Lipid emulsion administered intravenously or orally attenuates triglyceride accumulation and expression of inflammatory markers in the liver of nonobese mice fed parenteral nutrition formula.
The accumulation of hepatic TG and development of hepatic steatosis (HS) is a serious complication of the use of parenteral nutrition (PN) formulas containing a high percentage of dextrose. But whether fat emulsions or other nutrients can ameliorate the induction of HS by high-carbohydrate diets is still uncertain. We hypothesized that administration of a lipid emulsion (LE; Intralipid) and/or the vitamin A metabolite retinal (RAL) will reduce hepatic TG accumulation and attenuate indicators of inflammation. C57BL/6 male mice were fed PN formula as their only source of hydration and nutrition for 4-5 wk. In Expt. 1, mice were fed PN only or PN plus treatment with RAL (1 μg/g orally), LE (200 μL i.v.), or both LE and RAL. In Expt. 2, LE was orally administered at 4 and 13.5% of energy to PN-fed mice. All PN mice developed HS compared with mice fed normal chow (NC) and HS was reduced by LE. The liver TG mass was lower in the PN+LE and PN+RAL+LE groups compared with the PN and PN+RAL groups (P < 0.01) and in the 4% and 13.5% PN+LE groups compared with PN alone. Hepatic total retinol was higher in the RAL-fed mice (P < 0.0001), but RAL did not alter TG mass. mRNA transcripts for fatty acid synthase (Fasn) and sterol regulatory element-binding protein-1c (Srebpf1) were higher in the PN compared with the NC mice, but FAS protein and Srebpf1 mRNA were lower in the PN+LE groups compared with PN alone. The inflammation marker serum amyloid P component was also reduced. In summary, LE given either i.v. or orally may be sufficient to reduce the steatotic potential of orally fed high-dextrose formulas and may suppress the early development of HS during PN therapy.


[Hyperosmolar volume replacement in heart surgery].
The ideal solution for use in volume therapy is still a matter of debate. Hypertonic sodium (HS) solutions have been advocated for resuscitation from hemorrhagic shock (small volume resuscitation). As hypertonic fluids may also be of interest in cardiac surgery, the effects of a new HS solution were studied. METHODS. In 90 patients undergoing aorto-coronary bypass grafting studies were performed at three different periods: I (n = 30) after induction of anesthesia (before onset of the operation); II (n = 30) during cardiopulmonary bypass (CPB); III (n = 30) after termination of bypass. During these periods the patients were randomly allocated to one of three groups with 10 patients in each group: group 1 received a new hypertonic solution prepared in hydroxyethyl starch (HES) solution (72 g/l NaCl, 60 g/l HES, 2400 mosmol/l; HS-HES patients), group 2 received a 6% HES solution (200/0.5; HES patients), and group 3 received no volume infusion and served as controls. RESULTS. After the induction of anesthesia, significantly less HS-HES solution (4.5 +/- 0.5 ml/kg) than 6% HES solution (10.1 +/- 1.4 ml/kg) was necessary to double the baseline PCWP. The fluid balance during CPB was negative in the patients who had received HS-HES preoperatively (-0.03 +/- 0.01 ml/kg.min CPB), whereas 6% HES (+0.06 +/- 0.02 ml/kg.min CPB) and control patients (+0.13 +/- 0.03 ml/kg.min CPB) had a positive fluid balance. Both after the induction of anesthesia and after termination of bypass, CI increased more in the HS-HES group than in the HES patients, and it even decreased in the control group. SVR decreased in the HS-HES patients, whereas it increased in the control group. Rapid infusion of HS-HES during CPB was followed by a significant, but short-lasting decrease in MAP (-40 mmHg) and an increase in the oxygenator volume. Pulmonary gas exchange (= paO2) was least compromised in the HS-HES patients; the sodium concentration increased only in the HS-HES patients, but never exceeded 150 mmol/l. DISCUSSION. Cardiac surgery procedures offer a special situation for volume therapy as there is a possibility of deterioration in the macro- and microcirculation before, after, and during the period of CPB. Hemodynamic effects of the new HS-HES solution included an increase in CI and a decrease in SVR, which were not merely transient as has been reported which hypertonic saline solution used alone. It was also observed that HS-HES patients required significantly smaller volumes of fluids, both during CPB and during the early postoperative period. This effect seems to be due to a redistribution of interstitial fluid to the intravascular space, possibly decreasing tissue edema. CONCLUSION. The hypertonic saline HES solution adds a new dimension to volume therapy for cardiac surgery patients. The improvement in hemodynamics was effective and not only transient. Fluid requirements were significantly reduced during as well as after CPB, and pulmonary gas exchange was least compromised in these patients.


Airway management: induced tension pneumoperitoneum.
Pneumoperitoneum is not always associated with hollow viscus perforation. Such condition is called non-surgical or spontaneous pneumoperitoneum. Intrathoracic causes remain the most frequently reported mechanism inducing this potentially life threatening complication. This clinical condition is associated with therapeutic dilemma. We report a case of a massive isolated pneumoperitoneum causing acute abdominal hypertension syndrome, in a 75 year female, which occurred after difficult airway management and mechanical ventilation. Emergent laparotomy yielded to full recovery. The recognition of such cases for whom surgical management can be avoided is primordial to avoid unnecessary laparotomy and its associated morbidity particularly in the critically ill.


Impact of water coadsorption for carbon dioxide capture in microporous polymer sorbents.
Alcohol-containing polymer networks synthesized by Friedel-Crafts alkylation have surface areas of up to 1015 m(2)/g. Both racemic and chiral microporous binaphthol (BINOL) networks can be produced by a simple, one-step route. The BINOL networks show higher CO(2) capture capacities than their naphthol counterparts under idealized, dry conditions. In the presence of water vapor, however, these BINOL networks adsorb less CO(2) than more hydrophobic analogues, suggesting that idealized measurements may give a poor indication of performance under more realistic carbon capture conditions.


Recurrent Brachiocephalic Vein Stenosis as a Cause for Persistent Left-sided Transudative Pleural Effusion in a Hemodialysis Patient.
Effusion is common in dialysis patients. The most common causes include fluid overload due to renal failure and nonrenal causes like congestive heart failure and infection. We here report a case of left side transudative effusion due to brachiocephalic venous stenosis. A 34-year-old female who had chronic kidney disease V during transplant work-up was found to be having left arm swelling and left transudative effusion. Work-up for transudative effusion did not show any cardiac cause or liver problem. Her dialysis duration was optimized from 2 times a week to 3 times a week for 4 hr and her dry weight was adjusted. Despite adequate dialysis for 1 month, effusion on the left side persisted. She had a previous venoplasty for a stenosis in brachiocephalic vein but restenosis occurred again. Brachiocephalic vein stenting was performed which successfully lead to resolution of left arm swelling and left effusion. She was later on successfully transplanted. Brachiocephalic stenosis can cause ipsilateral transudative effusion. Venoplasty and stenting of the brachiocephalic vein lead to complete resolution of effusion.


Role of neuronal nitric oxide synthase in mediating renal hemodynamic changes during pregnancy.
Renal plasma flow (RPF) and glomerular filtration rate (GFR) are markedly increased during pregnancy. We recently reported that the renal hemodynamic changes observed during pregnancy in rats are associated with enhanced renal protein expression of neuronal nitric oxide synthase (nNOS). The purpose of this study was to determine the role of nNOS in mediating renal hemodynamic changes observed during pregnancy. To achieve this goal, we examined the effects of the nNOS inhibitor 7-nitroindazole (7-NI) on kidney function in normal conscious, chronically instrumented virgin (n = 6) and pregnant rats (n = 9) at day 16 of gestation. Infusion of 7-NI had no effect on RPF (4.7 +/- 0.7 vs. 4.8 +/- 0.9 ml/min), GFR (2.2 +/- 0.2 vs. 2.5 +/- 0.4 ml/min), or mean arterial pressure (MAP; 127 +/- 7 vs. 129 +/- 10 mmHg) in virgin rats. In contrast, 7-NI infused into pregnant rats decreased RPF (8.9 +/- 1.6 vs. 6.5 +/- 1.4 ml/min) and GFR (4.4 +/- 0.7 vs. 3.3 +/- 0.7 ml/min) while having no effect on MAP (123 +/- 4 vs. 123 +/- 3 mmHg). In summary, inhibition of nNOS in pregnant rats at midgestation results in significant decreases in RPF and GFR. nNOS inhibition in virgin rats had no effect on renal hemodynamics. These data suggest that nNOS may play a role in mediating the renal hemodynamic changes that occur during pregnancy.


Bacteria antibiotic resistance: New challenges and opportunities for implant-associated orthopedic infections.
There has been a dramatic increase in the emergence of antibiotic-resistant bacterial strains, which has made antibiotic choices for infection control increasingly limited and more expensive. In the U.S. alone, antibiotic-resistant bacteria cause at least 2 million infections and 23,000 deaths a year resulting in a $55-70 billion per year economic impact. Antibiotics are critical to the success of surgical procedures including orthopedic prosthetic surgeries, and antibiotic resistance is occurring in nearly all bacteria that infect people, including the most common bacteria that cause orthopedic infections, such as Staphylococcus aureus (S. aureus). Most clinical cases of orthopedic surgeries have shown that patients infected with antibiotic-resistant bacteria, such as methicillin-resistant S. aureus (MRSA), are associated with increased morbidity and mortality. This paper reviews the severity of antibiotic resistance at the global scale, the consequences of antibiotic resistance, and the pathways bacteria used to develop antibiotic resistance. It highlights the opportunities and challenges in limiting antibiotic resistance through approaches like the development of novel, non-drug approaches to reduce bacteria functions related to orthopedic implant-associated infections. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 36:22-32, 2018.


Spontaneous Intracranial Hypotension Followed by Intracranial Hypertension.
Spontaneous intracranial hypotension is a secondary cause of headache caused by suspected cerebrospinal fluid leaks. It is associated with vascular changes that may predispose to superficial siderosis. When treated with an epidural blood patch, rebound intracranial hypertension may ensue. A 55-year-old man presented with orthostatic headaches responsive to rest and hydration. Brain magnetic resonance revealed subdural collections, consistent with intracranial hypotension. Three weeks later, the patient experienced sudden severe holocranial headache and spontaneous subarachnoid hemorrhage was found. This resulted in rebound intracranial hypertension with bilateral papilledema and sixth-nerve palsy, which completely resolved with acetazolamide. Spontaneous intracranial hypotension may predispose to subarachnoid hemorrhage through vascular compensatory changes. Blood in subarachnoid space may seal the hidden cerebrospinal fluid leak or trigger an inflammatory reaction, leading to rebound intracranial hypertension, a well-known epidural blood patch complication.


