Overview of Helicobacter pylori Infection in Indonesia: What Distinguishes It from Countries with High Gastric Cancer Incidence?
Helicobacter pylori infects more than half the human population. However, the prevalence in Indonesia is low, as is the prevalence of gastric cancer. Hence, it could be instructive to compare these prevalence rates and their determining factors with those of countries that have high gastric cancer incidence. Ethnicity and genetic characteristics of H. pylori are important determinants of the H. pylori infection rate in Indonesia. The infection rate is higher in Bataknese, Papuans and Buginese than in Javanese, the predominant ethnic group. Ethnicity is also an important determinant of the genetic characteristics of H. pylori. Analysis of CagA in the EPIYA segment showed that the predominant genotypes in Papuans, Bataknese and Buginese are ABB-, ABDand ABC-type CagA, respectively. Meanwhile, in the countries with high gastric cancer incidence, almost all strains had East Asian type CagA. An antibiotic susceptibility evaluation showed that the standard triple therapy can still be used with caution in several cities. There is a very high rate of resistance to second-line regimens such as levofloxacin and metronidazole. Recent studies have shown that furazolidone, rifabutin and sitafloxacin are potential alternative treatments for antibiotic-resistant H. pylori infection in Indonesia. Rather than focusing on early detection and eradication as in countries with high gastric cancer prevalence, countries with low gastric cancer prevalence should focus on screening the several groups that have a high risk of gastric cancer.


Non-Hodgkin lymphoma presenting with numb chin syndrome.
Numb chin syndrome (NCS) is a rare yet potentially ominous sensory neuropathy characterised by unilateral hypoesthesia or paraesthesia over the lower lip, chin and occasionally gingival mucosa. Recognising NCS clinically is important as this may be a subtle sign of occult malignancy progression or relapses. Current expert opinion is that patients with NCS without apparent cause should be assumed to have a malignant aetiology until proven otherwise. By far the most common non-haematologic neoplastic cause of NCS is breast cancer, while the most common haematologic neoplastic cause is non-Hodgkin lymphoma (NHL). The pathophysiology of NCS has been shown to be either direct compression of the mental nerve by tumour mass, leptomeningeal invasion or a bony lesion at mental foramen. Here we report a case of NHL presenting with NCS with no evidence of metastasis in brain parenchyma, cerebrospinal fluid or mandibular bone. Instead, diffuse dural thickening and focal lesion in clivus were identified. We propose that these may represent novel mechanisms of NCS.


Human Brain Penetration Prediction Using Scaling Approach from Animal Machine Learning Models.
Machine learning (ML) approaches have been applied to predicting drug pharmacokinetic properties. Previously, we predicted rat unbound brain-to-plasma ratio (Kpuu,brain) by ML models. In this study, we aimed to predict human Kpuu,brain through animal ML models. First, we re-evaluated ML models for rat Kpuu,brain prediction by using trendy open-source packages. We then developed ML models for monkey Kpuu,brain prediction. Leave-one-out cross validation was utilized to rationally build models using a relatively small dataset. After establishing the monkey and rat ML models, human Kpuu,brain prediction was achieved by implementing the animal models considering appropriate scaling methods. Mechanistic NeuroPK models for the identical monkey and human dataset were treated as the criteria for comparison. Results showed that rat Kpuu,brain predictivity was successfully replicated. The optimal ML model for monkey Kpuu,brain prediction was superior to the NeuroPK model, where accuracy within 2-fold error was 78% (R2 = 0.76). For human Kpuu,brain prediction, rat model using relative expression factor (REF), scaled transporter efflux ratios (ERs), and monkey model using in vitro ERs can provide comparable predictivity to the NeuroPK model, where accuracy within 2-fold error was 71% and 64% (R2 = 0.30 and 0.52), respectively. We demonstrated that ML models can deliver promising Kpuu,brain prediction with several advantages: (1) predict reasonable animal Kpuu,brain; (2) prospectively predict human Kpuu,brain from animal models; and (3) can skip expensive monkey studies for human prediction by using the rat model. As a result, ML models can be a powerful tool for drug Kpuu,brain prediction in the discovery stage.


Spatial information analysis of chemotactic trajectories.
During bacterial chemotaxis, a cell acquires information about its environment by sampling changes in the local concentration of a chemoattractant, and then uses that information to bias its motion relative to the source of the chemoattractant. The trajectory of a chemotaxing bacteria is thus a spatial manifestation of the information gathered by the cell. Here we show that a recently developed approach for computing spatial information using Fourier coefficient probabilities, the k-space information (kSI), can be used to quantify the information in such trajectories. The kSI is shown to capture expected responses to gradients of a chemoattractant. We then extend the k-space approach by developing an experimental probability distribution (EPD) that is computed from chemotactic trajectories collected under a reference condition. The EPD accounts for connectivity and other constraints that the nature of the trajectories imposes on the k-space computation. The EPD is used to compute the spatial information from any trajectory of interest, relative to the reference condition. The EPD-based spatial information also captures the expected responses to gradients of a chemoattractant, although the results differ in significant ways from the original kSI computation. In addition, the entropy calculated from the EPD provides a useful measure of trajectory space. The methods developed are highly general, and can be applied to a wide range of other trajectory types as well as non-trajectory data.


Cyclooxygenase-2 inhibitors differentially attenuate pentylenetetrazol-induced seizures and increase of pro- and anti-inflammatory cytokine levels in the cerebral cortex and hippocampus of mice.
Seizures increase prostaglandin and cytokine levels in the brain. However, it remains to be determined whether cyclooxygenase-2 (COX-2) derived metabolites play a role in seizure-induced cytokine increase in the brain and whether anticonvulsant activity is shared by all COX-2 inhibitors. In this study we investigated whether three different COX-2 inhibitors alter pentylenetetrazol (PTZ)-induced seizures and increase of interleukin-1β (IL-1β), interleukin-6 (IL-6), interferon-γ (INF-γ), tumor necrosis factor-α (TNF-α) and interleukin-10 (IL-10) levels in the hippocampus and cerebral cortex of mice. Adult male albino Swiss mice received nimesulide, celecoxib or etoricoxib (0.2, 2 or 20mg/kg in 0.1% carboxymethylcellulose (CMC) in 5% Tween 80, p.o.). Sixty minutes thereafter the animals were injected with PTZ (50mg/kg, i.p.) and the latency to myoclonic jerks and to generalized tonic-clonic seizures were recorded. Twenty minutes after PTZ injection animals were killed and cytokine levels were measured. PTZ increased cytokine levels in the cerebral cortex and hippocampus. While celecoxib and nimesulide attenuated PTZ -induced increase of proinflammatory cytokines in the cerebral cortex, etoricoxib did not. Nimesulide was the only COX-2 inhibitors that attenuated PTZ-induced seizures. This effect coincided with an increase of IL-10 levels in the cerebral cortex and hippocampus, constituting circumstantial evidence that IL-10 increase may be involved in the anticonvulsant effect of nimesulide.


Is Gratitude Associated With Suicidal Ideation in Veterans With Mental Illness and Student Veterans With PTSD Symptoms?
The present study is aimed to identify the effect of gratitude as an adaptive regulating mechanism from suicidal ideation (SI) for veterans with mental illness (study 1) and student veterans with posttraumatic stress disorder (PTSD) symptoms (study 2) in the United States. Descriptive statistics and regression analyses were used to examine sociodemographic characteristics and relationships between gratitude and SI. Our study 1 consisted of 156 veterans with mental illness. The mean age for study 1 was 37.85. Our study 2 consisted of 232 student veterans with PTSD symptoms. The mean age for study 2 was 28.43. Higher gratitude scores in study 1 and study 2 were significantly associated with lower SI scores after adjusting for demographics and depression. This study partially supports the association between gratitude and SI in veterans with mental illness. Based on the results from this study, gratitude interventions may be effective in reducing SI when working with veterans with mental illness.


Inhibition of propofol anesthesia on functional connectivity between LFPs in PFC during rat working memory task.
Working memory (WM) refers to the temporary storage and manipulation of information necessary for performance of complex cognitive tasks. There is a growing interest in whether and how propofol anesthesia inhibits WM function. The aim of this study is to investigate the possible inhibition mechanism of propofol anesthesia based on the functional connections of multi-local field potentials (LFPs) and behavior during WM tasks. Adult SD rats were randomly divided into 3 groups: pro group (0.5 mg · kg(-1) · min(-1),2 h), PRO group (0.9 mg·kg(-1) · min(-1), 2 h) and control group. The experimental data were 16-channel LFPs obtained at prefrontal cortex with implanted microelectrode array in SD rats during WM tasks in Y-maze at 24, 48, 72, 96, 120 hours (day 1-day 5) after propofol anesthesia, and the behavior results of WM were recoded at the same time. Directed transfer function (DTF) method was applied to analyze the connections among LFPs directly. Furthermore, the causal networks were identified by DTF. The clustering coefficient (C), network density (D) and global efficiency (Eglobal ) were selected to describe the functional connectivity quantitatively. The results show that: comparing with the control group, the LFPs functional connectivity in pro group were no significantly difference (p>0.05); the connectivity in PRO group were significantly decreased (p<0.05 at 24 hours, p<0.05 at 48 hours), while no significant difference at 72, 96 and 120 hours for rats (p>0.05), which were consistent with the behavior results. These findings could lead to improved understanding the mechanism of inhibition of anesthesia on WM functions from the view of connections among LFPs.


Suppression of amber codons in Caulobacter crescentus by the orthogonal Escherichia coli histidyl-tRNA synthetase/tRNAHis pair.
While translational read-through of stop codons by suppressor tRNAs is common in many bacteria, archaea and eukaryotes, this phenomenon has not yet been observed in the α-proteobacterium Caulobacter crescentus. Based on a previous report that C. crescentus and Escherichia coli tRNA(His) have distinctive identity elements, we constructed E. coli tRNA(His) CUA, a UAG suppressor tRNA for C. crescentus. By examining the expression of three UAG codon- containing reporter genes (encoding a β-lactamase, the fluorescent mCherry protein, or the C. crescentus xylonate dehydratase), we demonstrated that the E. coli histidyl-tRNA synthetase/tRNA(His) CUA pair enables in vivo UAG suppression in C. crescentus. E. coli histidyl-tRNA synthetase (HisRS) or tRNA(His) CUA alone did not achieve suppression; this indicates that the E. coli HisRS/tRNA(His) CUA pair is orthogonal in C. crescentus. These results illustrate that UAG suppression can be achieved in C. crescentus with an orthogonal aminoacyl-tRNA synthetase/suppressor tRNA pair.


