Design and Realization of Integrated Management System for Data Interoperability between Point-of-Care Testing Equipment and Hospital Information System.
The purpose of this study was to design an integrated data management system based on the POCT1-A2, LIS2-A, LIS2-A2, and HL7 standard to ensure data interoperability between mobile equipment, such as point-of-care testing equipment and the existing hospital data system, its efficiency was also evaluated. The method of this study was intended to design and realize a data management system which would provide a solution for the problems that occur when point-of-care testing equipment is introduced to existing hospital data, after classifying such problems into connectivity, integration, and interoperability. This study also checked if the data management system plays a sufficient role as a bridge between the point-of-care testing equipment and the hospital information system through connection persistence and reliability testing, as well as data integration and interoperability testing. In comparison with the existing system, the data management system facilitated integration by improving the result receiving time, improving the collection rate, and by enabling the integration of disparate types of data into a single system. And it was found out that we can solve the problems related to connectivity, integration and interoperability through generating the message in standardized types. It is expected that the proposed data management system, which is designed to improve the integration point-of-care testing equipment with existing systems, will establish a solid foundation on which better medical service may be provided by hospitals by improving the quality of patient service.


[Angiomatoid malignant fibrous histiocytoma. Clinico-pathologic and immunohistochemical study of a case].
The results of a clinico-pathologic and immunohistochemical study of an angiomatoid malignant fibrous histiocytoma are reported. This lesion is an uncommon tumor of the superficial soft tissue, of low-grade malignancy, typical of adolescence and early adult life. The patient, a 10-year-old female, presented with a mass of the left popliteal fossa, treated with surgical excision of the tumor and the surrounding cutaneous and subcutaneous tissue. The tumor was a well-circumscribed, firm nodule measuring 2.5 x 1.0 cm. Histologically, it showed aggregates of spindled and rounded cells often lining cystic cavities filled with blood. The immunohistochemical analysis revealed a cytoplasmatic immunoreactivity for KP1 (CD68), which was taken as indicating that the tumoral mesenchymal cells had acquired phagocytic capacities. The patient is well without signs of local recurrence or metastatic disease 4 years after the surgical treatment. The case reported confirms that appropriate local surgery is the elective therapy for this type of soft tissue tumor.


Overexpression of TAZ promotes cell proliferation, migration and epithelial-mesenchymal transition in ovarian cancer.
The Hippo pathway is dysregulated in multiple types of human cancer, including ovarian cancer. Nuclear expression of yes-associated protein 1 (YAP1), a downstream transcription coactivator of the Hippo pathway, has been demonstrated to promote tumorigenesis in ovarian cancer and may serve as a poor prognostic indicator. However, transcriptional coactivator with PDZ binding motif (TAZ), a downstream target of the Hippo pathway and paralog of YAP in mammalian cells, has not been fully investigated in ovarian cancer. The present study aimed to investigate the dysregulation and biological function of TAZ in ovarian cancer. Reverse transcription-quantitative polymerase chain reaction and western blotting revealed that TAZ mRNA and protein levels, respectively, were upregulated in ovarian cancer, and a meta-analysis of ovarian cancer microarray datasets identified that increased expression of TAZ mRNA is correlated with poor prognosis in patients with ovarian cancer. In addition, TAZ-knockdown in ovarian cancer cells demonstrated that TAZ regulates the migration, proliferation and epithelial-mesenchymal transition of ovarian cancer cells. Furthermore, pharmacological disruption of the YAP/TAZ/TEA domain protein complex resulted in a decrease in ovarian cancer cell migration, proliferation and vimentin expression. The results of the present study indicate that the overexpression of TAZ is important in the development and progression of ovarian cancer, and may function as a potential drug target for treatment of this disease entity.


Calibration of instruments measuring reflectance and transmittance.
In calibrating instruments that measure reflectance and transmittance to a few tenths of a percent, it is desirable to have a sample that is smooth, uniform, nonabsorbing, and stable, so that the measured reflectance and transmittance will add to unity, and no light will be either absorbed or scattered outside the collecting optics. A properly prepared, thin, transparent, high index' film (such as CeO(2) or TiO(2)) on a fused quartz substrate is suitable for a calibration sample. Equations are given to calculate the reflectance and transmittance both at normal incidence and nonnormal incidence, as well as to correct for multiple reflections in the substrate and reflection from the back surface of the substrate. Factors such as aging and optical thickness nonuniformity, which can introduce systematic errors into the calibration, must be minimized by proper choice of materials and preparation techniques.


Prognostic value of matrix metalloproteinase-2 (MMP-2) expression in endometrial endometrioid adenocarcinoma.
Matrix metalloproteinase-2 (MMP-2), a member of the zinc-dependent metalloproteinase gene family, plays an important role in cancer invasion and metastasis. The current study aimed to evaluate whether the expression of MMP-2 is associated with survival in patients with endometrial endometrioid adenocarcinoma. The MMP-2 immunoreactive protein was evaluated from endometrioid adenocarcinoma of the endometrium in 112 patients treated at Oulu University Hospital, Finland. The median follow-up time was 88 months. The expression of MMP-2 was studied immunohistochemically in paraffin-embedded tissue samples from the primary tumours by using a specific monoclonal antibody to MMP-2. The MMP-2 protein was found in 80% of the primary tumours, including all histological grades. All grade 3 tumors were MMP-2-positive. At the end of the study period, 21 of the 22 (95%) patients presenting MMP-2-negative immunostaining were alive, whereas the corresponding figure for those with MMP-2-positive tumours was 78 out of 90 (87%). These data suggest that MMP-2 immunostaining negativity might be linked with a favourable prognosis in endometrial endometrioid adenocarcinoma.


Effectiveness and kinetics of ferrate as a disinfectant for ballast water.
This study examined whether ferrate could meet the international standards for successful ballast water treatment, including final concentrations of less than 1 CFU/mL of Enterococci, less than 2.5 CFU/mL of Escherichia coli, and less than 1 CFU/100 mL of Vibrio cholerae. Pure cultures of E. coli, Klebsiella pneumoniae, and V. cholerae, and a mixed culture of Enterococcus faecium and E. faecilis were grown in saline solution to simulate ballast water and were treated with dosages of ferrate ranging from 0.25 to 5.0 mg/L. A ferrate dose of 5 mg/L resulted in complete disinfection of all organisms tested, and smaller dosages were also very effective. Tailing was consistently observed, and the Hom's model (1972) appeared to most accurately represent the action of ferrate on these organisms. Salinity and pH did not adversely affect results, and regrowth was not a problem. Ferrate shows good potential as an effective disinfectant in the treatment of ballast water.


[Enhanced metastatic potential of rat RG2 glioblastoma cells transfected with CD44v (meta-1) sequence].
It is extremely rare for brain glioblastoma to metastasize extracranially. To elucidate whether glioblastoma cells remain non-metastatic when ectopically transplanted and CD44v gene is introduced, glioblastoma RG2-m cells were transfected with CD44v gene sequence encompassing v3-v10. After selection in culture medium with G418, CD44v expressing RG2-a cells were cloned. With RG2-a and its parental counterpart RG2-m, a series of experimental metastasis assays were performed in syngeneic F344 rats. When inoculated subcutaneously and in the foot-pad, both RG2-m and RG2-a cells metastasized spontaneously to the regional lymph nodes and lungs. However, metastasis of RG2-a was more severe and more organs were involved when compared to that of the parental RG2-m cells. The results indicate that glioblastoma becomes metastatic if extracranially transplanted and expression of CD44v would further enhance its metastatic patential.


[Experimental study on the characteristic features of sympathetic nervous system reactions in dogs with obstructive jaundice].
Possible abnormalities in the sympathetic nervous system responsible for circulatory disturbances with obstructive jaundice were investigated by determining the reactions of the heart and peripheral blood vessels using alpha.beta receptor stimulants or blockers. Mongrel dogs were randomly assigned to three groups: untreated (UT) and sham-operated (SO) controls and 3-week-old bile duct ligated (BDL). Under anesthesia with Nembutal, circulatory parameters and blood catecholamine concentration were measured. In term of alpha- and beta-adrenergic reactions, reactions in the sympathetic nervous system to alpha- and beta-receptor stimulants were examined. Mean arterial pressure (MAP) and heart rate were used as an alpha-adrenergic parameter and a beta-adrenergic parameter, respectively. The hemodynamic study in BDL group was characterized by a reduction in MAP (p less than 0.05), total peripheral resistance (p less than 0.005) and left ventricular stroke work (LVSW) (p less than 0.05) and by an increase in cardiac index (p less than 0.05). The blood norepinephrine concentration was significantly increased in jaundice (p less than 0.01). Reaction to the beta-receptor stimulant was significantly decreased in BDL group. In response to the alpha-receptor stimulant, lower reactivity was found in some animals in BDL group in comparison to SO group. Taking this into consideration with the increase in blood norepinephrine and the decrease in LVSW, the presence of abnormalities particularly in the beta-adrenergic system (receptor, cardiac muscle etc.) in jaundice is suggested to be a characteristic feature of reactions in the sympathetic nervous system. Such abnormalities are speculated to be responsible for postoperative shock.


On the effects of reflected waves in transient shear wave elastography.
In recent years, novel quantitative techniques have been developed to provide noninvasive and quantitative stiffness images based on shear wave propagation. Using radiation force and ultrafast ultrasound imaging, the supersonic shear imaging technique allows one to remotely generate and follow a transient plane shear wave propagating in vivo in real time. The tissue shear modulus, i.e., its stiffness, can then be estimated from the shear wave local velocity. However, because the local shear wave velocity is estimated using a time-of- flight approach, reflected shear waves can cause artifacts in the estimated shear velocity because the incident and reflected waves propagate in opposite directions. Such effects have been reported in the literature as a potential drawback of elastography techniques based on shear wave speed, particularly in the case of high stiffness contrasts, such as in atherosclerotic plaque or stiff lesions. In this letter, we present our implementation of a simple directional filter, previously used for magnetic resonance elastography, which separates the forward- and backward-propagating waves to solve this problem. Such a directional filter could be applied to many elastography techniques based on the local estimation of shear wave speed propagation, such as acoustic radiation force imaging (ARFI), shearwave dispersion ultrasound vibrometry (SDUV), needle-based elastography, harmonic motion imaging, or crawling waves when the local propagation direction is known and high-resolution spatial and temporal data are acquired.


