cancer treatment, nanotechnology-based approaches have opened new perspectives in many fields of medical research, including cardiovascular research. Nanotechnology could allow the delivery of molecules with specific biological activity at a sustained and controlled rate in heart tissue, in a cell-specific manner. Potentially, all the mediators and structural molecules involved in the fibrotic process could be selectively targeted by nanocarriers, but to date, only few experiences have been made in cardiac research. This review highlights the most prominent concepts that characterize both the field of cardiac reprogramming and a nanomedicine-based approach to cardiovascular diseases, hypothesizing a possible synergy between these two very promising fields of research in the treatment of heart failure.


Reduced Knoevenagel Reaction of Acetetracenylene-1,2-dione with Acceptor Units for Luminescent Tetracene Derivatives.
Acetetracenylene-1,2-dione reacted with 3-ethylrhodanine in the presence of piperidine and Hantzsch ester via a Knoevenagel condensation-reduction sequence to give a tetracene-rhodanine adduct. This reduced Knoevenagel product exhibited magenta luminescence with a fluorescence quantum yield of φ = 0.34 and fluorescence lifetime of τ = 13.2 ns in toluene. Electrochemical studies and charge carrier transport measurements revealed ambipolar properties with hole and electron mobilities of 5.1 × 10-7 and 1.6 × 10-4 cm2/(V s), respectively.


Therapeutic Implications of Caffeic Acid in Cancer and Neurological Diseases.
Caffeic acid (CA) is found abundantly in fruits, vegetables, tea, coffee, oils, and more. CA and its derivatives have been used for many centuries due to their natural healing and medicinal properties. CA possesses various biological and pharmacological activities, including antioxidant, anti-inflammatory, anticancer, and neuroprotective effects. The potential therapeutic effects of CA are mediated via repression and inhibition of transcription and growth factors. CA possesses potential anticancer and neuroprotective effects in human cell cultures and animal models. However, the biomolecular interactions and pathways of CA have been described highlighting the target binding proteins and signaling molecules. The current review focuses on CA's chemical, physical, and pharmacological properties, including antioxidant, anti-inflammatory, anticancer, and neuroprotective effects. We further described CA's characteristics and therapeutic potential and its future directions.


Polycomb Protein BMI-1 as a Potential Therapeutic Target in Mucinous Ovarian Cancer.
Mucinous ovarian carcinoma (mOC) is a rare subtype with distinct clinical characteristics and biological behavior that differentiate them from other epithelial ovarian cancers. This study aimed to evaluate BMI-1 expression as a potential target for therapeutic approaches in advanced stage mOC. We performed gene set, as well as transcription factor enrichment analysis and immunohistochemistry assessing of the BMI-1 protein levels in tissue specimens of eighteen mucinous ovarian cancer patients. To validate the clinical relevance of the findings, we performed cell viability assays and western blot analysis utilizing high-grade serous (HGSC) and mOC cell lines. BMI1 expression was not significantly associated with patient age, FIGO stage, lymph node status, and family history. With regard to progression-free survival, there was also no significant association (p=0.418). Cell viability was significant decreased in response to carboplatin in HGSC cells TYK-nu and OVHASO, and in mOC cell lines COV644 and EFO-27. Western blot analysis demonstrated various expression levels across all cell lines. BMI-1 could be a useful potential therapeutic target in some ovarian cancer patients, including mOC patients.


Use of patient decision aids increased younger women's reluctance to begin screening mammography: a systematic review and meta-analysis.
As breast cancer screening guidelines have changed recently, additional investigation is needed to understand changes in women's behavior after using breast cancer screening patient decision aids (BCS-PtDAs) and the potential effect on mammography utilization. This systematic review and meta-analysis sought to evaluate the effect of BCS-PtDAs on changes in women's intentions to undergo screening mammography and whether women deciding to begin or discontinue screening mammography displayed similar changes in screening intentions after using a BCS-PtDA. We searched Medline, Scopus, PsycINFO, CENTRAL, Health and Psychosocial Instruments, Health Technology Assessment Database, PsycARTICLES, and cited references in eligible papers for randomized controlled trials (RCTs) and observational studies, published through August 24, 2016. The proportions of women who did and not intend to undergo screening and who were uncertain about undergoing screening mammography were pooled, using risk ratios (RR) and random effects. According to the protocol, RCTs or observational studies and any language were considered eligible for systematic review if they included data about women for which shared decision making is recommended. We ultimately included six studies with screening intention data for 2040 women. Compared to usual care, the use of BCS-PtDAs in three RCTs resulted in significantly more women deciding not to undergo screening mammography (RR 1.48 [95% CI 1.04-2.13]; P = 0.03), particularly for younger (38-50 years) women (1.77 [1.34-2.34]; P < 0.001). The use of BCS-PtDAs had a non-significant effect on the intentions of older women (69-89 years) to discontinue screening. The use of BCS-PtDAs increased younger women's reluctance to undergo screening for breast cancer. The implementation of such BCS-PtDAs in clinical practice would be expected to result in a 77% increase in the number of younger women (aged 38-50) who do not intend to be screened, and as a consequence, may reduce utilization of screening mammography. The protocol of this review is registered in the PROSPERO database, #CRD42016036695.


How to Perform and Interpret Functional Magnetic Resonance Imaging Studies in Functional Gastrointestinal Disorders.
Functional neuroimaging studies have revealed the importance of the role of cognitive and psychological factors and the dysregulation of the brain-gut axis in functional gastrointestinal disorder patients. Although only a small number of neuroimaging studies have been conducted in functional gastrointestinal disorder patients, and despite the fact that the neuroimaging technique requires a high level of knowledge, the technique still has a great deal of potential. The application of functional magnetic resonance imaging (fMRI) technique in functional gastrointestinal disorders should provide novel methods of diagnosing and treating patients. In this review, basic knowledge and technical/practical issues of fMRI will be introduced to clinicians.


Should intensivist do routine abdominal ultrasound?
Roundworm infestation is common in tropical climate population with a low socioeconomic status. We describe a case of a young male with polytrauma accident who presented with small bowel dysfunction with a high gastric residual volume during enteral feeding. While searching the etiology, the intensivist performed bedside abdominal ultrasound (USG) as a part of whole body USG screening along with clinical examination using different frequency probes to examine bowel movement and ultimately found ascariasis to be the cause. This case report will boost up the wide use of bedside USG by critical care physicians in their patient workup.


Molecular biology of colorectal cancer: new targets.
Colorectal cancer is an ideal model in which to study malignant progression from the molecular-genetic perspective because different stages of the same malignancy coexist within each patient. Approximately 75% of colorectal cancer cases are sporadic and the remaining are familial disease, yet genetic mutations that have been identified account for only 5% to 6% of inherited cases. The two major pathways by which mutational changes leading to colorectal cancer occur are chromosomal instability and microsatellite instability. This article discusses genes and signaling pathways involved in development of inherited disease, as well as the association of some of these pathways with sporadic cases. Furthermore, therapies targeting active pathways in colorectal carcinogenesis, including the vascular endothelial growth factor and epidermal growth factor receptor tyrosine kinase, have shown promising results in clinical trials are now included in standard recommended treatment.


Meth mouth severity in response to drug-use patterns and dental access in methamphetamine users.
Meth mouth is the rapid development of tooth decay in methamphetamine users. Our study questioned whether drug-use patterns and dental care access are risk factors affecting the severity of meth mouth. Participants received dental examinations, and the number of decayed, missing and filled teeth (DMFT) were counted and used to measure meth mouth severity.


Divergent Longitudinal Propagation of White Matter Degradation in Logopenic and Semantic Variants of Primary Progressive Aphasia.
Clinico-pathological distinction of primary progressive aphasia (PPA) can be challenging at clinic presentation. In particular, cross-sectional neuroimaging signatures across the logopenic (lvPPA) and semantic (svPPA) variants are difficult to establish, with longitudinal profiles showing greater divergence. Assess longitudinal propagation of white matter degradation in lvPPA and svPPA to determine disease progression over time, and whether this reflects distinct underlying pathology. A cohort of 27 patients with dementia (12 lvPPA; 15 svPPA) and 12 healthy controls were assessed at baseline and 1-year follow-up on the Addenbrooke's Cognitive Examination-Revised and Sydney Language Battery. Diffusion weighted images were collected at both time-points and analyzed for longitudinal white matter change using DTI-TK and TBSS. LvPPA patients showed a significant decline in naming and repetition, over 1 year, while svPPA patients declined in naming and comprehension. Longitudinal imaging revealed widespread bilateral degradation of white matter tracts in lvPPA over a 1-year period with early involvement of the left posterior inferior longitudinal fasciculus (ILF). SvPPA demonstrated focal left lateralized white matter degradation involving the uncinate fasciculus (UF) and anterior ILF, propagating to the right UF with disease progression. LvPPA and svPPA cohorts showed distinct longitudinal cognitive and white matter profiles. We propose differences in multi-centric and focal white matter dysfunction in lvPPA and svPPA, respectively, reflect underlying pathological differences. The clinical relevance of white matter degradation and mechanisms underlying disease propagation are discussed.


Ability of plasma from patients with immune thrombocytopenic purpura (ITP) to promote the growth of megakaryocyte progenitors from normal bone marrow.
The ability of plasma from ITP patients (before and after splenectomy) to support the growth of megakaryocyte progenitors was compared with that from healthy subjects. Plasma Factor Index-Megakaryocyte PFI-Mk (ITP) which expressed resultant colony growth was significantly lower before splenectomy, but it normalized after splenectomy. (PFI-Mk) (ITP) did not relate neither to megakaryocyte nor to platelet counts. A positive correlation has been observed between megakaryocyte and platelet numbers in healthy subjects and in ITP patients after splenectomy, but not before splenectomy. The proportion of immature megakaryocytes was markedly higher in ITP marrow before splenectomy. This study indicates, that in ITP apart from antibodies directed to platelets and megakarocytes a low plasma stimulatory activity affected megakaryocytopoiesis.