[Prevalence and influence of risk factors on coronary shunting operations in patients with aterosclerosis of abdominal aorta and peripheral vessels].
Retrospective study analysis concerning the prevalence of risk factors for unfavorable outcomes after coronary operations in patients with peripheral arterial atherosclerosis is presented. Meta-analysis of individual risk factors was carried out. Frequency of complications after coronary shunting in patients with various concomitant diseases is evaluated. The multifactorial relative risk affecting hospital lethality is defined. The study includes 131 patients with generalized atherosclerosis, which have underwent myocardial revascularization at the first stage (the main group) and at the second stage have been operated on abdominal aorta and peripheral arteries. 1128 patients without peripheral arterial atherosclerosis have made the control group. They underwent only coronary shunting. All patients were treated from December of 1994 till June of 2006. Relying on the results of the study cumulative relative risk for unfavorable outcomes after revascularization is 1.8 times higher in patients from the main group than in patients from the control group, and the risk for primary complications is 2.03 times higher. Concomitant atherosclerotic arterial involvement among cardiosurgical patients is associated with high risk for stroke in postoperative period. In case of chronic renal failure risk factors are cumulated. In the main group lethality made 5% , which was higher as compared with the control group. Correlation of such risk factors as heart failure and renal failure (creatinine level more than 1.8 mg/dl) with lethality has been revealed among patients from the main group. Lethality risk raises in 5.30 times in the presence of heart failure in medical history, and raises in 13.15 times in case of initially elevated creatinine level. Age of patient didn't have any influence on lethality in early postoperative period.


Electroconvulsive therapy in a patient after radiation treatment of a brain metastasis: a case report.
Major depression has a high incidence in patients with cancer, but treatment guidelines for this vulnerable population are missing and antidepressants seem to be less effective than in patients not affected by cancer. We report the case of a patient with bronchial cancer with a single temporo-occipital brain metastasis that had been treated by radiotherapy (whole-brain radiation, 40 Gy, followed by a stereotactic radiotherapy, 15 Gy). The patient developed a major depressive episode and was successfully treated with electroconvulsive therapy without relevant adverse events. This case further underscores the safety and effectiveness of electroconvulsive therapy after radiotherapy of the brain and demonstrates a viable alternative for severely depressed patients with cancer who do not adequately respond to psychotherapy or pharmacotherapy alone.


Cloning of phenotypically different human lymphocytes originating from a single stem cell.
By using hypoxanthine guanine phosphoribosyltransferase (hprt) gene alterations and chromosome aberrations as in vivo cellular markers, human T, NK, and B cells originating from a single stem cell have been successfully cloned from the peripheral blood of an atomic bomb survivor from Hiroshima. These mutant lymphocytes were selectively cloned, taking advantage of their resistance to a purine analogue, 6-thioguanine. The cloned lymphocytes possessed the same hprt gene alterations and the same chromosome aberration (20q-), but exhibited different surface or functional phenotypes and different rearrangements of TCR or Ig genes. The chromosome aberration patterns strongly suggested that the original stem cell initiated differentiation into each cell type after exposure to atomic bomb radiation. Since the person studied here was exposed to the bomb at 17 yr age, the results suggested that common stem cells exist in adults for at least T, NK, and B cells. The use of hprt gene alterations as specific cellular markers provides a novel method for identifying stem cells in the lymphocyte lineage and for studying lymphocyte differentiation in humans.


Novel compounds of Djulis (Chenopodium formosanum Koidz) increases collagen, antioxidants, inhibits adipogenesis.
Djulis (Chenopodium formosanum Koidz), is rich in nutrients and contains various bioactive components such as polyphenols and alkaloids. The new compound has a broad application prospect, including food additives, health products, drugs, etc. The purpose of this study was to find out new compounds from Djulis. It was found that 24 compounds including 7 phenols, 11 flavonoids, 4 plant alkaloids, 2 sterols. Among those, TCI-CF-22-S (Methyl 3,6-dihydroxy-2-oxo-1,2,3,4-tetrahydroquinoline-3-carboxylate), TCI-CF-23-S (Methyl 6-hydroxy-2-oxo-1,2,3,4-tetrahydroquinoline-3-carboxylate), TCI-CF-24-S (Kaempferol-3-O-b-D-apifuranosyl-(1→2)-a-L-arabinopyranoside) were isolated from djulis sources for the first time, and the structures of compounds were assigned by 1D, 2D NMR spectroscopy. TCI-CF-01(Caffeic acid), TCI-CF-02 (20-Hydroxyecdysone), TCI-CF-03 (Japonicone), TCI-CF-04 (3,4-Dihydroxyphenylacetiate), TCI-CF-05 (Quercetin-3-O-rutinoside-7-O-rhamnopyranoside), TCI-CF-06 (Guanosine), TCI-CF-07(Adenine), TCI-CF-08 (Coumaric acid) increased collagen production, and TCI-CF-03 (Japonicone), TCI-CF-04 (3,4-Dihydroxyphenylacetiate), TCI-CF-06 (Guanosine), TCI-CF-17 (Rutin), TCI-CF-20 (Protocatechuic acid) decreased advanced glycation end products (AGEs). In addition, TCI-CF-22-S (Methyl 6-hydroxy-2-oxo-1,2,3,4-tetrahydroquinoline-3-carboxylate), TCI-CF-23-S (Methyl 3,6-dihydroxy-2-oxo-1,2,3,4-tetrahydroquinoline-3-carboxylate) inhibited the formation of fatty oil droplets. Djulis has 24 compounds that may have various applications, including increasing collagen production and reducing advanced glycation end products and fatty oil droplets.


Myocardial function in heart failure.
Overt cardiac failure usually presents with constant clinical features as consequences of the reduced pump action, associated with an increased adrenergic drive, independent of the underlying disease. However, the study of left ventricular function, before and during the phase of cardiac insufficiency, shows that different pathophysiological mechanisms are responsible for the symptoms and signs of reduced cardiac action. It is possible to recognize that cardiac failure is caused primarily by: (1) early severe depression of the inotropic state, i.e. dilated cardiomyopathies; (2) late inadequate level of ventricular hypertrophy, with normal contractility, i.e. aortic stenosis; (3) early inadequate level of hypertrophy and slightly reduced inotropic state, i.e. mitral insufficiency, and (4) late inadequate level of hypertrophy and severe progressive reduction in contractility, i.e. aortic insufficiency. The possibility of an 'in vivo' assessment of the different determinant parameters of left ventricular function (contractility, afterload, preload, fiber and chamber compliance) through echocardiography enables a better understanding of the mechanisms leading to the cardiac failure and a more efficient therapeutic approach.


[Plastic surgical treatment for malignant soft tissue tumors and refractory wounds].
To investigate the advantages of plastic surgical treatment for malignant soft tissue tumors and refractory wounds. According to the lesion type, location, and size, malignant tumors were excised including the 3 - 5 cm normal tissue around the tumor and the refractory wounds were debrided completely. The adjacent flaps or musculocutaneous flaps, or free flaps were selected to repair the defect. From 2003 to 2006, 21 cases were treated. All the flaps survived completely. The patients were followed up for 2 - 3 years with relapse in only one case with tumor. All the refractory wound healed. Excellent results can be achieved with plastic surgical technique for malignant soft tissue tumors and refractory wounds. Plastic surgical technique enhances the therapeutic effect of other surgical treatment.


Association of chlorophyll a/b-binding Pcb proteins with photosystems I and II in Prochlorothrix hollandica.
Action spectra for photosystem II (PSII)-driven oxygen evolution and of photosystem I (PSI)-mediated H(2) photoproduction and photoinhibition of respiration were used to determine the participation of chlorophyll (Chl) a/b-binding Pcb proteins in the functions of pigment apparatus of Prochlorothrix hollandica. Comparison of the in situ action spectra with absorption spectra of PSII and PSI complexes isolated from the cyanobacterium Synechocystis 6803 revealed a shoulder at 650 nm that indicated presence of Chl b in the both photosystems of P. hollandica. Fitting of two action spectra to absorption spectrum of the cells showed a chlorophyll ratio of 4:1 in favor of PSI. Effective antenna sizes estimated from photochemical cross-sections of the relevant photoreactions were found to be 192+/-28 and 139+/-15 chlorophyll molecules for the competent PSI and PSII reaction centers, respectively. The value for PSI is in a quite good agreement with previous electron microscopy data for isolated Pcb-PSI supercomplexes from P. hollandica that show a trimeric PSI core surrounded by a ring of 18 Pcb subunits. The antenna size of PSII implies that the PSII core dimers are associated with approximately 14 Pcb light-harvesting proteins, and form the largest known Pcb-PSII supercomplexes.


Transcatheter Amplatzer vascular plug-embolization of a giant postnephrectomy arteriovenous fistula combined with an aneurysm of the renal pedicle by through-and-through, arteriovenous access.
Although endovascular transcatheter embolization of arteriovenous fistulas is minimally invasive, the torrential flow prevailing within a fistula implies the risk of migration of the deployed embolization devices into the downstream venous and pulmonary circulation. We present the endovascular treatment of a giant postnephrectomy arteriovenous fistula between the right renal pedicle and the residual renal vein in a 63-year-old man. The purpose of this case report is to demonstrate that the Amplatzer vascular plug (AVP) can be safely positioned to embolize even relatively large arteriovenous fistulas (AVFs). Secondly, we illustrate that this occluder can even be introduced to the fistula via a transvenous catheter in cases where it is initially not possible to advance the deployment-catheter through a tortuous feeder artery. Migration of the vascular plug was ruled out at follow-up 4 months subsequently to the intervention. Thus, the Amplatzer vascular plug and the arteriovenous through-and-through guide wire access with subsequent transvenous deployment should be considered in similar cases.


