The Postural Effects on Electrical Activities of Heart in Apparently Healthy Young Adults.
Background The electrical activities of heart recorded as electrocardiogram (ECG) are mostly done in supine postures. The body postural changes have effects in these electrical activities in heart which needs to be properly recognized. Objective To find the variations in electrocardiogram during postural changes from supine to upright i.e. sitting and standing postures among apparently healthy young adults. Method A cross sectional study was carried out in Manipal College of Medical Sciences after the institutional ethical clearance. The apparently healthy 30 Nepalese male medical students between 18-25 years of age were enrolled. The electrocardiography was elicited in supine, sitting and standing postures in the participants after 5 minutes' interval between each procedure in each participant. Result The highest mean amplitudes of Q wave were seen in sitting postures (0.12±0.04 mm), R wave in standing postures (1.46±0.55 mm) and S wave also in standing postures (0.23±0.2 mm). The mean amplitudes of Q and S waves showed statistically significant difference when compared between supine and upright postures. The maximum QRS duration was found while sitting (0.08±0.01 ms)and maximum heart rate in standing posture (82.43±10.59/min). The mean comparison of heart rate was statistically highly significant when compared between supine and standing postures. The mean QRS frontal axis was comparatively increased while standing (64.30±39.29). Conclusion The electrical activities of heart vary during postural changes among apparently healthy young adults. These changes are most prominent when compared between supine and standing postures which urges for careful interpretation of electrocardiogram if it is done in upright postures.


Archaeal ancestors of eukaryotes: not so elusive any more.
The origin of eukaryotes is one of the hardest problems in evolutionary biology and sometimes raises the ominous specter of irreducible complexity. Reconstruction of the gene repertoire of the last eukaryotic common ancestor (LECA) has revealed a highly complex organism with a variety of advanced features but no detectable evolutionary intermediates to explain their origin. Recently, however, genome analysis of diverse archaea led to the discovery of apparent ancestral versions of several signature eukaryotic systems, such as the actin cytoskeleton and the ubiquitin network, that are scattered among archaea. These findings inspired the hypothesis that the archaeal ancestor of eukaryotes was an unusually complex form with an elaborate intracellular organization. The latest striking discovery made by deep metagenomic sequencing vindicates this hypothesis by showing that in phylogenetic trees eukaryotes fall within a newly identified archaeal group, the Lokiarchaeota, which combine several eukaryotic signatures previously identified in different archaea. The discovery of complex archaea that are the closest living relatives of eukaryotes is most compatible with the symbiogenetic scenario for eukaryogenesis.


Assessment of the Role of Vitamin D in the Treatment of Oral Lichen Planus.
Lichen planus is an autoimmune disease that can affect the skin and mucous membranes, including the oral mucosa. Vitamin D plays a very important role in the bone health along with boosting immunity. This study was carried out to assess the role of vitamin D in the treatment of oral lichen planus. A sample size of 450 was taken which included patients showing clinical presentation of oral lichen planus. The patients were equally divided into three different groups based on their vitamin D levels. The data were analyzed using SPSS version 26.0. The patients who were given the vitamin D supplementation showed the maximum improvement. The comparison of the data were found to be statistically significant. It was concluded that vitamin D played an important role in the treatment of oral lichen planus. The role of vitamin D in lichen planus needs to be explored. This study may be useful in conducting further study to assess the role in vitamin D supplementation in the treatment of oral lichen planus.


Improvements in the vapor-time profile analysis of explosive odorants using solid-phase microextraction.
A modified approach for characterization of the vapor-time profile of the headspace odors of explosives was developed using solid-phase microextraction (SPME) incorporating introduction of an externally-sampled internal standard (ESIS) followed by gas chromatography/mass spectrometry (GC/MS) analysis. With this new method, reproducibility of the measurements of 2-ethyl-1-hexanol and cyclohexanone were improved compared to previous work (Hoffman et al., 2009; Arthur and Pawliszyn, 1990) through the use of stable-isotope-labeled internal standards. Exposing the SPME fiber to the ESIS after sampling the target analyte proved to be advantageous, while still correcting for fiber variability and detector drift. For the analysis of high volatility compounds, incorporation of the ESIS using the SPME fiber in the retracted position minimized the subsequent competitive loss of the target analyte, allowing for much longer sampling times.


Design, Synthesis, and Biological Evaluation of Retinoic Acid-Related Orphan Receptor γt (RORγt) Agonist Structure-Based Functionality Switching Approach from In House RORγt Inverse Agonist to RORγt Agonist.
Retinoic acid receptor-related orphan receptor γt (RORγt) agonists are expected to provide a novel class of immune-activating anticancer drugs via activation of Th17 cells and Tc17 cells. Herein, we describe a novel structure-based functionality switching approach from in house well-optimized RORγt inverse agonists to potent RORγt agonists. We succeeded in the identification of potent RORγt agonist 5 without major chemical structure change. The biochemical response was validated by molecular dynamics simulation studies that showed a helix 12 stabilization effect of RORγt agonists. These results indicate that targeting helix 12 is an attractive and novel medicinal chemistry strategy for switching existing RORγt inverse agonists to agonists.


Efficacy of Short-Term Robot-Assisted Rehabilitation in Patients With Hand Paralysis After Stroke: A Randomized Clinical Trial.
We evaluated the effectiveness of robot-assisted motion and activity in additional to physiotherapy (PT) and occupational therapy (OT) on stroke patients with hand paralysis. A randomized controlled trial was conducted. Thirty-two patients, 34.4% female (mean ± SD age: 68.9 ± 11.6 years), with hand paralysis after stroke participated. The experimental group received 30 minutes of passive mobilization of the hand through the robotic device Gloreha (Brescia, Italy), and the control group received an additional 30 minutes of PT and OT for 3 consecutive weeks (3 d/wk) in addition to traditional rehabilitation. Outcomes included the National Institutes of Health Stroke Scale (NIHSS), Modified Ashworth Scale, Barthel Index (BI), Motricity Index (MI), short version of the Disabilities of the Arm, Shoulder and Hand (QuickDASH), and the visual analog scale (VAS) measurements. All measures were collected at baseline and end of the intervention (3 weeks). A significant effect of time interaction existed for NIHSS, BI, MI, and QuickDASH, after stroke immediately after the interventions (all, P < .001). The experimental group had a greater reduction in pain compared with the control group at the end of the intervention, a reduction of 11.3 mm compared with 3.7 mm, using the 100-mm VAS scale. In the treatment of pain and spasticity in hand paralysis after stroke, robot-assisted mobilization performed in conjunction with traditional PT and OT is as effective as traditional rehabilitation.


[Ultrasound elastography].
Noninvasive, ultrasound-based methods for visualizing and measuring tissue elasticity are becoming more and more common in routine practice. Using hepatic shear wave elastography, cut-off levels can help to detect the degree of relevant fibrosis (F ≥ 2) with a diagnostic accuracy using the area under the reader operating characteristic (AUROC) of 87 % and cirrhosis (F = 4, AUROC 93 %). Normal values virtually exclude liver cirrhosis (negative predictive value up to 97 %) and high shear wave velocities predict complications in the course of primary sclerosing cholangitis, liver cirrhosis and chronic hepatitis B or C. Elastography is of no relevant help in the differentiation of the dignity of hepatic lesions. Concerning thyroid or breast lesions, low shear wave velocities are indicative of benign lesions and in contrast, high velocities of malignant lesions. A differentiation between benign and malignant thyroid nodules is performed by elastography with a sensitivity of 89 % and a specificity of 82 %. In breast lesions a differentiation of nodes can be improved with elastography compared to B-mode ultrasound alone with a sensitivity of 97 % and a specificity of 83 %. Invasive biopsy punctures can therefore be specifically performed or can be omitted. Due to several influencing factors, in particular during liver elastography, the measurements need to be interpreted in the clinical context. In summary, ultrasound-based elastography provides helpful information for the detection of hepatic fibrosis and for further characterization of thyroid or breast lesions in addition to classical techniques, such as B-mode imaging and color Doppler.


Thyroid stimulating hormone stimulates the expression of glucose transporter 2 via its receptor in pancreatic β cell line, INS-1 cells.
Thyroid stimulating hormone (TSH) stimulates the secretion of thyroid hormones by binding the TSH receptor (TSHR). TSHR is well-known to be expressed in thyroid tissue, excepting it, TSHR has also been expressed in many other tissues. In this study, we have examined the expression of TSHR in rat pancreatic islets and evaluated the role of TSH in regulating pancreas-specific gene expression. TSHR was confirmed to be expressed in rodent pancreatic islets and its cell line, INS-1 cells. TSH directly affected the glucose uptake in INS cells by up-regulating the expression of GLUT2, and furthermore this process was blocked by SB203580, the specific inhibitor of the p38 MAPK signaling pathway. Similarly, TSH stimulated GLUT2 promoter activity, while both a dominant-negative p38MAPK α isoform (p38MAPK α-DN) and the specific inhibitor for p38MAPK α abolished the stimulatory effect of TSH on GLUT2 promoter activity. Finally, INS-1 cells treated with TSH showed increased protein level of glucokinase and enhanced glucose-stimulated insulin secretion. Together, these results confirm that TSHR is expressed in INS-1 cells and rat pancreatic islets, and suggest that activation of the p38MAPK α might be required for TSH-induced GLUT2 gene transcription in pancreatic β cells.


Modulation of Immune response by Ultra-violet light in HLA class-II transgenic mice.
Multiple Sclerosis (MS) is a chronic and debilitating disease of the central nervous system linked to both genetic and environmental factors. Among the genetic factors, MHC, especially HLA class-II, is strongly associated with predisposition to MS. Although in vitro studies have helped us understand some aspects of HLA class-II association with the disease, performing in vivo analysis is necessary in order to further understand this correlation. Studying the role of class-II genes in vivo is a difficult task due to the heterogeneity of human population, the complexity of MHC, and the strong linkage disequilibrium among different class-II genes. To overcome this challenge, we generated HLA class-II transgenic mice to study the role of these molecules in MS. Among the environmental factors linked with MS, ultra violet radiation (UVR)/vitamin-D is suggested to have protective effect against the development of the disease. Indeed, genetic studies have shown that presence of susceptible HLA-Class II and decrease in UVR exposure or vitamin D levels together increase risk of MS. Therefore, this study was designed to investigate the direct effect of UVR on immune response using novel humanized HLA-class II transgenic mice. HLA-class II transgenic mice expressing MS susceptible HLA-DR2 allele were treated with different doses of UVR (0.50-3.75 kJ/day) for seven consecutive days. T-cell proliferation, immune cell sub-populations and cytokines levels were analyzed. Our results show that treatment with UVR increased levels of regulatory CD4+FoxP3+ T cells and Gr1+ CD11b+ suppressive macrophages. Thus our study indicates that UVR modulates the immune response towards a tolerogenic phenotype in HLA-transgenic mice immunized with MOG35-55. Therefore, HLA class-II transgenic mice offer a novel tool to decipher the mechanism by which interaction between environmental and genetic factors play a role in predisposition and/or protection against development of MS.