Output Formation Containment for Multiagent Systems Under Multipoint Multipattern FDI Attacks: A Resilient Impulsive Compensation Control Approach.
The increasing number of devices and frequent interactions of agents from networked multiagent systems (MASs) exacerbate the risks of potential cyber attacks, especially the different point attacks and multiple pattern attacks. This article considers the output formation-containment problem for MASs under multipoint multipattern false data injection (FDI) attacks. The multipoint describes the attacks simultaneously occurring on the sensors, actuators, and communication channels; the multipattern captures that sensor and actuator attack signals are both continuous deterministic variables, and the communication channel attack signals are intermittent random variables, obeying the Bernoulli distribution. For such compromised MASs, a novel hybrid protocol is proposed, which integrates a state observer, an attack estimator, an impulsive interactor and a compensation controller. Thereinto, the state observer and the attack estimator are constructed to recover the unmeasured system states and the unknown FDI attack signals, respectively; the impulsive interactor is designed to guarantee that the neighbor's signals are transmitted only at impulsive instants, and meanwhile the channel attacks are randomly launched; using the recovered signals, the compensation controller is devised to alleviate the effect of attacks. A sufficient condition is identified, under which the output formation containment is achieved with cooperative uniform ultimate boundedness (UUB). Finally, simulation results are carried out to validate the effectiveness and advantages of the proposed approach.


Mixed solvent exposure and organic brain damage. A study of painters.
In recent years, the possible role of occupational solvent exposure as a cause of chronic effects on the brain has been a matter of increasing concern. The present study was undertaken with the purpose of further investigating this problem, trying to minimize confounding owing to effects of recent solvent exposure and a 'healthy worker' effect. This was accomplished by studying a historical cohort of painters. The material consists of a random sample of 85 painters, and as a non-exposed control group of 85 bricklayers, selected in the same way. Parts of the study are based on this sample supplemented by a sample of 9 painters and 14 bricklayers, selected among subjects with a high degree of complaints on mental impairment. On the basis of a detailed interview on previous solvent exposure, the painters were divided into three groups with low, medium and high solvent exposure, respectively. As signs of organic brain damage we used the degree of dementia and performance in psychometric tests as assessed at a neuropsychological examination; the degree of dyscoordination as assessed from clinical neurological tests; and the degree of cerebral atrophy as assessed from CT-scans of the brain. CT-scans were performed only on a specially selected subsample. The degree of dementia, dyscoordination, and cerebral atrophy increased significantly with the degree of solvent exposure. A similar, but non-significant association was found for the relation between performance in psychometric tests and solvent exposure. The degree of dementia, of dyscoordination, and of cerebral atrophy were positively associated with each other, suggesting that they reflect different aspects of a common underlying factor, an organic brain damage. A review of the literature compared with the results of the present study suggests that a number of studies may have been biased towards negative findings owing to the inclusion in the study material of large proportions of subjects with a solvent exposure that is too little to increase the risk of an organic brain damage. Conflicting results between different studies on performance in psychometric tests may also arise from insufficient adjustment for primary intellectual level.(ABSTRACT TRUNCATED AT 400 WORDS)


Eidetic imagery: longitudinal results in brain-damaged children.
There have only been a few attempts to assess whether eidetic imagery is inversely related to age. A sample of 15 known eidetikers from a previous study, having particular forms of brain damage, were retested after a lapse of 20 months. The hypothesis of the study was that older children are most likely to lose their capacity for seeing eidetic images over a period of 20 months than are younger children. The data confirmed the hypothesis and was interpreted as supporting the theory that eidetic imagery is a developmental process that decreases in importance over the course of a child's development.


Health literacy in Suriname.
Low health literacy is an independent predictor of cardiovascular mortality. However, data on health literacy in low- and middle-income countries are scarce. Therefore, we assessed the level of health literacy in Suriname, a middle-income country with a high cardiovascular mortality. We estimated health literacy in a convenience sample at an urban outpatient center in the capital and at a semirural health center, using the validated Rapid Estimate of Adult Literacy in Medicine adapted for the Dutch language (REALM-D) instrument. REALM-D scores vary from 0 to 66 (all correct). The primary outcome was the level of health literacy. Furthermore, we assessed the effect of age, sex, ethnicity, disease history, research location, and level of education on health literacy with multivariable linear regression. We included 99 volunteers (52% men; 51% urban research location) with a mean age of 44.9 years (SD 13.4). The mean REALM-D score was moderate: 48.6 (SD 8.1). Greater health literacy was associated with male sex, an urban research location, and a higher educational level. Health literacy was moderate in these Surinamese participants. Health care workers should take health literacy into account, and targeted interventions should be developed to improve health literacy in Suriname.


[Effects on welfare of children and adults with chronic disease caregivers].
Comparing the quality of caregivers' lives when they are related to child and adult patients suffering from chronic diseases (Cartagena, Colombia). This cross-sectional study was carried out on 91 child and 97 adult patient caregivers in three hospitals located in Cartagena, Colombia. Ferrell et al.'s psychometric test was used for ascertaining social well-being. Student's t-test was used for testing the effect of care-giving on physical, psychological, social and spiritual well-being. Females aged 18 to 59 predominated as caregivers in both groups. The percentage of child caregivers who had not completed primary school was higher than that of those looking after adults. Psychological and social welfare was most affected in stroke care-givers (48.7 cf 50.5 (T<0.05) and 21.8 cf 19.2 (T <0.05), respectively). Child caregivers were significantly more affected than adult caregivers regarding spiritual welfare (23.7 cf 22.6 (T<0.05)). There was no significant difference regarding physical wellbeing (10.5 cf 11.1 (T>0.05)). The experience of care-giving significantly modified people's perception of others' quality of life. Caregivers as an important source of informal care require health system support, particularly from nurses.


[Infant mortality in Great Britain: a review of historical knowledge].
This paper provides a concise review of what is known about long-term trends in infant mortality rates in Britain since the middle of the sixteenth century. It considers, first, various estimates of infant mortality based on E.A. Wrigley and R.S. Schofield's estimates of life expectancy at birth for England, 1541-1871, which it compares with equivalent series for groups of parishes and the families of the British peerage. Secondly, it explores the variations between infant mortality rates that were likely in different forms of environment, especially the urban and the rural. Thirdly, the paper suggests that the conditions affecting an individual's life chance in adulthood. It considers this possibility further using Thomas Hollingsworth's data for the British peerage. Fourthly, the paper attempts to provide some estimates of the social class variations in infant mortality in England and Wales in comparison with those in the USA at the end of the nineteenth and early years of the twentieth century. Lastly, some of these regularities are considered from an epidemiological perspective by examining cause of death patterns among children.


Association of LTBR polymorphisms with chronic hepatitis B virus infection and hepatitis B virus-related hepatocellular carcinoma.
Lymphotoxin-β receptor (LTβR) signaling is involved in hepatitis B virus (HBV) infection, hepatitis and liver carcinogenesis. However, the potential association between LTBR polymorphisms and HBV infection remains unclear. This study investigated the associations between LTBR polymorphisms and chronic HBV infection and HBV-related hepatocellular carcinoma (HCC). The study included 409 patients with chronic HBV infection, 73 HBV infection resolvers, and 197 healthy controls. Two polymorphisms rs12354 and rs3759333 were selected and genotyped by polymerase chain reaction-ligase detection reaction method. The frequencies of rs12354 genotype GT and allele T in HBV infection resolvers were significantly higher than those in patients with chronic HBV infection and healthy controls (genotype GT: 38.4% vs. 22.2% and 38.4% vs. 20.8%, P=0.004 and P=0.004, respectively; allele T: 20.5% vs. 13.1% and 20.5% vs. 12.9%, P=0.017 and P=0.028, respectively). The frequencies of rs3759333 genotypes and alleles between HBV patients, HBV infection resolvers and healthy controls had no statistical difference. The genotype and allele frequencies of rs12354 and rs3759333 had no statistical differences between chronic hepatitis B and HBV-related HCC patients. The serum LTβR levels and the overall survival rate between HBV-related HCC patients carrying different rs12354 and rs3759333 genotypes had no statistical differences. These results suggest that the LTBR rs12354 polymorphism might be associated with the spontaneous resolution of HBV infection. Additional studies with large sample size are needed to confirm and extend these findings.


Advanced Oxidation Process as a Postharvest Decontamination Technology To Improve Microbial Safety of Fresh Produce.
Fresh produce is frequently associated with outbreaks of foodborne diseases; thus, there is a need to develop effective intervention technologies and antimicrobial treatments to improve the microbial safety of fresh produce. Washing with chemical sanitizers, commonly used by the industry, is limited in its effectiveness and is viewed as a possible cross-contamination opportunity. This review discuses the advanced oxidation process (AOP), which involves generating highly reactive hydroxyl radicals to inactivate human pathogens. Ionizing irradiation, ultraviolet (UV) light, and cold plasma can be regarded as AOP; however, AOPs employing combinations of UV, H2O2, cold plasma, and ozone may be more promising because higher amounts of hydroxyl radicals are produced in comparison to the individual treatments and the combinative AOPs may be more consumer friendly than ionizing irradiation. When applied as a gaseous/aerosolized treatment, AOPs may have advantages over immersion treatments, considering the reactivity of hydroxyl radicals and presence of organic materials in wash water. Gaseous/aerosolized AOPs achieve up to 5 log reductions of pathogenic bacteria on fresh produce compared to reductions of 1-2 logs with aqueous sanitizers. Further research needs to be conducted on specific AOPs before being considered for commercialization, such as reduced formation of undesirable chemical byproducts, impact on quality, and scaled up studies.


Roentgenographic examination of the metacarpophalangeal joint.
Roentgenographic examination of the metacarpophalangeal joints of the index, long, ring and the little fingers is carried out routinely in antero-posterior (AP) and oblique lateral projections, while pictures in the straight lateral projection of each joint are hard to evaluate because of overprojection of the other metacarpal bones and proximal phalanges. A technique was devised to examine each joint separately in the straingt lateral projection by means of tomography. This is presented together with the technique for examination of the joint in the AP-projection. The tomograms in the lateral projection were found to be more valuable when carried out in active maximal extension as well as flexion. The great advantage of this method, particularly in examinations for scientific evaluation, has been demonstrated in repeated postoperative studies of 98 metacarpophalangeal joints.