Inhibition of in vitro concentrative prostaglandin accumulation by prostaglandins, prostaglandin analogues and by some inhibitors of organic anion transport.
1. Incubation of rabbit choroid plexus, anterior uvea (iris-ciliary body complex) or slices of kidney cortex in a medium containing tritium-labelled prostaglandin F(2alpha) ([3H]PGF(2alpha) or E1 ([3H]PGE1) results in a four- to thirteenfold concentrative accumulation of 3H activity. 2. Addition of PGF(2alpha, PGF(1) or PGA(1), any one of five PG analogues or a PG precursor, arachidonic acid, at a concentration of 10(-4) M reduced the active accumulation of [3H]PGs by 47-97%. Octanoic acid, at the same concentration, had only a moderate effect on the choroid plexus and no significant inhibitory effect on [3H]PFG(2alpha) accumulation by anterior uvea or kidney cortex. 3. Inhibition was also obtained with 2 mM iodoacetate (under anaerobic conditions) and with 10(-4) M diploretin phosphate, probenecid, iodipamide, indomethacin or dinitrophenol. Perchlorate (10(-4) M) and iodide (10(-4) or 10(-3) M) had no inhibitory effect while 10(-4) M p-aminohippuric acid had a significant inhibitory effect on the kidney cortex at a concentration of 10(-4) M and on the anterior uvea at 10(-3) M. 4. It is concluded that the apparent carrier mediated PG transport systems of the choroid plexus, anterior uvea and kidney cortex are not related to the iodide transport system, but may represent a subcomponent of the iodipamide transport system of these tissues. 5. These results suggest that the systemic distribution and the rate of renal excretion of PGs could be altered by high concentrations of PGs, pharmacologically less active PG analogues, some inhibitors of organic acid transport, and by some inhibitors of PG synthesis and PG action.


[Motor paresis with cheiro-oral topography due to small infarct in the internal capsule or the corona radiata].
We reported five patients having presented only with clumsy hand and dysarthria which resulted from motor paresis confined to one side of the fingers and the ipsilateral face and tongue. All of them were right-handed, and their manifestation was transient. They had no abnormalities of muscle tonus and sensation, and no ataxia. The features of these cases differed from those of the dysarthria-clumsy hand syndrome because of absence of ataxia, and could be distinguished from pure motor hemiplegia by a motor paresis with cheiro-oral topography. MRI examinations showed a localized lesion at the border between internal capsule and corona radiata (two cases), or in the corona radiata just over this region (three cases). In the former cases in which the internal capsule was involved, we confirmed the lesion in the genu and anterior half of the posterior limb of the internal capsule. The lesion was on the left side in all five patients. It has been known that the pyramidal tract consists of the large and small fibers. The large ones are localized in the posterior part of the posterior limb of the internal capsule, and the damage of them produces sustained and serious motor paralysis. The small ones are widely distributed in the genu and the posterior limb of the internal capsule. The findings of our study suggest that the small fibers have adjacent somatotopy for the hand and mouth in the region of the genu and the anterior part of the posterior limb of the internal capsule, and that the damage of them may lead to mild, transient motor paresis without spasticity.


Artificial intelligence applications in pediatric oncology diagnosis.
Artificial intelligence (AI) algorithms have been applied in abundant medical tasks with high accuracy and efficiency. Physicians can improve their diagnostic efficiency with the assistance of AI techniques for improving the subsequent personalized treatment and surveillance. AI algorithms fundamentally capture data, identify underlying patterns, achieve preset endpoints, and provide decisions and predictions about real-world events with working principles of machine learning and deep learning. AI algorithms with sufficient graphic processing unit power have been demonstrated to provide timely diagnostic references based on preliminary training of large amounts of clinical and imaging data. The sample size issue is an inevitable challenge for pediatric oncology considering its low morbidity and individual heterogeneity. However, this problem may be solved in the near future considering the exponential advancements of AI algorithms technically to decrease the dependence of AI operation on the amount of data sets and the efficiency of computing power. For instance, it could be a feasible solution by shifting convolutional neural networks (CNNs) from adults and sharing CNN algorithms across multiple institutions besides original data. The present review provides important insights into emerging AI applications for the diagnosis of pediatric oncology by systematically overviewing of up-to-date literature.


Obesity is associated with visit-to-visit systolic blood pressure variability in the US adults.
Evidence has accumulated showing that blood pressure variability is associated with cardiovascular disease. A substantial increase in the prevalence of obesity has been documented globally. Our objective was to examine the relation of total and central obesity on visit-to-visit blood pressure variability. We used data collected from the cross-sectional Third National Health and Nutrition Examination Survey, to examine the association of visit-to-visit blood pressure variability with body mass index and waist circumference. The analysis included 14,988 participants. The participants' mean age was 43.45 years. Visit-to-visit systolic blood pressure variability was associated with a body mass index ≥30 and a large waist circumference (beta coefficients were 0.25 and 0.31, respectively, P-values < 0.01). Neither the bivariate nor the multivariable analyses showed significant relationships between the obesity indicators and diastolic blood pressure variability. Obesity is associated with visit-to-visit systolic blood pressure variability. Additional research is required to replicate the reported results in prospective studies and evaluate approaches to reduce blood pressure variability observed in clinical settings among obese persons to reduce its subsequent complications.


Inclusion of gold nanoparticles into a discotic liquid crystalline matrix.
The thermophysical properties of mixtures of hexanethiolate-capped gold nanoparticles and three types of discotic liquid crystals, investigated using polarizing optical microscopy, differential scanning calorimetry and DC conductivity, indicate inclusion of gold nanoparticles into a matrix of triphenylene-based discotic liquid crystals.


Comparison of data mining techniques applied to fetal heart rate parameters for the early identification of IUGR fetuses.
The onset of fetal pathologies can be screened during pregnancy by means of Fetal Heart Rate (FHR) monitoring and analysis. Noticeable advances in understanding FHR variations were obtained in the last twenty years, thanks to the introduction of quantitative indices extracted from the FHR signal. This study searches for discriminating Normal and Intra Uterine Growth Restricted (IUGR) fetuses by applying data mining techniques to FHR parameters, obtained from recordings in a population of 122 fetuses (61 healthy and 61 IUGRs), through standard CTG non-stress test. We computed N=12 indices (N=4 related to time domain FHR analysis, N=4 to frequency domain and N=4 to non-linear analysis) and normalized them with respect to the gestational week. We compared, through a 10-fold crossvalidation procedure, 15 data mining techniques in order to select the more reliable approach for identifying IUGR fetuses. The results of this comparison highlight that two techniques (Random Forest and Logistic Regression) show the best classification accuracy and that both outperform the best single parameter in terms of mean AUROC on the test sets.


OASIS/CREB3L1 is induced by endoplasmic reticulum stress in human glioma cell lines and contributes to the unfolded protein response, extracellular matrix production and cell migration.
OASIS is a transcription factor similar to ATF6 that is activated by endoplasmic reticulum stress. In this study we investigated the expression of OASIS in human glioma cell lines and the effect of OASIS knock-down on the ER stress response and cell migration. OASIS mRNA was detected in three distinct glioma cell lines (U373, A172 and U87) and expression levels were increased upon treatment with ER stress-inducing compounds in the U373 and U87 lines. OASIS protein, which is glycosylated on Asn-513, was detected in the U373 and U87 glioma lines at low levels in control cells and protein expression was induced by ER stress. Knock-down of OASIS in human glioma cell lines resulted in an attenuated unfolded protein response to ER stress (reduced GRP78/BiP and GRP94 induction) and decreased expression of chondroitin sulfate proteoglycan extracellular matrix proteins, but induction of the collagen gene Col1a1 was unaffected. Cells in which OASIS was knocked-down exhibited altered cell morphology and reduced cell migration. These results suggest that OASIS is important for the ER stress response and maintenance of some extracellular matrix proteins in human glioma cells.


Overzealous cardiac massage leading to unintentional infant death.
The case of an 18-month child is presented, with a picture demonstrating the thoracic trauma, caused from a hand pressure movement, perpetrated with an open right palm, in an attempt to perform an external cardiac massage. The child showed continuous episodes of 'crying spells' that the medical staff considered as benign, but an overprotective and mentally unstable mother kept on violently 'resuscitating' her son during such episodes. The last episode was characterised with a strenuous massage of the thoracic wall, causing evident bruises and leading to a cardiac contusion. The mother who perpetrated the trauma was sentenced for manslaughter, after the accidental character of the event, as well as the severity of her family situation and the precarious living environment of a socially abandoned single-acting parent, were all taken into account. The particular psychopathology of the care giver (mother) and the characteristics of the inflicted thoracic blow are described.


Reduced folate status is common and increases disease risk. It can be corrected by daily ingestion of supplements or fortification.
The natural folates are chemically unstable and poorly bioavailable in contrast to the chemical form, folic acid. Consequently most people, even those on good diets, have less than optimal nutrition with respect to this vitamin. Increased risks associated with deficiency include neural tube defects (NTDs) (proven), ischaemic heart disease and stroke (probable), certain cancers and decline in cognitive function (possible). Supplements of folic acid at the population reference intake (400 microg/d) completely normalizes all of these risks. Such levels are safe as judged by decades of use in wide sectors of the population. The main drawback of supplements is with respect to their effectiveness in preventing NTDs. They must be taken periconceptionally and before most women realise that they are pregnant. No more than one fifth of women take supplements effectively, largely due to the fact that over half of pregnancies are unplanned. This has led to the alternative of mandatory fortification of flour with folic acid in the USA and Canada. The level for such fortification is suboptimal for NTD prevention, because of fear of overexposure in the elderly. Thus even fortified communities require advice to take supplements for optimum NTD prevention.


Operative Treatment of Lymphedema Using Suction-Assisted Lipectomy.
Surgical management of lymphedema includes removal of affected tissues (excisional procedures), or operations that create new lymphatic connections (physiologic procedures). The purpose of this study was to determine the efficacy of one type of excisional procedure, suction-assisted lipectomy, for extremity lymphedema. Patients treated in our Lymphedema Program between 2007 and 2015 with liposuction that had postoperative follow-up were reviewed. The diagnosis of lymphedema was made by history/physical examination and confirmed with lymphoscintigraphy. Patient sex, age, type of lymphedema (primary or secondary), location of disease, infection history, volume of lipoaspirate, and reduction of extremity volume were recorded. Fifteen patients were included, mean age was 45 years (range, 17-71). Six patients had secondary upper extremity lymphedema, and 9 patients had lower limb disease. Eight patients had a history of repeated cellulitis involving the lymphedematous extremity. Mean lipoaspirate volume was 1612 mL (range, 1200-2800) for the upper extremity and 2902 mL (range, 2000-4800) for the lower limb. Postoperative follow-up averaged 3.1 years. The mean reduction in excess extremity volume was 73% (range, 48% to 94%), and patients reported improvement in their quality of life. Suction-assisted lipectomy is an effective technique to reduce extremity volume for patients with lymphedema.