Competition and collaboration between different actin assembly pathways allows for homeostatic control of the actin cytoskeleton.
Tremendous insight into actin-associated proteins has come from careful biochemical and cell biological characterization of their activities and regulation. However, many studies of their cellular behavior have only considered each in isolation. Recent efforts reveal that assembly factors compete for polymerization-competent actin monomers, suggesting that actin is homeostatically regulated. It seems that a major regulatory component is competition between Arp2/3-activating nucleation promoting factors and profilin for actin monomers. The result is differential delivery of actin to different pathways, allowing for simultaneous assembly of competing F-actin structures and collaborative building of higher order cellular structures. Although there are likely to be additional factors that regulate actin homeostasis, especially in a cell type-dependent fashion, we advance the notion that competition between actin assembly factors results in a tunable system that can be adjusted according to extracellular and intracellular cues.


Inhibiting TNF-α signaling does not attenuate induction of endotoxin tolerance.
Tumor necrosis factor-alpha (TNF-α) is a central mediator of inflammatory responses elicited by Toll-like receptor agonists, such as the Gram-negative bacterial outer membrane antigen lipopolysaccharide (LPS). TNF-α is responsible for altering vascular permeability and activating infiltrating inflammatory cells, such as monocytes and neutrophils. Interestingly, TNF-α has also demonstrated the ability to induce tolerance to subsequent challenges with TNF-α or LPS in monocyte and macrophage cell populations. Tolerance is characterized by the inability to mount a typical inflammatory response during subsequent challenges following the initial exposure to an inflammatory mediator such as LPS. The ability of TNF-α to induce a tolerant-like state with regard to LPS is most likely a regulatory mechanism to prevent excessive inflammation. We hypothesized that the induction of tolerance or the degree of tolerance is dependent upon the production of TNF-α during the primary response to LPS. To investigate TNF-α-dependent tolerance, human monocytic THP-1 cells were treated with TNF-α-neutralizing antibodies or antagonistic TNF-α receptor antibodies before primary LPS stimulation and then monitored for the production of TNF-α during the primary and challenge stimulation. During the primary stimulation, anti-TNF-α treatment effectively attenuated the production of TNF-α and interleukin-1β; however, this reduced production did not impact the induction of endotoxin tolerance. These results demonstrate that interfering with TNF-α signaling attenuates production of inflammatory cytokines without affecting the induction of tolerance.


Role of the rostral medial medulla in the development of primary and secondary hyperalgesia after incision in the rat.
Descending influences from the rostral medial medulla (RMM) contribute to secondary hyperalgesia in persistent inflammatory, neuropathic, and visceral pain models. The current study examined if descending inhibition or facilitation from the RMM modulates primary and secondary hyperalgesia after incision in the rat hind limb. Bilateral RMM lesions were produced using the soma-selective neurotoxin ibotenic acid, and the effect of RMM lesion was examined on primary and secondary hyperalgesia 5 days after a plantar or gastrocnemius incision, respectively. Plantar incision reduced withdrawal thresholds to von Frey filaments applied adjacent to the incision (primary punctate hyperalgesia). The withdrawal thresholds were the same in RMM-lesioned and sham-operated rats. The response frequency to a blunt mechanical stimulus after plantar incision was increased (primary nonpunctate hyperalgesia) in both groups. Nonpunctate hyperalgesia was greater in lesioned rats on postoperative day 2 only; all other measures were not different. Primary heat hyperalgesia after plantar incision was not modulated by RMM lesion. Secondary punctate hyperalgesia after gastrocnemius incision was not affected by RMM lesion. Gastrocnemius incision did not produce secondary nonpunctate or heat hyperalgesia in either RMM lesion or sham rats. Primary and secondary hyperalgesia after an incision were not modulated by descending influence from the RMM. The lack of contribution of descending facilitatory influences from the RMM to secondary hyperalgesia after gastrocnemius incision supports the notion that incision-induced pain involves dissimilar mechanisms compared with inflammatory and neuropathic pain.


[Surgery of late complications of previous active treatment of lung tuberculosis with extrapleural plombage].
Between January 1984 and February 1997 10 patients with late complications of a former active collapse therapy were operated. In case of our patients between 1943 and 1960 the collaps therapy was carried out with the extrapleural instillation of plombs for therapy of pulmonary tuberculosis. At present main complications were infections of plombs with pleurobronchial and pleurocutaneus fistulas and perforation of plombs. By all patients both extirpation and pleurectomy were necessary. In case of 5 patients additionally lung resection was required, in case of 3 patients a thoracoplasty and by 1 patient a myoplasty. Although there are considerable destructions of lung parenchym in a part the results of long-term follow up are satisfactory: 6 patients are so far without complaints; only 1 patient died 10 years postoperative. Prerequisite for a successful therapy are the knowledge of the surgical methods of the collaps area, the used materials, the pathomorphological pulmonary changes and the good cooperation between pneumologists and thoracic surgeons.


Families and natural history of lipids in childhood: an 18-year follow-up study.
The natural history of total cholesterol and lipoprotein cholesterol in offspring was studied in relation to total cholesterol levels in their parents in the Epidemiological Prevention Study of Zoetermeer (EPOZ). All residents of 5 or more years who were living in two districts in the Dutch town of Zoetermeer were invited to participate in a study on indicators for chronic diseases between 1975 and 1978. In a random sample of 483 youngsters who were 5-19 years old, yearly measurements of cardiovascular risk factors were performed during a follow-up period of 18 years (average follow-up, 13.8 years). Total and subfraction cholesterol levels in offspring during follow-up were studied by tertiles of age-adjusted total cholesterol in their parents. Total and low density lipoprotein (LDL) cholesterol levels measured from childhood into young adulthood differed significantly between offspring whose fathers were in the highest total cholesterol tertile compared with those whose fathers were in the lowest tertile, amounting to 0.4 mmol/liter for total cholesterol and 0.5 mmol/liter for LDL cholesterol. Offspring differences by maternal tertiles amounted to 0.5 mmol/liter for total cholesterol and 0.6 mmol/liter for LDL cholesterol. Offspring (n = 53) with both parents in the upper cholesterol tertile had almost 1 mmol/liter higher cholesterol levels compared with offspring (n = 51) with both parents in the lowest tertile, whereas offspring (n = 48) with both parents in the middle tertile had intermediate levels. Differences remained after adjustment for sex, Quetelet index, systolic and diastolic blood pressure, and use of alcohol, cigarettes, and oral contraceptives. Offspring group differences in total and LDL cholesterol were already present in childhood and persisted into young adulthood. There was no clear relation between offspring change in cholesterol levels and parental total cholesterol levels. For high density lipoprotein cholesterol and its subfractions, no relations with parental total cholesterol levels were found. Based on the evidence of a strong positive relation between total cholesterol levels in parents and offspring levels of total and LDL cholesterol measured from childhood into young adulthood, the authors conclude that total and LDL cholesterol levels in offspring may already be characterized from young age and beyond through cholesterol levels in their parents.


The EVER genes - the genetic etiology of carcinogenesis in epidermodysplasia verruciformis and a possible role in non-epidermodysplasia verruciformis patients.
In recent years, the two adjacent novel EVER1 and EVER2 genes have been identified, whose mutations are responsible for the development of epidermodysplasia verruciformis (EV). Epidermodysplasia verruciformis is a rare, autosomal recessive genodermatosis associated with increased risk of skin carcinoma. Up to now 7 mutations in the EVER1 gene and 5 mutations in the EVER2 gene have been identified only in EV. It was also determined that the EVER genes belong to a novel gene family, the transmembrane channel-like (TMC) family, and are responsible for properly functioning zinc homeostasis. These observations have given new insights into EV pathogenesis.


Bacteriology of chronic discharging ears in Port Harcourt, Nigeria.
The objective of the study was to isolate and identify aerobic bacteria in chronic discharging ears and determine their antibiotic susceptibilities, which is essential for reasonable empiric treatment. Ear swabs of discharging ears aseptically collected from 102 patients of various age groups attending Ear, Nose, and Throat out-patient clinic at University of Port Harcourt Teaching Hospital were cultured for bacterial agents using blood agar, chocolate agar and MacConkey agar. Culture plates were incubated aerobically at 37 degrees C for 24-48 hours. Isolates were identified using standard microbiological methods. Members of the family enterobacteriaceae were identified using enterotubes. Antibiotic susceptibility test was carried out for 13 drugs using disc diffusion method. Seventy-eight percent of the patients studied were in the age group 0-14 years and there were more male infants than females. Gram negative bacteria comprised 75% of the isolates. Predominant isolates were Pseudomonas aeruginosa (41%), Proteus sp. (22%), Staphylococcus aureus (22%), Escherichia coli and other coliforms (11%). Drug susceptibility profile of the isolates showed that ceftazidime, ceftriazone and gentamycin were most effective drugs in vitro. The predominant bacterial agents in chronic discharging ears in Port Harcourt, Nigeria were gram negative bacteria and included Pseudomonas aeruginosa, Proteus sp., Escherichia coli. Gram positive bacterial constituted 25 percent of the isolates and included Staphylococcus aureus, Staphylococcus epidermidis and streptococcus sp. Ceftazidime, ceftrixone and gentamycin were the most effective drugs in vitro.


Revision Total Hip Arthroplasty Using a Cementless Cup Supporter and Iliac Autograft: A Minimum of 15-Year Follow-Up.
Bone deficiency in revision total hip arthroplasty is a surgical challenge. The Murata-Chiba cup supporter (MC support ring) is an acetabular component supporter for a cementless porous-coated cup. The purpose of this study is to examine the clinical and radiographic outcomes of reconstruction of acetabular bone deficiency using iliac autografts supported by an MC support ring in a revision setting with minimum 15-year follow-up. Fifty-nine consecutive revision total hip arthroplasties (57 patients) using the MC support ring were followed for a minimum of 15 years. Nine hips had American Academy of Orthopaedic Surgeons type II deficiency and 24 had type III defects of the acetabulum. Clinical outcomes were evaluated using the Harris hip score. Radiographic evaluation included assessment for loosening and bone graft incorporation. Kaplan-Meier survival analysis was performed. At a minimum 15-year follow-up (mean, 17.6 years), 32 patients (33 hips) were alive, 17 patients (18 hips) were deceased, and 8 patients (8 hips) were lost to follow-up. The mean Harris hip score improved from 44.3 to 77.2 at final follow-up. Four hips required reoperation due to deep infection (2 hips) and liner dissociation (2 hips), but no acetabular components were revised for aseptic loosening. Incorporation of the bone graft occurred in all cases. One unrevised patient had radiographic failure. Survivorship at 15 years with re-revision or radiographic failure as the end point was 90.6% (95% confidence interval, 83.0%-98.8%). The reconstruction of acetabular bone deficiency using autografts supported by an MC support ring provided satisfactory clinical and radiological results at 17.6 years postoperatively.