Probe for sensitive direct determination of sulphide ions based on gold nanoparticles.
A highly selective and sensitive optical sensor based on localised surface plasmon resonance (LSPR) of gold nanoparticles (AuNPs) for the determination of a sulphide ion in aqueous solution is presented. The existence of sulphide is change the intensity of the LSPR band around 520 nm. In this sensor, sulphide ions were recognised and measured by UV-vis spectrophotometry. Three factors such as pH, time and concentration of AuNPs have been studied. The optimisation of effective parameters is done by one at a time method. This method was simple, rapid and cost efficient for the detection of sulphide. The linear range is 1.00-10.00 (4.16-41.63 µM) ppm with the correlation coefficient of 0.9874 and the detection limit of 0.54 ppm. The relative standard deviation of the reported method is 1.01%.


Depletion of Inositol Polyphosphate 4-Phosphatase II Suppresses Callosal Axon Formation in the Developing Mice.
The corpus callosum is a bundle of nerve fibers that connects the two cerebral hemispheres and is essential for coordinated transmission of information between them. Disruption of early stages of callosal development can cause agenesis of the corpus callosum (AgCC), including both complete and partial callosal absence, causing mild to severe cognitive impairment. Despite extensive studies, the etiology of AgCC remains to be clarified due to the complicated mechanism involved in generating AgCC. The biological function of PI3K signaling including phosphatidylinositol-3,4,5-trisphosphate is well established in diverse biochemical processes including axon and dendrite morphogenesis, but the function of the closely related phosphatidylinositol-3,4,-bisphosphate (PI(3,4)P2) signaling, particularly in the nervous system, is largely unknown. Here, we provide the first report on the role of inositol polyphosphate 4-phosphatase II (INPP4B), a PI(3,4)P2 metabolizing 4-phosphatase in the regulation of callosal axon formation. Depleting INPP4B by in utero electroporation suppressed medially directed callosal axon formation. Moreover, depletion of INPP4B significantly attenuated formation of Satb2-positive pyramidal neurons and axon polarization in cortical neurons during cortical development. Taken together, these data suggest that INPP4B plays a role in the regulating callosal axon formation by controlling axon polarization and the Satb2-positive pyramidal neuron population. Dysregulation of INPP4B during cortical development may be implicated in the generation of partial AgCC.


40-µJ passively CEP-stable seed source for ytterbium-based high-energy optical waveform synthesizers.
We demonstrate experimentally for the first time a ~40-µJ two-octave-wide passively carrier-envelope phase (CEP)-stable parametric front-end for seeding an ytterbium (Yb)-pump-based, few-optical-cycle, high-energy optical parametric waveform synthesizer. The system includes a CEP-stable white-light continuum and two-channel optical parametric chirped pulse amplifiers (OPCPAs) in the near- and mid-infrared spectral regions spanning altogether a two-octave-wide spectrum driven by a regenerative amplifier. The output pulses are compressed and fully characterized to demonstrate the well-behaved spectral phase of this seed source.


Continent-Wide Climatic Variation Drives Local Adaptation in North American White Clover.
Climate-associated clines in adaptive polymorphisms are commonly cited as evidence of local adaptation within species. However, the contribution of the clinally varying trait to overall fitness is often unknown. To address this question, we examined survival, vegetative growth, and reproductive output in a central US common garden experiment using 161 genotypes of white clover (Trifolium repens L.) originating from 15 locations across North America. White clover is polymorphic for cyanogenesis (hydrogen cyanide release upon tissue damage), a chemical defense against generalist herbivores, and climate-associated cyanogenesis clines have repeatedly evolved across the species range. Over a 12-month experiment, we observed striking correlations between the population of origin and plant performance in the common garden, with climatic distance from the common garden site predicting fitness more accurately than geographic distance. Assessments of herbivore leaf damage over the 2015 growing season indicated marginally lower herbivory on cyanogenic plants; however, this effect did not result in increased fitness in the common garden location. Linear mixed modeling suggested that while cyanogenesis variation had little predictive value for vegetative growth, it is as important as climatic variation for predicting reproductive output in the central United States. Together, our findings suggest that knowledge of climate similarity, as well as knowledge of locally favored adaptive traits, will help to inform transplantation strategies for restoration ecology and other conservation efforts in the face of climate change.


Analgesic effects of 5-HT3 receptor antagonists.
Current research suggests an involvement of 5-HT3 receptors in peripheral and central perception and processing of pain as well as in inflammation. Tropisetron and other selective 5-HT3 receptor antagonists have been used successfully for pain reduction and treatment of related symptoms in patients diagnosed with fibromyalgia. This article proposes a concept of the underlying pathophysiology and mechanisms of action of 5-HT3 receptor antagonists in the context of the relevant clinical data on their application in patients with rheumatic disease.


Health impact assessment from building life cycles and trace metals in coarse particulate matter in urban office environments.
This study intends to determine the health impacts from two office life cycles (St.1 and St.2) using life cycle assessment (LCA) and health risk assessment of indoor metals in coarse particulates (particulate matter with diameters of less than 10µm). The first building (St.1) is located in the city centre and the second building (St.2) is located within a new development 7km away from the city centre. All life cycle stages are considered and was analysed using SimaPro software. The trace metal concentrations were determined by inductively couple plasma-mass spectrometry (ICP-MS). Particle deposition in the human lung was estimated using the multiple-path particle dosimetry model (MPPD). The results showed that the total human health impact for St.1 (0.027 DALY m-2) was higher than St.2 (0.005 DALY m-2) for a 50-year lifespan, with the highest contribution from the operational phase. The potential health risk to indoor workers was quantified as a hazard quotient (HQ) for non-carcinogenic elements, where the total values for ingestion contact were 4.38E-08 (St.1) and 2.59E-08 (St.2) while for dermal contact the values were 5.12E-09 (St.1) and 2.58E-09 (St.2). For the carcinogenic risk, the values for dermal and ingestion routes for both St.1 and St.2 were lower than the acceptable limit which indicated no carcinogenic risk. Particle deposition for coarse particles in indoor workers was concentrated in the head, followed by the pulmonary region and tracheobronchial tract deposition. The results from this study showed that human health can be significantly affected by all the processes in office building life cycle, thus the minimisation of energy consumption and pollutant exposures are crucially required.


Day-case tonsillectomy: a review of the literature.
Adenotonsillectomies are performed increasingly as day cases in North America and Canada. This paper analyses reports where such tonsillectomies were performed. It is possible to successfully select a group with lower risk of complications. Haemorrhage occurs either early in the post-operative period or later than 24 hours after operation. With good organization tonsillectomies can be safely performed as day cases.


The effect of test-enhanced spaced learning on the otolaryngology board and annual examination results: A quasi-experimental study.
In the test-enhanced spaced learning, educational contents are presented in small packages of well-developed test questions with a defined frequency to the learners. It is not clear that applying this educational style might have a positive impact on the summative assessment. Therefore, in this study, we assessed the effect of the test-enhanced spaced learning on the otolaryngology board and annual examinations of residency training. In a quasi-experimental study with consecutive sampling, all forty-four residents of otolaryngology in four levels of training in 2016 at Tehran University of Medical Sciences (TUMS) received daily-standardized multiple-choice questions with a twice-repeated frequency of 10 days. Individual feedback according to one's response to each test was provided. The results of national board and annual exam were compared with the same results of all residents of other universities and previous year TUMS' residents for whom spaced learning were not applied and they were considered as the control groups. The board exam had two parts, multiple-choice questions, and computer-based clinical examination. The annual exam format was multiple choice questions. The total score for each one was 150. Student's t-test and Mann-Whitney U test were used for comparative analyses. The mean of the board exam results showed statistically significant improvement compared to other medical schools (113.6±10.7 vs. 102.9±13.4 in multiple-choice questions, p-value= 0.048, 118.7±12.5 vs. 54.1±60.0 in the computer-based clinical examination, p-value<0.001), while similar comparison results in the previous year did not show any significant difference. Spaced learning with testing effect may be useful in the clinical education setting to improve the learning outcomes.


Characterization of pneumocystis major surface glycoprotein gene (msg) promoter activity in Saccharomyces cerevisiae.
Major surface glycoprotein (Msg), the most abundant cell surface protein of Pneumocystis, plays an important role in the interaction of this opportunistic pathogen with host cells, and its potential for antigenic variation may facilitate evasion of host immune responses. In the present study, we have identified and characterized the promoter region of msg in 3 species of Pneumocystis: P. carinii, P. jirovecii, and P. murina. Because Pneumocystis cannot be cultured, promoter activity was measured in Saccharomyces cerevisiae, a related fungus, using a yeast vector modified to utilize the gene coding for Renilla luciferase as a reporter gene. The 5'-flanking sequences of msg from all three Pneumocystis species showed considerable promoter activity, with increases in luciferase activity up to 15- to 44-fold above baseline. Progressive deletions helped define an ∼13-bp sequence in each Pneumocystis species that appears to be critical for promoter activity. Electrophoretic mobility shift analysis using P. carinii-specific msg promoter sequences demonstrated binding of nuclear proteins of S. cerevisiae. The 144-bp 5'-flanking region of P. murina msg showed 72% identity to that of P. carinii. The 5'-flanking region of P. jirovecii msg showed 58 and 61% identity to those of P. murina and P. carinii, respectively. The msg promoter is a good candidate for inclusion in a construct designed for genetic manipulation of Pneumocystis species.


Mapping protein-protein interactions within a stable complex of DNA primase and DnaB helicase from Bacillus stearothermophilus.
For the first time, we demonstrate directly a stable complex between a bacterial DnaG (primase) and DnaB (helicase). Utilizing fragments of both proteins, we are able to dissect interactions within this complex and provide direct evidence that it is the C-terminal domain of primase that interacts with DnaB. Furthermore, this C-terminal domain is sufficient to induce maximal stimulation of the helicase and ATPase activities of DnaB. However, the region of DnaB that interacts with the C-terminal domain of primase appears to comprise a surface on DnaB that includes regions from both of the previously identified N- and C-terminal domains. Using a combination of biochemical and physical techniques, we show that the helicase-primase complex comprises one DnaB hexamer and either two or three molecules of DnaG. Our results show that in Bacillus stearothermophilus the helicase-primase interaction at the replication fork may not be transient, as was shown to be the case in Escherichia coli. Instead, primase appears to interact with the helicase forming a tighter complex with enhanced ATPase and helicase activities.