Influence of orally administered epidermal growth factor on normal and damaged intestinal mucosa in rats.
The effect of orally administered epidermal growth factor (EGF) on the mucosal growth and hydrolase activity of normal and damaged small intestine was examined in rats. Adult rats fed EGF daily at 10 times the estimated daily intake of EGF from human milk showed increases in specific activity but not total activity of various brush-border hydrolases with unaffected mucosal protein content and villus-to-crypt ratios through day 9. Ingestion of EGF for 13 days resulted in significant decreases in mucosal protein content without changes in villus height or hydrolase activity. The effect of oral EGF on recovery of damaged intestine was studied in rats fed a liquid diet supplemented with EGF at 0, 1, 10, or 20 times the estimated daily intake from human milk after treatment with methotrexate (MTX) to induce acute intestinal injury. Animals treated with MTX showed significant reductions in body weight and small intestinal villus height, mucosal protein content, and hydrolase activities through day 6 posttreatment. Daily ingestion of EGF did not affect the MTX-induced reductions in mucosal protein content and hydrolase activity by day 3 but caused significant increases in mucosal disaccharidase and leucine aminopeptidase activity by day 6 at the 1- or 10-times human milk EGF levels. Similar changes were not observed in MTX-treated rats fed the 20-times human milk level of EGF. These studies suggest that oral EGF is capable of modulating mucosal protein levels and stimulating enterocyte hydrolase expression during repair of the intestinal mucosa.


Conditional cell reprogramming involves non-canonical β-catenin activation and mTOR-mediated inactivation of Akt.
The combination of irradiated fibroblast feeder cells and Rho kinase inhibitor, Y-267362, converts primary epithelial cells growing in vitro into an undifferentiated adult stem cell-like state that is characterized by long-term proliferation. This cell culture method also maintains the proliferation of adult epithelial stem cells from various tissues. Both primary and adult stem cells retain their tissue-specific differentiation potential upon removal of the culture conditions. Due to the ability to modulate the proliferation and differentiation of the cells, this method is referred to as conditional reprogramming and it is increasingly being used in studies of tumor heterogeneity, personalized medicine and regenerative medicine. However, little is known about the biology of these conditionally reprogrammed (CR) cells. Previously we showed that β-catenin activation, a hallmark of stem cells in vivo, occurs in CR human ectocervical cells (HECs). Here we show that β-catenin-dependent transcription is necessary for the induction of epithelial stem cell markers, and that β-catenin is activated via a non-canonical pathway that is independent of Wnt and Akt/GSK-3. Active Akt actually decreases due to increased mTOR signaling, with a consequent increase in dephosphorylated, active GSK-3. Despite the increase in active GSK-3, β-catenin associates with protein phosphatase 2A (PP2A) and is activated. Inhibition of PP2A catalytic activity reduces both the level of active β-catenin and the acute induction of stem cell markers, suggesting an important role for PP2A in the activation of β-catenin. Moreover, we demonstrate similar results using human prostate and breast cells, indicating that these changes are not restricted to ectocervical epithelial cells and may represent a more fundamental property of conditional reprogramming.


The plasma clearance rate of 131I-insulin in diabetic and obese patients and healthy persons.
The plasma clearance rate of 131I-insulin was studied in diabetic and obese patients and healthy persons. The aim of the investigation was to find out whether an accelerated degradation of insulin-probably due to the metabolism of insulin by adipocytes-causes slight forms of the diabetic syndrome. For the evaluation of the data a three-compartment model was used whereby the third compartment reflects the degradation of the intravenously administered 131I-insulin in the tissue. In this compartment 131I-insulin has a half life of 38.7 +/- 7.0 min for control persons (n = 19), 47.4 +/- 27.4 min for patients with a latent diabetes mellitus (n = 7), 34.2 +/- 8.5 min for the group with the subclinical diabetes (n = 5) and 47.6 +/- 16.2 min for the patients with an onset diabetes mellitus (n = 5). No significant difference was observed in the plasma clearance rate between healthy and diabetic persons. There is also no detectable correlation between the grade of obesity and the insulin clearance rate.


Expression of miR-21 and miR-138 in colon cancer and its effect on cell proliferation and prognosis.
Effect of miR-21 and miR-138 on the proliferation of colon cancer cells and their association with prognosis were investigated. Expression levels of miR-21 and miR-138 in colorectal cancer and normal adjacent tissues were compared. Differential expression of miR-21 and miR-138 in colon cancer tissues with different clinicopathological features were analyzed. miR-21 and miR-138 expression vectors were established and transfected into cells of colon cancer cell line SW480. Methyl thiazolyl tetrazolium (MTT) assay was used to detect the proliferation of SW480 cells. Kaplan-Meier method and log-rank test were used to study the relationship between miR-21 and miR-138 expression and prognosis. Cox proportional hazards model was used to analyze the factors related to prognosis of colon cancer. Expression level of miR-21 in colon cancer tissues was significantly higher than that in adjacent tissues, and expression level of miR-138 was lower in cancer tissues than in adjacent tissues (P<0.001). Expression of miR-21 and miR-138 was associated with the degree of differentiation, lymph node metastasis, distant metastasis, and TNM stage (P<0.05). miR-21 promotes proliferation of colon cancer cell line SW480, and miR-138 inhibits cell proliferation. Survival analysis showed that the survival time of patients with high expression of miR-21 was significantly shorter than that of patients with low expression of miR-21, while survival time of patients with high expression of miR-138 was significantly longer than that of patients with low expression of miR-138 (log-rank, P<0.05). miR-21 is highly expressed in colon cancer tissues and is positively associated with the degree of malignancy of patients but negatively associated with survival. miR-138 expression is low in colon cancer tissues and is negatively associated with the degree of malignancy of patients but positively associated with survival. miR-21 and miR-138 may be involved in the regulation of colon cancer cell proliferation.


Gapless magnetic and quasiparticle excitations due to the coexistence of antiferromagnetism and superconductivity in CeRhIn5: a study of 115In NQR under pressure.
We report systematic measurements of ac susceptibility, nuclear-quadrupole-resonance spectrum, and nuclear-spin-lattice-relaxation time (T1) on the pressure (P)-induced heavy-fermion superconductor CeRhIn5. The temperature (T) dependence of 1/T(1) at P=1.6 GPa has revealed that antiferromagnetism (AFM) and superconductivity (SC) coexist microscopically, exhibiting the respective transition at T(N)=2.8 K and T(MF)(c)=0.9 K. It is demonstrated that SC does not yield any trace of gap opening in low-lying excitations below T(onset)(c)=2 K, but T(MF)(c)=0.9 K, followed by a T(1)T=const law. These results point to the unconventional characteristics of SC coexisting with AFM. We highlight that both of the results deserve theoretical work on the gapless nature in the low-lying excitation spectrum due to the coexistence of AFM and SC and the lack of the mean-field regime below T(onset)(c)=2 K.


Achieving Skeletal Diversity in Peptide Macrocycles through The Use of Heterocyclic Grafts.
Despite their therapeutic potential, peptide macrocycles often suffer from drawbacks such as low membrane permeability, proteolytic instability, and conformational lability. As a result, there have been significant efforts to "depeptidize" amino acid-rich macrocycles through the incorporation of heterocyclic grafts into their backbones. In this concept article, we summarize selected recent methodologies that can be used to introduce heterocycles into cyclic peptides.


Exploring the Bilingual Phonological Space: Early Bilinguals' Discrimination of Coronal Stop Contrasts.
It is well known that the way monolingual listeners discriminate speech sounds is strongly influenced by their native (L1) sound system. Moreover, such perceptual constraints are not limited to monolinguals: multiple studies have found evidence of language-specificity in bilingual speech perception. However, the question of whether bilinguals have simultaneous access to both of their phonologies during non-native contrast discrimination has not been systematically examined. Namely, very few studies of bilinguals have specifically examined cases where a non-native contrast pair straddles the boundary between two sound systems, with one sound corresponding to a sound in the L1, and the other to a sound in the second language (L2), but with neither the L1 nor the L2 containing both. The current study aimed to do so by comparing the ability of early bilinguals to discriminate non-native phonetic contrasts consisting of sounds that exist in either their L1 or L2, but not in both. A forced-choice perception task compared two listener groups-Spanish-English bilinguals and English monolinguals-on their perception of Nepali dental-alveolar stop contrasts. Results showed that despite displaying some sensitivity to phonetic differences within each contrast pair, the bilingual group was unable to discriminate such "cross-language contrasts" significantly better than the monolingual English control group.


A rare case of embryonal rhabdomyosarcoma of the parapharyngeal space.
A 24-year-old man was admitted to our Otolaryngology Department following a head and neck CT scan performed for cranial trauma that showed a bulky neoformation in the right parapharyngeal space. Magnetic resonance imaging confirmed the presence of an oval formation with sharp margins and colliquative areas of necrosis involving the right parapharyngeal space. The mass was completely excised by a latero-cervical approach. Based on histological features and immunohistochemical analysis, a diagnosis of embryonal rhabdomyosarcoma of the parapharyngeal space was made. The incidental detection at this site of an embryonal rhabdomyosarcoma has never been reported in adult males.


Cre recombinase-dependent expression of a constitutively active mutant allele of the catalytic subunit of protein kinase A.
Using the cre-loxP recombination system, we generated a line of mice expressing a constitutively active catalytic subunit of Protein Kinase A (PKA) in a temporally and spatially regulated fashion. In the absence of cre recombinase the modified catalytic subunit allele is functionally silent, but after recombination the mutant allele is expressed, resulting in enhanced PKA effects at basal cAMP levels. Mice expressing the modified protein in hepatocytes using albumin-cre transgenics show defects in glucose homeostasis, glycogen storage, fructose 2,6-bisphosphate levels, and induction of glucokinase mRNA during feeding. Similar to animals lacking glucokinase in the liver (Postic et al.: J Biol Chem 274:305-315, 1999), these mice also have defects in glucose-stimulated insulin secretion, a hallmark of Type II diabetes. The widespread expression of PKA and the involvement of this kinase in a myriad of signaling pathways suggest that these animals will provide critical tools for the study of PKA function in vivo.