[Pitfalls in left atrial reduction. Superior neo-cava with pericardium].
Left atrial reduction is a surgical technique that has been proposed for eliminating chronic atrial fibrillation associated with mitral valve disease. A potential complication of the technique is the unnoticed rotation of the heart while the left atrium is anastomosed. Such an event makes it impossible to reconstruct the superior vena cava, leading to superior vena cava syndrome due to the rotation of that vessel. We report our experience with a case of left atrial reduction and rotation of the superior vena cava while it was being anastomosed. The complication was successfully resolved by placing an autologous pericardial tube between the two ends of the superior vena cava.


Antihyperglycemic Activity of the Leaves from Annona cherimola Miller and Rutin on Alloxan-induced Diabetic Rats.
Annona cherimola, known as "chirimoya" has been reported in Mexican traditional medicine for the treatment of diabetes. The aims of the present study were to validate and assess the traditional use of A. cherimola as an antidiabetic agent. The ethanol extract from A. cherimola (300 mg/kg, EEAc), subsequent fractions (100 mg/kg), and rutin (30 mg/kg) were studied on alloxan-induced type 2 diabetic (AITD) and normoglycemic rats. In addition, oral glucose tolerance test (OGTT) and oral sucrose tolerance test (OSTT) were performed in normoglycemic rats. Molecular docking technique was used to conduct the computational study. Bioassay-guided fractionation of EEAc afforded as major antihyperglycemic compound, rutin. EEAc attenuated postprandial hyperglycemia in acute test using AITD rats (331.5 mg/dL) carrying the glycemic levels to 149.2 mg/dL. Rutin after 2 h, attenuated postprandial hyperglycemia in an acute assay using AITD rats such as EEAc, with maximum effect (150.0 mg/dL) being seen at 4 h. The antihyperglycemic activities of EEAc and rutin were comparable with acarbose (151.3 mg/dL). In the subchronic assay on AITD rats, the EEAc and rutin showed a reduction of the blood glucose levels since the 1st week of treatment, reaching levels similar to normoglycemic state (116.9 mg/kg) that stayed constant for the rest of the assay. OGTT and OSTT showed that EEAc and rutin significantly lowered blood glucose levels in normoglycemic rats at 2 h after a glucose or sucrose load such as acarbose. Computational molecular docking showed that rutin interacted with four amino acids residues in the enzyme α-glucosidase. The results suggest that rutin an α-glucosidase inhibitor was responsible in part of the antihyperglycemic activity of A. cherimola. Its in vivo antihyperglycemic activity is in good agreement with the traditional use of A. cherimola for the treatment of diabetes. The ethanol extract from Annona cherimola (300 mg/kg, EEAc), subsequent fractions (100 mg/kg) and rutin (30 mg/kg) were studied on alloxan-induced type 2 diabetic (AITD) and normoglycemic rats. The results suggest that rutin; an α-glucosidase inhibitor was responsible in part of the antihyperglycemic activity of A. cherimola. Its in vivo antihyperglycemic activity is in good agreement with the traditional use of A. cherimola for the treatment of diabetes. Abbreviations Used: EEAc: The ethanol extract from Annona cherimola, AITD: Alloxan-induced type 2 diabetic rats, OGTT: Oral glucose tolerance test, OSTT: Oral sucrose tolerance test, DM: Diabetes mellitus.


[A case of male pseudohermaphroditism with structural abnormalities of Y chromosome (ring Y)].
A case of male pseudohermaphroditism with ring Y chromosome is reported. The patient was a 3-year-old boy with hypospadias and right cryptorchidism. Culture of peripheral lymphocytes demonstrated a chromosomal mosaicism of 45 X/46 X, r (Y). Moreover, the chromosomal study with high resolution Q-band method revealed the presence of double ring Y (ring Y and double ring Y with the ratio of 25: 5). A well-developed vagina was discovered by retrograde cystourethrography. Uterus and fallopian tubes were absent at exploratory laparotomy. The gonads existed in the scrotum on the left side and in the inguinal pouch on the right. Both gonads were proved to be testes histologically, but bilateral was deferens were absent and its remnant was found in the retroperitoneal cavity. Plastic surgery for the genital abnormalities was performed. Only 30 cases of ring Y chromosome have been reported in the world including our case and we briefly reviewed these cases.


In vivo and in vitro effect of sulfamethazine on hepatic mixed function oxidases in rats.
Sulfamethazine (SMZ) administration (ip, 3 d) of different doses to adult male rats showed significant increases in the electron transport components and activities of aminopyrine N-demethylase and aniline hydroxylase at the the 150 mg SMZ/kg dose level. However, 300 mg SMZ/kg doses produced a significant decrease in cytochrome P-450 and the activity of aminopyrine N-demethylase. In a longer duration study, 300 mg SMZ/kg caused significant decreases in cytochrome P-450 and in the activity of aminopyrine N-demethylase. The inducer dose of 150 mg SMZ/kg and the inhibitory dose of 300 mg SMZ/kg were selected for dosing young male, old male and adult female rats. Sulfamethazine administration to young male rats resulted in a significant induction of electron transport components and drug metabolizing enzymes at both dose levels. However, SMZ treatment of old rats produced significant decreases in electron transport components and aminopryine N-demethylase activity at both dose levels. A significant induction in the levels of electron transport components was observed with 150 mg SMZ/kg in female rats. All other parameters were unchanged. Sulfamethazine resulted in a mixed type of inhibition (Ki = 3.5 mM) of aminopyrine N-demethylase in vitro. Hydroxylated metabolites destructed the spectral and catalytic activity of cytochrome P-450. Our studies suggest that SMZ is a substrate of the mixed function oxidase system and induction is dependent on dosage, age and sex of the animals.


Plasma proprotein convertase subtilisin kexin type 9 levels are related to markers of cholesterol synthesis in familial combined hyperlipidemia.
Two recent independent studies showed that patients with familial combined hyperlipidemia (FCHL) have elevated plasma levels of proprotein convertase subtilisin kexin type 9 (PCSK9) and markers of cholesterol synthesis. Both PCSK9 expression and cholesterol synthesis are downstream effects of hepatic activation of sterol regulatory element binding protein 2 (SREBP2). The present study was conducted to study the relationship between plasma PCSK9 and markers of cholesterol synthesis in FCHL. Markers of cholesterol synthesis (squalene, desmosterol, lathosterol), cholesterol absorption (campesterol, sitosterol, cholestanol) and PCSK9 were measured in plasma of FCHL patients (n = 103) and their normolipidemic relatives (NLR; n = 240). Plasma PCSK9, lathosterol and desmosterol levels were higher in FCHL patients than their NLR (p < 0.001, age and sex adjusted). Heritability calculations demonstrated that 35% of the variance in PCSK9 levels could be explained by additive genetic effects (p < 0.001). Significant age- and sex-adjusted correlations were observed for the relationship between PCSK9 and lathosterol, both unadjusted and adjusted for cholesterol, in the overall FCHL population (both p < 0.001). Multivariate regression analyses, with PCSK9 as the dependent variable, showed that the regression coefficient for FCHL status decreased by 25% (from 0.8 to 0.6) when lathosterol was included. Nevertheless, FCHL status remained an independent contributor to plasma PCSK9 (p < 0.001). The present study confirms the previously reported high and heritable PCSK9 levels in FCHL patients. Furthermore, we now show that high PCSK9 levels are, in part, explained by plasma lathosterol, suggesting that SREBP2 activation partly accounts for elevated PCSK9 levels in FCHL.