CHIKUNGUNYA-ASSOCIATED UVEITIS AND EXUDATIVE RETINAL DETACHMENT: A CASE REPORT.
To report the first known case of bilateral granulomatous panuveitis secondary to chikungunya fever in the United States, acquired by a U.S. citizen traveling from an endemic region. Case report. A 47-year-old woman presented with 10 days of bilateral decreased vision and photophobia concurrent with a febrile illness contracted while visiting the Dominican Republic. She presented with bilateral granulomatous panuveitis and exudative retinal detachments. Extensive workup was negative with the exception of positive chikungunya virus immunoglobulin G and immunoglobulin M titers. Initially, she responded to corticosteroid treatment but developed recurrent inflammation 3 months after completing the initial treatment. Immunomodulatory therapy was initiated at the time of recurrence, and with immunomodulatory therapy alone her inflammation has been controlled for 6 months. The prevalence of chikungunya fever-related uveitis is increasing with the recent epidemics throughout the Americas. Inflammation can occur during the febrile illness or months later and can manifest in a variety of ways. Posterior segment inflammation is more commonly a delayed presentation. Previous reports suggest that chikungunya fever-related uveitis responds well to corticosteroid therapy. This is the first reported case of recurrent inflammation. Given the wide variety of presentations, chikungunya fever-related uveitis should be included in the differential diagnosis of all at-risk patients presenting with acute ocular inflammation, particularly those traveling from endemic regions.


Power Performance Verification of a Wind Farm Using the Friedman's Test.
In this paper, a method of verification of the power performance of a wind farm is presented. This method is based on the Friedman's test, which is a nonparametric statistical inference technique, and it uses the information that is collected by the SCADA system from the sensors embedded in the wind turbines in order to carry out the power performance verification of a wind farm. Here, the guaranteed power curve of the wind turbines is used as one more wind turbine of the wind farm under assessment, and a multiple comparison method is used to investigate differences between pairs of wind turbines with respect to their power performance. The proposed method says whether the power performance of the specific wind farm under assessment differs significantly from what would be expected, and it also allows wind farm owners to know whether their wind farm has either a perfect power performance or an acceptable power performance. Finally, the power performance verification of an actual wind farm is carried out. The results of the application of the proposed method showed that the power performance of the specific wind farm under assessment was acceptable.


Trauma and posttraumatic stress disorder in a rural primary care population in South Africa.
The aim of this study was to assess trauma events experienced and PTSD among 250 consecutive rural primary clinic patients (all Black Africans, 24% male and 76% female; M age 31.1 yr., SD = 11.8; range 18-65 years) in South Africa using the Trauma History Questionnaire and the PTSD Checklist-Civilian Version, interview administered. Results indicated that the mean number of traumatic events reported was 3.5 (SD = 2.9, range = 0-19) and was significantly higher among men (M= 4.9, SD = 3.5) than women (M = 3.0, SD = 2.6). Among the most frequently endorsed traumas among men were seeing someone seriously injured or killed (60%), serious accident (43.3%), and seeing dead bodies (43.3%), and among women natural disaster (mostly floods) (51.6%), news of a serious injury, life-threatening illness or unexpected death of someone close (31.1%), and seeing someone seriously injured or killed (30%). A current diagnosis of PTSD was found in 12.4% of the sample. Trauma incidence figures were high (M = 3.5) and were comparable with an urban Xhosa primary care population in South Africa (M = 3.8). A current indicative diagnosis of PTSD of 12.4% also compares with other studies; 19.9% among urban Xhosa primary care patients and 11.8% among American primary care patients.


[Characteristics of computed tomography of allergic fungal sinusitis].
To sum up the characteristics of computed tomography of allergic fungal sinusitis (AFS) and to compare the CT changes with the findings in the operation. The diagnostic role of CT scan was discussed. The CT scans of 21 patients diagnosed as AFS were analyzed. The patients ranged from 15 to 50 years old,there were 17 males and 4 females. The CT was scanned with both bony and soft tissue windows. The preoperative examinations included nasal endoscopy, skin prick test, total serum IgE and nasal secretion smear. The findings in the operation were compared with the preoperative CT scans. Histopathology and fungal smear were done postoperatively. Endoscopy showed that all patients had polyps with wasfy yellow or inspissated white secretion. Nine cases (11 sides) showed yellow-to-brown material similar to peanut butter in the nasal cavities. Nasal CT scan demonstrated unilateral lesion in 10 cases (10 sides) and bilateral lesions in 11 cases (22 sides), who were all pansinus diseases. CT scan demonstrated a sheet areas of high-attenuation like "ground glass" within sinuses coupled with soft tissue image around them. Bone erosion of anterior skull base was encountered in 3 cases (4 sides). One case showed the intracranial extension. Twenty cases had conceived nasal endoscopic sinus surgeries. One case underwent endoscopic sinus surgery combined with coronal approach. The yellow-to-brown material (allergic mucin) was detected in the cavities of 17 cases. Four cases had green-to-brown secretion like mud. After follow-up of 6 months to 7 years, 14 cases were cured, 7 cases improved. Among them, 3 cases had to get revision surgeries because of recurrence 2 years after surgery. The characteristic of a sheet area of high-attenuation like " ground glass" within sinuses coupled with soft tissue image around them in computed tomography of nasal sinus, accompanied with invasive expansion or bone erosion, has a diagnostic significance for AFS.


Minimally Invasive Scoliosis Correction in Parkinson Disease: Retrospective Case Series.
Parkinson disease (PD) is the second most common neurodegenerative disease in the United States. In the context of the disability inherent to PD, the additional physical challenges and pain from scoliosis can be debilitating for these patients. However, the magnitude of surgery required to correct the deformity combined with the medical co-morbidities and frailty in this population of patients makes surgery very risky. To investigate clinical presentations and outcomes of patients with PD that underwent minimally invasive long-segment fusion for scoliosis correction. A retrospective chart review was performed over the years 2007 to 2017 for patients diagnosed with PD undergoing long-segment spinal fusion (5 or more levels) with the use of circumferential minimally invasive spine surgery techniques. Data including age, sex, race, medical co-morbidities, presenting symptoms, radiographic findings, surgical procedure, case history, and complications were collected from the medical record. Retrospective chart review revealed three patients that met the inclusion criteria. They included 2 males and 1 female, with a mean age of 68.7 yr (range 63-75 yr). Ability to maintain upright posture, return to activities of daily living, and visual analog scale (VAS)-back improved in all patients at 1-yr follow-up. Results were durable at 2-yr follow-up. No medical complications were observed. The generally positive results suggest that minimally invasive technique could have significant benefits in this high-risk group of patients.


Defective calcium signalling in uraemic platelets and its amelioration with long-term erythropoietin therapy.
Chronic renal failure (CRF) is associated with prolonged bleeding time and impaired platelet adhesion and aggregation. Erythropoietin (Epo) administration improves platelet adhesion/aggregation and ameliorates prolongation of bleeding time in CRF. However, the mechanisms of improved platelet function after Epo therapy have not been fully elucidated. The present study examined the hypothesis that the improved uraemic platelet function after Epo therapy is, in part, due to correction of the platelet calcium signalling. Rats were randomized into four groups after 5/6 nephrectomies to produce CRF. The Epo-treated CRF group received Epo, 150 U/kg, twice weekly for 6 weeks to prevent anaemia; the felodipine and Epo-treated CRF group received Epo but was kept normotensive by felodipine treatment; the placebo-treated CRF group received placebo injections and became anaemic; and the iron-deficient CRF group received Epo but was kept anaemic by dietary iron-deficiency. A group of sham-operated rats was included as normal control. Basal and thrombin-stimulated platelet cytosolic calcium ([Ca(2+)](i)) were determined using a Ca(2+)-sensitive dye (fura-2). Platelets from placebo-treated CRF group exhibited a profound attenuation of thrombin-stimulated surge in [Ca(2+)](i), which is the final pathway of platelet activation. Long-term Epo administration led to a normalization of the thrombin-induced rise in platelet [Ca(2+)](i) in the CRF animals, independent of either haematocrit or blood pressure values. Further studies revealed that improved Ca(2+) signalling with Epo is associated with increased Ca(2+) uptake and expanded Ca(2+) stores in the platelets. The defective Ca(2+) signalling in uraemic animals and its improvement with chronic Epo therapy provides the biochemical basis of the previously reported platelet dysfunction and prolonged bleeding time in uraemic patients and animals, and their amelioration with chronic Epo therapy.


Subtle-but-smouldering myocardial injury after immune checkpoint inhibitor treatment accompanied by amyloid deposits.
Although cardiac troponin is a highly specific biomarker for myocardial cell injury, it is important to recognize the pitfalls of this test in the diagnosis and management of immune checkpoint inhibitor (ICI) myocarditis. We describe the challenging case of an 81-year-old woman with persistently high troponin after undergoing immunotherapy with ipilimumab and nivolumab, and histological evidence of amyloid deposition in the myocardium. The patient received immunosuppressive treatments based on the magnitude of troponin changes because myocarditis was clinically suspected. However, histological examination revealed the deposition of transthyretin amyloid fibrils with only minimal T-lymphocyte infiltration and no myocyte necrosis, suggesting transthyretin cardiac amyloidosis rather than ICI myocarditis. This case highlights the importance of assessing other causes of persistently high troponin, and the necessity of incorporating comprehensive histological and immunohistochemical examinations of the endomyocardial biopsy, especially when cardiovascular magnetic resonance imaging is inconclusive.


Efficacy of the College Drinkers Check-Up for Student Drinkers Living Off Campus.
Students living in off-campus housing consume more alcohol and experience more alcohol-related consequences than those living on campus, yet prevention efforts have not targeted this high-risk group specifically. The present study evaluated the efficacy of a brief, computer-delivered, alcohol intervention (the College Drinkers Check-Up [CDCU]) in reducing alcohol use and related consequences in a sample of college students living off campus. Students who lived off campus and reported at least one heavy drinking episode (4+/5+ drinks for females/males in one occasion) in the past 30 days completed the CDCU or assessment only during the first month of the school year (n = 326; 61% female). Participants in both conditions completed follow-up assessments at 1, 3, and 6 months. We hypothesized that participants who completed the CDCU would report fewer drinks per week and heavy drinking episodes, lower peak drinking quantities, and fewer alcohol-related consequences than those in the control group. Hierarchical linear modeling was used to examine changes in drinking outcomes across groups from baseline to 1-, 3-, and 6-month follow-ups. Significant effects of time indicated less drinking and fewer consequences at each follow-up relative to baseline. Compared with those in the control group, participants who received the CDCU reported significantly fewer heavy drinking episodes at 1 month, lower peak drinking quantities at 3 months, and fewer alcohol-related consequences at 1 and 3 months. Neither sex nor baseline drinking severity moderated intervention effects. The brief, online CDCU reduces heavy drinking and alcohol consequences in the short term among atrisk college students living off campus.