Increasing small intestinal permeability worsens colitis in the IL-10-/- mouse and prevents the induction of oral tolerance to ovalbumin.
Increased intestinal permeability is found in noninflamed portions of the gut of inflammatory bowel disease patients and in their first-degree relatives, suggesting that it is not a consequence of inflammation. Additionally, increased small intestinal permeability precedes colonic disease in animal models of inflammatory bowel disease. However, it is not known how small intestinal permeability modulates disease in the colon. The aim of this study was to determine if increasing small intestinal permeability modulates colonic inflammation in interleukin (IL)-10 mice and if an increase in permeability is sufficient to prevent oral tolerance to a dietary antigen. IL-10 mice were treated with the zonula occludens toxin pathway agonist AT-1002 for 8 weeks, and colitis severity was measured at 12 weeks of age. Wild-type mice were also treated with AT-1002 and fed ovalbumin (OVA) to determine the local and systemic immune response to this antigen under increased small intestinal permeability conditions. IL-10 mice treated with AT-1002 showed exacerbated colitis at 12 weeks of age. AT-1002 also induced a significant OVA-specific humoral response compared with mice that received OVA alone. In addition, the intestinal production of IL-10 and TGF-β in response to oral OVA was prevented when OVA was given with AT-1002. Increasing small intestinal permeability worsens colitis in IL-10 mice, and it prevents the development of oral tolerance to OVA in wild-type mice. This study suggests that small intestinal permeability is not merely a consequence of inflammation but a condition that leads to two of the main pathological features of inflammatory bowel disease.


Nocturnal activity in the green sea turtle alters daily profiles of melatonin and corticosterone.
In nature, green turtles (Chelonia mydas) can exhibit nocturnal activity in addition to their typically diurnal activity cycle. We examined whether nocturnal activity in captive and free-living green turtles altered daily plasma profiles of melatonin (MEL) and corticosterone (CORT). In captivity, diurnally active green turtles expressed distinct diel cycles in MEL and CORT; a nocturnal rise was observed in MEL and a diurnal rise was observed in CORT. However, when induced to perform both low- and high-intensity nocturnal activity, captive green turtles exhibited a significant decrease in MEL, compared to inactive controls. In contrast, plasma CORT increased significantly with nocturnal activity, and further, the relative increase in CORT was correlated with the intensity of the nocturnal behavior. In free-living green turtles that performed nocturnal activity including: nesting, mate searching, and feeding/swimming behaviors, plasma profiles in MEL and CORT exhibited relatively little, or no, daily fluctuation. Our findings demonstrate that nocturnal activity in green turtles is often associated with MEL and CORT profiles that resemble those measured during the day. We speculate that these conspicuous changes in MEL and CORT during nocturnal activity could either support or promote behaviors that enable acquisition of transient resources important to the survival and reproductive success of green turtles.


Renal Clear Cell Sarcoma - Anaplastic Variant: A Rare Entity.
Clear Cell Sarcoma of Kidney (CCSK) is known for its morphologic diversity, aggressive behaviour, tendency to recur and metastasis to bone. Amongst the various morphologic subtypes, anaplastic CCSK is associated with worse prognosis. Here, we report a case of this rare variant of CCSK. A five-year-old boy presented with history of lump and pain in abdomen since one week. The Computed Tomography (CT) scan revealed a large mass occupying the middle and inferior pole of right kidney. The clinical impression was Wilms tumour. Nephrectomy specimen was received and the diagnosis of CCSK anaplastic variant was offered only after excluding the differentials and after performing ancillary tests such as Immunohistochemistry (IHC). Thus, this case emphasizes the diagnostic challenges on morphology and the essential role of IHC in arriving at a definitive diagnosis, because failure to do so may deprive the child from optimal treatment.


Neither DNA hypomethylation nor changes in the kinetics of erythroid differentiation explain 5-azacytidine's ability to induce human fetal hemoglobin.
5-azacytidine (5-Aza) is a potent inducer of fetal hemoglobin (HbF) in people with beta-thalassemia and sickle cell disease. Two models have been proposed to explain this activity. The first is based on the drug's ability to inhibit global DNA methylation, including the fetal globin genes, resulting in their activation. The second is based on 5-Aza's cytotoxicity and observations that HbF production is enhanced during marrow recovery. We tested these models using human primary cells in an in vitro erythroid differentiation system. We found that doses of 5-Aza that produce near maximal induction of gamma-globin mRNA and HbF do not alter cell growth, differentiation kinetics, or cell cycle, but do cause a localized demethylation of the gamma promoter. However, when we reduced gamma promoter methylation to levels equivalent to those seen with 5-Aza or to the lower levels seen in primary fetal erythroid cells using DNMT1 siRNA and shRNA, we observed no induction of gamma-globin mRNA or HbF. These results suggest that 5-Aza induction of HbF is not the result of global DNA demethylation or of changes in differentiation kinetics, but involves an alternative, previously unrecognized mechanism. Other results suggest that posttranscriptional regulation plays an important role in the 5-Aza response.


PRES and Epilepsy: A Potential Long-Term Consequence of a "Reversible" Syndrome.
Epilepsy is very rarely attributed to posterior reversible encephalopathy syndrome (PRES). We report the case of a previously healthy 21-year-old who developed epilepsy with mesial temporal sclerosis following an episode of PRES related to a complicated Cesarean delivery. Neuroimaging at the time of PRES and 3 months after revealed the development of unilateral hippocampal volume loss following resolution of acute PRES-related brain edema. We discuss the incidence and importance of "non-reversible" sequelae of PRES and their implications for patient care.


Morphological and magnetic properties of superparamagnetic carbon-coated Fe nanoparticles produced by arc discharge.
Spherical carbon coated iron particles of nanometric diameter in the 5-10 nm range have been produced by arc discharge at near-atmospheric pressure conditions (using 5-8 x 10(4) Pa of He). The particles exhibit a crystalline dense iron core with an average diameter of 7.4 +/- 2.0 nm surrounded by a sealed carbon shell, shown by transmission electron microscopy (TEM), selected-area diffraction (SAED), energy-dispersive X-ray analysis (STEM-EDX) and electron energy loss spectroscopy (EELS). The SAED, EDX and EELS results indicate a lack of traces of core oxidized phases showing an efficient protection role of the carbon shell. The magnetic properties of the nanoparticles have been investigated in the 5-300 K temperature range using a superconducting quantum interference device (SQUID). The results reveal a superparamagnetic behaviour with an average monodomain diameter of 7.6 nm of the nanoparticles. The zero field cooled and field cooled (ZFC-FC) magnetization curves show a blocking temperature (T(B)) at room temperature very suitable for biomedical applications (drug delivery, magnetic resonance imaging, hyperthermia).


Expression levels of protein kinase C-alpha in non-small-cell lung cancer.
Current treatments of non-small-cell lung cancer (NSCLC) are inadequate and new therapies are being developed that target specific cellular signaling proteins associated with tumor growth. One potential target is protein kinase C (PKC)-alpha, a signaling molecule with an important role in cell regulation and proliferation. The present study examines the expression levels of PKC-alpha in NSCLC to better understand the distribution of PKC-alpha in NSCLC. We analyzed tumor specimens from an independent tumor tissue bank to determine PKC-alpha protein and messenger RNA gene expression in NSCLC. In addition, we used publicly available gene expression array data to further understand PKC-a-associated gene expression profiles in NSCLC. We found that PKC-alpha is highly expressed in < or = 20% of patients with NSCLC. We also found that PKC-alpha was preferentially expressed in adenocarcinoma compared with squamous cell carcinoma of the lung.


The bile duct anastomosis in liver transplantation.
In spite of the dramatic improvement of survival after orthotopic liver transplantation over the last decades, biliary tract complications are still the 'achilles heal' of liver transplantation with a potential risk of significant morbidity and mortality. Biliary leaks or strictures, the major types of biliary complications, may occur after direct choledocho-choledochostomy (CC) or Roux-Y choledocho-jejunostomy (CRY). The majority of these biliary complications, however, are often a consequence of surgical technique and therefore potentially amenable to improved surgical technique.


Hepatitis C virus infection and haemodialysis: experience of a district general hospital in Brunei Darussalam.
Hepatitis C virus (HCV) infection is prevalent among patients undergoing haemodialysis (HD). This study assessed the characteristics and outcomes of HCV infections among patients undergoing regular HD in a small dialysis centre. All patients (total 71, male 52 percent) who had HD were identified from the dialysis register and retrospectively reviewed. The mean age was 48.0 (+/- 14.7) years at the start of HD and the overall incidence of HCV IgG seropositivity (+) was 31 percent (22 patients). Ten patients were documented to have acquired HCV infection after starting HD, and nine cases before the institution of control measures. HCV RNA was detected in 14 of 17 (82.4 percent) patients who had RNA testing. Genotyping was done for seven patients; genotype 1a (two), genotype 1a/b (one) genotype 2b (one) and genotype 3a (three). HCV IgG (+) patients were younger, had longer duration of HD and had more transaminitis (all p-values less than 0.05) compared to HCV IgG (-) patients. Five patients had interferon treatment and three had sustained viral response (HCV RNA undetected at six months post-completion). At a mean HD duration of 54.8 (+/- 40.3) months, 25 patients (35.2 percent) died, with similar proportion from those HCV IgG (+) (31.8 percent) and those HCV IgG (-) (36.7 percent), respectively (p-value equal to 0.688). There were no difference in age (p-value equal to 0.444) and duration of HD (p-value equal to 0.534) between these two groups. None of the deaths were due to liver disease. HCV infection is common among patients attending HD and sharing of dialysis machines is an important factor. HCV infection was not a significant factor on the mortality in this study but longer follow-up is required.


Femtosecond time resolution in x-ray diffraction experiments.
This paper presents the theoretical background for a synthesis of femtosecond spectroscopy and x-ray diffraction. When a diffraction quality crystal with 0.1-0.3 mm overall dimensions is photoactivated by a femtosecond laser pulse (physical length = 0.3 microm), the evolution of molecules at separated points in the crystal will not be simultaneous because a finite time is required for the laser pulse to propagate through the body of the crystal. Utilizing this lack of global crystal synchronization, topographic x-ray diffraction may enable femtosecond temporal resolution to be achieved from reflection profiles in the diffraction pattern with x-ray exposures of picosecond or longer duration. Such x-ray pulses are currently available, and could be used to study femtosecond reaction dynamics at atomic resolution on crystals of both small- and macromolecules. A general treatment of excitation and diffraction geometries in relation to spatial and temporal resolution is presented.