Neuropsychologic (cognitive) disabilities in long-term survivors of childhood cancer.
Intelligence and academic achievement testing of long-term survivors of childhood cancer reveal a high incidence of memory deficits, visual-spatial skill impairment, and attention deficit disorders. While the results of various studies must be interpreted carefully, the data available identify CNS irradiation and the toxic synergism of CNS irradiation and intrathecal chemotherapy as primary etiologic factors in the neuropsychologic sequelae of curative therapy. Early education intervention is mandatory to identify survivors of childhood cancer who require assistance in overcoming intellectual disabilities.


Differential impacts of adiponectin on low-grade albuminuria between obese and nonobese persons without diabetes.
The goal of this study was to examine the association between adiponectin and low-grade albuminuria in nondiabetic persons and whether it differed between obese and nonobese individuals. Urinary albumin excretion (UAE) was assessed by overnight collection in 157 participants. Overall, as anticipated, 24-hour systolic blood pressure and fasting glucose levels were independent determinants of UAE (beta=0.254 and 0.176, respectively, P<.05). In obese persons (body mass index [BMI] >/=25 kg/m(2); n=63), adiponectin value was a significant negative determinant of UAE (beta=-0.256, P<.05) independent of blood pressure and glucose levels, whereas in nonobese participants (n=94) it was not. In an analysis of BMI and the median value of adiponectin (9.9 microg/mL), UAE was found to be significantly higher in obese persons with low adiponectin levels than in obese persons with high adiponectin levels (9.20 vs 5.11 microg/min; P<.05), even after adjustment for age, sex, blood pressure level, and glucose level. There was an inverse association between adiponectin and low-grade albuminuria in obese nondiabetic persons.


Atomization and Changes in Chemical Composition by Laser Ablation in Liquid prior to Determination of Trace Elements in Gallium Nitride.
Trace elements contained in single-crystal gallium nitride (GaN), which is a refractory material, were determined by inductively coupled plasma mass spectrometry with laser ablation in liquid (LAL) sampling. Particle size analysis by dynamic light scattering confirmed that LAL atomized the single-crystal GaN, and scanning electron microscopy/energy-dispersive X-ray spectrometry revealed that LAL sampling converted the GaN to gallium oxide particles. The atomization and changes in the chemical composition allowed for easy digestion of the sampled particles with nitric acid and a hot plate instead of with hydrochloric or sulfuric acid, a microwave digestion system, and a high-pressure vessel. Trace element analysis revealed the presence of trace Mg, Ge, Y, and Cd in single-crystal GaN, and the detection limits for these elements were 0.1 - 2 mg kg-1. The uncertainty derived from the small amount of sample used, which is a disadvantage of LAL sampling, was reduced by calculating the amount of sample ablated by measuring the concentration of the major element, Ga. We expect that the trace-element profiles of other refractory materials will be able to be determined by using this analytical approach.


Early weaning of calves after different dietary regimens affects later rumen development, growth, and carcass traits in Hanwoo cattle.
The main objective of this study was to determine the effect of different diets for early-weaned (EW) calves on rumen development, and how this affects fat deposition in the longissimus dorsi of adult Korean Hanwoo beef cattle. Three EW groups were established (each n = 12) in which two- week-old Hanwoo calves were fed for ten weeks with milk replacer+concentrate (T1), milk replacer+concentrate+ roughage (T2), or milk replacer+concentrate+30% starch (T3); a control group (n = 12) was weaned as normal. At six months, 5 calves of each group were slaughtered and their organs were assessed and rumen papillae growth rates were measured. The remaining calves (n = 7 in each group) were raised to 20 months for further analysis. Twenty-month-old EW calves had a higher body weight (BW), backfat thickness (BF), longissimus dorsi muscle area (LMA) and intramuscular fat (IMF) than the control (p<0.05). Organ growth, rumen histology, and gene expression patterns in the 6-month-old calves were positively related to the development of marbling in the loin, as assessed by ultrasound analysis (p<0.05). In the group fed the starch-enriched diet (T3), higher BW, BF, LMA, and IMF were present. The IMF beef quality score of 20-month-old cattle was 1+ for the T2 and T3 diets and 1 for the T1 diet (p<0.05). Papillae development was significantly greater in calves fed on high-concentrate diets and this may have resulted in the improved beef quality in the EW dietary groups compared to the control.


Quality of clinical studies in neurosurgical journals: signs of improvement over three decades.
The aim of this study was to evaluate the quality of clinical studies appearing in neurosurgical journals during three decades. Clinical studies published in 1982, 1992, and 2002 in Neurosurgery, Journal of Neurosurgery (JNS), and British Journal of Neurosurgery (BJN) were evaluated. The feature study types were categorized as follows: Type 1, prospective randomized controlled trials (PRCTs); Type 2, other prospective studies; Type 3, retrospective case-controlled and cross-sectional studies; and Type 4, case reports. Among a total of 786 articles, the following study types were identified: Type 1, eight (1%); Type 2, 46 (6%); Type 3, 81 (10%); and Type 4, 651 (83%). Overall, the proportion of study types did not differ among journals. Between 1982 and 2002, increases in the proportion of study Types 1 (0 compared with 2%, respectively), 2 (4 compared with 10%, respectively), and 3 (5 compared with 13%, respectively) and decreases in the proportion of study Type 4 (92 compared with 75%, respectively; p < 0.001) were apparent only in JNS and Neurosurgery (p < 0.01). Between 1982 and 2002, the median number of patients (two compared with 14, respectively) and the mean number of authors per study (3.4 compared with 4.8, respectively) increased (p < 0.001). The JNS had a greater mean number of authors per study than the other journals (p < 0.001). During the three decades evaluated, case reports remained the predominant study design in these prominent neurosurgical journals, notwithstanding the modest increases in study Types 1 and 2 and the associated escalations in author and patient numbers in the same period.


Pure autonomic failure.
Pure autonomic failure is a degenerative disorder of the peripheral autonomic nervous system. Patients experience symptomatic hypotension that requires them to sit, squat or lie down to prevent syncope. It is associated with characteristic histopathological findings, resulting in neuronal cytoplasmic inclusions in the peripheral autonomic nerves. These lesions are responsible for defects in the synthesis and release of norepinephrine from sympathetic nerve terminals, resulting in significant hypotension. Patients with autonomic failure also have exaggerated blood pressure responses to common stimuli such as food or fluid intake, heat, exercise and medications. Tilt table (head-up) testing is probably the test most commonly used to establish the diagnosis. However, simple office testing is also useful, such as having the patient stand after lying supine with blood pressure monitoring. Treatment options range from simply increasing fluid and salt intake, and using compressive garments, to medications administered orally, subcutaneously or intravenously in more severe cases.


Estimation of Cross-Immunity Between Drifted Strains of Influenza A/H3N2.
To determine the cross-immunity between influenza strains, we design a novel statistical method, which uses a theoretical model and clinical data on attack rates and vaccine efficacy among school children for two seasons after the 1968 A/H3N2 influenza pandemic. This model incorporates the distribution of susceptibility and the dependence of cross-immunity on the antigenic distance of drifted strains. We find that the cross-immunity between an influenza strain and the mutant that causes the next epidemic is 88%. Our method also gives estimates of the vaccine protection against the vaccinating strain, and the basic reproduction number of the 1968 pandemic influenza.


Analgesic activity of flupirtine maleate: a controlled double-blind study with diclofenac sodium in orthopaedics.
A controlled, parallel group study of the analgesic efficacy of flupirtine maleate, was compared against diclofenac sodium in 40 orthopaedic patients with post-operative pain. Clinically, both drugs were of equal analgesic efficacy. A mathematical model has been developed, however, to evaluate the speed, intensity and duration of the analgesic effect and provides data which significantly favour flupirtine maleate in the treatment of these patients.


Enhancing islet engraftment with rosiglitazone.
To study the role of a peroxisome proliferator-activated receptor agonist, rosiglitazone, on islet engraftment, streptozotocin-induced diabetic C57BL/6 mice were fed daily rosiglitazone (2.4 mg/kg) for 9 and 31 days starting 2 days before transplantation with 75 and 150 syngeneic islets, respectively. After receiving 75 islets and 9 days of rosiglitazone, half of the treated diabetic mice became normoglycemic at 4 weeks, while none were normoglycemic among those mice that did not receive treatment. After transplanting 150 islets and receiving 31 days of rosiglitazone, 80% of the treated diabetic mice became normoglycemic while the incidence was only 25% for the controls. The insulin content of the islet grafts in the rosiglitazone groups was 0.8 times (75-islet group) and 1.3 times (150-islet group) higher than that of control mice. The insulin content of pancreatic remnants did not differ significantly among all groups. An in vitro study revealed that the glucose-stimulated insulin secretion and insulin content of cultured islets was not different in the presence versus absence of 4.5 or 22.5 micromol/L rosiglitazone. In vitro study revealed that rosiglitazone inhibited the lipopolysaccharide-induced secretion of interleukin-1 beta and interferon-gamma from peritoneal exudate cells. In conclusion, our data suggest that short-term administration of rosiglitazone enhances islet engraftment.


Molecular anatomy of the early events in STIM1 activation - oligomerization or conformational change?
Decreased luminal endoplasmic reticulum (ER) Ca2+ concentration triggers oligomerization and clustering of the ER Ca2+ sensor STIM1 to promote its association with plasma membrane Orai1 Ca2+ channels leading to increased Ca2+ influx. A key step in STIM1 activation is the release of its SOAR domain from an intramolecular clamp formed with the STIM1 first coiled-coil (CC1) region. Using a truncated STIM1(1-343) molecule that captures or releases the isolated SOAR domain depending on luminal ER Ca2+ concentrations, we analyzed the early molecular events that control the intramolecular clamp formed between the CC1 and SOAR domains. We found that STIM1 forms constitutive dimers, and its CC1 domain can bind the SOAR domain of another STIM1 molecule in trans. Artificial oligomerization failed to liberate the SOAR domain or activate STIM1 unless the luminal Ca2+-sensing domains were removed. We propose that the release of SOAR from its CC1 interaction is controlled by changes in the orientation of the two CC1 domains in STIM1 dimers. Ca2+ unbinding in the STIM1 luminal domains initiates the conformational change allowing SOAR domain liberation and clustering, leading to Orai1 channel activation.