Beds, overlays and mattresses for preventing and treating pressure ulcers: an overview of Cochrane Reviews and network meta-analysis.
Pressure ulcers (also known as pressure injuries, pressure sores and bed sores) are localised injuries to the skin or underlying soft tissue, or both, caused by unrelieved pressure, shear or friction. Specific kinds of beds, overlays and mattresses are widely used with the aim of preventing and treating pressure ulcers. To summarise evidence from Cochrane Reviews that assess the effects of beds, overlays and mattresses on reducing the incidence of pressure ulcers and on increasing pressure ulcer healing in any setting and population. To assess the relative effects of different types of beds, overlays and mattresses for reducing the incidence of pressure ulcers and increasing pressure ulcer healing in any setting and population. To cumulatively rank the different treatment options of beds, overlays and mattresses in order of their effectiveness in pressure ulcer prevention and treatment. In July 2020, we searched the Cochrane Library. Cochrane Reviews reporting the effectiveness of beds, mattresses or overlays for preventing or treating pressure ulcers were eligible for inclusion in this overview. Two review authors independently screened search results and undertook data extraction and risk of bias assessment using the ROBIS tool. We summarised the reported evidence in an overview of reviews. Where possible, we included the randomised controlled trials from each included review in network meta-analyses. We assessed the relative effectiveness of beds, overlays and mattresses for preventing or treating pressure ulcers and their probabilities of being, comparably, the most effective treatment. We assessed the certainty of the evidence using the GRADE approach. We include six Cochrane Reviews in this overview of reviews, all at low or unclear risk of bias. Pressure ulcer prevention: four reviews (of 68 studies with 18,174 participants) report direct evidence for 27 pairwise comparisons between 12 types of support surface on the following outcomes: pressure ulcer incidence, time to pressure ulcer incidence, patient comfort response, adverse event rates, health-related quality of life, and cost-effectiveness. Here we focus on outcomes with some evidence at a minimum of low certainty. (1) Pressure ulcer incidence: our overview includes direct evidence for 27 comparisons that mostly (19/27) have very low-certainty evidence concerning reduction of pressure ulcer risk. We included 40 studies (12,517 participants; 1298 participants with new ulcers) in a network meta-analysis involving 13 types of intervention. Data informing the network are sparse and this, together with the high risk of bias in most studies informing the network, means most network contrasts (64/78) yield evidence of very low certainty. There is low-certainty evidence that, compared with foam surfaces (reference treatment), reactive air surfaces (e.g. static air overlays) (risk ratio (RR) 0.46, 95% confidence interval (CI) 0.29 to 0.75), alternating pressure (active) air surfaces (e.g. alternating pressure air mattresses, large-celled ripple mattresses) (RR 0.63, 95% CI 0.42 to 0.93), and reactive gel surfaces (e.g. gel pads used on operating tables) (RR 0.47, 95% CI 0.22 to 1.01) may reduce pressure ulcer incidence. The ranking of treatments in terms of effectiveness is also of very low certainty for all interventions. It is unclear which treatment is best for preventing ulceration. (2) Time to pressure ulcer incidence: four reviews had direct evidence on this outcome for seven comparisons. We included 10 studies (7211 participants; 699 participants with new ulcers) evaluating six interventions in a network meta-analysis. Again, data from most network contrasts (13/15) are of very low certainty. There is low-certainty evidence that, compared with foam surfaces (reference treatment), reactive air surfaces may reduce the hazard of developing new pressure ulcers (hazard ratio (HR) 0.20, 95% CI 0.04 to 1.05). The ranking of all support surfaces for preventing pressure ulcers in terms of time to healing is uncertain. (3) Cost-effectiveness: this overview includes direct evidence for three comparisons. For preventing pressure ulcers, alternating pressure air surfaces are probably more cost-effective than foam surfaces (moderate-certainty evidence). Pressure ulcer treatment: two reviews (of 12 studies with 972 participants) report direct evidence for five comparisons on: complete pressure ulcer healing, time to complete pressure ulcer healing, patient comfort response, adverse event rates, and cost-effectiveness. Here we focus on outcomes with some evidence at a minimum of low certainty. (1) Complete pressure ulcer healing: our overview includes direct evidence for five comparisons. There is uncertainty about the relative effects of beds, overlays and mattresses on ulcer healing. The corresponding network meta-analysis (with four studies, 397 participants) had only three direct contrasts and a total of six network contrasts. Again, most network contrasts (5/6) have very low-certainty evidence. There was low-certainty evidence that more people with pressure ulcers may heal completely using reactive air surfaces than using foam surfaces (RR 1.32, 95% CI 0.96 to 1.80). We are uncertain which surfaces have the highest probability of being the most effective (all very low-certainty evidence). (2) Time to complete pressure ulcer healing: this overview includes direct evidence for one comparison: people using reactive air surfaces may be more likely to have healed pressure ulcers compared with those using foam surfaces in long-term care settings (HR 2.66, 95% CI 1.34 to 5.17; low-certainty evidence). (3) Cost-effectiveness: this overview includes direct evidence for one comparison: compared with foam surfaces, reactive air surfaces may cost an extra 26 US dollars for every ulcer-free day in the first year of use in long-term care settings (low-certainty evidence). Compared with foam surfaces, reactive air surfaces may reduce pressure ulcer risk and may increase complete ulcer healing. Compared with foam surfaces, alternating pressure air surfaces may reduce pressure ulcer risk and are probably more cost-effective in preventing pressure ulcers. Compared with foam surfaces, reactive gel surfaces may reduce pressure ulcer risk, particularly for people in operating rooms and long-term care settings. There are uncertainties for the relative effectiveness of other support surfaces for preventing and treating pressure ulcers, and their efficacy ranking. More high-quality research is required; for example, for the comparison of reactive air surfaces with alternating pressure air surfaces. Future studies should consider time-to-event outcomes and be designed to minimise any risk of bias.


Expression of endoplasmic reticulum stress markers in the islets of patients with type 1 diabetes.
Endoplasmic reticulum (ER) stress may play a role in cytokine-mediated beta cell death in type 1 diabetes, but it remains controversial whether ER stress markers are present in islets from type 1 diabetic individuals. Therefore, we evaluated by immunostaining the expression of markers of the three main branches of the ER stress response in islets from 13 individuals with and 15 controls without type 1 diabetes (eight adults and seven children). Antibodies against the ER stress markers C/EBP homologous protein (CHOP), immunoglobulin heavy chain (BIP) and X-box binding protein 1 (XBP-1) were validated using HeLa cells treated with the ER stressor thapsigargin. These antibodies were then used to stain serial sections of paraffin-embedded pancreas from type 1 diabetic and non-diabetic individuals; samples were also immunostained for CD45, insulin and glucagon. Immunostaining intensities of the ER stress markers were quantified using a software-based, unbiased quantitative approach. Islets from individuals with type 1 diabetes showed increased levels of CHOP and, at least for insulitis-positive and beta cell-containing islets, BIP. XBP-1 expression was not, however, increased. Islet cells from individuals with type 1 diabetes display a partial ER stress response, with evidence of the induction of some, but not all, components of the unfolded protein response.


Missed Abortion Presented with Worsening Hyperemesis Gravidarum.
Hyperemesis gravidarum (HG) is the most common cause of in-patient hospitalizations during the first half of pregnancy. The etiology of HG has not yet been elucidated, and the treatment is mainly symptomatic. Untreated severe HG can lead to catastrophic maternal complications such as cardiac arrhythmia and death. In contrast, the impact of untreated severe HG on the fetuses remains contradictory. Evidence suggested that HG may increase the risk of a small for gestational age (GA) fetus. We here report a case of 32-year-old nulliparous woman, GA of 14 weeks, who presented with worsening HG and later had a diagnosis of missed abortion. More research is needed to clarify the possibility of HG as a contributory cause of abortion.


Arthrobacter vasquezii sp. nov., isolated from a soil sample from Union Glacier, Antarctica.
A Gram-stain-positive, catalase-positive, non-motile bacteria, with a rod-coccus cycle (designated as EH-1B-1T) was isolated from a soil sample from Union Glacier in Ellsworth Mountains, Antarctica. Strain EH-1B-1T had an optimal growth temperature of 28 °C and grew at pH 7-10. The major cellular fatty acids were anteiso-C15 : 0, iso-C15 : 0, C16 : 0 and anteiso-C17 : 0. The G+C content based on the whole genome sequence was 63.1 mol%. Strain EH-1B-1T was most closely related to members of the genus Arthrobacter, namely Arthrobacter subterraneus and Arthrobacter tumbae. The strain grew on tryptic soy agar, Reasoner's 2A agar, lysogeny broth agar and nutrient agar. The average nucleotide identity and digital DNA-DNA hybridization values between strain EH-1B-1T and its closest reference type strains ranged from 78 to 88 % and from 20.9 to 36.3 %, respectively. Based on phenotypic, chemotypic and genotypic evidence, it is proposed that strain EH-1B-1T represents a novel species of Arthrobacter, for which the name Arthrobacter vasquezii sp. nov. is proposed, with strain EH-1B-1T (RGM 3386T=LMG 32961T) as the type strain.


Design and biological activity of beta-hairpin-like antimicrobial peptide.
In the current study, we synthesized a 16-residue-long peptide VR with the aim of inspecting the feasibility to design beta-hairpin-like antimicrobial peptide. The peptide was designed by alternating arrangement of arginine and valine and linking two stranded antiparallel beta-sheet with a short loop segment (DPG) and a disulfide bridge. Antimicrobial and hemolytic activities were investigated. Melittin was chosen as a control peptide. We also tested bactericidal kinetics and salt sensitivity. Results show that VR had similar antibacterial activity compared with melittin. However, VR displayed much less hemolytic activity than melittin. These results suggest that VR had higher cell selectivity than melittin. The antibacterial activity of VR was not inhibited in the presence of 25 and 50 mmol/L NaCl. VR still possessed antibacterial activity in the presence of 100 mmol/L NaCl. Collectively, the de novo peptide VR displayed high antimicrobial activity, low hemolytic activity, and salt resistant, indicating that VR was a promising candidate for novel antimicrobial applications.


Transcranial eosinophilic granuloma manifested by a subcutaneous scalp mass. Differential diagnosis in children.
The differential diagnosis of nodular scalp lesions in a child is surprisingly extensive. To present a case of eosinophilic granuloma that was manifested by a scalp mass in a pediatric patient. The case is presented and the relevant literature is reviewed. The seriousness of some of these lesions requires a thorough evaluation, including noninvasive imaging, and carefully planned surgical intervention so that effective diagnosis and treatment are ensured. Surgical exposure of unsuspected central nervous system connections may lead to infection, hemorrhage, seizures, or other significant morbidity and mortality.


Highly significant change of the clinical course of relapsing and complicated peptic ulcer disease after cure of Helicobacter pylori infection.
The aim of the present study was to compare the rates of peptic ulcer recurrence and of complications in a cohort of 190 patients, before and up to 4 yr after eradication of Helicobacter pylori infection. 190 patients with recurrent and/or complicated H. pylori-positive peptic ulcer disease (duodenal ulcer, n = 124; gastric ulcer, n = 59; gastroduodenal double ulcer, n = 2; anastomotic ulcer after partial gastric resection, n = 5) were prospectively followed up to 4 yr after eradication of H. pylori. Patients were investigated clinically and endoscopically, including the assessment of H. pylori infection before treatment, 4 wk after cessation of the eradication therapy, in 1-yr intervals and when symptoms of the ulcer disease recurred. Cure of H. pylori infection was obtained by either omeprazole plus amoxicillin (n = 157) or oral triple therapy (n = 33). The overall ulcer relapse rate was 0.9% per patient year. Comparing the pre- and postherapeutical course of the disease, the 1-yr ulcer recurrence rate decreased from 67.9% to 1.1% (P < 0.0001), and the 2-yr relapse rate decreased from 91.1% to approximately 3.0% (calculation: 0.9% ulcer recurrences per patient year x 329 patient years) (P < 0.0001) without relevant differences between the two major groups of patients with either duodenal or gastric manifestation of their ulcer disease. Ulcer complications did not occur. The H. pylori recurrence rate was 2.6% in the 1st and 1.2% in the 2nd yr after eradication. In the 3rd and 4th yr, no H. pylori reinfections were detected. Cure of H. pylori infection was associated with a highly significant change of the disease history in this large group of patients with formerly relapsing and/or complicated peptic ulcers. In addition, H. pylori eradication is a stable phenomenon at least during the first 4 yr after treatment. Thus, H. pylori eradication should be considered in those patients with peptic ulcer disease severe enough to require avoidance of ulcer recurrence or its complications.