Use of ultrasonography in dysplasia of the immature hip.
Real-time ultrasonography reconstruction is an imaging technique of relatively recent origin that has dramatically affected the diagnosis and treatment of patients with hip dysplasia. Ultrasonography is replacing conventional radiography as the primary method of diagnosing hip dysplasia and evaluating its treatment during the first six to nine months of life. While conventional radiography reveals a familiar two-dimensional image of ossified structures and to a much lesser extent, soft-tissue structures, it has disadvantages that include ionizing radiation, a relative inability to evaluate unossified tissues, and an inability to gain three-dimensional information without supplemental techniques.


Forced eruption of a solitary nonrestorable tooth using mini-implants as anchorage: rationale and technique.
The need to place a restoration's margins on sound tooth material may require crown lengthening or forced eruption. The latter intervention may benefit from a severance of the tooth's circumferential fibers during the orthodontic process in an effort to stabilize the bone level. Orthodontic appliance design for the extrusive action, especially in the absence of neighboring teeth, may require the use of mini-implants, which are a useful adjunct in such situations. This case history describes the management of a maxillary left canine that lacked sound tooth material in the cervical zone for a proper ferrule. It was diagnosed as requiring extrusion so as to recruit it into an abutment role for a fixed partial denture design. This treatment modality was considered more favorable compared to the alternative of a crown lengthening procedure. The tooth in question was a strategic abutment in an old and failing porcelain-fused-to-metal fixed prosthesis. Fiberotomy permitted rapid extrusion of the canine and available sound tooth margins for crown preparation with a proper ferrule. Following 28 days of tooth stabilization the implants were easily removed and treatment continued as originally planned.


[Malignant ameloblastoma of the jaw: an analysis of 10 consecutive cases.].
To investigate the clinical and radiographic manifestations of malignant ameloblastoma of the jaw and methods for treatment. 10 consecutive cases of malignant ameloblastoma were treated in the Department of Oral and Maxillofacial Surgery, Ninth People's Hospital,Shanghai Second Medical University between 1991 and 2003. All the cases were proved to be malignant ameloblastoma by surgical pathology and followed up for 1 to 8 years. This paper reviewed the clinical manifestation, diagnosis and treatment of these 10 cases. Among the 10 cases of malignant ameloblastoma, 5 were female, 5 were male ,aged from 22 to 60 years. 4 cases were located in the maxilla, and 6 cases in the mandible.All the patients underwent partial mandibulectomy or maxillectomy combined with modified radical neck dissection or supraomohyoid dissection with flap repair at the same time. The follow up outcomes were satisfactory both in appearance and function without recurrence. Malignant ameloblastoma is a kind of low degree malignant tumors. Diagnosis is made by pathology. Operation is the only radical method of therapy.


Synthesis of metal selenide colloidal nanocrystals by the hot injection of selenium powder.
We describe the synthesis of metal selenide nanocrystals, including CdSe, ZnSe, CuInSe2 and Cu2(Zn,Sn)Se4, by the hot injection of selenium powder dispersed in a carrier solvent. Since this results in a fast and high yield nanocrystal formation, we argue that the approach is well suited for the low cost, large volume production of nanocrystals.


Notch-1 controls the expression of fatty acid-activated transcription factors and is required for adipogenesis.
Notch, a transmembrane receptor member of the homeotic epidermal growth factor-like family of proteins, participates in cell-to-cell signaling to control cell fate during development. Activated Notch-1 constructs lacking the extracellular region prevent differentiation of several mammalian cells in vitro. This effect, however, bypasses the normal mechanisms of cell-to-cell interactions in which Notch-1 participates. We investigated the role of Notch-1 in the hormone-induced adipocyte differentiation of 3T3-L1 fibroblasts, a paradigmatic model of adipogenesis that requires cell-to-cell contact. Unlike other differentiation models, Notch-1 expression and function were necessary conditions for adipogenesis. Impaired Notch-1 expression by antisense Notch-1 constructs prevented adipocyte differentiation. Strategies aimed at blocking putative Notch/ligand interactions also blocked adipogenesis, implicating Notch as a critical molecule in cell-to-cell signaling necessary for differentiation. Inhibition of Notch-1 expression or function decreased the expression of peroxisomal proliferator-activated receptors delta and gamma, transcription factors that control adipocyte differentiation and that are up-regulated at cell confluence. These results implicate Notch in the commitment of 3T3-L1 cells to undergo adipogenesis by controlling the expression of the principal regulators of this process.


[Diagnostic and Prognostic Possibilities of the Redox-Potential Electrochemical Measurements in Blood Plasma].
Determination of operating characteristics of the test based on blood plasma redox potential monitoring in patients with different patho- logical conditions associated with impaired oxygen metabolism during treatment in postoperative period and expanding the range of parameters of the developed method of investigation of blood plasma redox potential. It were examined healthy volunteers group as following group (n = 63), groups of patients with transplanted liver (n = 64), kidney (n = 59), and lungs (n = 7). Redox potential measurements were done by platinum electrode, reference electrode was silver-chlorine one. Potentiostate IPC-ProL was used to registrate and record a dependence redox potential via time. Time of measurement was 15 min. statistically significant differencees of redox potentials ranges was found in healthy volunteers and patients with transplanted kidney and liver. Ratio of measured redox potentials coincident with the values within the confidence interval in healthy volunteers was 12% in patients with transplanted kidney and 10% in patients with transplanted liver. We observed significant differences in the nature of changes of blood plasma's redox potential values in course of monitoring of subgroups of patients with and without complications after liver transplantation. It was found that sensitivity of electrochemical method was 85%, selectivity--69.8%, precision--85.2%. we discovered value ranges of blood plasma redox potential typicalfor different pathological states; we detected an interaction between the effect of treatment and quantitative changes in the values of the blood plasma redox potentials; criterion for early predicition of complications in patients with transplanted liver was proposed basing on redox potential monitoring during postoperative period.


Normative cerebrospinal fluid profiles in febrile infants.
To describe the cerebrospinal fluid (CSF) profiles of febrile infants aged 1 to 90 days with negative bacterial culture test results and negative results for enteroviruses with polymerase chain reaction. Statistical analysis of a retrospective cohort. CSF profiles from 823 infants with negative test results for infection were analyzed. For 677 infants with atraumatic lumbar punctures (red blood cell [RBC] count < 1000/mm(3)), the mean and median CSF white blood cell (WBC) counts were 4.3/mm(3) and 3.0/mm(3), respectively, with a range from 0 to 12/mm(3). Mean CSF WBC counts (6.1/mm(3) versus 3.1/mm(3) and 3.0/mm(3)) and protein levels (75.4 mg/dL versus 58.9 mg/dL and 39.2 mg/dL) were higher in the first month compared with months 2 and 3, respectively (P < .001 for all). CSF glucose levels were lower in the first month compared with month 3 (45.3 mg/dL versus 48.0 mg/dL and 57.7 mg/dL; P < .001). Increasing RBC counts were statistically associated with increasing WBC counts (P < .001). However, the contribution of RBC < 10,000/mm(3) was small, and the reference range for WBC in uninfected infants with traumatic lumbar punctures was 0 to 16/mm(3). CSF WBC counts in febrile infants without evidence of bacterial or enteroviral infection, even in those with traumatic lumbar puncture, are lower than reported in pediatric references.


Hygromycin B resistance mediates elimination of Leishmania virus from persistently infected parasites.
A series of pX63-HYG derivatives encoding Leishmania RNA virus 1-4 (LRV1-4) sequences were electroporated into cells of Leishmania strain M4147, a virus-infected strain of L. guyanensis. After 6 weeks of drug selection (hygromycin B), transfected parasites lacked detectable quantities of viral genomic double-stranded RNA, viral capsid protein, and RNA-dependent RNA polymerase (RDRP) activity. Evidence of viral infection was not recovered upon removal of the drug. While viral RNA transcripts were produced from electroporated expression vectors, as determined by reverse transcription-PCR, viral antigens were not detected, suggesting that the antiviral effects of hygromycin B are mediated through translation inhibition. A short-term selection study suggests that the LRV1-4 elimination may not only be a function of hygromycin B as a protein synthesis inhibitor but also possibly related to the mechanism of hygromycin B resistance in Leishmania strains.


[Sexual function in men with lower urinary tract symptoms].
Recently there have been several alternatives not only to improve symptoms but to retain an acceptable quality of life as well as to reduce the complications. Therefore the objective of this study was to evaluate quantitatively and qualitatively the degree of erectile dysfunction in the population of men with lower urinary tract symptoms (LUTS). Total 252 men with LUTS were investigated using the International Prostate Symptom Score (I-PSS) and sexual function inventory (SFI) consisting of sexual drive, erection and ejaculation. Spearman's rank order correlation was used to determine the degree of any correlation between age, the total I-PSS, the individual I-PSS questions and the various sexual function scores. 208 patient data were available for analysis. There were poor function patients in 67.8% for sexual drive, in 46.2% for erection and in 47.1% for ejaculation. On the other hand, 24% considered their sexual drive to be a big or medium problem, 20.7% for erection and 18.3% for ejaculation. Overall, 27.4% of the men were mostly or very dissatisfied with their sex life. There was a significant correlation between a patient's age and his score for each of the three sexual variables (p < 0.05). Furthermore, a significant correlation was noticed between the total I-PSS and the SFI score (p < 0.05). It might be suggested that the more symptomatic a patient for LUTS, the poorer his sexual function will be. About 20% men with LUTS are bothered by their sexual symptoms. Erectile dysfunction in dependent of age and the extent of LUTS. Consideration of the high population of erectile dysfunction in men with LUTS is necessary to the treatment of their urinary symptoms.


Anti-retroviral (ARV) rationing schemes in developing countries: a review article on strategies and ethical issues related to the successes and failures of ARV programmes.
When a patient receives a counterfeit drug, he/she becomes a victim of fraud medicine and is put at risk of developing adverse effects from unwanted medication that is not prescribed. These individuals health also becomes compromised because they are cheated of both successful treatment regimens and economically. Indeed counterfeit drugs pose many threats to society; not only to the individual in terms of the health side effects experienced, but also to the public in terms of trade relations, economic implications, and the effects on global pandemics. Apart from the pharmaceutical aspect in producing substandard drugs, there area also climatic or environmental factors as well as patients and economic factors. All these need to be addressed when considering any proper rationing strategy for antiretroviral drugs (ARVs) in sub-Saharan countries. Short of that, there is a great danger that the shelf life of ARV will be soon lost and once resistance comes in we will be in big problems.