The effect of age of acquisition on older individuals with and without cognitive impairments.
The present study compared the effects of age of acquisition (AoA) on object naming across groups of older individuals with cognitive impairments, healthy older controls, and young healthy controls. All participants named a set of 80 pictures, within which both AoA and frequency were manipulated orthogonally. Early-acquired objects were named faster than late-acquired objects across all groups. Response time also declined with age and with cognitive impairment between the groups. The effect of AoA differed across groups, with AoA effects being largest for the older group with cognitive impairments and smallest for the young control group. The present study adds strength to the suggestion that AoA of picture names is one of the factors that influence survival or loss of memories in dementia and cognitive decline, and this could therefore be used as a potential screening test for cognitive impairment disorders in the future.


Infrared spectroscopy study of structural changes in glass-forming salol.
We report the investigation of glass-forming salol upon different courses of the temperature changes from liquid to glass state and back using FT-IR spectroscopy measurements in the wide spectral and temperature ranges. The formation of the ordered clusters in supercooled liquid salol has been observed at 250 K. When the temperature is decreased further to 11 K these ordered clusters become an element of the glass structure. With increasing temperature to 270 K through the glass transition noticeable evolutions of the IR spectrum occurs up till the ordered clusters are developed into crystal. So produced crystal melts in the temperature range 300-310 K, that corresponds to the melting temperature of the metastable phase (Tmelt=302 K) . Thus, the crystalline structure of the ordered clusters corresponds to the structure of metastable phase and is monoclinic.


Urinary incontinence: is cesarean delivery protective?
About half of all women develop transient urinary incontinence during pregnancy. Three months postpartum, the prevalence and incidence rates of urinary incontinence are 9% to 31% and 7% to 15%, respectively. Antenatal incontinence increases the risk of postpartum incontinence, which in turn increases the risk of long-term persistent incontinence. After the first delivery, women delivered vaginally have two-fold more incontinence than those delivered by cesarean. The protective effect of cesarean on urinary incontinence may dissipate after further deliveries, decreases with age, and is not present in older women. Data are mixed about whether cesarean done before labor confers greater protection than cesarean done after labor. To understand the true impact of cesarean delivery on urinary incontinence, future studies must compare incontinence by planned (not actual) delivery modes, consider a woman's entire reproductive career, focus on leakage severe enough to be problematic, consider other bladder symptoms as well as incontinence, and take into account other risk factors, particularly antepartum urinary incontinence.


The Balance of Tissue Inhibitor of Metalloproteinase-1 and Matrix Metalloproteinase-9 in the Autoimmune Inner Ear Disease Patients.
Tissue inhibitor of metalloproteinase-1 (TIMP-1) is a protein implicated in the control of inflammation in a number of autoimmune diseases. We hypothesized that the balance of TIMP-1 and matrix metalloproteinase-9 (MMP-9) may influence the control or perpetuation of inflammation in corticosteroid-responsive (RES) and corticosteroid-resistant (NR) autoimmune inner ear disease (AIED) patients. In the present study, we observed that plasma from AIED patients exhibited greater levels of TIMP-1 values compared with normal healthy controls. TIMP-1 abrogates lipopolysaccharide-mediated interleukin (IL)-1β release from peripheral blood mononuclear cells in a dose-dependent manner. RES AIED patients have higher basal TIMP-1 levels and produce more TIMP-1 in response to IL-1β. Conversely, consistent with our previous studies, we found that NR patients have higher basal MMP-9 levels and produce more MMP-9 levels in response to IL-1β.


[Examination of Breast Cancer in the Super-Elderly Individuals(85 Years Old and Above)at Our Hospital].
The rate of aging in Japan has currently exceeded 28.1%. Moreover, it is expected that the rate of aging will continue to increase in the future. Under these circumstances, the opportunities to treat breast cancer in the super-elderly individuals are elevating. Here, we summarized and examined the cases who were 85 years or above in age and diagnosed with breast cancer at our hospital during the last 10 years. There were 29 cases(30 breasts), who were all female, with an average age of 89.6 years. Dementia coexisted in 17 cases, and an enlarged mass was the trigger for the discovery in most cases. For breast cancer in super-elderly females, it is necessary to treat it in the right proportion. Moreover, it is considered that the treatment policy should be decided considering the presence or absence of dementia and comorbidities. Also, the treatment regime should be decided upon full consultation with the surroundings, such as family members and long-term care facilities.


THE USE OF THE LIGASURE™ DEVICE FOR SCROTAL ABLATION IN MARSUPIALS.
Five sugar gliders ( Petaurus breviceps ), ranging in age from 3 mo to 3.5 yr of age, and one opossum ( Didelphis virginianus ), age 4.5 mo, presented for elective orchiectomy and scrotal ablation. The LigaSure™ device was safely used for orchiectomy and scrotal ablation in both species. Surgical time with the LigaSure was approximately 4 sec. No grooming of the incision site or self-mutilation was seen in the first 72 hr postoperatively. One sugar glider required postoperative wound care approximately 10 days postoperatively following incision-site grooming by a conspecific. The LigaSure provides a rapid, technologically simple and safe surgical technique for scrotal ablation and orchiectomy in the marsupial patient that minimizes surgical, anesthetic, and recovery times.


Preliminary Evidence For The Effects Of Aging And Multiple Sclerosis On Cognitive Performance: An Analysis Based On Effect Size Estimates.
Background/Study Context: Although cognitive impairment is common in persons with multiple sclerosis (MS), there are limited data on older adults with MS. The current pilot study involved a preliminary examination of cognitive impairments across a comprehensive neuropsychological assessment in older adults with MS compared with older adults without MS. Twenty older adults with MS and 20 older adults without MS (≥60 years of age) underwent cognitive assessments, including the Trail Making Test (TMT) and the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). The primary analytical model involved independent-samples t tests on the TMT and RBANS scores. The analysis focused on ½ SD (i.e., Cohen's d of 0.5) for judging the differences as meaningful. Overall, the study hypotheses were supported such that older adults with MS demonstrated decreased cognitive performance that exceeded ½ SD compared with the older adults without MS. This preliminary study demonstrated moderate and meaningful differences in cognitive performance in older adults with MS compared with older adults without MS. This suggests a clear need for identifying strategies for alleviating cognitive impairment in older adults with MS.


Outcomes of an intervention to reduce uncertainty among African American women with diabetes.
Poor adjustment to diabetes in older African American women may result from uncertainty, stemming from a lack of information about self-care activities, a complexity of self-care activities, comorbid conditions, and a lack of resources. This study evaluated a telephone intervention to reduce uncertainty (through problem-solving strategies, information, cognitive reframing, and improved patient-provider communication)--namely, to measure its effects on diabetes self-care and psychosocial adjustment. Sixty-eight older African American women were randomly assigned to an experimental group and a control group. The experimental group received the intervention for 4 weeks, and the control group received usual care. Psychosocial adjustment and self-care were measured in all participants at baseline and 6 weeks postbaseline. The experimental group reported increased participation in exercise (self-care component; p < .001) and improvement in psychosocial adjustment (p < .001). Thus, reducing the uncertainty related to diabetes self-care improves self-care exercise, as well as psychosocial adjustment.


Increased preclinical efficacy of irinotecan and floxuridine coencapsulated inside liposomes is associated with tumor delivery of synergistic drug ratios.
Whether anticancer drug combinations act synergistically or antagonistically often depends on the ratio of the agents being combined. We show here that combinations of irinotecan and floxuridine exhibit drug ratio-dependent cytotoxicity in a broad panel of tumor cell lines in vitro where a 1:1 molar ratio consistently provided synergy and avoided antagonism. In vivo delivery of irinotecan and floxuridine coencapsulated inside liposomes at the synergistic 1:1 molar ratio (referred to as CPX-1) lead to greatly enhanced efficacy compared to the two drugs administered as a saline-based cocktail in a number of human xenograft and murine tumor models. When compared to liposomal irinotecan or liposomal floxuridine, the therapeutic activity of CPX-1 in vivo was not only superior to the individual liposomal agents, but the extent of tumor growth inhibition was greater than that predicted for combining the activities of the individual agents. In contrast, liposome delivery of irinotecan:floxuridine ratios shown to be antagonistic in vitro provided antitumor activity that was actually less than that achieved with liposomal irinotecan alone, indicative of in vivo antagonism. Synergistic antitumor activity observed for CPX-1 was associated with maintenance of the 1:1 irinotecan:floxuridine molar ratio in plasma and tumor tissue over 16-24 h. In contrast, injection of the drugs combined in saline resulted in irinotecan:floxuridine ratios that changed 10-fold within 1 h in plasma and sevenfold within 4 h in tumor tissue. These results indicate that substantial improvements in the efficacy of drug combinations may be achieved by maintaining in vitro-identified synergistic drug ratios after systemic administration using drug delivery vehicles.


Effect of Intravenous Dexamethasone Dose on the Occurrence of Rebound Pain after Axillary Plexus Block in Ambulatory Surgery.
Rebound pain (RP) remains a challenge in ambulatory surgery, characterized by severe pain upon resolution of a peripheral nerve block (PNB). Intravenous (IV) administration of Dexamethasone (DEXA) potentiates PNB analgesic effect and reduces RP incidence although preventive effective dose remains undetermined. This retrospective analysis evaluates the preventive effect of IV DEXA on RP in outpatients undergoing upper limb surgery under axillary block. DEXA was divided into high (HD > 0.1 mg/kg) or low (LD < 0.1 mg/kg) doses. RP was defined as severe pain (NRS ≥ 7/10) within 24 h of PNB resolution. DEXA HD and LD patients were matched with control patients without DEXA (n = 55) from a previous randomized controlled study. Records of 118 DEXA patients were analyzed (DEXA dose ranged from 0.05 to 0.12 mg/kg). Intraoperative IV DEXA was associated with a significant reduction of the pain felt when PNB wore off as well as to a significant reduction of RP incidence (n = 27/118, 23% vs. 47% in controls, p = 0.002) with no effect related to the dose administered (p = 0.053). Our results support the administration of intraoperative DEXA as a preventive measure to reduce the occurrence of RP.


Diffusion-Weighted Magnetic Resonance Imaging Attenuation Factors and Their Selection for Cancer Diagnosis and Monitoring.
Diffusion-weighted imaging (DWI) is based on the detection of water molecule movement in interstitial and intracellular space, and that motion may be restricted in ischemia and in tumors. An early diagnosis and characterization of several cancer related diseases is possible with DWI. Diffusion-weighted images are therefore important for patient management. Knowledge of the technical requirements for DWI, including a suitable selection of b-values for differentiating between perfusion and true diffusion, as well as an understanding of the advantages and limitations of different b-values selections, is necessary to obtain reliable diagnostic results. The aim of this article is to review the fundamentals of the DWI technique, the common protocols used, b-value selection, and DWI's main contribution to neoplasm detection and staging.