Dengue epidemiology and pathogenesis: images of the future viewed through a mirror of the past.
Every year, millions of individuals throughout the world are seriously affected by dengue virus. The unavailability of a vaccine and of anti-viral drugs has made this mosquito-borne disease a serious health concern. Not only does dengue cause fatalities but it also has a profoundly negative economic impact. In recent decades, extensive research has been performed on epidemiology, vector biology, life cycle, pathogenesis, vaccine development and prevention. Although dengue research is still not at a stage to suggest definite hopes of a cure, encouraging significant advances have provided remarkable progress in the fight against infection. Recent developments indicate that both anti-viral drug and vaccine research should be pursued, in parallel with vector control programs.


Transmission multilayer polarizers for use in the 55-90 eV region.
Free-standing Al/YB(6) and Mo/Si transmission multilayer polarizers have been developed for use in the photon energy regions 55-72 eV and 72-90 eV, respectively, to improve the degree of polarization of synchrotron radiation light from beamline monochromators. The polarizance (polarizing ability) and transmittance of the Al/YB(6) multilayer for unpolarized light at 64 eV were 77% and 3.4%, respectively, and the polarizance and transmittance of the Mo/Si multilayer at 80 eV were 79% and 2.2%, respectively. By using the Mo/Si polarizer, the degree of polarization of the monochromated light at BL8B1 of UVSOR was increased from 95 to 99% in the 78-84 eV region.


Individualized Risk Estimation for Postoperative Complications After Surgery for Oral Cavity Cancer.
Postoperative complications after head and neck surgery carry the potential for significant morbidity. Estimating the risk of complications in an individual patient is challenging. To develop a statistical tool capable of predicting an individual patient's risk of developing a major complication after surgery for oral cavity squamous cell carcinoma. Retrospective case series derived from an institutional clinical oncologic database, augmented by medical record abstraction, at an academic tertiary care cancer center. Participants were 506 previously untreated adult patients with biopsy-proven oral cavity squamous cell carcinoma who underwent surgery between January 1, 2007, and December 31, 2012. The primary end point was a major postoperative complication requiring invasive intervention (Clavien-Dindo classification grades III-V). Patients treated between January 1, 2007, and December 31, 2008 (354 of 506 [70.0%]) comprised the modeling cohort and were used to develop a nomogram to predict the risk of developing the primary end point. Univariable analysis and correlation analysis were used to prescreen 36 potential predictors for incorporation in the subsequent multivariable logistic regression analysis. The variables with the highest predictive value were identified with the step-down model reduction method and included in the nomogram. Patients treated between January 1, 2007, and December 31, 2008 (152 of 506 [30.0%]) were used to validate the nomogram. Clinical characteristics were similar between the 2 cohorts for most comparisons. Thirty-six patients in the modeling cohort (10.2%) and 16 patients in the validation cohort (10.5%) developed a major postoperative complication. The 6 preoperative variables with the highest individual predictive value were incorporated within the nomogram, including body mass index, comorbidity status, preoperative white blood cell count, preoperative hematocrit, planned neck dissection, and planned tracheotomy. The nomogram predicted a major complication with a validated concordance index of 0.79. Inclusion of surgical operative variables in the nomogram maintained predictive accuracy (concordance index, 0.77). A statistical tool was developed that accurately estimates an individual patient's risk of developing a major complication after surgery for oral cavity squamous cell carcinoma.


Effectiveness of audiovisual distraction in behavior modification during dental caries assessment and sealant placement in children with autism spectrum disorder.
The aim of this study was to evaluate the effectiveness of audiovisual (AV) distraction in behavior modification during dental caries assessment and sealant placement in children with autism spectrum disorder. This study was conducted on 28 children diagnosed with autism spectrum disorder, aged 6.5-9.8 years. Children underwent one introductory (desensitization) appointment and three treatment sessions. During the introductory session, children had the procedures explained to them, they watched a movie projected on a screen while oral screening and assessment of cooperation level were carried out. In treatment session I, oral examination, charting, and dental x-rays were undertaken, whereas the children watched movies with or without video eyewear. During treatment sessions II/III, dental prophylaxis was carried out on upper and lower jaws in addition to the application of dental sealants on the right upper and lower and the left upper and lower permanent molars, respectively, while the children were distracted by cartoon movies using video eyewear. Changes in pulse oximeter and heart rate were recorded every 5 min. Independent samples t-test was used to assess the significance of changes in pulse and O2 saturation levels during each visit. International Caries Detection and Assessment System-code 2 was found to be the most prevalent (n = 58; 52%). A significant difference (P < 0.02) was observed in mean heart rate during dental screening of the upper and lower jaws with and without video eyewear. A decrease was observed in the mean heart rate during subsequent treatment sessions. Initial desensitization appointment and "tell-show-do" approach, followed by short and positive treatment sessions, assisted in gaining cooperation and improving behavior in the subjects. Video eyewear distraction proved an effective tool in managing children with autism spectrum disorder during noninvasive preventive dental procedures.


Influences of infaunal burrows on the community structure and activity of ammonia-oxidizing bacteria in intertidal sediments.
Influences of infaunal burrows constructed by the polychaete (Tylorrhynchus heterochaetus) on O(2) concentrations and community structures and abundances of ammonia-oxidizing bacteria (AOB) and nitrite-oxidizing bacteria (NOB) in intertidal sediments were analyzed by the combined use of a 16S rRNA gene-based molecular approach and microelectrodes. The microelectrode measurements performed in an experimental system developed in an aquarium showed direct evidence of O(2) transport down to a depth of 350 mm of the sediment through a burrow. The 16S rRNA gene-cloning analysis revealed that the betaproteobacterial AOB communities in the sediment surface and the burrow walls were dominated by Nitrosomonas sp. strain Nm143-like sequences, and most of the clones in Nitrospira-like NOB clone libraries of the sediment surface and the burrow walls were related to the Nitrospira marina lineage. Furthermore, we investigated vertical distributions of AOB and NOB in the infaunal burrow walls and the bulk sediments by real-time quantitative PCR (Q-PCR) assay. The AOB and Nitrospira-like NOB-specific 16S rRNA gene copy numbers in the burrow walls were comparable with those in the sediment surfaces. These numbers in the burrow wall at a depth of 50 to 55 mm from the surface were, however, higher than those in the bulk sediment at the same depth. The microelectrode measurements showed higher NH(4)(+) consumption activity at the burrow wall than those at the surrounding sediment. This result was consistent with the results of microcosm experiments showing that the consumption rates of NH(4)(+) and total inorganic nitrogen increased with increasing infaunal density in the sediment. These results clearly demonstrated that the infaunal burrows stimulated O(2) transport into the sediment in which otherwise reducing conditions prevailed, resulting in development of high NH(4)(+) consumption capacity. Consequently, the infaunal burrow became an important site for NH(4)(+) consumption in the intertidal sediment.


Mitochondrial Protein Akap1 Deletion Exacerbates Endoplasmic Reticulum Stress in Mice Exposed to Hyperoxia.
Acute lung injury (ALI) and its severe manifestation, acute respiratory distress syndrome (ARDS), are treated with high concentrations of supplementary oxygen. However, prolonged exposure to high oxygen concentrations stimulates the production of reactive oxygen species (ROS), which damages the mitochondria and accumulates misfolded proteins in the endoplasmic reticulum (ER). The mitochondrial protein A-kinase anchoring protein 1 (Akap1) is critical for mitochondrial homeostasis. It is known that Akap1 deficiency results in heart damage, neuronal development impairment, and mitochondrial malfunction in preclinical studies. Our laboratory recently revealed that deleting Akap1 increases the severity of hyperoxia-induced ALI in mice. To assess the role of Akap1 deletion in ER stress in lung injury, wild-type and Akap1 -/- mice were exposed to hyperoxia for 48 h. This study indicates that Akap1 -/- mice exposed to hyperoxia undergo ER stress, which is associated with an increased expression of BiP, JNK phosphorylation, eIF2α phosphorylation, ER stress-induced cell death, and autophagy. This work demonstrates that deleting Akap1 results in increased ER stress in the lungs of mice and that hyperoxia exacerbates ER stress-related consequences.


Ocular infections caused by Candida species: Type of species, in vitro susceptibility and treatment outcome.
To report clinical and microbiological profile of patients with ocular candidiasis. Patients with ocular candidiasis were retrospectively identified from microbiology records. Significant isolates of Candida species were identified by Vitek 2 compact system. Minimum inhibitory concentration (MIC) of antifungal agents such as amphotericin B, itraconazole, voriconazole, fluconazole and caspofungin was determined by E test and of natamycin by microbroth dilution assay. Data on treatment and outcome were collected from medical records. A total of 42 isolates of Candida were isolated from patients with keratitis-29, endophthalmitis-12 and orbital cellulitis-1. The most common species isolated was Candida albicans (12-keratitis, 4-endophthalmitis, 1-orbital cellulitis). All except one isolate were susceptible to amphotericin B. MIC of caspofungin was in the susceptible range in 28 (96.5%) corneal isolates while 12 out of 29 (41.3%) corneal isolates were sensitive to fluconazole. Resistance to voriconazole was seen in four corneal isolates. All isolates were susceptible to natamycin and all except two isolates were resistant or susceptible dose-dependent to itraconazole. Outcome of healed ulcer was achieved in 12/18 (66.6%) patients treated medically, while surgical intervention was required in 11 patients. Among the isolates from endophthalmitis patients, 11/12 were susceptible to amphotericin B, 6/12 to voriconazole and all to natamycin. Ten out of 11 patients (one patient required evisceration) with endophthalmitis were given intravitreal amphotericin B injection with variable outcome. Ocular candidiasis needs early and specific treatment for optimal results. Candida species continue to be susceptible to most commonly available antifungals including amphotericin B, voriconazole and natamycin.