Role of computed tomography angiography on the management of overt obscure gastrointestinal bleeding.
The role of computed tomography angiography (CTA) on the management of acute overt obscure gastrointestinal bleeding (OGIB) remains unclear. We designed a study to evaluate the impact of CTA before enteroscopy for acute overt OGIB. All patients undergoing CTA followed by enteroscopy for acute overt OGIB were enrolled in this retrospective study. Clinical characteristics and diagnosis were compared between patients with positive and negative CTA findings. We evaluated the impact of CTA on subsequent enteroscopy. From February 2008 to March 2015, 71 patients including 25 patients with positive CTA findings and 46 patients with negative CTA findings, were enrolled. All 25 patients with positive CTA findings were confirmed to have mid GI lesions, a significantly higher proportion than among patients with negative CTA findings (100% vs. 52.2%, respectively; P <0.001). CTA had a higher diagnostic yield for bleeding from tumor origin than from non-tumor origin (80.0% vs. 23.7%, respectively; P <0.001). The diagnostic yield of CTA and enteroscopy was 35.2% and 73.2%, respectively. The lesions could be identified by the initial route of enteroscopy in more patients with positive CTA findings than in those with negative CTA findings (92.0% vs. 47.8%, respectively; P <0.001). Lesions could be identified in seven of the 25 patients (28.0%) with positive CTA findings by using only push enteroscopy instead of single-balloon enteroscopy (SBE), but all 46 patients with negative CTA findings needed SBE for deep small-bowel examination. CTA is useful in the diagnosis of acute overt OGIB, especially in patients with bleeding from tumors. In addition, it also can show the precise location of bleeding, and guide subsequent enteroscopic management.


The role of ocular muscle proprioception during modifications in smooth pursuit output.
The output of the smooth pursuit (SP) system can be increased by adding a portion of the recorded eye motion onto target motion, producing a situation analogous to that occurring with weakened ocular muscles. This change is most likely the result of alterations in the signals that code eye and target motion. We have assessed the contribution of one such signal, that arising from ocular proprioception, to the modification process during monocular SP by preventing the motion of the non-viewing eye with a suction scleral lens. The large increases normally observed for SP velocity following the modification period were substantially reduced under these conditions. Similar alterations were also observed in a manual tracking task. These results demonstrate that ocular proprioceptive signals serve to stabilize the output of the SP system following perturbations, via the recoding of eye and target motion.


Evolution of DNA polymerase families: evidences for multiple gene exchange between cellular and viral proteins.
A phylogenetic analysis of the five major families of DNA polymerase is presented. Viral and plasmid sequences are included in this compilation along with cellular enzymes. The classification by Ito and Braithwaite (Ito and Braithwaite 1991) of the A, B, C, D, and X families has been extended to accommodate the "Y family" of DNA polymerases that are related to the eukaryotic RAD30 and the bacterial UmuC gene products. After analysis, our data suggest that no DNA polymerase family was universally conserved among the three biological domains and no simple evolutionary scenario could explain that observation. Furthermore, viruses and plasmids carry a remarkably diverse set of DNA polymerase genes, suggesting that lateral gene transfer is frequent and includes non-orthologous gene displacements between cells and viruses. The relationships between viral and host genes appear very complex. We propose that the gamma DNA polymerase of the mitochondrion replication apparatus is of phage origin and that this gene replaced the one in the bacterial ancestor. Often there was no obvious relation between the viral and the host DNA polymerase, but an interesting exception concerned the family B enzymes: in which ancient gene exchange can be detected between the viruses and their hosts. Additional evidence for horizontal gene transfers between cells and viruses comes from an analysis of the small damage-inducible DNA polymerases. Taken together, these findings suggest a complex evolutionary history of the DNA replication apparatus that involved significant exchanges between viruses, plasmids, and their hosts.


Metaplastic Carcinoma of the Breast Is More Aggressive Than Triple-negative Breast Cancer: A Study From a Single Institution and Review of Literature.
We aimed to describe our experience with metaplastic breast carcinoma (MBC), evaluate its clinical outcome compared with triple-negative breast cancer (TNBC), and provide a through and comprehensive review of the literature to date. We reviewed MBC cases (n = 46) from our institution. The following variables were recorded: tumor histologic subtype, Nottingham grade, tumor size, lymph node status, Tumor, Node, Metastases stage, biomarkers profile, patient's age and race, therapy modality (chemotherapy and radiation), and survival (disease-free survival [DFS] and overall survival [OS]). The clinical and pathological data for TNBC (n = 508) cases were extracted from the breast cancer database. To compare the survival between MBC and TNBC, a subgroup of MBC cases (n = 40) were matched with TNBC cases (n = 40) on the basis of known prognostic confounders. There were 17 of 46 (37%) cases with mesenchymal differentiation, 12 (26.1%) squamous cell carcinoma, 14 (30.4%) spindle cell carcinoma, and 3 (6.5%) mixed type. MBC presented at a more advanced stage than TNBC (P = .014) and was more likely to recur (34% vs. 15.5%; P = .004). More MBC patients died from disease than TNBC (29% vs. 16%; P = .05). In the multivariate analysis, MBC had approximately twice the risk of local recurrence than TNBC (95% confidence interval, 1.01-3.83; P = .05). MBC patients had worse DFS and OS than the matched TNBC patients (P < .001 and P = .033, respectively). A review of the literature comparing MBC versus TNBC is presented. Our results suggest that MBC is clinically more aggressive than TNBC. Further studies might help delineate the differences between these 2 entities.


CpG motifs are efficient adjuvants for DNA cancer vaccines.
DNA vaccines can induce impressive specific cellular immune response (IR) when taking advantage of their recognition as pathogen-associated molecular patterns (PAMP) through Toll-like receptors (TLR) expressed on/in cells of the innate immune system. Among the many types of PAMP, immunostimulatory DNA, so-called CpG motifs, was shown to interact specifically with TLR9, which is expressed in plasmacytoid dendritic cells (pDC), a key regulatory cell for the activation of innate and adaptive IR. We now report that CpG motifs, when introduced into the backbone, are a useful adjuvant for plasmid-based DNA (pDNA) vaccines to induce melanoma antigen-specific protective T cell responses in the Cloudman M3/DBA/2 model. The CpG-enriched pDNA vaccine induced protection against subsequent challenge with melanoma cells at significantly higher levels than its parental unmodified vector. Preferential induction of an antigen-specific, protective T cell response could be demonstrated by (i) induction of antigen-dependent tumor cell protection, (ii) complete loss of protection by in vivo CD4+/CD8+T cell- but not NK cell-depletion, and (iii) the detection of antigen-specific T cell responses but not of relevant NK cell activity in vitro. These results demonstrate that employing PAMP in pDNA vaccines improves the induction of protective, antigen-specific, T cell-mediated IR.


Toward flexible and wearable human-interactive health-monitoring devices.
This Progress Report introduces flexible wearable health-monitoring devices that interact with a person by detecting from and stimulating the body. Interactive health-monitoring devices should be highly flexible and attach to the body without awareness like a bandage. This type of wearable health-monitoring device will realize a new class of electronics, which will be applicable not only to health monitoring, but also to other electrical devices. However, to realize wearable health-monitoring devices, many obstacles must be overcome to economically form the active electrical components on a flexible substrate using macroscale fabrication processes. In particular, health-monitoring sensors and curing functions need to be integrated. Here recent developments and advancements toward flexible health-monitoring devices are presented, including conceptual designs of human-interactive devices.


Automatic measurement of skin wheals provoked by skin prick tests.
Skin prick tests (SPT) represent the standard method for the diagnosis of type-1 allergies. The skin wheals provoked by the SPTs are considered positive above certain cut-off diameters, usually 3 mm. At present their size is mostly estimated by measuring the diameter with rulers. Since the shape of wheals usually is not circular, the measurement of diameters leads to imprecise results. Therefore, we developed an algorithm for precisely measuring the wheals' area in mm(2) automatically. The average deviation of the automatic measurement on a test set achieved with the developed algorithm was 6.9 %. Compared to the maximum standard deviation of 6.59 % when measuring the manually redrawn outlines, the automatic method works sufficiently well.


Sucralfate for the prevention of early rebleeding following injection sclerotherapy for esophageal varices.
One hundred eighty patients with variceal bleeding and treated by long-term sclerotherapy were randomized into a prospective randomized controlled clinical trial to assess the efficacy of sucralfate in reducing the frequency of rebleeding from esophageal ulceration prior to variceal obliteration. Overall, 29 (32%) of the 92 patients treated with the addition of sucralfate rebled, compared to 37 (42%) of 88 patients managed by sclerotherapy alone (p less than 0.10), but when patients with well-compensated liver disease were considered, the respective figures were 14 (24%) and 25 (42%)--a statistically significant difference (p less than 0.05). The frequency (approximately 70%), number (per patient) and extent of sclerotherapy-induced esophageal mucosal ulceration were not different for the two groups, although proven rebleeding from the ulceration occurred less frequently in those receiving sucralfate (10 and 20 occasions, respectively, p less than 0.05). Mortality was not different for the two groups. Thus, use of sucralfate will reduce the frequency of rebleeding during long-term treatment by sclerotherapy, although benefit appears to be restricted to well-compensated patients and without an endoscopic overt effect upon esophageal mucosal ulceration.


Microsatellite analysis of primary and recurrent glial tumors suggests different modalities of clonal evolution of tumor cells.
Gliomas are characterized by highly variable biological behavior. After surgical resection and postoperative therapy they frequently recur with the same or higher-grade histology. Although a number of genetic aberrations have been described in gliomas of different histological types, the molecular mechanisms of the histological and clinical progression are poorly understood. In this study, we performed longitudinal microsatellite and mismatch repair gene analysis in paired samples of primary and recurrent gliomas in order to reveal whether genetic instability is associated with tumor progression. The 7 microsatellite loci of the 7 patients displayed a total of 18 (54.5%) alterations in the primary and 15 (45.5%) alterations in the recurrent gliomas as compared with the corresponding non-neoplastic cells, but no alterations were found in the hMLH1 and hMSH2 genes. These results suggest that microsatellite instability is associated with the development of the primary gliomas rather than with the recurrence or progression, and it is not associated with structural alterations in the hMLH1 or hMSH2 genes. Comparison of the microsatellite patterns in primary and secondary gliomas revealed 4 different modalities of clonal evolution, involving clonal identity, clonal deletion, clonal progression, and different clonality, suggesting that intensive clonal selection may play a central part in the recurrence of gliomas.