Analysis of Mycosporine-Like Amino Acids in Selected Algae and Cyanobacteria by Hydrophilic Interaction Liquid Chromatography and a Novel MAA from the Red Alga Catenella repens.
Mycosporine-like amino acids (MAAs), a group of small secondary metabolites found in algae, cyanobacteria, lichens and fungi, have become ecologically and pharmacologically relevant because of their pronounced UV-absorbing and photo-protective potential. Their analytical characterization is generally achieved by reversed phase HPLC and the compounds are often quantified based on molar extinction coefficients. As an alternative approach, in our study a fully validated hydrophilic interaction liquid chromatography (HILIC) method is presented. It enables the precise quantification of several analytes with adequate retention times in a single run, and can be coupled directly to MS. Excellent linear correlation coefficients (R² > 0.9991) were obtained, with limit of detection (LOD) values ranging from 0.16 to 0.43 µg/mL. Furthermore, the assay was found to be accurate (recovery rates from 89.8% to 104.1%) and precise (intra-day precision: 5.6%, inter-day precision ≤6.6%). Several algae were assayed for their content of known MAAs like porphyra-334, shinorine, and palythine. Liquid chromatography-mass spectrometry (LC-MS) data indicated a novel compound in some of them, which could be isolated from the marine species Catenella repens and structurally elucidated by nuclear magnetic resonance spectroscopy (NMR) as (E)-3-hydroxy-2-((5-hydroxy-5-(hydroxymethyl)-2-methoxy-3-((2-sulfoethyl)amino)cyclohex-2-en-1-ylidene)amino) propanoic acid, a novel MAA called catenelline.


Induction of human endothelial tissue factor expression by Neisseria meningitidis: the influence of bacterial killing and adherence to the endothelium.
Tissue factor (TF), a small membrane bound high affinity receptor for factor VII, has an important procoagulant role in the haemostatic dysfunction associated with severe sepsis. Using an in vitro model of human endothelial TF expression, defined strains of Neisseria meningitidis were found to upregulate endothelial cell procoagulant activity (PCA) in a dose dependent manner. This TF response was detected with as little as 10(4) cfu/ml and reached similar levels to those seen with high concentrations of purified endotoxin (> 1 ng/ml). Treatment of N. meningitidis with either adult donor immune serum, penicillin or gentamicin failed to enhance this PCA. Limulus amoebocyte lysate assay of lipopolysaccharide in bacterial culture filtrates together with polymyxin B inhibition experiments suggest that endotoxin is largely responsible for endothelial TF induction by N. meningitidis. Incubation of endothelial cells with N. meningitidis B1940 and B1940 siaD- (an eight-fold more adherent unencapsulated isogenic strain), revealed a significantly greater TF response to B1940 siaD- (P < 0.01). In conclusion, bacterial adhesion to the vessel wall and therefore local levels of endotoxin may be important determinants of the endothelial procoagulant response to N. meningitidis and the consequent coagulopathy commonly associated with the disease.


A rare 'incidentaloma' found on low-dose CT screening for lung cancer: 'scanner beware'.
Screening for lung cancer with low-dose computed tomography (LDCT) has been shown to reduce mortality and has been recommended by the U.S. Preventive Services Task Force for adults 55 to 80 years of age with a 30 pack-year smoking history who are either current smokers or those that quit within 15 years. However, the overwhelming majority of abnormalities detected are not from malignancy. We report a case of pulmonary Langerhans' cell histiocytosis, here-to-fore thought of as extremely uncommon, and make readers aware that this may be increasingly found as LDCT is more widely adopted.


Narrow (n,m)-distribution of single-walled carbon nanotubes grown using a solid supported catalyst.
Unusually structure-selective growth of single-walled carbon nanotubes (SWNTs) has been attained using a CVD method with a solid supported catalyst. In this method, CO feedstock disproportionates on silica-supported catalytic nanoclusters of Co that are formed in situ from mixed salts of Co and Mo. The nanotube products are analyzed by spectrofluorimetry to reveal distributions resolved at the level of individual (n,m) structures. Two structures, (6,5) and (7,5), together dominate the semiconducting nanotube distribution and comprise more than one-half of that population. The average diameter of produced SWNTs is only 0.81 nm, and a strong propensity is found favoring chiral angles near the armchair limit.


Client expectation from doctors: expectation - reality gap.
To determine client expectation from doctors, a descriptive survey was conducted amongst people above 18 years of age and doctors of Faridpur District. For this purpose a total of 400 patients and 30 doctors were involved. Both rural and urban population were included. A sample of 30 doctors was selected from the outdoor department of Faridpur Medical College Hospital (FMCH), one Thana Health Complex; Non-Govt. private practitioners working in Faridpur town and one Thana of Faridpur District. All had MBBS degree and had become doctors within the last 10 years. Data were collected and both quantitative and qualitative analyses were done. Focus group discussions were done among the people of Faridpur town and one Thana. The results showed that the majority of clients wanted (I) Experienced and skilled but inexpensive doctors. (II) Proper diagnosis (III) Good behaviour (IV) Free supply of medicine especially for the poor (V) Good clean hospital infrastructure (VI) Hospital to be in the vicinity of their residences. (VII) Both treatment and advice for prevention to be given by the doctors.


[Hypolipidemic action of F-1394, an acyl-CoA: cholesterol acyltransferase (ACAT) inhibitor, in high-fat diet fed beagle dogs].
In the present study, we investigated the hypolipidemic effect of F-1394, a potent and selective inhibitor of acyl-CoA: cholesterol acyltransferase (ACAT), in dogs fed with a high-fat diet consisting of regular foods, 5% cholesterol and 16% fat. The serum cholesterol levels in dogs reached the steady-state 1 week after the start of feeding of a high-fat diet and were about 2-fold greater than those in normolipidemic dogs. Graded administration of the doses of F-1394 (1-30 mg/kg/d) to the dogs fed with a high-fat diet prevented the elevation of serum cholesterol levels. In the hyperlipidemic dogs fed with a high-fat diet for 14 d before the start of the administration of F-1394, the oral administration of F-1394 at a dose of 1, 3 or 10 mg/kg/d for 21 d reduced the serum cholesterol levels in a dose-dependent manner. The estimated ID50 value was 7.2 +/- 0.3 mg/kg/d p. o. (12.1 +/- 0.5 mol/kg/d p. o.). F-1394 did not affect the body weight and no diarrhea was observed by the administration of F-1394. F-1394 at a dose of 10 mg/kg/d or more also significantly inhibited the increase of serum triglyceride levels 3 h after the feeding of high-fat diet. These results suggest that F-1394 inhibits the ACAT activity in the canine small intestine and, subsequently, the inhibition of ACAT activity contributes much to the prevention of cholesterol absorption via the gut, resulting in a decrease in serum cholesterol levels in the dogs fed with high-fat diet. Furthermore, F-1394 may also have an inhibitory effect on the triglyceride absorption via the gut, and the therapeutical use for postprandial hypertriglyceridemia is expected.


CD137 Signaling Promotes Endothelial Apoptosis by Inhibiting Nrf2 Pathway, and Upregulating NF-κB Pathway.
Endothelial dysfunction and apoptosis resulting from oxidative stress can lead to the development of atherosclerosis. Our group has previously showed that CD137 signaling contributes to the progression of atherosclerosis and the vulnerability of plaques. The aim of this study is to investigate the effects of CD137 signaling in atherosclerosis on endothelial cells (ECs) apoptosis and to explore the underlying mechanisms. Serum samples were collected from 11 patients with acute myocardial infarction and 4 controls. Peritoneal injection of agonist-CD137 recombinant protein in ApoE-/- mice was used to determine whether CD137 signaling can promote apoptosis in vivo, and human umbilical vein endothelial cells treated with agonist-CD137 recombinant protein, M5580 (a Nrf2 pathway agonist) and CAPE (a NF-κB pathway inhibitor) were used to explore the effect of Nrf2 and NF-κB pathway in CD137 signaling-induced ECs apoptosis in vitro. ELISA showed that Bcl-2 in the serum of AMI patients was lower than that of the control group, while TNF-α and sCD137 were higher than that of the control group. Confocal microscopy and Western blot analysis showed that the nuclear translocation of Nrf2 in the agonist-CD137 group was significantly inhibited, and the expression of its downstream antioxidant enzymes was also decreased when compared with control. Immunofluorescence and Western blot results showed that the nuclear translocation of NF-κB in the agonist-CD137 group was enhanced, and ELISA results showed that the secretion of proinflammatory cytokines in the agonist-CD137 group was increased. Immunofluorescence results revealed that ROS production in the agonist-CD137 group was higher than that in control, M5580 (a Nrf2 pathway agonist) and CAPE (a NF-κB pathway inhibitor) groups. In vitro studies using HUVECs and in vivo studies using high-fat-fed ApoE-/- mice showed that the number of apoptotic endothelial cells was the highest in the agonist-CD137 group. By contrast, both M5580 and CAPE treatments were able to reduce CD137 induced ECs apoptosis. Our results showed that CD137 signaling promotes ECs apoptosis through prooxidative and proinflammatory mechanisms, mediated by Nrf2 and NF-κB pathways, respectively.


Alterations in Soluble Class III Peroxidases of Maize Shoots by Flooding Stress.
Due to changing climate, flooding (waterlogged soils and submergence) becomes a major problem in agriculture and crop production. In the present study, the effect of waterlogging was investigated on peroxidases of maize (Zea mays L.) leaves. The plants showed typical adaptations to flooding stress, i.e., alterations in chlorophyll a/b ratios and increased basal shoot diameter. Seven peroxidase bands could be detected by first dimension modified SDS-PAGE and 10 bands by first dimension high resolution Clear Native Electrophoresis that altered in dependence on plant development and time of waterlogging. Native isoelectric focusing revealed three acidic to neutral and four alkaline guaiacol peroxidases that could be further separated by high resolution Clear Native Electrophorese in the second dimension. One neutral peroxidase (pI 7.0) appeared to be down-regulated within four hours after flooding, whereas alkaline peroxidases (pI 9.2, 8.0 and 7.8) were up-regulated after 28 or 52 h. Second dimensions revealed molecular masses of 133 kDa and 85 kDa for peroxidases at pI 8.0 and 7.8, respectively. Size exclusion chromatography revealed native molecular masses of 30-58 kDa for peroxidases identified as class III peroxidases and ascorbate peroxidases by mass spectrometry. Possible functions of these peroxidases in flooding stress will be discussed.