Involvement of auxin and CKs in boron deficiency induced changes in apical dominance of pea plants (Pisum sativum L.).
It has previously been shown that boron (B) deficiency inhibits growth of the plant apex, which consequently results in a relatively weak apical dominance, and a subsequent sprouting of lateral buds. Auxin and cytokinins (CKs) are the two most important phytohormones involved in the regulation of apical dominance. In this study, the possible involvement of these two hormones in B-deficiency-induced changes in apical dominance was investigated by applying B or the synthetic CK CPPU to the shoot apex of pea plants grown in nutrient solution without B supply. Export of IAA out of the shoot apex, as well as the level of IAA, Z/ZR and isopentenyl-adenine/isopentenyl-adenosine (i-Ade/i-Ado) in the shoot apex were assayed. In addition, polar IAA transport capacity was measured in two internodes of different ages using 3H-IAA. In B-deficient plants, both the level of auxin and CKs were reduced, and the export of auxin from the shoot apex was considerably decreased relative to plants well supplied with B. Application of B to the shoot apex restored the endogenous Z/ZR and IAA level to control levels and increased the export of IAA from the shoot apex, as well as the 3H-IAA transport capacity in the newly developed internodes. Further, B application to the shoot apex inhibited lateral bud growth and stimulated lateral root formation, presumably by stimulated polar IAA transport. Applying CPPU to the shoot apex, a treatment that stimulates IAA export under adequate B supply, considerably reduced the endogenous Z/ZR concentration in the shoot apex, but had no stimulatory effect on IAA concentration and transport in B-deficient plants. A similar situation appeared to exist in lateral buds of B-deficient plants as, in contrast to plants well supplied with B, application of CKs to these plants did not stimulate lateral bud growth. In contrast to the changes of Z/ZR levels in the shoot apex, which occurred after application of B or CPPU, the levels of i-Ade/i-Ado stayed more or less constant. These results suggest that there is a complex interaction between B supply and plant hormones, with a B-deficiency-induced inhibition of IAA export from the shoot apex as one of the earliest measurable events.


Searching for pharmacophoric patterns in databases of three-dimensional chemical structures.
This paper provides an overview of the research that has been carried out in Sheffield over the last decade into searching techniques for databases of three-dimensional (3D) chemical structures. A 3D structure or query pattern is represented by a labelled graph, in which the nodes and the edges of the graph are used to represent atoms and the associated inter-atomic distances, respectively. The presence of a pharmacophore in each of the structures in a database can then be tested by means of a subgraph isomorphism algorithm, the computational requirements of which are minimized by the use of an initial screening procedure that eliminates the majority of the structures from the subgraph-isomorphism search. Analogous graph-based representation and searching methods can also be used with flexible 3D structures: in this case, the edges of the graphs represent inter-atomic distance ranges and a final conformational search needs to be carried out for those molecules that match the query pharmacophore in the subgraph-isomorphism search. The paper also reviews related work on the automatic identification of pharmacophoric patterns and on 3D similarity searching.


Attitudes of Hong Kong medical students toward different modalities of treatment for cancer.
140 medical undergraduates in a Hong Kong medical school rated the usefulness of different modalities of cancer treatment for curative, medically palliative, and psychologically palliative care, respectively. Factor analyses showed that respondents used a Chinese versus non-Chinese cultural framework in conceptualizing modalities of treatment outside the conventional Western medical model. The functions of unconventional modalities were mainly for psychologically palliative care according to the respondents, although they did not regard these modalities as adversive to curative and medically palliative treatments. Among the Western medical modalities, surgery was rated as more useful for curative treatment while chemotherapy and radiotherapy were rated as more useful for symptom control. The implications of the findings for cancer care and further research were discussed.


Self-assembled monolayer initiated electropolymerization: a route to thin-film materials with enhanced photovoltaic performance.
Continuing progress in the field of organic polymer photovoltaic (PV) devices requires the development of new materials with better charge-transport efficiency. To improve this parameter, we have investigated surface-attached bilayer polymer PV thin films prepared starting from a covalently attached monolayer of an electroactive initiator using sequential electropolymerization of dithiophene and its derivatives. These systems were found to show significantly increased photocurrent generation quantum yields as compared to systems made through conventional approaches. In addition, the described PV thin films possess remarkable mechanical, air, and photostability. These properties likely arise from the more uniform and better ordered bulk layer morphologies as well as tighter covalently bonded contacts at the interfacial junctions, contributing to improved charge transport. While more studies on the fundamental reasons behind the discovered phenomenon are currently underway, this information can be readily applied to build more efficient organic polymer photovoltaics.


Diagnostic Accuracy and Acceptability of the Primary Care Posttraumatic Stress Disorder Screen for the Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition) Among US Veterans.
Posttraumatic stress disorder (PTSD) is a serious mental health disorder that can be effectively treated with empirically based practices. PTSD screening is essential for identifying undetected cases and providing patients with appropriate care. To determine whether the Primary Care PTSD screen for the Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition) (PC-PTSD-5) is a diagnostically accurate and acceptable measure for use in Veterans Affairs (VA) primary care clinics. This cross-sectional, diagnostic accuracy study enrolled participants from May 19, 2017, to September 26, 2018. Participants were recruited from primary care clinics across 2 VA Medical Centers. Session 1 was conducted in person, and session 2 was completed within 30 days via telephone. A consecutive sample of 1594 veterans, aged 18 years or older, who were scheduled for a primary care visit was recruited. Data analysis was performed from March 2019 to August 2020. In session 1, participants completed a battery of questionnaires. In session 2, a research assistant administered the PC-PTSD-5 to participants, and then a clinician assessor blind to PC-PTSD-5 results conducted a structured diagnostic interview for PTSD. The range of PC-PTSD-5 cut points overall and across gender was assessed, and diagnostic performance was evaluated by calculating weighted κ values. In total, 495 of 1594 veterans (31%) participated, and 396 completed all measures and were included in the analyses. Participants were demographically similar to the VA primary care population (mean [SD] age, 61.4 [15.5] years; age range, 21-93 years) and were predominantly male (333 participants [84.1%]) and White (296 of 394 participants [75.1%]). The PC-PTSD-5 had high levels of diagnostic accuracy for the overall sample (area under the receiver operating characteristic curve [AUC], 0.927; 95% CI, 0.896-0.959), men (AUC, 0.932; 95% CI, 0.894-0.969), and women (AUC, 0.899, 95% CI, 0.824-0.974). A cut point of 4 ideally balanced false negatives and false positives for the overall sample and for men. However, for women, this cut point resulted in high numbers of false negatives (6 veterans [33.3%]). A cut point of 3 fit better for women, despite increasing the number of false positives. Participants rated the PC-PTSD-5 as highly acceptable. The PC-PTSD-5 is an accurate and acceptable screening tool for use in VA primary care settings. Because performance parameters will change according to sample, clinicians should consider sample characteristics and screening purposes when selecting a cut point.


Central Serous Chorioretinopathy: Multimodal Imaging and Management Options.
Central serous chorioretinopathy (CSCR) is an idiopathic maculopathy characterized by thickened choroid, retinal pigment epithelial detachment, and variable subretinal fluid. CSCR predominantly affects young men, with risk factors including corticosteroid use, the type A behavior pattern, and psychological stress. While usually self-limited with a good visual prognosis, recurrent and persistent CSCR can lead to outer retinal and/or retinal pigment epithelial atrophy, choroidal neovascularization, and visual loss. This article reviews current multimodal imaging and treatment options, which include observation, mineralocorticoid receptor antagonists, thermal laser photocoagulation, and off-label photodynamic therapy with verteporfin.


Immunophenotypic features of acute myeloid leukemias overexpressing the interleukin 3 receptor alpha chain.
In a previous study we have shown that the interleukin-3 receptor alpha chain (IL-3Ralpha) is over expressed in about 45% of acute myeloid leukemias (AMLs) and this phenomenon was associated with high blast cell counts at diagnosis, high rate of cycling of leukemic blasts and with a worse prognosis. Here we have investigated the immunophenotypic features of 125 AML patients subdivided into three groups (IL-3R(high), IL-3R(middle) and IL-3R(low)) according to the level of IL-3Ralpha expression. AMLs over expressing the IL-3Ralpha represent a subgroup of AMLs with a peculiar immunophenotype mainly consisting in the elevated expression of CD34 and several receptor membrane tyrosine kinases, such as c-kit and flt3, and in a usually low expression of myeloid-associated antigens such as CD11b, CD14 and CD15. These findings suggest that IL-3Ralpha + + + AMLs are blocked at an early stage of differentiation and express at elevated levels several growth factor receptors. It is proposed that these findings may further help to understand the mechanisms involved in the development of high-risk acute leukemias.


Porphyrin, chlorin, and bacteriochlorin isothiocyanates: useful reagents for the synthesis of photoactive bioconjugates.
A novel method for conjugating porphyrins and related molecules to proteins has been developed. The method, which involves synthesizing porphyrins, chlorins, and bacteriochlorins bearing a single amine-reactive isothiocyanate group represents a facile system for protein labeling with these photoactive species. Problems associated with the noncovalent binding of porphyrins to proteins are highlighted, and a method for purifying conjugates to yield exclusively covalently bound porphyrin protein species is demonstrated. Biological activity of porphyrin-bovine serum albumin conjugates formed and purified by these methods is demonstrated using laser scanning confocal microscopy.


Synergistic Catalysis by "Polymeric Microzymes and Inorganic Nanozymes": The 1+1>2 Effect for Intramolecular Cyclization of Peptides.
In this work, we developed an efficient "molecularly imprinted polymer microzymes and inorganic magnetic nanozymes" synergistic catalysis strategy for the formation of disulfide bonds in peptides. The polymeric microzymes showed excellent selectivity toward the template peptide as well as the main reactant (linear peptide), and the Fe3O4 magnetic nanoparticle (MNP) nanozymes inhibited the intermolecular reaction during the formation of disulfide bonds in peptides. As a result, the integration of the two different artificial enzymes in one process facilitates the intramolecular cyclization in high product yields (59.3%) with excellent selectivity. Mechanism study indicates the synergistic effect was occurred by using a "reversed solid phase synthesis" strategy with an enhanced shift of reaction balance to product generation. We believe the synergistic catalysis by "polymeric microzymes and inorganic nanozymes" presented in the present work may open new opportunities in creation of multifunctional enzyme mimics for sensing, imaging, and drug delivery.