[Significance of anti-EPO receptor antibody in immune-related pancytopenia].
Objective: To confirm the presence of erythropoietin receptor (EPOR) antibody in patients with immune-related pancytopenia (IRP) and to evaluate the significance of EPOR in IRP. Methods: A total of 59 newly-diagnosed IRP patients, 62 patients with IRP in remission, 14 patients with aplastic anemia (AA), 15 patients with myelodysplastic syndromes (MDS) and 33 healthy controls were enrolled in this study from January 2013 to June 2015 in Tianjin Medical University General Hospital. The anti-EPOR antibody was detected by enzyme-linked immunosorbent assay(ELISA). The expression of EPOR mRNA was detected by quantitative real-time PCR (qRT-PCR). The correlation between the data and the clinical indicators of patients was analyzed. Results: The levels of anti-EPOR antibodies were higher in the newly-diagnosed IRP patients than in the remission IRP group, AA group, MDS group and controls(0.84±0.39 vs 0.46±0.25, 0.49±0.25, 0.50±0.25, 0.53±0.14, all P<0.05). The expression of EPOR- mRNA was up-regulated in the newly-diagnosed IRP group than in the remission IRP group and the controls. The positive rate of EPOR antibody was significantly elevated in the patients with low hemoglobin level (<100 g/L), positive GlycoA antibody, or low complement C3 (all P<0.05). Anti-EPOR antibody was significantly decreased in the IRP patients responding to immunosuppressive therapy. Conclusions: Anti-EPOR autoantibody is present in patients with IRP. Detection of anti-EPOR antibody has important clinical value in the diagnosis, differential diagnosis and treatment effect evaluation of IRP.


Evaluation of Substance P concentrations in the blood plasma of jugular and tail vein of healthy German Simmental cows.
Cattle strongly mask their pain, making the recognition and assessment of pain difficult. Different subjective and objective parameters to assess pain have been described. Substance P (SP), which is a neurotransmitter, is used to objectively evaluate nociception in cattle. However, SP concentrations have mainly been described in diseased animals, or animals subjected to painful procedures. To this day, no evaluation of SP in healthy adult cattle has been published. The objectives of this pilot study were to 1) assess the SP concentrations in healthy adult German Simmental cattle in the blood plasma, 2) compare the concentrations between the blood of the jugular and the tail vein, and 3) assess the concentrations in the blood of the tail vein every 6 h over a period of 24 h. A total of 52 healthy cattle of the German Simmental breed were included in this study. Animals were 5.0 ± 1.3 (mean ± SD) years old and between 117 and 239 (175.0 ± 34.1) days in milk. Blood samples were taken from the jugular vein (BJV, 07:45 a.m.) and the tail vein (TV1, 08:00 a.m.) each. Additional blood samples were taken every 6 h over the course of 24 h from the tail vein (TV2 - TV5). SP concentrations were analyzed using a commercial ELISA kit. Mean (± SD) and median SP concentrations were 1.087 ± 436 pg/ml and 984 pg/ml for BJV (range 502 - 2,337 pg/ml), and 920 ± 402 pg/ml and 818 pg/ml for TV1 (range 192 - 2,531 pg/ml), respectively. There was a significantly positive correlation between SP concentrations of BJV and TV1. SP concentrations between BJV and TV1 were significantly different, as were SP concentrations in the tail vein between sampling times over the course of 24 h. The results of this study show that blood samples to assess SP concentrations in cattle can be taken from the jugular as well as from the tail vein. There are high variations in concentrations between animals, and it is hard to define reference ranges for SP in healthy animals. Repeated blood samples should not be taken by repeated punctation of a vein but by use of a jugular vein catheter, which is a major limitation of the present study.


Approach to "Upset Stomach".
An "Upset stomach" is a common problem encountered by physicians involved in the care of children. It includes, diarrhea, vomiting or abdominal pain. Though often mild and self-limiting, at times there are uncommon life-threatening conditions that require urgent care. It is important for primary physicians to recognize "alarm signs" and make a referral to the specialist at the right time. At the same time it is important to recognize what is normal and re-assure the caregivers. A detailed history and a proper systemic examination are important at presentation, looking for any "red flags". Investigations are seldom needed and the treatment is symptomatic. In acute diarrhea, adequate hydration is the cornerstone of management, which includes recognizing the degree of dehydration and treating with oral rehydration solution and Zinc. Dysentery i.e., bloody diarrhea needs treatment with antibiotics. In children with predominant vomiting and abdominal pain, it is vital to make sure one is not dealing with a "surgical "cause. If the child is not settling, a repeated examination is useful to look for the persistence or evolution of abdominal signs. Vomiting does not localize the problem to the gastro- intestinal (GI) tract and a complete systemic examination is needed to rule out an extra GI cause.


County-Level Recreational Marijuana Policies and Local Policy Changes in Colorado and Washington State (2012-2019).
Policy Points In 2012, Colorado and Washington were the first states to legalize recreational marijuana through voter-initiated ballots. In these states, counties could restrict or ban local marijuana facilities through a variety of regulatory methods such as ordinances and zoning. County-level recreational marijuana policies in Washington and Colorado vary substantially, with 69.2% of Washington counties and 23.4% of Colorado counties allowing all types of recreational marijuana facilities as of April 1, 2019. After Colorado and Washington legalized recreational marijuana, many counties modified their marijuana policies over time, with shifts in county policy often preceded by advocacy and information-seeking activities. In 2012, Colorado and Washington were the first states to legalize recreational marijuana. Both allowed local governments to further regulate the availability of marijuana facilities in their jurisdictions. As early adopters, these states are important quasi-natural experiments to examine local marijuana policy and policy change processes, including key stakeholders and arguments. We conducted a policy scan of county-level recreational marijuana ordinances and regulations in Colorado and Washington. Data collected included policy documents from counties in both states and newspaper articles. We used a mixed-methods approach to describe the types of county-level recreational marijuana policies enacted by April 1, 2019; identify key policy stakeholders involved in local policy debates; and explore arguments used in support or opposition of county policies. We also selected four counties that represent three county policy environments (all marijuana facility types allowed, some marijuana facility types allowed, all marijuana facility types prohibited) and described the policy changes within these counties since recreational marijuana was legalized. By April 1, 2019, Colorado counties were less likely than Washington counties to allow marijuana facilities-48.4% of Colorado counties prohibited recreational marijuana facilities in their jurisdiction compared to 23.1% of Washington counties. Since state legalization, several counties in both states have made substantial marijuana facility policy modifications, often preceded by information-seeking activities. Primary stakeholders involved in policy debates included elected officials, law enforcement, individual growers/farmers, marijuana business license applicants, parents, and residents. Proponents referenced local economic gain, reduced crime, and potential health benefits of marijuana as arguments in favor of permitting local facilities, whereas opponents pointed to economic loss, negative health and public health issues, public safety concerns, and existing federal law. Both sides referenced local public opinion data to support their position. By early 2019, a patchwork of local marijuana policies was in place in Colorado and Washington. We identify key areas of policy and public health research needed to inform future local marijuana policy decisions, including the impact of legalization on public health outcomes (particularly for youth) and public safety.


Identifying drug-dependent persons in a survey: a note on methodological issues.
A survey of 2,064 male persons in a rural area revealed that 423 (20.5 per cent) expressed craving for one or more abused substances. Close relationships were found between self-expressed craving and daily use of a drug. These data also suggest that in a large-scale survey, self-expressed craving and frequency of drug use could be used for fairly reliable estimates of the state of dependence on a drug.


Surgical Accuracy of an Early Intervention Knee Implant Instrumentation System.
Accuracy of component and limb alignment are critical parameters for the long-term success of unicompartmental knee implants. In this study, we performed a laboratory evaluation of an instrumentation system which was designed for an early intervention (EI) type of unicompartmental knee. The accuracy of fit was evaluated by implanting in 20 sawbones full leg models. The overall alignment of the limb was compared pre- and postoperatively. The accuracy of placement of each component on its bone was measured. The mean overall alignment angle in the frontal plane was within 1° of target with less than 1° standard deviation. The components were positioned in frontal and sagittal planes with maximum errors of 2°. The angular accuracy was better than in studies reported in the literature for manual instruments, and almost approached the accuracy of computer-assisted systems. The position of the femoral component in the recess was within 1 mm in most cases but the sagittal flexion angle was variable with a standard deviation of 6°. Evaluation of a surgical technique in this way was a valuable method for determining accuracy and for highlighting any deficiencies in the system which could then be corrected.


The influence of the mobile phase pH and the stationary phase type on the selectivity tuning in high performance liquid chromatography nucleosides separation.
Analysis of the modified nucleosides is particularly important in the medical area because of a possibility of cancerogenic processes studies. The aim of this work was to study the selectivity tuning of modified nucleosides through the investigations of interactions analyte (modified nucleoside) <==> stationary phase <==> mobile phase. A series of homemade stationary phases with different surface properties has been utilized. All of them contain various interaction sites such as: cholesterol (SG-CHOL); n-acylamide (SG-CHOL, SG-AP); aminopropyl (SG-CHOL, SG-AP, SG-NH2, SG-MIX); cyanopropyl, phenyl, octyl (SG-MIX), octadecyl (SG-MIX, SG-C18) and silanols localized on the silica gel surface of all packings. The attempt to predict the main interactions responsible for the retention between nucleosides and stationary phase ligands was done on the basis of the elemental analysis, and proportional part of an individual ligand bonded to silica surface results. In order to study the influence of different packing types on the analyzed nucleosides retention, the relationship between pH of the mobile phase buffer and the selectivity of a stationary phase was investigated.


[A case of basaloid cell carcinoma of the anal canal in which complete response was obtained by chemoradiation therapy].
The patient was a 69-year-old woman with a chief complaint of melena, who had a palpable firm mass and tenderness on digital rectal examination. Colonoscopy (CS) showed a depressed hemorrhagic lesion 2cm in diameter on the left anterior wall of the anal canal near the dentate line. Biopsy examination yielded a diagnosis of basaloid cell carcinoma. On the basis of a diagnosis of clinical stage I (T1N0M0) anal canal cancer, chemoradiotherapy was performed. After treatment, no tumor cells were detected on biopsy. Basaloid cell carcinoma, accounting for about 1.6% of anal canal cancers, is rare. Only 4 among 62 reported cases (including our patient) received chemoradiation therapy.