Photocatalytic Activity of Ti-SBA-15/C3N4 for Degradation of 2,4-Dichlorophenoxyacetic Acid in Water under Visible Light.
In the present study, the photocatalytic activity of Ti-SBA-15/C3N4 catalysts was investigated to degrade 2,4-Dichlorophenoxyacetic acid (2,4-D) herbicides in water under visible light irradiation. The catalysts were synthesized via a simple hydrothermal method and characterized by various analytical techniques, including SAXS, N2 adsorption-desorption isotherms, Zeta potential, PL, FT-IR, XRF, TGA, and UV-DRS. Our study indicated that the 2.5Ti-SBA-15/C3N4 had higher efficiency in the degradation of 2,4-D than Ti-SBA-15 and C3N4. The decomposition of 2,4-D reached 60% under 180 minutes of visible light irradiation at room temperature on 2.5Ti-SBA-15/C3N4. Moreover, the degradation of 2,4-D on Ti-SBA-15/C3N4 was pseudo-first-order kinetics with the highest rate constant (0.00484 min-1), which was much higher than that obtained for other photocatalysts reported recently. Furthermore, the catalyst can be reused at least two times for photodegradation of 2,4-D solution under visible light irradiation within a slight decrease in catalytic activity.


Current status of endovascular repair of infrarenal abdominal aortic aneurysms in the context of 50 years of conventional repair.
The operative risk for conventional open repair of nonruptured infrarenal abdominal aortic aneurysms (AAAs) has steadily declined during the past several decades to the point that open procedures now can be done with a mortality rate of approximately 2% at tertiary referral centers. Nevertheless, population-based studies suggest that the mortality rate for open AAA repair remains nearly 7% in many communities, a finding that undoubtedly is influenced by a substantial risk for unfavorable outcomes in patients who represent less than ideal candidates for major abdominal operations on the basis of advanced age and the medical comorbidities that so often accompany it. Endovascular aneurysm repair (EVAR) is a landmark contribution to the management of such patients and has been associated with significant overall reductions in the operative mortality rate in statewide and national audits. This early advantage of EVAR comes at the price of a unique set of complications, secondary interventions, and related expenses, however, and randomized clinical trials of EVAR versus open repair have not yet demonstrated differences in survival or quality of life within 4 years of follow-up. Data from the Nationwide Inpatient Sample and other sources indicate that the mortality rate for open AAA repair appears to be less than 2% in patients who are 65 years of age or younger. This low operative risk may not justify exposure to whatever incidence of late complications the current generation of endografts may prove to have during the relatively long survival times that can be anticipated for these patients.


Enhanced propagation of adult human renal epithelial progenitor cells to improve cell sourcing for tissue-engineered therapeutic devices for renal diseases.
Renal cell therapy employing cells derived from adult renal epithelial cell (REC) progenitors promises to reduce the morbidity of patients with renal insufficiency due to acute renal failure and end stage renal disease. To this end, tissue engineered devices addressing the neglected biologic component of renal replacement therapy are being developed. Because human donor tissue is limited, novel enhanced progenitor cell propagation (EP) techniques have been developed and applied to adult human kidney transplant discards from six donors. Changes include more efficient digestion and the amplification of progenitors prior to terminal epithelial differentiation promoted by contact inhibition and the addition of retinoic acid. Differentiated morphology in EP populations was demonstrated by the ability to form polarized epithelium with tight junctions, apical central cilia and expression of brush border membrane enzymes. Evaluation of lipopolysaccharide stimulated interleukin-8 secretion and γ-glutamyl transpeptisade activity in EP derived cells was used to confirm therapeutic equivalence to REC obtained using published techniques, which have previously shown efficacy in large animal models and clinical trials. Yield exceeded 10(16) cells/gram cortex from the only kidney obtained due to an anatomical defect, while the average yield from diseased kidneys ranged from 1.1 × 10(9) to 8.8 × 10(11) cells/gram cortex, representing an increase of more than 10 doublings over standard methods. Application of the EP protocol to REC expansion has solved the problem of cell sourcing as the limiting factor to the manufacture of cell based therapies targeting renal diseases and may provide a method for autologous device fabrication from core kidney biopsies.


Evaluation of a new super-long-pulsed 810 nm diode laser for the removal of unwanted hair: the concept of thermal damage time.
Laser hair removal is based on the dual concepts of selective photothermolysis and thermal relaxation time. In most laser hair removal systems, light with emitted pulse durations of 2-50 msec targets hair follicles. A novel concept of laser hair removal uses the thermal damage time rather than the thermal relaxation time of the hair follicle. The follicle's thermal damage time is the amount of time required for diffusion of delivered laser energy from the treated hair to follicular-associated hair stem cells. This can range from 170 to 1000 msec. To investigate the theory of thermal damage time, we performed a pilot study to evaluate the clinical efficacy and side effect profile of a modified 810 nm diode laser device operating in a super-long-pulse mode (200-1000 msec). Ten female subjects with Fitzpatrick skin types I-VI received either one or two laser treatments at eight test sites. Super-long pulse durations of 200-1000 msec were evaluated with delivered fluences ranging from 23 to 115 J/cm2. Subjects were followed for 6 months after the first treatment. Subjects were evaluated for hair removal efficiency, optimal pulse duration and delivered fluence, and associated complication rate. The clinical results show that safe hair removal in all skin types can be accomplished with an 810 nm diode laser delivering super-long pulse durations. Pain and complications were greatest at the highest pulse duration (1000 msec) and the highest fluence (115 J/cm2). Optimal hair reduction at 6 months (31%) was achieved at a thermal diffusion time of 400 msec (46 J/cm2). The super-long pulsed 810 nm diode laser can safely remove unwanted hair in a full variety of skin types. Pain and increased risk of complications may preclude the use of the laser at very high fluences and pulse duration in the range of 1000 msec.


Bilateral knee pain in a high-level gymnast.
Gymnast wrist or distal radial physeal injury is a common entity among gymnasts of all levels. It can lead to chronic pain, inability to perform, and growth issues at the wrist for these young athletes. However, less has been reported about other overuse stress injuries in this group. We present the case of a prepubescent female gymnast complaining of chronic bilateral knee pain. She was found to have bilateral distal femoral physeal stress injuries and had a similar clinical course to any gymnast diagnosed with the same injury at the wrist.


Cloning and expression of genes encoding heat shock proteins in Liriomyza trifolii and comparison with two congener leafminer species.
The polyphagous agromyzid fly, Liriomyza trifolii, is a significant and important insect pest of ornamental and vegetable crops worldwide. The adaptation of insects to different environments is facilitated by heat shock proteins (HSPs), which play an important role in acclimation to thermal stress. In this study, we cloned and characterized five HSP-encoding genes of L. trifolii (Lthsp20, Lthsp40, Lthsp60, Lthsp70, and Lthsp90) and monitored their expression under different thermal stresses using real-time quantitative PCR. Pupae of L. trifolii were exposed to 19 different temperatures ranging from -20 to 45°C. The results revealed that Lthsp20, Lthsp40, Lthsp70 and Lthsp90 were significantly upregulated in response to both heat and cold stress, while Lthsp60 was induced only by heat temperatures. The temperatures of the onset (Ton) and maximal (Tmax) expression of the five Lthsps were also determined and compared with published Ton and Tmax values of homologous genes in L. sativae and L. huidobrensis. Although L. trifolii occurs primarily in southern China, it has cold tolerance comparable with the other two Liriomyza species. Based on the heat shock proteins expression patterns, L. trifolii has the capacity to tolerate extreme temperatures and the potential to disseminate to northern regions of China.


Isolation and characterization of subspecies of murine interferon alpha.
Interferon produced by mouse L-929 cells by incubation with poly(rI).poly(rC) is known to be composed of a mixture of MuIFN-alpha and MuIFN-beta. The alpha component was separated from the bete species by affinity chromatography over a monoclonal anti-MuIFN-beta agarose column and partially purified by gel filtration. MuIFN-alpha, prepared by this method was separated into at least five subspecies by chromatofocusing. The approximate pI values of these components are greater than or equal to 7.5, 6.5, 6.2, 5.9 and 5.6, respectively. Component 3 (pI 6.2) was the most prominent subspecies present in our MuIFN-alpha preparations, representing 40 to 50% of the total antiviral activity. Component 1 (pI greater than or equal to 7.5) which accounted for about 5% of the antiviral activity on mouse cells, differed in some properties from the other interferon subspecies. It showed a relatively high antiviral activity on heterologous cells and it was eluted from a Sephadex column after the other alpha subspecies. Furthermore, it showed a diminished binding to heparin as compared to the other MuIFN-alpha subspecies, indicating a lower affinity for polynucleotides.


Design and development of ultrathin-walled, nonkinking endotracheal tubes of a new "no-pressure" laryngeal seal design. A preliminary report.
Endotracheal tubes (ETTs) of conventional design and manufacture greatly increase the air-flow resistance of the upper airways. This increase in upper-airway resistance can lead to a significant increase in the work of breathing and may necessitate the use of assisted mechanical ventilation. Current ETTs are relatively stiff and contribute greatly to patient discomfort. The inflatable cuffs now mounted onto the ETTs function well in short-term use but impart significant morbidity when used over longer periods. These issues were addressed by the designing of a low-resistance ETT. Using new techniques, we developed ultrathin-walled, wire reinforced ETTs of conventional configuration and ETTs the oropharyngeal-section diameter of which was a few millimeters larger than the diameter of the tracheal section. The wall thickness was a constant 0.20 mm. The wire reinforcement was stainless steel flat wire or superelastic nickel-titanium alloy. The superelastic nickel-titanium alloy reinforcement made those ETTs crush-proof; after forceful manual compression, recovery was complete. To obtain a seal with the upper airways, we first shaped a short section of the oropharyngeal section of the ETT from round to oval (or egg-shaped) to conform better to the larynx. We then attached to this segment numerous soft, pliable, 0.025-0.075-mm-thick rings of polyurethane to occlude voids for potential air leaks from within the larynx. In vitro pressure-flow studies showed a decrease by as much as four- or fivefold in air-flow resistance in the adult ETT range, effectively increasing the internal diameter by 2.3-3.7 mm, compared with conventional ETTs of the same outside diameter. In vivo studies for 24 h in sheep showed no air leaks at airway pressures to 30 cmH2O and minimal leak at greater pressures. The gross appearance of the trachea was normal. Although the new tubes appear to offer advantages to those currently used, testing in humans is required to assess the clinical utility of the tube-cuff design.


Stimulatory effect of vegetables on intestinal drug metabolism in the rat.
The intestinal metabolism of hexobarbital, phenacetin, 7-ethoxycoumarin and benzo [a] pyrene in vitro was increased in rats fed either dried Brussels sprouts or dried cabbage in a nutritionally complete semisynthetic diet as compared to rats fed only the semisynthetic diet. Pretreatment of rats with several indoles present in Brussels sprouts and cabbage also stimulated intestinal drug metabolism, but the effect was smaller than when dried Brussels sprouts or dried cabbage was fed. The results obtained suggest a need for studies in man to determine whether vegetables and other dietary constituents can stimulate the intestinal metabolism of drugs and thereby alter their biological effects.