Orally Delivered Scorpion Antimicrobial Peptides Exhibit Activity against Pea Aphid (Acyrthosiphon pisum) and Its Bacterial Symbionts.
Aphids are severe agricultural pests that damage crops by feeding on phloem sap and vectoring plant pathogens. Chemical insecticides provide an important aphid control strategy, but alternative and sustainable control measures are required to avoid rapidly emerging resistance, environmental contamination, and the risk to humans and beneficial organisms. Aphids are dependent on bacterial symbionts, which enable them to survive on phloem sap lacking essential nutrients, as well as conferring environmental stress tolerance and resistance to parasites. The evolution of aphids has been accompanied by the loss of many immunity-related genes, such as those encoding antibacterial peptides, which are prevalent in other insects, probably because any harm to the bacterial symbionts would inevitably affect the aphids themselves. This suggests that antimicrobial peptides (AMPs) could replace or at least complement conventional insecticides for aphid control. We fed the pea aphids (Acyrthosiphon pisum) with AMPs from the venom glands of scorpions. The AMPs reduced aphid survival, delayed their reproduction, displayed in vitro activity against aphid bacterial symbionts, and reduced the number of symbionts in vivo. Remarkably, we found that some of the scorpion AMPs compromised the aphid bacteriome, a specialized organ that harbours bacterial symbionts. Our data suggest that scorpion AMPs holds the potential to be developed as bio-insecticides, and are promising candidates for the engineering of aphid-resistant crops.


Lactic dehydrogenase-immunoglobulin G kappa complex in a patient with idiopathic interstitial pneumonia.
A female patient with idiopathic interstitial pneumonia (IIP) was admitted again 40 months after the diagnosis due to progression of clinical findings and increased activity of serum lactic dehydrogenase (LDH). Analysis of LDH isoenzyme disclosed a broad band between LDH4 and LDH5. Gel filtration and immunoelectrophoresis showed that immunoglobulin (Ig) G (kappa type) bound the LDH. With prednisolone and azathioprine, her symptoms and radiological findings improved concomitant with a decrease in the serum LDH activity. The LDH-IgG kappa complex disappeared in the circulation 14 months after initiation of the therapy. We report circulating LDH-Ig complex in a patient with IIP, which may be related to the disease progression of IIP.


Cutting balloon angioplasty is superior to balloon angioplasty or stent implantation for small coronary artery disease.
The aim of this study is to demonstrate initial results and long-term outcomes of patients after receiving cutting balloon angioplasty (CBA), balloon angioplasty (BA), or stenting for small vessel diseases. We studied a total of 327 lesions of small coronary disease treated either by CBA (n=87), BA (n=130), or stenting (n=110) in two affiliated institutes. A small coronary artery was defined as a reference vessel <2.5 mm using quantitative coronary angiography (QCA). Angiographic restenosis was encountered in 31% of the CBA, 46.5% of the BA, and 43.9% of the stent (p=0.048). Major adverse cardiac events (death, myocardial infarction, and target lesion revascularization) at follow-up were significantly lower in the CBA compared to other groups (CBA, 20.3%; BA, 37.3%; stent, 33.3%; p=0.036). The CBA procedure provided superior angiographic and clinical outcomes to the stenting or BA. The CBA may be a cost-effective and reasonable approach for the treatment of lesions in small coronary diseases.


Surgical management of patients with severe anaemia due to acute blood loss: a case for withholding perioperative blood transfusion.
Twenty one consecutive patients who had an average packed cell volume (PCV) of 16.2% (range 13-25) due to acute blood loss were treated surgically without perioperative blood transfusion. All the surgical procedures were carried out under intravenous ketamine hydrochloride. The surgical wound in each patient healed by primary intention. The packed cell volume rose to 35% and above in an average of six weeks by use of oral haematinics. The only morbidity observed was dizziness which lasted for an average of six days in ten patients. There were no deaths and all the patients remained well at an average follow-up period of 42 weeks. The study shows that perioperative blood transfusion can be avoided in surgical care of most patients who have severe anaemia due to acute blood loss without mortality and without significant morbidity.


Reduced sleep efficiency, measured using an objective device, was related to an increased prevalence of home hypertension in Japanese adults.
Few studies have reported the relationship between reduced sleep efficiency and the prevalence of hypertension independent of sleep duration in Japan. This study aimed to evaluate whether reduced sleep efficiency, measured using an objective device for >1 week, was related to an increased prevalence of hypertension independent of sleep duration in the general Japanese population. We conducted a cross-sectional study of 904 participants aged ≥20 years who lived in Miyagi Prefecture, Japan. Sleep efficiency was measured using a contactless biomotion sleep sensor for 10 continuous days. The participants were classified into two groups according to their sleep efficiency: reduced (<90%) or not reduced (≥90%). Hypertension was defined as morning home blood pressure ≥135/85 mmHg or self-reported treatment for hypertension. Multivariable logistic regression models were used to obtain odds ratios (ORs) and 95% confidence intervals (CIs) to assess the relationship between sleep efficiency and hypertension adjusted for potential confounders. The results showed that two hundred and ninety-four individuals (32.5%) had reduced sleep efficiency, and 331 (36.6%) had hypertension. Individuals with reduced sleep efficiency had a higher body mass index and shorter sleep duration. In the multivariable analysis, reduced sleep efficiency was significantly related to an increased prevalence of hypertension (OR, 1.62; 95% CI, 1.15-2.28). In conclusion, reduced sleep efficiency was significantly related to an increased prevalence of hypertension in Japanese adults. Improvements in sleep efficiency may be important to reduce blood pressure in Japanese adults.


Compound exocytosis of secretory granules containing salivary chromogranin A in granular duct cells in rat submandibular gland: the last study in collaboration with the late Professor Noboru Yanaihara at Yanaihara Institute.
Chromogranin A (CgA) is a member of a family of chromogranins, which are co-stored and co-released with adrenaline and noradrenalin (NAd) in the adrenal medulla in response to stimulation of the splanchnic nerve. Double immunohistochemical staining is carried out by use of antibodies against CgA and 1,4,5-trisphosphate receptor type 2 (IP3R2) on the same sections prepared from the isolated and perfused submandibulllar gland of rat. In the control sections prepared from resting state, an intense IP3R2 immunoreactivity (IR) appeared preferentially at the apical pole of subpopulation of the granulated duct cells, in which CgA-like IR distributed throughout the cytoplasm. Electron-micrograph showed that the granular cells in the resting state stored numerous membrane-bound granules in the apical cytoplasm. Stimulation with 1 microM NAd caused rapid immediate increase in secretory responses. Sections prepared from the gland at the peak of secretory responses exhibited that, in the granular duct cells, the apically converge IP3R2 IR became diffuse and indistinguishable, and that the apical half of the cells was occupied, indicating that mobilization of Ca2+ from the IP3-sensitive pool may preferentially be involved in the secretory responses to alpha-adrenergic agonist.


Progress toward polio eradication--Somalia, 1998-2013.
Since the 1988 resolution of the World Health Assembly to eradicate polio, significant progress has been made toward achieving this goal, with the result that only Afghanistan, Nigeria, and Pakistan have never successfully interrupted endemic transmission of wild poliovirus. However, one of the greatest challenges of the Global Polio Eradication Initiative has been that of maintaining the polio-free status of countries in unstable regions with weak healthcare infrastructure, a challenge exemplified by Somalia, a country in the Horn of Africa region. Somalia interrupted indigenous transmission of wild poliovirus in 2002, 4 years after the country established its national polio eradication program. But political instability and protracted armed conflict, with significant disruption of the healthcare system, have left Somalia vulnerable to 2 imported outbreaks of wild poliovirus. The first occurred during 2005-2007, resulting in >200 cases of paralytic polio, whereas the second, which began in 2013, is currently ongoing. Despite immense challenges, the country has a sensitive surveillance system that has facilitated prompt detection of outbreaks, but its weak routine immunization system means that supplementary immunization activities constitute the primary strategy for reaching children with polio vaccines. Conducting vaccination campaigns in a setting of conflict has been at times hazardous, but the country's polio program has demonstrated resilience in overcoming many obstacles to ensure that children receive lifesaving polio vaccines. Regaining and maintaining Somalia's polio-free status will depend on finding innovative and lasting solutions to the challenge of administering vaccines in a setting of ongoing conflict and instability.


Kinetics of subcutaneous versus intravenous epoetin-beta in dogs, rats and mice.
The total body clearance of recombinant human erythropoietin (rhEPO) calculated per kilogram of body weight increased in the order man = dog < rat << mouse. The differences disappeared or were reversed when clearance was expressed per square meter of body surface. There was no similar species difference in terminal half life. Total body clearance increased with the dose in dogs and mice, but not in rats. The bioavailability from a subcutaneous depot was 80% in dogs, 76% in rats, and 70% in mice. The absorption from the subcutaneous depot is rapid in rats and mice, but slow in dogs. The pharmacodynamic activity of rhEPO injected by both routes was compared in polycythemic mice. The equipotent doses were 2.44 times higher with intravenous than with subcutaneous injection. Taking into account the bioavailability of 70% from a subcutaneous depot, one obtains a potency ratio of 3.5 for absorbed subcutaneous versus intravenous rhEPO.


Gastric syphilis: a systematic review of published cases of the last 50 years.
The authors conducted a systematic review of the English literature for cases of Gastric Syphilis (GS) in the last 50 years. The 34 studies which met selection criteria included 52 patients with GS. Of the reviewed patients, only 13% had a history of syphilis diagnosis and 46% had prior or concurrent clinical manifestations of the disease. Epigastric pain/fullness was the most common presenting symptom (92%) and epigastric tenderness being the most common sign. Gastric bleeding of variable intensity was documented in 35% of the cases. In the radiologic examinations, fibrotic narrowing and rigidity of the gastric wall was the most common finding (43%), followed by hypertrophic and irregular folds, while in endoscopy the most common lesion types were multiple ulcerations (48%), nodular mucosa, and erosions. The antrum was the most commonly affected area (56%). The majority of the patients received penicillin (83%) with a rapid resolution of their symptoms. Seventeen percent of the patients were treated surgically either due to a complication or due to strong suspicion of infiltrating tumor or lymphoma. The nonspecific clinical, radiologic, and pathologic characteristics of GS can establish it as a great imitator of other gastric diseases. GS should be considered in the differential diagnosis in patients at risk for sexually transmitted diseases who present with abdominal complaints and unusual endoscopic lesions and no other diagnosis is made, irrespective of the presence of H. pylori. The absence of primary or secondary luetic lesions should not deter one from considering GS.