Coelenterate Cnidae Capsules: Disulfide Linkages Revealed by Silver Cytochemistry and Their Differential Responses to Thiol Reagents.
The sulfur cytochemistry of cnidae from the Portuguese man-of-war Physalia physalis, the scyphozoan Cassiopeia xamachana, and the black coral Cirrhipathes luetkeni was evaluated on the basis of electron microscopy, X-ray microanalysis, amino acid analysis, and response to disulfide reducing agents. The cnidae examined included large and small holotrichous isorhizas in P. physalis, another small isorhiza in C. xamachana, and both spirocysts and microbasic mastigophore nematocysts in C. leutkeni. A strong reaction with methenamine-silver reagent was characteristic of all cnidae capsules, but the pattern and extent of that argentophilia was dependent upon the type of cnida and its state of maturity. The large isorhizas of P. physalis reacted primarily in the outermost capsule layers, but in C. xamachana isorhizas, silver stained the entire capsule with the exception of the outermost region. The small isorhizas of P. physalis and the mastigophore capsules of C. leutkeni stained throughout, whereas the spirocyst capsules were outlined by silver, clearly delineating the inner and outer layers. All of these reactions were abolished with alkylation, but only after treatment with disulfide reducing agents; alkylation alone diminished silver staining only slightly, indicating that the argentophilic response was due primarily to disulfide linkages. The cystine content of these cnidae varied from 4.1 to 4.7 mole percent for a given species, but amino acid analyses did not separate components of the cnidom. Cnidae, both within and among species, exhibited differential responses to the disulfide reducing agent dithiothreitol (DTT). Isolated, unfixed, large isorhizas of P. physalis discharged and appeared to dissolve rapidly in the presence of this reagent, whereas small isorhizas from both P. physalis and C. xamachana discharged, but dissolved slowly if at all. The discharge and solution responses of the capsule coincided with the complete development of the tubule. Cnidae containing an undeveloped or partially developed tubule were resistant to DTT, displayed a weak capsular argentophilia, and contained background levels of sulfur; these results suggest that formation of disulfide linkages is one of the final steps in capsular maturation. In contrast, mature nematocyst and spirocyst capsules in C. leutkeni tentacles were resistant to DTT among other reagents, despite the presence of disulfides. This suggests that other types of covalent, intermolecular linkages could play a prominent role in the development of capsular stability in this species.


A giant aneurysm of noncoronary sinus of Valsalva concomitant with aortic regurgitation and mitral regurgitation.
Aneurysms of the sinus of Valsalva (ASV) are rare, with an incidence ranging from 0.1% to 3.5% of all congenital cardiac defects and a prevalence of 0.009% in an autopsy series.ASVs occur much more frequently in the right coronary sinus of Valsalva. Previous reports, based on necropsy and cardiac surgery findings, estimated that 20% of ASVs are unruptured. Patients with an unruptured ASV may remain asymptomatic for a long period of time until rupture. They may also presented with dyspnea, palpitation, and angina-like chest pain. Aortic insufficiency in the patients with unruptured ASVs is common, and other valvular lesions can be observed in these patients as well. Echocardiography, as a noninvasive and portable tool, is widely used to detect ASVs. Additionally, computed tomography and cardiac magnetic resonance imaging, alone or in combination, can provide precise information about its anatomic extension and intrinsic characteristics of the pathology.


[Age related changes in the glycosidases of chick embryo eye tissues].
Studies have been made on the activity of glycosidases from eye tissues of developing chick embryos and adult hens. The enzymes of carbohydrates metabolism (hyaluronidase, beta-glycosidase and beta-galactosidase) from the sclera, cornea and ciliary body were examined. It was demonstrated that the distribution of glycosidases in different tissues of the eye is not identical. The activity of beta-glycosidase and beta-galactosidase in all the tissues of 14-day embryos is higher than in adult hens; sharp reduction of the activity was observed at the stage of eye opening. The activity of hyaluronidase in the sclera and cornea of chick embryos is maintained at a low level up to the stage of eye opening, being subjected to minor changes.


Production and Reconfiguration of Double Emulsions by Temperature Control.
Double emulsions are of great importance for both science and engineering. However, the production of multicore double-emulsion droplets is challenging and normally requires sophisticated microfluidic devices, which limits their availability to broader communities. Here, we propose a simple, precise, and scalable batch method for producing double emulsions with monodispersed multicores at milliliter per minute rates, using the most common means in laboratory, temperature. By rapidly cooling liquid crystal emulsions, the introduced temperature gradient around the emulsion droplets leads to the injection of monodispersed guest droplets to form double-emulsion droplets. The number of injected water droplets can be precisely controlled by adjusting the thermally induced mechanical force through the temperature difference and the cooling rate. In contrast to conventional microfluidic fabrication, this method processes all emulsion droplets simultaneously in a noncontact and in situ manner. Therefore, it has great flexibility, allows multiple processing of double emulsions of arbitrary shape, has good capacity for mass production, and offers excellent compatibility with technologies such as microfluidics. Finally, we demonstrate that temperature changes can also be used to release the inner droplets from the double emulsion. The proposed method offers a reversible tool for processing double emulsions with minimal cost and expertise and is applicable to droplet-based microsystems in materials science, photonics, sensors, pharmaceuticals, and biotechnology.


Capn4 overexpression underlies tumor invasion and metastasis after liver transplantation for hepatocellular carcinoma.
Liver transplantation (LT) is one of the best therapeutic options for nonresectable hepatocellular carcinoma (HCC). Unfortunately, some HCC patients succumb to the disease after LT, which reduces long- and medium-term survival. To identify the proteins associated with HCC invasion and metastasis, HCC patients undergoing LT with complete follow-up data were included in this study and were categorized into recurrence and nonrecurrence groups. We extracted the total protein from the acquired homogeneous tumor cells and applied a cleavable isotope-coded affinity tag technology to quantitate relative changes in protein levels between the two groups. We identified a total of 149 proteins with two-dimensional liquid chromatography coupled with tandem mass spectrometry, including 52 differentially expressed proteins by at least two-fold. Among them, calpain small subunit 1 (Capn4), a protein with relevant interactions with many migration-invasion-related proteins, has attracted more attention. First, Capn4 overexpression in the recurrence group was confirmed via real-time polymerase chain reaction and western blotting in another cohort of 40 HCC patients undergoing LT. Second, Capn4 was associated with enhanced invasiveness in vitro. The small interfering RNA-mediated knockdown expression of Capn4 in HCC cell lines significantly inhibited its mobile and invasive ability. Tissue microarray in a further 192 cases revealed that Capn4 significantly correlated with invasive phenotype of HCC, and univariate and multivariate analyses indicated that Capn4 is an independent prognostic factor for recurrence and survival of HCC patients. Our study revealed that Capn4 overexpression underlies invasion and metastasis after LT for HCC and might be a candidate biomarker for future diagnosis and a target for therapy.


Cone-beam computed tomography analysis of accessory maxillary ostium and Haller cells: Prevalence and clinical significance.
This study aimed to evaluate the prevalence of Haller cells and accessory maxillary ostium (AMO) in cone-beam computed tomography (CBCT) images, and to analyze the relationships among Haller cells, AMO, and maxillary sinusitis. Volumetric CBCT scans from 201 patients were retrieved from our institution's Digital Imaging and Communications in Medicine archive folder. Two observers evaluated the presence of Haller cells, AMO, and maxillary sinusitis in the CBCT scans. AMO was observed in 114 patients, of whom 27 (23.7%) had AMO exclusively on the right side, 26 (22.8%) only on the left side, and 61 (53.5%) bilaterally. Haller cells were identified in 73 (36.3%) patients. In 24 (32.9%) they were present exclusively on the right side, in 17 (23.3%) they were only present on the left side, and in 32 (43.8%) they were located bilaterally. Of the 73 (36.3%) patients with Haller cells, maxillary sinusitis was also present in 50 (68.5%). On using chi-square test, a significant association was observed between AMO and maxillary sinusitis in the presence of Haller cells. Our results showed AMO and Haller cells to be associated with maxillary sinusitis. This study provides evidence for the usefulness of CBCT in imaging the bony anatomy of the sinonasal complex with significantly higher precision and a smaller radiation dose.


Dementia and the law.
The care for patients with dementia raises many legal (and ethical) issues. This article explores some of the more important topics, i.e. (early) diagnosis of the disease, the availability and provision of care, treatment and non treatment decisions, and medical research with dementia patients.


Cloning and functional analysis of three genes encoding polygalacturonase-inhibiting proteins from Capsicum annuum and transgenic CaPGIP1 in tobacco in relation to increased resistance to two fungal pathogens.
Polygalacturonase-inhibiting proteins (PGIPs) are plant cell wall glycoproteins that can inhibit fungal endopolygalacturonases (PGs). The PGIPs directly reduce the aggressive potential of PGs. Here, we isolated and functionally characterized three members of the pepper (Capsicum annuum) PGIP gene family. Each was up-regulated at a different time following stimulation of the pepper leaves by Phytophthora capcisi and abiotic stresses including salicylic acid, methyl jasmonate, abscisic acid, wounding and cold treatment. Purified recombinant proteins individually inhibited activity of PGs produced by Alternaria alternata and Colletotrichum nicotianae, respectively, and virus-induced gene silencing in pepper conferred enhanced susceptibility to P. capsici. Because three PGIP genes acted similarily in conferring resistance to infection by P. capsici, and because individually purified proteins showed consistent inhibition against PG activity of both pathogens, CaPGIP1 was selected for manipulating transgenic tobacco. The crude proteins from transgenic tobacco exhibited distinct enhanced resistance to PG activity of both fungi. Moreover, the transgenic tobacco showed effective resistance to infection and a significant reduction in the number of infection sites, number of lesions and average size of lesions in the leaves. All results suggest that CaPGIPs may be involved in plant defense response and play an important role in a plant's resistance to disease.


Implementing and sustaining a mobile medical clinic for prenatal care and sexually transmitted infection prevention in rural Mysore, India.
In rural India, mobile medical clinics are useful models for delivering health promotion, education, and care. Mobile medical clinics use fewer providers for larger catchment areas compared to traditional clinic models in resource limited settings, which is especially useful in areas with shortages of healthcare providers and a wide geographical distribution of patients. From 2008 to 2011, we built infrastructure to implement a mobile clinic system to educate rural communities about maternal child health, train community health workers in common safe birthing procedures, and provide comprehensive antenatal care, prevention of mother-to-child transmission (PMTCT) of human immunodeficiency virus (HIV), and testing for specific infections in a large rural catchment area of pregnant women in rural Mysore. This was done using two mobile clinics and one walk-in clinic. Women were tested for HIV, hepatitis B, syphilis, and bacterial vaginosis along with random blood sugar, urine albumin, and anemia. Sociodemographic information, medical, and obstetric history were collected using interviewer-administered questionnaires in the local language, Kannada. Data were entered in Microsoft Excel and analyzed using Stata SE 14.1. During the program period, nearly 700 community workers and 100 health care providers were trained; educational sessions were delivered to over 15,000 men and women and integrated antenatal care and HIV/sexually transmitted infection testing was offered to 3545 pregnant women. There were 22 (0.6%) cases of HIV, 19 (0.5%) cases of hepatitis B, 2 (0.1%) cases of syphilis, and 250 (7.1%) cases of BV, which were identified and treated. Additionally, 1755 (49.5%) cases of moderate to severe anemia and 154 (4.3%) cases of hypertension were identified and treated among the pregnant women tested. Patient-centered mobile medical clinics are feasible, successful, and acceptable models that can be used to provide quality healthcare to pregnant women in rural and hard-to-reach settings. The high numbers of pregnant women attending mobile medical clinics show that integrated antenatal care with PMTCT services were acceptable and utilized. The program also developed and trained health professionals who continue to remain in those communities.