Loss of the SSeCKS/Gravin/AKAP12 gene results in prostatic hyperplasia.
SSeCKS/Gravin/AKAP12 (SSeCKS) is a kinase scaffolding protein that encodes metastasis-suppressor activity through the suppression of Src-mediated oncogenic signaling and vascular endothelial growth factor expression. SSeCKS expression is down-regulated in Src- and Ras-transformed fibroblasts, in human cancer cell lines and in several types of human cancer, including prostate. Normal human and mouse prostates express abundant SSeCKS in secretory epithelial cells and, to a lesser extent, in the surrounding mesenchyme. Here, we show that the loss of SSeCKS results in prostatic hyperplasia in the anterior and ventral lobes as well as increased levels of apoptosis throughout the prostate. Dysplastic foci were observed less frequently but were associated with the loss of E-cadherin staining and the loss of high molecular weight cytokeratin-positive basal epithelial cells. SSeCKS-null prostate tissues expressed significantly higher relative levels of AKT(poS473) compared with wild-type controls, suggesting that SSeCKS attenuates phosphatidylinositol-3-OH kinase signaling. The data suggest that SSeCKS-null mice have increased susceptibility for oncogenic transformation in the prostate.


Air-Coupled Ultrasonic Ferroelectret Receiver With Additional Bias Voltage.
High sensitivity is an important requirement for air-coupled ultrasonic sensors applied to materials testing. With a lower acoustic impedance than any piezoelectric material, charged cellular polypropylene (PP) offers better matching to air with a similar piezoelectric coefficient. The piezoelectric properties of charged cellular PP originate from their polarization, creating permanent internal voltage. The sensitivity of the sensor can be increased by applying additional dc bias voltage, as it has been done already for transmitters. This work presents the first ultrasonic sensor based on charged cellular PP including a high-voltage module providing dc bias voltage up to 2 kV. This bias voltage led to an increase in the signal-to-noise ratio of up to 15 ± 1 dB. The measurement of the received signal depending on the applied bias voltage is proposed as a new method of determining the internal voltage of ferroelectrets. The sensor combined with a cellular PP transmitter was applied to nondestructive testing of a rotor blade segment and glued-laminated timber, enabling imaging of the internal structure of these specimens with a thickness around 4 cm.


Mode of onset predicts etiological diagnosis of arterial ischemic stroke in children.
In children, early differentiation among various etiologies of arterial ischemic stroke (AIS) is important. Cerebral arteriopathy is a frequently identified cause of childhood stroke. Children with arteriopathies require a different therapeutic approach from children with AIS of nonarteriopathic origin. We aimed to investigate the association between temporal features of the onset of neurological symptoms and stroke etiology in children with AIS. From a consecutive cohort of children (6 months to 18 years) with a confirmed diagnosis of AIS at one center, we selected all patients with transient cerebral arteriopathy (n=10), postvaricella angiopathy (n=20), dissection (n=8), cardio-embolic (n=8), and cryptogenic stroke (n=10). We retrospectively reviewed medical charts for mode of onset and classified the onset as either abrupt, reaching maximum severity of symptoms within 30 minutes, or nonabrupt, including a progressing, stuttering, or recurring course. We compared the mode of onset in patients with known cerebral arteriopathy to those with nonarteriopathic stroke using multivariate logistic regression modeling. There were no significant differences for age, gender, location of infarction, seizures, and headache between the arteriopathic and nonarteriopathic group. Most children with nonarteriopathic AIS had an abrupt onset (72%), compared with 32% in children with arteriopathic stroke. With nonabrupt onset, the odds of having an arteriopathic etiology was 6.1 (95% CI, 1.6 to 22.8; P=0.007) after correction for possible confounders. Mode of onset predicts etiological diagnosis of childhood AIS and may guide prioritization of ancillary investigations and choice of treatment. A nonabrupt onset of symptoms is associated with arteriopathic stroke, particularly with presumed inflammatory arteriopathies.


Iatrogenic communications between aortic root and right ventricle/left atrium after transcatheter aortic valve replacement.
Transcatheter aortic valve replacement (TAVR) has emerged as an alternative, less invasive treatment option for patients with severe symptomatic aortic stenosis, who are high-risk for conventional surgical aortic valve replacement, due to co-morbidities. In addition to a 30-day 10% mortality risk there is a recognized range of complications, which commonly relate to vascular access trauma, paravalvular aortic regurgitation, and cerebrovascular events. In the following case reports, we discuss two previously unreported complications of TAVR: (i) an iatrogenic communication between the aortic root and the right ventricle and (ii) an iatrogenic communication between the aortic root and the left atrium. Informed written consent was obtained from both patients.


A case of severe diarrhoea caused by Cyclospora cayetanensis in an immunocompromised patient in northern Spain.
Cyclospora cayetanensis is a parasite that causes intestinal disease that can be especially severe in immunocompromised patients. Most cases occur in tropical and subtropical areas, and in industrialized countries their diagnosis is mostly linked to international travel or the ingestion of imported food. We describe this case of severe diarrhoea in a patient with diffuse large B cell lymphoma and no epidemiological risk factors that was successfully treated with trimethoprim-sulfamethoxazole (TMP-STX). C. cayetanensis is a pathogen that should be taken into account in patients with chronic diarrhoea, especially immunocompromised patients, even when no epidemiological risk factors are present.


TBARS and BDNF levels in newborns exposed to crack/cocaine during pregnancy: a comparative study.
To compare levels of a marker of lipid peroxidation (thiobarbituric acid reactive substances, TBARS) and brain-derived neurotrophic factor (BDNF) in umbilical cord blood (UCB) between newborns exposed to crack/cocaine in utero (exposed newborns [EN], n=57) and non-exposed newborns (NEN, n=99), as well as in maternal peripheral blood at delivery. This was a cross-sectional study. Potential confounders, including perinatal parameters, psychopathology, and use of other substances, were assessed. After adjusting for potential confounders, adjusted mean BDNF was significantly higher in EN (3.86 ng/mL, 95% confidence interval [95%CI] 2.29-5.43) than in NEN (0.85 ng/mL, 95%CI 0.47-1.23; p < 0.001; Cohen effect size: 1.12), and significantly lower in crack/cocaine mothers than in control mothers (4.03 ng/mL, 95%CI 2.87-5.18 vs. 6.67 ng/mL, 95%CI 5.60-7.74; p = 0.006). The adjusted mean TBARS level was significantly lower in EN (63.97 µM MDA, 95%CI 39.43-88.50) than NEN (177.04 µM MDA, 95%CI 140.93-213.14; p < 0.001; effect size = 0.84), with no difference between mother groups (p = 0.86). The changes in TBARS levels observed in EN suggest that fetuses exposed to cocaine mobilize endogenous antioxidant routes since very early stages of development. The increase in BDNF levels in EN might indicate changes in fetal development, whereas the changes in BDNF levels in mothers provide evidence of the complex metabolic processes involved in drug use during pregnancy.


Sentinel node biopsy in oral squamous cell carcinoma.
The clinical utility of sentinel node biopsy techniques for cutaneous melanoma has led multiple investigators to study the applicability of this approach to other solid tumors, including cancers of the upper aerodigestive tract, and especially the oral cavity. Preliminary data indicate that it may be useful for early oral cancers, with the exception of floor of mouth tumors, where technical challenges related to the proximity of the lymphatic basin remain a problem. A multi-institutional pathologic validation trial, involving sentinel node biopsy followed by completion selective neck dissection, has completed accrual. While central step sectioning and immunohistochemistry remain to be completed and analyzed, routine pathologic techniques provided negative predictive values of 96% for oral cancer excluding floor of mouth lesions. Subsequent trials need to involve clinical follow-up and evaluation for recurrence in the neck. We believe this technique may ultimately play a role in the management of early oral cancer.


Association between advanced oxidation protein products and 5-year mortality risk among amazon riparian elderly population.
Proteins are important targets of several modifications caused by oxidative stress, leading to structural changes and consequently partial or total loss of their functions. The oxidized proteins include advanced oxidation protein products (AOPP) derived from oxidation-modified albumin, as well as fibrinogen and lipoproteins. An increase in AOPP levels indicates an oxidative stress state and the presence of coexisting inflammation. Several investigations have also suggested an association between high AOPP levels and aging-related diseases. However, the link between elevated AOPP levels and elderly mortality risk has not yet been investigated. Here, we report on a 5-year longitudinal study that investigated the potential association between AOPP levels and mortality using a population-based representative sample of riparian elders living in Brazilian Amazon region (Maués-AM). Age, sex, socioeconomic and cultural conditions, chronic morbidities, polypharmacy, and previous morbidities were also tested as potential confounders. The AOPP levels were measured in 540 (84.78%) individuals, all of whom were followed over a 5-year period in order to establish the mortality rate. Within this study period, 74 (13.7%) elders died and 466 (86.3%) survived. The AOPP levels were higher among the elders who died within the 5-year period (46.27 ± 40.6 mmol/L) compared with those who survived (36.79 ± 20.84 mmol/L) (p = 0.002). The analysis confirmed the link between high AOPP levels and mortality risk, independent of other intervenient factors. These results suggest that elevated AOPP levels could be used to predict mortality risk in elderly patients.


[Dynamic study on expression of gelatinase A and its natural inhibitor during invasion and metastasis of induced lung cancer in Wistar rats].
To investigate the dynamic expression and its relation of gelatinase A (MMP-2), its natural inhibitor (TIMP-2) and DNA index (DI) changes during carcinogenesis, invasion and metastasis in Wistar rats. Squamous cell carcinoma of lung was induced with 3-methylcholanthrene (MCA) and diethyinitrosamine (DEN) in iodized oil by left intra-bronchial instillation in 80 Wistar rats. Immrno histochemistay (IHC) and in situ hybridigation were used in the monitor of MMP-2, TIMP-2 proteins and mRNA expression during invasion and metastasis of lung cancer in these rats, DNA index (DI) value was measured by guantitatove image analysis on feulgen stained sections. Along with the carcinogenis, the average poritive MNP-2 and TIMP-2 expressions increased, with positive rates of 8.5% - 85.7% and 6.4% - 35.7%. DI value also underwent the same changes (1.47 +/- 0.54) - (2.87 +/- 0.55). The difference of MMP-2 expression in carcinoma in situ versus early carcinoma and early carcinoma versus metastatic carcinoma are statistically significant (P < 0.05). Companing lung carcinome, the contrel group and non-cancerous lesions, the elevation of MNP-2 and TIMP-2 expressions were also sigmificant (P < 0.01). The DI elevation in carcinoma in situ and dysplasia were obviously significant (P < 0.05). Meanwhile a negative relation was noted in TINP-2 and MMP-2 expressions during carcinogenesis. There was a positive relation between MMP-2 expression and DNA poikiloidy (P < 0.01), which was related to the close relationship between MMP-2 and metastasis in advanced rat lung carcinoma (P < 0.05). The excess degradation and disruption of basement membranes by activated MMP-2 may be a key step in inducing lung cancer invasion and metastasis. The imbalance between MMP and TIMP may be a critical factor which affects biologic behavior of lung carcinogenesis, invasion and metastasis.