Timing and Duration of Sleep in Hospitalized Children: An Observational Study.
Sleep during hospitalization is important, but data on children's sleep quality during hospitalization are lacking. We sought to document sleep duration and awakenings in hospitalized children and explore associations between sleep and chronic care complexity, home sleep quality, and late-night food consumption. Children aged 2 to 17 years admitted to a hospitalist service for at least 24 hours were approached for participation. Children were video recorded from 20:00 to 08:00. Paired investigators reviewed recordings and extracted data. Investigators blinded to sleep data separately extracted clinical and demographic information. Analyses included Spearman correlations and linear and generalized linear regression models with t and Wald χ2 tests. The mean time subjects (n = 57) initiated sleep was 22:35 (range: 20:00-02:47), with a mean sleep duration of 475 minutes (89-719 minutes). Subjects awakened 2.2 times (0-7 times, SD: 1.9) per night, on average, with the average total time awake during those awakenings of 55.7 minutes (2-352 minutes, SD: 75 minutes). In multivariate analysis, children with private insurance had longer sleep duration. Additionally, subjects who ate a snack after 21:00 went to sleep much later (odds ratio: 9.5; confidence interval: 2.6 to 34.9) and had 64 minutes less total sleep time and spent less time in bed than patients who did not eat late (P = .007). Hospitalized children sleep less than recommended and experience frequent awakenings. Some demographic variables are related to sleep. Many hospitalized children also consume food at night, which is associated with later bedtime and less sleep. Future efforts to improve sleep in hospitalized children are needed.


Thiol-dependent regulation of glycerate metabolism in leaf extracts : the role of glycerate kinase in c(4) plants.
We have recently reported that the activity of maize leaf glycerate kinase [EC 184.108.40.206] is regulated in vivo by the light/dark transition, possibly involving the ferredoxin/thioredoxin mechanism, and that the stimulating effect of light can be mimicked in vitro by incubation of crude leaf extract with reducing compounds (LA Kleczkowski, DD Randall 1985 Plant Physiol 79: 274-277). In the present study it was found that the time course of thiol activation of the enzyme was substantially dependent on the presence of some low molecular weight inhibitor(s) of activation found both in leaf extracts and mesophyll chloroplasts. Activity of glycerate kinase from maize as well as wheat leaves increased upon greening of etiolated plants and was correlated with the development of photosynthetic apparatus in these species. The maize enzyme was strongly activated by thiols at all stages of development from etiolated to green seedlings. Thiol activation of glycerate kinase was observed for a number of C(4) plants, notably of the nicotinamide adenine dinucleotide phosphate-malic enzyme type, with the strongest effect found for the enzyme from leaf extracts of maize and sorghum (10- and 8-fold activation, respectively). Among the C(3) species tested, only the enzyme from soybean leaves was affected under the same conditions (1.6-fold activation). This finding was reflected by an apparent lack of cross-reactivity between the enzyme from maize leaves and antibodies raised against purified spinach leaf glycerate kinase. We suggest that, in addition to its role as a final step of photorespiration in leaves, glycerate kinase from C(4) species may serve as a part of the facilitative diffusion system for the intercellular transport of 3-phosphoglycerate. Simultaneous operation of both the passive and the facilitative diffusion mechanisms of 3-phosphoglycerate transport in C(4) plants is postulated.


Worksite and Community Health Promotion/Risk Reduction Project--Virginia, 1987-1991.
Because cardiovascular disease (CVD) is a leading cause of premature disability and death in the United States, approaches are needed to prevent this problem at the community level. In the Mount Rogers Health District (MRHD) (1990 population: 178,000), a six-county area in southwestern Virginia, age-adjusted death rates for CVD substantially exceed state and national averages. In August 1987, the MRHD implemented the Worksite and Community Health Promotion/Risk Reduction Project to help residents of this large, rural area improve their health by adopting healthy lifestyles and, consequently, reduce their risks for CVD and cancer. This report summarizes activities associated with the project and changes in health indicators for participants from April 1989 through May 1990.


Human Monkeypox: Epidemiologic and Clinical Characteristics, Diagnosis, and Prevention.
Recently, concern has been raised about the emergence of human monkeypox virus and the occasionally severe clinical presentation bearing resemblance to that of smallpox. In 2018 3 patients in the UK were diagnosed with monkeypox, and the frequency and geographic distribution of cases across West and Central Africa have increased in recent years. In Nigeria, most monkeypox patients are aged <40 years and lack cross-protective immunity because they were born after discontinuation of the smallpox eradication campaign. This article reviews the epidemiology, clinical features, and management of monkeypox and discusses its growing public health threat in this context.


In snow's footsteps: Commentary on shoe-leather and applied epidemiology.
The term shoe-leather epidemiology is often synonymous with field epidemiology or intervention epidemiology. All 3 terms imply investigations initiated in response to urgent public health problems and for which the investigative team does much of its work in the field (i.e., outside the office or laboratory). Alexander D. Langmuir is credited with articulating the concept of disease surveillance as it is applied to populations rather than individuals. He also founded the Epidemic Intelligence Service (EIS) Program in 1951, a 2-year training experience in applied epidemiology that places professionals in the field, domestically and internationally, in real-life situations. Today, 70-90 EIS officers are assigned each year to Centers for Disease Control and Prevention programs and to state and local health departments to meet the broad spectrum of challenges in chronic disease, injury prevention, violence, environmental health, occupational safety and health, and maternal and child health, as well as infectious diseases. Throughout their assignments, EIS officers are encouraged to strive for analytic rigor as well as public health consequence, which requires technical competence blended with good judgment and awareness of context. Effective applied epidemiologists must have skills beyond just epidemiology to improve a population's health; the field of applied epidemiology requires multiple team members, all having different but complementary skills, to be effective.


Resistance of chickens to Rous sarcoma virus challenge following immunization with a recombinant avian leukosis virus.
An attenuated recombinant avian leukosis virus (ALV) produced by recombinant DNA techniques was examined for its ability to provide resistance to Rous sarcoma virus (RSV) challenge. Specific-pathogen-free chicken embryos (18-day incubation) and hatched chicks inoculated with recombinant ALV produced significantly smaller tumors than sham-inoculated controls upon challenge with RSV 2 weeks postinoculation; inoculation with RAV-1 produced similar results. Specific-pathogen-free hens inoculated with recombinant ALV produced viral-protein-specific antibody that was transmitted to 100% of the progeny, as detected by enzyme-linked immunosorbent assay. Progeny of the inoculated hens produced significantly fewer tumors than sham-inoculated controls upon challenge with RSV at hatch, indicating that maternal antibody may be a factor in resistance to tumor development.


Differential Proteomic Analysis of Hepatocellular Carcinomas from Ppp2r5d Knockout Mice and Normal (Knockout) Livers.
Hepatocellular carcinoma (HCC) is the major type of primary liver cancer. Mice lacking the tumor-suppressive protein phosphatase 2A subunit B56δ (Ppp2r5d) spontaneously develop HCC, correlating with increased c-MYC oncogenicity. We used two-dimensional difference gel electrophoresis-coupled matrix-assisted laser desorption/ionization time-of-flight mass spectrometry to identify differential proteomes of livers from wild-type, non-cancerous and HCC-affected B56δ knockout mice. A total of 23 proteins were differentially expressed/regulated in liver between wild-type and non-cancerous knockout mice, and 119 between non-cancerous and HCC knockout mice ('cancer proteins'). Overlap with our reported differential transcriptome data was poor. Overall, 56% of cancer proteins were reported before in HCC proteomics studies; 44% were novel. Gene Ontology analysis revealed cancer proteins mainly associated with liver metabolism (18%) and mitochondria (15%). Ingenuity Pathway Analysis identified 'cancer' and 'gastrointestinal disease' as top hits. We identified several proteins for further exploration as novel potential HCC biomarkers, and independently underscored the relevance of Ppp2r5d knockout mice as a valuable hepatocarcinogenesis model.


Differential white blood cell count and type 2 diabetes: systematic review and meta-analysis of cross-sectional and prospective studies.
Biological evidence suggests that inflammation might induce type 2 diabetes (T2D), and epidemiological studies have shown an association between higher white blood cell count (WBC) and T2D. However, the association has not been systematically investigated. Studies were identified through computer-based and manual searches. Previously unreported studies were sought through correspondence. 20 studies were identified (8,647 T2D cases and 85,040 non-cases). Estimates of the association of WBC with T2D were combined using random effects meta-analysis; sources of heterogeneity as well as presence of publication bias were explored. The combined relative risk (RR) comparing the top to bottom tertile of the WBC count was 1.61 (95% CI: 1.45; 1.79, p = 1.5*10(-18)). Substantial heterogeneity was present (I(2) = 83%). For granulocytes the RR was 1.38 (95% CI: 1.17; 1.64, p = 1.5*10(-4)), for lymphocytes 1.26 (95% CI: 1.02; 1.56, p = 0.029), and for monocytes 0.93 (95% CI: 0.68; 1.28, p = 0.67) comparing top to bottom tertile. In cross-sectional studies, RR was 1.74 (95% CI: 1.49; 2.02, p = 7.7*10(-13)), while in cohort studies it was 1.48 (95% CI: 1.22; 1.79, p = 7.7*10(-5)). We assessed the impact of confounding in EPIC-Norfolk study and found that the age and sex adjusted HR of 2.19 (95% CI: 1.74; 2.75) was attenuated to 1.82 (95% CI: 1.45; 2.29) after further accounting for smoking, T2D family history, physical activity, education, BMI and waist circumference. A raised WBC is associated with higher risk of T2D. The presence of publication bias and failure to control for all potential confounders in all studies means the observed association is likely an overestimate.


Phase measurement using an interferometer having a filamentary spatial filter and an extended source of polychromatic light.
The theory of phase measurement by means of the interferometer using a filamentary spatial filter (IFSF) is extended to the case in which the source has finite width. Experimental results satisfactorily coincide with theoretically obtained characteristics. The examination of accuracy suggests that the error in phi/2pi can be easily restricted to within 0.01. It is hoped that the IFSF will improve efficiencies in the measurement of dispersive power of a fluid and the method of coincidence being used in the measurement of a distance between reflecting surfaces, because it can simultaneously measure phases in various wavelengths if a polychrometer is set in the rear of the image plane.