[Influence of data structure on the selection of statistic analysis methods].
In medical research, data is grouped either as per the design of the study or the selection of the sample. This structure must be taken into account in order to make correct estimates of the of the parameters and standard errors involved. This study is of the methodological type and is aimed at illustrating methods for estimating population-related methods and regression models with grouped data. For this purpose, nine variables from the First National Risk Factor and Preventive Measure Survey conducted in Cuba in 1995 are employed. The prevalence of high blood pressure is overestimated by 15% when the conventional estimators are used as compared with the weight-based and adjusted analysis. In the regression models for the body mass index based on the conventional procedures, sex, degree of schooling, degree of sedentariness, smoking habit, diastolic and systolic blood pressure were found to be significant. However, when the method taking into account the structure of conglomerates was employed, the degree of schooling and sedentariness ceased to be significant. When the random intercept model was adjusted, the 91.3% total variability was found to be explained by individual variables, the 8.7% variability being attributed to larger units. When estimating population-related parameters based on conglomerate-structure data involving inconsistent selection probabilities, the use of sample-related weights and analysis methods that take in the correlation among subjects (potential) for one same conglomerate. When adjusting regression models, it is not only important to efficiently estimate the coefficients, but rather the focus (aggregated or disaggregated) must be taken into account for modeling the problem under study.


Conversion of concept-specific decision confidence into integrative introspection in primates.
Introspection based on the integration of uncertain evidence is critical for acting upon abstract thinking and imagining future scenarios. However, it is unknown how confidence read-outs from multiple sources of different concepts are integrated, especially considering the relationships among the concepts. In this study, monkeys performed wagering based on an estimation of their performance in a preceding mnemonic decision. We found that the longer the response times for post-decision wagering, the more relieved the impairments having been caused by frontal disruption. This suggests the existence of a time-consuming compensatory metacognitive process. We found posterior inferior parietal lobe (pIPL) as its candidate, which was not coding the wagering per se (i.e., just high bet or low bet), but became more active when monkeys successfully chose the optimal bet option based on mnemonic decision performance. Thereafter, the pIPL prompts dorsal anterior cingulate cortex to carry the chosen wagering option. Our findings suggest a role for the pIPL in metacognitive concept integration.


Pancreatic stellate cell activation and MMP production in experimental pancreatic fibrosis.
The early events in pancreatic fibrosis are poorly understood. We examined the production of collagen and matrix metalloproteinases as well as the activation of pancreatic stellate cells in a rodent model of pancreatic fibrosis. Pancreatitis was induced in rats by hyperstimulation with cerulein (50 microg/kg/day ip) and concurrent pancreatic duct obstruction (SHOP model) for 96 h (n = 48). Sham animals were injected with saline and underwent laparotomy and manipulation of the pancreas with no duct obstruction (n = 28). Rats were sacrificed daily for 18 days. Serial pancreatic sections were stained with H&E [histology], trichrome [collagen], and alpha smooth muscle actin (alpha-SMA) antibodies [activated stellate cells]. Total pancreatic matrix metalloproteinase (MMP)-2 and 9 were determined by gelatin zymography. MMP-1 production was examined using Western blotting. There were occasional alpha-SMA-positive cells in the pancreatic parenchyma of normal and sham animals. Within 48 h of pancreatitis induction in SHOP animals, histologic evidence of pancreatic inflammation was present, and stellate cells (alpha-SMA-positive cells) appeared surrounding pancreatic acini. The appearance of these cells was followed by collagen deposition in the same area. MMP-1 and 2 proteins increased significantly during pancreatitis while MMP-9 did not. The pancreatic architecture returned to normal by 18 days after the induction of pancreatitis. Acute pancreatic inflammation results in stellate cell activation and collagen deposition in the same area. Collagen is then resorbed at a time when MMP-1 and 2 peak. The fibrosis of acute pancreatic inflammation in this model completely resolves with restoration of normal architecture.


Fabrication, in-vitro characterization, and enhanced in-vivo evaluation of carbopol-based nanoemulsion gel of apigenin for UV-induced skin carcinoma.
The aim of this study was to develop a potential novel formulation of carbopol-based nanoemulsion gel containing apigenin using tamarind gum emulsifier which was having the smallest droplet size, the highest drug content, and a good physical stability for Skin delivery. Apigenin loaded nanoemulsion was prepared by high speed homogenization method and they were characterized with respect to morphology, zeta potential, differential scanning calorimeter study, and penetration studies. In-vitro release studies and skin permeation of apigenin loaded nanoemulsion by goat abdominal skin was determined using Franz diffusion cell and confocal laser scanning microscope (CLSM). The cytotoxicity of the reported formulation was evaluated in HaCaT Cells (A) and A431 cells (B) by MTT assay. The nanoemulsion formulation showed droplet size, polydispersity index, and zeta potential of 183.31 nm, 0.532, and 31.9 mV, respectively. The nanoemulsions were characterized by TEM demonstrated spherical droplets and FTIR to ensure the compatibility among its ingredients. CLSM showed uniform fluorescence intensity across the entire depth of skin in nanocarriers treatment, indicating high penetrability of nanoemulsion gel through goatskin. The nanoemulsion gel showed toxicity on melanoma (A341) in a concentration range of 0.4-2.0 mg/ml, but less toxicity toward HaCaT cells. The carbopol-based nanoemulsion gel formulation of apigenin possesses better penetrability across goatskin as compared to marketed formulation. Hence, the study postulates that the novel nanoemulsion gel of apigenin can be proved fruitful for the treatment of skin cancer in near future.


Neural 22-carbon fatty acids in the weanling rat respond rapidly and specifically to a range of dietary linoleic to alpha-linolenic fatty acid ratios.
Changing the dietary ratio of the essential fatty acids (EFA), 18:2n6 and 18:3n3, while keeping the amounts of other fatty acids in the diet constant can rapidly and specifically alter the proportions of n6 and n3 22-carbon fatty acids in the brain of the weanling rat. A dietary 18:2n6/18:3n3 ratio of 165 versus 1.8 caused higher n6 and lower n3 22-carbon fatty acid levels, without changing total 22-carbon fatty acid levels, in phosphatidylethanolamine and phosphatidylcholine from several neural membrane fractions. This was apparent after only 2 weeks and showed no sign of plateauing after 12 weeks. Other neural fatty acids were essentially unaffected. The three most abundant 22-carbon fatty acids responded somewhat differently to increments in the dietary 18:2n6/18:3n3 ratio (1.8, 9, 36, and 165). Levels of 22:4n6 increased by similar absolute amounts for each four-fold increase in dietary 18:2n6/18:3n3 ratio; in contrast, the largest absolute changes in 22:5n6 and 22:6n3 levels occurred as the 18:2n6/18:3n3 ratio increased from 36 to 165. This study shows that the 18:2n6/18:3n3 ratio of diets high in fat (40% of energy) and adequate in EFA, both typical of diets in developed countries, can substantially and relatively quickly affect the 22-carbon fatty acids in the brain, even after the rapid accumulation of these fatty acids during neural growth has ceased.


Viral genome quantification as a tool for improving patient management: the example of HIV, HBV, HCV and CMV.
In recent years, new therapeutic options have led to enormous improvements in the management of certain chronic viral infections. Nevertheless, it has also become clear that such treatments require careful consideration and follow up. At the same time, a number of new technologies have been developed to measure quantitatively the concentration of viral genome in the patient's body fluids. Initially, these tests yielded important insights into the pathogenesis of viral infections and, in the case of human immunodeficiency virus (HIV), in fact revolutionized our understanding of its natural history. In addition, however, such 'viral load' tests have become vital tools in patient management; formerly pure research tools, they are now widely used in routine virological diagnosis, and a number of commercial assays have become available. In clinical virology, viral load testing serves four purposes: for diagnosis; to assess the patient's prognosis; as therapeutic markers to monitor the effect of antiviral treatment; and to estimate the patient's infectivity, i.e. the risk of transmission. In this review paper, we summarize the current role of viral genome quantification in the clinical management of patients infected with HIV, hepatitis B virus, hepatitis C virus and those at risk of developing human cytomegalovirus-related diseases.


Methods for Simultaneous Robot-World-Hand-Eye Calibration: A Comparative Study.
In this paper, we propose two novel methods for robot-world-hand-eye calibration and provide a comparative analysis against six state-of-the-art methods. We examine the calibration problem from two alternative geometrical interpretations, called 'hand-eye' and 'robot-world-hand-eye', respectively. The study analyses the effects of specifying the objective function as pose error or reprojection error minimization problem. We provide three real and three simulated datasets with rendered images as part of the study. In addition, we propose a robotic arm error modeling approach to be used along with the simulated datasets for generating a realistic response. The tests on simulated data are performed in both ideal cases and with pseudo-realistic robotic arm pose and visual noise. Our methods show significant improvement and robustness on many metrics in various scenarios compared to state-of-the-art methods.


[Objective assessment of the respiratory function of the larynx after fronto-lateral laryngectomy with epiglottoplasty and after supracricoid laryngectomy with CHP or CHEP].
Enlarged fronto-lateral laryngectomy with epiglottoplasty and supracricoid laryngectomy with cricohyoidopexy (CHP) or cricohyoidoepiglottopexy (CHEP) differ from each other as regards surgical technique, extent of the resection and method of reconstruction. Despite of that, selected carcinomas of the true vocal cord staged as T2N0, which are included in indications to all mentioned laryngectomies, can be equally treated with each of these methods. The aim of this study is objective evaluation of the respiratory function of the larynx after three types of operation and comparison of the results. Material included 64 patients treated during the period of 1993-2002: 39 patients after supracricoid laryngectomy (18 with CHP and 21 with CHEP) and 25 after enlarged fronto-lateral laryngectomy with epiglottoplasty. Spirometry was performed before and after the operation in 27 cases and only after the operation in 34 cases. The shapes of flow-volume loops and 32 spirometric parameters were evaluated. The decannulation rates were: a) 98,5% after enlarged fronto-lateral laryngectomy with epiglottoplasty, b) 80,6% after supracricoid laryngectomy with CHP, c) 70,1% after supracricoid laryngectomy with CHEP. Although the decannulation rate was better after CHP than after CHEP the spirometric parameters were better in patients after CHEP than in those after CHP. The airflow similar to normal was found in 15% patients after CHEP as well as after CHP and in 28% patients after epiglottoplasty. There were no restrictive abnormalities in the whole group of operated patients, but occurrences of obturation, especially inspiratory, were quite often. In conclusion, which follows from the comparison of three types of reconstructive laryngectomies, better results of respiratory function of the larynx were found after epiglottoplasty than after supracricoid laryngectomy with CHEP or CHP.