[Studies on the breeding by ion implantation and cultivation of mycophenolic acid producing strain].
Mycophenolic acid is produced by aerobic fermentation of several Penicillium species. It has a broad spectrum of activity like antitumor activity, antiviral, anti-psoriatic, immunosuppressive and anti-inflammatory activity. It also exhibits antibacterial and antifungal activities. The immunosuppressive effect of MPA has been important in treatment of organ rejection after organ transplant surgery. There is a continuous need to find improved process for efficiently obtaining superior MPA producing mutants. In recent years, the ion implantation technique has been widely applied in many fields and has been drawn morn concern. However there is no report in the field of mutational breeding of MPA producing strain. Penicillium brevicompactum M-51 was derived from MPA producing strain F-663 by varied mutational methods including U.V. and microwave irradiation. In the process of increasing the production of MPA from P. brevicompactum M-51, a mutant strain M-163 was obtained by means of N+ ion implantation. An decline-increase-decline tendency of strain survival rates was observed when the strain was implanted by N+ ion with dose from 20 2.6 x 10(13) ions/cm2 to 180 x 2.6 x 10(13) ions/cm2 under implantation energy 15 keV. It apparently appeared "saddle shape". And under the implantation dose of 140 x 2.6 x 10(13) ions/cm2, the variation rate and the positive variation rate of the strain had reached the highest values 88.9% and 63.4%, respectively. The HPLC results showed that MPA yield of P. brevicompactum M-163 was improved by 30.1%, and its productivity was rather stable through successive transfer of cultures. The effect of seed growth time on yield of MPA was studied, and the best seed age was 24h after incubation. In the mean time, the fermentative condition of M-163 was studied through orthogonal design. The major ingredients being investigated included carbon and nitrogen sources. Finally the optimized fermentation medium was obtained. The yield of MPA reached 2819g/mL in the optimized submerged fermentation progress. In conclusion, N+ ion implantation had been proven to be effective for mutational breeding of P. brevicompactum M-51. By means of N+ ion implantation and optimizing the fermentative condition, the yield of MPA was increased by 20.2 times than the wild-type stain F-663.


Multilevel nerve stimulator-guided paravertebral block as a sole anesthetic technique for breast cancer surgery in morbidly obese patients.
In this case series, we present the effectiveness of multilevel nerve stimulator-guided paravertebral block (PVB) technique in obese women of body mass index ≥30 kg/m(2) undergoing breast cancer surgery with or without axillary dissection. Twenty-six obese women were included in this case series. Block classification, hemodynamics and complication rate, postoperative nausea and vomiting, postoperative analgesic consumption, post-anesthesia care unit (PACU) stay, and hospital stay were recorded. All patients were hemodynamically stable during the operation, and no complications were noted. Patients stayed 69 min on average in the PACU and were discharged within 2 days. Confirmation of the landmark was established from the initial attempt in 61.5%. Surgical PVB was achieved in 76.9% of the patients; the failure rate of the technique was 11.5%. This case series suggested that the multilevel nerve stimulator-guided PVB may be an effective technique for obese patients undergoing breast cancer surgery, although further studies are needed to compare PVB and general anesthesia.


Macroprolactinaemia: contribution to hyperprolactinaemia in a district general hospital and evaluation of a screening test based on precipitation with polyethylene glycol.
For a period of 12 months all samples submitted for serum prolactin (PRL) assay and with PRL > 700 mU/L were examined by gel filtration chromatography. In 17 (25%) of 69 samples we found macroprolactin. The Delfia and Immuno 1 immunoassay systems gave similar PRL results with samples containing macroprolactin whereas the ACS 180 system gave lower results. With the Delfia and Immuno 1 systems samples containing substantial quantities of macroprolactin showed low recovery of PRL after precipitation with polyethylene glycol 6000 (PEG 6000) and this technique can be used as a screening test for macroprolactinaemia. We conclude that macroprolactinaemia is a common phenomenon and, in assays which detect this species, is a common cause of hyperprolactinaemia. Macroprolactinaemia may contribute to the difficulty in establishing an upper limit of the reference range for serum PRL. In our experience, patients with macroprolactinaemia do not exhibit features of the hyperprolactinaemia syndrome and it is important to recognize macroprolactin as the cause of hyperprolactinaemia to avoid unnecessary investigation and treatment.


Lactoylglutathione lyase, a critical enzyme in methylglyoxal detoxification, contributes to survival of Salmonella in the nutrient rich environment.
Glyoxalase I which is synonymously known as lactoylglutathione lyase is a critical enzyme in methylglyoxal (MG) detoxification. We assessed the STM3117 encoded lactoylglutathione lyase (Lgl) of Salmonella Typhimurium, which is known to function as a virulence factor, due in part to its ability to detoxify methylglyoxal. We found that STM3117 encoded Lgl isomerises the hemithioacetal adduct of MG and glutathione (GSH) into S-lactoylglutathione. Lgl was observed to be an outer membrane bound protein with maximum expression at the exponential growth phase. The deletion mutant of S. Typhimurium (Δlgl) exhibited a notable growth inhibition coupled with oxidative DNA damage and membrane disruptions, in accordance with the growth arrest phenomenon associated with typical glyoxalase I deletion. However, growth in glucose minimal medium did not result in any inhibition. Endogenous expression of recombinant Lgl in serovar Typhi led to an increased resistance and growth in presence of external MG. Being a metalloprotein, Lgl was found to get activated maximally by Co(2+) ion followed by Ni(2+), while Zn(2+) did not activate the enzyme and this could be attributed to the geometry of the particular protein-metal complex attained in the catalytically active state. Our results offer an insight on the pivotal role of the virulence associated and horizontally acquired STM3117 gene in non-typhoidal serovars with direct correlation of its activity in lending survival advantage to Salmonella spp.


Attachment to God, Images of God, and Psychological Distress in a Nationwide Sample of Presbyterians.
Drawing broadly on insights from attachment theory, the present study outlines a series of theoretical arguments linking styles of attachment to God, perceptions of the nature of God (i.e., God imagery), and stressful life events with psychological distress. Main effects and potential stress-moderator effects are then evaluated using data from a nationwide sample of elders and rank-and-file members of the Presbyterian Church (U.S.A.). Key findings indicate that secure attachment to God is inversely associated with distress, whereas both anxious attachment to God and stressful life events are positively related to distress. Once variations in patterns of attachment to God are controlled, there are no net effects of God imagery on levels of distress. There is only modest support for the hypothesis that God images moderate the effects of stressful life events on psychological distress, but no stress-moderator effects were found for attachment to God. Study limitations are identified, and findings are discussed in terms of their implications for religion-health research, as well as recent extensions of attachment theory.


[Role of muscles stabilizing the human shoulder joint].
Clinical observations of the surgeon-traumatologist demonstrate the role of the muscles inserting to the greater and smaller tubercles of the humerus for fixating the shoulder joint.


A combined hematoxylin-eosin, alkaline phosphatase and high-resolution microradiographic study of lacunes.
Lacunar infarcts (lacunes) are small, cystic lesions of the brain in patients with hypertension and/or diabetes. In order to improve our understanding of the relationship between lacunes and their blood vessels, the alkaline phosphatase (AP) technique of microvascular staining and high-resolution microradiography were employed in a three-dimensional study of 31 lacunes from 15 hypertensive subjects. A second aim was to compare the usefulness of the techniques with that of routine hematoxylin-eosin (HE) stain employed by previous investigators. Arteries were traced throughout their course. The lesions identified included intimal hyperplasia, hyalinization and atherosclerosis with variable narrowing and occasional occlusions. The small arterioles in the lacune cavities supplied adjacent intact brain. The AP technique clearly distinguished true lacunar infarcts from dilated perivascular spaces. AP and microradiography were superior to HE in showing the three dimensional details with far fewer sections. Four different types of relationships were observed between nutrient arteries and their lacunes, indicating that patterns of vascular involvement can be elucidated in brains of subjects dying with lacunar syndromes by using special techniques such as AP. Such patterns can be correlated with clinical risk factors such as hypercholesterolemia, hypertension etc., singly and in combination. Our data suggest that the natural history of lacunar infarcts may be changing in two ways--the number of lacunes per patient may be diminishing and white matter involvement may be increasing. Possible explanations for these changes are suggested.


The relationship between Helicobacter pylori infection and gastric adenocarcinoma in Northern Iran.
Colonization of the human stomach with Helicobacter pylori induces chronic gastritis and is associated with the development of gastric and duodenal ulcers, gastric carcinoma, and gastric mucosa-associated lymphoid tissue lymphoma. Infection with an H. pylori strain containing the cytotoxin-associated (cagA) gene (a marker for a pathogenicity island) may increase the risk of atrophic gastritis and gastric cancer. The exact role of H. pylori in gastric carcinogenesis is still being investigated. Hence, we assessed whether H. pylori infection is associated with the development of gastric adenocarcinoma in northern Iran. Gastric biopsy specimens from 168 patients suffering from gastric adenocarcinoma, gastric ulcer, and non-ulcer dyspepsia were analyzed by means of the polymerase chain reaction. H. pylori was detected in the gastric mucosa of 34 (75.5%) gastric adenocarcinoma, 56 (88.8%) gastric ulcer, and 36 (60%) non-ulcer dyspepsia. In patients with gastric adenocarcinoma, the cagA was less commonly found than those in noncancer patients (4/34 vs. 58/92, p < 0.05). Our work suggests that although H. pylori infection is significantly associated with gastric adenocarcinoma in northern Iran, the cagA is not the dominant virulence in development of gastric adenocarcinoma.


Absence of inferior pancreaticoduodenal artery compensated by dorsal pancreatic artery: a case report.
Consideration of new aspects of vascular anatomy of the pancreaticoduodenal region is required for further improvement of surgical procedures. Awareness of variations in arteries supplying the duodenum and pancreas can help in minimizing the blood loss during surgery. We report the absence of inferior pancreaticoduodenal artery, which was compensated by a large dorsal pancreatic artery arising from proximal part of the splenic artery. This artery replaced inferior pancreaticoduodenal artery and formed a large loop of anastomosis with the gastroduodenal artery.