[Atypical presentation of a carcinoid syndrome].
A 76-year-old woman presenting with right heart failure is reported. The investigation showed an ileal carcinoid tumour with multiple metastases and tricuspid regurgitation caused by a cardiac carcinoid lesion. Echocardiographic study and histopathological examination revealed typical characteristics of carcinoid heart disease. Nevertheless, except for the cardiac symptomatology, the patient did not show any other clinical manifestation of the carcinoid syndrome. Isolated right heart failure as the first sign of a carcinoid syndrome is rare; only two other cases have been described in the literature.


[Patterns of PCDD/Fs, PCBs and PCNs homologues in fly ash from cement kilns].
The concentrations and toxic equivalent (TEQ) values of PCDD/Fs, PCBs and PCNs in fly ash collected from three types of cement kilns (vertical shaft kiln, wet-process rotary kiln and dry-process rotary kiln) and two types of waste incinerators were determined, and the patterns of homologues and congeners were compared. The results showed that the total TEQ of PCDD/Fs, PCBs and PCNs in cement kiln fly ash, which were in the range of 4.0-62, 0.069-3.9 and 0.47-2.8 ng x kg(-1) respectively, were much lower than that of fly ash from waste incinerators. In cement kiln fly ash, the predominating PCDD/Fs homologues were TCDFs, and the chief 2, 3, 7, 8-PCDD/Fs congeners were OCDD, 2, 3, 7, 8-TCDF and 1, 2, 3, 4, 6, 7, 8-HpCDF. The patterns of PCBs homologues in cement kiln fly ash were similar to those of waste incinerators in which TeCB were predominating homologues. PCB77, PCB105, PCB118 were at higher concentrations than other co-polar PCBs. Different types of cement kiln fly ash presented similar PCNs homologue patterns. The predominant homologues were TeCN, whereas OcCN were not detected. PCN 66/67 which has dioxin like toxity was the most abundant congener in all fly ash.


Living Donor Liver Transplantation: Preoperative Planning and Postoperative Complications.
OBJECTIVE. The purposes of this article are to highlight the similarities and differences in workup and work flow across multiple institutions in the preoperative imaging assessment of liver donors; to lay the foundation for developing consensus guidelines; to illustrate clinically relevant anatomic variants; to introduce a standardized reporting template; and to review postprocessing work flow and postoperative donor complications. CONCLUSION. Further investigation and consensus are needed to determine protocols, time intervals, and duration of follow-up of liver donors that are cost-effective and clinically relevant.


Interphase in Polymer Nanocomposites.
The lightweight and high-strength functional nanocomposites are important in many practical applications. Natural biomaterials with excellent mechanical properties provide inspiration for improving the performance of composite materials. Previous studies have usually focused on the bionic design of the material's microstructure, sometimes overlooking the importance of the interphase in the nanocomposite system. In this Perspective, we will focus on the construction and control of the interphase in confined space and the connection between the interphase and the macroscopic properties of the materials. We shall survey the current understanding of the critical size of the interphase and discuss the general rules of interphase formation. We hope to raise awareness of the interphase concept and encourage more experimental and simulation studies on this subject, with the aim of an optimal design and controllable preparation of polymer nanocomposite materials.


Medicinal Cannabis and Implications for Workplace Health and Safety: Scoping Review of Systematic Reviews.
Although medicinal cannabis is prescribed for conditions such as pain, epilepsy, nausea and vomiting during cancer treatment, evidence about associated adverse side effects is still evolving. Because adverse events (AEs) might impact the performance of workers, it is important to consider their implications on workplace health and safety (WHS). This study aimed to map the types and prevalence of the AEs associated with medical cannabis and articulate how those events could impact WHS. A scoping review of systematic reviews and/or meta-analyses published between 2015 and March 2021 was performed to identify the AEs of medicinal cannabis in adults. Publications in English and full text available online were collected from Embase, MEDLINE, PsychINFO, PubMed, Scopus, and Web of Science. Of 1,326 papers identified from the initial search, 31 met the inclusion criteria and were analyzed. The studies reported various AEs with the most predominant being sedation, nausea/vomiting, dizziness, and euphoria. Acute and chronic pain was the most prevalent disorder under review. Adverse events associated with the use of medicinal cannabis could increase workplace risks, including decreased alertness and reaction times, increased absenteeism, reduced ability to safely drive or operate machinery and an increased probability of falling. Focused research into the risk to workers and workplaces from the use of medical cannabis and related human performance impairment is urgently warranted.


Perturbation of methionine metabolism in sheep with nitrous-oxide-induced inactivation of cobalamin.
Exposure of sheep to 36% nitrous oxide for 8 days (2-hr per day) led to 90%, 82% and 74% inhibition of 5-methyltetrahydrofolate-homocysteine methyltransferase in the liver, heart and brain, respectively, while there was no significant decrease in the activity of methylmalonyl-CoA mutase. There was also no change of betaine-homocysteine methyltransferase activity. The level of plasma methionine in nitrous-oxide-exposed sheep fell to 30% of its initial value. S-Adenosylmethionine level was reduced to 50% of the control value in the liver, and was also significantly decreased in the heart, but not in the brain. Excretion of formiminoglutamic acid and homocystine was also observed in the urine of sheep exposed to nitrous oxide. These results demonstrate that inhibition of 5-methyltetrahydrofolate-homocysteine methyltransferase causes a pronounced perturbation of methionine metabolism in sheep, suggesting that dietary methionine plus methionine synthesized from the methyl groups of betaine are not sufficient to meet the methyl needs for biological methylation reactions in this species and, in turn, emphasizing the role of 5-methyltetrahydrofolate-homocysteine methyltransferase in methionine synthesis in the sheep.


Quantitative angiographic morphology of the coronary artery lesions at risk of thrombotic occlusion.
Coronary angiography in acute myocardial infarction has revealed complicated atherosclerotic plaque and a high rate of thrombotic occlusion. However, the characteristics of lesions at high risk of subsequent occlusion are not well known. In the present study, the qualitative and quantitative angiographic features of 38 coronary artery lesions that occluded within 3 years to cause an acute myocardial infarction were compared with 64 control segments from the same patients that did not occlude. Compared with control lesions, the lesions that occluded were more likely to have a division branch originating within the stenosis (76% versus 52%, p less than 0.05). The percent lumen diameter reduction was more severe (47.5 +/- 17.8% versus 41 +/- 12.5%, p less than 0.05) and the inflow (21 +/- 10 degrees versus 16 +/- 7 degrees, p less than 0.05) and outflow (20 +/- 10 degrees versus 16 +/- 8 degrees, p less than 0.05) angles of the stenosis were steeper. Time to myocardial infarction after the angiogram interacted with the importance of these features (p less than 0.02). Thus, paired analysis of the lesions that occluded within 3 months and of the most severe control lesion from each patient showed percent lumen diameter reduction of 62.1 +/- 11.5% and 46.4 +/- 11.4%, respectively (p less than 0.001). The length of the stenosis, its asymmetry, and the irregularity of the contours did not help differentiate occlusive from control segments. Coronary artery lesions at high risk of thrombotic occlusion share common characteristics that favor higher shear stress and flow separation.


Structure Characterization of Polysaccharide from Chinese Yam (Dioscorea opposite Thunb.) and Its Growth-Promoting Effects on Streptococcus thermophilus.
To clarify the mechanisms underlying the growth-promoting effects of yam polysaccharide on Streptococcus thermophilus (S. thermophilus), the yam polysaccharide was extracted using a deep eutectic solvents (DESs) method and separated into four fractions by DEAE-cellulose 52. These fractions were used as the alternative carbon source to substitute lactose to compare their growth-promoting effects on S. thermophilus. Furthermore, their molecular weight, monosaccharide and functional groups' composition, microscopic forms and other basic structure characterizations were analyzed. The results showed that all the fractions could significantly promote S. thermophilus growth, and fractions exhibited significantly different growth-promoting effects, whose viable count increased by 6.14, 6.03, 11.48 and 11.29%, respectively, relative to those in the M17 broth medium. Structure-activity relationship analysis revealed that the high growth-promoting activity of yam polysaccharide might be more dependent on the higher molecular weight, the higher galacturonic acid content and its complex spatial configuration, and the existence of β-glycosides would make the yam polysaccharide have a better growth-promoting effect on S. thermophilus.


The role of zinc status in altered cardiac adenylate cyclase activity in diabetic rats.
Zinc deficiency and altered myocardial adenylate cyclase activity commonly occur in diabetes. To determine whether the zinc intake of the animal can account for the altered beta-adrenergic receptor activity in the diabetic heart, we determined the beta-adrenergic receptor number and isoproterenol-, NaF- and forskolin-stimulated adenylate cyclase activity in diabetic and control rats maintained on low, normal and high zinc diets for 3 weeks. Scatchard analysis of [125I]iodocyanopindolol binding to control heart membrane preparations revealed a binding capacity of 17.3 +/- 1.3 fmol/mg protein with a Kd of 35 +/- 1.0 pmol/l. Neither the diabetic state nor the zinc status altered these binding parameters. The isoproterenol-stimulated adenylate cyclase activity was significantly lower in diabetic rats on low zinc diets compared with controls. The NaF- (65.1 +/- 5.4 vs 60.8 +/- 6.4 pmol cAMP.mg protein-1.min-1) and forskolin-stimulated adenylate cyclase activities (161 +/- 9.3 vs 154 +/- 21.2 pmol cAMP.mg protein-1. min-1) were not significantly altered in diabetic rats. Low dietary zinc intake compared with high zinc diet significantly increased NaF- and forskolin-stimulated adenylate cyclase activity both in diabetic rats and controls. The effect of dietary zinc content on isoproterenol-stimulated adenylate cyclase was significant in control rats only. Thus zinc intake appears to be an important determinant of cardiac adenylate cyclase activity level. Additional factors peculiar to the diabetic state are involved in the modulation of beta-adrenergic responsiveness of the diabetic heart.