Delayed death due to traumatic dissection of the common carotid artery after attempted suicide by hanging.
Traumatic dissection of the carotid arteries is a rare cause of delayed death due to hanging. We report a case of delayed death two and a half months following attempted suicide by hanging where the patient was able to talk after being released from neck compression. The cause of death was aspiration pneumonia due to cerebral infarction secondary to traumatic dissection of the left common carotid artery due to attempted suicide by hanging. Carotid artery injuries should be examined in patients who were able to talk after an unsuccessful suicide attempt by hanging but who later died.


Aorto-left renal vein fistula: an unusual complication of abdominal aortic aneurysm.
A patient with an abdominal aortic aneurysm with a preaortic left renal vein fistula is presented. Review of the 7 reported cases of aorto-left renal vein fistulae demonstrates many similarities in the clinical presentation with aorto-caval fisulae. However, in addition to the triad of pain, pulsatile abdominal mass and bruit, commonly found in aorto-caval fistulae, the presence of hematuria, proteinuria, and azotemia suggests a renal vein fistula. Radiographic studies often demonstrate a large non-functional left kidney. Operative management of the fistula may be performed by a variety of maneuvers. All 7 patients survived. When repair was undertaken without delay, function in the left kidney returned to normal within two months postoperatively.


Sensitivity of fibroblasts derived from ataxia-telangiectasia patients to calicheamicin gamma 1I.
We report the hypersensitivity of SV40-transformed fibroblasts derived from ataxia telangiectasia (AT) patients to calicheamicin gamma 1I. In common with other free-radical generating agents such as bleomycin and ionizing radiation, treatment with calicheamicin gamma 1I reveals AT derived lines to be 6-fold more sensitive to this drug when compared to controls. Furthermore, in common with ionizing radiation, AT cells did not show dose-dependent inhibition of DNA synthesis after treatment with calicheamicin gamma 1I.


Nonspecific immunomodulators for recurrent respiratory tract infections, wheezing and asthma in children: a systematic review of mechanistic and clinical evidence.
To provide an overview of the mechanistic and clinical evidence for the use of nonspecific immunomodulators in paediatric respiratory tract infection (RTI) and wheezing/asthma prophylaxis. Nonspecific immunomodulators have a long history of empirical use for the prevention of RTIs in vulnerable populations, such as children. The past decade has seen an increase in both the number and quality of studies providing mechanistic and clinical evidence for the prophylactic potential of nonspecific immunomodulators against both respiratory infections and wheezing/asthma in the paediatric population. Orally administered immunomodulators result in the mounting of innate and adaptive immune responses to infection in the respiratory mucosa and anti-inflammatory effects in proinflammatory environments. Clinical data reflect these mechanistic effects in reductions in the recurrence of respiratory infections and wheezing events in high-risk paediatric populations. A new generation of clinical studies is currently underway with the power to position the nonspecific bacterial lysate immunomodulator OM-85 as a potential antiasthma prophylactic. An established mechanistic and clinical role for prophylaxis against paediatric respiratory infections by nonspecific immunomodulators exists. Clinical trials underway promise to provide high-quality data to establish whether a similar role exists in wheezing/asthma prevention.


Interleukin 6 and disease transformation in chronic myeloid leukemia: A Northeast Indian population study.
Interleukin 6 (IL6) has been suggested to be a valuable prognostic marker in chronic myeloid leukemia (CML). IL6 is a pleiotropic cytokine and plays an important role in immune response, hematopoiesis, and acute phase response. IL6 is regarded as a prominent target for clinical interventions. The aim of the present study was to investigate the serum levels of IL6 in CML to provide greater insight to their role in disease transformation in Indian patients. A total of 50 CML cases and 10 acute lymphocytic leukemia (ALL) cases along with 20 healthy controls were included in the study between 2015 and 2016. About 4 mL blood samples were collected from all cases in plain vial and serum was separated. Levels of IL6 were determined in all cases by enzyme-linked immunosorbent assay. The study suggests that both ALL and CML are associated with significantly elevated serum IL6 level than the healthy control group. Mean levels of serum IL6 are 223.4 ± 53.403 pg/mL in CML, 71.020 ± 29.549 pg/mL in ALL, and 5.360 ± 0.467 pg/mL in healthy control group. Serum IL6 correlated with different phases of CML. Mean IL6 levels are 50.93 ± 29.37 pg/mL in chronic phase (CP), 69.02 ± 22.60 pg/mL in accelerated phase (AP), and 652.77 ± 124.62 pg/mL in blast crisis (BC) phase of CML. In compared to CP and AP, in BC, IL-6 is significantly elevated ( P = 0.00 and 0.00, respectively); however, we did not find a significant difference in IL-6 serum levels between CP and AP ( P = 0.703). Study suggests that the detection of IL6 level in newly diagnosed patient can predict the severity of the disease. There might be association of level of IL6 with the disease transformation.


Computing Bulk Phase Raman Optical Activity Spectra from ab initio Molecular Dynamics Simulations.
We present our novel methodology for computing Raman optical activity (ROA) spectra of liquid systems from ab initio molecular dynamics (AIMD) simulations. The method is built upon the recent developments to obtain magnetic dipole moments from AIMD and to integrate molecular properties by using radical Voronoi tessellation. These techniques are used to calculate optical activity tensors for large and complex periodic bulk phase systems. Only AIMD simulations are required as input, and no time-consuming perturbation theory is involved. The approach relies only on the total electron density in each time step and can readily be combined with a wide range of electronic structure methods. To the best of our knowledge, these are the first computed ROA spectra for a periodic bulk phase system. As an example, the experimental ROA spectrum of liquid (R)-propylene oxide is reproduced very well.


Ligand Torsion Triggered Two Robust Fe-Tetratopic Carboxylate Frameworks with Enhanced Gas Uptake and Separation Performance.
By regulating the tetratopic carboxylate ligands, two robust Fe-MOFs (MOF=Metal-organic framework) comprising trigonal prismatic building blocks under a DMA/DMSO/HBF4 solvent system, namely, [(CH3 )2 NH2 ][FeII3 (OH)(BPTC)1.5 (DMSO)3 ] (SNNU-60) and [FeIII FeII2 (OH)(ABTC)1.5 (DMSO)3 ] (SNNU-61) (BPTC=3,3',5,5'-biphenyltetracarboxylic acid, ABTC=3,3',5,5'-azobenzenetetracarboxylic acid, SNNU=Shaanxi Normal University) have been successfully synthesized. The torsions between the benzene groups of the ligands result in two MOFs exhibiting completely different (4,6)-connected frameworks, which represent the only two MOF types constructed by [M3 (O/OH)(COO)6 ] trimeric building units and quadrilateral tetratopic carboxylate linkers until now. The robust Fe-MOFs SNNU-60 and SNNU-61 both exhibit high thermal/chemical stability, permanent microporosity, and excellent gas uptake capability for H2 , CO2 , C2 H2 , and C2 H4 under 1 bar. SNNU-60 in particular displays very high C2 H2 capture under low pressure (85 cm3 cm-3 at 0.15 bar and 298 K), which is among the top C2 H2 uptake MOF materials. Also, these two Fe-MOFs display high separation for CO2 and C2 -hydrocarbons over CH4 . Significantly, thanks to the high stability, suitable pore size, open Fe sites, and ion skeleton, SNNU-60 has extremely high C2 H2 /CH4 selectivity (83.6, 298 K), which surpasses most MOFs reported so far under the same conditions.


Road dust biases NDVI and alters edaphic properties in Alaskan arctic tundra.
Increased road-building activity in the arctic has the potential to impact adjacent ecosystems. Roads in permafrost regions are often built atop insulative gravel pads that generate dust plumes, altering soil chemistry and ecosystem function of nearby tundra. Here, we measure edaphic and vegetation characteristics along transects of decreasing dust deposition perpendicular to the Dalton Highway in northern Alaska. We quantify the impact of dust deposition on normalized difference vegetation index (NDVI), a proxy for aboveground plant biomass. Deposition of calcium carbonate-rich dust declined from 1.625 grams m-2 day-1 immediately adjacent to the road, to negligible levels 625 meters away. Along these transects from the road, we found declines in soil moisture and temperature, thaw depth, shrub height, and foliar nitrogen content, indicating that tundra roads create corridors with edaphic conditions favorable to vascular plant growth. At sites nearest the road, dust deposited on leaf surfaces reduced measured NDVI values by 0.24 by blocking reflectance properties of the underlying leaves. Our findings on the impacts of roads and dust deposition on adjacent tundra may aid planning of future infrastructure projects. We caution that dust deposition may negatively bias NDVI-based estimates of plant biomass, especially where unpaved roads are common.


T2 Magnetic Resonance Assay-Based Direct Detection of Three Lyme Disease-Related Borrelia Species in Whole-Blood Samples.
In early Lyme disease (LD), serologic testing is insensitive and seroreactivity may reflect active or past infection. In this study, we evaluated a novel assay for the direct detection of three species of Borrelia spirochetes in whole blood. The T2 magnetic resonance (T2MR) assay platform was used to amplify Borrelia DNA released from intact spirochetes and to detect amplicon. Analytical sensitivity was determined from blood spiked with known concentrations of spirochetes, and the assay's limit of detection was found to be in the single-cell-per-milliliter range: 5 cells/ml for B. afzelii and 8 cells/ml for Borrelia burgdorferi and Borrelia garinii Clinical samples (n = 66) from confirmed or suspected early LD patients were also analyzed. B. burgdorferi was detected using T2MR in 2/2 (100%) of blood samples from patients with confirmed early LD, based on the presence of erythema migrans and documentation of seroconversion or a positive real-time blood PCR. T2MR detected B. burgdorferi in blood samples from 17/54 (31%) of patients with probable LD, based on the presence of erythema migrans without documented seroconversion or of documented seroconversion in patients with a compatible clinical syndrome but without erythema migrans. Out of 21 clinical samples tested by real-time PCR, only 1 was positive and 13 were negative with agreement with T2MR. An additional 7 samples that were negative by real-time PCR were positive with T2MR. Therefore, T2MR enables a low limit of detection (LoD) for Borrelia spp. in whole blood samples and is able to detect B. burgdorferi in clinical samples.