Combining individual-based modeling and food microenvironment descriptions to predict the growth of Listeria monocytogenes on smear soft cheese.
An individual-based modeling (IBM) approach was developed to describe the behavior of a few Listeria monocytogenes cells contaminating smear soft cheese surface. The IBM approach consisted of assessing the stochastic individual behaviors of cells on cheese surfaces and knowing the characteristics of their surrounding microenvironments. We used a microelectrode for pH measurements and micro-osmolality to assess the water activity of cheese microsamples. These measurements revealed a high variability of microscale pH compared to that of macroscale pH. A model describing the increase in pH from approximately 5.0 to more than 7.0 during ripening was developed. The spatial variability of the cheese surface characterized by an increasing pH with radius and higher pH on crests compared to that of hollows on cheese rind was also modeled. The microscale water activity ranged from approximately 0.96 to 0.98 and was stable during ripening. The spatial variability on cheese surfaces was low compared to between-cheese variability. Models describing the microscale variability of cheese characteristics were combined with the IBM approach to simulate the stochastic growth of L. monocytogenes on cheese, and these simulations were compared to bacterial counts obtained from irradiated cheeses artificially contaminated at different ripening stages. The simulated variability of L. monocytogenes counts with the IBM/microenvironmental approach was consistent with the observed one. Contrasting situations corresponding to no growth or highly contaminated foods could be deduced from these models. Moreover, the IBM approach was more effective than the traditional population/macroenvironmental approach to describe the actual bacterial behavior variability.


Construction and characterization of a soybean yeast artificial chromosome library and identification of clones for the Rps6 region.
We report the construction and characterization of the first soybean yeast artificial chromosome (YAC) library using high-molecular weight DNA isolated from leaf nuclei of the cultivar Conrad 94 that carries Phytophthora resistance genes Rps1-k and Rps6. The quality of this library has been evaluated through analysis of 393 randomly selected YAC clones. The library consists of 36864 clones, of which approximately 19956 carry single soybean YACs with an average size of about 285 kb. The library represents approximately five soybean genome equivalents. The probability of finding any soybean sequences from this library is about 0.99. The library was screened for 43 SSR markers representing the whole soybean genome. We were able to identify positive YAC pools for 95% of the SSR markers. Two YAC clones carrying molecular markers linked to the Rps6 gene were identified. The YAC library reported here would be a useful resource for map-based cloning of agronomically important soybean genes and also to complement the effort towards construction of the physical map for the soybean genome.


[Evaluation of factors determining the efficiency of kinesotherapy in acute ischemic stroke patients].
The aim of this paper was to evaluate factors influencing the efficiency of kinesotherapy in acute ischemic stroke patients during the first rehabilitation stage. Forty patients with stroke, aged between 45 and 74 years, were enrolled in the study. The individual kinesotherapy of 30-45 minutes duration was applied for stroke patients 5 times a week. The efficiency of kinesotherapy was assessed by the modified Functional independence measure scale and the Motor assessment scale before and after treatment. Information about patient's gender, age, weight, brain lesion localization, stroke localization, the depth of lesion, aphasia, number of comorbidities, the beginning of kinesotherapy, patient's motivation and family member participation in the rehabilitation was taken according to a research protocol. The motor function of stroke patients significantly (p<0.05) improved after kinesotherapy sessions at the end of the first stage of rehabilitation. The lower efficiency (p<0.05) of kinesotherapy for acute stroke patients was determined by the brain lesion localization in the left hemisphere and middle cerebral artery, hemiplegia, sensomotor aphasia, and low motivation of the patient.


Influencing factors of sac shrinkage after endovascular aneurysm repair.
Sac shrinkage is considered a reliable surrogate marker of success after endovascular aneurysm repair (EVAR). Whereas sac shrinkage is the best expected outcome, predictive factors of sac shrinkage remain unclear. The aim of this study was to identify the role of preoperative and postoperative influencing factors of sac reduction after EVAR. Online searches across MEDLINE, Embase, and Cochrane Library medical databases were simultaneously performed. Study effects were pooled using a random-effects model, and forest plots were generated for every potential influencing factor. A total of 24 studies with 14,754 patients were included (mean age, 73.4 years; 76% male). At a mean follow-up of 24 months, the pooled shrinkage proportion was 47%. Random-effects meta-analysis revealed that renal impairment (odds ratio [OR], 0.74; 95% confidence interval [CI], 0.57-0.96), type I endoleaks (OR, 0.17; 95% CI, 0.08-0.39), type II endoleaks (OR, 0.21; 95% CI, 0.14-0.33), and combined type I and type II endoleaks (OR, 0.32; 95% CI, 0.22-0.47) were found to prevent sac shrinkage, whereas hypercholesterolemia (OR, 1.24; 95% CI, 1.02-1.51) and smoking (OR, 1.32; 95% CI, 1.17-1.49) have a significant positive impact on sac shrinkage. In addition, there was a trend toward the association between shrinkage and statin therapy (OR, 4.07; 95% CI, 1.02-16.32) and nearly significant negative impacts of coronary artery disease (OR, 0.84; 95% CI, 0.70-1.01), diabetes (OR, 0.79; 95% CI, 0.60-1.04), and sac thrombus (OR, 0.88; 95% CI, 0.77-1.01) on sac shrinkage. In this large meta-analysis of patients undergoing EVAR, we found that several comorbidity and postoperative factors were associated with postoperative sac shrinkage. These findings may contribute to a better understanding of the shrinkage process of patients undergoing EVAR.


Expression and clinical significance of AURKB gene in lung adenocarcinoma: Analysis based on the data-mining of bioinformatic database.
This study aimed to investigate the expression and clinical significance of aurora B kinase (AURKB) gene in lung adenocarcinoma (LUAD) by collecting relevant data in Oncomine database.Firstly, mRNA expression level of AURKB in LUAD was systematically analyzed using the ONCOMINE and the cancer genome atlas databases. Then, the association between AURKB expression and clinical parameters was investigated by UALCAN. The Kaplan-Meier Plotter was used to assess the prognostic significance of AURKB.Pooled analysis showed that AURKB was frequently up-regulated expression in LUAD. In addition, immunohistochemistry showed that AURKB was highly expressed in lung adenocarcinoma tissues, while it was weakly expressed in normal tissues. Subsequently, AURKB expression was identified to be negatively associated with Overall survival (P < 1e-16), post-progression survival (P = .017), first progression (P = 9.8e-09).This study confirms that increased expression of AURKB in LUAD is associated with poor prognosis, suggesting that AURKB might be used as a promising prognostic biomarker and novel therapeutic target for LUAD.


Primary hepatic mucosa-associated lymphoid tissue lymphoma: a case report and literature review.
Primary hepatic mucosa-associated lymphoid tissue (MALT) lymphoma is an extremely rare disease. We herein describe the findings in a 74-year-old man with elevated liver enzyme levels. Dynamic computed tomography showed focal biliary dilation and atrophy in the posterior segment, while dynamic magnetic resonance images revealed a small, highly enhanced small mass located at the root of posterior branch of the biliary ducts. As the mass was not detected on abdominal ultrasonography, a biopsy could not be performed. Cholangiocellular carcinoma was suspected, and surgery was performed. However, the surgically resected hepatic tumor was a nodule of aggregated lymphocytes that formed a lymphoepithelial lesion. Immunohistochemical analysis revealed that the lymphoma cells were positive for CD20 and CD79a, but negative for CD3. No other lymphoid lesions were found during additional postoperative examinations. Therefore, the patient was diagnosed with primary hepatic MALT lymphoma. He was also diagnosed with Helicobacter pylori infection, and thus, pylorus eradication was performed. At the time of this report, the patient was free of disease for 2 years without any additional treatment. The present case contributed to the diagnosis and management of this rare disease, as previously published case reports described varying imaging features; it also suggested that preoperative diagnosis was often difficult without biopsy.


Bacteriophage-induced modifications of host RNA polymerase.
Bacteriophages have developed an impressive array of ingenious mechanisms to modify bacterial host RNA polymerase to make it serve viral needs. In this review we summarize the current knowledge about two types of host RNA polymerase modifications induced by double-stranded DNA phages: covalent modifications and modifications through RNA polymerase-binding proteins. We interpret the biochemical and genetic data within the framework of a structure-function model of bacterial RNA polymerase and viral biology.


The relationship between quality of life after childbirth and the childbirth method in nulliparous women referred to healthcare centers in Sanandaj, Iran.
Postpartum period is associated with significant changes in the quality of women's lives. These changes can affect the health of both the mother and child. Given the importance of the postpartum period and the factors influencing quality of life after childbirth especially the method of childbirth, the aim of this study was to determine the relationship between quality of life after childbirth and the childbirth method in nulliparous women referred to healthcare centers in Sanandaj, Iran. In this cross-sectional study, ten healthcare centers in Sanandaj, Iran from 2014-to 2015 were chosen using a cluster random sampling method. The samples consisted of 410 nulliparous women. The Edinburgh postnatal depression scale was used for data collection in the third trimester of pregnancy. Those women with a score greater than 12 were excluded from this study. The quality of life in physical, psychological, social, environmental domains and the overall quality of life were measured and compared using the World Health Organization quality of life brief questionnaire. Data were analyzed using SPSS version 22. We used descriptive statistics, Chi-square, and t-test for the analyses of outcomes. The means of quality of life in the groups of vaginal and cesarean childbirth were 98.29±11.82 and 100.4±10.26, respectively, which had no statistically significant differences. Women with vaginal childbirth had the slightly higher quality of life scores than cesarean during 6 weeks after birth and later. Thus, providing more information to pregnant women to encourage them to use vaginal childbirth is suggested.