Written action plan in pediatric emergency room improves asthma prescribing, adherence, and control.
An acute-care visit for asthma often signals a management failure. Although a written action plan is effective when combined with self-management education and regular medical review, its independent value remains controversial. We examined the efficacy of providing a written action plan coupled with a prescription (WAP-P) to improve adherence to medications and other recommendations in a busy emergency department. We randomized 219 children aged 1-17 years to receive WAP-P (n = 109) or unformatted prescription (UP) (n = 110). All received fluticasone and albuterol inhalers, fitted with dose counters, to use at the discretion of the emergency physician. The main outcome was adherence to fluticasone (use/prescribed × 100%) over 28 days. Secondary outcomes included pharmacy dispensation of oral corticosteroids, β(2)-agonist use, medical follow-up, asthma education, acute-care visits, and control. Although both groups showed a similar drop in adherence in the initial 14 days, adherence to fluticasone was significantly higher over Days 15-28 in children receiving WAP-P (mean group difference, 16.13% [2.09, 29.91]). More WAP-P than UP patients filled their oral corticosteroid prescription (relative risk, 1.31 [1.07, 1.60]) and were well-controlled at 28 days (1.39 [1.04, 1.86]). Compared with UP, use of WAP-P increased physicians' prescription of maintenance fluticasone (2.47 [1.53, 3.99]) and recommendation for medical follow-up (1.87 [1.48, 2.35]), without group differences in other outcomes. Provision of a written action plan significantly increased patient adherence to inhaled and oral corticosteroids and asthma control and physicians' recommendation for maintenance fluticasone and medical follow-up, supporting its independent value in the acute-care setting. Clinical trial registered with www.clinicaltrials.gov (NCT 00381355).


Systemic but not intraocular Epo gene transfer protects the retina from light-and genetic-induced degeneration.
Molecules with neurotrophic activity are being evaluated for treatment of retinitis pigmentosa in animal models. In particular, great interest has been focused recently on erythropoietin (Epo). Evidence of its neurotrophic activity comes mainly from data demonstrating photoreceptor protection in a rodent light-damage model through systemic administration of a recombinant form of this hormone. Our goal was to test whether Epo retinal gene transfer can rescue or delay photoreceptor cell death. We delivered adeno-associated viral vectors encoding Epo intraocularly and, for comparison, intramuscularly to one light-induced and two genetic models of retinal degeneration. Intraocular Epo gene transfer resulted in sustained hormone expression in the eye, which was undetectable systemically. In contrast, Epo intramuscular gene transfer resulted in hormone secretion in the circulation, which was not detected in ocular fluids. The protein secreted from muscle and retina is of the same molecular weight as a commercial recombinant human Epo. Interestingly, following systemic but not intraocular Epo delivery, morphological photoreceptor protection was observed in the light-damage and rds/peripherin (Prph2) models of retinal degeneration. In the light-damage model, the morphological rescue was accompanied by a significant electrophysiological improvement of photoreceptor function. In contrast, no photoreceptor rescue was observed following Epo gene transfer in the rd10 model. This suggests that different apoptotic mechanisms, with varying sensitivities to Epo, occur in different retinal degeneration models. In conclusion, our data support Epo as a neuroprotective agent in some, but not all, retinal degenerations. Further, rescue is observed in specific models after systemic but not intraocular Epo gene transfer.


[Celiac disease].
Celiac disease is an enteropathy due to gluten intake in genetically predisposed persons (HLA DQ2/DQ8). Celiac disease occurs in adults and children at rates approaching 1% of population in Europe and USA. Clinical presentation of celiac disease is extremely varied. Anaemia, oral aphthous stomatis, amenorrhea or articular symptoms may reveal celiac disease. Diagnosis relies on evidence of duodenal villous atrophy and specific serum antibodies. Treatment relies on eviction of gluten (wheat, barley, rye). Gluten-free diet allows prevention of malignant complications and osteopenia. The main cause of resistance to gluten-free diet is its bad observance. On the contrary, serious complications of celiac disease, such as clonal refractory celiac sprue and intestinal T cell lymphoma need to be screen.


[Surgical alternatives in the treatment of anal abscesses].
Anal abscess is a pus collection localized in some of the regions around the anus and rectum. We reviewed the experience in the management of abscesses in Coloproctology Unit at the Gastroenterology Service in the General Hospital of Mexico. This is a retrospective, longitudinal and descriptive study in patients diagnosed as carriers of an anal abscess during the period from January 1998 to December 2002. During this period, 9,233 first consultations took place, 241 fulfilled inclusion criteria: 197 (81.74%) were male and 44 (18.25%) were female. Perianal abscesses affected 156 patients (64.73%), 51 ischiorectal abscesses (21.16%), 17 horseshoe (7.05%), 14 intersphincteric (5.80%) and 3 has supralevator abscesses (1.24%). There were 96.68% nonspecific anal abscesses. Simple drainage is an initial adequate management. Most patients (73%) were attended in the office. Pain was the most common symptom (99%). Perianal and ischiorectal localizations were the most frequently classified and there was no mortality.


Fractures of the zygomatic complex: a case report and review.
Traumatic injuries to the midface are not nearly as common in Canada as they are in the United States, but practitioners must still be prepared for the evaluation and treatment of patients presenting with midface fractures. This case report demonstrates the experience one individual who presented with the clinical signs and symptoms of midfacial trauma. Cases of this nature can be confidently managed by an oral and maxillofacial surgeon. A review provides knowledge regarding anatomic features, classification schemes and the diagnostic and therapeutic decisions encountered with the treatment of zygomatic complex fractures. The forward projection of the zygoma causes it to be frequently injured secondarily to blunt trauma of the midface, at the expense of protecting the orbit.


IMP3 expression in small-intestine neuroendocrine neoplasms: a new predictor of recurrence.
Small-intestine neuroendocrine neoplasms are heterogeneous neoplasms arising from endocrine cells of the intestinal mucosa. Ki-67 is the main determinant of prognosis in neuroendocrine neoplasms. However, the search for new prognostic makers represents a key point with regard to small-intestine neuroendocrine neoplasms. The oncofetal protein IMP3 plays a role in cell growth and its expression has a prognostic value in lung neoplasms. From January 1998 to August 2015, all the consecutive small-intestine neuroendocrine neoplasms patients suitable for surgery were included: 51 patients (32 males, median age 68 years) had small-intestine neuroendocrine neoplasms classified according to the WHO 2010 classification. In all the cases IMP3 expression was evaluated on primary tumors and, when available, on nodal and distant metastases. The medical records and pathological slides of these patients were used to determine the clinical characteristics, pathological diagnoses, and outcome information. The overall 5-year and 10-year survival rate were 53.9 and 42% respectively. At Cox proportional hazards regression grading was the major factor influencing both OS and progression-free survival at univariate (p = 0.0002 and 0.0051, respectively) and multivariate analysis (p = 0.0004 and 0.0043, respectively). Also IMP3 expression at the nodal metastases resulted a factor significantly associated with progression-free survival at both univariate (p = 0.0066) and multivariate analysis (p = 0.0059, HR 3.58). IMP3 expression did not correlate with the Ki-67 (p = n.s.). In this study, IMP3 at the nodal site resulted to be associated with low progression-free survival in small-intestine neuroendocrine neoplasms, independently of the Ki-67 index. We suggest that the integration of IMP3 and Ki-67 would help better stratify the risk of progression in small-intestine neuroendocrine neoplasms.


The long-term clinical course of generalized anxiety disorder.
Although generalized anxiety disorder (GAD) is a common disorder associated with significant levels of morbidity, little is known of its long-term course and outcomes. During the first 5 years, GAD follows a chronic course with low rates of remission and moderate rates of relapse/recurrence following remission. Retrospective studies suggest that this chronic pattern may last up to 20 years. It is hoped that, as with depression, long-term prospective studies in GAD will provide insight into the course, nature, and outcomes of the disorder over time. The studies will also identify any changes in the duration and severity of episodes of GAD over time, enabling treatments to effectively reflect the course of the disorder. Studies of other anxiety disorders and depression suggest that the course and outcome of the disorder may be influenced by certain factors such as stressful life events, anxiety sensitivity/negative affect, gender, subsyndromal symptoms, and comorbid disorders. Currently, studies are underway to determine the effects of these factors on the risk of relapse/recurrence, maintenance of full symptoms, and development of subsyndromal symptoms in GAD. GAD is currently underrecognized and undertreated, but it is hoped that this will change with the ever-increasing awareness of anxiety disorders. As treatment for GAD becomes more common, future prospective studies will identify the effect of therapy on the course and nature of the disorder, leading to increased understanding of GAD and the development of effective treatment strategies tailored for individual patients.


A case of psychogenic visual disturbance improved by staying at home after the declaration of a state of emergency in relation to the coronavirus disease.
The aim of this study is to report a 7-year-old girl with psychogenic visual disturbance that improved upon staying at home after the declaration of a state of emergency in relation to Coronavirus disease. Her uncorrected visual acuity (UCVA) in the right eye was 0.4 and in the left eye was 0.3. Slit-lamp examination and fundoscopy showed no abnormalities. She had a tight schedule on six days a week due to various lessons. To prevent the spread of infection, her school was closed, and she was not able to attend any lessons. She enjoyed spending time at home. Six months after her initial visit during school closure, her UCVA had improved to 1.2. The situation of staying at home may have had a positive psychological effect after removing factors contributing to her stress.


[Influence of processing on trace elements in traditional Chinese drugs].
By comparing the contents of nine trace elements in fourteen Chinese drugs (including thirty-six samples) before and after processing, this experiment was carried out primarily in search of the ways in which bears on trace element contents, so as to help improve the quality of processed drugs.


Effective Formation of Well-Defined Polymeric Microfibers and Nanofibers with Exceptional Uniformity by Simple Mechanical Needle Spinning.
The fabrication of nanofibers with a mechanical force has attracted increasing attention owing to its facile and easy fabrication. Herein, we demonstrate a novel and facile fabrication technique with the mechanical force, needle spinning, which utilizes a needle tip to draw a polymer solution to form fibrous structures. We studied the effect of the processing parameters to the nanofiber structure, namely, the pulling away speed, pulling away distances, needle size, and polymer concentration, which were systemically controlled. As the needle spinning provides an effective route to adjust those parameters, highly uniform nanofibers can be achieved. There are clear tendencies in the diameter; it was increased as the polymer concentration and needle size were increased, and was decreased as the pulling away distance and pulling away speed were increased. Needle spinning with a precise control of the processing parameter enables us to readily fabricate well-defined nanofibers, with controlled dimensions in diameter and length; plus, single nanofibers also can be easily formed. Those features cannot be realized in common spinning process such as electrospinning. Therefore, this technique will lead to further development of the use of mechanical force for nanofiber fabrication and will expand the range of nanofibers applications.