Prevention strategies for type 1 diabetes.
Type 1 diabetes (T1D) is a common chronic disease of childhood. Patients with T1D are at significant risk for developing serious health complications. Understanding of the genetics, environmental factors, and natural history of diabetes has lead to greater understanding of the etiology and epidemiology of T1D. Furthermore, technology has greatly improved glycemic control and reduction of complications. However, prevention of the development of diabetes remains elusive. This review article describes the past, current and upcoming strategies for diabetes prevention for patients at risk for developing autoimmunity, after antibody production, and patients with new onset diabetes.


Efficient synthesis of vinylene-linked conjugated porous networks via the Horner-Wadsworth-Emmons reaction for photocatalytic hydrogen evolution.
A simple, yet efficient synthetic approach for the construction of vinylene-linked conjugated porous networks was developed. Based on the Horner-Wadsworth-Emmons reaction, the condensation polymerization for the formation of an sp2 carbon-linkage can be achieved at room temperature. The resulting vinylene-linked frameworks exhibit a promising porous nature with the best surface area of up to 1373 m2 g-1. Their intrinsic conjugated architectures and semiconducting properties lead to photocatalytic evolution of hydrogen from water under visible light irradiation. This new synthesis method provides a facile means to prepare attractive sp2 carbon linked porous organic frameworks.


Magnetic resonance imaging of the long head of the biceps tendon: benefit of coplanar image.
To evaluate coplanar imaging of the long head of the biceps tendon. We retrospectively compared coronal oblique magnetic resonance images aligned with the principal supraspinatus tendon and with the intra-articular biceps tendon in 21 patients. Magnetic resonance images were analyzed for lesions depicted, including superior labral anteroposterior (SLAP) tears. Arthroscopic findings were reviewed. Coronal oblique images aligned with intra-articular biceps tendon depicted 18 (86%) of 21 coplanar intra-articular biceps tendons. Coplanar images identified 6 cases of tendinosis, 1 tear, 3 intra-articular ruptures, and 20 (95.2%) of 21 exact origins of the tendon. Arthroscopy revealed 18 SLAP tears. The detection of SLAP lesions between both coronal oblique magnetic resonance images was significantly different (P = 0.007). Advantages included imaging of the intra-articular biceps tendon with least partial-volume effects, definition of SLAP lesions and the tendinous origin at the supraglenoid tubercle, depiction of intra-articular bicipital ruptures, and increased sensitivity and specificity for intra-articular lesions.


BSE: a consequence of cattle feeding with glycated molecules host-unknown?
Although there is much evidence supporting a prion contribution in the pathogenesis of transmissible spongiform encephalopathies, a novel point of view as to the induction of the diseases can be proposed. It is hypothesized that neurodegenerative diseases, such as scrapie in sheep and goats and bovine spongiform encephalopathy in cattle (BSE), originate from the consumption of glycated proteins contained in their feed. These components are obtained during a high-temperature glycation process.


Postlicensure epidemiology of childhood vaccination: the Danish experience.
The efficacy, the ability to confer protection against a target disease and the safety of a vaccine are assessed in great detail before licensure. However, inherent limitations in the prelicensure assessment necessitate continued epidemiological evaluations of efficacy and safety issues after the introduction of vaccines into use. In Denmark, the opportunities available for epidemiological research are unique. In 2001, an initiative was undertaken to take advantage of these opportunities to study the postlicensure epidemiology of childhood vaccination with respect to effectiveness and safety. First, we describe the unique opportunities for postlicensure research in Denmark with respect to the data sources available and the epidemiological and statistical methods used. We then describe a number of recent postlicensure studies of effectiveness and safety that took advantage of these opportunities. Specifically, studies on the effectiveness of Haemophilus influenzae type b vaccination, the effectiveness of pertussis vaccination, the impact of a preschool pertussis booster on infant pertussis, measles-mumps-rubella vaccine and autism, thimerosal-containing vaccine and autism, measles-mumps-rubella vaccine and febrile seizures, childhood vaccination and Type 1 diabetes, and childhood vaccination and nontargeted infectious disease are discussed.


Effects of a 2x gravity environment on the ultrastructure of the gerbil parathyroid gland.
A number of studies concerning the effects of hypergravity on bone have shown increases in bone mass or bone dimensions. Correlative studies, which could provide clues to the mechanism for such a response, have been lacking. The purpose of the present study was to evaluate the ultrastructure of parathyroid glands of Mongolian gerbils exposed to a continuous 2 X gravity force for 60 d. It was found that the experimental animals had parathyroid glands which had a greater percentage of cheif cells in the active stage of their secretory cycle when compared with control animals. This result was interpreted to indicate an increase in parathyroid gland secretory activity and, hence, and increase in parathyroid hormone release. It was suggested that increased parathyroid secretory activity was necessary to maintain serum calcium levels of hypergravity animals within normal limits. Cellular forms resembling water clear cells and highly compact, degenerating cells were described in experimental animals but not in controls. Areas suggestive of cellular dissolution and disorganization were also reported in experimental parathyroids


Asymmetric expression of connexins between luminal epithelial- and myoepithelial- cells is essential for contractile function of the mammary gland.
Intercellular communication is essential for glandular functions and tissue homeostasis. Gap junctions couple cells homotypically and heterotypically and co-ordinate reciprocal responses between the different cell types. Connexins (Cxs) are the main mammalian gap junction proteins, and the distribution of some Cx subtypes in the heterotypic gap junctions is not symmetrical; in the murine mammary gland, Cx26, Cx30 and Cx32 are expressed only in the luminal epithelial cells and Cx43 is expressed only in myoepithelial cells. Expression of all four Cxs peaks during late pregnancy and throughout lactation suggesting essential roles for these proteins in the functional secretory activity of the gland. Transgenic (Tg) mice over-expressing Cx26 driven by keratin 5 promoter had an unexpected mammary phenotype: the mothers were unable to feed their pups to weaning age leading to litter starvation and demise in early to mid-lactation. The mammary gland of K5-Cx26 female mice developed normally and produced normal levels of milk protein, suggesting a defect in delivery rather than milk production. Because the mammary gland of K5-Cx26 mothers contained excessive milk, we hypothesized that the defect may be in an inability to eject the milk. Using ex vivo three-dimensional mammary organoid cultures, we showed that tissues isolated from wild-type FVB females contracted upon treatment with oxytocin, whereas, organoids from Tg mice failed to do so. Unexpectedly, we found that ectopic expression of Cx26 in myoepithelial cells altered the expression of endogenous Cx43 resulting in impaired gap junction communication, demonstrated by defective dye coupling in mammary epithelial cells of Tg mice. Inhibition of gap junction communication or knock-down of Cx43 in organoids from wild-type mice impaired contraction in response to oxytocin, recapitulating the observations from the mammary glands of Tg mice. We conclude that Cx26 acts as a trans-dominant negative for Cx43 function in myoepithelial cells, highlighting the importance of cell type-specific expression of Cxs for optimal contractile function of the mammary myoepithelium.


Evaluation of single bolus, dual-echo dynamic susceptibility contrast MRI protocols in brain tumor patients.
Relative cerebral blood volume (rCBV) obtained from dynamic susceptibility contrast (DSC) MRI is adversely impacted by contrast agent leakage in brain tumors. Using simulations, we previously demonstrated that multi-echo DSC-MRI protocols provide improvements in contrast agent dosing, pulse sequence flexibility, and rCBV accuracy. The purpose of this study is to assess the in-vivo performance of dual-echo acquisitions in patients with brain tumors (n = 59). To verify pulse sequence flexibility, four single-dose dual-echo acquisitions were tested with variations in contrast agent dose, flip angle, and repetition time, and the resulting dual-echo rCBV was compared to standard single-echo rCBV obtained with preload (double-dose). Dual-echo rCBV was comparable to standard double-dose single-echo protocols (mean (standard deviation) tumor rCBV 2.17 (1.28) vs. 2.06 (1.20), respectively). High rCBV similarity was observed (CCC = 0.96), which was maintained across both flip angle (CCC = 0.98) and repetition time (CCC = 0.96) permutations, demonstrating that dual-echo acquisitions provide flexibility in acquisition parameters. Furthermore, a single dual-echo acquisition was shown to enable quantification of both perfusion and permeability metrics. In conclusion, single-dose dual-echo acquisitions provide similar rCBV to standard double-dose single-echo acquisitions, suggesting contrast agent dose can be reduced while providing significant pulse sequence flexibility and complementary tumor perfusion and permeability metrics.


A novel natural-derived tilapia skin collagen mineralized with hydroxyapatite as a potential bone-grafting scaffold.
Collagen is widely used in medical field because of its excellent biocompatibility and bioactivity. To date, collagen for biomedical use is always derived from bovine or swine. The purpose of this study was to evaluate collagen-based biomaterials from non-mammalian donors for bone repair. Thus, tilapia skin collagen-hydroxyapatite (T-col/HAp) scaffolds were fabricated in three different proportions and then cross-linked with 1-ethyl-3-(3-dimethylaminopropyl) carbodiimide-N-hydroxysuccinimide (EDC-NHS). The scaffolds were evaluated for their microstructure, chemical and physical properties, mechanical strength and degradability. Then the in vitro responses of bone mesenchymal stem cells (BMSCs) to the scaffolds were investigated in terms of cellular proliferation, differentiation, and mineralization. At last, the scaffolds were implanted into rat skull critical defections to investigate the potential of osteogenic activities. As a result, the pore sizes and the porosities of the scaffolds were approximately 106.67-196.67 μm and 81.5%-66.7%. Pure collagen group showed a mechanical strength of 0.065 MPa, and the mechanical strength was significantly enhanced almost 17 times and 32 times in collagen/HAp ratio 1:4 and 1:9 groups. In vitro studies revealed the most prominent and healthy growth of BMSCs in collagen/HAp ratio 1:4 group. All the scaffolds showed certain osteogenic activities and those loaded with small amount of hydroxyapatite showed the strongest bioactivities. The micro-CT showed that the critical bone defect was almost filled with generated bone 6 months after implantation in collagen/HAp ratio 1:4 group. The biomechanics tests further confirmed the highest generated bone strength was in the collagen/HAp ratio 1:4 group. This study indicated aquatic collagen might be a potential alternative for type I collagen from mammals in bone tissue engineering. The combination of collagen and inorganic materials was also important and appropriate inorganic component loading can achieve both osteogenic quality and osteogenic efficiency to a certain extent.