Comparison of single-, double- and triple-combined testing, including Pap test, HPV DNA test and cervicography, as screening methods for the detection of uterine cervical cancer.
Cervical cancer is a serious disease that threatens the health of women worldwide. This study compared the sensitivities and false-positive rates of cervical cytology (Pap smear), human papilloma virus (HPV) DNA test, cervicography, first double-combined testing (cervical cytology and HPV DNA test), second double-combined testing (cervical cytology and cervicography) and triple-combined testing (cervical cytology, HPV DNA test and cervicography). The study included 261 patients screened for uterine cervical cancer. All women simultaneously underwent cervical cytology, HPV DNA test and cervicography for uterine cervical cancer screening and colposcopically directed biopsy for diagnostic evaluation. The triple-combined testing was consistently the most sensitive among the cervical screening tests. The second double-combined testing, with a sensitivity rate of 98.1% was more sensitive than the first double-combined test (92.3%). However, cervical cytology was most specific (93.5%) and showed the highest positive predictive value (77.8%). The sensitivity of cervical cytology was markedly improved in combination with HPV DNA test and cervicography. Thus, the triple-combined testing, which improves the high false negativity of cervical cytology, may be an effective tool in uterine cervical cancer screening, pending confirmation of the effectiveness in a mass screening study.


Rapid evolutionary divergence of Photosystem I core subunits PsaA and PsaB in the marine prokaryote Prochlorococcus.
The nucleotide sequences of the genes coding for the subunits of the Photosystem I (PS I) core, PsaA and PsaB were determined for the marine prokaryotic oxyphototrophs Prochlorococcus sp. MED4 (CCMP1378), P. marinus SS120 (CCMP1375) and Synechococcus sp. WH7803. Divergence of these sequences from those of both freshwater cyanobacteria and higher plants was remarkably high, given the conserved nature of PsaA and PsaB proteins. In particular, the PsaA of marine prokaryotes showed several specific insertions and deletions with regard to known PsaA sequences. Even in between the two Prochlorococcus strains, which correspond to two genetically different ecotypes with shifted growth irradiance optima, the sequence identity was only 80.2% for PsaA and 88.9% for PsaB. Possible causes and implications of the fast evolution rates of these two PS I core subunits are discussed.


Pericytes for Therapeutic Approaches to Ischemic Stroke.
Pericytes are perivascular multipotent cells located on capillaries. Although pericytes are discovered in the nineteenth century, recent studies have found that pericytes play an important role in maintaining the blood-brain barrier (BBB) and regulating the neurovascular system. In the neurovascular unit, pericytes perform their functions by coordinating the crosstalk between endothelial, glial, and neuronal cells. Dysfunction of pericytes can lead to a variety of diseases, including stroke and other neurological disorders. Recent studies have suggested that pericytes can serve as a therapeutic target in ischemic stroke. In this review, we first summarize the biology and functions of pericytes in the central nervous system. Then, we focus on the role of dysfunctional pericytes in the pathogenesis of ischemic stroke. Finally, we discuss new therapies for ischemic stroke based on targeting pericytes.


In silico models for dynamic connected cell cultures mimicking hepatocyte-endothelial cell-adipocyte interaction circle.
The biochemistry of a system made up of three kinds of cell is virtually impossible to work out without the use of in silico models. Here, we deal with homeostatic balance phenomena from a metabolic point of view and we present a new computational model merging three single-cell models, already available from our research group: the first model reproduced the metabolic behaviour of a hepatocyte, the second one represented an endothelial cell, and the third one described an adipocyte. Multiple interconnections were created among these three models in order to mimic the main physiological interactions that are known for the examined cell phenotypes. The ultimate aim was to recreate the accomplishment of the homeostatic balance as it was observed for an in vitro connected three-culture system concerning glucose and lipid metabolism in the presence of the medium flow. The whole model was based on a modular approach and on a set of nonlinear differential equations implemented in Simulink, applying Michaelis-Menten kinetic laws and some energy balance considerations to the studied metabolic pathways. Our in silico model was then validated against experimental datasets coming from literature about the cited in vitro model. The agreement between simulated and experimental results was good and the behaviour of the connected culture system was reproduced through an adequate parameter evaluation. The developed model may help other researchers to investigate further about integrated metabolism and the regulation mechanisms underlying the physiological homeostasis.


Effects of different doses of X-ray irradiation on cell apoptosis, cell cycle, DNA damage repair and glycolysis in HeLa cells.
The present study examined the radiation biological response of cancer cells to different fractional irradiation doses and investigates the optimal fractional irradiation dose with improved biological effects. Radiobiological studies were performed at the molecular and cellular levels to provide insights into DNA damage and repair, and the apoptosis mechanism of cells that were exposed to different doses of X-ray irradiation (0, 2, 4, 6, 8, 10, 12.5, 15 and 20 Gy). Evidence of increased reactive oxygen species (ROS), DNA double strand breaks (DSB), cellular apoptosis, G2/M phase proportion and inhibition of cell proliferation were observed following irradiation. Differences in the ROS amount and apoptotic percentages of cells between the 2 and 4 Gy groups were insignificant. Compared with 0 Gy, the expression of the apoptosis suppression protein B-cell lymphoma-2 was decreased following at increased irradiation doses. However, apoptosis-associated protein Bcl-2-associated X (Bax), caspase-9 and BH3 interacting domain death agonist (Bid) were elevated following irradiation, compared with the control group (0 Gy). Furthermore, the expression levels of Bax in the 6, 8, 10 and 12.5 Gy groups were significantly increased, compared with the other groups. Caspase-9 expression with 2, 4, 6 and 8 Gy were increased compared with other groups, and the Bid levels with 6 and 8 Gy were also increased compared with other groups. G2/M phase arrest was associated with the increase of checkpoint kinase 1 and reduction of cyclin dependent kinase 1. DNA damage repair was associated with the protein Ku70 in the 2, 8, 10, 12.5, 15 and 20 Gy groups were less than other group. Compared with other group, Ku80 levels were reduced in the 6 and 8 Gy groups, and Rad51 levels were reduced in the 2, 8 and 10 Gy groups. The expression of hypoxia inducible factor-1α, c-Myc and glucose transporter 1 (GLUT1) demonstrated an increasing trend following irradiation in a dose-dependent manner, but the expression of pyruvate kinase M2, in the 2-10 Gy irradiation groups, and GLUT1, in the 12.5, 15 and 20 Gy irradiation groups, were reduced, compared with the other groups. Considering the DNA damage repair and apoptosis mechanisms at molecular and cellular levels, it was concluded that 2, 6, 8 and 10 Gy may be the optimal fractional dose that can promote cell apoptosis, and inhibit DNA damage repair and glycolysis.


Imaging of renal cell carcinoma: state of the art and recent advances.
Renal cell carcinoma (RCC) is the 13th most common cancer worldwide and accounts for 4% of all adult malignancies. Herein the state of the art and recent advances in cross-sectional radiological imaging applied to RCC are reviewed, including ultrasonography, computed tomography, magnetic resonance imaging, and positron emission tomography. Literature search of peer-reviewed papers published by October 2010. In front of more conventional and widespread imaging tools, such as ultrasonography and computed tomography, an array of newer and attractive radiological modalities are under investigation and show promise to improve our ability to noninvasively detect renal tumors and its recurrences, accurately assess the extent of the disease, and reliably evaluate treatment response, particularly in the era of antiangiogenetic therapy. Recent major advances in radiological imaging techniques have considerably improved our ability to diagnose, stage and follow-up RCC. Further studies are needed to evaluate the potential of most recent and still investigational imaging tools.


Comparison of synthetic surfactants and biosurfactants in enhancing biodegradation of polycyclic aromatic hydrocarbons.
Polycyclic aromatic hydrocarbon (PAH) contamination of the environment represents a serious threat to the health of humans and ecosystems. Given the human health effects of PAHs, effective and cost-competitive remediation technologies are required. Bioremediation has shown promise as a potentially effective and low-cost treatment option, but concerns about the slow process rate and bioavailability limitations have hampered more widespread use of this technology. An option to enhance the bioavailability of PAHs is to add surfactants directly to soil in situ or ex situ in bioreactors. Surfactants increase the apparent solubility and desorption rate of the PAH to the aqueous phase. However, the results with some synthetic surfactants have shown that surfactant addition can actually inhibit PAH biodegradation via toxic interactions, stimulation of surfactant degraders, or sequestration of PAHs into surfactant micelles. Biosurfactants have been shown to have many of the positive effects of synthetic surfactants but without the drawbacks. They are biodegradable and nontoxic, and many biosurfactants do not produce true micelles, thus facilitating direct transfer of the surfactant-associated PAH to bacteria. The results with biosurfactants to date are promising, but further research to elucidate surfactant-PAH interactions in aqueous environments is needed to lead to predictive, mechanistic models of biosurfactant-enhanced PAH bioavailability and thus better bioremediation design.