Symptoms of depression in individuals with obstructive sleep apnea may be amenable to treatment with continuous positive airway pressure.
To assess the reversibility of symptoms of depression using continuous positive airway pressure (CPAP) in patients with obstructive sleep apnea (OSA). Patients referred to our center for evaluation of OSA who had a respiratory disturbance index (RDI) > or = 15 and who demonstrated a significant response to CPAP (> or = 50% drop in RDI) were evaluated for the symptoms of depression using the Beck Depression Inventory (BDI), and then reassessed after 4 to 6 weeks of treatment with CPAP at home. In this group of patients, the institution of CPAP therapy resulted in a significant (p < 0.0001) decrease in those symptoms of depression as assessed by the BDI (BDI at baseline, 4.1 +/- 3.7; BDI after CPAP, 1.0 +/- 2.0). This change in BDI was noted both in those individuals who had received an antidepressant prescription prior to referral, and in those who had not. An analysis of variance failed to reveal any effect on these data related to gender or baseline RDI. Patients with OSA may present to their primary care physician with symptoms suggesting a diagnosis of depression. In some of these individuals, the symptoms of depression may be ameliorated with CPAP.


Simplified clinical procedure for fitting and removing inlays/onlays prior to cementation.
This article describes a procedure in which polytetrafluoroethylene (PTFE) tape is used as a liner for fitting intracoronally retained, indirect restorations. The minimal thickness of the tape allows complete seating and confirmation of marginal fit of restorations during try-in, yet the tape is tough enough to permit trouble-free removal of the restoration afterward. Protection against inadvertent loss of the restoration can be gained if a knot is placed close to the occlusal surface of the restoration prior to its removal.


Formulation, sensory evaluation, proximate composition and storage stability of cassava strips produced from the composite flour of cassava and cowpea.
The study developed an acceptable formula for the production of cassava strips (a deep fried product) using composite flour of cassava/cowpea at four different levels of cowpea substitutions (100:0, 90:10, 80:20, and 70:30). Sensory properties, proximate composition, and shelf life at ambient temperature were determined. Proximate composition, shelf life, and microbial analysis were further done on the most preferred sample (80:20) and the control (100:0). Results showed a significant difference between the tested sample and the control, except in their moisture (4.1%-4.2%) and fiber (5.0%) contents which were similar. Protein content increased from 0.9% to 2.6%, fat 24.6% to 28.5%, carbohydrate 59.7% to 61.1%, and ash 1.8% to 2.5% in both control and most preferred sample. Results showed no changes in their peroxide value (2.4 mEq/kg), moisture content (4.1%), and bacterial count of 0 × 102 CFU/g at ambient storage temperature for 4 weeks. The addition of cowpea flour increased the nutritional quality of the cassava strips.


Application of contrast-enhanced ultrasound before inferior vena cava filter recovery.
This study aims to investigate the clinical value of contrast-enhanced ultrasound (CEU) before temporary inferior vena cava filter (IVCF) recovery in patients with deep venous thrombosis, in order to provide ultrasound signs for the recovery of IVCF in clinical practice. The CEU manifestations of patients with deep vein thrombosis before temporary IVCF recovery were retrospectively analyzed. With the manifestations of digital subtraction angiography (DSA) or results of the surgical recovery of IVCF as the standard, the detection rate of a thrombus in IVCF was compared between conventional ultrasound and CEU, and the role of CEU in detecting complications of IVCF was analyzed. In the 103 patients with IVCF, conventional ultrasound and CEU did not reveal any filter displacement and deformation, as well as infection. In 86 patients, filters were successfully recovered under DSA. In one patient, the filter was removed surgically. In 16 patients, recovery failed or was given up, and inferior vena cava (IVC) angiography was performed. The recovery rate of IVCF was 84.5%. Among all cases, thrombi were found within the filters or around the filter in 23 patients. The detection rate of thrombi was 47.8% (11/23) by conventional ultrasound and 82.6% (19/23) by CEU, and the difference between these two methods was statistically significant (P<0.05). CEU drew a misdiagnosis of thrombus within the filter in one patient, and the diagnosis was not confirmed after the recovery of the filter. The diagnostic coincidence rate of CEU for thrombus in the IVCF was 95.1%, and the positive predictive value was 95%. In another case, the foot of the IVCF pierced out of the wall of the IVC into the intestinal wall; and this was confirmed by DSA. Hence, recovery was given up. Thrombosis is the main complication after IVCF placement. CEU revealed typical manifestations of thrombi in the IVC, and has overcome the shortcoming of color Doppler ultrasound such as angular dependence. Its detection rate of thrombi within the IVCF was higher compared with conventional ultrasound. Hence, this method can serve as a simple and accurate method for evaluating whether IVCF is suitable for recovery. This study provides a reliable imaging basis for the clinical selection of the means and time of IVCF recovery, reducing unnecessary intervention procedure.


Chronic granulocytic leukemia cutis treated with hydroxyurea. Report of a case.
The clinical course of a patient with chronic granulocytic leukemia cutis associated with myeloid metaplasia is described. Cutaneous manifestations of leukemia appeared only at the sites of bone marrow aspiration and vena puncture. Radiotherapy to both spleen and skin and chemotherapy with busulfan failed to control spreading cutaneous lesions. Treatment with hydroxyurea was followed by a marked reduction in spleen size, a decrease in white cell count and healing of the skin lesions.


Antitumor effect of endostatin overexpressed in C6 glioma cells is associated with the down-regulation of VEGF.
Endostatin is an anti-angiogenic agent that blocks endothelial cell proliferation, tumor growth, and metastasis. Several lines of direct evidence show that gliomas express high levels of endostatin. However, the anti-angiogenic activity and cellular mechanisms of endostatin from tumor cells have not been completely elucidated. In this study, we established C6 glioblastoma (GBM) xenografts in nude mice by subcutaneously injecting glioma cell lines, C6-null cells, and stable transfected-C6 cells overexpressing mock vector (C6-mock) and endostatin (C6-endo). We found that overexpression of endostatin in C6-endo cells significantly suppressed the expression of VEGF in tumor cells in vivo as well as in vitro. Furthermore, the tumor growth derived from C6-endo cells was inhibited. Our data demonstrate that endostatin could play a direct role in inhibiting tumor cells, and suggest that enhancing endostatin expression in gliomas could be an effective treatment strategy.


Utility of methylation markers in cervical cancer early detection: appraisal of the state-of-the-science.
We wanted to identify the most promising methylation marker candidates for cervical cancer early detection. A systematic literature review was performed in Medline and weighted average frequencies for methylated genes stratified by tissue source and methods used were computed. 51 studies were identified analyzing 68 different genes for methylation in 4376 specimens across all stages of cervical carcinogenesis. 15 genes, DAPK1, RASSF1, CDH1, CDKN2A, MGMT, RARB, APC, FHIT, MLH1, TIMP3, GSTP1, CADM1, CDH13, HIC1, and TERT have been analyzed in 5 or more studies. The published data on these genes is highly heterogeneous; 7 genes (CDH1, FHIT, TERT, CDH13, MGMT, TIMP3, and HIC1) had a reported range of methylation frequencies in cervical cancers of greater than 60% between studies. Stratification by analysis method did not resolve the heterogeneity. Three markers, DAPK1, CADM1, and RARB, showed elevated methylation in cervical cancers consistently across studies. There is currently no methylation marker that can be readily translated for use in cervical cancer screening or triage settings. Large, well-conducted methylation profiling studies of cervical carcinogenesis could yield new candidates that are more specific for HPV-related carcinogenesis. New candidate markers need to be thoroughly validated in highly standardized assays.


Antibacterial screening of Rumex species native to the Carpathian Basin and bioactivity-guided isolation of compounds from Rumex aquaticus.
Plants belonging to the genus Rumex (family Polygonaceae) are used worldwide in traditional medicine for the treatment of various diseases caused by different microorganisms (e.g. bacteria-related dermatologic conditions, dysentery and enteritis). The present study focused on the antibacterial screening of Rumex species native to the Carpathian Basin, and isolation of compounds from one of the most efficient species, Rumex aquaticus. The antibacterial effects of n-hexane, chloroform and aqueous fractions of methanol extracts prepared from different parts of 14 Rumex species (R. acetosella, R. acetosa, R. alpinus, R. aquaticus, R. conglomeratus, R. crispus, R. hydrolapathum, R. obtusifolius subsp. obtusifolius, R. obtusifolius subsp. subalpinus, R. patientia, R. pulcher, R. scutatus, R. stenophyllus and R. thyrsiflorus) were investigated against Staphylococcus epidermidis, S. aureus, MRSA, Bacillus subtilis, Moraxella catarrhalis, Streptococcus pyogenes, S. pneumoniae, S. agalactiae, Pseudomonas aeruginosa, Escherichia coli and Klebsiella pneumoniae using the disc diffusion method. Mainly the n-hexane and chloroform extracts prepared from the roots of the plants displayed high antibacterial activity (inhibition zones>15mm) against one or more bacterial strains. The highly active extracts of the aerial part and root of R. aquaticus were subjected to a multistep separation procedure. 19 Compounds, among them naphthalenes (musizin, and its glucoside, torachrysone-glucoside, 2-methoxystypandrone), anthraquinones (emodin, chrysophanol, physcion, citreorosein, chrysophanol-8-O-glucoside), flavonoids (quercetin, quercetin-3,3'-dimethylether, isokaempferide, quercetin 3-O-arabinoside, quercetin 3-O-galactoside, catechin), stilbenes (resveratrol, piceid), and 1-stearoylglycerol were isolated from the plant. The antibacterial activities of isolated compounds were determined, and it was observed that especially naphthalenes exerted remarkable antibacterial effects against several bacterial strains.


Posterior lesser trochanter line should not be used as reference for assessing femoral version in CT scans: a retrospective reliability and agreement study.
Background The estimation of femoral version in preoperative planning of total hip arthroplasty and to assess complications after total hip arthroplasty is crucial. Recent studies have recommended the posterior lesser trochanter line as an intraoperative reference for estimating femoral version. We hypothesized, that if there is a correlation, the posterior lesser trochanter line could be used to assess femoral version in computed tomography (CT) scans. Purpose To evaluate the correlation between the posterior lesser trochanter line and the posterior femoral condyle axis. Material and Methods CT scans of 126 patients after unilateral total hip arthroplasty were analyzed by means of a newly developed digital planning software for CT scans. Both hips were measured, the angle between the posterior lesser trochanter line and the posterior femoral condyle axis was determined, and the relationship between both lines was evaluated. Results We found significant differences between male and female patients ( P < 0.001) and between left and right femora ( P = 0.001). There was no significant difference between healthy hips and hips with osteoarthritis after total hip arthroplasty ( P = 0.901). Conclusion There is no reliable correlation between posterior lesser trochanter line and posterior femoral condyle axis. Therefore, posterior lesser trochanter line should not be used to assess femoral version in CT scans. As a consequence, the gold standard for measuring femoral version should still be a three-dimensional CT scan of the whole femur.