Fluorescence of KCl Aqueous Solution: A Possible Spectroscopic Signature of Nucleation.
Ion pairing in water solutions alters both the water hydrogen-bond network and ion solvation, modifying the dynamics and properties of electrolyte water solutions. Here, we report an anomalous intrinsic fluorescence of KCl aqueous solution at room temperature and show that its intensity increases with the salt concentration. From the ab initio density functional theory (DFT) and time-dependent DFT modeling, we propose that the fluorescence emission could originate from the stiffening of the hydrogen bond network in the hydration shell of solvated ion-pairs that suppresses the fast nonradiative decay and allows the slower radiative channel to become a possible decay pathway. Because computations suggest that the fluorophores are the local ion-water structures present in the prenucleation phase, this band could be the signature of the incoming salt precipitation.


A Monte Carlo method for comparing generalized estimating equations to conventional statistical techniques for discounting data.
Discounting is the process by which outcomes lose value. Much of discounting research has focused on differences in the degree of discounting across various groups. This research has relied heavily on conventional null hypothesis significance tests that are familiar to psychologists, such as t-tests and ANOVAs. As discounting research questions have become more complex by simultaneously focusing on within-subject and between-group differences, conventional statistical testing is often not appropriate for the obtained data. Generalized estimating equations (GEE) are one type of mixed-effects model that are designed to handle autocorrelated data, such as within-subject repeated-measures data, and are therefore more appropriate for discounting data. To determine if GEE provides similar results as conventional statistical tests, we compared the techniques across 2,000 simulated data sets. The data sets were created using a Monte Carlo method based on an existing data set. Across the simulated data sets, the GEE and the conventional statistical tests generally provided similar patterns of results. As the GEE and more conventional statistical tests provide the same pattern of result, we suggest researchers use the GEE because it was designed to handle data that has the structure that is typical of discounting data.


Efficacy of local adrenalin injection during sacrococcygeal pilonidal sinus excision.
The most commonly preferred treatment method for sacrococcygeal pilonidal sinus disease is surgery. Peroperative and postoperative hemorrhages may develop frequently because of the increased vascularity of the region. The aim of this study was to evaluate the effects of adrenalin, a potent vasoconstrictor agent, on pilonidal sinus operations in comparison to a control group. A prospective, randomized, double-blind, clinical study was designed and 51 patients with symptomatic, uncomplicated pilonidal disease were included (44 males and 7 females; mean age 24.5, range 16-44 years). Adrenalin 0.1 mg with 10 ml 0.9% NaCl (1/100,000 dilution) was injected through the incision tracts to all layers and the base of the incision area in group 1 (n = 21). The same process was applied to group 2 (n = 21) with 10 ml physiological serum solution. Then, after removal of the sinus and its tracks, a suction-type drain was placed in the pouch in all cases and the incision was primarily closed. Peroperative and postoperative hemorrhage, and operation time were accepted as the evaluation criteria. Cases were followed for 6 months postoperatively. The amount of peroperative hemorrhage was 6.5 +/- 3.5 ml in group 1 and 17.5 +/- 9.5 ml in group 2 (p < 0.001). The postoperative hemorrhage was 11 +/- 7.5 ml in group 1 and 13.5 +/- 6 ml in group 2 (p > 0.05). The operation time was 14 +/- 5 min in group 1 and 22 +/- 8.5 min in group 2 (p < 0.05). No reactionary hemorrhage, hematoma or recurrence was seen during the follow-up period. Adrenalin injection is quite effective to decrease peroperative bleeding and operation time, but it does not decrease postoperative bleeding and the need for a drain.


Somatotype and cardiovascular risk factors in healthy adults.
Relationships between cardiovascular risk factors and Heath-Carter anthropometric somatotype components were considered in 642 healthy adults free from overt disease: 68 males and 177 females, 30-39 years, and 233 males and 224 females, 40-49 years of age. Risk factors included systolic and diastolic blood pressures (SBP, DBP), fasting glycemia (GLYC), triglycerides (TG), plasma cholesterol (CHOL), the high density lipoprotein cholesterol fraction (HDL-C), and the HDL-C/CHOL ratio. Correlations between risk factors and each somatotype component were calculated after controlling for the effects of the other two somatotype components. Correlations were generally low and at best moderate, with significant correlations ranging from -0.23 to +0.23 in males and -0.20 to +0.30 in females. The relationships were stronger in the older group, 40-49 years, but the pattern of correlations was different in men and women. Endomorphy tended to be positively related to risk factors in older females, whereas ectomorphy tended to be negatively related to risk factors in older males. Comparison of somatotypes of individuals at the extremes of the distributions for each risk factor (upper and lower tertiles) were generally consistent with the direction of the correlations. For each cardiovascular risk, those with a poorer profile tended to be more endomorphic and mesomorphic and less ectomorphic than those with a better profile, who were more ectomorphic and less endomorphic and mesomorphic. The association was more apparent in males than in females and more so in those 40-49 years of age than in the younger age group. Although the correlations suggest that body type is weakly associated with common cardiovascular risk factors in healthy men and women, somatotype associations are more apparent at the extremes of the distributions of specific risk factors. Am. J. Hum. Biol. 9:11-19 © 1997 Wiley-Liss, Inc.


Calculation of the absolute thermodynamic properties of association of host-guest systems from the intermolecular potential of mean force.
The authors report calculations of the intermolecular potential of mean force (PMF) in the case of the host-guest interaction. The host-guest system is defined by a water soluble calixarene and a cation. With an organic cation such as the tetramethylammonium cation, the calixarene forms an insertion complex, whereas with the Lanthane cation, the supramolecular assembly is an outer-sphere complex. The authors apply a modified free energy perturbation method and the force constraint technique to establish the PMF profiles as a function of the separation distance between the host and guest. They use the PMF profile for the calculation of the absolute thermodynamic properties of association that they compare to the experimental values previously determined. They finish by giving some structural features of the insertion and outer-sphere complexes at the Gibbs free energy minimum.


A more desirable balanced polyunsaturated fatty acid composition achieved by heterologous expression of Δ15/Δ4 desaturases in mammalian cells.
Arachidonic (ARA), eicosapentaenoic (EPA) and docosahexaenoic (DHA) acids are the most biologically active polyunsaturated fatty acids, but their biosyntheses in mammals are very limited. The biosynthesis of DHA is the most difficult, because this undergoes the Sprecher pathway--a further elongation step from docosapentaenoic acid (DPA), a Δ6-desaturase acting on a C24 fatty acid substrate followed by a peroxisomal chain shortening step. This paper reports the successful heterologous expression of two non-mammalian genes (with modification of codon usage), coding for Euglena gracilis Δ4-desaturase and Siganus canaliculatus Δ4-desaturase respectively, in mammalian cells (HEK293 cell line). Both of the Δ4-desaturases can efficiently function, directly converting DPA into DHA. Moreover, the cooperation of the E. gracilis Δ4-desaturase with C. elegans Δ15-desaturase (able to convert a number of n-6 PUFAs to their corresponding n-3 PUFAs) in transgenic HEK293 cells made a more desirable fatty acid composition--a drastically reduced n-6/n-3 PUFAs ratio and a high level of DHA as well as EPA and ARA. Our findings provide a basis for potential applications of the gene constructs for expression of Δ15/Δ4-desaturases in transgenic livestock to produce such a fatty acid profile in the related products, which certainly will bring benefit to human health.


Preparing antigens suitable for cross-presentation assays in vitro and in vivo.
Cross-presentation is defined as the ability of certain professional antigen-presenting cells to take up, process and present extracellular antigens on major histocompatibility class I (MHC-I) molecules to CD8+ T cells. The stimulation of naive cytotoxic CD8+ T cells by this process, termed cross-priming, is involved in many different responses, including those to tumors, pathogens, graft tissues, and self-antigens. Dendritic cells (DCs), a heterogeneous cell population, are endowed with the highest cross-priming capacity. Investigation of their cross-presentation capacities, important both for vaccination and for the induction of immune tolerance can be performed by in vivo and in vitro assays. In this chapter we describe the preparation of antigens that can be used to test cross-presentation via pinocytosis, receptor-mediated endocytosis, and phagocytosis.


The effects of bone erosion from aortic aneurysm on the regional uptake of FDG.
A 71-year-old white man with a known right-sided apical nonsmall cell lung carcinoma was referred for a F-18 FDG whole body PET-CT examination after chemotherapy before radiotherapy. A staging CT scan had revealed an asymptomatic fusiform 65 mm in diameter nondissecting aneurysm of the thoracic aorta just below the carina. An abnormal crescent-shaped uptake was identified at the margin between the aneurysm and the adjacent thoracic vertebral bodies. At this site a correspondingly shaped bone erosion on CT was proof of the chronic effects of the aneurysm. There were no signs of regional inflammation or malignancy. The FDG uptake was interpreted as evidence of ongoing nonmalignant bone remodeling secondary to the pulsating pressure of the aneurysm. This case demonstrates a potential pitfall in the interpretation of bone associated foci using FDG PET, and once again underlines the importance of correlated anatomic imaging for appropriate clinical management.


Ammonia Borane Dehydrogenation Catalyzed by (κ4-EP3)Co(H) [EP3 = E(CH2CH2PPh2)3; E = N, P] and H2 Evolution from Their Interaction with NH Acids.
Two Co(I) hydrides containing the tripodal polyphosphine ligand EP3, (κ4-EP3)Co(H) [E(CH2CH2PPh2)3; E = N (1), P (2)], have been exploited as ammonia borane (NH3BH3, AB) dehydrogenation catalysts in THF solution at T = 55 °C. The reaction has been analyzed experimentally through multinuclear (11B, 31P{1H}, 1H) NMR and IR spectroscopy, kinetic rate measurements, and kinetic isotope effect (KIE) determination with deuterated AB isotopologues. Both complexes are active in AB dehydrogenation, albeit with different rates and efficiency. While 1 releases 2 equiv of H2 per equivalent of AB in ca. 48 h, with concomitant borazine formation as the final "spent fuel", 2 produces 1 equiv of H2 only per equivalent of AB in the same reaction time, along with long-chain poly(aminoboranes) as insoluble byproducts. A DFT modeling of the first AB dehydrogenation step has been performed, at the M06//6-311++G** level of theory. The combination of the kinetic and computational data reveals that a simultaneous B-H/N-H activation occurs in the presence of 1, after a preliminary AB coordination to the metal center. In 2, no substrate coordination takes place, and the process is better defined as a sequential BH3/NH3 insertion process on the initially formed [Co]-NH2BH3 amidoborane complex. Finally, the reaction of 1 and 2 with NH-acids [AB and Me2NHBH3 (DMAB)] has been followed via VT-FTIR spectroscopy (in the -80 to +50 °C temperature range), with the aim of gaining a deeper experimental understanding of the dihydrogen bonding interactions that are at the origin of the observed H2 evolution.