Transverse waveguide mode suppression for Pt-electrode SAW resonators on quartz and LGS.
SAW resonators on ST-X quartz and langasite (LGS) [0°, 144°, 24°] are currently being used for hydrogen fluoride (HF) vapor sensing and high-temperature sensing, respectively. For these applications, the use of Pt-based electrodes allows the resonators to withstand the targeted harsh environments. This work reveals that for Pt-electrode resonators with conventional short-circuit gratings on the aforementioned quartz and LGS orientations, acoustic energy leaks from the grating region to the bus bars, thus degrading the resonator response. To resolve this problem, this paper proposes and implements open-circuit gratings for resonators fabricated with these substrate/metal combinations. The open-circuit gratings guide the acoustic energy within the grating region, resulting in greater quality factors and reduced losses in the resonator response. In addition, scalar potential theory is utilized in this work to identify transverse waveguide modes in the responses of open-circuit grating resonators on quartz and LGS. A transverse waveguide mode dispersion relation was derived to extend the scalar potential theory to account for asymmetry in the slowness curve around the propagation direction. This is the case for several commonly used LGS orientations, in particular LGS [0°, 144°, 24°]. Finally, this work addresses spurious transverse mode mitigation by scaling both the transducer's grating aperture and electrode overlap width. Open circuit grating resonators with appropriately scaled transducer designs were fabricated and tested, resulting in a 71% increase in quality factor and a spurious mode rejection of over 26 dBc for Pt-electrode devices on ST-X quartz. This progress directly translates into better frequency resolution and increased dynamic range for HF vapor sensors and high-temperature SAW devices.


Endogenous inhibitor of [3H]kainate binding to synaptic membrane in rat brain.
An understanding of the mechanism of kainic acid toxicity to neurons could provide important clues to pathogenesis of Huntington's chorea. The existence of high-affinity binding sites for kainate, a foreign compound, is suggestive of the existence of kainate-like substances in the brain. In addition to such neurotoxic kainate-like substances, and endogenous inhibitor of kainate binding may also exist in the brain to allow the synaptic function to operate normally. Based on this idea, the existence of molecules which inhibit [3H]kainate binding to synaptic membranes was examined in rat brain. An endogenous inhibitor of [3H]kainate binding to synaptic membranes was found in the supernatant obtained from synaptic membranes of rat brain. The inhibitor is a thermostable, basic protein with a relatively low molecular weight.


Feeding disorders in children: taking an interdisciplinary approach.
Feeding problems are common in children with special healthcare needs, and inquiring about feeding skills should be a routine part of the developmental assessment. Failure to meet normal feeding milestones, the presence of swallowing problems, and the presence or history of placement of a nasogastric or gastrostomy tube are all reasons to refer a child for a feeding evaluation. An interdisciplinary approach that includes the pediatrician along with a feeding team that includes a speech pathologist, occupational therapist, feeding-oriented nutritionist, and often others, should be taken to diagnose and manage feeding disorders in such children as early as possible for the best prognosis. However, caregivers also play a critical role in intervention, and effective management of feeding disorders should always be seen as a partnership between the caregiver and the interdisciplinary team. The additional benefit is the feeling of competence by the caregiver who is properly trained in the feeding of his/her special needs child. Providing caregivers with proper training as well as realistic goals, regular instruction for home practice, and the expectation for periodic setbacks, can help the child and the caregiver reap the most benefit from feeding intervention.


[About some peculiar features of gunshot wounds inflicted by shot-gun cartridges for the short-barreled weapons of the limited injurious power].
The cases of application of 'non-standard' ammunition constitute a serious challenge for the forensic medical expertise. Bearing in mind the importance of this issue, the authors report a case encountered in their practical work, namely a gunshot wound inflicted by the 'non-standard' shot-gun cartridges for the short-barreled weapons of the limited injurious power that required the expert evaluation. The case under consideration illustrates the peculiar features of the gunshot wound inflicted by 'non-standard' shot-gun cartridges for the short-barreled weapons of the limited injurious power. Moreover, the forensic medical expertise of this case exemplifies the effectiveness of the cooperation between various department of the Saint-Petersburg Bureau of Forensic Medical Expertise during investigation of the case being considered.


Correlation analysis between femoral trochlear dysplasia and anterior cruciate ligament injury based on CT measurement.
Anterior cruciate ligament (ACL) injury is the most common knee ligament injury. Femoral trochlear dysplasia (FTD) is an anatomic deformity characterized by a shallow trochlear angle and depth. There is limited research on the correlation between ACL injury and trochlear dysplasia. A total of 423 patients with an ACL injury who underwent ACL reconstruction and plain computed tomography (CT) follow-up scan one week after the operation in our hospital between January 2017 and March 2019 were enrolled in this study. A total of 352 patients (369 knees) without ACL injury served as a control group. The sulcus angle, trochlear facet asymmetry, trochlear depth, and lateral trochlear inclination were measured at 3 cm above the tibiofemoral joint. The notch width index (NWI) was measured on the CT axis, and the FTD was divided into four types according to the Dejour classification. The prevalence of FTD was significantly higher in the ACL injury group than in the control group (30.7% vs. 14.4%, χ2=30.834, P<0.001). The trochlear sulcus angle was higher, while the trochlear facet asymmetry and lateral trochlear inclination were significantly lower in the ACL injury group than in the control group (P<0.01). The NWI was 0.232 in the ACL injury group and 0.245 in the control group (P<0.01). In the ACL injury group, the NWI of patients with FTD was slightly smaller than that of the patients without FTD (P<0.01). Our findings indicate that FTD might be a significant risk factor for ACL injury. Whether FTD is related to ACL injury caused by smaller intercondylar notch needs further study.


Role of the receptor for bacteriophage lambda in the functioning of the maltose chemoreceptor of Escherichia coli.
Chemotaxis towards maltose is specifically defective in many strains of Escherichia coli carrying mutations affecting lamB, the gene coding for the outer membrane receptor for bacteriophage lambda. However, with one exception, the most extreme effect of lamB mutants on the maltose response as determined in the capillary assay is a shift to higher sugar concentrations and a reduction in the number of bacteria accumulated to about 25% of the wild-type level. The severity of the taxis defect is strongly correlated with reduced ability of the cells to take up the maltose present at 1 and 10 muM. Evidence presented here and in the accompanying paper indicates that the lambda receptor is involved in the transport of maltose at these concentrations. The effects of lamB mutations on maltose taxis can be explained by postulating that the high-affinity maltose transport system in which the lambda receptor participates transfers maltose from the surrounding medium across the outer membrane and into the periplasmic space. If the maltose chemoreceptor detects sugar present in the periplasmic space, and not molecules external to the outer membrane, then defective transport of low concentrations of maltose into the periplasm would result in the observed apparent reduction in the sensitivity of the maltose receptor. Thus, the lambda receptor protein would participate in maltose chemorecepton only indirectly through its role in maltose transport.


Stress-induced drinking in parents of adolescents with externalizing symptomatology: the moderating role of parent social support.
Parenting adolescents with externalizing symptomatology has been repeatedly shown to be stress-inducing for parents. One possible coping strategy for parents dealing with this chronic stress may be drinking. The current study extended previous research by examining the prospective relations between adolescents' externalizing behaviors and parents' negative affect and alcohol consumption. Additionally, the present study tested whether this mediated effect is a function of parental social support. Adolescents' externalizing symptoms prospectively predicted mothers' negative affect. Interestingly, however, mothers' negative affect prospectively predicted mothers' drinking only for those mothers with low social support. Furthermore, the mediated effect (Wave 1 adolescent externalizing symptoms --> Wave 2 mother negative affect --> Wave 3 mother drinking) was significant only for mothers with low social support. There were no effects of adolescents' externalizing symptoms on fathers.


Platinum-based versus non-platinum-based chemotherapy as first line treatment of inoperable, advanced gastric adenocarcinoma: a meta-analysis.
Although the platinum regimen is adopted widely nowadays in spite of the excessive side effects, there is still no international standard for palliative chemotherapy of advanced gastric cancer. This meta-analysis assessed the efficacy and tolerability of platinum versus non-platinum chemotherapy as first-line palliative treatment in patients with inoperable, advanced gastric cancer. Randomized phase II and III clinical trials on first-line palliative chemotherapy in inoperable, advanced gastric cancer were identified by electronic searches of PubMed, Embase, and the Cochrane Controlled Trial Register, and hand searches of relevant abstract books and reference lists. Response rates, overall survival, and toxicity were analyzed. Depending on whether new-generation agents (S-1, taxanes and irinotecan) were utilized, the non-platinum regimens were divided into two subgroup. Compared to non-platinum regimens containing new-generation agents, the use of platinum-based regimens was associated with better response (risk ratio (RR) = 1.94, 95%CI[1.48, 2.55], p<0.001), an increase of overall survival (hazard ratio (HR) = 0.85, 95%CI[0.78, 0.92], p<0.001), a higher risk of hematological and non-hematological toxicity. No statistically significant increase in response (RR = 1.03, 95%CI [0.85, 1.24], p = 0.76) or overall survival (HR = 1.07, 95%CI [0.88, 1.30], p = 0.49) was found when platinum therapies were compared to new-generation agent based combination regimens. The toxicity of platinum-based regimens was significantly higher for hematologic toxicity, nausea and vomiting, and neurotoxicity, but not for diarrhea and toxic death rate. New-generation agent based combination regimens achieved similar response rate and overall survival as platinum-based therapy that had generally higher side effects. S-1, taxanes and irinotecan seemed to be valid options for patients with inoperable, advanced gastric cancer as first-line chemotherapy.


Coexisting Brenner Tumor and Endometrial Carcinoma.
Brenner tumor is a rare ovarian neoplasm that is seen in women of the fifth to sixth decade. Classified as benign, borderline, and malignant, these tumors may be associated with estrogen production, thus altering the estrogen-progesterone ratio. High estrogen stimulates the endometrium and this is responsible for producing various pathologies, namely, hyperplasia, atypia, and carcinoma. Very few case reports have been published highlighting the same. A case report is being presented here of a coexisting Brenner tumor and well-differentiated endometrial carcinoma in a 55-year-old nulliparous postmenopausal woman.


[Coincidence of balloon cell melanoma with balloon cells in a dermal nevus].
We report a coincidence of balloon cell melanoma and balloon cell transformation in a dermal nevus of a 56 years old female patient. The foamy cells in both tumors with different dignity expressed S-100 and Vimentin. HMB45 was expressed in all balloon cells of the melanoma. Detection of HMB45 in some of the nevus-associated balloon cells was considered as an expression of cellular activation.