Virus-associated haemophagocytic lymphohistiocytosis in a young Filipino man.
Haemophagocytic lymphohistiocytosis (HLH) is a rare syndrome of pathological immune activation characterised by extreme inflammation. We present a case of a young Filipino man consulting for non-specific symptoms of fever, body malaise and weight loss. Prominent physical examination findings included gross pallor, cachexia and hepatosplenomegaly. Laboratory results revealed pancytopaenia, while bone marrow examination revealed haemophagocytosis. Further workup for HLH showed hypertriglyceridaemia, hypofibrinogenaemia and hyperferritinaemia (fulfilling 6 of 8 diagnostic criteria). Exhaustive serological and haematological examinations showed chronic hepatitis B virus infection and past evidence of Epstein-Barr virus infection as possible triggers. The patient was started on antiviral therapy, high-dose steroids and chemotherapy. He initially improved, but eventually succumbed to severe fungal sepsis and pulmonary haemorrhage. An autopsy confirmed the diagnosis of HLH.


Social stigma stops adolescents from using inhalers for asthma.
Forgetfulness, poor routines, inadequate inhaler technique, organisational difficulties and families not understanding or accepting their children's asthma are described as barriers to the use of inhalers among adolescents with asthma.


HIV-related stigma: adapting a theoretical framework for use in India.
Stigma complicates the treatment of HIV worldwide. We examined whether a multi-component framework, initially consisting of enacted, felt normative, and internalized forms of individual stigma experiences, could be used to understand HIV-related stigma in Southern India. In Study 1, qualitative interviews with a convenience sample of 16 people living with HIV revealed instances of all three types of stigma. Experiences of discrimination (enacted stigma) were reported relatively infrequently. Rather, perceptions of high levels of stigma (felt normative stigma) motivated people to avoid disclosing their HIV status. These perceptions often were shaped by stories of discrimination against other HIV-infected individuals, which we adapted as an additional component of our framework (vicarious stigma). Participants also varied in their acceptance of HIV stigma as legitimate (internalized stigma). In Study 2, newly developed measures of the stigma components were administered in a survey to 229 people living with HIV. Findings suggested that enacted and vicarious stigma influenced felt normative stigma; that enacted, felt normative, and internalized stigma were associated with higher levels of depression; and that the associations of depression with felt normative and internalized forms of stigma were mediated by the use of coping strategies designed to avoid disclosure of one's HIV serostatus.


Imported Talaromycosis in Oman in Advanced HIV: A Diagnostic Challenge Outside the Endemic Areas.
A 37-year-old male living in Oman was seen by his physician with complaints of cough, body aches with bilateral lower limb weakness and on and off fever. He was diagnosed with HIV infection and culture from blood and bone marrow grew Talaromyces marneffei. He had travelled to Malaysia on several occasions. Treatment with liposomal amphotericin B resulted in complete cure. This case is reported for its rarity and unusual presentation to alert clinicians and microbiologists to consider T. marneffei as an etiology in high risk individuals. Our case is the first recorded diagnosis of T. marneffei in Oman.


Yeast flocculation: competition between nonspecific repulsion and specific bonding in cell adhesion.
Yeast flocculation is governed by the competition between electrostatic repulsion (nonspecific interaction) and polysaccharide-protein bonds (specific interaction). The electrical surface potential, which is mainly due to phosphodiester linkages (of the cell wall phosphomannan), maintains the cells dispersed. Polysaccharides and proteins of the cell surface can readily penetrate the potential barrier and may establish specific bonds. The specific inhibition of flocculation by various mannosyl derivatives suggested that the protein receptor binds to the group Man alpha----3 Man alpha----PO4- ----6 Man alpha----2 Man alpha... of phosphomannan. Calcium, which is required for flocculation, could act as a bridge between the negatively charged groups of phosphomannan and those of the protein receptor. The role of calcium, however, cannot be restricted only to charge neutralization because other divalent cations inhibit flocculation; our results show that cation binding is governed by strong stereochemical constraints. Studies on protein-polysaccharide interactions have shown that electrical charges may remain uncompensated at short distance, but can be stabilized by hydrogen bonds. Calcium could induce a "locked" conformation of the receptor; this conformation is the only one capable of binding phosphomannan strongly enough to make cell adhesion possible.


Exploring the relationship between measures of self-esteem and psychological adjustment among adolescents with Asperger syndrome.
This exploratory study examines the relationships between self-esteem and psychological adjustment among 19 adolescents with Asperger syndrome and 19 typically developing adolescents using a model developed by Harter. The groups were matched for age (mean 13 years), sex (M:F 16:3) and ethnicity (white British). Participants completed four quantitative measures examining self-competencies, social approval, anxiety, depression and self-worth. Findings revealed significant group differences: the adolescents with Asperger syndrome perceived themselves to be less competent in social and athletic domains, and to receive less peer approval. Logistic regression analyses indicated that the variables studied were particularly relevant in distinguishing group differences and worked together in predicting group membership. Indeed the variables in the final model accurately predicted group membership for all individuals in the sample. Exploratory hierarchical multiple regression analyses suggested that the two groups had different patterns of relationships between measures of self-competencies, social approval and psychological outcomes.


Pituitary apoplexy precipitating diabetes insipidus.
To describe a case of pituitary apoplexy complicated by diabetes insipidus and to review management of patients with pituitary apoplexy and water excretion disturbances associated with transsphenoidal surgery. We describe clinical, laboratory, and radiologic findings in a patient with pituitary apoplexy and central diabetes insipidus. A 74-year-old woman presented with severe headache and sudden loss of vision for 12 hours, accompanied by thirst and frequent urination. Visual field examination demonstrated bitemporal hemianopsia. Her laboratory findings were significant for a serum sodium level of 152 mEq/L and urine specific gravity of <1.005. A magnetic resonance imaging scan of her pituitary gland identified a 3.5-cm suprasellar mass compressing the optic chiasm. She subsequently underwent transsphenoidal pituitary surgery with subtotal resection of this mass. Microscopic evaluation of tumor tissue revealed a pituitary adenoma with evidence of recent infarct and hemorrhage. Her clinical and biochemical course was consistent with the triphasic response that may occur after pituitary surgery related to damage to the hypothalamus and supraopticohypophyseal tract. Pituitary apoplexy may be rarely associated with diabetes insipidus.


Protective effect of buflomedil in a rat model of moderate cerebral ischemia.
Buflomedil hydrochloride (CAS 55837-25-7) is a vasoactive drug with a variety of pharmacodynamic properties. Although a number of studies have been carried out to verify the beneficial effect of buflomedil in ischemic peripheral conditions, few data are reported to justify the efficacious employment of buflomedil in the treatment of cerebrovascular diseases. The aim of the present study was to better investigate the neuroprotective effect of buflomedil in normal pentobarbital-anaesthetized rats subjected to transient bilateral common artery occlusion (BCO) for 20 min. Buflomedil hydrochloride (10 mg/kg) was administered by slow intravenous infusion (90 min), starting 1 h after the onset of ischemia. The rats were sacrificed 48 h after carotid clamping. BCO caused dramatic death of hippocampal CA1 pyramidal neurons, and a significant increase in circulating levels of neuron-specific enolase (NSE) and lactate. Treatment with buflomedil attenuated ischemia-induced histological loss and damage of CA1 pyramidal cells. Furthermore, in ischemic rats, the drug restored blood lactate concentrations and serum NSE concentrations to near normal levels. These data clearly demonstrate that buflomedil is able to protect brain neurons against damage following moderate global cerebral ischemia. One could speculate that this protective effect could be related to the capability of buflomedil to improve cerebral blood flow and energy metabolism, or to a smooth muscle relaxant effect on cerebral blood vessels.


Single dose radiocurability of four murine solid tumors and a predictive assay for the curability in situ.
Correlations between radiocurability and kinetic parameters were investigated in four transplantable tumor types in WHT/Ht mice. The radiation dose to achieve 50% tumor control at 120 days after irradiation, i.e., TCD50/120, was 30 Gy for squamous cell carcinoma H, 32 Gy for squamous cell carcinoma NOS, 46 Gy for rhabdomyosarcoma KAS, and 63 Gy for fibrosarcoma YAS. The tumor cell kinetic parameters investigated were specific growth delay, volume doubling time, 125I-iododeoxyuridine (IUdR) uptake rate, and specific cell loss rate. The specific cell loss rate was defined as the ratio of cell loss rate in non-irradiated tumors to the rate in irradiated tumors, and was obtained by measuring the retention rate of radioactivity in the tumors. No correlations were found between specific growth delay, volume doubling time, 125I-IUdR uptake rate, and TCD50. However, the specific cell loss rate correlated with the TCD50. Therefore, the 125I-IUdR labeling method may be useful as an in situ predictive assay for tumor radiocurability.


Quantification of (R)-[11C]PK11195 binding in rheumatoid arthritis.
Rheumatoid arthritis (RA) involves migration of macrophages into inflamed areas. (R)-[(11)C]PK11195 binds to peripheral benzodiazepine receptors, expressed on macrophages, and may be used to quantify inflammation using positron emission tomography (PET). This study evaluated methods for the quantification of (R)-[(11)C]PK11195 binding in the knee joints of RA patients. Data from six patients with RA were analysed. Dynamic PET scans were acquired in 3-D mode following (R)-[(11)C]PK11195 injection. During scanning arterial radioactivity concentrations were measured to determine the plasma (R)-[(11)C]PK11195 concentrations. Data were analysed using irreversible and reversible one-tissue and two-tissue compartment models and input functions with various types of metabolite correction. Model preferences according to the Akaike information criterion (AIC) and correlations between measures were evaluated. Correlations between distribution volume (V(d)) and standardized uptake values (SUV) were evaluated. AIC indicated optimal performance for a one-tissue reversible compartment model including blood volume. High correlations were observed between V(d) obtained using different input functions (R(2)=0.80-1.00) and between V(d) obtained with one- and two-tissue reversible compartment models (R(2)=0.75-0.94). A high correlation was observed between optimal V(d) and SUV after injection (R(2)=0.73). (R)-[(11)C]PK11195 kinetics in the knee were best described by a reversible single-tissue compartment model including blood volume. Applying metabolite corrections did not increase sensitivity. Due to the high correlation with V(d), SUV is a practical alternative for clinical use.